Interactive film scenes for tutor training in problem-based learning (PBL): dealing with difficult situations

PubMed Central

2010-01-01

Background In problem-based learning (PBL), tutors play an essential role in facilitating and efficiently structuring tutorials to enable students to construct individual cognitive networks, and have a significant impact on students' performance in subsequent assessments. The necessity of elaborate training to fulfil this complex role is undeniable. In the plethora of data on PBL however, little attention has been paid to tutor training which promotes competence in the moderation of specific difficult situations commonly encountered in PBL tutorials. Methods Major interactive obstacles arising in PBL tutorials were identified from prior publications. Potential solutions were defined by an expert group. Video clips were produced addressing the tutor's role and providing exemplary solutions. These clips were embedded in a PBL tutor-training course at our medical faculty combining PBL self-experience with a non-medical case. Trainees provided pre- and post-intervention self-efficacy ratings regarding their PBL-related knowledge, skills, and attitudes, as well as their acceptance and the feasibility of integrating the video clips into PBL tutor-training (all items: 100 = completely agree, 0 = don't agree at all). Results An interactive online tool for PBL tutor training was developed comprising 18 video clips highlighting difficult situations in PBL tutorials to encourage trainees to develop and formulate their own intervention strategies. In subsequent sequences, potential interventions are presented for the specific scenario, with a concluding discussion which addresses unresolved issues. The tool was well accepted and considered worth the time spent on it (81.62 ± 16.91; 62.94 ± 16.76). Tutors considered the videos to prepare them well to respond to specific challenges in future tutorials (75.98 ± 19.46). The entire training, which comprised PBL self-experience and video clips as integral elements, improved tutor's self-efficacy with respect to dealing with

Difficult Temperament Moderates Links between Maternal Responsiveness and Children's Compliance and Behavior Problems in Low-Income Families

ERIC Educational Resources Information Center

Kochanska, Grazyna; Kim, Sanghag

2013-01-01

Background: Research has shown that interactions between young children's temperament and the quality of care they receive predict the emergence of positive and negative socioemotional developmental outcomes. This multimethod study addresses such interactions, using observed and mother-rated measures of difficult temperament, children's…

"It's a Difficult Matter": Historical Perspectives on the Enduring Problem of the Practicum in Teacher Preparation

ERIC Educational Resources Information Center

Vick, Malcolm

2006-01-01

Current reviews of teacher education pay considerable attention to problems associated with the practicum, and often claim to propose major changes in order to improve the quality of new graduates. Many of the problems they address concerning the practicum and its relation to the "theoretical" component of programs are longstanding, and…

An Ethnomethodological Perspective on How Middle School Students Addressed a Water Quality Problem

ERIC Educational Resources Information Center

Belland, Brian R.; Gu, Jiangyue; Kim, Nam Ju; Turner, David J.

2016-01-01

Science educators increasingly call for students to address authentic scientific problems in science class. One form of authentic science problem--socioscientific issue--requires that students engage in complex reasoning by considering both scientific and social implications of problems. Computer-based scaffolding can support this process by…

The Difficult Gallbladder: A Safe Approach to a Dangerous Problem.

PubMed

Santos, B Fernando; Brunt, L Michael; Pucci, Michael J

2017-06-01

Laparoscopic cholecystectomy is a common surgical procedure, and remains the gold standard for the management of benign gallbladder and biliary disease. While this procedure can be technically straightforward, it can also represent one of the most challenging operations facing surgeons. This dichotomy of a routine operation performed so commonly that poses such a hidden risk of severe complications, such as bile duct injury, must keep surgeons steadfast in the pursuit of safety. The "difficult gallbladder" requires strict adherence to the Culture of Safety in Cholecystectomy, which promotes safety first and assists surgeons in managing or avoiding difficult operative situations. This review will discuss the management of the difficult gallbladder and propose the use of subtotal fenestrating cholecystectomy as a definitive option during this dangerous situation.

School Nurses' Perceived Prevalence and Competence to Address Student Mental Health Problems

ERIC Educational Resources Information Center

Stephan, Sharon H.; Connors, Elizabeth H.

2013-01-01

Due to under-identification of student mental health problems and limited specialty mental health providers in schools, school nurses are often faced with identifying and addressing student mental health needs. This exploratory study assessed prevalence and types of student mental health problems encountered by school nurses, as well as their…

Collaborative capacity, problem framing, and mutual trust in addressing the wildland fire social problem: An annotated reading list

Treesearch

Jeffrey J. Brooks; Alexander N. Bujak; Joseph G. Champ; Daniel R. Williams

2006-01-01

We reviewed, annotated, and organized recent social science research and developed a framework for addressing the wildland fire social problem. We annotated articles related to three topic areas or factors, which are critical for understanding collective action, particularly in the wildland-urban interface. These factors are collaborative capacity, problem framing, and...

The molecular matching problem

NASA Technical Reports Server (NTRS)

Kincaid, Rex K.

1993-01-01

Molecular chemistry contains many difficult optimization problems that have begun to attract the attention of optimizers in the Operations Research community. Problems including protein folding, molecular conformation, molecular similarity, and molecular matching have been addressed. Minimum energy conformations for simple molecular structures such as water clusters, Lennard-Jones microclusters, and short polypeptides have dominated the literature to date. However, a variety of interesting problems exist and we focus here on a molecular structure matching (MSM) problem.

Addressing Complex Challenges through Adaptive Leadership: A Promising Approach to Collaborative Problem Solving

ERIC Educational Resources Information Center

Nelson, Tenneisha; Squires, Vicki

2017-01-01

Organizations are faced with solving increasingly complex problems. Addressing these issues requires effective leadership that can facilitate a collaborative problem solving approach where multiple perspectives are leveraged. In this conceptual paper, we critique the effectiveness of earlier leadership models in tackling complex organizational…

Commentary: getting real on addressing health care disparities and other systems problems.

PubMed

Madara, James L

2012-06-01

Physician membership organizations vary in the extent of their engagement in activities to address health disparities. Increasing engagement of those organizations not already highly active in this critical area is, thus, an opportunity. Studies that provide definitional contours of key issues, like disparities, are necessary and must be iteratively refined. However, parallel activities of intervention with measured outcomes to assess the effects of these interventions are necessary to truly address major problems in the health care system. To date, work in the problem definition category exceeds work toward intervention in and mitigation of these problems with measured outcomes. Many problems in health care, including disparities, are now sufficiently understood that it is time to shift focus toward bold intervention with measured outcomes. Optimal approaches that yield superior outcomes generally require collaboration across the provider-payer spectrum and the private sectors, including physicians, hospitals, insurers, etc. Stakeholders are now free to act in such coordinated fashion; it only requires social capital that permits cooperation and compromise. Interventions for problems such as health care disparities can be developed in the private sector and mirrored by government payers if physicians and organizations can get real about collaborating to implement outcomes-based initiatives to improve the health of all patients.

On Using Meta-Modeling and Multi-Modeling to Address Complex Problems

ERIC Educational Resources Information Center

Abu Jbara, Ahmed

2013-01-01

Models, created using different modeling techniques, usually serve different purposes and provide unique insights. While each modeling technique might be capable of answering specific questions, complex problems require multiple models interoperating to complement/supplement each other; we call this Multi-Modeling. To address the syntactic and…

Families and Positive Behavior Support: Addressing Problem Behavior in Family Contexts.

ERIC Educational Resources Information Center

Lucyshyn, Joseph M., Ed.; Dunlap, Glen, Ed.; Albin, Richard W., Ed.

The 19 chapters of this volume address theory, research, and practice concerning positive behavior support with families of children and youth with developmental disabilities and problem behavior. The chapters are: (1) "Positive Behavior Support with Families" (Joseph Lucyshyn and others); (2) "Finding Positive Behavior Support One…

Difficult Concepts

NASA Astrophysics Data System (ADS)

Fosbury, R.

2005-12-01

Beautiful colour images of the sky are both a blessing and a curse for the communication of astronomy to the public. While undoubtedly attractive, they can obscure the fact that discoveries are often made in astrophysics using techniques and measurements that are much more difficult to grasp and certainly less appealing to view. Should we try to explain such concepts as spectroscopy, polarimetry and interferometry, or is it a lost cause? The most effective approach to this problem may be to lead the audience to ask the question themselves: "But how do you know that?"

Crisis management during anaesthesia: difficult intubation.

PubMed

Paix, A D; Williamson, J A; Runciman, W B

2005-06-01

Anaesthetists may experience difficulty with intubation unexpectedly which may be associated with difficulty in ventilating the patient. If not well managed, there may be serious consequences for the patient. A simple structured approach to this problem was developed to assist the anaesthetist in this difficult situation. To examine the role of a specific sub-algorithm for the management of difficult intubation. The potential performance of a structured approach developed by review of the literature and analysis of each of the relevant incidents among the first 4000 reported to the Australian Incident Monitoring Study (AIMS) was compared with the actual management as reported by the anaesthetists involved. There were 147 reports of difficult intubation capable of analysis among the first 4000 incidents reported to AIMS. The difficulty was unexpected in 52% of cases; major physiological changes occurred in 37% of these cases. Saturation fell below 90% in 22% of cases, oesophageal intubation was reported in 19%, and an emergency transtracheal airway was required in 4% of cases. Obesity and limited neck mobility and mouth opening were the most common anatomical contributing factors. The data confirm previously reported failures to predict difficult intubation with existing preoperative clinical tests and suggest an ongoing need to teach a pre-learned strategy to deal with difficult intubation and any associated problem with ventilation. An easy-to-follow structured approach to these problems is outlined. It is recommended that skilled assistance be obtained (preferably another anaesthetist) when difficulty is expected or the patient's cardiorespiratory reserve is low. Patients should be assessed postoperatively to exclude any sequelae and to inform them of the difficulties encountered. These should be clearly documented and appropriate steps taken to warn future anaesthetists.

History Museums and Social Cohesion: Building Identity, Bridging Communities, and Addressing Difficult Issues

ERIC Educational Resources Information Center

Rosenberg, Tracy Jean

2011-01-01

Museums have the capacity to enhance social cohesion, which is the product of a trusting, connected community. History museums and historic sites, in particular, can serve communities by stimulating dialogue on difficult issues, accurately representing all the people of a nation, and creating forums for discussion among groups with disparate…

Guidelines and algorithms for managing the difficult airway.

PubMed

Gómez-Ríos, M A; Gaitini, L; Matter, I; Somri, M

2018-01-01

The difficult airway constitutes a continuous challenge for anesthesiologists. Guidelines and algorithms are key to preserving patient safety, by recommending specific plans and strategies that address predicted or unexpected difficult airway. However, there are currently no "gold standard" algorithms or universally accepted standards. The aim of this article is to present a synthesis of the recommendations of the main guidelines and difficult airway algorithms. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Achieving Success with More Students: Addressing the Problem of Students At Risk, K-12.

ERIC Educational Resources Information Center

Pennsylvania State Dept. of Education, Harrisburg.

This resource book was developed to provide information that state and local leaders can use to stimulate discussion of the problem of students at risk and support the planning of initiatives that address the problem. An overview defines students at risk, summarizes the content of the book, and lists recent reports and publications on the problem…

Is Principled Pragmatism a Viable Framework for Addressing Complex Problems?

NASA Astrophysics Data System (ADS)

Islam, S.

2017-12-01

Complex water problems are connected with many competing and often conflicting values, interests, and tools. These problems can't be addressed through simply applying dogmatic principles or a deal-making pragmatic approach. Because these problems are interconnected and interdependent, a final solution can't be pre-specified. Any intervention to a complex problem requires attention to both principles and pragmatism. Strict adherence to principles without pragmatism is often not actionable; pure pragmatism exercised without guiding principles is not sustainable. In a colloquial sense, pragmatism is often taken to suggest practical, opportunistic, and expedient approaches at the expense of principles. This perception appears to be rooted in the dichotomy between "being pragmatic" and "being ideological". The notion of principled pragmatism attempts to get away from this duality by focusing on how to make ideas clear and actionable. In other words, how to connect our thoughts to action given the context, constraints, and capacity. Principled pragmatism - rooted in equity and sustainability as guiding principles for water management - approach attempts to synthesize symbolic aspirations with realistic assessment to chart a trajectory of actionable subset of implementable solutions. Case studies from the Ganges Basin will show the utility of principled pragmatism for water management in a changing world.

Routing and Addressing Problems in Large Metropolitan-Scale Internetworks. ISI Research Report.

ERIC Educational Resources Information Center

Finn, Gregory G.

This report discusses some of the problems and limitations in existing internetwork design for the connection of packet-switching networks of different technologies and presents an algorithm that has been shown to be suitable for internetworks of unbounded size. Using a new form of address and a flat routing mechanism called Cartesian routing,…

How Are 2-Year US Colleges Addressing Student Alcohol Use and Related Problems?

ERIC Educational Resources Information Center

Lenk, Kathleen M.; Nelson, Toben F.; Erickson, Darin J.; Toomey, Traci L.

2015-01-01

A considerable amount of attention and research has been dedicated to addressing alcohol use and related problems among students at 4-year colleges; however, less attention has been given to alcohol-related issues among students at 2-year technical/community colleges. This article describes research that expands on a study by Chiauzzi and…

Investigation of learning environment for arithmetic word problems by problem posing as sentence integration in Indonesian language

NASA Astrophysics Data System (ADS)

Hasanah, N.; Hayashi, Y.; Hirashima, T.

2017-02-01

Arithmetic word problems remain one of the most difficult area of teaching mathematics. Learning by problem posing has been suggested as an effective way to improve students’ understanding. However, the practice in usual classroom is difficult due to extra time needed for assessment and giving feedback to students’ posed problems. To address this issue, we have developed a tablet PC software named Monsakun for learning by posing arithmetic word problems based on Triplet Structure Model. It uses the mechanism of sentence-integration, an efficient implementation of problem-posing that enables agent-assessment of posed problems. The learning environment has been used in actual Japanese elementary school classrooms and the effectiveness has been confirmed in previous researches. In this study, ten Indonesian elementary school students living in Japan participated in a learning session of problem posing using Monsakun in Indonesian language. We analyzed their learning activities and show that students were able to interact with the structure of simple word problem using this learning environment. The results of data analysis and questionnaire suggested that the use of Monsakun provides a way of creating an interactive and fun environment for learning by problem posing for Indonesian elementary school students.

Drilling Regolith: Why Is It So Difficult?

NASA Astrophysics Data System (ADS)

Schmitt, H. H.

2017-10-01

The Apollo rotary percussive drill system penetrated the lunar regolith with reasonable efficiency; however, extraction of the drill core stem proved to be very difficult on all three missions. Retractable drill stem flutes may solve this problem.

Validated questionnaires heighten detection of difficult asthma comorbidities.

PubMed

Radhakrishna, Naghmeh; Tay, Tunn Ren; Hore-Lacy, Fiona; Stirling, Robert; Hoy, Ryan; Dabscheck, Eli; Hew, Mark

2017-04-01

Multiple extra-pulmonary comorbidities contribute to difficult asthma, but their diagnosis can be challenging and time consuming. Previous data on comorbidity detection have focused on clinical assessment, which may miss certain conditions. We aimed to locate relevant validated screening questionnaires to identify extra-pulmonary comorbidities that contribute to difficult asthma, and evaluate their performance during a difficult asthma evaluation. MEDLINE was searched to identify key extra-pulmonary comorbidities that contribute to difficult asthma. Screening questionnaires were chosen based on ease of use, presence of a cut-off score, and adequate validation to help systematically identify comorbidities. In a consecutive series of 86 patients referred for systematic evaluation of difficult asthma, questionnaires were administered prior to clinical consultation. Six difficult asthma comorbidities and corresponding screening questionnaires were found: sinonasal disease (allergic rhinitis and chronic rhinosinusitis), vocal cord dysfunction, dysfunctional breathing, obstructive sleep apnea, anxiety and depression, and gastro-oesophageal reflux disease. When the questionnaires were added to the referring clinician's impression, the detection of all six comorbidities was significantly enhanced. The average time for questionnaire administration was approximately 40 minutes. The use of validated screening questionnaires heightens detection of comorbidities in difficult asthma. The availability of data from a battery of questionnaires prior to consultation can save time and allow clinicians to systematically assess difficult asthma patients and to focus on areas of particular concern. Such an approach would ensure that all contributing comorbidities have been addressed before significant treatment escalation is considered.

SIMS: addressing the problem of heterogeneity in databases

NASA Astrophysics Data System (ADS)

Arens, Yigal

1997-02-01

The heterogeneity of remotely accessible databases -- with respect to contents, query language, semantics, organization, etc. -- presents serious obstacles to convenient querying. The SIMS (single interface to multiple sources) system addresses this global integration problem. It does so by defining a single language for describing the domain about which information is stored in the databases and using this language as the query language. Each database to which SIMS is to provide access is modeled using this language. The model describes a database's contents, organization, and other relevant features. SIMS uses these models, together with a planning system drawing on techniques from artificial intelligence, to decompose a given user's high-level query into a series of queries against the databases and other data manipulation steps. The retrieval plan is constructed so as to minimize data movement over the network and maximize parallelism to increase execution speed. SIMS can recover from network failures during plan execution by obtaining data from alternate sources, when possible. SIMS has been demonstrated in the domains of medical informatics and logistics, using real databases.

Multidimensional Family Therapy: Addressing Co-Occurring Substance Abuse and Other Problems among Adolescents with Comprehensive Family-Based Treatment

PubMed Central

Rowe, Cynthia L.

2010-01-01

Synopsis Adolescent substance abuse rarely occurs without other psychiatric and developmental problems, yet it is often treated and researched as if it can be isolated from comorbid conditions. Few comprehensive interventions are available that effectively address the range of co-occurring problems associated with adolescent substance abuse. This article reviews the clinical interventions and research evidence supporting the use of Multidimensional Family Therapy (MDFT) for adolescents with substance abuse and co-occurring problems. MDFT is uniquely suited to address adolescent substance abuse and related disorders given its comprehensive interventions that systematically target the multiple interacting risk factors underlying many developmental disruptions of adolescence. PMID:20682221

How do Dutch GPs address work-related problems? A focus group study.

PubMed

de Kock, Cornelis A; Lucassen, Peter L B J; Spinnewijn, Laura; Knottnerus, J André; Buijs, Peter C; Steenbeek, Romy; Lagro-Janssen, Antoine L M

2016-09-01

In the Netherlands, there is a lack of knowledge about general practitioners' (GPs) perception of their role regarding patients' occupation and work related problems (WRP). As work and health are closely related, and patients expect help from their GPs in this area, a better understanding is needed of GPs' motivation to address WRP. To explore GPs' opinions on their role in the area of work and health. This is a qualitative study using three focus groups with Dutch GPs from the catchment area of a hospital in the Southeast of the Netherlands. The group was heterogeneous in characteristics such as sex, age, and practice setting. Three focus groups were convened with 18 GPs. The moderator used an interview guide. Two researchers analysed verbatim transcripts using constant comparative analysis. We distinguished three items: (a) work context in a GP's integrated consultation style; (b) counselling about sick leave; (c) cooperation with occupational physicians (OPs). The participants are willing to address the topic and counsel about sick leave. They consider WRP in patients with medically unexplained symptoms (MUS) challenging. They tend to advise these patients to continue working as they think this will ultimately benefit them. The participating GPs seemed well aware of the relation between work and health but need more knowledge, communication skills and better cooperation with occupational physicians to manage work-related problems. [Box: see text].

Student Homicidal Violence in Schools: An International Problem

ERIC Educational Resources Information Center

Bondu, Rebecca; Cornell, Dewey G.; Scheithauer, Herbert

2011-01-01

School homicides have become a worldwide phenomenon. In the decade following the Columbine shooting there have been at least forty similar events in other countries. This article addresses the international scope of this problem and some of the complex conceptual issues that make student homicidal violence difficult to define and study. Meaningful…

Addressing College Drinking as a Statewide Public Health Problem: Key Findings From the Maryland Collaborative.

PubMed

Arria, Amelia M; Jernigan, David H

2018-03-01

Excessive drinking among college students is a serious and pervasive public health problem. Although much research attention has focused on developing and evaluating evidence-based practices to address college drinking, adoption has been slow. The Maryland Collaborative to Reduce College Drinking and Related Problems was established in 2012 to bring together a network of institutions of higher education in Maryland to collectively address college drinking by using both individual-level and environmental-level evidence-based approaches. In this article, the authors describe the findings of this multilevel, multicomponent statewide initiative. To date, the Maryland Collaborative has succeeded in providing a forum for colleges to share knowledge and experiences, strengthen existing strategies, and engage in a variety of new activities. Administration of an annual student survey has been useful for guiding interventions as well as evaluating progress toward the Maryland Collaborative's goal to measurably reduce high-risk drinking and its radiating consequences on student health, safety, and academic performance and on the communities surrounding college campuses. The experiences of the Maryland Collaborative exemplify real-world implementation of evidence-based approaches to reduce this serious public health problem.

Why Is the Overheating Problem Difficult: the Role of Entropy

NASA Technical Reports Server (NTRS)

Liou, Meng-Sing

2013-01-01

The development of computational fluid dynamics over the last few decades has yielded enormous successes and capabilities being routinely employed today; however there remain some open problems to be properly resolved-some are fundamental in nature and some resolvable by operational changes. These two categories are distinguished and broadly explored previously. One, that belongs to the former, is the so-called overheating problem, especially in rarefying flow. This problem up to date still dogs every method known to the author; a solution to it remains elusive. The study in this paper concludes that: (1) the entropy increase is quantitatively linked to the increase in the temperature increase, (2) it is argued that the overheating is inevitable in the current shock capturing or traditional finite difference framework, and (3) a simple hybrid method is proposed that removes the overheating problem in the rarefying problems, but also retains the property of accurate shock capturing. This remedy (enhancement of current numerical methods) can be included easily in the present Eulerian codes.

Potential effects of the introduction of the discrete address beacon system data link on air/ground information transfer problems

NASA Technical Reports Server (NTRS)

Grayson, R. L.

1981-01-01

This study of Aviation Safety Reporting System reports suggests that benefits should accure from implementation of discrete address beacon system data link. The phase enhanced terminal information system service is expected to provide better terminal information than present systems by improving currency and accuracy. In the exchange of air traffic control messages, discrete address insures that only the intended recipient receives and acts on a specific message. Visual displays and printer copy of messages should mitigate many of the reported problems associated with voice communications. The problems that remain unaffected include error in addressing the intended recipient and messages whose content is wrong but are otherwise correct as to format and reasonableness.

Association for Academic Surgery presidential address: sticky floors and glass ceilings.

PubMed

Greenberg, Caprice C

2017-11-01

This 2017 Presidential Address for the Association for Academic Surgery was delivered on February 8, 2017. It addresses the difficult topic of gender disparities in surgery. Mixing empirical data with personal anecdotes, Dr. Caprice Greenberg provides an insightful overview of this difficult challenge facing the surgical discipline and practical advice on how we can begin to address it. Copyright © 2017 Elsevier Inc. All rights reserved.

Addressing the Missing Instructional Data Problem: Using a Teacher Log to Document Tier 1 Instruction

ERIC Educational Resources Information Center

Kurz, Alexander; Elliott, Stephen N.; Roach, Andrew T.

2015-01-01

Response-to-intervention (RTI) systems posit that Tier 1 consists of high-quality general classroom instruction using evidence-based methods to address the needs of most students. However, data on the extent to which general education teachers provide such instruction are rarely collected. This missing instructional data problem may result in RTI…

[Quality assurance in airway management: education and training for difficult airway management].

PubMed

Kaminoh, Yoshiroh

2006-01-01

Respiratory problem is one of the main causes of death or severe brain damage in perioperative period. Three major factors of respiratory problem are esophageal intubation, inadequate ventilation, and difficult airway. The wide spread of pulse oximeter and capnograph reduced the incidences of esophageal intubation and inadequate ventilation, but the difficult airway still occupies the large portion in the causes of adverse events during anesthesia. "Practice guideline for management of the difficult airway" was proposed by American Society of Anesthesiologists (ASA) in 1992 and 2002. Improvement of knowledge, technical skills, and cognitive skills are necessary for the education and training of the difficult airway management. "The practical seminar of difficult airway management (DAM practical seminar)" has been cosponsored by the Japanese Association of Medical Simulation (JAMS) in the 51 st and 52 nd annual meetings of Japanese Society of Anesthesiologists and the 24th annual meeting of Japanese Society for Clinical Anesthesia. The DAM practical seminar is composed of the lecture session for ASA difficult airway algorithm, the hands-on training session for technical skills, and the scenario-based training session for cognitive skills. Ninty six Japanese anesthesiologists have completed the DAM practical seminar in one year. "The DAM instructor course" should be immediately prepared to organize the seminar more frequently.

The Stanford Prison Experiment: Implications for the Care of the "Difficult" Patient.

PubMed

Onishi, So L; Hebert, Randy S

2016-02-01

Approximately 15% of patients are perceived by clinicians as "difficult." Early theories about difficult patients focused on patients' and clinicians' characteristics, often underemphasizing the influence of the environment on patients' behavior. The Stanford Prison Experiment, a classic experiment in the psychology of human behavior, provides a broader systems approach for understanding the environmental influences on patient behavior. A systems approach to the care of the difficult patient takes into consideration not only the patient's characteristics but also the health care environment and the more distal environments (ie, familial, societal, and cultural). Clinicians who are aware of the multilevel impact of these various environments on the behavior of patients are better equipped to understand, address, and hopefully even prevent difficult patient encounters. © The Author(s) 2014.

Pervasive Sensing: Addressing the Heterogeneity Problem

NASA Astrophysics Data System (ADS)

O'Grady, Michael J.; Murdoch, Olga; Kroon, Barnard; Lillis, David; Carr, Dominic; Collier, Rem W.; O'Hare, Gregory M. P.

2013-06-01

Pervasive sensing is characterized by heterogeneity across a number of dimensions. This raises significant problems for those designing, implementing and deploying sensor networks, irrespective of application domain. Such problems include for example, issues of data provenance and integrity, security, and privacy amongst others. Thus engineering a network that is fit-for-purpose represents a significant challenge. In this paper, the issue of heterogeneity is explored from the perspective of those who seek to harness a pervasive sensing element in their applications. A initial solution is proposed based on the middleware construct.

Overcoming barriers to addressing education problems with research design: a panel discussion.

PubMed

Yarris, Lalena M; Gruppen, Larry D; Hamstra, Stanley J; Anders Ericsson, K; Cook, David A

2012-12-01

A plenary panel session at the 2012 Academic Emergency Medicine consensus conference "Education Research in Emergency Medicine: Opportunities, Challenges, and Strategies for Success" discussed barriers educators face in imagining, designing, and implementing studies to address educational challenges. This proceedings article presents a general approach to getting started in education research. Four examples of studies from the medical education literature that illustrate a distinct way to approach specific research questions are discussed. The study designs used are applicable to a variety of education research problems in emergency medicine (EM). Potential applications of studies are discussed, as well as effects and lessons learned. © 2012 by the Society for Academic Emergency Medicine.

Professional Support for Families in Difficult Life Situations

ERIC Educational Resources Information Center

Zakirova, Venera G.; Gaysina, Guzel I.; Raykova, Elena

2016-01-01

Relevance of the problem stated in the article is determined by the presence of a significant number of families in difficult life situations who need in professional support and socio-psychological assistance. The article aims to substantiate the effectiveness of the structural-functional model of professional supporting for families in difficult…

A child with a difficult airway: what do I do next?

PubMed

Engelhardt, Thomas; Weiss, Markus

2012-06-01

Difficulties in pediatric airway management are common and continue to result in significant morbidity and mortality. This review reports on current concepts in approaching a child with a difficult airway. Routine airway management in healthy children with normal airways is simple in experienced hands. Mask ventilation (oxygenation) is always possible and tracheal intubation normally simple. However, transient hypoxia is common in these children usually due to unexpected anatomical and functional airway problems or failure to ventilate during rapid sequence induction. Anatomical airway problems (upper airway collapse and adenoid hypertrophy) and functional airway problems (laryngospasm, bronchospasm, insufficient depth of anesthesia and muscle rigidity, gastric hyperinflation, and alveolar collapse) require urgent recognition and treatment algorithms due to insufficient oxygen reserves. Early muscle paralysis and epinephrine administration aids resolution of these functional airway obstructions. Children with an 'impaired' normal (foreign body, allergy, and inflammation) or an expected difficult (scars, tumors, and congenital) airway require careful planning and expertise. Training in the recognition and management of these different situations as well as a suitably equipped anesthesia workstation and trained personnel are essential. The healthy child with an unexpected airway problem requires clear strategies. The 'impaired' normal pediatric airway may be handled by anesthetists experienced with children, whereas the expected difficult pediatric airway requires dedicated pediatric anesthesia specialist care and should only be managed in specialized centers.

Moving beyond disrespect and abuse: addressing the structural dimensions of obstetric violence.

PubMed

Sadler, Michelle; Santos, Mário Jds; Ruiz-Berdún, Dolores; Rojas, Gonzalo Leiva; Skoko, Elena; Gillen, Patricia; Clausen, Jette A

2016-05-01

During recent decades, a growing and preoccupying excess of medical interventions during childbirth, even in physiological and uncomplicated births, together with a concerning spread of abusive and disrespectful practices towards women during childbirth across the world, have been reported. Despite research and policy-making to address these problems, changing childbirth practices has proved to be difficult. We argue that the excessive rates of medical interventions and disrespect towards women during childbirth should be analysed as a consequence of structural violence, and that the concept of obstetric violence, as it is being used in Latin American childbirth activism and legal documents, might prove to be a useful tool for addressing structural violence in maternity care such as high intervention rates, non-consented care, disrespect and other abusive practices. Copyright © 2016 Elsevier Inc. All rights reserved.

Computational strategies to address chromatin structure problems

NASA Astrophysics Data System (ADS)

Perišić, Ognjen; Schlick, Tamar

2016-06-01

While the genetic information is contained in double helical DNA, gene expression is a complex multilevel process that involves various functional units, from nucleosomes to fully formed chromatin fibers accompanied by a host of various chromatin binding enzymes. The chromatin fiber is a polymer composed of histone protein complexes upon which DNA wraps, like yarn upon many spools. The nature of chromatin structure has been an open question since the beginning of modern molecular biology. Many experiments have shown that the chromatin fiber is a highly dynamic entity with pronounced structural diversity that includes properties of idealized zig-zag and solenoid models, as well as other motifs. This diversity can produce a high packing ratio and thus inhibit access to a majority of the wound DNA. Despite much research, chromatin’s dynamic structure has not yet been fully described. Long stretches of chromatin fibers exhibit puzzling dynamic behavior that requires interpretation in the light of gene expression patterns in various tissue and organisms. The properties of chromatin fiber can be investigated with experimental techniques, like in vitro biochemistry, in vivo imagining, and high-throughput chromosome capture technology. Those techniques provide useful insights into the fiber’s structure and dynamics, but they are limited in resolution and scope, especially regarding compact fibers and chromosomes in the cellular milieu. Complementary but specialized modeling techniques are needed to handle large floppy polymers such as the chromatin fiber. In this review, we discuss current approaches in the chromatin structure field with an emphasis on modeling, such as molecular dynamics and coarse-grained computational approaches. Combinations of these computational techniques complement experiments and address many relevant biological problems, as we will illustrate with special focus on epigenetic modulation of chromatin structure.

Identifying problem and compulsive gamblers.

PubMed Central

van Es, R.

2000-01-01

OBJECTIVE: To present a meta-analysis of current research on the prevalence, identification, and treatment of problem and compulsive gamblers. QUALITY OF EVIDENCE: Problem and compulsive gambling was not a socio-scientific concern until the last two decades. Hence research on this topic is limited. The summary and analysis for this paper relied on computer searches of journal and news abstracts in addition to direct contact with organizations addressing the identification and treatment of compulsive gamblers. MAIN MESSAGE: An estimated 5% of those who gamble run into problems. About 1% of those who gamble are predicted to experience serious problems. Successful treatment of problem and compulsive gambling continues to be a challenge. Although cognitive therapy has been the favoured approach, a combination of several therapeutic approaches is advocated. CONCLUSIONS: Problem and compulsive gambling can present a real health threat. As with other addictions, treatment strategies continue to be a baffling social problem. Aware and informed physicians can have a pivotal role in the difficult process of identifying, acknowledging, and remediating problem and compulsive gambling. PMID:10907572

Locating difficult veins for venepuncture and cannulation.

PubMed

Shaw, Sally Jane

2017-02-15

Vein location and assessment are essential to improve the success rates for vascular access. However, problems remain with first attempt success rates for peripheral cannulation and locating difficult veins. Practitioners may not be aware of developments in technology and aids to assist in the location and assessment of veins to achieve vascular access. This article provides an overview of two vein location aids that can be used to locate difficult veins: the IV-eye vein imager and the Vacuderm tourniquet. It discusses the patient factors that can increase the difficulty of vein assessment and location, and emphasises the importance of vessel health and preservation, and vein palpation. Practitioners should be experienced and skilled in the assessment of veins, and they are encouraged to revisit how they locate and assess veins.

Activity Theory as a Tool to Address the Problem of Chemistry's Lack of Relevance in Secondary School Chemical Education

ERIC Educational Resources Information Center

Van Aalsvoort, Joke

2004-01-01

In a previous article, the problem of chemistry's lack of relevance in secondary chemical education was analysed using logical positivism as a tool. This article starts with the hypothesis that the problem can be addressed by means of activity theory, one of the important theories within the sociocultural school. The reason for this expectation is…

What is occupational therapy’s role in addressing sleep problems among older adults?

PubMed Central

Leland, Natalie E.; Marcione, Nicole; Niemiec, Stacey L. Schepens; Don Fogelberg, Kaivalya Kelkar

2014-01-01

Sleep problems, prevalent among older adults, are associated with poor outcomes and high healthcare costs. In 2008, rest and sleep became its own area of occupation in the AOTA Occupational Therapy Practice Framework. This scoping review examined a broad context of sleep research in order to highlight efficacious interventions for older adults that fall within the occupational therapy scope of practice and present an agenda for research and practice. Four sleep intervention areas clearly aligned with the Practice Framework, including cognitive behavioral therapy for insomnia, physical activity, and multi-component interventions. Occupational therapy is primed to address sleep problems by targeting the context and environment, performance patterns, and limited engagement in evening activities that may contribute to poor sleep. Occupational therapy researchers and clinicians need to work collaboratively to establish the evidence-base for occupation-centered sleep interventions in order to improve the health and quality of life of the older adult. PMID:24844879

Addressing Dynamic Issues of Program Model Checking

NASA Technical Reports Server (NTRS)

Lerda, Flavio; Visser, Willem

2001-01-01

Model checking real programs has recently become an active research area. Programs however exhibit two characteristics that make model checking difficult: the complexity of their state and the dynamic nature of many programs. Here we address both these issues within the context of the Java PathFinder (JPF) model checker. Firstly, we will show how the state of a Java program can be encoded efficiently and how this encoding can be exploited to improve model checking. Next we show how to use symmetry reductions to alleviate some of the problems introduced by the dynamic nature of Java programs. Lastly, we show how distributed model checking of a dynamic program can be achieved, and furthermore, how dynamic partitions of the state space can improve model checking. We support all our findings with results from applying these techniques within the JPF model checker.

Difficult relationships between parents and physicians of children with cancer: A qualitative study of parent and physician perspectives.

PubMed

Mack, Jennifer W; Ilowite, Maya; Taddei, Sarah

2017-02-15

Previous work on difficult relationships between patients and physicians has largely focused on the adult primary care setting and has typically held patients responsible for challenges. Little is known about experiences in pediatrics and more serious illness; therefore, we examined difficult relationships between parents and physicians of children with cancer. This was a cross-sectional, semistructured interview study of parents and physicians of children with cancer at the Dana-Farber Cancer Institute and Boston Children's Hospital (Boston, Mass) in longitudinal primary oncology relationships in which the parent, physician, or both considered the relationship difficult. Interviews were audiotaped, transcribed, and subjected to a content analysis. Dyadic parent and physician interviews were performed for 29 relationships. Twenty were experienced as difficult by both parents and physicians; 1 was experienced as difficult by the parent only; and 8 were experienced as difficult by the physician only. Parent experiences of difficult relationships were characterized by an impaired therapeutic alliance with physicians; physicians experienced difficult relationships as demanding. Core underlying issues included problems of connection and understanding (n = 8), confrontational parental advocacy (n = 16), mental health issues (n = 2), and structural challenges to care (n = 3). Although problems of connection and understanding often improved over time, problems of confrontational advocacy tended to solidify. Parents and physicians both experienced difficult relationships as highly distressing. Although prior conceptions of difficult relationships have held patients responsible for challenges, this study has found that difficult relationships follow several patterns. Some challenges, such as problems of connection and understanding, offer an opportunity for healing. However, confrontational advocacy appears especially refractory to repair; special

Dealing with Institutional Racism on Campus: Initiating Difficult Dialogues and Social Justice Advocacy Interventions

ERIC Educational Resources Information Center

D'Andrea, Michael; Daniels, Judy

2007-01-01

The authors describe social justice advocacy interventions to initiate difficult discussions at the university where they are employed. They emphasize the need to foster difficult dialogues about the problem of institutional racism among students, faculty members, and administrators where they work. The Privileged Identity Exploration (PIE) model…

Using literature to help physician-learners understand and manage "difficult" patients.

PubMed

Shapiro, J; Lie, D

2000-07-01

Despite significant clinical and research efforts aimed at recognizing and managing "difficult" patients, such patients remain a frustrating experience for many clinicians. This is especially true for primary care residents, who are required to see a significant volume of patients with diverse and complex problems, but who may not have adequate training and life experience to enable them to deal with problematic doctor-patient situations. Literature--short stories, poems, and patient narratives--is a little-explored educational tool to help residents in understanding and working with difficult patients. In this report, the authors examine the mechanics of using literature to teach about difficult patients, including structuring the learning environment, establishing learning objectives, identifying teaching resources and appropriate pedagogic methods, and incorporating creative writing assignments. They also present an illustrative progression of a typical literature-based teaching session about a difficult patient.

[Optimistic perspectives in communicating difficult news on fetal development].

PubMed

Ostermann, Ana Cristina; Frezza, Minéia; Rosa, Rafael Machado

2017-08-21

Communicating diagnostic news in health contexts is a potentially difficult event for all parties involved. However, despite this task's presence in the physician-patient context, it is rarely addressed during clinical training. The current study thus aimed to describe and evaluate how difficult news can be toned down during genetic counseling sessions involving cases of fetal syndromes and/or malformations. The study analyzed 33 naturalistic interactions (i.e. real situations), taped and transcribed, according to the theoretical and methodological perspective of Conversation Analysis, with an ethnomethodological basis. These interactions consisted of sessions in clinical genetics with pregnant women seen at the fetal medicine service of a reference hospital for maternal and child health in the Brazilian Unified National Health System (SUS). The analysis showed that communicating difficult news can be accompanied by optimistic perspectives that are scaled-up according to each situation's severity. In the absence of a positive diagnosis, the appointments can conclude with positive aspects such as recommendations for palliative care, so that the patient always leaves the appointment with some kind of recommendation. This study proposes to innovate and expand the scope of studies on communicating difficult news in the physician-patient relationship in Brazil, precisely by developing an analysis of real interactions in genetic counseling and thus providing interactional backing for training health professionals that deal with this challenge in their routine work.

Student homicidal violence in schools: an international problem.

PubMed

Bondü, Rebecca; Cornell, Dewey G; Scheithauer, Herbert

2011-01-01

School homicides have been become a worldwide phenomenon. In the decade following the Columbine shooting there have been at least forty similar events in other countries. This article addresses the international scope of this problem and some of the complex conceptual issues that make student homicidal violence difficult to define and study. Meaningful research on risk and protective factors that can inform evidence-based preventive models is summarized. Copyright © 2011 Wiley Periodicals, Inc., A Wiley Company.

Managing the Difficult Child.

ERIC Educational Resources Information Center

Murphy, Linda; Della Corte, Suzanne

1990-01-01

This newsletter issue focuses on ways parents can manage the difficult child with special needs. Characteristics of the difficult child are listed including poor listening skills, irritableness, impulsivity, and tendency to have tantrums. Typical reactions to the difficult child by parents, siblings, other relatives, neighbors, the school, and…

Convocation address.

PubMed

Swaminathan, M S

1998-07-01

This address delivered to the 40th convocation of the International Institute for Population Sciences in India in 1998 opens by noting that a shortage of jobs for youth is India's most urgent problem but that the problems that attend the increasing numbers of elderly also require serious attention. The address then notes that the Earth's population is growing at an unsustainable rate while economic inequities among countries are increasing, so that, while intellectual property is becoming the most important asset in developed countries, nutritional anemia among pregnant women causes their offspring to be unable to achieve their full intellectual potential from birth. Next, the address uses a discussion of the 18th-century work on population of the Marquis de Condorcet and of Thomas Malthus to lead into a consideration of estimated increased needs of countries like India and China to import food grains in the near future. Next, the progress of demographic transition in Indian states is covered and applied to Mahbub ul Haq's measure of human deprivation developed for and applied to the region of the South Asian Association for Regional Cooperation (India, Pakistan, Bangladesh, Nepal, Sri Lanka, Bhutan, and the Maldives). The address continues by reiterating some of the major recommendations forwarded by a government of India committee charged in 1995 with drafting a national population policy. Finally, the address suggests specific actions that could be important components of the Hunger-Free India Programme and concludes that all success rests on the successful implementation of appropriate population policies.

Difficult physician-patient relationships.

PubMed

Reifsteck, S W

1998-01-01

Changes in the delivery of health care services in the United States are proceeding so rapidly that many providers are asking how the working relationships between doctors and patients will be effected. Accelerated by cost containment, quality improvement and the growth of managed care, these changes have caused some critics to feel that shorter visits and gatekeeper systems will promote an adversarial relationship between physicians and patients. However, proponents of the changing system feel that better prevention, follow-up care and the attention to customer service these plans can offer will lead to increased patient satisfaction and improved doctor-patient communication. Dedicated to addressing these concerns, the Bayer Institute for Health Care Communication was established in 1987 as a continuing medical education program (CME) focusing on this topic. A half-day workshop on clinician-patient communication to enhance health outcomes was introduced in 1992 and a second workshop, "Difficult' Clinician-Patient Relationships," was developed two years later. The two courses discussed in this article are offered to all physicians, residents, medical students, mid-level providers and other interested staff within the Carle system.

When I Whisper, Nobody Listens: Helping Young People Write about Difficult Issues.

ERIC Educational Resources Information Center

Frost, Helen

This book offers guidance on how teachers can help their students write about sensitive topics or provide pragmatic suggestions for developing the skill and sensitivity necessary to venture into such difficult terrain. The book addresses students' need to articulate their thoughts and feelings about violence, anger, drug use, peer pressure, and…

Distraction during learning with hypermedia: difficult tasks help to keep task goals on track

PubMed Central

Scheiter, Katharina; Gerjets, Peter; Heise, Elke

2014-01-01

In educational hypermedia environments, students are often confronted with potential sources of distraction arising from additional information that, albeit interesting, is unrelated to their current task goal. The paper investigates the conditions under which distraction occurs and hampers performance. Based on theories of volitional action control it was hypothesized that interesting information, especially if related to a pending goal, would interfere with task performance only when working on easy, but not on difficult tasks. In Experiment 1, 66 students learned about probability theory using worked examples and solved corresponding test problems, whose task difficulty was manipulated. As a second factor, the presence of interesting information unrelated to the primary task was varied. Results showed that students solved more easy than difficult probability problems correctly. However, the presence of interesting, but task-irrelevant information did not interfere with performance. In Experiment 2, 68 students again engaged in example-based learning and problem solving in the presence of task-irrelevant information. Problem-solving difficulty was varied as a first factor. Additionally, the presence of a pending goal related to the task-irrelevant information was manipulated. As expected, problem-solving performance declined when a pending goal was present during working on easy problems, whereas no interference was observed for difficult problems. Moreover, the presence of a pending goal reduced the time on task-relevant information and increased the time on task-irrelevant information while working on easy tasks. However, as revealed by mediation analyses these changes in overt information processing behavior did not explain the decline in problem-solving performance. As an alternative explanation it is suggested that goal conflicts resulting from pending goals claim cognitive resources, which are then no longer available for learning and problem solving. PMID

Vortex generator design for aircraft inlet distortion as a numerical optimization problem

NASA Technical Reports Server (NTRS)

Anderson, Bernhard H.; Levy, Ralph

1991-01-01

Aerodynamic compatibility of aircraft/inlet/engine systems is a difficult design problem for aircraft that must operate in many different flight regimes. Takeoff, subsonic cruise, supersonic cruise, transonic maneuvering, and high altitude loiter each place different constraints on inlet design. Vortex generators, small wing like sections mounted on the inside surfaces of the inlet duct, are used to control flow separation and engine face distortion. The design of vortex generator installations in an inlet is defined as a problem addressable by numerical optimization techniques. A performance parameter is suggested to account for both inlet distortion and total pressure loss at a series of design flight conditions. The resulting optimization problem is difficult since some of the design parameters take on integer values. If numerical procedures could be used to reduce multimillion dollar development test programs to a small set of verification tests, numerical optimization could have a significant impact on both cost and elapsed time to design new aircraft.

Addressing Society's Problems in a Global Studies Class.

ERIC Educational Resources Information Center

Pesce, Louis; And Others

1996-01-01

Describes the adaptation of the Future Problem-Solving Process (FPS) in a global studies class. The process applies state-of-the-art critical thinking and problem solving to unstable areas such as the Middle East and the former Soviet Union. Includes handouts directing the students through the process. (MJP)

The Crisis Manual for Early Childhood Teachers: How To Handle the Really Difficult Problems.

ERIC Educational Resources Information Center

Miller, Karen

More and more teachers report the increasing incidence of crises in children's lives, crises that interfere with the child's ability to learn. Noting that developmentally appropriate curricula must respond to the issues of immediate concern and interest to children, this source book assists teachers in facing difficult issues in the classroom and…

Evidence-Based Practices for Addressing Classroom Behavior Problems

ERIC Educational Resources Information Center

Park, Hye-Suk Lee; Lynch, Sharon A.

2014-01-01

Teachers of young children can plan proactively so that they avoid some of the serious problem behaviors in the classroom. The strategies presented in this article are part of a problem solving approach to challenging behavior based on the principles of positive behavioral support. Although these methods presented here have research-based…

In Situ Airborne Instrumentation: Addressing and Solving Measurement Problems in Ice Clouds

DOE PAGES

Baumgardner, Darrel; Kok, Greg; Avallone, L.; ...

2012-02-01

A meeting of 31 international experts on in situ measurements from aircraft was held to identify unresolved questions concerning ice formation and evolution in ice clouds, assess the current state of instrumentation that can address these problems, introduce emerging technology that may overcome current measurement issues and recommend future courses of action that can improve our understanding of ice cloud microphysical processes and their impact on the environment. The meeting proceedings and outcome has been described in detail in a manuscript submitted to the Bulletin of the American Meteorological Society (BAMS) on March 24, 2011. This paper is currently undermore » review. The remainder of this summary, in the following pages, is the text of the BAMS article. A technical note that will be published by the National Center for Atmospheric Research is currently underway and is expected to be published before the end of the year.« less

End-of-life issues: difficult decisions and dealing with grief.

PubMed

Loomis, Beth

2009-06-01

People face many challenging psychosocial and spiritual issues as they approach the end of their lives, and caregivers need advice on how to help them. Choosing among treatment options, handling grief, addressing unfinished business, and coping with loss of self-sufficiency are difficult for the dying person, and caregivers must deal with surrogate decision making, raw emotions in the patient and in family members, and the caregivers' own grief. Listening and coping skills are discussed.

When Your Child Is Difficult: Solve Your Toughest Child-Raising Problems with a Four-Step Plan That Works.

ERIC Educational Resources Information Center

Silberman, Mel

Written for parents, this book discusses four steps for dealing with children's difficult behavior. The book is divided into two parts. Part 1, "The Building Blocks," discusses baseline perspectives parents need to establish in order to effectively deal with difficult behavior. Topics covered include: (1) parents' dual roles as caregivers and…

Outcomes of an Innovative Evidence-Based Practice Project: Building a Difficult-Access Team in the Emergency Department.

PubMed

Whalen, Madeleine; Maliszewski, Barbara; Sheinfeld, Rebecca; Gardner, Heather; Baptiste, Diana

2018-04-25

Difficult venous access is a common problem in health care-especially in the emergency setting-that relies on quick diagnostics to differentiate patient acuities and administer critical medications. The creation of a dedicated team to address difficult venous access (DVA) is a possible solution to the problems of delayed venous access, yet no studies have been published on implementing such a team in the emergency department. This was a quasi-experimental study in an urban emergency department. Researchers performed chart audits of staff-identified patients with DVA to gather baseline data. A DVA team was subsequently implemented 16 hours a day, 7 days a week. Data were recorded on patients referred to the team and included time, number of IV attempts, and patient characteristics. Baseline data were collected on 53 patients, and postintervention data included 135 patients. The implementation of a DVA team decreased the mean lab order-to-lab completion time by 115 minutes (P < 0.0001). Decreases in the number of attempts were not statistically significant. Patients requiring increased numbers of IV attempts also had many common characteristics including history of multiple attempts, poor skin quality, and IV drug use. The use of a dedicated team for DVA reduces the lag time from physician orders to actionable diagnostics or administration of medication. A dedicated DVA technician is a concrete solution to threats of patient safety, as well as ED crowding, and has the potential to affect both patient- and department-level care. Copyright © 2018 Elsevier Inc. All rights reserved.

Gender-based generalisations in school nurses' appraisals of and interventions addressing students' mental health.

PubMed

Rosvall, Per-Åke; Nilsson, Stefan

2016-08-30

There has been an increase of reports describing mental health problems in adolescents, especially girls. School nurses play an important role in supporting young people with health problems. Few studies have considered how the nurses' gender norms may influence their discussions. To investigate this issue, semi-structured interviews focusing on school nurses' work with students who have mental health problems were conducted. Transcripts of interviews with Swedish school nurses (n = 15) from the Help overcoming pain early project (HOPE) were analysed using theories on gender as a theoretical framework and then organised into themes related to the school nurses' provision of contact and intervention. The interviewees were all women, aged between 42-63 years, who had worked as nurses for 13-45 years, and as school nurses for 2-28 years. Five worked in upper secondary schools (for students aged 16-19) and 10 in secondary schools (for students aged 12-16). The results show that school nurses more commonly associated mental health problems with girls. When the school nurses discussed students that were difficult to reach, boys in particular were mentioned. However, very few nurses mentioned specific intervention to address students' mental health problems, and all of the mentioned interventions were focused on girls. Some of the school nurses reported that it was more difficult to initiate a health dialogue with boys, yet none of the nurses had organized interventions for the boys. We conclude that generalisations can sometimes be analytically helpful, facilitating, for instance, the identification of problems in school nurses' work methods and interventions. However, the most important conclusion from our research, which applied a design that is not commonly used, is that more varied approaches, as well as a greater awareness of potential gender stereotype pitfalls, are necessary to meet the needs of diverse student groups.

