From office tools to community supports: The need for infrastructure to address the social determinants of health in paediatric practice.

PubMed

Fazalullasha, Fatima; Taras, Jillian; Morinis, Julia; Levin, Leo; Karmali, Karima; Neilson, Barbara; Muskat, Barbara; Bloch, Gary; Chan, Kevin; McDonald, Maureen; Makin, Sue; Ford-Jones, E Lee

2014-04-01

Previous research has highlighted the importance of addressing the social determinants of health to improve child health outcomes. However, significant barriers exist that limit the paediatrician's ability to properly address these issues. Barriers include a lack of clinical time, resources, training and education with regard to the social determinants of health; awareness of community resources; and case-management capacity. General practice recommendations to help the health care provider link patients to the community are insufficient. The objective of the current article was to present options for improving the link between the office and the community, using screening questions incorporating physician-based tools that link community resources. Simple interventions, such as routine referral to early-year centres and selected referral to public health home-visiting programs, may help to address populations with the greatest needs.

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

ERIC Educational Resources Information Center

Alston, Curtis E.

2013-01-01

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

Addressing the Developmental and Mental Health Needs of Young Children in Foster Care

PubMed Central

LESLIE, LAUREL K.; GORDON, JEANNE N.; LAMBROS, KATINA; PREMJI, KAMILA; PEOPLES, JOHN; GIST, KRISTIN

2006-01-01

Research over the past two decades has consistently documented the high rates of young children entering the child protective services/child welfare system with developmental and mental health problems. There is an emerging evidence base for the role of early intervention services in improving outcomes for children with developmental and mental health problems in the general population that heavily relies on accurate and appropriate screening and assessment practices. The Child Welfare League of America, the American Academy of Pediatrics, and the American Academy of Child and Adolescent Psychiatry have all published guidelines concerning the importance of comprehensive assessments and appropriate referral to early intervention services for children entering out-of-home care. Recent federal legislation (P.L. 108–36) calls for increased collaboration between child welfare and public agencies to address the developmental and mental health needs of young children in foster care. This paper provides a framework for health, developmental, and mental health professionals seeking to partner with child welfare to develop and implement programs addressing these critical issues. PMID:15827467

Do therapeutic homework assignments address areas of need for individuals with severe mental illness?

PubMed

Kelly, Peter J; Deane, Frank P

2011-04-01

The current study explores the types of homework assignments used in a recovery orientated case management approach. It also examines the relationship between the types of homework used and the clients' area of need as rated on the CANSAS. There were 129 client and mental health case manager dyads that participated in the study. Written copies of all homework assignments administered during the 12-month research period were collected (N = 1,054). The homework assignments were categorised according to the 'type' and the 'need domain addressed by the task'. The majority of these tasks were behavioural in nature. On a group level homework tended to broadly address areas of need for clients in the study. Only 2 of the 1,054 homework assignments administered directly addressed areas of Intimate Relationships or Sexual Expression. The importance of addressing Intimate Relationship and Sexual Expression within mental health case management is discussed.

Recovery Housing: Evolving Models to Address Resident Needs.

PubMed

Mericle, Amy A; Polcin, Douglas L; Hemberg, Jordana; Miles, Jennifer

2017-01-01

Recovery housing is a service delivery modality that simultaneously addresses the social support and housing needs of those in recovery from substance use disorders. This article describes a group of recovery homes in Texas (N = 10) representing a lesser-studied type of recovery housing, one which explicitly bridges treatment and peer support by providing a variety of recovery support services. All residents meet with a recovery coach, undergo regular drug screening, and have access to intensive outpatient treatment-a program that was developed specifically to support the needs of residents in the homes. Unlike the Oxford House TM model and California sober living houses, which are primarily financed through resident fees, these homes are supported through a mix of resident fees as well as private and public insurance. While adhering to some aspects of the social model of recovery, none of these homes would meet criteria to be considered a true social model program, largely because residents have a limited role in the governance of the homes. Residences like the ones in this study are not well-represented in the literature and more research is needed.

From office tools to community supports: The need for infrastructure to address the social determinants of health in paediatric practice

PubMed Central

Fazalullasha, Fatima; Taras, Jillian; Morinis, Julia; Levin, Leo; Karmali, Karima; Neilson, Barbara; Muskat, Barbara; Bloch, Gary; Chan, Kevin; McDonald, Maureen; Makin, Sue; Ford-Jones, E Lee

2014-01-01

Previous research has highlighted the importance of addressing the social determinants of health to improve child health outcomes. However, significant barriers exist that limit the paediatrician’s ability to properly address these issues. Barriers include a lack of clinical time, resources, training and education with regard to the social determinants of health; awareness of community resources; and case-management capacity. General practice recommendations to help the health care provider link patients to the community are insufficient. The objective of the current article was to present options for improving the link between the office and the community, using screening questions incorporating physician-based tools that link community resources. Simple interventions, such as routine referral to early-year centres and selected referral to public health home-visiting programs, may help to address populations with the greatest needs. PMID:24855416

Addressing the Skills Gap in Saudi Arabia: Does Vocational Education Address the Needs of Private Sector Employers?

ERIC Educational Resources Information Center

Baqadir, Abdullah; Patrick, Fiona; Burns, George

2011-01-01

This article reports the findings of data drawn from doctoral research on the extent to which recent changes in vocational training have addressed a perceived skills gap between the needs of private sector employers and potential workers in Saudi Arabia. While the Saudi government has made efforts to enhance the quality of vocational education,…

Medical education--addressing the needs of the dying child.

PubMed

Charlton, R

1996-07-01

This paper reviews the formulation of attitudes, the acquisition of knowledge and the development of skills which together enable medical practitioners to provide comprehensive palliative care for terminally ill children. Ideally, these should be developed to such an extent that a 'good death' can be achieved. Current medical education does not address these areas and the associated issues, including the breaking of bad news, understanding the grief reaction to serious illness and children's perceptions of death. Neither does training include how to take management decisions concerning informed consent, the transition from active treatment to palliative care, symptom control and choosing the place for care. These, and the unintentional attitude that regards the dying child as a 'medical failure', are discussed, together with the need to meet the needs of the parents and siblings, and the effects of bereavement. Finally, recommendations are made for undergraduate curricula and the need to emphasize the relationship of caring for the family unit, and not just the patient.

Partnering with Communities to Address the Mental Health Needs of Rural Veterans

ERIC Educational Resources Information Center

Kirchner, JoAnn E.; Farmer, Mary Sue; Shue, Valorie M.; Blevins, Dean; Sullivan, Greer

2011-01-01

Purpose: Many veterans who face mental illness and live in rural areas never obtain the mental health care they need. To address these needs, it is important to reach out to community stakeholders who are likely to have frequent interactions with veterans, particularly those returning from Operations Enduring and Iraqi Freedom (OEF/OIF). Methods:…

Using participatory action research in a community-based initiative addressing complex mental health needs.

PubMed

Knightbridge, Stephen M; King, Robert; Rolfe, Timothy J

2006-04-01

This paper describes the first phase of a larger project that utilizes participatory action research to examine complex mental health needs across an extensive group of stakeholders in the community. Within an objective qualitative analysis of focus group discussions the social ecological model is utilized to explore how integrative activities can be informed, planned and implemented across multiple elements and levels of a system. Seventy-one primary care workers, managers, policy-makers, consumers and carers from across the southern metropolitan and Gippsland regions of Victoria, Australia took part in seven focus groups. All groups responded to an identical set of focusing questions. Participants produced an explanatory model describing the service system, as it relates to people with complex needs, across the levels of social ecological analysis. Qualitative themes analysis identified four priority areas to be addressed in order to improve the system's capacity for working with complexity. These included: (i) system fragmentation; (ii) integrative case management practices; (iii) community attitudes; and (iv) money and resources. The emergent themes provide clues as to how complexity is constructed and interpreted across the system of involved agencies and interest groups. The implications these findings have for the development and evaluation of this community capacity-building project were examined from the perspective of constructing interventions that address both top-down and bottom-up processes.

Challenges Addressing Unmet Need for Contraception: Voices of Family Planning Service Providers in Rural Tanzania.

PubMed

Baraka, Jitihada; Rusibamayila, Asinath; Kalolella, Admirabilis; Baynes, Colin

2015-12-01

Provider perspectives have been overlooked in efforts to address the challenges of unmet need for family planning (FP). This qualitative study was undertaken in Tanzania, using 22 key informant interviews and 4 focus group discussions. The research documents perceptions of healthcare managers and providers in a rural district on the barriers to meeting latent demand for contraception. Social-ecological theory is used to interpret the findings, illustrating how service capability is determined by the social, structural and organizational environment. Providers' efforts to address unmet need for FP services are constrained by unstable reproductive preferences, low educational attainment, and misconceptions about contraceptive side effects. Societal and organizational factors--such as gender dynamics, economic conditions, religious and cultural norms, and supply chain bottlenecks, respectively--also contribute to an adverse environment for meeting needs for care. Challenges that healthcare providers face interact and produce an effect which hinders efforts to address unmet need. Interventions to address this are not sufficient unless the supply of services is combined with systems strengthening and social engagement strategies in a way that reflects the multi-layered, social institutional problems.

Mental health and addiction workforce development: federal leadership is needed to address the growing crisis.

PubMed

Hoge, Michael A; Stuart, Gail W; Morris, John; Flaherty, Michael T; Paris, Manuel; Goplerud, Eric

2013-11-01

The mental health and addiction workforce has long been plagued by shortages, high turnover, a lack of diversity, and concerns about its effectiveness. This article presents a framework to guide workforce policy and practice, emphasizing the need to train other health care providers as well as individuals in recovery to address behavioral health needs; strengthen recruitment, retention, and training of specialist behavioral health providers; and improve the financial and technical assistance infrastructure to better support and sustain the workforce. The pressing challenge is to scale up existing plans and strategies and to implement them in ways that have a meaningful impact on the size and effectiveness of the workforce. The aging and increasing diversity of the US population, combined with the expanded access to services that will be created by health reform, make it imperative to take immediate action.

Addressing women's health needs and improving birth outcomes: results from a peer-to-peer state Medicaid learning project.

PubMed

Johnson, Kay

2012-08-01

High rates of maternal mortality, infant mortality, and preterm births, as well as continuing disparities in pregnancy outcomes, have prompted a number of state Medicaid agencies to focus on improving the quality and continuity of care delivered to women of childbearing age. As part of a peer-to-peer learning project, seven Medicaid agencies worked to develop the programs, policies, and infrastructures needed to identify and reduce women's health risks either prior to or between pregnancies. The states also identified public health strategies. These strategies led to a policy checklist to help leaders in other states identify improvement opportunities that fit within their programs' eligibility requirements, quality improvement objectives, and health system resources. Many of the identified programs and policies may help states use the upcoming expansion of the Medicaid program to improve women's health and thereby reduce adverse birth outcomes.

Information Needs of Women: Addressing Diverse Factors in the Indian Context.

ERIC Educational Resources Information Center

Dasgupta, Kalpana

This paper addresses the diverse facts that influence the information seeking behavior of women in India, including: (1) the type of information women need; (2) social factors (i.e., caste, class, urban/rural, literate/illiterate, educated/uneducated); (3) economic factors (i.e., employed, unemployed, employed in organized sector, employed in the…

Shaping NASA's Earth Science Enterprise Workforce Development Initiative to Address Industry Needs

NASA Technical Reports Server (NTRS)

Rosage, David; Meeson, Blanche W. (Technical Monitor)

2001-01-01

It has been well recognized that the commercial remote sensing industry will expand in new directions, resulting in new applications, thus requiring a larger, more skilled workforce to fill the new positions. In preparation for this change, NASA has initiated a Remote Sensing Professional Development Program to address the workforce needs of this emerging industry by partnering with the private sector, academia, relevant professional societies, and other R&D organizations. Workforce needs will in part include understanding current industry concerns, personnel competencies, current and future skills, growth rates, geographical distributions, certifications, and sources of pre-service and in-service personnel. Dave Rosage of the NASA Goddard Space Flight Center and a panel of MAPPS members will lead a discussion to help NASA specifically address private firms' near and long-term personnel needs to be included in NASA's Remote Sensing Professional Development Program. In addition, Dave Rosage will present perspectives on how remote sensing technologies are evolving, new NASA instruments being developed, and what future workforce skills are expected to support these new developments.

Pandemic Influenza Planning: Addressing the Needs of Children

PubMed Central

Barrios, Lisa; Cordell, Ralph; Delozier, David; Gorman, Susan; Koenig, Linda J.; Odom, Erica; Polder, Jacquelyn; Randolph, Jean; Shimabukuro, Tom; Singleton, Christa

2009-01-01

Children represent one quarter of the US population. Because of its enormous size and special needs, it is critically important to address this population group in pandemic influenza planning. Here we describe the ways in which children are vulnerable in a pandemic, provide an overview of existing plans, summarize the resources available, and, given our experience with influenza A(H1N1), outline the evolving lessons we have learned with respect to planning for a severe influenza pandemic. We focus on a number of issues affecting children—vaccinations, medication availability, hospital capacity, and mental health concerns—and emphasize strategies that will protect children from exposure to the influenza virus, including infection control practices and activities in schools and child care programs. PMID:19797738

Addressing Data Access Needs of the Long-tail Distribution of Geoscientists

NASA Astrophysics Data System (ADS)

Malik, T.; Foster, I.

2012-12-01

Geoscientists must increasingly consider data from multiple disciplines and make intelligent connections between the data in order to advance research frontiers in mission critical problems. As a first step towards making timely and relevant connections, scientists require data and resource access, made available through simple and efficient protocols and web services that allows them to conveniently transmit, acquire, process, and inspect data and metadata. The last decade witnessed some vital data and resource access barriers being crossed. "Big iron" data infrastructures enabled geoscientists with large volumes of simulation and observational datasets, protocols made data access convenient, and strong governing bodies ensured standards for interoperability, repeatability and auditability. All this remarkable growth in access, however, addresses needs of publishers of large data and ignores consumers of that data. To-date limited access mechanisms exist for the consumers, who fetch subsets, analyze them, and, more often than not, generate new data and analysis, which finally gets published in scientific articles. In this session, we will highlight the data access needs of the long-tail distribution of geoscientists and a state-of-the art cyber-infrastructure approaches proposed to address those needs. The needs and the state-of-the-art arose from discussions held with geoscientists as part of the EarthCube Data Access Workshop, which was coordinated by the authors. Our presentation will summarize the proceedings of the Data Access workshop. It will present qualifying characteristics of solutions that will continue to serve the needs of these scientists in the long-term. Finally, we will present some cyber-infrastructure efforts in building such solutions and also provide a vision of the future CI in which such solutions can be useful.

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.

Filling gaps in a large reserve network to address freshwater conservation needs.

PubMed

Hermoso, Virgilio; Filipe, Ana Filipa; Segurado, Pedro; Beja, Pedro

2015-09-15

Freshwater ecosystems and biodiversity are among the most threatened at global scale, but efforts for their conservation have been mostly peripheral to terrestrial conservation. For example, Natura 2000, the world's largest network of protected areas, fails to cover adequately the distribution of rare and endangered aquatic species, and lacks of appropriate spatial design to make conservation for freshwater biodiversity effective. Here, we develop a framework to identify a complementary set of priority areas and enhance the conservation opportunities of Natura 2000 for freshwater biodiversity, using the Iberian Peninsula as a case study. We use a systematic planning approach to identify a minimum set of additional areas that would help i) adequately represent all freshwater fish, amphibians and aquatic reptiles at three different target levels, ii) account for key ecological processes derived from riverscape connectivity, and iii) minimize the impact of threats, both within protected areas and propagated from upstream unprotected areas. Addressing all these goals would need an increase in area between 7 and 46%, depending on the conservation target used and strength of connectivity required. These new priority areas correspond to subcatchments inhabited by endangered and range restricted species, as well as additional subcatchments required to improve connectivity among existing protected areas and to increase protection against upstream threats. Our study should help guide future revisions of the design of Natura 2000, while providing a framework to address deficiencies in reserve networks for adequately protecting freshwater biodiversity elsewhere. Copyright © 2015 Elsevier Ltd. All rights reserved.

Addressing Patients' Veteran Status: Primary Care Providers' Knowledge, Comfort, and Educational Needs.

PubMed

Vest, Bonnie M; Kulak, Jessica; Hall, Victoria M; Homish, Gregory G

2018-06-01

The military population is frequently overlooked in civilian primary care due to an assumption that they are treated at the Veterans Health Administration (VA). However, less than 50% of eligible veterans receive VA treatment. Primary care providers (PCPs) may need support in addressing veterans' needs. This regional pilot study explored the current state of practice among primary care providers as it pertains to assessing patients' veteran status and their knowledge of and comfort with treating common conditions in this population. An electronic survey was administered to PCPs (N=102) in Western New York. Survey questions asked about assessing military status, understanding of military-related health problems, and thoughts on the priority of addressing these issues in practice. Data were analyzed using descriptive summary statistics. The majority (56%; n=54) of respondents indicated they never or rarely ask their patients about military service, and only 19% (n=18) said they often or always ask. Seventy-one percent (n=68) of providers agreed or strongly agreed it was important to know if their patient was a veteran. Participants indicated limited knowledge about military stressors, resources available for military populations, and common medical conditions impacting veterans. Our pilot results demonstrate that in a regional sample of primary care providers, providers rarely ask patients about their military history; however, they feel it is important information for patient care. While further study is needed, it may be necessary to provide education, specifically pertaining to military culture and health-related sequelae, to address barriers that may be limiting PCPs' provision of care for this population.

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

The Role of Nutrition-Related Initiatives in Addressing Community Health Needs Assessments

ERIC Educational Resources Information Center

George, Daniel R.; Rovniak, Liza S.; Dillon, Judy; Snyder, Gail

2017-01-01

Academic Health Centers and nonprofit hospitals are exploring strategies to meet Affordable Care Act mandates requiring tax-exempt institutions to address community health needs, which commonly include major chronic illnesses. We explore the implications of this regulatory landscape, describing methods that nonprofit health care institutions are…

Current Priorities for Public Health Practice in Addressing the Role of Human Genomics in Improving Population Health

PubMed Central

Khoury, Muin J.; Bowen, Michael S.; Burke, Wylie; Coates, Ralph J.; Dowling, Nicole F.; Evans, James P.; Reyes, Michele; St. Pierre, Jeannette

2017-01-01

In spite of accelerating human genome discoveries in a wide variety of diseases of public health significance, the promise of personalized health care and disease prevention based on genomics has lagged behind. In a time of limited resources, public health agencies must continue to focus on implementing programs that can improve health and prevent disease now. Nevertheless, public health has an important and assertive leadership role in addressing the promise and pitfalls of human genomics for population health. Such efforts are needed not only to implement what is known in genomics to improve health but also to reduce potential harm and create the infrastructure needed to derive health benefits in the future. PMID:21406285

Desalinated drinking water in the GCC countries - The need to address consumer perceptions.

PubMed

Shomar, Basem; Hawari, Jalal

2017-10-01

The Gulf Cooperation Council (GCC) countries consist of Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. These countries depend mainly on seawater desalination to meet their water needs. Although great emphasis is given to characterize desalinated water for its physicochemical and microbial properties, e.g. presence of metals, other organic contaminants and for bacteria, sensorial characteristics including smell, taste and color have not received the same attention. This is possibly attributed to the fact that inhabitants of GCC States do not use desalinated tap water for drinking consumption, rather they depend on locally produced or imported bottled water where color, taste and odor are not problematic. To address the consumer needs and perceptions of drinking desalinated water in GCC countries, water quality standards and guidelines, should respond to the public concern about other sensorial characteristics (organoleptic properties) including taste, odor, and trigeminal sensations. Often the root causes of color and smell in water are attributed to the presence of organic and inorganic contaminants and to bacterial growth which is frequently accompanied by the production of metabolites and byproducts that are obnoxious. The unpleasant sensorial problems associated with desalinated drinking tap water may constitute the driving force for most people in GCC countries to depend on bottled water. To encourage people in the GCC countries to consume desalinated tap water, it is essential that water testing include measurements of physicochemical properties, biofilm presence and organoleptic parameters to improve overall water quality. This review highlights the contribution of organoleptics for consumers of desalinated tap water. It extends water quality research to be addressed by standards for organoleptic parameters in desalinated drinking water. Accordingly, consumer awareness and outreach campaigns should be implemented to encourage people

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.;

Strong Start Wraparound: Addressing the Complex Needs of Mothers in Early Recovery

ERIC Educational Resources Information Center

Teel, M. Kay

2014-01-01

The Strong Start Study tested an innovative, High-Fidelity Wraparound intervention with families in early recovery from substance use. The Strong Start Wraparound model addressed the complex needs of pregnant and parenting women who were in early recovery to increase the protective factors of parental resilience, social connections, concrete…

Design of comprehensive Alzheimer's disease centers to address unmet national needs.

PubMed

Trojanowski, John Q; Arnold, Steven E; Karlawish, Jason H; Brunden, Kurt; Cary, Mark; Davatzikos, Christos; Detre, John; Gaulton, Glen; Grossman, Murray; Hurtig, Howard; Jedrziewski, Kathryn; McCluskey, Leo; Naylor, Mary; Polsky, Daniel; Schellenberg, Gerard D; Siderowf, Andrew; Shaw, Leslie M; Van Deerlin, Vivianna; Wang, Li-San; Werner, Rachel; Xie, Sharon X; Lee, Virginia M-Y

2010-03-01

The problem of Alzheimer's disease (AD) exemplifies the challenges of dealing with a broad range of aging-related chronic disorders that require long-term, labor-intensive, and expensive care. As the baby boom generation ages and brain diseases become more prevalent, the need to confront the pending health care crisis is more urgent than ever before. Indeed, there is now a critical need to expand significantly the national effort to solve the problem of AD, with special focus on prevention. The Campaign to Prevent Alzheimer's Disease by 2020 (PAD2020) aims to create a new paradigm for planning and supporting the organization of worldwide cooperative research networks to develop new technologies for early detection and treatments of aging-related memory and motor impairments. PAD 2020 is developing an implementation plan to justify (1) increasing the federal budget for research, (2) developing novel national resources to discover new interventions for memory and motor disorders, and (3) creating innovative and streamlined decision-making processes for selecting and supporting new ideas. Since 1978 the National Institute on Aging or National Institute of Health (NIH) established an extensive national network of AD research facilities at academic institutions including AD Centers (ADCs), Consortium to Establish a Registry for AD, AD Cooperative Study (ADCS), AD Drug Discovery Program, National Alzheimer's Coordinating Center, National Cell Repository for AD, and AD Neuroimaging Initiative. However, despite the success of these programs and their critical contributions, they are no longer adequate to meet the challenges presented by AD. PAD 2020 is designed to address these changes by improving the efficiency and effectiveness of these programs. For example, the ADCs (P30s and P50s) can be enhanced by converting some into Comprehensive Alzheimer's Disease Centers (CADCs) to support not only research, but also by being demonstration projects on care/treatment, clinical

Collaborative socioeconomic tool development to address management and planning needs

USGS Publications Warehouse

Richardson, Leslie A.; Huber, Christopher; Cullinane Thomas, Catherine; Donovan, Elizabeth; Koontz, Lynne M.

2014-01-01

Public lands and resources managed by the National Park Service (NPS) and other land management agencies provide a wide range of social and economic benefits to both nearby local communities and society as a whole, ranging from job creation, to access to unique recreational opportunities, to subsistence and tribal uses of the land. Over the years, there has been an increased need to identify and analyze the socioeconomic effects of the public’s use of NPS lands and resources, and the wide range of NPS land management decisions. This need stems from laws such as the National Environmental Policy Act (NEPA), increased litigation and appeals on NPS management decisions, as well as an overall need to demonstrate how parks benefit communities and the American public. To address these needs, the U.S. Geological Survey (USGS) and NPS have an ongoing partnership to collaboratively develop socioeconomic tools to support planning needs and resource management. This article discusses two such tools. The first, Assessing Socioeconomic Planning Needs (ASPN), was developed to help NPS planners and managers identify key social and economic issues that can arise as a result of land management actions. The second tool, the Visitor Spending Effects (VSE) model, provides a specific example of a type of analysis that may be recommended by ASPN. The remainder of this article discusses the development, main features, and plans for future versions and applications of both ASPN and the VSE.

Symposium on 'Intervention policies for deprived households' Policy initiatives to address low-income households' nutritional needs in the UK.

PubMed

Dowler, Elizabeth

2008-08-01

Members of low-income households in the UK are more likely to have patterns of food and nutrient intakes that are less inclined to lead to good health outcomes in the short and long term. Health inequalities, including the likelihood of child and adulthood obesity, have long been documented in the UK and show little sign of improving so far, despite 10 years of attention from a government that has committed itself to addressing them. Following the Acheson Inquiry into Inequalities in Health (1998) in England a number of initiatives to tackle inequalities in food and diet were established, both nationally and within the devolved nations of Scotland, Wales and Northern Ireland. Nevertheless, until recently, there has been no overall strategic policy addressing the food and nutritional needs of low-income households. The present paper reviews how the problems have been constructed and understood and how they have been addressed, briefly drawing on recent evaluations of food and nutrition policies in Scotland and Wales. The contemporary challenge is to frame cross-cutting policy initiatives that move beyond simple targeting and local actions, encompass a life-course approach and recognise both the diversity of households that fall into 'low-income' categories and the need for 'upstream' intervention.

Needs Assessment: Who Needs It?

ERIC Educational Resources Information Center

Hays, Donald G.; Linn, Joan K.

This monograph addresses the issue of needs assessment in the educational process and how it applies to the school counselor's role. The authors provide information on the process of needs assessment, from the initial step of obtaining commitment to the final outcome of improved program planning and development. Using an example common to many…

Activating people to address their health care needs: learning from people with lived experience of chronic illnesses.

PubMed

Stanhope, Victoria; Henwood, Benjamin F

2014-08-01

One of the primary goals of health care reform is improving the quality and reducing the costs of care for people with co-morbid mental health and physical health conditions. One strategy is to integrate primary and behavioral health care through care coordination and patient activation. This qualitative study using community based participatory research methods informs the development of integrated care by presenting the perspectives of those with lived experience of chronic illnesses and homelessness. Themes presented include the internal and external barriers to addressing health needs and the key role of peer support in overcoming these barriers.

Virtual reality applications for addressing the needs of those aging with disability.

