Cooperation of international Research Infrastructures to address environmental global challenges

NASA Astrophysics Data System (ADS)

Bonet García, Francisco J.; Suárez-Muñoz, María; Conchubhair, Diarmuid O.; Dohna, Tina; Lo Bue, Nadia

2017-04-01

Human impact on the planet is causing a set of global environmental problems that threaten the wellbeing of current and future generations. Examples of these environmental problems include climate change, decline of biodiversity, alteration of biogeochemical cycles, ocean acidification, etc. These environmental Global Challenges (GCs) are transnational and complex, combining elements of both natural and social factors. Providing solutions for these challenges can be significantly enhanced through the collaboration of various related institutions, governments and stakeholders. A deeper understanding of the causes and consequences of GCs, as well as the processes which control them is required. Environmental Research Infrastructures (DANUBIUS-RI) are key players in this learning process. Covering many fields of research, it is through RIs collaboration that GCs can be more fully addressed. However, the collaboration among environmental RIs is still limited nationally as well as internationally. Although contact is encouraged and interactions are common practice, there are few cases where RI managers initiate and foster transnational collaborations in order to address specific problems. The COOP+ project aims to explore and strengthen cooperation among global RIs by bringing various RIs together and working on the identification of requirements, strengths, knowledge gaps and other relevant items in regard to the selected GCs. For this purpose, 13 GCs have been selected: coral bleaching, marine debris, noise impact on marine fauna, Arctic sea ice melting, pollinators decline, threatened species, agriculture pollutants, nitrogen cycle, carbon and GHG, geohazards and extreme events, estuaries, global urbanization process, and ozone depletion. These GCs are being analysed and described by multidisciplinary teams of experts composed of scientists, RIs operators and other stakeholders. This assessment will derive a list of tasks and requirements to be fulfilled by the

Applying evolutionary biology to address global challenges

PubMed Central

Carroll, Scott P.; Jørgensen, Peter Søgaard; Kinnison, Michael T.; Bergstrom, Carl T.; Denison, R. Ford; Gluckman, Peter; Smith, Thomas B.; Strauss, Sharon Y.; Tabashnik, Bruce E.

2014-01-01

Two categories of evolutionary challenges result from escalating human impacts on the planet. The first arises from cancers, pathogens and pests that evolve too quickly, and the second from the inability of many valued species to adapt quickly enough. Applied evolutionary biology provides a suite of strategies to address these global challenges that threaten human health, food security, and biodiversity. This review highlights both progress and gaps in genetic, developmental and environmental manipulations across the life sciences that either target the rate and direction of evolution, or reduce the mismatch between organisms and human-altered environments. Increased development and application of these underused tools will be vital in meeting current and future targets for sustainable development. PMID:25213376

Freight transportation : strategies needed to address planning and financing limitations

DOT National Transportation Integrated Search

2003-12-01

The General Accounting Office (GAO) was asked to address (1) the challenges to freight mobility, (2) the limitations key stakeholders have encountered in addressing these challenges, and (3) strategies that may aid decision makers in enhancing freigh...

Addressing tomorrow's DMO technical challenges today

NASA Astrophysics Data System (ADS)

Milligan, James R.

2009-05-01

Distributed Mission Operations (DMO) is essentially a type of networked training that pulls in participants from all the armed services and, increasingly, allies to permit them to "game" and rehearse highly complex campaigns, using a mix of local, distant, and virtual players. The United States Air Force Research Laboratory (AFRL) is pursuing Science and Technology (S&T) solutions to address technical challenges associated with distributed communications and information management as DMO continues to progressively scale up the number, diversity, and geographic dispersal of participants in training and rehearsal exercises.

NREL, SolarCity Addressing Challenges of High Penetrations of Distributed

Science.gov Websites

Companies NREL, SolarCity Addressing Challenges of High Penetrations of Distributed Photovoltaics NREL is , reliability, and stability challenges of interconnecting high penetrations of distributed photovoltaics (PV country that distributed solar is not a liability for reliability-and can even be an asset. Project Impact

Key Challenges in the Reform of Governance, Quality Assurance, and Finance in Vietnamese Higher Education--A Case Study

ERIC Educational Resources Information Center

Dao, Khanh Van

2015-01-01

Vietnam's higher education is highly centralized in terms of its governance and management. A couple of higher education reform plans have been introduced over the past decade but they seem to result in poor outcomes. This paper addresses the challenges faced in the areas of governance, quality assurance and finance by a "key" university…

Adequately Addressing Pediatric Obesity: Challenges Faced by Primary Care Providers.

PubMed

Shreve, Marilou; Scott, Allison; Vowell Johnson, Kelly

2017-07-01

To assess the challenges primary care providers encounter when providing counseling for pediatric patients identified as obese. A survey assessed the current challenges and barriers to the screening and treatment of pediatric obesity for providers in northwest Arkansas who provide care to families. The survey consisted of 15 Likert scale questions and 4 open-ended questions. Time, resources, comfort, and cultural issues were reported by providers as the biggest barriers in screening and the treatment of pediatric obesity. All providers reported lack of time as a barrier to providing the care needed for obese children. Cultural barriers of both the provider and client were identified as factors, which negatively affect the care and treatment of obese children. Primary care providers continue to experience challenges when addressing pediatric obesity. In this study, a lack of adequate time to address obesity was identified as the most significant current barrier and may likely be tied to physician resources. Although reimbursement for obesity is increasing, the level of reimbursement does not support the time or the resources needed to treat patients. Many providers reported their patients' cultural view of obesity influenced how they counsel their patients. Increasing providers' knowledge concerning differences in how weight is viewed or valued may assist them in the assessment and care of obese pediatric patients. The challenges identified in previous research continue to limit providers when addressing obesity. Although progress has been made regarding knowledge of guidelines, continuing effort is needed to tackle the remaining challenges. This will allow for earlier identification and intervention, resulting in improved outcomes in pediatric obesity.

Addressing Earth Science Data Access Challenges through User Experience Research

NASA Astrophysics Data System (ADS)

Hemmings, S. N.; Banks, B.; Kendall, J.; Lee, C. M.; Irwin, D.; Toll, D. L.; Searby, N. D.

2013-12-01

The NASA Capacity Building Program (Earth Science Division, Applied Sciences Program) works to enhance end-user capabilities to employ Earth observation and Earth science (EO/ES) data in decision-making. Open data access and user-tailored data delivery strategies are critical elements towards this end. User Experience (UX) and User Interface (UI) research methods can offer important contributions towards addressing data access challenges, particularly at the interface of science application/product development and product transition to end-users. This presentation focuses on developing nation contexts and describes methods, results, and lessons learned from two recent UX/UI efforts conducted in collaboration with NASA: the SERVIRglobal.net redesign project and the U.S. Water Partnership (USWP) Portal development effort. SERVIR, a collaborative venture among NASA, USAID, and global partners, seeks to improve environmental management and climate change response by helping governments and other stakeholders integrate EO and geospatial technologies into decision-making. The USWP, a collaboration among U.S. public and private sectors, harnesses U.S.-based resources and expertise to address water challenges in developing nations. SERVIR's study, conducted from 2010-2012, assessed and tested user needs, preferences, and online experiences to generate a more user-friendly online data portal at SERVIRglobal.net. The portal provides a central access interface to data and products from SERVIR's network of hubs in East Africa, the Hindu Kush Himalayas, and Mesoamerica. The second study, conducted by the USWP Secretariat and funded by the U.S. Department of State, seeks to match U.S.-based water information resources with developing nation stakeholder needs. The USWP study utilizes a multi-pronged approach to identify key design requirements and to understand the existing water data portal landscape. Adopting UX methods allows data distributors to design customized UIs that

Time for a change: addressing R&D and commercialization challenges for antibacterials

PubMed Central

Payne, David J.; Miller, Linda Federici; Findlay, David; Anderson, James; Marks, Lynn

2015-01-01

The antibacterial therapeutic area has been described as the perfect storm. Resistance is increasing to the point that our hospitals encounter patients infected with untreatable pathogens, the overall industry pipeline is described as dry and most multinational pharmaceutical companies have withdrawn from the area. Major contributing factors to the declining antibacterial industry pipeline include scientific challenges, clinical/regulatory hurdles and low return on investment. This paper examines these challenges and proposes approaches to address them. There is a need for a broader scientific agenda to explore new approaches to discover and develop antibacterial agents. Additionally, ideas of how industry and academia could be better integrated will be presented. While promising progress in the regulatory environment has been made, more streamlined regulatory paths are still required and the solutions will lie in global harmonization and clearly defined guidance. Creating the right incentives for antibacterial research and development is critical and a new commercial model for antibacterial agents will be proposed. One key solution to help resolve both the problem of antimicrobial resistance (AMR) and lack of new drug development are rapid, cost-effective, accurate point of care diagnostics that will transform antibacterial prescribing and enable more cost-effective and efficient antibacterial clinical trials. The challenges of AMR are too great for any one group to resolve and success will require leadership and partnerships among academia, industry and governments globally. PMID:25918443

Key challenges in the development and implementation of telehealth projects.

PubMed

Joseph, Victor; West, Robert M; Shickle, Darren; Keen, Justin; Clamp, Susan

2011-01-01

A literature review was carried out to identify the key challenges in the implementation of telehealth. This was followed by a survey of organisations in England involved in telehealth projects in order to understand the challenges they faced. Ten of the 13 health or local authority organisations surveyed had telehealth projects and three were at the planning stage. The analysis revealed seven key challenges facing implementers of telehealth in England. Based on the findings from the literature review and the survey, a model was constructed and a checklist drawn up. The model contained the following elements: identifying issues, needs and partners; producing a strategy; securing funding; implementing changes; and monitoring and evaluating a telehealth project. The checklist was validated by using key informants from the organisations originally surveyed. The checklist may be useful to guide telehealth development and implementation in the future.

Addressing challenges for future strategic-level emergency management: reframing, networking, and capacity-building.

PubMed

Bosomworth, Karyn; Owen, Christine; Curnin, Steven

2017-04-01

The mounting frequency and intensity of natural hazards, alongside growing interdependencies between social-technical and ecological systems, are placing increased pressure on emergency management. This is particularly true at the strategic level of emergency management, which involves planning for and managing non-routine, high-consequence events. Drawing on the literature, a survey, and interviews and workshops with Australia's senior emergency managers, this paper presents an analysis of five core challenges that these pressures are creating for strategic-level emergency management. It argues that emphasising 'emergency management' as a primary adaptation strategy is a retrograde step that ignores the importance of addressing socio-political drivers of vulnerabilities. Three key suggestions are presented that could assist the country's strategic-level emergency management in tackling these challenges: (i) reframe emergency management as a component of disaster risk reduction rather than them being one and the same; (ii) adopt a network governance approach; and (iii) further develop the capacities of strategic-level emergency managers. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Do textbooks address known learning challenges in area measurement? A comparative analysis

NASA Astrophysics Data System (ADS)

Hong, Dae S.; Choi, Kyong Mi; Runnalls, Cristina; Hwang, Jihyun

2018-02-01

This study compared area lessons from Korean textbooks and US standard-based textbooks to understand differences and similarities among these textbooks, as well as how these textbooks address known learning challenges in area measurement. Several well-known challenges have been identified in previous studies, such as covering, array structure, and linking array structure to area formula. We were interested in knowing if textbooks addressed these issues in their treatments of area measurement and, in doing so, provided students with opportunities to overcome or become familiar with known challenges. The results show that both countries' textbooks demonstrated similar limitations; only few area and area-related lessons are covered and three important learning challenges in area measurement are not covered well, which need to be informed to practicing teachers.

Addressing the Grand Challenge of atmospheric carbon dioxide: geologic sequestration vs. biological recycling

PubMed Central

2011-01-01

On February 15, 2008, the National Academy of Engineering unveiled their list of 14 Grand Challenges for Engineering. Building off of tremendous advancements in the past century, these challenges were selected for their role in assuring a sustainable existence for the rapidly increasing global community. It is no accident that the first five Challenges on the list involve the development of sustainable energy sources and management of environmental resources. While the focus of this review is to address the single Grand Challenge of "develop carbon sequestration methods", is will soon be clear that several other Challenges are intrinsically tied to it through the principles of sustainability. How does the realm of biological engineering play a role in addressing these Grand Challenges? PMID:22047501

Aviation Security: Efforts to Measure Effectiveness and Address Challenges

DTIC Science & Technology

2003-11-05

AND SUBTITLE AVIATION SECURITY Efforts to Meassure Effectiveness and Address Challenges 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT...screeners in becoming more adept at detecting hard -to-spot threat objects. However, TIP was shut down immediately following the September 11

Addressing strategy execution challenges to lead sustainable change.

PubMed

Shirey, Maria R

2011-01-01

This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author discusses strategy execution challenges that must be addressed to lead sustainable change.

Cross-sector partnerships and public health: challenges and opportunities for addressing obesity and noncommunicable diseases through engagement with the private sector.

PubMed

Johnston, Lee M; Finegood, Diane T

2015-03-18

Over the past few decades, cross-sector partnerships with the private sector have become an increasingly accepted practice in public health, particularly in efforts to address infectious diseases in low- and middle-income countries. Now these partnerships are becoming a popular tool in efforts to reduce and prevent obesity and the epidemic of noncommunicable diseases. Partnering with businesses presents a means to acquire resources, as well as opportunities to influence the private sector toward more healthful practices. Yet even though collaboration is a core principle of public health practice, public-private or nonprofit-private partnerships present risks and challenges that warrant specific consideration. In this article, we review the role of public health partnerships with the private sector, with a focus on efforts to address obesity and noncommunicable diseases in high-income settings. We identify key challenges-including goal alignment and conflict of interest-and consider how changes to partnership practice might address these.

Time for a change: addressing R&D and commercialization challenges for antibacterials.

PubMed

Payne, David J; Miller, Linda Federici; Findlay, David; Anderson, James; Marks, Lynn

2015-06-05

The antibacterial therapeutic area has been described as the perfect storm. Resistance is increasing to the point that our hospitals encounter patients infected with untreatable pathogens, the overall industry pipeline is described as dry and most multinational pharmaceutical companies have withdrawn from the area. Major contributing factors to the declining antibacterial industry pipeline include scientific challenges, clinical/regulatory hurdles and low return on investment. This paper examines these challenges and proposes approaches to address them. There is a need for a broader scientific agenda to explore new approaches to discover and develop antibacterial agents. Additionally, ideas of how industry and academia could be better integrated will be presented. While promising progress in the regulatory environment has been made, more streamlined regulatory paths are still required and the solutions will lie in global harmonization and clearly defined guidance. Creating the right incentives for antibacterial research and development is critical and a new commercial model for antibacterial agents will be proposed. One key solution to help resolve both the problem of antimicrobial resistance (AMR) and lack of new drug development are rapid, cost-effective, accurate point of care diagnostics that will transform antibacterial prescribing and enable more cost-effective and efficient antibacterial clinical trials. The challenges of AMR are too great for any one group to resolve and success will require leadership and partnerships among academia, industry and governments globally. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Challenges to using a business case for addressing health disparities.

PubMed

Lurie, Nicole; Somers, Stephen A; Fremont, Allen; Angeles, January; Murphy, Erin K; Hamblin, Allison

2008-01-01

The authors consider the challenges to quantifying both the business case and the social case for addressing disparities, which is central to achieving equity in the U.S. health care system. They describe the practical and methodological challenges faced by health plans exploring the business and social cases for undertaking disparity-reducing interventions. Despite these challenges, sound business and quality improvement principles can guide health care organizations seeking to reduce disparities. Place-based interventions may help focus resources and engage health care and community partners who can share in the costs of-and gains from-such efforts.

Biological approaches for addressing the grand challenge of providing access to clean drinking water.

PubMed

Riley, Mark R; Gerba, Charles P; Elimelech, Menachem

2011-03-31

The U.S. National Academy of Engineering (NAE) recently published a document presenting "Grand Challenges for Engineering". This list was proposed by leading engineers and scientists from around the world at the request of the U.S. National Science Foundation (NSF). Fourteen topics were selected for these grand challenges, and at least seven can be addressed using the tools and methods of biological engineering. Here we describe how biological engineers can address the challenge of providing access to clean drinking water. This issue must be addressed in part by removing or inactivating microbial and chemical contaminants in order to properly deliver water safe for human consumption. Despite many advances in technologies this challenge is expanding due to increased pressure on fresh water supplies and to new opportunities for growth of potentially pathogenic organisms.

Biological approaches for addressing the grand challenge of providing access to clean drinking water

PubMed Central

2011-01-01

The U.S. National Academy of Engineering (NAE) recently published a document presenting "Grand Challenges for Engineering". This list was proposed by leading engineers and scientists from around the world at the request of the U.S. National Science Foundation (NSF). Fourteen topics were selected for these grand challenges, and at least seven can be addressed using the tools and methods of biological engineering. Here we describe how biological engineers can address the challenge of providing access to clean drinking water. This issue must be addressed in part by removing or inactivating microbial and chemical contaminants in order to properly deliver water safe for human consumption. Despite many advances in technologies this challenge is expanding due to increased pressure on fresh water supplies and to new opportunities for growth of potentially pathogenic organisms. PMID:21453515

Key outcomes and addressing remaining challenges--perspectives from a final evaluation of the China GAVI project.

PubMed

Yang, Weizhong; Liang, Xiaofeng; Cui, Fuqiang; Li, Li; Hadler, Stephen C; Hutin, Yvan J; Kane, Mark; Wang, Yu

2013-12-27

During the China GAVI project, implemented between 2002 and 2010, more than 25 million children received hepatitis B vaccine with the support of project, and the vaccine proved to be safe and effective. With careful consideration for project savings, China and GAVI continually adjusted the budget, additionally allowing the project to spend operational funds to support demonstration projects to improve timely birth dose (TBD), conduct training of EPI staff, and to monitor the project impact. Results from the final evaluation indicated the achievement of key outcomes. As a result of government co-investment, human resources at county level engaged in hepatitis B vaccination increased from 29 per county on average in 2002 to 66 in 2009. All project counties funded by the GAVI project use auto-disable syringes for hepatitis B vaccination and other vaccines. Surveyed hepatitis B vaccine coverage increased from 71% in 2002 to 93% in 2009 among infants. The HBsAg prevalence declined from 9.67% in 1992 to 0.96% in 2006 among children under 5 years of age. However, several important issues remain: (1) China still accounts for the largest annual number of perinatal HBV infections (estimated 84,121) in the WHO WPR region; (2) China still lacks a clear national policy for safe injection of vaccines; (3) vaccination of high risk adults and protection of health care workers are still not implemented; (4) hepatitis B surveillance needs to be refined to more accurately monitor acute hepatitis B; and (5) a program for treatment of persons with chronic HBV infection is needed. Recommendations for future hepatitis B control include: using the lessons learned from the China GAVI project for future introductions of new vaccines; addressing unmet needs with a second generation hepatitis B program to reach every infant, including screening mothers, and providing HBIG for infants born to HBsAg positive mothers; expanding vaccination to high risk adults; addressing remaining unsafe

Technical challenges in designing post-marketing eCRFs to address clinical safety and pharmacovigilance needs.

PubMed

Lu, Zhengwu

2010-01-01

To identify key challenges and propose technical considerations in designing electronic case report form (eCRF) for post-marketing studies, the author undertakes a comprehensive literature review of peer reviewed and grey literature to assess the key aspects, processes, standards, recommendations, and best practices in designing eCRFs based on industry experience in designing and supporting electronic data capture (EDC) studies. Literature search using strings on MEDLINE and PUBMED returned few papers directly related to CRF design. Health informatics and general practice journals were searched and results reviewed. Many conference, government commission, health professional and special interests group websites provide relevant information from practical experience - summarization of this information is presented. Further, we presented a list of concrete technical considerations in dealing with EDC technology/system limitations based on literature assessment and industry implementation experience. It is recognized that cross-functional teams be involved in eCRF design process and decision making. To summarize the keys in designing eCRFs to address post-market study safety and pharmacovigilance needs, the first is to identify required data elements from the study protocol supporting data analyses and reporting requirements. Secondly, accepted best practices, CDASH & CDISC guidelines, and company internal or therapeutic unit standard should be considered and applied. Coding (MedDRA & WHODD) mapping should be managed and implemented as well when possible. Finally, we need to be on top of the EDC technologies, challenge the technologies, drive EDC improvement via working with vendors, and utilize the technologies to drive clinical effectiveness. Copyright (c) 2009 Elsevier Inc. All rights reserved.

Towards addressing transient learning challenges in undergraduate physics: an example from electrostatics

NASA Astrophysics Data System (ADS)

Fredlund, T.; Linder, C.; Airey, J.

2015-09-01

In this article we characterize transient learning challenges as learning challenges that arise out of teaching situations rather than conflicts with prior knowledge. We propose that these learning challenges can be identified by paying careful attention to the representations that students produce. Once a transient learning challenge has been identified, teachers can create interventions to address it. By illustration, we argue that an appropriate way to design such interventions is to create variation around the disciplinary-relevant aspects associated with the transient learning challenge.

Challenges faced by multidisplinary new investigators on addressing grand challenges in global health

PubMed Central

2014-01-01

Background The grand challenges approach aims to spark innovative and transformative strategies to overcome barriers to significant global health issues. Grand Challenges Canada endorses an ‘Integrated Innovation™’ approach that focuses on the intersection of scientific/technological, social and business innovation. In this article we explore themes emerging from a dialogue between the authors, who are multidisciplinary recipients of the ‘Rising Stars in Global Health’ award from Grand Challenges Canada, regarding benefits of engaging in integrated innovation research, and recommendations for how this approach may develop in the future. Discussion Our dialogue followed a semi-structured interview format that addressed three topics: 1) reflections on applying an Integrated Innovation™ approach for global health; 2) thoughts on participation in the Grand Challenges 2012 meeting; and 3) authors’ visions of Grand Challenges Canada and the Grand Challenge movement towards 2020. The dialogue was transcribed verbatim and we used thematic analysis techniques to identify, analyze and report themes in the data. Benefits of working using the Grand Challenges approach centered on two themes: a) the potential for scientific breakthrough and b) building interdisciplinary collaborations and a community of scholars. Challenges and opportunities for Grand Challenges in moving forward included: a) capacity building, particularly regarding Integrated Innovation™ and scale-up planning; b) interdisciplinary and international mentorship for new investigators; and c) potential for future commercialization. Conclusions Our discussion highlighted that Integrated Innovation™ offers the opportunity to develop new theories, methods and approaches to global health while simultaneously fostering a collaborative spirit grounded in international, interdisciplinary collaborations. However, the arguable over-emphasis on corporatization poses a major challenge for new investigators

Challenges faced by multidisplinary new investigators on addressing grand challenges in global health.

PubMed

Logie, Carmen; Dimaras, Helen; Fortin, Anny; Ramón-García, Santiago

2014-04-15

The grand challenges approach aims to spark innovative and transformative strategies to overcome barriers to significant global health issues. Grand Challenges Canada endorses an 'Integrated Innovation™' approach that focuses on the intersection of scientific/technological, social and business innovation. In this article we explore themes emerging from a dialogue between the authors, who are multidisciplinary recipients of the 'Rising Stars in Global Health' award from Grand Challenges Canada, regarding benefits of engaging in integrated innovation research, and recommendations for how this approach may develop in the future. Our dialogue followed a semi-structured interview format that addressed three topics: 1) reflections on applying an Integrated Innovation™ approach for global health; 2) thoughts on participation in the Grand Challenges 2012 meeting; and 3) authors' visions of Grand Challenges Canada and the Grand Challenge movement towards 2020. The dialogue was transcribed verbatim and we used thematic analysis techniques to identify, analyze and report themes in the data. Benefits of working using the Grand Challenges approach centered on two themes: a) the potential for scientific breakthrough and b) building interdisciplinary collaborations and a community of scholars. Challenges and opportunities for Grand Challenges in moving forward included: a) capacity building, particularly regarding Integrated Innovation™ and scale-up planning; b) interdisciplinary and international mentorship for new investigators; and c) potential for future commercialization. Our discussion highlighted that Integrated Innovation™ offers the opportunity to develop new theories, methods and approaches to global health while simultaneously fostering a collaborative spirit grounded in international, interdisciplinary collaborations. However, the arguable over-emphasis on corporatization poses a major challenge for new investigators. We propose a more balanced way forward

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

Policy recommendations for addressing privacy challenges associated with cell-based research and interventions.

PubMed

Ogbogu, Ubaka; Burningham, Sarah; Ollenberger, Adam; Calder, Kathryn; Du, Li; El Emam, Khaled; Hyde-Lay, Robyn; Isasi, Rosario; Joly, Yann; Kerr, Ian; Malin, Bradley; McDonald, Michael; Penney, Steven; Piat, Gayle; Roy, Denis-Claude; Sugarman, Jeremy; Vercauteren, Suzanne; Verhenneman, Griet; West, Lori; Caulfield, Timothy

2014-02-03

The increased use of human biological material for cell-based research and clinical interventions poses risks to the privacy of patients and donors, including the possibility of re-identification of individuals from anonymized cell lines and associated genetic data. These risks will increase as technologies and databases used for re-identification become affordable and more sophisticated. Policies that require ongoing linkage of cell lines to donors' clinical information for research and regulatory purposes, and existing practices that limit research participants' ability to control what is done with their genetic data, amplify the privacy concerns. To date, the privacy issues associated with cell-based research and interventions have not received much attention in the academic and policymaking contexts. This paper, arising out of a multi-disciplinary workshop, aims to rectify this by outlining the issues, proposing novel governance strategies and policy recommendations, and identifying areas where further evidence is required to make sound policy decisions. The authors of this paper take the position that existing rules and norms can be reasonably extended to address privacy risks in this context without compromising emerging developments in the research environment, and that exceptions from such rules should be justified using a case-by-case approach. In developing new policies, the broader framework of regulations governing cell-based research and related areas must be taken into account, as well as the views of impacted groups, including scientists, research participants and the general public. This paper outlines deliberations at a policy development workshop focusing on privacy challenges associated with cell-based research and interventions. The paper provides an overview of these challenges, followed by a discussion of key themes and recommendations that emerged from discussions at the workshop. The paper concludes that privacy risks associated with cell

Policy recommendations for addressing privacy challenges associated with cell-based research and interventions

PubMed Central

2014-01-01

Background The increased use of human biological material for cell-based research and clinical interventions poses risks to the privacy of patients and donors, including the possibility of re-identification of individuals from anonymized cell lines and associated genetic data. These risks will increase as technologies and databases used for re-identification become affordable and more sophisticated. Policies that require ongoing linkage of cell lines to donors’ clinical information for research and regulatory purposes, and existing practices that limit research participants’ ability to control what is done with their genetic data, amplify the privacy concerns. Discussion To date, the privacy issues associated with cell-based research and interventions have not received much attention in the academic and policymaking contexts. This paper, arising out of a multi-disciplinary workshop, aims to rectify this by outlining the issues, proposing novel governance strategies and policy recommendations, and identifying areas where further evidence is required to make sound policy decisions. The authors of this paper take the position that existing rules and norms can be reasonably extended to address privacy risks in this context without compromising emerging developments in the research environment, and that exceptions from such rules should be justified using a case-by-case approach. In developing new policies, the broader framework of regulations governing cell-based research and related areas must be taken into account, as well as the views of impacted groups, including scientists, research participants and the general public. Summary This paper outlines deliberations at a policy development workshop focusing on privacy challenges associated with cell-based research and interventions. The paper provides an overview of these challenges, followed by a discussion of key themes and recommendations that emerged from discussions at the workshop. The paper concludes that

7 Key Challenges for Visualization in Cyber Network Defense

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

Best, Daniel M.; Endert, Alexander; Kidwell, Dan

In this paper we present seven challenges, informed by two user studies, to be considered when developing a visualization for cyber security purposes. Cyber security visualizations must go beyond isolated solutions and “pretty picture” visualizations in order to make impact to users. We provide an example prototype that addresses the challenges with a description of how they are met. Our aim is to assist in increasing utility and adoption rates for visualization capabilities in cyber security.

Multiple-level stakeholder engagement in malaria clinical trials: addressing the challenges of conducting clinical research in resource-limited settings.

PubMed

Mtove, George; Kimani, Joshua; Kisinza, William; Makenga, Geofrey; Mangesho, Peter; Duparc, Stephan; Nakalembe, Miriam; Phiri, Kamija S; Orrico, Russell; Rojo, Ricardo; Vandenbroucke, Pol

2018-03-22

with key stakeholders at international and national levels enabled the Sponsoring Entities to address challenges by aligning the study design with the requirements of health and regulatory agencies and to understand and address healthcare infrastructure needs prior to trial initiation. Local stakeholder engagement, including community members, study participants, and family enabled the investigators to address challenges by ensuring that study design and conduct were adapted to local considerations and ensuring accurate information about the study aims was shared with the public. ClinicalTrials.gov, ID: NCT01103063 . Registered on 7 April 2010.

A proposed reductionist solution to address the methodological challenges of inconsistent reflexology maps and poor experimental controls in reflexology research: a discussion paper.

PubMed

Jones, Jenny; Thomson, Patricia; Lauder, William; Leslie, Stephen J

2013-03-01

Reflexology is a complex massage intervention, based on the concept that specific areas of the feet (reflex points) correspond to individual internal organs within the body. Reflexologists trained in the popular Ingham reflexology method claim that massage to these points, using massage techniques unique to reflexology, stimulates an increase in blood supply to the corresponding organ. Reflexology researchers face two key methodological challenges that need to be addressed if a specific treatment-related hemodynamic effect is to be scientifically demonstrated. The first is the problem of inconsistent reflexology foot maps; the second is the issue of poor experimental controls. This article proposes a potential experimental solution that we believe can address both methodological challenges and in doing so, allow any specific hemodynamic treatment effect unique to reflexology to experimentally reveal itself.

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

Determining the efficacy of national strategies aimed at addressing the challenges facing health personnel working in rural areas in KwaZulu-Natal, South Africa.

PubMed

Mburu, Grace; George, Gavin

2017-07-31

Shortages of Human Resources for Health (HRH) in rural areas are often driven by poor working and living conditions, inadequate salaries and benefits, lack of training and career development opportunities amongst others. The South African government has adopted a human resource strategy for the health sector in 2011 aimed at addressing these challenges. This study reviews the challenges faced by health personnel against government strategies aimed at attracting and retaining health personnel in these underserved areas. The study was conducted in six primary health care service sites in the Hlabisa sub-district of Umkhanyakude, located in northern KwaZulu-Natal, South Africa. The study population comprised 25 health workers including 11 professional nurses, 4 staff nurses and 10 doctors (4 medical doctors, 3 foreign medical doctors and 3 doctors undertaking community service). Qualitative data were collected from semi-structured interviews and analysed using thematic analysis. Government initiatives including the rural allowance, deployment of foreign medical doctors and the presence of health personnel undertaking their community service in rural areas are positively viewed by health personnel working in rural health facilities. However, poor living and working conditions, together with inadequate personal development opportunities, remain unresolved challenges. It is these challenges that will continue to dissuade experienced health personnel from remaining in these underserved areas. South Africa's HRH strategy for the Health Sector 2012/13-2015/16 had highlighted the key challenges raised by respondents and identified strategies aimed at addressing these challenges. Implementation of these strategies is key to improving both living and working conditions, and providing health personnel with opportunities for further development will require inter-ministerial collaboration if the HRH 2030 objectives are to be realised.

Strategies to Address Common Challenges When Teaching in an Active Learning Classroom

ERIC Educational Resources Information Center

Petersen, Christina I.; Gorman, Kristen S.

2014-01-01

This chapter provides practical strategies for addressing common challenges that arise for teachers in active learning classrooms. Our strategies come from instructors with experience teaching in these environments.

Health care financing in Asia: key issues and challenges.

PubMed

Kwon, Soonman

2011-09-01

This article examines the major elements of health care financing such as financial risk protection, resource generation, resource pooling, and purchasing and payment; provides key lessons; and discusses the challenges for health care financing systems of Asian countries. With the exception of Japan, Korea, Taiwan, and Thailand, most health care systems of Asia provide very limited financial risk protection. The role of public prepaid schemes such as tax and social health insurance is minimal, and out-of-pocket payment is a major source of financing. The large informal sector is a major challenge to the extension of population coverage in many low-income countries of Asia, which must seek the optimal mix of tax subsidy and health insurance for universal coverage. Implementation of effective payment systems to control the behavior of health care providers is also a key factor in the success of health care financing reform in Asia.

Dopamine signaling and myopia development: What are the key challenges.

PubMed

Zhou, Xiangtian; Pardue, Machelle T; Iuvone, P Michael; Qu, Jia

2017-11-01

In the face of an "epidemic" increase in myopia over the last decades and myopia prevalence predicted to reach 2.5 billion people by the end of this decade, there is an urgent need to develop effective and safe therapeutic interventions to slow down this "myopia booming" and prevent myopia-related complications and vision loss. Dopamine (DA) is an important neurotransmitter in the retina and mediates diverse functions including retina development, visual signaling, and refractive development. Inspired by the convergence of epidemiological and animal studies in support of the inverse relationship between outdoor activity and risk of developing myopia and by the close biological relationship between light exposure and dopamine release/signaling, we felt it is timely and important to critically review the role of DA in myopia development. This review will revisit several key points of evidence for and against DA mediating light control of myopia: 1) the causal role of extracellular retinal DA levels, 2) the mechanism and action of dopamine D1 and D2 receptors and 3) the roles of cellular/circuit retinal pathways. We examine the experiments that show causation by altering DA, DA receptors and visual pathways using pharmacological, transgenic, or visual environment approaches. Furthermore, we critically evaluate the safety issues of a DA-based treatment strategy and some approaches to address these issues. The review identifies the key questions and challenges in translating basic knowledge on DA signaling and myopia from animal studies into effective pharmacological treatments for myopia in children. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

MO-FG-BRB-01: Investing to Address the Global Cancer Challenge

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

Atun, R.

2015-06-15

corresponding potential benefits of addressing this challenge. To describe what radiation therapy infrastructure, in terms of facilities, equipment and personnel, will be required to address this challenge. To describe models of addressing personnel and infrastructure mobilization and capacity building within regions where significant cancer treatment disparities exist.« less

Determining the efficacy of national strategies aimed at addressing the challenges facing health personnel working in rural areas in KwaZulu-Natal, South Africa

PubMed Central

2017-01-01

Background Shortages of Human Resources for Health (HRH) in rural areas are often driven by poor working and living conditions, inadequate salaries and benefits, lack of training and career development opportunities amongst others. The South African government has adopted a human resource strategy for the health sector in 2011 aimed at addressing these challenges. Aim This study reviews the challenges faced by health personnel against government strategies aimed at attracting and retaining health personnel in these underserved areas. Setting The study was conducted in six primary health care service sites in the Hlabisa sub-district of Umkhanyakude, located in northern KwaZulu-Natal, South Africa. Methods The study population comprised 25 health workers including 11 professional nurses, 4 staff nurses and 10 doctors (4 medical doctors, 3 foreign medical doctors and 3 doctors undertaking community service). Qualitative data were collected from semi-structured interviews and analysed using thematic analysis. Results Government initiatives including the rural allowance, deployment of foreign medical doctors and the presence of health personnel undertaking their community service in rural areas are positively viewed by health personnel working in rural health facilities. However, poor living and working conditions, together with inadequate personal development opportunities, remain unresolved challenges. It is these challenges that will continue to dissuade experienced health personnel from remaining in these underserved areas. Conclusion South Africa’s HRH strategy for the Health Sector 2012/13–2015/16 had highlighted the key challenges raised by respondents and identified strategies aimed at addressing these challenges. Implementation of these strategies is key to improving both living and working conditions, and providing health personnel with opportunities for further development will require inter-ministerial collaboration if the HRH 2030 objectives are to be

Addressing the Analytic Challenges of Cross-Sectional Pediatric Pneumonia Etiology Data

PubMed Central

Feikin, Daniel R.; Scott, J. Anthony G.; Zeger, Scott L.; Murdoch, David R.; O’Brien, Katherine L.; Deloria Knoll, Maria

2017-01-01

Abstract Despite tremendous advances in diagnostic laboratory technology, identifying the pathogen(s) causing pneumonia remains challenging because the infected lung tissue cannot usually be sampled for testing. Consequently, to obtain information about pneumonia etiology, clinicians and researchers test specimens distant to the site of infection. These tests may lack sensitivity (eg, blood culture, which is only positive in a small proportion of children with pneumonia) and/or specificity (eg, detection of pathogens in upper respiratory tract specimens, which may indicate asymptomatic carriage or a less severe syndrome, such as upper respiratory infection). While highly sensitive nucleic acid detection methods and testing of multiple specimens improve sensitivity, multiple pathogens are often detected and this adds complexity to the interpretation as the etiologic significance of results may be unclear (ie, the pneumonia may be caused by none, one, some, or all of the pathogens detected). Some of these challenges can be addressed by adjusting positivity rates to account for poor sensitivity or incorporating test results from controls without pneumonia to account for poor specificity. However, no classical analytic methods can account for measurement error (ie, sensitivity and specificity) for multiple specimen types and integrate the results of measurements for multiple pathogens to produce an accurate understanding of etiology. We describe the major analytic challenges in determining pneumonia etiology and review how the common analytical approaches (eg, descriptive, case-control, attributable fraction, latent class analysis) address some but not all challenges. We demonstrate how these limitations necessitate a new, integrated analytical approach to pneumonia etiology data. PMID:28575372

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

PubMed Central

2013-01-01

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

Making Pedagogical Decisions to Address Challenges of Joint Jewish-Bedouin Environmental Projects in Israel

ERIC Educational Resources Information Center

Alkaher, Iris; Tal, Tali

2016-01-01

This interpretive study identifies challenges of working with Bedouin and Jewish Israeli youth in two multicultural projects: education for sustainability and place-conscious education. It also describes the ways the adult project leaders addressed these challenges and their views on the effectiveness of their decisions. Participants comprised 16…

Strategies for Addressing the Challenges of Patient-Centered Medical Home Implementation: Lessons from Oregon.

PubMed

Gelmon, Sherril; Bouranis, Nicole; Sandberg, Billie; Petchel, Shauna

2018-01-01

Patient-centered medical homes (PCMHs) are at the forefront of the transformation of primary care as part of health systems reform. Despite robust literature describing implementation challenges, few studies describe strategies being used to overcome these challenges. This article addresses this gap through observations of exemplary PCMHs in Oregon, where the Oregon Health Authority supports and recognizes Patient-Centered Primary Care Homes (PCPCH). Twenty exemplary PCPCHs were selected using program scores, with considerations for diversity in clinic characteristics. Between 2015 and 2016, semistructured interviews and focus groups were completed with 85 key informants. Clinics reported similar challenges implementing the PCPCH model, including shifting patterns of care use, fidelity to the PCPCH model, and refining care processes. The following ten implementation strategies emerged: expanding access through care teams, preventing unnecessary emergency department visits through patient outreach, improved communication and referral tracking with outside providers, prioritization of selected program metrics, implementing patient-centered practices, developing continuous improvement capacity through committees and "champions," incorporating preventive services and chronic disease management, standardization of workflows, customizing electronic health records, and integration of mental health. Clinic leaders benefited from understanding the local context in which they were operating. Despite differences in size, ownership, geography, and population, all clinic leaders were observed to be proponents of strategies commonly associated with a "learning organization": systems thinking, personal mastery, mental models, shared vision, and team. Clinics can draw on their own characteristics, use state resources, and look to established PCMHs to build the evidence base for implementation in primary care. © Copyright 2018 by the American Board of Family Medicine.

Addressing the Big-Earth-Data Variety Challenge with the Hierarchical Triangular Mesh

NASA Technical Reports Server (NTRS)

Rilee, Michael L.; Kuo, Kwo-Sen; Clune, Thomas; Oloso, Amidu; Brown, Paul G.; Yu, Honfeng

2016-01-01

We have implemented an updated Hierarchical Triangular Mesh (HTM) as the basis for a unified data model and an indexing scheme for geoscience data to address the variety challenge of Big Earth Data. We observe that, in the absence of variety, the volume challenge of Big Data is relatively easily addressable with parallel processing. The more important challenge in achieving optimal value with a Big Data solution for Earth Science (ES) data analysis, however, is being able to achieve good scalability with variety. With HTM unifying at least the three popular data models, i.e. Grid, Swath, and Point, used by current ES data products, data preparation time for integrative analysis of diverse datasets can be drastically reduced and better variety scaling can be achieved. In addition, since HTM is also an indexing scheme, when it is used to index all ES datasets, data placement alignment (or co-location) on the shared nothing architecture, which most Big Data systems are based on, is guaranteed and better performance is ensured. Moreover, our updated HTM encoding turns most geospatial set operations into integer interval operations, gaining further performance advantages.

Makerere University College of Health Sciences’ role in addressing challenges in health service provision at Mulago National Referral Hospital

PubMed Central

2011-01-01

Background Mulago National Referral Hospital (MNRH), Uganda’s primary tertiary and teaching hospital, and Makerere University College of Health Sciences (MakCHS) have a close collaborative relationship. MakCHS students complete clinical rotations at MNRH, and MakCHS faculty partner with Mulago staff in clinical care and research. In 2009, as part of a strategic planning process, MakCHS undertook a qualitative study to examine care and service provision at MNRH, identify challenges, gaps, and solutions, and explore how MakCHS could contribute to improving care and service delivery at MNRH. Methods Key informant interviews (n=23) and focus group discussions (n=7) were conducted with nurses, doctors, administrators, clinical officers and other key stakeholders. Interviews and focus groups were tape recorded and transcribed verbatim, and findings were analyzed through collaborative thematic analysis. Results Challenges to care and service delivery at MNRH included resource constraints (staff, space, equipment, and supplies), staff inadequacies (knowledge, motivation, and professionalism), overcrowding, a poorly functioning referral system, limited quality assurance, and a cumbersome procurement system. There were also insufficiencies in the teaching of professionalism and communication skills to students, and patient care challenges that included lack of access to specialized services, risk of infections, and inappropriate medications. Suggestions for how MakCHS could contribute to addressing these challenges included strengthening referral systems and peripheral health center capacity, and establishing quality assurance mechanisms. The College could also strengthen the teaching of professionalism, communication and leadership skills to students, and monitor student training and develop courses that contribute to continuous professional development. Additionally, the College could provide in-service education for providers on professionalism, communication skills

EPA Leadership on Science, Innovation, and Decision Support Tools for Addressing Current and Future Challenges.

PubMed

Hecht, Alan D; Ferster, Aaron; Summers, Kevin

2017-10-16

When the U.S. Environmental Protection Agency (EPA) was established nearly 50 years ago, the nation faced serious threats to its air, land, and water, which in turn impacted human health. These threats were effectively addressed by the creation of EPA (in 1970) and many subsequent landmark environmental legislations which in turn significantly reduced threats to the Nation's environment and public health. A key element of historic legislation is research aimed at dealing with current and future problems. Today we face national and global challenges that go beyond classic media-specific (air, land, water) environmental legislation and require an integrated paradigm of action and engagement based on (1) innovation based on science and technology, (2) stakeholder engagement and collaboration, and (3) public education and support. This three-pronged approach recognizes that current environmental problems, include social as well as physical and environmental factors, are best addressed through collaborative problem solving, the application of innovation in science and technology, and multiple stakeholder engagement. To achieve that goal, EPA's Office of Research and Development (ORD) is working directly with states and local communities to develop and apply a suite of accessible decision support tools (DST) that aim to improve environmental conditions, protect human health, enhance economic opportunity, and advance a resilient and sustainability society. This paper showcases joint EPA and state actions to develop tools and approaches that not only meet current environmental and public health challenges, but do so in a way that advances sustainable, healthy, and resilient communities well into the future. EPA's future plans should build on current work but aim to effectively respond to growing external pressures. Growing pressures from megatrends are a major challenge for the new Administration and for cities and states across the country. The recent hurricanes hitting

International and cross-cultural issues: six key challenges for our professions.

PubMed

Marshall, Julie

2003-01-01

This paper discusses a number of key challenges facing professionals who work with people who have communication disabilities. The challenges are related to working internationally and in a cross-culturally competent way. Each challenge is discussed, drawing on material from a range of sources, including the papers in the final 2003 edition of FOLIA PHONIATRICA ET LOGOPAEDICA ('International and Cross-Cultural Issues'). The challenges discussed cover how experiences from majority world countries can be used to benefit services elsewhere, 'mainstreaming' commitment to cross-cultural competence, learning from relationships with other professionals, influencing research practice, responding to requests to work internationally and finally, dealing with cultural differences that challenge working practices. Some solutions are suggested and additional questions posed. Copyright 2003 S. Karger AG, Basel

Addressing the Analytic Challenges of Cross-Sectional Pediatric Pneumonia Etiology Data.

PubMed

Hammitt, Laura L; Feikin, Daniel R; Scott, J Anthony G; Zeger, Scott L; Murdoch, David R; O'Brien, Katherine L; Deloria Knoll, Maria

2017-06-15

Despite tremendous advances in diagnostic laboratory technology, identifying the pathogen(s) causing pneumonia remains challenging because the infected lung tissue cannot usually be sampled for testing. Consequently, to obtain information about pneumonia etiology, clinicians and researchers test specimens distant to the site of infection. These tests may lack sensitivity (eg, blood culture, which is only positive in a small proportion of children with pneumonia) and/or specificity (eg, detection of pathogens in upper respiratory tract specimens, which may indicate asymptomatic carriage or a less severe syndrome, such as upper respiratory infection). While highly sensitive nucleic acid detection methods and testing of multiple specimens improve sensitivity, multiple pathogens are often detected and this adds complexity to the interpretation as the etiologic significance of results may be unclear (ie, the pneumonia may be caused by none, one, some, or all of the pathogens detected). Some of these challenges can be addressed by adjusting positivity rates to account for poor sensitivity or incorporating test results from controls without pneumonia to account for poor specificity. However, no classical analytic methods can account for measurement error (ie, sensitivity and specificity) for multiple specimen types and integrate the results of measurements for multiple pathogens to produce an accurate understanding of etiology. We describe the major analytic challenges in determining pneumonia etiology and review how the common analytical approaches (eg, descriptive, case-control, attributable fraction, latent class analysis) address some but not all challenges. We demonstrate how these limitations necessitate a new, integrated analytical approach to pneumonia etiology data. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Shared Electronic Health Record Systems: Key Legal and Security Challenges.

PubMed

Christiansen, Ellen K; Skipenes, Eva; Hausken, Marie F; Skeie, Svein; Østbye, Truls; Iversen, Marjolein M

2017-11-01

Use of shared electronic health records opens a whole range of new possibilities for flexible and fruitful cooperation among health personnel in different health institutions, to the benefit of the patients. There are, however, unsolved legal and security challenges. The overall aim of this article is to highlight legal and security challenges that should be considered before using shared electronic cooperation platforms and health record systems to avoid legal and security "surprises" subsequent to the implementation. Practical lessons learned from the use of a web-based ulcer record system involving patients, community nurses, GPs, and hospital nurses and doctors in specialist health care are used to illustrate challenges we faced. Discussion of possible legal and security challenges is critical for successful implementation of shared electronic collaboration systems. Key challenges include (1) allocation of responsibility, (2) documentation routines, (3) and integrated or federated access control. We discuss and suggest how challenges of legal and security aspects can be handled. This discussion may be useful for both current and future users, as well as policy makers.

MO-FG-BRB-03: Addressing the Cancer Challenge: International Cancer Experts Corps

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

Coleman, N.

corresponding potential benefits of addressing this challenge. To describe what radiation therapy infrastructure, in terms of facilities, equipment and personnel, will be required to address this challenge. To describe models of addressing personnel and infrastructure mobilization and capacity building within regions where significant cancer treatment disparities exist.« less

Addressing the next challenges: A summary of the 22nd international symposium on hepatitis C virus and related viruses.

PubMed

Baumert, Thomas F; Schuster, Catherine; Cosset, François-Loïc; Dubuisson, Jean; Hofmann, Maike; Tautz, Norbert; Zeisel, Mirjam B; Thimme, Robert

2016-04-01

Following the discovery of the hepatitis C virus (HCV) more than 25 years ago the field has succeeded to develop methods that have changed the safety of blood products, understand the molecular virology, epidemiology and clinical disease of HCV, and identify specific targets for the development of direct-acting antivirals for HCV cure. Nevertheless, major clinical and scientific challenges remain: therapy is still only available to a fraction of infected patients worldwide and many patients remain undiagnosed and/or live in countries where therapy is unattainable. An urgently needed HCV vaccine to eradicate infection remains still elusive. Scientifically, major questions remain regarding the life cycle, pathogenesis and mechanisms of viral clearance and persistence. Addressing these challenges, this meeting report reviews key findings of the 22nd International Symposium on Hepatitis C Virus and Related Viruses in Strasbourg, France from October 9 to 13, 2015. Copyright © 2016 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Addressing informatics challenges in Translational Research with workflow technology.

PubMed

Beaulah, Simon A; Correll, Mick A; Munro, Robin E J; Sheldon, Jonathan G

2008-09-01

Interest in Translational Research has been growing rapidly in recent years. In this collision of different data, technologies and cultures lie tremendous opportunities for the advancement of science and business for organisations that are able to integrate, analyse and deliver this information effectively to users. Workflow-based integration and analysis systems are becoming recognised as a fast and flexible way to build applications that are tailored to scientific areas, yet are built on a common platform. Workflow systems are allowing organisations to meet the key informatics challenges in Translational Research and improve disease understanding and patient care.

The role of public-private partnerships in addressing the biomedical innovation challenge.

PubMed

Said, Maya; Zerhouni, Elias

2014-11-01

Without a step change in the productivity of pharmaceutical research and development, it will be difficult to tackle the public health challenges facing societies worldwide. Public–private partnerships could play a key role in achieving this step change, but they need to be well designed and led.

Addressing the key communication barriers between microbiology laboratories and clinical units: a qualitative study

PubMed Central

Skodvin, Brita; Aase, Karina; Brekken, Anita Løvås; Charani, Esmita; Lindemann, Paul Christoffer; Smith, Ingrid

2017-01-01

Abstract Background Many countries are on the brink of establishing antibiotic stewardship programmes in hospitals nationwide. In a previous study we found that communication between microbiology laboratories and clinical units is a barrier to implementing efficient antibiotic stewardship programmes in Norway. We have now addressed the key communication barriers between microbiology laboratories and clinical units from a laboratory point of view. Methods Qualitative semi-structured interviews were conducted with 18 employees (managers, doctors and technicians) from six diverse Norwegian microbiological laboratories, representing all four regional health authorities. Interviews were recorded and transcribed verbatim. Thematic analysis was applied, identifying emergent themes, subthemes and corresponding descriptions. Results The main barrier to communication is disruption involving specimen logistics, information on request forms, verbal reporting of test results and information transfer between poorly integrated IT systems. Furthermore, communication is challenged by lack of insight into each other’s area of expertise and limited provision of laboratory services, leading to prolonged turnaround time, limited advisory services and restricted opening hours. Conclusions Communication between microbiology laboratories and clinical units can be improved by a review of testing processes, educational programmes to increase insights into the other’s area of expertise, an evaluation of work tasks and expansion of rapid and point-of-care test services. Antibiotic stewardship programmes may serve as a valuable framework to establish these measures. PMID:28633405

The Sanford Science Education Center: Addressing Key Design Challenges in Sharing Complex Science with Diverse Audiences

ERIC Educational Resources Information Center

Inverness Research, 2016

2016-01-01

In facilities throughout the United States and abroad, communities of scientists share infrastructure, instrumentation, and equipment to conduct scientific research. In these large facilities--laboratories, accelerators, telescope arrays, and research vessels--scientists are researching key questions that have the potential to make a significant…

Addressing challenges to MMPI-2-RF-based testimony: questions and answers.

PubMed

Ben-Porath, Yossef S

2012-11-01

Introduction of a new version of a psychological test brings with it challenges that can be accentuated by the adversarial nature of the legal process. In the case of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF), these challenges can be addressed by becoming familiar with the rationale for and the methods used in revising the inventory, the information contained in the test manuals, and the growing peer-reviewed literature on the test. Potential challenges to MMPI-2-RF-based testimony are identified in this article and discussed in question and answer format. The questions guiding this discussion are based on the Daubert factors, established in 1993 by the US Supreme Court as criteria for gauging the scientific validity of proffered expert testimony. The answers to these questions apply more broadly to testimony in depositions, pre-trial hearings, and at trial. Consideration of the MMPI-2-RF in light of the Daubert factors indicates that the instrument has been subjected to extensive empirical testing and that a substantial peer-reviewed literature is available to guide and support its use. Information about the known and potential rate of error associated with MMPI-2-RF scores is available, and standard procedures for administration, scoring, and interpretation of the inventory are detailed in the test administration manual. Indicators of MMPI-2-RF acceptance can be cited, and criticisms of the MMPI-2-RF can be addressed with information available in the test documents and an extensive, modern, and actively growing peer-reviewed literature.

Organization for rare diseases India (ORDI) - addressing the challenges and opportunities for the Indian rare diseases' community.

PubMed

Rajasimha, Harsha Karur; Shirol, Prasannakumar Basayya; Ramamoorthy, Preveen; Hegde, Madhuri; Barde, Sangeeta; Chandru, Vijay; Ravinandan, M E; Ramchandran, Ramani; Haldar, Kasturi; Lin, Jimmy C; Babar, Imran A; Girisha, Katta M; Srinivasan, Sudha; Navaneetham, Duraiswamy; Battu, Rajani; Devarakonda, Rajashree; Kini, Usha; Vijayachandra, Kinnimulki; Verma, Ishwar C

2014-08-13

In order to address the unmet needs and create opportunities that benefit patients with rare disease in India, a group of volunteers created a not-for-profit organization named Organization for Rare Diseases India (ORDI; www.ordindia.org). ORDI plans to represent the collective voice and advocate the needs of patients with rare diseases and other stakeholders in India. The ORDI team members come from diverse backgrounds such as genetics, molecular diagnostics, drug development, bioinformatics, communications, information technology, patient advocacy and public service. ORDI builds on the lessons learned from numerous similar organizations in the USA, European Union and disease-specific rare disease foundations in India. In this review, we provide a background on the landscape of rare diseases and the organizations that are active in this area globally and in India. We discuss the unique challenges in tackling rare diseases in India, and highlight the unmet needs of the key stakeholders of rare diseases. Finally, we define the vision, mission, goals and objectives of ORDI, identify the key developments in the health care context in India and welcome community feedback and comments on our approach.

Ethics in occupational health: deliberations of an international workgroup addressing challenges in an African context.