Time to address the problems at the neural interface

NASA Astrophysics Data System (ADS)

Durand, Dominique M.; Ghovanloo, Maysam; Krames, Elliot

2014-04-01

interface with the CNS. In 2013, two symposia were held independently to discuss this problem: one was held at the International Neuromodulation Society's 11th World Congress in Berlin and supported by the International Neuromodulation Society1 and the other at the 6th International Neural Engineering conference in San Diego2 and was supported by the NSF. Clearly, the neuromodulation and the neural engineering communities are keen to solve this problem. Experts from the field were assembled to discuss the problems and potential solutions. Although many important points were raised, few emerged as key issues. (1) The ability to access remotely and reliably internal neural signals . Although some of the technological problems have already been solved, this ability to access neural signals is still a significant problem since reliable and robust transcutaneous telemetry systems with large numbers of signals, each with wide bandwidth, are not readily available to researchers. (2) A translation strategy taking basic research to the clinic . The lack of understanding of the biological response to implanted constructs and the inability to monitor the sites and match the mechanical properties of the probe to the neural tissue properties continue to be an unsolved problem. In addition, the low levels of collaboration among neuroscientists, clinicians, patients and other stakeholders throughout different phases of research and development were considered to be significant impediments to progress. (3) Fundamental tools development procedures for neural interfacing . There are many laboratories testing various devices with different sets of criteria, but there is no consensus on the failure modes. The reliability, robustness of metrics and testing standards for such devices have not been established, either in academia or in industry. To start addressing this problem, the FDA has established a laboratory to test the reliability of some neural devices. Although the discussion was mostly

Everyday beliefs about sources of advice for the parents of difficult children.

PubMed

Sonuga-Barke, E J; Thompson, M; Balding, J

1993-01-01

Parents were asked which sources of advice families with difficult children should seek. The results suggested a similar hierarchy of agencies for both boys and girls with emotional and behavioural problems. Teachers, doctors, child psychiatrists and health visitors all received strong positive ratings, books about children with problems received moderate positive ratings, religious leaders received the strongest negative ratings and grandparents and friends received neutral ratings. Implications for service provision are discussed.

Addressing Problems Encountered in Case-Based Teaching

ERIC Educational Resources Information Center

Turgeon, A. J.

2007-01-01

TURF 436 (Case Studies in Turfgrass Management) is the capstone course for turfgrass science majors at the Pennsylvania State University. Students are introduced to problems and complex problematic situations encountered in the management of golf and sports turf and in professional lawn-care operations. Following completion of the orientation case…

Addressing the Curriculum Problem in Doctoral Education

ERIC Educational Resources Information Center

Green, Bill

2012-01-01

How best to understand the curriculum problem in doctoral research education: that is the question that this paper engages. It begins by noting that curriculum as such is little referenced and inadequately theorised in higher education and certainly in doctoral education, and indeed has been described as a "missing term". The paper then…

Methods for measuring denitrification: Diverse approaches to a difficult problem

USGS Publications Warehouse

Groffman, Peter M; Altabet, Mary A.; Böhlke, J.K.; Butterbach-Bahl, Klaus; David, Mary B.; Firestone, Mary K.; Giblin, Anne E.; Kana, Todd M.; Nielsen , Lars Peter; Voytek, Mary A.

2006-01-01

Denitrification, the reduction of the nitrogen (N) oxides, nitrate (NO3−) and nitrite (NO2−), to the gases nitric oxide (NO), nitrous oxide (N2O), and dinitrogen (N2), is important to primary production, water quality, and the chemistry and physics of the atmosphere at ecosystem, landscape, regional, and global scales. Unfortunately, this process is very difficult to measure, and existing methods are problematic for different reasons in different places at different times. In this paper, we review the major approaches that have been taken to measure denitrification in terrestrial and aquatic environments and discuss the strengths, weaknesses, and future prospects for the different methods. Methodological approaches covered include (1) acetylene-based methods, (2) 15N tracers, (3) direct N2 quantification, (4) N2:Ar ratio quantification, (5) mass balance approaches, (6) stoichiometric approaches, (7) methods based on stable isotopes, (8) in situ gradients with atmospheric environmental tracers, and (9) molecular approaches. Our review makes it clear that the prospects for improved quantification of denitrification vary greatly in different environments and at different scales. While current methodology allows for the production of accurate estimates of denitrification at scales relevant to water and air quality and ecosystem fertility questions in some systems (e.g., aquatic sediments, well-defined aquifers), methodology for other systems, especially upland terrestrial areas, still needs development. Comparison of mass balance and stoichiometric approaches that constrain estimates of denitrification at large scales with point measurements (made using multiple methods), in multiple systems, is likely to propel more improvement in denitrification methods over the next few years.

An anatomy of countertransference: staff reactions to difficult psychiatric hospital patients.

PubMed

Colson, D B; Allen, J G; Coyne, L; Dexter, N; Jehl, N; Mayer, C A; Spohn, H

1986-09-01

Countertransference among hospital staff was investigated as part of ongoing research on difficult-to-treat psychiatric hospital patients. Staff's ratings of their emotional reactions to 127 patients on long-term units were analyzed by factor analysis, and the resulting factors were correlated by discipline with patient problem behaviors. Among the conclusions were that different forms of psychopathology elicit characteristic patterns of emotional reaction from staff; that some dimensions of psychopathology, particularly suicidal-depressed behavior and violence-agitation, elicit different emotional reactions among different disciplines, thus laying the groundwork for division among staff; and that the more difficult the process of hospital treatment, the more likely staff will experience a variety of emotions.

Teachers Are Designers: Addressing Problems of Practice in Education

ERIC Educational Resources Information Center

Henriksen, Danah; Richardson, Carmen

2017-01-01

Teachers may be confused or put off by buzzwords like "design thinking," but the concept is a useful one: To solve stubborn, everyday problems of practice in schools, they should approach those problems strategically and systematically. Specifically, explain the authors, teachers gain new insights into challenges they face when they take…

Patients with difficult intubation may need referral to sleep clinics.

PubMed

Chung, Frances; Yegneswaran, Balaji; Herrera, Francisco; Shenderey, Alex; Shapiro, Colin M

2008-09-01

Upper airway abnormalities carry the risk of obstructive sleep apnea (OSA) and difficult tracheal intubations. Both conditions contribute to significant clinical problems and have increased perioperative morbidity and mortality. We hypothesized that patients who presented with difficult intubation would have a very high prevalence of OSA and that those with unexpected difficult intubation may require referral to sleep clinics for polysomnography (PSG). Patients classified as a grade 4 Cormack and Lehane on direct laryngoscopic view, and who required more than two attempts for successful endotracheal intubation, were referred to the study by consultant anesthesiologists at four hospitals. Apnea-hypopnea index (AHI) data and postoperative events were collected. Patients with AHI >5/h were considered positive for OSA. Clinical and PSG variables were compared using t-tests and chi(2) test. Over a 20-mo period, 84 patients with a difficult intubation were referred into the study. Thirty-three patients agreed to participate. Sixty-six percent (22 of 33) had OSA (AHI >5/h). Of the 22 OSA patients, 10 patients (64%) had mild OSA (AHI 5-15), 6 (18%) had moderate OSA (AHI >15/h), and 6 (18%) had severe OSA (AHI >30/h). Of the 33 patients, 11 patients (33%) were recommended for continuous positive airway pressure treatment. Between the OSA group and the non-OSA group, there were significant differences in gender, neck size, and the quality of sleep, but there were no significant differences in age and body mass index. Sixty-six percent of patients with unexpected difficult intubation who consented to undergo a sleep study were diagnosed with OSA by PSG. Patients with difficult intubation are at high risk for OSA and should be screened for signs and symptoms of sleep apnea. Screening for OSA should be considered by referral to a sleep clinic for PSG.

Reaction Workup Planning: A Structured Flowchart Approach, Exemplified in Difficult Aqueous Workup of Hydrophilic Products

ERIC Educational Resources Information Center

Hill, George B.; Sweeney, Joseph B.

2015-01-01

Reaction workup can be a complex problem for those facing novel synthesis of difficult compounds for the first time. Workup problem solving by systematic thinking should be inculcated as mid-graduate-level is reached. A structured approach is proposed, building decision tree flowcharts to analyze challenges, and an exemplar flowchart is presented…

Exploring the Lived Experience of Difficult Sleep and Good Sleep Among Psychiatric Inpatients.

PubMed

Zust, Barbara Lois; Gruenberg, Marjorie E; Sendelbach, Susan Ellen

2016-01-01

The purpose of this qualitative study was to explore psychiatric inpatients' reflections on their experiences with sleep throughout their lives. Fourteen patients in an acute care behavioral health unit agreed to participate in this study. Participants met individually with a researcher to reflect on times in their lives when they experienced good sleep; times when they had difficulty sleeping; and times when difficult sleep was resolved. The major findings of the study indicated that feeling alone with life problems triggered difficult sleep; while feelings of belonging and purpose were associated with good sleep.

An Address on the Population Problem: Address to the Massachusetts Institute of Technology.

ERIC Educational Resources Information Center

McNamara, Robert S.

In this speech, Robert McNamara examines the background of the world population problem, analyzes its current trends, evaluates the measures available to deal with it, and suggests actions governments and others can take to help solve it. It now appears that significant fertility decline may have begun in developing countries. Data seem to…

An efficient and accurate solution methodology for bilevel multi-objective programming problems using a hybrid evolutionary-local-search algorithm.

PubMed

Deb, Kalyanmoy; Sinha, Ankur

2010-01-01

Bilevel optimization problems involve two optimization tasks (upper and lower level), in which every feasible upper level solution must correspond to an optimal solution to a lower level optimization problem. These problems commonly appear in many practical problem solving tasks including optimal control, process optimization, game-playing strategy developments, transportation problems, and others. However, they are commonly converted into a single level optimization problem by using an approximate solution procedure to replace the lower level optimization task. Although there exist a number of theoretical, numerical, and evolutionary optimization studies involving single-objective bilevel programming problems, not many studies look at the context of multiple conflicting objectives in each level of a bilevel programming problem. In this paper, we address certain intricate issues related to solving multi-objective bilevel programming problems, present challenging test problems, and propose a viable and hybrid evolutionary-cum-local-search based algorithm as a solution methodology. The hybrid approach performs better than a number of existing methodologies and scales well up to 40-variable difficult test problems used in this study. The population sizing and termination criteria are made self-adaptive, so that no additional parameters need to be supplied by the user. The study indicates a clear niche of evolutionary algorithms in solving such difficult problems of practical importance compared to their usual solution by a computationally expensive nested procedure. The study opens up many issues related to multi-objective bilevel programming and hopefully this study will motivate EMO and other researchers to pay more attention to this important and difficult problem solving activity.

Effective communication during difficult conversations.

PubMed

Polito, Jacquelyn M

2013-06-01

A strong interest and need exist in the workplace today to master the skills of conducting difficult conversations. Theories and strategies abound, yet none seem to have found the magic formula with universal appeal and success. If it is such an uncomfortable skill to master is it better to avoid or initiate such conversations with employees? Best practices and evidence-based management guide us to the decision that quality improvement dictates effective communication, even when difficult. This brief paper will offer some suggestions for strategies to manage difficult conversations with employees. Mastering the skills of conducting difficult conversations is clearly important to keeping lines of communication open and productive. Successful communication skills may actually help to avert confrontation through employee engagement, commitment and appropriate corresponding behavior

Activity theory as a tool to address the problem of chemistry's lack of relevance in secondary school chemical education

NASA Astrophysics Data System (ADS)

van Aalsvoort, Joke

In a previous article, the problem of chemistry's lack of relevance in secondary chemical education was analysed using logical positivism as a tool. This article starts with the hypothesis that the problem can be addressed by means of activity theory, one of the important theories within the sociocultural school. The reason for this expectation is that, while logical positivism creates a divide between science and society, activity theory offers a model of society in which science and society are related. With the use of this model, a new course for grade nine has been constructed. This results in a confirmation of the hypothesis, at least at a theoretical level. A comparison with the Salters' approach is made in order to demonstrate the relative merits of a mediated way of dealing with the problem of the lack of relevance of chemistry in chemical education.

Ineffective Healthcare Technology Management in Benin’s Public Health Sector: The Perceptions of Key Actors and Their Ability to Address the Main Problems

PubMed Central

Houngbo, P. Thierry; De Cock Buning, Tjard; Bunders, Joske; Coleman, Harry L. S.; Medenou, Daton; Dakpanon, Laurent; Zweekhorst, Marjolein

2017-01-01

Background: Low-income countries face many contextual challenges to manage healthcare technologies effectively, as the majority are imported and resources are constrained to a greater extent. Previous healthcare technology management (HTM) policies in Benin have failed to produce better quality of care for the population and costeffectiveness for the government. This study aims to identify and assess the main problems facing HTM in Benin’s public health sector, as well as the ability of key actors within the sector to address these problems. Methods: We conducted 2 surveys in 117 selected health facilities. The first survey was based on 377 questionnaires and 259 interviews, and the second involved observation and group interviews at health facilities. The Temple-Bird Healthcare Technology Package System (TBHTPS), tailored to the context of Benin’s health system, was used as a conceptual framework. Results: The findings of the first survey show that 85% of key actors in Benin’s HTM sector characterized the system as failing in components of the TBHTPS framework. Biomedical, clinical, healthcare technology engineers and technicians perceived problems most severely, followed by users of equipment, managers and hospital directors, international organization officers, local and foreign suppliers, and finally policy-makers, planners and administrators at the Ministry of Health (MoH). The 5 most important challenges to be addressed are policy, strategic management and planning, and technology needs assessment and selection – categorized as major enabling inputs (MEI) in HTM by the TBHTPS framework – and installation and commissioning, training and skill development and procurement, which are import and use activities (IUA). The ability of each key actor to address these problems (the degree of political or administrative power they possess) was inversely proportional to their perception of the severity of the problems. Observational data gathered during site

The Mastery Matrix for Integration Praxis: The development of a rubric for integration practice in addressing weight-related public health problems.

PubMed

Berge, Jerica M; Adamek, Margaret; Caspi, Caitlin; Grannon, Katherine Y; Loth, Katie A; Trofholz, Amanda; Nanney, Marilyn S

2018-06-01

In response to the limitations of siloed weight-related intervention approaches, scholars have called for greater integration that is intentional, strategic, and thoughtful between researchers, health care clinicians, community members, and policy makers as a way to more effectively address weight and weight-related (e.g., obesity, diabetes, cardiovascular disease, cancer) public health problems. The Mastery Matrix for Integration Praxis was developed by the Healthy Eating and Activity across the Lifespan (HEAL) team in 2017 to advance the science and praxis of integration across the domains of research, clinical practice, community, and policy to address weight-related public health problems. Integrator functions were identified and developmental stages were created to generate a rubric for measuring mastery of integration. Creating a means to systematically define and evaluate integration praxis and expertise will allow for more individuals and teams to master integration in order to work towards promoting a culture of health. Copyright © 2018 Elsevier Inc. All rights reserved.

The Social Essentials of Learning: An Experimental Investigation of Collaborative Problem Solving and Knowledge Construction in Mathematics Classrooms in Australia and China

ERIC Educational Resources Information Center

Chan, Man Ching Esther; Clarke, David; Cao, Yiming

2018-01-01

Interactive problem solving and learning are priorities in contemporary education, but these complex processes have proved difficult to research. This project addresses the question "How do we optimise social interaction for the promotion of learning in a mathematics classroom?" Employing the logic of multi-theoretic research design,…

Addressing Sexual Harassment

ERIC Educational Resources Information Center

Young, Ellie L.; Ashbaker, Betty Y.

2008-01-01

This article discusses ways on how to address the problem of sexual harassment in schools. Sexual harassment--simply defined as any unwanted and unwelcome sexual behavior--is a sensitive topic. Merely providing students, parents, and staff members with information about the school's sexual harassment policy is insufficient; schools must take…

Brown Superfund Basic research Program: a multistakeholder partnership addresses real-world problems in contaminated communities.

PubMed

Senier, Laura; Hudson, Benjamin; Fort, Sarah; Hoover, Elizabeth; Tillson, Rebecca; Brown, Phil

2008-07-01

The NIEHS funds several basic and applied research programs, many of which also require research translation or outreach. This paper reports on a project by the Brown University Superfund Basic Research Program (SBRP), in which outreach and research translation teams collaborated with state regulatory agency personnel and community activists on a legislative initiative to mitigate the financial impacts of living in a contaminated community. The Environmentally Compromised Home Ownership (ECHO) program makes home equity loans of up to $25,000 available to qualified applicants. This collaboration provides a case study in community engagement and demonstrates how research translation and outreach activities that are clearly differentiated yet well-integrated can improve a suite of basic and applied research. Although engaging diverse constituencies can be difficult community-engaged translation and outreach have the potential to make research findings more useful to communities, address some of the social impacts of contamination, and empower stakeholders to pursue their individual and collectively held goals for remediation. The NIEHS has recently renewed its commitment to community-engaged research and advocacy, making this an optimal time to reflect on how basic research programs that engage stakeholders through research translation and outreach can add value to the overall research enterprise.

Addressing Problem Behavior at Recess Using Peer Praise Notes

ERIC Educational Resources Information Center

Teerlink, Elise; Caldarella, Paul; Anderson, Darlene H.; Richardson, Michael J.; Guzman, E. Geovanni

2017-01-01

School recess, though beneficial to students in many ways, can be a problematic setting due to inadequate supervision, structure, and safety. A peer praise note (PPN) intervention was implemented on the recess playground to address these concerns at a Title I elementary school. Researchers used a single-subject reversal design across all students…

Addressing Beyond Standard Model physics using cosmology

NASA Astrophysics Data System (ADS)

Ghalsasi, Akshay

We have consensus models for both particle physics (i.e. standard model) and cosmology (i.e. LambdaCDM). Given certain assumptions about the initial conditions of the universe, the marriage of the standard model (SM) of particle physics and LambdaCDM cosmology has been phenomenally successful in describing the universe we live in. However it is quite clear that all is not well. The three biggest problems that the SM faces today are baryogenesis, dark matter and dark energy. These problems, along with the problem of neutrino masses, indicate the existence of physics beyond SM. Evidence of baryogenesis, dark matter and dark energy all comes from astrophysical and cosmological observations. Cosmology also provides the best (model dependent) constraints on neutrino masses. In this thesis I will try address the following problems 1) Addressing the origin of dark energy (DE) using non-standard neutrino cosmology and exploring the effects of the non-standard neutrino cosmology on terrestrial and cosmological experiments. 2) Addressing the matter anti-matter asymmetry of the universe.

Effective use of real-life events as tools for teaching-learning clinical pharmacology in a problem-based learning curriculum.

PubMed

James, Henry; Al Khaja, Khalid A; Sequeira, Reginald P

2015-01-01

This paper describes how in a problem-based learning (PBL) medical curriculum, having identified the learning outcomes, problems can be developed from real-life events for teaching-learning clinical pharmacology topics for which PBL cases might be inadequate. Such problems can be very interesting and educational. Using the story of the development and withdrawal of rofecoxib (Vioxx(®)), we developed a problem for undergraduate medical students to address important issues related to clinical pharmacology and therapeutics such as new drug development, preclinical testing, clinical trials, adverse drug reactions, professionalism, and critical appraisal of literature. These topics would otherwise be difficult to address in patient-based problems. The evaluation of the problem based on pooled feedback from 57 tutorial groups, each comprising 8-10 students, collected over 5 years, supported the effectiveness of the problem. A systematic approach described in this paper can be used for the development and validation of educational material for introducing focal topics of pharmacology/clinical pharmacology integrated with other disciplines in innovative medical (and other health profession) curricula.

Patient safety and the problem of many hands

PubMed Central

Dixon-Woods, Mary; Pronovost, Peter

2016-01-01

Summary Healthcare worldwide is faced with a crisis of patient safety: every day, everywhere, patients are injured during the course of their care. Notwithstanding occasional successes in relation to specific harms, safety as a system characteristic has remained elusive. We propose that one neglected reason why the safety problem has proved so stubborn is that healthcare suffers from a pathology known in the public administration literature as the problem of many hands. It is a problem that arises in contexts where multiple actors – organizations, individuals, groups – each contribute to effects seen at system level, but it remains difficult to hold any single actor responsible for these effects. Efforts by individual actors, including local quality improvement projects, may have the paradoxical effect of undermining system safety. Many challenges cannot be resolved by individual organisations, since they require whole-sector coordination and action. We call for recognition of the problem of many hands and for attention to be given to how it might most optimally be addressed in a healthcare context. PMID:26912578

Address tracing for parallel machines

NASA Technical Reports Server (NTRS)

Stunkel, Craig B.; Janssens, Bob; Fuchs, W. Kent

1991-01-01

Recently implemented parallel system address-tracing methods based on several metrics are surveyed. The issues specific to collection of traces for both shared and distributed memory parallel computers are highlighted. Five general categories of address-trace collection methods are examined: hardware-captured, interrupt-based, simulation-based, altered microcode-based, and instrumented program-based traces. The problems unique to shared memory and distributed memory multiprocessors are examined separately.

Conceptual, Methodological, and Ethical Problems in Communicating Uncertainty in Clinical Evidence

PubMed Central

Han, Paul K. J.

2014-01-01

The communication of uncertainty in clinical evidence is an important endeavor that poses difficult conceptual, methodological, and ethical problems. Conceptual problems include logical paradoxes in the meaning of probability and “ambiguity”— second-order uncertainty arising from the lack of reliability, credibility, or adequacy of probability information. Methodological problems include questions about optimal methods for representing fundamental uncertainties and for communicating these uncertainties in clinical practice. Ethical problems include questions about whether communicating uncertainty enhances or diminishes patient autonomy and produces net benefits or harms. This article reviews the limited but growing literature on these problems and efforts to address them and identifies key areas of focus for future research. It is argued that the critical need moving forward is for greater conceptual clarity and consistent representational methods that make the meaning of various uncertainties understandable, and for clinical interventions to support patients in coping with uncertainty in decision making. PMID:23132891

The Evolution of Chemical High-Throughput Experimentation To Address Challenging Problems in Pharmaceutical Synthesis.

PubMed

Krska, Shane W; DiRocco, Daniel A; Dreher, Spencer D; Shevlin, Michael

2017-12-19

The structural complexity of pharmaceuticals presents a significant challenge to modern catalysis. Many published methods that work well on simple substrates often fail when attempts are made to apply them to complex drug intermediates. The use of high-throughput experimentation (HTE) techniques offers a means to overcome this fundamental challenge by facilitating the rational exploration of large arrays of catalysts and reaction conditions in a time- and material-efficient manner. Initial forays into the use of HTE in our laboratories for solving chemistry problems centered around screening of chiral precious-metal catalysts for homogeneous asymmetric hydrogenation. The success of these early efforts in developing efficient catalytic steps for late-stage development programs motivated the desire to increase the scope of this approach to encompass other high-value catalytic chemistries. Doing so, however, required significant advances in reactor and workflow design and automation to enable the effective assembly and agitation of arrays of heterogeneous reaction mixtures and retention of volatile solvents under a wide range of temperatures. Associated innovations in high-throughput analytical chemistry techniques greatly increased the efficiency and reliability of these methods. These evolved HTE techniques have been utilized extensively to develop highly innovative catalysis solutions to the most challenging problems in large-scale pharmaceutical synthesis. Starting with Pd- and Cu-catalyzed cross-coupling chemistry, subsequent efforts expanded to other valuable modern synthetic transformations such as chiral phase-transfer catalysis, photoredox catalysis, and C-H functionalization. As our experience and confidence in HTE techniques matured, we envisioned their application beyond problems in process chemistry to address the needs of medicinal chemists. Here the problem of reaction generality is felt most acutely, and HTE approaches should prove broadly enabling

Patients whom neurologists find difficult to help

PubMed Central

Carson, A; Stone, J; Warlow, C; Sharpe, M

2004-01-01

Objective: To test the hypothesis that patients whose symptoms were less explained by organic disease would be perceived as more difficult to help. Methods: In a consecutive series of 300 new neurology outpatients, neurologists indicated on four point Likert-type scales how "difficult to help" they found the patient and to what extent the patient's symptoms were explained by organic disease. The patients' demographics, health status, number of somatic symptoms, and mental state were also assessed. Results: The neurologists rated 143 patients (48%) as "not at all difficult" to help, 111 (37%) as "somewhat difficult", 27 (9%) as "very difficult", and 18 (6%) as "extremely difficult". A logistic regression model was constructed and the hypothesis that patients whose symptoms were less explained by organic disease would be perceived as more difficult to help was supported. The only other measured variable that contributed to perceived difficulty was physical disability, but it explained only a small amount of the variance. Conclusions: Neurologists find patients whose symptoms are not explained by organic disease more difficult to help than their other patients. PMID:15548505

Social cognition and social problem solving abilities in individuals with alcohol use disorder.

PubMed

Schmidt, Tobias; Roser, Patrik; Juckel, Georg; Brüne, Martin; Suchan, Boris; Thoma, Patrizia

2016-11-01

Up to now, little is known about higher order cognitive abilities like social cognition and social problem solving abilities in alcohol-dependent patients. However, impairments in these domains lead to an increased probability for relapse and are thus highly relevant in treatment contexts. This cross-sectional study assessed distinct aspects of social cognition and social problem solving in 31 hospitalized patients with alcohol use disorder (AUD) and 30 matched healthy controls (HC). Three ecologically valid scenario-based tests were used to gauge the ability to infer the mental state of story characters in complicated interpersonal situations, the capacity to select the best problem solving strategy among other less optimal alternatives, and the ability to freely generate appropriate strategies to handle difficult interpersonal conflicts. Standardized tests were used to assess executive function, attention, trait empathy, and memory, and correlations were computed between measures of executive function, attention, trait empathy, and tests of social problem solving. AUD patients generated significantly fewer socially sensitive and practically effective solutions for problematic interpersonal situations than the HC group. Furthermore, patients performed significantly worse when asked to select the best alternative among a list of presented alternatives for scenarios containing sarcastic remarks and had significantly more problems to interpret sarcastic remarks in difficult interpersonal situations. These specific patterns of impairments should be considered in treatment programs addressing impaired social skills in individuals with AUD.

The analysis of 146 patients with difficult laparoscopic cholecystectomy

PubMed Central

Bat, Orhan

2015-01-01

Introduction: Laparoscopic cholecystectomy (LC) is very commonly performed surgical intervention. Acute or chronic cholecystitis, adhesions due to previous upper abdomen surgeries, Mirrizi’s syndrome and obesity are common clinical conditions that can be associated with difficult cholecystectomy. In this study, we evaluated and scored the patients with difficult surgical exploration during laparoscopic cholecystectomy. Material and Method: All patients who underwent LC from 2010 to 2015 were retrospectively rewieved. According to intraoperative findings DLC cases were described and classified. Class I difficulty: Adhesion of omentum majus, transverse colon, duodenum to the fundus of the gallbladder. Class II difficulty: Adhesions in Calot’s triangle and difficulty in dissection of cystic artery and cystic duct Class III difficulty: Difficulty in dissection of gallbladder bed (scleroathrophic gallbladder, hemorrhage from liver during dissection of gallbladder, chirotic liver). Class IV difficulty: Difficulty in exploration of gallbladder due to intraabdominal adhesions including technical problems. Results: A total of 146 patients were operated with DLC. The most common difficulty type was Class I difficulty (88 patients/60.2%). Laparoscopic cholecystectomy was converted to laparotomy in 98 patients. Operation time was found to be related with conversion to open surgery (P<0.05). Wound infection rate was also statistically higher in conversion group (P<0.05). The opertion time was found to be longest with Class II difficulty. Conversion rate to open surgery was also highest with Class II difficulty group. Conclusion: Class II difficulty characterized by severe adhesions in calot’s triangle is most serious problem among all DLC cases. They have longer operation time and higher conversion rate. PMID:26629124

The analysis of 146 patients with difficult laparoscopic cholecystectomy.

PubMed

Bat, Orhan

2015-01-01

Laparoscopic cholecystectomy (LC) is very commonly performed surgical intervention. Acute or chronic cholecystitis, adhesions due to previous upper abdomen surgeries, Mirrizi's syndrome and obesity are common clinical conditions that can be associated with difficult cholecystectomy. In this study, we evaluated and scored the patients with difficult surgical exploration during laparoscopic cholecystectomy. All patients who underwent LC from 2010 to 2015 were retrospectively rewieved. According to intraoperative findings DLC cases were described and classified. Class I difficulty: Adhesion of omentum majus, transverse colon, duodenum to the fundus of the gallbladder. Class II difficulty: Adhesions in Calot's triangle and difficulty in dissection of cystic artery and cystic duct Class III difficulty: Difficulty in dissection of gallbladder bed (scleroathrophic gallbladder, hemorrhage from liver during dissection of gallbladder, chirotic liver). Class IV difficulty: Difficulty in exploration of gallbladder due to intraabdominal adhesions including technical problems. A total of 146 patients were operated with DLC. The most common difficulty type was Class I difficulty (88 patients/60.2%). Laparoscopic cholecystectomy was converted to laparotomy in 98 patients. Operation time was found to be related with conversion to open surgery (P<0.05). Wound infection rate was also statistically higher in conversion group (P<0.05). The opertion time was found to be longest with Class II difficulty. Conversion rate to open surgery was also highest with Class II difficulty group. Class II difficulty characterized by severe adhesions in calot's triangle is most serious problem among all DLC cases. They have longer operation time and higher conversion rate.

Addressing the critical health problem of adolescent substance use through health care, research, and public policy.

PubMed

Feinstein, Emily C; Richter, Linda; Foster, Susan E

2012-05-01

The use of addictive substances-tobacco, alcohol, and other drugs-during adolescence interferes with brain development and increases the risk of serious health and mental health conditions, including addiction. Yet, adolescents live in a culture in which family, social, community, and media influences regularly bombard them with pro-substance use messages, creating an environment in which substance use is considered an expected behavior, rather than a considerable health risk. To prevent the significant harm that falls to teens and young adults because of substance use, The National Center on Addiction and Substance Abuse at Columbia University (CASA Columbia) undertook a study to explore how adolescent brain development relates to the risk of substance use and addiction; the cultural influences that create an environment in which substance use is considered normative behavior; individual factors that make some teens more disposed to substance use and addiction; and evidence-based prevention and treatment strategies for addressing this problem. The recently published report Adolescent Substance Use: America's #1 Public Health Problem concludes that risky substance use is a major public health problem that can be ameliorated through evidence-based public health measures, including education about the disease and its risk factors, screenings, and clinical interventions, and that addiction can be treated and managed effectively within routine health care practice and specialty care. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

"Growing" Education in Difficult Environments Promoting Problem Solving: A Case from Palestine

ERIC Educational Resources Information Center

Jabr, Dua

2009-01-01

This paper presents a collaborative educational experiment "The Death of the Dead Sea: A Problem Based Learning" that was applied in two governmental high schools in Ramallah, Palestine in the school year 2006-2007. The students' role was to raise awareness to the phenomenon of the saltiest lake that shrinks towards extinction. In spite…

Adenomyosis: Difficult to Diagnose, and Difficult to Treat

PubMed Central

2001-01-01

Drug therapy may be effective in controlling symptoms but the frequent coexistence of endometriosis and the lack of controlled studies make their efficacy difficult to quantify. Danazol IUD has been shown to reduce symptoms. Conservative surgery involving endomyometrial ablation, laparoscopic myometrial electrocoagulation or excision has proven to be effective in more than 50% of patients, although follow up has been restricted to three years. Arterial uterine artery embolization is a new technique which may be tried before considering hysterectomy. Hysterectomy may still be necessary in severe cases of adenomyosis. PMID:18493552

The Brown Superfund Basic Research Program: A Multistakeholder Partnership Addresses Real-World Problems in Contaminated Communities

PubMed Central

Senier, Laura; Hudson, Benjamin; Fort, Sarah; Hoover, Elizabeth; Tillson, Rebecca; Brown, Phil

2008-01-01

The NIEHS funds several basic and applied research programs, many of which also require research translation or outreach. This paper reports on a project by the Brown University Superfund Basic Research Program (SBRP), in which outreach and research translation teams collaborated with state regulatory agency personnel and community activists on a legislative initiative to mitigate the financial impacts of living in a contaminated community. The Environmentally Compromised Home Ownership (ECHO) program makes home equity loans of up to $25,000 available to qualified applicants. This collaboration provides a case study in community engagement and demonstrates how research translation and outreach activities that are clearly differentiated yet well integrated can improve a suite of basic and applied research. Although engaging diverse constituencies can be difficult, community-engaged translation and outreach have the potential to make research findings more useful to communities, address some of the social impacts of contamination, and empower stakeholders to pursue their individual and collectively-held goals for remediation. The NIEHS has recently renewed its commitment to community-engaged research and advocacy, making this an optimal time to reflect on how basic research programs that engage stakeholders through research translation and outreach can add value to the overall research enterprise. PMID:18677987

The stories they tell: How third year medical students portray patients, family members, physicians, and themselves in difficult encounters.

PubMed

Shapiro, Johanna; Rakhra, Pavandeep; Wong, Adrianne

2016-10-01

Physicians have long had patients whom they have labeled "difficult", but little is known about how medical students perceive difficult encounters with patients. In this study, we analyzed 134 third year medical students' reflective essays written over an 18-month period about difficult student-patient encounters. We used a qualitative computerized software program, Atlas.ti to analyze students' observations and reflections. Main findings include that students described patients who were angry and upset; noncompliant with treatment plans; discussed "nonmedical" problems; fearful, worried, withdrawn, or "disinterested" in their health. Students often described themselves as anxious, uncertain, confused, and frustrated. Nevertheless, they saw themselves behaving in empathic and patient-centered ways while also taking refuge in "standard" behaviors not necessarily appropriate to the circumstances. Students rarely mentioned receiving guidance from attendings regarding how to manage these challenging interactions. These third-year medical students recognized the importance of behaving empathically in difficult situations and often did so. However, they often felt overwhelmed and frustrated, resorting to more reductive behaviors that did not match the needs of the patient. Students need more guidance from attending physicians in order to approach difficult interactions with specific problem-solving skills while maintaining an empathic, patient-centered context.

Aviation Security: Slow Progress in Addressing Long-Standing Screener Performance Problems

DTIC Science & Technology

2000-03-16

aviation security , in particular airport screeners. Securing an air transportation system the size of this nation’s-with hundreds of airports, thousands of aircraft, and tens of thousands of flights daily carrying millions of passengers and pieces of baggage-is a difficult task. Events over the past decade have shown that the threat of terrorism against the United States is an ever-present danger. Aviation is an attractive target for terrorists, and because the air transportation system is critical to the nation’s well-being, protecting it is an important

Analysis of Network Address Shuffling as a Moving Target Defense

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

Carroll, Thomas E.; Crouse, Michael B.; Fulp, Errin W.

2014-06-10

Address shuffling is a type of moving target defense that prevents an attacker from reliably contacting a system by periodically remapping network addresses. Although limited testing has demonstrated it to be effective, little research has been conducted to examine the theoretical limits of address shuffling. As a result, it is difficult to understand how effective shuffling is and under what circumstances it is a viable moving target defense. This paper introduces probabilistic models that can provide insight into the performance of address shuffling. These models quantify the probability of attacker success in terms of network size, quantity of addresses scanned,more » quantity of vulnerable systems, and the frequency of shuffling. Theoretical analysis will show that shuffling is an acceptable defense if there is a small population of vulnerable systems within a large network address space, however shuffling has a cost for legitimate users. These results will also be shown empirically using simulation and actual traffic traces.« less

Distributed parameter system coupled ARMA expansion identification and adaptive parallel IIR filtering - A unified problem statement. [Auto Regressive Moving-Average

NASA Technical Reports Server (NTRS)

Johnson, C. R., Jr.; Balas, M. J.

1980-01-01

A novel interconnection of distributed parameter system (DPS) identification and adaptive filtering is presented, which culminates in a common statement of coupled autoregressive, moving-average expansion or parallel infinite impulse response configuration adaptive parameterization. The common restricted complexity filter objectives are seen as similar to the reduced-order requirements of the DPS expansion description. The interconnection presents the possibility of an exchange of problem formulations and solution approaches not yet easily addressed in the common finite dimensional lumped-parameter system context. It is concluded that the shared problems raised are nevertheless many and difficult.

Modeling visual problem solving as analogical reasoning.

PubMed

Lovett, Andrew; Forbus, Kenneth

2017-01-01

We present a computational model of visual problem solving, designed to solve problems from the Raven's Progressive Matrices intelligence test. The model builds on the claim that analogical reasoning lies at the heart of visual problem solving, and intelligence more broadly. Images are compared via structure mapping, aligning the common relational structure in 2 images to identify commonalities and differences. These commonalities or differences can themselves be reified and used as the input for future comparisons. When images fail to align, the model dynamically rerepresents them to facilitate the comparison. In our analysis, we find that the model matches adult human performance on the Standard Progressive Matrices test, and that problems which are difficult for the model are also difficult for people. Furthermore, we show that model operations involving abstraction and rerepresentation are particularly difficult for people, suggesting that these operations may be critical for performing visual problem solving, and reasoning more generally, at the highest level. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Developing predictive systems models to address complexity and relevance for ecological risk assessment.

PubMed

Forbes, Valery E; Calow, Peter

2013-07-01

Ecological risk assessments (ERAs) are not used as well as they could be in risk management. Part of the problem is that they often lack ecological relevance; that is, they fail to grasp necessary ecological complexities. Adding realism and complexity can be difficult and costly. We argue that predictive systems models (PSMs) can provide a way of capturing complexity and ecological relevance cost-effectively. However, addressing complexity and ecological relevance is only part of the problem. Ecological risk assessments often fail to meet the needs of risk managers by not providing assessments that relate to protection goals and by expressing risk in ratios that cannot be weighed against the costs of interventions. Once more, PSMs can be designed to provide outputs in terms of value-relevant effects that are modulated against exposure and that can provide a better basis for decision making than arbitrary ratios or threshold values. Recent developments in the modeling and its potential for implementation by risk assessors and risk managers are beginning to demonstrate how PSMs can be practically applied in risk assessment and the advantages that doing so could have. Copyright © 2013 SETAC.

Training Teachers To Work in Schools Considered Difficult. Fundamentals of Educational Planning Series, Number 59.

ERIC Educational Resources Information Center

Auduc, Jean-Louis

This book outlines challenges involved in ensuring that teacher training becomes the gateway to implementation of appropriate strategies for students to achieve and for managing the problems of authority, discipline, and aggressive behavior. The six chapters examine: (1) "Teaching in Schools or Classes Considered Difficult: A Contemporary…

Proposing a health promotion framework to address gambling problems in Australian Indigenous communities.

PubMed

Fogarty, Marisa; Coalter, Nicola; Gordon, Ashley; Breen, Helen

2018-02-01

Gambling impacts affect Australian Indigenous families and communities in diverse and complex ways. Indigenous people throughout Australia engage in a broad range of regulated and unregulated gambling activities. Challenges in this area include the complexities that come with delivering services and programmes between the most remote regions, to highly populated towns and cities of Australia. There is little knowledge transfer between states and territories in Australia and no conceptual understanding or analysis of what constitutes 'best practice' in gambling service delivery for Indigenous people, families and communities. This article reviews health promotion approaches used in Australia, with a particular focus on Indigenous and gambling-based initiatives. Contributing to this review is an examination of health promotion strategies used in Indigenous gambling service delivery in the Northern Territory, New South Wales and Western Australia, demonstrating diversity and innovation in approaches. The article concludes by emphasizing the potential value of adopting health promotion strategies to underpin programme and service delivery for addressing gambling problems in Australian Indigenous communities. However, success is contingent on robust, evidence-based programme design, implementation and evaluation that adhere to health promotion principles. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Research of future network with multi-layer IP address

NASA Astrophysics Data System (ADS)

Li, Guoling; Long, Zhaohua; Wei, Ziqiang

2018-04-01

The shortage of IP addresses and the scalability of routing systems [1] are challenges for the Internet. The idea of dividing existing IP addresses between identities and locations is one of the important research directions. This paper proposed a new decimal network architecture based on IPv9 [11], and decimal network IP address from E.164 principle of traditional telecommunication network, the IP address level, which helps to achieve separation and identification and location of IP address, IP address form a multilayer network structure, routing scalability problem in remission at the same time, to solve the problem of IPv4 address depletion. On the basis of IPv9, a new decimal network architecture is proposed, and the IP address of the decimal network draws on the E.164 principle of the traditional telecommunication network, and the IP addresses are hierarchically divided, which helps to realize the identification and location separation of IP addresses, the formation of multi-layer IP address network structure, while easing the scalability of the routing system to find a way out of IPv4 address exhausted. In addition to modifying DNS [10] simply and adding the function of digital domain, a DDNS [12] is formed. At the same time, a gateway device is added, that is, IPV9 gateway. The original backbone network and user network are unchanged.

Problem of glider models

NASA Technical Reports Server (NTRS)

Lippisch, Espenlaub

1922-01-01

Any one endeavoring to solve the problem of soaring flight is confronted not only by structural difficulties, but also by the often far more difficult aerodynamic problem of flight properties and efficiency, which can only be determined by experimenting with the finished glider.

Nice or effective? Social problem solving strategies in patients with major depressive disorder.

PubMed

Thoma, Patrizia; Schmidt, Tobias; Juckel, Georg; Norra, Christine; Suchan, Boris

2015-08-30

Our study addressed distinct aspects of social problem solving in 28 hospitalized patients with Major Depressive Disorder (MDD) and 28 matched healthy controls. Three scenario-based tests assessed the ability to infer the mental states of story characters in difficult interpersonal situations, the capacity to freely generate good strategies for dealing with such situations and the ability to identify the best solutions among less optimal alternatives. Also, standard tests assessing attention, memory, executive function and trait empathy were administered. Compared to controls, MDD patients showed impaired interpretation of other peoples' sarcastic remarks but not of the mental states underlying other peoples' actions. Furthermore, MDD patients generated fewer strategies that were socially sensitive and practically effective at the same time or at least only socially sensitive. Overall, while the free generation of adequate strategies for difficult social situations was impaired, recognition of optimal solutions among alternatives was spared in MDD patients. Higher generation scores were associated with higher trait empathy and cognitive flexibility scores. We suggest that this specific pattern of impairments ought to be considered in the development of therapies addressing impaired social skills in MDD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Difficult issues in mentoring: recommendations on making the "undiscussable" discussable.

PubMed

Bickel, Janet; Rosenthal, Susan L

2011-10-01

Many mentoring relationships do not reach fruition because the individuals fail to bridge a critical difference. When a difference prevents a learning partnership from achieving its potential, the loss is multidimensional for the individuals and the institution--wasting opportunities for the fostering of current and future talent. Insights into when such impasses are likely to arise may help both mentors and mentees address what feels "undiscussable." The authors offer numerous examples of how differences related to ethnicity, language, gender, and generation may interfere with the development of mentoring relationships. Next, the authors offer recommendations on preparing for and handling difficult conversations, including creating safety, noticing assumptions and emotions, and raising sensitive issues. Virtually all faculty can become more effective at communicating across differences and addressing difficulties that prevent mentoring relationships from achieving their potential. The pay-offs for these efforts are indisputable: increased effect in the limited time available for mentoring, an expanded legacy of positive influence, and enhanced communication and leadership skills. The honing of these relational skills enhances the colleagueship and teamwork on which virtually all research, clinical, and educational enterprises depend. Academic health centers that systematically support mentoring enhance institutional stability, talent development, and leadership capacity.

Addressing Issues Related to Technology and Engineering

ERIC Educational Resources Information Center

Technology Teacher, 2008

2008-01-01

This article presents an interview with Michael Hacker and David Burghardt, codirectors of Hoftra University's Center for Technological Literacy. Hacker and Burghardt address issues related to technology and engineering. They argue that teachers need to be aware of the problems kids are facing, and how to present these problems in an engaging…

The aggregated unfitted finite element method for elliptic problems

NASA Astrophysics Data System (ADS)

Badia, Santiago; Verdugo, Francesc; Martín, Alberto F.

2018-07-01

Unfitted finite element techniques are valuable tools in different applications where the generation of body-fitted meshes is difficult. However, these techniques are prone to severe ill conditioning problems that obstruct the efficient use of iterative Krylov methods and, in consequence, hinders the practical usage of unfitted methods for realistic large scale applications. In this work, we present a technique that addresses such conditioning problems by constructing enhanced finite element spaces based on a cell aggregation technique. The presented method, called aggregated unfitted finite element method, is easy to implement, and can be used, in contrast to previous works, in Galerkin approximations of coercive problems with conforming Lagrangian finite element spaces. The mathematical analysis of the new method states that the condition number of the resulting linear system matrix scales as in standard finite elements for body-fitted meshes, without being affected by small cut cells, and that the method leads to the optimal finite element convergence order. These theoretical results are confirmed with 2D and 3D numerical experiments.

Bioethicists Can and Should Contribute to Addressing Racism

PubMed Central

Danis, Marion; Wilson, Yolonda; White, Amina

2016-01-01

The problems of racism and racially-motivated violence in predominantly African American communities in the US are complex, multifactorial and historically rooted. While these problems are also deeply morally troubling, bioethicists have not contributed substantially to addressing them. Concern for justice has been one of the core commitments of bioethics. For this and other reasons, bioethicists should contribute to addressing these problems. We consider how bioethicists can offer meaningful contributions to the public discourse, research, teaching, training, policy development and academic scholarship in response to the alarming and persistent patterns of racism and implicit biases associated with it. To make any useful contribution, bioethicists will require preparation and should expect to play a significant role through collaborative action with others. PMID:26982911

Bioethicists Can and Should Contribute to Addressing Racism.

PubMed

Danis, Marion; Wilson, Yolonda; White, Amina

2016-01-01

The problems of racism and racially motivated violence in predominantly African American communities in the United States are complex, multifactorial, and historically rooted. While these problems are also deeply morally troubling, bioethicists have not contributed substantially to addressing them. Concern for justice has been one of the core commitments of bioethics. For this and other reasons, bioethicists should contribute to addressing these problems. We consider how bioethicists can offer meaningful contributions to the public discourse, research, teaching, training, policy development, and academic scholarship in response to the alarming and persistent patterns of racism and implicit biases associated with it. To make any useful contribution, bioethicists will require preparation and should expect to play a significant role through collaborative action with others.

Improving socket design to prevent difficult removal of locking screws.

PubMed

Lin, Chen-Huei; Chao, Ching-Kong; Tang, Yi-Hsuan; Lin, Jinn

2018-03-01

Reports of driver slippage leading to difficult locking screw removals have increased since the adoption of titanium for screw fabrication; the use of titanium is known to cause cross-threading and cold welding. Such problems occur most frequently in screws with hex sockets, and may cause serious surgical complications. This study aimed to improve screw socket design to prevent slippage and difficult screw removal. Three types of small sockets (hex, Torx, and cruciate) and six types of large sockets (hex, Torx, Octatorx, Torx+ I, Torx+ II, and Torx+ III) with screw head diameters of 5.5 mm were manufactured from titanium, and corresponding screwdrivers were manufactured from stainless steel. The screw heads and drivers were mounted on a material testing machine, and torsional tests were conducted to simulate screw usage in clinical settings at two insertion depths: 1 and 2 mm. Ten specimens were tested from each design, and the maximum torque and failure patterns were recorded and compared. For small sockets in 2 mm conditions, the hex with the largest driver core had the highest torque, followed by Torx and cruciate. In these tests, the drivers were twisted off in all specimens. However, under the 1 mm condition, the hex slipped and the torque decreased markedly. Overall, torque was higher for large sockets than for small sockets. The Octatorx, with a large core and simultaneous deformation of the driver and socket lobes, had the highest torque at almost twice that of the small hex. The hex had the lowest torque, a result of slippage in both the 1 and 2 mm conditions. Torx plus designs, with more designed degrees of freedom, were able to maintain a higher driving angle and larger core for higher torque. The hex design showed slipping tendencies with a marked decrease in torque, especially under conditions with inadequate driver engagement. Large sockets allowed for substantial increases in torque. The Torx, Octatorx, and Torx plus designs displayed

Federal Activities Addressing Violence in Schools. Special Report.

ERIC Educational Resources Information Center

Barrios, Lisa C., Comp.

Many federal agencies actively address the problem of violence in schools by acquiring and disseminating information about school violence and supporting strategies that work to reduce violence. This document provides an inventory of federal activities addressing violence in schools. It was designed to facilitate coordination of federal school…

Workplace Motivation and Addressing Sexual Harassment in the Organization

DTIC Science & Technology

2010-07-01

performance of employees who self- regulate towards high-level and difficult goals can translate into more precise hiring practices of employees who may...significance of the development of personality and self- regulation Workplace Motivation & Addressing Sexual Harassment, 13 of behavior (p. 68...be relatively autonomous, that is, regulated through a person‘s acquired goals and values. (p. 225) Related to this, Vallerand, Pelletier, and

Uncommon strategies for a common problem: addressing racism in family therapy.

PubMed

Laszloffy, T A; Hardy, K V

2000-01-01

Race and racism have a profound effect on our daily lives and the practice of family therapy. Whether individual or institutional level, overt or covert, intentional or unintentional, there are a variety of ways in which racism can infiltrate the therapeutic process. Before therapists can take steps to address racism effectively within the context of family therapy, it is important to attend to the development of their racial awareness and racial sensitivity. These provide the critical foundation upon which specific skills and strategies associated with effectively identifying and responding to racism in therapy are based. This article defines racial awareness and sensitivity and provides suggestions for enhancing both. In the section that follows, three major ways in which racism can infiltrate the therapeutic process are described. Skills and strategies for addressing each of these in family therapy are presented.

Toward Solving the Problem of Problem Solving: An Analysis Framework

ERIC Educational Resources Information Center

Roesler, Rebecca A.

2016-01-01

Teaching is replete with problem solving. Problem solving as a skill, however, is seldom addressed directly within music teacher education curricula, and research in music education has not examined problem solving systematically. A framework detailing problem-solving component skills would provide a needed foundation. I observed problem solving…

Addressing the Spectrum of Adolescent Weight-Related Problems: Engaging Parents and Communities

ERIC Educational Resources Information Center

Neumark-Sztainer, Dianne

2007-01-01

Weight-related problems, including eating disorders, disordered eating, and obesity, are prevalent among adolescents. School and community-based educators and health care providers have an important role to play in the prevention of weight-related problems in youth. This article includes: 1) a brief overview of weight-related problems in…

Addressing Medical Errors in Hand Surgery

PubMed Central

Johnson, Shepard P.; Adkinson, Joshua M.; Chung, Kevin C.

2014-01-01

Influential think-tank such as the Institute of Medicine has raised awareness about the implications of medical errors. In response, organizations, medical societies, and institutions have initiated programs to decrease the incidence and effects of these errors. Surgeons deal with the direct implications of adverse events involving patients. In addition to managing the physical consequences, they are confronted with ethical and social issues when caring for a harmed patient. Although there is considerable effort to implement system-wide changes, there is little guidance for hand surgeons on how to address medical errors. Admitting an error is difficult, but a transparent environment where patients are notified of errors and offered consolation and compensation is essential to maintain trust. Further, equipping hand surgeons with a guide for addressing medical errors will promote compassionate patient interaction, help identify system failures, provide learning points for safety improvement, and demonstrate a commitment to ethically responsible medical care. PMID:25154576

Promoting Interdisciplinary Collaboration: Trainees Addressing Siloed Medical Education

ERIC Educational Resources Information Center

Kitts, Robert Li; Christodoulou, Joanna; Goldman, Stuart

2011-01-01

Objective: Professional siloing within medical institutions has been identified as a problem in medical education, including resident training. The authors discuss how trainees from different disciplines can collaborate to address this problem. Method: A group of trainees from psychiatry, developmental medicine, neurology, and education came…

Little Known, Much Needed: Addressing the Cocurricular Needs of LGBTQ Students

ERIC Educational Resources Information Center

Ivory, Brian T.

2012-01-01

Due to the invisible nature of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) undergraduate population, it is difficult for student affairs professionals at community colleges to identify and address the needs of sexual minority students on campus. Given the lack of literature regarding LGBTQ students at community colleges, student…

Must "Hard Problems" Be Hard?

ERIC Educational Resources Information Center

Kolata, Gina

1985-01-01

To determine how hard it is for computers to solve problems, researchers have classified groups of problems (polynomial hierarchy) according to how much time they seem to require for their solutions. A difficult and complex proof is offered which shows that a combinatorial approach (using Boolean circuits) may resolve the problem. (JN)

"Difficult" Colorectal Polyps - Therapeutic Approach.