PubMed

Rizzo, Albert; Requejo, Phil; Winstein, Carolee J; Lange, Belinda; Ragusa, Gisele; Merians, Alma; Patton, James; Banerjee, Pat; Aisen, Mindy

2011-01-01

As persons with disabilities age, progressive declines in health and medical status can challenge the adaptive resources required to maintain functional independence and quality of life [1]. These challenges are further compounded by economic factors, medication side effects, loss of a spouse or caregiver, and psychosocial disorders [1-2]. With the gradual loss of functional independence and increased reliance on others for transportation, access to general medical and rehabilitation care can be jeopardized [2]. The combination of these factors when seen in the context of the average increase in lifespan in industrialized societies has lead to a growing crisis that is truly global in proportion. While research indicates that functional motor capacity can be improved, maintained, or recovered via consistent participation in a motor exercise and rehabilitation regimen [3], independent adherence to such preventative and/or rehabilitative programming outside the clinic setting is notoriously low [1]. This state of affairs has produced a compelling and ethical motivation to address the needs of individuals who are aging with disabilities by promoting home-based access to low-cost, interactive virtual reality (VR) systems designed to engage and motivate individuals to participate with "game"-driven physical activities and rehabilitation programming. The creation of such systems could serve to enhance, maintain and rehabilitate the sensorimotor processes that are needed to maximize independence and quality of life. This is the theme of the research to be presented at this MMVR workshop.

Critical Care Nurses' Perceived Need for Guidance in Addressing Spirituality in Critically Ill Patients.

PubMed

Canfield, Christina; Taylor, Debi; Nagy, Kimberly; Strauser, Claire; VanKerkhove, Karen; Wills, Stephanie; Sawicki, Patricia; Sorrell, Jeanne

2016-05-01

The term spirituality is highly subjective. No common or universally accepted definition for the term exists. Without a clear definition, each nurse must reconcile his or her own beliefs within a framework mutually suitable for both nurse and patient. To examine individual critical care nurses' definition of spirituality, their comfort in providing spiritual care to patients, and their perceived need for education in providing this care. Individual interviews with 30 nurses who worked in a critical care unit at a large Midwestern teaching hospital. Nurses generally feel comfortable providing spiritual care to critically ill patients but need further education about multicultural considerations. Nurses identified opportunities to address spiritual needs throughout a patient's stay but noted that these needs are usually not addressed until the end of life. A working definition for spirituality in health care was developed: That part of person that gives meaning and purpose to the person's life. Belief in a higher power that may inspire hope, seek resolution, and transcend physical and conscious constraints. ©2016 American Association of Critical-Care Nurses.

AACP Strategy for Addressing the Professional Development Needs of Department Chairs

PubMed Central

Rodriguez, Tobias E.; Weinstein, George; Sorofman, Bernard A.; Bosso, John A.; Kerr, Robert A.; Haden, N. Karl

2012-01-01

Objectives. Characterize the skills and abilities required for department chairs, identify development needs, and then create AACP professional development programs for chairs. Methods. A 30-question electronic survey was sent to AACP member department chairs related to aspects of chairing an academic department. Results. The survey identified development needs in the leadership, management, and personal abilities required for effective performance as department chair. The information was used to prioritize topics for subsequent AACP development programs. Subsequent programs conducted at AACP Interim and Annual Meetings were well attended and generally received favorable reviews from participants. A list of development resources was placed on the AACP website. Conclusions. This ongoing initiative is part of an AACP strategy to identify and address the professional development needs of department chairs. Survey results may also inform faculty members and other academic leaders about the roles and responsibilities of department chairs. PMID:22919099

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

PubMed

Taylor, Rosemary A; Taylor, Steven S

2018-06-27

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

75 FR 51831 - Request for Measures of Health Plan Efforts To Address Health Plan Members' Health Literacy Needs

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Request for Measures of Health Plan Efforts To Address Health Plan Members' Health Literacy Needs AGENCY: Agency for... well health plans and health providers address health plan enrollees' health literacy needs and how...

Informing Severely III Patients: Needs, Shortcomings and Strategies for Improvement

PubMed Central

Strohbuecker, Barbara; Gaertner, Jan; Stock, Stephanie

2011-01-01

Summary The scope of palliative care has expanded gradually over the last decade. Provision of palliative care is not restricted to the last months of life as in some out-dated concepts. It addresses the needs of severely ill patients in all care settings (in- and outpatients, home care, hospices). Particularly in the last years, the value of integrating palliative care early in the disease trajectory of life-threatening and incurable diseases has become increasingly acknowledged. In order for patients to fully benefit from the concept of early integration of palliative care, they need to be provided with information tailored to their disease trajectory. For example, patients and relatives need to know how symptoms such as pain, depression, fatigue, breathlessness, or anxiety can be alleviated. The patients’ knowledge and understanding will support the coping process, improve comfort and enhance patient participation and autonomy. Since information needs are highly individual and vary throughout the course of the disease, an interactive approach of assessing the patients’ needs and responding to them adequately is mandatory. In this article, the information needs of advanced cancer patients and their families are explained, shortcomings of the present information concepts are discussed, and an integrative approach to responding to patients’ information needs throughout the care pathway is advocated. PMID:21547020

Improving the Pharmacologic Management of Pain in Older Adults: Identifying the Research Gaps and Methods to Address Them

PubMed Central

Reid, M. C.; Bennett, David A.; Chen, Wen G.; Eldadah, Basil A.; Farrar, John T.; Ferrell, Bruce; Gallagher, Rollin M.; Hanlon, Joseph T.; Herr, Keela; Horn, Susan D.; Inturrisi, Charles E.; Lemtouni, Salma; Lin, Yu Woody; Michaud, Kaleb; Morrison, R. Sean; Neogi, Tuhina; Porter, Linda L.; Solomon, Daniel H.; Von Korff, Michael; Weiss, Karen; Witter, James; Zacharoff, Kevin L.

2011-01-01

Objective There has been a growing recognition of the need for better pharmacologic management of chronic pain among older adults. To address this need, the National Institutes of Health Pain Consortium sponsored an “Expert Panel Discussion on the Pharmacological Management of Chronic Pain in Older Adults” conference in September, 2010, to identify research gaps and strategies to address them. Specific emphasis was placed on ascertaining gaps regarding use of opioid and non-steroidal anti-inflammatory medications because of continued uncertainties regarding their risks and benefits. Design Eighteen panel members provided oral presentations; each was followed by a multidisciplinary panel discussion. Meeting transcripts and panelists’ slide presentations were reviewed to identify the gaps, and the types of studies and research methods panelists suggested could best address them. Results Fifteen gaps were identified in the areas of treatment(e.g., uncertainty regarding the long-term safety and efficacy of commonly prescribed analgesics), epidemiology (e.g., lack of knowledge regarding the course of common pain syndromes), and implementation(e.g., limited understanding of optimal strategies to translate evidence-based pain treatments into practice). Analyses of data from electronic health care databases, observational cohort studies, and ongoing cohort studies (augmented with pain and other relevant outcomes measures) were felt to be practical methods for building an age-appropriate evidence base to improve the pharmacologic management of pain in later life. Conclusions Addressing the gaps presented in the current report was judged by the panel to have substantial potential to improve the health and well being of older adults with chronic pain. PMID:21834914

Warfarin therapy: in need of improvement after all these years

PubMed Central

Kimmel, Stephen E

2010-01-01

Background Warfarin therapy has been used clinically for over 60 years, yet continues to be problematic because of its narrow therapeutic index and large inter-individual variability in patient response. As a result, warfarin is a leading cause of serious medication-related adverse events, and its efficacy is also suboptimal. Objective To review factors that are responsible for variable response to warfarin, including clinical, environmental, and genetic factors, and to explore some possible approaches to improving warfarin therapy. Results Recent efforts have focused on developing dosing algorithms that included genetic information to try to improve warfarin dosing. These dosing algorithms hold promise, but have not been fully validated or tested in rigorous clinical trials. Perhaps equally importantly, adherence to warfarin is a major problem that should be addressed with innovative and cost-effective interventions. Conclusion Additional research is needed to further test whether interventions can be used to improve warfarin dosing and outcomes. PMID:18345947

Identifying and Addressing the Needs of Adolescents and Young Adults With Cancer: Summary of an Institute of Medicine Workshop

PubMed Central

Beaupin, Lynda K.; Demark-Wahnefried, Wendy; Fasciano, Karen; Ganz, Patricia A.; Hayes-Lattin, Brandon; Hudson, Melissa M.; Nevidjon, Brenda; Oeffinger, Kevin C.; Rechis, Ruth; Richardson, Lisa C.; Seibel, Nita L.; Smith, Ashley W.

2015-01-01

Cancer is the leading disease-related cause of death in adolescents and young adults (AYAs). This population faces many short- and long-term health and psychosocial consequences of cancer diagnosis and treatment, but many programs for cancer treatment, survivorship care, and psychosocial support do not focus on the specific needs of AYA cancer patients. Recognizing this health care disparity, the National Cancer Policy Forum of the Institute of Medicine convened a public workshop to examine the needs of AYA patients with cancer. Workshop participants identified many gaps and challenges in the care of AYA cancer patients and discussed potential strategies to address these needs. Suggestions included ways to improve access to care for AYAs, to deliver cancer care that better meets the medical and psychosocial needs of AYAs, to develop educational programs for providers who care for AYA cancer survivors, and to enhance the evidence base for AYAs with cancer by facilitating participation in research. PMID:25568146

Addressing the Needs of Substance Abusing Adolescents: A Guide for Professional School Counselors

ERIC Educational Resources Information Center

Sikes, April; Cole, Rebekah F.; McBride, Rebecca; Fusco, Angela; Lauka, Justin

2009-01-01

As individuals with multiple needs, substance abusing adolescents may seek the support and assistance of school counselors. The purpose of this article is to provide professional school counselors with information they can use to assist students with substance abuse issues. Specifically, this article examines (a) complexity of addressing substance…

DESIGN OF COMPREHENSIVE ALZHEIMER’S DISEASE CENTERS TO ADDRESS UNMET NATIONAL NEEDS

PubMed Central

Trojanowski, John Q.; Arnold, Steven E.; Karlawish, Jason H.; Brunden, Kurt; Cary, Mark; Davatzikos, Christos; Detre, John; Gaulton, Glen; Grossman, Murray; Hurtig, Howard; Jedrziewski, Kathryn; McCluskey, Leo; Naylor, Mary; Polsky, Daniel; Schellenberg, Gerard D.; Siderowf, Andrew; Shaw, Leslie M.; Van Deerlin, Vivianna; Wang, Li-San; Werner, Rachel; Xie, Sharon X.; Lee, Virginia M.-Y.

2010-01-01

The problem of Alzheimer’s disease (AD) exemplifies the challenges of dealing with a broad range of aging related chronic disorders that require long-term, labor-intensive and expensive care. As the “baby-boom” generation ages and brain diseases become more prevalent, the need to confront the pending health care crisis is more urgent than ever before. Indeed, there is now a critical need to expand significantly the national effort to solve the problem of AD with special focus on prevention. The “Prevent Alzheimer’s Disease 2020” (PAD 2020) initiative aims to create a new paradigm for planning and supporting the organization of worldwide cooperative research networks to develop new technologies for early detection and treatments of aging related memory and motor impairments. PAD 2020 is developing an implementation plan to justify: a) increasing the federal budget for research; b) developing novel national resources to discover new interventions for memory and motor disorders; c) creating innovative and streamlined decision-making processes for selecting and supporting new ideas. Since 1978, the National Institute on Aging (NIA/NIH) established an extensive national network of AD research facilities at academic institutions including: AD Centers (ADCs), Consortium to Establish a Registry for AD (CERAD), AD Cooperative Study (ADCS), AD Drug Discovery Program, National Alzheimer’s Coordinating Center (NACC), National Cell Repository for AD (NCRAD), and AD Neuroimaging Initiative (ADNI). However, despite the success of these program and their critical contributions, they are no longer adequate to meet the challenges presented by AD. PAD2020 is designed to address these changes by improving the efficiency and effectiveness of these programs. For example, the ADCs (P30s and P50s) can be enhanced by converting some into Comprehensive AD Centers (CADCs) to support not only research, but also by being demonstration projects on care/ treatment, clinical trials

An address geocoding method for improving rural spatial information infrastructure

NASA Astrophysics Data System (ADS)

Pan, Yuchun; Chen, Baisong; Lu, Zhou; Li, Shuhua; Zhang, Jingbo; Zhou, YanBing

2010-11-01

The transition of rural and agricultural management from divisional to integrated mode has highlighted the importance of data integration and sharing. Current data are mostly collected by specific department to satisfy their own needs and lake of considering on wider potential uses. This led to great difference in data format, semantic, and precision even in same area, which is a significant barrier for constructing an integrated rural spatial information system to support integrated management and decision-making. Considering the rural cadastral management system and postal zones, the paper designs a rural address geocoding method based on rural cadastral parcel. It puts forward a geocoding standard which consists of absolute position code, relative position code and extended code. It designs a rural geocoding database model, and addresses collection and update model. Then, based on the rural address geocoding model, it proposed a data model for rural agricultural resources management. The results show that the address coding based on postal code is stable and easy to memorize, two-dimensional coding based on the direction and distance is easy to be located and memorized, while extended code can enhance the extensibility and flexibility of address geocoding.

Extending the Reach of National Assessments: Addressing Local and Regional Needs

NASA Astrophysics Data System (ADS)

Lewis, K.; Carter, T.

2016-12-01

While climate change is global in scope, many impacts of greatest societal concern (and accompanying response decisions) occur on local to regional scales. The U.S. Global Change Research Program (USGCRP) is tasked with conducting quadrennial national climate assessments, and efforts for the fourth such assessment (NCA4) are underway. Recognizing that there is a growing appetite for climate information on more local scales, however, USGCRP is actively pursuing higher-resolution scientific information, while also seeking engagement with local and regional entities to ensure that NCA4 is well-positioned to address users' needs across geospatial scales. Effectively meeting user needs at regional scales requires robust observations and projections at sub-national scales, as well as a widespread network of agencies and organizations. We discuss our efforts to leverage existing relationships to identify potential users and their needs early in the assessment process. We also discuss plans for future mechanisms to engage additional regional stakeholders from resource managers to policy makers and scientists not only for quadrennial assessment but as part of a sustained process.

Assessing spirituality. Healthcare organizations must address their employees' spiritual needs.

PubMed

Bazan, W; Dwyer, D

1998-01-01

Catholic institutions need to respond to their managers, physicians, and other employees experiencing deep pain about the meaning and purpose of life. Initial approaches to people in spiritual distress include "tough love", codependence, and assistance programs, along with prayer and compassion. But a different approach that gives people the space and freedom to pursue their spiritual search and ask questions to discover deeper meaning in life may be more effective. It allows them to accept that they are where they need to be on their spiritual journey, even if that place is painful. Healthcare organizations can, through their structures and culture, create environments that promote this spiritual work. The entire organization must be spiritually grounded. Organizations can develop specific programs to address employees' spiritual yearnings, including: Private spiritual direction or companionship Formal mentoring Renewal days or retreats Spirituality programs for professionals Organizations must consider spirituality in recruiting, uphold policies on spirituality, and ensure physicians receive the same spiritual support as other employees. Resources should be allocated for expanded spiritual services, quiet places for reflection, meditation and related classes, traditional retreats, and qualified personnel.

The Progress of US Hospitals in Addressing Community Health Needs.

PubMed

Cramer, Geri Rosen; Singh, Simone R; Flaherty, Stephen; Young, Gary J

2017-02-01

To identify how US tax-exempt hospitals are progressing in regard to community health needs assessment (CHNA) implementation following the Patient Protection and Affordable Care Act. We analyzed data on more than 1500 tax-exempt hospitals in 2013 to assess patterns in CHNA implementation and to determine whether a hospital's institutional and community characteristics are associated with greater progress. Our findings show wide variation among hospitals in CHNA implementation. Hospitals operating as part of a health system as well as hospitals participating in a Medicare accountable care organization showed greater progress in CHNA implementation whereas hospitals serving a greater proportion of uninsured showed less progress. We also found that hospitals reporting the highest level of CHNA implementation progress spent more on community health improvement. Hospitals widely embraced the regulations to perform a CHNA. Less is known about how hospitals are moving forward to improve population health through the implementation of programs to meet identified community needs.

Attitudes towards Addressing Medical Absenteeism of Students: A Qualitative Study among Principals and Special Education Needs Coordinators in Dutch Secondary Schools.

PubMed

Vanneste, Yvonne; van de Loo, Marlou; Feron, Frans; Rots-de Vries, Carin; van de Goor, Ien

2016-01-01

Reducing school absenteeism benefits the health and educational opportunities of young people. The Dutch intervention Medical Advice for Sick-reported Students (abbreviated as MASS) was developed to address school absenteeism due to sickness reporting, also called medical absenteeism. This study is part of a research project on the effectiveness of MASS and explores factors that influence the implementation and dissemination of the intervention, from schools' perspectives. The research questions include reasons schools have to implement MASS, their experiences in the implementation of MASS and their views on what is needed to ensure sustainable implementation. A qualitative research method was used. Semi-structured interviews were held with nine principals and eight special education needs coordinators, working in nine secondary schools that apply MASS. Inductive content analysis was carried out. The main reasons for schools to address medical absenteeism were their concerns about students' well-being and future prospects and their wish to share these concerns with students' parents. Participants also mentioned the wish to raise the threshold for reporting sick. According to the participants, MASS makes it easier for teachers to enter into conversation with students and their parents about medical absence. MASS prevents damage to the relationship with parents and medical problems being missed. In implementing MASS the main obstacles are teachers' dialogue about medical absence with students and their parents, teachers' follow-up of the feedback of the youth health care physicians (YHCPs), and correct registration. The participants were convinced that MASS also improves collaboration with parents regarding the optimization of care for students. MASS allows schools to identify students at risk of dropout at an early stage and to optimise guidance of these students. The intervention matches schools' need to address medical absenteeism by providing a clear framework

Attitudes towards Addressing Medical Absenteeism of Students: A Qualitative Study among Principals and Special Education Needs Coordinators in Dutch Secondary Schools

PubMed Central

Feron, Frans; Rots – de Vries, Carin; van de Goor, Ien

2016-01-01

Background Reducing school absenteeism benefits the health and educational opportunities of young people. The Dutch intervention Medical Advice for Sick-reported Students (abbreviated as MASS) was developed to address school absenteeism due to sickness reporting, also called medical absenteeism. This study is part of a research project on the effectiveness of MASS and explores factors that influence the implementation and dissemination of the intervention, from schools’ perspectives. The research questions include reasons schools have to implement MASS, their experiences in the implementation of MASS and their views on what is needed to ensure sustainable implementation. Methods A qualitative research method was used. Semi-structured interviews were held with nine principals and eight special education needs coordinators, working in nine secondary schools that apply MASS. Inductive content analysis was carried out. Findings The main reasons for schools to address medical absenteeism were their concerns about students’ well-being and future prospects and their wish to share these concerns with students’ parents. Participants also mentioned the wish to raise the threshold for reporting sick. According to the participants, MASS makes it easier for teachers to enter into conversation with students and their parents about medical absence. MASS prevents damage to the relationship with parents and medical problems being missed. In implementing MASS the main obstacles are teachers’ dialogue about medical absence with students and their parents, teachers’ follow-up of the feedback of the youth health care physicians (YHCPs), and correct registration. The participants were convinced that MASS also improves collaboration with parents regarding the optimization of care for students. Conclusions MASS allows schools to identify students at risk of dropout at an early stage and to optimise guidance of these students. The intervention matches schools’ need to address

Job Performance: Improvement Needed

ERIC Educational Resources Information Center

Goodman, Jacob

1974-01-01

Personnel directors of 38 business firms responded to a questionnaire rating 24 employee traits related to competencies, attitudes, skills, and personality which needed improvement. Five traits were common among the rank order one to five to both retailer and commercial and service organization respondents: oral communication, initiative,…

Weight Gain Prevention among Midlife Women: A Randomized Controlled Trial to Address Needs Related to the Physical and Social Environment.

PubMed

Perry, Courtney D; Degeneffe, Dennis; Davey, Cynthia; Kollannoor-Samuel, Grace; Reicks, Marla

2016-05-25

Women tend to gain weight at midlife (40-60 years) increasing risk of obesity-related chronic diseases. Within specific eating occasions, needs related to the physical and social environment may result in less healthy eating behavior, which can lead to weight gain over time. The purpose of this study was to determine if a dietitian-delivered nutrition counseling intervention tailored to eating occasion needs could improve diet and prevent weight gain among midlife women over two years. A randomized controlled trial was conducted with healthy midlife women (n = 354) in one U.S. metropolitan area. The intervention group (n = 185) received ten hours of individual nutrition counseling from dietitians over six months, while women in a control group (n = 169) received no counseling. Measured height, weight and waist circumference, and dietary intakes were collected at baseline and every six months over two years. Mixed linear models were used to test for intervention effect on change in outcome variables over time. Dietary intakes of fruit, reduced/low-fat dairy foods and refined grains were significantly improved over time in the intervention compared to control group. However, the intervention had no effect on weight over time (p = 0.48). Nutrition counseling tailored to address eating occasion needs improved self-reported diet but did not significantly affect weight change.

Using structured and unstructured data to identify patients' need for services that address the social determinants of health.

PubMed

Vest, Joshua R; Grannis, Shaun J; Haut, Dawn P; Halverson, Paul K; Menachemi, Nir

2017-11-01

Increasingly, health care providers are adopting population health management approaches that address the social determinants of health (SDH). However, effectively identifying patients needing services that address a SDH in primary care settings is challenging. The purpose of the current study is to explore how various data sources can identify adult primary care patients that are in need of services that address SDH. A cross-sectional study described patients in need of SDH services offered by a safety-net hospital's federally qualified health center clinics. SDH services of social work, behavioral health, nutrition counseling, respiratory therapy, financial planning, medical-legal partnership assistance, patient navigation, and pharmacist consultation were offered on a co-located basis and were identified using structured billing and scheduling data, and unstructured electronic health record data. We report the prevalence of the eight different SDH service needs and the patient characteristics associated with service need. Moreover, characteristics of patients with SDH services need documented in structured data sources were compared with those documented by unstructured data sources. More than half (53%) of patients needed SDH services. Those in need of such services tended to be female, older, more medically complex, and higher utilizers of services. Structured and unstructured data sources exhibited poor agreement on patient SDH services need. Patients with SDH services need documented by unstructured data tended to be more complex. The need for SDH services among a safety-net population is high. Identifying patients in need of such services requires multiple data sources with structured and unstructured data. Copyright © 2017. Published by Elsevier B.V.

Supporting Adults to Address Their Literacy Needs Using E-Learning

ERIC Educational Resources Information Center

Fletcher, Jo; Nicholas, Karen; Davis, Niki

2011-01-01

Many adults need help with literacy learning. This is extremely challenging for the tertiary education sector and workplace-situated learning organisations. E-learning may be an effective and efficient way to improve the delivery of teaching of basic skills to learners. Our research study included five embedded case studies within one tertiary…

How Can Health Information Technologies Contribute to Improve Health Care Services for High-Need Patients?

PubMed

Nøhr, Christian; Botin, Lars; Zhu, Xinxin

2017-01-01

This paper discusses how health information technologies like tele-care, tele-health and tele-medicine can improve the condition for high-need patients, specifically in relation to access. The paper addresses specifically the values of timeliness and equity and how tele technological solutions can support and enhance these values. The paper introduces to the concept of scaffolding, which constitutes the framework for dynamic, appropriate, caring and embracing approaches for engaging and involving high-need patients that are vulnerable and exposed. A number of specific considerations for designing tele-technologies for high-need patients are derived, and the paper concludes that ethical and epistemological criterions for design are needed in order to meet the needs and requirements of the weak and exposed.

Improving Test Preparation for Students with Special Needs: Web-Based Tutorial, Student Charting, and a Text Reader

ERIC Educational Resources Information Center

Menard, Lauren A.

2011-01-01

Obstacles to the classroom implementation of the fourth grade Math component of Louisiana's web-based testing tutorial were addressed in this informal pilot. Technology integration improved standardized test preparation for students with special needs. Supplemental test preparation sessions give the benefits of (a) increased familiarity with…

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

Interrogating Single-Sex Classes as a Strategy for Addressing Boys' Educational and Social Needs

ERIC Educational Resources Information Center

Martino, Wayne; Mills, Martin; Lingard, Bob

2005-01-01

This paper explores the policy of single-sex classes that is currently being adopted in some schools as a strategy for addressing boys educational and social needs. It draws on research in one Australian government, coeducational primary school to examine teachers' and students' experiences of this strategy. Interviews with the principal, male and…

Addressing policy needs for prevention and control of type 2 diabetes in India.

PubMed

Atre, Sachin

2015-09-01

India carries nearly one-fifth of the global burden of diabetes cases, the majority of which are of type 2 diabetes. Recognising the need for controlling diabetes, the Government of India has initiated a national level programme for prevention and control of diabetes along with other non-communicable diseases in 2008. Despite being piloted and implemented, there is hardly any published literature about the national level situation of diabetes and its control efforts. The present article is written with the aim to fill this gap to some extent and to provide a situational analysis of the diabetes problem in India in a holistic way, addressing policy needs for the national programme. It focuses on three main areas, namely, awareness of diabetes, costs of drugs for its treatment and healthcare-system related issues. It argues that poor coverage and weak implementation of the national level programme are major forces that push patients to seek help in the weakly regulated private sector. Approaching the private sector is likely to increase the cost of care, which in turn can lead to an increased financial burden for patients and their families due to factors such as patients' lack of awareness about diabetes, poor drug price regulation and prescriptions including combinations and/or patented products of medicines used for treating diabetes by the private sector. This article addresses several needs such as strengthening the national programme and increasing its reach to unreached districts, exerting drug price regulation and implementing community-based participatory programmes for prevention and management of type 2 diabetes. It also underscores a need for piloting and implementing a robust national level electronic reporting system for diabetes programmes. © Royal Society for Public Health 2015.