PubMed

London, Leslie; Tangwa, Godfrey; Matchaba-Hove, Reginald; Mkhize, Nhlanhla; Nwabueze, Remi; Nyika, Aceme; Westerholm, Peter

2014-06-23

International codes of ethics play an important role in guiding professional practice in developing countries. In the occupational health setting, codes developed by international agencies have substantial import on protecting working populations from harm. This is particularly so under globalisation which has transformed processes of production in fundamental ways across the globe. As part of the process of revising the Ethical Code of the International Commission on Occupational Health, an Africa Working Group addressed key challenges for the relevance and cogency of an ethical code in occupational health for an African context through an iterative consultative process. Firstly, even in the absence of strong legal systems of enforcement, and notwithstanding the value of legal institutionalisation of ethical codes, guidelines alone may offer advantageous routes to enhancing ethical practice in occupational health. Secondly, globalisation has particularly impacted on health and safety at workplaces in Africa, challenging occupational health professionals to be sensitive to, and actively redress imbalance of power. Thirdly, the different ways in which vulnerability is exemplified in the workplace in Africa often places the occupational health professional in invidious positions of Dual Loyalty. Fourth, the particular cultural emphasis in traditional African societies on collective responsibilities within the community impacts directly on how consent should be sought in occupational health practice, and how stigma should be dealt with, balancing individual autonomy with ideas of personhood that are more collective as in the African philosophy of ubuntu. To address stigma, practitioners need to be additionally sensitive to how power imbalances at the workplace intersect with traditional cultural norms related to solidarity. Lastly, particularly in the African context, the inseparability of workplace and community means that efforts to address workplace hazards demand

Ethics in occupational health: deliberations of an international workgroup addressing challenges in an African context

PubMed Central

2014-01-01

Background International codes of ethics play an important role in guiding professional practice in developing countries. In the occupational health setting, codes developed by international agencies have substantial import on protecting working populations from harm. This is particularly so under globalisation which has transformed processes of production in fundamental ways across the globe. As part of the process of revising the Ethical Code of the International Commission on Occupational Health, an Africa Working Group addressed key challenges for the relevance and cogency of an ethical code in occupational health for an African context through an iterative consultative process. Discussion Firstly, even in the absence of strong legal systems of enforcement, and notwithstanding the value of legal institutionalisation of ethical codes, guidelines alone may offer advantageous routes to enhancing ethical practice in occupational health. Secondly, globalisation has particularly impacted on health and safety at workplaces in Africa, challenging occupational health professionals to be sensitive to, and actively redress imbalance of power. Thirdly, the different ways in which vulnerability is exemplified in the workplace in Africa often places the occupational health professional in invidious positions of Dual Loyalty. Fourth, the particular cultural emphasis in traditional African societies on collective responsibilities within the community impacts directly on how consent should be sought in occupational health practice, and how stigma should be dealt with, balancing individual autonomy with ideas of personhood that are more collective as in the African philosophy of ubuntu. To address stigma, practitioners need to be additionally sensitive to how power imbalances at the workplace intersect with traditional cultural norms related to solidarity. Lastly, particularly in the African context, the inseparability of workplace and community means that efforts to address

Enabling a new Paradigm to Address Big Data and Open Science Challenges

NASA Astrophysics Data System (ADS)

Ramamurthy, Mohan; Fisher, Ward

2017-04-01

also need to give scientists an ecosystem that includes data, tools, workflows and other services needed to perform analytics, integration, interpretation, and synthesis - all in the same environment or platform. Instead of moving data to processing systems near users, as is the tradition, the cloud permits one to bring processing, computing, analysis and visualization to data - so called data proximate workbench capabilities, also known as server-side processing. In this talk, I will present the ongoing work at Unidata to facilitate a new paradigm for doing science by offering a suite of tools, resources, and platforms to leverage cloud technologies for addressing both big data and Open Science/reproducibility challenges. That work includes the development and deployment of new protocols for data access and server-side operations and Docker container images of key applications, JupyterHub Python notebook tools, and cloud-based analysis and visualization capability via the CloudIDV tool to enable reproducible workflows and effectively use the accessed data.

Key Challenges and Future Directions for Educational Research on Scientific Argumentation

ERIC Educational Resources Information Center

Henderson, J. Bryan; McNeill, Katherine L.; González-Howard, María; Close, Kevin; Evans, Mat

2018-01-01

At the 2015 "NARST: A Worldwide Organization for Improving Science Teaching and Learning Through Research" Annual International Conference, a group of scholars held an extended pre-conference workshop to discuss key challenges and future directions faced by argumentation researchers around the world. This wide-ranging group of…

Air Force Officer Accession Planning: Addressing Key Gaps in Meeting Career Field Academic Degree Requirements for Nonrated Officers

DTIC Science & Technology

2016-06-09

C O R P O R A T I O N Research Report Air Force Officer Accession Planning Addressing Key Gaps in Meeting Career Field Academic Degree Requirements...various Air Force missions in particular career fields. Key to this goal for nonrated officers is establishing and enforcing academic degree...35 Developing Accession Targets by Academic Degree Type

Addressing the Challenges in Tonsillectomy Research to Inform Health Care Policy: A Review.

PubMed

Mandavia, Rishi; Schilder, Anne G M; Dimitriadis, Panagiotis A; Mossialos, Elias

2017-09-01

Eighty-five percent of investment in medical research has been wasted, with lack of effect on clinical practice and policy. There is increasing effort to improve the likelihood of research being used to influence clinical practice and policy. Tonsillectomy is one of the most common otorhinolaryngologic surgical procedures, and its frequency, cost, and morbidity create a clear need for evidence-based guidelines and policy. The first systematic review on tonsillectomy was conducted 40 years ago and highlighted the lack of definitive evidence for the procedure. Since that study, the body of evidence has still not been able to sufficiently inform policy. This review provides an overview of the key challenges in research to inform tonsillectomy policy and recommendations to help bridge the evidence-policy gap. The challenges in using research to inform policy can be summarized as 4 main themes: (1) non-policy-focused evidence and lack of available evidence, (2) quality of evidence, (3) communication of research findings, and (4) coordinating time frames. Researchers and decision makers should be aware of the limitations of research designs and conflicts of interest that can undermine policy decisions. Researchers must work with decision makers and patients throughout the research process to identify areas of unmet need and political priority, align research and policy time frames, and disseminate research findings. Incentives for researchers should be reorganized to promote dissemination of findings. It is important to consider why evidence gaps in tonsillectomy research have not been addressed during the past 40 years despite considerable investment in time and resources. These findings and recommendations will help produce research that is more responsive to policy gaps and more likely to result in policy changes.

Megacities and Large Urban Complexes - WMO Role in Addressing Challenges and Opportunities

NASA Astrophysics Data System (ADS)

Terblanche, Deon; Jalkanen, Liisa

2013-04-01

Megacities and Large Urban Complexes - WMO Role in Addressing Challenges and Opportunities Deon E. Terblanche and Liisa Jalkanen dterblanche@wmo.int ljalkanen@wmo.int World Meteorological Organization, Geneva, Switzerland The 21st Century could amongst others, become known as the century in which our species has evolved from Homo sapiens to Homo urbanus. By now the urban population has surpassed the rural population and the rate of urbanization will continue at such a pace that by 2050 urban dwellers could outnumber their rural counterpart by more than two to one. Most of this growth in urban population will occur in developing countries and along coastal areas. Urbanization is to a large extent the outcome of humans seeking a better life through improved opportunities presented by high-density communities. Megacities and large urban complexes provide more job opportunities and social structures, better transport and communication links and a relative abundance of physical goods and services when compared to most rural areas. Unfortunately these urban complexes also present numerous social and environmental challenges. Urban areas differ from their surroundings by morphology, population density, and with high concentration of industrial activities, energy consumption and transport. They also pose unique challenges to atmospheric modelling and monitoring and create a multi-disciplinary spectrum of potential threats, including air pollution, which need to be addressed in an integrated way. These areas are also vulnerable to the changing climate and its implications to sea-level and extreme events, air quality and related health impacts. Many urban activities are significantly impacted by weather events that would not be considered to be of high impact in less densely populated areas. For instance, moderate precipitation events can cause flooding and landslides as modified urban catchments generally have higher run-off to rainfall ratios than their more pristine rural

Addressing the key communication barriers between microbiology laboratories and clinical units: a qualitative study.

PubMed

Skodvin, Brita; Aase, Karina; Brekken, Anita Løvås; Charani, Esmita; Lindemann, Paul Christoffer; Smith, Ingrid

2017-09-01

Many countries are on the brink of establishing antibiotic stewardship programmes in hospitals nationwide. In a previous study we found that communication between microbiology laboratories and clinical units is a barrier to implementing efficient antibiotic stewardship programmes in Norway. We have now addressed the key communication barriers between microbiology laboratories and clinical units from a laboratory point of view. Qualitative semi-structured interviews were conducted with 18 employees (managers, doctors and technicians) from six diverse Norwegian microbiological laboratories, representing all four regional health authorities. Interviews were recorded and transcribed verbatim. Thematic analysis was applied, identifying emergent themes, subthemes and corresponding descriptions. The main barrier to communication is disruption involving specimen logistics, information on request forms, verbal reporting of test results and information transfer between poorly integrated IT systems. Furthermore, communication is challenged by lack of insight into each other's area of expertise and limited provision of laboratory services, leading to prolonged turnaround time, limited advisory services and restricted opening hours. Communication between microbiology laboratories and clinical units can be improved by a review of testing processes, educational programmes to increase insights into the other's area of expertise, an evaluation of work tasks and expansion of rapid and point-of-care test services. Antibiotic stewardship programmes may serve as a valuable framework to establish these measures. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.

The changing global landscape of health and disease: addressing challenges and opportunities for sustaining progress towards control and elimination of neglected tropical diseases (NTDs).

PubMed

Molyneux, David H; Dean, Laura; Adekeye, Oluwatosin; Stothard, J Russell; Theobald, Sally

2018-03-16

The drive to control neglected tropical diseases (NTDs) has had many successes but to reach defined targets new approaches are required. Over the last decade, NTD control programmes have benefitted from increased resources, and from effective partnerships and long-term pharmaceutical donations. Although the NTD agenda is broader than those diseases of parasitic aetiology there has been a massive up-scaling of the delivery of medicines to some billion people annually. Recipients are often the poorest, with the aspiration that NTD programmes are key to universal health coverage as reflected within the 2030 United Nations sustainable development goals (SDGs). To reach elimination targets, the community will need to adapt global events and changing policy environments to ensure programmes are responsive and can sustain progress towards NTD targets. Innovative thinking embedded within regional and national health systems is needed. Policy makers, managers and frontline health workers are the mediators between challenge and change at global and local levels. This paper attempts to address the challenges to end the chronic pandemic of NTDs and achieve the SDG targets. It concludes with a conceptual framework that illustrates the interactions between these key challenges and opportunities and emphasizes the health system as a critical mediator.

Key challenges in future Li-battery research.

PubMed

Tarascon, J-M

2010-07-28

Batteries are a major technological challenge in this new century as they are a key method to make more efficient use of energy. Although today's Li-ion technology has conquered the portable electronic markets and is still improving, it falls short of meeting the demands dictated by the powering of both hybrid electric vehicles and electric vehicles or by the storage of renewable energies (wind, solar). There is room for optimism as long as we pursue paradigm shifts while keeping in mind the concept of materials sustainability. Some of these concepts, relying on new ways to prepare electrode materials via eco-efficient processes, on the use of organic rather than inorganic materials or new chemistries will be discussed. Achieving these concepts will require the inputs of multiple disciplines.

Identifying and Addressing Themes of Job Dissatisfaction for Secondary Principals

ERIC Educational Resources Information Center

De Jong, David; Grundmeyer, Trent; Yankey, Julie

2017-01-01

Secondary principals serve in important roles that are complex, high-stress, and include demanding job responsibilities. Key stakeholders such as superintendents, school board members, and legislators must understand the challenges facing secondary principals in order to address the current themes of job dissatisfaction. Using new survey data…

Developing CALL for Heritage Languages: "The 7 Keys of the Dragon"

ERIC Educational Resources Information Center

Revithiadou, Anthi; Kourtis-Kazoullis, Vasilia; Soukalopoulou, Maria; Konstantoudakis, Konstantinos; Zarras, Christos

2015-01-01

In this article we present an interactive extensible software, "The 7 Keys of the Dragon," for the teaching/learning of Albanian and Russian to students that attend primary and secondary education in Greece with the respective languages as their heritage languages. We address the key challenges we encountered during the conceptualization…

Managing the pursuit of health and wealth: the key challenges.

PubMed

Fidler, David P; Drager, Nick; Lee, Kelley

2009-01-24

This article forms part of a six-part Series on trade and health, and sets the stage for this Series by analysing key aspects of the relationship between trade and health. The Series takes stock of this relation and provides timely analysis of the key challenges facing efforts to achieve an appropriate balance between trade and health across a diverse range of issues. This introductory article reviews how trade and health have risen and expanded on global policy agendas in the past decade in unprecedented ways, describes how trade and health issues are respectively governed in international relations, examines the ongoing search for policy coherence between the two policy spheres, and highlights the topics of the remaining articles in the Series.

Managing the pursuit of health and wealth: the key challenges

PubMed Central

Fidler, David P; Drager, Nick; Lee, Kelley

2009-01-01

This article forms part of a six-part Series on trade and health, and sets the stage for this Series by analysing key aspects of the relationship between trade and health. The Series takes stock of this relation and provides timely analysis of the key challenges facing efforts to achieve an appropriate balance between trade and health across a diverse range of issues. This introductory article reviews how trade and health have risen and expanded on global policy agendas in the past decade in unprecedented ways, describes how trade and health issues are respectively governed in international relations, examines the ongoing search for policy coherence between the two policy spheres, and highlights the topics of the remaining articles in the Series. PMID:19167061

Advances in addressing technical challenges of point-of-care diagnostics in resource-limited settings

PubMed Central

Wang, ShuQi; Lifson, Mark A.; Inci, Fatih; Liang, Li-Guo; Sheng, Ye-Feng; Demirci, Utkan

2016-01-01

The striking prevalence of HIV, TB and malaria, as well as outbreaks of emerging infectious diseases, such as influenza A (H7N9), Ebola and MERS, poses great challenges for patient care in resource-limited settings (RLS). However, advanced diagnostic technologies cannot be implemented in RLS largely due to economic constraints. Simple and inexpensive point-of-care (POC) diagnostics, which rely less on environmental context and operator training, have thus been extensively studied to achieve early diagnosis and treatment monitoring in non-laboratory settings. Despite great input from material science, biomedical engineering and nanotechnology for developing POC diagnostics, significant technical challenges are yet to be overcome. Summarized here are the technical challenges associated with POC diagnostics from a RLS perspective and the latest advances in addressing these challenges are reviewed. PMID:26777725

Interweaving Knowledge Resources to Address Complex Environmental Health Challenges

PubMed Central

Anderson, Beth Ellen; Suk, William A.

2015-01-01

Background Complex problems do not respect academic disciplinary boundaries. Environmental health research is complex and often moves beyond these boundaries, integrating diverse knowledge resources to solve such challenges. Here we describe an evolving paradigm for interweaving approaches that integrates widely diverse resources outside of traditional academic environments in full partnerships of mutual respect and understanding. We demonstrate that scientists, social scientists, and engineers can work with government agencies, industry, and communities to interweave their expertise into metaphorical knowledge fabrics to share understanding, resources, and enthusiasm. Objective Our goal is to acknowledge and validate how interweaving research approaches can contribute to research-driven, solution-oriented problem solving in environmental health, and to inspire more members of the environmental health community to consider this approach. Discussion The National Institutes of Health’s National Institute of Environmental Health Sciences Superfund Research Program (SRP), as mandated by Congress, has evolved to become a program that reaches across a wide range of knowledge resources. SRP fosters interweaving multiple knowledge resources to develop innovative multidirectional partnerships for research and training. Here we describe examples of how motivation, ideas, knowledge, and expertise from different people, institutions, and agencies can integrate to tackle challenges that can be as complex as the resources they bring to bear on it. Conclusions By providing structure for interweaving science with its stakeholders, we are better able to leverage resources, increase potential for innovation, and proactively ensure a more fully developed spectrum of beneficial outcomes of research investments. Citation Anderson BE, Naujokas MF, Suk WA. 2015. Interweaving knowledge resources to address complex environmental health challenges. Environ Health Perspect 123:1095–1099

Interweaving Knowledge Resources to Address Complex Environmental Health Challenges.

PubMed

Anderson, Beth Ellen; Naujokas, Marisa F; Suk, William A

2015-11-01

Complex problems do not respect academic disciplinary boundaries. Environmental health research is complex and often moves beyond these boundaries, integrating diverse knowledge resources to solve such challenges. Here we describe an evolving paradigm for interweaving approaches that integrates widely diverse resources outside of traditional academic environments in full partnerships of mutual respect and understanding. We demonstrate that scientists, social scientists, and engineers can work with government agencies, industry, and communities to interweave their expertise into metaphorical knowledge fabrics to share understanding, resources, and enthusiasm. Our goal is to acknowledge and validate how interweaving research approaches can contribute to research-driven, solution-oriented problem solving in environmental health, and to inspire more members of the environmental health community to consider this approach. The National Institutes of Health's National Institute of Environmental Health Sciences Superfund Research Program (SRP), as mandated by Congress, has evolved to become a program that reaches across a wide range of knowledge resources. SRP fosters interweaving multiple knowledge resources to develop innovative multidirectional partnerships for research and training. Here we describe examples of how motivation, ideas, knowledge, and expertise from different people, institutions, and agencies can integrate to tackle challenges that can be as complex as the resources they bring to bear on it. By providing structure for interweaving science with its stakeholders, we are better able to leverage resources, increase potential for innovation, and proactively ensure a more fully developed spectrum of beneficial outcomes of research investments. Anderson BE, Naujokas MF, Suk WA. 2015. Interweaving knowledge resources to address complex environmental health challenges. Environ Health Perspect 123:1095-1099; http://dx.doi.org/10.1289/ehp.1409525.

Unmanned Aerial Systems: Further Actions Needed to Fully Address Air Force and Army Pilot Workforce Challenges

DTIC Science & Technology

2016-03-16

UNMANNED AERIAL SYSTEMS Further Actions Needed to Fully Address Air Force and Army Pilot Workforce Challenges...Armed Services, U.S. Senate March 16, 2016 UNMANNED AERIAL SYSTEMS Further Actions Needed to Fully Address Air Force and Army Pilot Workforce ...High-performing organizations use complete and current data to inform their strategic human capital planning and remain open to reevaluating workforce

Strategies to increase demand for maternal health services in resource-limited settings: challenges to be addressed.

PubMed

Elmusharaf, Khalifa; Byrne, Elaine; O'Donovan, Diarmuid

2015-09-08

Universal health access will not be achieved unless women are cared for in their own communities and are empowered to take decisions about their own health in a supportive environment. This will only be achieved by community-based demand side interventions for maternal health access. In this review article, we highlight three common strategies to increase demand-side barriers to maternal healthcare access and identify the main challenges that still need to be addressed for these strategies to be effective. Common demand side strategies can be grouped into three categories:(i) Financial incentives/subsidies; (ii) Enhancing patient transfer, and; (iii) Community involvement. The main challenges in assessing the effectiveness or efficacy of these interventions or strategies are the lack of quality evidence on their outcome and impact and interventions not integrated into existing health or community systems. However, what is highlighted in this review and overlooked in most of the published literature on this topic is the lack of knowledge about the context in which these strategies are to be implemented. We suggest three challenges that need to be addressed to create a supportive environment in which these demand-side strategies can effectively improve access to maternal health services. These include: addressing decision-making norms, engaging in intergenerational dialogue, and designing contextually appropriate communication strategies.

The Challenges and Triumphs in Addressing Students' Intersectional Identities for Black Culture Centers

ERIC Educational Resources Information Center

Harris, Jessica C.; Patton, Lori D.

2017-01-01

This study examines how directors of Black culture centers (BCCs) address Black students' intersectional identities. We highlight the challenges that directors of BCCs face as they attempt to preserve a race salient agenda, while accounting for other critical facets of students' social identities. Findings explore how directors hold differing…

The challenge of spin–orbit-tuned ground states in iridates: a key issues review

NASA Astrophysics Data System (ADS)

Cao, Gang; Schlottmann, Pedro

2018-04-01

Effects of spin–orbit interactions in condensed matter are an important and rapidly evolving topic. Strong competition between spin–orbit, on-site Coulomb and crystalline electric field interactions in iridates drives exotic quantum states that are unique to this group of materials. In particular, the ‘J eff  =  ½’ Mott state served as an early signal that the combined effect of strong spin–orbit and Coulomb interactions in iridates has unique, intriguing consequences. In this Key Issues Review, we survey some current experimental studies of iridates. In essence, these materials tend to defy conventional wisdom: absence of conventional correlations between magnetic and insulating states, avoidance of metallization at high pressures, ‘S-shaped’ I–V characteristic, emergence of an odd-parity hidden order, etc. It is particularly intriguing that there exist conspicuous discrepancies between current experimental results and theoretical proposals that address superconducting, topological and quantum spin liquid phases. This class of materials, in which the lattice degrees of freedom play a critical role seldom seen in other materials, evidently presents some profound intellectual challenges that call for more investigations both experimentally and theoretically. Physical properties unique to these materials may help unlock a world of possibilities for functional materials and devices. We emphasize that, given the rapidly developing nature of this field, this Key Issues Review is by no means an exhaustive report of the current state of experimental studies of iridates.

Ares Knowledge Capture: Summary and Key Themes Presentation

NASA Technical Reports Server (NTRS)

Coates, Ralph H.

2011-01-01

This report has been developed by the National Aeronautics and Space Administration (NASA) Human Exploration and Operations Mission Directorate (HEOMD) Risk Management team in close coordination with the MSFC Chief Engineers Office. This document provides a point-in-time, cumulative, summary of actionable key lessons learned derived from the design project. Lessons learned invariably address challenges and risks and the way in which these areas have been addressed. Accordingly the risk management thread is woven throughout the document.

Elections: DOD Needs More Comprehensive Planning to Address Military and Overseas Absentee Voting Challenges

DTIC Science & Technology

2016-04-01

Acknowledgments Contact Acknowledgments Related GAO Products Page 75 GAO-16-378 DOD Overseas Absentee Voting U.S. Postal Service: Actions... Products Page 76 GAO-16-378 DOD Overseas Absentee Voting Election Reform: Nine States’ Experiences Implementing Federal Requirements for...ELECTIONS DOD Needs More Comprehensive Planning to Address Military and Overseas Absentee Voting Challenges

Expanded Learning Time and Opportunities: Key Principles, Driving Perspectives, and Major Challenges

ERIC Educational Resources Information Center

Blyth, Dale A.; LaCroix-Dalluhn, Laura

2011-01-01

If expanded learning is going to make a real difference, then three key principles must inform how communities overcome challenges and assure equitable access to learning opportunities. Much of today's debate is framed in the language of formal education systems--students, classrooms, schools--even though part of the expansion seeks to engage a…

Addressing global change challenges for Central Asian socio-ecosystems

NASA Astrophysics Data System (ADS)

Qi, Jiaguo; Bobushev, Temirbek S.; Kulmatov, Rashid; Groisman, Pavel; Gutman, Garik

2012-06-01

Central Asia is one of the most vulnerable regions on the planet earth to global climate change, depending on very fragile natural resources. The Soviet legacy has left the five countries (Kazakhstan, Tajikistan, Kyrgyzstan, Turkmenistan, and Uzbekistan) with a highly integrated system but they are facing great challenges with tensions that hinder regional coordination of food and water resources. With increasing climate variability and warming trend in the region, food and water security issues become even more crucial now and, if not addressed properly, could affect the regional stability. The long-term drivers of these two most critical elements, food and water, are climate change; the immediate and probably more drastic factors affecting the food and water security are land uses driven by institutional change and economic incentives. As a feedback, changes in land use and land cover have directly implications on water uses, food production, and lifestyles of the rural community in the region. Regional and international efforts have been made to holistically understand the cause, extent, rate and societal implications of land use changes in the region. Much of these have been understood, or under investigation by various projects, but solutions or research effort to develop solutions, to these urgent regional issues are lacking. This article, serves as an introduction to the special issue, provides a brief overview of the challenges facing the Central Asian countries and various international efforts in place that resulted in the publications of this special issue.

E-referral Solutions: Successful Experiences, Key Features and Challenges- a Systematic Review.

PubMed

Naseriasl, Mansour; Adham, Davoud; Janati, Ali

2015-06-01

around the world health systems constantly face increasing pressures which arise from many factors, such as an ageing population, patients and providers demands for equipment's and services. In order to respond these challenges and reduction of health system's transactional costs, referral solutions are considered as a key factor. This study was carried out to identify referral solutions that have had successes. relevant studies identified using keywords of referrals, consultation, referral system, referral model, referral project, electronic referral, electronic booking, health system, healthcare, health service and medical care. These searches were conducted using PubMed, ProQuest, Google Scholar, Scopus, Emerald, Web of Knowledge, Springer, Science direct, Mosby's index, SID, Medlib and Iran Doc data bases. 4306 initial articles were obtained and refined step by step. Finally, 27 articles met the inclusion criteria. we identified seventeen e-referral systems developed in UK, Norway, Finland, Netherlands, Denmark, Scotland, New Zealand, Canada, Australia, and U.S. Implemented solutions had variant degrees of successes such as improved access to specialist care, reduced wait times, timeliness and quality of referral communication, accurate health information transfer and integration of health centers and services. each one of referral solutions has both positive and changeable aspects that should be addressed according to sociotechnical conditions. These solutions are mainly formed in a small and localized manner.

Rising to the challenge: addressing the concerns of people working in the sex industry.

PubMed

Shaver, Frances M; Lewis, Jacqueline; Maticka-Tyndale, Eleanor

2011-02-01

In September 2010, three Canadian Criminal Code provisions related to prostitution were ruled unconstitutional because they increase the risk of harm to people working in the sex industry (PWSI). Using data from studies with PWSI and key informants conducted in several Canadian cities, we examine three domains related to worker health and safety: occupational health and safety, perceptions of and behaviors toward workers, and access to essential services. Addressing these issues necessitates moving beyond decriminalization. We conclude that using a harm reduction/labor rights framework would enhance our ability to address issues related to the physical, social, and mental well-being as well as rights of PWSI.

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…

Different perspectives on the key challenges facing rural health: The challenges of power and knowledge.

PubMed

Malatzky, Christina; Bourke, Lisa

2018-05-25

To examine the effects of dominant knowledge in rural health, including how they shape issues central to rural health. In particular, this article examines the roles of: (i) deficit knowledge of rural health workforce; (ii) dominant portrayals of generalism; and (iii) perceptions of inferiority about rural communities in maintaining health disparities between rural- and metropolitan-based Australians. A Foucauldian framework is applied to literature, evidence, case studies and key messages in rural health. Three scenarios are used to provide practical examples of specific knowledge that is prioritised or marginalised. The analysis of three areas in rural health identifies how deficit knowledge is privileged despite it undermining the purpose of rural health. First, deficit knowledge highlights the workforce shortage rather than the type of work in rural practice or the oversupply of workforce in metropolitan areas. Second, the construction of generalist practice as less skilled and more monotonous undermines other knowledge that it is diverse and challenging. Third, dominant negative stereotypes of rural communities discourage rural careers and highlight undesirable aspects of rural practice. The privileging of deficit knowledge pertaining to rural health workforce, broader dominant discourses of generalism and the nature of rural Australian communities reproduces many of the key challenges in rural health today, including persisting health disparities between rural- and metropolitan-based Australians. To disrupt the operations of power that highlight deficit knowledge and undermine other knowledge, we need to change the way in which rural health is currently constructed and understood. © 2018 National Rural Health Alliance Ltd.

Addressing Open Water Data Challenges in the Bureau of Reclamation

NASA Astrophysics Data System (ADS)

Brekke, L. D.; Danner, A.; Nagode, J.; Rocha, J.; Poulton, S.; Anderson, A.

2017-12-01

The Bureau of Reclamation is largest wholesaler of water in the United States. Located in the 17 western states, Reclamation serves water to 31 million people, provides irrigated water to 20 percent of Western farmers, and is the second largest producer of hydroelectric power in the United States. Through these activities, Reclamation generates large amounts of water and water-related data, describing reservoirs and river system conditions, hydropower, environmental compliance activities, infrastructure assets, and other aspects of Reclamation's mission activities. Reclamation aims to make water and water-related data sets more easily found, accessed, and used in decision-making activities in order to benefit the public, private sector, and research communities. Historically, there has not been an integrated, bureau-wide system to store data in machine-readable formats; nor a system to permit centralized browsing, open access, and web-services. Reclamation began addressing these limitations by developing the Reclamation Water Information System (RWIS), released in Spring 2017 (https://water.usbr.gov/). A bureau-wide team contributed to RWIS development, including water data stewards, database administrators, and information technology (IT) specialists. The first RWIS release publishes reservoir time series data from Reclamation's five regions and includes a map interface for sites identification, a query interface for data discovery and access, and web-services for automated retrieval. As RWIS enhancement continues, the development team is developing a companion system - the Reclamation Information Sharing Environment (RISE) - to provide access to the other data subjects and types (geospatial, documents). While RWIS and RISE are promising starts, Reclamation continues to face challenges in addressing open water data goals: making data consolidation and open publishing a value-added activity for programs that publish data locally, going beyond providing open access

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

Moving beyond regression techniques in cardiovascular risk prediction: applying machine learning to address analytic challenges

PubMed Central

Goldstein, Benjamin A.; Navar, Ann Marie; Carter, Rickey E.

2017-01-01

Abstract Risk prediction plays an important role in clinical cardiology research. Traditionally, most risk models have been based on regression models. While useful and robust, these statistical methods are limited to using a small number of predictors which operate in the same way on everyone, and uniformly throughout their range. The purpose of this review is to illustrate the use of machine-learning methods for development of risk prediction models. Typically presented as black box approaches, most machine-learning methods are aimed at solving particular challenges that arise in data analysis that are not well addressed by typical regression approaches. To illustrate these challenges, as well as how different methods can address them, we consider trying to predicting mortality after diagnosis of acute myocardial infarction. We use data derived from our institution's electronic health record and abstract data on 13 regularly measured laboratory markers. We walk through different challenges that arise in modelling these data and then introduce different machine-learning approaches. Finally, we discuss general issues in the application of machine-learning methods including tuning parameters, loss functions, variable importance, and missing data. Overall, this review serves as an introduction for those working on risk modelling to approach the diffuse field of machine learning. PMID:27436868

Notification: Key Management Challenges Confronting the U.S. Chemical Safety and Hazard Investigation Board

EPA Pesticide Factsheets

June 9, 2014. The OIG is beginning work to update the fiscal year 2014 list of areas we consider to be the key management challenges confronting the U.S. Chemical Safety and Hazard Investigation Board (CSB).

Early access programs: Benefits, challenges, and key considerations for successful implementation

PubMed Central

Patil, Sanjaykumar

2016-01-01

Early access programs, (EAPs) are adopted by an increasing number of pharma companies due to several benefits offered by these programs. EAPs offer ethical, compliant, and controlled mechanisms of access to investigational drugs outside of the clinical trial space and before the commercial launch of the drug, to patients with life-threatening diseases having no treatment options available. In addition to the development of positive relationships with key opinion leaders (KOL), patients, advocacy groups and regulators, the data captured from the implementation of EAPs supports in the formulation of global commercialization strategies. This white paper outlines various circumstances to be considered for the implementation of EAPs named patient programs, the regulatory landscape, the benefits and challenges associated with implementing these programs and the key considerations for their successful implementation. PMID:26955570

Mind the gap: implementation challenges break the link between HIV/AIDS research and practice.

PubMed

MacCarthy, Sarah; Reisner, Sari; Hoffmann, Michael; Perez-Brumer, Amaya; Silva-Santisteban, Alfonso; Nunn, Amy; Bastos, Leonardo; Vasconcellos, Mauricio Teixeira Leite de; Kerr, Ligia; Bastos, Francisco Inácio; Dourado, Inês

2016-11-03

Sampling strategies such as respondent-driven sampling (RDS) and time-location sampling (TLS) offer unique opportunities to access key populations such as men who have sex with men (MSM) and transgender women. Limited work has assessed implementation challenges of these methods. Overcoming implementation challenges can improve research quality and increase uptake of HIV services among key populations. Drawing from studies using RDS in Brazil and TLS in Peru, we summarize challenges encountered in the field and potential strategies to address them. In Brazil, study site selection, cash incentives, and seed selection challenged RDS implementation with MSM. In Peru, expansive geography, safety concerns, and time required for study participation complicated TLS implementation with MSM and transgender women. Formative research, meaningful participation of key populations across stages of research, and transparency in study design are needed to link HIV/AIDS research and practice. Addressing implementation challenges can close gaps in accessing services among those most burdened by the epidemic.

Mind the gap: implementation challenges break the link between HIV/AIDS research and practice

PubMed Central

MacCarthy, Sarah; Reisner, Sari; Hoffmann, Michael; Perez-Brumer, Amaya; Silva-Santisteban, Alfonso; Nunn, Amy; Bastos, Leonardo; de Vasconcellos, Mauricio Teixeira Leite; Kerr, Ligia; Bastos, Francisco Inácio; Dourado, Inês

2018-01-01

Sampling strategies such as respondent-driven sampling (RDS) and time-location sampling (TLS) offer unique opportunities to access key populations such as men who have sex with men (MSM) and transgender women. Limited work has assessed implementation challenges of these methods. Overcoming implementation challenges can improve research quality and increase uptake of HIV services among key populations. Drawing from studies using RDS in Brazil and TLS in Peru, we summarize challenges encountered in the field and potential strategies to address them. In Brazil, study site selection, cash incentives, and seed selection challenged RDS implementation with MSM. In Peru, expansive geography, safety concerns, and time required for study participation complicated TLS implementation with MSM and transgender women. Formative research, meaningful participation of key populations across stages of research, and transparency in study design are needed to link HIV/AIDS research and practice. Addressing implementation challenges can close gaps in accessing services among those most burdened by the epidemic. PMID:27828609

Social Justice Leadership and Inclusion: Exploring Challenges in an Urban District Struggling to Address Inequities

ERIC Educational Resources Information Center

DeMatthews, David; Mawhinney, Hanne

2014-01-01

Research Approach: This cross case study describes the challenges that two principals working in one urban school district addressed while attempting to transform their school cultures to embrace an inclusion model. Analysis of interviews and observations in each school revealed the actions, values, and orientations of the individual leaders and…

Addressing the Challenges and Needs of English-Speaking Caribbean Immigrant Students: Guidelines for School Counselors

ERIC Educational Resources Information Center

Morrison, Stephaney; Bryan, Julia

2014-01-01

Caribbean students are among the distinct immigrant groups in U.S. public schools with particular needs to be addressed by school counselors. This article discusses the challenges Caribbean immigrant students face that create obstacles to their academic and personal/social success. Guidelines for school counselors are outlined, which can be used…

Using Linked Electronic Health Records to Estimate Healthcare Costs: Key Challenges and Opportunities.

PubMed

Asaria, Miqdad; Grasic, Katja; Walker, Simon

2016-02-01

This paper discusses key challenges and opportunities that arise when using linked electronic health records (EHR) in health economics and outcomes research (HEOR), with a particular focus on estimating healthcare costs. These challenges and opportunities are framed in the context of a case study modelling the costs of stable coronary artery disease in England. The challenges and opportunities discussed fall broadly into the categories of (1) handling and organising data of this size and sensitivity; (2) extracting clinical endpoints from datasets that have not been designed and collected with such endpoints in mind; and (3) the principles and practice of costing resource use from routinely collected data. We find that there are a number of new challenges and opportunities that arise when working with EHR compared with more traditional sources of data for HEOR. These call for greater clinician involvement and intelligent use of sensitivity analysis.

Addressing practical challenges in utility optimization of mobile wireless sensor networks

NASA Astrophysics Data System (ADS)

Eswaran, Sharanya; Misra, Archan; La Porta, Thomas; Leung, Kin

2008-04-01

This paper examines the practical challenges in the application of the distributed network utility maximization (NUM) framework to the problem of resource allocation and sensor device adaptation in a mission-centric wireless sensor network (WSN) environment. By providing rich (multi-modal), real-time information about a variety of (often inaccessible or hostile) operating environments, sensors such as video, acoustic and short-aperture radar enhance the situational awareness of many battlefield missions. Prior work on the applicability of the NUM framework to mission-centric WSNs has focused on tackling the challenges introduced by i) the definition of an individual mission's utility as a collective function of multiple sensor flows and ii) the dissemination of an individual sensor's data via a multicast tree to multiple consuming missions. However, the practical application and performance of this framework is influenced by several parameters internal to the framework and also by implementation-specific decisions. This is made further complex due to mobile nodes. In this paper, we use discrete-event simulations to study the effects of these parameters on the performance of the protocol in terms of speed of convergence, packet loss, and signaling overhead thereby addressing the challenges posed by wireless interference and node mobility in ad-hoc battlefield scenarios. This study provides better understanding of the issues involved in the practical adaptation of the NUM framework. It also helps identify potential avenues of improvement within the framework and protocol.

Next-generation clinical trials: Novel strategies to address the challenge of tumor molecular heterogeneity.

PubMed

Catenacci, Daniel V T

2015-05-01

The promise of 'personalized cancer care' with therapies toward specific molecular aberrations has potential to improve outcomes. However, there is recognized heterogeneity within any given tumor-type from patient to patient (inter-patient heterogeneity), and within an individual (intra-patient heterogeneity) as demonstrated by molecular evolution through space (primary tumor to metastasis) and time (after therapy). These issues have become hurdles to advancing cancer treatment outcomes with novel molecularly targeted agents. Classic trial design paradigms are challenged by heterogeneity, as they are unable to test targeted therapeutics against low frequency genomic 'oncogenic driver' aberrations with adequate power. Usual accrual difficulties to clinical trials are exacerbated by low frequencies of any given molecular driver. To address these challenges, there is need for innovative clinical trial designs and strategies implementing novel diagnostic biomarker technologies to account for inter-patient molecular diversity and scarce tissue for analysis. Importantly, there is also need for pre-defined treatment priority algorithms given numerous aberrations commonly observed within any one individual sample. Access to multiple available therapeutic agents simultaneously is crucial. Finally intra-patient heterogeneity through time may be addressed by serial biomarker assessment at the time of tumor progression. This report discusses various 'next-generation' biomarker-driven trial designs and their potentials and limitations to tackle these recognized molecular heterogeneity challenges. Regulatory hurdles, with respect to drug and companion diagnostic development and approval, are considered. Focus is on the 'Expansion Platform Design Types I and II', the latter demonstrated with a first example, 'PANGEA: Personalized Anti-Neoplastics for Gastro-Esophageal Adenocarcinoma'. Applying integral medium-throughput genomic and proteomic assays along with a practical

Moving beyond regression techniques in cardiovascular risk prediction: applying machine learning to address analytic challenges.

PubMed

Goldstein, Benjamin A; Navar, Ann Marie; Carter, Rickey E

2017-06-14

Risk prediction plays an important role in clinical cardiology research. Traditionally, most risk models have been based on regression models. While useful and robust, these statistical methods are limited to using a small number of predictors which operate in the same way on everyone, and uniformly throughout their range. The purpose of this review is to illustrate the use of machine-learning methods for development of risk prediction models. Typically presented as black box approaches, most machine-learning methods are aimed at solving particular challenges that arise in data analysis that are not well addressed by typical regression approaches. To illustrate these challenges, as well as how different methods can address them, we consider trying to predicting mortality after diagnosis of acute myocardial infarction. We use data derived from our institution's electronic health record and abstract data on 13 regularly measured laboratory markers. We walk through different challenges that arise in modelling these data and then introduce different machine-learning approaches. Finally, we discuss general issues in the application of machine-learning methods including tuning parameters, loss functions, variable importance, and missing data. Overall, this review serves as an introduction for those working on risk modelling to approach the diffuse field of machine learning. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Cardiology.

Characteristics of Treatment Decisions to Address Challenging Behaviors in Children with Autism Spectrum Disorder.

PubMed

Anixt, Julia S; Meinzen-Derr, Jareen; Estridge, Halley; Smith, Laura; Brinkman, William B

2018-05-01

To describe the characteristics of treatment decisions to address challenging behaviors in children with autism spectrum disorder (ASD). Parents of children aged 4 to 15 years with ASD seen in a developmental behavioral pediatric (DBP) clinic completed validated measures to characterize their child's behaviors and their own level of stress. Parents reported their treatment priority before the visit. During the visit, we assessed shared decision making (SDM) using the Observing Patient Involvement (OPTION) scale and alignment of the clinician's treatment plan with the parent's priority. Before and after the visit, parents rated their uncertainty about the treatment plan using the Decisional Conflict Scale (DCS). We calculated descriptive statistics for the measures. Fifty-four families participated. Children were a mean (SD) age of 8.8 (3.3) years, and 87% were male. Children had a variety of behavioral challenges, and parents reported high levels of stress. Commonly reported parent treatment priorities were hyperactivity, tantrums, anxiety, and poor social skills. Levels of SDM were low, with a mean (SD) OPTION score of 24.5 (9.7). Parent priorities were addressed in 65% of treatment plans. Approximately 69% of parents had elevated DCS scores before the visit. Although levels of decisional conflict were lower after the visit compared with before the visit (p < 0.03), 46% of parents continued to report high scores on the DCS. Parents leave DBP visits with feelings of uncertainty about treatment decisions and with treatment plans that do not always address their priorities. SDM interventions hold promise to improve the quality of ASD treatment decisions.

The next organizational challenge: finding and addressing diagnostic error.

PubMed

Graber, Mark L; Trowbridge, Robert; Myers, Jennifer S; Umscheid, Craig A; Strull, William; Kanter, Michael H

2014-03-01

Although health care organizations (HCOs) are intensely focused on improving the safety of health care, efforts to date have almost exclusively targeted treatment-related issues. The literature confirms that the approaches HCOs use to identify adverse medical events are not effective in finding diagnostic errors, so the initial challenge is to identify cases of diagnostic error. WHY HEALTH CARE ORGANIZATIONS NEED TO GET INVOLVED: HCOs are preoccupied with many quality- and safety-related operational and clinical issues, including performance measures. The case for paying attention to diagnostic errors, however, is based on the following four points: (1) diagnostic errors are common and harmful, (2) high-quality health care requires high-quality diagnosis, (3) diagnostic errors are costly, and (4) HCOs are well positioned to lead the way in reducing diagnostic error. FINDING DIAGNOSTIC ERRORS: Current approaches to identifying diagnostic errors, such as occurrence screens, incident reports, autopsy, and peer review, were not designed to detect diagnostic issues (or problems of omission in general) and/or rely on voluntary reporting. The realization that the existing tools are inadequate has spurred efforts to identify novel tools that could be used to discover diagnostic errors or breakdowns in the diagnostic process that are associated with errors. New approaches--Maine Medical Center's case-finding of diagnostic errors by facilitating direct reports from physicians and Kaiser Permanente's electronic health record--based reports that detect process breakdowns in the followup of abnormal findings--are described in case studies. By raising awareness and implementing targeted programs that address diagnostic error, HCOs may begin to play an important role in addressing the problem of diagnostic error.

The European Medicines Agency's strategies to meet the challenges of Alzheimer disease.

PubMed

Haas, Manuel; Mantua, Valentina; Haberkamp, Marion; Pani, Luca; Isaac, Maria; Butlen-Ducuing, Florence; Vamvakas, Spiros; Broich, Karl

2015-04-01

Regulatory agencies have a key role in facilitating the development of new drugs for Alzheimer disease, particularly given the challenges associated with early intervention. Here, we highlight the strategies of the European Medicines Agency to help address such challenges.

Addressing Complex Problems: Using Authentic Audiences and Challenges to Develop Adaptive Leadership and Socially Responsible Agency in Leadership Learners

ERIC Educational Resources Information Center

Andenoro, Anthony C.; Sowcik, Matthew J.; Balser, Teresa C.

2017-01-01

Complex and adaptive challenges threaten human well-being and sustainability. However, our leadership graduates often lack the capacity and or commitment to address these challenges in a meaningful way. This paper details a five-year study exploring the impact of an interdisciplinary undergraduate course on the development of global capacities,…

Global challenges keynote address in memoriam to colleagues lost in the Malaysia airlines 17 crash

PubMed Central

Hankins, Catherine A.

2016-01-01

ABSTRACT Six colleagues working in the HIV field were killed when their flight en route to Kuala Lumpur was shot down over the Ukraine. This report is drawn from the in memoriam keynote opening address given at the 12th International AIDS Impact conference in Amsterdam in 2015. It highlights their tangible and valued roles in the HIV response and looks forward to the road ahead. It describes the ways in which we can build on their legacy to address current global challenges in HIV prevention and treatment and to mobilise the intensified, focused resources that are needed to turn the HIV epidemic on its head. PMID:26963879

Global challenges keynote address in memoriam to colleagues lost in the Malaysia airlines 17 crash.

PubMed

Hankins, Catherine A

2016-01-01

Six colleagues working in the HIV field were killed when their flight en route to Kuala Lumpur was shot down over the Ukraine. This report is drawn from the in memoriam keynote opening address given at the 12th International AIDS Impact conference in Amsterdam in 2015. It highlights their tangible and valued roles in the HIV response and looks forward to the road ahead. It describes the ways in which we can build on their legacy to address current global challenges in HIV prevention and treatment and to mobilise the intensified, focused resources that are needed to turn the HIV epidemic on its head.

Challenges created by data dissemination and access restrictions when attempting to address community concerns: individual privacy versus public wellbeing.

PubMed

Colquhoun, Amy; Aplin, Laura; Geary, Janis; Goodman, Karen J; Hatcher, Juanita

2012-05-08

Population health data are vital for the identification of public health problems and the development of public health strategies. Challenges arise when attempts are made to disseminate or access anonymised data that are deemed to be potentially identifiable. In these situations, there is debate about whether the protection of an individual's privacy outweighs potentially beneficial public health initiatives developed using potentially identifiable information. While these issues have an impact at planning and policy levels, they pose a particular dilemma when attempting to examine and address community concerns about a specific health problem. Research currently underway in northern Canadian communities on the frequency of Helicobacter pylori infection and associated diseases, such as stomach cancer, is used in this article to illustrate the challenges that data controls create on the ability of researchers and health officials to address community concerns. Barriers are faced by public health professionals and researchers when endeavouring to address community concerns; specifically, provincial cancer surveillance departments and community-driven participatory research groups face challenges related to data release or access that inhibit their ability to effectively address community enquiries. The resulting consequences include a limited ability to address misinformation or to alleviate concerns when dealing with health problems in small communities. The development of communication tools and building of trusting relationships are essential components of a successful investigation into community health concerns. It may also be important to consider that public wellbeing may outweigh the value of individual privacy in these situations. As such, a re-evaluation of data disclosure policies that are applicable in these circumstances should be considered.

Building Interdisciplinary Research Capacity: a Key Challenge for Ecological Approaches in Public Health.

PubMed

Galway, Lindsay P; Parkes, Margot W; Allen, Diana; Takaro, Tim K

2016-01-01

The shortcomings of public health research informed by reductionist and fragmented biomedical approaches and the emergence of wicked problems are fueling a renewed interest in ecological approaches in public health. Despite the central role of interdisciplinarity in the context of ecological approaches in public health research, inadequate attention has been given to the specific challenge of doing interdisciplinary research in practice. As a result, important knowledge gaps exist with regards to the practice of interdisciplinary research. We argue that explicit attention towards the challenge of doing interdisciplinary research is critical in order to effectively apply ecological approaches to public health issues. This paper draws on our experiences developing and conducting an interdisciplinary research project exploring the links among climate change, water, and health to highlight five specific insights which we see as relevant to building capacity for interdisciplinary research specifically, and which have particular relevance to addressing the integrative challenges demanded by ecological approaches to address public health issues. These lessons include: (i) the need for frameworks that facilitate integration; (ii) emphasize learning-by-doing; (iii) the benefits of examining issues at multiple scales; (iv) make the implicit, explicit; and (v) the need for reflective practice. By synthesizing and sharing experiences gained by engaging in interdisciplinary inquiries using an ecological approach, this paper responds to a growing need to build interdisciplinary research capacity as a means for advancing the ecological public health agenda more broadly.

Building Interdisciplinary Research Capacity: a Key Challenge for Ecological Approaches in Public Health

PubMed Central

Galway, Lindsay P.; Parkes, Margot W.; Allen, Diana; Takaro, Tim K.

2016-01-01

The shortcomings of public health research informed by reductionist and fragmented biomedical approaches and the emergence of wicked problems are fueling a renewed interest in ecological approaches in public health. Despite the central role of interdisciplinarity in the context of ecological approaches in public health research, inadequate attention has been given to the specific challenge of doing interdisciplinary research in practice. As a result, important knowledge gaps exist with regards to the practice of interdisciplinary research. We argue that explicit attention towards the challenge of doing interdisciplinary research is critical in order to effectively apply ecological approaches to public health issues. This paper draws on our experiences developing and conducting an interdisciplinary research project exploring the links among climate change, water, and health to highlight five specific insights which we see as relevant to building capacity for interdisciplinary research specifically, and which have particular relevance to addressing the integrative challenges demanded by ecological approaches to address public health issues. These lessons include: (i) the need for frameworks that facilitate integration; (ii) emphasize learning-by-doing; (iii) the benefits of examining issues at multiple scales; (iv) make the implicit, explicit; and (v) the need for reflective practice. By synthesizing and sharing experiences gained by engaging in interdisciplinary inquiries using an ecological approach, this paper responds to a growing need to build interdisciplinary research capacity as a means for advancing the ecological public health agenda more broadly. PMID:29546171

Interventions and assessment tools addressing key concepts people need to know to appraise claims about treatment effects: a systematic mapping review.

PubMed

Austvoll-Dahlgren, Astrid; Nsangi, Allen; Semakula, Daniel

2016-12-29

People's ability to appraise claims about treatment effects is crucial for informed decision-making. Our objective was to systematically map this area of research in order to (a) provide an overview of interventions targeting key concepts that people need to understand to assess treatment claims and (b) to identify assessment tools used to evaluate people's understanding of these concepts. The findings of this review provide a starting point for decisions about which key concepts to address when developing new interventions, and which assessment tools should be considered. We conducted a systematic mapping review of interventions and assessment tools addressing key concepts important for people to be able to assess treatment claims. A systematic literature search was done by a reserach librarian in relevant databases. Judgement about inclusion of studies and data collection was done by at least two researchers. We included all quantitative study designs targeting one or more of the key concepts, and targeting patients, healthy members of the public, and health professionals. The studies were divided into four categories: risk communication and decision aids, evidence-based medicine and critical appraisal, understanding of controlled trials, and science education. Findings were summarised descriptively. We included 415 studies, of which the interventions and assessment tools we identified included only a handful of the key concepts. The most common key concepts in interventions were "Treatments usually have beneficial and harmful effects," "Treatment comparisons should be fair," "Compare like with like," and "Single studies can be misleading." A variety of assessment tools were identified, but only four assessment tools included 10 or more key concepts. There is great potential for developing learning and assessment tools targeting key concepts that people need to understand to assess claims about treatment effects. There is currently no instrument covering

Elementary and Secondary Education: Flexibility Initiatives Do Not Address Districts' Key Concerns about Federal Requirements. Report to Congressional Requesters.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Health, Education, and Human Services Div.

The Government Accounting Office (GAO) was asked to: (1) describe major federal requirements that affect school districts; (2) identify key issues school districts face in implementing these requirements; and (3) analyze the impact of the Department of Education's flexibility initiatives on school districts' ability to address these implementation…

An SSH key management system: easing the pain of managing key/user/account associations

NASA Astrophysics Data System (ADS)

Arkhipkin, D.; Betts, W.; Lauret, J.; Shiryaev, A.

2008-07-01

Cyber security requirements for secure access to computing facilities often call for access controls via gatekeepers and the use of two-factor authentication. Using SSH keys to satisfy the two factor authentication requirement has introduced a potentially challenging task of managing the keys and their associations with individual users and user accounts. Approaches for a facility with the simple model of one remote user corresponding to one local user would not work at facilities that require a many-to-many mapping between users and accounts on multiple systems. We will present an SSH key management system we developed, tested and deployed to address the many-to-many dilemma in the environment of the STAR experiment. We will explain its use in an online computing context and explain how it makes possible the management and tracing of group account access spread over many sub-system components (data acquisition, slow controls, trigger, detector instrumentation, etc.) without the use of shared passwords for remote logins.

Key challenges and priorities for modelling European grasslands under climate change.

PubMed

Kipling, Richard P; Virkajärvi, Perttu; Breitsameter, Laura; Curnel, Yannick; De Swaef, Tom; Gustavsson, Anne-Maj; Hennart, Sylvain; Höglind, Mats; Järvenranta, Kirsi; Minet, Julien; Nendel, Claas; Persson, Tomas; Picon-Cochard, Catherine; Rolinski, Susanne; Sandars, Daniel L; Scollan, Nigel D; Sebek, Leon; Seddaiu, Giovanna; Topp, Cairistiona F E; Twardy, Stanislaw; Van Middelkoop, Jantine; Wu, Lianhai; Bellocchi, Gianni

2016-10-01

Grassland-based ruminant production systems are integral to sustainable food production in Europe, converting plant materials indigestible to humans into nutritious food, while providing a range of environmental and cultural benefits. Climate change poses significant challenges for such systems, their productivity and the wider benefits they supply. In this context, grassland models have an important role in predicting and understanding the impacts of climate change on grassland systems, and assessing the efficacy of potential adaptation and mitigation strategies. In order to identify the key challenges for European grassland modelling under climate change, modellers and researchers from across Europe were consulted via workshop and questionnaire. Participants identified fifteen challenges and considered the current state of modelling and priorities for future research in relation to each. A review of literature was undertaken to corroborate and enrich the information provided during the horizon scanning activities. Challenges were in four categories relating to: 1) the direct and indirect effects of climate change on the sward 2) climate change effects on grassland systems outputs 3) mediation of climate change impacts by site, system and management and 4) cross-cutting methodological issues. While research priorities differed between challenges, an underlying theme was the need for accessible, shared inventories of models, approaches and data, as a resource for stakeholders and to stimulate new research. Developing grassland models to effectively support efforts to tackle climate change impacts, while increasing productivity and enhancing ecosystem services, will require engagement with stakeholders and policy-makers, as well as modellers and experimental researchers across many disciplines. The challenges and priorities identified are intended to be a resource 1) for grassland modellers and experimental researchers, to stimulate the development of new research

Key Issues in Hymenoptera Venom Allergy: An Update.

PubMed

Alfaya Arias, T; Soriano Gómis, V; Soto Mera, T; Vega Castro, A; Vega Gutiérrez, J M; Alonso Llamazares, A; Antolín Amérigo, D; Carballada Gonzalez, F J; Dominguez Noche, C; Gutierrez Fernandez, D; Marques Amat, L; Martinez Arcediano, A; Martinez San Ireneo, M; Moreno Ancillo, A; Puente Crespo, Y; Ruiz Leon, B; Sánchez Morillas, L

In this review, the Hymenoptera Allergy Committee of the SEAIC analyzes the most recent scientific literature addressing problems related to the diagnosis of hymenoptera allergy and to management of venom immunotherapy. Molecular diagnosis and molecular risk profiles are the key areas addressed. The appearance of new species of hymenoptera that are potentially allergenic in Spain and the associated diagnostic and therapeutic problems are also described. Finally, we analyze the issue of mast cell activation syndrome closely related to hymenoptera allergy, which has become a new diagnostic challenge for allergists given its high prevalence in patients with venom anaphylaxis.