PubMed

Alecu, M; Simion, L; Ionescu, S; Brătucu, E; Straja, N D

2015-01-01

Endoscopic polypectomy is the gold standard in the treatment of colorectal polyps. The importance of polypectomy rests primarily on the fact that polyp-type lesions present a high risk of malignant degeneration, colorectal polyps being able, if left unattended therapeutically, to generate a colorectal cancer (CRC) - a lesion with a far more negative prognosis. Although preferable, endoscopic polypectomy of colorectal polyps is not always possible, multiple factors generating difficulties in performing this therapeutic measure. We performed a retrospective study in the First Surgical Clinic of the "Prof. Dr. Alexandu Trestioreanu" Bucharest Oncology Institute, spanning a period of 3 years (2008-2011), in which time 224 patients were diagnosed by colonoscopy with colorectal polyps, of whom 222 patients benefited from endoscopic polypectomy. The aim of the study was to identify "difficult" polyps and to identify the criteria for endoscopic surgery versus classic surgery as a therapeutic indication. Presence of "difficult" polyps was observed in 37.56% of the patients diagnosed with colorectal polyps. In over 88% of cases endoscopic polypectomy was possible, and for the remaining patients classic surgery was the therapeutic solution opted for. Presence of "difficult" polyps generates inconveniences in performing endoscopic polypectomy, increasing the risk of postoperative complication occurrence, as well as the duration of the operation. If the criteria for characterizing polyps as "difficult" are relatively well-established, the choice between endoscopic and classic surgery as a therapeutic measure is left at the free will of the operating surgeon, with the exception of situations in which classic surgery is resorted to for oncological reasons. Celsius.

Management of the difficult airway.

PubMed

Schwartz, D E; Wiener-Kronish, J P

1991-09-01

For clinicians involved in airway management, a plan of action for dealing with the difficult airway or a failed intubation should be developed well in advance of encountering a patient in whom intubation is not routine. When difficulty is anticipated, the equipment necessary for performing a difficult intubation should be immediately available. It also is prudent to have a surgeon skilled in performing a tracheotomy and a criothyroidotomy stand by. The intubation should be attempted in the awake state, preferably using the fiberoptic bronchoscope. The more challenging situation is when the difficult airway is confronted unexpectedly. After the first failed attempt at laryngoscopy, head position should be checked and the patient ventilated with oxygen by mask. A smaller styletted tube and possibly a different laryngoscope blade should be selected for a second attempt at intubation. The fiberoptic bronchoscope and other equipment for difficult intubation should be obtained. A second attempt should then be made. If this is unsuccessful, the patient should be reoxygenated, and assistance including a skilled anesthesiologist and surgeon should be summoned. On a third attempt, traction to the tongue can be applied by an assistant, a tube changer could be used to enter the larynx, or one of the other special techniques previously described can be used. If this third attempt fails, it may be helpful to have a physician more experienced in airway management attempt intubation after oxygen has been administered to the patient. If all attempts are unsuccessful, then invasive techniques to secure the airway will have to be performed.

Emotional distance to so-called difficult patients.

PubMed

Michaelsen, Jette Joost

2012-03-01

To explore nurses' relationships with patients they regard as being difficult. How do nurses feel about such patients and relate to them, and what are the consequences for nurse and patient? A qualitative study inspired by hermeneutic phenomenology was conducted. The data were obtained through participant observation and interviewing in a home nursing unit in a Danish municipality. During an initial 3 month period, eighteen participant observations were conducted with 12 nurses during their visits to 96 patients. During the following 3 months, 12 more participant observations were made with three nurses visiting 50 patients. Four of these patients whom the three nurses found difficult were selected and six interviews conducted with these patients. Eleven interviews were conducted with five nurses. Patients' case records were studied and four meetings with the staff were arranged to discuss the findings. Data collection lasted 18 months in all. Three strategies were identified: persuasion, avoidance (emotional distance), and compromise. Interestingly, in the relationship with a particular patient, the avoidance strategy did not necessarily represent the terminal stage, since a nurse could revert to the compromise strategy. Some of the nurses experienced painful emotions regarding these interactions. The avoidance strategy (emotional distance) resulted in important social and health problems of some patients not being recognized, and some nurses using it expressed the fear of losing contact with their emotional lives. The compromise strategy gave possibilities for dialogue.   The focus was mainly on the nurses and their perspectives. It would be interesting to study in greater detail the perspectives of the patients. © 2011 The Author. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

Problem Solvers: Problem--How Long Can You Stand?

ERIC Educational Resources Information Center

Teaching Children Mathematics, 2010

2010-01-01

Healthy lifestyles are increasingly emphasized these days. This month the authors begin a series of mathematical problems that also address physical activity. They hope that these problems offer opportunities to investigate mathematics and also reinforce the desire to lead a healthy life. In their first problem of the academic year, students…

A hybrid heuristic for the multiple choice multidimensional knapsack problem

NASA Astrophysics Data System (ADS)

Mansi, Raïd; Alves, Cláudio; Valério de Carvalho, J. M.; Hanafi, Saïd

2013-08-01

In this article, a new solution approach for the multiple choice multidimensional knapsack problem is described. The problem is a variant of the multidimensional knapsack problem where items are divided into classes, and exactly one item per class has to be chosen. Both problems are NP-hard. However, the multiple choice multidimensional knapsack problem appears to be more difficult to solve in part because of its choice constraints. Many real applications lead to very large scale multiple choice multidimensional knapsack problems that can hardly be addressed using exact algorithms. A new hybrid heuristic is proposed that embeds several new procedures for this problem. The approach is based on the resolution of linear programming relaxations of the problem and reduced problems that are obtained by fixing some variables of the problem. The solutions of these problems are used to update the global lower and upper bounds for the optimal solution value. A new strategy for defining the reduced problems is explored, together with a new family of cuts and a reformulation procedure that is used at each iteration to improve the performance of the heuristic. An extensive set of computational experiments is reported for benchmark instances from the literature and for a large set of hard instances generated randomly. The results show that the approach outperforms other state-of-the-art methods described so far, providing the best known solution for a significant number of benchmark instances.

A hybrid algorithm optimization approach for machine loading problem in flexible manufacturing system

NASA Astrophysics Data System (ADS)

Kumar, Vijay M.; Murthy, ANN; Chandrashekara, K.

2012-05-01

The production planning problem of flexible manufacturing system (FMS) concerns with decisions that have to be made before an FMS begins to produce parts according to a given production plan during an upcoming planning horizon. The main aspect of production planning deals with machine loading problem in which selection of a subset of jobs to be manufactured and assignment of their operations to the relevant machines are made. Such problems are not only combinatorial optimization problems, but also happen to be non-deterministic polynomial-time-hard, making it difficult to obtain satisfactory solutions using traditional optimization techniques. In this paper, an attempt has been made to address the machine loading problem with objectives of minimization of system unbalance and maximization of throughput simultaneously while satisfying the system constraints related to available machining time and tool slot designing and using a meta-hybrid heuristic technique based on genetic algorithm and particle swarm optimization. The results reported in this paper demonstrate the model efficiency and examine the performance of the system with respect to measures such as throughput and system utilization.

Addressing the policy cacophony does not require more evidence: an argument for reframing obesity as caloric overconsumption.

PubMed

Shelley, Jacob J

2012-11-30

Numerous policies have been proposed to address the public health problem of obesity, resulting in a policy cacophony. The noise of so many policy options renders it difficult for policymakers to determine which policies warrant implementation. This has resulted in calls for more and better evidence to support obesity policy. However, it is not clear that evidence is the solution. This paper argues that to address the policy cacophony it is necessary to rethink the problem of obesity, and more specifically, how the problem of obesity is framed. This paper argues that the frame "obesity" be replaced by the frame "caloric overconsumption", concluding that the frame caloric overconsumption can overcome the obesity policy cacophony. Frames are important because they influence public policy. Understood as packages that define issues, frames influence how best to approach a problem. Consequently, debates over public policy are considered battles over framing, with small shifts in how an issue is framed resulting in significant changes to the policy environment. This paper presents a rationale for reframing the problem of obesity as caloric overconsumption. The frame "obesity" contributes to the policy cacophony by including policies aimed at both energy output and energy input. However, research increasingly demonstrates that energy input is the primary cause of obesity, and that increases in energy input are largely attributable to the food environment. By focusing on policies that aim to prevent increases in energy input, the frame caloric overconsumption will reduce the noise of the obesity policy cacophony. While the proposed frame will face some challenges, particularly industry opposition, policies aimed at preventing caloric overconsumption have a clearer focus, and can be more politically palatable if caloric overconsumption is seen as an involuntary risk resulting from the food environment. The paper concludes that policymakers will be able to make better sense

Organizational Behavior: Coping with Difficult Co-Workers.

ERIC Educational Resources Information Center

Arnold, Vanessa D.; Roach, Terry D.

1992-01-01

Discusses the need for students to learn to recognize and cope with difficult co-workers. Describes a few types of personalities that exhibit difficult or disturbed behavior and offers suggestions for coping with these personalities. (JOW)

Ultrasonography in the preoperative difficult airway assessment.

PubMed

Fulkerson, Justin S; Moore, Heather M; Anderson, Tristan S; Lowe, Robert F

2017-06-01

To evaluate the utility of ultrasound for detection of the difficult intubation in a preoperative setting. PubMed, Ovid, CINAHL Plus Full Text, and Google Scholar searches using ["difficult airway" OR "difficult intubation" OR "difficult laryngoscopy" OR "difficult ventilation"] AND [ultrasonography OR sonography OR ultrasound] without date limitations. Abstracts without publications, case reports, letters, textbooks, unrelated topics, or foreign language articles were excluded. Ancestry references were included from the reviewed articles. Two reviewers independently performed the query. Each study was reviewed using the STARD checklist to assess blinding, incomplete data reporting, subject attrition, and selection of appropriate statistical tests. Ten studies were included. All used convenience sampling of adult subjects requiring direct laryngoscopy in elective surgical settings. One study is retrospective and nine are prospective observational. Populations included non-obese, obese, pregnant, and thyroidectomy patients in the United States, Turkey, Israel, Canada, Portugal, and China. Airway locations scanned are variable using different protocols and patient positioning. The outcome variable is uniformly the Cormack-Lehane Grade. 114 of the 681 total subjects had difficult laryngoscopies. Significance for sonographic prediction of difficult laryngoscopy occurred at three locations: hyomental distance [52.6 ± 5.8 mm (p < 0.01)], anterior tissue at the hyoid bone [16.9 mm (95 % CI 11.9-21.9) and 15.9 ± 2.7 mm (p < 0.0001)], and the thyrohyoid membrane [34.7 mm (95 % CI 28.8-40.7) and 23.9 ± 3.4 mm (p < 0.0001) and 28.25 ± 4.43 mm (p < 0.001)]. The vocal cords and sternal notch levels have conflicting significance. Limitations include the heterogeneous populations and lack of standard scanning protocols.

Road-traffic injuries: confronting disparities to address a global-health problem.

PubMed

Ameratunga, Shanthi; Hijar, Martha; Norton, Robyn

2006-05-06

Evidence suggests that the present and projected global burden of road-traffic injuries is disproportionately borne by countries that can least afford to meet the health service, economic, and societal challenges posed. Although the evidence base on which these estimates are made remains somewhat precarious in view of the limited data systems in most low-income and middle-income countries (as per the classification on the World Bank website), these projections highlight the essential need to address road-traffic injuries as a public-health priority. Most well-evaluated effective interventions do not directly focus on efforts to protect vulnerable road users, such as motorcyclists and pedestrians. Yet, these groups comprise the majority of road-traffic victims in low-income and middle-income countries, and consequently, the majority of the road-traffic victims globally. Appropriately responding to these disparities in available evidence and prevention efforts is necessary if we are to comprehensively address this global-health dilemma.

Side-branch technique for difficult guidewire placement in coronary bifurcation lesion.

PubMed

He, Xingwei; Gao, Bo; Liu, Yujian; Li, Zhuxi; Zeng, Hesong

2016-01-01

Despite tremendous advances in technology and skills, percutaneous coronary intervention (PCI) of bifurcation lesion (BL) remains a particular challenge for the interventionalist. During bifurcation PCI, safe guidewire placement in the main branch (MB) and the side branch (SB) is the first step for successful procedure. However, in certain cases, the complex pattern of vessel anatomy and the mix of plaque distribution may make target vessel wiring highly challenging. Therefore, specific techniques are required for solving this problem. Hereby, we describe a new use of side-branch technique for difficult guidewire placement in BL. Copyright © 2015 Elsevier Inc. All rights reserved.

Singular perturbation analysis of AOTV-related trajectory optimization problems

NASA Technical Reports Server (NTRS)

Calise, Anthony J.; Bae, Gyoung H.

1990-01-01

The problem of real time guidance and optimal control of Aeroassisted Orbit Transfer Vehicles (AOTV's) was addressed using singular perturbation theory as an underlying method of analysis. Trajectories were optimized with the objective of minimum energy expenditure in the atmospheric phase of the maneuver. Two major problem areas were addressed: optimal reentry, and synergetic plane change with aeroglide. For the reentry problem, several reduced order models were analyzed with the objective of optimal changes in heading with minimum energy loss. It was demonstrated that a further model order reduction to a single state model is possible through the application of singular perturbation theory. The optimal solution for the reduced problem defines an optimal altitude profile dependent on the current energy level of the vehicle. A separate boundary layer analysis is used to account for altitude and flight path angle dynamics, and to obtain lift and bank angle control solutions. By considering alternative approximations to solve the boundary layer problem, three guidance laws were derived, each having an analytic feedback form. The guidance laws were evaluated using a Maneuvering Reentry Research Vehicle model and all three laws were found to be near optimal. For the problem of synergetic plane change with aeroglide, a difficult terminal boundary layer control problem arises which to date is found to be analytically intractable. Thus a predictive/corrective solution was developed to satisfy the terminal constraints on altitude and flight path angle. A composite guidance solution was obtained by combining the optimal reentry solution with the predictive/corrective guidance method. Numerical comparisons with the corresponding optimal trajectory solutions show that the resulting performance is very close to optimal. An attempt was made to obtain numerically optimized trajectories for the case where heating rate is constrained. A first order state variable inequality

The Positive Effect of Resilience on Stress and Business Outcomes in Difficult Work Environments.

PubMed

Shatté, Andrew; Perlman, Adam; Smith, Brad; Lynch, Wendy D

2017-02-01

To examine whether resilience has a protective effect in difficult work environments. A survey of 2063 individuals measured individual resilience, stress, burnout, sleep problems, likelihood of depression, job satisfaction, intent to quit, absences, and productivity. It also measured work characteristics: job demands, job influence, and social support. Multivariate and logistic regression models examined the main effects and interactions of resilience and job characteristics. High strain work environments (high demand, low influence, and low support) have an unfavorable effect on all outcomes. Resilience has a protective effect on all outcomes. For stress, burnout, and sleep, higher resilience has a more protective effect under low-strain conditions. For depression, absence and productivity, resilience has a more protective effect when job strain is high. Workers with high resilience have better outcomes in difficult work environments.

Using ecotechnology to address water quality and wetland habitat loss problems in the Mississippi basin: a hierarchical approach.

PubMed

Day, John W; Yañéz Arancibia, Alejandro; Mitsch, William J; Lara-Dominguez, Ana Laura; Day, Jason N; Ko, Jae-Young; Lane, Robert; Lindsey, Joel; Lomeli, David Zarate

2003-12-01

Human activities are affecting the environment at continental and global scales. An example of this is the Mississippi basin where there has been a large scale loss of wetlands and water quality deterioration over the past century. Wetland and riparian ecosystems have been isolated from rivers and streams. Wetland loss is due both to drainage and reclamation, mainly for agriculture, and to isolation from the river by levees, as in the Mississippi delta. There has been a decline in water quality due to increasing use of fertilizers, enhanced drainage and the loss of wetlands for cleaning water. Water quality has deteriorated throughout the basin and high nitrogen in the Mississippi river is causing a large area of hypoxia in the Gulf of Mexico adjacent to the Mississippi delta. Since the causes of these problems are distributed over the basin, the solution also needs to be distributed over the basin. Ecotechnology and ecological engineering offer the only ecologically sound and cost-effective method of solving these problems. Wetlands to promote nitrogen removal, mainly through denitrification but also through burial and plant uptake, offer a sound ecotechnological solution. At the level of the Mississippi basin, changes in farming practices and use of wetlands for nitrogen assimilation can reduce nitrogen levels in the River. There are additional benefits of restoration of wetland and riverine ecosystems, flood control, reduction in public health threats, and enhanced wildlife and fisheries. At the local drainage basin level, the use of river diversions in the Mississippi delta can address both problems of coastal land loss and water quality deterioration. Nitrate levels in diverted river water are rapidly reduced as water flows through coastal watersheds. At the local level, wetlands are being used to treat municipal wastewater. This is a cost-effective method, which results in improved water quality, enhanced wetland productivity and increased accretion. The

Drinkers and bettors: investigating the complementarity of alcohol consumption and problem gambling.

PubMed

French, Michael T; Maclean, Johanna Catherine; Ettner, Susan L

2008-07-01

Regulated gambling is a multi-billion dollar industry in the United States with greater than 100% increases in revenue over the past decade. Along with this rise in gambling popularity and gaming options comes an increased risk of addiction and the associated social costs. This paper focuses on the effect of alcohol use on gambling-related problems. Variables correlated with both alcohol use and gambling may be difficult to observe, and the inability to include these items in empirical models may bias coefficient estimates. After addressing the endogeneity of alcohol use when appropriate, we find strong evidence that problematic gambling and alcohol consumption are complementary activities.

Drinkers and Bettors: Investigating the Complementarity of Alcohol Consumption and Problem Gambling

PubMed Central

Maclean, Johanna Catherine; Ettner, Susan L.

2009-01-01

Regulated gambling is a multi-billion dollar industry in the United States with greater than 100 percent increases in revenue over the past decade. Along with this rise in gambling popularity and gaming options comes an increased risk of addiction and the associated social costs. This paper focuses on the effect of alcohol use on gambling-related problems. Variables correlated with both alcohol use and gambling may be difficult to observe, and the inability to include these items in empirical models may bias coefficient estimates. After addressing the endogeneity of alcohol use when appropriate, we find strong evidence that problematic gambling and alcohol consumption are complementary activities. PMID:18430523

[New therapeutic strategies for the treatment of difficult wounds].

PubMed

Onesti, M G; Bitonti, Adriana; Fino, P; Ciotti, M; Scuderi, N

2008-05-01

The medical-surgical treatment of the difficult wounds represents a socio-sanitary problem in continuous growth, currently involving in our Country around 2,000,000 people. The "difficult wound" is a loss of cutaneous substances, usually due to multifactorial pathogenesis, that do not spontaneously lead to a complete recovery. Numerous studies in the literature have evidenced that the use of the advanced wound dressings allows to reach the best clinical and economic results in the process of recovery of the difficult wounds. The advanced would dressing assures a longer period of permanence on the injury and shorten the time of treatment and, as a consequence, it is required a smaller number of applications in comparison with the traditional medications. The Wound Bed Preparation (WBP) can be defined as the global and coordinate management of the cutaneous injury, enabling to chip off the local barriers to the recovery, or promoting the effectiveness of the innovative therapeutic instruments. The term advanced wound dressing indicates the dressing material having biocompatibility characteristics. The purpose of the advanced wound dressings is the one to create the ideal environment for the cicatrization process and isolate the wound from traumas and external infections. The "Difficult Wounds" Unit of the Department of Plastic and Reconstructive Surgery of the Policlinico Umberto I in Rome, from January to December 2006, treated 570 patients (308 men and 262 women), whose age was between 2 days and 85 years, affected by ulcers of various nature. Among our cases, 200 patients were selected and randomly separated in two different groups: group A consisting of 100 patients entirely treated with traditional medications; group B composed by 100 patients treated with advanced dressings. Every patient has locally been treated with periodic and specific medications, according to the type of difficult wound, and subsequently they proceeded to find out how to treat the

[Clinical interview in psychiatric difficult situations].

PubMed

Lorettu, Liliana; Nivoli, Gian Carlo; Milia, Paolo; Depalmas, Cristiano; Clerici, Massimo; Nivoli, Alessandra M A

2017-01-01

There are here described a number of basic principles underlying an effective clinical interview in psychiatric difficult situations (violent or suicidal patients, victims of serious physical and psychological damages, authors of inadequate or anti-social requests to the therapist). The aim of the present study is to provide the psychiatric operator with useful skills for the optimal management of the interview in difficult situations both at diagnostically and therapeutically level. The methodology was based on examination of the literature and personal experience of the authors. The authors highlighted 18 working hypothesis that may represent beneficial instruments in situations of difficult psychiatric interview. Further studies will deepen under the clinical, actuarial and statistical validity the principles covered in various clinical and crisis situations with difficulty to the interview, in relation also to specific types of patients for a more updated training of the operators in the field of mental health.

Discussion of Extinction-Based Behavioral Sleep Interventions for Young Children and Reasons Why Parents May Find Them Difficult

PubMed Central

Etherton, Hayley; Blunden, Sarah; Hauck, Yvonne

2016-01-01

The majority of behavioral sleep interventions for young children involve extinction procedures where parents must ignore their child's cries for a period. Many parents have difficulties with this, contributing to attrition, non-compliance, and treatment avoidance. Yet why these methods are difficult to implement has rarely been addressed in the literature. This paper discusses seven potential reasons why parents may find extinction sleep interventions difficult: enduring crying, practical considerations, fear of repercussions, misinformation, incongruence with personal beliefs, different cultural practices, and parent wellness. These reasons are discussed in relation to the current literature. Practicing health professionals and sleep researchers could benefit from an awareness of these issues when suggesting extinction interventions and offering alternatives which may be more appropriate for family circumstances and facilitate parental informed choice. Citation: Etherton H, Blunden S, Hauck Y. Discussion of extinction-based behavioral sleep interventions for young children and reasons why parents may find them difficult. J Clin Sleep Med 2016;12(11):1535–1543. PMID:27655457

Innovative Use of the Law to Address Complex Global Health Problems Comment on "The Legal Strength of International Health Instruments - What It Brings toGlobal Health Governance?"

PubMed

Walls, Helen L; Ooms, Gorik

2017-05-20

Addressing the increasingly globalised determinants of many important problems affecting human health is a complex task requiring collective action. We suggest that part of the solution to addressing intractable global health issues indeed lies with the role of new legal instruments in the form of globally binding treaties, as described in the recent article of Nikogosian and Kickbusch. However, in addition to the use of international law to develop new treaties, another part of the solution may lie in innovative use of existing legal instruments. A 2015 court ruling in The Hague, which ordered the Dutch government to cut greenhouse gas emissions by at least 25% within five years, complements this perspective, suggesting a way forward for addressing global health problems that critically involves civil society and innovative use of existing domestic legal instruments. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Difficult Knowledge and Social Studies (Teacher) Education

ERIC Educational Resources Information Center

Garrett, H. James

2010-01-01

Social studies education is a field in which those involved--teachers and students--encounter what can be called "difficult knowledge". Difficult knowledge is a theoretical construct suggesting that when an individual encounters representations of social and historical trauma in a learning situation there exists a host of emotional and pedagogical…

Addressing the underperformance of faculty and staff.

PubMed

Kenner, Carole; Pressler, Jana L

2006-01-01

Many new nursing leaders assuming work as deans, assistant deans, or interim deans have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, both deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.

Working Together Differently: Addressing the Housing Crisis in Oregon

ERIC Educational Resources Information Center

Ramaley, Judith A.

2017-01-01

Universities are being asked to prepare our students to navigate successfully in a complex and interconnected world and to contribute to the solution of difficult problems at work and in the communities where they live. Our universities must do the same. We must adapt our approaches to education, scholarship and community involvement in order to…

How anaesthesiologists understand difficult airway guidelines-an interview study.

PubMed

Knudsen, Kati; Pöder, Ulrika; Nilsson, Ulrica; Högman, Marieann; Larsson, Anders; Larsson, Jan

2017-11-01

In the practice of anaesthesia, clinical guidelines that aim to improve the safety of airway procedures have been developed. The aim of this study was to explore how anaesthesiologists understand or conceive of difficult airway management algorithms. A qualitative phenomenographic design was chosen to explore anaesthesiologists' views on airway algorithms. Anaesthesiologists working in three hospitals were included. Individual face-to-face interviews were conducted. Four different ways of understanding were identified, describing airway algorithms as: (A) a law-like rule for how to act in difficult airway situations; (B) a cognitive aid, an action plan for difficult airway situations; (C) a basis for developing flexible, personal action plans for the difficult airway; and (D) the experts' consensus, a set of scientifically based guidelines for handling the difficult airway. The interviewed anaesthesiologists understood difficult airway management guidelines/algorithms very differently.

The Positive Effect of Resilience on Stress and Business Outcomes in Difficult Work Environments

PubMed Central

Shatté, Andrew; Perlman, Adam; Smith, Brad; Lynch, Wendy D.

2017-01-01

Objective: To examine whether resilience has a protective effect in difficult work environments. Methods: A survey of 2063 individuals measured individual resilience, stress, burnout, sleep problems, likelihood of depression, job satisfaction, intent to quit, absences, and productivity. It also measured work characteristics: job demands, job influence, and social support. Multivariate and logistic regression models examined the main effects and interactions of resilience and job characteristics. Results: High strain work environments (high demand, low influence, and low support) have an unfavorable effect on all outcomes. Resilience has a protective effect on all outcomes. For stress, burnout, and sleep, higher resilience has a more protective effect under low-strain conditions. For depression, absence and productivity, resilience has a more protective effect when job strain is high. Conclusions: Workers with high resilience have better outcomes in difficult work environments. PMID:28002352

Treatment of Difficult Asthma

PubMed Central

Bowie, Dennis M.

1991-01-01

The difficult asthmatic patient should first be managed by confirming the diagnosis and eliminating any aggravating environmental or occupational factors, including medication use. Proper treatment requires rational addition of drugs in a logical sequence. It is most important to ensure proper inhaler technique, patient compliance, effective doctor-patient communication, and proper patient monitoring. ImagesFigure 2 PMID:21229079

Teaching Problem Solving without Modeling through "Thinking Aloud Pair Problem Solving."

ERIC Educational Resources Information Center

Pestel, Beverly C.

1993-01-01

Reviews research relevant to the problem of unsatisfactory student problem-solving abilities and suggests a teaching strategy that addresses the issue. Author explains how she uses teaching aloud problem solving (TAPS) in college chemistry and presents evaluation data. Among the findings are that the TAPS class got fewer problems completely right,…

How anaesthesiologists understand difficult airway guidelines—an interview study

PubMed Central

Knudsen, Kati; Nilsson, Ulrica; Larsson, Anders; Larsson, Jan

2017-01-01

Background In the practice of anaesthesia, clinical guidelines that aim to improve the safety of airway procedures have been developed. The aim of this study was to explore how anaesthesiologists understand or conceive of difficult airway management algorithms. Methods A qualitative phenomenographic design was chosen to explore anaesthesiologists’ views on airway algorithms. Anaesthesiologists working in three hospitals were included. Individual face-to-face interviews were conducted. Results Four different ways of understanding were identified, describing airway algorithms as: (A) a law-like rule for how to act in difficult airway situations; (B) a cognitive aid, an action plan for difficult airway situations; (C) a basis for developing flexible, personal action plans for the difficult airway; and (D) the experts’ consensus, a set of scientifically based guidelines for handling the difficult airway. Conclusions The interviewed anaesthesiologists understood difficult airway management guidelines/algorithms very differently. PMID:29299973

Improving extreme-scale problem solving: assessing electronic brainstorming effectiveness in an industrial setting.

PubMed

Dornburg, Courtney C; Stevens, Susan M; Hendrickson, Stacey M L; Davidson, George S

2009-08-01

An experiment was conducted to compare the effectiveness of individual versus group electronic brainstorming to address difficult, real-world challenges. Although industrial reliance on electronic communications has become ubiquitous, empirical and theoretical understanding of the bounds of its effectiveness have been limited. Previous research using short-term laboratory experiments have engaged small groups of students in answering questions irrelevant to an industrial setting. The present experiment extends current findings beyond the laboratory to larger groups of real-world employees addressing organization-relevant challenges during the course of 4 days. Employees and contractors at a national laboratory participated, either in a group setting or individually, in an electronic brainstorm to pose solutions to a real-world problem. The data demonstrate that (for this design) individuals perform at least as well as groups in producing quantity of electronic ideas, regardless of brainstorming duration. However, when judged with respect to quality along three dimensions (originality, feasibility, and effectiveness), the individuals significantly (p < .05) outperformed the group. When quality is used to benchmark success, these data indicate that work-relevant challenges are better solved by aggregating electronic individual responses rather than by electronically convening a group. This research suggests that industrial reliance on electronic problem-solving groups should be tempered, and large nominal groups may be more appropriate corporate problem-solving vehicles.

Teaching genetics using hands-on models, problem solving, and inquiry-based methods

NASA Astrophysics Data System (ADS)

Hoppe, Stephanie Ann

Teaching genetics can be challenging because of the difficulty of the content and misconceptions students might hold. This thesis focused on using hands-on model activities, problem solving, and inquiry-based teaching/learning methods in order to increase student understanding in an introductory biology class in the area of genetics. Various activities using these three methods were implemented into the classes to address any misconceptions and increase student learning of the difficult concepts. The activities that were implemented were shown to be successful based on pre-post assessment score comparison. The students were assessed on the subjects of inheritance patterns, meiosis, and protein synthesis and demonstrated growth in all of the areas. It was found that hands-on models, problem solving, and inquiry-based activities were more successful in learning concepts in genetics and the students were more engaged than tradition styles of lecture.

Update on Difficult Polypectomy Techniques.

PubMed

Ngamruengphong, Saowanee; Pohl, Heiko; Haito-Chavez, Yamile; Khashab, Mouen A

2016-01-01

Endoscopists often encounter colon polyps that are technically difficult to resect. These lesions traditionally were managed surgically, with significant potential morbidity and mortality. Recent advances in endoscopic techniques and instruments have allowed endoscopists to safely and effectively remove colorectal lesions with high technical and clinical success and potentially avoid invasive surgery. Endoscopic mucosal resection (EMR) has gained acceptance as the first-line therapy for large colorectal lesions. Endoscopic submucosal dissection (ESD) has been reported to be associated with higher rate of en bloc resection and less risk of short-time recurrence, but with an increased risk of adverse events. Therefore, the role of colorectal ESD should be restricted to lesions with high-risk morphologic features of submucosal invasion. In this article, we review the recent literature on the endoscopic management of difficult colorectal neoplasms.

Message Passing vs. Shared Address Space on a Cluster of SMPs

NASA Technical Reports Server (NTRS)

Shan, Hongzhang; Singh, Jaswinder Pal; Oliker, Leonid; Biswas, Rupak

2000-01-01

The convergence of scalable computer architectures using clusters of PCs (or PC-SMPs) with commodity networking has become an attractive platform for high end scientific computing. Currently, message-passing and shared address space (SAS) are the two leading programming paradigms for these systems. Message-passing has been standardized with MPI, and is the most common and mature programming approach. However message-passing code development can be extremely difficult, especially for irregular structured computations. SAS offers substantial ease of programming, but may suffer from performance limitations due to poor spatial locality, and high protocol overhead. In this paper, we compare the performance of and programming effort, required for six applications under both programming models on a 32 CPU PC-SMP cluster. Our application suite consists of codes that typically do not exhibit high efficiency under shared memory programming. due to their high communication to computation ratios and complex communication patterns. Results indicate that SAS can achieve about half the parallel efficiency of MPI for most of our applications: however, on certain classes of problems SAS performance is competitive with MPI. We also present new algorithms for improving the PC cluster performance of MPI collective operations.

Nanotechnology for sustainability: what does nanotechnology offer to address complex sustainability problems?

NASA Astrophysics Data System (ADS)

Wiek, Arnim; Foley, Rider W.; Guston, David H.

2012-09-01

Nanotechnology is widely associated with the promise of positively contributing to sustainability. However, this view often focuses on end-of-pipe applications, for instance, for water purification or energy efficiency, and relies on a narrow concept of sustainability. Approaching sustainability problems and solution options from a comprehensive and systemic perspective instead may yield quite different conclusions about the contribution of nanotechnology to sustainability. This study conceptualizes sustainability problems as complex constellations with several potential intervention points and amenable to different solution options. The study presents results from interdisciplinary workshops and literature reviews that appraise the contribution of the selected nanotechnologies to mitigate such problems. The study focuses exemplarily on the urban context to make the appraisals tangible and relevant. The solution potential of nanotechnology is explored not only for well-known urban sustainability problems such as water contamination and energy use but also for less obvious ones such as childhood obesity. Results indicate not only potentials but also limitations of nanotechnology's contribution to sustainability and can inform anticipatory governance of nanotechnology in general, and in the urban context in particular.

Addressing the minimum fleet problem in on-demand urban mobility.

PubMed

Vazifeh, M M; Santi, P; Resta, G; Strogatz, S H; Ratti, C

2018-05-01

Information and communication technologies have opened the way to new solutions for urban mobility that provide better ways to match individuals with on-demand vehicles. However, a fundamental unsolved problem is how best to size and operate a fleet of vehicles, given a certain demand for personal mobility. Previous studies 1-5 either do not provide a scalable solution or require changes in human attitudes towards mobility. Here we provide a network-based solution to the following 'minimum fleet problem', given a collection of trips (specified by origin, destination and start time), of how to determine the minimum number of vehicles needed to serve all the trips without incurring any delay to the passengers. By introducing the notion of a 'vehicle-sharing network', we present an optimal computationally efficient solution to the problem, as well as a nearly optimal solution amenable to real-time implementation. We test both solutions on a dataset of 150 million taxi trips taken in the city of New York over one year 6 . The real-time implementation of the method with near-optimal service levels allows a 30 per cent reduction in fleet size compared to current taxi operation. Although constraints on driver availability and the existence of abnormal trip demands may lead to a relatively larger optimal value for the fleet size than that predicted here, the fleet size remains robust for a wide range of variations in historical trip demand. These predicted reductions in fleet size follow directly from a reorganization of taxi dispatching that could be implemented with a simple urban app; they do not assume ride sharing 7-9 , nor require changes to regulations, business models, or human attitudes towards mobility to become effective. Our results could become even more relevant in the years ahead as fleets of networked, self-driving cars become commonplace 10-14 .

Selective Prevention: Addressing Vulnerability to Problem Drug Use in Europe

ERIC Educational Resources Information Center

Burkhart, Gregor; Gyarmathy, V. Anna; Bo, Alessandra

2011-01-01

Following the 2003 publication of the European Union (EU) Council Recommendations and the 2005-2008 and 2009-2012 EU Drugs Action Plans, increasing attention has been given in EU member states' drug policies to populations that are vulnerable to problem drug use (PDU). Monitoring data reported to the EMCDDA by designated agencies from 30 countries…

Looking beyond first-world problems: an emerging global workplace is encouraging more biomedical engineers to address the health issues of the developing world.

PubMed

Tucker, Lindsay

2014-01-01

Each year, the developed world is flooded with complex new medical technologies, from robotic prosthetics to remote-controlled aspirin implants. Meanwhile, only about 10% of health research funds are spent addressing the pressing problems of developing nations, although these countries make up 93% of the worldwide burden of disease. In short, while a small fraction of the world pops brand-name pharmaceuticals, the majority suffers from poor sanitation, contaminated drinking water, preventable disease, and child mortality.

Split gender identity: problem or solution? Proposed parameters for addressing the gender dysphoric patient.

PubMed

Osborne, Cynthia; Wise, Thomas N

2002-01-01

Working with the gender dysphoric patient is complex because of the various clinical issues that arise. One issue that has not been addressed in the psychiatric literature is whether to address the patient with the biologically congruent pronoun or name or with the patient's preferred-gender pronoun or cross-gender name. This article presents clinical examples that allow a template to be developed for pronoun use in working with such patients. Whether the clinician uses biologically congruent names and pronouns may depend upon the patient's progress in adopting the cross gender role as well whether family or friends either know or accept such changes. In certain situations, such as meetings with family members, the therapist may address the patient with gender congruent names; whereas on other occasions use cross-gender pronouns or names.

Organisational perspectives on addressing differential attainment in postgraduate medical education: a qualitative study in the UK

PubMed Central

Viney, Rowena; Jayaweera, Hirosha; Griffin, Ann

2018-01-01

Objectives To explore how representatives from organisations with responsibility for doctors in training perceive risks to the educational progression of UK medical graduates from black and minority ethnic groups (BME UKGs), and graduates of non-UK medical schools (international medical graduates (IMGs)). To identify the barriers to and facilitators of change. Design Qualitative semistructured individual and group interview study. Setting Postgraduate medical education in the UK. Participants Individuals with roles in examinations and/or curriculum design from UK medical Royal Colleges. Employees of NHS Employers. Results Representatives from 11 medical Royal Colleges (n=29) and NHS Employers (n=2) took part (55% medically qualified, 61% male, 71% white British/Irish, 23% Asian/Asian British, 6% missing ethnicity). Risks were perceived as significant, although more so for IMGs than for BME UKGs. Participants based significance ratings on evidence obtained largely through personal experience. A lack of evidence led to downgrading of significance. Participants were pessimistic about effecting change, two main barriers being sensitivities around race and the isolation of interventions. Participants felt that organisations should acknowledge problems, but felt concerned about being transparent without a solution; and talking about race with trainees was felt to be difficult. Participants mentioned 63 schemes aiming to address differential attainment, but these were typically local or specialty-specific, were not aimed at BME UKGs and were largely unevaluated. Participants felt that national change was needed, but only felt empowered to effect change locally or within their specialty. Conclusions Representatives from organisations responsible for training doctors perceived the risks faced by BME UKGs and IMGs as significant but difficult to change. Strategies to help organisations address these risks include: increased openness to discussing race (including ethnic

Wicked Problems in Natural Hazard Assessment and Mitigation

NASA Astrophysics Data System (ADS)

Stein, S.; Steckler, M. S.; Rundle, J. B.; Dixon, T. H.

2017-12-01

Social scientists have defined "wicked" problems that are "messy, ill-defined, more complex than we fully grasp, and open to multiple interpretations based on one's point of view... No solution to a wicked problem is permanent or wholly satisfying, which leaves every solution open to easy polemical attack." These contrast with "tame" problems in which necessary information is available and solutions - even if difficult and expensive - are straightforward to identify and execute. Updating the U.S.'s aging infrastructure is a tame problem, because what is wrong and how to fix it are clear. In contrast, addressing climate change is a wicked problem because its effects are uncertain and the best strategies to address them are unclear. An analogous approach can be taken to natural hazard problems. In tame problems, we have a good model of the process, good information about past events, and data implying that the model should predict future events. In such cases, we can make a reasonable assessment of the hazard that can be used to develop mitigation strategies. Earthquake hazard mitigation for San Francisco is a relatively tame problem. We understand how the earthquakes result from known plate motions, have information about past earthquakes, and have geodetic data implying that future similar earthquakes will occur. As a result, it is straightforward to develop and implement mitigation strategies. However, in many cases, hazard assessment and mitigation is a wicked problem. How should we prepare for a great earthquake on plate boundaries where tectonics favor such events but we have no evidence that they have occurred and hence how large they may be or how often to expect them? How should we assess the hazard within plates, for example in the New Madrid seismic zone, where large earthquakes have occurred but we do not understand their causes and geodetic data show no strain accumulating? How can we assess the hazard and make sensible policy when the recurrence of

The effects of sexism, psychological distress, and difficult sexual situations on U.S. women's sexual risk behaviors.

PubMed

Choi, Kyung-Hee; Bowleg, Lisa; Neilands, Torsten B

2011-10-01

Women represent almost half of the people living with HIV worldwide. Although social discrimination has been recognized as a major obstacle to HIV prevention, few empirical studies have examined the effects of sexism on women's HIV sexual risk behaviors. We analyzed data collected from an ethnically diverse sample of 754 women attending family planning clinics in the San Francisco Bay Area. A majority of respondents reported lifetime experiences of sexism (e.g., 94% reported sexual harassment). Structural equation modeling results demonstrated that experiences of sexism and reports of recent unprotected sex with a primary or a secondary sexual partner were linked through psychological distress and difficult sexual situations. Our results suggest the need to develop HIV prevention strategies for women that address two mechanisms-psychological distress and difficult sexual situations-that link social discrimination to women's sexual risk for HIV.

All India Difficult Airway Association 2016 guidelines for the management of unanticipated difficult tracheal intubation in adults.

PubMed

Myatra, Sheila Nainan; Shah, Amit; Kundra, Pankaj; Patwa, Apeksh; Ramkumar, Venkateswaran; Divatia, Jigeeshu Vasishtha; Raveendra, Ubaradka S; Shetty, Sumalatha Radhakrishna; Ahmed, Syed Moied; Doctor, Jeson Rajan; Pawar, Dilip K; Ramesh, Singaravelu; Das, Sabyasachi; Garg, Rakesh

2016-12-01

The All India Difficult Airway Association (AIDAA) guidelines for management of the unanticipated difficult airway in adults provide a structured, stepwise approach to manage unanticipated difficulty during tracheal intubation in adults. They have been developed based on the available evidence; wherever robust evidence was lacking, or to suit the needs and situation in India, recommendations were arrived at by consensus opinion of airway experts, incorporating the responses to a questionnaire sent to members of the AIDAA and the Indian Society of Anaesthesiologists. We recommend optimum pre-oxygenation and nasal insufflation of 15 L/min oxygen during apnoea in all patients, and calling for help if the initial attempt at intubation is unsuccessful. Transnasal humidified rapid insufflations of oxygen at 70 L/min (transnasal humidified rapid insufflation ventilatory exchange) should be used when available. We recommend no more than three attempts at tracheal intubation and two attempts at supraglottic airway device (SAD) insertion if intubation fails, provided oxygen saturation remains ≥ 95%. Intubation should be confirmed by capnography. Blind tracheal intubation through the SAD is not recommended. If SAD insertion fails, one final attempt at mask ventilation should be tried after ensuring neuromuscular blockade using the optimal technique for mask ventilation. Failure to intubate the trachea as well as an inability to ventilate the lungs by face mask and SAD constitutes 'complete ventilation failure', and emergency cricothyroidotomy should be performed. Patient counselling, documentation and standard reporting of the airway difficulty using a 'difficult airway alert form' must be done. In addition, the AIDAA provides suggestions for the contents of a difficult airway cart.

The Compound Atwood Machine Problem

ERIC Educational Resources Information Center

Coelho, R. Lopes

2017-01-01

The present paper accounts for progress in physics teaching in the sense that a problem, which has been closed to students for being too difficult, is gained for the high school curriculum. This problem is the compound Atwood machine with three bodies. Its introduction into high school classes is based on a recent study on the weighing of an…

Oral to nasal tube exchange under fibroscopic view: a new technique for nasal intubation in a predicted difficult airway.

PubMed

Monclus, Enric; Garcés, Antonio; Artés, David; Mabrock, Maged

2008-07-01

For a predicted difficult airway, oral intubation techniques are well established in pediatric anesthesia, but nasotracheal intubation remains a problem. There are many reports concerning this, but the risk of bleeding, added to the lack of cooperation make this procedure difficult and hazardous. We describe a modification of the nasal intubation technique in two stages. First an oral intubation and then exchanging the oral for a nasal tube, in the case of a 13-year-old boy affected by an advanced stage of cherubism. Oral intubation using a laryngeal mask technique has already been reported, but problems appear during the exchange procedure and even more when direct laryngoscopy is impossible. Fiberscopic control of the exchange, and the introduction of a Cook Exchange Catheter into the trachea through the oral tube before withdrawal, permits oxygenation of the patient and acts as a guide for oral tube reintroduction if required.

Encountering unexpected difficult airway: relationship with the intubation difficulty scale

PubMed Central

Koh, Wonuk; Kim, Hajung; Kim, Kyongsun; Ro, Young-Jin

2016-01-01

Background An unexpected difficult intubation can be very challenging and if it is not managed properly, it may expose the encountered patient to significant risks. The intubation difficulty scale (IDS) has been used as a validated method to evaluate a global degree of intubation difficulty. The aims of this study were to evaluate the prevalence and characteristics of unexpected difficult intubation using the IDS. Methods We retrospectively reviewed 951 patients undergoing elective surgery in a single medical center. Patients expected to have a difficult intubation or who had history of difficult intubation were excluded. Each patient was assessed by the IDS scoring system with seven variables. Total prevalence of difficult intubation and the contributing individual factors were further analyzed. Results For the 951 patients, the difficult intubation cases presenting IDS > 5 was 5.8% of total cases (n = 55). The prevalence of Cormack-Lehane Grade 3 or 4 was 16.2% (n = 154). Most of the difficult intubation cases were managed by simple additional maneuvers and techniques such as stylet application, additional lifting force and laryngeal pressure. Conclusions Unexpected difficult airway was present in 5.8% of patients and most was managed effectively. Among the components of IDS, the Cormack-Lehane grade was most sensitive for predicting difficult intubation. PMID:27274369

Examining problem solving in physics-intensive Ph.D. research

NASA Astrophysics Data System (ADS)

Leak, Anne E.; Rothwell, Susan L.; Olivera, Javier; Zwickl, Benjamin; Vosburg, Jarrett; Martin, Kelly Norris

2017-12-01

Problem-solving strategies learned by physics undergraduates should prepare them for real-world contexts as they transition from students to professionals. Yet, graduate students in physics-intensive research face problems that go beyond problem sets they experienced as undergraduates and are solved by different strategies than are typically learned in undergraduate coursework. This paper expands the notion of problem solving by characterizing the breadth of problems and problem-solving processes carried out by graduate students in physics-intensive research. We conducted semi-structured interviews with ten graduate students to determine the routine, difficult, and important problems they engage in and problem-solving strategies they found useful in their research. A qualitative typological analysis resulted in the creation of a three-dimensional framework: context, activity, and feature (that made the problem challenging). Problem contexts extended beyond theory and mathematics to include interactions with lab equipment, data, software, and people. Important and difficult contexts blended social and technical skills. Routine problem activities were typically well defined (e.g., troubleshooting), while difficult and important ones were more open ended and had multiple solution paths (e.g., evaluating options). In addition to broadening our understanding of problems faced by graduate students, our findings explore problem-solving strategies (e.g., breaking down problems, evaluating options, using test cases or approximations) and characteristics of successful problem solvers (e.g., initiative, persistence, and motivation). Our research provides evidence of the influence that problems students are exposed to have on the strategies they use and learn. Using this evidence, we have developed a preliminary framework for exploring problems from the solver's perspective. This framework will be examined and refined in future work. Understanding problems graduate students

Discussion of Extinction-Based Behavioral Sleep Interventions for Young Children and Reasons Why Parents May Find Them Difficult.

PubMed

Etherton, Hayley; Blunden, Sarah; Hauck, Yvonne

2016-11-15

The majority of behavioral sleep interventions for young children involve extinction procedures where parents must ignore their child's cries for a period. Many parents have difficulties with this, contributing to attrition, non-compliance, and treatment avoidance. Yet why these methods are difficult to implement has rarely been addressed in the literature. This paper discusses seven potential reasons why parents may find extinction sleep interventions difficult: enduring crying, practical considerations, fear of repercussions, misinformation, incongruence with personal beliefs, different cultural practices, and parent wellness. These reasons are discussed in relation to the current literature. Practicing health professionals and sleep researchers could benefit from an awareness of these issues when suggesting extinction interventions and offering alternatives which may be more appropriate for family circumstances and facilitate parental informed choice. © 2016 American Academy of Sleep Medicine

A Multi-Systemic School-Based Approach for Addressing Childhood Aggression

ERIC Educational Resources Information Center

Runions, Kevin

2008-01-01

School-based approaches to addressing aggression in the early grades have focused on explicit curriculum addressing social and emotional processes. The current study reviews research on the distinct modes of aggression, the status of current research on social and emotional processing relevant to problems of aggression amongst young children, as…

Solving Classical Insight Problems without Aha! Experience: 9 Dot, 8 Coin, and Matchstick Arithmetic Problems

ERIC Educational Resources Information Center

Danek, Amory H.; Wiley, Jennifer; Öllinger, Michael

2016-01-01

Insightful problem solving is a vital part of human thinking, yet very difficult to grasp. Traditionally, insight has been investigated by using a set of established "insight tasks," assuming that insight has taken place if these problems are solved. Instead of assuming that insight takes place during every solution of the 9 Dot, 8 Coin,…

Metacognition: Student Reflections on Problem Solving

ERIC Educational Resources Information Center

Wismath, Shelly; Orr, Doug; Good, Brandon

2014-01-01

Twenty-first century teaching and learning focus on the fundamental skills of critical thinking and problem solving, creativity and innovation, and collaboration and communication. Metacognition is a crucial aspect of both problem solving and critical thinking, but it is often difficult to get students to engage in authentic metacognitive…

Residualization is not the answer: Rethinking how to address multicollinearity.

PubMed

York, Richard

2012-11-01

Here I show that a commonly used procedure to address problems stemming from collinearity and multicollinearity among independent variables in regression analysis, "residualization", leads to biased coefficient and standard error estimates and does not address the fundamental problem of collinearity, which is a lack of information. I demonstrate this using visual representations of collinearity, hypothetical experimental designs, and analyses of both artificial and real world data. I conclude by noting the importance of examining methodological practices to ensure that their validity can be established based on rational criteria. Copyright © 2012 Elsevier Inc. All rights reserved.

Big data, little security: Addressing security issues in your platform

NASA Astrophysics Data System (ADS)

Macklin, Thomas; Mathews, Joseph

2017-05-01

This paper describes some patterns for information security problems that consistently emerge among traditional enterprise networks and applications, both with respect to cyber threats and data sensitivity. We draw upon cases from qualitative studies and interviews of system developers, network operators, and certifiers of military applications. Specifically, the problems discussed involve sensitivity of data aggregates, training efficacy, and security decision support in the human machine interface. While proven techniques can address many enterprise security challenges, we provide additional recommendations on how to further improve overall security posture, and suggest additional research thrusts to address areas where known gaps remain.

Novel tool wear monitoring method in milling difficult-to-machine materials using cutting chip formation

NASA Astrophysics Data System (ADS)

Zhang, P. P.; Guo, Y.; Wang, B.

2017-05-01

The main problems in milling difficult-to-machine materials are the high cutting temperature and rapid tool wear. However it is impossible to investigate tool wear in machining. Tool wear and cutting chip formation are two of the most important representations for machining efficiency and quality. The purpose of this paper is to develop the model of tool wear with cutting chip formation (width of chip and radian of chip) on difficult-to-machine materials. Thereby tool wear is monitored by cutting chip formation. A milling experiment on the machining centre with three sets cutting parameters was performed to obtain chip formation and tool wear. The experimental results show that tool wear increases gradually along with cutting process. In contrast, width of chip and radian of chip decrease. The model is developed by fitting the experimental data and formula transformations. The most of monitored errors of tool wear by the chip formation are less than 10%. The smallest error is 0.2%. Overall errors by the radian of chip are less than the ones by the width of chip. It is new way to monitor and detect tool wear by cutting chip formation in milling difficult-to-machine materials.

Texts, Structure, and Collaboration: Reflections of a Professional Development Addressing Homophobia in Secondary Schools

ERIC Educational Resources Information Center

Jones, Joseph R.

2015-01-01

Homophobia is an incredible problem within educational settings. Therefore, we must begin examining how we can address the challenge in an effective manner. Researchers postulate professional development (PD) discussing homophobia is an appropriate method to address the problem. To date, there is little published literature that discusses how a PD…

HRD in Difficult Times. Symposium.