The Wind Forecast Improvement Project (WFIP). A Public-Private Partnership Addressing Wind Energy Forecast Needs

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

Wilczak, James M.; Finley, Cathy; Freedman, Jeff

The Wind Forecast Improvement Project (WFIP) is a public-private research program, the goals of which are to improve the accuracy of short-term (0-6 hr) wind power forecasts for the wind energy industry and then to quantify the economic savings that accrue from more efficient integration of wind energy into the electrical grid. WFIP was sponsored by the U.S. Department of Energy (DOE), with partners that include the National Oceanic and Atmospheric Administration (NOAA), private forecasting companies (WindLogics and AWS Truepower), DOE national laboratories, grid operators, and universities. WFIP employed two avenues for improving wind power forecasts: first, through the collectionmore » of special observations to be assimilated into forecast models to improve model initial conditions; and second, by upgrading NWP forecast models and ensembles. The new observations were collected during concurrent year-long field campaigns in two high wind energy resource areas of the U.S. (the upper Great Plains, and Texas), and included 12 wind profiling radars, 12 sodars, 184 instrumented tall towers and over 400 nacelle anemometers (provided by private industry), lidar, and several surface flux stations. Results demonstrate that a substantial improvement of up to 14% relative reduction in power root mean square error (RMSE) was achieved from the combination of improved NOAA numerical weather prediction (NWP) models and assimilation of the new observations. Data denial experiments run over select periods of time demonstrate that up to a 6% relative improvement came from the new observations. The use of ensemble forecasts produced even larger forecast improvements. Based on the success of WFIP, DOE is planning follow-on field programs.« less

Addressing the Needs of Transgender Military Veterans: Better Access and More Comprehensive Care.

PubMed

Dietert, Michelle; Dentice, Dianne; Keig, Zander

2017-01-01

Purpose: There is a gap in social science literature addressing issues of access and quality of care for transgender military veterans. Psychologists, medical doctors, and other health professionals are beginning to address some of the barriers present in the Department of Veterans Affairs (VA) system that affect veterans who are also transgender and intersex. Over a 7-year period, between 2006 and 2013, 2600 transgender veterans were served by the VA. Data from several surveys revealed that most transgender veterans perceive the Veterans Health Administration (VHA) to be less than accommodating for their special needs. The goal of this study was to investigate the experiences of a sample of transgender veterans with regard to their experiences with healthcare services provided by the VHA. Methods: Using snowball sampling techniques, we were able to recruit 22 transgender military veterans to participate in our study. A combination of telephone interviews and questionnaires provided data from veterans in various branches of the military throughout the United States. Results: Findings indicate that even though the VHA is working to address issues of inequality for transgender veterans, our participants indicated that there are still some problems with administration of care, proper training of staff and physicians, and availability of comprehensive services for the unique healthcare needs of transgender individuals. Conclusion: Since our data were collected, the VA has worked to bridge the gap by focusing on increased training for VHA providers and staff and establishing LGBT programs at VA facilities. However, we suggest that one key area of importance should continue to focus on how mental health and medical providers and ancillary staff are trained to interact with and provide care for their transgender patients.

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.

Addressing sexual health needs: a comparison of a one-stop shop with separate genitourinary medicine and family planning services.

PubMed

French, Rebecca S; Mercer, Catherine H; Robinson, Angela J; Gerressu, Makeda; Rogstad, Karen E

2010-10-01

Little evidence is available on the extent to which one-stop shops address users' sexual health needs and the extent to which they identify additional needs users may not have identified. As part of the One-Stop Shop Evaluation, a questionnaire was designed to compare the reasons for users' visits and the reported outcomes of visits at a one-stop shop with the experiences of users in separate genitourinary medicine (GUM) and contraceptive clinics. The difference in the proportions of those attending the one-stop shop and those attending the control sites services for a sexually transmitted infection (STI)-related reason who were diagnosed with an STI was minimal, but those attending for an STI-related reason in the one-stop shop were more likely to receive an additional contraceptive outcome. Women attending for a contraceptive-related reason at the one-stop shop were more likely to have an STI screen than those attending the control sites for the same reason, but there was little difference in the proportions amongst this group receiving an STI diagnosis or receiving treatment. When focusing on women attending for a pregnancy-related reason, one-stop shop users were more likely to have received contraceptive advice or supplies. It was not possible in our evaluation to determine the relative effectiveness of the one-stop shop in comparison to the traditional GUM and contraceptive clinics in improving sexual health status, however the one-stop shop was more likely to address additional sexual health needs that service users may not have previously identified.

GRACEnet: addressing policy needs through coordinated cross-location research

USGS Publications Warehouse

Jawson, Michael D.; Walthall, Charles W.; Shafer, Steven R.; Liebig, Mark; Franzluebbers, Alan J.; Follett, Ronald F.

2012-01-01

GRACEnet (Greenhouse gas Reduction through Agricultural Carbon Enhancement network) was conceived to build upon ongoing USDA Agricultural Research Service (ARS) research to improve soil productivity, while addressing the challenges and opportunities of interest in C sequestration from a climate change perspective. The vision for GRACEnet was and remains: Knowledge and information used to implement scientifically based agricultural management practices from the field to national policy scales on C sequestration, greenhouse gas (GHG) emissions, and environmental benefits. The national focus of GRACEnet uses a standardized approach by ARS laboratories and university and land manager (e.g. farmer and rancher) cooperators to assess C sequestration and GHG emission from different crop and grassland systems. Since 2002, GRACEnet has significantly expanded GHG mitigation science and delivered usable information to agricultural research and policy organizations. Recent developments suggest GRACEnet will have international impact by contributing leadership and technical guidance for the Global Research Alliance on Agricultural Greenhouse Gases.

A Task-Based Needs Analysis for Australian Aboriginal Students: Going beyond the Target Situation to Address Cultural Issues

ERIC Educational Resources Information Center

Oliver, Rhonda; Grote, Ellen; Rochecouste, Judith; Exell, Michael

2013-01-01

While needs analyses underpin the design of second language analytic syllabi, the methodologies undertaken are rarely examined. This paper explores the value of multiple data sources and collection methods for developing a needs analysis model to enable vocational education and training teachers to address the needs of Australian Aboriginal…

Faculty development to improve teaching at a health sciences center: a needs assessment.

PubMed

Scarbecz, Mark; Russell, Cynthia K; Shreve, Robert G; Robinson, Melissa M; Scheid, Cheryl R

2011-02-01

There has been increasing interest at health science centers in improving the education of health professionals by offering faculty development activities. In 2007-08, as part of an effort to expand education-related faculty development offerings on campus, the University of Tennessee Health Science Center surveyed faculty members in an effort to identify faculty development activities that would be of interest. Factor analysis of survey data indicated that faculty interests in the areas of teaching and learning can be grouped into six dimensions: development of educational goals and objectives, the use of innovative teaching techniques, clinical teaching, improving traditional teaching skills, addressing teaching challenges, and facilitating participation. There were significant differences in the level of interest in education-related faculty development activities by academic rank and by the college of appointment. Full professors expressed somewhat less interest in faculty development activities than faculty members of lower ranks. Faculty members in the Colleges of Medicine and Dentistry expressed somewhat greater interest in faculty development to improve traditional teaching skills. The policy implications of the survey results are discussed, including the need for faculty development activities that target the needs of specific faculty groups.

Classroom Management Strategies to Address the Needs of Sudanese Refugee Learners: Support Document--Methodology and Literature Review

ERIC Educational Resources Information Center

Burgoyne, Ursula; Hull, Oksana

2007-01-01

This document presents the methodology and literature review for the research report "Classroom Management Strategies to Address the Needs of Sudanese Refugee Learners" (ED499673), which examined the extent to which English language, literacy and numeracy teachers used classroom management strategies to meet the needs of adult Sudanese…

25 CFR 162.515 - How must a WEEL address ownership of permanent improvements?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false How must a WEEL address ownership of permanent improvements? 162.515 Section 162.515 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER LEASES AND PERMITS Wind and Solar Resource Leases Weels § 162.515 How must a WEEL address...

25 CFR 162.515 - How must a WEEL address ownership of permanent improvements?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false How must a WEEL address ownership of permanent improvements? 162.515 Section 162.515 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER LEASES AND PERMITS Wind and Solar Resource Leases Weels § 162.515 How must a WEEL address...

How Northwest Region States Are Supporting Schools in Need of Improvement. Issues & Answers. REL 2007-No. 009

ERIC Educational Resources Information Center

Davis, Deborah; Krasnoff, Basha; Moilanen, Carolyn; Sather, Susan; Kushman, James

2007-01-01

This study examines the systems of technical assistance and support that Northwest Region states implemented during 2005-2006 for schools in need of improvement. By highlighting key characteristics and differences among state systems, the intent is to stimulate an analysis of what states can do and what issues they might address to move schools…

Organizational culture: an important context for addressing and improving hospital to community patient discharge.

PubMed

Hesselink, Gijs; Vernooij-Dassen, Myrra; Pijnenborg, Loes; Barach, Paul; Gademan, Petra; Dudzik-Urbaniak, Ewa; Flink, Maria; Orrego, Carola; Toccafondi, Giulio; Johnson, Julie K; Schoonhoven, Lisette; Wollersheim, Hub

2013-01-01

Organizational culture is seen as having a growing impact on quality and safety of health care, but its impact on hospital to community patient discharge is relatively unknown. To explore aspects of organizational culture to develop a deeper understanding of the discharge process. A qualitative study of stakeholders in the discharge process. Grounded Theory was used to analyze the data. In 5 European Union countries, 192 individual and 25 focus group interviews were conducted with patients and relatives, hospital physicians, hospital nurses, general practitioners, and community nurses. Three themes emerged representing aspects of organizational culture: a fragmented hospital to primary care interface, undervaluing administrative tasks relative to clinical tasks in the discharge process, and lack of reflection on the discharge process or process improvement. Nine categories were identified: inward focus of hospital care providers, lack of awareness to needs, skills, and work patterns of the professional counterpart, lack of a collaborative attitude, relationship between hospital and primary care providers, providing care in a "here and now" situation, administrative work considered to be burdensome, negative attitude toward feedback, handovers at discharge ruled by habits, and appreciating and integrating new practices. On the basis of the data, we hypothesize that the extent to which hospital care providers value handovers and the outreach to community care providers is critical to effective hospital discharge. Community care providers often are insufficiently informed about patient outcomes. Ongoing challenges with patient discharge often remain unspoken with opportunities for improvement overlooked. Interventions that address organizational culture as a key factor in discharge improvement efforts are needed.

Student nurses need more than maths to improve their drug calculating skills.

PubMed

Wright, Kerri

2007-05-01

Nurses need to be able to calculate accurate drug calculations in order to safely administer drugs to their patients (NMC, 2002). Studies have shown however that nurses do not always have the necessary skills to calculate accurate drug dosages and are potentially administering incorrect dosages of drugs to their patients (Hutton, M. 1998. Nursing Mathematics: the importance of application. Nursing Standard 13(11), 35-38; Kapborg, I. 1994. Calculation and administration of drug dosage by Swedish nurses, Student Nurses and Physicians. International Journal for Quality in Health Care 6(4), 389-395; O'Shea, E. 1999. Factors contributing to medication errors: a literature review. Journal of Advanced Nursing 8, 496-504; Wilson, A. 2003. Nurses maths: researching a practical approach. Nursing Standard 17(47), 33-36). The literature indicates that in order to improve drug calculations strategies need to focus on both the mathematical skills and conceptual skills of student nurses so they can interpret clinical data into drug calculations to be solved. A study was undertaken to investigate the effectiveness of implementing several strategies which focussed on developing the mathematical and conceptual skills of student nurses to improve their drug calculation skills. The study found that implementing a range of strategies which addressed these two developmental areas significantly improved the drug calculation skills of nurses. The study also indicates that a range of strategies has the potential ensuring that the skills taught are retained by the student nurses. Although the strategies significantly improved the drug calculation skills of student nurses, the fact that only 2 students were able to achieve 100% in their drug calculation test indicates a need for further research into this area.

Addressing the religious and spiritual needs of dying patients by healthcare staff in Korea: patient perspectives in a multi-religious Asian country.

PubMed

Kang, Jina; Shin, Dong Wook; Choi, Jin Young; Park, Chang Hae; Baek, Young Ji; Mo, Ha Na; Song, Mi Ok; Park, Shin Ae; Moon, Do Ho; Son, Ki Young

2012-04-01

We investigated how patients' spiritual and religious needs are addressed by healthcare staff in inpatient palliative care centers in Korea, a multi-religious country. We performed a cross-sectional, multicenter survey of terminal cancer patients in inpatient palliative care centers. Approximately half (50.5%) of the patients reported that their spiritual and religious needs were addressed by healthcare staff. Patients whose needs were addressed reported better quality of life (QoL), as measured using the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire for Palliative Care, than patients whose needs were not addressed (p<0.05), although these groups did not differ when measured using the Comprehensive QoL Scale. Patients with a religious affiliation [adjusted odds ratio (aOR), 2.38; 95% confidence interval (CI), 0.70-8.05], those who were admitted to a religious palliative care center (aOR, 2.61; 95% CI, 0.86-7.96), and those whose religious affiliation was the same as that of the palliative care center (aOR, 2.42; 95% CI, 0.96-6.07) tended to have their spiritual and religious needs addressed, although not statistically significant. Although patients whose spiritual and religious needs were addressed by healthcare staff showed significantly better QoL, such needs were not addressed in a significant proportion of patients, especially those who were not religious or were admitted to non-religious palliative care centers. Strategies should be developed to ensure that spiritual care is provided to all patients with terminal cancer, regardless of the religious background of the patient. Copyright © 2011 John Wiley & Sons, Ltd.

Support needs for medication use and the suitability of eHealth technologies to address these needs: a focus group study of older patients with rheumatoid arthritis

PubMed Central

Mathijssen, Elke GE; Vriezekolk, Johanna E; Eijsbouts, Agnes MM; van den Hoogen, Frank HJ; van den Bemt, Bart JF

2018-01-01

Objective The objectives of this study were to explore the needs of patients with rheumatoid arthritis (RA) regarding support for medication use and to gain insight into their perspective on the suitability of eHealth technologies to address these needs. Methods Three focus groups were conducted with 28 patients with RA. Audio recordings made during the focus groups were transcribed verbatim. Two researchers independently performed an inductive, thematic analysis on the data (ie, the transcripts and field notes). Results The following three themes that described support needs of patients with RA for medication use were identified in the data: 1) informational support; 2) practical support; and 3) emotional support. Informational support reflected the provision of information and facts, including advice, suggestions, and feedback from health care providers. Practical support included the reinforcement of practical skills as well as the provision of medication aids and pharmacy services. Emotional support reflected a trusted patient–health care provider relationship, characterized by good communication. Although potential advantages of eHealth technologies to address the patients’ support needs were recognized, concerns over matters such as personal interaction with health care providers, privacy and data security, and the quality and reliability of online information were prevalent. Conclusion Patients with RA have informational, practical, and emotional support needs for medication use. Informational support seems to be most important. From the patients’ perspective, eHealth technologies may have the potential to address these needs. However, these technologies are regarded as a complement to, rather than a replacement of, current practices. PMID:29563778

Lived Experiences of School Counselors Who Address Mental Health Needs through Evidenced-Based Educational Programs

ERIC Educational Resources Information Center

Olds, Kelley Yvette

2017-01-01

The purpose of this phenomenological qualitative study was to explore the lived experiences of school counselors who address the mental health needs of students through at least one of the following educational evidenced-based programs: Positive Behavior Intervention and Supports, Response to Intervention, Restorative Practices, and Student…

Addressing the Needs of Transgender Military Veterans: Better Access and More Comprehensive Care

PubMed Central

Dietert, Michelle; Dentice, Dianne; Keig, Zander

2017-01-01

Abstract Purpose: There is a gap in social science literature addressing issues of access and quality of care for transgender military veterans. Psychologists, medical doctors, and other health professionals are beginning to address some of the barriers present in the Department of Veterans Affairs (VA) system that affect veterans who are also transgender and intersex. Over a 7-year period, between 2006 and 2013, 2600 transgender veterans were served by the VA. Data from several surveys revealed that most transgender veterans perceive the Veterans Health Administration (VHA) to be less than accommodating for their special needs. The goal of this study was to investigate the experiences of a sample of transgender veterans with regard to their experiences with healthcare services provided by the VHA. Methods: Using snowball sampling techniques, we were able to recruit 22 transgender military veterans to participate in our study. A combination of telephone interviews and questionnaires provided data from veterans in various branches of the military throughout the United States. Results: Findings indicate that even though the VHA is working to address issues of inequality for transgender veterans, our participants indicated that there are still some problems with administration of care, proper training of staff and physicians, and availability of comprehensive services for the unique healthcare needs of transgender individuals. Conclusion: Since our data were collected, the VA has worked to bridge the gap by focusing on increased training for VHA providers and staff and establishing LGBT programs at VA facilities. However, we suggest that one key area of importance should continue to focus on how mental health and medical providers and ancillary staff are trained to interact with and provide care for their transgender patients. PMID:28861546

The GÉANT network: addressing current and future needs of the HEP community

NASA Astrophysics Data System (ADS)

Capone, Vincenzo; Usman, Mian

2015-12-01

The GÉANT infrastructure is the backbone that serves the scientific communities in Europe for their data movement needs and their access to international research and education networks. Using the extensive fibre footprint and infrastructure in Europe the GÉANT network delivers a portfolio of services aimed to best fit the specific needs of the users, including Authentication and Authorization Infrastructure, end-to-end performance monitoring, advanced network services (dynamic circuits, L2-L3VPN, MD-VPN). This talk will outline the factors that help the GÉANT network to respond to the needs of the High Energy Physics community, both in Europe and worldwide. The Pan-European network provides the connectivity between 40 European national research and education networks. In addition, GÉANT also connects the European NRENs to the R&E networks in other world region and has reach to over 110 NREN worldwide, making GÉANT the best connected Research and Education network, with its multiple intercontinental links to different continents e.g. North and South America, Africa and Asia-Pacific. The High Energy Physics computational needs have always had (and will keep having) a leading role among the scientific user groups of the GÉANT network: the LHCONE overlay network has been built, in collaboration with the other big world REN, specifically to address the peculiar needs of the LHC data movement. Recently, as a result of a series of coordinated efforts, the LHCONE network has been expanded to the Asia-Pacific area, and is going to include some of the main regional R&E network in the area. The LHC community is not the only one that is actively using a distributed computing model (hence the need for a high-performance network); new communities are arising, as BELLE II. GÉANT is deeply involved also with the BELLE II Experiment, to provide full support to their distributed computing model, along with a perfSONAR-based network monitoring system. GÉANT has also

Helping social workers address the educational needs of foster children.

PubMed

Zetlin, Andrea G; Weinberg, Lois A; Kimm, Christina

2005-07-01

The main aim was to evaluate the effectiveness of the Education Initiative, an intervention program in one of the largest urban counties in the US seeking to increase the responsiveness of social workers to the educational needs of foster children. A pre-post test control group design was used. Data from case files and social workers were examined at the start of the project and 18 months later to determine changes in social workers' (a) knowledge and practices regarding school programs and services and (b) maintenance of educational records for children on their caseloads. Data were analyzed from approximately 300 case files and over 200 questionnaires completed by social workers. Findings indicated that social workers who received training and had access to an education liaison (1) increased their knowledge about the school system and (2) were more likely to gather current educational data and comment on schooling needs in the case files. On questionnaires measuring knowledge and practices, supervisory social workers showed no gains while case workers increased their levels of knowledge and involvement. Evaluative data from both sources support the effectiveness of this collaborative model between the school and child welfare agency for addressing the educational needs of foster youth. Social workers in the pilot offices knew more and focused more on the school experience of youth on their caseloads than workers in the control offices. They reported more educational information in the case files and solicited current progress reports from the schools. Discrepancies between worker and school reported performance data raise questions as to whether social workers by themselves are the most effective advocates for foster children.

Addressing Student Mental Health Needs by Providing Direct and Indirect Services and Building Alliances in the Community

ERIC Educational Resources Information Center

Kaffenberger, Carol J.; O'Rorke-Trigiani, Judith

2013-01-01

Given that 20% of students experience mental health issues that interfere with school performance and most of these students will turn first to their school for help, school counselors need to consider how they can best serve this population. This article describes how school counselors can address the mental health needs of students by providing…

Forging a critical alliance: Addressing the research needs of the United States critical illness and injury community.

PubMed

Cobb, J Perren; Ognibene, Frederick P; Ingbar, David H; Mann, Henry J; Hoyt, David B; Angus, Derek C; Thomas, Alvin V; Danner, Robert L; Suffredini, Anthony F

2009-12-01

Discuss the research needs of the critical illness and injury communities in the United States. Workshop session held during the 5 National Institutes of Health Symposium on the Functional Genomics of Critical Illness and Injury (November 15, 2007). The current clinical research infrastructure misses opportunities for synergy and does not address many important needs. In addition, it remains challenging to rapidly and properly implement system-wide changes based upon reproducible evidence from clinical research. Author presentations, panel discussion, attendee feedback. The critical illness and injury research communities seek better communication and interaction, both of which will improve the breadth and quality of acute care research. Success in meeting these needs should come from cooperative and strategic actions that favor collaboration, standardization of protocols, and strong leadership. An alliance framed on common goals will foster collaboration among experts to better promote clinical trials within the critically ill or injured patient population. The U.S. Critical Illness and Injury Trials Group was funded to create a clinical research framework that can reduce the barriers to investigation using an investigator-initiated, evidence-driven, inclusive approach that has proven successful elsewhere. This alliance will provide an annual venue for systematic review and strategic planning that will include framing the research agenda, raising awareness for the value of acute care research, gathering and promoting best practices, and bolstering the critical care workforce.

Training Social Workers and Human Service Professionals to Address the Complex Financial Needs of Clients

ERIC Educational Resources Information Center

Frey, Jodi Jacobson; Hopkins, Karen; Osteen, Philip; Callahan, Christine; Hageman, Sally; Ko, Jungyai

2017-01-01

In social work and other community-based human services settings, clients often present with complex financial problems. As a need for more formal training is beginning to be addressed, evaluation of existing training is important, and this study evaluates outcomes from the Financial Stability Pathway (FSP) project. Designed to prepare…

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 a Context-aware Medical Application to Address Information Needs for Extubation Decisions

PubMed Central

Zhu, Xinxin; Lord, William

2005-01-01

Information overload has been one of the causes of preventable medical errors [1] and escalating costs [2]. A context-aware application with embedded clinical knowledge is proposed to provide practitioners with the appropriate amount of information and content. We developed a prototype of a context-aware medical application to address clinicians’ information needs that arise in a data-intensive unit, the Cardio-Thoracic Intensive Care Unit (CTICU). A major clinical decision supported by the prototype, the extubation decision, is illustrated. PMID:16779455

Addressing the Mental Health Needs of Pregnant and Parenting Adolescents

PubMed Central

Beers, Lee; Southammakosane, Cathy; Lewin, Amy

2014-01-01

Adolescent parenthood is associated with a range of adverse outcomes for young mothers, including mental health problems such as depression, substance abuse, and posttraumatic stress disorder. Teen mothers are also more likely to be impoverished and reside in communities and families that are socially and economically disadvantaged. These circumstances can adversely affect maternal mental health, parenting, and behavior outcomes for their children. In this report, we provide an overview of the mental health challenges associated with teen parenthood, barriers that often prevent teen mothers from seeking mental health services, and interventions for this vulnerable population that can be integrated into primary care services. Pediatricians in the primary care setting are in a unique position to address the mental health needs of adolescent parents because teens often turn to them first for assistance with emotional and behavioral concerns. Consequently, pediatricians can play a pivotal role in facilitating and encouraging teen parents’ engagement in mental health treatment. PMID:24298010

Improving Assessment Tasks through Addressing Our Unconscious Limits to Change

ERIC Educational Resources Information Center

Joughin, Gordon; Dawson, Phillip; Boud, David

2017-01-01

Despite widespread recognition of the need to improve assessment in higher education, assessment tasks in individual courses are too often dominated by conventional methods. While changing assessment depends on many factors, improvements to assessment ultimately depend on the decisions and actions of individual educators. This paper considers…

Strategies for Addressing the University Library Users' Changing Needs and Practices in Sub-Saharan Africa

ERIC Educational Resources Information Center

Musoke, Maria G. N.

2008-01-01

The paper presents a Sub-Saharan African academic Librarian's experience in trying to address the changing needs and practices of university library users. Special reference is made to Makerere University Library. Most of the changes have been brought about by the various paradigm shifts in teaching, learning and research, as well as advances in…

Using Primary Care to Address Violence against Women in Intimate Partner Relationships: Professional Training Needs.

PubMed

Torralbas-Fernández, Aida; Calcerrada-Gutiérrez, Marybexy

2016-10-01

Unified, prevention- and community-oriented, Cuba's National Health System is well positioned to address social problems such as gender violence against women. It is sometimes taken for granted that family doctors, family nurses and psychologists in the health system should be able to deal with such cases. However, some studies among these professionals have revealed misconceptions about intimate partner violence, an insufficient understanding of its causes, and greater tolerance of psychological violence than of physical and sexual violence. Cuba needs to train family doctors and clinical psychologists who are knowledgeable about the subject so that they can take part in the development and implementation of intersectoral education and prevention policies and programs, provide assistance to women who have been victims of violence, and work together with community members to create support networks that serve as monitoring mechanisms. Primary care is the ideal setting for raising awareness of the need for greater intersectoral action to systematically address violence against women. KEYWORDS Professional training, doctors, clinical psychologists, gender, spousal abuse, domestic violence, family violence, family relationships, Cuba.

Addressing tuberculosis patients' medical and socio-economic needs: a comprehensive programmatic approach.

PubMed

Contreras, Carmen C; Millones, Ana K; Santa Cruz, Janeth; Aguilar, Margot; Clendenes, Martin; Toranzo, Miguel; Llaro, Karim; Lecca, Leonid; Becerra, Mercedes C; Yuen, Courtney M

2017-04-01

For a cohort of patients with tuberculosis in Carabayllo, Peru, we describe the prevalence of medical comorbidities and socio-economic needs, the efforts required by a comprehensive support programme ('TB Cero') to address them and the success of this programme in linking patients to care. Patients diagnosed with tuberculosis in Carabayllo underwent evaluations for HIV, diabetes, mental health and unmet basic needs. For patients initiating treatment during 14 September, 2015-15 May, 2016, we abstracted data from evaluation forms and a support request system. We calculated the prevalence of medical comorbidities and the need for socio-economic support at the time of tuberculosis diagnosis, as well as the proportion of patients successfully linked to care or support. Of 192 patients, 83 (43%) had at least one medical comorbidity other than tuberculosis. These included eight (4%) patients with HIV, 12 (6%) with diabetes and 62 (32%) deemed at risk for a mental health condition. Of patients who required follow-up for a comorbidity, 100% initiated antiretroviral therapy, 71% attended endocrinology consultations and 66% attended psychology consultations. Of 126 (65%) patients who completed the socio-economic evaluation, 58 (46%) reported already receiving food baskets from the municipality, and 79 (63%) were given additional support, most commonly food vouchers and assistance in accessing health care. Carabayllo tuberculosis patients face many challenges in addition to tuberculosis. A collaborative, comprehensive treatment support programme can achieve high rates of linkage to care for these needs. © 2017 John Wiley & Sons Ltd.