Engineering the LISA Project: Systems Engineering Challenges

NASA Technical Reports Server (NTRS)

Evans, Jordan P.

2006-01-01

The Laser Interferometer Space Antenna (LISA) is a joint NASA/ESA mission to detect and measure gravitational waves with periods from 1 s to 10000 s. The systems engineering challenges of developing a giant interferometer, 5 million kilometers on a side, an: numerous. Some of the key challenges are presented in this paper. The organizational challenges imposed by sharing the engineering function between three centers (ESA ESTEC, NASA GSFC, and JPL) across nine time zones are addressed. The issues and approaches to allocation of the acceleration noise and measurement sensitivity budget terms across a traditionally decomposed system are discussed. Additionally, using LISA to detect gravitational waves for the first time presents significant data analysis challenges, many of which drive the project system design. The approach to understanding the implications of science data analysis on the system is also addressed.

Key on demand (KoD) for software-defined optical networks secured by quantum key distribution (QKD).

PubMed

Cao, Yuan; Zhao, Yongli; Colman-Meixner, Carlos; Yu, Xiaosong; Zhang, Jie

2017-10-30

Software-defined optical networking (SDON) will become the next generation optical network architecture. However, the optical layer and control layer of SDON are vulnerable to cyberattacks. While, data encryption is an effective method to minimize the negative effects of cyberattacks, secure key interchange is its major challenge which can be addressed by the quantum key distribution (QKD) technique. Hence, in this paper we discuss the integration of QKD with WDM optical networks to secure the SDON architecture by introducing a novel key on demand (KoD) scheme which is enabled by a novel routing, wavelength and key assignment (RWKA) algorithm. The QKD over SDON with KoD model follows two steps to provide security: i) quantum key pools (QKPs) construction for securing the control channels (CChs) and data channels (DChs); ii) the KoD scheme uses RWKA algorithm to allocate and update secret keys for different security requirements. To test our model, we define a security probability index which measures the security gain in CChs and DChs. Simulation results indicate that the security performance of CChs and DChs can be enhanced by provisioning sufficient secret keys in QKPs and performing key-updating considering potential cyberattacks. Also, KoD is beneficial to achieve a positive balance between security requirements and key resource usage.

Principles of Positive Behaviour Supports: Using the FBA as a Problem-Solving Approach to Address Challenging Behaviours beyond Special Populations

ERIC Educational Resources Information Center

Moreno, Gerardo; Bullock, Lyndal M.

2011-01-01

The Functional Behavioural Assessment (FBA) is an investigative process that examines the context of challenging behaviours in the classroom. Information gleaned from the FBA process is used to develop a behaviour intervention plan to address the challenging behaviour and teach a socially acceptable replacement behaviour. However, the FBA has…

Addressing challenges for youths with mobility devices in winter conditions.

PubMed

Morales, Ernesto; Lindsay, Sally; Edwards, Geoffrey; Howell, Lori; Vincent, Claude; Yantzi, Nicole; Gauthier, Véronique

2018-01-01

Winter-related research about the experience of navigating in the urban context has mostly focused on the elderly population with physical disabilities. The aim of this project was to explore potential design solutions to enhance young people's mobility devices and the built environment to improve accessibility and participation in winter. A multi-method qualitative design process included the following steps: (1) in-depth interviews; (2) photo elicitation; (3) individual co-design sessions; and (4) group co-design sessions (i.e., focus group). The participants were 13 youths (nine males and four females), aged 12-21, who used a wheelchair (12 power chair users and one manual wheelchair), for some with their parents, others without their parents, according to the parents' willingness to participate or not in the study (n = 13). The first two authors conducted group co-design sessions with mechanical engineers and therapists/clinicians in two Canadian cities to discuss the feasibility of the designs. Results (findings): The youths and their parents reported different winter-related challenges and proposed specific design solutions to enhance their participation and inclusion in winter activities. Seven of these designs were presented at two group co-design sessions of therapists/clinicians and engineers. Two designs were found to be feasible: (1) a traction device for wheelchairs in snow and (2) a mat made of rollers to clean snow and dirt from tires. The results of this research highlight the frustrations and challenges youths who use wheelchairs encounter in winter and a need for new solutions to ensure greater accessibility in winter. Therapists/clinicians and designers should address winter-related accessibility problems in areas with abundant snow. Implications for Rehabilitation Several studies show that current urban contexts do not necessarily respond accurately to the needs of individuals with limited mobility. Winter-related research about the

Educational Leadership: Key Challenges and Ethical Tensions

ERIC Educational Resources Information Center

Duignan, Patrick

2007-01-01

"Educational Leadership" is a major research book on contemporary leadership challenges for educational leaders. In this groundbreaking new work, educational leaders in schools, including teachers, are provided with ways of analysing and resolving common but complex leadership challenges. Ethical tensions inherent in these challenges are…

A systematic literature review of the key challenges for developing the structure of public health economic models.

PubMed

Squires, Hazel; Chilcott, James; Akehurst, Ronald; Burr, Jennifer; Kelly, Michael P

2016-04-01

To identify the key methodological challenges for public health economic modelling and set an agenda for future research. An iterative literature search identified papers describing methodological challenges for developing the structure of public health economic models. Additional multidisciplinary literature searches helped expand upon important ideas raised within the review. Fifteen articles were identified within the formal literature search, highlighting three key challenges: inclusion of non-healthcare costs and outcomes; inclusion of equity; and modelling complex systems and multi-component interventions. Based upon these and multidisciplinary searches about dynamic complexity, the social determinants of health, and models of human behaviour, six areas for future research were specified. Future research should focus on: the use of systems approaches within health economic modelling; approaches to assist the systematic consideration of the social determinants of health; methods for incorporating models of behaviour and social interactions; consideration of equity; and methodology to help modellers develop valid, credible and transparent public health economic model structures.

Strengthening health information systems to address health equity challenges.

PubMed Central

Nolen, Lexi Bambas; Braveman, Paula; Dachs, J. Norberto W.; Delgado, Iris; Gakidou, Emmanuela; Moser, Kath; Rolfe, Liz; Vega, Jeanette; Zarowsky, Christina

2005-01-01

Special studies and isolated initiatives over the past several decades in low-, middle- and high-income countries have consistently shown inequalities in health among socioeconomic groups and by gender, race or ethnicity, geographical area and other measures associated with social advantage. Significant health inequalities linked to social (dis)advantage rather than to inherent biological differences are generally considered unfair or inequitable. Such health inequities are the main object of health development efforts, including global targets such as the Millennium Development Goals, which require monitoring to evaluate progress. However, most national health information systems (HIS) lack key information needed to assess and address health inequities, namely, reliable, longitudinal and representative data linking measures of health with measures of social status or advantage at the individual or small-area level. Without empirical documentation and monitoring of such inequities, as well as country-level capacity to use this information for effective planning and monitoring of progress in response to interventions, movement towards equity is unlikely to occur. This paper reviews core information requirements and potential databases and proposes short-term and longer term strategies for strengthening the capabilities of HIS for the analysis of health equity and discusses HIS-related entry points for supporting a culture of equity-oriented decision-making and policy development. PMID:16184279

Notification: Key Management Challenges Confronting the U.S. Chemical Safety and Hazard Investigation Board - FY2016

EPA Pesticide Factsheets

January 21, 2016. The EPA OIG is beginning work to update for fiscal year 2016 its list of proposed key management challenges and internal control weaknesses confronting the U.S. Chemical Safety and Hazard Investigation Board (CSB).

From Assistant Teacher to Teacher: Challenges and Pathways in Situated Pre-Service Teacher Education

ERIC Educational Resources Information Center

Strangeways, Al

2017-01-01

Vocational pathways to Higher Education have a key role in opening teacher education to under-represented groups but bring with them particular challenges. Teacher educators need to address the challenges faced by these learners, of not only connecting their learning but also challenging their knowledge, and doing so in an invested work…

Scaling-up HIV responses with key populations in West Africa.

PubMed

Wheeler, Tisha; Wolf, R Cameron; Kapesa, Laurent; Cheng Surdo, Alison; Dallabetta, Gina

2015-03-01

Despite decades of HIV responses in pockets of West and Central Africa (WCA), the HIV response with key populations remains an understudied area. Recently, there has been a proliferation of studies highlighting epidemiologic and behavioral data that challenge attitudes of complacency among donors and country governments uncomfortable in addressing key populations. The articles in this series highlight new studies that provide a better understanding of the epidemiologic and structural burden facing key populations in the WCA region and how to improve responses through more effective targeting. Key populations face pervasive structural barriers including institutional and sexual violence and an intersection of stigma, criminalization, and marginalization as sexual minorities. Despite decades of smaller interventions that have shown the importance of integrated services for key populations, there remains incongruent provision of outreach or testing or family planning pointing to sustained risk. There remains an incongruent resource provision for key populations where they shoulder the burden of HIV and their access to services alone could turn around HIV epidemics within the region. These proximal and distal determinants must be addressed in regional efforts, led by the community, and resourced for scale, targeting those most at risk for the acquisition and transmission of HIV. This special issue builds the knowledge base for the region focusing on interventions that remove barriers to service access including treatment uptake for those living with HIV. Better analysis and use of data for strategic planning are shown to lead to more effective targeting of prevention, care, and HIV treatment programs with key populations. These articles further demonstrate the immediate need for comprehensive action to address HIV among key populations throughout the WCA region.

Key Competencies for Education in a European Context: Narratives of Accountability or Care

ERIC Educational Resources Information Center

Deakin, Ruth

2008-01-01

This article addresses the ideological challenges and opportunities presented by the European Commission's commitment to the identification of key competencies for education and training, and the development of indicators which can be used to monitor and evaluate progress towards these competences across the European Union. It explores the…

Facilitators, challenges, and collaborative activities in faith and health partnerships to address health disparities.

PubMed

Kegler, Michelle C; Hall, Sarah M; Kiser, Mimi

2010-10-01

Interest in partnering with faith-based organizations (FBOs) to address health disparities has grown in recent years. Yet relatively little is known about these types of partnerships. As part of an evaluation of the Institute for Faith and Public Health Collaborations, representatives of 34 faith-health teams (n = 61) completed semi-structured interviews. Interviews were tape recorded, transcribed, and coded by two members of the evaluation team to identify themes. Major facilitators to faith-health collaborative work were passion and commitment, importance of FBOs in communities, favorable political climate, support from community and faith leaders, diversity of teams, and mutual trust and respect. Barriers unique to faith and health collaboration included discomfort with FBOs, distrust of either health agencies or FBOs, diversity within faith communities, different agendas, separation of church and state, and the lack of a common language. Findings suggest that faith-health partnerships face unique challenges but are capable of aligning resources to address health disparities.

Managing flood risks in the Mekong Delta: How to address emerging challenges under climate change and socioeconomic developments.

PubMed

Hoang, Long Phi; Biesbroek, Robbert; Tri, Van Pham Dang; Kummu, Matti; van Vliet, Michelle T H; Leemans, Rik; Kabat, Pavel; Ludwig, Fulco

2018-02-24

Climate change and accelerating socioeconomic developments increasingly challenge flood-risk management in the Vietnamese Mekong River Delta-a typical large, economically dynamic and highly vulnerable delta. This study identifies and addresses the emerging challenges for flood-risk management. Furthermore, we identify and analyse response solutions, focusing on meaningful configurations of the individual solutions and how they can be tailored to specific challenges using expert surveys, content analysis techniques and statistical inferences. Our findings show that the challenges for flood-risk management are diverse, but critical challenges predominantly arise from the current governance and institutional settings. The top-three challenges include weak collaboration, conflicting management objectives and low responsiveness to new issues. We identified 114 reported solutions and developed six flood management strategies that are tailored to specific challenges. We conclude that the current technology-centric flood management approach is insufficient given the rapid socioecological changes. This approach therefore should be adapted towards a more balanced management configuration where technical and infrastructural measures are combined with institutional and governance resolutions. Insights from this study contribute to the emerging repertoire of contemporary flood management solutions, especially through their configurations and tailoring to specific challenges.

Online Learning: Addressing Challenges and Seizing Opportunities. Oregon

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

Online Learning: Addressing Challenges and Seizing Opportunities. Minnesota

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

Online Learning: Addressing Challenges and Seizing Opportunities. Hawaii

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

Online Learning: Addressing Challenges and Seizing Opportunities. Idaho

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

Online Learning: Addressing Challenges and Seizing Opportunities. Wisconsin

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

Challenges, Realities, Strategies: The Master Plan for Florida Postsecondary Education for the 21st Century.

ERIC Educational Resources Information Center

Florida State Postsecondary Education Planning Commission, Tallahassee.

A new master plan for higher education in Florida is presented which focuses on the central challenges facing the state and its higher education institutions. The following sections address three key challenges and suggest strategies to help policymakers and governing boards promote positive change. The section on the challenge of improved use of…

Addressing the Challenges of Hepatitis C Virus Resistance and Treatment Failure.

PubMed

Colpitts, Che C; Baumert, Thomas F

2016-08-16

Chronic hepatitis C is a major cause of chronic liver disease, including liver cirrhosis and hepatocellular carcinoma. The development of direct-acting antivirals (DAAs) revolutionized hepatitis C virus (HCV) treatment by offering genuine prospects for the first comprehensive cure of a chronic viral infection in humans. While antiviral resistance is a significant limitation for interferon-based therapies, resistance and treatment failure still appear to be present in a small fraction of patients even in state-of-the-art DAA combination therapies. Therefore, treatment failure and resistance still remain a clinical challenge for the management of patients not responding to DAAs. In this special issue of Viruses on HCV drug resistance, mechanisms of antiviral resistance for different classes of antiviral drugs are described. Furthermore, the detection and monitoring of resistance in clinical practice, the clinical impact of resistance in different patient groups and strategies to prevent and address resistance and treatment failure using complementary antiviral strategies are reviewed.

Another Challenge for Africa: Ethnic Stability

DTIC Science & Technology

2011-03-24

is a cultural , deep-seated personal matter to the African people. Still, ethnicity is a key foundational challenge for Africa to adequately address...Issues, Diplomacy as an Element of National Power CLASSIFICATION: Unclassified Ethnicity is a cultural , deep-seated personal matter to the...history, geography, political system, economics, demographics, culture , and languages. From a U.S. perspective, most know of Africa from news

Family caregiving challenges in advanced colorectal cancer: patient and caregiver perspectives.

PubMed

Mosher, Catherine E; Adams, Rebecca N; Helft, Paul R; O'Neil, Bert H; Shahda, Safi; Rattray, Nicholas A; Champion, Victoria L

2016-05-01

Family caregivers of advanced colorectal cancer patients may be at increased risk for psychological distress. Yet their key challenges in coping with the patient's illness are not well understood. Soliciting both patient and caregiver perspectives on these challenges would broaden our understanding of the caregiving experience. Thus, the purpose of this research was to identify caregivers' key challenges in coping with their family member's advanced colorectal cancer from the perspective of patients and caregivers. Individual, semi-structured qualitative interviews were conducted with 23 advanced colorectal cancer patients and 23 primary family caregivers. Interview data were analyzed via thematic analysis. In nearly all cases, patient and caregiver reports of the caregiver's key challenge were discrepant. Across patient and caregiver reports, caregivers' key challenges included processing emotions surrounding the patient's initial diagnosis or recurrence and addressing the patient's practical and emotional needs. Other challenges included coping with continual uncertainty regarding the patient's potential functional decline and prognosis and observing the patient suffer from various physical symptoms. Findings suggest that eliciting the perspectives of both patients and caregivers regarding caregivers' challenges provides a more comprehensive understanding of their experience. Results also point to the need to assist caregivers with the emotional and practical aspects of caregiving.

Nanoscale content-addressable memory

NASA Technical Reports Server (NTRS)

Davis, Bryan (Inventor); Principe, Jose C. (Inventor); Fortes, Jose (Inventor)

2009-01-01

A combined content addressable memory device and memory interface is provided. The combined device and interface includes one or more one molecular wire crossbar memories having spaced-apart key nanowires, spaced-apart value nanowires adjacent to the key nanowires, and configurable switches between the key nanowires and the value nanowires. The combination further includes a key microwire-nanowire grid (key MNG) electrically connected to the spaced-apart key nanowires, and a value microwire-nanowire grid (value MNG) electrically connected to the spaced-apart value nanowires. A key or value MNGs selects multiple nanowires for a given key or value.

Coach strategies for addressing psychosocial challenges during the return to sport from injury.

PubMed

Podlog, Leslie; Dionigi, Rylee

2010-09-01

The purpose of this study was to examine coach strategies for addressing athletes' psychosocial challenges in returning to sport following injury rehabilitation. Qualitative interviews with eight elite coaches from the Western Australian Institute of Sport (WAIS) in Perth, Australia revealed that coaches facilitated athletes' return to sport from injury through a variety of means, but did not typically provide systematic forms of assistance. Coaches commented that the idiosyncratic nature of the injury experience meant that they needed to apply strategies consistent with athletes' particular psychosocial needs. Such strategies included: (a) coordination of a "team approach" to rehabilitation; (b) fostering open communication with athletes and treatment team members; (c) social support; (d) positive thinking and goal setting; and (e) role models. Analysis of these strategies revealed that coaches attempted to address competence, autonomy, and relatedness needs in facilitating athletes' return from injury. These findings suggest that self-determination theory may be a valuable approach for examining coach forms of assistance regarding athletes' return to competition following injury. Findings are discussed in relation to injury literature and self-determination theory. Suggestions for future research are also presented.

Federal Aviation Administration : reauthorization provides opportunities to address key agency challenges

DOT National Transportation Integrated Search

2003-04-10

Much has changed since the Wendell H. Ford Aviation Investment and Reform Act for the 21st Century (AIR-21) reauthorized the Federal Aviation Administration's (FAA) programs 3 years ago. At that time, air traffic was increasing, and concerns about co...

Multi-disciplinary interoperability challenges (Ian McHarg Medal Lecture)

NASA Astrophysics Data System (ADS)

Annoni, Alessandro

2013-04-01

Global sustainability research requires multi-disciplinary efforts to address the key research challenges to increase our understanding of the complex relationships between environment and society. For this reason dependence on ICT systems interoperability is rapidly growing but, despite some relevant technological improvement is observed, in practice operational interoperable solutions are still lacking. Among the causes is the absence of a generally accepted definition of "interoperability" in all its broader aspects. In fact the concept of interoperability is just a concept and the more popular definitions are not addressing all challenges to realize operational interoperable solutions. The problem become even more complex when multi-disciplinary interoperability is required because in that case solutions for interoperability of different interoperable solution should be envisaged. In this lecture the following definition will be used: "interoperability is the ability to exchange information and to use it". In the lecture the main challenges for addressing multi-disciplinary interoperability will be presented and a set of proposed approaches/solutions shortly introduced.

Commentary: Pediatric eHealth Interventions: Common Challenges During Development, Implementation, and Dissemination

PubMed Central

Steele, Ric G.; Connelly, Mark A.; Palermo, Tonya M.; Ritterband, Lee M.

2014-01-01

Objective To provide an overview of common challenges that pediatric eHealth researchers may encounter when planning, developing, testing, and disseminating eHealth interventions along with proposed solutions for addressing these challenges. Methods The article draws on the existing eHealth literature and the authors’ collective experience in pediatric eHealth research. Results and conclusions The challenges associated with eHealth interventions and their proposed solutions are multifaceted and cut across a number of areas from eHealth program development through dissemination. Collaboration with a range of individuals (e.g., multidisciplinary colleagues, commercial entities, primary stakeholders) is the key to eHealth intervention success. To ensure adequate resources for design, development, and planning for sustainability, a number of public and private sources of funding are available. A study design that addresses ethical concerns and security issues is critical to ensure scientific integrity and intervention dissemination. Table I summarizes key issues to consider during eHealth intervention development, testing, and dissemination. PMID:24816766

Exploring a Community of Practice Model for Professional Development to Address Challenges to Classroom Practices in Early Childhood

ERIC Educational Resources Information Center

Christ, Tanya; Wang, X. Christine

2013-01-01

This study explored whether or not, and how, an on-site and research-teacher community of practice model for professional development addressed the challenges to classroom practices in a Head Start program. Data sources included interviews with teachers, videos of planning and teaching sessions, and the researchers' fieldwork log and reflective…

Defense Civil Support: DOD Needs to Identify National Guards Cyber Capabilities and Address Challenges in Its Exercises

DTIC Science & Technology

2016-09-01

Congress. Consequently, as prepared now, this report does not help DOD leaders identify assets that could be used in a cyber crisis scenario...Guidance. GAO-13-128. Washington, D.C.: October 24, 2012. Defense Cyber Efforts: Management Improvements Needed to Enhance Programs Protecting the...DEFENSE CIVIL SUPPORT DOD Needs to Identify National Guard’s Cyber Capabilities and Address Challenges in Its

Addressing China's grand challenge of achieving food security while ensuring environmental sustainability.

PubMed

Lu, Yonglong; Jenkins, Alan; Ferrier, Robert C; Bailey, Mark; Gordon, Iain J; Song, Shuai; Huang, Jikun; Jia, Shaofeng; Zhang, Fusuo; Liu, Xuejun; Feng, Zhaozhong; Zhang, Zhibin

2015-02-01

China's increasingly urbanized and wealthy population is driving a growing and changing demand for food, which might not be met without significant increase in agricultural productivity and sustainable use of natural resources. Given the past relationship between lack of access to affordable food and political instability, food security has to be given a high priority on national political agendas in the context of globalization. The drive for increased food production has had a significant impact on the environment, and the deterioration in ecosystem quality due to historic and current levels of pollution will potentially compromise the food production system in China. We discuss the grand challenges of not only producing more food but also producing it sustainably and without environmental degradation. In addressing these challenges, food production should be considered as part of an environmental system (soil, air, water, and biodiversity) and not independent from it. It is imperative that new ways of meeting the demand for food are developed while safeguarding the natural resources upon which food production is based. We present a holistic approach to both science and policy to ensure future food security while embracing the ambition of achieving environmental sustainability in China. It is a unique opportunity for China to be a role model as a new global player, especially for other emerging economies.

Key successes and challenges in providing mental health care in an urban male remand prison: a qualitative study.

PubMed

Samele, Chiara; Forrester, Andrew; Urquía, Norman; Hopkin, Gareth

2016-04-01

This study aimed to describe the workings of an urban male remand prison mental health service exploring the key challenges and successes, levels of integration and collaboration with other services. A purposive sampling was used to recruit key prison and healthcare professionals for in-depth interviews. A thematic analysis was used to analyse transcripts based on an initial coding frame of several predefined themes. Other key themes were also identified. Twenty-eight interviews were conducted. Prisoners referred to the service had complex, sometimes acute mental illness requiring specialist assessment and treatment. Key successes of the in-reach service included the introduction of an open referral system, locating a mental health nurse at reception to screen all new prisoners and a zoning system to prioritise urgent or non-urgent cases. Achieving an integrated system of healthcare was challenging because of the numerous internal and external services operating across the prison, a highly transient population, limited time and space to deliver services and difficulties with providing inpatient care (e.g., establishing the criteria for admission and managing patient flow). Collaborative working between prison and healthcare staff was required to enable best care for prisoners. The prison mental health in-reach service worked well in assessing and prioritising those who required specialist mental health care. Although the challenges of working within the prison context limited what the in-reach team could achieve. Further work was needed to improve the unit environment and how best to target and deliver inpatient care within the prison.

Qualitative Approaches to Research in Counselling and Psychotherapy: Issues and Challenges.

ERIC Educational Resources Information Center

McLeod, John

1996-01-01

Discusses key issues which address the distinctive dilemmas and challenges associated with qualitative approaches to evaluating counseling. Investigates such concerns as relationships with research participants, ethics, reflexivity, methodological choice, communicability, perspective, and obviousness. Makes some suggestions regarding the link…

Tailored combination prevention packages and PrEP for young key populations

PubMed Central

Pettifor, Audrey; Nguyen, Nadia L; Celum, Connie; Cowan, Frances M; Go, Vivian; Hightow-Weidman, Lisa

2015-01-01

Introduction Young key populations, defined in this article as men who have sex with men, transgender persons, people who sell sex and people who inject drugs, are at particularly high risk for HIV. Due to the often marginalized and sometimes criminalized status of young people who identify as members of key populations, there is a need for HIV prevention packages that account for the unique and challenging circumstances they face. Pre-exposure prophylaxis (PrEP) is likely to become an important element of combination prevention for many young key populations. Objective In this paper, we discuss important challenges to HIV prevention among young key populations, identify key components of a tailored combination prevention package for this population and examine the role of PrEP in these prevention packages. Methods We conducted a comprehensive review of the evidence to date on prevention strategies, challenges to prevention and combination prevention packages for young key populations. We focused specifically on the role of PrEP in these prevention packages and on young people under the age of 24, and 18 in particular. Results and discussion Combination prevention packages that include effective, acceptable and scalable behavioural, structural and biologic interventions are needed for all key populations to prevent new HIV infections. Interventions in these packages should meaningfully involve beneficiaries in the design and implementation of the intervention, and take into account the context in which the intervention is being delivered to thoughtfully address issues of stigma and discrimination. These interventions will likely be most effective if implemented in conjunction with strategies to facilitate an enabling environment, including increasing access to HIV testing and health services for PrEP and other prevention strategies, decriminalizing key populations’ practices, increasing access to prevention and care, reducing stigma and discrimination, and

Challenges in image-guided therapy system design.

PubMed

Dimaio, Simon; Kapur, Tina; Cleary, Kevin; Aylward, Stephen; Kazanzides, Peter; Vosburgh, Kirby; Ellis, Randy; Duncan, James; Farahani, Keyvan; Lemke, Heinz; Peters, Terry; Lorensen, William Bill; Gobbi, David; Haller, John; Clarke, Laurence Larry; Pizer, Stephen; Taylor, Russell; Galloway, Robert; Fichtinger, Gabor; Hata, Nobuhiko; Lawson, Kimberly; Tempany, Clare; Kikinis, Ron; Jolesz, Ferenc

2007-01-01

System development for image-guided therapy (IGT), or image-guided interventions (IGI), continues to be an area of active interest across academic and industry groups. This is an emerging field that is growing rapidly: major academic institutions and medical device manufacturers have produced IGT technologies that are in routine clinical use, dozens of high-impact publications are published in well regarded journals each year, and several small companies have successfully commercialized sophisticated IGT systems. In meetings between IGT investigators over the last two years, a consensus has emerged that several key areas must be addressed collaboratively by the community to reach the next level of impact and efficiency in IGT research and development to improve patient care. These meetings culminated in a two-day workshop that brought together several academic and industrial leaders in the field today. The goals of the workshop were to identify gaps in the engineering infrastructure available to IGT researchers, develop the role of research funding agencies and the recently established US-based National Center for Image Guided Therapy (NCIGT), and ultimately to facilitate the transfer of technology among research centers that are sponsored by the National Institutes of Health (NIH). Workshop discussions spanned many of the current challenges in the development and deployment of new IGT systems. Key challenges were identified in a number of areas, including: validation standards; workflows, use-cases, and application requirements; component reusability; and device interface standards. This report elaborates on these key points and proposes research challenges that are to be addressed by a joint effort between academic, industry, and NIH participants.

Social media and pharmacovigilance: A review of the opportunities and challenges

PubMed Central

Sloane, Richard; Osanlou, Orod; Lewis, David; Bollegala, Danushka; Maskell, Simon; Pirmohamed, Munir

2015-01-01

Adverse drug reactions come at a considerable cost on society. Social media are a potentially invaluable reservoir of information for pharmacovigilance, yet their true value remains to be fully understood. In order to realize the benefits social media holds, a number of technical, regulatory and ethical challenges remain to be addressed. We outline these key challenges identifying relevant current research and present possible solutions. PMID:26147850

Key considerations in designing a speech brain-computer interface.

PubMed

Bocquelet, Florent; Hueber, Thomas; Girin, Laurent; Chabardès, Stéphan; Yvert, Blaise

2016-11-01

Restoring communication in case of aphasia is a key challenge for neurotechnologies. To this end, brain-computer strategies can be envisioned to allow artificial speech synthesis from the continuous decoding of neural signals underlying speech imagination. Such speech brain-computer interfaces do not exist yet and their design should consider three key choices that need to be made: the choice of appropriate brain regions to record neural activity from, the choice of an appropriate recording technique, and the choice of a neural decoding scheme in association with an appropriate speech synthesis method. These key considerations are discussed here in light of (1) the current understanding of the functional neuroanatomy of cortical areas underlying overt and covert speech production, (2) the available literature making use of a variety of brain recording techniques to better characterize and address the challenge of decoding cortical speech signals, and (3) the different speech synthesis approaches that can be considered depending on the level of speech representation (phonetic, acoustic or articulatory) envisioned to be decoded at the core of a speech BCI paradigm. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Challenges for a Local Service Agency to Address Domestic Violence –A Case Study From Rural Indonesia

PubMed Central

Hayati, Elli Nur; Emmelin, Maria; Eriksson, Malin

2014-01-01

Since the launch of a Zero Tolerance Policy in Indonesia, several policies to address domestic violence have been enacted. The obligation of local governments to establish service units for women survivors of domestic violence is one of them. Since domestic violence is a sensitive and complex issue in Indonesia it is important to understand how governmentally regulated services function in practice. This case study aimed to explore challenges faced by a local service agency in managing service provision for women survivors of domestic violence in rural Indonesia. Data from one focus group discussion (12 participants), four individual interviews, six short narratives, two days of participant observation, as well as archive reviews were collected. All data were analyzed using Grounded Theory Situational Analysis. The major challenge faced by the local agency was the low priority that was given them by the local authorities, mirrored also in low involvement by the assigned volunteers in the daily service. The study also identified a gap between the socio-cultural arena and the law & policy arena that needs to be bridged to avoid that the two arenas address domestic violence in a contradictory way. Budget allocation to support the sustainability of the daily routines of service agencies has to be given priority. There is also a need for careful considerations regarding the composition of personnel involved within daily management of service agencies addressing domestic violence. To bridge the gap between the legal systems and traditional cultural values, culturally adjusted alternative justice systems could be developed to increase women’s access to legal support. PMID:25363105

Key ecological challenges for closed systems facilities

NASA Astrophysics Data System (ADS)

Nelson, Mark; Dempster, William F.; Allen, John P.

2013-07-01

Closed ecological systems are desirable for a number of purposes. In space life support systems, material closure allows precious life-supporting resources to be kept inside and recycled. Closure in small biospheric systems facilitates detailed measurement of global ecological processes and biogeochemical cycles. Closed testbeds facilitate research topics which require isolation from the outside (e.g. genetically modified organisms; radioisotopes) so their ecological interactions and fluxes can be studied separate from interactions with the outside environment. But to achieve and maintain closure entails solving complex ecological challenges. These challenges include being able to handle faster cycling rates and accentuated daily and seasonal fluxes of critical life elements such as carbon dioxide, oxygen, water, macro- and mico-nutrients. The problems of achieving sustainability in closed systems for life support include how to handle atmospheric dynamics including trace gases, producing a complete human diet, recycling nutrients and maintaining soil fertility, the maintenance of healthy air and water and preventing the loss of critical elements from active circulation. In biospheric facilities, the challenge is also to produce analogues to natural biomes and ecosystems, studying processes of self-organization and adaptation in systems that allow specification or determination of state variables and cycles which may be followed through all interactions from atmosphere to soils. Other challenges include the dynamics and genetics of small populations, the psychological challenges for small isolated human groups and backup technologies and strategic options which may be necessary to ensure long-term operation of closed ecological systems.

Challenges for Policy Makers and Organizational Leaders: Addressing Trends in Mental Health Inequalities

PubMed Central

Rentmeester, Christy A.

2013-01-01

We typically think of acutely and chronically mentally ill patients as those who belong in psychiatric hospitals and the latter category of patients belonging in “regular” hospitals, but the intersection of physical and mental illness draws attention to important challenges for policy makers and organizational leaders. This article illuminates some broad trends in the health status of people with mental illnesses, canvasses important features of inequalities suffered by people with mental illnesses, and suggests strategies for systemic reform. Most reform recommendations I offer are in the area of healthcare organization leadership and management. Other key reforms will likely be legislative, regulatory, and insurance-related. Social and cultural reforms in organizational practices and structures will also be critical. PMID:24596844

Data monitoring committees: Promoting best practices to address emerging challenges.

PubMed

Fleming, Thomas R; DeMets, David L; Roe, Matthew T; Wittes, Janet; Calis, Karim A; Vora, Amit N; Meisel, Alan; Bain, Raymond P; Konstam, Marvin A; Pencina, Michael J; Gordon, David J; Mahaffey, Kenneth W; Hennekens, Charles H; Neaton, James D; Pearson, Gail D; Andersson, Tomas Lg; Pfeffer, Marc A; Ellenberg, Susan S

2017-04-01

Data monitoring committees are responsible for safeguarding the interests of study participants and assuring the integrity and credibility of clinical trials. The independence of data monitoring committees from sponsors and investigators is essential in achieving this mission. Creative approaches are needed to address ongoing and emerging challenges that potentially threaten data monitoring committees' independence and effectiveness. An expert panel of representatives from academia, industry and government sponsors, and regulatory agencies discussed these challenges and proposed best practices and operating principles for effective functioning of contemporary data monitoring committees. Prospective data monitoring committee members need better training. Options could include didactic instruction as well as apprenticeships to provide real-world experience. Data monitoring committee members should be protected against legal liability arising from their service. While avoiding breaches in confidentiality of interim data remains a high priority, data monitoring committees should have access to unblinded efficacy and safety data throughout the trial to enable informed judgments about risks and benefits. Because overly rigid procedures can compromise their independence, data monitoring committees should have the flexibility necessary to best fulfill their responsibilities. Data monitoring committee charters should articulate principles that guide the data monitoring committee process rather than list a rigid set of requirements. Data monitoring committees should develop their recommendations by consensus rather than through voting processes. The format for the meetings of the data monitoring committee should maintain the committee's independence and clearly establish the leadership of the data monitoring committee chair. The independent statistical group at the Statistical Data Analysis Center should have sufficient depth of knowledge about the study at hand and

Data Access, Interoperability and Sustainability: Key Challenges for the Evolution of Science Capabilities

NASA Astrophysics Data System (ADS)

Walton, A. L.

2015-12-01

In 2016, the National Science Foundation (NSF) will support a portfolio of activities and investments focused upon challenges in data access, interoperability, and sustainability. These topics are fundamental to science questions of increasing complexity that require multidisciplinary approaches and expertise. Progress has become tractable because of (and sometimes complicated by) unprecedented growth in data (both simulations and observations) and rapid advances in technology (such as instrumentation in all aspects of the discovery process, together with ubiquitous cyberinfrastructure to connect, compute, visualize, store, and discover). The goal is an evolution of capabilities for the research community based on these investments, scientific priorities, technology advances, and policies. Examples from multiple NSF directorates, including investments by the Advanced Cyberinfrastructure Division, are aimed at these challenges and can provide the geosciences research community with models and opportunities for participation. Implications for the future are highlighted, along with the importance of continued community engagement on key issues.

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

PubMed

Feeley, Kathleen M; Jones, Emily A

2006-09-01

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

Social media and pharmacovigilance: A review of the opportunities and challenges.

PubMed

Sloane, Richard; Osanlou, Orod; Lewis, David; Bollegala, Danushka; Maskell, Simon; Pirmohamed, Munir

2015-10-01

Adverse drug reactions come at a considerable cost on society. Social media are a potentially invaluable reservoir of information for pharmacovigilance, yet their true value remains to be fully understood. In order to realize the benefits social media holds, a number of technical, regulatory and ethical challenges remain to be addressed. We outline these key challenges identifying relevant current research and present possible solutions. © 2015 The British Pharmacological Society.

Ethical challenges in resuscitation.

PubMed

Mentzelopoulos, Spyros D; Slowther, Anne-Marie; Fritz, Zoe; Sandroni, Claudio; Xanthos, Theodoros; Callaway, Clifton; Perkins, Gavin D; Newgard, Craig; Ischaki, Eleni; Greif, Robert; Kompanje, Erwin; Bossaert, Leo

2018-06-01

A rapidly evolving resuscitation science provides more effective treatments to an aging population with multiple comorbidites. Concurrently, emergency care has become patient-centered. This review aims to describe challenges associated with the application of key principles of bioethics in resuscitation and post-resuscitation care; propose actions to address these challenges; and highlight the need for evidence-based ethics and consensus on ethical principles interpretation. Following agreement on the article's outline, subgroups of 2-3 authors provided narrative reviews of ethical issues concerning autonomy and honesty, beneficence/nonmaleficence and dignity, justice, specific practices/circumstances such as family presence during resuscitation, and emergency research. Proposals for addressing ethical challenges were also offered. Respect for patient autonomy can be realized through honest provision of information, shared decision-making, and advance directives/care planning. Essential prerequisites comprise public and specific healthcare professionals' education, appropriate regulatory provisions, and allocation of adequate resources. Regarding beneficence/nonmaleficence, resuscitation should benefit patients, while avoiding harm from futile interventions; pertinent practice should be based on neurological prognostication and patient/family-reported outcomes. Regarding dignity, aggressive life-sustaining treatments against patients preferences should be avoided. Contrary to the principle of justice, resuscitation quality may be affected by race/income status, age, ethnicity, comorbidity, and location (urban versus rural or country-specific/region-specific). Current evidence supports family presence during resuscitation. Regarding emergency research, autonomy should be respected without hindering scientific progress; furthermore, transparency of research conduct should be promoted and funding increased. Major ethical challenges in resuscitation science need to be

Efficacy of a training program designed to help address challenges faced by health promotion volunteers.

PubMed

Taguchi, Atsuko; Murayama, Hiroshi; Arakawa, Mihoko; Terao, Atsushi

2017-01-01

Objective　To evaluate the effectiveness of a training program designed to address the following three challenges facing health promotion volunteers: lack of new volunteers, short tenure of volunteering, and failure to build a collaborative relationship with other civic organizations.Methods　Thirty-eight volunteer leaders representing 36 school districts (one from each district and two additional leaders) from southern parts of Shiga Prefecture participated in the training program. Four training sessions were conducted between July 2012 and January 2013. Each session lasted for 2 hours. The program included a lecture, group work, and role playing, all of which centered on the challenges experienced by the volunteers and possible solutions. Those who participated constituted the "training group," and other volunteers in the same area of Shiga, who did not take part in the program, made up the "non-training group." A third, control group consisted of health promotion volunteers based in City A, located outside the areas where the training occurred. To compare the three groups, we collected data before and after the training. The main evaluation index comprised the following three survey items: having confidence in recruiting new volunteers, having confidence in overcoming the difficulties or discouragement to continue to volunteer, and having confidence in explaining their activities to other local organizations to earn their cooperation. These questions were asked in a self-administered questionnaire using a 6-point Likert scale (1: strongly disagree, 6: strongly agree).Results　The data were compared among the training group (28 out of the 38 participants completed the survey), non-training group (n=293), and control group (n=107). On the question about recruiting new volunteers, the training group's mean score increased from 2.9 (standard deviation (SD)=1.3) to 3.3 (SD=1.0) following the training, and the improvement relative to the other two groups was

World Health organization guidelines for management of acute stress, PTSD, and bereavement: key challenges on the road ahead.

PubMed

Tol, Wietse A; Barbui, Corrado; Bisson, Jonathan; Cohen, Judith; Hijazi, Zeinab; Jones, Lynne; de Jong, Joop T V M; Magrini, Nicola; Omigbodun, Olayinka; Seedat, Soraya; Silove, Derrick; Souza, Renato; Sumathipala, Athula; Vijayakumar, Lakshmi; Weissbecker, Inka; Zatzick, Douglas; van Ommeren, Mark

2014-12-01

Wietse Tol and colleagues discuss some of the key challenges for implementation of new WHO guidelines for stress-related mental health disorders in low- and middle-income countries. Please see later in the article for the Editors' Summary.

The Challenge of Violence. [Student Text and] Teacher's Guide.

ERIC Educational Resources Information Center

Croddy, Marshall; Degelman, Charles; Hayes, Bill

This document addresses violence as one of the key challenges facing the democratic and pluralistic republic under the framework of the Constitution and its Bill of Rights. Primary focus is on criminal violence and the factors and behaviors that contribute to violent crime. The text is organized into three chapters: (1) "The Problem of…

Re-thinking wastewater landscapes: combining innovative strategies to address tomorrow's urban wastewater treatment challenges.

PubMed

Smith, B R

2009-01-01

Most major cities worldwide face urban water management challenges relating to drinking supply, stormwater and wastewater treatment, and ecological preservation. In light of climate change and finite natural resources, addressing these challenges in sustainable ways will require innovative solutions arising from interdisciplinary collaboration. This article summarizes five major urban water management strategies that bridge the fields of engineering, ecology, landscape architecture, and urban planning. A conceptual implementation of these strategies is demonstrated through a design for a small constructed wetland treatment system in San Francisco, California. The proposed decentralized system described in this article consists of a detention basin, vegetated and open free water surface wetlands, and ultraviolet disinfection. In wet weather, the system would detain and treat combined sewer discharges (CSD), and in dry weather it would treat residential greywater for toilet flushing and irrigation in a nearby neighborhood. It is designed to adapt over time to changing climatic conditions and treatment demands. Importantly, this proposal demonstrates how constructed wetland engineers can incorporate multiple benefits into their systems, offering a vision of how wastewater infrastructure can be an attractive community, educational, recreational, and habitat amenity through the integration of engineering, ecology, and landscape design.

Online Learning: Addressing Challenges and Seizing Opportunities. New Mexico

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

Online Learning: Addressing Challenges and Seizing Opportunities. New Hampshire

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

National health inequality monitoring: current challenges and opportunities.

PubMed

Hosseinpoor, Ahmad Reza; Bergen, Nicole; Schlotheuber, Anne; Boerma, Ties

National health inequality monitoring needs considerably more investment to realize equity-oriented health improvements in countries, including advancement towards the Sustainable Development Goals. Following an overview of national health inequality monitoring and the associated resource requirements, we highlight challenges that countries may encounter when setting up, expanding or strengthening national health inequality monitoring systems, and discuss opportunities and key initiatives that aim to address these challenges. We provide specific proposals on what is needed to ensure that national health inequality monitoring systems are harnessed to guide the reduction of health inequalities.

Veno-venous ECMO: a synopsis of nine key potential challenges, considerations, and controversies

PubMed Central

2014-01-01

Background Following the 2009 H1N1 Influenza pandemic, extracorporeal membrane oxygenation (ECMO) emerged as a viable alternative in selected, severe cases of ARDS. Acute Respiratory Distress Syndrome (ARDS) is a major public health problem. Average medical costs for ARDS survivors on an annual basis are multiple times those dedicated to a healthy individual. Advances in medical and ventilatory management of severe lung injury and ARDS have improved outcomes in some patients, but these advances fail to consistently “rescue” a significant proportion of those affected. Discussion Here we present a synopsis of the challenges, considerations, and potential controversies regarding veno-venous ECMO that will be of benefit to anesthesiologists, surgeons, and intensivists, especially those newly confronted with care of the ECMO patient. We outline a number of points related to ECMO, particularly regarding cannulation, pump/oxygenator design, anticoagulation, and intravascular fluid management of patients. We then address these challenges/considerations/controversies in the context of their potential future implications on clinical approaches to ECMO patients, focusing on the development and advancement of standardized ECMO clinical practices. Summary Since the 2009 H1N1 pandemic ECMO has gained a wider acceptance. There are challenges that still must be overcome. Further investigations of the benefits and effects of ECMO need to be undertaken in order to facilitate the implementation of this technology on a larger scale. PMID:25110462

International Nursing: Constructing an Advanced Practice Registered Nurse Practice Model in the UAE: Using Innovation to Address Cultural Implications and Challenges in an International Enterprise.

PubMed

Behrens, Sue A

Despite utilization of the advanced practice registered nurse (APRN) in the United States health care system, there is little information about the introduction, utilization, and challenges of the APRN role globally, especially in the Middle East. This article will look at how one hospital in the United Arab Emirates introduced the APRN role to a health care environment of a country where it has not been recognized historically. Cultural challenges and barriers for the implementation of the role include regulatory, societal, and institutional. Innovation and collaboration are necessary to address these challenges and barriers and to pave the way for a successful advanced practice model pilot, as well as for the future use of the role. Innovation is also one of the key performance indicators for the country's health care. However, the idea of advanced practice is a new concept that has been outside the mainstream health care practice for the United Arab Emirates. To help with the implementation, a road map was developed to outline the steps necessary to provide a safe practice environment. The plan included aligning with the ministry of health nursing and midwifery council, as well as the Health Authority of Abu Dhabi, to help them learn more about the US model of advanced practice, along with benefits, and outcomes of the role. Developing the role of the APRN will benefit the future state of the health care infrastructure for not only the United Arab Emirates but throughout the Middle East.

Building Connections: Strategies to Address Rurality and Accessibility Challenges

ERIC Educational Resources Information Center

Hartman, Sara; Hines-Bergmeier, Jennifer

2015-01-01

Operating a museum in a high poverty, underserved area creates many challenges related to accessibility, programming, and funding. Over the course of nearly a decade, the Ohio Valley Museum of Discovery (OVMoD) has identified several organizational practices that help mitigate these challenges. Located in the southeastern corner of Appalachian…

Importance of Broken Gauge Symmetry in Addressing Three, Key, Unanswered Questions Posed by Low Nuclear Reactions (LENR's)

NASA Astrophysics Data System (ADS)

Chubb, Scott

2003-03-01

Three, Key, Unanswered Questions posed by LENR's are: 1. How do we explain the lack of high energy particles (HEP's)? 2. Can we understand and prioritize the way coupling can occur between nuclear- and atomic- lengthscales, and 3. What are the roles of Surface-Like (SL), as opposed to Bulk-Like (BL), processes in triggering nuclear phenomena. One important source of confusion associated with each of these questions is the common perception that the quantum mechanical phases of different particles are not correlated with each other. When the momenta p of interacting particles is large, and reactions occur rapidly (between HEP's, for example), this is a valid assumption. But when the relative difference in p becomes vanishingly small, between one charge, and many others, as a result of implicit electromagnetic coupling, each charge can share a common phase, relative to the others, modulo 2nπ, where n is an integer, even when outside forces are introduced. The associated forms of broken gauge symmetry, distinguish BL from SL phenomena, at room temperature, also explain super- and normal- conductivity in solids, and can be used to address the Three, Key, Unanswered Questions posed by LENR's.

Prioritizing vulnerable children: why should we address inequity?

PubMed

Joshua, P; Zwi, K; Moran, P; White, L

2015-11-01

Children and young people from vulnerable population groups, including Indigenous Australians, those in out of home care, those with disabilities and those from refugee families, have difficulties in accessing health services and are at high risk of adverse outcomes, driving population health inequity. Although heterogeneous, these groups face common disadvantage and shared challenges in health service utilization. This study aims to analyse the demographics of vulnerable child populations in NSW, the rationale for focussing on their health needs and strategies for addressing population health inequity. A literature review was undertaken on vulnerable child populations and successful strategies for improving their health outcomes. NSW data on vulnerable children were collated. Vulnerable children in NSW are estimated to comprise 10-20% of the childhood population. Efforts to improve their health and well-being can be justified based on child rights, a focus on equity and effectiveness of care, public opinion and the evidence base supporting such interventions. Targeted (subpopulation specific) interventions and delivery of universally applied (population wide) strategies that disproportionately benefit vulnerable populations have been shown to be effective in reducing healthcare disparities. Most available information relates to specific vulnerable population groups. However, some effective strategies and key principles are broadly applicable to the vulnerable child population as a whole. Vulnerable children should be a key focus of healthcare interventions if inequities are to be addressed. © 2015 John Wiley & Sons Ltd.

Addressing China’s grand challenge of achieving food security while ensuring environmental sustainability

PubMed Central

Lu, Yonglong; Jenkins, Alan; Ferrier, Robert C.; Bailey, Mark; Gordon, Iain J.; Song, Shuai; Huang, Jikun; Jia, Shaofeng; Zhang, Fusuo; Liu, Xuejun; Feng, Zhaozhong; Zhang, Zhibin

2015-01-01

China’s increasingly urbanized and wealthy population is driving a growing and changing demand for food, which might not be met without significant increase in agricultural productivity and sustainable use of natural resources. Given the past relationship between lack of access to affordable food and political instability, food security has to be given a high priority on national political agendas in the context of globalization. The drive for increased food production has had a significant impact on the environment, and the deterioration in ecosystem quality due to historic and current levels of pollution will potentially compromise the food production system in China. We discuss the grand challenges of not only producing more food but also producing it sustainably and without environmental degradation. In addressing these challenges, food production should be considered as part of an environmental system (soil, air, water, and biodiversity) and not independent from it. It is imperative that new ways of meeting the demand for food are developed while safeguarding the natural resources upon which food production is based. We present a holistic approach to both science and policy to ensure future food security while embracing the ambition of achieving environmental sustainability in China. It is a unique opportunity for China to be a role model as a new global player, especially for other emerging economies. PMID:26601127

New and improved proteomics technologies for understanding complex biological systems: Addressing a grand challenge in the life sciences

PubMed Central

Hood, Leroy E.; Omenn, Gilbert S.; Moritz, Robert L.; Aebersold, Ruedi; Yamamoto, Keith R.; Amos, Michael; Hunter-Cevera, Jennie; Locascio, Laurie

2014-01-01

This White Paper sets out a Life Sciences Grand Challenge for Proteomics Technologies to enhance our understanding of complex biological systems, link genomes with phenotypes, and bring broad benefits to the biosciences and the US economy. The paper is based on a workshop hosted by the National Institute of Standards and Technology (NIST) in Gaithersburg, MD, 14–15 February 2011, with participants from many federal R&D agencies and research communities, under the aegis of the US National Science and Technology Council (NSTC). Opportunities are identified for a coordinated R&D effort to achieve major technology-based goals and address societal challenges in health, agriculture, nutrition, energy, environment, national security, and economic development. PMID:22807061

Ability of institutions to address new challenges

Treesearch

B. Cashore; G. Galloway; F. Cubbage; D. Humphreys; P. Katila; K. Levin; A. Maryudi; C. McDermott; Kathleen McGinley

2010-01-01

What types of institutional configurations hold the most promise in fostering efforts for long-term amelioration of enduring environmental, social, and economic challenges facing the world’s forests? This chapter presents, and applies an analytical framework with which to review research findings and analyses that shed light on what appear to be the most promising...

Challenges and Opportunities for Tribal Waters: Addressing Disparities in Safe Public Drinking Water on the Crow Reservation in Montana, USA.

PubMed

Doyle, John T; Kindness, Larry; Realbird, James; Eggers, Margaret J; Camper, Anne K

2018-03-21

Disparities in access to safe public drinking water are increasingly being recognized as contributing to health disparities and environmental injustice for vulnerable communities in the United States. As the Co-Directors of the Apsaálooke Water and Wastewater Authority (AWWWA) for the Crow Tribe, with our academic partners, we present here the multiple and complex challenges we have addressed in improving and maintaining tribal water and wastewater infrastructure, including the identification of diverse funding sources for infrastructure construction, the need for many kinds of specialized expertise and long-term stability of project personnel, ratepayer difficulty in paying for services, an ongoing legacy of inadequate infrastructure planning, and lack of water quality research capacity. As a tribal entity, the AWWWA faces additional challenges, including the complex jurisdictional issues affecting all phases of our work, lack of authority to create water districts, and additional legal and regulatory gaps-especially with regards to environmental protection. Despite these obstacles, the AWWWA and Crow Tribe have successfully upgraded much of the local water and wastewater infrastructure. We find that ensuring safe public drinking water for tribal and other disadvantaged U.S. communities will require comprehensive, community-engaged approaches across a broad range of stakeholders to successfully address these complex legal, regulatory, policy, community capacity, and financial challenges.

Challenges and Opportunities for Tribal Waters: Addressing Disparities in Safe Public Drinking Water on the Crow Reservation in Montana, USA

PubMed Central

Doyle, John T.; Kindness, Larry; Realbird, James; Camper, Anne K.

2018-01-01

Disparities in access to safe public drinking water are increasingly being recognized as contributing to health disparities and environmental injustice for vulnerable communities in the United States. As the Co-Directors of the Apsaálooke Water and Wastewater Authority (AWWWA) for the Crow Tribe, with our academic partners, we present here the multiple and complex challenges we have addressed in improving and maintaining tribal water and wastewater infrastructure, including the identification of diverse funding sources for infrastructure construction, the need for many kinds of specialized expertise and long-term stability of project personnel, ratepayer difficulty in paying for services, an ongoing legacy of inadequate infrastructure planning, and lack of water quality research capacity. As a tribal entity, the AWWWA faces additional challenges, including the complex jurisdictional issues affecting all phases of our work, lack of authority to create water districts, and additional legal and regulatory gaps—especially with regards to environmental protection. Despite these obstacles, the AWWWA and Crow Tribe have successfully upgraded much of the local water and wastewater infrastructure. We find that ensuring safe public drinking water for tribal and other disadvantaged U.S. communities will require comprehensive, community-engaged approaches across a broad range of stakeholders to successfully address these complex legal, regulatory, policy, community capacity, and financial challenges. PMID:29561815

COOP+ project: Promoting the cooperation of international Research Infrastructures to address global environmental challenges.

NASA Astrophysics Data System (ADS)

Bonet-García, F.; Järvi, L.; Asmi, A.; Suárez-Muñoz, M.

2016-12-01

Humanity must face enormous environmental challenges including biodiversity decline, climate change, ocean acidification, sea level rise and overpopulation. The research infrastructures (RIs) created in the last decades worldwide cover a wide range of spatial and thematic scales and collect information about the functioning of Earth ecosystems. However, we need to go one step forward: understand and simulate the functioning of the Earth as a complex system in a global change scenario. Cooperation among international RIs as well as multidisciplinary work are mandatory to achieve this challenging objective. COOP+ (EU Horizon 2020 project) aims to strengthen the links and coordination of European environmental RIs with their international counterparts. COOP+ will create cooperation threads among international research infrastructures using environmental Global Challenges (GCs) as thematic guidelines. These GCs are polyhedral and sometimes wicked problems that threaten the sustainability of our modern societies from a social and environmental perspective. This contribution describes how COOP+ uses GCs as guidelines to foster cooperation among RIs. First we have created an open survey to collect ideas about GCs within the different scientific communities. We present the structure of this survey as well as the preliminary information that it contains. The survey will be accepting responses during the project life (September 2018). We also describe the structure of a template that will be used to collaboratively characterize some selected GCs under the point of view of RIs. The main idea is to assess how RIs can be useful to address global environmental problems. We encourage all scientists related to RIs communities to participate in this process.