ERIC Educational Resources Information Center

2002

This document contains three papers on challenges facing human resource development today. "In Difficult Times: Influences of Attitudes and Expectations Towards Training and Redeployment Opportunities in a Hospital Retraction Programme" (Sandra Watson, Jeff Hyman) presents reasons behind the low uptake of training and redeployment…

Counting Tree Growth Rings Moderately Difficult to Distinguish

Treesearch

C. B. Briscoe; M. Chudnoff

1964-01-01

There is an extensive literature dealing with techniques and gadgets to facilitate counting tree growth rings. A relatively simple method is described below, satisfactory for species too difficult to count in the field, but not sufficiently difficult to require the preparation of microscope slides nor staining techniques.

Lessons Learned During Solutions of Multidisciplinary Design Optimization Problems

NASA Technical Reports Server (NTRS)

Patnaik, Suna N.; Coroneos, Rula M.; Hopkins, Dale A.; Lavelle, Thomas M.

2000-01-01

Optimization research at NASA Glenn Research Center has addressed the design of structures, aircraft and airbreathing propulsion engines. During solution of the multidisciplinary problems several issues were encountered. This paper lists four issues and discusses the strategies adapted for their resolution: (1) The optimization process can lead to an inefficient local solution. This deficiency was encountered during design of an engine component. The limitation was overcome through an augmentation of animation into optimization. (2) Optimum solutions obtained were infeasible for aircraft and air-breathing propulsion engine problems. Alleviation of this deficiency required a cascading of multiple algorithms. (3) Profile optimization of a beam produced an irregular shape. Engineering intuition restored the regular shape for the beam. (4) The solution obtained for a cylindrical shell by a subproblem strategy converged to a design that can be difficult to manufacture. Resolution of this issue remains a challenge. The issues and resolutions are illustrated through six problems: (1) design of an engine component, (2) synthesis of a subsonic aircraft, (3) operation optimization of a supersonic engine, (4) design of a wave-rotor-topping device, (5) profile optimization of a cantilever beam, and (6) design of a cvlindrical shell. The combined effort of designers and researchers can bring the optimization method from academia to industry.

The compound Atwood machine problem

NASA Astrophysics Data System (ADS)

Lopes Coelho, R.

2017-05-01

The present paper accounts for progress in physics teaching in the sense that a problem, which has been closed to students for being too difficult, is gained for the high school curriculum. This problem is the compound Atwood machine with three bodies. Its introduction into high school classes is based on a recent study on the weighing of an Atwood machine.

Review article: video-laryngoscopy: another tool for difficult intubation or a new paradigm in airway management?

PubMed

Paolini, Jean-Baptiste; Donati, François; Drolet, Pierre

2013-02-01

An adequate airway management plan is essential for patient safety. Recently, new tools have been developed as alternatives to direct laryngoscopy and intubation. Among these, video-laryngoscopy has enjoyed a rapid increase in popularity and is now considered by many as the first-line technique in airway management. This paradigm shift may have an impact on patient safety. Studies show that video-laryngoscopes are associated with better glottic visualization, a higher success rate for difficult airways, and a faster learning curve, resulting in a higher success rate for intubations by novice physicians. Thus, unanticipated difficult intubations may be less frequent if video-laryngoscopy is used as the first-line approach. In addition, on-screen viewing by the operator creates a new dynamic interaction during airway management. The entire operating room team can assess progress in real time, which enhances communication and improves teaching. However, if video-laryngoscopes become standard tools for tracheal intubation, these more costly devices will need to be widely available in all locations where airway management is conducted. Furthermore, algorithms for difficult intubation will require modification, and the question of selecting alternate devices will arise. If the incidence of difficult intubation decreases, the lack of motivation to teach and learn the use of alternative devices might adversely impact patient safety. The greater effectiveness of video-laryngoscopes associated with multi-person visualization could enhance overall patient safety during airway management. However, the routine use of video-laryngoscopy also introduces some issues that need to be addressed to avoid potentially dangerous pitfalls.

Identification and addressing reduction-related misconceptions

NASA Astrophysics Data System (ADS)

Gal-Ezer, Judith; Trakhtenbrot, Mark

2016-07-01

Reduction is one of the key techniques used for problem-solving in computer science. In particular, in the theory of computation and complexity (TCC), mapping and polynomial reductions are used for analysis of decidability and computational complexity of problems, including the core concept of NP-completeness. Reduction is a highly abstract technique that involves revealing close non-trivial connections between problems that often seem to have nothing in common. As a result, proper understanding and application of reduction is a serious challenge for students and a source of numerous misconceptions. The main contribution of this paper is detection of such misconceptions, analysis of their roots, and proposing a way to address them in an undergraduate TCC course. Our observations suggest that the main source of the misconceptions is the false intuitive rule "the bigger is a set/problem, the harder it is to solve". Accordingly, we developed a series of exercises for proactive prevention of these misconceptions.

Solving optimization problems on computational grids.

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

Wright, S. J.; Mathematics and Computer Science

2001-05-01

Multiprocessor computing platforms, which have become more and more widely available since the mid-1980s, are now heavily used by organizations that need to solve very demanding computational problems. Parallel computing is now central to the culture of many research communities. Novel parallel approaches were developed for global optimization, network optimization, and direct-search methods for nonlinear optimization. Activity was particularly widespread in parallel branch-and-bound approaches for various problems in combinatorial and network optimization. As the cost of personal computers and low-end workstations has continued to fall, while the speed and capacity of processors and networks have increased dramatically, 'cluster' platforms havemore » become popular in many settings. A somewhat different type of parallel computing platform know as a computational grid (alternatively, metacomputer) has arisen in comparatively recent times. Broadly speaking, this term refers not to a multiprocessor with identical processing nodes but rather to a heterogeneous collection of devices that are widely distributed, possibly around the globe. The advantage of such platforms is obvious: they have the potential to deliver enormous computing power. Just as obviously, however, the complexity of grids makes them very difficult to use. The Condor team, headed by Miron Livny at the University of Wisconsin, were among the pioneers in providing infrastructure for grid computations. More recently, the Globus project has developed technologies to support computations on geographically distributed platforms consisting of high-end computers, storage and visualization devices, and other scientific instruments. In 1997, we started the metaneos project as a collaborative effort between optimization specialists and the Condor and Globus groups. Our aim was to address complex, difficult optimization problems in several areas, designing and implementing the algorithms and the software

Drastic Measures for Difficult Times

ERIC Educational Resources Information Center

Galuszka, Peter

2008-01-01

This article discusses how colleges and universities are taking drastic measure for difficult times. Hit hard by the global financial crisis, colleges are cutting their budgets in ways that prompt fears about access and retention for minority students. Schools are considering layoffs, unpaid furloughs for faculty and staff, hiring freezes and…

Quantum annealing for the number-partitioning problem using a tunable spin glass of ions

PubMed Central

Graß, Tobias; Raventós, David; Juliá-Díaz, Bruno; Gogolin, Christian; Lewenstein, Maciej

2016-01-01

Exploiting quantum properties to outperform classical ways of information processing is an outstanding goal of modern physics. A promising route is quantum simulation, which aims at implementing relevant and computationally hard problems in controllable quantum systems. Here we demonstrate that in a trapped ion setup, with present day technology, it is possible to realize a spin model of the Mattis-type that exhibits spin glass phases. Our method produces the glassy behaviour without the need for any disorder potential, just by controlling the detuning of the spin-phonon coupling. Applying a transverse field, the system can be used to benchmark quantum annealing strategies which aim at reaching the ground state of the spin glass starting from the paramagnetic phase. In the vicinity of a phonon resonance, the problem maps onto number partitioning, and instances which are difficult to address classically can be implemented. PMID:27230802

The effect of problem structure on problem-solving: an fMRI study of word versus number problems.

PubMed

Newman, Sharlene D; Willoughby, Gregory; Pruce, Benjamin

2011-09-02

It has long been thought that word problems are more difficult to solve than number/equation problems. However, recent findings have begun to bring this broadly believed idea into question. The current study examined the processing differences between these two types of problems. The behavioral results presented here failed to show an overwhelming advantage for number problems. In fact, there were more errors for the number problems than the word problems. The neuroimaging results reported demonstrate that there is significant overlap in the processing of what, on the surface, appears to be completely different problems that elicit different problem-solving strategies. Word and number problems rely on a general network responsible for problem-solving that includes the superior posterior parietal cortex, the horizontal segment of the intraparietal sulcus which is hypothesized to be involved in problem representation and calculation as well as the regions that have been linked to executive aspects of working memory such as the pre-SMA and basal ganglia. While overlap was observed, significant differences were also found primarily in language processing regions such as Broca's and Wernicke's areas for the word problems and the horizontal segment of the intraparietal sulcus for the number problems. Copyright © 2011 Elsevier B.V. All rights reserved.

Predicting Growth Curves of Early Childhood Externalizing Problems: Differential Susceptibility of Children with Difficult Temperament

ERIC Educational Resources Information Center

Mesman, Judi; Stoel, Reinoud; Bakermans-Kranenburg, Marian J.; van IJzendoorn, Marinus H.; Juffer, Femmie; Koot, Hans M.; Alink, Lenneke R. A.

2009-01-01

Using an accelerated longitudinal design, the development of externalizing problems from age 2 to 5 years was investigated in relation to maternal psychopathology, maternal parenting, gender, child temperament, and the presence of siblings. The sample consisted of 150 children selected at age 2-3 years for having high levels of externalizing…

Addressing Climate Change in Long-Term Water Planning Using Robust Decisionmaking

NASA Astrophysics Data System (ADS)

Groves, D. G.; Lempert, R.

2008-12-01

Addressing climate change in long-term natural resource planning is difficult because future management conditions are deeply uncertain and the range of possible adaptation options are so extensive. These conditions pose challenges to standard optimization decision-support techniques. This talk will describe a methodology called Robust Decisionmaking (RDM) that can complement more traditional analytic approaches by utilizing screening-level water management models to evaluate large numbers of strategies against a wide range of plausible future scenarios. The presentation will describe a recent application of the methodology to evaluate climate adaptation strategies for the Inland Empire Utilities Agency in Southern California. This project found that RDM can provide a useful way for addressing climate change uncertainty and identify robust adaptation strategies.

Addressing the third gamma problem in PET

NASA Astrophysics Data System (ADS)

Schueller, M. J.; Mulnix, T. L.; Christian, B. T.; Jensen, M.; Holm, S.; Oakes, T. R.; Roberts, A. D.; Dick, D. W.; Martin, C. C.; Nickles, R. J.

2003-02-01

PET brings the promise of quantitative imaging of the in-vivo distribution of any positron emitting nuclide, a list with hundreds of candidates. All but a few of these, the "pure positron" emitters, have isotropic coincident gamma rays that give rise to misrepresented events in the sinogram and in the resulting reconstructed image. Of particular interest are /sup 10/C, /sup 14/O, /sup 38/K, /sup 52m/Mn, /sup 60/Cu, /sup 61/Cu, /sup 94m/Tc, and /sup 124/I, each having high-energy gammas that are Compton-scattered down into the 511 keV window. The problems arising from the "third gamma," and its accommodation by standard scatter correction algorithms, were studied empirically, employing three scanner models (CTI 933/04, CTI HR+ and GE Advance), imaging three phantoms (line source, NEMA scatter and contrast/detail), with /sup 18/F or /sup 38/K and /sup 72/As mimicking /sup 14/O and /sup 10/C, respectively, in 2-D and 3-D modes. Five findings emerge directly from the image analysis. The third gamma: 1) does, obviously, tax the single event rate of the PET scanners, particularly in the absence of septa, from activity outside of the axial field of view; 2) does, therefore, tax the random rate, which is second order in singles, although the gamma is a prompt coincidence partner; 3) does enter the sinogram as an additional flat background, like randoms, but unlike scatter; 4) is not seriously misrepresented by the scatter algorithm which fits the correction to the wings of the sinogram; and 5) does introduce additional statistical noise from the subsequent subtraction, but does not seriously compromise the detectability of lesions as seen in the contrast/detail phantom. As a safeguard against the loss of accuracy in image quantitation, fiducial sources of known activity are included in the field of view alongside of the subject. With this precaution, a much wider selection of imaging agents can enjoy the advantages of positron emission tomography.

Motivation to Address Self-Reported Hearing Problems in Adults with Normal Hearing Thresholds

ERIC Educational Resources Information Center

Alicea, Carly C. M.; Doherty, Karen A.

2017-01-01

Purpose: The purpose of this study was to compare the motivation to change in relation to hearing problems in adults with normal hearing thresholds but who report hearing problems and that of adults with a mild-to-moderate sensorineural hearing loss. Factors related to their motivation were also assessed. Method: The motivation to change in…

Addressing Cultural Diversity: Effects of a Problem-Based Intercultural Learning Unit

ERIC Educational Resources Information Center

Busse, Vera; Krause, Ulrike-Marie

2015-01-01

This article explores to what extent a problem-based learning unit in combination with cooperative learning and affectively oriented teaching methods facilitates intercultural learning. As part of the study, students reflected on critical incidents, which display misunderstandings or conflicts that arise as a result of cultural differences. In…

Addressing Students' Difficulties with Faraday's Law: A Guided Problem Solving Approach

ERIC Educational Resources Information Center

Zuza, Kristina; Almudí, José-Manuel; Leniz, Ane; Guisasola, Jenaro

2014-01-01

In traditional teaching, the fundamental concepts of electromagnetic induction are usually quickly analyzed, spending most of the time solving problems in a more or less rote manner. However, physics education research has shown that the fundamental concepts of the electromagnetic induction theory are barely understood by students. This article…

Addressing the Antibiotic Resistance Problem with Probiotics: Reducing the Risk of Its Double-Edged Sword Effect

PubMed Central

Imperial, Ivan C. V. J.; Ibana, Joyce A.

2016-01-01

Antibiotic resistance is a global public health problem that requires our attention. Indiscriminate antibiotic use is a major contributor in the introduction of selective pressures in our natural environments that have significantly contributed in the rapid emergence of antibiotic-resistant microbial strains. The use of probiotics in lieu of antibiotic therapy to address certain health conditions in both animals and humans may alleviate these antibiotic-mediated selective pressures. Probiotic use is defined as the actual application of live beneficial microbes to obtain a desired outcome by preventing diseased state or improving general health. Multiple studies have confirmed the beneficial effects of probiotic use in the health of both livestock and humans. As such, probiotics consumption is gaining popularity worldwide. However, concerns have been raised in the use of some probiotics strains that carry antibiotic resistance genes themselves, as they have the potential to pass the antibiotic resistance genes to pathogenic bacteria through horizontal gene transfer. Therefore, with the current public health concern on antibiotic resistance globally, in this review, we underscore the need to screen probiotic strains that are used in both livestock and human applications to assure their safety and mitigate their potential in significantly contributing to the spread of antibiotic resistance genes in our natural environments. PMID:28018315

Automatic mesh adaptivity for hybrid Monte Carlo/deterministic neutronics modeling of difficult shielding problems

DOE PAGES

Ibrahim, Ahmad M.; Wilson, Paul P.H.; Sawan, Mohamed E.; ...

2015-06-30

The CADIS and FW-CADIS hybrid Monte Carlo/deterministic techniques dramatically increase the efficiency of neutronics modeling, but their use in the accurate design analysis of very large and geometrically complex nuclear systems has been limited by the large number of processors and memory requirements for their preliminary deterministic calculations and final Monte Carlo calculation. Three mesh adaptivity algorithms were developed to reduce the memory requirements of CADIS and FW-CADIS without sacrificing their efficiency improvement. First, a macromaterial approach enhances the fidelity of the deterministic models without changing the mesh. Second, a deterministic mesh refinement algorithm generates meshes that capture as muchmore » geometric detail as possible without exceeding a specified maximum number of mesh elements. Finally, a weight window coarsening algorithm decouples the weight window mesh and energy bins from the mesh and energy group structure of the deterministic calculations in order to remove the memory constraint of the weight window map from the deterministic mesh resolution. The three algorithms were used to enhance an FW-CADIS calculation of the prompt dose rate throughout the ITER experimental facility. Using these algorithms resulted in a 23.3% increase in the number of mesh tally elements in which the dose rates were calculated in a 10-day Monte Carlo calculation and, additionally, increased the efficiency of the Monte Carlo simulation by a factor of at least 3.4. The three algorithms enabled this difficult calculation to be accurately solved using an FW-CADIS simulation on a regular computer cluster, eliminating the need for a world-class super computer.« less

Mind wandering while reading easy and difficult texts.

PubMed

Feng, Shi; D'Mello, Sidney; Graesser, Arthur C

2013-06-01

Mind wandering is a phenomenon in which attention drifts away from the primary task to task-unrelated thoughts. Previous studies have used self-report methods to measure the frequency of mind wandering and its effects on task performance. Many of these studies have investigated mind wandering in simple perceptual and memory tasks, such as recognition memory, sustained attention, and choice reaction time tasks. Manipulations of task difficulty have revealed that mind wandering occurs more frequently in easy than in difficult conditions, but that it has a greater negative impact on performance in the difficult conditions. The goal of this study was to examine the relation between mind wandering and task difficulty in a high-level cognitive task, namely reading comprehension of standardized texts. We hypothesized that reading comprehension may yield a different relation between mind wandering and task difficulty than has been observed previously. Participants read easy or difficult versions of eight passages and then answered comprehension questions after reading each of the passages. Mind wandering was reported using the probe-caught method from several previous studies. In contrast to the previous results, but consistent with our hypothesis, mind wandering occurred more frequently when participants read difficult rather than easy texts. However, mind wandering had a more negative influence on comprehension for the difficult texts, which is consistent with the previous data. The results are interpreted from the perspectives of the executive-resources and control-failure theories of mind wandering, as well as with regard to situation models of text comprehension.

The Role of Expository Writing in Mathematical Problem Solving

ERIC Educational Resources Information Center

Craig, Tracy S.

2016-01-01

Mathematical problem-solving is notoriously difficult to teach in a standard university mathematics classroom. The project on which this article reports aimed to investigate the effect of the writing of explanatory strategies in the context of mathematical problem solving on problem-solving behaviour. This article serves to describe the…

The Effects of Sexism, Psychological Distress, and Difficult Sexual Situations on U.S. Women’s Sexual Risk Behaviors

PubMed Central

Choi, Kyung-Hee; Bowleg, Lisa; Neilands, Torsten B.

2011-01-01

Women represent almost half of the people living with HIV worldwide. Although social discrimination has been recognized as a major obstacle to HIV prevention, few empirical studies have examined the effects of sexism on women’s HIV sexual risk behaviors. We analyzed data collected from an ethnically diverse sample of 754 women attending family planning clinics in the San Francisco Bay Area. A majority of respondents reported lifetime experiences of sexism (e.g., 94% reported sexual harassment). Structural equation modeling results demonstrated that experiences of sexism and reports of recent unprotected sex with a primary or a secondary sexual partner were linked through psychological distress and difficult sexual situations. Our results suggest the need to develop HIV prevention strategies for women that address two mechanisms ---psychological distress and difficult sexual situations --- that link social discrimination to women’s sexual risk for HIV. PMID:22010804

Hierarchical auto-configuration addressing in mobile ad hoc networks (HAAM)

NASA Astrophysics Data System (ADS)

Ram Srikumar, P.; Sumathy, S.

2017-11-01

Addressing plays a vital role in networking to identify devices uniquely. A device must be assigned with a unique address in order to participate in the data communication in any network. Different protocols defining different types of addressing are proposed in literature. Address auto-configuration is a key requirement for self organizing networks. Existing auto-configuration based addressing protocols require broadcasting probes to all the nodes in the network before assigning a proper address to a new node. This needs further broadcasts to reflect the status of the acquired address in the network. Such methods incur high communication overheads due to repetitive flooding. To address this overhead, a new partially stateful address allocation scheme, namely Hierarchical Auto-configuration Addressing (HAAM) scheme is extended and proposed. Hierarchical addressing basically reduces latency and overhead caused during address configuration. Partially stateful addressing algorithm assigns addresses without the need for flooding and global state awareness, which in turn reduces the communication overhead and space complexity respectively. Nodes are assigned addresses hierarchically to maintain the graph of the network as a spanning tree which helps in effectively avoiding the broadcast storm problem. Proposed algorithm for HAAM handles network splits and merges efficiently in large scale mobile ad hoc networks incurring low communication overheads.

The Right Network for the Right Problem

ERIC Educational Resources Information Center

Gomez, Louis M.; Russell, Jennifer L.; Bryk, Anthony S.; LeMahieu, Paul G.; Mejia, Eva M.

2016-01-01

Educators are realizing that individuals working in isolation can't adequately address the teaching and learning problems that face us today. Collective action networks are needed. Sharing networks use collective energy to support individual action and agency, whereas execution networks typically address complex problems that require sustained…

Promoting Health by Addressing Basic Needs: Effect of Problem Resolution on Contacting Health Referrals.

PubMed

Thompson, Tess; Kreuter, Matthew W; Boyum, Sonia

2016-04-01

Members of vulnerable populations have heightened needs for health services. One advantage of integrating health risk assessment and referrals into social service assistance systems such as 2-1-1 is that such systems help callers resolve problems in other areas (e.g., housing). Callers to 2-1-1 in Missouri (N= 1,090) with at least one behavioral risk factor or cancer screening need were randomly assigned to one of three health referral interventions: verbal referrals only, verbal referrals + a tailored mailed reminder, or verbal referrals + telephone health navigator. After 1 month, we assessed whether the nonhealth problems that prompted the 2-1-1 call had been resolved. Logistic regression estimated effects of having the problem resolved on calling a health referral. Callers were predominantly female (85%) and had a high school education or less (61%); nearly half (47%) had incomes under $10,000. The most common service requests were for utility assistance (35%), home/family problems (23%), and rent/mortgage assistance (12%). At follow-up, 38% of callers reported that all problems prompting their 2-1-1 call had been resolved, and 24% reported calling a health referral. Resolving all problems prompting the 2-1-1 call was associated with a higher odds of contacting a health referral (odds ratio = 1.44, 95% confidence interval [1.02, 2.05]) compared to people whose problems were not resolved. Multifaceted interventions that help meet non-health-related needs and provide support in reaching health-related goals may promote health in vulnerable populations. © 2015 Society for Public Health Education.

Promoting Health by Addressing Basic Needs: Effect of Problem Resolution on Contacting Health Referrals

PubMed Central

Thompson, Tess; Kreuter, Matthew; Boyum, Sonia

2016-01-01

Members of vulnerable populations have heightened needs for health services. One advantage of integrating health risk assessment and referrals into social service assistance systems such as 2-1-1 is that such systems help callers resolve problems in other areas (e.g. housing). Callers to 2-1-1 in Missouri (N=1090) with at least one behavioral risk factor or cancer screening need were randomly assigned to one of three health referral interventions: verbal referrals only, verbal referrals + a tailored mailed reminder, or verbal referrals + telephone health navigator. After one month, we assessed whether the non-health problems that prompted the 2-1-1 call had been resolved. Logistic regression estimated effects of having the problem resolved on calling a health referral. Callers were predominantly female (85%) and had a high school education or less (61%); nearly half (47%) had incomes under $10,000. The most common service requests were for utility assistance (35%), home/family problems (23%), and rent/mortgage assistance (12%). At follow-up, 38% of callers reported that all problems prompting their 2-1-1 call had been resolved, and 24% reported calling a health referral. Resolving all problems prompting the 2-1-1 call was associated with a higher odds of contacting a health referral (OR = 1.44, 95% CI 1.02-2.05) compared to people whose problems were not resolved. Multifaceted interventions that help meet non-health-related needs and provide support in reaching health-related goals may promote health in vulnerable populations. PMID:26293458

Applying Critical Race Theory to Group Model Building Methods to Address Community Violence.

PubMed

Frerichs, Leah; Lich, Kristen Hassmiller; Funchess, Melanie; Burrell, Marcus; Cerulli, Catherine; Bedell, Precious; White, Ann Marie

2016-01-01

Group model building (GMB) is an approach to building qualitative and quantitative models with stakeholders to learn about the interrelationships among multilevel factors causing complex public health problems over time. Scant literature exists on adapting this method to address public health issues that involve racial dynamics. This study's objectives are to (1) introduce GMB methods, (2) present a framework for adapting GMB to enhance cultural responsiveness, and (3) describe outcomes of adapting GMB to incorporate differences in racial socialization during a community project seeking to understand key determinants of community violence transmission. An academic-community partnership planned a 1-day session with diverse stakeholders to explore the issue of violence using GMB. We documented key questions inspired by critical race theory (CRT) and adaptations to established GMB "scripts" (i.e., published facilitation instructions). The theory's emphasis on experiential knowledge led to a narrative-based facilitation guide from which participants created causal loop diagrams. These early diagrams depict how violence is transmitted and how communities respond, based on participants' lived experiences and mental models of causation that grew to include factors associated with race. Participants found these methods useful for advancing difficult discussion. The resulting diagrams can be tested and expanded in future research, and will form the foundation for collaborative identification of solutions to build community resilience. GMB is a promising strategy that community partnerships should consider when addressing complex health issues; our experience adapting methods based on CRT is promising in its acceptability and early system insights.

Neurodevelopmental Profile, Growth, and Psychosocial Environment of Preterm Infants with Difficult Feeding Behavior at Age 2 Years.

PubMed

Crapnell, Tara L; Woodward, Lianne J; Rogers, Cynthia E; Inder, Terrie E; Pineda, Roberta G

2015-12-01

To examine the association of difficult feeding behaviors in very preterm infants at age 2 years with growth and neurodevelopmental outcomes and family factors and functioning. Eighty children born ≤30 weeks gestation were studied from birth until age 2 years. Feeding difficulties were assessed using the Eating Subscale of the Infant-Toddler Social Emotional Assessment at age 2 years, along with growth measurement and developmental testing. Maternal mental health and family factors were assessed using standardized questionnaires. ANOVA and χ(2) analyses were performed to determine associations between feeding difficulties and growth, neurodevelopmental outcomes, and family characteristics. Twenty-one children (26%) were at risk for feeding difficulties, and an additional 18 (23%) had definite feeding difficulties at age 2 years. Those with feeding difficulties were more likely to be subject to a range of neurodevelopmental problems, including impaired cognition (P = .02), language (P = .04), motor (P = .01), and socioemotional (P < .007) skills. Compared with the parents of children with fewer feeding difficulties, parents of the children with feeding difficulties had higher parenting stress (P = .02) and reported more difficulty managing their child's behavior (P = .002) and more frequent parent-child interaction problems (P = .002). No associations were found between difficult feeding behaviors and growth, maternal mental health, or family factors. Difficult feeding behaviors in children born very preterm appear to be highly comorbid with other developmental and family challenges, including neurodevelopmental impairment and parent-child interaction difficulties. Focusing on improving feeding skills, in conjunction with supporting positive parent-child interactions, may be beneficial for improving outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

Optimising the management of patients with difficult asthma.

PubMed

Palmer, Evelyn; Higgins, Bernard

2015-11-01

Asthma affects 5.4 million people in the UK, around 1 in 12 of the population. Between 5 and 10% of asthma (depending on the definition used) is categorised as difficult asthma, a term which generally refers to patients who continue to experience symptoms and frequent exacerbations despite the prescription of high-dose asthma therapy. Difficult asthma is an indication for specialist review by an appropriate respiratory physician, but close liaison between primary, secondary and tertiary care is critical and it is therefore important that primary care health professionals should be aware of the principles of management. One of the most important questions to ask is whether the individual with difficult asthma is taking their treatment Identifying this, however, is not easy. GPs could assess prescription uptake, looking for low use of preventers and excess use of short-acting bronchodilators. Newer means of assessing adherence have been developed. Inhaler devices that can monitor completion and timing of actuations have been produced. Meters that measure FeNO are available. A recent UK study found that 12 out of 100 patients referred for difficult asthma did not have reversible airflow obstruction or a history suggestive of asthma. Diagnoses included COPD, cystic fibrosis, cardiomyopathy, respiratory muscle dysfunction and severe anxiety with vocal cord dysfunction.

Addressing domestic violence in primary care: what the physician needs to know

PubMed Central

Usta, Jinan; Taleb, Rim

2014-01-01

Domestic violence (DV) is quite prevalent and negatively impacts the health and mental wellbeing of those affected. Victims of DV are frequent users of health service, yet they are infrequently recognized. Physicians tend to treat the presenting complaints without addressing the root cause of the problem. Lack of knowledge on adequately managing cases of DV and on appropriate ways to help survivors is commonly presented as a barrier. This article presents the magnitude of the problem of DV in the Arab world, highlights the role of the primary care physician in addressing this problem, and provides practical steps that can guide the clinician in the Arab world in giving a comprehensive and culturally sensitive service to the survivors of DV. PMID:24647277

COPS: Large-scale nonlinearly constrained optimization problems

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

Bondarenko, A.S.; Bortz, D.M.; More, J.J.

2000-02-10

The authors have started the development of COPS, a collection of large-scale nonlinearly Constrained Optimization Problems. The primary purpose of this collection is to provide difficult test cases for optimization software. Problems in the current version of the collection come from fluid dynamics, population dynamics, optimal design, and optimal control. For each problem they provide a short description of the problem, notes on the formulation of the problem, and results of computational experiments with general optimization solvers. They currently have results for DONLP2, LANCELOT, MINOS, SNOPT, and LOQO.

Barriers to addressing substance abuse in domestic violence court.

PubMed

Riger, Stephanie; Bennett, Larry W; Sigurvinsdottir, Rannveig

2014-03-01

Substance abuse commonly co-occurs with intimate partner violence among both perpetrators and survivors. Specialized courts that focus on intimate partner violence provide a unique opportunity to address both problems simultaneously, but research has yet to identify whether this happens. In this qualitative study of a domestic violence court in a large midwestern metropolitan area, key informants were interviewed to understand how the Court treats substance abuse. Results indicate that substance abuse typically is not identified among perpetrators or survivors going through the Court unless it is mentioned in a police report. Barriers to such identification are the organization of the Court, bounded definition of actors' roles in the Court, limited resources, and negative attitudes towards survivors. These results suggest that specialized courts that attend to only one problem may overlook the possibility of addressing issues that commonly co-occur.

Multidimensional Functional Behaviour Assessment within a Problem Analysis Framework.

ERIC Educational Resources Information Center

Ryba, Ken; Annan, Jean

This paper presents a new approach to contextualized problem analysis developed for use with multimodal Functional Behaviour Assessment (FBA) at Massey University in Auckland, New Zealand. The aim of problem analysis is to simplify complex problems that are difficult to understand. It accomplishes this by providing a high order framework that can…

Content addressable memory project

NASA Technical Reports Server (NTRS)

Hall, J. Storrs; Levy, Saul; Smith, Donald E.; Miyake, Keith M.

1992-01-01

A parameterized version of the tree processor was designed and tested (by simulation). The leaf processor design is 90 percent complete. We expect to complete and test a combination of tree and leaf cell designs in the next period. Work is proceeding on algorithms for the computer aided manufacturing (CAM), and once the design is complete we will begin simulating algorithms for large problems. The following topics are covered: (1) the practical implementation of content addressable memory; (2) design of a LEAF cell for the Rutgers CAM architecture; (3) a circuit design tool user's manual; and (4) design and analysis of efficient hierarchical interconnection networks.

Organisational perspectives on addressing differential attainment in postgraduate medical education: a qualitative study in the UK.

PubMed

Woolf, Katherine; Viney, Rowena; Rich, Antonia; Jayaweera, Hirosha; Griffin, Ann

2018-03-09

To explore how representatives from organisations with responsibility for doctors in training perceive risks to the educational progression of UK medical graduates from black and minority ethnic groups (BME UKGs), and graduates of non-UK medical schools (international medical graduates (IMGs)). To identify the barriers to and facilitators of change. Qualitative semistructured individual and group interview study. Postgraduate medical education in the UK. Individuals with roles in examinations and/or curriculum design from UK medical Royal Colleges. Employees of NHS Employers. Representatives from 11 medical Royal Colleges (n=29) and NHS Employers (n=2) took part (55% medically qualified, 61% male, 71% white British/Irish, 23% Asian/Asian British, 6% missing ethnicity). Risks were perceived as significant, although more so for IMGs than for BME UKGs. Participants based significance ratings on evidence obtained largely through personal experience. A lack of evidence led to downgrading of significance. Participants were pessimistic about effecting change, two main barriers being sensitivities around race and the isolation of interventions. Participants felt that organisations should acknowledge problems, but felt concerned about being transparent without a solution; and talking about race with trainees was felt to be difficult. Participants mentioned 63 schemes aiming to address differential attainment, but these were typically local or specialty-specific, were not aimed at BME UKGs and were largely unevaluated. Participants felt that national change was needed, but only felt empowered to effect change locally or within their specialty. Representatives from organisations responsible for training doctors perceived the risks faced by BME UKGs and IMGs as significant but difficult to change. Strategies to help organisations address these risks include: increased openness to discussing race (including ethnic differences in attainment among UKGs); better sharing of

Identifying the mathematics middle year students use as they address a community issue

NASA Astrophysics Data System (ADS)

Marshman, Margaret

2017-03-01

Middle year students often do not see the mathematics in the real world whereas the Australian Curriculum: Mathematics aims for students to be "confident and creative users and communicators of mathematics" (Australian Curriculum Assessment and Reporting Authority [ACARA] 2012). Using authentic and real mathematics tasks can address this situation. This paper is an account of how, working within a Knowledge Producing Schools' framework, a group of middle year students addressed a real community issue, the problem of the lack of a teenage safe space using mathematics and technology. Data were collected for this case study via journal observations and reflections, semi-structured interviews, samples of the students' work and videos of students working. The data were analysed by identifying the mathematics the students used determining the function and location of the space and focused on problem negotiation, formulation and solving through the statistical investigation cycle. The paper will identify the mathematics and statistics these students used as they addressed a real problem in their local community.

Stage-related behavioural problems in the 1-4 year old child: parental expectations in a child development unit referral group compared with a control group.

PubMed

Ticehurst, R L; Henry, R L

1989-02-01

Behavioural problems in preschool (1-4 years) children are a common cause of referral to health services. Parents of children presenting to the child development unit with behavioural problems (n = 18) were compared with a control group (n = 45). A questionnaire was utilized to examine the parents' expectations of the children's behaviours. As might be expected, the parents of children presenting to the Unit rated their children as having more difficult behaviours. These parents had unrealistic expectations, particularly for the 'negative' behaviours (disobedience, temper tantrums, defiance and whinging). However, they were able to anticipate normal age-related difficulties in some problem areas (dawdling during mealtimes, masturbating, not sharing toys and being jealous of one's siblings). Counselling should address the issue of matching the expectations of parents with the individual rates of development of their children.

Content-addressable read/write memories for image analysis

NASA Technical Reports Server (NTRS)

Snyder, W. E.; Savage, C. D.

1982-01-01

The commonly encountered image analysis problems of region labeling and clustering are found to be cases of search-and-rename problem which can be solved in parallel by a system architecture that is inherently suitable for VLSI implementation. This architecture is a novel form of content-addressable memory (CAM) which provides parallel search and update functions, allowing speed reductions down to constant time per operation. It has been proposed in related investigations by Hall (1981) that, with VLSI, CAM-based structures with enhanced instruction sets for general purpose processing will be feasible.

Non-Clinical Interventions for Families with Temperamentally Difficult Children.

ERIC Educational Resources Information Center

Mettetal, Gwendolyn

This study sought to determine if general parent education, in the form of books and workshops, was an effective intervention in cases of moderate parental distress due to difficult child temperament. The parents of six "difficult" children answered questionnaires and were interviewed over several years concerning their child's temperament and its…

Home Economics Reading Skills: Problems and Selected References.

ERIC Educational Resources Information Center

Cranney, A. Garr; And Others

Home economics presents at least eight problems to secondary school reading teachers. These problems include poor readers, difficult reading material, lack of reading materials, teachers' lack of training in reading instruction, scarce information about home economics for reading teachers, diversity of the home economics field (requiring a wide…

Facilitating Difficult Dialogues at the Intersections of Religious Privilege

ERIC Educational Resources Information Center

Watt, Sherry K.

2009-01-01

A core definition of a "difficult dialogue" is a verbal or written exchange of ideas or opinions among citizens within a community that centers on an awakening of potentially conflicting views about beliefs and values. As informed by Fried's definition of religious privilege (2007), difficult dialogue at the intersections of religious privilege…

Extending the ARS Experimental Watersheds to Address Regional Issues

NASA Astrophysics Data System (ADS)

Marks, D.; Goodrich, D. C.; Winstral, A.; Bosch, D. D.; Pool, D.

2001-12-01

The USDA-Agricultural Research Service's (ARS) Watershed Research Program maintains and operates a diverse, geog raphically distributed, nested, multi-scale, national ex perimental watershed network. This network, much of which has been operational for more than 40 years (several more than 60 years), constitutes one the best networks of its kind in the world. The watershed network and its instrumentation was primarily established to assess the hydrologic impacts of watershed conservation and management practices. It has evolved, through development of long-term hydrologic data, as a network of high quality outdoor laboratories for addressing emerging science issues facing hydrologists and resource managers. While the value of the experimental watershed for investigating precipitation, climatic, and hydrologic processes is unquestioned, extending the results from these investigations to other sites and larger areas is more difficult. ARS experimental watersheds are a few hundred km2 or smaller making it challenging to address regional scale issues. To address this the ARS watershed program is, with a suite of partners from universities and other federal agencies, enlarging its research focus to extend beyond the boundaries of the experimental watershed. In this poster we present several examples of this effort, with suggestions on how, using the experimental watershed and its core, a larger scale hydrologic observatory could be developed and maintained.

Dual-Use Partnership Addresses Performance Problems with "Y" Pattern Control Valves

NASA Technical Reports Server (NTRS)

Bailey, John W.

2004-01-01

A Dual-Use Cooperative Agreement between the Propulsion Test Directorate (PTD) at Stennis Space Center (SSC) and Oceaneering Reflange, Inc. of Houston, TX has produced an improved 'Y' pattern split-body control valve for use in the propulsion test facilities at Stennis Space Center. The split-body, or clamped bonnet technology, provides for a 'cleaner' valve design featuring enhanced performance and increased flow capacity with extended life expectancy. Other points addressed by the partnership include size, weight and costs. Overall size and weight of each valve will be reduced by 50% compared to valves currently in use at SSC. An initial procurement of two 10 inch valves will result in an overall cost reduction of 15% or approximately $50,000 per valve.

Multidisciplinary Difficult Airway Course: An Essential Educational Component of a Hospital-Wide Difficult Airway Response Program.

PubMed

Leeper, W Robert; Haut, Elliott R; Pandian, Vinciya; Nakka, Sajan; Dodd-O, Jeffrey; Bhatti, Nasir; Hunt, Elizabeth A; Saheed, Mustapha; Dalesio, Nicholas; Schiavi, Adam; Miller, Christina; Kirsch, Thomas D; Berkow, Lauren

2018-04-05

A hospital-wide difficult airway response team was developed in 2008 at The Johns Hopkins Hospital with three central pillars: operations, safety monitoring, and education. The objective of this study was to assess the outcomes of the educational pillar of the difficult airway response team program, known as the multidisciplinary difficult airway course (MDAC). The comprehensive, full-day MDAC involves trainees and staff from all provider groups who participate in airway management. The MDAC occurs within the Johns Hopkins Medicine Simulation Center approximately four times per year and uses a combination of didactic lectures, hands-on sessions, and high-fidelity simulation training. Participation in MDAC is the main intervention being investigated in this study. Data were collected prospectively using course evaluation survey with quantitative and qualitative components, and prepost course knowledge assessment multiple choice questions (MCQ). Outcomes include course evaluation scores and themes derived from qualitative assessments, and prepost course knowledge assessment MCQ scores. Tertiary care academic hospital center PARTICIPANTS: Students, residents, fellows, and practicing physicians from the departments of Surgery, Otolaryngology Head and Neck Surgery, Anesthesiology/Critical Care Medicine, and Emergency Medicine; advanced practice providers (nurse practitioners and physician assistants), nurse anesthetists, nurses, and respiratory therapists. Totally, 23 MDACs have been conducted, including 499 participants. Course evaluations were uniformly positive with mean score of 86.9 of 95 points. Qualitative responses suggest major value from high-fidelity simulation, the hands-on skill stations, and teamwork practice. MCQ scores demonstrated significant improvement: median (interquartile range) pre: 69% (60%-81%) vs post: 81% (72%-89%), p < 0.001. Implementation of a MDAC successfully disseminated principles and protocols to all airway providers. Demonstrable

Teaching Difficult Topics with Primary Sources

ERIC Educational Resources Information Center

Potter, Lee Ann

2011-01-01

"Difficult" or "challenging" topics to teach include racism, violence, genocide, bullying, gangs, abuse (physical, emotional, and substance), slavery, suffering, hatred, terrorism, war, disease, loss, addiction, and more. But by confronting them with students, in the safety of a classroom through thoughtfully constructed lessons (ones that take…

Preferred Psychological Internet Resources for Addressing Anxiety Disorders, Parenting Problems, Eating Disorders, and Chemical Dependency.

ERIC Educational Resources Information Center

Morse, Laura; Doran, Matt; Simonin, Danielle; Smith, Allyson; Maloney, Colleen; Wright, Cara; Underwood, Michelle; Hoppel, Andrea; O'Donnell, Shannon; Chambliss, Catherine

Although the Internet offers information about psychological problems and support resources for behavioral health problems, the quality of this information varies widely. So as to offer guidance in this area, preferred sites pertaining to anxiety disorders, parenting problems, eating disorders, and chemical dependency were analyzed. A total of 365…

Monitoring Affect States during Effortful Problem Solving Activities

ERIC Educational Resources Information Center

D'Mello, Sidney K.; Lehman, Blair; Person, Natalie

2010-01-01

We explored the affective states that students experienced during effortful problem solving activities. We conducted a study where 41 students solved difficult analytical reasoning problems from the Law School Admission Test. Students viewed videos of their faces and screen captures and judged their emotions from a set of 14 states (basic…

Approaches used by employee assistance programs to address perpetration of intimate partner violence.

PubMed

Walters, Jennifer L Hardison; Pollack, Keshia M; Clinton-Sherrod, Monique; Lindquist, Christine H; McKay, Tasseli; Lasater, Beth M

2012-01-01

Employee Assistance Programs (EAPs) are workplace resources available to employees with problems impacting work performance. EAPs are well-positioned to address intimate partner violence (IPV), a major public health problem with workplace impacts. A purposeful sample of 28 EAPs across the United States was surveyed to identify policies and programs to address IPV, including perpetration. Most EAPs did not report having standardized approaches for addressing IPV perpetration. EAPs also described significant barriers to identifying IPV perpetrators, with the majority relying on self-disclosure on the part of the perpetrator when contacting the EAP. These results suggest that many EAPs--even when interacting with employees who present with issues known to correlate with IPV--are missing a potential opportunity to assess and intervene with IPV perpetrators.

The BCI competition. III: Validating alternative approaches to actual BCI problems.

PubMed

Blankertz, Benjamin; Müller, Klaus-Robert; Krusienski, Dean J; Schalk, Gerwin; Wolpaw, Jonathan R; Schlögl, Alois; Pfurtscheller, Gert; Millán, José del R; Schröder, Michael; Birbaumer, Niels

2006-06-01

A brain-computer interface (BCI) is a system that allows its users to control external devices with brain activity. Although the proof-of-concept was given decades ago, the reliable translation of user intent into device control commands is still a major challenge. Success requires the effective interaction of two adaptive controllers: the user's brain, which produces brain activity that encodes intent, and the BCI system, which translates that activity into device control commands. In order to facilitate this interaction, many laboratories are exploring a variety of signal analysis techniques to improve the adaptation of the BCI system to the user. In the literature, many machine learning and pattern classification algorithms have been reported to give impressive results when applied to BCI data in offline analyses. However, it is more difficult to evaluate their relative value for actual online use. BCI data competitions have been organized to provide objective formal evaluations of alternative methods. Prompted by the great interest in the first two BCI Competitions, we organized the third BCI Competition to address several of the most difficult and important analysis problems in BCI research. The paper describes the data sets that were provided to the competitors and gives an overview of the results.

Disarming Contankerous People: Coping with Difficult Personalities in ECE Work Settings

ERIC Educational Resources Information Center

Hernandez, Luis; Smith, Connie Jo

2009-01-01

Difficult personalities come in a variety of roles in just about every setting. While types have been identified in the typical corporate and business culture, difficult work personalities also inhabit the world of early childhood education (ECE) workplaces. Because difficult people have an impact on workplace morale and productivity, the topic…

Problems Facing Rural Schools.

ERIC Educational Resources Information Center

Stewart, C. E.; And Others

Problems facing rural Scottish schools range from short term consideration of daily operation to long term consideration of organizational alternatives. Addressed specifically, such problems include consideration of: (1) liaison between a secondary school and its feeder primary schools; (2) preservice teacher training for work in small, isolated…

Hierarchy problem and BSM physics

NASA Astrophysics Data System (ADS)

Bhattacharyya, Gautam

2017-10-01

The `hierarchy problem' plagues the Standard Model of particle physics. The source of this problem is our inability to answer the following question: Why is the Higgs mass so much below the GUT or Planck scale? A brief description about how `supersymmetry' and `composite Higgs' address this problem is given here.

Use of a Mathematics Word Problem Strategy to Improve Achievement for Students with Mild Disabilities

ERIC Educational Resources Information Center

Taber, Mary R.

2013-01-01

Mathematics can be a difficult topic both to teach and to learn. Word problems specifically can be difficult for students with disabilities because they have to conceptualize what the problem is asking for, and they must perform the correct operation accurately. Current trends in mathematics instruction stem from the National Council of Teachers…

Social problem solving in carers of young people with a first episode of psychosis: a randomized controlled trial.

PubMed

McCann, Terence V; Cotton, Sue M; Lubman, Dan I

2017-08-01

Caring for young people with first-episode psychosis is difficult and demanding, and has detrimental effects on carers' well-being, with few evidence-based resources available to assist carers to deal with the problems they are confronted with in this situation. We aimed to examine if completion of a self-directed problem-solving bibliotherapy by first-time carers of young people with first-episode psychosis improved their social problem solving compared with carers who only received treatment as usual. A randomized controlled trial was carried out through two early intervention psychosis services in Melbourne, Australia. A sample of 124 carers were randomized to problem-solving bibliotherapy or treatment as usual. Participants were assessed at baseline, 6- and 16-week follow-up. Intent-to-treat analyses were used and showed that recipients of bibliotherapy had greater social problem-solving abilities than those receiving treatment as usual, and these effects were maintained at both follow-up time points. Our findings affirm that bibliotherapy, as a low-cost complement to treatment as usual for carers, had some effects in improving their problem-solving skills when addressing problems related to the care and support of young people with first-episode psychosis. © 2015 The Authors. Early Intervention in Psychiatry published by Wiley Publishing Asia Pty Ltd.

Problem-Framing: A perspective on environmental problem-solving

NASA Astrophysics Data System (ADS)

Bardwell, Lisa V.

1991-09-01

The specter of environmental calamity calls for the best efforts of an involved public. Ironically, the way people understand the issues all too often serves to discourage and frustrate rather than motivate them to action. This article draws from problem-solving perspectives offered by cognitive psychology and conflict management to examine a framework for thinking about environmental problems that promises to help rather than hinder efforts to address them. Problem-framing emphasizes focusing on the problem definition. Since how one defines a problem determines one's understanding of and approach to that problem, being able to redefine or reframe a problem and to explore the “problem space” can help broaden the range of alternatives and solutions examined. Problem-framing incorporates a cognitive perspective on how people respond to information. It explains why an emphasis on problem definition is not part of people's typical approach to problems. It recognizes the importance of structure and of having ways to organize that information on one's problem-solving effort. Finally, problem-framing draws on both cognitive psychology and conflict management for strategies to manage information and to create a problem-solving environment that not only encourages participation but can yield better approaches to our environmental problems.

Ecosystem services and cooperative fisheries research to address a complex fishery problem

EPA Science Inventory

The St. Louis River represents a complex fishery management problem. Current fishery management goals have to be developed taking into account bi-state commercial, subsistence and recreational fisheries which are valued for different characteristics by a wide range of anglers, as...

The problem of motivating teaching staff in a complex amalgamation.

PubMed

Kenrick, M A

1993-09-01

This paper addresses some of the problems brought about by the merger of a number of schools of nursing into a new complex amalgamation. A very real concern in the new colleges of nursing and midwifery in the United Kingdom is the effect of amalgamation on management systems and staff morale. The main focus of this paper is the motivation of staff during this time of change. There is currently a lack of security amongst staff and in many instances the personal job satisfaction of nurse teachers and managers of nurse education has been reduced, which has made the task of motivating staff difficult. Hence, two major theories of motivation and the implications of these theories for managers of nurse education are discussed. The criteria used for the selection of managers within the new colleges, leadership styles and organizational structures are reviewed. The amalgamations have brought about affiliation with higher-education institutions. Some problems associated with these mergers and the effects on the motivation of staff both within the higher-education institutions and the nursing colleges are outlined. Strategies for overcoming some of the problems are proposed including job enlargement, job enrichment, potential achievement rewards and the use of individual performance reviews which may be useful for assessing the ability of all staff, including managers, in the new amalgamations.

Exact solution of large asymmetric traveling salesman problems.

PubMed

Miller, D L; Pekny, J F

1991-02-15

The traveling salesman problem is one of a class of difficult problems in combinatorial optimization that is representative of a large number of important scientific and engineering problems. A survey is given of recent applications and methods for solving large problems. In addition, an algorithm for the exact solution of the asymmetric traveling salesman problem is presented along with computational results for several classes of problems. The results show that the algorithm performs remarkably well for some classes of problems, determining an optimal solution even for problems with large numbers of cities, yet for other classes, even small problems thwart determination of a provably optimal solution.

Wicked problems and a 'wicked' solution.

PubMed

Walls, Helen L

2018-04-13

'Wicked' is the term used to describe some of the most challenging and complex issues of our time, many of which threaten human health. Climate change, biodiversity loss, persisting poverty, the advancing obesity epidemic, and food insecurity are all examples of such wicked problems. However there is a strong body of evidence describing the solutions for addressing many of these problems. Given that much is known about how many of these problems could be addressed - and given the risks of not acting - what will it take to create the 'tipping point' needed for effective action? A recent (2015) court ruling in The Hague held that the Dutch government's stance on climate change was illegal, ordering them to cut greenhouse gas emissions by at least 25% within 5 years (by 2020), relative to 1990 levels. The case was filed on behalf of 886 Dutch citizens, suing the government for violating human rights and climate changes treaties by failing to take adequate action to prevent the harmful impacts of climate change. This judicial ruling has the potential to provide a way forward, inspiring other civil movements and creating a template from which to address other wicked problems. This judicial strategy to address the need to lower greenhouse gas emissions in the Netherlands is not a magic bullet, and requires a particular legal and institutional setting. However it has the potential to be a game-changer - providing an example of a strategy for achieving domestic regulatory change that is likely to be replicable in some countries elsewhere, and providing an example of a particularly 'wicked' (in the positive, street-slang sense of the word) strategy to address seemingly intractable and wicked problems.

Neurodevelopmental Profile, Growth, and Psychosocial Environment of Preterm Infants with Difficult Feeding Behavior at Two Years of Age

PubMed Central

Crapnell, Tara L.; Woodward, Lianne J.; Rogers, Cynthia E.; Inder, Terrie E.; Pineda, Roberta G.