Improving Teacher Quality for Colorado Science Teachers in High Need Schools

ERIC Educational Resources Information Center

Stevenson, Mark; Stevenson, Cerissa; Cooner, Donna

2015-01-01

This article describes the evaluation of an online professional development program funded by the State of Colorado to address the need for highly qualified science teachers in high need and/or rural school districts. Recruitment and the retention of highly qualified educators in high need and/or rural school districts is a critical factor…

Understanding and Addressing the Global Need for Orthopaedic Trauma Care.

PubMed

Agarwal-Harding, Kiran J; von Keudell, Arvind; Zirkle, Lewis G; Meara, John G; Dyer, George S M

2016-11-02

➤The burden of musculoskeletal trauma is high worldwide, disproportionately affecting the poor, who have the least access to quality orthopaedic trauma care.➤Orthopaedic trauma care is essential, and must be a priority in the horizontal development of global health systems.➤The education of surgeons, nonphysician clinicians, and ancillary staff in low and middle income countries is central to improving access to and quality of care.➤Volunteer surgical missions from rich countries can sustainably expand and strengthen orthopaedic trauma care only when they serve a local need and build local capacity.➤Innovative business models may help to pay for care of the poor. Examples include reducing costs through process improvements and cross-subsidizing from profitable high-volume activities.➤Resource-poor settings may foster innovations in devices or systems with universal applicability in orthopaedics. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Sex education for local tourism/hospitality employees: addressing a local health need.

PubMed

Bauer, Irmgard L

2009-11-01

Health concerns arising from sexual relationships between tourists and locals usually focus on the travelling public. The local sex partners' health, and their impact on their communities' health, seem far less acknowledged. This paper describes a local health education session which implemented recommendations based on a study in Cuzco/Peru on tourists' and locals' views, knowledge, attitudes and experiences relating to sexual relationships between them. On location, fifteen discotheque employees received a health education session at the establishment's owner's request. Concluding from the positive experience, it is argued that researchers should, where possible, respond to requests to deliver ad hoc health education sessions while on location to address an identified local health need.

Addressing the Needs of Homeless Students.

ERIC Educational Resources Information Center

Holloway, John H.

2003-01-01

Reviews studies on the plight and needs of homeless students. Includes reports on family mobility and school attendance, dysfunctional families, and school intervention strategies. (Contains 11 references.) (PKP)

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.

Linking Obesity Prevention and Mental Health Promotion to Address Health Disparities.

PubMed

Claydon, Elizabeth; Austin, Anna; Smith, Megan V

2016-05-01

Considerable racial health disparities exist, especially in mental health and obesity. However, few approaches exist to address obesity and mental health simultaneously in minority groups. An intervention to address mental health in a low-income, minority group of urban mothers was designed using results from a needs assessment. Participating women were asked to rank their top health concerns and personal goals. Along with mental health concerns and basic needs, the majority of mothers desired assistance with improving their physical well-being. These results are surprising, but lend credence to creating interventions that aim to address both mental health and obesity concerns simultaneously.

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 Literacy and Numeracy to Improve Diabetes Care

PubMed Central

Cavanaugh, Kerri; Wallston, Kenneth A.; Gebretsadik, Tebeb; Shintani, Ayumi; Huizinga, Mary Margaret; Davis, Dianne; Gregory, Rebecca Pratt; Malone, Robb; Pignone, Michael; DeWalt, Darren; Elasy, Tom A.; Rothman, Russell L.

2009-01-01

OBJECTIVE Diabetic patients with lower literacy or numeracy skills are at greater risk for poor diabetes outcomes. This study evaluated the impact of providing literacy- and numeracy-sensitive diabetes care within an enhanced diabetes care program on A1C and other diabetes outcomes. RESEARCH DESIGN AND METHODS In two randomized controlled trials, we enrolled 198 adult diabetic patients with most recent A1C ≥7.0%, referred for participation in an enhanced diabetes care program. For 3 months, control patients received care from existing enhanced diabetes care programs, whereas intervention patients received enhanced programs that also addressed literacy and numeracy at each institution. Intervention providers received health communication training and used the interactive Diabetes Literacy and Numeracy Education Toolkit with patients. A1C was measured at 3 and 6 months follow-up. Secondary outcomes included self-efficacy, self-management behaviors, and treatment satisfaction. RESULTS At 3 months, both intervention and control patients had significant improvements in A1C from baseline (intervention −1.50 [95% CI −1.80 to −1.02]; control −0.80 [−1.10 to −0.30]). In adjusted analysis, there was greater improvement in A1C in the intervention group than in the control group (P = 0.03). At 6 months, there were no differences in A1C between intervention and control groups. Self-efficacy improved from baseline for both groups. No significant differences were found for self-management behaviors or satisfaction. CONCLUSIONS A literacy- and numeracy-focused diabetes care program modestly improved self-efficacy and glycemic control compared with standard enhanced diabetes care, but the difference attenuated after conclusion of the intervention. PMID:19741187

Improving Evaluation to Address the Unintended Consequences of Health Information Technology:

PubMed Central

Ammenwerth, E.; Hyppönen, H.; de Keizer, N.; Nykänen, P.; Rigby, M.; Scott, P.; Talmon, J.; Georgiou, A.

2016-01-01

Summary Background and objectives With growing use of IT by healthcare professionals and patients, the opportunity for any unintended effects of technology to disrupt care health processes and outcomes is intensified. The objectives of this position paper by the IMIA Working Group (WG) on Technology Assessment and Quality Development are to highlight how our ongoing initiatives to enhance evaluation are also addressing the unintended consequences of health IT. Methods Review of WG initiatives Results We argue that an evidence-based approach underpinned by rigorous evaluation is fundamental to the safe and effective use of IT, and for detecting and addressing its unintended consequences in a timely manner. We provide an overview of our ongoing initiatives to strengthen study design, execution and reporting by using evaluation frameworks and guidelines which can enable better characterization and monitoring of unintended consequences, including the Good Evaluation Practice Guideline in Health Informatics (GEP-HI) and the Statement on Reporting of Evaluation Studies in Health Informatics (STARE-HI). Indicators to benchmark the adoption and impact of IT can similarly be used to monitor unintended effects on healthcare structures, processes and outcome. We have also developed EvalDB, a web-based database of evaluation studies to promulgate evidence about unintended effects and are developing the content for courses to improve training in health IT evaluation. Conclusion Evaluation is an essential ingredient for the effective use of IT to improve healthcare quality and patient safety. WG resources and skills development initiatives can facilitate a proactive and evidence-based approach to detecting and addressing the unintended effects of health IT. PMID:27830232

Need for Improvement of Rural School Facilities.

ERIC Educational Resources Information Center

Hodges, V. Pauline

The Government Accounting Agency estimates that one third of the nation's schools are in need of extensive repairs or replacement of one or more buildings. The condition of America's rural schools are at a crisis stage and need to be improved to continue to educate rural youth. This paper profiles the state of rural schools' infrastructure, rural…

Multiple Behavior Change Intervention to Improve Detection of Unmet Social Needs and Resulting Resource Referrals.

PubMed

Colvin, Jeffrey D; Bettenhausen, Jessica L; Anderson-Carpenter, Kaston D; Collie-Akers, Vicki; Plencner, Laura; Krager, Molly; Nelson, Brooke; Donnelly, Sara; Simmons, Julia; Higinio, Valeria; Chung, Paul J

2016-03-01

It is critical that pediatric residents learn to effectively screen families for active and addressable social needs (ie, negative social determinants of health). We sought to determine 1) whether a brief intervention teaching residents about IHELP, a social needs screening tool, could improve resident screening, and 2) how accurately IHELP could detect needs in the inpatient setting. During an 18-month period, interns rotating on 1 of 2 otherwise identical inpatient general pediatrics teams were trained in IHELP. Interns on the other team served as the comparison group. Every admission history and physical examination (H&P) was reviewed for IHELP screening. Social work evaluations were used to establish the sensitivity and specificity of IHELP and document resources provided to families with active needs. During a 21-month postintervention period, every third H&P was reviewed to determine median duration of continued IHELP use. A total of 619 admissions met inclusion criteria. Over 80% of intervention team H&Ps documented use of IHELP. The percentage of social work consults was nearly 3 times greater on the intervention team than on the comparison team (P < .001). Among H&Ps with documented use of IHELP, specificity was 0.96 (95% confidence interval 0.87-0.99) and sensitivity was 0.63 (95% confidence interval 0.50-0.73). Social work provided resources for 78% of positively screened families. The median duration of screening use by residents after the intervention was 8.1 months (interquartile range 1-10 months). A brief intervention increased resident screening and detection of social needs, leading to important referrals to address those needs. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Multiple Behavior Change Intervention to Improve Detection of Unmet Social Needs and Resulting Resource Referrals

PubMed Central

Colvin, Jeffrey D.; Bettenhausen, Jessica L.; Anderson-Carpenter, Kaston D.; Collie-Akers, Vicki; Plencner, Laura; Krager, Molly; Nelson, Brooke; Donnelly, Sara; Simmons, Julia; Higinio, Valeria; Chung, Paul J.

2015-01-01

Objective It is critical that pediatric residents learn to effectively screen families for active and addressable social needs (i.e., negative social determinants of health.) We sought to determine 1) whether a brief intervention teaching residents about IHELP, a social needs screening tool, could improve resident screening, and 2) how accurately IHELP could detect needs in the inpatient setting. Methods During an 18-month period, interns rotating on one of two otherwise identical inpatient general pediatrics teams were trained in IHELP. Interns on the other team served as the comparison group. Every admission history and physical (H&P) was reviewed for IHELP screening. Social work evaluations were used to establish the sensitivity and specificity of IHELP and document resources provided to families with active needs. During a 21-month post-intervention period, every third H&P was reviewed to determine median duration of continued IHELP use. Results 619 admissions met inclusion criteria. Over 80% of intervention team H&Ps documented use of IHELP. The percentage of social work consults was nearly 3 times greater on the intervention team than on the comparison team (P<0.001). Among H&Ps with documented use of IHELP, specificity was 0.96 (95% CI 0.87–0.99) and sensitivity was 0.63 (95% CI 0.50–0.73). Social work provided resources for 78% of positively screened families. The median duration of screening use by residents after the intervention was 8.1 months (IQR 1–10 months) Conclusions A brief intervention increased resident screening and detection of social needs, leading to important referrals to address those needs. PMID:26183003

Social workers' roles in addressing the complex end-of-life care needs of elders with advanced chronic disease.

PubMed

Kramer, Betty J

2013-01-01

This study examined social workers' roles in caring for low-income elders with advanced chronic disease in an innovative, community-based managed care program, from the perspective of elders, family, team members, and social workers. The results are drawn from a larger longitudinal, multimethod case study. Sources of data include survey reports of needs addressed by social workers for 120 deceased elders, five focus groups with interdisciplinary team members, and in-depth interviews with 14 elders and 10 of their family caregivers. A thematic conceptual matrix was developed to detail 32 distinctive social work roles that address divergent needs of elders, family, and team members. Distinctive perceptions of social workers' roles were identified for the different stakeholder groups (i.e., elders, family caregivers, team members, and social workers). Findings from this study may inform supervisors and educators regarding training needs of those preparing to enter the rapidly growing workforce of gerontological social workers who may be called upon to care for elders at the end of life. Training is particularly warranted to help social workers gain the skills needed to more successfully treat symptom management, depression, anxiety, agitation, grief, funeral planning, and spiritual needs that are common to the end of life.

Randomized Multilevel Intervention to Improve Outcomes of Residents in Nursing Homes in Need of Improvement

PubMed Central

Rantz, Marilyn J.; Nahm, Helen E.; Zwygart-Stauffacher, Mary; Hicks, Lanis; Mehr, David; Flesner, Marcia; Petroski, Gregory F.; Madsen, Richard W.; Scott-Cawiezell, Jill

2012-01-01

Purpose A comprehensive multilevel intervention was tested to build organizational capacity to create and sustain improvement in quality of care and subsequently improve resident outcomes in nursing homes in need of improvement. Intervention facilities (n=29) received a two-year multilevel intervention with monthly on-site consultation from expert nurses with graduate education in gerontological nursing. Attention control facilities (n=29) that also needed to improve resident outcomes received monthly information about aging and physical assessment of elders. Design and Methods Randomized clinical trial of nursing homes in need of improving resident outcomes of bladder and bowel incontinence, weight loss, pressure ulcers, and decline in activities of daily living (ADL). It was hypothesized that following the intervention, experimental facilities would have better resident outcomes, higher quality of care, higher staff retention, more organizational attributes of improved working conditions than control facilities, similar staffing and staff mix, and lower total and direct care costs. Results The intervention did improve quality of care (p=0.02); there were improvements in pressure ulcers (p=0.05), weight loss (p=0.05). Staff retention, organizational working conditions, staffing, and staff mix and most costs were not affected by the intervention. Leadership turnover was surprisingly excessive in both intervention and control groups. Implications Some facilities that are in need of improving quality of care and resident outcomes are able to build the organizational capacity to improve while not increasing staffing or costs of care. Improvement requires continuous supportive consultation and leadership willing to involve staff and work together to build the systematic improvements in care delivery needed. PMID:21816681

Addressing the burden of epilepsy: Many unmet needs.

PubMed

Beghi, Ettore

2016-05-01

the presence of comorbidity. Although in several countries the costs of epilepsy are met by the national health systems, out-of-pocket costs may be a relevant fraction of the overall costs, especially in countries where the public management of health care is suboptimal or non-existent. Epilepsy strongly affects patients' independence, psychological health and emotional adjustment. Epilepsy impairs all aspects of health-related quality of life. Awareness and attitudes of the public about epilepsy may significantly affect the burden of the disease. All these factors add to the burden of the disease. However, many of the factors implicated in the onset of epilepsy, its course and treatment can be favorably addressed with appropriate strategic plans. More research is needed to investigate and manage the medical and psychosocial implications of epilepsy. Copyright © 2016 Elsevier Ltd. All rights reserved.

Addressing Behavior Needs by Disability Category

ERIC Educational Resources Information Center

Serfass, Cynthia

2009-01-01

The purpose of this study was to determine whether students with identified behavioral needs were provided a different level of behavioral intervention based on their special education disability category verification. A second purpose of this study was to determine what caused potential differences as interpreted by individuals working in the…

Implementing a Public Health Approach to Addressing Mental Health Needs in a University Setting: Lessons and Challenges

ERIC Educational Resources Information Center

Parcover, Jason; Mays, Sally; McCarthy, Amy

2015-01-01

The mental health needs of college students are placing increasing demands on counseling center resources, and traditional outreach efforts may be outdated or incomplete. The public health model provides an approach for reaching more students, decreasing stigma, and addressing mental health concerns before they reach crisis levels. Implementing a…

Case Studies on Using Strengths and Interests to Address the Needs of Students with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Lanou, Aaron; Hough, Lauren; Powell, Elizabeth

2012-01-01

Students on the autism spectrum present with difficulties in a variety of areas, including social understanding, emotional regulation, academics, and behavior. Professionals working in the field of autism must identify and address these areas of need given each individual child's specific cognitive profiles. In this article the authors highlight…

Critical Issues That Need to Be Addressed to Improve Outcomes for Patients With Carotid Stenosis.

PubMed

Abbott, Anne

2016-05-01

Significant improvement in outcomes for patients with carotid stenosis requires liberation from the historic fixation with randomization and a procedurally based, late-stage, reactive approach to medical care. We require a multipronged and multidisciplinary approach that includes all of the following: (i) removal of overreliance on, and biased use of, randomized trial data; (ii) using accurate ways to rank evidence quality and relevance; (iii) improved research reporting standards; (iv) building quality assurance and other research capability into routine practice; (v) producing evidence-true rather than evidence-based guidelines; (vi) bringing current optimal medical treatment to the community and measuring its effectiveness; (vii) funding only interventions known to help patients when and where they are treated and use the savings to fund vital research, including quality assurance in routine practice; and (viii) recognize that making the indication for carotid procedures obsolete is a good thing. © The Author(s) 2016.

Building non-traditional collaborations to innovatively address climate-related scientific and management needs

NASA Astrophysics Data System (ADS)

Bamzai, A.; Mcpherson, R. A.

2014-12-01

The South Central Climate Science Center (SC-CSC) is one of eight regional centers formed by the U.S. Department of the Interior in order to provide decision makers with the science, tools, and information they need to address the impacts of climate variability and change on their areas of responsibility. The SC-CSC is operated through the U.S. Geological Survey, in partnership with a consortium led by the University of Oklahoma that also includes Texas Tech University, Oklahoma State University, Louisiana State University, the Chickasaw Nation, the Choctaw Nation of Oklahoma, and NOAA's Geophysical Fluid Dynamics Lab (GFDL). The SC-CSC is distinct from all other CSCs in that we have strategically included non-traditional collaborators directly within our governing consortium. The SC-CSC is the only CSC to include any Tribal nations amongst our consortium (the Chickasaw Nation and the Choctaw Nation of Oklahoma) and to employ a full-time tribal liaison. As a result and in partnership with Tribes, we are able to identify the unique challenges that the almost 70 federally recognized Tribes within our region face. We also can develop culturally sensitive research projects or outreach efforts that bridge western science and traditional knowledge to address their needs. In addition, the SC-CSC is the only CSC to include another federal institution (GFDL) amongst our consortium membership. GFDL is a world-leader in climate modeling and model interpretation. Partnering GFDL's expertise in the evaluation of climate models and downscaling methods with the SC-CSC's stakeholder-driven approach allows for the generation and dissemination of guidance documents and training to accompany the high quality datasets already in development. This presentation will highlight the success stories and co-benefits of the SC-CSC's collaborations with Tribal nations and with GFDL, as well as include information on how other partners can connect to our ongoing efforts.

Addressing the mental health needs of looked after children in foster care: the experiences of foster carers.

PubMed

York, W; Jones, J

2017-03-01

WHAT IS KNOWN ON THE SUBJECT?: In the UK and internationally, the number of looked after children is increasing year on year. Mental health problems among looked after children are significantly higher than in the general population, and the uptake of mental health services for these children is low. There is a poor prognosis for children with untreated mental health problems; this is further compounded if the child is within the care system. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This study adds to our understanding of foster carers' experiences of the mental health needs of looked after children and demonstrates some of the challenges associated with accessing appropriate and timely mental health services. New knowledge derived from this research is that the barriers to accessing Child and Adolescent Mental Health Services (CAMHS) are not at the time of initial referral as previously reported, but later, once within the mental health system with long waiting times experienced particularly for specialist services. This study provides new insights into the experience of being a foster carer and the levels of support and resources needed that directly relate to the viability of the placement. The majority of the foster carers interviewed were from a Black and Minority Ethnic (BME) background, previously under-represented in this research area. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: A number of areas in current CAMHS provision need addressing with a focus on accessibility, consultation and support for foster carers. Waiting times need to be addressed, and improved communication with other agencies is also highlighted. CAMHS nurses are well placed to develop and deliver a comprehensive care package to foster carers, offering more tailored support to them whilst enabling the children and young people in their care to access and engage more effectively with mental health services. Introduction Despite well-documented vulnerabilities to mental health problems

Department of Energy: Fundamental Reassessment Needed to Address Major Mission, Structure, and Accountability Problems

DTIC Science & Technology

2001-12-01

addition, the Defense Nuclear Facilities Safety Board warned in 1997 that, given likely future reductions in DOE’s budget, the department needed to...future leaders of the acquisition workforce. The Defense Nuclear Facilities Safety Board’s 2000 report credited DOE with taking steps to improve the...technical capabilities of personnel at its defense nuclear facilities , but pointed out the need for DOE’s leadership to pay increased attention to this

Public reporting needed to improve the health of Tennesseans.

PubMed

Bailey, James E; Gibson, Deborah

2005-11-01

Tennessee providers are recognizing an urgent need for a new and improved model of healthcare, characterized by transparent accountability to consumers. Meaningful health system improvements will require broad public disclosure of healthcare performance data at the hospital, clinic and community levels using nationally recognized standards. All Tennessee communities need a routine community health report card, to help their citizens to work together toward their most important health goals.

Air Force Training: Further Analysis and Planning Needed to Improve Effectiveness

DTIC Science & Technology

2016-09-01

training, and (3) established virtual training plans that include desirable characteristics of a comprehensive strategy. GAO reviewed Air Force training...requirements may not reflect current and emerging training needs, because the Air Force has not comprehensively reassessed the assumptions underlying them...include all desirable characteristics of a comprehensive strategy, such as a risk-based investment strategy or a time line for addressing training needs

Clinical-Community Partnerships to Identify Patients With Food Insecurity and Address Food Needs

PubMed Central

Siegel, Karen R.; Calhoun, Holly; Kim, Sonia A.; Garcia, Sandra P.; Hoeting, Natalie M.; Harris, Diane M.; Khan, Laura Kettel; Smith, Bryce; Blanck, Heidi M.; Barnett, Kevin; Haddix, Anne C.

2017-01-01

Introduction More than 42 million people in the United States are food insecure. Although some health care entities are addressing food insecurity among patients because of associations with disease risk and management, little is known about the components of these initiatives. Methods The Systematic Screening and Assessment Method was used to conduct a landscape assessment of US health care entity–based programs that screen patients for food insecurity and connect them with food resources. A network of food insecurity researchers, experts, and practitioners identified 57 programs, 22 of which met the inclusion criteria of being health care entities that 1) screen patients for food insecurity, 2) link patients to food resources, and 3) target patients including adults aged 50 years or older (a focus of this assessment). Data on key features of each program were abstracted from documentation and telephone interviews. Results Most programs (n = 13) focus on patients with chronic disease, and most (n = 12) partner with food banks. Common interventions include referrals to or a list of food resources (n = 19), case managers who navigate patients to resources (n = 15), assistance with federal benefit applications (n = 14), patient education and skill building (n = 13), and distribution of fruit and vegetable vouchers redeemable at farmers markets (n = 8). Most programs (n = 14) routinely screen all patients. Conclusion The programs reviewed use various strategies to screen patients, including older adults, for food insecurity and to connect them to food resources. Research is needed on program effectiveness in improving patient outcomes. Such evidence can be used to inform the investments of potential stakeholders, including health care entities, community organizations, and insurers. PMID:29144894

What Learning Environments Best Address 21st-Century Students' Perceived Needs at the Secondary Level of Instruction?

ERIC Educational Resources Information Center

Lemley, J. Brett; Schumacher, Gary; Vesey, Winona

2014-01-01

The purpose of a recent study was to determine what learning environments best address the needs of 21st-century students at the secondary level. This study concluded that the presence of a positive 21st-century learning environment is related to student satisfaction and student-teacher relationships. While the majority of the literature on…

The Math You Need at Baylor University: Improving Quantitative Skills in an Introductory Geology Lab Course

NASA Astrophysics Data System (ADS)

Browning, S.

2014-12-01

The Math You Need (TMYN) modules were introduced at Baylor University in fall 2012 to address issues of math anxiety common among freshmen non-majors completing their lab science requirement, and to reduce lab time spent reviewing basic math concepts. Modules and associated assessment questions commonly use geoscience examples to illustrate the mathematical principles involved, reinforcing topics addressed in lab. Large enrollments in the course selected for these modules necessitate multiple graduate teaching assistants in the lab, making the online nature of the modules and minimal required involvement of the teaching assistants even more valuable. Students completed three selected modules before encountering associated topics in lab, as well as a pre and post-test to gauge improvement. This presentation will review lessons learned and changes made in the first two years of TMYN at Baylor. Results indicate continued increases in mean pre to post test scores (e.g. 3.2% in fall 2012 to 11.9% in spring 2014), percentage of student pre to post- test improvement (59% in fall 2012 to 72% in spring 2014) and student participation (95 in fall 2012 to 186 in spring 2014). Continued use of these modules is anticipated.

Addressing multimorbidity to improve healthcare and economic sustainability

PubMed Central

Colombo, Francesca; García-Goñi, Manuel; Schwierz, Christoph

2016-01-01

Patients with multimorbidity are responsible for more than half of all healthcare utilization, challenging the healthcare budgets of all European nations. Although the European Union is showing signs of a fragile economic recovery, achieving sustainable growth will depend on delivering a combination of fiscal responsibility, structural reforms, and improved efficiency. Addressing the challenges of multimorbidity and providing more effective, affordable, and sustainable care, has climbed the political agenda at a global, European, and national level. Current healthcare systems are poorly adapted to cope with the challenges of patients with multimorbidity. Little is known about the epidemiology and natural history of multimorbidity; the evidence base is weak; clinical guidelines are not always relevant to this population; and financing and delivery systems have not evolved to adequately measure and reward quality and performance. Pockets of innovation are, however, beginning to emerge. In Spain, for example, the ongoing economic crisis has forced regional governments to deliver substantial efficiency savings and, with this in mind, integrated care programmes have been introduced across the country for people with chronic disease and multimorbidity. Early results suggest that formalized integrated care for patients with multimorbidity improves their perceptions of care coordination, reduces hospital and emergency admissions and readmissions, and reduces average costs per capita. Such innovations require meaningful investments at a national level – something that is now supported within the framework of the European Union’s Stability and Growth Pact. PMID:29090168

Addressing multimorbidity to improve healthcare and economic sustainability.

PubMed

Colombo, Francesca; García-Goñi, Manuel; Schwierz, Christoph

2016-01-01

Patients with multimorbidity are responsible for more than half of all healthcare utilization, challenging the healthcare budgets of all European nations. Although the European Union is showing signs of a fragile economic recovery, achieving sustainable growth will depend on delivering a combination of fiscal responsibility, structural reforms, and improved efficiency. Addressing the challenges of multimorbidity and providing more effective, affordable, and sustainable care, has climbed the political agenda at a global, European, and national level. Current healthcare systems are poorly adapted to cope with the challenges of patients with multimorbidity. Little is known about the epidemiology and natural history of multimorbidity; the evidence base is weak; clinical guidelines are not always relevant to this population; and financing and delivery systems have not evolved to adequately measure and reward quality and performance. Pockets of innovation are, however, beginning to emerge. In Spain, for example, the ongoing economic crisis has forced regional governments to deliver substantial efficiency savings and, with this in mind, integrated care programmes have been introduced across the country for people with chronic disease and multimorbidity. Early results suggest that formalized integrated care for patients with multimorbidity improves their perceptions of care coordination, reduces hospital and emergency admissions and readmissions, and reduces average costs per capita. Such innovations require meaningful investments at a national level - something that is now supported within the framework of the European Union's Stability and Growth Pact.