Nanotechnology: Development and challenges in Indonesia

NASA Astrophysics Data System (ADS)

Joni, I. Made; Muthukannan, Vanitha; Hermawan, Wawan; Panatarani, Camellia

2018-02-01

Nanotechnology today is regarded as a revolutionary technology that can help to address the key needs related to energy, environment, health and agriculture in developing countries. This paper is a short review on the development and challenges of nanotechnology in Indonesia. Nanotechnology offers great potential benefits, there is emerging concerns arising from its novel physicochemical properties. The main applications of nanotechnology in the different sectors which is vital and its economic impact in Indonesia is also discussed. The achievment and development of nanotechnology including synthesis and dispersion of nanoparticles (NPs) and its applications in various fields is briefly addressed in Nanotehcnology and Graphene Research Center, Universitas Padjadjaran (Unpad). Despite significant progress in developmental goals, many challenges in the development of nanotechnology proccesing need to be resolved such as support infrastructure and evolution of new form of collaborative arrangements between various sectors and policies which is emerged as an important factor enabling development.

Work Keys USA.

ERIC Educational Resources Information Center

Work Keys USA, 1998

1998-01-01

"Work Keys" is a comprehensive program for assessing and teaching workplace skills. This serial "special issue" features 18 first-hand reports on Work Keys projects in action in states across North America. They show how the Work Keys is helping businesses and educators solve the challenge of building a world-class work force.…

Addressing the challenges of GRACE application in basins with hydraulic fracturing activity

NASA Astrophysics Data System (ADS)

Read, L.; Ruybal, C.; Hogue, T. S.; Hinojosa, M. P.

2016-12-01

Despite the growing number of studies that employ GRACE to quantify groundwater resources we have found no published studies on whether GRACE is also accounting for subsurface mass redistributions related to energy development activities from oil production, water production, and wastewater injection. Given the similar densities of water and crude oil (water is 1.0g/cc, crude oil is 0.8-0.9g/cc) and the fact that large volumes of oil and water are extracted on a monthly basis for hydraulic fracturing or reinjected as a means of waste disposal, it is important to determine whether GRACE is detecting mass redistributions from energy development to be able to correctly infer changes in water mass. The purpose of this study is to investigate whether GRACE measurements are impacted by energy development activities and offer a methodology for determining whether this activity should be considered when evaluating changes in terrestrial water storage, groundwater storage, or any other prediction involving quantification of groundwater. To address this question we compiled a dataset from the Bakken Play in North Dakota to use as a case study, where oil production was significant and increased exponentially from 2002-2015, and groundwater withdrawals for agriculture were relatively stable and limited. Preliminary results indicate that oil and gas production is of a similar scale and thus important to include when calculating groundwater changes. Broadly, this research addresses the challenges and uncertainties in applying GRACE to quantify groundwater or terrestrial water changes in energy-active basins, namely in accounting for oil reservoir changes, production, and injection rates, as well as the process of data collection in proprietary systems.

A model for integrating clinical care and basic science research, and pitfalls of performing complex research projects for addressing a clinical challenge.

PubMed

Steck, R; Epari, D R; Schuetz, M A

2010-07-01

The collaboration of clinicians with basic science researchers is crucial for addressing clinically relevant research questions. In order to initiate such mutually beneficial relationships, we propose a model where early career clinicians spend a designated time embedded in established basic science research groups, in order to pursue a postgraduate qualification. During this time, clinicians become integral members of the research team, fostering long term relationships and opening up opportunities for continuing collaboration. However, for these collaborations to be successful there are pitfalls to be avoided. Limited time and funding can lead to attempts to answer clinical challenges with highly complex research projects characterised by a large number of "clinical" factors being introduced in the hope that the research outcomes will be more clinically relevant. As a result, the complexity of such studies and variability of its outcomes may lead to difficulties in drawing scientifically justified and clinically useful conclusions. Consequently, we stress that it is the basic science researcher and the clinician's obligation to be mindful of the limitations and challenges of such multi-factorial research projects. A systematic step-by-step approach to address clinical research questions with limited, but highly targeted and well defined research projects provides the solid foundation which may lead to the development of a longer term research program for addressing more challenging clinical problems. Ultimately, we believe that it is such models, encouraging the vital collaboration between clinicians and researchers for the work on targeted, well defined research projects, which will result in answers to the important clinical challenges of today. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

ADDRESSING ENVIRONMENTAL ENGINEERING CHALLENGES WITH COMPUTATIONAL FLUID DYNAMICS

EPA Science Inventory

In the field of environmental engineering, modeling tools are playing an ever larger role in addressing air quality issues, including source pollutant emissions, atmospheric dispersion and human exposure risks. More detailed modeling of environmental flows requires tools for c...

Unpacking the concept of land degradation neutrality and addressing its operation through the Rio Conventions.

PubMed

Akhtar-Schuster, Mariam; Stringer, Lindsay C; Erlewein, Alexander; Metternicht, Graciela; Minelli, Sara; Safriel, Uriel; Sommer, Stefan

2017-06-15

The world's commitment towards land degradation neutrality (LDN) became enshrined in various international agreements and decisions throughout the year 2015. The challenge now becomes one of addressing its operation, in order to achieve these new policy goals and targets by the year 2030. Advancing LDN demands attention to what the concept seeks to achieve, as well as unravelling the perspectives of the key multi-lateral environmental agreements through which progress can be made. The three Rio Conventions (the UN Convention to Combat Desertification (UNCCD), the UN Framework Convention on Climate Change (UNFCCC) and the Convention on Biological Diversity (CBD)) all play key roles in shaping the international LDN governance and implementation context. Their different but related foci create a number of challenges and opportunities for advancing LDN. In this paper we critically analyze the literature to elucidate potential challenges and opportunities in moving LDN towards implementation, considering the mandates and objectives of all three Rio Conventions. We first unpack the concept of LDN's aspirations. We highlight the importance of the definitions and terminology used, and the relationships between those definitions, terms and the actors using them, as well as their implications in framing the range of policy actions and synergies that could benefit progress towards multiple Sustainable Development Goals. We then examine the LDN pilot project spearheaded by the UNCCD to identify key lessons for LDN implementation. Synthesizing these lessons, we present a portfolio of blended interventions that seeks to address the aspirations of the UNCCD, UNFCCC and CBD in the LDN space, identifying synergistic options for national actions to move towards LDN. Overall, our analysis provides insights in advancing LDN from its current position as a policy target, towards synergetic action. Copyright © 2016 Elsevier Ltd. All rights reserved.

Resident education in 2011: three key challenges on the road ahead.

PubMed

Van Eaton, Erik G; Tarpley, John L; Solorzano, Carmen C; Cho, Clifford S; Weber, Sharon M; Termuhlen, Paula M

2011-04-01

Two important changes in the past decade have altered the landscape of graduate medical education (GME) in the U.S. The national restrictions on trainee duty hours mandated by the Accreditation Council for Graduate Medical Education (ACGME) were the most visible and generated much controversy. Equally important is the ACGME Outcome Project, which mandates competency-based training. Both of these changes have unique implications for surgery trainees, who traditionally spent long hours caring for patients in the hospital, and who must be assessed in 2 broad domains: their medical care of pre- and postoperative patients, and their technical skill with procedures in and out of the operating room. This article summarizes 3 key challenges that lie ahead for surgical educators. First, the changes in duty hours in the past 7 years are summarized, and the conversation about added restrictions planned for July 2011 is reviewed. Next, the current state of the assessment of competency among surgical trainees is reviewed, with an outline of the challenges that need to be overcome to achieve widespread, competency-based training in surgery. Finally, the article summarizes the problems caused by increased reliance on handoffs among trainees as they compensate for decreased time in the hospital, and suggests changes that need to be made to improve safety and efficiency, including how to use handoffs as part of our educational evaluation of residents. Copyright © 2011 Mosby, Inc. All rights reserved.

Current Challenges for HTCMC Aero-Propulsion Components

NASA Technical Reports Server (NTRS)

DiCarlo, James A.; Bansal, Narottam P.

2007-01-01

In comparison to the best metallic materials, HTCMC aero-propulsion engine components offer the opportunity of reduced weight and higher temperature operation, with corresponding improvements in engine cooling requirements, emissions, thrust, and specific fuel consumption. Although much progress has been made in the development of advanced HTCMC constituent materials and processes, major challenges still remain for their implementation into these components. The objectives of this presentation are to briefly review (1) potential HTCMC aero-propulsion components and their generic material performance requirements, (2) recent progress at NASA and elsewhere concerning advanced constituents and processes for meeting these requirements, (3) key HTCMC component implementation challenges that are currently being encountered, and (4) on-going activities within the new NASA Fundamental Aeronautics Program that are addressing these challenges.

DIII-D research to address key challenges for ITER and fusion energy

NASA Astrophysics Data System (ADS)

Buttery, R. J.; the DIII-D Team

2015-10-01

DIII-D has made significant advances in the scientific basis for fusion energy. The physics mechanism of resonant magnetic perturbation (RMP) edge localized mode (ELM) suppression is revealed as field penetration at the pedestal top, and reduced coil set operation was demonstrated. Disruption runaway electrons were effectively quenched by shattered pellets; runaway dissipation is explained by pitch angle scattering. Modest thermal quench radiation asymmetries are well described NIMROD modelling. With good pedestal regulation and error field correction, low torque ITER baselines have been demonstrated and shown to be compatible with an ITER test blanket module simulator. However performance and long wavelength turbulence degrade as low rotation and electron heating are approached. The alternative QH mode scenario is shown to be compatible with high Greenwald density fraction, with an edge harmonic oscillation demonstrating good impurity flushing. Discharge optimization guided by the EPED model has discovered a new super H-mode with doubled pedestal height. Lithium injection also led to wider, higher pedestals. On the path to steady state, 1 MA has been sustained fully noninductively with βN = 4 and RMP ELM suppression, while a peaked current profile scenario provides attractive options for ITER and a βN = 5 future reactor. Energetic particle transport is found to exhibit a critical gradient behaviour. Scenarios are shown to be compatible with radiative and snowflake divertor techniques. Physics studies reveal that the transition to H mode is locked in by a rise in ion diamagnetic flows. Intrinsic rotation in the plasma edge is demonstrated to arise from kinetic losses. New 3D magnetic sensors validate linear ideal MHD, but identify issues in nonlinear simulations. Detachment, characterized in 2D with sub-eV resolution, reveals a radiation shortfall in simulations. Future facility development targets burning plasma physics with torque free electron heating, the path to steady state with increased off axis currents, and a new divertor solution for fusion reactors.

DIII-D research to address key challenges for ITER and fusion energy

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

Buttery, Richard J.

DIII-D has made significant advances in the scientific basis for fusion energy. The physics mechanism of resonant magnetic perturbation (RMP) edge localized mode (ELM) suppression is revealed as field penetration at the pedestal top, and reduced coil set operation was demonstrated. Disruption runaway electrons were effectively quenched by shattered pellets; runaway dissipation is explained by pitch angle scattering. Modest thermal quench radiation asymmetries are well described NIMROD modeling. With good pedestal regulation and error field correction, low torque ITER baselines have been demonstrated and shown to be compatible with an ITER test blanket module simulator. However performance and long wavelengthmore » turbulence degrade as low rotation and electron heating are approached. The alternative QH mode scenario is shown to be compatible with high Greenwald density fraction, with an edge harmonic oscillation demonstrating good impurity flushing. Discharge optimization guided by the EPED model has discovered a new super H-mode with doubled pedestal height. Lithium injection also led to wider, higher pedestals. On the path to steady state, 1 MA has been sustained fully non inductively with β N = 4 and RMP ELM suppression, while a peaked current profile scenario provides attractive options for ITER and a β N = 5 future reactor. Energetic particle transport is found to exhibit a critical gradient behavior. Scenarios are shown to be compatible with radiative and snowflake diverter techniques. Physics studies reveal that the transition to H mode is locked in by a rise in ion diamagnetic flows. Intrinsic rotation in the plasma edge is demonstrated to arise from kinetic losses. New 3D magnetic sensors validate linear ideal MHD, but identify issues in nonlinear simulations. Detachment, characterized in 2D with sub-eV resolution, reveals a radiation shortfall in simulations. As a result, future facility development targets burning plasma physics with torque free electron heating, the path to steady state with increased off axis currents, and a new divertor solution for fusion reactors.« less

DIII-D research to address key challenges for ITER and fusion energy

DOE PAGES

Buttery, Richard J.

2015-07-29

DIII-D has made significant advances in the scientific basis for fusion energy. The physics mechanism of resonant magnetic perturbation (RMP) edge localized mode (ELM) suppression is revealed as field penetration at the pedestal top, and reduced coil set operation was demonstrated. Disruption runaway electrons were effectively quenched by shattered pellets; runaway dissipation is explained by pitch angle scattering. Modest thermal quench radiation asymmetries are well described NIMROD modeling. With good pedestal regulation and error field correction, low torque ITER baselines have been demonstrated and shown to be compatible with an ITER test blanket module simulator. However performance and long wavelengthmore » turbulence degrade as low rotation and electron heating are approached. The alternative QH mode scenario is shown to be compatible with high Greenwald density fraction, with an edge harmonic oscillation demonstrating good impurity flushing. Discharge optimization guided by the EPED model has discovered a new super H-mode with doubled pedestal height. Lithium injection also led to wider, higher pedestals. On the path to steady state, 1 MA has been sustained fully non inductively with β N = 4 and RMP ELM suppression, while a peaked current profile scenario provides attractive options for ITER and a β N = 5 future reactor. Energetic particle transport is found to exhibit a critical gradient behavior. Scenarios are shown to be compatible with radiative and snowflake diverter techniques. Physics studies reveal that the transition to H mode is locked in by a rise in ion diamagnetic flows. Intrinsic rotation in the plasma edge is demonstrated to arise from kinetic losses. New 3D magnetic sensors validate linear ideal MHD, but identify issues in nonlinear simulations. Detachment, characterized in 2D with sub-eV resolution, reveals a radiation shortfall in simulations. As a result, future facility development targets burning plasma physics with torque free electron heating, the path to steady state with increased off axis currents, and a new divertor solution for fusion reactors.« less

A Nominal Balloon Instrument Payload to Address Questions from the Planetary Decadal Survey

NASA Astrophysics Data System (ADS)

Young, Eliot; Kremic, Tibor; Dankanich, John

The Planetary Science Decadal Survey (entitled "Visions and Voyages for Planetary Science in the Decade 2013 - 2022", available online at https://solarsystem.nasa.gov/2013decadal/) serves as a roadmap for activities to be pursued by the Planetary Science Division of NASA's Science Mission Directorate. This document outlines roughly 200 key research areas and questions in chapters covering different parts of the solar system (e.g., Mars, Small Bodies, etc.). We have reviewed the Decadal Survey to assess whether any of the key questions can be addressed by high altitude balloon-borne payloads. Although some questions can only be answered by in situ experiments, we found that approximately one quarter of the key questions were well suited to balloon payloads. In many of those cases, balloons were competitive or superior to other existing facilities, including HST, SOFIA or Keck telescopes. We will present specific telescope and instrument bench designs that are capable of addressing key questions in the Decadal Survey. The instrument bench takes advantage of two of the main benefits of high-altitude observations: diffraction-limited imaging in visible and UV wavelengths and unobstructed spectroscopy in near-IR (1 - 5 microns) wavelengths. Our optical prescription produces diffraction-limited PSFs in both visible and IR beams. We will discuss pointing and thermal stability, two of the main challenges facing a balloon-borne telescope.

New and improved proteomics technologies for understanding complex biological systems: addressing a grand challenge in the life sciences.

PubMed

Hood, Leroy E; Omenn, Gilbert S; Moritz, Robert L; Aebersold, Ruedi; Yamamoto, Keith R; Amos, Michael; Hunter-Cevera, Jennie; Locascio, Laurie

2012-09-01

This White Paper sets out a Life Sciences Grand Challenge for Proteomics Technologies to enhance our understanding of complex biological systems, link genomes with phenotypes, and bring broad benefits to the biosciences and the US economy. The paper is based on a workshop hosted by the National Institute of Standards and Technology (NIST) in Gaithersburg, MD, 14-15 February 2011, with participants from many federal R&D agencies and research communities, under the aegis of the US National Science and Technology Council (NSTC). Opportunities are identified for a coordinated R&D effort to achieve major technology-based goals and address societal challenges in health, agriculture, nutrition, energy, environment, national security, and economic development. © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Addressing Emerging Risks: Scientific and Regulatory Challenges Associated with Environmentally Persistent Free Radicals.

PubMed

Dugas, Tammy R; Lomnicki, Slawomir; Cormier, Stephania A; Dellinger, Barry; Reams, Margaret

2016-06-08

Airborne fine and ultrafine particulate matter (PM) are often generated through widely-used thermal processes such as the combustion of fuels or the thermal decomposition of waste. Residents near Superfund sites are exposed to PM through the inhalation of windblown dust, ingestion of soil and sediments, and inhalation of emissions from the on-site thermal treatment of contaminated soils. Epidemiological evidence supports a link between exposure to airborne PM and an increased risk of cardiovascular and pulmonary diseases. It is well-known that during combustion processes, incomplete combustion can lead to the production of organic pollutants that can adsorb to the surface of PM. Recent studies have demonstrated that their interaction with metal centers can lead to the generation of a surface stabilized metal-radical complex capable of redox cycling to produce ROS. Moreover, these free radicals can persist in the environment, hence their designation as Environmentally Persistent Free Radicals (EPFR). EPFR has been demonstrated in both ambient air PM2.5 (diameter < 2.5 µm) and in PM from a variety of combustion sources. Thus, low-temperature, thermal treatment of soils can potentially increase the concentration of EPFR in areas in and around Superfund sites. In this review, we will outline the evidence to date supporting EPFR formation and its environmental significance. Furthermore, we will address the lack of methodologies for specifically addressing its risk assessment and challenges associated with regulating this new, emerging contaminant.

Addressing Emerging Risks: Scientific and Regulatory Challenges Associated with Environmentally Persistent Free Radicals

PubMed Central

Dugas, Tammy R.; Lomnicki, Slawomir; Cormier, Stephania A.; Dellinger, Barry; Reams, Margaret

2016-01-01

Airborne fine and ultrafine particulate matter (PM) are often generated through widely-used thermal processes such as the combustion of fuels or the thermal decomposition of waste. Residents near Superfund sites are exposed to PM through the inhalation of windblown dust, ingestion of soil and sediments, and inhalation of emissions from the on-site thermal treatment of contaminated soils. Epidemiological evidence supports a link between exposure to airborne PM and an increased risk of cardiovascular and pulmonary diseases. It is well-known that during combustion processes, incomplete combustion can lead to the production of organic pollutants that can adsorb to the surface of PM. Recent studies have demonstrated that their interaction with metal centers can lead to the generation of a surface stabilized metal-radical complex capable of redox cycling to produce ROS. Moreover, these free radicals can persist in the environment, hence their designation as Environmentally Persistent Free Radicals (EPFR). EPFR has been demonstrated in both ambient air PM2.5 (diameter < 2.5 µm) and in PM from a variety of combustion sources. Thus, low-temperature, thermal treatment of soils can potentially increase the concentration of EPFR in areas in and around Superfund sites. In this review, we will outline the evidence to date supporting EPFR formation and its environmental significance. Furthermore, we will address the lack of methodologies for specifically addressing its risk assessment and challenges associated with regulating this new, emerging contaminant. PMID:27338429

Research and Technology Development Activities to Address the DOE-EM Environmental Mercury Challenge

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

Pierce, Eric M; Peterson, Mark J

Technology Development Program, Small Business Innovative Research (SBIR), and EM s Minority Serving Institutions Partnership Program. Collectively, these multi-institutional and multidisciplinary programs are generating new tools, knowledge, and remediation approaches that will enable efficient cleanup of mercury contaminated systems locally and globally. In this talk we will highlight the progress made to date in addressing key knowledge gaps required to solve this watershed-scale conundrum.« less

Stirring up the Mud: Using a Community-Based Participatory Approach to Address Health Disparities through a Faith-Based Initiative

PubMed Central

Kaplan, Sue A.; Ruddock, Charmaine; Golub, Maxine; Davis, Joyce; Foley, Robert; Devia, Carlos; Rosen, Rosa; Berry, Carolyn; Barretto, Brenda; Carter, Toni; Irish-Spencer, Evalina; Marchena, Maria; Purcaro, Ellenrita; Calman, Neil

2011-01-01

This case study provides a mid-course assessment of the Bronx Health REACH faith-based initiative four years into its implementation. The study uses qualitative methods to identify lessons learned and to reflect on the benefits and challenges of using a community-based participatory approach for the development and evaluation of a faith-based program designed to address health disparities. Key findings concern the role of pastoral leadership, the importance of providing a religious context for health promotion and health equality messages, the challenges of creating a bilingual/bi-cultural program, and the need to provide management support to the lay program coordinators. The study also identifies lessons learned about community-based evaluation and the importance of addressing community concern about the balance between evaluation and program. Finally, the study identifies the challenges that lie ahead, including issues of program institution-alization and sustainability. PMID:20168022

Rewards and challenges of family practice

PubMed Central

Manca, Donna P.; Varnhagen, Stanley; Brett-MacLean, Pamela; Allan, G. Michael; Szafran, Olga; Ausford, Allen; Rowntree, Carol; Rumzan, Ismael; Turner, Diana

2007-01-01

OBJECTIVE To identify and describe the important rewards and challenges that affect family physicians in Alberta. DESIGN Web-based qualitative study using the Delphi method. SETTING Province of Alberta. PARTICIPANTS Twenty-eight family physicians practising in Alberta. METHODS The study website presented a description of the project, ethical information, a calendar of events, and contact information. Delphi surveys and demographic questionnaires were password protected. Five rounds of surveys were conducted between May 2004 and January 2005. Participants were notified of each round of surveys and prompted by e–mail ifthey did not respond. FINDINGS Participants identified 8 key rewards and 9 key challenges. The research team identified 2 additional challenges that were validated by participants. In order of perceived importance, key rewards were providing diverse and comprehensive care; providing preventive care; having relationships with patients and their families; being an immersed witness to the human condition; providing continuity of care and receiving ongoing feedback; having flexibility and control of practice and job security; maintaining and acquiring skills and knowledge; teaching and sharing knowledge and gaining experience and mentoring. The challenges, in order of perceived need to be addressed, were workload and time pressures and meeting demands; the need to promote the rewards of family practice to those considering joining the profession; overhead and income inequities; getting respect from specialists; the need to ensure that the rewards identified are not adversely affected by primary care reform; lack of availability of specialists, procedures, tests, and other resources; running a practice as a small business; paperwork, telephone calls, and forms; maintaining and acquiring skills and knowledge; patients’ expectations; and medicolegal issues, insurance paperwork, and dealing with medical claims related to motor vehicle accidents. CONCLUSION

Resources and Recommendations for Using Transcriptomics to Address Grand Challenges in Comparative Biology

PubMed Central

Mykles, Donald L.; Burnett, Karen G.; Durica, David S.; Joyce, Blake L.; McCarthy, Fiona M.; Schmidt, Carl J.; Stillman, Jonathon H.

2016-01-01

High-throughput RNA sequencing (RNA-seq) technology has become an important tool for studying physiological responses of organisms to changes in their environment. De novo assembly of RNA-seq data has allowed researchers to create a comprehensive catalog of genes expressed in a tissue and to quantify their expression without a complete genome sequence. The contributions from the “Tapping the Power of Crustacean Transcriptomics to Address Grand Challenges in Comparative Biology” symposium in this issue show the successes and limitations of using RNA-seq in the study of crustaceans. In conjunction with the symposium, the Animal Genome to Phenome Research Coordination Network collated comments from participants at the meeting regarding the challenges encountered when using transcriptomics in their research. Input came from novices and experts ranging from graduate students to principal investigators. Many were unaware of the bioinformatics analysis resources currently available on the CyVerse platform. Our analysis of community responses led to three recommendations for advancing the field: (1) integration of genomic and RNA-seq sequence assemblies for crustacean gene annotation and comparative expression; (2) development of methodologies for the functional analysis of genes; and (3) information and training exchange among laboratories for transmission of best practices. The field lacks the methods for manipulating tissue-specific gene expression. The decapod crustacean research community should consider the cherry shrimp, Neocaridina denticulata, as a decapod model for the application of transgenic tools for functional genomics. This would require a multi-investigator effort. PMID:27639274

Feasibility of an International Multiple Sclerosis Rehabilitation Data Repository: Perceived Challenges and Motivators for Sharing Data.

PubMed

Bradford, Elissa Held; Baert, Ilse; Finlayson, Marcia; Feys, Peter; Wagner, Joanne

2018-01-01

Multiple sclerosis (MS) rehabilitation evidence is limited due to methodological factors, which may be addressed by a data repository. We describe the perceived challenges of, motivators for, interest in participating in, and key features of an international MS rehabilitation data repository. A multimethod sequential investigation was performed with the results of two focus groups, using nominal group technique, and study aims informing the development of an online questionnaire. Percentage agreement and key quotations illustrated questionnaire findings. Subgroup comparisons were made between clinicians and researchers and between participants in North America and Europe. Rehabilitation professionals from 25 countries participated (focus groups: n = 21; questionnaire: n = 166). The top ten challenges (C) and motivators (M) identified by the focus groups were database control/management (C); ethical/legal concerns (C); data quality (C); time, effort, and cost (C); best practice (M); uniformity (C); sustainability (C); deeper analysis (M); collaboration (M); and identifying research needs (M). Percentage agreement with questionnaire statements regarding challenges to, motivators for, interest in, and key features of a successful repository was at least 80%, 85%, 72%, and 83%, respectively, across each group of statements. Questionnaire subgroup analysis revealed a few differences (P < .05), including that clinicians more strongly identified with improving best practice as a motivator. Findings support clinician and researcher interest in and potential for success of an international MS rehabilitation data repository if prioritized challenges and motivators are addressed and key features are included.

GEOSS: Addressing Big Data Challenges

NASA Astrophysics Data System (ADS)

Nativi, S.; Craglia, M.; Ochiai, O.

2014-12-01

In the sector of Earth Observation, the explosion of data is due to many factors including: new satellite constellations, the increased capabilities of sensor technologies, social media, crowdsourcing, and the need for multidisciplinary and collaborative research to face Global Changes. In this area, there are many expectations and concerns about Big Data. Vendors have attempted to use this term for their commercial purposes. It is necessary to understand whether Big Data is a radical shift or an incremental change for the existing digital infrastructures. This presentation tries to explore and discuss the impact of Big Data challenges and new capabilities on the Global Earth Observation System of Systems (GEOSS) and particularly on its common digital infrastructure called GCI. GEOSS is a global and flexible network of content providers allowing decision makers to access an extraordinary range of data and information at their desk. The impact of the Big Data dimensionalities (commonly known as 'V' axes: volume, variety, velocity, veracity, visualization) on GEOSS is discussed. The main solutions and experimentation developed by GEOSS along these axes are introduced and analyzed. GEOSS is a pioneering framework for global and multidisciplinary data sharing in the Earth Observation realm; its experience on Big Data is valuable for the many lessons learned.

Commentary: pediatric eHealth interventions: common challenges during development, implementation, and dissemination.

PubMed

Wu, Yelena P; Steele, Ric G; Connelly, Mark A; Palermo, Tonya M; Ritterband, Lee M

2014-07-01

To provide an overview of common challenges that pediatric eHealth researchers may encounter when planning, developing, testing, and disseminating eHealth interventions along with proposed solutions for addressing these challenges. The article draws on the existing eHealth literature and the authors' collective experience in pediatric eHealth research. The challenges associated with eHealth interventions and their proposed solutions are multifaceted and cut across a number of areas from eHealth program development through dissemination. Collaboration with a range of individuals (e.g., multidisciplinary colleagues, commercial entities, primary stakeholders) is the key to eHealth intervention success. To ensure adequate resources for design, development, and planning for sustainability, a number of public and private sources of funding are available. A study design that addresses ethical concerns and security issues is critical to ensure scientific integrity and intervention dissemination. Table I summarizes key issues to consider during eHealth intervention development, testing, and dissemination. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Nutritional issues for older adults: addressing degenerative ageing with long-term studies.

PubMed

de Groot, Lisette C P G M

2016-05-01

The ageing process is influenced by a variety of factors, including extrinsic, malleable lifestyle variables. The present paper deals with the epidemiological evidence for the role of dietary patterns and key nutritional concerns in relation to survival and ageing-related disorders that present themselves in later life. Healthful dietary patterns appear to be most relevant in old age. Specific nutritional concerns are related to vitamin D, vitamin B12 and protein malnutrition. An important challenge to further expand the knowledge base is currently addressed by the NuAge project, acknowledging the complexity of the ageing process and integrating different dimensions of research into human healthy ageing. In the meantime, reversing poor adherence to existing guidelines for a healthy diet remains a first challenge in public health nutritional practices.

Addressing recent docking challenges: A hybrid strategy to integrate template-based and free protein-protein docking.

PubMed

Yan, Yumeng; Wen, Zeyu; Wang, Xinxiang; Huang, Sheng-You

2017-03-01

Protein-protein docking is an important computational tool for predicting protein-protein interactions. With the rapid development of proteomics projects, more and more experimental binding information ranging from mutagenesis data to three-dimensional structures of protein complexes are becoming available. Therefore, how to appropriately incorporate the biological information into traditional ab initio docking has been an important issue and challenge in the field of protein-protein docking. To address these challenges, we have developed a Hybrid DOCKing protocol of template-based and template-free approaches, referred to as HDOCK. The basic procedure of HDOCK is to model the structures of individual components based on the template complex by a template-based method if a template is available; otherwise, the component structures will be modeled based on monomer proteins by regular homology modeling. Then, the complex structure of the component models is predicted by traditional protein-protein docking. With the HDOCK protocol, we have participated in the CPARI experiment for rounds 28-35. Out of the 25 CASP-CAPRI targets for oligomer modeling, our HDOCK protocol predicted correct models for 16 targets, ranking one of the top algorithms in this challenge. Our docking method also made correct predictions on other CAPRI challenges such as protein-peptide binding for 6 out of 8 targets and water predictions for 2 out of 2 targets. The advantage of our hybrid docking approach over pure template-based docking was further confirmed by a comparative evaluation on 20 CASP-CAPRI targets. Proteins 2017; 85:497-512. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Good practices and challenges in addressing poliomyelitis and measles in the European Union.

PubMed

Kinsman, John; Stöven, Svenja; Elgh, Fredrik; Murillo, Pilar; Sulzner, Michael

2018-04-06

All European Union (EU) and European Economic Area (EEA) Member States have pledged to ensure political commitment towards sustaining the region's poliomyelitis-free status and eliminating measles. However, there remain significant gaps between policy and practice in many countries. This article reports on an assessment conducted for the European Commission that aimed to support improvements in preparedness and response to poliomyelitis and measles in Europe. A documentary review was complemented by qualitative interviews with professionals working in International and EU agencies, and in at-risk or recently affected EU/EEA Member States (six each for poliomyelitis and measles). Twenty-six interviews were conducted on poliomyelitis and 24 on measles; the data were subjected to thematic analysis. Preliminary findings were then discussed at a Consensus Workshop with 22 of the interviewees and eight other experts. Generic or disease-specific plans exist in the participating countries and cross-border communications during outbreaks were generally reported as satisfactory. However, surveillance systems are of uneven quality, and clinical expertise for the two diseases is limited by a lack of experience. Serious breaches of protocol have recently been reported from companies producing poliomyelitis vaccines, and vaccine coverage rates for both diseases were also sub-optimal. A set of suggested good practices to address these and other challenges is presented. Poliomyelitis and measles should be brought fully onto the policy agendas of all EU/EEA Member States, and adequate resources provided to address them. Each country must abide by the relevant commitments that they have already made.

Quantum key distribution with untrusted detectors

NASA Astrophysics Data System (ADS)

González, P.; Rebón, L.; Ferreira da Silva, T.; Figueroa, M.; Saavedra, C.; Curty, M.; Lima, G.; Xavier, G. B.; Nogueira, W. A. T.

2015-08-01

Side-channel attacks currently constitute the main challenge for quantum key distribution (QKD) to bridge theory with practice. So far two main approaches have been introduced to address this problem, (full) device-independent QKD and measurement-device-independent QKD. Here we present a third solution that might exceed the performance and practicality of the previous two in circumventing detector side-channel attacks, which arguably is the most hazardous part of QKD implementations. Our proposal has, however, one main requirement: the legitimate users of the system need to ensure that their labs do not leak any unwanted information to the outside. The security in the low-loss regime is guaranteed, while in the high-loss regime we already prove its robustness against some eavesdropping strategies.

Challenges in achieving patient participation: A review of how patient participation is addressed in empirical studies.

PubMed

Angel, Sanne; Frederiksen, Kirsten Norup

2015-09-01

For decades, it has been an ideal in western countries that individuals should participate in society as self-governing and autonomous subjects; however, this ideal does not always correspond to the actual experiences of individuals in their encounters with health professionals. This review identifies how empirical studies address challenges in achieving patient participation in clinical nursing. We conducted a literature search for studies of patient participation in PubMed, Cinahl, PsychInfo and Scopus. In a systematic review using Garrard's matrix method, we selected empirical studies that focused on patients' participation in health services. The empirical studies we investigated addressed the relationship between patient and nurse, knowledge, contact time with the patient, severity of illness and the effect of age on the degree of patient involvement. Every study thus investigated assessed patient participation as being achievable. None of the studies questioned the foundation for patient participation, which has been described in theoretical articles. The main explanation for difficulties in achieving patient participation was that expectations concerning the extent and quality of participation could be unrealistic and lead to dissatisfaction. Studies on patient participation identify challenges due to the nature of the relationship between laypersons and professionals, and the embedded difference in situation and knowledge. This difference may be reduced by time and a mutually positive attitude. But participation in its ideal form cannot be achieved because of this fundamental difference. Therefore, the optimal level of patient participation can only be achieved within a framework which provides both patients and health professionals with adequate time to build relationships and shared knowledge. Copyright © 2015 Elsevier Ltd. All rights reserved.

Monitoring biological diversity: strategies, tools, limitations, and challenges

USGS Publications Warehouse

Beever, E.A.

2006-01-01

Monitoring is an assessment of the spatial and temporal variability in one or more ecosystem properties, and is an essential component of adaptive management. Monitoring can help determine whether mandated environmental standards are being met and can provide an early-warning system of ecological change. Development of a strategy for monitoring biological diversity will likely be most successful when based upon clearly articulated goals and objectives and may be enhanced by including several key steps in the process. Ideally, monitoring of biological diversity will measure not only composition, but also structure and function at the spatial and temporal scales of interest. Although biodiversity monitoring has several key limitations as well as numerous theoretical and practical challenges, many tools and strategies are available to address or overcome such challenges; I summarize several of these. Due to the diversity of spatio-temporal scales and comprehensiveness encompassed by existing definitions of biological diversity, an effective monitoring design will reflect the desired sampling domain of interest and its key stressors, available funding, legal requirements, and organizational goals.

Key enzymes and proteins of crop insects as candidate for RNAi based gene silencing

PubMed Central

Kola, Vijaya Sudhakara Rao; Renuka, P.; Madhav, Maganti Sheshu; Mangrauthia, Satendra K.

2015-01-01

RNA interference (RNAi) is a mechanism of homology dependent gene silencing present in plants and animals. It operates through 21–24 nucleotides small RNAs which are processed through a set of core enzymatic machinery that involves Dicer and Argonaute proteins. In recent past, the technology has been well appreciated toward the control of plant pathogens and insects through suppression of key genes/proteins of infecting organisms. The genes encoding key enzymes/proteins with the great potential for developing an effective insect control by RNAi approach are actylcholinesterase, cytochrome P450 enzymes, amino peptidase N, allatostatin, allatotropin, tryptophan oxygenase, arginine kinase, vacuolar ATPase, chitin synthase, glutathione-S-transferase, catalase, trehalose phosphate synthase, vitellogenin, hydroxy-3-methylglutaryl coenzyme A reductase, and hormone receptor genes. Through various studies, it is demonstrated that RNAi is a reliable molecular tool which offers great promises in meeting the challenges imposed by crop insects with careful selection of key enzymes/proteins. Utilization of RNAi tool to target some of these key proteins of crop insects through various approaches is described here. The major challenges of RNAi based insect control such as identifying potential targets, delivery methods of silencing trigger, off target effects, and complexity of insect biology are very well illustrated. Further, required efforts to address these challenges are also discussed. PMID:25954206

A Novel Device Addressing Design Challenges for Passive Fluid Phase Separations Aboard Spacecraft

NASA Astrophysics Data System (ADS)

Weislogel, M. M.; Thomas, E. A.; Graf, J. C.

2009-07-01

Capillary solutions have long existed for the control of liquid inventories in spacecraft fluid systems such as liquid propellants, cryogens and thermal fluids for temperature control. Such large length scale, `low-gravity,' capillary systems exploit container geometry and fluid properties—primarily wetting—to passively locate or transport fluids to desired positions for a variety of purposes. Such methods have only been confidently established if the wetting conditions are known and favorable. In this paper, several of the significant challenges for `capillary solutions' to low-gravity multiphase fluids management aboard spacecraft are briefly reviewed in light of applications common to life support systems that emphasize the impact of the widely varying wetting properties typical of aqueous systems. A restrictive though no less typifying example of passive phase separation in a urine collection system is highlighted that identifies key design considerations potentially met by predominately capillary solutions. Sample results from novel scale model prototype testing aboard a NASA low-g aircraft are presented that support the various design considerations.

Conservation biology in Asia: the major policy challenges.

PubMed

McNeely, Jeffrey A; Kapoor-Vijay, Promila; Zhi, Lu; Olsvig-Whittaker, Linda; Sheikh, Kashif M; Smith, Andrew T

2009-08-01

With about half the world's human population and booming economies, Asia faces numerous challenges to its biodiversity. The Asia Section of the Society for Conservation Biology has identified some key policy issues in which significant progress can be made. These include developing new sources of funding for forest conservation; identifying potential impacts of energy alternatives on the conservation of biodiversity; curbing the trade in endangered species of plants and animals; a special focus on the conservation of mountain biodiversity; enhancing relevant research; ensuring that conservation biology contributes to major international conventions and funding mechanisms; using conservation biology to build a better understanding of zoonotic diseases; more effectively addressing human-animal conflicts; enhancing community-based conservation; and using conservation biology to help address the pervasive water-deficit problems in much of Asia. These challenges can be met through improved regional cooperation among the relevant stakeholders.

Key Objectives Bank: Year 9. Key Stage 3: National Strategy.

ERIC Educational Resources Information Center

Department for Education and Skills, London (England).

In each sub-section of the "Framework for Teaching English: Years 7, 8 and 9," certain key objectives are identified in boldface print. These objectives are key because they signify skills or understanding which are crucial to pupils' language development. They are challenging for the age group and are important markers of progress. This…

Large system change challenges: addressing complex critical issues in linked physical and social domains

NASA Astrophysics Data System (ADS)

Waddell, Steve; Cornell, Sarah; Hsueh, Joe; Ozer, Ceren; McLachlan, Milla; Birney, Anna

2015-04-01

Most action to address contemporary complex challenges, including the urgent issues of global sustainability, occurs piecemeal and without meaningful guidance from leading complex change knowledge and methods. The potential benefit of using such knowledge is greater efficacy of effort and investment. However, this knowledge and its associated tools and methods are under-utilized because understanding about them is low, fragmented between diverse knowledge traditions, and often requires shifts in mindsets and skills from expert-led to participant-based action. We have been engaged in diverse action-oriented research efforts in Large System Change for sustainability. For us, "large" systems can be characterized as large-scale systems - up to global - with many components, of many kinds (physical, biological, institutional, cultural/conceptual), operating at multiple levels, driven by multiple forces, and presenting major challenges for people involved. We see change of such systems as complex challenges, in contrast with simple or complicated problems, or chaotic situations. In other words, issues and sub-systems have unclear boundaries, interact with each other, and are often contradictory; dynamics are non-linear; issues are not "controllable", and "solutions" are "emergent" and often paradoxical. Since choices are opportunity-, power- and value-driven, these social, institutional and cultural factors need to be made explicit in any actionable theory of change. Our emerging network is sharing and building a knowledge base of experience, heuristics, and theories of change from multiple disciplines and practice domains. We will present our views on focal issues for the development of the field of large system change, which include processes of goal-setting and alignment; leverage of systemic transitions and transformation; and the role of choice in influencing critical change processes, when only some sub-systems or levels of the system behave in purposeful ways

Addressing climate challenges in developing countries

NASA Astrophysics Data System (ADS)

Tilmes, Simone; Monaghan, Andrew; Done, James

2012-04-01

Advanced Study Program/Early Career Scientist Assembly Workshop on Regional Climate Issues in Developing Countries; Boulder, Colorado, 19-22 October 2011 The Early Career Scientist Assembly (ECSA) and the Advanced Study Program of the National Center for Atmospheric Research (NCAR) invited 35 early-career scientists from nearly 20 countries to attend a 3-day workshop at the NCAR Mesa Laboratory prior to the World Climate Research Programme (WCRP) Open Science Conference in October 2011. The goal of the workshop was to examine a range of regional climate challenges in developing countries. Topics included regional climate modeling, climate impacts, water resources, and air quality. The workshop fostered new ideas and collaborations between early-career scientists from around the world. The discussions underscored the importance of establishing partnerships with scientists located in typically underrepresented countries to understand and account for the local political, economic, and cultural factors on which climate change is superimposed.

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.

Ethical challenges within Veterans Administration healthcare facilities: perspectives of managers, clinicians, patients, and ethics committee chairpersons.

PubMed

Foglia, Mary Beth; Pearlman, Robert A; Bottrell, Melissa; Altemose, Jane K; Fox, Ellen

2009-04-01

To promote ethical practices, healthcare managers must understand the ethical challenges encountered by key stakeholders. To characterize ethical challenges in Veterans Administration (VA) facilities from the perspectives of managers, clinicians, patients, and ethics consultants. We conducted focus groups with patients (n = 32) and managers (n = 38); semi-structured interviews with managers (n = 31), clinicians (n = 55), and ethics committee chairpersons (n = 21). Data were analyzed using content analysis. Managers reported that the greatest ethical challenge was fairly distributing resources across programs and services, whereas clinicians identified the effect of resource constraints on patient care. Ethics committee chairpersons identified end-of-life care as the greatest ethical challenge, whereas patients identified obtaining fair, respectful, and caring treatment. Perspectives on ethical challenges varied depending on the respondent's role. Understanding these differences can help managers take practical steps to address these challenges. Further, ethics committees seemingly, are not addressing the range of ethical challenges within their institutions.

The challenges in defining and measuring diagnostic error.

PubMed

Zwaan, Laura; Singh, Hardeep

2015-06-01

Diagnostic errors have emerged as a serious patient safety problem but they are hard to detect and complex to define. At the research summit of the 2013 Diagnostic Error in Medicine 6th International Conference, we convened a multidisciplinary expert panel to discuss challenges in defining and measuring diagnostic errors in real-world settings. In this paper, we synthesize these discussions and outline key research challenges in operationalizing the definition and measurement of diagnostic error. Some of these challenges include 1) difficulties in determining error when the disease or diagnosis is evolving over time and in different care settings, 2) accounting for a balance between underdiagnosis and overaggressive diagnostic pursuits, and 3) determining disease diagnosis likelihood and severity in hindsight. We also build on these discussions to describe how some of these challenges can be addressed while conducting research on measuring diagnostic error.

Strategic management and organizational behavior in dental education: reflections on key issues in an environment of change.

PubMed

Dunning, David G; Durham, Timothy M; Lange, Brian M; Aksu, Mert N

2009-06-01

With issues such as shrinking revenue, access to care, faculty workloads, and graying faculty, dental schools are faced with difficult challenges that fall to dental school deans to manage. Do dental school deans have the organizational skill sets and ethical frameworks necessary to address the challenges now facing dental schools? The purpose of this article is to pose questions and suggestions regarding some of the key issues in dental colleges today and to stimulate discussion in the dental community about needed changes in dental education.

Across the Atlantic cooperation to address international challenges in eHealth and health IT: managing toward a common goal.

PubMed

Friedman, Charles P; Iakovidis, Ilias; Debenedetti, Laurent; Lorenzi, Nancy M

2009-11-01

Countries on both sides of the Atlantic Ocean have invested in health information and communication technologies. Since eHealth challenges cross borders a European Union-United States of America conference on public policies relating to health IT and eHealth was held October 20-21, 2008 in Paris, France. The conference was organized around the four themes: (1) privacy and security, (2) health IT interoperability, (3) deployment and adoption of health IT, and (4) Public Private Collaborative Governance. The four key themes framed the discussion over the two days of plenary sessions and workshops. Key findings of the conference were organized along the four themes. (1) Privacy and security: Patients' access to their own data and key elements of a patient identification management framework were discussed. (2) Health IT interoperability: Three significant and common interoperability challenges emerged: (a) the need to establish common or compatible standards and clear guidelines for their implementation, (b) the desirability for shared certification criteria and (c) the need for greater awareness of the importance of interoperability. (3) Deployment and adoption of health IT: Three major areas of need emerged: (a) a shared knowledge base and assessment framework, (b) public-private collaboration and (c) and effective organizational change strategies. (4) Public Private Collaborative Governance: Sharing and communication are central to success in this area. Nations can learn from one another about ways to develop harmonious, effective partnerships. Three areas that were identified as highest priority for collaboration included: (1) health data security, (2) developing effective strategies to ensure healthcare professionals' acceptance of health IT tools, and (3) interoperability.

Insect anaphylaxis: addressing clinical challenges.

PubMed

Tracy, James M; Lewis, Elena J; Demain, Jeffrey G

2011-08-01

Few allergic reactions are as potentially life-threatening, or frightening to the patient, as anaphylaxis. Food, medications, and insect stings are the three most common triggers of anaphylaxis, but insect allergy provides the best opportunity to understand the biology of anaphylaxis. If the physician can establish a diagnosis of insect allergy, treatment with nearly 98% effectiveness can be initiated. However, sometimes patients have a compelling history of insect sting anaphylaxis, but negative skin and blood tests. This situation presents us with a fascinating opportunity to understand the biology of insect anaphylaxis. Recent and ongoing work shows that occult mast cell disease may be critical in insect anaphylaxis. Mastocytosis, serum tryptase and basophil biology are key elements; genetic markers may potentially help us diagnose at-risk individuals and determine proper treatment. Understanding basophil activation may play an additional role both in diagnosis and knowing when therapy might be terminated. Mast cell disease, serum tryptase and basophil biology are providing an opportunity to better understand and manage insect allergy. This evolving understanding should improve long-term management of insect anaphylaxis and help us to better understand the clinical dilemma of appropriate management of the history-positive patient in which testing is unable to detect venom-specific IgE. Furthermore, omalizumab's immunomodulatory effects may play a role in difficult-to-treat insect allergy and mastocytosis. Finally, unrelated to these, but still important as an ongoing risk factor, is the continued underutilization of epinephrine for both acute and long-term management of insect anaphylaxis.

PM₂.₅ opened a door to public participation addressing environmental challenges in China.

PubMed

Huang, Ganlin

2015-02-01

China has long been regarded as a centralized society where the public has little influence on decision-making. Such a top-down management scheme is perceived as a major obstacle to address complicated environment issues. The recent public campaign in China to urge creation of a nationwide PM₂.₅ monitoring network and mitigation plan provides an unprecedented case of how the public participated and influenced policy-making in a centralized society. This paper reviews key incidents in the campaign chronologically. Here we identify information technology, public awareness of air quality's health impacts and the fact air quality affects everyone as public goods as the major factors promoting public participation. This case demonstrates that public participation can happen in a centralized, top-down society such as China. Continued environmental deterioration may stimulate similar campaigns for other issues. We anticipate this essay to be a starting point for more studies on how environmental issues stimulate incremental social change by making people involved in decision-making process, especially in societies where they are rarely able to do so. Copyright © 2014 Elsevier Ltd. All rights reserved.

Top 10 Ways To Improve Public Schools. Innovative Solutions To Help Address the Issues and Challenges Facing Most Public School Districts.

ERIC Educational Resources Information Center

Texas State Comptroller of Public Accounts, Austin.

This report offers the top 10 challenges identified by public schools and the ways that the Texas School Performance Review (TSPR) suggests that these issues be addressed. The TSPR ensures that scarce education resources are spent in the classroom. For a TSPR review, the TSPR team is invited in for months of detailed study, during which it asks…

Nanotechnology: Opportunities and Challenges

NASA Technical Reports Server (NTRS)

Meyyappan, Meyya

2003-01-01

Nanotechnology seeks to exploit novel physical, chemical, biological, mechanical, electrical, and other properties, which arise primarily due to the nanoscale nature of certain materials. A key example is carbon nanotubes (CNTs) which exhibit unique electrical and extraordinary mechanical properties and offer remarkable potential for revolutionary applications in electronics devices, computing, and data storage technology, sensors, composites, nanoelectromechanical systems (NEMS), and as tip in scanning probe microscopy (SPM) for imaging and nanolithography. Thus the CNT synthesis, characterization, and applications touch upon all disciplines of science and engineering. This presentation will provide an overview and progress report on this and other major research candidates in Nanotechnology and address opportunities and challenges ahead.

Resources and Recommendations for Using Transcriptomics to Address Grand Challenges in Comparative Biology.

PubMed

Mykles, Donald L; Burnett, Karen G; Durica, David S; Joyce, Blake L; McCarthy, Fiona M; Schmidt, Carl J; Stillman, Jonathon H

2016-12-01

High-throughput RNA sequencing (RNA-seq) technology has become an important tool for studying physiological responses of organisms to changes in their environment. De novo assembly of RNA-seq data has allowed researchers to create a comprehensive catalog of genes expressed in a tissue and to quantify their expression without a complete genome sequence. The contributions from the "Tapping the Power of Crustacean Transcriptomics to Address Grand Challenges in Comparative Biology" symposium in this issue show the successes and limitations of using RNA-seq in the study of crustaceans. In conjunction with the symposium, the Animal Genome to Phenome Research Coordination Network collated comments from participants at the meeting regarding the challenges encountered when using transcriptomics in their research. Input came from novices and experts ranging from graduate students to principal investigators. Many were unaware of the bioinformatics analysis resources currently available on the CyVerse platform. Our analysis of community responses led to three recommendations for advancing the field: (1) integration of genomic and RNA-seq sequence assemblies for crustacean gene annotation and comparative expression; (2) development of methodologies for the functional analysis of genes; and (3) information and training exchange among laboratories for transmission of best practices. The field lacks the methods for manipulating tissue-specific gene expression. The decapod crustacean research community should consider the cherry shrimp, Neocaridina denticulata, as a decapod model for the application of transgenic tools for functional genomics. This would require a multi-investigator effort. © The Author 2016. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

17th Workshop on MHD Stability Control: addressing the disruption challenge for ITER

NASA Astrophysics Data System (ADS)

Buttery, Richard

2013-08-01

This annual workshop on magnetohydrodynamic stability control was held on 5-7 November 2012 at Columbia University in the city of New York, in the aftermath of a violent hydrodynamic instability event termed 'Hurricane Sandy'. Despite these challenging circumstances, Columbia University managed an excellent meeting, enabling the full participation of the community. This Workshop has been held since 1996 to help in the development of understanding and control of magnetohydrodynamic (MHD) instabilities for future fusion reactors. It covers a wide range of stability topics—from disruptions, to tearing modes, error fields, edge-localized modes (ELMs), resistive wall modes (RWMs) and ideal MHD—spanning many device types (tokamaks, stellarators and reversed field pinches) to identify commonalities in the physics and a means of control. The theme for 2012 was 'addressing the disruption challenge for ITER', and thus the first day had a heavy focus on both the avoidance and mitigation of disruptions in ITER. Key elements included understanding how to apply 3D fields to maintain stability, as well as managing the disruption process itself through mitigating loads in the thermal quench and handling so called 'runaway electrons'. This culminated in a panel discussion on the disruption mitigation strategy for ITER, which noted that heat load asymmetries during the thermal quench appear to be an artifact of MHD processes, and that runaway electron generation may be inevitable, suggesting research should focus on control and dissipation of the runaway beam. The workshop was combined this year with the annual US-Japan MHD Workshop, with a special section looking more deeply at 'Fundamentals of 3D Perturbed Equilibrium Control', with interesting sessions on 3D equilibrium reconstruction, RWM physics, novel control concepts such as non-magnetic sensing, adaptive control, q < 2 tokamak operation, and the effects of flow. The final day turned to tearing mode interactions

On the road to a stronger public health workforce: visual tools to address complex challenges.

PubMed

Drehobl, Patricia; Stover, Beth H; Koo, Denise

2014-11-01

The public health workforce is vital to protecting the health and safety of the public, yet for years, state and local governmental public health agencies have reported substantial workforce losses and other challenges to the workforce that threaten the public's health. These challenges are complex, often involve multiple influencing or related causal factors, and demand comprehensive solutions. However, proposed solutions often focus on selected factors and might be fragmented rather than comprehensive. This paper describes approaches to characterizing the situation more comprehensively and includes two visual tools: (1) a fishbone, or Ishikawa, diagram that depicts multiple factors affecting the public health workforce; and (2) a roadmap that displays key elements-goals and strategies-to strengthen the public health workforce, thus moving from the problems depicted in the fishbone toward solutions. The visual tools aid thinking about ways to strengthen the public health workforce through collective solutions and to help leverage resources and build on each other's work. The strategic roadmap is intended to serve as a dynamic tool for partnership, prioritization, and gap assessment. These tools reflect and support CDC's commitment to working with partners on the highest priorities for strengthening the workforce to improve the public's health. Published by Elsevier Inc.

Reaching Each Student: National Challenge and Organizational Commitment. Addresses to the College Board National Forum, October 31-November 2, 1990, Boston, Massachusetts.

ERIC Educational Resources Information Center

College Board, New York, NY.

Four speakers addressed the College Board National Forum on "Reaching Each Student" in the Fall of 1990 in Boston, Massachusetts. John F. Akers, Chairman of the Board at International Business Machines in his speech "Reaching Each Student: A Business Perspective" challenged the College Board to work with American business to…

Physical Unclonable Function Hardware Keys Utilizing Kirchhoff-Law Secure Key Exchange and Noise-Based Logic

NASA Astrophysics Data System (ADS)

Kish, Laszlo B.; Kwan, Chiman

Weak unclonable function (PUF) encryption key means that the manufacturer of the hardware can clone the key but not anybody else. Strong unclonable function (PUF) encryption key means that even the manufacturer of the hardware is unable to clone the key. In this paper, first we introduce an "ultra" strong PUF with intrinsic dynamical randomness, which is not only unclonable but also gets renewed to an independent key (with fresh randomness) during each use via the unconditionally secure key exchange. The solution utilizes the Kirchhoff-law-Johnson-noise (KLJN) method for dynamical key renewal and a one-time-pad secure key for the challenge/response process. The secure key is stored in a flash memory on the chip to provide tamper-resistance and nonvolatile storage with zero power requirements in standby mode. Simplified PUF keys are shown: a strong PUF utilizing KLJN protocol during the first run and noise-based logic (NBL) hyperspace vector string verification method for the challenge/response during the rest of its life or until it is re-initialized. Finally, the simplest PUF utilizes NBL without KLJN thus it can be cloned by the manufacturer but not by anybody else.