2015-01-01

Objectives To examine the association of difficult feeding behaviors in very preterm infants at two years of age with growth and neurodevelopmental outcomes and family factors and functioning. Study design Eighty children born ≤30 weeks gestation were studied from birth until two years of age. Feeding difficulties were assessed using the Eating Subscale of the Infant-Toddler Social Emotional Assessment at age two years alongside growth and developmental testing. Maternal mental health and family factors were assessed using standardized questionnaires. ANOVA and chi-square analyses were used to determine associations between feeding difficulties and growth, neurodevelopmental outcomes, and family characteristics. Results Twenty-one (26%) of the cohort were at risk for feeding difficulties, and an additional 18 (23%) had definite feeding difficulties at age two years. Those with feeding difficulties were more likely to be subject to a range of neurodevelopmental problems including impaired cognition (p=0.02), language (p=0.04), motor (p=0.01) and socio-emotional (p<0.007) skills. Parents of very preterm born children with feeding difficulties had higher parenting stress (p=0.02) and reported more difficulty managing their child’s behavior (p=0.002) and more frequent parent-child interaction problems (p=0.002) than parents of children with fewer feeding difficulties. No associations were found between difficult feeding behaviors and growth, maternal mental health, and family factors. Conclusions Difficult feeding behaviors in children born very preterm appear to be highly comorbid with other developmental and family challenges, including neurodevelopmental impairment and parent-child interaction difficulties. Focusing on improving feeding skills, in conjunction with supporting positive parent-child interactions, may be beneficial for improving outcomes. PMID:26490123

Typology of person-environment fit constellations: a platform addressing accessibility problems in the built environment for people with functional limitations.

PubMed

Slaug, Björn; Schilling, Oliver; Iwarsson, Susanne; Carlsson, Gunilla

2015-09-02

Making the built environment accessible for all regardless of functional capacity is an important goal for public health efforts. Considerable impediments to achieving this goal suggest the need for valid measurements of acccessibility and for greater attention to the complexity of person-environment fit issues. To address these needs, this study aimed to provide a methodological platform, useful for further research and instrument development within accessibility research. This was accomplished by the construction of a typology of problematic person-environment fit constellations, utilizing an existing methodology developed to assess and analyze accessibility problems in the built environment. By means of qualitative review and statistical methods we classified the person-environment fit components covered by an existing application which targets housing accessibility: the Housing Enabler (HE) instrument. The International Classification of Functioning, Disability and Health (ICF) was used as a conceptual framework. Qualitative classification principles were based on conceptual similarities and for quantitative analysis of similarities, Principal Component Analysis was carried out. We present a typology of problematic person-environment fit constellations classified along three dimensions: 1) accessibility problem range and severity 2) aspects of functioning 3) environmental context. As a result of the classification of the HE components, 48 typical person-environment fit constellations were recognised. The main contribution of this study is the proposed typology of person-environment fit constellations. The typology provides a methodological platform for the identification and quantification of problematic person-environment fit constellations. Its link to the globally accepted ICF classification system facilitates communication within the scientific and health care practice communities. The typology also highlights how relations between aspects of functioning

Parental Reflective Functioning Moderates the Relationship between Difficult Temperament in Infancy and Behavior Problems in Toddlerhood

ERIC Educational Resources Information Center

Wong, Kristyn; Stacks, Ann M.; Rosenblum, Katherine L.; Muzik, Maria

2017-01-01

This study assessed the links between infant negative affect, parental reflective functioning (RF), and toddler behavior problems in a sample of 84 women and their infants. Mothers provided self-report demographic data and completed the Infant Behavior Questionnaire-Revised during a home visit when the infant was 7 months old. They also completed…

Impact of Context-Rich, Multifaceted Problems on Students' Attitudes Towards Problem-Solving

NASA Astrophysics Data System (ADS)

Ogilvie, Craig

2008-04-01

Young scientists and engineers need strong problem-solving skills to enable them to address the broad challenges they will face in their careers. These challenges will likely be ill-defined and open-ended with either unclear goals, insufficient constraints, multiple possible solutions, and different criteria for evaluating solutions so that our young scientists and engineers must be able to make judgments and defend their proposed solutions. In contrast, many students believe that problem-solving is being able to apply set procedures or algorithms to tasks and that their job as students is to master an ever-increasing list of procedures. This gap between students' beliefs and the broader, deeper approaches of experts is a strong barrier to the educational challenge of preparing students to succeed in their future careers. To start to address this gap, we have used multi-faceted, context-rich problems in a sophomore calculus-based physics course. To assess whether there was any change in students' attitudes or beliefs towards problem-solving, students were asked to reflect on their problem-solving at the beginning and at the end of the semester. These reflections were coded as containing one or more problem-solving ideas. The change in students' beliefs will be shown in this talk.

Network Function Virtualization (NFV) based architecture to address connectivity, interoperability and manageability challenges in Internet of Things (IoT)

NASA Astrophysics Data System (ADS)

Haseeb, Shariq; Hashim, Aisha Hassan A.; Khalifa, Othman O.; Faris Ismail, Ahmad

2017-11-01

IoT aims to interconnect sensors and actuators built into devices (also known as Things) in order for them to share data and control each other to improve existing processes for making people’s life better. IoT aims to connect between all physical devices like fridges, cars, utilities, buildings and cities so that they can take advantage of small pieces of information collected by each one of these devices and derive more complex decisions. However, these devices are heterogeneous in nature because of various vendor support, connectivity options and protocol suit. Heterogeneity of such devices makes it difficult for them to leverage on each other’s capabilities in the traditional IoT architecture. This paper highlights the effects of heterogeneity challenges on connectivity, interoperability, management in greater details. It also surveys some of the existing solutions adopted in the core network to solve the challenges of massive IoT deployments. Finally, the paper proposes a new architecture based on NFV to address the problems.

The Problems of Dissection.

ERIC Educational Resources Information Center

Davis, Pat

1997-01-01

Describes some problems of classroom dissection including the cruelty that animals destined for the laboratory suffer. Discusses the multilevel approach that the National Anti-Vivisection Society (NAVS) has developed to address the problems of animal dissection such as offering a dissection hotline, exhibiting at science teacher conferences, and…

When Benefits Are Difficult to Measure.

ERIC Educational Resources Information Center

Birdsall, William C.

1987-01-01

It is difficult to apply benefit cost analysis to human service programs. This paper explains "threshold benefit analysis," the derivation of the minimum dollar value which the benefits must attain in order for their value to equal the intervention costs. The method is applied to a mobility training program. (BS)

Coping with Stress in Difficult Times.

ERIC Educational Resources Information Center

Terrill, Jerry L.

1993-01-01

Generally, amount of stress generated by difficult situations is inversely proportional to one's perceived control over them. Stressed-out principals are advised to work on their attitude, create new personal focus (a hobby or exercise program), initiate new professional focus, be good to themselves, rely on well-established support systems, and…

Unusual tumour ablations: report of difficult and interesting cases.

PubMed

Mauri, Giovanni; Nicosia, Luca; Varano, Gianluca Maria; Shyn, Paul; Sartori, Sergio; Tombesi, Paola; Di Vece, Francesca; Orsi, Franco; Solbiati, Luigi

2017-01-01

Image-guided ablations are nowadays applied in the treatment of a wide group of diseases and in different organs and regions, and every day interventional radiologists have to face more difficult and unusual cases of tumour ablation. In the present case review, we report four difficult and unusual cases, reporting some tips and tricks for a successful image-guided treatment.

Physical inactivity as a policy problem: applying a concept from policy analysis to a public health issue.

PubMed

Rütten, Alfred; Abu-Omar, Karim; Gelius, Peter; Schow, Diana

2013-03-07

Despite the recent rapid development of policies to counteract physical inactivity (PI), only a small number of systematic analyses on the evolution of these policies exists. In this article we analyze how PI, as a public health issue, "translates" into a policy-making issue. First, we discuss why PI has become an increasingly important public health issue during the last two decades. We then follow Guy Peters and conceptualize PI as a "policy problem" that has the potential to be linked to policy instruments and policy impact. Analysis indicates that PI is a policy problem that i) is chronic in nature; ii) involves a high degree of political complexity; iii) can be disaggregated into smaller scales; iv) is addressed through interventions that can be difficult to "sell" to the public when their benefits are not highly divisible; v) cannot be solved by government spending alone; vi) must be addressed through a broad scope of activities; and vii) involves interdependencies among both multiple sectors and levels of government.We conclude that the new perspective on PI proposed in this article might be useful and important for i) describing and mapping policies to counteract PI in different contexts; ii) evaluating whether or not existing policy instruments are appropriate to the policy problem of PI, and iii) explaining the factors and processes that underlie policy development and implementation. More research is warranted in all these areas. In particular, we propose to focus on comparative analyses of how the problem of PI is defined and tackled in different contexts, and on the identification of truly effective policy instruments that are designed to "solve" the PI policy problem.

The Development, Implementation, and Evaluation of a Problem Solving Heuristic

ERIC Educational Resources Information Center

Lorenzo, Mercedes

2005-01-01

Problem-solving is one of the main goals in science teaching and is something many students find difficult. This research reports on the development, implementation and evaluation of a problem-solving heuristic. This heuristic intends to help students to understand the steps involved in problem solving (metacognitive tool), and to provide them…

[VDT worker's posture and workload in free-address office system].

PubMed

Iwakiri, Kazuyuki; Mori, Ippei; Sotoyama, Midori; Nose, Kaori; Ochiai, Takanori; Jonai, Hiroshi; Saito, Susumu

2006-01-01

A free-address system is a new office layout in which a worker can freely sit in their favorite place with a computer and materials. Since this layout has recently been introduced in offices, we conducted a questionnaire survey which aimed to clarify the effects of the free-address system on visual display terminals (VDT) workers' posture and workload. A total of 203 male VDT workers who were system engineers aged 20 to 59 using a notebook computer were evaluated, of whom 150 used the free-address layout, and 53 used the fixed-address layout. The free-address layout was effective in the improvement of individual work space compared with the fixed-address layout. Also, in this layout the worker did not feel dissatisfaction with communication or support between workers. However, workers using the free-address layout assumed an unsuitable work posture, without adjusting the height of their chairs. Furthermore, this layout might have risk factors which increase neck/shoulder and low back stiffness and/or pain. Therefore, the free-address layout may have incipient problems, and it will be necessary to examine further the effects of this layout on VDT worker's health.

The bright side of being blue: Depression as an adaptation for analyzing complex problems

PubMed Central

Andrews, Paul W.; Thomson, J. Anderson

2009-01-01

Depression ranks as the primary emotional problem for which help is sought. Depressed people often have severe, complex problems, and rumination is a common feature. Depressed people often believe that their ruminations give them insight into their problems, but clinicians often view depressive rumination as pathological because it is difficult to disrupt and interferes with the ability to concentrate on other things. Abundant evidence indicates that depressive rumination involves the analysis of episode-related problems. Because analysis is time consuming and requires sustained processing, disruption would interfere with problem-solving. The analytical rumination (AR) hypothesis proposes that depression is an adaptation that evolved as a response to complex problems and whose function is to minimize disruption of rumination and sustain analysis of complex problems. It accomplishes this by giving episode-related problems priority access to limited processing resources, by reducing the desire to engage in distracting activities (anhedonia), and by producing psychomotor changes that reduce exposure to distracting stimuli. Because processing resources are limited, the inability to concentrate on other things is a tradeoff that must be made to sustain analysis of the triggering problem. The AR hypothesis is supported by evidence from many levels, including genes, neurotransmitters and their receptors, neurophysiology, neuroanatomy, neuroenergetics, pharmacology, cognition and behavior, and the efficacy of treatments. In addition, we address and provide explanations for puzzling findings in the cognitive and behavioral genetics literatures on depression. In the process, we challenge the belief that serotonin transmission is low in depression. Finally, we discuss implications of the hypothesis for understanding and treating depression. PMID:19618990

Advancing efforts to address youth violence involvement.

PubMed

Weist, M D; Cooley-Quille, M

2001-06-01

Discusses the increased public attention on violence-related problems among youth and the concomitant increased diversity in research. Youth violence involvement is a complex construct that includes violence experienced in multiple settings (home, school, neighborhood) and in multiple forms (as victims, witnesses, perpetrators, and through family members, friends, and the media). Potential impacts of such violence involvement are considerable, including increased internalizing and externalizing behaviors among youth and future problems in school adjustment and life-course development. This introductory article reviews key dimensions of youth-related violence, describes an American Psychological Association Task Force (Division 12) developed to advance relevant research, and presents examples of national resources and efforts that attempt to address this critical public health issue.

Using vignettes to assess contributions to the work of addressing child mental health problems in primary care.

PubMed

Wissow, Lawrence S; Zafar, Waleed; Fothergill, Kate; Ruble, Anne; Slade, Eric

2016-01-22

To further efforts to integrate mental health and primary care, this study develops a novel approach to quantifying the amount and sources of work involved in shifting care for common mental health problems to pediatric primary care providers. Email/web-based survey of a convenience sample (n = 58) of Maryland pediatricians (77% female, 58% at their site 10 or more years; 44% in private practice, 52 % urban, 48 % practicing with a co-located mental health provider). Participants were asked to review 11 vignettes, which described primary care management of child/youth mental health problems, and rate them on an integer-based ordinal scale for the overall amount of work involved compared to a 12th reference vignette describing an uncomplicated case of ADHD. Respondents were also asked to indicate factors (time, effort, stress) accounting for their ratings. Vignettes presented combinations of three diagnoses (ADHD, anxiety, and depression) and three factors (medical co-morbidity, psychiatric co-morbidity, and difficult families) reported to complicate mental health care. The reference case was pre-assigned a work value of 2. Estimates of the relationship of diagnosis and complicating factors with workload were obtained using linear regression, with random effects at the respondent level. The 58 pediatricians gave 593 vignette responses. Depression was associated with a 1.09 unit (about 50%) increase in work (95% CL .94, 1.25), while anxiety did not differ significantly from the reference case of uncomplicated ADHD (p = .28). Although all three complicating factors increased work ratings compared with the reference case, family complexity and psychiatric co-morbidity did so the most (.87 and 1.07 units, respectively, P < .001) while medical co-morbidity increased it the least (.44 units, p < .001). Factors most strongly associated with increased overall work were physician time, physician mental effort, and stress; those least strongly associated were

Addressing substance abuse and violence in substance use disorder treatment and batterer intervention programs.

PubMed

Timko, Christine; Valenstein, Helen; Lin, Patricia Y; Moos, Rudolf H; Stuart, Gregory L; Cronkite, Ruth C

2012-09-07

Substance use disorders and perpetration of intimate partner violence (IPV) are interrelated, major public health problems. We surveyed directors of a sample of substance use disorder treatment programs (SUDPs; N=241) and batterer intervention programs (BIPs; N=235) in California (70% response rate) to examine the extent to which SUDPs address IPV, and BIPs address substance abuse. Generally, SUDPs were not addressing co-occurring IPV perpetration in a formal and comprehensive way. Few had a policy requiring assessment of potential clients, or monitoring of admitted clients, for violence perpetration; almost one-quarter did not admit potential clients who had perpetrated IPV, and only 20% had a component or track to address violence. About one-third suspended or terminated clients engaging in violence. The most common barriers to SUDPs providing IPV services were that violence prevention was not part of the program's mission, staff lacked training in violence, and the lack of reimbursement mechanisms for such services. In contrast, BIPs tended to address substance abuse in a more formal and comprehensive way; e.g., one-half had a policy requiring potential clients to be assessed, two-thirds required monitoring of substance abuse among admitted clients, and almost one-half had a component or track to address substance abuse. SUDPs had clients with fewer resources (marriage, employment, income, housing), and more severe problems (both alcohol and drug use disorders, dual substance use and other mental health disorders, HIV + status). We found little evidence that services are centralized for individuals with both substance abuse and violence problems, even though most SUDP and BIP directors agreed that help for both problems should be obtained simultaneously in separate programs. SUDPs may have difficulty addressing violence because they have a clientele with relatively few resources and more complex psychological and medical needs. However, policy change can modify

Students' and Teachers' Conceptual Metaphors for Mathematical Problem Solving

ERIC Educational Resources Information Center

Yee, Sean P.

2017-01-01

Metaphors are regularly used by mathematics teachers to relate difficult or complex concepts in classrooms. A complex topic of concern in mathematics education, and most STEM-based education classes, is problem solving. This study identified how students and teachers contextualize mathematical problem solving through their choice of metaphors.…

Incidence and predictors of difficult nasotracheal intubation with airway scope.

PubMed

Ono, Koyu; Goto, Tomoko; Nakai, Daishi; Ueki, Shuhei; Takenaka, Seiichiro; Moriya, Tomomi

2014-10-01

The airway scope (AWS) improves views of the larynx during orotracheal intubation. However, the role of the AWS in routine nasotracheal intubation has not been studied adequately. One hundred and three patients undergoing dental and maxillofacial surgery that required general anesthesia and nasotracheal intubation were enrolled. The study was approved by our Institution Review Board, and written informed consent was obtained from all patients. We evaluated the success rate of AWS intubation and the incidence of difficult nasotracheal intubation using a modified intubation difficulty scale (IDS) to examine preoperative characteristics and intubation profiles. Categories were difficult intubation (IDS ≥5), mildly difficult (IDS = 1-4), and intubation without difficulty (IDS = 0). We also assessed the incidence of the use of Magill forceps or cuff inflation (the cuff of endotracheal tube is inflated with 10-15 ml air) to guide the endotracheal tube into the glottis. AWS nasotracheal intubation was 100% successful. The cuff inflation technique was used in 37 patients. Neither Magill forceps nor other devices were needed for any patient during AWS use. The incidence of difficult nasotracheal intubation was 10% (n = 10). Of the patients, 61% (n = 63) had mildly difficult intubation and 29% (n = 30) had no difficulty. Patients with difficult intubation were more likely to be male and to have a larger tongue and a higher Cormack grade than in the other two groups. Complications, involving minor soft tissue injury, were observed in only 1 patient (1%). The AWS achieves a high success rate for nasotracheal intubation with cuff inflation in patients undergoing dental and maxillofacial surgery.

Incidence and predictors of difficult laryngoscopy in 11,219 pediatric anesthesia procedures.

PubMed

Heinrich, Sebastian; Birkholz, Torsten; Ihmsen, Harald; Irouschek, Andrea; Ackermann, Andreas; Schmidt, Joachim

2012-08-01

Difficult laryngoscopy in pediatric patients undergoing anesthesia. This retrospective analysis was conducted to investigate incidence and predictors of difficult laryngoscopy in a large cohort of pediatric patients receiving general anesthesia with endotracheal intubation. Young age and craniofacial dysmorphy are predictors for the difficult pediatric airway and difficult laryngoscopy. For difficult laryngoscopy, other general predictors are not yet described. Retrospectively, from a 5-year period, data from 11.219 general anesthesia procedures in pediatric patients with endotracheal intubation using age-adapted Macintosh blades in a single center (university hospital) were analyzed statistically. The overall incidence of difficult laryngoscopy [Cormack and Lehane (CML) grade III and IV] was 1.35%. In patients younger than 1 year, the incidence of CML III or IV was significantly higher than in the older patients (4.7% vs 0.7%). ASA Physical Status III and IV, a higher Mallampati Score (III and IV) and a low BMI were all associated (P < 0.05) with difficult laryngoscopy. Patients undergoing oromaxillofacial surgery and cardiac surgery showed a significantly higher rate of CML III/IV findings. The general incidence of difficult laryngoscopy in pediatric anesthesia is lower than in adults. Our results show that the risk of difficult laryngoscopy is much higher in patients below 1 year of age, in underweight patients and in ASA III and IV patients. The underlying disease might also contribute to the risk. If the Mallampati score could be obtained, prediction of difficult laryngoscopy seems to be reliable. Our data support the existing recommendations for a specialized anesthesiological team to provide safe anesthesia for infants and neonates. © 2012 Blackwell Publishing Ltd.

Education Technologies in Addressing the Problem of Forming the Socially Active Individual

ERIC Educational Resources Information Center

Popova, Irina N.

2016-01-01

The article is devoted to the analysis of technological support of the educational process in solving the problem of forming the socially active individual. The authors studied the value of the category "social activity" and analyzed educational technologies that have an impact on its formation. The obtained results gave the possibility…

TEMPERAMENT, FAMILY ENVIRONMENT, AND BEHAVIOR PROBLEMS IN CHILDREN WITH NEW-ONSET SEIZURES

PubMed Central

Baum, Katherine T.; Byars, Anna W.; deGrauw, Ton J.; Johnson, Cynthia S.; Perkins, Susan M.; Dunn, David W.; Bates, John E.; Austin, Joan K.

2007-01-01

Children with epilepsy, even those with new-onset seizures, exhibit relatively high rates of behavior problems. The purpose of this study was to explore the relationships among early temperament, family adaptive resources, and behavior problems in children with new-onset seizures. Our major goal was to test whether family adaptive resources moderated the relationship between early temperament dimensions and current behavior problems in 287 children with new-onset seizures. Two of the three temperament dimensions (difficultness and resistance to control) were positively correlated with total, internalizing, and externalizing behavior problems (all p < 0.0001). The third temperament dimension, unadaptability, was positively correlated with total and internalizing problems (p < 0.01). Family adaptive resources moderated the relationships between temperament and internalizing and externalizing behavior problems at school. Children with a difficult early temperament who live in a family environment with low family mastery are at the greatest risk for behavior problems. PMID:17267291

Evaluation of the Effectiveness of a Problem-Solving Intervention Addressing Barriers to Cardiovascular Disease Prevention Behaviors in 3 Underserved Populations: Colorado, North Carolina, West Virginia, 2009

PubMed Central

Bryant, Lucinda L.; Leary, Janie M.; Vu, Maihan B.; Hill-Briggs, Felicia; Samuel-Hodge, Carmen D.; McMilin, Colleen R.; Keyserling, Thomas C.

2014-01-01

Introduction In low-income and underserved populations, financial hardship and multiple competing roles and responsibilities lead to difficulties in lifestyle change for cardiovascular disease (CVD) prevention. To improve CVD prevention behaviors, we adapted, pilot-tested, and evaluated a problem-solving intervention designed to address barriers to lifestyle change. Methods The sample consisted of 81 participants from 3 underserved populations, including 28 Hispanic or non-Hispanic white women in a western community (site 1), 31 African-American women in a semirural southern community (site 2), and 22 adults in an Appalachian community (site 3). Incorporating focus group findings, we assessed a standardized intervention involving 6-to-8 week group sessions devoted to problem-solving in the fall of 2009. Results Most sessions were attended by 76.5% of participants, demonstrating participant adoption and engagement. The intervention resulted in significant improvement in problem-solving skills (P < .001) and perceived stress (P < .05). Diet, physical activity, and weight remained stable, although 72% of individuals reported maintenance or increase in daily fruit and vegetable intake, and 67% reported maintenance or increase in daily physical activity. Conclusion Study results suggest the intervention was acceptable to rural, underserved populations and effective in training them in problem-solving skills and stress management for CVD risk reduction. PMID:24602586

Addressing contrasting cognitive models in scientific collaboration

NASA Astrophysics Data System (ADS)

Diviacco, P.

2012-04-01

If the social aspects of scientific communities and their internal dynamics is starting to be recognized and acknowledged in the everyday lives of scientists, it is rather difficult for them to find tools that could support their activities consistently with this perspective. Issues span from gathering researchers to mutual awareness, from information sharing to building meaning, with the last one being particularly critical in research fields as the geo-sciences, that deal with the reconstruction of unique, often non-reproducible, and contingent processes. Reasoning here is, in fact, mainly abductive, allowing multiple and concurrent explanations for the same phenomenon to coexist. Scientists bias one hypothesis over another not only on strictly logical but also on sociological motivations. Following a vision, scientists tend to evolve and isolate themselves from other scientists creating communities characterized by different cognitive models, so that after some time these become incompatible and scientists stop understanding each other. We address these problems as a communication issue so that the classic distinction into three levels (syntactic, semantic and pragmatic) can be used. At the syntactic level, we highlight non-technical obstacles that condition interoperability and data availability and transparency. At the semantic level, possible incompatibilities of cognitive models are particularly evident, so that using ontologies, cross-domain reconciliation should be applied. This is a very difficult task to perform since the projection of knowledge by scientists, in the designated community, is political and thus can create a lot of tension. The strategy we propose to overcome these issues pertains to pragmatics, in the sense that it is intended to acknowledge the cultural and personal factors each partner brings into the collaboration and is based on the idea that meaning should remain a flexible and contingent representation of possibly divergent views

An integrated approach to addressing addiction and depression in college students.

PubMed

Eisen, Arri; Kushner, Howard; McLeod, Mark; Queen, Edward; Gordon, Jonathan; Ford, John L

2009-01-01

The authors present an integrated, interdisciplinary approach to address the problem of increasing student mental health issues on college campuses. The model uses addiction and depression as lenses into the problem and links residence life and academic and community internship experiences. The project has a positive impact on student attitudes and actions and strengthens and broadens the campus network required to ensure optimal student mental health.

[Correlation between obstructive apnea syndrome and difficult airway in ENT surgery].

PubMed

Pera, Marcia Hiray; Tardelli, Maria Angela; Novo, Neil Ferreira; Juliano, Yara; Silva, Helga Cristina Almeida da

2017-12-21

ENT patients with obstructive sleep apnea syndrome have a tendency of collapsing the upper airways in addition to anatomical obstacles. Obstructive sleep apnea syndrome is related to the increased risk of difficult airway and also increased perioperative complications. In order to identify these patients in the preoperative period, the STOP Bang questionnaire has been highlighted because it is summarized and easy to apply. Evaluate through the STOP Bang questionnaire whether patients undergoing ENT surgery with a diagnosis of obstructive sleep apnea syndrome have a higher risk of complications, particularly the occurrence of difficult airway. Measurements of anatomical parameters for difficult airway and questionnaire application for clinical prediction of obstructive sleep apnea syndrome were performed in 48 patients with a previous polysomnographic study. The sample detected difficult airway in about 18.7% of patients, all of them with obstructive sleep apnea syndrome. This group had older age, cervical circumference > 40cm, ASA II and Cormack III/IV. Patients with obstructive sleep apnea syndrome had higher body mass index, cervical circumference, and frequent apnea. In subgroup analysis, the group with severe obstructive sleep apnea syndrome showed a significantly higher SB score compared to patients without this syndrome or with a mild/moderate obstructive sleep apnea syndrome. The STOP Bang questionnaire was not able to predict difficult airway and mild obstructive sleep apnea syndrome, but it identified marked obstructive sleep apnea syndrome. All patients with difficult airway had moderate and marked obstructive sleep apnea syndrome, although this syndrome did not involve difficult airway. The variables Cormack III/IV and BMI greater than 35 Kg.m -2 were able to predict difficult airway and obstructive sleep apnea syndrome, respectively. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

THE FOREMAN PROBLEM IN JAPANESE INDUSTRY.

ERIC Educational Resources Information Center

THURLEY, KEITH

BRITAIN STUDIED SUPERVISORY TRAINING IN JAPAN, IN ORDER TO GAIN INSIGHT INTO ITS OWN TRAINING PROBLEMS. TRADITIONAL SUPERVISION IN JAPANESE INDUSTRY HAD PRODUCED INCAPABLE FOREMEN THROUGH SENIORITY PROMOTION, CAUSED DIFFICULT RELATIONSHIPS BECAUSE OF AUTHORITARIAN ATTITUDES, AND FAILED TO CLARIFY AUTHORITY ROLES. THE GOVERNMENT RECOMMENDED MORE…

Baccalaureate Student Perceptions of Challenging Family Problems: Building Bridges to Acceptance

ERIC Educational Resources Information Center

Floyd, Melissa; Gruber, Kenneth J.

2011-01-01

This study explored the attitudes of 147 undergraduate social work majors to working with difficult families. Students indicated which problems (from a list of 42, including hot topics such as homosexuality, transgender issues, abortion, and substance abuse) they believed they would find most difficult to work with and provided information…

Evolving neural networks for strategic decision-making problems.

PubMed

Kohl, Nate; Miikkulainen, Risto

2009-04-01

Evolution of neural networks, or neuroevolution, has been a successful approach to many low-level control problems such as pole balancing, vehicle control, and collision warning. However, certain types of problems-such as those involving strategic decision-making-have remained difficult for neuroevolution to solve. This paper evaluates the hypothesis that such problems are difficult because they are fractured: The correct action varies discontinuously as the agent moves from state to state. A method for measuring fracture using the concept of function variation is proposed and, based on this concept, two methods for dealing with fracture are examined: neurons with local receptive fields, and refinement based on a cascaded network architecture. Experiments in several benchmark domains are performed to evaluate how different levels of fracture affect the performance of neuroevolution methods, demonstrating that these two modifications improve performance significantly. These results form a promising starting point for expanding neuroevolution to strategic tasks.

[Partnership around difficult teenagers in Brest].

PubMed

Saint-André, Stéphane; Botbol, Michel

2013-01-01

The issues surrounding difficult teenagers results in professionals formalising a partnership. Certain areas of focus are identified such as getting to know each other better in order to understand each other better, working in a "common language", understanding professional identities, or embracing long term partnership. Pressure to assess and rationalise spending, as well as political challenges, must be taken into consideration.

Addressing multi-label imbalance problem of surgical tool detection using CNN.

PubMed

Sahu, Manish; Mukhopadhyay, Anirban; Szengel, Angelika; Zachow, Stefan

2017-06-01

A fully automated surgical tool detection framework is proposed for endoscopic video streams. State-of-the-art surgical tool detection methods rely on supervised one-vs-all or multi-class classification techniques, completely ignoring the co-occurrence relationship of the tools and the associated class imbalance. In this paper, we formulate tool detection as a multi-label classification task where tool co-occurrences are treated as separate classes. In addition, imbalance on tool co-occurrences is analyzed and stratification techniques are employed to address the imbalance during convolutional neural network (CNN) training. Moreover, temporal smoothing is introduced as an online post-processing step to enhance runtime prediction. Quantitative analysis is performed on the M2CAI16 tool detection dataset to highlight the importance of stratification, temporal smoothing and the overall framework for tool detection. The analysis on tool imbalance, backed by the empirical results, indicates the need and superiority of the proposed framework over state-of-the-art techniques.

Efforts to Empower Teachers in Ethiopia to Address Local Environmental Problems: Achievements and Limitations

ERIC Educational Resources Information Center

Dalelo, Aklilu

2009-01-01

It is believed that the possibilities of integrating environmental issues into the formal and nonformal education programs depend on the capacity of teachers who put such programs into effect. A pilot project, aimed at building the capacity of schools in Ethiopia to address key environmental issues, was initiated in 2004. Among the major…

Addressing parenting concerns of bone marrow transplant patients: opening (and closing) Pandora's box.

PubMed

Moore, C W; Rauch, P K

2006-12-01

Although a significant number of adults undergoing stem cell transplant (SCT) or bone marrow transplantation (BMT) care for dependent children, and these treatments pose significant challenges for families, research has virtually ignored the impact of parenting on patients' quality of life during BMT/SCT and children's responses to having a parent undergo these treatments. Physicians rarely inquire about parenting concerns related to the extended hospitalizations necessitated by these treatments, yet clinical experience suggests that addressing patient concerns about children's reactions to cancer and BMT/SCT can improve the experience of the patient and the patient's family, and help the medical team respond effectively to sources of patients' distress. Parents frequently want to know what reactions to expect from children, thus general developmental information is reviewed, and recommendations given for when professional help for children is warranted. A key way for parents to support their children is with open, honest communication; however, parents often find it extremely difficult to talk about cancer and BMT/SCT with their children. The medical team can assist patients' efforts to communicate with and support their children by asking about a patient's children, providing some targeted information, and discussing the potential impact of treatments on parenting capacity. Inquiring about and addressing parenting concerns may initially seem difficult, but can ultimately facilitate stronger doctor-patient alliances, and more compassionate care.

Can Innovation Save Gifted Education? 2010 NAGC Presidential Address

ERIC Educational Resources Information Center

Robinson, Ann

2012-01-01

Connecting innovation with gifted education is a necessity not only in the current political climate but also because it is a field with deeply held beliefs about the importance of problem solving, creativity, imagination, and invention--all critical components of innovation. In this address, the author focuses on three key ideas. First, she…

The difficult mountain: enriched composition in adjective–noun phrases

PubMed Central

Pickering, Martin J.; McElree, Brian

2012-01-01

When readers need to go beyond the straightforward compositional meaning of a sentence (i.e., when enriched composition is required), costly additional processing is the norm. However, this conclusion is based entirely on research that has looked at enriched composition between two phrases or within the verb phrase (e.g., the verb and its complement in … started the book …) where there is a discrepancy between the semantic expectations of the verb and the semantics of the noun. We carried out an eye-tracking experiment investigating enriched composition within a single noun phrase, as in the difficult mountain. As compared with adjective–noun phrases that allow a straightforward compositional interpretation (the difficult exercise), the coerced phrases were more difficult to process. These results indicate that coercion effects can be found in the absence of a typing violation and within a single noun phrase. PMID:21826403

Environmental problem solving

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

Miller, A.

Human influences create both environmental problems and barriers to effective policy aimed at addressing those problems. In effect, environmental managers manage people as much as they manage the environment. Therefore, they must gain an understanding of the psychological and sociopolitical dimensions of environmental problems that they are attempting to resolve. The author reappraises conventional analyses of environmental problems using lessons from the psychosocial disciplines. The author combines the disciplines of ecology, political sociology and psychology to produce a more adaptive approach to problem-solving that is specifically geared toward the environmental field. Numerous case studies demonstrate the practical application of theorymore » in a way that is useful to technical and scientific professionals as well as to policymakers and planners.« less

An overview of adaptive model theory: solving the problems of redundancy, resources, and nonlinear interactions in human movement control.

PubMed

Neilson, Peter D; Neilson, Megan D

2005-09-01

Adaptive model theory (AMT) is a computational theory that addresses the difficult control problem posed by the musculoskeletal system in interaction with the environment. It proposes that the nervous system creates motor maps and task-dependent synergies to solve the problems of redundancy and limited central resources. These lead to the adaptive formation of task-dependent feedback/feedforward controllers able to generate stable, noninteractive control and render nonlinear interactions unobservable in sensory-motor relationships. AMT offers a unified account of how the nervous system might achieve these solutions by forming internal models. This is presented as the design of a simulator consisting of neural adaptive filters based on cerebellar circuitry. It incorporates a new network module that adaptively models (in real time) nonlinear relationships between inputs with changing and uncertain spectral and amplitude probability density functions as is the case for sensory and motor signals.

75 FR 57006 - Addressing Policy and Logistical Challenges to Smart Grid Implementation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-17

... electric vehicles, photovoltaic cells, wind turbines, or inflexible nuclear plants? What approaches make... generation and electric vehicles into the electric system; detect and address equipment problems and outages...

Indirect addressing and load balancing for faster solution to Mandelbrot Set on SIMD architectures

NASA Technical Reports Server (NTRS)

Tomboulian, Sherryl

1989-01-01

SIMD computers with local indirect addressing allow programs to have queues and buffers, making certain kinds of problems much more efficient. Examined here are a class of problems characterized by computations on data points where the computation is identical, but the convergence rate is data dependent. Normally, in this situation, the algorithm time is governed by the maximum number of iterations required by each point. Using indirect addressing allows a processor to proceed to the next data point when it is done, reducing the overall number of iterations required to approach the mean convergence rate when a sufficiently large problem set is solved. Load balancing techniques can be applied for additional performance improvement. Simulations of this technique applied to solving Mandelbrot Sets indicate significant performance gains.

Co-evolution for Problem Simplification

NASA Technical Reports Server (NTRS)

Haith, Gary L.; Lohn, Jason D.; Cplombano, Silvano P.; Stassinopoulos, Dimitris

1999-01-01

This paper explores a co-evolutionary approach applicable to difficult problems with limited failure/success performance feedback. Like familiar "predator-prey" frameworks this algorithm evolves two populations of individuals - the solutions (predators) and the problems (prey). The approach extends previous work by rewarding only the problems that match their difficulty to the level of solut,ion competence. In complex problem domains with limited feedback, this "tractability constraint" helps provide an adaptive fitness gradient that, effectively differentiates the candidate solutions. The algorithm generates selective pressure toward the evolution of increasingly competent solutions by rewarding solution generality and uniqueness and problem tractability and difficulty. Relative (inverse-fitness) and absolute (static objective function) approaches to evaluating problem difficulty are explored and discussed. On a simple control task, this co-evolutionary algorithm was found to have significant advantages over a genetic algorithm with either a static fitness function or a fitness function that changes on a hand-tuned schedule.

Does ego development increase during midlife? The effects of openness and accommodative processing of difficult events.

PubMed

Lilgendahl, Jennifer Pals; Helson, Ravenna; John, Oliver P

2013-08-01

Although Loevinger's model of ego development is a theory of personality growth, there are few studies that have examined age-related change in ego level over developmentally significant periods of adulthood. To address this gap in the literature, we examined mean-level change and individual differences in change in ego level over 18 years of midlife. In this longitudinal study, participants were 79 predominantly White, college-educated women who completed the Washington University Sentence Completion Test in early (age 43) and late (age 61) midlife as well as measures of the trait of Openness (ages 21, 43, 52, and 61) and accommodative processing (assessed from narratives of difficult life events at age 52). As hypothesized, the sample overall showed a mean-level increase in ego level from age 43 to age 61. Additionally, a regression analysis showed that both the trait of Openness at age 21 and accommodative processing of difficult events that occurred during (as opposed to prior to) midlife were each predictive of increasing ego level from age 43 to age 61. These findings counter prior claims that ego level remains stable during adulthood and contribute to our understanding of the underlying processes involved in personality growth in midlife. © 2012 Wiley Periodicals, Inc.

How Schools Address Students' Mental Health and Drug and Alcohol Concerns and Problems: Lessons from Student Assistance Programs

ERIC Educational Resources Information Center

Fertman, Carl I.; Tarasevich, Susan L.

2004-01-01

Conversations with school superintendents, board members, principals, teachers, counselors, and nurses about their students' social and emotional health show how actively they are working to help students confront difficult issues. Topping the list of issues are drug and alcohol use and abuse, depression, and violence among students. Equally…

Communicating Difficult and Taboo Information: A How-To Guide for Commanders.

PubMed

Moosey, Matthew

2016-01-01

Military commanders frequently mention that communicating difficult or taboo information is especially challenging. In the context of gender-integrated ground combat service there may be additional communication challenges for military commanders who may be unaccustomed to leading both men and women. Often, military commanders must communicate and deliver difficult information, or information that causes a negative emotional response from the communicator or the intended audience. This article is intended to identify some of these challenges and present practical examples and tips for military commanders to effectively communicate difficult or taboo topics and information. In addition, this article is a call for communication experts to reach out to military leaders and offer appropriate assistance in facilitating and delivering difficult communication. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Procedural versus Content-Related Hints for Word Problem Solving: An Exploratory Study

ERIC Educational Resources Information Center

Kock, W. D.; Harskamp, E. G.

2016-01-01

For primary school students, mathematical word problems are often more difficult to solve than straightforward number problems. Word problems require reading and analysis skills, and in order to explain their situational contexts, the proper mathematical knowledge and number operations have to be selected. To improve students' ability in solving…

Explaining Difficult Ideas: Spotting, Tackling, and Rendering Them Sensible for Lay Readers.

ERIC Educational Resources Information Center

Rowan, Katherine E.

1990-01-01

Offers a definition of explanatory text, and summarizes research on why abstract concepts and principles are difficult for lay readers to understand. Describes a three-week unit for composition classes on spotting difficult ideas, diagnosing the type of difficulty they pose, and selecting the text features most likely to make them less difficult.…

Problem Solving on a Monorail.

ERIC Educational Resources Information Center

Barrow, Lloyd H.; And Others

1994-01-01

This activity was created to address a lack of problem-solving activities for elementary children. A "monorail" activity from the Evening Science Program for K-3 Students and Parents program is presented to illustrate the problem-solving format. Designed for performance at stations by groups of two students. (LZ)

Employee assistance programs: a workplace resource to address intimate partner violence.

PubMed

Pollack, Keshia M; Austin, Whitney; Grisso, Jeane Ann

2010-04-01

Intimate partner violence (IPV) is a major public health problem with significant impact on the workplace. Employee assistance programs (EAPs) are a confidential benefit to assist employees and their families with a variety of problems that may negatively affect their job performance. The purpose of this systematic review is to study the extant literature to identify articles that have explored the role of EAPs in addressing IPV. We searched Medline, PsychINFO, and Cumulative Index of Nursing and Allied Health Literature (CINAHL) for English-language papers that have explored how EAPs can address IPV. Articles published through 2008 were included. Our review yielded nine articles, mostly from EAP-centered journals. Nearly all of the studies were published before the year 2000 and primarily describe the need for EAPs to be more engaged in preventing violence against women. Most of the studies were commentaries, often using case reports to support recommendations on how EAPs could address IPV. Results from the two intervention studies revealed close connections between EAP clients being treated for alcoholism and IPV perpetration and the effectiveness of a standardized tool to identify EAP clients experiencing IPV. Research in this area is in its infancy, and more studies are needed to inform the formulation of evidence-based policies and programs that guide the role of EAPs in addressing IPV. The lack of research on how EAPs address IPV is alarming, as many employers state that they often refer employees affected by IPV to the EAP for assistance.

Doing Science that Matters to Address India's Water Crisis.

NASA Astrophysics Data System (ADS)

Srinivasan, V.

2017-12-01

Addressing water security in developing regions involves predicting water availability under unprecedented rates of population and economic growth. India is one of the most water stressed countries in the world. Despite appreciable increases in funding for water research, high quality science that is usable by stakeholders remains elusive. The absence of usable research, has been driven by notions of what is publishable in the developed world. This can be attributed to the absence of problem driven research on questions that actually matter to stakeholders, unwillingness to transcend disciplinary boundaries and the demise of a field-work research culture in favour of computer simulation. Yet the combination of rapid change, inadequate data and human modifications to watersheds poses a challenge, as researchers face a poorly constrained water resources modelling problem. Instead, what India and indeed all developing regions need is to approach the problem from first principles, identifying the most critical knowledge gaps, then prioritizing data collection using novel sensing and modelling approaches to address them. This might also necessitate consideration of underlying social and governance drivers of hydrologic change. Using examples from research in the Cauvery Basin, a highly contentious inter-state river basin, I offer some insights into framing "use-inspired" research agenda and show how the research generates not just new scientific insights but may be translated into practice.

Addressing sleep disturbances: An opportunity to prevent cardiometabolic disease?

PubMed Central

GRANDNER, MICHAEL A.

2014-01-01

There is increasing awareness of the role of sleep disturbance as an important factor in health and disease. Although subclinical sleep disturbances (insufficient sleep duration or inadequate sleep quality) may be difficult to assess with conceptual and/or methodological clarity, this review attempts to summarize and synthesize these findings. First, the concept of sleep disturbance in a public health context is introduced, to provide context and rationale. Second, operational definitions of ‘cardiometabolic disease’ and ‘sleep disturbance’ are offered, to address many unclear operationalizations. Third, the extant literature is summarized regarding short or long sleep duration and/or insufficient sleep, insomnia and insomnia symptoms, general (non-specific sleep disturbances), circadian rhythm abnormalities that result in sleep disturbances, and, briefly, sleep-disordered breathing. Fourth, the review highlights the social/behavioural context of sleep, including discussions of sleep and race/ethnicity, socio-economic position, and other social/environmental factors, in order to place these findings in a social-environmental context relevant to public health. Fifth, the review highlights the issue of sleep as a domain of health behaviour and addresses issues regarding development of healthy sleep interventions. Finally, a research agenda of future directions is proposed. PMID:24892892

The Efficacy of Using Diagrams When Solving Probability Word Problems in College

ERIC Educational Resources Information Center

Beitzel, Brian D.; Staley, Richard K.

2015-01-01

Previous experiments have shown a deleterious effect of visual representations on college students' ability to solve total- and joint-probability word problems. The present experiments used conditional-probability problems, known to be more difficult than total- and joint-probability problems. The diagram group was instructed in how to use tree…

Challenges in an Aging Society: Presidential Address to APPAM

ERIC Educational Resources Information Center

Swartz, Katherine

2010-01-01

The United States is at a critical crossroads in its history right now. The public policy problems that the people are facing are complex and interrelated, and the demographic changes that are about to significantly change their country are not well understood by large numbers of people. In this presidential address to the Association for Public…

Questions That Science Teachers Find Difficult (II).

ERIC Educational Resources Information Center

Goodwin, Alan

2003-01-01

Presents some questions that science teachers find difficult. Focuses on three further questions relating to "simple" everyday situations that are normally explained in terms of the kinetic theory of matter. Identifies looking at the difference between chemical and physical changes as the most problematic question. (Author/YDS)

A Case Study of Team-Initiated Problem Solving Addressing Student Behavior in One Elementary School

ERIC Educational Resources Information Center

Todd, Anne W.; Horner, Robert H.; Berry, Dorothy; Sanders, Carol; Bugni, Michelle; Currier, Allison; Potts, Nicky; Newton, J. Stephen; Algozzine, Bob; Algozzine, Kate

2012-01-01

Team-Initiated Problem Solving (TIPS) is an approach for organizing school team meetings to improve identification of targeted problems, use of data in the development of solutions, and development of implemented action plans. TIPS has been demonstrated in single-case and randomized controlled trial studies to improve the effectiveness of teams to…

Could HPS Improve Problem-Solving?

ERIC Educational Resources Information Center

Coelho, Ricardo Lopes

2013-01-01

It is generally accepted nowadays that History and Philosophy of Science (HPS) is useful in understanding scientific concepts, theories and even some experiments. Problem-solving strategies are a significant topic, since students' careers depend on their skill to solve problems. These are the reasons for addressing the question of whether problem…

Merox catalyst innovation solves difficult kerosene treating problems

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

Verachtert, T.A.; Salazar, J.R.; Staehle, B.E.

1985-03-01

The UOP* Merox* process has enjoyed more than 25 years of successful commercial application. It is applied to treatment of mercaptanrich hydrocarbon streams ranging from a light gas to liquids as heavy as 350/sup 0/C (650/sup 0/F) endpoint diesel fuel. Although Merox has been applied successfully to many kerosenes, there are kerosenes from certain crudes that could not be treated using the standard Merox system. Recent UOP Merox research has centered on the development of new catalysts. From this research, an improved catalyst system (Merox 10*) for kerosene treatment now makes the Merox process applicable to the sweetening of anymore » kerosene boiling range material from any crude oil source now in production. This Merox catalyst innovation also could replace the more expensive hydrotreating still being used by refiners for reducing the mercaptan content of distillates. This paper discusses the application of the Merox process to the treatment of higher boiling fuels, particularly kerosene and jet fuel; however, it should be understood that the treatment of illuminating kerosene, stove oil, diesel fuel, and light furnace oil is quite similar although generally less complicated. Comparative economics and commercial data are provided for the Merox 10 and conventional fixed bed Merox systems. The well established superior economics of Merox over an equivalent duty hydrotreater are presented.« less

SGR reform and nephrology: difficult problems, potential solutions.

PubMed

Velez, Ruben; Singer, Dale; Blaser, Robert

2012-09-01

In light of the massive uncertainty with both the federal government in general and health policy priorities specifically, it is probably constructive to focus on the things we know for sure. In Medicare Part B reimbursement, the SGR system is fundamentally flawed, and must be replaced. All of Congress has recognized this fact, and there is legislation in the House that would move the ball forward on SGR repeal and replacement. Likewise, coordinated care models like ACOs offer a logical process for achieving a triple aim: improving individual health care, improving population health, and promoting cost efficiency in health care. Hopefully, policy makers in Washington will recognize and act on these truths as well.

The Problem Solving Studio: An Apprenticeship Environment for Aspiring Engineers

ERIC Educational Resources Information Center

Le Doux, Joseph M.; Waller, Alisha A.

2016-01-01

This paper describes the problem-solving studio (PSS) learning environment. PSS was designed to teach students how to solve difficult analytical engineering problems without resorting to rote memorization of algorithms, while at the same time developing their deep conceptual understanding of the course topics. There are several key features of…

New Perspectives on Human Problem Solving

ERIC Educational Resources Information Center

Goldstone, Robert L.; Pizlo, Zygmunt

2009-01-01

In November 2008 at Purdue University, the 2nd Workshop on Human Problem Solving was held. This workshop, which was a natural continuation of the first workshop devoted almost exclusively to optimization problems, addressed a wider range of topics that reflect the scope of the "Journal of Problem Solving." The workshop was attended by 35…

Fatigue in hospital nurses - 'Supernurse' culture is a barrier to addressing problems: A qualitative interview study.

PubMed

Steege, Linsey M; Rainbow, Jessica G

2017-02-01

Fatigue in hospital nurses is associated with decreased nurse satisfaction, increased turnover and negative patient outcomes. Addressing fatigue in nurses has been identified as a priority by many organizations worldwide in an effort to promote both a culture of patient safety and a healthy nursing workforce. The overall aim of this study was to explore barriers and facilitators within the hospital nurse work system to nurse coping and fatigue. The purpose of this paper is to describe emergent themes that offer new insight describing the relationships among nurse perceptions of fatigue, nursing professional culture, and implications for the nursing workforce. A qualitative exploratory study was used to explore nurse identified sources, barriers to addressing, and consequences of fatigue. Twenty-two nurses working in intensive care and medical-surgical units within a large academic medical center in the United States participated in the interviews. Interviews with the participants followed a semi-structured interview guide that included questions eliciting participants' views on nurse fatigue levels, consequences of fatigue, and barriers to addressing fatigue. The interview transcripts were analyzed using directed content analysis guided by the Systems Engineering Initiative for Patient Safety (SEIPS) model. Additional themes that did not directly align with the SEIPS model were also identified. All nurses in the current study experienced fatigue; yet they had varying perspectives on the importance of addressing fatigue in relation to other health systems challenges. A new construct related to nursing professional culture was identified and defined as "Supernurse". Identified subthemes of Supernurse include: extraordinary powers used for good; cloak of invulnerability; no sidekick; Kryptonite, and an alterego. These values, beliefs, and behaviors define the specific aspects of nursing professional culture that can act as barriers to fatigue risk management programs

Disruption of Alluvial Fan Processes in a Cascade Range Stream, and Attempts to Address the Resulting Problems...

NASA Astrophysics Data System (ADS)

DeVries, P.

2016-12-01

Alluvial fan processes have been altered in two ways on Mouse Creek, tributary of the Sauk River, WA. A county road and low profile bridge were built in the vicinity of a large scale break in slope, and a berm was built upstream along one bank to confine flows. The system has a high sediment load from episodic mass wasting upstream. Over 10 years of survey data and analyses provide a case study of aggradation, flooding, and avulsion processes above the road crossing, and of efforts to address the resulting problems. The berm precluded fan deposition upstream, and appears to have shifted the deposition zone downstream closer to the bridge, leading to an avulsion and impacting upstream migration of salmon to spawning habitat. In addition, the bed elevation of the channel is now higher than the historic fan surface on the other side of the berm. The bridge was raised to reduce the road crossing influence on sediment transport and deposition, which worked for a while locally until the avulsion developed, which accelerated aggradation in the former main channel above the bridge. Plans have been developed for removing the berm and allowing the stream to re-engage its fan. The key design question presently is: should the berm be excavated to its toe on the channel side to accelerate restoration of depositional processes, or should a semblance of bankfull morphology be retained?

Pharmacotherapeutic approaches for treating psoriasis in difficult-to-treat areas.