Addressing the needs for international training, qualifications, and career development in occupational hygiene.

PubMed

Alesbury, Roger J; Bailey, Stephen R

2014-03-01

Thirteen member societies of the International Occupational Hygiene Association (IOHA), all 11 national certification bodies, and IOHA itself are now cooperating in a new international training and qualification system. The structure broadens access to occupational hygiene education and training worldwide and complements existing professional accreditation schemes. There are currently 46 Approved Training Providers in the scheme and up to the end of June 2013, approaching 200 courses had been delivered in more than 32 countries, with nearly 2400 examinations taken in 7 languages. This influx of students, particularly in developing countries, is helping to address the worldwide need to combat occupational illness and is creating the foundation for sustainable growth in provision of occupational hygiene globally. The scheme originated in 2006, when the authors were instrumental in bringing together a group of senior hygienists to review the needs of industry. The resulting position paper, reflecting the perspective of major multi-national companies, was subject to widespread consultation with a diverse group of stakeholders from across the world. This led to the formation of the Occupational Hygiene Training Association (OHTA), as a not-for-profit organization, to operate the system. It is accessible through the OHlearning website that provides free downloads of educational materials and details of training events. In this commentary, we outline the needs that brought this about, identify the key stakeholders involved, review what has been done so far, and discuss some plans for the future.

A needs assessment on addressing environmental health issues within reproductive health service provision: Considerations for continuing education and support.

PubMed

Williamson, Linzi; Sangster, Sarah; Bayly, Melanie; Gibson, Kirstian; Lawson, Karen; Clark, Megan

2017-12-01

This needs assessment was initially undertaken to explore the beliefs and knowledge of nurses and physicians about the impact of environmental toxicants on maternal and infant health, as well as to describe current practice and needs related to addressing environmental health issues (EHI). One hundred and thirty-five nurses (n = 99) and physicians (n = 36) working in Saskatchewan completed an online survey. Survey questions were designed to determine how physicians and nurses think about and incorporate environmental health issues into their practice and means of increasing their capacity to do so. Although participants considered it important to address EHIs with patients, in actual practice they do so with only moderate frequency. Participants reported low levels of knowledge about EHIs' impact on health, and low levels of confidence discussing them with patients. Participants requested additional information on EHIs, especially in the form of online resources. The results suggests that while nurses and physicians consider EHIs important to address with patients, more education, support, and resources would increase their capacity to do so effectively. Based on the findings, considerations and recommendations for continuing education in this area have been provided.

An improved genetic algorithm for increasing the addressing accuracy of encoding fiber Bragg grating sensor network

NASA Astrophysics Data System (ADS)

Liu, Huanlin; Wang, Chujun; Chen, Yong

2018-01-01

Large-capacity encoding fiber Bragg grating (FBG) sensor network is widely used in modern long-term health monitoring system. Encoding FBG sensors have greatly improved the capacity of distributed FBG sensor network. However, the error of addressing increases correspondingly with the enlarging of capacity. To address the issue, an improved algorithm called genetic tracking algorithm (GTA) is proposed in the paper. In the GTA, for improving the success rate of matching and reducing the large number of redundant matching operations generated by sequential matching, the individuals are designed based on the feasible matching. Then, two kinds of self-crossover ways and a dynamic variation during mutation process are designed to increase the diversity of individuals and to avoid falling into local optimum. Meanwhile, an assistant decision is proposed to handle the issue that the GTA cannot solve when the variation of sensor information is highly overlapped. The simulation results indicate that the proposed GTA has higher accuracy compared with the traditional tracking algorithm and the enhanced tracking algorithm. In order to address the problems of spectrum fragmentation and low sharing degree of spectrum resources in survivable.

Need to Address Evidence-Based Practice in Educational Administration

ERIC Educational Resources Information Center

Kowalski, Theodore

2009-01-01

Purpose: This article presents a case for addressing evidence-based practice (EBP) in educational administration. Content is arranged around four objectives: (a) summarizing the status of educational administration as a profession, (b) defining evidence and the model, (c) explaining EBP's social and professional merit, and (d) identifying barriers…

Addressing the unmet need for visualizing conditional random fields in biological data

PubMed Central

2014-01-01

Background The biological world is replete with phenomena that appear to be ideally modeled and analyzed by one archetypal statistical framework - the Graphical Probabilistic Model (GPM). The structure of GPMs is a uniquely good match for biological problems that range from aligning sequences to modeling the genome-to-phenome relationship. The fundamental questions that GPMs address involve making decisions based on a complex web of interacting factors. Unfortunately, while GPMs ideally fit many questions in biology, they are not an easy solution to apply. Building a GPM is not a simple task for an end user. Moreover, applying GPMs is also impeded by the insidious fact that the “complex web of interacting factors” inherent to a problem might be easy to define and also intractable to compute upon. Discussion We propose that the visualization sciences can contribute to many domains of the bio-sciences, by developing tools to address archetypal representation and user interaction issues in GPMs, and in particular a variety of GPM called a Conditional Random Field(CRF). CRFs bring additional power, and additional complexity, because the CRF dependency network can be conditioned on the query data. Conclusions In this manuscript we examine the shared features of several biological problems that are amenable to modeling with CRFs, highlight the challenges that existing visualization and visual analytics paradigms induce for these data, and document an experimental solution called StickWRLD which, while leaving room for improvement, has been successfully applied in several biological research projects. Software and tutorials are available at http://www.stickwrld.org/ PMID:25000815

Water safety in the bush: strategies for addressing training needs in remote areas.

PubMed

Beattie, N; Shaw, P; Larson, A

2008-01-01

This article describes a unique, remote, water safety-training program delivered to 11 remote Australian communities during 2006-2007. The program, known as 'Water Safety in the Bush', was developed by Combined Universities Centre for Rural Health in Geraldton Western Australia in consultation with the Commonwealth Government Department of Health and Ageing, and the Royal Life Saving Society of Australia. Drowning and near drowning are major causes of childhood death and injury in rural and remote Australia, making improved water safety awareness and skills a public health priority. Water Safety in the Bush employed a flexible, community development model to meet the special requirements of remote and isolated communities. The model had three elements: coordination by a local organisation; a water safety instruction program based on a Royal Life Saving Society of Australia curriculum adapted to meet local priorities; and strategies for sustainability. In the delivery of the program a total of 873 children and 219 adults received swimming and water safety instruction; 47 adults and older children received first-aid training; and 38 community members became AUSTAWIM (the Australian Council for the Teaching of Swimming and Water Safety) accredited instructors. Project evaluation showed parents and community organisations were very satisfied with the program which met a real need. Parents and instructors gave evidence of children's increased skills in water safety, swimming ability, life-saving and water confidence. Training programs with greater contact hours showed greater skill gains. Sustainability strategies included accreditation of local AUSTSWIM instructors, the erection of water safety signs, sourcing of continuing funding, and the introduction of water safety theory into the school curriculum. Flexibility was the major success factor. Within the parameters of minimum guidelines, communities were encouraged to choose the timing, venue and delivery mode of the

What about Me?: A Practicum Addressing the Needs of Children Who Have a Preschool Sibling with Impaired Hearing.

ERIC Educational Resources Information Center

Weston, Marsha C.

This practicum developed a special program to serve the elementary school child who has a preschool sibling with a hearing impairment. A special book addressing the cognitive and emotional needs of the siblings was written and distributed to 35 children whose families were enrolled in a clinic-sponsored correspondence program and to 15 children…

Challenges of using quality improvement methods in nursing homes that "need improvement".

PubMed

Rantz, Marilyn J; Zwygart-Stauffacher, Mary; Flesner, Marcia; Hicks, Lanis; Mehr, David; Russell, Teresa; Minner, Donna

2012-10-01

Qualitatively describe the adoption of strategies and challenges experienced by intervention facilities participating in a study targeted to improve quality of care in nursing homes "in need of improvement". To describe how staff use federal quality indicator/quality measure (QI/QM) scores and reports, quality improvement methods and activities, and how staff supported and sustained the changes recommended by their quality improvement teams. A randomized, two-group, repeated-measures design was used to test a 2-year intervention for improving quality of care and resident outcomes in facilities in "need of improvement". Intervention group (n = 29) received an experimental multilevel intervention designed to help them: (1) use quality-improvement methods, (2) use team and group process for direct-care decision-making, (3) focus on accomplishing the basics of care, and (4) maintain more consistent nursing and administrative leadership committed to communication and active participation of staff in decision-making. A qualitative analysis revealed a subgroup of homes likely to continue quality improvement activities and readiness indicators of homes likely to improve: (1) a leadership team (nursing home administrator, director of nurses) interested in learning how to use their federal QI/QM reports as a foundation for improving resident care and outcomes; (2) one of the leaders to be a "change champion" and make sure that current QI/QM reports are consistently printed and shared monthly with each nursing unit; (3) leaders willing to involve all staff in the facility in educational activities to learn about the QI/QM process and the reports that show how their facility compares with others in the state and nation; (4) leaders willing to plan and continuously educate new staff about the MDS and federal QI/QM reports and how to do quality improvement activities; (5) leaders willing to continuously involve all staff in quality improvement committee and team activities so

Training needs analysis for MSMEs: how to improve training effectiveness

NASA Astrophysics Data System (ADS)

Rohayati, Y.; Wulandari, S.

2017-12-01

The study aims to analyze training needs for MSMEs in the area of Kabupaten Bandung by selecting the case of MSMEs joined in Association for Agricultural Product Process, focusing on marketing as the main topic of the training. The needs analysis was required to improve training participation and effectiveness. Both aspects are important to notice since making MSMEs participate in training is not an easy task. Similarly, the needs analysis was carried out to anticipate participants’ thoughts that the training does not give any benefits for them or is ineffective because it does not meet their needs although it was actually to help MSMEs improve their marketing knowledge expected to lead to their success. This research involved 100 MSMEs with business ages starting from less than five years to more than 15 years. Those involved MSMEs were dominated by MSMEs targeting local marketing areas. The data were collected by survey and judgmental sampling technique. By conducting a descriptive analysis, it can be concluded that the needs of SMEs on marketing training materials should focus on improving marketing skills such as product development, sales, and use of marketing media as well as discussing legal aspects such as the need for certification and product brand. The results of the study also concluded that there is a need for training that is supplemented by making visits to more successful SMEs as well as practices with on the job training methods.

Progress in Space Weather Modeling and Observations Needed to Improve the Operational NAIRAS Model Aircraft Radiation Exposure Predictions

NASA Astrophysics Data System (ADS)

Mertens, C. J.; Kress, B. T.; Wiltberger, M. J.; Tobiska, W.; Xu, X.

2011-12-01

The Nowcast of Atmospheric Ionizing Radiation for Aviation Safety (NAIRAS) is a prototype operational model for predicting commercial aircraft radiation exposure from galactic and solar cosmic rays. NAIRAS predictions are currently streaming live from the project's public website, and the exposure rate nowcast is also available on the SpaceWx smartphone app for iPhone, IPad, and Android. Cosmic rays are the primary source of human exposure to high linear energy transfer radiation at aircraft altitudes, which increases the risk of cancer and other adverse health effects. Thus, the NAIRAS model addresses an important national need with broad societal, public health and economic benefits. The processes responsible for the variability in the solar wind, interplanetary magnetic field, solar energetic particle spectrum, and the dynamical response of the magnetosphere to these space environment inputs, strongly influence the composition and energy distribution of the atmospheric ionizing radiation field. During the development of the NAIRAS model, new science questions were identified that must be addressed in order to obtain a more reliable and robust operational model of atmospheric radiation exposure. Addressing these science questions require improvements in both space weather modeling and observations. The focus of this talk is to present these science questions, the proposed methodologies for addressing these science questions, and the anticipated improvements to the operational predictions of atmospheric radiation exposure. The overarching goal of this work is to provide a decision support tool for the aviation industry that will enable an optimal balance to be achieved between minimizing health risks to passengers and aircrew while simultaneously minimizing costs to the airline companies.

Suicide Risk Protocols: Addressing the Needs of High Risk Youths Identified through Suicide Prevention Efforts and in Clinical Settings

ERIC Educational Resources Information Center

Heilbron, Nicole; Goldston, David; Walrath, Christine; Rodi, Michael; McKeon, Richard

2013-01-01

Several agencies have emphasized the importance of establishing clear protocols or procedures to address the needs of youths who are identified as suicidal through suicide prevention programs or in emergency department settings. What constitutes optimal guidelines for developing and implementing such protocols, however, is unclear. At the request…

Managing Within Constraints: Balancing U.S. Army Forces to Address a Full Spectrum of Possible Operational Needs

DTIC Science & Technology

2010-09-01

Address a Full Spectrum of Possible Operational Needs David R. Graham, Project Leader Robert B. Magruder, Project Leader John R. Brinkerhoff James L...R. Graham, Project Leader Robert B. Magruder, Project Leader John R. Brinkerhoff James L. Adams Richard P. Diehl Colin M. Doyle Anthony C. Hermes...operations in rapid succession or even at the same time. The vertical Spectrum is characterized by Lieutenant General James M. Dubik as follows: Army units

Addressing the need for staff support among nurses caring for the AIDS population.

PubMed

Pasacreta, J V; Jacobsen, P B

1989-01-01

More and more nurses are caring for individuals with AIDS-spectrum disorders. When nurses become involved in hospital-based AIDS treatment, major psychosocial issues can arise. In settings where nursing personnel have limited or no experience working with patients with AIDS, fear of contagion is a major issue. This fear has both rational and irrational components. In general, providing up-to-date information in a small group setting can effectively reduce irrational fears. Rational fears, which are not as easily dealt with, should be a stimulus for behavior change (e.g., adoption of precautionary guidelines for reducing the possibility of accidental infection). Different issues arise among nurses specializing in AIDS care and include burnout, a sense of professional isolation, and the need to establish personal boundaries in dealing with patients. Guidelines are offered for establishing a group approach to address these concerns and to handle the sensitive issues that may arise.

Addressing the Health and Wellness Needs of Vulnerable Rockaway Residents in the Wake of Hurricane Sandy: Findings From a Health Coaching and Community Health Worker Program.

PubMed

Russell, David; Oberlink, Mia R; Shah, Shivani; Evans, Lauren; Bassuk, Karen

To describe the design and participants of a program that employed health coaches and community health workers to address the social, health, and long-term disaster recovery needs of Rockaway residents roughly 2 years after Hurricane Sandy made landfall. Baseline and exit questionnaires, containing demographic, health, and health care utilization measures, were administered to participants at the start and end of the program. Enrollment and encounter information was captured in program administrative records. Descriptive statistics were used to summarize participant characteristics, personal goals, referrals to local organizations and agencies, and outcomes. Qualitative analyses were used to identify recurring themes in challenges faced by participants and barriers to health and wellness. The program served 732 community residents, of whom 455 (62%) completed baseline and exit questionnaires. Participants were directly and/or indirectly impacted by Hurricane Sandy through property damage, closures of health care facilities, limited employment opportunities, and trouble securing affordable housing. Furthermore, many participants faced considerable adversities and struggled to manage chronic health conditions. Personal goals set by participants included locating health care and other resources (44%), weight management and healthy eating (35%), and self-management of chronic conditions (24%). Health coaches and community health workers engaged participants an average of 4 times-providing counseling and referrals to local organizations and services, including medical and dental services (29%), city-issued identification cards (27%), and health insurance and other entitlements (23%). Comparisons of baseline and exit surveys indicated significant improvements in self-reported health, health care utilization, and confidence managing health issues. No significant improvement was observed in the use of preventive health care services. The program represents a model for

IMPROVEMENT OF WATER MAIN INSPECTION TECHNOLOGY

EPA Science Inventory

This document is a handout of a slide presentation that addresses improvement of water main inspection technology. The slide presentation addresses the need for improved inspection technology (e.g., 237,000 main breaks/yr); the limits on main break prevention; and, the adverse ...

25 CFR 162.544 - How must a WSR lease address ownership of permanent improvements?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false How must a WSR lease address ownership of permanent improvements? 162.544 Section 162.544 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER LEASES AND PERMITS Wind and Solar Resource Leases Wsr Leases § 162.544 How must a WSR lease...

25 CFR 162.544 - How must a WSR lease address ownership of permanent improvements?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false How must a WSR lease address ownership of permanent improvements? 162.544 Section 162.544 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER LEASES AND PERMITS Wind and Solar Resource Leases Wsr Leases § 162.544 How must a WSR lease...

"The Maasai Need Cows and the Cows Need Maasai," the Use of a Photovoice Approach to Assess Animal Health Needs.

PubMed

van der Meer, Frank; Clancy, Eoin; Thomas, Adam; Kutz, Susan; Hatfield, Jennifer; Orsel, Karin

2015-01-01

The Maasai pastoralists in sub-Saharan Africa depend on their livestock for income and food. Livestock production can be significantly improved by addressing animal health concerns. We explored the use of photovoice, a participatory action research method, to strengthen our understanding of the Maasai's animal health needs. Nine interviewees, representing warriors, elders, and women, identified animal, social, and human health themes. The use of photography provided a new medium for Maasai to express their needs and a focus for researcher-participant communications, thereby facilitating new insights across language and cultural barriers.

Perceived success in addressing end-of-life care needs of low-income elders and their families: what has family conflict got to do with it?

PubMed

Kramer, Betty J; Yonker, James A

2011-01-01

The purpose of this study was to examine the predictors of perceived success in addressing the end-of-life care needs of low-income older adults and their family members. Perceived success is defined as the clinician's subjective assessment of the extent to which end-of-life care needs of the patient and family have been met by the interdisciplinary team. The results are drawn from a larger longitudinal multimethod case study designed to understand how end-of-life care is provided to a diverse group of frail elders in an innovative, fully "integrated," managed care program. Data were generated from 120 social work surveys detailing care experiences and outcomes particular to 120 elder deaths. Significant predictors of perceived success for addressing patient needs included patient care needs (β=0.17, P≤0.05), race (β=0.19, P≤0.05), patient preferences elicited (β=0.29, P≤0.01) and honored (β=0.20, P≤0.05), and family conflict (β=-0.24, P≤0.01). Significant predictors of perceived success for addressing family needs included family care needs (β=0.30, P≤0.001), team and administrative resources (β=0.19, P≤0.01), patient preferences honored (β=0.16, P≤0.05), quality of relationship with patient (β=0.27, P≤0.001) and family (β=0.23, P≤0.01), and family conflict (β=-0.31, P≤0.001). This study provides preliminary evidence of differential correlates and predictors of perceived success for addressing patient and family needs, highlighting the detrimental influence of family conflict. Future research is needed to better understand the kinds of assessment and intervention protocols that might prevent or ameliorate conflict and enhance structures and process-of-care variables to facilitate more successful outcomes. Copyright © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Bulk Fuel: Actions Needed to Improve DODs Fuel Consumption Budget Data

DTIC Science & Technology

2016-09-01

BULK FUEL Actions Needed to Improve DOD’s Fuel Consumption Budget Data Report to Congressional Committees...16-644, a report to congressional committees. September 2016 BULK FUEL Actions Needed to Improve DOD’s Fuel Consumption Budget Data What GAO...of about $10.1 billion in fiscal year 2015 but differed from budget estimates, which officials largely attributed to changes in operations and

Addressing health literacy in patient decision aids

PubMed Central

2013-01-01

Background Effective use of a patient decision aid (PtDA) can be affected by the user’s health literacy and the PtDA’s characteristics. Systematic reviews of the relevant literature can guide PtDA developers to attend to the health literacy needs of patients. The reviews reported here aimed to assess: 1. a) the effects of health literacy / numeracy on selected decision-making outcomes, and b) the effects of interventions designed to mitigate the influence of lower health literacy on decision-making outcomes, and 2. the extent to which existing PtDAs a) account for health literacy, and b) are tested in lower health literacy populations. Methods We reviewed literature for evidence relevant to these two aims. When high-quality systematic reviews existed, we summarized their evidence. When reviews were unavailable, we conducted our own systematic reviews. Results Aim 1: In an existing systematic review of PtDA trials, lower health literacy was associated with lower patient health knowledge (14 of 16 eligible studies). Fourteen studies reported practical design strategies to improve knowledge for lower health literacy patients. In our own systematic review, no studies reported on values clarity per se, but in 2 lower health literacy was related to higher decisional uncertainty and regret. Lower health literacy was associated with less desire for involvement in 3 studies, less question-asking in 2, and less patient-centered communication in 4 studies; its effects on other measures of patient involvement were mixed. Only one study assessed the effects of a health literacy intervention on outcomes; it showed that using video to improve the salience of health states reduced decisional uncertainty. Aim 2: In our review of 97 trials, only 3 PtDAs overtly addressed the needs of lower health literacy users. In 90% of trials, user health literacy and readability of the PtDA were not reported. However, increases in knowledge and informed choice were reported in those studies

Smoking Cessation Intervention for Female Prisoners: Addressing an Urgent Public Health Need

PubMed Central

Eldridge, Gloria; Weaver, Michael; Villalobos, Gabriela; Stitzer, Maxine; Best, Al

2008-01-01

Objectives. We tested the efficacy of a combined pharmacologic and behavioral smoking cessation intervention among women in a state prison in the southern United States. Methods. The study design was a randomized controlled trial with a 6-month waitlist control group. The intervention was a 10-week group intervention combined with nicotine replacement therapy. Two hundred and fifty participants received the intervention, and 289 were in the control group. Assessments occurred at baseline; end of treatment; 3, 6, and 12 months after treatment; and at weekly sessions for participants in the intervention group. Results. The intervention was efficacious compared with the waitlist control group. Point prevalence quit rates for the intervention group were 18% at end of treatment, 17% at 3-month follow-up, 14% at 6-month follow-up, and 12% at 12-month follow-up, quit rates that are consistent with outcomes from community smoking-cessation interventions. Conclusions. Female prisoners are interested in smoking cessation interventions and achieved point-prevalence quit rates similar to community samples. Augmenting tobacco control policies in prison with smoking cessation interventions has the potential to address a significant public health need. PMID:18703440

Ethical issues raised in addressing the needs of people with serious mental disorders in complex emergencies.

PubMed

Wissow, Lawrence S; Rutkow, Lainie; Kass, Nancy E; Rabins, Peter V; Vernick, Jon S; Hodge, James G

2012-03-01

Recent manmade and natural disasters highlight weaknesses in the public health systems designed to protect populations from harm and minimize disruption of the social and built environments. Emergency planning and response efforts have, as a result, focused largely on ensuring populations' physical well-being during and after a disaster. Many public health authorities, including the World Health Organization, have recognized the importance of addressing both mental and physical health concerns in emergency plans. Individuals with mental disorders represent a notable proportion of the overall population, and anticipating their needs is critical to comprehensive emergency planning and response efforts. Because people with serious mental disorders historically have been stigmatized, and many individuals with mental disorders may be unable to care for themselves, ethical guidance may be of assistance to those engaged in emergency planning and response. This article considers several broad categories of ethical issues that arise during emergencies for people with serious mental disorders and offers recommendations for ways in which emergency planners and other stakeholders can begin to address these ethical challenges.

“The Maasai Need Cows and the Cows Need Maasai,” the Use of a Photovoice Approach to Assess Animal Health Needs

PubMed Central

van der Meer, Frank; Clancy, Eoin; Thomas, Adam; Kutz, Susan; Hatfield, Jennifer; Orsel, Karin

2015-01-01

The Maasai pastoralists in sub-Saharan Africa depend on their livestock for income and food. Livestock production can be significantly improved by addressing animal health concerns. We explored the use of photovoice, a participatory action research method, to strengthen our understanding of the Maasai’s animal health needs. Nine interviewees, representing warriors, elders, and women, identified animal, social, and human health themes. The use of photography provided a new medium for Maasai to express their needs and a focus for researcher–participant communications, thereby facilitating new insights across language and cultural barriers. PMID:26664973

Does influenza vaccination improve pregnancy outcome? Methodological issues and research needs.

PubMed

Savitz, David A; Fell, Deshayne B; Ortiz, Justin R; Bhat, Niranjan

2015-11-25

Evidence that influenza vaccination during pregnancy is safe and effective at preventing influenza disease in women and their children through the first months of life is increasing. Several reports of reduced risk of adverse outcomes associated with influenza vaccination have generated interest in its potential for improving pregnancy outcome. Gavi, the Vaccine Alliance, estimates maternal influenza immunization programs in low-income countries would have a relatively modest impact on mortality compared to other new or under-utilized vaccines, however the impact would be substantially greater if reported vaccine effects on improved pregnancy outcomes were accurate. Here, we examine the available evidence and methodological issues bearing on the relationship between influenza vaccination and pregnancy outcome, particularly preterm birth and fetal growth restriction, and summarize research needs. Evidence for absence of harm associated with vaccination at a point in time is not symmetric with evidence of benefit, given the scenario in which vaccination reduces risk of influenza disease and, in turn, risk of adverse pregnancy outcome. The empirical evidence for vaccination preventing influenza in pregnant women is strong, but the evidence that influenza itself causes adverse pregnancy outcomes is inconsistent and limited in quality. Studies of vaccination and pregnancy outcome have produced mixed evidence of potential benefit but are limited in terms of influenza disease assessment and control of confounding, and their analytic methods often fail to fully address the longitudinal nature of pregnancy and influenza prevalence. We recommend making full use of results of randomized trials, re-analysis of existing observational studies to account for confounding and time-related factors, and quantitative assessment of the potential benefits of vaccination in improving pregnancy outcome, all of which should be informed by the collective engagement of experts in influenza

Answering the Knock of Opportunity: Addressing the Data Needs for California's English Learners. Policy Brief

ERIC Educational Resources Information Center

Perez, Maria; Shambaugh, Larisa S.; Parrish, Tom

2008-01-01

California currently faces an opportunity to develop an effective data system that can assist in improving the state's future understanding of the educational progress of English learners (ELs). This policy brief outlines the needs for good data on ELs and makes recommendations for creating an effective longitudinal data system for ELs. It…

Pregnancy as an ideal time for intervention to address the complex needs of black and minority ethnic women: views of British midwives.