How to Tackle Key Challenges in the Promotion of Physical Activity among Older Adults (65+): The AEQUIPA Network Approach

PubMed Central

Forberger, Sarah; Bammann, Karin; Bauer, Jürgen; Boll, Susanne; Bolte, Gabriele; Brand, Tilman; Hein, Andreas; Koppelin, Frauke; Lippke, Sonia; Meyer, Jochen; Pischke, Claudia R.; Voelcker-Rehage, Claudia; Zeeb, Hajo

2017-01-01

The paper introduces the theoretical framework and methods/instruments used by the Physical Activity and Health Equity: Primary Prevention for Healthy Ageing (AEQUIPA) prevention research network as an interdisciplinary approach to tackle key challenges in the promotion of physical activity among older people (65+). Drawing on the social-ecological model, the AEQUIPA network developed an interdisciplinary methodological design including quantitative/qualitative studies and systematic reviews, while combining expertise from diverse fields: public health, psychology, urban planning, sports sciences, health technology and geriatrics. AEQUIPA tackles key challenges when promoting physical activity (PA) in older adults: tailoring of interventions, fostering community readiness and participation, strengthening intersectoral collaboration, using new technological devices and evaluating intervention generated inequalities. AEQUIPA aims to strengthen the evidence base for age-specific preventive PA interventions and to yield new insights into the explanatory power of individual and contextual factors. Currently, the empirical work is still underway. First experiences indicate that the network has achieved a strong regional linkage with communities, local stakeholders and individuals. However, involving inactive persons and individuals from minority groups remained challenging. A review of existing PA intervention studies among the elderly revealed the potential to assess equity effects. The results will add to the theoretical and methodological discussion on evidence-based age-specific PA interventions and will contribute to the discussion about European and national health targets. PMID:28375177

How to Tackle Key Challenges in the Promotion of Physical Activity among Older Adults (65+): The AEQUIPA Network Approach.

PubMed

Forberger, Sarah; Bammann, Karin; Bauer, Jürgen; Boll, Susanne; Bolte, Gabriele; Brand, Tilman; Hein, Andreas; Koppelin, Frauke; Lippke, Sonia; Meyer, Jochen; Pischke, Claudia R; Voelcker-Rehage, Claudia; Zeeb, Hajo

2017-04-04

The paper introduces the theoretical framework and methods/instruments used by the Physical Activity and Health Equity: Primary Prevention for Healthy Ageing (AEQUIPA) prevention research network as an interdisciplinary approach to tackle key challenges in the promotion of physical activity among older people (65+). Drawing on the social-ecological model, the AEQUIPA network developed an interdisciplinary methodological design including quantitative/qualitative studies and systematic reviews, while combining expertise from diverse fields: public health, psychology, urban planning, sports sciences, health technology and geriatrics. AEQUIPA tackles key challenges when promoting physical activity (PA) in older adults: tailoring of interventions, fostering community readiness and participation, strengthening intersectoral collaboration, using new technological devices and evaluating intervention generated inequalities. AEQUIPA aims to strengthen the evidence base for age-specific preventive PA interventions and to yield new insights into the explanatory power of individual and contextual factors. Currently, the empirical work is still underway. First experiences indicate that thenetwork has achieved a strong regional linkage with communities, local stakeholders and individuals. However, involving inactive persons and individuals from minority groups remained challenging. A review of existing PA intervention studies among the elderly revealed the potential to assess equity effects. The results will add to the theoretical and methodological discussion on evidence-based age-specific PA interventions and will contribute to the discussion about European and national health targets.

Strategies to address management challenges in larger intensive care units.

PubMed

Matlakala, M C; Bezuidenhout, M C; Botha, A D H

2015-10-01

To illustrate the need for and suggest strategies that will enhance sustainable management of a large intensive care unit (ICU). The challenges faced by intensive care nursing in South Africa are well documented. However, there appear to be no strategies available to assist nurses to manage large ICUs or for ICU managers to deal with problems as they arise. Data sources to illustrate the need for strategies were challenges described by ICU managers in the management of large ICUs. A purposive sample of managers was included in individual interviews during compilation of evidence regarding the challenges experienced in the management of large ICUs. The challenges were presented at the Critical Care Society of Southern Africa Congress held on 28 August to 2 September 2012 in Sun City North-West province, South Africa. Five strategies are suggested for the challenges identified: divide the units into sections; develop a highly skilled and effective nursing workforce to ensure delivery of quality nursing care; create a culture to retain an effective ICU nursing team; manage assets; and determine the needs of ICU nurses. ICUs need measures to drive the desired strategies into actions to continuously improve the management of the unit. Future research should be aimed at investigating the effectiveness of the strategies identified. This research highlights issues relating to large ICUs and the strategies will assist ICU managers to deal with problems related to large unit sizes, shortage of trained ICU nurses, use of agency nurses, shortage of equipment and supplies and stressors in the ICU. The article will make a contribution to the body of nursing literature on management of ICUs. © 2014 John Wiley & Sons Ltd.

Addressing implementation challenges during guideline development - a case study of Swedish national guidelines for methods of preventing disease.

PubMed

Richter-Sundberg, Linda; Kardakis, Therese; Weinehall, Lars; Garvare, Rickard; Nyström, Monica E

2015-01-22

Many of the world's life threatening diseases (e.g. cancer, heart disease, stroke) could be prevented by eliminating life-style habits such as tobacco use, unhealthy diet, physical inactivity and excessive alcohol use. Incorporating evidence-based research on methods to change unhealthy lifestyle habits in clinical practice would be equally valuable. However gaps between guideline development and implementation are well documented, with implications for health care quality, safety and effectiveness. The development phase of guidelines has been shown to be important both for the quality in guideline content and for the success of implementation. There are, however, indications that guidelines related to general disease prevention methods encounter specific barriers compared to guidelines that are diagnosis-specific. In 2011 the Swedish National board for Health and Welfare launched guidelines with a preventive scope. The aim of this study was to investigate how implementation challenges were addressed during the development process of these disease preventive guidelines. Seven semi-structured interviews were conducted with members of the guideline development management group. Archival data detailing the guideline development process were also collected and used in the analysis. Qualitative data were analysed using content analysis as the analytical framework. The study identified several strategies and approaches that were used to address implementation challenges during guideline development. Four themes emerged from the analysis: broad agreements and consensus about scope and purpose; a formalized and structured development procedure; systematic and active involvement of stakeholders; and openness and transparency in the specific guideline development procedure. Additional factors concerning the scope of prevention and the work environment of guideline developers were perceived to influence the possibilities to address implementation issues. This case study

Addressing refugee health through evidence-based policies: a case study

PubMed Central

de Bocanegra, Heike Thiel; Carter-Pokras, Olivia; Ingleby, J. David; Pottie, Kevin; Tchangalova, Nedelina; Allen, Sophia I.; Smith-Gagen, Julie; Hidalgo, Bertha

2017-01-01

The cumulative total of persons forced to leave their country for fear of persecution or organized violence reached an unprecedented 24.5 million by the end of 2015. Providing equitable access to appropriate health services for these highly diverse newcomers poses challenges for receiving countries. In this case study, we illustrate the importance of translating epidemiology into policy to address the health needs of refugees by highlighting examples of what works as well as identifying important policy-relevant gaps in knowledge. First, we formed an international working group of epidemiologists and health services researchers to identify available literature on the intersection of epidemiology, policy, and refugee health. Second, we created a synopsis of findings to inform a recommendation for integration of policy and epidemiology to support refugee health in the US and other high-income receiving countries. Third, we identified eight key areas to guide the involvement of epidemiologists in addressing refugee health concerns. The complexity and uniqueness of refugee health issues, and the need to develop sustainable management information systems, require epidemiologists to expand their repertoire of skills to identify health patterns among arriving refugees, monitor access to appropriately designed health services, address inequities, and communicate with policy makers and multidisciplinary teams. PMID:28554498

Partitioned key-value store with atomic memory operations

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

Bent, John M.; Faibish, Sorin; Grider, Gary

A partitioned key-value store is provided that supports atomic memory operations. A server performs a memory operation in a partitioned key-value store by receiving a request from an application for at least one atomic memory operation, the atomic memory operation comprising a memory address identifier; and, in response to the atomic memory operation, performing one or more of (i) reading a client-side memory location identified by the memory address identifier and storing one or more key-value pairs from the client-side memory location in a local key-value store of the server; and (ii) obtaining one or more key-value pairs from themore » local key-value store of the server and writing the obtained one or more key-value pairs into the client-side memory location identified by the memory address identifier. The server can perform functions obtained from a client-side memory location and return a result to the client using one or more of the atomic memory operations.« less

Addressing HIV/AIDS challenges in Uganda: does social capital generation by NGOs matter?

PubMed

Muriisa, Roberts Kabeba; Jamil, Ishtiaq

2011-01-01

HIV/AIDS has had devastating impacts in many countries, Uganda in particular. However, Uganda is depicted as one of the most successful countries in fighting HIV/AIDS. Among others, Uganda's success story is attributed to the open general environment which allows open discussions surrounding HIV/AIDS when other countries such as South Africa and Kenya denied the existence of the disease in their countries. In addition, the success is attributed to the policy which allowed many actors to participate in the fight against the disease. The primary focus of this article is to map the process of social capital generation by NGOs and how social capital benefits enhance mitigation of HIV/AIDS challenges in Uganda. The key to social capital is nurturing relationships. In this regard, HIV/AIDS NGOs play a central role in the way individuals, groups and communities interact, and how various kinds of social relations are forged with people living with HIV/AIDS and especially for those who are HIV infected. NGOs' success in reducing the number of HIV/AIDS cases in Uganda is based on their abilities to generate social capital. This involves inclusion and building social networks and empowerment at the individual and community levels, and disseminating information to reduce social stigma as well as discrimination. We used a mixed-method strategy to collect data for this study. We used a structured questionnaire having quantitative and qualitative question sets which focused on different social capital measurement indicators. We used observations and in-depth face-to-face interviews. A major finding of the study is that the ways individuals and groups are connected and interact with each other are important mechanisms for alleviating HIV/AIDS challenges in Uganda.

Global Antimicrobial Stewardship: A Closer Look at the Formidable Implementation Challenges

PubMed Central

Tiong, John J. L.; Loo, Jason S. E.; Mai, Chun-Wai

2016-01-01

Antimicrobial stewardship (AMS) has been touted as one of the key strategies required in tackling worldwide escalation of antibiotic resistance. Although AMS has optimized antibiotic usage and reduced the incidence of resistance development in some regions, its full global potential has been curtailed by various AMS-impeding factors. This article seeks to highlight in a detailed perspective, the key challenges that hamper global AMS endeavors, some of which include the paucity of effective implementation strategies that cater for the challenging settings of developing nations, the slow response of governments, uncoordinated AMS activities as well as implementation fragmentation across different sectors and countries. The authors of this article call upon all stakeholders to pay attention to these seemingly obvious but often under-addressed problems. If left unresolved, this may render all current and future AMS initiatives pointless. PMID:27899924

Addressing educational challenges in veterinary medicine through the use of distance education.

PubMed

Murray, Amanda L; Sischo, William M

2007-01-01

The veterinary profession is currently facing many educational challenges, including an insufficient capacity to train and educate veterinarians for the multiple disciplines within the profession, a shortage of veterinarians in private and public practice, a shortage of faculty, a lack of human and professional diversity, and a rising cost of education resulting in extreme student debt loads. As a methodology for teaching, distance education (DE) has the potential to address many of these issues. By its very nature, DE can increase the capacity of current facilities and faculty. In addition, DE can allow students to acquire the necessary knowledge at less cost. This article describes a model for incorporating DE in the form of interactive Web-based courses, in conjunction with short, intensive residential programs, for the lecture portions of courses taught in the pre-veterinary, veterinary, and post-veterinary educational periods. In this model, the Web-based courses are used to convey the necessary core knowledge required at each step of the educational process. The residential portions are then used to apply the knowledge in such a way as to combine clinical applications with research in basic and applied sciences. Distance education can provide increased flexibility, high-quality educational experiences, and a less costly alternative for students while maximizing the reach of current faculty efforts and the capacity of existing physical structures.

Strategies to Address Challenging Behaviour in Young Children with Down Syndrome

ERIC Educational Resources Information Center

Feeley, Kathleen; Jones, Emily

2008-01-01

Children with Down syndrome are at an increased risk for engaging in challenging behaviour that may present problems within community, leisure, and educational settings, and, in many instances, precludes them from accessing these environments. Factors contributing to the occurrence of challenging behaviours include characteristics associated with…

Key issues and challenges in developing a pedagogical intervention in the simulation skills center--an action research study.

PubMed

Reierson, Inger Åse; Hvidsten, Anne; Wighus, Marianne; Brungot, Solvor; Bjørk, Ida Torunn

2013-07-01

Simulation skills centers (SSC) are considered important learning arenas for preparing and qualifying nursing students. Limited clinical placements and claims of diminished learning opportunities raise concerns that newly educated nurses lack proficiency in many psychomotor skills. Accordingly, there is an increased focus on learning in the SSC. However, it has been questioned if the pedagogical underpinning of teaching and learning in the SSC is missing or unclear. At a bachelor nursing education in Norway, there was a desire to change practice and enhance learning in the SSC by systematic use of The Model of Practical Skill Performance (Bjørk and Kirkevold, 2000). A participatory action research design was chosen. A pedagogical intervention was developed and implemented in 2010 in a cohort of eighty-seven first year bachelor nursing students during their basic nursing skill course. The intervention is shortly described. This article reports key issues and challenges that emerged during development of the new intervention. Data to inform the study were collected via thorough meeting minutes and the project leader's logbook, and analyzed using fieldnotes analysis. Six key issues and challenges were identified. These are presented and discussed consecutively in light of their importance for development and implementation of the new intervention. Copyright © 2013 Elsevier Ltd. All rights reserved.

Balancing the Tensions and Meeting the Conceptual Challenges of Education for Sustainable Development and Climate Change

ERIC Educational Resources Information Center

Blum, Nicole; Nazir, Joanne; Breiting, Soren; Goh, Kim Chuan; Pedretti, Erminia

2013-01-01

This paper addresses one of the key challenges for work on education, sustainable development and climate change: the overall conceptualisation of central ideas such as Environmental Education (EE), Education for Sustainable Development (ESD) and Climate Change Education (CCE). What do these concepts mean in diverse contexts and amongst diverse…

A strategy to address the nursing faculty shortage.

PubMed

Ganley, Barbara J; Sheets, Ingrid

2009-07-01

This article describes one university's experience in creating a master's geriatric clinical nurse specialist-nurse educator program to address the nursing faculty shortage and the need for geriatric clinical nurse specialists. The successes and challenges are outlined, and curricular ideas that may be beneficial to other nursing programs also are presented. This program has enhanced the university's pool of clinical instructors, increased its ability to provide services to older adults, and allowed faculty to instruct and focus undergraduates in the distinctions of geriatric nursing care. The biggest challenges faced were marketing and recruitment of nurses; these challenges were addressed, and possible solutions are offered. The most immediate benefit of this program was the generation of geriatric clinical nurse specialists.

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…

Addressing the challenges of ECMO simulation.

PubMed

Alinier, Guillaume; Hassan, Ibrahim Fawzy; Alsalemi, Abdullah; Al Disi, Mohammed; Ait Hssain, Ali; Labib, Ahmed; Alhomsi, Yahya; Bensaali, Fayçal; Amira, Abbes; Ibrahim, Abdulsalam Saif

2018-05-01

The patient's condition and high-risk nature of extracorporeal membrane oxygenation (ECMO) therapy force clinical services to ensure clinicians are properly trained and always ready to deal effectively with critical situations. Simulation-based education (SBE), from the simplest approaches to the most immersive modalities, helps promote optimum individual and team performance. The risks of SBE are negative learning, inauthenticity in learning and over-reliance on the participants' suspension of disbelief. This is especially relevant to ECMO SBE as circuit/patient interactions are difficult to fully simulate without confusing circuit alterations. Our efforts concentrate on making ECMO simulation easier and more realistic in order to reduce the current gap there is between SBE and real ECMO patient care. Issues to be overcome include controlling the circuit pressures, system failures, patient issues, blood colour and cost factors. Key to our developments are the hospital-university collaboration and research funding. A prototype ECMO simulator has been developed that allows for realistic ECMO SBE. The system emulates the ECMO machine interface with remotely controllable pressure parameters, haemorrhaging, line chattering, air bubble noise and simulated blood colour change. The prototype simulator allows the simulation of common ECMO emergencies through innovative solutions that enhance the fidelity of ECMO SBE and reduce the requirement for suspension of disbelief from participants. Future developments will encompass the patient cannulation aspect.

Ethical challenges facing veterinary professionals in Ireland: results from Policy Delphi with vignette methodology

PubMed Central

Magalhães-Sant'Ana, M.; More, S. J.; Morton, D. B.; Hanlon, A.

2016-01-01

Ethics is key to the integrity of the veterinary profession. Despite its importance, there is a lack of applied research on the range of ethical challenges faced by veterinarians. A three round Policy Delphi with vignette methodology was used to record the diversity of views on ethical challenges faced by veterinary professionals in Ireland. Forty experts, comprising veterinary practitioners, inspectors and nurses, accepted to participate. In round 1, twenty vignettes describing a variety of ethically challenging veterinary scenarios were ranked in terms of ethical acceptability, reputational risk and perceived standards of practice. Round 2 aimed at characterising challenges where future policy development or professional guidance was deemed to be needed. In round 3, possible solutions to key challenges were explored. Results suggest that current rules and regulations are insufficient to ensure best veterinary practices and that a collective approach is needed to harness workable solutions for the identified ethical challenges. Challenges pertaining mostly to the food chain seem to require enforcement measures whereas softer measures that promote professional discretion were preferred to address challenges dealing with veterinary clinical services. These findings can support veterinary representative bodies, advisory committees and regulatory authorities in their decision making, policy and regulation. PMID:27613779

Ethical challenges facing veterinary professionals in Ireland: results from Policy Delphi with vignette methodology.

PubMed

Magalhães-Sant'Ana, M; More, S J; Morton, D B; Hanlon, A

2016-10-29

Ethics is key to the integrity of the veterinary profession. Despite its importance, there is a lack of applied research on the range of ethical challenges faced by veterinarians. A three round Policy Delphi with vignette methodology was used to record the diversity of views on ethical challenges faced by veterinary professionals in Ireland. Forty experts, comprising veterinary practitioners, inspectors and nurses, accepted to participate. In round 1, twenty vignettes describing a variety of ethically challenging veterinary scenarios were ranked in terms of ethical acceptability, reputational risk and perceived standards of practice. Round 2 aimed at characterising challenges where future policy development or professional guidance was deemed to be needed. In round 3, possible solutions to key challenges were explored. Results suggest that current rules and regulations are insufficient to ensure best veterinary practices and that a collective approach is needed to harness workable solutions for the identified ethical challenges. Challenges pertaining mostly to the food chain seem to require enforcement measures whereas softer measures that promote professional discretion were preferred to address challenges dealing with veterinary clinical services. These findings can support veterinary representative bodies, advisory committees and regulatory authorities in their decision making, policy and regulation. British Veterinary Association.

Experiences addressing health-related financial challenges with disease management among African American women with asthma.

PubMed

Patel, Minal R; Caldwell, Cleopatra H; Id-Deen, Effat; Clark, Noreen M

2014-06-01

Despite economic hardship, compliance with self-management regimens is still evident among individuals and families managing chronic disease. The purpose of this study was to describe how women with asthma address cost-related challenges to management of their condition. In 2012 and 2013, four focus groups were conducted in Southeast Michigan with 26 African American women with asthma, recruited based on maximum variation sampling procedures. A semi-structured interview protocol was employed by trained facilitators. Coded transcripts were analyzed for themes regarding means to reduce the impact of the cost of asthma management. Major themes identified were acceptance of the status quo; stockpiling and sharing medicines; utilizing community assistance programs; reaching out to healthcare providers and social networks for help; foregoing self-management; and utilizing urgent care. Awareness of strategies that are helpful to patients in reducing out-of-pocket costs may better equip service providers and others to develop interventions to make useful strategies more widely available.

Experiences addressing health-related financial challenges with disease management among African American women with asthma

PubMed Central

Patel, Minal R.; Caldwell, Cleopatra H.; Id-Deen, Effat; Clark, Noreen M.

2018-01-01

Objective Despite economic hardship, compliance with self-management regimens is still evident among individuals and families managing chronic disease. The purpose of this study was to describe how women with asthma address cost-related challenges to management of their condition. Methods In 2012 and 2013, four focus groups were conducted in Southeast Michigan with 26 African American women with asthma, recruited based on maximum variation sampling procedures. A semi-structured interview protocol was employed by trained facilitators. Coded transcripts were analyzed for themes regarding means to reduce the impact of the cost of asthma management. Results Major themes identified were acceptance of the status quo; stockpiling and sharing medicines; utilizing community assistance programs; reaching out to healthcare providers and social networks for help; foregoing self-management; and utilizing urgent care. Conclusions Awareness of strategies that are helpful to patients in reducing out-of-pocket costs may better equip service providers and others to develop interventions to make useful strategies more widely available. PMID:24471517

Key factors of clinical research network capacity building.

PubMed

Li, Guowei; Wu, Qianyu; Jin, Yanling; Vanniyasingam, Thuva; Thabane, Lehana

2018-01-01

In general, clinical research network capacity building refers to programs aimed at enhancing networks of researchers to conduct clinical research. Although in the literature there is a large body of research on how to develop and build capacity in clinical research networks, the conceptualizations and implementations remain controversial and challenging. Moreover, the experiences learnt from the past accomplishments and failures can assist in the future capacity building efforts to be more practical, effective and efficient. In this paper, we aim to provide an overview of capacity building in clinical research network by (1) identifying the key barriers to clinical research network capacity building, (2) providing insights into how to overcome those obstacles, and (3) sharing our experiences in collaborating with national and international partners to build capacity in clinical research networks. In conclusion, we have provided some insight into how to address the key factors of clinical research network capacity building and shared some empirical experiences. A successful capacity building practice requires a joint endeavor to procure sufficient resources and support from the relevant stakeholders, to ensure its efficiency, cost-effectiveness, and sustainability.

Challenges of standardized continuous quality improvement programs in community pharmacies: the case of SafetyNET-Rx.

PubMed

Boyle, Todd A; MacKinnon, Neil J; Mahaffey, Thomas; Duggan, Kellie; Dow, Natalie

2012-01-01

Research on continuous quality improvement (CQI) in community pharmacies lags in comparison to service, manufacturing, and various health care sectors. As a result, very little is known about the challenges community pharmacies face when implementing CQI programs in general, let alone the challenges of implementing a standardized and technologically sophisticated one. This research identifies the initial challenges of implementing a standardized CQI program in community pharmacies and how such challenges were addressed by pharmacy staff. Through qualitative interviews, a multisite study of the SafetyNET-Rx CQI program involving community pharmacies in Nova Scotia, Canada, was performed to identify such challenges. Interviews were conducted with the CQI facilitator (ie, staff pharmacist or technician) in 55 community pharmacies that adopted the SafetyNET-Rx program. Of these 55 pharmacies, 25 were part of large national corporate chains, 22 were part of banner chains, and 8 were independent pharmacies. A total of 10 different corporate chains and banners were represented among the 55 pharmacies. Thematic content analysis using well-established coding procedures was used to explore the interview data and elicit the key challenges faced. Six major challenges were identified, specifically finding time to report, having all pharmacy staff involved in quality-related event (QRE) reporting, reporting apprehensiveness, changing staff relationships, meeting to discuss QREs, and accepting the online technology. Challenges were addressed in a number of ways including developing a manual-online hybrid reporting system, managers paying staff to meet after hours, and pharmacy managers showing visible commitment to QRE reporting and learning. This research identifies key challenges to implementing CQI programs in community pharmacies and also provides a starting point for future research relating to how the challenges of QRE reporting and learning in community pharmacies change

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.

Practical Challenges of Systems Thinking and Modeling in Public Health

PubMed Central

Trochim, William M.; Cabrera, Derek A.; Milstein, Bobby; Gallagher, Richard S.; Leischow, Scott J.

2006-01-01

Objectives. Awareness of and support for systems thinking and modeling in the public health field are growing, yet there are many practical challenges to implementation. We sought to identify and describe these challenges from the perspectives of practicing public health professionals. Methods. A systems-based methodology, concept mapping, was used in a study of 133 participants from 2 systems-based public health initiatives (the Initiative for the Study and Implementation of Systems and the Syndemics Prevention Network). This method identified 100 key challenges to implementation of systems thinking and modeling in public health work. Results. The project resulted in a map identifying 8 categories of challenges and the dynamic interactions among them. Conclusions. Implementation by public health professionals of the 8 simple rules we derived from the clusters in the map identified here will help to address challenges and improve the organization of systems that protect the public’s health. PMID:16449581

End-of-life care in advanced kidney disease: ethical and legal issues and key challenges for black and minority ethnic groups.

PubMed

Cronin, Antonia J

2014-09-01

Advances in modern medical technology have gone so far that it is now possible for machinery to keep people alive. To some extent this has led to a misperception in society that death can almost always be postponed because life-sustaining extracorporeal machinery of some sort or another, for example a dialysis machine, can prevent it. However, for some, being kept alive connected to a dialysis machine for four hours three times a week does not represent or even come close to an existence or quality of life they consider valuable. It may even cause unnecessary distress. This may be because they have reached a point at the end of their lives where they would like the focus of their treatment or care to become that which enables them to live as well as possible until they die. In these circumstances treatment and care should properly be that which enables the supportive and palliative care needs of both patient and family to be identified and met throughout the last phase of life and into bereavement. Identifying and acknowledging the importance of such a paradigm shift in the delivery of healthcare, and above all facilitating it, includes taking on the responsibility, incumbent upon us all, to address the ethical issues that are brought into focus. In this paper, I examine some of these issues. I consider the ways in which underlying theoretical ethical principles have informed the development of professional guidance and highlight the dynamic relationship this guidance has with the law. Finally, I demonstrate the ways in which it can be usefully applied to inform and assist clinical decision-making. Key challenges for BAME groups are addressed. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

The Untold Story: Examining Ontario's Community Health Centres' Initiatives to Address Upstream Determinants of Health

PubMed Central

Collins, Patricia A.; Resendes, Sarah J.; Dunn, James R.

2014-01-01

Background: Unlike traditional primary care centres, part of the Community Health Centre (CHC) mandate is to address upstream health determinants. In Ontario, CHCs refer to these activities as Community Initiatives (CIs); yet, little is known about how CIs operate. The objective of this study was to examine the scope, resource requirements, partnerships, successes and challenges among selected Ontario CIs. Methods: We conducted qualitative interviews with 10 CHC staff members representing 11 CIs across Ontario. CIs were identified through an online inventory, recruited by e-mail and interviewed between March and June 2011. Results: Most CIs aim to increase community participation, while addressing social isolation and poverty. They draw minimal financial resources from their CHC, and employ highly skilled staff to support implementation. Most enlist support from various partners, and use numerous methods for community engagement. Successes include improved community relations, increased opportunities for education and employment and rewarding partnerships, while insufficient funding was a commonly identified challenge. Conclusions: Despite minimal attention from researchers and funders, our findings suggest that CIs play key capacity-building roles in vulnerable communities across Ontario, and warrant further investigation. PMID:25410693

Addressing risks to advance mental health research.

PubMed

Iltis, Ana S; Misra, Sahana; Dunn, Laura B; Brown, Gregory K; Campbell, Amy; Earll, Sarah A; Glowinski, Anne; Hadley, Whitney B; Pies, Ronald; Dubois, James M

2013-12-01

Risk communication and management are essential to the ethical conduct of research, yet addressing risks may be time consuming for investigators and institutional review boards may reject study designs that seem too risky. This can discourage needed research, particularly in higher-risk protocols or those enrolling potentially vulnerable individuals, such as those with some level of suicidality. Improved mechanisms for addressing research risks may facilitate much needed psychiatric research. To provide mental health researchers with practical approaches to (1) identify and define various intrinsic research risks, (2) communicate these risks to others (eg, potential participants, regulatory bodies, and society), (3) manage these risks during the course of a study, and (4) justify the risks. As part of a National Institute of Mental Health-funded scientific meeting series, a public conference and a closed-session expert panel meeting were held on managing and disclosing risks in mental health clinical trials. The expert panel reviewed the literature with a focus on empirical studies and developed recommendations for best practices and further research on managing and disclosing risks in mental health clinical trials. No institutional review board-review was required because there were no human subjects. Challenges, current data, practical strategies, and topics for future research are addressed for each of 4 key areas pertaining to management and disclosure of risks in clinical trials: identifying and defining risks, communicating risks, managing risks during studies, and justifying research risks. Empirical data on risk communication, managing risks, and the benefits of research can support the ethical conduct of mental health research and may help investigators better conceptualize and confront risks and to gain institutional review board-approval.

Technological challenges of addressing new and more complex migrating products from novel food packaging materials.

PubMed

Munro, Ian C; Haighton, Lois A; Lynch, Barry S; Tafazoli, Shahrzad

2009-12-01

The risk assessment of migration products resulting from packaging material has and continues to pose a difficult challenge. In most jurisdictions, there are regulatory requirements for the approval or notification of food contact substances that will be used in packaging. These processes generally require risk assessment to ensure safety concerns are addressed. The science of assessing food contact materials was instrumental in the development of the concept of Threshold of Regulation and the Threshold of Toxicological Concern procedures. While the risk assessment process is in place, the technology of food packaging continues to evolve to include new initiatives, such as the inclusion of antimicrobial substances or enzyme systems to prevent spoilage, use of plastic packaging intended to remain on foods as they are being cooked, to the introduction of more rigid, stable and reusable materials, and active packaging to extend the shelf-life of food. Each new technology brings with it the potential for exposure to new and possibly novel substances as a result of migration, interaction with other chemical packaging components, or, in the case of plastics now used in direct cooking of products, degradation products formed during heating. Furthermore, the presence of trace levels of certain chemicals from packaging that were once accepted as being of low risk based on traditional toxicology studies are being challenged on the basis of reports of adverse effects, particularly with respect to endocrine disruption, alleged to occur at very low doses. A recent example is the case of bisphenol A. The way forward to assess new packaging technologies and reports of very low dose effects in non-standard studies of food contact substances is likely to remain controversial. However, the risk assessment paradigm is sufficiently robust and flexible to be adapted to meet these challenges. The use of the Threshold of Regulation and the Threshold of Toxicological Concern concepts may

Challenging Assumptions: What Do We Need to Address in Our Disaster Risk Reduction Efforts?

PubMed

Codreanu, Tudor A; Ngo, Hanh; Robertson, Andrew; Celenza, Antonio

2017-04-01

Introduction Specific knowledge and skills are required, especially in the first 72 hours post-disaster, to bridge the time gap until essential services are restored and Emergency Medical Services (EMS) can focus on individuals' needs. This study explores disaster knowledge and preparedness in the first 72 hours as a function of the individual's engagement in discussions about disasters, and several other factors (both at personal and community/country level), as well as the entities/organizations perceived by the individual as being responsible for disaster risk reduction (DRR) education. A prospective, cross-sectional survey of 3,829 final-year high-school students was conducted in nine countries with different levels of disaster risk and economic development. Regression analyses examined the relationship between a 72-hour disaster preparedness composite outcome (ability to make water safe for drinking, knowledge of water potability, home evacuation skill, and improvising a safe room) and a series of independent predictors. Respondents from countries with lower economic development were significantly better prepared for the first 72 hours post-disaster than those from developed countries (OR=767.45; CI=13.75-48,822.94; P=.001). While several independent predictors showed a significant main effect, combined disaster risk education (DRE) efforts, as a partnership between school and local government, had the best predictive value (OR=3.52; CI=1.48-8.41; P=.005). Disaster preparedness in final-year high-school students is significantly better in developing countries. Further improvement requires a convergent effort in aligning the most effective educational policies and actions to best address the individual's and the community needs. Codreanu TA , Ngo H , Robertson A , Celenza A . Challenging assumptions: what do we need to address in our disaster risk reduction efforts? Prehosp Disaster Med. 2017;32(2):134-147.

Evaluating programs that address ideological issues: ethical and practical considerations for practitioners and evaluators.

PubMed

Lieberman, Lisa D; Fagen, Michael C; Neiger, Brad L

2014-03-01

There are important practical and ethical considerations for organizations in conducting their own, or commissioning external, evaluations and for both practitioners and evaluators, when assessing programs built on strongly held ideological or philosophical approaches. Assessing whether programs "work" has strong political, financial, and/or moral implications, particularly when expending public dollars, and may challenge objectivity about a particular program or approach. Using a case study of the evaluation of a school-based abstinence-until-marriage program, this article discusses the challenges, lessons learned, and ethical responsibilities regarding decisions about evaluation, specifically associated with ideologically driven programs. Organizations should consider various stakeholders and views associated with their program to help identify potential pitfalls in evaluation. Once identified, the program or agency needs to carefully consider its answers to two key questions: Do they want the answer and are they willing to modify the program? Having decided to evaluate, the choice of evaluator is critical to assuring that ethical principles are maintained and potential skepticism or criticism of findings can be addressed appropriately. The relationship between program and evaluator, including agreements about ownership and eventual publication and/or promotion of data, should be addressed at the outset. Programs and organizations should consider, at the outset, their ethical responsibility when findings are not expected or desired. Ultimately, agencies, organizations, and programs have an ethical responsibility to use their data to provide health promotion programs, whether ideologically founded or not, that appropriately and effectively address the problems they seek to solve.

Notification: FY 2017 Update of Proposed Key Management Challenges and Internal Control Weaknesses Confronting the U.S. Chemical Safety and Hazard Investigation Board

EPA Pesticide Factsheets

Jan 5, 2017. The EPA OIG is beginning work to update for fiscal year 2017 its list of proposed key management challenges and internal control weaknesses confronting the U.S. Chemical Safety and Hazard Investigation Board (CSB).

Addressing metacognitive capacity for self reflection in the psychotherapy for schizophrenia: a conceptual model of the key tasks and processes.

PubMed

Lysaker, Paul H; Buck, Kelly D; Carcione, Antonino; Procacci, Michelle; Salvatore, Giampaolo; Nicolò, Guiseppe; Dimaggio, Giancarlo

2011-03-01

Recognition that recovery from schizophrenia may involve a deepening of the experience of being in the world has led to the possibility that psychotherapy may play a key role in treatment by enhancing metacognition, or the capacity to think about thinking. While the potential of psychotherapy to enhance metacognition in non-psychotic disorders has been discussed in depth, little has been written about how psychotherapy may systematically address metacognition in schizophrenia. Accordingly, the current paper formulates a model of how psychotherapy might address one specific element of metacognition, namely self-reflectivity. Procedures are outlined for assessing clients' capacity for self-reflectivity within narrative contexts during psychotherapy. Targeted interventions are identified which are tailored to clients' capacities in the moment and which assist clients to think about their own thinking at the level of which they are capable. This may lead clients over time to develop a greater ability to engage in acts of increasingly complex self-reflectivity. Individual psychotherapy can be modified and utilized to assist persons with schizophrenia to move towards recovery by assisting them to develop the capacity for self-reflectivity. This may lead to clients having a fuller experience of themselves as a being in the world with a richer and more coherent personal narrative. © 2010 The British Psychological Society.

Study of Health Outcomes in School Children: Key Challenges and Lessons Learned from the Framingham Schools' Natural History of Nevi Study

ERIC Educational Resources Information Center

Geller, Alan C.; Oliveria, Susan A.; Bishop, Marilyn; Buckminster, Marcia; Brooks, Katie R.; Halpern, Allan C.

2007-01-01

Background: We describe the planning, recruitment, key challenges, and lessons learned in the development of a study of the evolution of nevi (moles) among children in a school setting. Methods: This population-based study of digital photography and dermoscopy of the child's back (overview, close-up, and dermoscopic images) and genetic specimens…

RSA-Based Password-Authenticated Key Exchange, Revisited

NASA Astrophysics Data System (ADS)

Shin, Seonghan; Kobara, Kazukuni; Imai, Hideki

The RSA-based Password-Authenticated Key Exchange (PAKE) protocols have been proposed to realize both mutual authentication and generation of secure session keys where a client is sharing his/her password only with a server and the latter should generate its RSA public/private key pair (e, n), (d, n) every time due to the lack of PKI (Public-Key Infrastructures). One of the ways to avoid a special kind of off-line (so called e-residue) attacks in the RSA-based PAKE protocols is to deploy a challenge/response method by which a client verifies the relative primality of e and φ(n) interactively with a server. However, this kind of RSA-based PAKE protocols did not give any proof of the underlying challenge/response method and therefore could not specify the exact complexity of their protocols since there exists another security parameter, needed in the challenge/response method. In this paper, we first present an RSA-based PAKE (RSA-PAKE) protocol that can deploy two different challenge/response methods (denoted by Challenge/Response Method1 and Challenge/Response Method2). The main contributions of this work include: (1) Based on the number theory, we prove that the Challenge/Response Method1 and the Challenge/Response Method2 are secure against e-residue attacks for any odd prime e (2) With the security parameter for the on-line attacks, we show that the RSA-PAKE protocol is provably secure in the random oracle model where all of the off-line attacks are not more efficient than on-line dictionary attacks; and (3) By considering the Hamming weight of e and its complexity in the. RSA-PAKE protocol, we search for primes to be recommended for a practical use. We also compare the RSA-PAKE protocol with the previous ones mainly in terms of computation and communication complexities.

Nuclear Explosion Monitoring Advances and Challenges

NASA Astrophysics Data System (ADS)

Baker, G. E.

2015-12-01

We address the state-of-the-art in areas important to monitoring, current challenges, specific efforts that illustrate approaches addressing shortcomings in capabilities, and additional approaches that might be helpful. The exponential increase in the number of events that must be screened as magnitude thresholds decrease presents one of the greatest challenges. Ongoing efforts to exploit repeat seismic events using waveform correlation, subspace methods, and empirical matched field processing holds as much "game-changing" promise as anything being done, and further efforts to develop and apply such methods efficiently are critical. Greater accuracy of travel time, signal loss, and full waveform predictions are still needed to better locate and discriminate seismic events. Important developments include methods to model velocities using multiple types of data; to model attenuation with better separation of source, path, and site effects; and to model focusing and defocusing of surface waves. Current efforts to model higher frequency full waveforms are likely to improve source characterization while more effective estimation of attenuation from ambient noise holds promise for filling in gaps. Censoring in attenuation modeling is a critical problem to address. Quantifying uncertainty of discriminants is key to their operational use. Efforts to do so for moment tensor (MT) inversion are particularly important, and fundamental progress on the statistics of MT distributions is the most important advance needed in the near term in this area. Source physics is seeing great progress through theoretical, experimental, and simulation studies. The biggest need is to accurately predict the effects of source conditions on seismic generation. Uniqueness is the challenge here. Progress will depend on studies that probe what distinguishes mechanisms, rather than whether one of many possible mechanisms is consistent with some set of observations.

Neoepitopes as cancer immunotherapy targets: key challenges and opportunities.

PubMed

Brennick, Cory A; George, Mariam M; Corwin, William L; Srivastava, Pramod K; Ebrahimi-Nik, Hakimeh

2017-03-01

Over the last half century, it has become well established that cancers can elicit a host immune response that can target them with high specificity. Only within the last decade, with the advances in high-throughput gene sequencing and bioinformatics approaches, are we now on the forefront of harnessing the host's immune system to treat cancer. Recently, some strides have been taken toward understanding effective tumor-specific MHC I restricted epitopes or neoepitopes. However, many fundamental questions still remain to be addressed before this therapy can live up to its full clinical potential. In this review, we discuss the major hurdles that lie ahead and the work being done to address them.

The importance of fungi and mycology for addressing major global challenges*.

PubMed

Lange, Lene

2014-12-01

In the new bioeconomy, fungi play a very important role in addressing major global challenges, being instrumental for improved resource efficiency, making renewable substitutes for products from fossil resources, upgrading waste streams to valuable food and feed ingredients, counteracting life-style diseases and antibiotic resistance through strengthening the gut biota, making crop plants more robust to survive climate change conditions, and functioning as host organisms for production of new biological drugs. This range of new uses of fungi all stand on the shoulders of the efforts of mycologists over generations: the scientific discipline mycology has built comprehensive understanding within fungal biodiversity, classification, evolution, genetics, physiology, ecology, pathogenesis, and nutrition. Applied mycology could not make progress without this platform. To unfold the full potentials of what fungi can do for both environment and man we need to strengthen the field of mycology on a global scale. The current mission statement gives an overview of where we are, what needs to be done, what obstacles to overcome, and which potentials are within reach. It further provides a vision for how mycology can be strengthened: The time is right to make the world aware of the immense importance of fungi and mycology for sustainable global development, where land, water and biological materials are used in a more efficient and more sustainable manner. This is an opportunity for profiling mycology by narrating the role played by fungi in the bioeconomy. Greater awareness and appreciation of the role of fungi can be used to build support for mycology around the world. Support will attract more talent to our field of study, empower mycologists around the world to generate more funds for necessary basic research, and strengthen the global mycology network. The use of fungi for unlocking the full potentials of the bioeconomy relies on such progress. The fungal kingdom can be an

Can estrogens be considered as key elements of the challenge hypothesis? The case of intrasexual aggression in a cichlid fish.

PubMed

Scaia, María Florencia; Morandini, Leonel; Noguera, CristobalAlejandro; Trudeau, Vance L; Somoza, Gustavo Manuel; Pandolfi, Matías

2018-06-20

Territorial aggression has been widely studied in males and it has been historically suggested that androgens are key mediators of this behavior. However, more recent evidence suggests that it is the aromatization to estrogens, rather than androgens themselves, that is key to regulating this behavior. Females also display aggressive behaviors, but the physiological regulation of female aggression is still understudied when compared to males. In this context, the challenge hypothesis postulates that male-male aggressive interactions stimulate the production of androgens in males in periods of social instability. Here we determine plasma sex steroid levels in Cichlasoma dimerus to assess whether estrogens are related to aggressive behavior and to test the challenge hypothesis in both males and females. We set-up challenge trials as intrasexual dyadic encounters and determined androgen and estrogen levels before and after the trial in both winners and losers. Even though there were no differences in initial estradiol-17β plasma levels between male winners and losers, initial levels were higher (p = .046) in female winners than in losers, while there were no differences in testosterone or 11-ketotestosterone levels. After trials, both males and females showed elevated levels of estradiol-17β and both androgens, but only males exhibited a significant 1.45, 5.42 and 3.2-fold increase in estradiol-17β, testosterone and 11-ketotestosterone, respectively (p = .023, p = .016, p = .018). Moreover, changes in circulating levels of estradiol-17β in females after the trials do not depend on their reproductive status or on the outcome of the contest. We suggest that female aggression is associated with initial levels of estradiol-17β, and that the challenge hypothesis, originally defined for androgens, could also be extended to estrogens. Copyright © 2018. Published by Elsevier Inc.

A Canadian Effort to Address Fractions Teaching and Learning Challenges

ERIC Educational Resources Information Center

Yearley, Shelley; Bruce, Catherine D.

2014-01-01

Teaching and learning fraction concepts provides challenges in primary schools all over the world. In this article, Shelley Yearley and Catherine Bruce describe a fractions-based research project conducted in Ontario, Canada.

Microsurgery robots: addressing the needs of high-precision surgical interventions.

PubMed

Mattos, Leonardo S; Caldwell, Darwin G; Peretti, Giorgio; Mora, Francesco; Guastini, Luca; Cingolani, Roberto

2016-01-01

Robotics has a significant potential to enhance the overall capacity and efficiency of healthcare systems. Robots can help surgeons perform better quality operations, leading to reductions in the hospitalisation time of patients and in the impact of surgery on their postoperative quality of life. In particular, robotics can have a significant impact on microsurgery, which presents stringent requirements for superhuman precision and control of the surgical tools. Microsurgery is, in fact, expected to gain importance in a growing range of surgical specialties as novel technologies progressively enable the detection, diagnosis and treatment of diseases at earlier stages. Within such scenarios, robotic microsurgery emerges as one of the key components of future surgical interventions, and will be a vital technology for addressing major surgical challenges. Nonetheless, several issues have yet to be overcome in terms of mechatronics, perception and surgeon-robot interfaces before microsurgical robots can achieve their full potential in operating rooms. Research in this direction is progressing quickly and microsurgery robot prototypes are gradually demonstrating significant clinical benefits in challenging applications such as reconstructive plastic surgery, ophthalmology, otology and laryngology. These are reassuring results offering confidence in a brighter future for high-precision surgical interventions.

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.

Numerical simulation of turbulent combustion: Scientific challenges

NASA Astrophysics Data System (ADS)

Ren, ZhuYin; Lu, Zhen; Hou, LingYun; Lu, LiuYan

2014-08-01

Predictive simulation of engine combustion is key to understanding the underlying complicated physicochemical processes, improving engine performance, and reducing pollutant emissions. Critical issues as turbulence modeling, turbulence-chemistry interaction, and accommodation of detailed chemical kinetics in complex flows remain challenging and essential for high-fidelity combustion simulation. This paper reviews the current status of the state-of-the-art large eddy simulation (LES)/prob-ability density function (PDF)/detailed chemistry approach that can address the three challenging modelling issues. PDF as a subgrid model for LES is formulated and the hybrid mesh-particle method for LES/PDF simulations is described. Then the development need in micro-mixing models for the PDF simulations of turbulent premixed combustion is identified. Finally the different acceleration methods for detailed chemistry are reviewed and a combined strategy is proposed for further development.

Implementing Peer Learning in Clinical Education: A Framework to Address Challenges In the "Real World".

PubMed

Tai, Joanna Hong Meng; Canny, Benedict J; Haines, Terry P; Molloy, Elizabeth K

2017-01-01

Phenomenon: Peer learning has many benefits and can assist students in gaining the educational skills required in future years when they become teachers themselves. Peer learning may be particularly useful in clinical learning environments, where students report feeling marginalized, overwhelmed, and unsupported. Educational interventions often fail in the workplace environment, as they are often conceived in the "ideal" rather than the complex, messy real world. This work sought to explore barriers and facilitators to implementing peer learning activities in a clinical curriculum. Previous peer learning research results and a matrix of empirically derived peer learning activities were presented to local clinical education experts to generate discussion around the realities of implementing such activities. Potential barriers and limitations of and strategies for implementing peer learning in clinical education were the focus of the individual interviews. Thematic analysis of the data identified three key considerations for real-world implementation of peer learning: culture, epistemic authority, and the primacy of patient-centered care. Strategies for peer learning implementation were also developed from themes within the data, focusing on developing a culture of safety in which peer learning could be undertaken, engaging both educators and students, and establishing expectations for the use of peer learning. Insights: This study identified considerations and strategies for the implementation of peer learning activities, which took into account both educator and student roles. Reported challenges were reflective of those identified within the literature. The resultant framework may aid others in anticipating implementation challenges. Further work is required to test the framework's application in other contexts and its effect on learner outcomes.

Message Variability and Heterogeneity: A Core Challenge for Communication Research

PubMed Central

Slater, Michael D.; Peter, Jochen; Valkenberg, Patti

2015-01-01

Messages are central to human social experience, and pose key conceptual and methodological challenges in the study of communication. In response to these challenges, we outline a systematic approach to conceptualizing, operationalizing, and analyzing messages. At the conceptual level, we distinguish between two core aspects of messages: message variability (the defined and operationalized features of messages) and message heterogeneity (the undefined and unmeasured features of messages), and suggest preferred approaches to defining message variables. At the operational level, we identify message sampling, selection, and research design strategies responsive to issues of message variability and heterogeneity in experimental and survey research. At the analytical level, we highlight effective techniques to deal with message variability and heterogeneity. We conclude with seven recommendations to increase rigor in the study of communication through appropriately addressing the challenges presented by messages. PMID:26681816

Addressing refugee health through evidence-based policies: a case study.

PubMed

Thiel de Bocanegra, Heike; Carter-Pokras, Olivia; Ingleby, J David; Pottie, Kevin; Tchangalova, Nedelina; Allen, Sophia I; Smith-Gagen, Julie; Hidalgo, Bertha

2018-06-01

The cumulative total of persons forced to leave their country for fear of persecution or organized violence reached an unprecedented 24.5 million by the end of 2015. Providing equitable access to appropriate health services for these highly diverse newcomers poses challenges for receiving countries. In this case study, we illustrate the importance of translating epidemiology into policy to address the health needs of refugees by highlighting examples of what works as well as identifying important policy-relevant gaps in knowledge. First, we formed an international working group of epidemiologists and health services researchers to identify available literature on the intersection of epidemiology, policy, and refugee health. Second, we created a synopsis of findings to inform a recommendation for integration of policy and epidemiology to support refugee health in the United States and other high-income receiving countries. Third, we identified eight key areas to guide the involvement of epidemiologists in addressing refugee health concerns. The complexity and uniqueness of refugee health issues, and the need to develop sustainable management information systems, require epidemiologists to expand their repertoire of skills to identify health patterns among arriving refugees, monitor access to appropriately designed health services, address inequities, and communicate with policy makers and multidisciplinary teams. Copyright © 2017 Elsevier Inc. All rights reserved.

Challenges for strengthening the health workforce in the Lao People's Democratic Republic: perspectives from key stakeholders.

PubMed

Qian, Yi; Yan, Fei; Wang, Wei; Clancy, Shayna; Akkhavong, Kongsap; Vonglokham, Manithong; Outhensackda, Somphou; Østbye, Truls

2016-11-29

The Lao People's Democratic Republic is facing a critical shortage and maldistribution of health workers. Strengthening of the health workforce has been adopted as one of the five priorities of the National Health Sector Strategy (2013-2025). This study aims to identify, explore, and better understand the key challenges for strengthening the Laotian health workforce. This study applied exploratory and descriptive qualitative methods and adapted a working life-span framework. Twenty-three key stakeholders with particular insights into the current situation of the health workforce were purposively recruited for in-depth interviews. Important policy documents were also collected from key informants during the interviews. Thematic analysis was employed for the textual data using MAXQDA 10. The overarching problem is that there is a perceived severe shortage of skilled health workers (doctors, nurses, and midwives) and lab technicians, especially in primary health facilities and rural areas. Key informants also identified five problems: insufficient production of health workers both in quantity and quality, a limited national budget to recruit enough health staff and provide sufficient and equitable salaries and incentives, limited management capacity, poor recruitment for work in rural areas, and lack of well-designed continuing education programs for professional development. These problems are interrelated, both in how the issues arise and in the effect they have on one another. To improve the distribution of health workers in rural areas, strategies for increasing production and strengthening retention should be well integrated for better effectiveness. It is also essential to take the Laotian-specific context into consideration during intervention development and implementation. Furthermore, the government should acknowledge the inadequate health management capacity and invest to improve human resource management capacity at all levels. Finally, assessment of

Scoping review of health promotion and disease prevention interventions addressed to elderly people.

PubMed

Duplaga, Mariusz; Grysztar, Marcin; Rodzinka, Marcin; Kopec, Agnieszka

2016-09-05

The ageing of modern societies remains one of the greatest challenges for health and social systems. To respond to this challenge, we need effective strategies assuring healthy active life for elderly people. Health promotion and related activities are perceived as a key intervention, which can improve wellbeing in later life. The main aim of this study is the identification and classification of such interventions addressed to older adults and elderly. Therefore, the strategy based on the scoping review as a feasible tool for exploring this domain, summarizing research findings and identifying gaps of evidence, was applied. The scoping review relies on the analysis of previous reviews of interventions aimed at older adults (55-64 years old) and elderly persons (65 years and above) assessed for their effectiveness in the framework of a systematic review and/or meta-analysis. The search strategy was based on the identification of interventions reported as health promotion, primary disease prevention, screening or social support. In the analysis, the reviews published from January 2000 to April 2015 were included. The search strategy yielded 334 systematic reviews and/or meta-analyses addressed to target groups of interest, 182 of them assessed interventions belonging to health promotion, 219 to primary prevention, 34 to screening and 35 to social support. The studies focused on elderly (65 years and above) made up 40.4 % of all retrieved reviews and those addressing population of 55 years and above accounted for 24.0 %. Interventions focused on health maintenance and improvement in elderly and older adults represent frequently combined health promotion and disease prevention actions. Many interventions of this type are not addressed exclusively to elderly populations and/or older adults but are designed for the general population. The most common types of interventions addressed to elderly and older adults in the area of health promotion include health

Can nurses rise to the public health challenge? How a novel solution in nurse education can address this contemporary question.

PubMed

Turner-Wilson, Angela L; Mills, Anne M; Rees, Karen

2017-10-01

This paper raises the problem of how improvements in health outcomes, a key component in many governments' strategies, can be achieved. The work highlights a novel undergraduate educational approach which offers solutions to public health challenges within nursing. Against the backdrop of one UK university institution it discusses approaches that can guide nursing students towards a deeper understanding and engagement within the principles of public health. It then proposes how nurses can use their learning to become leaders of health improvement. Copyright © 2017 Elsevier Ltd. All rights reserved.

Addressing Challenges in Studies of Behavioral Responses of Whales to Noise.

PubMed

Cato, Douglas H; Dunlop, Rebecca A; Noad, Michael J; McCauley, Robert D; Kniest, Eric; Paton, David; Kavanagh, Ailbhe S

2016-01-01

Studying the behavioral response of whales to noise presents numerous challenges. In addition to the characteristics of the noise exposure, many factors may affect the response and these must be measured and accounted for in the analysis. An adequate sample size that includes matching controls is crucial if meaningful results are to be obtained. Field work is thus complicated, logistically difficult, and expensive. This paper discusses some of the challenges and how they are being met in a large-scale multiplatform project in which humpback whales are exposed to the noise of seismic air guns.

Teaching Digital Natives: Promoting Information Literacy and Addressing Instructional Challenges

ERIC Educational Resources Information Center

Neumann, Crystal

2016-01-01

Technology must be used as a teaching and learning tool to help students succeed. However, educators must be proactive in identifying some of the pitfalls of technology, such as information illiteracy. The phenomenological study covers how English instructors from Indianapolis, who teach first year students, address information literacy and the…

Climate change challenges for central banks and financial regulators

NASA Astrophysics Data System (ADS)

Campiglio, Emanuele; Dafermos, Yannis; Monnin, Pierre; Ryan-Collins, Josh; Schotten, Guido; Tanaka, Misa

2018-06-01

The academic and policy debate regarding the role of central banks and financial regulators in addressing climate-related financial risks has rapidly expanded in recent years. This Perspective presents the key controversies and discusses potential research and policy avenues for the future. Developing a comprehensive analytical framework to assess the potential impact of climate change and the low-carbon transition on financial stability seems to be the first crucial challenge. These enhanced risk measures could then be incorporated in setting financial regulations and implementing the policies of central banks.

Oral health in Libya: addressing the future challenges.