PubMed

Kivelevitch, Dario; Frieder, Jillian; Watson, Ian; Paek, So Yeon; Menter, M Alan

2018-04-01

Despite great therapeutic advancements in psoriasis, four notable difficult-to-treat areas including the scalp, nails, intertriginous (including genitals), and palmoplantar regions, pose a challenge to both physicians and patients. Localized disease of these specific body regions inflicts a significant burden on patients' quality of life and requires an adequate selection of treatments. Areas covered: This manuscript discusses appropriate therapies and important treatment considerations for these difficult-to-treat areas based on the available clinical data from the literature. Expert opinion: Clinical trials assessing therapies for the difficult-to-treat areas have been inadequate. With the first biological clinical trial for genital psoriasis pending publication, it is with hope that other biological agents will be evaluated for region-specific psoriasis. A greater understanding of the genetic and immunologic aspects of regional psoriasis, as well as identification of unique biomarkers, will further guide management decisions. For example, the recent discovery of the IL-36 receptor gene for generalized pustular psoriasis may prove valuable for other forms of psoriasis. Ultimately, identification of the most beneficial treatments for each psoriasis subtype and difficult-to-treat area will provide patients with maximal quality of life.

Wireless Sensor Networks - Node Localization for Various Industry Problems

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

Derr, Kurt; Manic, Milos

Fast, effective monitoring following airborne releases of toxic substances is critical to mitigate risks to threatened population areas. Wireless sensor nodes at fixed predetermined locations may monitor such airborne releases and provide early warnings to the public. A challenging algorithmic problem is determining the locations to place these sensor nodes while meeting several criteria: 1) provide complete coverage of the domain, and 2) create a topology with problem dependent node densities, while 3) minimizing the number of sensor nodes. This manuscript presents a novel approach to determining optimal sensor placement, Advancing Front mEsh generation with Constrained dElaunay Triangulation and Smoothingmore » (AFECETS) that addresses these criteria. A unique aspect of AFECETS is the ability to determine wireless sensor node locations for areas of high interest (hospitals, schools, high population density areas) that require higher density of nodes for monitoring environmental conditions, a feature that is difficult to find in other research work. The AFECETS algorithm was tested on several arbitrary shaped domains. AFECETS simulation results show that the algorithm 1) provides significant reduction in the number of nodes, in some cases over 40%, compared to an advancing front mesh generation algorithm, 2) maintains and improves optimal spacing between nodes, and 3) produces simulation run times suitable for real-time applications.« less

Wireless Sensor Networks - Node Localization for Various Industry Problems

DOE PAGES

Derr, Kurt; Manic, Milos

2015-06-01

Fast, effective monitoring following airborne releases of toxic substances is critical to mitigate risks to threatened population areas. Wireless sensor nodes at fixed predetermined locations may monitor such airborne releases and provide early warnings to the public. A challenging algorithmic problem is determining the locations to place these sensor nodes while meeting several criteria: 1) provide complete coverage of the domain, and 2) create a topology with problem dependent node densities, while 3) minimizing the number of sensor nodes. This manuscript presents a novel approach to determining optimal sensor placement, Advancing Front mEsh generation with Constrained dElaunay Triangulation and Smoothingmore » (AFECETS) that addresses these criteria. A unique aspect of AFECETS is the ability to determine wireless sensor node locations for areas of high interest (hospitals, schools, high population density areas) that require higher density of nodes for monitoring environmental conditions, a feature that is difficult to find in other research work. The AFECETS algorithm was tested on several arbitrary shaped domains. AFECETS simulation results show that the algorithm 1) provides significant reduction in the number of nodes, in some cases over 40%, compared to an advancing front mesh generation algorithm, 2) maintains and improves optimal spacing between nodes, and 3) produces simulation run times suitable for real-time applications.« less

Addressing Disruptive Behaviors in an after School Program Classroom: The Effects of the Daily Behavior Report Card

ERIC Educational Resources Information Center

McCorvey, Zamecia J.

2013-01-01

There is a need to address behavior discipline problems in special and general education setting classrooms. Disruptive behaviors are a major concern as they create excessive stress and demands for classroom teachers and school administrators to address them. Effective interventions are needed to properly address them. Moreover, classroom…

The Interference of Stereotype Threat with Women's Generation of Mathematical Problem-Solving Strategies.

ERIC Educational Resources Information Center

Quinn, Diane M.; Spencer, Steven J.

2001-01-01

Investigated whether stereotype threat would depress college women's math performance. In one test, men outperformed women when solving word problems, though women performed equally when problems were converted into numerical equivalents. In another test, participants solved difficult problems in high or reduced stereotype threat conditions. Women…

What's Difficult about Chemistry? An Irish Perspective

ERIC Educational Resources Information Center

Childs, Peter E.; Sheehan, Maria

2009-01-01

This semi-longitudinal investigation identified the chemistry topics that the majority of Irish chemistry pupils/students find difficult, from Junior Certificate level (age 15/16 years) right the way through to University level (age 18+). Pupils/students completed a five point, Likert-type questionnaire listing the topics covered in the different…

Fast and Efficient Discrimination of Traveling Salesperson Problem Stimulus Difficulty

ERIC Educational Resources Information Center

Dry, Matthew J.; Fontaine, Elizabeth L.

2014-01-01

The Traveling Salesperson Problem (TSP) is a computationally difficult combinatorial optimization problem. In spite of its relative difficulty, human solvers are able to generate close-to-optimal solutions in a close-to-linear time frame, and it has been suggested that this is due to the visual system's inherent sensitivity to certain geometric…

New and Emerging Problems in School Adminstration.

ERIC Educational Resources Information Center

TenHaken, Richard E.

This paper examines a number of problems facing school board members and educational administrators today and suggests some possible approaches to addressing those problems effectively. In considering each problem area, the author emphasizes its impact on the activities and responsibilities of school officials and discusses concrete steps they can…

Addressing Cultural and Native Language Interference in Second Language Acquisition

ERIC Educational Resources Information Center

Allard, Daniele; Bourdeau, Jacqueline; Mizoguchi, Riichiro

2011-01-01

This paper addresses the problem of cultural and native language interference in second/foreign language acquisition. More specifically, it examines issues of interference that can be traced to a student's native language and that also have a cultural component. To this effect, an understanding of what actually comprises both interference and…

Psychiatrists' relationships with industry: the principal-agent problem.

PubMed

Appelbaum, Paul S; Gold, Azgad

2010-01-01

Psychiatrists' relationships with the pharmaceutical and device industries have been a growing focus of attention, with questions raised about the impact of those relationships on prescribing practices, diagnostic criteria, practice guidelines, continuing education, conduct and reporting of research, and patients' and public trust. Indeed, these concerns exist for the medical profession as a whole, with various remedial measures proposed. We suggest that such relationships can be understood as giving rise to a "principal-agent problem," which occurs when an agent (here, a physician) is engaged to advance the interests of another party, the principal (typically a patient), but also faces incentives to promote other interests. Studies suggest that at least some relationships--which include attending industry-sponsored presentations, meeting with marketing representatives, and accepting samples--can alter psychiatrists' and other physicians' behavior in ways that can compromise patients' interests, and that industry-funded research may create bias in the medical literature. These effects are difficult to detect in specific cases, however, because of asymmetries of information and may not be apparent even to physicians themselves. Principal-agent analysis suggests that the possible responses to such problems, including appeals to ethical principles, monitoring behavior, and managing risk-inducing situations, should include consideration of aligning agents' incentives with principals' interests. This type of analysis underscores the similarity of the issues raised by physicians' relationships with industry to problems that arise more generally in society, thus reducing physicians' potential affective responses to these issues and efforts to address them. Finally, such analysis directs attention to the benefits and costs of each alternative, thereby encouraging reliance on evidence as a basis for policy.

High levels of IGF-1 predict difficult intubation of patients with acromegaly.

PubMed

Zhang, Yu; Guo, Xiaopeng; Pei, Lijian; Zhang, Zhuhua; Tan, Gang; Xing, Bing

2017-08-01

To investigate the characteristics of difficult intubation and identify novel efficient predictors in patients with acromegaly. Patients with either untreated acromegaly or non-functional pituitary adenomas were enrolled. Patients with acromegaly underwent hormone assays, upper airway computed tomography and magnetic resonance imaging examinations and preoperative overnight polysomnography. The modified Mallampati classification, mouth opening, neck circumference, and neck extension were assessed, and the Cormack-Lehane grades and the time of tracheal intubation were recorded. Patients with acromegaly had a higher incidence of difficult intubation (62.5%). The time of tracheal intubation was prolonged, the neck circumference was enlarged, and the neck extension was confined. In patients with acromegaly and difficult intubation, the insulin-like growth factor 1 levels and apnea/hypoxia index were significantly higher compared to patients without difficult intubation (1115.40 ± 253.73 vs. 791.67 ± 206.62 ng/ml, P = 0.020; 22.17 ± 23.25 vs. 2.47 ± 2.84, P = 0.026, respectively). The bilateral regression analysis revealed that high levels of insulin-like growth factor 1 were an independent risk factor for developing difficult intubation (p = 0.042, Exp B = 1.006). The modified Mallampati classification was positively correlated with apnea/hypoxia index and could be calculated using the following logarithmic equation: MMC = 0.2982 * ln (AHI) + 2.1836. In patients with acromegaly, neck movement is confined, the time of tracheal intubation is prolonged, and the neck circumference is enlarged, and these patients suffer from an increased incidence of difficult intubation (62.5%) during anesthesia induction. The apnea/hypoxia index and insulin-like growth factor 1 levels are both increased in acromegalic patients with difficult intubation, and elevated insulin-like growth factor 1 levels are an independent risk factor of difficult

Solving Constraint Satisfaction Problems with Networks of Spiking Neurons

PubMed Central

Jonke, Zeno; Habenschuss, Stefan; Maass, Wolfgang

2016-01-01

Network of neurons in the brain apply—unlike processors in our current generation of computer hardware—an event-based processing strategy, where short pulses (spikes) are emitted sparsely by neurons to signal the occurrence of an event at a particular point in time. Such spike-based computations promise to be substantially more power-efficient than traditional clocked processing schemes. However, it turns out to be surprisingly difficult to design networks of spiking neurons that can solve difficult computational problems on the level of single spikes, rather than rates of spikes. We present here a new method for designing networks of spiking neurons via an energy function. Furthermore, we show how the energy function of a network of stochastically firing neurons can be shaped in a transparent manner by composing the networks of simple stereotypical network motifs. We show that this design approach enables networks of spiking neurons to produce approximate solutions to difficult (NP-hard) constraint satisfaction problems from the domains of planning/optimization and verification/logical inference. The resulting networks employ noise as a computational resource. Nevertheless, the timing of spikes plays an essential role in their computations. Furthermore, networks of spiking neurons carry out for the Traveling Salesman Problem a more efficient stochastic search for good solutions compared with stochastic artificial neural networks (Boltzmann machines) and Gibbs sampling. PMID:27065785

Using Predictor-Corrector Methods in Numerical Solutions to Mathematical Problems of Motion

ERIC Educational Resources Information Center

Lewis, Jerome

2005-01-01

In this paper, the author looks at some classic problems in mathematics that involve motion in the plane. Many case problems like these are difficult and beyond the mathematical skills of most undergraduates, but computational approaches often require less insight into the subtleties of the problems and can be used to obtain reliable solutions.…

Teaching Water: Connecting across Disciplines and into Daily Life to Address Complex Societal Issues

ERIC Educational Resources Information Center

Eisen, Arri; Hall, Anne; Lee, Tong Soon; Zupko, Jack

2009-01-01

A central problem in higher education is how to best develop in students interdisciplinary thinking and application skills necessary to work and engage effectively in the twenty-first century. Traditional university structures make addressing this problem especially challenging. Using as a model courses with diverse perspectives on water taught by…

Addressing the Academic and Social Needs of Young Male Students through School-Based Mentoring

ERIC Educational Resources Information Center

Alston, Curtis E.

2013-01-01

This study addressed the problem within the U.S. public school system to sustainably meet the academic and social needs of its African American male students. The administrative team of the elementary school in this study desired an evaluation of a school-based male mentoring program that was designed to address these needs. The program, Gentlemen…

SEMINAR PUBLICATION: MANAGING ENVIRONMENTAL PROBLEMS AT INACTIVE AND ABANDONED METALS MINE SITES

EPA Science Inventory

Environmental problems associated with abandoned and inactive mines are addressed along with some approaches to resolving those problems, including case studies demonstrating technologies that have worked. New technologies being investigated are addressed also.

Analysis of Arguments Constructed by First-Year Engineering Students Addressing Electromagnetic Induction Problems

ERIC Educational Resources Information Center

Almudi, Jose Manuel; Ceberio, Mikel

2015-01-01

This study explored the quality of arguments used by first-year engineering university students enrolled in a traditional physics course dealing with electromagnetic induction and related problem solving where they had to assess whether the electromagnetic induction phenomenon would occur. Their conclusions were analyzed for the relevance of the…

Preventing musculoskeletal disorders in clinical dentistry: strategies to address the mechanisms leading to musculoskeletal disorders.

PubMed

Valachi, Bethany; Valachi, Keith

2003-12-01

The authors reviewed studies to identify methods for dental operators to use to prevent the development of musculoskeletal disorders, or MSDs. The authors reviewed studies that related to the prevention of MSDs among dental operators. Some studies investigated the relationship between the biomechanics of seated working postures and physiological damage or pain. Other studies suggested that repeated unidirectional twisting of the trunk can lead to low back pain, while yet other studies examined the detrimental effects of working in one position for prolonged periods. Additional studies confirmed the roles that operators' flexibility and core strength can play in balanced musculoskeletal health and the need for operators to know how to properly adjust ergonomic equipment. This review indicates that strategies to prevent the multifactorial problem of dental operators' developing MSDs exist. These strategies address deficiencies in operator position, posture, flexibility, strength and ergonomics. Education and additional research are needed to promote an understanding of the complexity of the problem and to address the problem's multifactorial nature. A comprehensive approach to address the problem of MSDs in dentistry represents a paradigm shift in how operators work. New educational models that incorporate a multifactorial approach can be developed to help dental operators manage and prevent MSDs effectively.

[Analysis of difficult problems on European Union laws and regulations of traditional herbal medicinal products].

PubMed

Qu, Li-Ping; Zhang, Xiao-Qun; Xiong, Yan; Wang, Yi-Tao; Zou, Wen-Jun

2017-10-01

Registration of Chinese patent medicine in European Union (EU) is of great significance to the internationalization of traditional Chinese medicine as EU market acts as an important position in the global botanical market. In retrospect, the domestic studies on EU regulations of traditional herbal medicinal products have been conducted for more than 10 years, but there is still some cognitive bias and lack of research. In this paper, a review of the relevant research progress and the main misunderstanding problems about Directive 2004/24/EC, like the centralized and decentralized supervision system of traditional herbal medicinal products in the EU, marketing authorization procedures for traditional herbal medicinal products, Community Herbal Monograph and List Entries, would be systematically analyzed, so as to provide reference for the registration of Chinese patent medicine in EU. Copyright© by the Chinese Pharmaceutical Association.

Some Legal Problems of Satellite Transmission.

ERIC Educational Resources Information Center

Siebert, Fred S.

Now that the technical aspects of satellite transmission have been solved, there remain the more complex and difficult problems of maintaining both order in outer space and the rights of nations and individuals as these rights may be affected by broadcasts transmitted by satellite stations. These broadcasts, whether beamed to a ground station or…

Endoscopic management of difficult common bile duct stones

PubMed Central

Trikudanathan, Guru; Navaneethan, Udayakumar; Parsi, Mansour A

2013-01-01

Endoscopy is widely accepted as the first treatment option in the management of bile duct stones. In this review we focus on the alternative endoscopic modalities for the management of difficult common bile duct stones. Most biliary stones can be removed with an extraction balloon, extraction basket or mechanical lithotripsy after endoscopic sphincterotomy. Endoscopic papillary balloon dilation with or without endoscopic sphincterotomy or mechanical lithotripsy has been shown to be effective for management of difficult to remove bile duct stones in selected patients. Ductal clearance can be safely achieved with peroral cholangioscopy guided laser or electrohydraulic lithotripsy in most cases where other endoscopic treatment modalities have failed. Biliary stenting may be an alternative treatment option for frail and elderly patients or those with serious co morbidities. PMID:23345939

Concussion treatment after combat trauma: development of a telephone based, problem solving intervention for service members.

PubMed

Bell, Kathleen R; Brockway, Jo Ann; Fann, Jesse R; Cole, Wesley R; St De Lore, Jef; Bush, Nigel; Lang, Ariel J; Hart, Tessa; Warren, Michael; Dikmen, Sureyya; Temkin, Nancy; Jain, Sonia; Raman, Rema; Stein, Murray B

2015-01-01

Military service members (SMs) and veterans who sustain mild traumatic brain injuries (mTBI) during combat deployments often have co-morbid conditions but are reluctant to seek out therapy in medical or mental health settings. Efficacious methods of intervention that are patient-centered and adaptable to a mobile and often difficult-to-reach population would be useful in improving quality of life. This article describes a new protocol developed as part of a randomized clinical trial of a telephone-mediated program for SMs with mTBI. The 12-session program combines problem solving training (PST) with embedded modules targeting depression, anxiety, insomnia, and headache. The rationale and development of this behavioral intervention for implementation with persons with multiple co-morbidities is described along with the proposed analysis of results. In particular, we provide details regarding the creation of a treatment that is manualized yet flexible enough to address a wide variety of problems and symptoms within a standard framework. The methods involved in enrolling and retaining an often hard-to-study population are also highlighted. Copyright © 2014 Elsevier Inc. All rights reserved.

Faculty Teaching Diversity through Difficult Dialogues: Stories of Challenges and Success

ERIC Educational Resources Information Center

Gayles, Joy Gaston; Kelly, Bridget Turner; Grays, Shaefny; Zhang, Jing Jing; Porter, Kamaria P.

2015-01-01

Teaching diversity courses in graduate preparation programs is likely to trigger difficult dialogues that evoke a range of emotional responses. Difficult dialogues on diversity topics must be managed effectively in order to enhance multicultural competence. This interpretive study examined the experiences of faculty who teach diversity courses in…

Cognitive Development, Genetics Problem Solving, and Genetics Instruction: A Critical Review.

ERIC Educational Resources Information Center

Smith, Mike U.; Sims, O. Suthern, Jr.

1992-01-01

Review of literature concerning problem solving in genetics and Piagetian stage theory. Authors conclude the research suggests that formal-operational thought is not strictly required for the solution of the majority of classical genetics problems; however, some genetic concepts are difficult for concrete operational students to understand.…

BMI as a Predictor for Potential Difficult Tracheal Intubation in Males.

PubMed

Uribe, Alberto A; Zvara, David A; Puente, Erika G; Otey, Andrew J; Zhang, Jianying; Bergese, Sergio D

2015-01-01

Difficult tracheal intubation is a common source of mortality and morbidity in surgical and critical care settings. The incidence reported of difficult tracheal intubation is 0.1%-13% and reaches 14% in the obese population. The objective of our retrospective study was to investigate and compare the utility of body mass index (BMI) as indicator of difficult tracheal intubation in males and females. We performed a retrospective chart review of patients who underwent abdominal surgeries with American Society of Anesthesiologists I to V under general anesthesia requiring endotracheal intubation. The following information was obtained from medical records for analysis: gender, age, height, weight, BMI, length of patient stay in the Post Anesthesia Care Unit, past medical history of sleep apnea, Mallampati score, and the American Society of Anesthesiologists classification assigned by the anesthesia care provider performing the endotracheal intubation. Of 4303 adult patients, 1970 (45.8%) men and 2333 (54.2%) women were enrolled in the study. Within this group, a total of 1673 (38.9%) patients were morbidly obese. The average age of the study group was 51.4 ± 15.8 and the average BMI was 29.7 ± 8.2 kg/m(2). The overall incidence of the encountered difficult intubations was 5.23% or 225 subjects. Thus, our results indicate that BMI is a reliable predictor of difficult tracheal intubation predominantly in the male population; another strong predictor, with a positive linear correlation, being the Mallampati score. In conclusion, our data shows that BMI is a reliable indicator of potential difficult tracheal intubation only in male surgical patients.

Are Teacher and Principal Candidates Prepared to Address Student Cyberbullying?

ERIC Educational Resources Information Center

Styron, Ronald A., Jr.; Bonner, Jessica L.; Styron, Jennifer L.; Bridgeforth, James; Martin, Cecelia

2016-01-01

The purpose of this study was to examine the preparation of teacher and principal candidates to address problems created in K-12 settings as a result of cyberbullying. Participants included teacher and principal preparation students. Findings indicated that respondents were familiar with the most common forms of cyberbullying and its impact on…

Oversight of human participants research: identifying problems to evaluate reform proposals.

PubMed

Emanuel, Ezekiel J; Wood, Anne; Fleischman, Alan; Bowen, Angela; Getz, Kenneth A; Grady, Christine; Levine, Carol; Hammerschmidt, Dale E; Faden, Ruth; Eckenwiler, Lisa; Muse, Carianne Tucker; Sugarman, Jeremy

2004-08-17

The oversight of research involving human participants is widely believed to be inadequate. The U.S. Congress, national commissions, the Department of Health and Human Services, the Institute of Medicine, numerous professional societies, and others are proposing remedies based on the assumption that the main problems are researchers' conflict of interest, lack of institutional review board (IRB) resources, and the volume and complexity of clinical research. Developing appropriate reform proposals requires carefully delineating the problems of the current system to know what reforms are needed. To stimulate a more informed and meaningful debate, we delineate 15 current problems into 3 broad categories. First, structural problems encompass 8 specific problems related to the way the research oversight system is organized. Second, procedural problems constitute 5 specific problems related to the operations of IRB review. Finally, performance assessment problems include 2 problems related to absence of systematic assessment of the outcomes of the oversight system. We critically assess proposed reforms, such as accreditation and central IRBs, according to how well they address these 15 problems. None of the reforms addresses all 15 problems. Indeed, most focus on the procedural problems, failing to address either the structure or the performance assessment problems. Finally, on the basis of the delineation of problems, we outline components of a more effective reform proposal, including bringing all research under federal oversight, a permanent advisory committee to address recurrent ethical issues in clinical research, mandatory single-time review for multicenter research protocols, additional financial support for IRB functions, and a standardized system for collecting and disseminating data on both adverse events and the performance assessment of IRBs.

Complex Problem Solving: What It Is and What It Is Not

PubMed Central

Dörner, Dietrich; Funke, Joachim

2017-01-01

Computer-simulated scenarios have been part of psychological research on problem solving for more than 40 years. The shift in emphasis from simple toy problems to complex, more real-life oriented problems has been accompanied by discussions about the best ways to assess the process of solving complex problems. Psychometric issues such as reliable assessments and addressing correlations with other instruments have been in the foreground of these discussions and have left the content validity of complex problem solving in the background. In this paper, we return the focus to content issues and address the important features that define complex problems. PMID:28744242

Distributed problem solving by pilots and dispatchers

NASA Technical Reports Server (NTRS)

Orasanu, Judith; Wich, Mike; Fischer, Ute; Jobe, Kim; Mccoy, Elaine; Beatty, Roger; Smith, Phil

1993-01-01

The study addressed the following question: Are flight planning problems solved differently by PILOTS and DISPATCHERS when they work alone versus when they work together? Aspect of their performance that were of interest include the following: Problem perception and definition; Problem solving strategies and information use; Options considered; Solution and rational; and errors.

Addressing the Wicked Problem of Quality in Higher Education: Theoretical Approaches and Implications

ERIC Educational Resources Information Center

Krause, Kerri-Lee

2012-01-01

This article explores the wicked problem of quality in higher education, arguing for a more robust theorising of the subject at national, institutional and local department level. The focus of the discussion rests on principles for theorising in more rigorous ways about the multidimensional issue of quality. Quality in higher education is proposed…

Financial abuse of older people by a family member: a difficult terrain for service providers in Australia.

PubMed

Adams, Valerie Margaret; Bagshaw, Dale; Wendt, Sarah; Zannettino, Lana

2014-01-01

Financial abuse by a family member is the most common form of abuse experienced by older Australians, and early intervention is required. National online surveys of 228 chief executive officers and 214 aged care service providers found that, while they were well placed to recognize financial abuse, it was often difficult to intervene successfully. Problems providers encountered included difficulties in detecting abuse, the need for consent before they could take action, the risk that the abusive family member would withdraw the client from the service, and a lack of resources to deal with the complexities inherent in situations of financial abuse.

Difficult intubation: are you prepared for it?

PubMed

Balcom, C

1994-01-01

The endotracheal intubation of a patient for surgery requires an anaesthetist who is aided by a skilled and experienced helper. This paper explores reasons why some patients are difficult to intubate. Some are predictable on pre-operative assessment and others are not. Suggestions are given on how the helper is useful to the anaesthetist in this potentially critical situation.

Addressing Student Difficulties with Buoyancy

NASA Astrophysics Data System (ADS)

Wagner, D. J.; Cohen, Sam; Moyer, Adam

2009-11-01

This study is part of an ongoing effort to develop a diagnostic test assessing student understanding of fluids. In particular, this paper addresses a question involving density and buoyancy, which was used in the study of reference [1]. The "five blocks" question, which asks students to predict the final location of blocks released from rest when submerged and explain their reasoning, has been administered to hundreds of students in three different introductory courses at Grove City College for the past four years. We used the common student responses to craft a multiple-select version of the five blocks problem in 2008. This paper will present the effects that changing workshop activities have had on student performance on the five block question.

Addressing Passive Smoking in Children

PubMed Central

Hutchinson, Sasha G.; Kuijlaars, Jennifer S.; Mesters, Ilse; Muris, Jean W. M.; van Schayck, Constant P.; Dompeling, Edward; Feron, Frans J. M.

2014-01-01

Background A significant number of parents are unaware or unconvinced of the health consequences of passive smoking (PS) in children. Physicians could increase parental awareness by giving personal advice. Aim To evaluate the current practices of three Dutch health professions (paediatricians, youth health care physicians, and family physicians) regarding parental counselling for passive smoking (PS) in children. Methods All physicians (n = 720) representing the three health professions in Limburg, the Netherlands, received an invitation to complete a self-administered electronic questionnaire including questions on their: sex, work experience, personal smoking habits, counselling practices and education regarding PS in children. Results The response rate was 34%. One tenth (11%) of the responding physicians always addressed PS in children, 32% often, 54% occasionally and 4% reported to never attend to it. The three health professions appeared comparable regarding their frequency of parental counselling for PS in children. Addressing PS was more likely when children had respiratory problems. Lack of time was the most frequently mentioned barrier, being very and somewhat applicable for respectively 14% and 43% of the physicians. One fourth of the responders had received postgraduate education about PS. Additionally, 49% of the responders who did not have any education about PS were interested in receiving it. Conclusions Physicians working in the paediatric field in Limburg, the Netherlands, could more frequently address PS in children with parents. Lack of time appeared to be the most mentioned barrier and physicians were more likely to counsel parents for PS in children with respiratory complaints/diseases. Finally, a need for more education on parental counselling for PS was expressed. PMID:24809443

Using Sequence Diagrams to Detect Communication Problems Between Systems

NASA Technical Reports Server (NTRS)

Lindvall, Mikael; Ackermann, Chris; Stratton, William C.; Sibol, Deane E.; Ray, Arnab; Yonkwa, Lyly; Kresser, Jan; Godfrey, Sally H.; Knodel, Jens

2008-01-01

Many software systems are evolving complex system of systems (SoS) for which inter-system communication is both mission-critical and error-prone. Such communication problems ideally would be detected before deployment. In a NASA-supported Software Assurance Research Program (SARP) project, we are researching a new approach addressing such problems. In this paper, we show that problems in the communication between two systems can be detected by using sequence diagrams to model the planned communication and by comparing the planned sequence to the actual sequence. We identify different kinds of problems that can be addressed by modeling the planned sequence using different level of abstractions.

Addressing Barriers to Learning. Volume 13, Number 2. Spring 2008

ERIC Educational Resources Information Center

Center for Mental Health in Schools at UCLA, 2008

2008-01-01

Concern about responding to behavior problems and promoting social and emotional learning are related and are embedded into the arenas we frame to encompass the content of student/learning supports. How these concerns are addressed is critical to the type of school and classroom climate that emerges and to student engagement and re-engagement in…

Cloud Feedbacks on Climate: A Challenging Scientific Problem

ScienceCinema

Norris, Joe

2017-12-22

One reason it has been difficult to develop suitable social and economic policies to address global climate change is that projected global warming during the coming century has a large uncertainty range. The primary physical cause of this large uncertainty range is lack of understanding of the magnitude and even sign of cloud feedbacks on the climate system. If Earth's cloudiness responded to global warming by reflecting more solar radiation back to space or allowing more terrestrial radiation to be emitted to space, this would mitigate the warming produced by increased anthropogenic greenhouse gases. Contrastingly, a cloud response that reduced solar reflection or terrestrial emission would exacerbate anthropogenic greenhouse warming. It is likely that a mixture of responses will occur depending on cloud type and meteorological regime, and at present, we do not know what the net effect will be. This presentation will explain why cloud feedbacks have been a challenging scientific problem from the perspective of theory, modeling, and observations. Recent research results on observed multidecadal cloud-atmosphere-ocean variability over the Pacific Ocean will also be shown, along with suggestions for future research.

Managing Human Resources. Greater OPM Leadership Needed To Address Critical Challenges. Report to the Congress.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. General Government Div.

The General Accounting Office examined the Office of Personnel Management's (OPM's) leadership role in addressing critical human resource problems and preparing the government to meet future challenges. Federal managers, OPM employees, and federal personnel officials were surveyed to study federal government problems in hiring, managing, and…

Structured communication: teaching delivery of difficult news with simulated resuscitations in an emergency medicine clerkship.

PubMed

Lamba, Sangeeta; Nagurka, Roxanne; Offin, Michael; Scott, Sandra R

2015-03-01

The objective is to describe the implementation and outcomes of a structured communication module used to supplement case-based simulated resuscitation training in an emergency medicine (EM) clerkship. We supplemented two case-based simulated resuscitation scenarios (cardiac arrest and blunt trauma) with role-play in order to teach medical students how to deliver news of death and poor prognosis to family of the critically ill or injured simulated patient. Quantitative outcomes were assessed with pre and post-clerkship surveys. Secondarily, students completed a written self-reflection (things that went well and why; things that did not go well and why) to further explore learner experiences with communication around resuscitation. Qualitative analysis identified themes from written self-reflections. A total of 120 medical students completed the pre and post-clerkship surveys. Majority of respondents reported that they had witnessed or role-played the delivery of difficult news, but only few had real-life experience of delivering news of death (20/120, 17%) and poor prognosis (34/120, 29%). This communication module led to statistically significant increased scores for comfort, confidence, and knowledge with communicating difficult news of death and poor prognosis. Pre-post scores increased for those agreeing with statements (somewhat/very much) for delivery of news of poor prognosis: comfort 69% to 81%, confidence 66% to 81% and knowledge 76% to 90% as well as for statements regarding delivery of news of death: comfort 52% to 68%, confidence 57% to 76% and knowledge 76% to 90%. Respondents report that patient resuscitations (simulated and/or real) generated a variety of strong emotional responses such as anxiety, stress, grief and feelings of loss and failure. A structured communication module supplements simulated resuscitation training in an EM clerkship and leads to a self-reported increase in knowledge, comfort, and competence in communicating difficult news of

Structured Communication: Teaching Delivery of Difficult News with Simulated Resuscitations in an Emergency Medicine Clerkship

PubMed Central

Lamba, Sangeeta; Nagurka, Roxanne; Offin, Michael; Scott, Sandra R.

2015-01-01

competence in communicating difficult news of death and poor prognosis to family. Educators may need to seek ways to address the strong emotions generated in learners with real and simulated patient resuscitations. PMID:25834685

IESIP - AN IMPROVED EXPLORATORY SEARCH TECHNIQUE FOR PURE INTEGER LINEAR PROGRAMMING PROBLEMS

NASA Technical Reports Server (NTRS)

Fogle, F. R.

1994-01-01

IESIP, an Improved Exploratory Search Technique for Pure Integer Linear Programming Problems, addresses the problem of optimizing an objective function of one or more variables subject to a set of confining functions or constraints by a method called discrete optimization or integer programming. Integer programming is based on a specific form of the general linear programming problem in which all variables in the objective function and all variables in the constraints are integers. While more difficult, integer programming is required for accuracy when modeling systems with small numbers of components such as the distribution of goods, machine scheduling, and production scheduling. IESIP establishes a new methodology for solving pure integer programming problems by utilizing a modified version of the univariate exploratory move developed by Robert Hooke and T.A. Jeeves. IESIP also takes some of its technique from the greedy procedure and the idea of unit neighborhoods. A rounding scheme uses the continuous solution found by traditional methods (simplex or other suitable technique) and creates a feasible integer starting point. The Hook and Jeeves exploratory search is modified to accommodate integers and constraints and is then employed to determine an optimal integer solution from the feasible starting solution. The user-friendly IESIP allows for rapid solution of problems up to 10 variables in size (limited by DOS allocation). Sample problems compare IESIP solutions with the traditional branch-and-bound approach. IESIP is written in Borland's TURBO Pascal for IBM PC series computers and compatibles running DOS. Source code and an executable are provided. The main memory requirement for execution is 25K. This program is available on a 5.25 inch 360K MS DOS format diskette. IESIP was developed in 1990. IBM is a trademark of International Business Machines. TURBO Pascal is registered by Borland International.

Addressing chronic operational issues at the W. M. Keck Observatory

NASA Astrophysics Data System (ADS)

Nordin, Tom; Matsuda, Richard

2016-07-01

The W. M. Keck Observatory (WMKO) has a good track record at addressing large critical faults which impact observing. Our performance tracking and correcting chronic minor faults has been mixed, yet this class of problems has a significant negative impact on scientific productivity and staff effectiveness. We have taken steps to address this shortcoming. This paper outlines the creation of a program to identify, categorize and rank these chronic operational issues, track them over time, and develop management options for their resolution. The success of the program at identifying these chronic operational issues and the advantages of dedicating observatory resources to this endeavor are presented.

Application of Kinesio Taping method for newborn swallowing difficultly

PubMed Central

Lin, Chien-Lin; Wu, Wei-Ting; Chang, Ke-Vin; Lin, Hong-Yi; Chou, Li-Wei

2016-01-01

Abstract Background: Preterm infants are at an increased risk of sucking problems, swallowing difficulty, and poor nourishment. During the neonatal period, the neurobehavioral organization of a preterm baby is poor compared with that of appropriate gestational age infants. Kinesio Taping has been widely used for edema control, joint protection, and proprioception training. With the help of augmentation of the sensory input for muscle facilitation and inhibition through tapping, the coordination of the target muscle groups can be improved. Until now, no research is available on the use of Kinesio Taping for the swallowing difficulty of infant. Methods: We reported a preterm infant suffering from brain edema at birth and swallowing difficultly until 40 weeks. The swallowing reflex was delayed. Moreover, lip closure and rooting reflex combined with the dysfunction grade of jaw movement were poor. We performed KT methods on the baby under the theory of the direction of the tape for facilitate or inhibit the muscle. Result: After the Kinesio Taping treatment, the sucking function was improved with good lip closure.One week later, the baby was discharged without the use of an oral gastric tube. Conclusion: Kinesio Taping contributed significantly to the improvement of impaired sucking and swallowing and could be implemented as a regular rehabilitative approach for infants suffering from these difficulties. PMID:27495080

Protection of mineral deposits - a way towards difficult compromises

NASA Astrophysics Data System (ADS)

Radwanek-Bąk, Barbara; Nieć, Marek

2014-05-01

Mineral deposits are non-renewable natural resources. Their protection and reasonable exploitation are crucial requests resulting from sustainable development principles. Those are also fundamental issues in frame of the intergeneration justice and fairness concept. Protection of mineral resources should be based on interrelated activities: maintaining the possibility of economic use of the identified mineral resources, reduced consumption of mineral resources and ensuring satisfactory results of new prospecting and development of innovative technologies for the mineral resources base. The main problem with guarantee to the use of mineral resources is the accessibility to sites with documented deposits and prospective areas of their occurrence. Often, this contradicts with the interests of residents, planners and needs of the biotic environment protection, thus is often a source of conflicts. Legislative regulations are necessary to mitigate such arguable matters. SWOT analysis carried out with respect to introducing such legal regulations serves to identify the sources of conflicts and difficulties associated with their solution. Consensus reaching is a difficult task, so all decision makers are required to show their mutual understanding and willingness to achieve the goals taking into consideration all benefits for the population (including future generations). Foundations for finding the middle ground are: making the communities aware of their demands on minerals and of indispensable conditions for satisfying these demands; providing complete and accessible information; factual, non-emotional negotiations between decision makers and the public.

Courage and Compassion: Virtues in Caring for So-Called "Difficult" Patients.

PubMed

Hawking, Michael; Curlin, Farr A; Yoon, John D

2017-04-01

What, if anything, can medical ethics offer to assist in the care of the "difficult" patient? We begin with a discussion of virtue theory and its application to medical ethics. We conceptualize the "difficult" patient as an example of a "moral stress test" that especially challenges the physician's character, requiring the good physician to display the virtues of courage and compassion. We then consider two clinical vignettes to flesh out how these virtues might come into play in the care of "difficult" patients, and we conclude with a brief proposal for how medical educators might cultivate these essential character traits in physicians-in-training. © 2017 American Medical Association. All Rights Reserved.

New generation of content addressable memories for associative processing

NASA Astrophysics Data System (ADS)

Lewis, H. G., Jr.; Giambalov, Paul

2000-05-01

Content addressable memories (CAMS) store both key and association data. A key is presented to the CAN when it is searched and all of the addresses are scanned in parallel to find the address referenced by the key. When a match occurs, the corresponding association is returned. With the explosion of telecommunications packet switching protocols, large data base servers, routers and search engines a new generation of dense sub-micron high throughput CAMS has been developed. The introduction of this paper presents a brief history and tutorial on CAMS, their many uses and advantages, and describes the architecture and functionality of several of MUSIC Semiconductors CAM devices. In subsequent sections of the paper we address using Associative Processing to accommodate the continued increase in sensor resolution, number of spectral bands, required coverage, the desire to implement real-time target cueing, and the data flow and image processing required for optimum performance of reconnaissance and surveillance Unmanned Aerial Vehicles (UAVs). To be competitive the system designer must provide the most computational power, per watt, per dollar, per cubic inch, within the boundaries of cost effective UAV environmental control systems. To address these problems we demonstrate leveraging DARPA and DoD funded Commercial Off-the-Shelf technology to integrate CAM based Associative Processing into a real-time heterogenous multiprocessing system for UAVs and other platforms with limited weight, volume and power budgets.

Problem-solving strategies of women undergoing chemotherapy for breast cancer.

PubMed

Lyons, Kathleen D; Erickson, Kelly S; Hegel, Mark T

2012-02-01

Many women undergoing chemotherapy for breast cancer experience side effects that make it difficult to perform daily occupations. To summarize the types of challenges, goals, and adaptive strategies identified by women with stage 1-3 breast cancer participating in a pilot study of Problem-solving Treatment-Occupational Therapy (PST-OT). Content analysis of 80 PST-OT sessions. Women addressed 11 types of challenging activities, with exercise and instrumental activities of daily living (IADL) being the most common. Most women set a goal to adapt a current activity, but also set goals to find a new activity, plan the steps of a current activity, or gather information about a possible activity change in the future. The adaptive strategies generated by the women were grouped into five types. Most often they found ways to add a new step to an activity, but they also brainstormed about when, how, where, and with whom they could do activities. The women were usually trying to adapt familiar activities but also were looking for ways to include new, healthy occupations into their routines.

Time Dependent Heterogeneous Vehicle Routing Problem for Catering Service Delivery Problem

NASA Astrophysics Data System (ADS)

Azis, Zainal; Mawengkang, Herman

2017-09-01

The heterogeneous vehicle routing problem (HVRP) is a variant of vehicle routing problem (VRP) which describes various types of vehicles with different capacity to serve a set of customers with known geographical locations. This paper considers the optimal service deliveries of meals of a catering company located in Medan City, Indonesia. Due to the road condition as well as traffic, it is necessary for the company to use different type of vehicle to fulfill customers demand in time. The HVRP incorporates time dependency of travel times on the particular time of the day. The objective is to minimize the sum of the costs of travelling and elapsed time over the planning horizon. The problem can be modeled as a linear mixed integer program and we address a feasible neighbourhood search approach to solve the problem.

Substrate noise coupling: a pain for mixed-signal systems (Keynote Address)

NASA Astrophysics Data System (ADS)

Wambacq, Piet; Van der Plas, Geert; Donnay, Stephane; Badaroglu, Mustafa; Soens, Charlotte

2005-06-01

Crosstalk from digital to analog in mixed-signal ICs is recognized as one of the major roadblocks for systems-on-chip (SoC) in future CMOS technologies. This crosstalk mainly happens via the semiconducting silicon substrate, which is usually treated as a ground node by analog and RF designers. The substrate noise coupling problem leads more and more to malfunctioning or extra design iterations. One of the reasons is that the phenomenon of substrate noise coupling is difficult to model and hence difficult to understand. It can be caused by the switching of thousands or millions of gates and depends on layout details. From the generation side (the digital domain), coping with the large amount of noise generators can be solved by macromodeling. On the other hand, the impact of substrate noise on the analog circuits requires careful modeling at the level of transistors and parasitics of layout, power supply, package, PCB, Comparison to measurements of macromodeling at the digital side and careful modeling at the analog side, shows that both the generation and the impact of substrate noise can be predicted with an accuracy of a few dB. In addition, this combination of macromodeling at the digital side and careful modeling at the analog side leads to an understanding of the problem, which can be used for digital low-noise design techniques to minimize the generation of noise, and substrate noise immune design of analog/RF circuits.

Sociodrama: Group Creative Problem Solving in Action.

ERIC Educational Resources Information Center

Riley, John F.

1990-01-01

Sociodrama is presented as a structured, yet flexible, method of encouraging the use of creative thinking to examine a difficult problem. An example illustrates the steps involved in putting sociodrama into action. Production techniques useful in sociodrama include the soliloquy, double, role reversal, magic shop, unity of opposites, and audience…

Endotypes of difficult-to-control asthma in inner-city African American children

PubMed Central

Brown, K. R.; Krouse, R. Z.; Calatroni, A.; Visness, C. M.; Sivaprasad, U.; Kercsmar, C. M.; Matsui, E. C.; West, J. B.; Makhija, M. M.; Gill, M. A.; Kim, H.; Kattan, M.; Pillai, D.; Gern, J. E.; Busse, W. W.; Togias, A.; Liu, A. H.

2017-01-01

African Americans have higher rates of asthma prevalence, morbidity, and mortality in comparison with other racial groups. We sought to characterize endotypes of childhood asthma severity in African American patients in an inner-city pediatric asthma population. Baseline blood neutrophils, blood eosinophils, and 38 serum cytokine levels were measured in a sample of 235 asthmatic children (6–17 years) enrolled in the NIAID (National Institute of Allergy and Infectious Diseases)-sponsored Asthma Phenotypes in the Inner City (APIC) study (ICAC (Inner City Asthma Consortium)-19). Cytokines were quantified using a MILLIPLEX panel and analyzed on a Luminex analyzer. Patients were classified as Easy-to-Control or Difficult-to-Control based on the required dose of controller medications over one year of prospective management. A multivariate variable selection procedure was used to select cytokines associated with Difficult-to-Control versus Easy-to-Control asthma, adjusting for age, sex, blood eosinophils, and blood neutrophils. In inner-city African American children, 12 cytokines were significant predictors of Difficult-to-Control asthma (n = 235). CXCL-1, IL-5, IL-8, and IL-17A were positively associated with Difficult-to-Control asthma, while IL-4 and IL-13 were positively associated with Easy-to-Control asthma. Using likelihood ratio testing, it was observed that in addition to blood eosinophils and neutrophils, serum cytokines improved the fit of the model. In an inner-city pediatric population, serum cytokines significantly contributed to the definition of Difficult-to-Control asthma endotypes in African American children. Mixed responses characterized by TH2 (IL-5) and TH17-associated cytokines were associated with Difficult-to-Control asthma. Collectively, these data may contribute to risk stratification of Difficult-to-Control asthma in the African American population. PMID:28686637

Integrating Address Geocoding, Land Use Regression, and Spatiotemporal Geostatistical Estimation for Groundwater Tetrachloroethylene

PubMed Central

Messier, Kyle P.; Akita, Yasuyuki; Serre, Marc L.

2012-01-01

Geographic Information Systems (GIS) based techniques are cost-effective and efficient methods used by state agencies and epidemiology researchers for estimating concentration and exposure. However, budget limitations have made statewide assessments of contamination difficult, especially in groundwater media. Many studies have implemented address geocoding, land use regression, and geostatistics independently, but this is the first to examine the benefits of integrating these GIS techniques to address the need of statewide exposure assessments. A novel framework for concentration exposure is introduced that integrates address geocoding, land use regression (LUR), below detect data modeling, and Bayesian Maximum Entropy (BME). A LUR model was developed for Tetrachloroethylene that accounts for point sources and flow direction. We then integrate the LUR model into the BME method as a mean trend while also modeling below detects data as a truncated Gaussian probability distribution function. We increase available PCE data 4.7 times from previously available databases through multistage geocoding. The LUR model shows significant influence of dry cleaners at short ranges. The integration of the LUR model as mean trend in BME results in a 7.5% decrease in cross validation mean square error compared to BME with a constant mean trend. PMID:22264162

Integrating address geocoding, land use regression, and spatiotemporal geostatistical estimation for groundwater tetrachloroethylene.

PubMed

Messier, Kyle P; Akita, Yasuyuki; Serre, Marc L

2012-03-06

Geographic information systems (GIS) based techniques are cost-effective and efficient methods used by state agencies and epidemiology researchers for estimating concentration and exposure. However, budget limitations have made statewide assessments of contamination difficult, especially in groundwater media. Many studies have implemented address geocoding, land use regression, and geostatistics independently, but this is the first to examine the benefits of integrating these GIS techniques to address the need of statewide exposure assessments. A novel framework for concentration exposure is introduced that integrates address geocoding, land use regression (LUR), below detect data modeling, and Bayesian Maximum Entropy (BME). A LUR model was developed for tetrachloroethylene that accounts for point sources and flow direction. We then integrate the LUR model into the BME method as a mean trend while also modeling below detects data as a truncated Gaussian probability distribution function. We increase available PCE data 4.7 times from previously available databases through multistage geocoding. The LUR model shows significant influence of dry cleaners at short ranges. The integration of the LUR model as mean trend in BME results in a 7.5% decrease in cross validation mean square error compared to BME with a constant mean trend.

Nursing Home Consultation: Difficult Residents and Frustrated Staff.

ERIC Educational Resources Information Center

Block, Christopher; And Others

1987-01-01

Night shift nursing home aides who received in-service training in behavior therapy designed and implemented intervention programs for two of their most difficult residents. Describes programs and their outcomes. Discusses use of staff members as agents of behavior change. (Author/NB)

Some unsolved problems in discrete mathematics and mathematical cybernetics

NASA Astrophysics Data System (ADS)

Korshunov, Aleksei D.

2009-10-01

There are many unsolved problems in discrete mathematics and mathematical cybernetics. Writing a comprehensive survey of such problems involves great difficulties. First, such problems are rather numerous and varied. Second, they greatly differ from each other in degree of completeness of their solution. Therefore, even a comprehensive survey should not attempt to cover the whole variety of such problems; only the most important and significant problems should be reviewed. An impersonal choice of problems to include is quite hard. This paper includes 13 unsolved problems related to combinatorial mathematics and computational complexity theory. The problems selected give an indication of the author's studies for 50 years; for this reason, the choice of the problems reviewed here is, to some extent, subjective. At the same time, these problems are very difficult and quite important for discrete mathematics and mathematical cybernetics. Bibliography: 74 items.

Innately Split Model for Job-shop Scheduling Problem

NASA Astrophysics Data System (ADS)

Ikeda, Kokolo; Kobayashi, Sigenobu

Job-shop Scheduling Problem (JSP) is one of the most difficult benchmark problems. GA approaches often fail searching the global optimum because of the deception UV-structure of JSPs. In this paper, we introduce a novel framework model of GA, Innately Split Model (ISM) which prevents UV-phenomenon, and discuss on its power particularly. Next we analyze the structure of JSPs with the help of the UV-structure hypothesys, and finally we show ISM's excellent performance on JSP.

Self-affirmation improves problem-solving under stress.

PubMed

Creswell, J David; Dutcher, Janine M; Klein, William M P; Harris, Peter R; Levine, John M

2013-01-01

High levels of acute and chronic stress are known to impair problem-solving and creativity on a broad range of tasks. Despite this evidence, we know little about protective factors for mitigating the deleterious effects of stress on problem-solving. Building on previous research showing that self-affirmation can buffer stress, we tested whether an experimental manipulation of self-affirmation improves problem-solving performance in chronically stressed participants. Eighty undergraduates indicated their perceived chronic stress over the previous month and were randomly assigned to either a self-affirmation or control condition. They then completed 30 difficult remote associate problem-solving items under time pressure in front of an evaluator. Results showed that self-affirmation improved problem-solving performance in underperforming chronically stressed individuals. This research suggests a novel means for boosting problem-solving under stress and may have important implications for understanding how self-affirmation boosts academic achievement in school settings.

Integrating Worked Examples into Problem Posing in a Web-Based Learning Environment

ERIC Educational Resources Information Center

Hsiao, Ju-Yuan; Hung, Chun-Ling; Lan, Yu-Feng; Jeng, Yoau-Chau

2013-01-01

Most students always lack of experience and perceive difficult regarding problem posing. The study hypothesized that worked examples may have benefits for supporting students' problem posing activities. A quasi-experiment was conducted in the context of a business mathematics course for examining the effects of integrating worked examples into…

Insight into the ten-penny problem: guiding search by constraints and maximization.

PubMed

Öllinger, Michael; Fedor, Anna; Brodt, Svenja; Szathmáry, Eörs

2017-09-01

For a long time, insight problem solving has been either understood as nothing special or as a particular class of problem solving. The first view implicates the necessity to find efficient heuristics that restrict the search space, the second, the necessity to overcome self-imposed constraints. Recently, promising hybrid cognitive models attempt to merge both approaches. In this vein, we were interested in the interplay of constraints and heuristic search, when problem solvers were asked to solve a difficult multi-step problem, the ten-penny problem. In three experimental groups and one control group (N = 4 × 30) we aimed at revealing, what constraints drive problem difficulty in this problem, and how relaxing constraints, and providing an efficient search criterion facilitates the solution. We also investigated how the search behavior of successful problem solvers and non-solvers differ. We found that relaxing constraints was necessary but not sufficient to solve the problem. Without efficient heuristics that facilitate the restriction of the search space, and testing the progress of the problem solving process, the relaxation of constraints was not effective. Relaxing constraints and applying the search criterion are both necessary to effectively increase solution rates. We also found that successful solvers showed promising moves earlier and had a higher maximization and variation rate across solution attempts. We propose that this finding sheds light on how different strategies contribute to solving difficult problems. Finally, we speculate about the implications of our findings for insight problem solving.

Space Situational Awareness: Difficult, Expensive and Necessary

DTIC Science & Technology

2014-12-01

Senior Leader Perspective November–December 2014 Air & Space Power Journal | 6 Space Situational Awareness Difficult, Expensive—and Necessary Dr...authors thank Gen William Shelton for his thoughtful and insightful comments. Disclaimer: The views and opinions expressed or implied in the Journal ...permission. If it is reproduced, the Air and Space Power Journal requests a courtesy line. Report Documentation Page Form ApprovedOMB No. 0704-0188

A connectionist model for diagnostic problem solving

NASA Technical Reports Server (NTRS)

Peng, Yun; Reggia, James A.