PubMed

Aquino, Maria Raisa Jessica V; Edge, Dawn; Smith, Debbie M

2015-03-01

maternal health inequalities exist across the world. In the United Kingdom, whilst there are variations within and between groups, Black and Minority Ethnic (BME) women tend to have worse maternal health outcomes than White British women. However, there is limited information about BME women's experience of maternity services. Midwives are central to the provision of safe maternity care but little is known about their perceptions of ethnically-based inequalities in maternal healthcare. Therefore, this study explored a cohort of midwives' experiences of providing care for BME women, focussing on their views on the relationship between maternal health inequalities and service delivery. using a specifically-designed topic guide, 20 semi-structured interviews were conducted with qualified midwives in one National Health Service (NHS) Trust in the North West of England over a two-month period. Data were subsequently transcribed and thematically analysed. three main and seven sub-themes were identified. Firstly, 'language' summarised difficulties midwives experienced in engaging with women whose English was limited. Secondly, 'expectations of maternity care' outlined the mismatch between midwives and women's expectations of maternity care. Finally, 'complex needs extending beyond maternity care' highlighted the necessity of inter-agency working to address women's care holistically when their needs transcend the scope of maternity services. Midwives' accounts indicated that they strive to provide equitable care but encountered numerous barriers in doing so. Paradoxically, this might contribute to inequalities in service delivery. In midwives' view, unrestricted access to interpretation and translation services is essential for provision of effective, holistic maternity care. Participants also advocated education for both women and midwives. For the former, this would improve BME women's understanding of health and care systems, potentially leading to more realistic

Addressing the Needs of Preschool Children in the Context of Disasters and Terrorism: Assessment, Prevention, and Intervention.

PubMed

Wolmer, Leo; Hamiel, Daniel; Pardo-Aviv, Lee; Laor, Nathaniel

2017-07-01

The goal of this paper is to review the research literature regarding the needs of preschoolers in the context of disasters and terrorism with the aim of understanding the existing methods for assessment, prevention, and intervention to provide recommendations and point out required research and development. We differentiate between screening tools that provide initial evaluation and assessment tools for diagnosing preschooler children's pathology and review possible interventions that address the preschool child's needs before, during, and after the incident itself. We also emphasize the lack of dissemination and research of prevention programs and mass interventions for preschoolers. Programs for community mass prevention and intervention for preschoolers should be developed and evaluated and interventions should be adapted for individual and group delivery. Moreover, the increase in the number of children refugees requires cultural adaptations of assessment measures and interventions.

SaludABLEOmaha: improving readiness to address obesity through healthy lifestyle in a Midwestern Latino community, 2011-2013.

PubMed

Frerichs, Leah; Brittin, Jeri; Robbins, Regina; Steenson, Sharalyn; Stewart, Catherine; Fisher, Christopher; Huang, Terry T-K

2015-02-12

A community's readiness for change is a precursor to the effective application of evidence-based practices for health promotion. Research is lacking regarding potential strategies to improve readiness to address obesity-related health issues in underserved communities. This case study describes SaludABLEOmaha, an initiative to increase readiness of residents in a Midwestern Latino community to address obesity and adopt healthy lifestyles. SaludABLEOmaha emphasized 2 core approaches, youth activism and collaboration among public and private institutions, which we applied to planning and implementing tactics in support of 3 interconnected strategies: 1) social marketing and social media, 2) service learning in schools (ie, curricula that integrate hands-on community service with instruction and reflection), and 3) community and business engagement. Following the Community Readiness Model protocol (http://triethniccenter.colostate.edu/communityReadiness.htm), structured interviews were conducted with community leaders and analyzed before and 2.5 years after launch of the program. The community increased in readiness from stage 3 of the Community Readiness Model, "vague awareness," at baseline to stage 5, "preparation," at follow-up. SaludABLEOmaha improved community readiness (eg, community knowledge, community climate), which probably contributed to the observed increase in readiness to address obesity through healthy lifestyle. Community mobilization approaches such as youth activism integrated with social marketing and social media tactics can improve community responsiveness to obesity prevention and diminish health disparities.

A Child's Health Is the Public's Health: Progress and Gaps in Addressing Pediatric Needs in Public Health Emergencies.

PubMed

Dziuban, Eric J; Peacock, Georgina; Frogel, Michael

2017-09-01

Children are the most prevalent vulnerable population in US society and have unique needs during the response to and recovery from public health emergencies. The physiological, behavioral, developmental, social, and mental health differences of children require specific attention in preparedness efforts. Despite often being more severely affected in disasters, children's needs are historically underrepresented in preparedness. Since 2001, much progress has been made in addressing this disparity through better pediatric incorporation in preparedness planning from national to local levels. Innovative approaches, policies, and collaborations contribute to these advances. However, many gaps remain in the appropriate and proportional inclusion of children in planning for public health emergencies. Successful models of pediatric planning can be developed, evaluated, and widely disseminated to ensure that further progress can be achieved.

The Need for Comprehensive Health Care Quality Measures for Older Adults.

PubMed

MacLeod, Stephanie; Schwebke, Kay; Hawkins, Kevin; Ruiz, Joann; Hoo, Emma; Yeh, Charlotte S

2017-10-24

Research indicates that older adults receive only about half of their recommended care, with varying quality and limited attention to social issues impacting their health through the most commonly used quality measures. Additionally, many existing measures neglect to address nonclinical social determinants of health. Evidence of the need for more comprehensive measures for seniors is growing. The primary purpose of this article, which is supported by a limited review of literature, is to describe gaps among current quality measures in addressing certain nonclinical needs of older adults, including key social determinants of health. In doing so, the authors describe their position on the need for expanded measures to incorporate these factors to improve care and quality of life. The authors conducted a limited review of the literature to inform this article, focusing specifically on selected measures for older adults rather than a broader systematic review of all measures. Most research identified was related to clinical practice guidelines rather than quality measures of care as applied to older adults. Furthermore, the literature reviewed reflected limited evidence of efforts to tailor quality measures for the unique social needs of older adults, confirming a potential gap in this area. A growing need exists for improved quality measures specifically designed to help providers address the unique social needs of older adults. Filling this gap will improve overall understanding of seniors and help them to achieve optimal health and successful aging.

Strategies for addressing barriers to publishing pediatric quality improvement research.

PubMed

Van Cleave, Jeanne; Dougherty, Denise; Perrin, James M

2011-09-01

Advancing the science of quality improvement (QI) requires dissemination of the results of QI. However, the results of few QI interventions reach publication. To identify barriers to publishing results of pediatric QI research and provide practical strategies that QI researchers can use to enhance publishability of their work. We reviewed and summarized a workshop conducted at the Pediatric Academic Societies 2007 meeting in Toronto, Ontario, Canada, on conducting and publishing QI research. We also interviewed 7 experts (QI researchers, administrators, journal editors, and health services researchers who have reviewed QI manuscripts) about common reasons that QI research fails to reach publication. We also reviewed recently published pediatric QI articles to find specific examples of tactics to enhance publishability, as identified in interviews and the workshop. We found barriers at all stages of the QI process, from identifying an appropriate quality issue to address to drafting the manuscript. Strategies for overcoming these barriers included collaborating with research methodologists, creating incentives to publish, choosing a study design to include a control group, increasing sample size through research networks, and choosing appropriate process and clinical quality measures. Several well-conducted, successfully published QI studies in pediatrics offer guidance to other researchers in implementing these strategies in their own work. Specific, feasible approaches can be used to improve opportunities for publication in pediatric, QI, and general medical journals.

Education and Training to Address Specific Needs During the Career Progression of Surgeons.

PubMed

Sachdeva, Ajit K; Blair, Patrice Gabler; Lupi, Linda K

2016-02-01

Surgeons have specific education and training needs as they enter practice, progress through the core period of active practice, and then as they wind down their clinical work before retirement. These transitions and the career progression process, combined with the dynamic health care environment, present specific opportunities for innovative education and training based on practice-based learning and improvement, and continuous professional development methods. Cutting-edge technologies, blended models, simulation, mentoring, preceptoring, and integrated approaches can play critical roles in supporting surgeons as they provide the best surgical care throughout various phases of their careers. Copyright © 2016 Elsevier Inc. All rights reserved.

Ionic liquids for addressing unmet needs in healthcare

PubMed Central

Agatemor, Christian; Ibsen, Kelly N.; Tanner, Eden E. L.

2018-01-01

Abstract Advances in the field of ionic liquids have opened new applications beyond their traditional use as solvents into other fields especially healthcare. The broad chemical space, rich with structurally diverse ions, and coupled with the flexibility to form complementary ion pairs enables task‐specific optimization at the molecular level to design ionic liquids for envisioned functions. Consequently, ionic liquids now are tailored as innovative solutions to address many problems in medicine. To date, ionic liquids have been designed to promote dissolution of poorly soluble drugs and disrupt physiological barriers to transport drugs to targeted sites. Also, their antimicrobial activity has been demonstrated and could be exploited to prevent and treat infectious diseases. Metal‐containing ionic liquids have also been designed and offer unique features due to incorporation of metals. Here, we review application‐driven investigations of ionic liquids in medicine with respect to current status and future potential. PMID:29376130

Improving Catastrophe Modeling for Business Interruption Insurance Needs.

PubMed

Rose, Adam; Huyck, Charles K

2016-10-01

While catastrophe (CAT) modeling of property damage is well developed, modeling of business interruption (BI) lags far behind. One reason is the crude nature of functional relationships in CAT models that translate property damage into BI. Another is that estimating BI losses is more complicated because it depends greatly on public and private decisions during recovery with respect to resilience tactics that dampen losses by using remaining resources more efficiently to maintain business function and to recover more quickly. This article proposes a framework for improving hazard loss estimation for BI insurance needs. Improved data collection that allows for analysis at the level of individual facilities within a company can improve matching the facilities with the effectiveness of individual forms of resilience, such as accessing inventories, relocating operations, and accelerating repair, and can therefore improve estimation accuracy. We then illustrate the difference this can make in a case study example of losses from a hurricane. © 2016 Society for Risk Analysis.

Improved selectivity from a wavelength addressable device for wireless stimulation of neural tissue

PubMed Central

Seymour, Elif Ç.; Freedman, David S.; Gökkavas, Mutlu; Özbay, Ekmel; Sahin, Mesut; Ünlü, M. Selim

2014-01-01

Electrical neural stimulation with micro electrodes is a promising technique for restoring lost functions in the central nervous system as a result of injury or disease. One of the problems related to current neural stimulators is the tissue response due to the connecting wires and the presence of a rigid electrode inside soft neural tissue. We have developed a novel, optically activated, microscale photovoltaic neurostimulator based on a custom layered compound semiconductor heterostructure that is both wireless and has a comparatively small volume (<0.01 mm3). Optical activation provides a wireless means of energy transfer to the neurostimulator, eliminating wires and the associated complications. This neurostimulator was shown to evoke action potentials and a functional motor response in the rat spinal cord. In this work, we extend our design to include wavelength selectivity and thus allowing independent activation of devices. As a proof of concept, we fabricated two different microscale devices with different spectral responsivities in the near-infrared region. We assessed the improved addressability of individual devices via wavelength selectivity as compared to spatial selectivity alone through on-bench optical measurements of the devices in combination with an in vivo light intensity profile in the rat cortex obtained in a previous study. We show that wavelength selectivity improves the individual addressability of the floating stimulators, thus increasing the number of devices that can be implanted in close proximity to each other. PMID:24600390

Partnership Patterns: Addressing Emotional Needs in Early Intervention

ERIC Educational Resources Information Center

Brotherson, Mary Jane; Summers, Jean Ann; Naig, Lisa A.; Kyzar, Kathleen; Friend, Anna; Epley, Pamela; Gotto, George S., IV; Turnbull, Ann P.

2010-01-01

Home visiting in early intervention is the primary model for delivering services and building partnerships with children and families. Using interviews with early interventionists and family members, this study investigated the extent to which families' and professionals' emotional needs were met during home visits and what factors contributed to…

PARTNERING TO IMPROVE HUMAN EXPOSURE METHODS

EPA Science Inventory

Methods development research is an application-driven scientific area that addresses programmatic needs. The goals are to reduce measurement uncertainties, address data gaps, and improve existing analytical procedures for estimating human exposures. Partnerships have been develop...

Using Local Data to Address Abandoned Property: Lessons Learned From a Community Health Partnership.

PubMed

Teixeira, Samantha; Kolke, Demi

A growing body of research highlights the role of the built environment in promoting or impeding health. This research suggests that environmental issues like abandoned properties exact a toll on physical and mental health. We describe a community partnership aimed at improving community health through equitable land use policies and blight remediation. A collaboration between the University of Pittsburgh and Operation Better Block, Inc. (OBB), a community development corporation in Pittsburgh, was formed. We implemented an intervention to address property abandonment using data-driven techniques. In addition to successful advocacy for city-wide policies addressing abandonment, 80% of the properties that were part of our intervention were improved or addressed by the city. Balancing the needs of community and academic partners can be challenging, but our experiences suggest that community health partnerships to address built environmental issues may be an important conduit to health promotion.

Meaningful activities for improving the wellbeing of people with dementia: beyond mere pleasure to meeting fundamental psychological needs.

PubMed

Nyman, Samuel R; Szymczynska, Paulina

2016-03-01

Dementia is being increasingly recognised as a major public health issue for our ageing populations. A critical aspect of supporting people with dementia is facilitating their participation in meaningful activities. However, research to date has not drawn on theories of ageing from developmental psychology that would help undergird the importance of such meaningful activity. For the first time, we connect existing activity provision for people with dementia with developmental psychology theories of ageing. We reviewed the literature in two stages: first, we narratively searched the literature to demonstrate the relevance of psychological theories of ageing for provision of meaningful activities for people with dementia, and in particular focused on stage-based theories of adult development (Carl Jung and Erik Erikson), gerotranscendence (Tornstam), selective optimisation with compensation (Baltes and Baltes), and optimisation in primary and secondary control (Heckhausen and Schulz). Second, we systematically searched PubMed and PsycINFO for studies with people with dementia that made use of the aforementioned theories. The narrative review highlights that activity provision for people with dementia goes beyond mere pleasure to meeting fundamental psychological needs. More specifically, that life review therapy and life story work address the need for life review; spiritual/religious activities address the need for death preparation; intergenerational activities address the need for intergenerational relationships; re-acquaintance with previously conducted leisure activities addresses the need for a sense of control and to achieve life goals; and pursuit of new leisure activities addresses the need to be creative. The systematic searches identified two studies that demonstrated the utility of applying Erikson's theory of psychosocial development to dementia care. We argue for the importance of activity provision for people with dementia to help promote wellbeing

Federal metering data analysis needs and existing tools

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

Henderson, Jordan W.; Fowler, Kimberly M.

2015-07-01

Agencies have been working to improve their metering data collection, management, and analysis efforts over the last decade (since EPAct 2005) and will continue to address these challenges as new requirements and data needs come into place. Unfortunately there is no “one-size-fits-all” solution. As agencies continue to expand their capabilities to use metered consumption data to reducing resource use and improve operations, the hope is that shared knowledge will empower others to follow suit. This paper discusses the Federal metering data analysis needs and some existing tools.

Assessing, Analyzing, and Adapting: Improving a Graduate Student Instruction Program through Needs Assessment

ERIC Educational Resources Information Center

Roszkowski, Beth; Reynolds, Gretchen

2013-01-01

This article highlights an assessment of library instruction needs among graduate students in the social sciences. The article addresses the development and implementation of the assessment and the application of assessment results to an established set of library instruction workshops. The article provides a detailed summary of assessment…

Improving public health evaluation: a qualitative investigation of practitioners' needs.

PubMed

Denford, Sarah; Lakshman, Rajalakshmi; Callaghan, Margaret; Abraham, Charles

2018-01-30

In 2011, the House of Lords published a report on Behaviour Change, in which they report that "a lot more could, and should, be done to improve the evaluation of interventions." This study aimed to undertake a needs assessment of what kind of evaluation training and materials would be of most use to UK public health practitioners by conducting interviews with practitioners about everyday evaluation practice and needed guidance and materials. Semi-structured interviews were conducted with 32 public health practitioners in two UK regions, Cambridgeshire and the South West. Participants included directors of public health, consultants in public health, health improvement advisors, public health intelligence, and public health research officers. A topic guide included questions designed to explore participants existing evaluation practice and their needs for further training and guidance. Data were analysed using thematic analyses. Practitioners highlighted the need for evaluation to defend the effectiveness of existing programs and protect funding provisions. However, practitioners often lacked training in evaluation, and felt unqualified to perform such a task. The majority of practitioners did not use, or were not aware of many existing evaluation guidance documents. They wanted quality-assured, practical guidance that relate to the real world settings in which they operate. Practitioners also mentioned the need for better links and support from academics in public health. Whilst numerous guidance documents supporting public health evaluation exist, these documents are currently underused by practitioners - either because they are not considered useful, or because practitioners are not aware of them. Integrating existing guides into a catalogue of guidance documents, and developing a new-quality assured, practical and useful document may support the evaluation of public health programs. This in turn has the potential to identify those programs that are effective

The Role of Food Banks in Addressing Food Insecurity: A Systematic Review.

PubMed

Bazerghi, Chantelle; McKay, Fiona H; Dunn, Matthew

2016-08-01

Food banks play a major role in the food aid sector by distributing donated and purchased groceries directly to food insecure families. The public health implications of food insecurity are significant, particularly as food insecurity has a higher prevalence among certain population groups. This review consolidates current knowledge about the function and efficacy of food banks to address food insecurity. A systematic review was conducted. Thirty-five publications were reviewed, of which 14 examined food security status, 13 analysed nutritional quality of food provided, and 24 considered clients' needs in relation to food bank use. This review found that while food banks have an important role to play in providing immediate solutions to severe food deprivation, they are limited in their capacity to improve overall food security outcomes due to the limited provision of nutrient-dense foods in insufficient amounts, especially from dairy, vegetables and fruits. Food banks have the potential to improve food security outcomes when operational resources are adequate, provisions of perishable food groups are available, and client needs are identified and addressed.

Addressing Medical Needs of Adolescents and Adults with Autism Spectrum Disorders in a Primary Care Setting

ERIC Educational Resources Information Center

Saqr, Youssra; Braun, Erika; Porter, Kyle; Barnette, Debra; Hanks, Christopher

2018-01-01

Little has been reported about how to improve health care access and delivery for adolescents and adults with autism spectrum disorder. To understand the contributions to the health disparities in the autism spectrum disorder population, we conducted two independent research approaches to learn about current medical needs. A retrospective chart…

Health and Household Air Pollution from Solid Fuel Use: The Need for Improved Exposure Assessment

PubMed Central

Peel, Jennifer L.; Balakrishnan, Kalpana; Breysse, Patrick N.; Chillrud, Steven N.; Naeher, Luke P.; Rodes, Charles E.; Vette, Alan F.; Balbus, John M.

2013-01-01

Background: Nearly 3 billion people worldwide rely on solid fuel combustion to meet basic household energy needs. The resulting exposure to air pollution causes an estimated 4.5% of the global burden of disease. Large variability and a lack of resources for research and development have resulted in highly uncertain exposure estimates. Objective: We sought to identify research priorities for exposure assessment that will more accurately and precisely define exposure–response relationships of household air pollution necessary to inform future cleaner-burning cookstove dissemination programs. Data Sources: As part of an international workshop in May 2011, an expert group characterized the state of the science and developed recommendations for exposure assessment of household air pollution. Synthesis: The following priority research areas were identified to explain variability and reduce uncertainty of household air pollution exposure measurements: improved characterization of spatial and temporal variability for studies examining both short- and long-term health effects; development and validation of measurement technology and approaches to conduct complex exposure assessments in resource-limited settings with a large range of pollutant concentrations; and development and validation of biomarkers for estimating dose. Addressing these priority research areas, which will inherently require an increased allocation of resources for cookstove research, will lead to better characterization of exposure–response relationships. Conclusions: Although the type and extent of exposure assessment will necessarily depend on the goal and design of the cookstove study, without improved understanding of exposure–response relationships, the level of air pollution reduction necessary to meet the health targets of cookstove interventions will remain uncertain. Citation: Clark ML, Peel JL, Balakrishnan K, Breysse PN, Chillrud SN, Naeher LP, Rodes CE, Vette AF, Balbus JM. 2013. Health

Improving Education and Training for Educational Administrators and Managers: Urgent Needs.

ERIC Educational Resources Information Center

Hughes, M. G.

This paper advocates giving urgent attention to improving the education and training of educational administrators and managers, realizing the need to respond to rapid and far-reaching political and social change worldwide, and to consequent change within national educational systems. The improvement of administrative structures and the…

CUSTOMS SERVICE MODERNIZATION: Management Improvements Needed on High-Risk Automated Commercial Environment Project

DTIC Science & Technology

2002-05-01

GAO United States General Accounting OfficeReport to Congressional CommitteesMay 2002 CUSTOMS SERVICE MODERNIZATION Management Improvements Needed...from... to) - Title and Subtitle CUSTOMS SERVICE MODERNIZATION: Management Improvements Needed on High-Risk Automated Commercial Environment... Customs management of ACE. Subject Terms Report Classification unclassified Classification of this page unclassified Classification of Abstract

Civil society organizations: capacity to address the needs of the urban poor in Nairobi.

PubMed

Ekirapa, Akaco; Mgomella, George S; Kyobutungi, Catherine

2012-11-01

We conducted a needs assessment that describes the landscape of civil society organizations (CSOs) in three informal settlements around Nairobi, Kenya. The numbers of CSOs have rapidly increased in areas underserved by governments including poor urban neighbourhoods but little is known about CSOs capacity to meet the priority health needs of the urban poor. It is also unclear why, despite a proliferation of CSOs, residents still experience unimproved health outcomes. We collected data on core activities, financial management, and governance structures. Of the 952 CSOs assessed, 47 per cent reported HIV/AIDS counselling, prevention, and treatment as their core activity. Most CSOs reported good financial management systems and governance structures but responses were not validated. Representation in district health stakeholder fora was low; most CSOs did not have the capacity to effectively deliver services that would have impact. For CSOs to realize the desired goal to improve the well-being of low-income populations, programmes to build their management capacity are essential.

Preparing Special Educators in Eastern North Carolina To Use Assistive Technology: A Multimedia Approach to Addressing Training Needs Unique to Rural Areas.

ERIC Educational Resources Information Center

Darrow, Melissa; And Others

This paper describes a project addressing the assistive technology training needs of teachers of children with disabilities in rural eastern North Carolina, through development of a multimedia software tutorial service. The project utilized both a special education/assistive technology professional and an instructional technology professional to…

Addressing mental health disparities through clinical competence not just cultural competence: the need for assessment of sociocultural issues in the delivery of evidence-based psychosocial rehabilitation services.

PubMed

Yamada, Ann-Marie; Brekke, John S

2008-12-01

Recognition of ethnic/racial disparities in mental health services has not directly resulted in the development of culturally responsive psychosocial interventions. There remains a fundamental need for assessment of sociocultural issues that have been linked with the expectations, needs, and goals of culturally diverse consumers with severe and persistent mental illness. The authors posit that embedding the assessment of sociocultural issues into psychosocial rehabilitation practice is one step in designing culturally relevant empirically supported practices. It becomes a foundation on which practitioners can examine the relevance of their interventions to the diversity encountered in everyday practice. This paper provides an overview of the need for culturally and clinically relevant assessment practices and asserts that by improving the assessment of sociocultural issues the clinical competence of service providers is enhanced. The authors offer a conceptual framework for linking clinical assessment of sociocultural issues to consumer outcomes and introduce an assessment tool adapted to facilitate the process in psychosocial rehabilitation settings. Emphasizing competent clinical assessment skills will ultimately offer a strategy to address disparities in treatment outcomes for understudied populations of culturally diverse consumers with severe and persistent mental illness.

Addressing Mental Health Disparities through Clinical Competence Not Just Cultural Competence: The Need for Assessment of Sociocultural Issues in the Delivery of Evidence-Based Psychosocial Rehabilitation Services

PubMed Central

Yamada, Ann-Marie; Brekke, John S

2008-01-01

Recognition of ethnic/racial disparities in mental health services has not directly resulted in the development of culturally responsive psychosocial interventions. There remains a fundamental need for assessment of sociocultural issues that have been linked with the expectations, needs, and goals of culturally diverse consumers with severe and persistent mental illness. The authors posit that embedding the assessment of sociocultural issues into psychosocial rehabilitation practice is one step in designing culturally relevant empirically supported practices. It becomes a foundation on which practitioners can examine the relevance of their interventions to the diversity encountered in everyday practice. This paper provides an overview of the need for culturally and clinically relevant assessment practices and asserts that by improving the assessment of sociocultural issues the clinical competence of service providers is enhanced. The authors offer a conceptual framework for linking clinical assessment of sociocultural issues to consumer outcomes and introduce an assessment tool adapted to facilitate the process in psychosocial rehabilitation settings. Emphasizing competent clinical assessment skills will ultimately offer a strategy to address disparities in treatment outcomes for understudied populations of culturally diverse consumers with severe and persistent mental illness. PMID:18778881

Improvement of Patient- and Family-Specific Care for Children with Special Behavioral Needs in the Emergency Setting: A Behavioral Needs Education.

PubMed

Brynes, Nicole; Lee, Heeyoung; Ren, Dianxu; Beach, Michael

2017-05-01

Improvements in staff training, identification, and treatment planning for children with special health care needs who have behavioral issues are routinely recommended, but a literature review revealed no coherent plans targeted specifically toward pediatric ED staff. An educational module was delivered to emergency staff along with a survey before and after and 1 month after the intervention to examine comfort in working with children with behavioral special needs and the ability to deliver specialized care. Child life consultations in the pediatric emergency department were measured 3 months before and 3 months after the education was provided. A total of 122 staff participated and reported clinically significant improvements across all areas of care that were maintained at 1 month. To the best of our knowledge, this project represents the first quality improvement project offering behavioral needs education to emergency staff at a large pediatric hospital with an examination of its impact on staff competence, comfort, and outcomes. A large-scale educational module is a practical option for improvement in pediatric ED staff competence in caring for patients with behavioral special needs. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

Southwest Region: A Report Identifying and Addressing the Educational Needs

ERIC Educational Resources Information Center

US Department of Education, 2011

2011-01-01

The Educational Technical Assistance Act of 2002, authorized the Southwest Regional Advisory Committee (RAC), whose members represent the states of Arkansas, Louisiana, New Mexico, Oklahoma, and Texas, to identify and prioritize the region's educational needs and recommend how those needs can be met. The Southwest RAC conducted three public…

Redesigning Health Care Practices to Address Childhood Poverty.