PubMed

Peeran, Syed Wali; Altaher, Omar Basheer; Peeran, Syed Ali; Alsaid, Fatma Mojtaba; Mugrabi, Marei Hamed; Ahmed, Aisha Mojtaba; Grain, Abdulgader

2014-01-01

Libya is a vast country situated in North Africa, having a relatively better functioning economy with a scanty population. This article is the first known attempt to review the current state of oral health care in Libya and to explore the present trends and future challenges. Libyan health system, oral health care, and human resources with the present status of dental education are reviewed comprehensively. A bibliographic study of oral health research and publications has been carried out. The results point toward a common indicator that oral health-related research is low. Strategies have to be developed to educate the medical and dental professionals, to update the current curriculum and enable the system to be competent in all aspects of oral health care management.

Oral health in Libya: addressing the future challenges

PubMed Central

Peeran, Syed Wali; Altaher, Omar Basheer; Peeran, Syed Ali; Alsaid, Fatma Mojtaba; Mugrabi, Marei Hamed; Ahmed, Aisha Mojtaba; Grain, Abdulgader

2014-01-01

Libya is a vast country situated in North Africa, having a relatively better functioning economy with a scanty population. This article is the first known attempt to review the current state of oral health care in Libya and to explore the present trends and future challenges. Libyan health system, oral health care, and human resources with the present status of dental education are reviewed comprehensively. A bibliographic study of oral health research and publications has been carried out. The results point toward a common indicator that oral health–related research is low. Strategies have to be developed to educate the medical and dental professionals, to update the current curriculum and enable the system to be competent in all aspects of oral health care management. PMID:24666627

Research strategies for addressing uncertainties

USGS Publications Warehouse

Busch, David E.; Brekke, Levi D.; Averyt, Kristen; Jardine, Angela; Welling, Leigh; Garfin, Gregg; Jardine, Angela; Merideth, Robert; Black, Mary; LeRoy, Sarah

2013-01-01

Research Strategies for Addressing Uncertainties builds on descriptions of research needs presented elsewhere in the book; describes current research efforts and the challenges and opportunities to reduce the uncertainties of climate change; explores ways to improve the understanding of changes in climate and hydrology; and emphasizes the use of research to inform decision making.

New challenges for grizzly bear management in Yellowstone National Park

USGS Publications Warehouse

van Manen, Frank T.; Gunther, Kerry A.

2016-01-01

A key factor contributing to the success of grizzly bear Ursus arctos conservation in the Greater Yellowstone Ecosystem has been the existence of a large protected area, Yellowstone National Park. We provide an overview of recovery efforts, how demographic parameters changed as the population increased, and how the bear management program in Yellowstone National Park has evolved to address new management challenges over time. Finally, using the management experiences in Yellowstone National Park, we present comparisons and perspectives regarding brown bear management in Shiretoko National Park.

Centennial Challenges Program Overview: How NASA Successfully Involves the General Public in the Solving of Current Technology Gaps

NASA Technical Reports Server (NTRS)

Roman, Monsi C.; Kim, Tony; Sudnik, Janet; Sivak, Amy; Porter, Molly; Cylar, Rosaling; Cavanaugh, Dominique; Krome, Kim

2017-01-01

The National Aeronautics and Space Administration (NASA) Centennial Challenges Program, part of the Space Technology Mission Directorate (STMD), addresses key technology needs of NASA and the nation, while facilitating new sources of innovation outside the traditional community. This is done by the direct engagement of the public at large, through the offering of Congressional authorized prize purses and associated challenges developed by NASA and the aerospace community and set up as a competition awarding the prize money for achieving the specified technology goal.

Communicative challenges in the home care of older persons - a qualitative exploration.

PubMed

Sundler, Annelie J; Eide, Hilde; van Dulmen, Sandra; Holmström, Inger K

2016-10-01

To explore communicative challenges in encounters between nurse assistants and older persons during home care visits. The older population is increasing worldwide. Currently, there is a shift in care for older people from institutional care to home care. Providing home care in a person's home involves several challenges, including the complexity of communication. A descriptive observational design with a qualitative approach was used. The data consisted of audio recordings of real-life encounters during home care visits between nurse assistants and older persons, collected in 2014. A hermeneutic phenomenological analysis was conducted. Communicative challenges were identified: (a) in situations where the older persons had a different view than the nurse assistants on the care task and its content; and (b) when unexpected actions or turns occurred in the communication. Challenges included older person's existential issues, fragility and worries and concerns, which often appeared to be only vaguely expressed and difficult to verbally detect and tackle. This engendered a risk of misinterpretation or ignorance of these challenges. The findings point to the importance of communication as the key to facilitate person-centred home care. Communication training should focus more on addressing needs and existential issues in older persons. Person-centred home care for older persons needs to be addressed at both an individual and an organizational level. © 2016 John Wiley & Sons Ltd.

Addressing vaccine hesitancy: The potential value of commercial and social marketing principles and practices.

PubMed

Nowak, Glen J; Gellin, Bruce G; MacDonald, Noni E; Butler, Robb

2015-08-14

Many countries and communities are dealing with groups and growing numbers of individuals who are delaying or refusing recommended vaccinations for themselves or their children. This has created a need for immunization programs to find approaches and strategies to address vaccine hesitancy. An important source of useful approaches and strategies is found in the frameworks, practices, and principles used by commercial and social marketers, many of which have been used by immunization programs. This review examines how social and commercial marketing principles and practices can be used to help address vaccine hesitancy. It provides an introduction to key marketing and social marketing concepts, identifies some of the major challenges to applying commercial and social marketing approaches to immunization programs, illustrates how immunization advocates and programs can use marketing and social marketing approaches to address vaccine hesitancy, and identifies some of the lessons that commercial and non-immunization sectors have learned that may have relevance for immunization. While the use of commercial and social marketing practices and principles does not guarantee success, the evidence, lessons learned, and applications to date indicate that they have considerable value in fostering vaccine acceptance. Copyright © 2015. Published by Elsevier Ltd.

Engage key social concepts for sustainability

Treesearch

C. C. Hicks; A. Levine; A. Agrawal; X. Basurto; S. J. Breslow; C. Carothers; Susan Charnley; S. Coulthard; N. Dolsak; J. Donatuto; C. Garcia-Quijano; M. B. Mascia; K. Norman; M. R. Poe; T. Satterfield; K. St. Martin; P. S. Levin

2016-01-01

With humans altering climate processes, biogeochemical cycles, and ecosystem functions (1), governments and societies confront the challenge of shaping a sustainable future for people and nature. Policies and practices to address these challenges must draw on social sciences, along with natural sciences and engineering (2). Although various social science approaches...

Nature-Based Solutions in the EU: Innovating with nature to address social, economic and environmental challenges.

PubMed

Faivre, Nicolas; Fritz, Marco; Freitas, Tiago; de Boissezon, Birgit; Vandewoestijne, Sofie

2017-11-01

Contemporary societies are facing a broad range of challenges, from pressures on human health and well-being to natural capital depletion, and the security of food, water and energy. These challenges are deeply intertwined with global processes, such as climate change and with local events such as natural disasters. The EU's research & innovation (R&I) policy is now seeking to address these challenges from a new perspective, with Nature-Based Solutions, and turn them into innovation opportunities that optimise the synergies between nature, society and the economy. Nature-Based Solutions can be an opportunity for innovation, and are here promoted by both policymakers and practitioners as a cost-effective way of creating a greener, more sustainable, and more competitive economy. Since 2013, the European Commission has devoted particular attention to Nature-Based Solutions through consultations and dialogues that sought to make the concept of these solutions more concrete and to define the concept's place within the spectrum of ecosystem-based approaches. In 2014, the Commission launched an expert group, which conducted further analysis, and made recommendations to help increase the use of Nature-Based Solutions and bring nature back into cities. In 2015, a survey was conducted on citizens' views and perceptions of 'Nature in Cities' to provide further insight for future work. Based on these elements and on results from running EU projects, the Commission has developed an R&I agenda for Nature-Based Solutions and has published targeted calls for proposals for large-scale demonstration projects in this field in 2016 and 2017. Additional R&I actions at EU level that promote systemic Nature-Based Solutions and their benefits to cities and territories are planned with the aim to improve the implementation capacity and evidence base for deploying Nature-Based Solutions and developing corresponding future markets. They are also expected to foster an interdisciplinary R

Reading handprinted addresses on IRS tax forms

NASA Astrophysics Data System (ADS)

Ramanaprasad, Vemulapati; Shin, Yong-Chul; Srihari, Sargur N.

1996-03-01

The hand-printed address recognition system described in this paper is a part of the Name and Address Block Reader (NABR) system developed by the Center of Excellence for Document Analysis and Recognition (CEDAR). NABR is currently being used by the IRS to read address blocks (hand-print as well as machine-print) on fifteen different tax forms. Although machine- print address reading was relatively straightforward, hand-print address recognition has posed some special challenges due to demands on processing speed (with an expected throughput of 8450 forms/hour) and recognition accuracy. We discuss various subsystems involved in hand- printed address recognition, including word segmentation, word recognition, digit segmentation, and digit recognition. We also describe control strategies used to make effective use of these subsystems to maximize recognition accuracy. We present system performance on 931 address blocks in recognizing various fields, such as city, state, ZIP Code, street number and name, and personal names.

Challenges in microbial ecology: building predictive understanding of community function and dynamics

PubMed Central

Widder, Stefanie; Allen, Rosalind J; Pfeiffer, Thomas; Curtis, Thomas P; Wiuf, Carsten; Sloan, William T; Cordero, Otto X; Brown, Sam P; Momeni, Babak; Shou, Wenying; Kettle, Helen; Flint, Harry J; Haas, Andreas F; Laroche, Béatrice; Kreft, Jan-Ulrich; Rainey, Paul B; Freilich, Shiri; Schuster, Stefan; Milferstedt, Kim; van der Meer, Jan R; Groβkopf, Tobias; Huisman, Jef; Free, Andrew; Picioreanu, Cristian; Quince, Christopher; Klapper, Isaac; Labarthe, Simon; Smets, Barth F; Wang, Harris; Soyer, Orkun S

2016-01-01

The importance of microbial communities (MCs) cannot be overstated. MCs underpin the biogeochemical cycles of the earth's soil, oceans and the atmosphere, and perform ecosystem functions that impact plants, animals and humans. Yet our ability to predict and manage the function of these highly complex, dynamically changing communities is limited. Building predictive models that link MC composition to function is a key emerging challenge in microbial ecology. Here, we argue that addressing this challenge requires close coordination of experimental data collection and method development with mathematical model building. We discuss specific examples where model–experiment integration has already resulted in important insights into MC function and structure. We also highlight key research questions that still demand better integration of experiments and models. We argue that such integration is needed to achieve significant progress in our understanding of MC dynamics and function, and we make specific practical suggestions as to how this could be achieved. PMID:27022995

Addressing the social determinants of health at the local level: Opportunities and challenges.

PubMed

Fosse, E; Helgesen, M K; Hagen, S; Torp, S

2018-02-01

The gradient in health inequalities reflects a relationship between health and social circumstance, demonstrating that health worsens as you move down the socio-economic scale. For more than a decade, the Norwegian National government has developed policies to reduce social inequalities in health by levelling the social gradient. The adoption of the Public Health Act in 2012 was a further movement towards a comprehensive policy. The main aim of the act is to reduce social health inequalities by adopting a Health in All Policies approach. The municipalities are regarded key in the implementation of the act. The SODEMIFA project aimed to study the development of the new public health policy, with a particular emphasis on its implementation in municipalities. In the SODEMIFA project, a mixed-methods approach was applied, and the data consisted of surveys as well as qualitative interviews. The informants were policymakers at the national and local level. Our findings indicate that the municipalities had a rather vague understanding of the concept of health inequalities, and even more so, the concept of the social gradient in health. The most common understanding was that policy to reduce social inequalities concerned disadvantaged groups. Accordingly, policies and measures would be directed at these groups, rather than addressing the social gradient. A movement towards an increased understanding and adoption of the new, comprehensive public health policy was observed. However, to continue this process, both local and national levels must stay committed to the principles of the act.

Planetary Atmosphere and Surfaces Chamber (PASC): A Platform to Address Various Challenges in Astrobiology

NASA Astrophysics Data System (ADS)

Mateo-Marti, Eva

2014-08-01

stability and presence of certain minerals on planetary surfaces and the potential habitability of microorganisms under various planetary environmental conditions can be studied using our apparatus. Therefore, these simulation chambers can address multiple different challenging and multidisciplinary astrobiological studies.

Addressing Reticence: The Challenge of Engaging Reluctant Adult ESL Students

ERIC Educational Resources Information Center

Carter, Steven J.; Henrichsen, Lynn E.

2015-01-01

Reticence frequently prevents adult ESL learners from learning as much as they otherwise might. The nature of second-language learning requires frequent performance that may challenge students' self-concepts, leading to reticence and self-consciousness. To reduce or prevent this problem, teachers must employ appropriate pedagogical and classroom…

Addressing a Nation's Challenge: Graduate Programs in Gerontology in Israel

ERIC Educational Resources Information Center

Carmel, Sara; Lowenstein, Ariela

2007-01-01

Like other developed nations, Israel has rapidly aged. This demographic revolution has created new challenges for Israeli society. We describe the societal background, including the emerging societal needs, solutions, and problems, as well as the professional principles, which guided us in developing the first two Israeli academic programs in…

Challenges of Applying a Comprehensive Model of Intervention Fidelity

PubMed Central

Bosak, Kelly; Pozehl, Bunny; Yates, Bernice

2014-01-01

Applying a comprehensive model of fidelity to interventions delivered by Information and Communication Technology (ICT) has multiple challenges. Fidelity must be considered in the design, implementation, evaluation, and reporting of the intervention. The fidelity strategies must address the unique aspects of the technology, including training providers to instruct participants to use the technology and to provide standardized feedback, rather than deliver the intervention in-person. Other challenges include the nonspecific effects resulting from participants accessing unintended content in interventions delivered by the Internet. ICT allows participant receipt and enactment of intervention skills to be assessed by electronic evidence, rather than in-person observation. Interventions using ICT, such as the Internet are unique, and there is less control of participant interaction with various electronic components. Monitoring participant use and providing standardized feedback for receipt and enactment of intervention skills is key to ensuring intervention fidelity. The final challenges involve evaluating and reporting fidelity. PMID:21474676

MO-DE-207-04: Imaging educational program on solutions to common pediatric imaging challenges

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

Krishnamurthy, R.

This imaging educational program will focus on solutions to common pediatric imaging challenges. The speakers will present collective knowledge on best practices in pediatric imaging from their experience at dedicated children’s hospitals. The educational program will begin with a detailed discussion of the optimal configuration of fluoroscopes for general pediatric procedures. Following this introduction will be a focused discussion on the utility of Dual Energy CT for imaging children. The third lecture will address the substantial challenge of obtaining consistent image post -processing in pediatric digital radiography. The fourth and final lecture will address best practices in pediatric MRI includingmore » a discussion of ancillary methods to reduce sedation and anesthesia rates. Learning Objectives: To learn techniques for optimizing radiation dose and image quality in pediatric fluoroscopy To become familiar with the unique challenges and applications of Dual Energy CT in pediatric imaging To learn solutions for consistent post-processing quality in pediatric digital radiography To understand the key components of an effective MRI safety and quality program for the pediatric practice.« less

Doing qualitative research on suicide in a developing country: practical and ethical challenges.

PubMed

Mugisha, James; Knizek, Birthe Loa; Kinyanda, Eugene; Hjelmeland, Heidi

2011-01-01

This article describes and discusses the challenges faced by researchers who conducted a qualitative interview study on attitudes toward suicide among the Baganda, Uganda. Many of the challenges addressed in this article have not been described earlier in suicide research conducted in the developing world. The aim of this study was to explore attitudes and cultural responses toward suicide among the Baganda, Uganda. Data were collected and analyzed using grounded theory. A total of 28 focus group discussions and 30 key informant interviews were conducted. The findings of this study are organized under two broad categories: community access challenges and expectation challenges. Community access challenges entailed cultural, legal, rapport, informed consent, language, and other research process related issues that could hinder effective access to the study respondents. Expectation challenges concerned how to deal with the immediate and strategic needs of the study communities. This study demonstrates that culturally sensitive approaches to data collection can reduce ethical challenges and, through innovative approaches, practical challenges faced during data collection can be minimized.

Addressing Physics Grand Challenges Using the Jefferson Lab FEL

NASA Astrophysics Data System (ADS)

Williams, Gwyn P.

2006-11-01

The Jefferson Lab Free Electron Laser[1] is the first of the so-called 4^th generation light sources to go operational. Capable of delivering extraordinarily bright, tunable light in ultrafast pulses from THz[2] through infrared to UV, the facility extends the experimental reach of accelerator-based light-sources by many orders of magnitude. This allows new opportunities to study many of the ``Grand Challenges'' recently defined by the Office of Science, Basic Energy Sciences Division, most of which are concerned with understandings of equilibrium and non-equilibrium behavior of materials in physics, chemistry and biology using precise pump and probe techniques. Specifically, in condensed matter physics, the JLab FEL permits new studies which go beyond earlier studies of reductionist behavior to those which examine emergent behavior. Thus, the understanding of high Tc superconductivity, colossal magneto-resistance, and observations of the breakdown of the Born-Oppenheimer approximation, are examples of collective behavior which is now treated theoretically via the concept of quasiparticles. In this presentation we will describe the dual pathways of light source development and physics challenges, and then show how they are combined in experiments that allow new insights to be developed to understand material function. We will illustrate this with details of the evolution of accelerator-based light sources, and with examples of work performed to date. References: [1] Neil et al. Phys. Rev.Letts 84, 662 (2000). [2] Carr, Martin, McKinney, Neil, Jordan & Williams, Nature 420, 153 (2002).

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

Preventing and Addressing Challenging Behavior: Common Questions and Practical Strategies

ERIC Educational Resources Information Center

Hemmeter, Mary Louise; Ostrosky, Michaelene M.; Corso, Robert M.

2012-01-01

The purpose of this article is to offer preschool teachers strategies for preventing challenging behavior and supporting the development of social skills and emotional competencies. This article is framed in a question and answer format using questions from teachers who the authors have worked with in the past. These questions and strategies are…

Public Key Infrastructure Study

DTIC Science & Technology

1994-04-01

commerce. This Public Key Infrastructure (PKI) study focuses on the United States Federal Government operations, but also addresses national and global ... issues in order to facilitate the interoperation of protected electronic commerce among the various levels of government in the U.S., private citizens

Performance-based incentives may be appropriate to address challenges to delivery of prevention of vertical transmission of HIV services in rural Mozambique: a qualitative investigation.

PubMed

Schuster, Roseanne C; de Sousa, Octávio; Rivera, Jacqueline; Olson, Rebecca; Pinault, Delphine; Young, Sera L

2016-10-07

in record and referral systems and better integrating community-based health workers into the health system. Concerns about the implementation of incentives included neglect of non-incentivized tasks and distorted motivation among colleagues. We found that highly motivated health workers encountered severe opportunity challenges in their PVT mandate. PBIs have the potential to address key barriers that facility- and community-based health workers encounter when delivering PVT services, specifically by building upon existing intrinsic motivation and leveraging highly valued social recognition. We recommend a controlled intervention to monitor incentives' effects on worker motivation and non-incentivized tasks to generate insights about the feasibility of PBIs to improve the delivery of PVT services.

Identifying and Addressing Challenges to Research in University Laboratory Preschools

ERIC Educational Resources Information Center

File, Nancy

2012-01-01

Research Findings: This essay offers a review of challenges that university laboratory preschools face in providing a site for research that fits with other components of the program mission. An argument is made to consider paradigm shifts in research questions and methods that move away from traditions within the fields that study children's…

Culture X: addressing barriers to physical activity in Samoa.

PubMed

Heard, Emma Marie; Auvaa, Leveti; Conway, Brooke A

2017-08-01

There is an urgent need to address the epidemic rates of non-communicable diseases globally, and the Pacific Island region is of particular concern. Increasing physical activity participation plays an important role in reducing some of the key risk factors for non-communicable diseases including obesity and being overweight. In order to address low levels of physical activity, it is essential to understand the key barriers and facilitating factors experienced by specific population groups. The purpose of this study is to investigate key facilitating factors for participation in a dance aerobic initiative, Culture X, developed in the Pacific Island country, Samoa. The study further aims to understand ways in which the programme assists participants in addressing barriers to physical activity. Face-to-face interviews running from 10 to 20 min were conducted with 28 Culture X participants in order to gain a deep understanding of participants' personal perspectives with regard to barriers and facilitating factors to physical activity. Findings suggest the inclusion of key cultural components (including, traditional dance moves and music, prayer, community orientation and family inclusiveness) were integral for supporting ongoing participation in Culture X. These components further assisted participants in addressing important personal and social barriers to physical activity (including lack of motivation and enjoyment, lack of confidence, time management, family and social commitments and lack of support). This study highlights creative ways that health promotion in the Pacific Island region can encourage physical activity and informs health promotion literature regarding the importance of placing local culture at the heart of behaviour change initiatives. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

E-DECIDER Disaster Response and Decision Support Cyberinfrastructure: Technology and Challenges

NASA Astrophysics Data System (ADS)

Glasscoe, M. T.; Parker, J. W.; Pierce, M. E.; Wang, J.; Eguchi, R. T.; Huyck, C. K.; Hu, Z.; Chen, Z.; Yoder, M. R.; Rundle, J. B.; Rosinski, A.

2014-12-01

Timely delivery of critical information to decision makers during a disaster is essential to response and damage assessment. Key issues to an efficient emergency response after a natural disaster include rapidly processing and delivering this critical information to emergency responders and reducing human intervention as much as possible. Essential elements of information necessary to achieve situational awareness are often generated by a wide array of organizations and disciplines, using any number of geospatial and non-geospatial technologies. A key challenge is the current state of practice does not easily support information sharing and technology interoperability. NASA E-DECIDER (Emergency Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response) has worked with the California Earthquake Clearinghouse and its partners to address these issues and challenges by adopting the XChangeCore Web Service Data Orchestration technology and participating in several earthquake response exercises. The E-DECIDER decision support system provides rapid delivery of advanced situational awareness data products to operations centers and emergency responders in the field. Remote sensing and hazard data, model-based map products, information from simulations, damage detection, and crowdsourcing is integrated into a single geospatial view and delivered through a service oriented architecture for improved decision-making and then directly to mobile devices of responders. By adopting a Service Oriented Architecture based on Open Geospatial Consortium standards, the system provides an extensible, comprehensive framework for geospatial data processing and distribution on Cloud platforms and other distributed environments. While the Clearinghouse and its partners are not first responders, they do support the emergency response community by providing information about the damaging effects earthquakes. It is critical for decision makers to maintain a situational awareness

Challenges and opportunities for translating medical microdevices: insights from the programmable bio-nano-chip

PubMed Central

McRae, Michael P; Simmons, Glennon; McDevitt, John T

2016-01-01

This perspective highlights the major challenges for the bioanalytical community, in particular the area of lab-on-a-chip sensors, as they relate to point-of-care diagnostics. There is a strong need for general-purpose and universal biosensing platforms that can perform multiplexed and multiclass assays on real-world clinical samples. However, the adoption of novel lab-on-a-chip/microfluidic devices has been slow as several key challenges remain for the translation of these new devices to clinical practice. A pipeline of promising medical microdevice technologies will be made possible by addressing the challenges of integration, failure to compete with cost and performance of existing technologies, requisite for new content, and regulatory approval and clinical adoption. PMID:27071710

The role and challenges of the food industry in addressing chronic disease

PubMed Central

2010-01-01

Summary Increasingly, food companies play an important role in stemming the rising burden of nutrition-related chronic diseases. Concrete actions taken by these companies include global public commitments to address food reformulation, consumer information, responsible marketing, promotion of healthy lifestyles, and public-private partnerships. These actions are reviewed together with eleven specific PepsiCo goals and commitments that address products, the marketplace, and communities at large. Interim progress on these goals and commitments are discussed as well as constraints hampering faster progress. Further disease prevention depends on increasing implementation of private-public initiatives. PMID:20509876

Addressing the Challenge of Molecular Change: An Interim Report

NASA Astrophysics Data System (ADS)

Levine, Raphael D.

2018-04-01

Invited by the editorial committee of the Annual Review of Physical Chemistry to "contribute my autobiography," I present it here, as I understand the term. It is about my parents, my mentors, my coworkers, and my friends in learning and the scientific problems that we tried to address. Courtesy of the editorial assistance of Annual Reviews, some of the science is in the figure captions and sidebars. I am by no means done: I am currently trying to fuse the quantitative rigor of physical chemistry with systems biology while also dealing with a post-Born-Oppenheimer regime in electronic dynamics and am attempting to instruct molecules to perform advanced logic.

Addressing the Challenge of Molecular Change: An Interim Report.

PubMed

Levine, Raphael D

2018-04-20

Invited by the editorial committee of the Annual Review of Physical Chemistry to "contribute my autobiography," I present it here, as I understand the term. It is about my parents, my mentors, my coworkers, and my friends in learning and the scientific problems that we tried to address. Courtesy of the editorial assistance of Annual Reviews, some of the science is in the figure captions and sidebars. I am by no means done: I am currently trying to fuse the quantitative rigor of physical chemistry with systems biology while also dealing with a post-Born-Oppenheimer regime in electronic dynamics and am attempting to instruct molecules to perform advanced logic.

First Crewed Flight: Rationale, Considerations and Challenges from the Constellation Experience

NASA Technical Reports Server (NTRS)

Noriega, Carlos; Arceneaux, William; Williams, Jeffrey A.; Rhatigan, Jennifer L.

2011-01-01

NASA's Constellation Program has made the most progress in a generation towards building an integrated human-rated spacecraft and launch vehicle. During that development, it became clear that NASA's human-rating requirements lacked the specificity necessary to defend a program plan, particularly human-rating test flight plans, from severe budget challenges. This paper addresses the progress Constellation achieved, problems encountered in clarifying and defending a human-rating certification plan, and discusses key considerations for those who find themselves in similar straits with future human-rated spacecraft and vehicles. We assert, and support with space flight data, that NASA's current human-rating requirements do not adequately address "unknown-unknowns", or the unexpected things the hardware can reveal to the designer during test.

Addressing unmeasured confounding in comparative observational research.

PubMed

Zhang, Xiang; Faries, Douglas E; Li, Hu; Stamey, James D; Imbens, Guido W

2018-04-01

Observational pharmacoepidemiological studies can provide valuable information on the effectiveness or safety of interventions in the real world, but one major challenge is the existence of unmeasured confounder(s). While many analytical methods have been developed for dealing with this challenge, they appear under-utilized, perhaps due to the complexity and varied requirements for implementation. Thus, there is an unmet need to improve understanding the appropriate course of action to address unmeasured confounding under a variety of research scenarios. We implemented a stepwise search strategy to find articles discussing the assessment of unmeasured confounding in electronic literature databases. Identified publications were reviewed and characterized by the applicable research settings and information requirements required for implementing each method. We further used this information to develop a best practice recommendation to help guide the selection of appropriate analytical methods for assessing the potential impact of unmeasured confounding. Over 100 papers were reviewed, and 15 methods were identified. We used a flowchart to illustrate the best practice recommendation which was driven by 2 critical components: (1) availability of information on the unmeasured confounders; and (2) goals of the unmeasured confounding assessment. Key factors for implementation of each method were summarized in a checklist to provide further assistance to researchers for implementing these methods. When assessing comparative effectiveness or safety in observational research, the impact of unmeasured confounding should not be ignored. Instead, we suggest quantitatively evaluating the impact of unmeasured confounding and provided a best practice recommendation for selecting appropriate analytical methods. Copyright © 2018 John Wiley & Sons, Ltd.

Social Work Grand Challenges: Leaders' Perceptions of the Potential for Partnering with Business.

PubMed

Long, Ashley

2018-04-23

Social work's ability to address complex societal problems such as those identified in the American Academy of Social Work and Social Welfare's Grand Challenges for Social Work is reliant on being innovative in how we prepare social workers and how we collaborate with others, including business. This research seeks to understand how leaders of major social work organizations perceive potential partnership with the business sector-including both possible threats and opportunities. Interviews were conducted with those serving on the Council on Social Work Education's Leadership Roundtable. The research explores how emerging partnership models can be helpful and ways in which the profession can prepare practitioners for better partnering with the business sector. Qualitative findings identify four key strategies to address the grand challenges and enhance partnerships: (1) more interdisciplinary work is needed, (2) social work students need to be adequately equipped for collaborative work, (3) a cohesive message is needed from the field, and (4) the potential benefits for partnering with business outweigh the risks.

Challenges in tackling tuberculosis on the Thai-Myanmar border: findings from a qualitative study with health professionals.

PubMed

Kaji, Aiko; Thi, Sein Sein; Smith, Terrence; Charunwatthana, Prakaykaew; Nosten, Francois H

2015-10-09

Myanmar and Thailand belong to the top 22 high burden countries for tuberculosis (TB). Health care organizations play an essential role in addressing TB control in the two bridging border jurisdictions, Tak province, Thailand and Myawaddy district, Kayin state, Myanmar. However, health professionals face difficulties in TB control effort due to the nature of fluid population movements, resource constraints and ambiguous mechanisms to implement collaboration along the border. The purpose of this study is to identify the challenges to TB control among Myanmar migrants faced by stakeholders, focusing on the area of collaboration and interaction along the border. The study conducted in-depth interviews with health policy makers and health care providers responsible for developing and implementing policies and TB programs in Tak province, Thailand and Myawaddy district, Kayin state, Myanmar. The participants included members of government organizations, United Nations agencies, community based organizations, and international NGO. One or two key stakeholders from each organization were approached to participate in the study. We gathered baseline information to identify TB policies and programs available on websites, brochures, and publications. Observations including field notes were made on site. The data transcriptions were coded for qualitative data analysis. Coding also developed categories that led to key themes. A total of 31 respondents (18 in Thailand and 13 in Myanmar) participated in the study. The main theme reported by participants was challenges in limited corroboration and coordination among stakeholders. Unstructured information sharing and lack of communication hindered the stakeholders from engaging in TB control. The respondents stressed that referral mechanisms across the border need to be strengthened. Other challenges were associated with increasing loss to follow up and subsequent MDR cases, constraints of service delivery, shortage of human

The organisational and human resource challenges facing primary care trusts: protocol of a multiple case study

PubMed Central

2001-01-01

Background The study is designed to assess the organisational and human resource challenges faced by Primary Care Trusts (PCTs). Its objectives are to: specify the organisational and human resources challenges faced by PCTs in fulfilling the roles envisaged in government and local policy; examine how PCTs are addressing these challenges, in particular, to describe the organisational forms they have adopted, and the OD/HR strategies and initiatives they have planned or in place; assess how effective these structures, strategies and initiatives have been in enabling the PCTs to meet the organisational and human resources challenges they face; identify the factors, both internal to the PCT and in the wider health community, which have contributed to the success or failure of different structures, strategies and initiatives. Methods The study will be undertaken in three stages. In Stage 1 the key literature on public sector and NHS organisational development and human resources management will be reviewed, and discussions will be held with key researchers and policy makers working in this area. Stage 2 will focus on detailed case studies in six PCTs designed to examine the organisational and human resources challenges they face. Data will be collected using semi-structured interviews, group discussion, site visits, observation of key meetings and examination of local documentation. The findings from the case study PCTs will be cross checked with a Reference Group of up to 20 other PCG/Ts, and key officers working in organisational development or primary care at local, regional and national level. In Stage 3 analysis of findings from the preparatory work, the case studies and the feedback from the Reference Group will be used to identify practical lessons for PCTs, key messages for policy makers, and contributions to further theoretical development. PMID:11737883

25th anniversary article: key points for high-mobility organic field-effect transistors.

PubMed

Dong, Huanli; Fu, Xiaolong; Liu, Jie; Wang, Zongrui; Hu, Wenping

2013-11-20

Remarkable progress has been made in developing high performance organic field-effect transistors (OFETs) and the mobility of OFETs has been approaching the values of polycrystalline silicon, meeting the requirements of various electronic applications from electronic papers to integrated circuits. In this review, the key points for development of high mobility OFETs are highlighted from aspects of molecular engineering, process engineering and interface engineering. The importance of other factors, such as impurities and testing conditions is also addressed. Finally, the current challenges in this field for practical applications of OFETs are further discussed. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Water and fire safety issues addressed.

PubMed

Arrowsmith, Mike

2014-11-01

One of the four conference streams at last month's Healthcare Estates 2014 event focused on some of the key engineering challenges and opportunities facing healthcare estates managers and healthcare engineers. Mike Arrowsmith, HEJ's technical editor, provides an overview of the engineering sessions at this year's IHEEM conference.

Endangered species and nature conservation: science issues and challenges.

PubMed

Szaro, Robert C

2008-06-01

The issues and challenges facing us in ensuring the survival of as many species and ecosystems as possible call for a renewed research focus to address how to improve management strategies and policy making now and into the future. The key issues to be addressed by activities of the International Union of Forest Research Organization's (IUFRO) Task Force on Endangered Species and Nature Conservation include such issues as: (i) preventing species from being listed by maintaining species populations at sufficient levels that they do not require listing; (ii) recovering threatened and endangered species; (iii) developing management practices and strategies; (iv) balancing actions affecting suites of threatened or endangered species; (v) developing conservation strategies for species without definitive taxonomic treatments; (vi) dealing with global change; (vii) dealing with invasive species; and (viii) restoring critical habitats. © 2008 ISZS, Blackwell Publishing and IOZ/CAS.

Differentiated Pedagogy to Address Learner Diversity in Secondary Physical Education

ERIC Educational Resources Information Center

Jarvis, Jane M.; Pill, Shane A.; Noble, Anna G.

2017-01-01

This article discusses the challenge of addressing student diversity in secondary physical education (PE) classes. Contemporary curriculum documents and teacher standards emphasize differentiated pedagogy in order to engage and challenge all learners. However, the reality of designing effective learning experiences for diverse students represents…

Developing culturally adapted lifestyle interventions for South Asian migrant populations: a qualitative study of the key success factors and main challenges.

PubMed

Terragni, L; Beune, E; Stronks, K; Davidson, E; Qureshi, S; Kumar, B; Diaz, E

2018-06-11

South Asian migrant populations have a high risk of non-communicable diseases, such as type 2 diabetes (T2D). The aim of this study is to provide in-depth insight into key success factors and challenges in developing culturally adapted lifestyle interventions to prevent T2D within South Asian migrant populations. The study has a qualitative research design. In-depth interviews, using a semi-structured interview guide, were conducted with eight researchers and project leaders from five studies of culturally adapted lifestyle interventions for South Asian migrant populations. Data were analysed using a grounded theory approach. Four main themes emerged as key factors for success: 'approaching the community in the right way', 'the intervention as a space for social relations', 'support from public authorities' and 'being reflexive and flexible'. Two themes emerged as challenges: 'struggling with time' and 'overemphasising cultural differences'. Our findings augment existing research by establishing the importance of cooperation at the organisational and institutional levels, of fostering the creation of social networks through interventions and of acknowledging the multiplicity of identities and resources among individuals of the same ethnic origin. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Technology Challenges for Deep-Throttle Cryogenic Engines for Space Exploration

NASA Technical Reports Server (NTRS)

Brown, Kendall K.; Nelson, Karl W.

2005-01-01

Historically, cryogenic rocket engines have not been used for in-space applications due to their additional complexity, the mission need for high reliability, and the challenges of propellant boil-off. While the mission and vehicle architectures are not yet defined for the lunar and Martian robotic and human exploration objectives, cryogenic rocket engines offer the potential for higher performance and greater architecture/mission flexibility. In-situ cryogenic propellant production could enable a more robust exploration program by significantly reducing the propellant mass delivered to low earth orbit, thus warranting the evaluation of cryogenic rocket engines versus the hypergolic bi-propellant engines used in the Apollo program. A multi-use engine. one which can provide the functionality that separate engines provided in the Apollo mission architecture, is desirable for lunar and Mars exploration missions because it increases overall architecture effectiveness through commonality and modularity. The engine requirement derivation process must address each unique mission application and each unique phase within each mission. The resulting requirements, such as thrust level, performance, packaging, bum duration, number of operations; required impulses for each trajectory phase; operation after extended space or surface exposure; availability for inspection and maintenance; throttle range for planetary descent, ascent, acceleration limits and many more must be addressed. Within engine system studies, the system and component technology, capability, and risks must be evaluated and a balance between the appropriate amount of technology-push and technology-pull must be addressed. This paper will summarize many of the key technology challenges associated with using high-performance cryogenic liquid propellant rocket engine systems and components in the exploration program architectures. The paper is divided into two areas. The first area describes how the mission

Technology Challenges for Deep-Throttle Cryogenic Engines for Space Exploration

NASA Astrophysics Data System (ADS)

Brown, Kendall K.; Nelson, Karl W.

2005-02-01

Historically, cryogenic rocket engines have not been used for in-space applications due to their additional complexity, the mission need for high reliability, and the challenges of propellant boil-off. While the mission and vehicle architectures are not yet defined for the lunar and Martian robotic and human exploration objectives, cryogenic rocket engines offer the potential for higher performance and greater architecture/mission flexibility. In-situ cryogenic propellant production could enable a more robust exploration program by significantly reducing the propellant mass delivered to low earth orbit, thus warranting the evaluation of cryogenic rocket engines versus the hypergolic bipropellant engines used in the Apollo program. A multi-use engine, one which can provide the functionality that separate engines provided in the Apollo mission architecture, is desirable for lunar and Mars exploration missions because it increases overall architecture effectiveness through commonality and modularity. The engine requirement derivation process must address each unique mission application and each unique phase within each mission. The resulting requirements, such as thrust level, performance, packaging, burn duration, number of operations; required impulses for each trajectory phase; operation after extended space or surface exposure; availability for inspection and maintenance; throttle range for planetary descent, ascent, acceleration limits and many more must be addressed. Within engine system studies, the system and component technology, capability, and risks must be evaluated and a balance between the appropriate amount of technology-push and technology-pull must be addressed. This paper will summarize many of the key technology challenges associated with using high-performance cryogenic liquid propellant rocket engine systems and components in the exploration program architectures. The paper is divided into two areas. The first area describes how the mission

Addressing disparities and achieving equity: cultural competence, ethics, and health-care transformation.

PubMed

Betancourt, Joseph R; Corbett, James; Bondaryk, Matthew R

2014-01-01

The passage of health-care reform and current efforts in payment reform signal the beginning of a significant transformation of the US health-care system. An entire new set of structures is being developed to facilitate increased access to care that is cost-effective and of high quality. As described in The Institute of Medicine report "Crossing the Quality Chasm," our nation is charting a path toward quality health care that aims to be safe, efficient, effective, timely, patient-centered, and equitable. As our health-care system rapidly undergoes dramatic transformation, several truths-and challenges-remain. First, racial and ethnic disparities in health care persist and are a clear sign of inequality in quality. Second, although the root causes for these disparities are complex, there exists a well-developed set of evidence-based approaches to address them; among these is improving the cultural competence of health-care providers and the health-care system. Third, as part of our care redesign, we must assure that we are prepared to meet the ethical challenges ahead and reassert the importance of equity, fairness, and caring as key building blocks of a new care delivery system. As we move ahead, it is critical to assure that our health-care system is culturally competent and has the capacity to deliver high-quality care for all, while eliminating disparities and assuring equity. Disparities are unjust, unethical, costly, and unacceptable-and integrating strategies to achieve equity as part of our health-care system's transformation will give us an incredible opportunity to comprehensively address them.

Review of 11 national policies for rare diseases in the context of key patient needs.

PubMed

Dharssi, Safiyya; Wong-Rieger, Durhane; Harold, Matthew; Terry, Sharon

2017-03-31

Rare diseases collectively exert a global public health burden in the severity of their manifestations and the total number of people they afflict. For many patients, considerable barriers exist in terms of access to appropriate care, delayed diagnosis and limited or non-existing treatment options. Motivated by these challenges, the rare disease patient community has played a critical role, elevating the patient voice and mobilizing legislation to support the development of programs that address the needs of patients with rare diseases.The US Orphan Drug Act of 1983 served as a key milestone in this journey, providing a roadmap for other countries to introduce and implement similar orphan drug legislation; more recently, the European Union (EU) has gone further to encourage the widespread adoption and implementation of rare disease plans or strategies designed to more adequately address the comprehensive needs of patients with rare diseases. Despite these legislative efforts and the growing contributions of patient advocacy groups in moving forward implementation and adoption of rare disease programs, gaps still exist across the policy landscape for several countries. To gain deeper insights into the challenges and opportunities to address key needs of rare disease patients, it is critical to define the current status of rare disease legislation and policy across a geographically and economically diverse selection of countries. We analyzed the rare disease policy landscape across 11 countries: Germany, France, the United Kingdom, Canada, Bulgaria, Turkey, Argentina, Mexico, Brazil, China, and Taiwan. The status and implementation of policy was evaluated for each country in the context of key patient needs across 5 dimensions: improving coordination of care, diagnostic resources, access to treatments, patient awareness and support, and promoting innovative research. Our findings highlight the continuing role of the patient community in driving the establishment and

Addressing Criticality in Rare Earth Elements via Permanent Magnets Recycling

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

Nlebedim, I. C.; King, A. H.

Rare earth elements (REEs) are critical for many advanced technologies and are faced with potential supply disruptions. Recycling of permanent magnets (PMs) can be good sources for REEs which can help minimize global dependence on freshly mined REEs, but PMs are rarely recycled. Recycling of PMs has been discussed with respect to improving REEs resource sustainability. Some challenges to be addressed in order to establish industrially deployable technologies for PMs recycling have also been discussed, including profitability, energy efficiency and environmental impacts. Key considerations for promoting circular economy via PMs recycling is proposed with the focus on deciding the targetmore » points in the supply chain at which the recycled products will be inserted. Important technical considerations for recycling different forms of waste PMs, including swarfs, slags, shredded and intact hard disk drives magnets, have been presented. Lastly, the aspects of circular economy considered include reusing magnets, remanufacturing magnets and recovering of REEs from waste PMs.« less

Addressing Criticality in Rare Earth Elements via Permanent Magnets Recycling

DOE PAGES

Nlebedim, I. C.; King, A. H.

2017-12-12

Rare earth elements (REEs) are critical for many advanced technologies and are faced with potential supply disruptions. Recycling of permanent magnets (PMs) can be good sources for REEs which can help minimize global dependence on freshly mined REEs, but PMs are rarely recycled. Recycling of PMs has been discussed with respect to improving REEs resource sustainability. Some challenges to be addressed in order to establish industrially deployable technologies for PMs recycling have also been discussed, including profitability, energy efficiency and environmental impacts. Key considerations for promoting circular economy via PMs recycling is proposed with the focus on deciding the targetmore » points in the supply chain at which the recycled products will be inserted. Important technical considerations for recycling different forms of waste PMs, including swarfs, slags, shredded and intact hard disk drives magnets, have been presented. Lastly, the aspects of circular economy considered include reusing magnets, remanufacturing magnets and recovering of REEs from waste PMs.« less

Addressing Criticality in Rare Earth Elements via Permanent Magnets Recycling

NASA Astrophysics Data System (ADS)

Nlebedim, I. C.; King, A. H.

2017-12-01

Rare earth elements (REEs) are critical for many advanced technologies and are faced with potential supply disruptions. Recycling of permanent magnets (PMs) can be good sources for REEs which can help minimize global dependence on freshly mined REEs, but PMs are rarely recycled. Recycling of PMs has been discussed with respect to improving REEs resource sustainability. Some challenges to be addressed in order to establish industrially deployable technologies for PMs recycling have also been discussed, including profitability, energy efficiency and environmental impacts. Key considerations for promoting circular economy via PMs recycling is proposed with the focus on deciding the target points in the supply chain at which the recycled products will be inserted. Important technical considerations for recycling different forms of waste PMs, including swarfs, slags, shredded and intact hard disk drives magnets, have been presented. The aspects of circular economy considered include reusing magnets, remanufacturing magnets and recovering of REEs from waste PMs.

Addressing Criticality in Rare Earth Elements via Permanent Magnets Recycling

NASA Astrophysics Data System (ADS)

Nlebedim, I. C.; King, A. H.

2018-02-01

Rare earth elements (REEs) are critical for many advanced technologies and are faced with potential supply disruptions. Recycling of permanent magnets (PMs) can be good sources for REEs which can help minimize global dependence on freshly mined REEs, but PMs are rarely recycled. Recycling of PMs has been discussed with respect to improving REEs resource sustainability. Some challenges to be addressed in order to establish industrially deployable technologies for PMs recycling have also been discussed, including profitability, energy efficiency and environmental impacts. Key considerations for promoting circular economy via PMs recycling is proposed with the focus on deciding the target points in the supply chain at which the recycled products will be inserted. Important technical considerations for recycling different forms of waste PMs, including swarfs, slags, shredded and intact hard disk drives magnets, have been presented. The aspects of circular economy considered include reusing magnets, remanufacturing magnets and recovering of REEs from waste PMs.

Community-based participatory research in Little Haiti: challenges and lessons learned.

PubMed

Kobetz, Erin; Menard, Janelle; Diem, Joshua; Barton, Betsy; Blanco, Jenny; Pierre, Larry; Auguste, Pascale D; Etienne, Marie; Brewster, Cheryl

2009-01-01

Community-based participatory research (CBPR) is an effective methodology for developing relevant interventions with socially marginalized communities. However, implementing CBPR methods is challenging for several reasons. This paper presents challenges encountered in the context of an ongoing CBPR initiative in Little Haiti in Miami, Florida, and describes the solutions used to address them. We sought to describe the challenges faced and lessons learned while conducting CBPR in Little Haiti. Community-academic partnerships were created to guide the creation of culturally relevant cancer interventions and research. Historical distrust of research, cultural constructions of health and illness, and literacy issues are key considerations when developing partnerships with Haitian and other marginalized, immigrant communities. Partnerships are fostered over time through demonstrated mutual commitment to improving health and building community capacity. Communities must play an active role throughout the research process to ensure that studies are culturally relevant, and ensuing intervention, sustainable.

Addressing Psychosocial Factors with Library Mentoring

ERIC Educational Resources Information Center

Farrell, Bridget; Alabi, Jaena; Whaley, Pambanisha; Jenda, Claudine

2017-01-01

The majority of articles on mentoring in the library and information science field address career development by emphasizing the orientation process for new librarians and building the requisite skills for a specific job. Few articles deal with the psychological and social challenges that many early-career and minority librarians face, which can…

Addressing South Africa's Engineering Skills Gaps

ERIC Educational Resources Information Center

Hall, Jonathan; Sandelands, Eric

2009-01-01

Purpose: This paper aims to provide a case study of how engineering skills gaps are being addressed by Murray & Roberts in South Africa. Design/methodology/approach: The paper focuses on skills challenges in South Africa from a reflective practitioner perspective, exploring a case example from an industry leader. Findings: The paper explores…

Community health clinical education in Canada: part 2--developing competencies to address social justice, equity, and the social determinants of health.

PubMed

Cohen, Benita E; Gregory, David

2009-01-01

Recently, several Canadian professional nursing associations have highlighted the expectations that community health nurses (CHNs) should address the social determinants of health and promote social justice and equity. These developments have important implications for (pre-licensure) CHN clinical education. This article reports the findings of a qualitative descriptive study that explored how baccalaureate nursing programs in Canada address the development of competencies related to social justice, equity, and the social determinants of health in their community health clinical courses. Focus group interviews were held with community health clinical course leaders in selected Canadian baccalaureate nursing programs. The findings foster understanding of key enablers and challenges when providing students with clinical opportunities to develop the CHN role related to social injustice, inequity, and the social determinants of health. The findings may also have implications for nursing programs internationally that are addressing these concepts in their community health clinical courses.

Challenges in the Accurate Surveillance of Booster Seat and Bicycle Helmet Usage by Children: Lessons from the Field

PubMed Central

Pankratz, Curt; Warda, Lynne; Piotrowski, Caroline

2016-01-01

Motor vehicle collisions and bicycle collisions and falls are a leading cause of death by preventable injury for children. In order to design, implement and evaluate campaigns and programs aimed at improving child safety, accurate surveillance is needed. This paper examined the challenges that confront efforts to collect surveillance data relevant to child traffic safety, including observation, interview, and focus group methods. Strategies to address key challenges in order to improve the efficiency and accuracy of surveillance methods were recommended. The potential for new technology to enhance existing surveillance methods was also explored. PMID:27399749

Addressing Sexual Violence as Student Affairs Work

ERIC Educational Resources Information Center

Landreman, Lisa M.; Williamsen, Kaaren M.

2018-01-01

In this chapter, we outline the challenges campuses face in addressing sexual violence and Title IX compliance. We argue that there are critical roles for student affairs professionals in Title IX work in developing effective campus sexual violence prevention and response strategies.

New Methods to Address Old Challenges: The Use of Administrative Data for Longitudinal Replication Studies of Child Maltreatment

PubMed Central

Hurren, Emily; Stewart, Anna; Dennison, Susan

2017-01-01

Administrative data are crucial to the “big data” revolution of social science and have played an important role in the development of child maltreatment research. These data are also of value to administrators, policy makers, and clinicians. The focus of this paper is the use of administrative data to produce and replicate longitudinal studies of child maltreatment. Child protection administrative data have several advantages. They are often population-based, and allow longitudinal examination of child maltreatment and complex multi-level analyses. They also allow comparison across subgroups and minority groups, remove burden from individuals to disclose traumatic experiences, and can be less biased than retrospective recall. Finally, they can be linked to data from other agencies to explore comorbidity and outcomes, and are comparatively cost and time effective. The benefits and challenges associated with the use of administrative data for longitudinal child maltreatment research become magnified when these data are used to produce replications. Techniques to address challenges and support future replication efforts include developing a biographical understanding of the systems from which the data are drawn, using multiple data sources to contextualize the data and research results, recognizing and adopting various approaches to replication, and documenting all data coding and manipulation processes. These techniques are illustrated in this paper via a case study of previous replication work. PMID:28914775

New Methods to Address Old Challenges: The Use of Administrative Data for Longitudinal Replication Studies of Child Maltreatment.

PubMed

Hurren, Emily; Stewart, Anna; Dennison, Susan

2017-09-15

Administrative data are crucial to the "big data" revolution of social science and have played an important role in the development of child maltreatment research. These data are also of value to administrators, policy makers, and clinicians. The focus of this paper is the use of administrative data to produce and replicate longitudinal studies of child maltreatment. Child protection administrative data have several advantages. They are often population-based, and allow longitudinal examination of child maltreatment and complex multi-level analyses. They also allow comparison across subgroups and minority groups, remove burden from individuals to disclose traumatic experiences, and can be less biased than retrospective recall. Finally, they can be linked to data from other agencies to explore comorbidity and outcomes, and are comparatively cost and time effective. The benefits and challenges associated with the use of administrative data for longitudinal child maltreatment research become magnified when these data are used to produce replications. Techniques to address challenges and support future replication efforts include developing a biographical understanding of the systems from which the data are drawn, using multiple data sources to contextualize the data and research results, recognizing and adopting various approaches to replication, and documenting all data coding and manipulation processes. These techniques are illustrated in this paper via a case study of previous replication work.

Predicting Key Events in the Popularity Evolution of Online Information.

PubMed

Hu, Ying; Hu, Changjun; Fu, Shushen; Fang, Mingzhe; Xu, Wenwen

2017-01-01

The popularity of online information generally experiences a rising and falling evolution. This paper considers the "burst", "peak", and "fade" key events together as a representative summary of popularity evolution. We propose a novel prediction task-predicting when popularity undergoes these key events. It is of great importance to know when these three key events occur, because doing so helps recommendation systems, online marketing, and containment of rumors. However, it is very challenging to solve this new prediction task due to two issues. First, popularity evolution has high variation and can follow various patterns, so how can we identify "burst", "peak", and "fade" in different patterns of popularity evolution? Second, these events usually occur in a very short time, so how can we accurately yet promptly predict them? In this paper we address these two issues. To handle the first one, we use a simple moving average to smooth variation, and then a universal method is presented for different patterns to identify the key events in popularity evolution. To deal with the second one, we extract different types of features that may have an impact on the key events, and then a correlation analysis is conducted in the feature selection step to remove irrelevant and redundant features. The remaining features are used to train a machine learning model. The feature selection step improves prediction accuracy, and in order to emphasize prediction promptness, we design a new evaluation metric which considers both accuracy and promptness to evaluate our prediction task. Experimental and comparative results show the superiority of our prediction solution.

Multiscale Modeling in Computational Biomechanics: Determining Computational Priorities and Addressing Current Challenges

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

Tawhai, Merryn; Bischoff, Jeff; Einstein, Daniel R.

2009-05-01

Abstract In this article, we describe some current multiscale modeling issues in computational biomechanics from the perspective of the musculoskeletal and respiratory systems and mechanotransduction. First, we outline the necessity of multiscale simulations in these biological systems. Then we summarize challenges inherent to multiscale biomechanics modeling, regardless of the subdiscipline, followed by computational challenges that are system-specific. We discuss some of the current tools that have been utilized to aid research in multiscale mechanics simulations, and the priorities to further the field of multiscale biomechanics computation.

Regional Seminars to Address Current Nuclear Export Control Issues

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

Killinger, Mark H.

2002-07-01

The control of nuclear-related exports, a critical component of the nonproliferation regime, is facing several opportunities and challenges. As countries sign and ratify the International Atomic Energy Agency's (IAEA) safeguards Additional Protocol (AP), they will begin to report far more export information, including exports of a list of items similar to the Nuclear Supplier Group's Trigger List that existed when the AP was developed in the mid-1990s. This positive development contrasts with challenges such as globalization, transshipments, and tracking of end-uses. Pacific Northwest National Laboratory is proposing that the US Department of Energy (DOE) develop regional seminars that address thesemore » types of issues related to export/import controls. The DOE seminars would be designed to supplement regional seminars sponsored by the IAEA and member states on topics related to the Additional Protocol (referred to as "IAEA seminars"). The topic of nuclear export/import controls is not thoroughly addressed in the IAEA seminars. The proposed DOE seminars would therefore have two objectives: familiarizing countries with the export/import provisions of the Additional Protocol, and addressing challenges such as those noted above. The seminars would be directed particularly at countries that have not ratified the AP, and at regions where export-related problems are particularly prevalent. The intent is to encourage governments to implement more effective nuclear export control systems that meet the challenges of the 21st century.« less

Patient and healthcare perspectives on the importance and efficacy of addressing spiritual issues within an interdisciplinary bone marrow transplant clinic: a qualitative study

PubMed Central

Sinclair, Shane; McConnell, Shelagh; Raffin Bouchal, Shelley; Ager, Naree; Booker, Reanne; Enns, Bert; Fung, Tak

2015-01-01

Objectives The purpose of this study was to use a qualitative approach to better understand the importance and efficacy of addressing spiritual issues within an interdisciplinary bone marrow transplant clinic from the perspectives of patients and healthcare providers. Setting Participants were recruited from the bone marrow transplant clinic of a large urban outpatient cancer care centre in western Canada. Participants: Focus groups were conducted with patients (n=7) and healthcare providers (n=9) to explore the importance of addressing spiritual issues across the treatment trajectory and to identify factors associated with effectively addressing these needs. Results Data were analysed using the qualitative approach of latent content analysis. Addressing spiritual issues was understood by patients and healthcare providers, as a core, yet under addressed, component of comprehensive care. Both sets of participants felt that addressing basic spiritual issues was the responsibility of all members of the interdisciplinary team, while recognising the need for specialised and embedded support from a spiritual care professional. While healthcare providers felt that the impact of the illness and treatment had a negative effect on patients’ spiritual well-being, patients felt the opposite. Skills, challenges, key time points and clinical indicators associated with addressing spiritual issues were identified. Conclusions Despite a number of conceptual and clinical challenges associated with addressing spiritual issues patients and their healthcare providers emphasised the importance of an integrated approach whereby basic spiritual issues are addressed by members of the interdisciplinary team and by an embedded spiritual care professional, who in addition also provides specialised support. The identification of clinical issues associated with addressing spiritual needs provides healthcare providers with clinical guidance on how to better integrate this aspect of care into

Addressing Challenges to Public Understanding of Science: Epistemic Cognition, Motivated Reasoning, and Conceptual Change

ERIC Educational Resources Information Center

Sinatra, Gale M.; Kienhues, Dorothe; Hofer, Barbara K.