1989-01-01

A competition-based connectionist model for solving diagnostic problems is described. The problems considered are computationally difficult in that (1) multiple disorders may occur simultaneously and (2) a global optimum in the space exponential to the total number of possible disorders is sought as a solution. The diagnostic problem is treated as a nonlinear optimization problem, and global optimization criteria are decomposed into local criteria governing node activation updating in the connectionist model. Nodes representing disorders compete with each other to account for each individual manifestation, yet complement each other to account for all manifestations through parallel node interactions. When equilibrium is reached, the network settles into a locally optimal state. Three randomly generated examples of diagnostic problems, each of which has 1024 cases, were tested, and the decomposition plus competition plus resettling approach yielded very high accuracy.

Special Medical Problems of Athletes.

ERIC Educational Resources Information Center

Couch, Joan M.

1987-01-01

This article addresses the situations in which athletes with special needs and considerations participate in sports. The health problems discussed are diabetes mellitus, exercise-induced asthma, exercise-induced anaphylaxis, and epilepsy. (MT)

Presidential Address National Academy of Neuropsychology Conference Boston 2017.

PubMed

Meyers, John E

2018-05-05

This presidential address attempts to predict the future directions of neuropsychology. Predicting the future is always a difficult thing. By examining population trends such as aging and demographics, a clearer picture becomes visible. The population is getting older and more ethnically diverse. Also, examination of the spending trends in health care indicates that neuropsychology needs to be able to adapt to working with larger population-based patient care as well as individual patient care. Shifts in the demographics of neuropsychology, in that the profession previously was 70% male dominate and now is >70% female dominant are also discussed. Trends in NAN's speaker and leader demographics are examined as well as the need to stay current in the trends and latest neuropsychological research lest we become dinosaurs in the next 5-10 years. Recommendations for new neuropsychologists and post-doctoral fellows are also presented.

The value of ASSR threshold-based bilateral hearing aid fitting in children with difficult or unreliable behavioral audiometry.

PubMed

Vlastarakos, Petros V; Vasileiou, Alexandra; Nikolopoulos, Thomas P

2017-12-01

We conducted an analysis to assess the relative contribution of auditory brainstem response (ABR) testing and auditory steady-state response (ASSR) testing in providing appropriate hearing aid fitting in hearing-impaired children with difficult or unreliable behavioral audiometry. Of 150 infants and children who had been referred to us for hearing assessment as part of a neonatal hearing screening and cochlear implantation program, we identified 5 who exhibited significant discrepancies between click-ABR and ASSR testing results and difficult or unreliable behavioral audiometry. Hearing aid fitting in pediatric cochlear implant candidates for a trial period of 3 to 6 months is a common practice in many implant programs, but monitoring the progress of the amplified infants and providing appropriate hearing aid fitting can be challenging. If we accept the premise that we can assess the linguistic progress of amplified infants with an acceptable degree of certainty, the auditory behavior that we are monitoring presupposes appropriate bilateral hearing aid fitting. This may become very challenging in young children, or even in older children with difficult or unreliable behavioral audiometry results. This challenge can be addressed by using data from both ABR and ASSR testing. Fitting attempts that employ data from only ABR testing provide amplification that involves the range of spoken language but is not frequency-specific. Hearing aid fitting should also incorporate and take into account ASSR data because reliance on ABR testing alone might compromise the validity of the monitoring process. In conclusion, we believe that ASSR threshold-based bilateral hearing aid fitting is necessary to provide frequency-specific amplification of hearing and appropriate propulsion in the prelinguistic vocalizations of monitored infants.

Braving difficult choices alone: children's and adolescents' medical decision making.

PubMed

Ruggeri, Azzurra; Gummerum, Michaela; Hanoch, Yaniv

2014-01-01

What role should minors play in making medical decisions? The authors examined children's and adolescents' desire to be involved in serious medical decisions and the emotional consequences associated with them. Sixty-three children and 76 adolescents were presented with a cover story about a difficult medical choice. Participants were tested in one of four conditions: (1) own informed choice; (2) informed parents' choice to amputate; (3) informed parents' choice to continue a treatment; and (4) uninformed parents' choice to amputate. In a questionnaire, participants were asked about their choices, preference for autonomy, confidence, and emotional reactions when faced with a difficult hypothetical medical choice. Children and adolescents made different choices and participants, especially adolescents, preferred to make the difficult choice themselves, rather than having a parent make it. Children expressed fewer negative emotions than adolescents. Providing information about the alternatives did not affect participants' responses. Minors, especially adolescents, want to be responsible for their own medical decisions, even when the choice is a difficult one. For the adolescents, results suggest that the decision to be made, instead of the agent making the decision, is the main element influencing their emotional responses and decision confidence. For children, results suggest that they might be less able than adolescents to project how they would feel. The results, overall, draw attention to the need to further investigate how we can better involve minors in the medical decision-making process.

Braving Difficult Choices Alone: Children's and Adolescents' Medical Decision Making

PubMed Central

Ruggeri, Azzurra; Gummerum, Michaela; Hanoch, Yaniv

2014-01-01

Objective What role should minors play in making medical decisions? The authors examined children's and adolescents' desire to be involved in serious medical decisions and the emotional consequences associated with them. Methods Sixty-three children and 76 adolescents were presented with a cover story about a difficult medical choice. Participants were tested in one of four conditions: (1) own informed choice; (2) informed parents' choice to amputate; (3) informed parents' choice to continue a treatment; and (4) uninformed parents' choice to amputate. In a questionnaire, participants were asked about their choices, preference for autonomy, confidence, and emotional reactions when faced with a difficult hypothetical medical choice. Results Children and adolescents made different choices and participants, especially adolescents, preferred to make the difficult choice themselves, rather than having a parent make it. Children expressed fewer negative emotions than adolescents. Providing information about the alternatives did not affect participants' responses. Conclusions Minors, especially adolescents, want to be responsible for their own medical decisions, even when the choice is a difficult one. For the adolescents, results suggest that the decision to be made, instead of the agent making the decision, is the main element influencing their emotional responses and decision confidence. For children, results suggest that they might be less able than adolescents to project how they would feel. The results, overall, draw attention to the need to further investigate how we can better involve minors in the medical decision-making process. PMID:25084274

Nonlinear Multidimensional Assignment Problems Efficient Conic Optimization Methods and Applications

DTIC Science & Technology

2015-06-24

WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Arizona State University School of Mathematical & Statistical Sciences 901 S...SUPPLEMENTARY NOTES 14. ABSTRACT The major goals of this project were completed: the exact solution of previously unsolved challenging combinatorial optimization... combinatorial optimization problem, the Directional Sensor Problem, was solved in two ways. First, heuristically in an engineering fashion and second, exactly

Address-event-based platform for bioinspired spiking systems

NASA Astrophysics Data System (ADS)

Jiménez-Fernández, A.; Luján, C. D.; Linares-Barranco, A.; Gómez-Rodríguez, F.; Rivas, M.; Jiménez, G.; Civit, A.

2007-05-01

Address Event Representation (AER) is an emergent neuromorphic interchip communication protocol that allows a real-time virtual massive connectivity between huge number neurons, located on different chips. By exploiting high speed digital communication circuits (with nano-seconds timings), synaptic neural connections can be time multiplexed, while neural activity signals (with mili-seconds timings) are sampled at low frequencies. Also, neurons generate "events" according to their activity levels. More active neurons generate more events per unit time, and access the interchip communication channel more frequently, while neurons with low activity consume less communication bandwidth. When building multi-chip muti-layered AER systems, it is absolutely necessary to have a computer interface that allows (a) reading AER interchip traffic into the computer and visualizing it on the screen, and (b) converting conventional frame-based video stream in the computer into AER and injecting it at some point of the AER structure. This is necessary for test and debugging of complex AER systems. In the other hand, the use of a commercial personal computer implies to depend on software tools and operating systems that can make the system slower and un-robust. This paper addresses the problem of communicating several AER based chips to compose a powerful processing system. The problem was discussed in the Neuromorphic Engineering Workshop of 2006. The platform is based basically on an embedded computer, a powerful FPGA and serial links, to make the system faster and be stand alone (independent from a PC). A new platform is presented that allow to connect up to eight AER based chips to a Spartan 3 4000 FPGA. The FPGA is responsible of the network communication based in Address-Event and, at the same time, to map and transform the address space of the traffic to implement a pre-processing. A MMU microprocessor (Intel XScale 400MHz Gumstix Connex computer) is also connected to the FPGA

“Extra Oomph:” Addressing Housing Disparities through Medical Legal Partnership Interventions

PubMed Central

Hernández, Diana

2016-01-01

Low-income households face common and chronic housing problems that have known health risks and legal remedies. The Medical Legal Partnership (MLP) program presents a unique opportunity to address housing problems and improve patient health through legal assistance offered in clinical settings. Drawn from in-depth interviews with 72 patients, this study investigated the outcomes of MLP interventions and compares results to similarly disadvantaged participants with no access to MLP services. Results indicate that participants in the MLP group were more likely to achieve adequate, affordable and stable housing than those in the comparison group. Study findings suggest that providing access to legal services in the healthcare setting can effectively address widespread health disparities rooted in problematic housing. Implications for policy and scalability are discussed with the conclusion that MLPs can shift professionals’ consciousness as they work to improve housing and health trajectories for indigent groups using legal approaches. PMID:27867247

Solving fuzzy shortest path problem by genetic algorithm

NASA Astrophysics Data System (ADS)

Syarif, A.; Muludi, K.; Adrian, R.; Gen, M.

2018-03-01

Shortest Path Problem (SPP) is known as one of well-studied fields in the area Operations Research and Mathematical Optimization. It has been applied for many engineering and management designs. The objective is usually to determine path(s) in the network with minimum total cost or traveling time. In the past, the cost value for each arc was usually assigned or estimated as a deteministic value. For some specific real world applications, however, it is often difficult to determine the cost value properly. One way of handling such uncertainty in decision making is by introducing fuzzy approach. With this situation, it will become difficult to solve the problem optimally. This paper presents the investigations on the application of Genetic Algorithm (GA) to a new SPP model in which the cost values are represented as Triangular Fuzzy Number (TFN). We adopts the concept of ranking fuzzy numbers to determine how good the solutions. Here, by giving his/her degree value, the decision maker can determine the range of objective value. This would be very valuable for decision support system in the real world applications.Simulation experiments were carried out by modifying several test problems with 10-25 nodes. It is noted that the proposed approach is capable attaining a good solution with different degree of optimism for the tested problems.

A Restorationist Views the Modernist/Post Modernist Debate. (Presidential Address).

ERIC Educational Resources Information Center

Flinders, Neil J.

The nation's schools and society in general face serious problems that are largely rooted in moral and spiritual issues. Modern philosophy has led to a secular culture in which the existence of a divine God has been rejected, and man has become his own God, his own standard of measurement. These issues are addressed from the point of view of a…

Multi-Conformer Ensemble Docking to Difficult Protein Targets

DOE PAGES

Ellingson, Sally R.; Miao, Yinglong; Baudry, Jerome; ...

2014-09-08

We investigate large-scale ensemble docking using five proteins from the Directory of Useful Decoys (DUD, dud.docking.org) for which docking to crystal structures has proven difficult. Molecular dynamics trajectories are produced for each protein and an ensemble of representative conformational structures extracted from the trajectories. Docking calculations are performed on these selected simulation structures and ensemble-based enrichment factors compared with those obtained using docking in crystal structures of the same protein targets or random selection of compounds. We also found simulation-derived snapshots with improved enrichment factors that increased the chemical diversity of docking hits for four of the five selected proteins.more » A combination of all the docking results obtained from molecular dynamics simulation followed by selection of top-ranking compounds appears to be an effective strategy for increasing the number and diversity of hits when using docking to screen large libraries of chemicals against difficult protein targets.« less

Addressing Social Determinants Of Health Through Medical-Legal Partnerships.

PubMed

Regenstein, Marsha; Trott, Jennifer; Williamson, Alanna; Theiss, Joanna

2018-03-01

The US health care system needs effective tools to address complex social and environmental issues that perpetuate health inequities, such as food insecurity, education and employment barriers, and substandard housing conditions. The medical-legal partnership is a collaborative intervention that embeds civil legal aid professionals in health care settings to address seemingly intractable social problems that contribute to poor health outcomes and health disparities. More than three hundred health care organizations are home to medical-legal partnerships. This article draws upon national survey data and field research to identify three models of the medical-legal partnership that health care organizations have adopted and the core elements of infrastructure that they share. Financing and commitment from health care organizations are key considerations for sustaining and scaling up the medical-legal partnership as a health equity intervention.

First on the List: Effectiveness at Self-Regulation and Prioritizing Difficult Exercise Goal Pursuit

PubMed Central

Delose, Julie E.; vanDellen, Michelle R.; Hoyle, Rick H.

2015-01-01

Identifying and understanding the goal pursuit strategies that distinguish effective self-regulators from less effective self-regulators is important for elucidating how individuals achieve their goals. We suggest that the timing of plans for difficult goal pursuits is one differentiation. A pilot study shows that effective self-regulators tend to believe they are best suited to pursue difficult goals earlier in the day, and two studies provide evidence that effective and less effective self-regulators differ in the timing of their plans for difficult goal pursuits. Results indicate that when exercising is perceived as difficult goal pursuit, effective self-regulators prioritize that difficult goal pursuit by planning to exercise earlier in the day whereas less effective self-regulators plan exercise for later in the day. PMID:26957951

Reframing and addressing horizontal violence as a workplace quality improvement concern.

PubMed

Taylor, Rosemary A; Taylor, Steven S

2018-06-27

To reframe horizontal violence as a quality improvement concern. Although the number of studies exploring horizontal violence has increased, evidence supporting the effectiveness of current interventions is weak and the problem persists. Often framed as an individual or interpersonal issue, horizontal violence has been recognized as a complex phenomenon that can only be understood through an examination of social, individual and organizational factors. As such, interventions to address horizontal violence must be applied systemically and address contributions from all sources. This is a discussion paper. This discussion is based on results of a study of nurses' perceptions of horizontal violence and review of the literature. Context is recognized as a contributing factor in human behavior, yet often overlooked in interventions to address horizontal violence. Moving the focus away from the individual and investigating systems contributions to horizontal violence using existing quality improvement frameworks is suggested. To date, efforts to address horizontal violence have not been proven effective. There is a call for a wider application and investigation of interventions. This reframing provides the system level application suggested and would address a broader range of factors contributing to the perpetuation of the phenomenon. © 2018 Wiley Periodicals, Inc.

Sub-problem Optimization With Regression and Neural Network Approximators

NASA Technical Reports Server (NTRS)

Guptill, James D.; Hopkins, Dale A.; Patnaik, Surya N.

2003-01-01

Design optimization of large systems can be attempted through a sub-problem strategy. In this strategy, the original problem is divided into a number of smaller problems that are clustered together to obtain a sequence of sub-problems. Solution to the large problem is attempted iteratively through repeated solutions to the modest sub-problems. This strategy is applicable to structures and to multidisciplinary systems. For structures, clustering the substructures generates the sequence of sub-problems. For a multidisciplinary system, individual disciplines, accounting for coupling, can be considered as sub-problems. A sub-problem, if required, can be further broken down to accommodate sub-disciplines. The sub-problem strategy is being implemented into the NASA design optimization test bed, referred to as "CometBoards." Neural network and regression approximators are employed for reanalysis and sensitivity analysis calculations at the sub-problem level. The strategy has been implemented in sequential as well as parallel computational environments. This strategy, which attempts to alleviate algorithmic and reanalysis deficiencies, has the potential to become a powerful design tool. However, several issues have to be addressed before its full potential can be harnessed. This paper illustrates the strategy and addresses some issues.

Developing Difficult Dialogues: An Evaluation of Classroom Implementation

ERIC Educational Resources Information Center

Placier, Peggy; Kroner, Crystal; Burgoyne, Suzanne; Worthington, Roger

2012-01-01

The University of Missouri (MU) participated in the Ford Foundation's Difficult Dialogues Initiative (DDI) supporting faculty development projects at over 40 institutions of higher education from 2006-2010. This paper reports findings from an evaluation conducted with instructors who not only engaged in faculty development workshops but also…

Videolaryngoscopy versus Fiber-optic Intubation through a Supraglottic Airway in Children with a Difficult Airway: An Analysis from the Multicenter Pediatric Difficult Intubation Registry.

PubMed

Burjek, Nicholas E; Nishisaki, Akira; Fiadjoe, John E; Adams, H Daniel; Peeples, Kenneth N; Raman, Vidya T; Olomu, Patrick N; Kovatsis, Pete G; Jagannathan, Narasimhan; Hunyady, Agnes; Bosenberg, Adrian; Tham, See; Low, Daniel; Hopkins, Paul; Glover, Chris; Olutoye, Olutoyin; Szmuk, Peter; McCloskey, John; Dalesio, Nicholas; Koka, Rahul; Greenberg, Robert; Watkins, Scott; Patel, Vikram; Reynolds, Paul; Matuszczak, Maria; Jain, Ranu; Khalil, Samia; Polaner, David; Zieg, Jennifer; Szolnoki, Judit; Sathyamoorthy, Kumar; Taicher, Brad; Riveros Perez, N Ricardo; Bhattacharya, Solmaletha; Bhalla, Tarun; Stricker, Paul; Lockman, Justin; Galvez, Jorge; Rehman, Mohamed; Von Ungern-Sternberg, Britta; Sommerfield, David; Soneru, Codruta; Chiao, Franklin; Richtsfeld, Martina; Belani, Kumar; Sarmiento, Lina; Mireles, Sam; Bilen Rosas, Guelay; Park, Raymond; Peyton, James

2017-09-01

The success rates and related complications of various techniques for intubation in children with difficult airways remain unknown. The primary aim of this study is to compare the success rates of fiber-optic intubation via supraglottic airway to videolaryngoscopy in children with difficult airways. Our secondary aim is to compare the complication rates of these techniques. Observational data were collected from 14 sites after management of difficult pediatric airways. Patient age, intubation technique, success per attempt, use of continuous ventilation, and complications were recorded for each case. First-attempt success and complications were compared in subjects managed with fiber-optic intubation via supraglottic airway and videolaryngoscopy. Fiber-optic intubation via supraglottic airway and videolaryngoscopy had similar first-attempt success rates (67 of 114, 59% vs. 404 of 786, 51%; odds ratio 1.35; 95% CI, 0.91 to 2.00; P = 0.16). In subjects less than 1 yr old, fiber-optic intubation via supraglottic airway was more successful on the first attempt than videolaryngoscopy (19 of 35, 54% vs. 79 of 220, 36%; odds ratio, 2.12; 95% CI, 1.04 to 4.31; P = 0.042). Complication rates were similar in the two groups (20 vs. 13%; P = 0.096). The incidence of hypoxemia was lower when continuous ventilation through the supraglottic airway was used throughout the fiber-optic intubation attempt. In this nonrandomized study, first-attempt success rates were similar for fiber-optic intubation via supraglottic airway and videolaryngoscopy. Fiber-optic intubation via supraglottic airway is associated with higher first-attempt success than videolaryngoscopy in infants with difficult airways. Continuous ventilation through the supraglottic airway during fiber-optic intubation attempts may lower the incidence of hypoxemia.

Mathematical Problem Solving through Sequential Process Analysis

ERIC Educational Resources Information Center

Codina, A.; Cañadas, M. C.; Castro, E.

2015-01-01

Introduction: The macroscopic perspective is one of the frameworks for research on problem solving in mathematics education. Coming from this perspective, our study addresses the stages of thought in mathematical problem solving, offering an innovative approach because we apply sequential relations and global interrelations between the different…

Personal and parental problem drinking: effects on problem-solving performance and self-appraisal.

PubMed

Slavkin, S L; Heimberg, R G; Winning, C D; McCaffrey, R J

1992-01-01

This study examined the problem-solving performances and self-appraisals of problem-solving ability of college-age subjects with and without parental history of problem drinking. Contrary to our predictions, children of problem drinkers (COPDs) were rated as somewhat more effective in their problem-solving skills than non-COPDs, undermining prevailing assumptions about offspring from alcoholic households. While this difference was not large and was qualified by other variables, subjects' own alcohol abuse did exert a detrimental effect on problem-solving performance, regardless of parental history of problem drinking. However, a different pattern was evident for problem-solving self-appraisals. Alcohol-abusing non-COPDs saw themselves as effective problem-solvers while alcohol-abusing COPDs appraised themselves as poor problem-solvers. In addition, the self-appraisals of alcohol-abusing COPDs were consistent with objective ratings of solution effectiveness (i.e., they were both negative) while alcohol-abusing non-COPDs were overly positive in their appraisals, opposing the judgments of trained raters. This finding suggests that the relationship between personal alcohol abuse and self-appraised problem-solving abilities may differ as a function of parental history of problem drinking. Limitations on the generalizability of findings are addressed.

Measuring Avoidance and Inflexibility in Weight Related Problems

ERIC Educational Resources Information Center

Lillis, Jason; Hayes, Steven C.

2008-01-01

There is growing evidence that experiential avoidance and psychological inflexibility plays a role in a variety of clinical presentations, including health problems. The present study presents preliminary data on a new measure of these processes in relation to difficult weight-related thoughts, feelings, and actions: The Acceptance and Action…

Difficult to control atopic dermatitis

PubMed Central

2013-01-01

Difficult to control atopic dermatitis (AD) presents a therapeutic challenge and often requires combinations of topical and systemic treatment. Anti-inflammatory treatment of severe AD most commonly includes topical glucocorticosteroids and topical calcineurin antagonists used for exacerbation management and more recently for proactive therapy in selected cases. Topical corticosteroids remain the mainstay of therapy, the topical calcineurin inhibitors tacrolimus and pimecrolimus are preferred in certain locations. Systemic anti-inflammatory treatment is an option for severe refractory cases. Microbial colonization and superinfection contribute to disease exacerbation and thus justify additional antimicrobial / antiseptic treatment. Systemic antihistamines (H1) may relieve pruritus but do not have sufficient effect on eczema. Adjuvant therapy includes UV irradiation preferably of UVA1 wavelength. “Eczema school” educational programs have been proven to be helpful. PMID:23663504

"As a matter of fact, this is not difficult to understand!": the addresses to the reader in Greek and Latin pharmacological poetry.

PubMed

Hautala, Svetlana

2014-01-01

Once written down, every pharmacological text becomes open to all kinds of distortion of its content. It may have been inaccurately copied, for example, or its dosages may have been intentionally altered. The transcription in verse of pharmacological preparations was supposed to protect the text against any distortion, for metrical demands of verse do not easily allow for the substitution of the specified quantities of a remedy's ingredients. Furthermore, rhythmical poetry can facilitate memorization of the prescriptions. Beside its very practical functions, this production was not alien to inspiration from the Muses, and physicians shared with poets the right to invoke the gods' favour for their lines. The present paper focuses on the addresses to the readers in Greek and Latin pharmacological poetry; it shows how the practical function of preserving and transmitting information was interwoven with the author's own literary ambitions.

Productive friction: how difficult business partnerships can accelerate innovation.

PubMed

Hagel, John; Brown, John Seely

2005-02-01

Companies are becoming more dependent on business partners, but coordinating with outsiders takes its toll. Negotiating terms, monitoring performance, and, if needs are not being met, switching from one partner to another require time and money. Such transaction costs, Ronald Coase explained in his 1937 essay "The Nature of the Firm," drove many organizations to bring their activities in-house. But what if Coase placed too much emphasis on these costs? What if friction between companies can be productive? Indeed, as John Hagel and John Seely Brown point out, interactions between organizations can yield benefits beyond the goods or services contracted for. Companies get better at what they do--and improve faster than their competitors--by working with outsiders whose specialized capabilities complement their own. Different enterprises bring different perspectives and competencies. When these enterprises tackle a problem together, they dramatically increase the chances for innovative solutions. Of course, misunderstandings often arise when people with different backgrounds and skill sets try to collaborate. Opposing sides may focus on the distance that separates them rather than the common challenges they face. How can companies harness friction so that it builds capabilities? Start by articulating performance goals that everyone buys into. Then make sure people are using tangible prototypes to wrangle over. Finally, assemble teams with committed people who bring different perspectives to the table. As individual problems are being addressed, take care that the underpinnings of shared meaning and trust are also being woven between the companies. Neither can be dictated--but they can be cultivated. Without them, the performance fabric quickly unravels, and business partnerships disintegrate into rivalrous competition.

Self-Affirmation Improves Problem-Solving under Stress

PubMed Central

Creswell, J. David; Dutcher, Janine M.; Klein, William M. P.; Harris, Peter R.; Levine, John M.

2013-01-01

High levels of acute and chronic stress are known to impair problem-solving and creativity on a broad range of tasks. Despite this evidence, we know little about protective factors for mitigating the deleterious effects of stress on problem-solving. Building on previous research showing that self-affirmation can buffer stress, we tested whether an experimental manipulation of self-affirmation improves problem-solving performance in chronically stressed participants. Eighty undergraduates indicated their perceived chronic stress over the previous month and were randomly assigned to either a self-affirmation or control condition. They then completed 30 difficult remote associate problem-solving items under time pressure in front of an evaluator. Results showed that self-affirmation improved problem-solving performance in underperforming chronically stressed individuals. This research suggests a novel means for boosting problem-solving under stress and may have important implications for understanding how self-affirmation boosts academic achievement in school settings. PMID:23658751

Deciphering the Distance between Distance Education and Working Professionals in Difficult Geographies

ERIC Educational Resources Information Center

Pandey, Jatin; Singh, Manjari

2015-01-01

This study investigates the factors that draw working professionals towards distance education programs, and the factors that sustain their distance education experience. The study is conducted in difficult terrains of Uttarakhand, a hilly state in India which helps us investigate the phenomenon in difficult geographies. Through interviews of ten…

Balloon-assisted tracking: a must-know technique to overcome difficult anatomy during transradial approach.

PubMed

Patel, Tejas; Shah, Sanjay; Pancholy, Samir; Rao, Sunil; Bertrand, Olivier F; Kwan, Tak

2014-02-01

To examine the use and outcomes of balloon-assisted tracking (BAT) technique for dealing with complexities of arm and chest vasculature during transradial approach (TRA) at a single high volume radial center. TRA has been used for coronary angiography and percutaneous coronary interventions (PCI) around the world. Different techniques have been described to address the anatomical issues and tortuosities for successful completion of coronary angiography and PCI. This study describes the use of BAT technique and associated outcomes during real world clinical practice. Subjects comprised 63 patients, (out of total 8,245 patients between January 2011 and December 2012) in whom we encountered significantly complex anatomical course in radial, brachial, or subclavian region, leading to difficult advancement of a diagnostic or a guide catheter despite trying all standard maneuvers. In all of them BAT technique was used and they were retrospectively analyzed for the purpose of this study. About 63 (0.76%) of 8,245 patients met the study criteria. Twenty-five (39.7%) patients had very small RA. Twenty-two (34.9%) had severe RA tortuosity. Four (6.3%) had complex RA loops. Six (9.5%) had severe RA spasm and six (9.5%) had severe subclavian tortuosity and/or stenosis. We encountered technical failure in three (4.8%) patients (two had very small RA and one had 360 degree RA loop). BAT technique was useful to address the anatomical issues and tortuosities of radial, brachial, and subclavian vasculature during TRA. Copyright © 2013 Wiley Periodicals, Inc.

Exact solution for the optimal neuronal layout problem.

PubMed

Chklovskii, Dmitri B

2004-10-01

Evolution perfected brain design by maximizing its functionality while minimizing costs associated with building and maintaining it. Assumption that brain functionality is specified by neuronal connectivity, implemented by costly biological wiring, leads to the following optimal design problem. For a given neuronal connectivity, find a spatial layout of neurons that minimizes the wiring cost. Unfortunately, this problem is difficult to solve because the number of possible layouts is often astronomically large. We argue that the wiring cost may scale as wire length squared, reducing the optimal layout problem to a constrained minimization of a quadratic form. For biologically plausible constraints, this problem has exact analytical solutions, which give reasonable approximations to actual layouts in the brain. These solutions make the inverse problem of inferring neuronal connectivity from neuronal layout more tractable.

Designs of goal-free problems for trigonometry learning

NASA Astrophysics Data System (ADS)

Retnowati, E.; Maulidya, S. R.

2018-03-01

This paper describes the designs of goal-free problems particularly for trigonometry, which may be considered a difficult topic for high school students.Goal-free problem is an instructional design developed based on a Cognitive load theory (CLT). Within the design, instead of asking students to solve a specific goal of a mathematics problem, the instruction is to solve as many Pythagoras as possible. It was assumed that for novice students, goal-free problems encourage students to pay attention more to the given information and the mathematical principles that can be applied to reveal the unknown variables. Hence, students develop more structured knowledge while solving the goal-free problems. The resulted design may be used in regular mathematics classroom with some adjustment on the difficulty level and the allocated lesson time.

[Difficult teenagers: the challenges of interdisciplinarity].

PubMed

Saint-Andrté, Stéphane; Botbola, Michel

2013-01-01

The adolescents in great distress, because of ruptures in the course of their lives and of their chaotic family environment, need educational and social actions. The consensual point of view is that responding to the needs of the so called "difficult adolescents" implies the involvement of educational, therapeutic and judicial services. Nevertheless, the usual tendency to categorize the users with the idea it will permit to guide them to the appropriate skill field and the transgressive characteristic of these adolescents' behaviours lead all these services to reject them and send them to the two other services.

EEG Estimates of Cognitive Workload and Engagement Predict Math Problem Solving Outcomes

ERIC Educational Resources Information Center

Beal, Carole R.; Galan, Federico Cirett

2012-01-01

In the present study, the authors focused on the use of electroencephalography (EEG) data about cognitive workload and sustained attention to predict math problem solving outcomes. EEG data were recorded as students solved a series of easy and difficult math problems. Sequences of attention and cognitive workload estimates derived from the EEG…

Genetic evidence of multiple loci in dystocia - difficult labour

PubMed Central

2010-01-01

Background Dystocia, difficult labour, is a common but also complex problem during childbirth. It can be attributed to either weak contractions of the uterus, a large infant, reduced capacity of the pelvis or combinations of these. Previous studies have indicated that there is a genetic component in the susceptibility of experiencing dystocia. The purpose of this study was to identify susceptibility genes in dystocia. Methods A total of 104 women in 47 families were included where at least two sisters had undergone caesarean section at a gestational length of 286 days or more at their first delivery. Study of medical records and a telephone interview was performed to identify subjects with dystocia. Whole-genome scanning using Affymetrix genotyping-arrays and non-parametric linkage (NPL) analysis was made in 39 women exhibiting the phenotype of dystocia from 19 families. In 68 women re-sequencing was performed of candidate genes showing suggestive linkage: oxytocin (OXT) on chromosome 20 and oxytocin-receptor (OXTR) on chromosome 3. Results We found a trend towards linkage with suggestive NPL-score (3.15) on chromosome 12p12. Suggestive linkage peaks were observed on chromosomes 3, 4, 6, 10, 20. Re-sequencing of OXT and OXTR did not reveal any causal variants. Conclusions Dystocia is likely to have a genetic component with variations in multiple genes affecting the patient outcome. We found 6 loci that could be re-evaluated in larger patient cohorts. PMID:20587075

Small Village Planning Problems in the Netherlands.

ERIC Educational Resources Information Center

Groot, Jacob P.

The problems associated with small villages are among the most difficult in Dutch physical planning, for they encompass the support of minimum social services in small towns and villages; the preservation of areas of ecological and scenic value; the acommodation of a growing population desirous of a home in the country or continued country living;…

Recall Performance for Content-Addressable Memory Using Adiabatic Quantum Optimization

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

Imam, Neena; Humble, Travis S.; McCaskey, Alex

A content-addressable memory (CAM) stores key-value associations such that the key is recalled by providing its associated value. While CAM recall is traditionally performed using recurrent neural network models, we show how to solve this problem using adiabatic quantum optimization. Our approach maps the recurrent neural network to a commercially available quantum processing unit by taking advantage of the common underlying Ising spin model. We then assess the accuracy of the quantum processor to store key-value associations by quantifying recall performance against an ensemble of problem sets. We observe that different learning rules from the neural network community influence recallmore » accuracy but performance appears to be limited by potential noise in the processor. The strong connection established between quantum processors and neural network problems supports the growing intersection of these two ideas.« less

Myth 5: Creativity Is Too Difficult to Measure

ERIC Educational Resources Information Center

Treffinger, Donald J.

2009-01-01

In his 1982 response to the myth that "creativity is too difficult to measure," Dr. Joe Khatena (a long-time contributor to the literature on creativity), characterized creativity as the "most exciting dimension of mental functioning." Building on a three-dimensional view of creativity (emphasizing the "individual," the "environment," and the…

A taxonomy of inductive problems.

PubMed

Kemp, Charles; Jern, Alan

2014-02-01

Inductive inferences about objects, features, categories, and relations have been studied for many years, but there are few attempts to chart the range of inductive problems that humans are able to solve. We present a taxonomy of inductive problems that helps to clarify the relationships between familiar inductive problems such as generalization, categorization, and identification, and that introduces new inductive problems for psychological investigation. Our taxonomy is founded on the idea that semantic knowledge is organized into systems of objects, features, categories, and relations, and we attempt to characterize all of the inductive problems that can arise when these systems are partially observed. Recent studies have begun to address some of the new problems in our taxonomy, and future work should aim to develop unified theories of inductive reasoning that explain how people solve all of the problems in the taxonomy.

Alcohol highway safety : problem update

DOT National Transportation Integrated Search

1998-04-01

Author's abstract: This document examines new literature and data on selected alcohol-crash targets or problems that have become available since the November 1989 State of Knowledge review. Specifically, this update addresses research since the 1989 ...

A model for addressing navigation limitations and metacognitive constraints in hypermedia training systems

NASA Technical Reports Server (NTRS)

Freedman, Glenn B.

1990-01-01

A model for addressing navigation limitations and metacognitive constraints in hypermedia training systems is presented in the form of the viewgraphs. The following subject areas are covered: samples of software and people problems; system design; and hypermedia training system.

Educational Reform as a Dynamic System of Problems and Solutions: Towards an Analytic Instrument

ERIC Educational Resources Information Center

Luttenberg, Johan; Carpay, Thérèse; Veugelers, Wiel

2013-01-01

Large-scale educational reforms are difficult to realize and often fail. In the literature, the course of reform and problems associated with this are frequently discussed. The explanations and recommendations then provided are so diverse that it is difficult to gain a comprehensive overview of what factors are at play and how to take them into…

The resolvent of singular integral equations. [of kernel functions in mixed boundary value problems

NASA Technical Reports Server (NTRS)

Williams, M. H.

1977-01-01

The investigation reported is concerned with the construction of the resolvent for any given kernel function. In problems with ill-behaved inhomogeneous terms as, for instance, in the aerodynamic problem of flow over a flapped airfoil, direct numerical methods become very difficult. A description is presented of a solution method by resolvent which can be employed in such problems.

Image Coding Based on Address Vector Quantization.

NASA Astrophysics Data System (ADS)

Feng, Yushu

Image coding is finding increased application in teleconferencing, archiving, and remote sensing. This thesis investigates the potential of Vector Quantization (VQ), a relatively new source coding technique, for compression of monochromatic and color images. Extensions of the Vector Quantization technique to the Address Vector Quantization method have been investigated. In Vector Quantization, the image data to be encoded are first processed to yield a set of vectors. A codeword from the codebook which best matches the input image vector is then selected. Compression is achieved by replacing the image vector with the index of the code-word which produced the best match, the index is sent to the channel. Reconstruction of the image is done by using a table lookup technique, where the label is simply used as an address for a table containing the representative vectors. A code-book of representative vectors (codewords) is generated using an iterative clustering algorithm such as K-means, or the generalized Lloyd algorithm. A review of different Vector Quantization techniques are given in chapter 1. Chapter 2 gives an overview of codebook design methods including the Kohonen neural network to design codebook. During the encoding process, the correlation of the address is considered and Address Vector Quantization is developed for color image and monochrome image coding. Address VQ which includes static and dynamic processes is introduced in chapter 3. In order to overcome the problems in Hierarchical VQ, Multi-layer Address Vector Quantization is proposed in chapter 4. This approach gives the same performance as that of the normal VQ scheme but the bit rate is about 1/2 to 1/3 as that of the normal VQ method. In chapter 5, a Dynamic Finite State VQ based on a probability transition matrix to select the best subcodebook to encode the image is developed. In chapter 6, a new adaptive vector quantization scheme, suitable for color video coding, called "A Self -Organizing

Robust parallel iterative solvers for linear and least-squares problems, Final Technical Report

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

Saad, Yousef

2014-01-16

The primary goal of this project is to study and develop robust iterative methods for solving linear systems of equations and least squares systems. The focus of the Minnesota team is on algorithms development, robustness issues, and on tests and validation of the methods on realistic problems. 1. The project begun with an investigation on how to practically update a preconditioner obtained from an ILU-type factorization, when the coefficient matrix changes. 2. We investigated strategies to improve robustness in parallel preconditioners in a specific case of a PDE with discontinuous coefficients. 3. We explored ways to adapt standard preconditioners formore » solving linear systems arising from the Helmholtz equation. These are often difficult linear systems to solve by iterative methods. 4. We have also worked on purely theoretical issues related to the analysis of Krylov subspace methods for linear systems. 5. We developed an effective strategy for performing ILU factorizations for the case when the matrix is highly indefinite. The strategy uses shifting in some optimal way. The method was extended to the solution of Helmholtz equations by using complex shifts, yielding very good results in many cases. 6. We addressed the difficult problem of preconditioning sparse systems of equations on GPUs. 7. A by-product of the above work is a software package consisting of an iterative solver library for GPUs based on CUDA. This was made publicly available. It was the first such library that offers complete iterative solvers for GPUs. 8. We considered another form of ILU which blends coarsening techniques from Multigrid with algebraic multilevel methods. 9. We have released a new version on our parallel solver - called pARMS [new version is version 3]. As part of this we have tested the code in complex settings - including the solution of Maxwell and Helmholtz equations and for a problem of crystal growth.10. As an application of polynomial preconditioning we considered

Spectral collocation for multiparameter eigenvalue problems arising from separable boundary value problems

NASA Astrophysics Data System (ADS)

Plestenjak, Bor; Gheorghiu, Călin I.; Hochstenbach, Michiel E.

2015-10-01

In numerous science and engineering applications a partial differential equation has to be solved on some fairly regular domain that allows the use of the method of separation of variables. In several orthogonal coordinate systems separation of variables applied to the Helmholtz, Laplace, or Schrödinger equation leads to a multiparameter eigenvalue problem (MEP); important cases include Mathieu's system, Lamé's system, and a system of spheroidal wave functions. Although multiparameter approaches are exploited occasionally to solve such equations numerically, MEPs remain less well known, and the variety of available numerical methods is not wide. The classical approach of discretizing the equations using standard finite differences leads to algebraic MEPs with large matrices, which are difficult to solve efficiently. The aim of this paper is to change this perspective. We show that by combining spectral collocation methods and new efficient numerical methods for algebraic MEPs it is possible to solve such problems both very efficiently and accurately. We improve on several previous results available in the literature, and also present a MATLAB toolbox for solving a wide range of problems.

Terrible Twos: Why Are 2-Year-Olds So Difficult?

MedlinePlus

... about the terrible twos. Why are 2-year-olds so difficult? Answers from Jay L. Hoecker, M. ... of Privacy Practices Notice of Nondiscrimination Manage Cookies Advertising Mayo Clinic is a not-for-profit organization ...

Universal Design Problem Solving

ERIC Educational Resources Information Center

Sterling, Mary C.

2004-01-01

Universal design is made up of four elements: accessibility, adaptability, aesthetics, and affordability. This article addresses the concept of universal design problem solving through experiential learning for an interior design studio course in postsecondary education. Students' experiences with clients over age 55 promoted an understanding of…

Breaking Down Difficult Family Patterns. Fostering Families. A Specialized Training Program Designed for Foster Care Workers & Foster Care Parents.

ERIC Educational Resources Information Center

Schatz, Mona Struhsaker; And Others

This module is part of a training program for foster parents and foster care workers offered at Colorado State University. The module examines the functioning of families with addictive and dependent members. The module's learning objectives address: (1) indicators of addiction problems in families, and cycles of substance use and abuse; (2) roles…

Dynamically Reconfigurable Approach to Multidisciplinary Problems

NASA Technical Reports Server (NTRS)

Alexandrov, Natalie M.; Lewis, Robert Michael

2003-01-01

The complexity and autonomy of the constituent disciplines and the diversity of the disciplinary data formats make the task of integrating simulations into a multidisciplinary design optimization problem extremely time-consuming and difficult. We propose a dynamically reconfigurable approach to MDO problem formulation wherein an appropriate implementation of the disciplinary information results in basic computational components that can be combined into different MDO problem formulations and solution algorithms, including hybrid strategies, with relative ease. The ability to re-use the computational components is due to the special structure of the MDO problem. We believe that this structure can and should be used to formulate and solve optimization problems in the multidisciplinary context. The present work identifies the basic computational components in several MDO problem formulations and examines the dynamically reconfigurable approach in the context of a popular class of optimization methods. We show that if the disciplinary sensitivity information is implemented in a modular fashion, the transfer of sensitivity information among the formulations under study is straightforward. This enables not only experimentation with a variety of problem formations in a research environment, but also the flexible use of formulations in a production design environment.

A hybrid symbolic/finite-element algorithm for solving nonlinear optimal control problems

NASA Technical Reports Server (NTRS)

Bless, Robert R.; Hodges, Dewey H.

1991-01-01

The general code described is capable of solving difficult nonlinear optimal control problems by using finite elements and a symbolic manipulator. Quick and accurate solutions are obtained with a minimum for user interaction. Since no user programming is required for most problems, there are tremendous savings to be gained in terms of time and money.

Radiofrequency ablation of hepatocellular carcinoma in difficult locations: Strategies and long-term outcomes

PubMed Central

Yang, Wei; Yan, Kun; Wu, Gong-Xiong; Wu, Wei; Fu, Ying; Lee, Jung-Chieh; Zhang, Zhong-Yi; Wang, Song; Chen, Min-Hua

2015-01-01

AIM: To investigate the treatment strategies and long-term outcomes of radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) in difficult locations and to compare the results with non-difficult HCC. METHODS: From 2004 to 2012, a total of 470 HCC patients underwent ultrasound-guided percutaneous RFA. Among these HCC patients, 382 with tumors located ≤ 5 mm from a major vessel/bile duct (n = 87), from peripheral important structures (n = 232) or from the liver capsule (n = 63) were regarded as difficult cases. There were 331 male patients and 51 female patients, with an average age of 55.3 ± 10.1 years old. A total of 235 and 147 patients had Child-Pugh class A and class B liver function, respectively. The average tumor size was 3.4 ± 1.2 cm. Individual treatment strategies were developed to treat these difficult cases. During the same period, 88 HCC patients with tumors that were not in difficult locations served as the control group. In the control group, 74 patients were male, and 14 patients were female, with an average age of 57.4 ± 11.8 years old. Of these, 62 patients and 26 patients had Child-Pugh class A and class B liver function, respectively. Regular follow-up after RFA was performed to assess treatment efficacy. Survival results were generated from Kaplan-Meier estimates, and multivariate analysis was performed using the Cox regression model. RESULTS: Early tumor necrosis rate in the difficult group was similar to that in the control group (97.6% vs 94.3%, P = 0.080). The complication rate in the difficult group was significantly higher than that in the control group (4.9% vs 0.8%, P = 0.041). The follow-up period ranged from 6 to 116 mo, with an average of 28 ± 22.4 mo. Local progression rate in the difficult group was significantly higher than that in the control group (12.7% vs 7.1%, P = 0.046). However, the 1-, 3-, 5-, and 7-year overall survival rates in the difficult group were not significantly different from those in the control

Emerging Infections Program Efforts to Address Health Equity

PubMed Central

Vugia, Duc J.; Bennett, Nancy M.; Moore, Matthew R.

2015-01-01

The Emerging Infections Program (EIP), a collaboration between (currently) 10 state health departments, their academic center partners, and the Centers for Disease Control and Prevention, was established in 1995. The EIP performs active, population-based surveillance for important infectious diseases, addresses new problems as they arise, emphasizes projects that lead to prevention, and develops and evaluates public health practices. The EIP has increasingly addressed the health equity challenges posed by Healthy People 2020. These challenges include objectives to increase the proportion of Healthy People–specified conditions for which national data are available by race/ethnicity and socioeconomic status as a step toward first recognizing and subsequently eliminating health inequities. EIP has made substantial progress in moving from an initial focus on monitoring social determinants exclusively through collecting and analyzing data by race/ethnicity to identifying and piloting ways to conduct population-based surveillance by using area-based socioeconomic status measures. PMID:26291875

Noticing relevant problem features: activating prior knowledge affects problem solving by guiding encoding

PubMed Central

Crooks, Noelle M.; Alibali, Martha W.

2013-01-01

This study investigated whether activating elements of prior knowledge can influence how problem solvers encode and solve simple mathematical equivalence problems (e.g., 3 + 4 + 5 = 3 + __). Past work has shown that such problems are difficult for elementary school students (McNeil and Alibali, 2000). One possible reason is that children's experiences in math classes may encourage them to think about equations in ways that are ultimately detrimental. Specifically, children learn a set of patterns that are potentially problematic (McNeil and Alibali, 2005a): the perceptual pattern that all equations follow an “operations = answer” format, the conceptual pattern that the equal sign means “calculate the total”, and the procedural pattern that the correct way to solve an equation is to perform all of the given operations on all of the given numbers. Upon viewing an equivalence problem, knowledge of these patterns may be reactivated, leading to incorrect problem solving. We hypothesized that these patterns may negatively affect problem solving by influencing what people encode about a problem. To test this hypothesis in children would require strengthening their misconceptions, and this could be detrimental to their mathematical development. Therefore, we tested this hypothesis in undergraduate participants. Participants completed either control tasks or tasks that activated their knowledge of the three patterns, and were then asked to reconstruct and solve a set of equivalence problems. Participants in the knowledge activation condition encoded the problems less well than control participants. They also made more errors in solving the problems, and their errors resembled the errors children make when solving equivalence problems. Moreover, encoding performance mediated the effect of knowledge activation on equivalence problem solving. Thus, one way in which experience may affect equivalence problem solving is by influencing what students encode about the

Efficient authentication scheme based on near-ring root extraction problem

NASA Astrophysics Data System (ADS)

Muthukumaran, V.; Ezhilmaran, D.

2017-11-01

An authentication protocolis the type of computer communication protocol or cryptography protocol specifically designed for transfer of authentication data between two entities. We have planned a two new entity authentication scheme on the basis of root extraction problem near-ring in this article. We suggest that this problem is suitably difficult to serve as a cryptographic assumption over the platform of near-ring N. The security issues also discussed.

Why Is It Difficult to Predict Language Impairment and Outcome in Patients with Aphasia after Stroke?

PubMed Central

Kasselimis, Dimitrios; Varkanitsa, Maria; Selai, Caroline; Potagas, Constantin; Evdokimidis, Ioannis

2014-01-01

One of the most devastating consequences of stroke is aphasia. Communication problems after stroke can severely impair the patient's quality of life and make even simple everyday tasks challenging. Despite intense research in the field of aphasiology, the type of language impairment has not yet been localized and correlated with brain damage, making it difficult to predict the language outcome for stroke patients with aphasia. Our primary objective is to present the available evidence that highlights the difficulties of predicting language impairment after stroke. The different levels of complexity involved in predicting the lesion site from language impairment and ultimately predicting the long-term outcome in stroke patients with aphasia were explored. Future directions and potential implications for research and clinical practice are highlighted. PMID:24829592

High-performance parallel analysis of coupled problems for aircraft propulsion

NASA Technical Reports Server (NTRS)

Felippa, C. A.; Farhat, C.; Lanteri, S.; Gumaste, U.; Ronaghi, M.

1994-01-01

Applications are described of high-performance parallel, computation for the analysis of complete jet engines, considering its multi-discipline coupled problem. The coupled problem involves interaction of structures with gas dynamics, heat conduction and heat transfer in aircraft engines. The methodology issues addressed include: consistent discrete formulation of coupled problems with emphasis on coupling phenomena; effect of partitioning strategies, augmentation and temporal solution procedures; sensitivity of response to problem parameters; and methods for interfacing multiscale discretizations in different single fields. The computer implementation issues addressed include: parallel treatment of coupled systems; domain decomposition and mesh partitioning strategies; data representation in object-oriented form and mapping to hardware driven representation, and tradeoff studies between partitioning schemes and fully coupled treatment.

My favorite tips for engaging the difficult patient on consultation-liaison psychiatry services.

PubMed

Knesper, David J

2007-06-01

Disengagement is the main enemy for the consultation-liaison psychiatrist. The goal of the first interview is to transform the unwilling, uncooperative, and often difficult and hostile patient into an engaged interview participant. Otherwise, the interview is an unproductive interrogation and an unpleasant power struggle. Once the difficult patient is engaged, the more typical psychiatric interview can begin. The three interview-engagement tips or techniques described are among the author's favorite ways to overcome the impediments to engagement most often associated with difficult patients.

Addressing Bullying Problems in Irish Schools and in Cyberspace: A Challenge for School Management

ERIC Educational Resources Information Center

Corcoran, Lucie; Mc Guckin, Conor

2014-01-01

Background: School management, in Ireland and also internationally, are currently faced with the problem of peer aggression among students both in a traditional school context and in a cyber context. Although Irish school principals are obliged to implement policy and procedures to counter bullying among students, there is a need for guidance that…

URISA Address Standard

EPA Pesticide Factsheets

The Urban and Regional Information Systems Association (URISA) standard for addresses. The document covers thoroughfare, landmark, and postal addresses within the United States, including its outlying territories and possessions.

Doing science in difficult socioeconomic circumstances.

PubMed

Karasmanis, Eva P

2018-06-01

Doing scientific research can be a challenging, but creative and rewarding career. However, the challenge of doing research is orders of magnitude more difficult for scientists lacking access to the necessary resources. Resource-scarce environments are quite common worldwide and are highly contingent on the financial and social climate of one's location. Through the experiences of four scientists, this Perspective explores the challenges associated with doing research in disadvantaged socioeconomic circumstances. By reflecting on the humble beginnings of these scientists, we examine the motivation to stay in or leave one's home country, and how hardships can be leveraged to cultivate passionate and productive researchers.

Attacking a Dense Problem: A Learner-Centered Approach to Teaching Density

ERIC Educational Resources Information Center

Hitt, Austin M.

2005-01-01

Density is a difficult concept for students to learn because it is abstract and because it is derived from the concepts of mass and volume. The solution is to address density at each of the three levels of scientific understanding: macroscopic, particle/modeling, and symbolic. This article demonstrates how to help students gain a conceptual…

Models of performance of evolutionary program induction algorithms based on indicators of problem difficulty.

PubMed

Graff, Mario; Poli, Riccardo; Flores, Juan J

2013-01-01

Modeling the behavior of algorithms is the realm of evolutionary algorithm theory. From a practitioner's point of view, theory must provide some guidelines regarding which algorithm/parameters to use in order to solve a particular problem. Unfortunately, most theoretical models of evolutionary algorithms are difficult to apply to realistic situations. However, in recent work (Graff and Poli, 2008, 2010), where we developed a method to practically estimate the performance of evolutionary program-induction algorithms (EPAs), we started addressing this issue. The method was quite general; however, it suffered from some limitations: it required the identification of a set of reference problems, it required hand picking a distance measure in each particular domain, and the resulting models were opaque, typically being linear combinations of 100 features or more. In this paper, we propose a significant improvement of this technique that overcomes the three limitations of our previous method. We achieve this through the use of a novel set of features for assessing problem difficulty for EPAs which are very general, essentially based on the notion of finite difference. To show the capabilities or our technique and to compare it with our previous performance models, we create models for the same two important classes of problems-symbolic regression on rational functions and Boolean function induction-used in our previous work. We model a variety of EPAs. The comparison showed that for the majority of the algorithms and problem classes, the new method produced much simpler and more accurate models than before. To further illustrate the practicality of the technique and its generality (beyond EPAs), we have also used it to predict the performance of both autoregressive models and EPAs on the problem of wind speed forecasting, obtaining simpler and more accurate models that outperform in all cases our previous performance models.