PubMed

Fierman, Arthur H; Beck, Andrew F; Chung, Esther K; Tschudy, Megan M; Coker, Tumaini R; Mistry, Kamila B; Siegel, Benjamin; Chamberlain, Lisa J; Conroy, Kathleen; Federico, Steven G; Flanagan, Patricia J; Garg, Arvin; Gitterman, Benjamin A; Grace, Aimee M; Gross, Rachel S; Hole, Michael K; Klass, Perri; Kraft, Colleen; Kuo, Alice; Lewis, Gena; Lobach, Katherine S; Long, Dayna; Ma, Christine T; Messito, Mary; Navsaria, Dipesh; Northrip, Kimberley R; Osman, Cynthia; Sadof, Matthew D; Schickedanz, Adam B; Cox, Joanne

2016-04-01

Child poverty in the United States is widespread and has serious negative effects on the health and well-being of children throughout their life course. Child health providers are considering ways to redesign their practices in order to mitigate the negative effects of poverty on children and support the efforts of families to lift themselves out of poverty. To do so, practices need to adopt effective methods to identify poverty-related social determinants of health and provide effective interventions to address them. Identification of needs can be accomplished with a variety of established screening tools. Interventions may include resource directories, best maintained in collaboration with local/regional public health, community, and/or professional organizations; programs embedded in the practice (eg, Reach Out and Read, Healthy Steps for Young Children, Medical-Legal Partnership, Health Leads); and collaboration with home visiting programs. Changes to health care financing are needed to support the delivery of these enhanced services, and active advocacy by child health providers continues to be important in effecting change. We highlight the ongoing work of the Health Care Delivery Subcommittee of the Academic Pediatric Association Task Force on Child Poverty in defining the ways in which child health care practice can be adapted to improve the approach to addressing child poverty. Copyright © 2016 Academic Pediatric Association. All rights reserved.

Pacific Region: A Report Identifying and Addressing the Educational Needs

ERIC Educational Resources Information Center

US Department of Education, 2011

2011-01-01

This report represents the deliberations of the Pacific Regional Advisory Committee (RAC), one of 10 RACs established under the Educational Technical Assistance Act of 2002 to assess the educational needs of the region. The committee's report outlines educational needs across the state, districts, and territories of Hawai'i, the Commonwealth of…

Addressing dysfunctional relations among healthcare teams: improving team cooperation through applied organizational theories.

PubMed

Horwitz, Sujin K; Horwitz, Irwin B; Barshes, Neal R

2011-01-01

Previous research has demonstrated that communication failure and interpersonal conflicts are significant impediments among health-care teams to assess complex information and engage in the meaningful collaboration necessary for optimizing patient care. Despite the prolific research on the role of effective teamwork in accomplishing complex tasks, such findings have been traditionally applied to business organizations and not medical contexts. This chapter, therefore, reviews and applies four theories from the fields of organizational behavior (OB) and organization development (OD) as potential means for improving team interaction in health-care contexts. This study is unique in its approach as it addresses the long-standing problems that exist in team communication and cooperation in health-care teams by applying well-established theories from the organizational literature. The utilization and application of the theoretical constructs discussed in this work offer valuable means by which the efficacy of team work can be greatly improved in health-care organizations.

Adapting the Patient-Centered Medical Home to Address Psychosocial Adversity: Results of a Qualitative Study.

PubMed

Vu, Cecilia; Rothman, Emily; Kistin, Caroline J; Barton, Kelly; Bulman, Barb; Budzak-Garza, Ann; Olson-Dorff, Denyse; Bair-Merritt, Megan H

The patient-centered medical home (PCMH) seeks to improve population health. However, PCMH models often focus on improving treatment of chronic diseases rather than on addressing psychosocial adversity. We sought to gather key stakeholder input about how PCMHs might feasibly and sustainably address psychosocial adversity within their patient populations. We conducted 25 semistructured interviews with key stakeholders, such as physicians, nurses, medical assistants, and patients. The audiorecorded interviews focused on participants' perceptions of the best ways to modify the PCMH to address patients' psychosocial adversity. To facilitate information gathering, a fictional patient case was presented. Analyses were conducted using a 3-stage content-analysis process. Participants identified provider-related and systems-level changes necessary for addressing these psychosocial adversities effectively. On the provider level, participants thought that practitioners should foster trusting relationships with patients and should be emotionally present as patients describe their life experiences. Participants also emphasized that providers need to have sensitive conversations about adversity and resilience. On a systems level, participants discussed that documentation must balance privacy and include relevant information in the medical record. In addition, care should be delivered not by a single provider but by a team that has a longitudinal relationship with the patient; this care team should include behavioral health support. Participants provided practical strategies and highlighted provider and systems level changes to adequately address patients' prior psychosocial adversity. Future studies need to assess the degree to which such a trauma-informed approach improves patient access, outcomes, and care quality, and reduces cost. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Improved method for roadside barrier length of need modeling using real-world trajectories.

PubMed

Johnson, Nicholas S; Thomson, Robert; Gabler, Hampton C

2015-07-01

The 2011 AASHTO Roadside Design Guide (RDG) contains perhaps the most widely used procedure for choosing an appropriate length of need (LON) for roadside barriers. However, this procedure has several limitations. The procedure uses a highly simplified model of vehicle departure, and the procedure does not allow designers to specify an explicit level of protection. A new procedure for choosing LON that addresses these limitations is presented in this paper. This new procedure is based on recent, real-world road departure trajectories and uses this departure data in a more realistic way. The new procedure also allows LON to be specified for a precisely known level of protection - a level which can be based on number of crashes, injury outcomes or even estimated crash cost - while still remaining straightforward and quick to use like the 2011 RDG procedure. In this analysis, the improved procedure was used to explore the effects of the RDG procedure's assumptions. LON recommendations given by the 2011 RDG procedure were compared with recommendations given by this improved procedure. For 55 mph roads, the 2011 RDG procedure appears to lead to a LON sufficient to intercept between 80% and 90% of right-side departures that would otherwise strike a hazard located 10 m from the roadway. For hazards closer than 10 m, the 2011 RDG procedure intercepts progressively higher percentages of real-world departures. This suggests the protection level provided by the 2011 RDG procedure varies with the hazard offset, becoming more conservative as the hazard moves closer to the roadway. The improved procedure, by comparison, gives a consistent protection level regardless of hazard location. Copyright © 2015. Published by Elsevier Ltd.

Pilot study of medical-legal partnership to address social and legal needs of patients.

PubMed

Weintraub, Dana; Rodgers, Melissa A; Botcheva, Luba; Loeb, Anna; Knight, Rachael; Ortega, Karina; Heymach, Brooke; Sandel, Megan; Huffman, Lynne

2010-05-01

As a preliminary investigation of the effectiveness of medical-legal partnership in pediatrics, we conducted a 36-month prospective cohort study of the impact of clinic- and hospital-based legal services. We hypothesized that integration of legal services into pediatric settings would increase families' awareness of and access to legal and social services, decrease barriers to health care for children, and improve child health. Health care providers referred families with legal or social needs to the Peninsula Family Advocacy Program (FAP). Fifty four families completed both baseline and six-month follow-up assessments. Comparison of follow-up with baseline demonstrated significantly increased proportions of families who utilized food and income supports and significantly decreased proportions of families avoiding health care due to lack of health insurance or concerns about cost. Two-thirds of respondents reported improved child health and well-being. This study suggests that adding an attorney to the medical team increases awareness of and access to social and legal services.

Mobilizing cross-sector community partnerships to address the needs of criminal justice-involved older adults: a framework for action.

PubMed

Metzger, Lia; Ahalt, Cyrus; Kushel, Margot; Riker, Alissa; Williams, Brie

2017-09-11

Purpose The rapidly increasing number of older adults cycling through local criminal justice systems (jails, probation, and parole) suggests a need for greater collaboration among a diverse group of local stakeholders including professionals from healthcare delivery, public health, and criminal justice and directly affected individuals, their families, and advocates. The purpose of this paper is to develop a framework that local communities can use to understand and begin to address the needs of criminal justice-involved older adults. Design/methodology/approach The framework included solicit input from community stakeholders to identify pressing challenges facing criminal justice-involved older adults, conduct needs assessments of criminal justice-involved older adults and professionals working with them; implement quick-response interventions based on needs assessments; share findings with community stakeholders and generate public feedback; engage interdisciplinary group to develop an action plan to optimize services. Findings A five-step framework for creating an interdisciplinary community response is an effective approach to action planning and broad stakeholder engagement on behalf of older adults cycling through the criminal justice system. Originality/value This study proposes the Criminal Justice Involved Older Adults in Need of Treatment Initiative Framework for establishing an interdisciplinary community response to the growing population of medically and socially vulnerable criminal justice-involved older adults.

Appalachian Region: A Report Identifying and Addressing the Educational Needs

ERIC Educational Resources Information Center

US Department of Education, 2011

2011-01-01

This report presents the deliberations of the Appalachia Regional Advisory Committee (Appalachia RAC), one of 10 RACs established under the Educational Technical Assistance Act of 2002 (20 U.S.C. sections 9601 et. seq.) to assess the educational needs of the region. The Committee's report outlines the educational needs across the four states of…

Central Region: A Report Identifying and Addressing the Educational Needs

ERIC Educational Resources Information Center

US Department of Education, 2011

2011-01-01

This report presents the deliberations of the Central Regional Advisory Committee (RAC), one of 10 RACs established under the Educational Technical Assistance Act of 2002 (20 U.S.C. sections 9601 et. seq.) to assess the educational needs of the region. The committee's report outlines the educational needs across the states of Colorado, Kansas,…

Computer Security: Improvements Needed to Reduce Risk to Critical Federal Operations and Assets

DTIC Science & Technology

2001-11-09

COMPUTER SECURITY Improvements Needed to Reduce Risk to Critical Federal Operations and Assets Statement of Robert F. Dacey Director, Information...Improvements Needed to Reduce Risk to Critical Federal Operations and Assets Contract Number Grant Number Program Element Number Author(s...The benefits have been enormous. Vast amounts of information are now literally at our fingertips, facilitating research on virtually every topic

Midwest Region: A Report Identifying and Addressing the Educational Needs

ERIC Educational Resources Information Center

US Department of Education, 2011

2011-01-01

This report presents the deliberations of the Midwest Regional Advisory Committee (MW RAC), one of 10 RACs established under the Educational Technical Assistance Act of 2002 (20 U.S.C. sections 9601 et. seq.) to assess the educational needs of the region. The committee's report outlines the educational needs across the seven states of Illinois,…

SaludABLEOmaha: Improving Readiness to Address Obesity Through Healthy Lifestyle in a Midwestern Latino Community, 2011–2013

PubMed Central

Frerichs, Leah; Brittin, Jeri; Robbins, Regina; Steenson, Sharalyn; Stewart, Catherine; Fisher, Christopher

2015-01-01

Background A community’s readiness for change is a precursor to the effective application of evidence-based practices for health promotion. Research is lacking regarding potential strategies to improve readiness to address obesity-related health issues in underserved communities. Community Context This case study describes SaludABLEOmaha, an initiative to increase readiness of residents in a Midwestern Latino community to address obesity and adopt healthy lifestyles. Methods SaludABLEOmaha emphasized 2 core approaches, youth activism and collaboration among public and private institutions, which we applied to planning and implementing tactics in support of 3 interconnected strategies: 1) social marketing and social media, 2) service learning in schools (ie, curricula that integrate hands-on community service with instruction and reflection), and 3) community and business engagement. Following the Community Readiness Model protocol (http://triethniccenter.colostate.edu/communityReadiness.htm), structured interviews were conducted with community leaders and analyzed before and 2.5 years after launch of the program. Outcome The community increased in readiness from stage 3 of the Community Readiness Model, “vague awareness,” at baseline to stage 5, “preparation,” at follow-up. Interpretation SaludABLEOmaha improved community readiness (eg, community knowledge, community climate), which probably contributed to the observed increase in readiness to address obesity through healthy lifestyle. Community mobilization approaches such as youth activism integrated with social marketing and social media tactics can improve community responsiveness to obesity prevention and diminish health disparities. PMID:25674679

MVO Automation Platform: Addressing Unmet Needs in Clinical Laboratories with Microcontrollers, 3D Printing, and Open-Source Hardware/Software.

PubMed

Iglehart, Brian

2018-05-01

Laboratory automation improves test reproducibility, which is vital to patient care in clinical laboratories. Many small and specialty laboratories are excluded from the benefits of automation due to low sample number, cost, space, and/or lack of automation expertise. The Minimum Viable Option (MVO) automation platform was developed to address these hurdles and fulfill an unmet need. Consumer 3D printing enabled rapid iterative prototyping to allow for a variety of instrumentation and assay setups and procedures. Three MVO versions have been produced. MVOv1.1 successfully performed part of a clinical assay, and results were comparable to those of commercial automation. Raspberry Pi 3 Model B (RPI3) single-board computers with Sense Hardware Attached on Top (HAT) and Raspberry Pi Camera Module V2 hardware were remotely accessed and evaluated for their suitability to qualify the latest MVOv1.2 platform. Sense HAT temperature, barometric pressure, and relative humidity sensors were stable in climate-controlled environments and are useful in identifying appropriate laboratory spaces for automation placement. The RPI3 with camera plus digital dial indicator logged axis travel experiments. RPI3 with camera and Sense HAT as a light source showed promise when used for photometric dispensing tests. Individual well standard curves were necessary for well-to-well light and path length compensations.

Assessing and Addressing Students' Scientific Literacy Needs in Physical Geology

NASA Astrophysics Data System (ADS)

Campbell-Stone, E. A.; Myers, J. D.

2005-12-01

Exacting excellence equally from university students around the globe can be accomplished by providing all students with necessary background tools to achieve mastery of their courses, even if those tools are not part of normal content. As instructors we hope to see our students grasp the substance of our courses, make mental connections between course material and practical applications, and use this knowledge to make informed decisions as citizens. Yet many educators have found that students enter university-level introductory courses in mathematics, science and engineering without adequate academic preparation. As part of a FIPSE-funded project at the University of Wyoming, the instructors of the Physical Geology course have taken a new approach to tackling the problem of lack of scientific/mathematic skills in incoming students. Instead of assuming that students should already know or will learn these skills on their own, they assess students' needs and provide them the opportunity to master scientific literacies as they learn geologic content. In the introductory geology course, instructors identified two categories of literacies, or basic skills that are necessary for academic success and citizen participation. Fundamental literacies include performing simple quantitative calculations, making qualitative assessments, and reading and analyzing tables and graphs. Technical literacies are those specific to understanding geology, and comprise the ability to read maps, visualize changes through time, and conceptualize in three dimensions. Because these skills are most easily taught in lab, the in-house lab manual was rewritten to be both literacy- and content-based. Early labs include simple exercises addressing literacies in the context of geological science, and each subsequent lab repeats exposure to literacies, but at increasing levels of difficulty. Resources available to assist students with literacy mastery include individual instruction, a detailed

Addressing diabetes at the crossroads of global pandemic and regional culture: Comment on "The curse of wealth - Middle Eastern countries need to address the rapidly rising burden of diabetes".

PubMed

Hsu, William C; Gabbay, Robert A

2014-07-01

As diabetes and obesity rates continue to climb at astronomical rates in the Middle East, future generations are at an even greater risk for diabetes and the associated complications. Many factors are at play and it is clear that creative solutions are needed to retool provider resources in the Middle East towards prevention of diabetes and its complications while leveraging technology to maximize outreach within the accepted cultural norms. Only by building the capacity to address the current diabetes burden as well focusing on prevention for the future, can Middle East countries create a strong infrastructure for a successful future.

Improving America's Schools Act

NASA Technical Reports Server (NTRS)

Cradler, John; Bridgforth, Elizabeth

1995-01-01

The Improving America's Schools ACT (IASA) emphasizes coherent systemic education reform, with Goals 2000 setting common standards for IASA and the recently authorized School-to-Work Program. IASA addresses the need to raise academic achievement, increase opportunities to learn, improve professional development, increase community involvement, utilize instructional applications of technology, and improve assessment, and allow more local flexibility in the use of funds.

Achievement for All: improving psychosocial outcomes for students with special educational needs and disabilities.

PubMed

Humphrey, Neil; Lendrum, Ann; Barlow, Alexandra; Wigelsworth, Michael; Squires, Garry

2013-04-01

Students with special educational needs and disabilities (SEND) are at a greatly increased risk of experiencing poor psychosocial outcomes. Developing effective interventions that address the cause of these outcomes has therefore become a major policy priority in recent years. We report on a national evaluation of the Achievement for All (AfA) programme that was designed to improve outcomes for students with SEND through: (1) academic assessment, tracking and intervention, (2) structured conversations with parents, and (3) developing provision to improve wider outcomes (e.g. positive relationships). Using a quasi-experimental, pre-test-post-test control group design, we assessed the impact of AfA on teacher ratings of the behaviour problems, positive relationships and bullying of students with SEND over an 18-month period. Participants were 4758 students with SEND drawn from 323 schools across England. Our main impact analysis demonstrated that AfA had a significant impact on all three response variables when compared to usual practice. Hierarchical linear modelling of data from the intervention group highlighted a range of school-level contextual factors and implementation activities and student-level individual differences that moderated the impact of AfA on our study outcomes. The implications of our findings are discussed, and study strengths and limitations are noted. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Development of an In-Service Course To Assist Subject-Matter Teachers in Addressing the Unique Needs of Students Having Limited English Proficiency.

ERIC Educational Resources Information Center

Piscitelli, Christine D.

An inservice teacher education course was designed to address the problems of content-area teachers in teaching limited-English-proficient (LEP) students. Goals were for content-area teachers: (1) to gain sensitivity to and understanding of the special needs of this population; (2) to become aware of the cultural and linguistic diversity and…

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

PubMed Central

Usta, Jinan; Taleb, Rim

2014-01-01

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

Applications of process improvement techniques to improve workflow in abdominal imaging.

PubMed

Tamm, Eric Peter

2016-03-01

Major changes in the management and funding of healthcare are underway that will markedly change the way radiology studies will be reimbursed. The result will be the need to deliver radiology services in a highly efficient manner while maintaining quality. The science of process improvement provides a practical approach to improve the processes utilized in radiology. This article will address in a step-by-step manner how to implement process improvement techniques to improve workflow in abdominal imaging.

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.

Convocation address.

PubMed

Swaminathan, M S

1998-07-01

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

Urgent Need for Improved Mental Health Care and a More Collaborative Model of Care

PubMed Central

Lake, James; Turner, Mason Spain

2017-01-01

Current treatments and the dominant model of mental health care do not adequately address the complex challenges of mental illness, which accounts for roughly one-third of adult disability globally. These circumstances call for radical change in the paradigm and practices of mental health care, including improving standards of clinician training, developing new research methods, and re-envisioning current models of mental health care delivery. Because of its dominant position in the US health care marketplace and its commitment to research and innovation, Kaiser Permanente (KP) is strategically positioned to make important contributions that will shape the future of mental health care nationally and globally. This article reviews challenges facing mental health care and proposes an agenda for developing a collaborative care model in primary care settings that incorporates conventional biomedical therapies and complementary and alternative medicine approaches. By moving beyond treatment delivery via telephone and secure video and providing earlier interventions through primary care clinics, KP is shifting the paradigm of mental health care to a collaborative care model focusing on prevention. Recommendations are to expand current practices to include integrative treatment strategies incorporating evidence-based biomedical and complementary and alternative medicine modalities that can be provided to patients using a collaborative care model. Recommendations also are made for an internal research program aimed at investigating the efficacy and cost-effectiveness of promising complementary and alternative medicine and integrative treatments addressing the complex needs of patients with severe psychiatric disorders, many of whom respond poorly to treatments available in KP mental health clinics. PMID:28898197

Improvements Needed in Managing Scope Changes and Oversight of Construction Projects at Camp Lemonnier, Djibouti

DTIC Science & Technology

2016-09-30

Improvements Needed in Managing Scope Changes and Oversight of Construction Projects at Camp Lemonnier, Djibouti S E P T E M B E R 3 0 , 2 0 1 6 Report...Improvements Needed in Managing Scope Changes and Oversight of Construction Projects at Camp Lemonnier, Djibouti Visit us at www.dodig.mil Objective We...Findings (cont’d) ii │ DODIG-2016-141 (Project No. D2014-D000RE-0157.000) Results in Brief Improvements Needed in Managing Scope Changes and Oversight

Using life cycle assessment to address stakeholders' potential for improving municipal solid waste management.

PubMed

de Andrade Junior, Milton Aurelio Uba; Zanghelini, Guillherme Marcelo; Soares, Sebastião Roberto

2017-05-01

Because the consumption of materials is generally higher than their recovery rate, improving municipal solid waste (MSW) management is fundamental for increasing the efficiency of natural resource use and consumption in urban areas. More broadly, the characteristics of a MSW management system influence the end-of-life (EOL) impacts of goods consumed by households. We aim to indicate the extent to which greenhouse gas emissions from a MSW management system can be reduced by increasing waste paper recycling. We also address the stakeholders' contribution for driving transition towards an improved scenario. Life cycle assessment (LCA) addresses the EOL impacts of the paper industry, driven by the characteristics of MSW management in Florianópolis, Brazil, by varying the level of stakeholders' commitment through different recycling scenarios. The results show that 41% of the climate change impacts from waste paper management could be reduced when increasing the waste paper recycling rates and reducing waste paper landfilling. To achieve such emissions reduction, the industry contribution to the MSW management system would have to increase from 17% in the business-as-usual scenario to 74% in the target scenario. We were able to measure the differences in stakeholders' contribution by modelling the MSW management system processes that are under the industry's responsibility separately from the processes that are under the government's responsibility, based on the Brazilian legal framework. The conclusions indicate that LCA can be used to support policy directions on reducing the impacts of MSW management by increasing resource recovery towards a circular economy.

Development of the Community Health Improvement Navigator Database of Interventions.

PubMed

Roy, Brita; Stanojevich, Joel; Stange, Paul; Jiwani, Nafisa; King, Raymond; Koo, Denise

2016-02-26

With the passage of the Patient Protection and Affordable Care Act, the requirements for hospitals to achieve tax-exempt status include performing a triennial community health needs assessment and developing a plan to address identified needs. To address community health needs, multisector collaborative efforts to improve both health care and non-health care determinants of health outcomes have been the most effective and sustainable. In 2015, CDC released the Community Health Improvement Navigator to facilitate the development of these efforts. This report describes the development of the database of interventions included in the Community Health Improvement Navigator. The database of interventions allows the user to easily search for multisector, collaborative, evidence-based interventions to address the underlying causes of the greatest morbidity and mortality in the United States: tobacco use and exposure, physical inactivity, unhealthy diet, high cholesterol, high blood pressure, diabetes, and obesity.

Development of the Community Health Improvement Navigator Database of Interventions

PubMed Central

Roy, Brita; Stanojevich, Joel; Stange, Paul; Jiwani, Nafisa; King, Raymond; Koo, Denise

2016-01-01

Summary With the passage of the Patient Protection and Affordable Care Act, the requirements for hospitals to achieve tax-exempt status include performing a triennial community health needs assessment and developing a plan to address identified needs. To address community health needs, multisector collaborative efforts to improve both health care and non–health care determinants of health outcomes have been the most effective and sustainable. In 2015, CDC released the Community Health Improvement Navigator to facilitate the development of these efforts. This report describes the development of the database of interventions included in the Community Health Improvement Navigator. The database of interventions allows the user to easily search for multisector, collaborative, evidence-based interventions to address the underlying causes of the greatest morbidity and mortality in the United States: tobacco use and exposure, physical inactivity, unhealthy diet, high cholesterol, high blood pressure, diabetes, and obesity. PMID:26917110

Achievement for All: Improving Psychosocial Outcomes for Students with Special Educational Needs and Disabilities

ERIC Educational Resources Information Center

Humphrey, Neil; Lendrum, Ann; Barlow, Alexandra; Wigelsworth, Michael; Squires, Garry

2013-01-01

Students with special educational needs and disabilities (SEND) are at a greatly increased risk of experiencing poor psychosocial outcomes. Developing effective interventions that address the cause of these outcomes has therefore become a major policy priority in recent years. We report on a national evaluation of the Achievement for All (AfA)…

Controls Over Army Deployable Disbursing System Payments Need Improvement

DTIC Science & Technology

2011-08-17

Controls Over Army Deployable Disbursing System Payments Need Improvement Report No. D-2011-101 August 17, 2011 Report...DRIVE ARLINGTON VIRGINIA 22202-4704 August 17, 20 ll MEMORANDUM FOR UNDER SECRETARY OF DEFENSE (COMPTROLLER)/ CHI EF FINANCIAL OFFICER, DOD...We appreciate the comtes ies extended to the staff. Please direct questions to me at (703) 60 1-5868 (DSN 664-5868). p~ Q . ;n~ Patricia A. Marsh

An Interprofessional Education Project to Address Veterans' Healthcare Needs

ERIC Educational Resources Information Center

Peterson, Jane; Brommelsiek, Margaret; Amelung, Sarah Knopf

2017-01-01

Background/Objective: The number of veterans and their families seeking healthcare and support within civilian communities is increasing worldwide. There is a need for healthcare providers to provide sensitive, comprehensive care for veterans with both physical and behavioral health conditions. Many civilian providers are unfamiliar with veterans'…

Existential and spiritual needs in mental health care: an ethical and holistic perspective.

PubMed

Koslander, Tiburtius; da Silva, António Barbosa; Roxberg, Asa

2009-03-01

This study illuminates how existential needs and spiritual needs are connected with health care ethics and individuals' mental health and well-being. The term existential needs is defined as the necessity of experiencing life as meaningful, whereas the term spiritual needs is defined as the need of deliverance from despair, guilt and/or sin, and of pastoral care. It discusses whether or not patients' needs are holistically addressed in Western health care systems that neglect patients' existential and spiritual needs, because of their biomedical view of Man which recognizes only patients' physical needs. It excludes a holistic health care which considers all needs, expressed by patients in treatment of mental illness. Addressing all needs is important for patients' improvement and recovery. For some patients, this is the only way to regain their mental health and well-being.

Distribution of Funds and Mentoring of Finance Officers for the Afghanistan National Army Payroll Need Improvement

DTIC Science & Technology

2012-02-29

National Army Payroll Need Improvement Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the collection of...Funds and Mentoring of Finance Officers for the Afghanistan National Army Payroll Need Improvement 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c...SUBJECT: Distribution of Funds and Mentoring of Finance Officers for the Afghanistan National Army Payroll Need Improvement (Report No. DODIG-2012-058

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.