2014-01-01

Science is of critical importance to daily life in a knowledge society and has a significant influence on many everyday decisions. As scientific problems increase in their number and complexity, so do the challenges facing the public in understanding these issues. Our objective is to focus on 3 of those challenges: the challenge of reasoning about…

2010 Panel on the Biomaterials Grand Challenges

PubMed Central

Reichert, William “Monty”; Ratner, Buddy D.; Anderson, James; Coury, Art; Hoffman, Allan S.; Laurencin, Cato T.; Tirrell, David

2014-01-01

In 2009, the National Academy for Engineering issued the Grand Challenges for Engineering in the 21st Century comprised of 14 technical challenges that must be addressed to build a healthy, profitable, sustainable, and secure global community (http://www.engineeringchallenges.org). Although crucial, none of the NEA Grand Challenges adequately addressed the challenges that face the biomaterials community. In response to the NAE Grand Challenges, Monty Reichert of Duke University organized a panel entitled Grand Challenges in Biomaterials at the at the 2010 Society for Biomaterials Annual Meeting in Seattle. Six members of the National Academies—Buddy Ratner, James Anderson, Allan Hoffman, Art Coury, Cato Laurencin, and David Tirrell—were asked to propose a grand challenge to the audience that, if met, would significantly impact the future of biomaterials and medical devices. Successfully meeting these challenges will speed the 60-plus year transition from commodity, off-the-shelf biomaterials to bioengineered chemistries, and biomaterial devices that will significantly advance our ability to address patient needs and also to create new market opportunities. PMID:21171147

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

ERIC Educational Resources Information Center

Pook, Katja

2011-01-01

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

Probiotics and prebiotics--perspectives and challenges.

PubMed

Figueroa-González, Ivonne; Quijano, Guillermo; Ramírez, Gerardo; Cruz-Guerrero, Alma

2011-06-01

Owing to their health benefits, probiotics and prebiotics are nowadays widely used in yogurts and fermented milks, which are leader products of functional foods worldwide. The world market for functional foods has grown rapidly in the last three decades, with an estimated size in 2003 of ca US$ 33 billion, while the European market estimation exceeded US$ 2 billion in the same year. However, the production of probiotics and prebiotics at industrial scale faces several challenges, including the search for economical and abundant raw materials for prebiotic production, the low-cost production of probiotics and the improvement of probiotic viability after storage or during the manufacturing process of the functional food. In this review, functional foods based on probiotics and prebiotics are introduced as a key biotechnological field with tremendous potential for innovation. A concise state of the art addressing the fundamentals and challenges for the development of new probiotic- and prebiotic-based foods is presented, the niches for future research being clearly identified and discussed. Copyright © 2011 Society of Chemical Industry.

Developing content for an interprofessional training on fear of cancer recurrence (FCR): Key informant interviews of healthcare professionals, researchers and cancer survivors.

PubMed

Berrett-Abebe, Julie; Cadet, Tamara; Vitello, Joan; Maramaldi, Peter

2018-04-10

Growing numbers of cancer survivors are receiving healthcare through primary care practitioners, who often lack cancer-specific expertise to effectively treat survivors' concerns. Addressing that gap, this study aimed to develop content for a training on fear of cancer recurrence (FCR), a common concern in survivorship. Grounded in naturalistic inquiry, 42 key-informant interviews were conducted, transcribed, and analyzed for themes. Participants were healthcare professionals, researchers, and cancer survivors Results: Results included themes ranging from: rich conceptualizations of FCR, opportunities and challenges for addressing FCR in healthcare settings, interventions to address FCR, and important information to include in a training on FCR. This paper provides content for an interprofessional training and highlights the importance of developing trainings for interprofessional teams, given identified barriers that physicians face in addressing FCR and other psychosocial concerns of survivors in primary care.

Warren K. Sinclair Keynote Address: Current challenges in countering radiological terrorism.

PubMed

Poston, John W

2005-11-01

Terrorism, although perhaps known by other names, is not a new phenomenon. It dates back to Roman times and perhaps even further in world history. Caleb Carr says terrorism "is simply the contemporary name given to, and the modern permutation of, warfare deliberately waged against civilians with the purpose of destroying their will to support either their leaders or policies... " In modern times, in the United States, there have been isolated violent acts of citizens against each other, although these acts often were directed toward symbols of the federal government. In the Middle East and other parts of the world, acts of violence against U.S. citizens and military personnel date back into the early 1960's. Some of these acts seem to be almost random in nature. But these events occurred in distant lands of sometimes uncertain locations to the American public, who soon forgot them and their important message. Even though there had been at least one other attempt on the World Trade Center, it was not until 11 September 2001 that successful, large-scale acts of terrorism came to our shores. In 1998, the National Council on Radiation Protection and Measurements (NCRP) formed a Scientific Committee and charged the committee with the task of providing a report on the state of preparation and the potential use by terrorists of radiation and radioactivity. The draft report of the Committee was produced a year in advance of the events of 11 September 2001 and was published in its final form about a month after these terrible events. The report brought together, in one place, information that existed in a number of areas, not all of which were easily accessible. However, there were a number of gaps in the information and in the planning and preparation for such events. These were reflected in a series of recommendations for organization, planning, and training, as well as for research and development in a number of areas. This brief presentation will address a few selected

Strategies for Helping Parents of Young Children Address Challenging Behaviors in the Home

ERIC Educational Resources Information Center

Chai, Zhen; Lieberman-Betz, Rebecca

2016-01-01

Challenging behavior can be defined as any repeated pattern of behavior, or perception of behavior, that interferes with or is at risk of interfering with optimal learning or engagement in prosocial interactions with peers and adults. It is generally accepted in young children that challenging behaviors serve some sort of communicative purpose--to…

Challenges to collaboration in school mental health and strategies for overcoming them.

PubMed

Weist, Mark D; Mellin, Elizabeth A; Chambers, Kerri L; Lever, Nancy A; Haber, Deborah; Blaber, Christine

2012-02-01

This article reviews challenges to collaboration in school mental health (SMH) and presents practical strategies for overcoming them. The importance of collaboration to the success of SMH programs is reviewed, with a particular focus on collaboration between school- and community-employed professionals. Challenges to effective collaboration between school- and community-employed professionals in SMH are considered. Strategies for overcoming challenges to effective collaboration are presented. Marginalization of the SMH agenda, limited interdisciplinary teamwork, restricted coordination mechanisms, confidentiality concerns, and resource and funding issues are key challenges to collaboration. Strategies targeted toward each of these challenges may help improve the effectiveness of SMH programs and ultimately student outcomes. Collaboration between school- and community-employed professionals is critical to the success of SMH programs. Despite its promise, the success of SMH programs can be jeopardized by ineffective collaboration between school- and community-employed professionals. Strategies to overcome marginalization, promote authentic interdisciplinary teamwork, build effective coordination mechanisms, protect student and family confidentiality, and promote policy change and resource enhancements should be addressed in SMH improvement planning. © 2012, American School Health Association.

Addressing the Global Burden of Breast Cancer

Cancer.gov

The US National Cancer Institute’s Center for Global Health (CGH) has been a key partner in a multi-institutional expert team that has developed a set of publications to address foundational concerns in breast cancer care across the cancer care continuum and within limited resource settings.

Seafood traceability: current needs, available tools, and biotechnological challenges for origin certification.

PubMed

Leal, Miguel Costa; Pimentel, Tânia; Ricardo, Fernando; Rosa, Rui; Calado, Ricardo

2015-06-01

Market globalization and recurring food safety alerts have resulted in a growing consumer awareness of the need for food traceability. This is particularly relevant for seafood due to its perishable nature and importance as a key protein source for the population of the world. Here, we provide an overview of the current needs for seafood origin traceability, along with the limitations and challenges for its implementation. We focus on geochemical, biochemical, and molecular tools and how they should be optimized to be implemented globally and to address our societal needs. We suggest that seafood traceability is key to enforcing food safety regulations and fisheries control, combat fraud, and fulfill present and future expectations of conscientious producers, consumers, and authorities. Copyright © 2015 Elsevier Ltd. All rights reserved.

Bayesian calibration of coarse-grained forces: Efficiently addressing transferability

NASA Astrophysics Data System (ADS)

Patrone, Paul N.; Rosch, Thomas W.; Phelan, Frederick R.

2016-04-01

Generating and calibrating forces that are transferable across a range of state-points remains a challenging task in coarse-grained (CG) molecular dynamics. In this work, we present a coarse-graining workflow, inspired by ideas from uncertainty quantification and numerical analysis, to address this problem. The key idea behind our approach is to introduce a Bayesian correction algorithm that uses functional derivatives of CG simulations to rapidly and inexpensively recalibrate initial estimates f0 of forces anchored by standard methods such as force-matching. Taking density-temperature relationships as a running example, we demonstrate that this algorithm, in concert with various interpolation schemes, can be used to efficiently compute physically reasonable force curves on a fine grid of state-points. Importantly, we show that our workflow is robust to several choices available to the modeler, including the interpolation schemes and tools used to construct f0. In a related vein, we also demonstrate that our approach can speed up coarse-graining by reducing the number of atomistic simulations needed as inputs to standard methods for generating CG forces.

Biometric Methods for Secure Communications in Body Sensor Networks: Resource-Efficient Key Management and Signal-Level Data Scrambling

NASA Astrophysics Data System (ADS)

Bui, Francis Minhthang; Hatzinakos, Dimitrios

2007-12-01

As electronic communications become more prevalent, mobile and universal, the threats of data compromises also accordingly loom larger. In the context of a body sensor network (BSN), which permits pervasive monitoring of potentially sensitive medical data, security and privacy concerns are particularly important. It is a challenge to implement traditional security infrastructures in these types of lightweight networks since they are by design limited in both computational and communication resources. A key enabling technology for secure communications in BSN's has emerged to be biometrics. In this work, we present two complementary approaches which exploit physiological signals to address security issues: (1) a resource-efficient key management system for generating and distributing cryptographic keys to constituent sensors in a BSN; (2) a novel data scrambling method, based on interpolation and random sampling, that is envisioned as a potential alternative to conventional symmetric encryption algorithms for certain types of data. The former targets the resource constraints in BSN's, while the latter addresses the fuzzy variability of biometric signals, which has largely precluded the direct application of conventional encryption. Using electrocardiogram (ECG) signals as biometrics, the resulting computer simulations demonstrate the feasibility and efficacy of these methods for delivering secure communications in BSN's.

Pharmaceutical Market Access: current state of affairs and key challenges - results of the Market Access Launch Excellence Inventory (MALEI).

PubMed

Koch, Marcus A

2015-01-01

To take inventory of the current state of affairs of Market Access Launch Excellence in the life sciences industry. To identify key gaps and challenges for Market Access (MA) and discuss how they can be addressed. To generate a baseline for benchmarking MA launch excellence. An online survey was conducted with pharmaceutical executives primarily working in MA, marketing, or general management. The survey aimed to evaluate MA excellence prerequisites across the product life cycle (rated by importance and level of implementation) and to describe MA activity models in the respective companies. Composite scores were calculated from respondents' ratings and answers. Implementation levels of MA excellence prerequisites generally lagged behind their perceived importance. Item importance and the respective level of implementation correlated well, which can be interpreted as proof of the validity of the questionnaire. The following areas were shown to be particularly underimplemented: 1) early integration of MA and health economic considerations in research and development decision making, 2) developing true partnerships with payers, including the development of services 'beyond the pill', and 3) consideration of human resource and talent management. The concept of importance-adjusted implementation levels as a hybrid parameter was introduced and shown to be a viable tool for benchmarking purposes. More than 70% of respondents indicated that their companies will invest broadly in MA in terms of capital and headcount within the next 3 years. MA (launch) excellence needs to be further developed in order to close implementation gaps across the entire product life cycle. As MA is a comparatively young pharmaceutical discipline in a complex and dynamic environment, this effort will require strategic focus and dedication. The Market Access Launch Excellence Inventory benchmarking tool may help guide decision makers to prioritize their endeavors.

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...

Centennial Challenges

NASA Image and Video Library

2010-02-26

Doug Comstock, NASA's Director, Innovative Partnership Office, speaks during a ceremony for winners and participants of NASA’s 2009 Centennial Challenges, Friday, Feb. 26, 2010, at NASA Headquarters in Washington. The year-long competition addresses a range of technical challenges that support NASA's missions in aeronautics and space with a goal of encouraging novel solutions from non-traditional sources. Photo Credit: (NASA/Paul E. Alers)

Grand challenges for integrated USGS science—A workshop report

USGS Publications Warehouse

Jenni, Karen E.; Goldhaber, Martin B.; Betancourt, Julio L.; Baron, Jill S.; Bristol, R. Sky; Cantrill, Mary; Exter, Paul E.; Focazio, Michael J.; Haines, John W.; Hay, Lauren E.; Hsu, Leslie; Labson, Victor F.; Lafferty, Kevin D.; Ludwig, Kristin A.; Milly, Paul C. D.; Morelli, Toni L.; Morman, Suzette A.; Nassar, Nedal T.; Newman, Timothy R.; Ostroff, Andrea C.; Read, Jordan S.; Reed, Sasha C.; Shapiro, Carl D.; Smith, Richard A.; Sanford, Ward E.; Sohl, Terry L.; Stets, Edward G.; Terando, Adam J.; Tillitt, Donald E.; Tischler, Michael A.; Toccalino, Patricia L.; Wald, David J.; Waldrop, Mark P.; Wein, Anne; Weltzin, Jake F.; Zimmerman, Christian E.

2017-06-30

Executive SummaryThe U.S. Geological Survey (USGS) has a long history of advancing the traditional Earth science disciplines and identifying opportunities to integrate USGS science across disciplines to address complex societal problems. The USGS science strategy for 2007–2017 laid out key challenges in disciplinary and interdisciplinary arenas, culminating in a call for increased focus on a number of crosscutting science directions. Ten years on, to further the goal of integrated science and at the request of the Executive Leadership Team (ELT), a workshop with three dozen invited scientists spanning different disciplines and career stages in the Bureau convened on February 7–10, 2017, at the USGS John Wesley Powell Center for Analysis and Synthesis in Fort Collins, Colorado.The workshop focused on identifying “grand challenges” for integrated USGS science. Individual participants identified nearly 70 potential grand challenges before the workshop and through workshop discussions. After discussion, four overarching grand challenges emerged:Natural resource security,Societal risk from existing and emerging threats,Smart infrastructure development, andAnticipatory science for changing landscapes.Participants also identified a “comprehensive science challenge” that highlights the development of integrative science, data, models, and tools—all interacting in a modular framework—that can be used to address these and other future grand challenges:Earth Monitoring, Analyses, and Projections (EarthMAP)EarthMAP is our long-term vision for an integrated scientific framework that spans traditional scientific boundaries and disciplines, and integrates the full portfolio of USGS science: research, monitoring, assessment, analysis, and information delivery.The Department of Interior, and the Nation in general, have a vast array of information needs. The USGS meets these needs by having a broadly trained and agile scientific workforce. Encouraging and supporting

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.

Inter-Professional Primary Care Practices Addressing Diabetes Prevention and Management

ERIC Educational Resources Information Center

Beagrie, Lesley

2011-01-01

Imagine a partnership of university and community which addresses the needs of the community to keep its citizens healthy as long as possible. Through a planning exercise to address the community's needs in primary health care and health promotion, the university has developed key strategic directions to help support the needs of the community it…

Solar Sail Roadmap Mission GN and C Challenges

NASA Technical Reports Server (NTRS)

Heaton, Andrew F.

2005-01-01

The NASA In-Space Propulsion program is funding development work for solar sails to enhance future scientific opportunities. Key to this effort are scientific solar sail roadmap missions identified by peer review. The two near-term missions of interest are L1 Diamond and Solar Polar Imager. Additionally, the New Millennium Program is sponsoring the Space Technology 9 (ST9) demonstration mission. Solar sails are one of five technologies competing for the ST9 flight demonstration. Two candidate solar sail missions have been identified for a potential ST9 flight. All the roadmap missions and candidate flight demonstration missions face various GN&C challenges. A variety of efforts are underway to address these challenges. These include control actuator design and testing, low thrust optimization studies, attitude control system design and modeling, control-structure interaction studies, trajectory control design, and solar radiation pressure model development. Here we survey the various efforts underway and identify a few of specific recent interest and focus.

Addressing overuse of health services in health systems: a critical interpretive synthesis.

PubMed

Ellen, Moriah E; Wilson, Michael G; Vélez, Marcela; Shach, Ruth; Lavis, John N; Grimshaw, Jeremy M; Moat, Kaelan A

2018-06-15

Health systems are increasingly focusing on the issue of 'overuse' of health services and how to address it. We developed a framework focused on (1) the rationale and context for health systems prioritising addressing overuse, (2) elements of a comprehensive process and approach to reduce overuse and (3) implementation considerations for addressing overuse. We conducted a critical interpretive synthesis informed by a stakeholder-engagement process. The synthesis identified relevant empirical and non-empirical articles about system-level overuse. Two reviewers independently screened records, assessed for inclusion and conceptually mapped included articles. From these, we selected a purposive sample, created structured summaries of key findings and thematically synthesised the results. Our search identified 3545 references, from which we included 251. Most articles (76%; n = 192) were published within 5 years of conducting the review and addressed processes for addressing overuse (63%; n = 158) or political and health system context (60%; n = 151). Besides negative outcomes at the patient, system and global level, there were various contextual factors to addressing service overuse that seem to be key issue drivers. Processes for addressing overuse can be grouped into three elements comprising a comprehensive approach, including (1) approaches to identify overused health services, (2) stakeholder- or patient-led approaches and (3) government-led initiatives. Key implementation considerations include the need to develop 'buy in' from stakeholders and citizens. Health systems want to ensure the use of high-value services to keep citizens healthy and avoid harm. Our synthesis can be used by policy-makers, stakeholders and researchers to understand how the issue has been prioritised, what approaches have been used to address it and implementation considerations. PROSPERO CRD42014013204 .

Native Language Experience Shapes Neural Basis of Addressed and Assembled Phonologies

PubMed Central

Mei, Leilei; Xue, Gui; Lu, Zhong-Lin; He, Qinghua; Wei, Miao; Zhang, Mingxia; Dong, Qi; Chen, Chuansheng

2015-01-01

Previous studies have suggested differential engagement of addressed and assembled phonologies in reading Chinese and alphabetic languages (e.g., English) and the modulatory role of native language in learning to read a second language. However, it is not clear whether native language experience shapes the neural mechanisms of addressed and assembled phonologies. To address this question, we trained native Chinese and native English speakers to read the same artificial language (based on Korean Hangul) either through addressed (i.e., whole-word mapping) or assembled (i.e., grapheme-to-phoneme mapping) phonology. We found that, for both native Chinese and native English speakers, addressed phonology relied on the regions in the ventral pathway, whereas assembled phonology depended on the regions in the dorsal pathway. More importantly, we found that the neural mechanisms of addressed and assembled phonologies were shaped by native language experience. Specifically, two key regions for addressed phonology (i.e., the left middle temporal gyrus and right inferior temporal gyrus) showed greater activation for addressed phonology in native Chinese speakers, while one key region for assembled phonology (i.e., the left supramarginal gyrus) showed more activation for assembled phonology in native English speakers. These results provide direct neuroimaging evidence for the effect of native language experience on the neural mechanisms of phonological access in a new language and support the assimilation-accommodation hypothesis. PMID:25858447

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.

On the security of a simple three-party key exchange protocol without server's public keys.

PubMed

Nam, Junghyun; Choo, Kim-Kwang Raymond; Park, Minkyu; Paik, Juryon; Won, Dongho

2014-01-01

Authenticated key exchange protocols are of fundamental importance in securing communications and are now extensively deployed for use in various real-world network applications. In this work, we reveal major previously unpublished security vulnerabilities in the password-based authenticated three-party key exchange protocol according to Lee and Hwang (2010): (1) the Lee-Hwang protocol is susceptible to a man-in-the-middle attack and thus fails to achieve implicit key authentication; (2) the protocol cannot protect clients' passwords against an offline dictionary attack; and (3) the indistinguishability-based security of the protocol can be easily broken even in the presence of a passive adversary. We also propose an improved password-based authenticated three-party key exchange protocol that addresses the security vulnerabilities identified in the Lee-Hwang protocol.

On the Security of a Simple Three-Party Key Exchange Protocol without Server's Public Keys

PubMed Central

Nam, Junghyun; Choo, Kim-Kwang Raymond; Park, Minkyu; Paik, Juryon; Won, Dongho

2014-01-01

Authenticated key exchange protocols are of fundamental importance in securing communications and are now extensively deployed for use in various real-world network applications. In this work, we reveal major previously unpublished security vulnerabilities in the password-based authenticated three-party key exchange protocol according to Lee and Hwang (2010): (1) the Lee-Hwang protocol is susceptible to a man-in-the-middle attack and thus fails to achieve implicit key authentication; (2) the protocol cannot protect clients' passwords against an offline dictionary attack; and (3) the indistinguishability-based security of the protocol can be easily broken even in the presence of a passive adversary. We also propose an improved password-based authenticated three-party key exchange protocol that addresses the security vulnerabilities identified in the Lee-Hwang protocol. PMID:25258723

Academic Research Library as Broker in Addressing Interoperability Challenges for the Geosciences

NASA Astrophysics Data System (ADS)

Smith, P., II

2015-12-01

Data capture is an important process in the research lifecycle. Complete descriptive and representative information of the data or database is necessary during data collection whether in the field or in the research lab. The National Science Foundation's (NSF) Public Access Plan (2015) mandates the need for federally funded projects to make their research data more openly available. Developing, implementing, and integrating metadata workflows into to the research process of the data lifecycle facilitates improved data access while also addressing interoperability challenges for the geosciences such as data description and representation. Lack of metadata or data curation can contribute to (1) semantic, (2) ontology, and (3) data integration issues within and across disciplinary domains and projects. Some researchers of EarthCube funded projects have identified these issues as gaps. These gaps can contribute to interoperability data access, discovery, and integration issues between domain-specific and general data repositories. Academic Research Libraries have expertise in providing long-term discovery and access through the use of metadata standards and provision of access to research data, datasets, and publications via institutional repositories. Metadata crosswalks, open archival information systems (OAIS), trusted-repositories, data seal of approval, persistent URL, linking data, objects, resources, and publications in institutional repositories and digital content management systems are common components in the library discipline. These components contribute to a library perspective on data access and discovery that can benefit the geosciences. The USGS Community for Data Integration (CDI) has developed the Science Support Framework (SSF) for data management and integration within its community of practice for contribution to improved understanding of the Earth's physical and biological systems. The USGS CDI SSF can be used as a reference model to map to Earth

Successes and challenges of north-south partnerships - key lessons from the African/Asian Regional Capacity Development projects.

PubMed

Färnman, Rosanna; Diwan, Vishal; Zwarenstein, Merrick; Atkins, Salla

2016-01-01

Increasing efforts are being made globally on capacity building. North-south research partnerships have contributed significantly to enhancing the research capacity in low- and middle-income countries (LMICs) over the past few decades; however, a lack of skilled researchers to inform health policy development persists, particularly in LMICs. The EU FP7 funded African/Asian Regional Capacity Development (ARCADE) projects were multi-partner consortia aimed to develop a new generation of highly trained researchers from universities across the globe, focusing on global health-related subjects: health systems and services research and research on social determinants of health. This article aims to outline the successes, challenges and lessons learned from the life course of the projects, focusing on the key outputs and experiences of developing and implementing these two projects together with sub-Saharan African, Asian and European institution partners. Sixteen participants from 12 partner institutions were interviewed. The data were analysed using thematic content analysis, which resulted in four themes and three sub-categories. These data were complemented by a review of project reports. The results indicated that the ARCADE projects have been successful in developing and delivering courses, and have reached over 920 postgraduate students. Some partners thought the north-south and south-south partnerships that evolved during the project were the main achievement. However, others found there to be a 'north-south divide' in certain aspects. Challenges included technical constraints and quality assurance. Additionally, adapting new teaching and learning methods into current university systems was challenging, combined with not being able to award students with credits for their degrees. The ARCADE projects were introduced as an innovative and ambitious project idea, although not designed appropriately for all partner institutions. Some challenges were underestimated

Key Facts about Higher Education in Washington. 2012

ERIC Educational Resources Information Center

Washington Higher Education Coordinating Board, 2012

2012-01-01

"Key Facts about Higher Education in Washington" provides vital data to chart higher education's progress and challenges. First published in 2002 by the Washington Higher Education Coordinating Board, this annual report highlights "Key Facts" about Washington's postsecondary institutions--including faculty, students, budgets,…

Key challenges for nanotechnology: Standardization of ecotoxicity testing.

PubMed

Cerrillo, Cristina; Barandika, Gotzone; Igartua, Amaya; Areitioaurtena, Olatz; Mendoza, Gemma

2017-04-03

Nanotechnology is expected to contribute to the protection of the environment, but many uncertainties exist regarding the environmental and human implications of manufactured nanomaterials (MNMs). Contradictory results have been reported for their ecotoxicity to aquatic organisms, which constitute one of the most important pathways for their entrance and transfer throughout the food web. The present review is focused on the international strategies that are laying the foundations of the ecotoxicological assessment of MNMs. Specific advice is provided on the preparation of MNM dispersions in the culture media of the organisms, which is considered a key factor to overcome the limitations in the standardization of the test methodologies.

Predicting Key Events in the Popularity Evolution of Online Information

PubMed Central

Fu, Shushen; Fang, Mingzhe; Xu, Wenwen

2017-01-01

The popularity of online information generally experiences a rising and falling evolution. This paper considers the “burst”, “peak”, and “fade” key events together as a representative summary of popularity evolution. We propose a novel prediction task—predicting when popularity undergoes these key events. It is of great importance to know when these three key events occur, because doing so helps recommendation systems, online marketing, and containment of rumors. However, it is very challenging to solve this new prediction task due to two issues. First, popularity evolution has high variation and can follow various patterns, so how can we identify “burst”, “peak”, and “fade” in different patterns of popularity evolution? Second, these events usually occur in a very short time, so how can we accurately yet promptly predict them? In this paper we address these two issues. To handle the first one, we use a simple moving average to smooth variation, and then a universal method is presented for different patterns to identify the key events in popularity evolution. To deal with the second one, we extract different types of features that may have an impact on the key events, and then a correlation analysis is conducted in the feature selection step to remove irrelevant and redundant features. The remaining features are used to train a machine learning model. The feature selection step improves prediction accuracy, and in order to emphasize prediction promptness, we design a new evaluation metric which considers both accuracy and promptness to evaluate our prediction task. Experimental and comparative results show the superiority of our prediction solution. PMID:28046121

When doctor becomes patient: challenges and strategies in caring for physician-patients.

PubMed

Domeyer-Klenske, Amy; Rosenbaum, Marcy

2012-01-01

The current study was aimed at exploring the challenges that arise in the doctor-patient relationship when the patient is also a physician and identifying strategies physicians use to meet these challenges. No previous research has systematically investigated primary care physicians' perspectives on caring for physician-patients. Family medicine (n=15) and general internal medicine (n=14) physicians at a large Midwestern university participated in semi-structured interviews where they were asked questions about their experiences with physician-patients and the strategies they used to meet the unique needs of this patient population. Thematic analysis was used to identify common responses. Three of the challenges most commonly discussed by physician participants were: (1) maintaining boundaries between relationships with colleagues or between roles as physician/colleague/friend, (2) avoiding assumptions about patient knowledge and health behaviors, and (3) managing physician-patients' access to informal consultations, personal test results, and opinions from other colleagues. We were able to identify three main strategies clinicians use in addressing these perceived challenges: (1) Ignore the physician-patient's background, (2) Acknowledge the physician-patient's background and negotiate care, and (3) Allow care to be driven primarily by the physician-patient. It is important that primary care physicians understand the challenges inherent in treating physicians and develop a strategy with which they are comfortable addressing them. Explicitly communicating with the physician-patient to ensure boundaries are maintained, assumptions about the physician-patient are avoided, and physician-patient access is properly managed are key to providing quality care to physician-patients.

Addressing non-communicable diseases in Malaysia: an integrative process of systems and community

PubMed Central

2014-01-01

The prevalence of non-communicable diseases (NCDs) and NCD risk factors in Malaysia have risen substantially in the last two decades. The Malaysian Ministry of Health responded by implementing, “The National Strategic Plan for Non-Communicable Diseases (NSP-NCD) 2010-2014”, and the “NCD Prevention 1Malaysia” (NCDP-1M) programme. This paper outlines the primary health system context in which the NCDP-1M is framed. We also discuss the role of community in facilitating the integration of this programme, and outline some of the key challenges in addressing the sustainability of the plan over the next few years. The paper thus provides an analysis of an integration of a programme that involved a multi-sectoral approach with the view to contributing to a broader discourse on the development of responsive health systems. PMID:25080846

Setting objectives for managing Key deer

USGS Publications Warehouse

Diefenbach, Duane R.; Wagner, Tyler; Stauffer, Glenn E.

2014-01-01

The U.S. Fish and Wildlife Service (FWS) is responsible for the protection and management of Key deer (Odocoileus virginianus clavium) because the species is listed as Endangered under the Endangered Species Act (ESA). The purpose of the ESA is to protect and recover imperiled species and the ecosystems upon which they depend. There are a host of actions that could possibly be undertaken to recover the Key deer population, but without a clearly defined problem and stated objectives it can be difficult to compare and evaluate alternative actions. In addition, management goals and the acceptability of alternative management actions are inherently linked to stakeholders, who should be engaged throughout the process of developing a decision framework. The purpose of this project was to engage a representative group of stakeholders to develop a problem statement that captured the management problem the FWS must address with Key deer and identify objectives that, if met, would help solve the problem. In addition, the objectives were organized in a hierarchical manner (i.e., an objectives network) to show how they are linked, and measurable attributes were identified for each objective. We organized a group of people who represented stakeholders interested in and potentially affected by the management of Key deer. These stakeholders included individuals who represented local, state, and federal governments, non-governmental organizations, the general public, and local businesses. This stakeholder group met five full days over the course of an eight-week period to identify objectives that would address the following problem:“As recovery and removal from the Endangered Species list is the purpose of the Endangered Species Act, the U.S. Fish and Wildlife Service needs a management approach that will ensure a sustainable, viable, and healthy Key deer population. Urbanization has affected the behavior and population dynamics of the Key deer and the amount and characteristics

Voluntary medical male circumcision: a qualitative study exploring the challenges of costing demand creation in eastern and southern Africa.

PubMed

Bertrand, Jane T; Njeuhmeli, Emmanuel; Forsythe, Steven; Mattison, Sarah K; Mahler, Hally; Hankins, Catherine A

2011-01-01

This paper proposes an approach to estimating the costs of demand creation for voluntary medical male circumcision (VMMC) scale-up in 13 countries of eastern and southern Africa. It addresses two key questions: (1) what are the elements of a standardized package for demand creation? And (2) what challenges exist and must be taken into account in estimating the costs of demand creation? We conducted a key informant study on VMMC demand creation using purposive sampling to recruit seven people who provide technical assistance to government programs and manage budgets for VMMC demand creation. Key informants provided their views on the important elements of VMMC demand creation and the most effective funding allocations across different types of communication approaches (e.g., mass media, small media, outreach/mobilization). The key finding was the wide range of views, suggesting that a standard package of core demand creation elements would not be universally applicable. This underscored the importance of tailoring demand creation strategies and estimates to specific country contexts before estimating costs. The key informant interviews, supplemented by the researchers' field experience, identified these issues to be addressed in future costing exercises: variations in the cost of VMMC demand creation activities by country and program, decisions about the quality and comprehensiveness of programming, and lack of data on critical elements needed to "trigger the decision" among eligible men. Based on this study's findings, we propose a seven-step methodological approach to estimate the cost of VMMC scale-up in a priority country, based on our key assumptions. However, further work is needed to better understand core components of a demand creation package and how to cost them. Notwithstanding the methodological challenges, estimating the cost of demand creation remains an essential element in deriving estimates of the total costs for VMMC scale-up in eastern and

Narrative Research Addressing the Challenges of a Career in Professional Sports

ERIC Educational Resources Information Center

Frankl, Daniel

2013-01-01

The purpose of this article is to highlight the challenges that accomplished young athletes face as they aspire to become professional athletes. The data used in this study was derived from selected lived and told sport experiences of undergraduate and graduate kinesiology majors who were former competitive athletes. Additional data was derived…

Key Technologies of Phone Storage Forensics Based on ARM Architecture

NASA Astrophysics Data System (ADS)

Zhang, Jianghan; Che, Shengbing

2018-03-01

Smart phones are mainly running Android, IOS and Windows Phone three mobile platform operating systems. The android smart phone has the best market shares and its processor chips are almost ARM software architecture. The chips memory address mapping mechanism of ARM software architecture is different with x86 software architecture. To forensics to android mart phone, we need to understand three key technologies: memory data acquisition, the conversion mechanism from virtual address to the physical address, and find the system’s key data. This article presents a viable solution which does not rely on the operating system API for a complete solution to these three issues.

Addressing Challenges in Web Accessibility for the Blind and Visually Impaired

ERIC Educational Resources Information Center

Guercio, Angela; Stirbens, Kathleen A.; Williams, Joseph; Haiber, Charles

2011-01-01

Searching for relevant information on the web is an important aspect of distance learning. This activity is a challenge for visually impaired distance learners. While sighted people have the ability to filter information in a fast and non sequential way, blind persons rely on tools that process the information in a sequential way. Learning is…

Challenges for health care providers, parents and patients who face a child hood cancer diagnosis in Zambia.

PubMed

Walubita, Mulima; Sikateyo, Bornwell; Zulu, Joseph M

2018-05-02

Zambia is experiencing high prevalence of childhood cancer. However, very few children access and complete treatment for cancer. This study aimed to document the challenges for health care providers, parents and patients who face a child hood cancer diagnosis in Zambia, and their coping strategies. This was an exploratory health facility-based qualitative study that was conducted at a Paediatric oncology ward at referral hospital in Zambia. In-depth individual interviews conducted with fifteen (15) caregivers and seven (7) key informants were analysed using thematic analysis. Several challenges related to managing the childhood cancer diagnosis were recorded. Individual and family challenges were inadequate knowledge on childhood cancer, lack of finances to meet treatment and transport costs as well as long period of hospitalisation that affected women's ability to perform multiple responsibilities. Whereas challenges at community level were inadequate support to address emotional and physical distress and social stigmatisation experienced by caregivers. Health systems issues included inadequate specialised health workers, poor communication among health workers, limited space and beds as well as insufficient supplies such as blood. Cultural related factors were the belief that cancer is a product of witchcraft as well as religious beliefs regarding the role of faith healing in childhood cancer treatment. Coping strategies used by parents/ caregivers included praying to God, material support from organisations and church as well as delaying having another child. Addressing the challenges for health care providers, parents and patients who face a childhood cancer diagnosis may require adopting a systems or an ecological approach that allows developing strategies that simultaneously address challenges related to the individual, family, community, health system and cultural aspects.

African Science Leaders Focus on Key Challenges and Opportunities

NASA Astrophysics Data System (ADS)

Showstack, Randy

2014-08-01

While dozens of African presidents were in Washington, D. C., in early August to meet with U.S. president Barack Obama during the first U.S.-Africa Leaders Summit, African science ministers and science academy officials held their own gathering at the U.S. National Academy of Sciences (NAS) to focus on challenges and opportunities related to environmental protection, climate change, development, health, poverty, technology, and other issues.

Internet and mobile technologies: addressing the mental health of trauma survivors in less resourced communities.

PubMed

Ruzek, J I; Yeager, C M

2017-01-01

Internet and mobile technologies offer potentially critical ways of delivering mental health support in low-resource settings. Much evidence indicates an enormous negative impact of mental health problems in low- and middle-income countries (LMICs), and many of these problems are caused, or worsened, by exposure to wars, conflicts, natural and human-caused disasters, and other traumatic events. Though specific mental health treatments have been found to be efficacious and cost-effective for low-resource settings, most individuals living in these areas do not have access to them. Low-intensity task-sharing interventions will help, but there is a limit to the scalability and sustainability of human resources in these settings. To address the needs of trauma survivors, it will be important to develop and implement Internet and mobile technology resources to help reduce the scarcity, inequity, and inefficiency of current mental health services in LMICs. Mobile and Internet resources are experiencing a rapid growth in LMICs and can help address time, stigma, and cost barriers and connect those who have been socially isolated by traumatic events. This review discusses current research in technological interventions in low-resource settings and outlines key issues and future challenges and opportunities. Though formidable challenges exist for large-scale deployment of mobile and Internet mental health technologies, work to date indicates that these technologies are indeed feasible to develop, evaluate, and deliver to those in need of mental health services, and that they can be effective.

NATO: Key to Success in Afghanistan

DTIC Science & Technology

2011-03-24

of Military Studies Research Paper September 2009- April 2010 4. TITLE AND SUBTITLE Sa. CONTRACT NUMBER NATO: Key to Success in Afghanistan N /A Sb...GRANT NUMBER N /A Sc. PROGRAM ELEMENT NUMBER N /A 6. AUTHOR(S) Sd. PROJECT NUMBER Major F Walls GBR RM N /A Se. TASK NUMBER N /A Sf. WORK UNIT...NUMBER N /A 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION USMC Command and Staff College REPORT NUMBER Marine Corps

Centennial Challenges

NASA Image and Video Library

2010-02-26

NASA Administrator Charles Bolden, right, and Doug Comstock, left, stand with David Masten, of Masten Space Systems, during a ceremony for winners and participants of NASA’s 2009 Centennial Challenges, Friday, Feb. 26, 2010, at NASA Headquarters in Washington. The year-long competition addresses a range of technical challenges that support NASA's missions in aeronautics and space with a goal of encouraging novel solutions from non-traditional sources. Photo Credit: (NASA/Paul E. Alers)

Mars outpost - System and operations challenges

NASA Technical Reports Server (NTRS)

Roberts, Barney; Guerra, Lisa

1990-01-01

The paper addresses the challenges inherent in establishing an outpost on the planet Mars. For background purposes, the unique, remote Martian environment and the developmental phases of a settlement in such an environment are discussed. Challenges are identified in terms of surface systems and operations. Due to its importance to habitability, the life support system (LSS) is highlighted with various options identified. Operations for the Mars outpost, earth-based and local, are characterized by a decentralized concept. The challenge of integrating logistics analysis early in system design and operations strategy is also addressed. In order to understand and reduce the system and operations challenges, the application of terrestrial and lunar testbeds is explained.

Donor Research in Australia: Challenges and Promise

PubMed Central

Masser, Barbara; Smith, Geoff; Williams, Lisa A.

2014-01-01

Summary Donors are the key to the core business of Blood Collection Agencies (BCAs). However, historically, they have not been a focus of research undertaken by these organizations. This model is now changing, with significant donor research groups established in a number of countries, including Australia. Donor research in the Australian Red Cross Blood Service (Blood Service) is concentrated in the Donor and Community Research (DCR) team. Cognizant of the complex and ever-changing landscape with regard to optimal donor management, the DCR team collaborates with academics located at universities around Australia to coordinate a broad program of research that addresses both short- and-long term challenges to the blood supply. This type of collaboration is not, however, without challenges. Two major collaborative programs of the Blood Service's research, focusing on i) the recruitment and retention of plasmapheresis donors and ii) the role of the emotion pride in donor motivation and return, are showcased to elucidate how the challenges of conducting collaborative BCA research can be met. In so doing, these and the other research programs described herein demonstrate how the Blood Service supports and contributes to research that not only revises operational procedures but also contributes to advances in basic science. PMID:25254025

Key Concepts for and Assessment of an Undergraduate Class that Engages Engineering Students in Climate Change Grand Challenge

NASA Astrophysics Data System (ADS)

Powers, S. E.; DeWaters, J.; Dhaniyala, S.

2015-12-01

Engineers must take a leading role in addressing the challenges of mitigating climate change and adapting to the inevitable changes that our world is facing. Yet climate change classes targeting engineering students are scarce. Technical education must focus on the problem formulation and solutions that consider multiple, complex interactions between engineered systems and the Earth's climate system and recognize that transformation raises societal challenges, including trade-offs among benefits, costs, and risks. Moreover, improving engineering students' climate science literacy will require strategies that also inspire students' motivation to work toward their solution. A climate science course for engineers has been taught 5 semesters as part of a NASA Innovations in Climate Education program grant (NNXlOAB57A). The basic premise of this project was that effective instruction must incorporate scientifically-based knowledge and observations and foster critical thinking, problem solving, and decision-making skills. Lecture, in-class cooperative and computer-based learning and a semester project provide the basis for engaging students in evaluating effective mitigation and adaptation solutions. Policy and social issues are integrated throughout many of the units. The objective of this presentation is to highlight the content and pedagogical approach used in this class that helped to contribute to significant gains in engineering students' climate literacy and critical thinking competencies. A total of 89 students fully participated in a pre/post climate literacy questionnaire. As a whole, students demonstrated significant gains in climate-related content knowledge (p<0.001), affect (p<0.001), and behavior (p=0.002). Mean post scores were above a 'passing' cutoff (70%) for all three subscales. Assessment of semester project reports with a critical thinking rubric showed that the students did an excellent job of formulating problem statements and solutions in a

Standards, Assessment, and Readiness: Addressing Postsecondary Transition Issues across State Lines

ERIC Educational Resources Information Center

Michelau, Demarée K.

2015-01-01

This brief describes major challenges ahead for states, institutions, and most importantly, students as the standards and assessments from the Common Core Standards (CCSS) are implemented. It also offers recommendations to create a network structure that would assist K-12 and higher education leaders in addressing those challenges. To begin the…

The evolution of process-based hydrologic models: historical challenges and the collective quest for physical realism

NASA Astrophysics Data System (ADS)

Clark, Martyn P.; Bierkens, Marc F. P.; Samaniego, Luis; Woods, Ross A.; Uijlenhoet, Remko; Bennett, Katrina E.; Pauwels, Valentijn R. N.; Cai, Xitian; Wood, Andrew W.; Peters-Lidard, Christa D.

2017-07-01

The diversity in hydrologic models has historically led to great controversy on the correct approach to process-based hydrologic modeling, with debates centered on the adequacy of process parameterizations, data limitations and uncertainty, and computational constraints on model analysis. In this paper, we revisit key modeling challenges on requirements to (1) define suitable model equations, (2) define adequate model parameters, and (3) cope with limitations in computing power. We outline the historical modeling challenges, provide examples of modeling advances that address these challenges, and define outstanding research needs. We illustrate how modeling advances have been made by groups using models of different type and complexity, and we argue for the need to more effectively use our diversity of modeling approaches in order to advance our collective quest for physically realistic hydrologic models.

The evolution of process-based hydrologic models: historical challenges and the collective quest for physical realism

NASA Astrophysics Data System (ADS)

Clark, M. P.; Nijssen, B.; Wood, A.; Mizukami, N.; Newman, A. J.

2017-12-01

The diversity in hydrologic models has historically led to great controversy on the "correct" approach to process-based hydrologic modeling, with debates centered on the adequacy of process parameterizations, data limitations and uncertainty, and computational constraints on model analysis. In this paper, we revisit key modeling challenges on requirements to (1) define suitable model equations, (2) define adequate model parameters, and (3) cope with limitations in computing power. We outline the historical modeling challenges, provide examples of modeling advances that address these challenges, and define outstanding research needs. We illustrate how modeling advances have been made by groups using models of different type and complexity, and we argue for the need to more effectively use our diversity of modeling approaches in order to advance our collective quest for physically realistic hydrologic models.

Key challenges and recent progress in batteries, fuel cells, and hydrogen storage for clean energy systems

NASA Astrophysics Data System (ADS)

Chalk, Steven G.; Miller, James F.

Reducing or eliminating the dependency on petroleum of transportation systems is a major element of US energy research activities. Batteries are a key enabling technology for the development of clean, fuel-efficient vehicles and are key to making today's hybrid electric vehicles a success. Fuel cells are the key enabling technology for a future hydrogen economy and have the potential to revolutionize the way we power our nations, offering cleaner, more efficient alternatives to today's technology. Additionally fuel cells are significantly more energy efficient than combustion-based power generation technologies. Fuel cells are projected to have energy efficiency twice that of internal combustion engines. However before fuel cells can realize their potential, significant challenges remain. The two most important are cost and durability for both automotive and stationary applications. Recent electrocatalyst developments have shown that Pt alloy catalysts have increased activity and greater durability than Pt catalysts. The durability of conventional fluorocarbon membranes is improving, and hydrocarbon-based membranes have also shown promise of equaling the performance of fluorocarbon membranes at lower cost. Recent announcements have also provided indications that fuel cells can start from freezing conditions without significant deterioration. Hydrogen storage systems for vehicles are inadequate to meet customer driving range expectations (>300 miles or 500 km) without intrusion into vehicle cargo or passenger space. The United States Department of Energy has established three centers of Excellence for hydrogen storage materials development. The centers are focused on complex metal hydrides that can be regenerated onboard a vehicle, chemical hydrides that require off-board reprocessing, and carbon-based storage materials. Recent developments have shown progress toward the 2010 DOE targets. In addition DOE has established an independent storage material testing center

Pharmaceutical Market Access: current state of affairs and key challenges – results of the Market Access Launch Excellence Inventory (MALEI)

PubMed Central

Koch, Marcus A.

2015-01-01

Objectives To take inventory of the current state of affairs of Market Access Launch Excellence in the life sciences industry. To identify key gaps and challenges for Market Access (MA) and discuss how they can be addressed. To generate a baseline for benchmarking MA launch excellence. Methodology An online survey was conducted with pharmaceutical executives primarily working in MA, marketing, or general management. The survey aimed to evaluate MA excellence prerequisites across the product life cycle (rated by importance and level of implementation) and to describe MA activity models in the respective companies. Composite scores were calculated from respondents’ ratings and answers. Results Implementation levels of MA excellence prerequisites generally lagged behind their perceived importance. Item importance and the respective level of implementation correlated well, which can be interpreted as proof of the validity of the questionnaire. The following areas were shown to be particularly underimplemented: 1) early integration of MA and health economic considerations in research and development decision making, 2) developing true partnerships with payers, including the development of services ‘beyond the pill’, and 3) consideration of human resource and talent management. The concept of importance-adjusted implementation levels as a hybrid parameter was introduced and shown to be a viable tool for benchmarking purposes. More than 70% of respondents indicated that their companies will invest broadly in MA in terms of capital and headcount within the next 3 years. Conclusions MA (launch) excellence needs to be further developed in order to close implementation gaps across the entire product life cycle. As MA is a comparatively young pharmaceutical discipline in a complex and dynamic environment, this effort will require strategic focus and dedication. The Market Access Launch Excellence Inventory benchmarking tool may help guide decision makers to prioritize

New resources to address antibiotic resistance are just a click away

PubMed Central

Dowd-Schmidtke, C; Tremblay, G; Gale-Rowe, M; Dodds, J; Finley, R

2014-01-01

Antibiotic resistance is a complex issue with multiple causes, and there are many roles to play in addressing it. As part of its response, the Public Health Agency of Canada is launching a pilot antibiotic awareness campaign for Canadian families and health care professionals. Coinciding with Antibiotic Awareness Week, starting on November 17, 2014, the goal of this campaign is to improve knowledge and awareness of antibiotic resistance in Canada. To achieve this, the Agency has developed a suite of resources for both Canadian families and health care providers featuring a variety of key messages explaining antibiotic resistance, why it is important, and how to reduce the risks associated with it. Resources for Canadian families include an online informational video, an educational brochure, and infographics for both adults and children. Resources for health care professionals include two online Continuing Medical Education Modules, a letter that physicians can sign and provide to parents explaining why an antibiotic was not prescribed, and two webinars to present trends in antimicrobial resistance (AMR) and antimicrobial use. Health professionals will also receive an electronic postcard and a bilingual campaign poster. Promoting the campaign messages and using these campaign resources will support health professionals in discussions about antibiotic resistance with their patients or clients, and in their continuing efforts to be part of the solution in addressing this important global health challenge.

New resources to address antibiotic resistance are just a click away.

PubMed

Dowd-Schmidtke, C; Tremblay, G; Gale-Rowe, M; Dodds, J; Finley, R

2014-11-07

Antibiotic resistance is a complex issue with multiple causes, and there are many roles to play in addressing it. As part of its response, the Public Health Agency of Canada is launching a pilot antibiotic awareness campaign for Canadian families and health care professionals. Coinciding with Antibiotic Awareness Week, starting on November 17, 2014, the goal of this campaign is to improve knowledge and awareness of antibiotic resistance in Canada. To achieve this, the Agency has developed a suite of resources for both Canadian families and health care providers featuring a variety of key messages explaining antibiotic resistance, why it is important, and how to reduce the risks associated with it. Resources for Canadian families include an online informational video, an educational brochure, and infographics for both adults and children. Resources for health care professionals include two online Continuing Medical Education Modules, a letter that physicians can sign and provide to parents explaining why an antibiotic was not prescribed, and two webinars to present trends in antimicrobial resistance (AMR) and antimicrobial use. Health professionals will also receive an electronic postcard and a bilingual campaign poster. Promoting the campaign messages and using these campaign resources will support health professionals in discussions about antibiotic resistance with their patients or clients, and in their continuing efforts to be part of the solution in addressing this important global health challenge.

Key Issues in Instructional Computer Graphics.

ERIC Educational Resources Information Center

Wozny, Michael J.

1981-01-01

Addresses key issues facing universities which plan to establish instructional computer graphics facilities, including computer-aided design/computer aided manufacturing systems, role in curriculum, hardware, software, writing instructional software, faculty involvement, operations, and research. Thirty-seven references and two appendices are…

Challenges to Integrating Pharmacogenetic Testing into Medication Therapy Management

PubMed Central

Allen LaPointe, Nancy M.; Moaddeb, Jivan

2015-01-01

Background Some have proposed the integration of pharmacogenetic (PGx) testing into medication therapy management (MTM) to enable further refinement of treatment(s) to reduce risk of adverse responses and improve efficacy. PGx testing involves the analysis of genetic variants associated with therapeutic or adverse response and may be useful in enhancing the ability to identify ineffective and/or harmful drugs or drug combinations. This “enhanced” MTM might also reduce patient concerns about side effects and increase confidence that the medication is effective, addressing two key factors that impact patient adherence - concern and necessity. However, the feasibility and effectiveness of the integration of PGx testing into MTM in clinical practice has not yet been determined. Objectives In this paper, we consider some of the challenges to the integration and delivery of PGx testing in MTM services. What is already known about this subject While the addition of pharmacogenetic testing has been suggested, little literature exists exploring the challenges or feasibility of doing so. PMID:25803768

HNSciCloud - Overview and technical Challenges

NASA Astrophysics Data System (ADS)

Gasthuber, Martin; Meinhard, Helge; Jones, Robert

2017-10-01

HEP is only one of many sciences with sharply increasing compute requirements that cannot be met by profiting from Moore’s law alone. Commercial clouds potentially allow for realising larger economies of scale. While some small-scale experience requiring dedicated effort has been collected, public cloud resources have not been integrated yet with the standard workflows of science organisations in their private data centres; in addition, European science has not ramped up to significant scale yet. The HELIX NEBULA Science Cloud project - HNSciCloud, partly funded by the European Commission, addresses these points. Ten organisations under CERN’s leadership, covering particle physics, bioinformatics, photon science and other sciences, have joined to procure public cloud resources as well as dedicated development efforts towards this integration. The HNSciCloud project faces the challenge to accelerate developments performed by the selected commercial providers. In order to guarantee cost efficient usage of IaaS resources across a wide range of scientific communities, the technical requirements had to be carefully constructed. With respect to current IaaS offerings, dataintensive science is the biggest challenge; other points that need to be addressed concern identity federations, network connectivity and how to match business practices of large IaaS providers with those of public research organisations. In the first section, this paper will give an overview of the project and explain the findings so far. The last section will explain the key points of the technical requirements and present first results of the experience of the procurers with the services in comparison to their’on-premise’ infrastructure.

The psychosocial challenges of solid organ transplant recipients during childhood.

PubMed

Annunziato, Rachel A; Jerson, Bradley; Seidel, Jordan; Glenwick, David S

2012-11-01

A large proportion of pediatric solid organ transplant recipients are young children, yet dedicated studies on the challenges faced by these patients are sparse. The present article aims to provide a summary of key considerations for pediatric solid organ transplant teams, describing what challenges are more likely for younger patients and how they might identify and address these circumstances. Our findings suggest that the mental health of patients and caregivers, issues at school, neurocognitive difficulties, and self-management are areas of particular relevance for children. We offer several recommendations that stem from these identified areas of concern. Dedicated focus on the well-being of younger patients could in the long-term stave off adverse events that are often associated with adolescence. In the short-term, certainly intervening in any of these domains could lead to improved quality of life during childhood. © 2012 John Wiley & Sons A/S.

Addressing Challenges to the Design & Test of Operational Lighting Environments for the International Space Station

NASA Technical Reports Server (NTRS)

Clark, Toni A.

2014-01-01

In our day to day lives, the availability of light, with which to see our environment, is often taken for granted. The designers of land based lighting systems use sunlight and artificial light as their toolset. The availability of power, quantity of light sources, and variety of design options are often unlimited. The accessibility of most land based lighting systems makes it easy for the architect and engineer to verify and validate their design ideas. Failures with an implementation, while sometimes costly, can easily be addressed by renovation. Consider now, an architectural facility orbiting in space, 260 miles above the surface of the earth. This human rated architectural facility, the International Space Station (ISS) must maintain operations every day, including life support and appropriate human comforts without fail. The facility must also handle logistics of regular shipments of cargo, including new passengers. The ISS requires accommodations necessary for human control of machine systems. Additionally, the ISS is a research facility and supports investigations performed inside and outside its livable volume. Finally, the facility must support remote operations and observations by ground controllers. All of these architectural needs require a functional, safe, and even an aesthetic lighting environment. At Johnson Space Center, our Habitability and Human Factors team assists our diverse customers with their lighting environment challenges, via physical test and computer based analysis. Because of the complexity of ISS operational environment, our team has learned and developed processes that help ISS operate safely. Because of the dynamic exterior lighting environment, uses computational modeling to predict the lighting environment. The ISS' orbit exposes it to a sunrise every 90 minutes, causing work surfaces to quickly change from direct sunlight to earthshine to total darkness. Proper planning of vehicle approaches, robotics operations, and crewed

Addressing current challenges in cancer immunotherapy with mathematical and computational modelling.