Using Technology to Meet the Developmental Needs of Deaf Students To Improve Their Mathematical Word Problem Solving Skills.

ERIC Educational Resources Information Center

Kelly, Ronald R.

2003-01-01

Presents "Project Solve," a web-based problem-solving instruction and guided practice for mathematical word problems. Discusses implications for college students for whom reading and comprehension of mathematical word problem solving are difficult, especially learning disabled students. (Author/KHR)

1989 Teacher of the Year: Address Delivered at GCSS Annual Convention, November, 1989.

ERIC Educational Resources Information Center

Bicouvaris, Mary V.

1990-01-01

The 1989 Teacher of the Year, Mary V. Bicouvaris discusses social studies education, public education, and teachers. Stresses the importance of geographic and international education and addresses the problems of falling test scores, use of illegal drugs, teenage pregnancies, and school dropouts. (RW)

Difficult temperament and negative parenting in early childhood: a genetically informed cross-lagged analysis.

PubMed

Micalizzi, Lauren; Wang, Manjie; Saudino, Kimberly J

2017-03-01

A genetically informed longitudinal cross-lagged model was applied to twin data to explore etiological links between difficult temperament and negative parenting in early childhood. The sample comprised 313 monozygotic (MZ) and dizygotic (DZ) twin pairs. Difficult temperament and negative parenting were assessed at ages 2 and 3 using parent ratings. Both constructs were interrelated within and across age (rs .34-.47) and showed substantial stability (rs .65-.68). Difficult temperament and negative parenting were influenced by genetic and environmental factors at ages 2 and 3. The genetic and nonshared environmental correlations (rs .21-.76) at both ages suggest overlap at the level of etiology between the phenotypes. Significant bidirectional associations between difficult temperament and negative parenting were found. The cross-lagged association from difficult temperament at age 2 to negative parenting at age 3 and from negative parenting at age 2 and difficult temperament at age 3 were due to genetic, shared environmental, and nonshared environmental factors. Substantial novel genetic and nonshared environmental influences emerged at age 3 and suggest change in the etiology of these constructs over time. © 2015 John Wiley & Sons Ltd.

Difficult temperament and negative parenting in early childhood: a genetically informed cross-lagged analysis

PubMed Central

Micalizzi, Lauren; Wang, Manjie; Saudino, Kimberly J.

2015-01-01

A genetically informed longitudinal cross-lagged model was applied to twin data to explore etiological links between difficult temperament and negative parenting in early childhood. The sample comprised 313 monozygotic (MZ) and dizygotic (DZ) twin pairs. Difficult temperament and negative parenting were assessed at ages 2 and 3 using parent ratings. Both constructs were interrelated within and across age (rs .34–.47) and showed substantial stability (rs .65–.68). Difficult temperament and negative parenting were influenced by genetic and environmental factors at ages 2 and 3. The genetic and nonshared environmental correlations (rs .21–.76) at both ages suggest overlap at the level of etiology between the phenotypes. Significant bidirectional associations between difficult temperament and negative parenting were found. The cross-lagged association from difficult temperament at age 2 to negative parenting at age 3 and from negative parenting at age 2 and difficult temperament at age 3 were due to genetic, shared environmental, and nonshared environmental factors. Substantial novel genetic and nonshared environmental influences emerged at age 3 and suggest change in the etiology of these constructs over time. PMID:26490166

An Assessment of the Effect of Collaborative Groups on Students' Problem-Solving Strategies and Abilities

ERIC Educational Resources Information Center

Cooper, Melanie M.; Cox, Charles T., Jr.; Nammouz, Minory; Case, Edward; Stevens, Ronald

2008-01-01

Improving students' problem-solving skills is a major goal for most science educators. While a large body of research on problem solving exists, assessment of meaningful problem solving is very difficult, particularly for courses with large numbers of students in which one-on-one interactions are not feasible. We have used a suite of software…

Addressing dual agency: getting specific about the expectations of professionalism.

PubMed

Tilburt, Jon C

2014-01-01

Professionalism requires that physicians uphold the best interests of patients while simultaneously insuring just use of health care resources. Current articulations of these obligations like the American Board of Internal Medicine (ABIM) Foundation's Physician Charter do not reconcile how these obligations fit together when they conflict. This is the problem of dual agency. The most common ways of dealing with dual agency: "bunkering"--physicians act as though societal cost issues are not their problem; "bailing"--physicians assume that they are merely agents of society and deliver care typically based on a strongly consequentialist public health ethic; or "balancing"--a vaguely specified attempt to uphold both patient welfare and societal need for judicious resource use simultaneously--all fail. Here I propose how the problem of dual agency might begin to be addressed with rigor and consistency. Without dealing with the dual agency problem and getting more specific about how to reconcile its norms when they conflict, the expectations of professionalism risk being written off as cute, nonbinding aphorisms from the medical profession.

Befriending for mental health problems: processes of helping.

PubMed

Mitchell, Gemma; Pistrang, Nancy

2011-06-01

One avenue for addressing the social consequences of mental health problems is through befriending, a supportive relationship in which one-to-one companionship is provided on a regular basis. Although there is some evidence that befriending can improve psychological and social functioning, little is known about how it works. This qualitative study aimed to understand the helping processes occurring in befriending relationships, from the perspectives of both befriendees and befrienders. Semi-structured interviews were conducted individually and jointly with eight befriendees and their corresponding befrienders. Thematic analysis was carried out on the data set of 23 interviews. The analysis generated nine themes concerning qualities of the relationship valued by befriendees and befrienders (e.g., empathy and mutuality), processes of making meaning (e.g., considering alternative perspectives), and how change was effected in befriendees' lives (e.g., learning how to have healthier relationships with others). The accounts emphasized the importance of the quality of the relationship itself, and highlighted aspects of the relationship that were sometimes difficult to negotiate. The findings suggest that befriending shares commonalities with other types of psychological help. However, it is also characterized by some particular challenges, such as establishing an empathic relationship and managing boundaries and endings. ©2010 The British Psychological Society.

Trading a Problem-solving Task

NASA Astrophysics Data System (ADS)

Matsubara, Shigeo

This paper focuses on a task allocation problem, especially cases where the task is to find a solution in a search problem or a constraint satisfaction problem. If the search problem is hard to solve, a contractor may fail to find a solution. Here, the more computational resources such as the CPU time the contractor invests in solving the search problem, the more a solution is likely to be found. This brings about a new problem that a contractee has to find an appropriate level of the quality in a task achievement as well as to find an efficient allocation of a task among contractors. For example, if the contractee asks the contractor to find a solution with certainty, the payment from the contractee to the contractor may exceed the contractee's benefit from obtaining a solution, which discourages the contractee from trading a task. However, solving this problem is difficult because the contractee cannot ascertain the contractor's problem-solving ability such as the amount of available resources and knowledge (e.g. algorithms, heuristics) or monitor what amount of resources are actually invested in solving the allocated task. To solve this problem, we propose a task allocation mechanism that is able to choose an appropriate level of the quality in a task achievement and prove that this mechanism guarantees that each contractor reveals its true information. Moreover, we show that our mechanism can increase the contractee's utility compared with a simple auction mechanism by using computer simulation.

Two heads are better than one: Australian tobacco control experts' and mental health change champions' consensus on addressing the problem of high smoking rates among people with mental illness.

PubMed

Rowley, Della; Lawn, Sharon; Coveney, John

2016-04-01

Objective The aims of the present study were to explore the beliefs of Australian experts in tobacco control and change champions working in mental health and tobacco cessation, and to identify measures for addressing the problem of high smoking rates for people with mental illness. Methods Qualitative interviews were undertaken to explore participants' views, and the Delphi technique was used to achieve consensus on ways in which the problem would be best addressed. Results This consensus centred on the need for leadership within the mental health system. The problem was reconceptualised from being solely the responsibility of the mental health sector into an issue that requires the combined resources of a partnership and shared leadership between government and non-government services, public health leaders, policy makers and people with mental illness and their families. Conclusions Collaboration would raise the priority of the issue, reduce the debilitating effect of stigma and discrimination within the mental health sector and would place smoking reduction firmly on the political and public agenda. A recovery-orientated focus would increase the skill base and be inclusive of workers, families and carers of people with mental illness who face smoking issues on a daily basis. Reconceptualising this as an issue that would benefit from cooperation and partnerships would disrupt the notion that the problem is solely the responsibility of the mental health sector. What is known about the topic? Rates of smoking have remained high for people with mental illness despite population-wide public health strategies successfully reducing smoking rates in the general population. For people with mental illness, the benefits of quitting smoking for both their mental and physical health are overshadowed by concerns about the complexity of their needs. There is a lack of knowledge about how smoking cessation support can be improved to increase success rates in smokers with

Questions Addressed to V.V. Putin during an Internet Conference on Careers

ERIC Educational Resources Information Center

Agranovich, M.; Zair-Bek, S.; Seliverstova, I.; Shishmakova, E.

2007-01-01

On instructions from the Ministry of Education of the Russian Federation, the Federal Institute for the Development of Education prepared an analytical report on the topic "Questions Addressed to Russian President V.V. Putin During an Internet Conference on 6 July 2006 on the Problems of "Career"." That document presents an…

Self-teaching neural network learns difficult reactor control problem

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

Jouse, W.C.

1989-01-01

A self-teaching neural network used as an adaptive controller quickly learns to control an unstable reactor configuration. The network models the behavior of a human operator. It is trained by allowing it to operate the reactivity control impulsively. It is punished whenever either the power or fuel temperature stray outside technical limits. Using a simple paradigm, the network constructs an internal representation of the punishment and of the reactor system. The reactor is constrained to small power orbits.

Dynamic Flow Management Problems in Air Transportation

NASA Technical Reports Server (NTRS)

Patterson, Sarah Stock

1997-01-01

In 1995, over six hundred thousand licensed pilots flew nearly thirty-five million flights into over eighteen thousand U.S. airports, logging more than 519 billion passenger miles. Since demand for air travel has increased by more than 50% in the last decade while capacity has stagnated, congestion is a problem of undeniable practical significance. In this thesis, we will develop optimization techniques that reduce the impact of congestion on the national airspace. We start by determining the optimal release times for flights into the airspace and the optimal speed adjustment while airborne taking into account the capacitated airspace. This is called the Air Traffic Flow Management Problem (TFMP). We address the complexity, showing that it is NP-hard. We build an integer programming formulation that is quite strong as some of the proposed inequalities are facet defining for the convex hull of solutions. For practical problems, the solutions of the LP relaxation of the TFMP are very often integral. In essence, we reduce the problem to efficiently solving large scale linear programming problems. Thus, the computation times are reasonably small for large scale, practical problems involving thousands of flights. Next, we address the problem of determining how to reroute aircraft in the airspace system when faced with dynamically changing weather conditions. This is called the Air Traffic Flow Management Rerouting Problem (TFMRP) We present an integrated mathematical programming approach for the TFMRP, which utilizes several methodologies, in order to minimize delay costs. In order to address the high dimensionality, we present an aggregate model, in which we formulate the TFMRP as a multicommodity, integer, dynamic network flow problem with certain side constraints. Using Lagrangian relaxation, we generate aggregate flows that are decomposed into a collection of flight paths using a randomized rounding heuristic. This collection of paths is used in a packing integer

AI techniques for a space application scheduling problem

NASA Technical Reports Server (NTRS)

Thalman, N.; Sparn, T.; Jaffres, L.; Gablehouse, D.; Judd, D.; Russell, C.

1991-01-01

Scheduling is a very complex optimization problem which can be categorized as an NP-complete problem. NP-complete problems are quite diverse, as are the algorithms used in searching for an optimal solution. In most cases, the best solutions that can be derived for these combinatorial explosive problems are near-optimal solutions. Due to the complexity of the scheduling problem, artificial intelligence (AI) can aid in solving these types of problems. Some of the factors are examined which make space application scheduling problems difficult and presents a fairly new AI-based technique called tabu search as applied to a real scheduling application. the specific problem is concerned with scheduling application. The specific problem is concerned with scheduling solar and stellar observations for the SOLar-STellar Irradiance Comparison Experiment (SOLSTICE) instrument in a constrained environment which produces minimum impact on the other instruments and maximizes target observation times. The SOLSTICE instrument will gly on-board the Upper Atmosphere Research Satellite (UARS) in 1991, and a similar instrument will fly on the earth observing system (Eos).

The patient-zero problem with noisy observations

NASA Astrophysics Data System (ADS)

Altarelli, Fabrizio; Braunstein, Alfredo; Dall'Asta, Luca; Ingrosso, Alessandro; Zecchina, Riccardo

2014-10-01

A belief propagation approach has been recently proposed for the patient-zero problem in SIR epidemics. The patient-zero problem consists of finding the initial source of an epidemic outbreak given observations at a later time. In this work, we study a more difficult but related inference problem, in which observations are noisy and there is confusion between observed states. In addition to studying the patient-zero problem, we also tackle the problem of completing and correcting the observations to possibly find undiscovered infected individuals and false test results. Moreover, we devise a set of equations, based on the variational expression of the Bethe free energy, to find the patient-zero along with maximum-likelihood epidemic parameters. We show, by means of simulated epidemics, that this method is able to infer details on the past history of an epidemic outbreak based solely on the topology of the contact network and a single snapshot of partial and noisy observations.

A Radio Model: A Community Strategy To Address the Problems and Needs of Mexican American Women Farmworkers.

ERIC Educational Resources Information Center

Lopez-Trevino, Maria Elena

Interviews with 60 Mexican-American female farmworkers in the Coachella Valley (California) identified their major problems, needs, and suggestions of topics to be presented in a community-based educational radio program. Two major problems identified by these women were low wages and occupational exposure to pesticides. Contrary to cultural…

Transactional relations between caregiving stress, executive functioning, and problem behavior from early childhood to early adolescence

PubMed Central

LaGasse, Linda L.; Conradt, Elisabeth; Karalunas, Sarah L.; Dansereau, Lynne M.; Butner, Jonathan E.; Shankaran, Seetha; Bada, Henrietta; Bauer, Charles R.; Whitaker, Toni M.; Lester, Barry M.

2016-01-01

Developmental psychopathologists face the difficult task of identifying the environmental conditions that may contribute to early childhood behavior problems. Highly stressed caregivers can exacerbate behavior problems, while children with behavior problems may make parenting more difficult and increase caregiver stress. Unknown is: (1) how these transactions originate, (2) whether they persist over time to contribute to the development of problem behavior and (3) what role resilience factors, such as child executive functioning, may play in mitigating the development of problem behavior. In the present study, transactional relations between caregiving stress, executive functioning, and behavior problems were examined in a sample of 1,388 children with prenatal drug exposures at three developmental time points: early childhood (birth-age 5), middle childhood (ages 6 to 9), and early adolescence (ages 10 to 13). Transactional relations differed between caregiving stress and internalizing versus externalizing behavior. Targeting executive functioning in evidence-based interventions for children with prenatal substance exposure who present with internalizing problems and treating caregiving psychopathology, depression, and parenting stress in early childhood may be particularly important for children presenting with internalizing behavior. PMID:27427803

Promoting Health by Addressing Basic Needs: Effect of Problem Resolution on Contacting Health Referrals

ERIC Educational Resources Information Center

Thompson, Tess; Kreuter, Matthew W.; Boyum, Sonia

2016-01-01

Members of vulnerable populations have heightened needs for health services. One advantage of integrating health risk assessment and referrals into social service assistance systems such as 2-1-1 is that such systems help callers resolve problems in other areas (e.g., housing). Callers to 2-1-1 in Missouri (N = 1,090) with at least one behavioral…

Application of an engineering problem-solving methodology to address persistent problems in patient safety: a case study on retained surgical sponges after surgery.

PubMed

Anderson, Devon E; Watts, Bradley V

2013-09-01

Despite innumerable attempts to eliminate the postoperative retention of surgical sponges, the medical error persists in operating rooms worldwide and places significant burden on patient safety, quality of care, financial resources, and hospital/physician reputation. The failure of countless solutions, from new sponge counting methods to radio labeled sponges, to truly eliminate the event in the operating room requires that the emerging field of health-care delivery science find innovative ways to approach the problem. Accordingly, the VA National Center for Patient Safety formed a unique collaboration with a team at the Thayer School of Engineering at Dartmouth College to evaluate the retention of surgical sponges after surgery and find a solution. The team used an engineering problem solving methodology to develop the best solution. To make the operating room a safe environment for patients, the team identified a need to make the sponge itself safe for use as opposed to resolving the relatively innocuous counting methods. In evaluation of this case study, the need for systematic engineering evaluation to resolve problems in health-care delivery becomes clear.

The Identity-Location Binding Problem.

PubMed

Howe, Piers D L; Ferguson, Adam

2015-09-01

The binding problem is fundamental to visual perception. It is the problem of associating an object's visual properties with itself and not with some other object. The problem is made particular difficult because different properties of an object, such as its color, shape, size, and motion, are often processed independently, sometimes in different cortical areas. The results of these separate analyses have to be combined before the object can be seen as a single coherent entity as opposed to a collection of unconnected features. Visual bindings are typically initiated and updated in a serial fashion, one object at a time. Here, we show that one type of binding, location-identity bindings, can be updated in parallel. We do this by using two complementary techniques, the simultaneous-sequential paradigm and systems factorial technology. These techniques make different assumptions and rely on different behavioral measures, yet both came to the same conclusion. Copyright © 2014 Cognitive Science Society, Inc.

Prevalence of difficult venous access and associated risk factors in highly complex hospitalised patients.

PubMed

Armenteros-Yeguas, Victoria; Gárate-Echenique, Lucía; Tomás-López, Maria Aranzazu; Cristóbal-Domínguez, Estíbaliz; Moreno-de Gusmão, Breno; Miranda-Serrano, Erika; Moraza-Dulanto, Maria Inmaculada

2017-12-01

To estimate the prevalence of difficult venous access in complex patients with multimorbidity and to identify associated risk factors. In highly complex patients, factors like ageing, the need for frequent use of irritant medication and multiple venous catheterisations to complete treatment could contribute to exhaustion of venous access. A cross-sectional study was conducted. 'Highly complex' patients (n = 135) were recruited from March 2013-November 2013. The main study variable was the prevalence of difficult venous access, assessed using one of the following criteria: (1) a history of difficulties obtaining venous access based on more than two attempts to insert an intravenous line and (2) no visible or palpable veins. Other factors potentially associated with the risk of difficult access were also measured (age, gender and chronic illnesses). Univariate analysis was performed for each potential risk factor. Factors with p < 0·2 were then included in multivariable logistic regression analysis. Odds ratios were also calculated. The prevalence of difficult venous access was 59·3%. The univariate logistic regression analysis indicated that gender, a history of vascular access complications and osteoarticular disease were significantly associated with difficult venous access. The multivariable logistic regression showed that only gender was an independent risk factor and the odds ratios was 2·85. The prevalence of difficult venous access is high in this population. Gender (female) is the only independent risk factor associated with this. Previous history of several attempts at catheter insertion is an important criterion in the assessment of difficult venous access. The prevalence of difficult venous access in complex patients is 59·3%. Significant risk factors include being female and a history of complications related to vascular access. © 2017 John Wiley & Sons Ltd.

Radiofrequency ablation for hepatocellular carcinoma: assistant techniques for difficult cases.

PubMed

Inoue, Tatsuo; Minami, Yasunori; Chung, Hobyung; Hayaishi, Sousuke; Ueda, Taisuke; Tatsumi, Chie; Takita, Masahiro; Kitai, Satoshi; Hatanaka, Kinuyo; Ishikawa, Emi; Yada, Norihisa; Hagiwara, Satoru; Ueshima, Kazuomi; Kudo, Masatoshi

2010-07-01

To confirm the safety and effectiveness of techniques to assist radiofrequency ablation (RFA) for difficult cases, we retrospectively evaluated successful treatment rates, early complications and local tumor progressions. Between June 1999 and April 2009, a total of 341 patients with 535 nodules were treated as difficult cases. Artificial pleural effusion assisted ablation was performed on 64 patients with 82 nodules. Artificial ascites-assisted ablation was performed on 11 patients with 13 nodules. Cooling by endoscopic nasobiliary drainage (ENBD) tube-assisted ablation was performed on 6 patients with 8 nodules. When the tumors were not well visualized with conventional B-mode ultrasonography (US), contrast-enhanced US-assisted ablation with Levovist or Sonazoid or virtual CT sonography-assisted ablation was performed. Contrast-enhanced US-assisted ablation was performed on 139 patients with 224 nodules and virtual CT sonography-assisted ablation was performed on 121 patients with 209 nodules. In total, complete ablation was achieved in 514 of 535 (96%) nodules in difficult cases. For RFA with artificial pleural effusion, artificial ascites and ENBD, complete response was confirmed in all cases. For contrast-enhanced US- and CT sonography-assisted ablation, complete response was 95%. Early complications were recognized in 24 cases (4.5%). All cases recovered with no invasive treatment. Local tumor recurrence was investigated in 377 nodules of 245 patients, and 69 (18%) nodules were positive. Tumor recurrences in each assisted technique were 14.7% in artificial pleural effusion cases, 7% in artificial ascites, 12.5% in ENBD tube cases, 31% in virtual CT sonography, and 8.5% in contrast-enhanced US. Although local tumor progression needs to be carefully monitored, assisted techniques of RFA for difficult cases are well tolerated and expand the indications of RFA. Copyright (c) 2010 S. Karger AG, Basel.

'Nursing research culture' in the context of clinical nursing practice: addressing a conceptual problem.

PubMed

Berthelsen, Connie Bøttcher; Hølge-Hazelton, Bibi

2017-05-01

To report an analysis of the concept of nursing research culture in the context of clinical nursing practice. Nursing research culture should be valued for its contribution to improving patient care and should be considered as a routine hospital activity. However, the demand for efficiency, nurses' barriers to research use and the lack of definition of the concept of nursing research culture make it difficult to establish. Concept analysis. Data were collected through a literature review in PubMed, CINAHL and PsycINFO during March 2016. Walker and Avant's eight-step framework for concept analysis. Five defining attributes of nursing research culture in the context of clinical nursing practice were identified: strong monodisciplinary nursing professionalism, academic thinking and socialization, research use as a part of daily nursing practice, acceptance by colleagues and management and facilitation of resources from management and organization. Although the method of concept analysis has been criticized and heavily debated, the development of nursing research cultures based on the defining attributes and antecedents of the concept will be important to emphasize evidence-based clinical nursing care. Further research should support the development and the implementation of nursing research culture in clinical nursing practice. © 2016 John Wiley & Sons Ltd.

Addressing Health Disparities through Multi-institutional, Multidisciplinary Collaboratories

PubMed Central

Fleming, Erik S.; Perkins, James; Easa, David; Conde, José G.; Baker, Richard S.; Southerland, William M.; Dottin, Robert; Benabe, Julio E.; Ofili, Elizabeth O.; Bond, Vincent C.; McClure, Shelia A.; Sayre, Michael H.; Beanan, Maureen J.; Norris, Keith C.

2009-01-01

The national research leadership has recently become aware of the tremendous potential of translational research as an approach to address health disparities. The Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) is a research network that supports multi-institutional, multidisciplinary collaboration with a focus on key diseases and conditions for which disproportionately adverse racial and ethnic health disparities exist. The RTRN is designed to facilitate the movement of scientific advances across the translational research spectrum by providing researchers at different institutions with the infrastructure and tools necessary to collaborate on interdisciplinary and transdisciplinary research projects relating to specific health outcomes for which major racial/ethnic disparities exist. In the past, the difficulty of overcoming the restrictions imposed by time and space have made it difficult to carry out this type of large-scale, multilevel collaboration efficiently. To address this formidable challenge, the RTRN will deploy a translational research cluster system that uses “cyber workspaces” to bring researchers with similar interests together by using online collaboratory technology. These virtual meeting environments will provide a number of tools, including videoconferences (seminars, works in progress, meetings); project management tools (WebCT, Microsoft Share Point); and posting areas for projects, concepts, and other research and educational activities. This technology will help enhance access to resources across institutions with a common mission, minimize many of the logistical hurdles that impede intellectual exchange, streamline the planning and implementation of innovative interdisciplinary research, and assess the use of protocols and practices to assist researchers in interacting across and within cyber workspaces. PMID:18646341

Addressing health disparities through multi-institutional, multidisciplinary collaboratories.

PubMed

Fleming, Erik S; Perkins, James; Easa, David; Conde, José G; Baker, Richard S; Southerland, William M; Dottin, Robert; Benabe, Julio E; Ofili, Elizabeth O; Bond, Vincent C; McClure, Shelia A; Sayre, Michael H; Beanan, Maureen J; Norris, Keith C

2008-01-01

The national research leadership has recently become aware of the tremendous potential of translational research as an approach to address health disparities. The Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) is a research network that supports multi-institutional, multidisciplinary collaboration with a focus on key diseases and conditions for which disproportionately adverse racial and ethnic health disparities exist. The RTRN is designed to facilitate the movement of scientific advances across the translational research spectrum by providing researchers at different institutions with the infrastructure and tools necessary to collaborate on interdisciplinary and transdisciplinary research projects relating to specific health outcomes for which major racial/ethnic disparities exist. In the past, the difficulty of overcoming the restrictions imposed by time and space have made it difficult to carry out this type of large-scale, multilevel collaboration efficiently. To address this formidable challenge, the RTRN will deploy a translational research cluster system that uses "cyber workspaces" to bring researchers with similar interests together by using online collaboratory technology. These virtual meeting environments will provide a number of tools, including videoconferences (seminars, works in progress, meetings); project management tools (WebCT, Microsoft Share Point); and posting areas for projects, concepts, and other research and educational activities. This technology will help enhance access to resources across institutions with a common mission, minimize many of the logistical hurdles that impede intellectual exchange, streamline the planning and implementation of innovative interdisciplinary research, and assess the use of protocols and practices to assist researchers in interacting across and within cyber workspaces.

Class and Home Problems: Humidification, a True "Home" Problem for p. Chemical Engineer

ERIC Educational Resources Information Center

Condoret, Jean-Stephane

2012-01-01

The problem of maintaining hygrothermal comfort in a house is addressed using the chemical engineer's toolbox. A simple dynamic modelling proved to give a good description of the humidification of the house in winter, using a domestic humidifier. Parameters of the model were identified from a simple experiment. Surprising results, especially…

What Highly Effective Leaders Do during Difficult Times

ERIC Educational Resources Information Center

Raisor, Michael Louis

2011-01-01

The purpose of this study was to determine what the most highly effective leaders do during difficult times to be successful. The backdrop of the study was the 2009 $300 million cuts to the Indiana K-12 education budget, a uniform crisis that affected all 293 public school districts at the same time. The subjects in this study were those…

Municipalities' Priority Problems and Prospect of Establishing Ordinance to Measures for Marginal Hamlets

NASA Astrophysics Data System (ADS)

Nakanishi, Mayumi; Hoshino, Satoshi; Hashimoto, Shizuka; Kuki, Yasuaki

The problems of Marginal Hamlets are getting worse, in which more than half of the population is over 65 and community-based life is difficult. To contribute to effective policy making, we conducted a questionnaire survey to members of the National Liaison Council of ‘Suigen no Sato’ constituted to share information about problems and effective counter measures for marginal hamlets. Our study clarified that first, most of respondents had common problems such as lack of job-opportunities and animal damage on farm, and second, though most of respondents recognized the effectiveness of selecting target communities in policy implementations, it is difficult for municipal governments to establish such ordinance provided that councilors and those who were not living in areas of policy target wouldn't agree with it. Finally, we pointed out the roles of national and prefectural governments to help municipal governments effectively cope with such entangled situations.

Matched Interface and Boundary Method for Elasticity Interface Problems

PubMed Central

Wang, Bao; Xia, Kelin; Wei, Guo-Wei

2015-01-01

Elasticity theory is an important component of continuum mechanics and has had widely spread applications in science and engineering. Material interfaces are ubiquity in nature and man-made devices, and often give rise to discontinuous coefficients in the governing elasticity equations. In this work, the matched interface and boundary (MIB) method is developed to address elasticity interface problems. Linear elasticity theory for both isotropic homogeneous and inhomogeneous media is employed. In our approach, Lamé’s parameters can have jumps across the interface and are allowed to be position dependent in modeling isotropic inhomogeneous material. Both strong discontinuity, i.e., discontinuous solution, and weak discontinuity, namely, discontinuous derivatives of the solution, are considered in the present study. In the proposed method, fictitious values are utilized so that the standard central finite different schemes can be employed regardless of the interface. Interface jump conditions are enforced on the interface, which in turn, accurately determines fictitious values. We design new MIB schemes to account for complex interface geometries. In particular, the cross derivatives in the elasticity equations are difficult to handle for complex interface geometries. We propose secondary fictitious values and construct geometry based interpolation schemes to overcome this difficulty. Numerous analytical examples are used to validate the accuracy, convergence and robustness of the present MIB method for elasticity interface problems with both small and large curvatures, strong and weak discontinuities, and constant and variable coefficients. Numerical tests indicate second order accuracy in both L∞ and L2 norms. PMID:25914439

A Case Study Approach to Nursing Home Placement: Smooth and Difficult Cases and Implications for Nursing.

PubMed

Koplow, Sarah M; Gallo, Agatha M; Knafl, Kathleen A; Vincent, Catherine; Paun, Olimpia; Gruss, Valerie

2015-07-01

Nursing home placement is one of the most challenging aspects of the caregiving journey. A case study approach was used to understand the experiences of caregivers during the first few months following nursing home placement. Two caregivers were selected from a larger qualitative descriptive study because their experiences exemplified smooth and difficult transitions for both themselves and their older family member. The caregivers were interviewed shortly after placement and 3 months post-placement. Four major contextual issues were identified that indicated the similarities and differences between the two cases, including (a) the caregiver's relationship with the older adult during the home caregiving time and post nursing home placement, (b) the circumstances surrounding placement, (c) support systems, and (d) continued involvement in care post-placement. Nursing home staff who understand these issues and address concerns through family-centered care can ease the transition and promote successful collaborations between staff and families. Copyright 2015, SLACK Incorporated.

Breaking difficult news in a newborn setting: Down syndrome as a paradigm.

PubMed

Dent, Karin M; Carey, John C

2006-08-15

Breaking the difficult news of an unexpected diagnosis to parents in the newborn setting is a common occurrence in genetic counseling. Many clinical geneticists and genetic counselors have had the challenge of delivering a postnatal diagnosis of Down syndrome to parents of newborns. Down syndrome is a common chromosome condition occurring in approximately 1 in 800 live births. Presenting the diagnosis to families must be accomplished in a supportive, positive, caring, and honest manner. However, there are few scientific data and little instruction in training programs on how best to convey this news in an appropriate manner. Several articles in the literature over the last three decades have proposed various guidelines for the so-called informing interview. Discussions of parents' preferences and experiences in receiving this news have also been documented. Few reports, however, have focused on breaking difficult news of the diagnosis of a genetic condition to parents in a newborn setting in the genetics literature. In this paper, we will review the medical literature on delivering difficult news, specifically focused on that regarding the diagnosis of Down syndrome in the newborn setting. We propose a theoretical framework from which the informing interview can be planned and future outcome data can be measured. In this way, researchers of this theme can investigate the process, including the healthcare professionals' delivery of difficult news and make recommendations for continued improvement of the process. Our model can be generalized to breaking difficult news for a variety of other congenital conditions.

Transboundary environmental assessment: lessons from OTAG. The Ozone Transport Assessment Group.

PubMed

Farrell, Alexander E; Keating, Terry J

2002-06-15

The nature and role of assessments in creating policy for transboundary environmental problems is discussed. Transboundary environmental problems are particularly difficult to deal with because they typically require cooperation among independent political jurisdictions (e.g., states or nations) which face differing costs and benefits and which often have different technical capabilities and different interests. In particular, transboundary pollution issues generally involve the problem of an upstream source and a downstream receptor on opposite sides of a relevant political boundary, making it difficult for the jurisdiction containing the receptor to obtain relief from the pollution problem. The Ozone Transport Assessment Group (OTAG) addressed such a transboundary problem: the long-range transport of tropospheric ozone (i.e., photochemical smog) across the eastern United States. The evolution of the science and policy that led to OTAG, the OTAG process, and its outcomes are presented. Lessons that are available to be learned from the OTAG experience, particularly for addressing similar transboundary problems such as regional haze, are discussed.

Linear complementarity formulation for 3D frictional sliding problems

USGS Publications Warehouse

Kaven, Joern; Hickman, Stephen H.; Davatzes, Nicholas C.; Mutlu, Ovunc

2012-01-01

Frictional sliding on quasi-statically deforming faults and fractures can be modeled efficiently using a linear complementarity formulation. We review the formulation in two dimensions and expand the formulation to three-dimensional problems including problems of orthotropic friction. This formulation accurately reproduces analytical solutions to static Coulomb friction sliding problems. The formulation accounts for opening displacements that can occur near regions of non-planarity even under large confining pressures. Such problems are difficult to solve owing to the coupling of relative displacements and tractions; thus, many geomechanical problems tend to neglect these effects. Simple test cases highlight the importance of including friction and allowing for opening when solving quasi-static fault mechanics models. These results also underscore the importance of considering the effects of non-planarity in modeling processes associated with crustal faulting.

EPA Announces Collaborative Innovative Research in Mass. and New York to Address State Environmental Issues

EPA Pesticide Factsheets

Today, the U.S. Environmental Protection Agency (EPA) announced research projects addressing priority environmental and human health problems in 14 states through partnerships between EPA’s research office, regional offices, and states.

Obstructive sleep apnea as a risk factor associated with difficult airway management - A narrative review.

PubMed

Leong, Siaw May; Tiwari, Akhilesh; Chung, Frances; Wong, David T

2018-03-01

The association between obstructive sleep apnea (OSA) and difficult airway had been studied in various clinical trials but the relationship between the two conditions has not been clearly established. The objective of this narrative review is to determine if OSA is a risk factor associated with difficult airway. The OVID Medline in process, Medline (vis Pub Med), EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science and SCOPUS were searched up to April 2016 using specific keywords. Inclusion criteria were: [1] airway management in patients with a diagnosis of OSA, [2] comparison of airway management between OSA and non-OSA patients, [3] publications or abstracts in the English language. The incidence of difficult airway between OSA and non-OSA patients was compared using Chi-square analysis or Fisher's exact test. Ten studies were included in the final review. Overall, the incidence of difficult tracheal intubation was higher in OSA patients versus non-OSA patients [56/386 (14.5%) vs. 69/897 (7.7%); P=0.0002]. OSA patients also have a higher incidence of difficult mask ventilation [115/4626 (2.5%) vs. 471/64,684 (0.7%); P<0.0001]. Compared to non-OSA patients, OSA was not associated with difficulty in the use of a supraglottic airway (SGA) device [10/663 (1.5%) vs. 162/15,171 (1.1%); P=0.38]. No studies compared difficult surgical airway in OSA and non-OSA patients. OSA was found to be a risk factor associated with difficult tracheal intubation and difficult mask ventilation. There was no association between OSA and difficult SGA use. Copyright © 2017 Elsevier Inc. All rights reserved.

Preschoolers Grow Their Brains: Shifting Mindsets for Greater Resiliency and Better Problem Solving

ERIC Educational Resources Information Center

Pawlina, Shelby; Stanford, Christie

2011-01-01

Challenges, mistakes, and problems are inherent every day in learning activities and social interactions. How children think about and respond to those difficult situations has an impact on how they see themselves as being able to shape their own learning and on how they handle the next problem that comes their way. Building resilience means…

Optically addressed ultra-wideband phased antenna array

NASA Astrophysics Data System (ADS)

Bai, Jian

Demands for high data rate and multifunctional apertures from both civilian and military users have motivated development of ultra-wideband (UWB) electrically steered phased arrays. Meanwhile, the need for large contiguous frequency is pushing operation of radio systems into the millimeter-wave (mm-wave) range. Therefore, modern radio systems require UWB performance from VHF to mm-wave. However, traditional electronic systems suffer many challenges that make achieving these requirements difficult. Several examples includes: voltage controlled oscillators (VCO) cannot provide a tunable range of several octaves, distribution of wideband local oscillator signals undergo high loss and dispersion through RF transmission lines, and antennas have very limited bandwidth or bulky sizes. Recently, RF photonics technology has drawn considerable attention because of its advantages over traditional systems, with the capability of offering extreme power efficiency, information capacity, frequency agility, and spatial beam diversity. A hybrid RF photonic communication system utilizing optical links and an RF transducer at the antenna potentially provides ultra-wideband data transmission, i.e., over 100 GHz. A successful implementation of such an optically addressed phased array requires addressing several key challenges. Photonic generation of an RF source with over a seven-octave bandwidth has been demonstrated in the last few years. However, one challenge which still remains is how to convey phased optical signals to downconversion modules and antennas. Therefore, a feed network with phase sweeping capability and low excessive phase noise needs to be developed. Another key challenge is to develop an ultra-wideband array antenna. Modern frontends require antennas to be compact, planar, and low-profile in addition to possessing broad bandwidth, conforming to stringent space, weight, cost, and power constraints. To address these issues, I will study broadband and miniaturization

Clinicians' recognition and management of emotions during difficult healthcare conversations.

PubMed

Martin, Elliott B; Mazzola, Natalia M; Brandano, Jessica; Luff, Donna; Zurakowski, David; Meyer, Elaine C

2015-10-01

To examine the most commonly reported emotions encountered among healthcare practitioners when holding difficult conversations, including frequency and impact on care delivery. Interprofessional learners from a range of experience levels and specialties completed self-report questionnaires prior to simulation-based communication workshops. Clinicians were asked to describe up to three emotions they experienced when having difficult healthcare conversations; subsequent questions used Likert-scales to measure frequency of each emotion, and whether care was affected. 152 participants completed questionnaires, including physicians, nurses, and psychosocial professionals. Most commonly reported emotions were anxiety, sadness, empathy, frustration, and insecurity. There were significant differences in how clinicians perceived these different emotions affecting care. Empathy and anxiety were emotions perceived to influence care more than sadness, frustration, and insecurity. Most clinicians, regardless of clinical experience and discipline, find their emotional state influences the quality of their care delivery. Most clinicians rate themselves as somewhat to quite capable of recognizing and managing their emotions, acknowledging significant room to grow. Further education designed to increase clinicians' recognition of, reflection on, and management of emotion would likely prove helpful in improving their ability to navigate difficult healthcare conversations. Interventions aimed at anxiety management are particularly needed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

IgE-blocking therapy for difficult-to-treat asthma: a brief review.

PubMed

Marshall, Gailen D; Sorkness, Christine A

2004-03-01

To review the characteristics of difficult-to-treat asthma and describe patients who may benefit from therapy with the recently approved humanized monoclonal antiimmunoglobulin E (IgE) antibody, omalizumab. Up to 20 percent of patients have difficult-to-treat asthma. These patients consume a disproportionate share of asthma care resources. Clinical and economic outcomes can be improved via improved self-management, increased adherence to prescribed therapy, and better compliance to national asthma treatment guidelines. These patients also may benefit from therapies that directly target mechanisms responsible for persistent airway inflammation and elicit favorable clinical responses. Effective asthma control remains difficult in a small cohort of patients with persistent, severe airway inflammation. Management strategies that improve asthma control and reduce exacerbations can improve clinical outcomes and minimize health care resource utilization.

A Pilot Study Evaluating "Dojo," a Videogame Intervention for Youths with Externalizing and Anxiety Problems.

PubMed

Schuurmans, Angela A T; Nijhof, Karin S; Vermaes, Ignace P R; Engels, Rutger C M E; Granic, Isabela

2015-10-01

Externalizing problems, which are the main reason for youth referrals to mental health agencies, are highly persistent and predict a range of negative outcomes. Youths with externalizing problems are also frequently comorbid with anxiety. Among the most widely recognized evidence-based treatments is cognitive behavioral therapy (CBT). Although CBT principles seem to be sound, effect sizes remain moderate, suggesting improvements could be made to this conventional treatment approach. The main premise of the current pilot study is to investigate the feasibility of implementing a videogame intervention ("Dojo" [Gamedesk, Los Angeles, CA]) that incorporates CBT principles and aims to address the limitations of conventional CBT delivery models, with the ultimate goal of improving outcomes for this difficult-to-treat population. "Dojo" is an emotion management game that helps youths to recognize and control their physiological and emotional arousal. We explored the implementation and user experience of "Dojo" in a sample of eight adolescents in residential treatment for both externalizing and anxiety problems. Participants attended all sessions without complaints. They evaluated "Dojo" very positively and exhibited high compliance during the training sessions. We encountered some problems with session scheduling and obtaining mentor reports. Quantitative data show the predicted decrease in three out of four measurements. The smooth implementation, high user satisfaction, high self-reported compliance during training sessions, and initial outcome results all indicate the high potential "Dojo" holds as an innovative intervention. If additional rigorously designed randomized controlled trials prove to be successful, "Dojo" can be a cost-effective way to engage high-risk youths in effective intervention.

Genetics problem solving and worldview

NASA Astrophysics Data System (ADS)

Dale, Esther

The research goal was to determine whether worldview relates to traditional and real-world genetics problem solving. Traditionally, scientific literacy emphasized content knowledge alone because it was sufficient to solve traditional problems. The contemporary definition of scientific literacy is, "The knowledge and understanding of scientific concepts and processes required for personal decision-making, participation in civic and cultural affairs and economic productivity" (NRC, 1996). An expanded definition of scientific literacy is needed to solve socioscientific issues (SSI), complex social issues with conceptual, procedural, or technological associations with science. Teaching content knowledge alone assumes that students will find the scientific explanation of a phenomenon to be superior to a non-science explanation. Formal science and everyday ways of thinking about science are two different cultures (Palmer, 1999). Students address this rift with cognitive apartheid, the boxing away of science knowledge from other types of knowledge (Jedege & Aikenhead, 1999). By addressing worldview, cognitive apartheid may decrease and scientific literacy may increase. Introductory biology students at the University of Minnesota during fall semester 2005 completed a written questionnaire-including a genetics content-knowledge test, four genetic dilemmas, the Worldview Assessment Instrument (WAI) and some items about demographics and religiosity. Six students responded to the interview protocol. Based on statistical analysis and interview data, this study concluded the following: (1) Worldview, in the form of metaphysics, relates to solving traditional genetic dilemmas. (2) Worldview, in the form of agency, relates to solving traditional genetics problems. (3) Thus, worldview must be addressed in curriculum, instruction, and assessment.

The Effects of Differentiating Instruction by Learning Styles on Problem Solving in Cooperative Groups

ERIC Educational Resources Information Center

Westbrook, Amy F.

2011-01-01

It can be difficult to find adequate strategies when teaching problem solving in a standard based mathematics classroom. The purpose of this study was to improve students' problem solving skills and attitudes through differentiated instruction when working on lengthy performance tasks in cooperative groups. This action research studied for 15 days…

Identifying and Investigating Difficult Concepts in Engineering Mechanics and Electric Circuits. Research Brief

ERIC Educational Resources Information Center

Streveler, Ruth; Geist, Monica; Ammerman, Ravel; Sulzbach, Candace; Miller, Ronald; Olds, Barbara; Nelson, Mary

2007-01-01

This study extends ongoing work to identify difficult concepts in thermal and transport science and measure students' understanding of those concepts via a concept inventory. Two research questions provided the focal point: "What important concepts in electric circuits and engineering mechanics do students find difficult to learn?" and…

Automatic procedures for the synthesis of difficult peptides using oxyma as activating reagent: A comparative study on the use of bases and on different deprotection and agitation conditions.

PubMed

Caporale, A; Doti, N; Monti, A; Sandomenico, A; Ruvo, M

2018-04-01

Solid-Phase Peptide Synthesis (SPPS) is a rapid and efficient methodology for the chemical synthesis of peptides and small proteins. However, the assembly of peptide sequences classified as "difficult" poses severe synthetic problems in SPPS for the occurrence of extensive aggregation of growing peptide chains which often leads to synthesis failure. In this framework, we have investigated the impact of different synthetic procedures on the yield and final purity of three well-known "difficult peptides" prepared using oxyma as additive for the coupling steps. In particular, we have comparatively investigated the use of piperidine and morpholine/DBU as deprotection reagents, the addition of DIPEA, collidine and N-methylmorpholine as bases to the coupling reagent. Moreover, the effect of different agitation modalities during the acylation reactions has been investigated. Data obtained represent a step forward in optimizing strategies for the synthesis of "difficult peptides". Copyright © 2018 Elsevier Inc. All rights reserved.

Teaching the Pressure-Flow Hypothesis of Phloem Transport in a Problem-Solving Session

ERIC Educational Resources Information Center

Clifford, Paul

2004-01-01

Problem solving is an ideal learning strategy, especially for topics that are perceived as difficult to teach. As an example, a format is described for a problem-solving session designed to help students understand the pressure-flow hypothesis of phloem transport in plants. Five key facts and their discussion can lead to the conclusion that a…

Scaling up to address data science challenges

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

Wendelberger, Joanne R.

Statistics and Data Science provide a variety of perspectives and technical approaches for exploring and understanding Big Data. Partnerships between scientists from different fields such as statistics, machine learning, computer science, and applied mathematics can lead to innovative approaches for addressing problems involving increasingly large amounts of data in a rigorous and effective manner that takes advantage of advances in computing. Here, this article will explore various challenges in Data Science and will highlight statistical approaches that can facilitate analysis of large-scale data including sampling and data reduction methods, techniques for effective analysis and visualization of large-scale simulations, and algorithmsmore » and procedures for efficient processing.« less

Scaling up to address data science challenges

DOE PAGES

Wendelberger, Joanne R.

2017-04-27

Statistics and Data Science provide a variety of perspectives and technical approaches for exploring and understanding Big Data. Partnerships between scientists from different fields such as statistics, machine learning, computer science, and applied mathematics can lead to innovative approaches for addressing problems involving increasingly large amounts of data in a rigorous and effective manner that takes advantage of advances in computing. Here, this article will explore various challenges in Data Science and will highlight statistical approaches that can facilitate analysis of large-scale data including sampling and data reduction methods, techniques for effective analysis and visualization of large-scale simulations, and algorithmsmore » and procedures for efficient processing.« less

Internet computer coaches for introductory physics problem solving

NASA Astrophysics Data System (ADS)

Xu Ryan, Qing

The ability to solve problems in a variety of contexts is becoming increasingly important in our rapidly changing technological society. Problem-solving is a complex process that is important for everyday life and crucial for learning physics. Although there is a great deal of effort to improve student problem solving skills throughout the educational system, national studies have shown that the majority of students emerge from such courses having made little progress toward developing good problem-solving skills. The Physics Education Research Group at the University of Minnesota has been developing Internet computer coaches to help students become more expert-like problem solvers. During the Fall 2011 and Spring 2013 semesters, the coaches were introduced into large sections (200+ students) of the calculus based introductory mechanics course at the University of Minnesota. This dissertation, will address the research background of the project, including the pedagogical design of the coaches and the assessment of problem solving. The methodological framework of conducting experiments will be explained. The data collected from the large-scale experimental studies will be discussed from the following aspects: the usage and usability of these coaches; the usefulness perceived by students; and the usefulness measured by final exam and problem solving rubric. It will also address the implications drawn from this study, including using this data to direct future coach design and difficulties in conducting authentic assessment of problem-solving.

Data mining for water resource management part 2 - methods and approaches to solving contemporary problems

USGS Publications Warehouse

Roehl, Edwin A.; Conrads, Paul

2010-01-01

This is the second of two papers that describe how data mining can aid natural-resource managers with the difficult problem of controlling the interactions between hydrologic and man-made systems. Data mining is a new science that assists scientists in converting large databases into knowledge, and is uniquely able to leverage the large amounts of real-time, multivariate data now being collected for hydrologic systems. Part 1 gives a high-level overview of data mining, and describes several applications that have addressed major water resource issues in South Carolina. This Part 2 paper describes how various data mining methods are integrated to produce predictive models for controlling surface- and groundwater hydraulics and quality. The methods include: - signal processing to remove noise and decompose complex signals into simpler components; - time series clustering that optimally groups hundreds of signals into "classes" that behave similarly for data reduction and (or) divide-and-conquer problem solving; - classification which optimally matches new data to behavioral classes; - artificial neural networks which optimally fit multivariate data to create predictive models; - model response surface visualization that greatly aids in understanding data and physical processes; and, - decision support systems that integrate data, models, and graphics into a single package that is easy to use.

Interference of psychological factors in difficult-to-control asthma.

PubMed

Halimi, Laurence; Vachier, Isabelle; Varrin, Muriel; Godard, Philippe; Pithon, Gérard; Chanez, Pascal

2007-01-01

Most patients with asthma can be controlled with suitable medication, but 5-10% of them remain difficult to control despite optimal management. We investigated whether patients with difficult-to-control asthma (DCA) or controlled asthma (CA) differ with respect to psychological factors, such as general control beliefs on life events. DCA was defined as an absence of control despite optimal management. Recent control was measured using the Asthma Control Questionnaire. General control beliefs were investigated using a Locus of Control scale (LOC). Patients with DCA had a significantly higher external LOC as compared to patients with CA (P=0.01). In the DCA group, the hospital admission rate was highly significant in association with the external LOC (P=0.004) as compared to the internal LOC trend. This study showed that patients with DCA had different general control beliefs which might have hampered their management and interfered with their therapeutic adherence. The present findings could enhance management of DCA in a clinical setting.

Addressing Mental Health Needs in Our Schools: Supporting the Role of School Counselors

ERIC Educational Resources Information Center

Collins, Traci P.

2014-01-01

School counselors are a well-positioned resource to reach the significant number of children and adolescents with mental health problems. In this special school counseling issue of "The Professional Counselor," some articles focus on systemic, top-down advocacy efforts as the point of intervention for addressing child and adolescent…

Finite element solution of optimal control problems with state-control inequality constraints

NASA Technical Reports Server (NTRS)

Bless, Robert R.; Hodges, Dewey H.

1992-01-01

It is demonstrated that the weak Hamiltonian finite-element formulation is amenable to the solution of optimal control problems with inequality constraints which are functions of both state and control variables. Difficult problems can be treated on account of the ease with which algebraic equations can be generated before having to specify the problem. These equations yield very accurate solutions. Owing to the sparse structure of the resulting Jacobian, computer solutions can be obtained quickly when the sparsity is exploited.

Parallel Preconditioning for CFD Problems on the CM-5

NASA Technical Reports Server (NTRS)

Simon, Horst D.; Kremenetsky, Mark D.; Richardson, John; Lasinski, T. A. (Technical Monitor)

1994-01-01

Up to today, preconditioning methods on massively parallel systems have faced a major difficulty. The most successful preconditioning methods in terms of accelerating the convergence of the iterative solver such as incomplete LU factorizations are notoriously difficult to implement on parallel machines for two reasons: (1) the actual computation of the preconditioner is not very floating-point intensive, but requires a large amount of unstructured communication, and (2) the application of the preconditioning matrix in the iteration phase (i.e. triangular solves) are difficult to parallelize because of the recursive nature of the computation. Here we present a new approach to preconditioning for very large, sparse, unsymmetric, linear systems, which avoids both difficulties. We explicitly compute an approximate inverse to our original matrix. This new preconditioning matrix can be applied most efficiently for iterative methods on massively parallel machines, since the preconditioning phase involves only a matrix-vector multiplication, with possibly a dense matrix. Furthermore the actual computation of the preconditioning matrix has natural parallelism. For a problem of size n, the preconditioning matrix can be computed by solving n independent small least squares problems. The algorithm and its implementation on the Connection Machine CM-5 are discussed in detail and supported by extensive timings obtained from real problem data.