PubMed

Konstorum, Anna; Vella, Anthony T; Adler, Adam J; Laubenbacher, Reinhard C

2017-06-01

The goal of cancer immunotherapy is to boost a patient's immune response to a tumour. Yet, the design of an effective immunotherapy is complicated by various factors, including a potentially immunosuppressive tumour microenvironment, immune-modulating effects of conventional treatments and therapy-related toxicities. These complexities can be incorporated into mathematical and computational models of cancer immunotherapy that can then be used to aid in rational therapy design. In this review, we survey modelling approaches under the umbrella of the major challenges facing immunotherapy development, which encompass tumour classification, optimal treatment scheduling and combination therapy design. Although overlapping, each challenge has presented unique opportunities for modellers to make contributions using analytical and numerical analysis of model outcomes, as well as optimization algorithms. We discuss several examples of models that have grown in complexity as more biological information has become available, showcasing how model development is a dynamic process interlinked with the rapid advances in tumour-immune biology. We conclude the review with recommendations for modellers both with respect to methodology and biological direction that might help keep modellers at the forefront of cancer immunotherapy development. © 2017 The Author(s).

Seaworthy Quantum Key Distribution Design and Validation (SEAKEY)

DTIC Science & Technology

2016-03-10

Contractor Address: 10 Moulton Street, Cambridge, MA 02138 Title of the Project: Seaworthy Quantum Key Distribution Design and Validation (SEAKEY...Technologies Kathryn Carson Program Manager Quantum Information Processing 2 | P a g e Approved for public release; distribution is...we have continued work calculating the key rates achievable parametrically with receiver performance. In addition, we describe the initial designs

How Can eHealth Technology Address Challenges Related to Multimorbidity? Perspectives from Patients with Multiple Chronic Conditions.

PubMed

Zulman, Donna M; Jenchura, Emily C; Cohen, Danielle M; Lewis, Eleanor T; Houston, Thomas K; Asch, Steven M

2015-08-01

Patient eHealth technology offers potential support for disease self-management, but the value of existing applications for patients with multiple chronic conditions (MCCs) is unclear. To understand self-management and health care navigation challenges that patients face due to MCCs and to identify opportunities to support these patients through new and enhanced eHealth technology. After administering a screening survey, we conducted 10 focus groups of 3-8 patients grouped by age, sex, and common chronic conditions. Patients discussed challenges associated with having MCCs and their use of (and desires from) technology to support self-management. Three investigators used standard content analysis methods to code the focus group transcripts. Emergent themes were reviewed with all collaborators, and final themes and representative quotes were validated with a sample of participants. Fifty-three individuals with ≥3 chronic conditions and experience using technology for health-related purposes. Focus group participants had an average of five chronic conditions. Participants reported using technology most frequently to search for health information (96%), communicate with health care providers (92%), track medical information (83%), track medications (77%), and support decision-making about treatment (55%). Three themes emerged to guide eHealth technology development: (1) Patients with MCCs manage a high volume of information, visits, and self-care tasks; (2) they need to coordinate, synthesize, and reconcile health information from multiple providers and about different conditions; (3) their unique position at the hub of multiple health issues requires self-advocacy and expertise. Focus groups identified desirable eHealth resources and tools that reflect these themes. Although patients with multiple health issues use eHealth technology to support self-care for specific conditions, they also desire tools that transcend disease boundaries. By addressing the holistic

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

Where are they now? Cash and Counseling successes and challenges over time

PubMed Central

Simon-Rusinowitz, Lori; Schwartz, Abby J.; Loughlin, Dawn; Sciegaj, Mark; Mahoney, Kevin J.; Donkoh, Yaw

2014-01-01

The positive results of the Cash & Counseling Demonstration and Evaluation (CCDE) led to the funding of a replication project that included 12 more states in 2008. Since then, the political and economic environments have changed. The authors sought to investigate how well the three original and 12 replication CCDE programs are coping with current challenges, and how their experiences may inform the growth and sustainability of emerging participant-directed programs. Semistructured telephone interviews were conducted with the 15 Cash & Counseling state program administrators. Key topics addressed included: successful aspects of state programs, biggest challenges for each program, and information program administrators would like to learn from state colleagues. Themes related to budget issues (e.g., staff shortages and program funding cuts) and non-budget related issues (e.g., understanding of program operations) emerged from the interviews. State program administrators also discussed program successes. To promote the sustainability and growth of participant-directed programs, existing participant-directed programs should be tied to national policy trends as well as review whether or not the programs address participant-directed principles. The development of new participant-directed programs should be based on other states’ experiences as discussed in this paper. PMID:25750590

MEASUREMENT ISSUES IN HOME-VISITING RESEARCH WITHIN TRIBAL COMMUNITIES: CHALLENGES AND STRATEGIES.

PubMed

Whitesell, Nancy Rumbaugh; Bolan, Marc; Chomos, Julianna C; Heath, Debra; Miles, Jon; Salvador, Melina; Whitmore, Corrie; Barlow, Allison

2018-05-04

In this article, Tribal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) grantees share strategies they have developed and adopted to address the most common barriers to effective measurement (and thus to effective evaluation) encountered in the course of implementation and evaluation of their home-visiting programs. We identify key challenges in measuring outcomes in Tribal MIECHV Programs and provide practical examples of various strategies used to address these challenges within diverse American Indian and Alaska Native cultural and contextual settings. Notably, high-quality community engagement is a consistent thread throughout these strategies and fundamental to successful measurement in these communities. These strategies and practices reflect the experiences and innovative solutions of practitioners working on the ground to deliver and evaluate intervention programs to tribal communities. They may serve as models for getting high-quality data to inform intervention while working within the constraints and requirements of program funding. The utility of these practical solutions extends beyond the Tribal MIECHV grantees and offers the potential to inform a broad array of intervention evaluation efforts in tribal and other community contexts. © 2018 Michigan Association for Infant Mental Health.

Addressing unwarranted clinical variation: A rapid review of current evidence.

PubMed

Harrison, Reema; Manias, Elizabeth; Mears, Stephen; Heslop, David; Hinchcliff, Reece; Hay, Liz

2018-05-15

Unwarranted clinical variation (UCV) can be described as variation that can only be explained by differences in health system performance. There is a lack of clarity regarding how to define and identify UCV and, once identified, to determine whether it is sufficiently problematic to warrant action. As such, the implementation of systemic approaches to reducing UCV is challenging. A review of approaches to understand, identify, and address UCV was undertaken to determine how conceptual and theoretical frameworks currently attempt to define UCV, the approaches used to identify UCV, and the evidence of their effectiveness. Rapid evidence assessment (REA) methodology was used. A range of text words, synonyms, and subject headings were developed for the major concepts of unwarranted clinical variation, standards (and deviation from these standards), and health care environment. Two electronic databases (Medline and Pubmed) were searched from January 2006 to April 2017, in addition to hand searching of relevant journals, reference lists, and grey literature. Results were merged using reference-management software (Endnote) and duplicates removed. Inclusion criteria were independently applied to potentially relevant articles by 3 reviewers. Findings were presented in a narrative synthesis to highlight key concepts addressed in the published literature. A total of 48 relevant publications were included in the review; 21 articles were identified as eligible from the database search, 4 from hand searching published work and 23 from the grey literature. The search process highlighted the voluminous literature reporting clinical variation internationally; yet, there is a dearth of evidence regarding systematic approaches to identifying or addressing UCV. Wennberg's classification framework is commonly cited in relation to classifying variation, but no single approach is agreed upon to systematically explore and address UCV. The instances of UCV that warrant investigation and

Addressing Wife Abuse in Mexican Immigrant Couples: Challenges for Family Social Workers

ERIC Educational Resources Information Center

Hancock, Tina

2006-01-01

This article addresses wife abuse in undocumented Mexican immigrant couples and suggests an ecosystems treatment approach that takes into consideration the structural forces of oppression and discrimination on abusive behaviors in the home and combines individual, family and community level interventions to help immigrant men stop the abuse.…

Addressing the hidden dimension in nursing education: promoting cultural competence.

PubMed

Carter, Kimberly F; Xu, Yu

2007-01-01

The authors describe a cultural competence quality enhancement process to address the retention challenge of students who speak English as second language and international students as part of a school of nursing's continuous program quality improvement to achieve excellence. The process, strategies, outcomes, and evaluation of the training program are detailed within the given geographical, institutional, and curriculum context. Lessons and continuing challenges are also specified.

OECD, "Key Competencies" and the New Challenges of Educational Inequality

ERIC Educational Resources Information Center

Takayama, Keita

2013-01-01

In this paper, I develop a critique of the Organization for Economic Cooperation and Development (OECD)-based lifelong learning policy discourse with a particular focus on "key competencies" (KCs) and its equity implications for school curricular policies. First, I review the discussion of KCs in the writings by the OECD-affiliated…

Supportability Challenges, Metrics, and Key Decisions for Future Human Spaceflight

NASA Technical Reports Server (NTRS)

Owens, Andrew C.; de Weck, Olivier L.; Stromgren, Chel; Cirillo, William; Goodliff, Kandyce

2017-01-01

Future crewed missions beyond Low Earth Orbit (LEO) represent a logistical challenge that is unprecedented in human space flight. Astronauts will travel farther and stay in space for longer than any previous mission, far from timely abort or resupply from Earth. Under these conditions, supportability { defined as the set of system characteristics that influence the logistics and support required to enable safe and effective operations of systems { will be a much more significant driver of space system lifecycle properties than it has been in the past. This paper presents an overview of supportability for future human space flight. The particular challenges of future missions are discussed, with the differences between past, present, and future missions highlighted. The relationship between supportability metrics and mission cost, performance, schedule, and risk is also discussed. A set of pro- posed strategies for managing supportability is presented (including reliability growth, uncertainty reduction, level of repair, commonality, redundancy, In-Space Manufacturing (ISM) (including the use of material recycling and In-Situ Resource Utilization (ISRU) for spares and maintenance items), reduced complexity, and spares inventory decisions such as the use of predeployed or cached spares - along with a discussion of the potential impacts of each of those strategies. References are provided to various sources that describe these supportability metrics and strategies, as well as associated modeling and optimization techniques, in greater detail. Overall, supportability is an emergent system characteristic and a holistic challenge for future system development. System designers and mission planners must carefully consider and balance the supportability metrics and decisions described in this paper in order to enable safe and effective beyond-LEO human space flight.

Addressing Methodological Challenges in Large Communication Datasets: Collecting and Coding Longitudinal Interactions in Home Hospice Cancer Care

PubMed Central

Reblin, Maija; Clayton, Margaret F; John, Kevin K; Ellington, Lee

2015-01-01

In this paper, we present strategies for collecting and coding a large longitudinal communication dataset collected across multiple sites, consisting of over 2000 hours of digital audio recordings from approximately 300 families. We describe our methods within the context of implementing a large-scale study of communication during cancer home hospice nurse visits, but this procedure could be adapted to communication datasets across a wide variety of settings. This research is the first study designed to capture home hospice nurse-caregiver communication, a highly understudied location and type of communication event. We present a detailed example protocol encompassing data collection in the home environment, large-scale, multi-site secure data management, the development of theoretically-based communication coding, and strategies for preventing coder drift and ensuring reliability of analyses. Although each of these challenges have the potential to undermine the utility of the data, reliability between coders is often the only issue consistently reported and addressed in the literature. Overall, our approach demonstrates rigor and provides a “how-to” example for managing large, digitally-recorded data sets from collection through analysis. These strategies can inform other large-scale health communication research. PMID:26580414

Successes and challenges of north–south partnerships – key lessons from the African/Asian Regional Capacity Development projects

PubMed Central

Färnman, Rosanna; Diwan, Vishal; Zwarenstein, Merrick; Atkins, Salla

2016-01-01

Introduction Increasing efforts are being made globally on capacity building. North–south research partnerships have contributed significantly to enhancing the research capacity in low- and middle-income countries (LMICs) over the past few decades; however, a lack of skilled researchers to inform health policy development persists, particularly in LMICs. The EU FP7 funded African/Asian Regional Capacity Development (ARCADE) projects were multi-partner consortia aimed to develop a new generation of highly trained researchers from universities across the globe, focusing on global health-related subjects: health systems and services research and research on social determinants of health. This article aims to outline the successes, challenges and lessons learned from the life course of the projects, focusing on the key outputs and experiences of developing and implementing these two projects together with sub-Saharan African, Asian and European institution partners. Design Sixteen participants from 12 partner institutions were interviewed. The data were analysed using thematic content analysis, which resulted in four themes and three sub-categories. These data were complemented by a review of project reports. Results The results indicated that the ARCADE projects have been successful in developing and delivering courses, and have reached over 920 postgraduate students. Some partners thought the north–south and south–south partnerships that evolved during the project were the main achievement. However, others found there to be a ‘north–south divide’ in certain aspects. Challenges included technical constraints and quality assurance. Additionally, adapting new teaching and learning methods into current university systems was challenging, combined with not being able to award students with credits for their degrees. Conclusion The ARCADE projects were introduced as an innovative and ambitious project idea, although not designed appropriately for all partner

Enablers and challenges to occupational therapists’ research engagement: A qualitative study

PubMed Central

Di Bona, Laura; Wenborn, Jennifer; Field, Becky; Hynes, Sinéad M; Ledgerd, Ritchard; Mountain, Gail; Swinson, Tom

2017-01-01

Introduction To develop occupational therapy’s evidence base and improve its clinical outcomes, occupational therapists must increase their research involvement. Barriers to research consumption and leadership are well documented, but those relating to delivering research interventions, less so. Yet, interventions need to be researched within practice to demonstrate their clinical effectiveness. This study aims to improve understanding of challenges and enablers experienced by occupational therapists who deliver interventions within research programmes. Method Twenty-eight occupational therapists who participated in the Valuing Active Life in Dementia (VALID) research programme reported their experiences in five focus groups. Data were analysed thematically to identify key and subthemes. Results Occupational therapists reported that overwhelming paperwork, use of videos, recruitment and introducing a new intervention challenged their research involvement, whereas support, protected time and a positive attitude enabled it. The impact of these challenges and enablers varied between therapists and organisations. Conclusion Challenges and enablers to research involvement can be identified but must be addressed within individual and organisational contexts. Multifaceted collective action to minimise challenges and maximise enablers can facilitate clinicians’ involvement in research. Using this approach should enable occupational therapists to increase their research involvement, thus demonstrating the clinical effectiveness of their interventions. PMID:29170592

Addressing challenges of modulation transfer function measurement with fisheye lens cameras

NASA Astrophysics Data System (ADS)

Deegan, Brian M.; Denny, Patrick E.; Zlokolica, Vladimir; Dever, Barry; Russell, Laura

2015-03-01

Modulation transfer function (MTF) is a well defined and accepted method of measuring image sharpness. The slanted edge test, as defined in ISO12233 is a standard method of calculating MTF, and is widely used for lens alignment and auto-focus algorithm verification. However, there are a number of challenges which should be considered when measuring MTF in cameras with fisheye lenses. Due to trade-offs related Petzval curvature, planarity of the optical plane is difficult to achieve in fisheye lenses. It is therefore critical to have the ability to accurately measure sharpness throughout the entire image, particularly for lens alignment. One challenge for fisheye lenses is that, because of the radial distortion, the slanted edges will have different angles, depending on the location within the image and on the distortion profile of the lens. Previous work in the literature indicates that MTF measurements are robust for angles between 2 and 10 degrees. Outside of this range, MTF measurements become unreliable. Also, the slanted edge itself will be curved by the lens distortion, causing further measurement problems. This study summarises the difficulties in the use of MTF for sharpness measurement in fisheye lens cameras, and proposes mitigations and alternative methods.

Key handling in wireless sensor networks

NASA Astrophysics Data System (ADS)

Li, Y.; Newe, T.

2007-07-01

With the rapid growth of Wireless Sensor Networks (WSNs), many advanced application areas have received significant attention. However, security will be an important factor for their full adoption. Wireless sensor nodes pose unique challenges and as such traditional security protocols, used in traditional networks cannot be applied directly. Some new protocols have been published recently with the goal of providing both privacy of data and authentication of sensor nodes for WSNs. Such protocols can employ private-key and/or public key cryptographic algorithms. Public key algorithms hold the promise of simplifying the network infrastructure required to provide security services such as: privacy, authentication and non-repudiation, while symmetric algorithms require less processing power on the lower power wireless node. In this paper a selection of key establishment/agreement protocols are reviewed and they are broadly divided into two categories: group key agreement protocols and pair-wise key establishment protocols. A summary of the capabilities and security related services provided by each protocol is provided.

Addressing Parental Vaccination Questions in the School Setting

ERIC Educational Resources Information Center

Luthy, Karlen E.; Burningham, Jana; Eden, Lacey M.; Macintosh, Janelle L. B.; Beckstrand, Renea L.

2016-01-01

School nurses work in a unique environment with key opportunities to address parental concerns and questions regarding their child's health. A common concern for parents during school enrollment is childhood vaccination safety and efficacy. As public health leaders, school nurses are well respected among parents, therefore school nurses are in a…

Seaworthy Quantum Key Distribution Design and Validation (SEAKEY)

DTIC Science & Technology

2015-05-27

Address: 10 Moulton Street, Cambridge, MA 02138 Title of the Project: Seaworthy Quantum Key Distribution Design and Validation (SEAKEY...Technologies Kathryn Carson Program Manager Quantum Information Processing Report Documentation Page Form ApprovedOMB No. 0704-0188 Public...2016 4. TITLE AND SUBTITLE Seaworthy Quantum Key Distribution Design and Validation (SEAKEY) 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM

Issues and Challenges Facing Flexible Lithium-Ion Batteries for Practical Application.

PubMed

Cha, Hyungyeon; Kim, Junhyeok; Lee, Yoonji; Cho, Jaephil; Park, Minjoon

2017-12-27

With the advent of flexible electronics, lithium-ion batteries have become a key component of high performance energy storage systems. Thus, considerable effort is made to keep up with the development of flexible lithium-ion batteries. To date, many researchers have studied newly designed batteries with flexibility, however, there are several significant challenges that need to be overcome, such as degradation of electrodes under external load, poor battery performance, and complicated cell preparation procedures. In addition, an in-depth understanding of the current challenges for flexible batteries is rarely addressed in a systematical and practical way. Herein, recent progress and current issues of flexible lithium-ion batteries in terms of battery materials and cell designs are reviewed. A critical overview of important issues and challenges for the practical application of flexible lithium-ion batteries is also provided. Finally, the strategies are discussed to overcome current limitations of the practical use of flexible lithium-based batteries, providing a direction for future research. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

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.

Building Partnerships to Address Community Geoscience Priorities: A Brief History of the Thriving Earth Exchange (TEX) Model and its Evolution

NASA Astrophysics Data System (ADS)

Finn, C.; Udu-gama, N.; Pandya, R.; Leshin, L. A.; McEntee, C.; Williams, B. M.; Goodwin, M.

2016-12-01

Increasingly, communities around the world are being challenged by extremes in climatic change and natural hazards and a lack of key natural resources. In many cases, such communities do not have access to the experts and resources they need to address these changes. While partnerships are being developed to address these challenges, there is a need to bring communities and scientists together equitably. Thriving Earth Exchange (TEX), a program powered by the American Geophysical Union (AGU), seeks to connect communities by offering them scientists that can work with them on developing effective solutions for their real-life climate change, natural hazards and/or natural resources challenges. TEX advocates community science - the notion that scientists and communities equitably work together to identify how science can advance local priorities such that it produces local impact, guides future research and generates solutions that can be shared. The concept for TEX evolved from 2011 AGU Council discussions on potential options for impacting AGU's upcoming Centennial. The concept started as a single "Grand Challenge" concept, but evolved through several trails and iterations to today's vibrant TEX program and model. The TEX process is not for every community or scientist. In order to ensure that a community can proceed through a project with a scientist, TEX has found that they often must have a mandate to work on the issue at hand. For instance, if a planning department is tasked with doing a climate vulnerability assessment, a project looking at how heat extremes affect the elderly could probably proceed without interruption from other internal community processes. In some cases, available funds acts as an impetus for a community to seek action. Yet at other times, an individual's passion to address a community challenge may be the spark required to turn ideas into action. This presentation will provide an overview of the TEX genesis within AGU, and its growth and

The evolution of process-based hydrologic models: historical challenges and the collective quest for physical realism

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

Clark, Martyn P.; Bierkens, Marc F. P.; Samaniego, Luis

The diversity in hydrologic models has historically led to great controversy on the correct approach to process-based hydrologic modeling, with debates centered on the adequacy of process parameterizations, data limitations and uncertainty, and computational constraints on model analysis. Here, we revisit key modeling challenges on requirements to (1) define suitable model equations, (2) define adequate model parameters, and (3) cope with limitations in computing power. We outline the historical modeling challenges, provide examples of modeling advances that address these challenges, and define outstanding research needs. We also illustrate how modeling advances have been made by groups using models of different type and complexity,more » and we argue for the need to more effectively use our diversity of modeling approaches in order to advance our collective quest for physically realistic hydrologic models.« less

The evolution of process-based hydrologic models: historical challenges and the collective quest for physical realism

DOE PAGES

Clark, Martyn P.; Bierkens, Marc F. P.; Samaniego, Luis; ...

2017-07-11

The diversity in hydrologic models has historically led to great controversy on the correct approach to process-based hydrologic modeling, with debates centered on the adequacy of process parameterizations, data limitations and uncertainty, and computational constraints on model analysis. Here, we revisit key modeling challenges on requirements to (1) define suitable model equations, (2) define adequate model parameters, and (3) cope with limitations in computing power. We outline the historical modeling challenges, provide examples of modeling advances that address these challenges, and define outstanding research needs. We also illustrate how modeling advances have been made by groups using models of different type and complexity,more » and we argue for the need to more effectively use our diversity of modeling approaches in order to advance our collective quest for physically realistic hydrologic models.« less

A Promising Approach to Addressing America's Biggest Challenges. Needle-Moving Community Collaboratives

ERIC Educational Resources Information Center

Jolin, Michele; Schmitz, Paul; Seldon, Willa

2012-01-01

Communities face powerful challenges--a high-school dropout epidemic, youth unemployment, teen pregnancy--that require powerful solutions. In a climate of increasingly constrained resources, those solutions must help communities to achieve more with less. A new kind of community collaborative--an approach that aspires to significant,…

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.

Addressing current and future challenges for the NHS: the role of good leadership.

PubMed

Elton, Lotte

2016-10-03

Purpose This paper aims to describe and analyse some of the ways in which good leadership can enable those working within the National Health Service (NHS) to weather the changes and difficulties likely to arise in the coming years, and takes the format of an essay written by the prize-winner of the Faculty of Medical Leadership and Management's Student Prize. The Faculty of Medical Leadership and Management ran its inaugural Student Prize in 2015-2016, which aimed at medical students with an interest in medical leadership. In running the Prize, the Faculty hoped to foster an enthusiasm for and understanding of the importance of leadership in medicine. Design/methodology/approach The Faculty asked entrants to discuss the role of good leadership in addressing the current and future challenges faced by the NHS, making reference to the Leadership and Management Standards for Medical Professionals published by the Faculty in 2015. These standards were intended to help guide current and future leaders and were grouped into three categories, namely, self, team and corporate responsibility. Findings This paper highlights the political nature of health care in the UK and the increasing impetus on medical professionals to navigate debates on austerity measures and health-care costs, particularly given the projected deficit in NHS funding. It stresses the importance of building organisational cultures prizing transparency to prevent future breaches in standards of care and the value of patient-centred approaches in improving satisfaction for both patients and staff. Identification of opportunities for collaboration and partnership is emphasised as crucial to assuage the burden that lack of appropriate social care places on clinical services. Originality/value This paper offers a novel perspective - that of a medical student - on the complex issues faced by the NHS over the coming years and utilises a well-regarded set of standards in conceptualising the role that health

Barriers, Challenges, and Decision-Making in the Letter Writing Process for Gender Transition.

PubMed

Budge, Stephanie L; Dickey, Lore M

2017-03-01

This article addresses the challenges that clinicians face in writing letters of support for transgender and gender-diverse clients. It addresses common but challenging clinical representations to help the reader understand the nuances associated with writing letters. Three cases are presented. The first addresses systemic challenges, the second addresses management of care, and the third addresses co-occurring mental health concerns. Recommendations for practice are provided based on the experiences included within the 3 case examples. Copyright © 2016 Elsevier Inc. All rights reserved.

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

ERIC Educational Resources Information Center

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

2007-01-01

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

NASA Space Rocket Logistics Challenges

NASA Technical Reports Server (NTRS)

Bramon, Chris; Neeley, James R.; Jones, James V.; Watson, Michael D.; Inman, Sharon K.; Tuttle, Loraine

2014-01-01

The Space Launch System (SLS) is the new NASA heavy lift launch vehicle in development and is scheduled for its first mission in 2017. SLS has many of the same logistics challenges as any other large scale program. However, SLS also faces unique challenges. This presentation will address the SLS challenges, along with the analysis and decisions to mitigate the threats posed by each.

Moral experience and ethical challenges in an emergency department in Pakistan: emergency physicians' perspectives.

PubMed

Zafar, Waleed

2015-04-01

Emergency departments (ED) are often stressful environments posing unique ethical challenges-issues that primarily raise moral rather than clinical concerns-in patient care. Despite this, there are very few reports of what emergency physicians find ethically challenging in their everyday work. Emergency medicine (EM) is a relatively young but rapidly growing specialty that is gaining acceptance worldwide. The aim of this study was to explore the perspectives of EM residents and physicians regarding the common ethical challenges they face during patient care in one of only two academic EM departments in Pakistan. These challenges could then be addressed in residents' training and departmental practice guidelines. A qualitative research design was employed and in-depth interviews were conducted with ED physicians. Participants were encouraged to think of specific examples from their work, to highlight the particular ethical concerns raised and to describe in detail the process by which those concerns were addressed or left unresolved. Transcripts were analysed using grounded theory methods. Thirteen participants were interviewed and they described four key challenges: how to provide highest quality care with limited resources; how to be truthful to patients; what to do when it is not possible to provide or continue treatment to patients; and when (and when not) to offer life-sustaining treatments. Participants' accounts provided important insights into how physicians tried to resolve these challenges in the 'local moral world' of an ED in Pakistan. The study highlights the need for developing systematic and contextually appropriate mechanisms for resolving common ethical challenges in the EDs and for training residents in moral problem solving. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A key for the Forest Service hardwood tree grades

Treesearch

Gary W. Miller; Leland F. Hanks; Harry V., Jr. Wiant

1986-01-01

A dichotomous key organizes the USDA Forest Service hardwood tree grade specifications into a stepwise procedure for those learning to grade hardwood sawtimber. The key addresses the major grade factors, tree size, surface characteristics, and allowable cull deductions in a series of paried choices that lead the user to a decision regarding tree grade.

A systematic review of cost-effectiveness modeling of pharmaceutical therapies in neuropathic pain: variation in practice, key challenges, and recommendations for the future.

PubMed

Critchlow, Simone; Hirst, Matthew; Akehurst, Ron; Phillips, Ceri; Philips, Zoe; Sullivan, Will; Dunlop, Will C N

2017-02-01

Complexities in the neuropathic-pain care pathway make the condition difficult to manage and difficult to capture in cost-effectiveness models. The aim of this study is to understand, through a systematic review of previous cost-effectiveness studies, some of the key strengths and limitations in data and modeling practices in neuropathic pain. Thus, the aim is to guide future research and practice to improve resource allocation decisions and encourage continued investment to find novel and effective treatments for patients with neuropathic pain. The search strategy was designed to identify peer-reviewed cost-effectiveness evaluations of non-surgical, pharmaceutical therapies for neuropathic pain published since January 2000, accessing five key databases. All identified publications were reviewed and screened according to pre-defined eligibility criteria. Data extraction was designed to reflect key data challenges and approaches to modeling in neuropathic pain and based on published guidelines. The search strategy identified 20 cost-effectiveness analyses meeting the inclusion criteria, of which 14 had original model structures. Cost-effectiveness modeling in neuropathic pain is established and increasing across multiple jurisdictions; however, amongst these studies, there is substantial variation in modeling approach, and there are common limitations. Capturing the effect of treatments upon health outcomes, particularly health-related quality-of-life, is challenging, and the health effects of multiple lines of ineffective treatment, common for patients with neuropathic pain, have not been consistently or robustly modeled. To improve future economic modeling in neuropathic pain, further research is suggested into the effect of multiple lines of treatment and treatment failure upon patient outcomes and subsequent treatment effectiveness; the impact of treatment-emergent adverse events upon patient outcomes; and consistent and appropriate pain measures to inform

Ethical Challenges in the Teaching of Multicultural Course Work

ERIC Educational Resources Information Center

Fier, Elizabeth Boyer; Ramsey, MaryLou

2005-01-01

The authors explore the ethical issues and challenges frequently encountered by counselor educators of multicultural course work. Existing ethics codes are examined, and the need for greater specificity with regard to teaching courses of multicultural content is addressed. Options for revising existing codes to better address the challenges of…

A Model Driven Framework to Address Challenges in a Mobile Learning Environment

ERIC Educational Resources Information Center

Khaddage, Ferial; Christensen, Rhonda; Lai, Wing; Knezek, Gerald; Norris, Cathie; Soloway, Elliot

2015-01-01

In this paper a review of the pedagogical, technological, policy and research challenges and concepts underlying mobile learning is presented, followed by a brief description of categories of implementations. A model Mobile learning framework and dynamic criteria for mobile learning implementations are proposed, along with a case study of one site…

Student Leadership: Challenges and Possibilities

ERIC Educational Resources Information Center

Nel, Willy

2016-01-01

In my attempt to adhere to the request that I provide an interpretation of the theme for the session, "Critical Engagement, Innovation and Inclusivity", and cognisant of the primary audience, I weave student leadership responsibilities, challenges and possibilities into the address. Events since the plenary address have however…

Enhancement Of Glucosinolate and Isothiocyanate Profiles in Brassicaceae Crops: Addressing Challenges in Breeding for Cultivation, Storage, and Consumer-Related Traits.

PubMed

Bell, Luke; Wagstaff, Carol

2017-11-01

Glucosinolates (GSLs) and isothiocyanates (ITCs) produced by Brassicaceae plants are popular targets for analysis due to the health benefits associated with them. Breeders aim to increase the concentrations in commercial varieties; however, there are few examples of this. The most well-known is Beneforté broccoli, which has increased glucoraphanin/sulforaphane concentrations compared to those of conventional varieties. It was developed through traditional breeding methods with considerations for processing, consumption, and health made throughout this process. Many studies presented in the literature do not take a holistic approach, and key points about breeding, cultivation methods, postharvest storage, sensory attributes, and consumer preferences are not properly taken into account. In this review, we draw together data for multiple species and address how such factors can influence GSL profiles. We encourage researchers and institutions to engage with industry and consumers to produce research that can be utilized in the improvement of Brassicaceae crops.

Key Challenges for Life Science Payloads on the Deep Space Gateway

NASA Astrophysics Data System (ADS)

Anthony, J. H.; Niederwieser, T.; Zea, L.; Stodieck, L.

2018-02-01

Compared to ISS, Deep Space Gateway life science payloads will be challenged by deep space radiation and non-continuous habitation. The impacts of these two differences on payload requirements, design, and operations are discussed.

Homodyne Phase-Shift-Keying Systems: Past Challenges and Future Opportunities

NASA Astrophysics Data System (ADS)

Kazovsky, Leonid G.; Kalogerakis, Georgios; Shaw, Wei-Tao

2006-12-01

Homodyne phase-shift-keying systems can achieve the best receiver sensitivity and the longest transmission distance among all optical communication systems. This paper reviews recent research efforts in the field and examines future possibilities that might lead toward potential practical use of these systems. Additionally, phase estimation techniques based on feed-forward phase recovery and digital delay-lock loop approaches are examined, simulated, and compared.

Community Coordinated Modeling Center: Addressing Needs of Operational Space Weather Forecasting

NASA Technical Reports Server (NTRS)

Kuznetsova, M.; Maddox, M.; Pulkkinen, A.; Hesse, M.; Rastaetter, L.; Macneice, P.; Taktakishvili, A.; Berrios, D.; Chulaki, A.; Zheng, Y.;

Cancer and aging: Epidemiology and methodological challenges.

PubMed

Pedersen, Jacob K; Engholm, Gerda; Skytthe, Axel; Christensen, Kaare

2016-01-01

Epidemiological cancer data shed light on key questions within basic science, clinical medicine and public health. For decades, Denmark has had linkable health registers that contain individual level data on the entire population with virtually complete follow-up. This has enabled high quality studies of cancer epidemiology and minimized the challenges often faced in many countries, such as uncertain identification of the study base, age misreporting, and low validity of the cancer diagnoses. However, methodological challenges still remain to be addressed, especially in cancer epidemiology studies among the elderly and the oldest-old. For example, a characteristic pattern for many cancer types is that the incidence increases up to a maximum at about ages 75-90 years and is then followed by a decline or a leveling off at the oldest ages. It has been suggested that the oldest individuals may be asymptomatic, or even insusceptible to cancer. An alternative interpretation is that this pattern is an artifact due to lower diagnostic intensity among the elderly and oldest-old caused by higher levels of co-morbidities in this age group. Currently, the available cancer epidemiology data are not able to provide clear evidence for any of these hypotheses.

Metrological challenges for measurements of key climatological observables Part 2: oceanic salinity

NASA Astrophysics Data System (ADS)

Pawlowicz, R.; Feistel, R.; McDougall, T. J.; Ridout, P.; Seitz, S.; Wolf, H.

2016-02-01

Salinity is a key variable in the modelling and observation of ocean circulation and ocean-atmosphere fluxes of heat and water. In this paper, we examine the climatological relevance of ocean salinity, noting fundamental deficiencies in the definition of this key observable, and its lack of a secure foundation in the International System of Units, the SI. The metrological history of salinity is reviewed, problems with its current definitions and measurement practices are analysed, and options for future improvements are discussed in conjunction with the recent seawater standard TEOS-10.

Intercultural Identities: Addressing the Global Dimension through Art Education

ERIC Educational Resources Information Center

Bianchi, June

2011-01-01

Recent educational policy and practice have established an extended role for all subjects in addressing children and young peoples' academic and interpersonal development, with strategies facilitating key skills and wider learning across areas of Citizenship and Personal, Social and Health education providing an integrated approach to education…

Communication Challenges in Neonatal Encephalopathy.

PubMed

Lemmon, Monica E; Donohue, Pamela K; Parkinson, Charlamaine; Northington, Frances J; Boss, Renee D

2016-09-01

Families must process complex information related to neonatal encephalopathy and therapeutic hypothermia. In this mixed methods study, semi-structured interviews were performed with parents whose infants were enrolled in an existing longitudinal cohort study of therapeutic hypothermia between 2011 and 2014. Thematic saturation was achieved after 20 interviews. Parental experience of communicating with clinicians was characterized by 3 principle themes. Theme 1 highlighted that a fragmented communication process mirrored the chaotic maternal and neonatal course. Parents often received key information about neonatal encephalopathy and therapeutic hypothermia from maternal clinicians. Infant medical information was often given to 1 family member (60%), who felt burdened by the responsibility to relay that information to others. Families universally valued the role of the bedside nurse, who was perceived as the primary source of communication for most (75%) families. Theme 2 encompassed the challenges of discussing the complex therapy of therapeutic hypothermia: families appreciated clinicians who used lay language and provided written material, and they often felt overwhelmed by technical information that made it hard to understand the "big picture" of their infant's medical course. Theme 3 involved the uncertain prognosis after neonatal encephalopathy. Parents appreciated specific expectations about their infant's long-term development, and experienced long-term distress about prognostic uncertainty. Communicating complex and large volumes of information in the midst of perinatal crisis presents inherent challenges for both clinicians and families. We identified an actionable set of communication challenges that can be addressed with targeted interventions. Copyright © 2016 by the American Academy of Pediatrics.

Keys to Transition: The California Model.

ERIC Educational Resources Information Center

Kearly, Patt

This publication addresses basic issues related to the concept of transition as it is applied to students with disabilities in California. Following a pretest (and its answer key), the document uses a question and answer format to discuss common concerns about transition, normalization, the school role, the "Bridges" model developed by…

A Key to the New Library.

ERIC Educational Resources Information Center

Gerryts, Egbert; Pienaar, Heila

This paper discusses finding the key to a new library in order to ensure its future, stressing the importance of alignment between strategy and people. The first section addresses management philosophy for renewal, including replacing the inflexible hierarchical pyramidal structure by a network organization with a service and competency management…

Symposium: Animal welfare challenges for today and tomorrow.

PubMed

Vizzier Thaxton, Yvonne; Christensen, Karen D; Mench, Joy A; Rumley, Elizabeth R; Daugherty, Christine; Feinberg, Bruce; Parker, Molly; Siegel, Paul; Scanes, Colin G

2016-09-01

The increasing separation of the public from production agriculture means there is often a lack of knowledge among consumers about current production practices and a perception that increased productivity and economic efficiency are necessarily associated with a decline in animal welfare. A symposium was organized to present information about animal welfare issues and the challenges they pose for both scientists and the poultry and allied industries. Companion papers provide information about understanding public attitudes and physiological/immunological approaches to welfare assessment, while this paper outlines current and future challenges to egg and meat production and industry responses to those challenges. For broiler chickens, increases in growth rate result in corollary increases in metabolic heat generation and water consumption, leading to the need for continuing improvements in housing, ventilation, and litter management. Stocking densities, lighting programs, muscle myopathies, and use of antibiotics are also areas that require research attention. In the layer industry, the key challenge is housing, with the industry undergoing a shift from conventional cage housing to alternatives like enriched colonies or cage-free. While these alternative systems have hen welfare advantages, there are also welfare disadvantages that require the development of mitigation strategies, and it is also essential to address associated issues including economic, environmental, egg safety, and worker health impacts. Concerns on the horizon include euthanasia of surplus male chicks and spent hens as well as beak-trimming. The humaneness of slaughter methods is an important welfare and consumer confidence issue, and the current regulations for poultry slaughter in the USA are discussed and compared to those for livestock. The poultry and allied industries, including retailers, are responding to these concerns by consulting with experts, developing science-based animal care

Challenges in the management of haemophilia on transition from adolescence to adulthood.

PubMed

Brand, Brigitte; Dunn, Spencer; Kulkarni, Roshni

2015-12-01

Patients with haemophilia undergo many transitions during their lives, but the period between adolescence and adulthood is particularly challenging. During this time, the patient must deal with all of the typical biological, social and emotional changes associated with this phase of life, whilst at the same time, adapting his lifestyle to the needs of his condition, transferring from paediatric to adult services and, most importantly, accepting increasing (and ultimately full) responsibility for managing his condition. Parents may also find their diminishing role equally challenging. Perhaps not surprisingly, given the challenges that adolescents face, treatment adherence during this time is generally low, which can lead to recurrent joint bleeds, chronic pain and reduced quality of life. To address the challenges, it is critical that a transition programme is put in place that meets the needs of not only the patient, but also his parents and healthcare providers. Key elements of the plan are a multidisciplinary approach, early planning, patient education and appropriate follow-up. A successful programme will equip all parties with the skills to deal with the challenges of transition from adolescence to adulthood, ensuring that the benefits of treatment in childhood are maintained, thus optimising health outcomes and quality of life. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

NASA Langley's Approach to the Sandia's Structural Dynamics Challenge Problem

NASA Technical Reports Server (NTRS)

Horta, Lucas G.; Kenny, Sean P.; Crespo, Luis G.; Elliott, Kenny B.

2007-01-01

The objective of this challenge is to develop a data-based probabilistic model of uncertainty to predict the behavior of subsystems (payloads) by themselves and while coupled to a primary (target) system. Although this type of analysis is routinely performed and representative of issues faced in real-world system design and integration, there are still several key technical challenges that must be addressed when analyzing uncertain interconnected systems. For example, one key technical challenge is related to the fact that there is limited data on target configurations. Moreover, it is typical to have multiple data sets from experiments conducted at the subsystem level, but often samples sizes are not sufficient to compute high confidence statistics. In this challenge problem additional constraints are placed as ground rules for the participants. One such rule is that mathematical models of the subsystem are limited to linear approximations of the nonlinear physics of the problem at hand. Also, participants are constrained to use these models and the multiple data sets to make predictions about the target system response under completely different input conditions. Our approach involved initially the screening of several different methods. Three of the ones considered are presented herein. The first one is based on the transformation of the modal data to an orthogonal space where the mean and covariance of the data are matched by the model. The other two approaches worked solutions in physical space where the uncertain parameter set is made of masses, stiffnesses and damping coefficients; one matches confidence intervals of low order moments of the statistics via optimization while the second one uses a Kernel density estimation approach. The paper will touch on all the approaches, lessons learned, validation 1 metrics and their comparison, data quantity restriction, and assumptions/limitations of each approach. Keywords: Probabilistic modeling, model validation

Voluntary Medical Male Circumcision: A Qualitative Study Exploring the Challenges of Costing Demand Creation in Eastern and Southern Africa

PubMed Central

Bertrand, Jane T.; Njeuhmeli, Emmanuel; Forsythe, Steven; Mattison, Sarah K.; Mahler, Hally; Hankins, Catherine A.

2011-01-01

Background This paper proposes an approach to estimating the costs of demand creation for voluntary medical male circumcision (VMMC) scale-up in 13 countries of eastern and southern Africa. It addresses two key questions: (1) what are the elements of a standardized package for demand creation? And (2) what challenges exist and must be taken into account in estimating the costs of demand creation? Methods and Findings We conducted a key informant study on VMMC demand creation using purposive sampling to recruit seven people who provide technical assistance to government programs and manage budgets for VMMC demand creation. Key informants provided their views on the important elements of VMMC demand creation and the most effective funding allocations across different types of communication approaches (e.g., mass media, small media, outreach/mobilization). The key finding was the wide range of views, suggesting that a standard package of core demand creation elements would not be universally applicable. This underscored the importance of tailoring demand creation strategies and estimates to specific country contexts before estimating costs. The key informant interviews, supplemented by the researchers' field experience, identified these issues to be addressed in future costing exercises: variations in the cost of VMMC demand creation activities by country and program, decisions about the quality and comprehensiveness of programming, and lack of data on critical elements needed to “trigger the decision” among eligible men. Conclusions Based on this study's findings, we propose a seven-step methodological approach to estimate the cost of VMMC scale-up in a priority country, based on our key assumptions. However, further work is needed to better understand core components of a demand creation package and how to cost them. Notwithstanding the methodological challenges, estimating the cost of demand creation remains an essential element in deriving estimates of the

Challenges in Fingertip Replantation

PubMed Central

Kim, Jin-Soo; Yang, Jae-Won; Lee, Dong-Chul; Ki, Sae-Hwi; Roh, Si-Young

2013-01-01

Fingertip amputation is a challenging injury to manage. Among various reconstructive procedures, replantation results in superior outcome, but is seldom considered in many institutions. From the identification of vessel ends to reanastomosis of the submillimeter vessels, fingertip's highly specialized anatomy requires technical excellence. By addressing these anatomic challenges, fingertip replantation can be a routine reconstructive option for microvascular surgeons. PMID:24872765

Addressing Challenges to Enhance the Bioactives of Withania somnifera through Organ, Tissue, and Cell Culture Based Approaches

PubMed Central

Singh, Pritika; Guleri, Rupam; Angurala, Amrita; Kaur, Kuldeep; Kaur, Kulwinder; Kaul, Sunil C.; Wadhwa, Renu

2017-01-01

Withania somnifera is a highly valued medicinal plant in traditional home medicine and is known for a wide range of bioactivities. Its commercial cultivation is adversely affected by poor seed viability and germination. Infestation by various pests and pathogens, survival under unfavourable environmental conditions, narrow genetic base, and meager information regarding biosynthesis of secondary metabolites are some of the other existing challenges in the crop. Biotechnological interventions through organ, tissue, and cell culture provide promising options for addressing some of these issues. In vitro propagation facilitates conservation and sustainable utilization of the existing germplasms and broadening the genetic base. It would also provide means for efficient and rapid mass propagation of elite chemotypes and generating uniform plant material round the year for experimentation and industrial applications. The potential of in vitro cell/organ cultures for the production of therapeutically valuable compounds and their large-scale production in bioreactors has received significant attention in recent years. In vitro culture system further provides distinct advantage for studying various cellular and molecular processes leading to secondary metabolite accumulation and their regulation. Engineering plants through genetic transformation and development of hairy root culture system are powerful strategies for modulation of secondary metabolites. The present review highlights the developments and sketches current scenario in this field. PMID:28299323

Addressing the STEM Challenge by Expanding Specialty Math and Science High Schools

ERIC Educational Resources Information Center

Atkinson, Robert D.; Hugo, Janet; Lundgren, Dennis; Shapiro, Martin J.; Thomas, Jerald

2007-01-01

If America is to succeed in the innovation-powered global economy, boosting math and science skills will be critical. This is why a wide array of task forces and organizations has recently raised the clarion call for more and better scientists and engineers. While the policy proposals offered are wide ranging, one key policy innovation has…

Impact challenges in community science-with-practice: lessons from PROSPER on transformative practitioner-scientist partnerships and prevention infrastructure development.

PubMed

Spoth, Richard; Greenberg, Mark

2011-09-01

At present, evidence-based programs (EBPs) to reduce youth violence are failing to translate into widespread community practice, despite their potential for impact on this pervasive public health problem. In this paper we address two types of challenges in the achievement of such impact, drawing upon lessons from the implementation of a partnership model called PROSPER. First, we address five key challenges in the achievement of community-level impact through effective community planning and action: readiness and mobilization of community teams; maintaining EBP implementation quality; sustaining community teams and EBPs; demonstrating community-level impact; and continuous, proactive technical assistance. Second, we consider grand challenges in the large-scale translation of EBPs: (1) building, linking and expanding existing infrastructures to support effective EBP delivery systems, and (2) organizing networks of practitioner-scientist partnerships-networks designed to integrate diffusion of EBPs with research that examines effective strategies to do so. The PROSPER partnership model is an evidence-based delivery system for community-based prevention and has evolved through two decades of NIH-funded research, assisted by land grant universities' Cooperative Extension Systems. Findings and lessons of relevance to each of the challenges are summarized. In this context, we outline how practitioner-scientist partnerships can serve to transform EBP delivery systems, particularly in conjunction with supportive federal policy.

Addressable multi-nozzle electrohydrodynamic jet printing with high consistency by multi-level voltage method

NASA Astrophysics Data System (ADS)

Pan, Yanqiao; Huang, YongAn; Guo, Lei; Ding, Yajiang; Yin, Zhouping

2015-04-01

It is critical and challenging to achieve the individual jetting ability and high consistency in multi-nozzle electrohydrodynamic jet printing (E-jet printing). We proposed multi-level voltage method (MVM) to implement the addressable E-jet printing using multiple parallel nozzles with high consistency. The fabricated multi-nozzle printhead for MVM consists of three parts: PMMA holder, stainless steel capillaries (27G, outer diameter 400 μm) and FR-4 extractor layer. The key of MVM is to control the maximum meniscus electric field on each nozzle. The individual jetting control can be implemented when the rings under the jetting nozzles are 0 kV and the other rings are 0.5 kV. The onset electric field for each nozzle is ˜3.4 kV/mm by numerical simulation. Furthermore, a series of printing experiments are performed to show the advantage of MVM in printing consistency than the "one-voltage method" and "improved E-jet method", by combination with finite element analyses. The good dimension consistency (274μm, 276μm, 280μm) and position consistency of the droplet array on the hydrophobic Si substrate verified the enhancements. It shows that MVM is an effective technique to implement the addressable E-jet printing with multiple parallel nozzles in high consistency.

Challenges and key research questions for yaws eradication.

PubMed

Marks, Michael; Mitjà, Oriol; Vestergaard, Lasse S; Pillay, Allan; Knauf, Sascha; Chen, Cheng-Yen; Bassat, Quique; Martin, Diana L; Fegan, David; Taleo, Fasihah; Kool, Jacob; Lukehart, Sheila; Emerson, Paul M; Solomon, Anthony W; Ye, Tun; Ballard, Ronald C; Mabey, David C W; Asiedu, Kingsley B

2015-10-01

Yaws is endemic in west Africa, southeast Asia, and the Pacific region. To eradicate yaws by 2020, WHO has launched a campaign of mass treatment with azithromycin. Progress has been made towards achievement of this ambitious goal, including the validation of point-of-care and molecular diagnostic tests and piloting of the strategy in several countries, including Ghana, Vanuatu, and Papua New Guinea. Gaps in knowledge need to be addressed to allow refinement of the eradication strategy. Studies exploring determinants of the spatial distribution of yaws are needed to help with the completion of baseline mapping. The finding that Haemophilus ducreyi causes lesions similar to yaws is particularly important and further work is needed to assess the effect of azithromycin on these lesions. The integration of diagnostic tests into different stages of the eradication campaign needs investigation. Finally, studies must be done to inform the optimum mass-treatment strategy for sustainable interruption of transmission. Copyright © 2015 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd.. All rights reserved.

Strategies to Address English Language Writing Challenges Faced by International Graduate Students in the US

ERIC Educational Resources Information Center

Ravichandran, Swathi; Kretovics, Mark; Kirby, Kara; Ghosh, Ankita

2017-01-01

Since 2000, there has been a 72% increase in the number of international students attending US institutions of higher education. The increase, specifically of international graduate students, has brought to light the writing challenges experienced by this population of students. This study explored specific writing challenges experienced by…

America's Children: Key National Indicators of Well-Being, 2011

ERIC Educational Resources Information Center

Cook, Traci; Blachman, Dara; Dye, Jane; Macartney, Suzanne; Lukacs, Susan; Howie, LaJeana; Kena, Grace; Sonnenberg, William; Axelrad, Daniel; Steffen, Barry; Truman, Jennifer; Cotto, Jessica; Jekielek, Susan; Mueggenborg, Mary; Coleman-Jensen, Alisha; Denton, Stephanie; Avenevoli, Shelli; Singleton, James; Knighton, Cindi; Han, Beth; O'Connell, Kellie; Guenther, Patricia; Hiza, Hazel; Kuczynski, Kevin; Koegel, Kristin; Radel, Laura

2011-01-01

"America's Children: Key National Indicators of Well-Being, 2011" is a compendium of indicators depicting both the promises and the challenges confronting our Nation's young people. The report, the 15th in an ongoing series, presents 41 key indicators on important aspects of children's lives. These indicators are drawn from the most…

Information and communication technologies and gender in climate change and green economy: Situating women’s opportunities and challenges in Zambian policies and strategies

PubMed Central

2016-01-01

Zambia’s 2012 report on the United Nations Conference on Sustainable Development (RIO +20) identifies existing opportunities on the country’s transitioning to green economy. The RIO +20 conference of 2012 has resulted in new momentum in addressing problems of sustainable development. However, this article argues that there are practical challenges that require paying attention to, especially those involving women. The article addressed one key question: To what extent can women participate in the transitioning process to green economy in Zambia and what opportunities and challenges exists? The study used document analysis to answer the above question. National policy documents were reviewed to understand interventions on environmental management. Whilst going through the documents, the study used gender analysis frameworks (education, skills, roles in family and society, access to infrastructure) to bring out qualitative and quantitative information on women. Using suggested green economy interventions in the literature as benchmark, qualitative analysis was used to project possible participation of women in green economy activities and possible challenges to be faced. The study found that participation of women will be limited despite existing opportunities because of challenges of access to information and communication technology infrastructures, low educational levels and skills and financial constraints. As Zambia undergoes a transitioning process, these limitations should be addressed in planned green economy policies and interventions to maximise benefits.

WaterWorld, a spatial hydrological model applied at scales from local to global: key challenges to local application

NASA Astrophysics Data System (ADS)

Burke, Sophia; Mulligan, Mark

2017-04-01

WaterWorld is a widely used spatial hydrological policy support system. The last user census indicates regular use by 1029 institutions across 141 countries. A key feature of WaterWorld since 2001 is that it comes pre-loaded with all of the required data for simulation anywhere in the world at a 1km or 1 ha resolution. This means that it can be easily used, without specialist technical ability, to examine baseline hydrology and the impacts of scenarios for change or management interventions to support policy formulation, hence its labelling as a policy support system. WaterWorld is parameterised by an extensive global gridded database of more than 600 variables, developed from many sources, since 1998, the so-called simTerra database. All of these data are available globally at 1km resolution and some variables (terrain, land cover, urban areas, water bodies) are available globally at 1ha resolution. If users have access to better data than is pre-loaded, they can upload their own data. WaterWorld is generally applied at the national or basin scale at 1km resolution, or locally (for areas of <10,000km2) at 1ha resolution, though continental (1km resolution) and global (10km resolution) applications are possible so it is a model with local to global applications. WaterWorld requires some 140 maps to run including monthly climate data, land cover and use, terrain, population, water bodies and more. Whilst publically-available terrain and land cover data are now well developed for local scale application, climate and land use data remain a challenge, with most global products being available at 1km or 10km resolution or worse, which is rather coarse for local application. As part of the EartH2Observe project we have used WFDEI (WATCH Forcing Data methodology applied to ERA-Interim data) at 1km resolution to provide an alternative input to WaterWorld's preloaded climate data. Here we examine the impacts of that on key hydrological outputs: water balance, water quality

The distinction between key ideas in teaching school physics and key ideas in the discipline of physics

NASA Astrophysics Data System (ADS)

Deng, Zongyi

2001-05-01

The distinction between key ideas in teaching a high school science and key ideas in the corresponding discipline of science has been largely ignored in scholarly discourse about what science teachers should teach and about what they should know. This article clarifies this distinction through exploring how and why key ideas in teaching high school physics differ from key ideas in the discipline of physics. Its theoretical underpinnings include Dewey's (1902/1990) distinction between the psychological and the logical and Harré's (1986) epistemology of science. It analyzes how and why the key ideas in teaching color, the speed of light, and light interference at the high school level differ from the key ideas at the disciplinary level. The thesis is that key ideas in teaching high school physics can differ from key ideas in the discipline in some significant ways, and that the differences manifest Dewey's distinction. As a result, the article challenges the assumption of equating key ideas in teaching a high school science with key ideas in the corresponding discipline of science, and the assumption that having a college degree in science is sufficient to teach high school science. Furthermore, the article expands the concept of pedagogical content knowledge by arguing that key ideas in teaching high school physics constitute an essential component.

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…

Integrated mixed methods policy analysis for sustainable food systems: trends, challenges and future research.

PubMed

Cuevas, Soledad