SKyTeach: Addressing the need for Science and Math Teachers in Kentucky

NASA Astrophysics Data System (ADS)

Bonham, Scott

2008-10-01

The shortage of good science and math teachers is a chronic problem that threatens to undermine the future of our profession and economy. While our world is becoming increasingly dependent on technology, many high schools do not even offer physics, in part due to of the unavailability of a qualified teacher. The entire state of Kentucky typically produces 0-2 new physics teachers per year, compared to 200+ elementary teachers per year from WKU alone. The picture is not much better in math and other sciences. SKyTeach is a new program at WKU to address this great need and is part of a national effort to replicate the successful UTeach program. The University of Texas UTeach program graduates 70-90 new math and science teachers a year, in the process providing them with a strong preparation based on current research on how people learn science and math, experience teaching in real classrooms from the start, and strong mentoring and support. UTeach graduates stay in the classroom at rates above the national average, and some fairly quickly move into leadership positions within their schools. A key element is good collaboration between the college of science, that of education, local P-12 schools, and others. Last year thirteen universities across the nation were selected as part of an effort to replicate the UTeach program nation-wide. This effort is supported by the National Science and Math Initiative in a partnership with the UTeach Institute. Our first cohort of students has started this fall, and we have had many successes and challenges as we move forward.

A Child’s Health Is the Public’s Health: Progress and Gaps in Addressing Pediatric Needs in Public Health Emergencies

PubMed Central

Peacock, Georgina; Frogel, Michael

2017-01-01

Children are the most prevalent vulnerable population in US society and have unique needs during the response to and recovery from public health emergencies. The physiological, behavioral, developmental, social, and mental health differences of children require specific attention in preparedness efforts. Despite often being more severely affected in disasters, children’s needs are historically underrepresented in preparedness. Since 2001, much progress has been made in addressing this disparity through better pediatric incorporation in preparedness planning from national to local levels. Innovative approaches, policies, and collaborations contribute to these advances. However, many gaps remain in the appropriate and proportional inclusion of children in planning for public health emergencies. Successful models of pediatric planning can be developed, evaluated, and widely disseminated to ensure that further progress can be achieved. PMID:28892439

Addressing the healthcare needs of older Lesbian, Gay, Bisexual, and Transgender patients in medical school curricula: a call to action.

PubMed

Cannon, Sophie M; Shukla, Vipul; Vanderbilt, Allison A

2017-01-01

Medical students matriculating in the coming years will be faced with treating an expansive increase in the population of older lesbian, gay, bisexual, and transgender (LGBT) patients. While these patients face healthcare concerns similar to their non-LGBT aging peers, the older LGBT community has distinct healthcare needs and faces well-documented healthcare disparities. In order to reduce these healthcare barriers, medical school curricula must prepare and educate future physicians to treat this population while providing high quality, culturally-competent care. This article addresses some of the unique healthcare needs of the aging LGBT population with an emphasis on social concerns and healthcare disparities. It provides additional curricular recommendations to aid in the progressive augmentation of medical school curricula. Liaison Committee on Medical Education (LCME); LGBT: Lesbian, gay, bisexual, transgender.

Ballistic Testing for Interceptor Body Armor Inserts Needs Improvement

DTIC Science & Technology

2011-08-01

030, “Ballistic Testing and Product Quality Surveillance for the Interceptor Body Armor - Vest Components Need Improvement,” January 3, 2011. This...Body Armor Ballistic Inserts Interceptor Body Armor (IBA) is a modular body armor system that consists of an outer tactical vest , ballistic inserts...altitude tests was because the ceramic ballistic inserts are solid structures that are not sensitive to reduced pressure and moisture. PM SEQ offered no

Water Information System Platforms Addressing Critical Societal Needs in the Mena Region

NASA Technical Reports Server (NTRS)

Habib, Shahid; Kfouri, Claire; Peters, Mark

2012-01-01

The MENA region includes 18 countries, the occupied Palestinian territories and Western Sahara. However, the region of interest for this study has a strategic interest in countries adjacent to the Mediterranean Sea, which includes, Morocco, Tunisia, Egypt, Lebanon and Jordan. The 90% of the water in the MENA region is used for the agriculture use. By the end of this century. this region is projected to experience an increase of 3 C to 5 C in mean temperatures and a 20% decline in precipitation (lPCC, 2007). Due to lower precipitation, water run-off is projected to drop by 20% to 30% in most of MENA by 2050 Reduced stream flow and groundwater recharge might lead to a reduction in water supply of 10% or greater by 2050. Therefore, per IPCC projections in temperature rise and precipitation decline in the region, the scarcity of water will become more acute with population growth, and rising demand of food in the region. Additionally, the trans boundary water issues will continue to plague the region in terms of sharing data for better management of water resources. Such pressing issues have brought The World Bank, USAID and NASA to jointly collaborate for establishing integrated, modern, up to date NASA developed capabilities for countries in the MENA region for addressing water resource issues and adapting to climate change impacts for improved decision making and societal benefit. This initiative was launched in October 2011 and is schedule to be completed by the end of2015.

Addressing Individual Difficulties in Reading: Issues Relating to Reading Recovery and Pause, Prompt, Praise

ERIC Educational Resources Information Center

Wearmouth, Janice

2004-01-01

Recently the DfES has issued guidance on ways to address the needs of students who experience difficulties in literacy through Wave Three provision in the National Literacy Strategy (DfES, 2002). This guidance raises the issue of what kind of programmes might be initiated in mainstream schools that will improve what is available generally for…

Hazardous Waste: EPA’s Generation and Management Data Need Further Improvement

DTIC Science & Technology

1990-02-01

regulation published; System fully implemented inventory reporting system system partially implemented Page S0 GAO/PEMD403 E]PA’ Hardons Waste Data Need...the Page 75 GAO/PEMD4B3 EPA’s Hardons Waste Data Need Further Improvement ChSSW 4 Asuessmn t MmofN wNnO umbumma operating permit restricted the

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…

Report: Improved Management Practices Needed to Increase Use of Exchange Network

EPA Pesticide Factsheets

Report #2007-P-00030, August 20, 2007. EPA established a partnership with the Exchange Network’s governance bodies to assist them with accomplishing Network initiatives, more improvements are needed to ensure Network partners fully utilize the Network.

Report: Improved Contract Administration Needed for the Customer Technology Solutions Contract

EPA Pesticide Factsheets

Report #13-P-0398, September 16, 2013. Based on our review of the WCF contract EPW08034, which ended September 2012, the EPA needs to improve its contract administration to assist in managing other similar type contracts.

An interprofessional education project to address the health care needs of women transitioning from prison to community reentry.

PubMed

Busen, Nancy H

2014-01-01

With the implementation of the Patient Protection and Affordable Care Act, the need for health care providers to work collaboratively in teams to provide cost-effective, quality health care has become even more apparent because an estimated additional 22 million Americans gain health care coverage by 2014. The need for evidenced-based care that combines the expertise of various disciplines has been acknowledged by policy makers and health educators. With support from national Association for Prevention, Teaching and Research, an interprofessional education course was designed and implemented by health professionals in nursing, nutrition, and dentistry, in collaboration with a local community agency, to address the health care needs of women transitioning from prison to the community. Health care needs of women in prison are often overlooked, and access to care is limited. When released from prison, utilization of even basic health services is rare. Four interactive teaching-learning sessions were offered at a residential facility for women in transition over a 12-week period. Topics were selected based on feedback from the participants and included stress reduction, self-beast examination, hypertension, and common dental conditions. Teaching methods and materials were interactive and designed for sustainability. The model for this interprofessional education project, which employed a service-learning approach, can be adapted for other communities. Working with our communities requires innovative thinking to be effective but provides an enriching life experience to those involved. A community-based reciprocal learning environment benefits all partners in the real-world environment. Copyright © 2014 Elsevier Inc. All rights reserved.

Self-Guided Web-Based Interventions: Scoping Review on User Needs and the Potential of Embodied Conversational Agents to Address Them

PubMed Central

Kelders, Saskia M; Van Gemert-Pijnen, Julia EWC

2017-01-01

productive user relationship. Mapping the user needs on the ECAs’ capabilities suggests that different kinds of ECAs may provide different solutions for improving the adherence levels. Conclusions Autonomous ECAs that do not respond to a user’s expressed emotion in real time but take on empathic roles may be sufficient to motivate users to some extent. It is unclear whether those types of ECAs are competent enough and create sufficient believability among users to address the user’s deeper needs for support and empathy. Responsive ECAs may offer a better solution. However, at present, most of these ECAs have difficulties to assess a user’s emotional state in real time during an open dialogue. By conducting future research with relationship theory–based ECAs, the added value of ECAs toward user needs can be better understood. PMID:29146567

[The Design Requirements for an E-Health Management Platform: Addressing the Needs of Adolescent Girls at High Risk of Metabolic Syndrome].

PubMed

Su, Mei-Chen; Chen, Wen-Chin; Liu, Chieh-Yu; Jou, Hei-Jen; Hsiao, Ya-Chu; Tsao, Lee-Ing

2015-10-01

The rising prevalence of metabolic syndrome among adolescents has not been effectively addressed by current campus-based health promotions. Using the Internet in these promotions may help health professionals achieve better healthcare management. The purpose of the present study was to explore the design requirements of an e-health management platform from the subjective perspective of adolescent girls who were at a high risk of metabolic syndrome. The findings may provide a reference for designing nursing interventions that more effectively promote healthly lifestyle habits to adolescents. This qualitative study employed a snowball approach and used a semi-structured interview guide to collect data. A total of 20 Taiwanese adolescent females who were at a high risk of metabolic syndrome, aged 16-20 years, able to speak Mandarin or Taiwanese, and willing to participate and to have their sessions tape-recorded were enrolled as participants and engaged individually in in-depth interviews. The constant comparative method was used to inductively analyze the interview data. Five main themes related to the e-health management platform emerged from the data. These themes included: an attractive and user-friendly website interface, access to reliable information and resources, provision of tailored health information, access to peer support, and self-monitoring and learning tools. The findings highlight the key design needs of an e-Health management platform from the perspective of adolescent girls who are at a high risk of metabolic syndrome. The identified themes may be addressed in future revisions / developments of these platforms in order to better address the needs of this vulnerable population and to effectively reduce the incidence of metabolic syndrome. The authors hope that the results of the present study may be used to provide better healthcare and support for adolescent girls with metabolic syndrome.

Addressing the workplace needs of Western Australian midwives: a Delphi study.

PubMed

Hauck, Yvonne L; Bayes, Sara J; Robertson, Jeanette M

2012-05-01

To determine the workplace needs of Western Australian midwives working in public metropolitan secondary hospitals. Using a three-round Delphi approach, Round 1 incorporated focus groups and a questionnaire. Fifteen focus groups were conducted with midwives also having the option of contributing through an open-ended questionnaire. During Round 2, 38 items reflecting seven themes were prioritised with a final ranking performed in Round 3. In total, 114 midwives participated in Round 1, 72 in Round 2 and 89 in Round 3. During Round 1, workplace needs identified as being met included: working across all areas of midwifery; ability to work in areas of interest; opportunity to work with low to moderate risk women; supportive colleagues; accessible parking; hospital close to home and friendly work atmosphere. Round 2 items revealed the five top unmet needs as: adequate midwifery staff coverage; access to maintained equipment; competitive pay scales; patient safety issues and opportunities to implement midwifery models. The top ranked needs from Round 3 included: recognising the unpredictable nature of midwifery services; provision of competent medical coverage, and adequate midwifery staff coverage. Demand for maternity services is unpredictable; however, in order to maintain a sustainable maternity workforce, WA midwives' prioritised needs would suggest health management focus upon expanding the availability of midwifery models of care, fostering flexible working conditions and ensuring collaboration between maternity health professionals occurs within clinically safe staffing levels.

Invisible, Marginalized, and Stigmatized: Understanding and Addressing the Needs of Atheist Students

ERIC Educational Resources Information Center

Goodman, Kathleen M.; Mueller, John A.

2009-01-01

In this chapter, the authors introduce the topic of atheist students to the field of student affairs. The authors provide definitions of relevant terms related to the perspectives and principles of atheists. Then, they briefly address the demographics of atheism and focus on atheist student experiences on college campuses. The authors conclude…

Mid-Atlantic Region: A Report Identifying and Addressing the Educational Needs

ERIC Educational Resources Information Center

US Department of Education, 2011

2011-01-01

This report presents the deliberations of the Mid-Atlantic Regional Advisory Committee (RAC), one of 10 RACs established under the Educational Technical Assistance Act of 2002 (20 U.S.C. sections 9601 et. seq.) to assess the educational needs of the region. The committee's report outlines the educational needs across the District of Columbia and…

Student Perceptions of Using Games to Address Science Literacy

NASA Astrophysics Data System (ADS)

Keller, Cara M.

The purpose of this qualitative evaluative case study was to gain insight into how students perceived the efficacy of using games to address their science literacy concerns. Scientists in the United States are concerned with the lack of science literacy. The No Child Left Behind Act of 2001 requires proficiency in reading, mathematics, language arts, and science by the completion of the 2013--2014 school year. The high school participating in this study received substandard test scores on both the 2009 state graduation test and the science portion of the ACT test. The research question included understanding how students perceive the use of games in addressing their science literacy needs. The data from the student journals, field notes, and transcribed class discussions were analyzed using a 6 step method that included coding the data into main themes. The triangulated data were used to both gain insight into student perspective and inform game development. Constructivist theories formed the conceptual framework of the study. The findings of the study suggested that games may prove a valuable tool in science literacy attainment. The study indicated that games were perceived by the students to be effective tools in meeting their learning needs. Implications for positive social change included providing students, educators, and administrators with game resources that can be used to meet the science learning needs of struggling students, thereby improving science scores on high stakes tests.

Addressing the Need for Independence in the CSE Model

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

Abercrombie, Robert K; Ferragut, Erik M; Sheldon, Frederick T

2011-01-01

Abstract Information system security risk, defined as the product of the monetary losses associated with security incidents and the probability that they occur, is a suitable decision criterion when considering different information system architectures. Risk assessment is the widely accepted process used to understand, quantify, and document the effects of undesirable events on organizational objectives so that risk management, continuity of operations planning, and contingency planning can be performed. One technique, the Cyberspace Security Econometrics System (CSES), is a methodology for estimating security costs to stakeholders as a function of possible risk postures. In earlier works, we presented a computationalmore » infrastructure that allows an analyst to estimate the security of a system in terms of the loss that each stakeholder stands to sustain, as a result of security breakdowns. Additional work has applied CSES to specific business cases. The current state-of-the-art of CSES addresses independent events. In typical usage, analysts create matrices that capture their expert opinion, and then use those matrices to quantify costs to stakeholders. This expansion generalizes CSES to the common real-world case where events may be dependent.« less

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.

Treating ADHD: addressing the needs of college students.

PubMed

Culpepper, Larry; King, Paul

2012-04-01

College students with undiagnosed attention-deficit/hyperactivity disorder (ADHD) exhibit varying symptoms and may have trouble in class, be involved in driving accidents, be late to appointments, be disruptive, and abuse alcohol. Clinicians and others in a position to recognize and identify behaviors indicative of ADHD should either complete a thorough assessment for ADHD, including disorders that commonly co-occur with or are mistaken for the illness, or refer students to someone who can. For students with a comprehensive evaluation who are diagnosed with ADHD, special accommodations are available on campus. Clinicians can provide students with several strategies to manage their disorder and improve their chances of having a successful academic career. © Copyright 2012 Physicians Postgraduate Press, Inc.

What does an e-mail address add? - Doing health and technology at home.

PubMed

Andreassen, Hege K

2011-02-01

There is increasing interest in using electronic mail and other electronic health technologies (e-health technologies) in patient follow-ups. This study sheds light on patients' reception of provider-initiated e-health in their everyday environments. In a research project carried out in Norway (2005-2007), an electronic address for a hospital dermatology ward was offered to 50 patient families for improved access to expert advice from the patients' homes. Drawing on semi-structured interviews with 12 families, this paper explores how the electronic address was integrated into everyday health practice. The research illuminates how the electronic address did not only represent changes related to treatment procedures and frequency or nature of expert contact; it was also important to other practices in the everyday lives of the families of patients with chronic illness. Once in place on the patients' computers, the electronic address was ascribed at least four different roles: it was used as the intended riverbed for a flow of information, but also as a safety alarm, as a shield to the medical gaze and as a token of competence in care and parenting. The multiplicity in use and reception of an electronic address in patient settings illustrates the need to include patients' everyday practices in current professional and political discussions of e-mail and other e-health technologies. Thus this paper argues that there is a need for research on electronic patient-provider communication that moves beyond frequency of use and questions on how technology will affect medical encounters. Social science equally needs to investigate how provider-initiated e-health technologies gets involved in patients' moral and social performance of health and illness in everyday life. Copyright © 2010 Elsevier Ltd. All rights reserved.

Defense Logistics: Improved Performance Measures and Information Needed for Assessing Asset Visibility Initiatives

DTIC Science & Technology

2017-03-01

Accountability Office Highlights of GAO-17-183, a report to congressional committees March 2017 DEFENSE LOGISTICS Improved Performance Measures ...DEFENSE LOGISTICS Improved Performance Measures and Information Needed for Assessing Asset Visibility Initiatives...Report to Congressional Committees March 2017 GAO-17-183 United States Government Accountability Office United States Government

Medical Interpreting: Improving Communication with Your Patients.

ERIC Educational Resources Information Center

Tebble, Helen

The guide is designed for physicians and other medical practitioners who need to work with medical interpreters to improve communication with patients. Special attention is given to the Australian context. An introductory section discusses the need for medical interpreters and explains the guide's organization. Subsequent sections address these…

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.

Pregnant adolescents living with HIV: what we know, what we need to know, where we need to go.

PubMed

Callahan, Tegan; Modi, Surbhi; Swanson, Jennifer; Ng'eno, Bernadette; Broyles, Laura N

2017-08-04

HIV-infected pregnant and breastfeeding adolescents are a particularly vulnerable group that require special attention and enhanced support to achieve optimal maternal and infant outcomes. The objective of this paper is to review published evidence about antenatal care (ANC) service delivery and outcomes for HIV-infected pregnant adolescents in low-income country settings, identify gaps in knowledge and programme services and highlight the way forward to improve clinical outcomes of this vulnerable group. Emerging data from programmes in sub-Saharan Africa highlight that HIV-infected pregnant adolescents have poorer prevention of mother-to-child HIV transmission (PMTCT) service outcomes, including lower PMTCT service uptake, compared to HIV-infected pregnant adults. In addition, the limited evidence available suggests that there may be higher rates of mother-to-child HIV transmission among infants of HIV-infected pregnant adolescents. While the reasons for the inferior outcomes among adolescents in ANC need to be further explored and addressed, there is sufficient evidence that immediate operational changes are needed to address the unique needs of this population. Such changes could include integration of adolescent-friendly services into PMTCT settings or targeting HIV-infected pregnant adolescents with enhanced retention and follow-up activities.

Collaborating with Communities and Higher Education to Address the Health-care Needs of Individuals with Disabilities in Ecuador.

PubMed

Cech, Donna J; Alvarado, Zully J

2017-01-01

Individuals with disabilities experience inequities in access to health care, education, employment, and social inclusion. Causes for Change International (CCI), a non-governmental Organization (NGO), using a community-based rehabilitation approach has worked for 20 years to build self-sufficiency, improve health-care services, and education for women, children, and persons with disabilities in Ecuador. CCI initially addressed health; advocacy for individuals with disabilities; and promoted educational opportunities for children with disabilities, starting in one rural community. CCI's outreach has expanded through Ecuador's coastal provinces, Andean provinces, and Galapagos Islands. CCI also focused on local health-care workforce development, developing employment skills for individuals with disabilities and social inclusion for this population. CCI collaborated with local organizations, government, and universities to provide resources, managed by local leadership. Key program elements of the CCI approach include (1) develop trust between CCI, local communities, local agencies, and government; (2) empower local groups to assume leadership and sustain programs; (3) support communities and groups invested in developing self-sufficiency; and (4) strengthen collaborations and partnerships between local and international organizations, universities, and government agencies. Key lessons learned by CCI are to be supportive of cultural differences; understand that limited financial and material resources may limit the program development; recognize that it is difficult not to foster dependent relationships with communities and appreciate the importance of working with and within the host country's governmental systems. CCI is expanding its service base to other regions of Ecuador and is focusing on development of the Ecuadorian health-care workforce and social inclusion opportunities for individuals with disability. The efforts of a small NGO have helped build

Collaborating with Communities and Higher Education to Address the Health-care Needs of Individuals with Disabilities in Ecuador

PubMed Central

Cech, Donna J.; Alvarado, Zully J.

2017-01-01

Individuals with disabilities experience inequities in access to health care, education, employment, and social inclusion. Causes for Change International (CCI), a non-governmental Organization (NGO), using a community-based rehabilitation approach has worked for 20 years to build self-sufficiency, improve health-care services, and education for women, children, and persons with disabilities in Ecuador. CCI initially addressed health; advocacy for individuals with disabilities; and promoted educational opportunities for children with disabilities, starting in one rural community. CCI’s outreach has expanded through Ecuador’s coastal provinces, Andean provinces, and Galapagos Islands. CCI also focused on local health-care workforce development, developing employment skills for individuals with disabilities and social inclusion for this population. CCI collaborated with local organizations, government, and universities to provide resources, managed by local leadership. Key program elements of the CCI approach include (1) develop trust between CCI, local communities, local agencies, and government; (2) empower local groups to assume leadership and sustain programs; (3) support communities and groups invested in developing self-sufficiency; and (4) strengthen collaborations and partnerships between local and international organizations, universities, and government agencies. Key lessons learned by CCI are to be supportive of cultural differences; understand that limited financial and material resources may limit the program development; recognize that it is difficult not to foster dependent relationships with communities and appreciate the importance of working with and within the host country’s governmental systems. CCI is expanding its service base to other regions of Ecuador and is focusing on development of the Ecuadorian health-care workforce and social inclusion opportunities for individuals with disability. The efforts of a small NGO have helped build

Handbook for Conducting School Climate Improvement Projects.

ERIC Educational Resources Information Center

Howard, Eugene; And Others

This book discusses practical ways to improve a school's climate by increasing both productivity and satisfaction concurrently. Chapter 1, "Defining School Climate," identifies the overarching goals of school climate improvement, the basic human needs that school climate must address, the factors that make up a school's climate and…

Ballistic Testing and Product Quality Surveillance for the Interceptor Body Armor - Vest Components Need Improvement

DTIC Science & Technology

2011-01-03

six contracts. Interceptor Body Armor – Vest Components IBA is a modular body armor system that consists of an OTV, ceramic plates , and components...Armor - Vest Components Need Improvement Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the...Ballistic Testing and Product Quality Surveillance for the Interceptor Body Armor - Vest Components Need Improvement 5a. CONTRACT NUMBER 5b. GRANT

Case Managers' Perspectives On What They Need To Do Their Job

PubMed Central

Eack, Shaun M.; Greeno, Catherine G.; Christian-Michaels, Stephen; Dennis, Amy; Anderson, Carol M.

2013-01-01

Objective To identify the perceived training needs of case managers working on community support teams in a community mental health center serving a semi-rural/suburban area. Methods Semi-structured interviews were conducted with 18 case managers and 3 supervisors to inquire about areas of training need in case management. Interviews were coded and analyzed for common themes regarding training needs and methods of training improvement. Results Identified training needs called for a hands-on, back to basics approach that included education on the symptoms of severe mental illness, co-morbid substance use problems, and methods of engaging consumers. A mentoring model was proposed as a potential vehicle for disseminating knowledge in these domains. Conclusions Case managers identify significant training needs that would address their basic understanding of severe mental illness. Programs targeting these needs may result in improved outcomes for case managers and the individuals with psychiatric disabilities. PMID:19346211

Bureau of Indian Affairs Schools: New Facilities Management Information System Promising, but Improved Data Accuracy Needed.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC.

A General Accounting Office (GAO) study evaluated the Bureau of Indian Affairs' (BIA) new facilities management information system (FMIS). Specifically, the study examined whether the new FMIS addresses the old system's weaknesses and meets BIA's management needs, whether BIA has finished validating the accuracy of data transferred from the old…

What are the needs of adolescents and young adults after a cancer treatment? A Delphi study.

PubMed

Galán, S; de la Vega, R; Tomé Pires, C; Racine, M; Solé, E; Jensen, M P; Miró, J

2017-03-01

Advances in the early detection of cancer and the development of more effective treatments have resulted in a larger number of adolescents and young adults (AYAs), becoming cancer survivors. However, knowledge regarding their needs and if those needs are adequately addressed remains limited. The aims of this study were to: (1) better understand the needs of AYAs after cancer treatment; (2) analyse the importance of those needs; (3) determine which needs are not adequately addressed; and (4) test the hypothesis that AYA cancer survivors have different needs than adult survivors. Twenty-nine health oncology professionals, 17 AYA survivors and 12 relatives of AYA survivors participated in the Delphi study. The needs identified could be classified into six categories, and all were rated as highly important by all participants. The category perceived as least adequately addressed across the three groups was 'Counselling and psychological support.' The findings provide important new information regarding the needs of AYA cancer survivors that can inform the development of interventions to improve the quality of life of these individuals. © 2016 John Wiley & Sons Ltd.

DOD Financial Management: Significant Efforts Still Needed for Remediating Audit Readiness Deficiencies

DTIC Science & Technology

2017-02-01

19As defined in generally accepted government auditing standards, information technology controls...Financial Improvement and Audit Readiness (FIAR) Plan Status Report, while DOD continues to make progress in addressing information technology ...DOD FINANCIAL MANAGEMENT Significant Efforts Still Needed for Remediating Audit Readiness Deficiencies Report to

State of the District Address, 1982.

ERIC Educational Resources Information Center

Koltai, Leslie

This address by the Chancellor of the Los Angeles Community College District (LACCD) discusses recent and long-term changes in the district's programs, educational quality, and financial standing, and suggests means for future improvements. First, the paper highlights the district's achievements in improving transfer education and developing new…

Tailoring Clinical Services to Address the Unique Needs of Adolescents from the Pregnancy Test to Parenthood

PubMed Central

Daley, Alison Moriarty; Sadler, Lois S.; Reynolds, Heather Dawn

2013-01-01

Clinicians across disciplines and practice settings are likely to encounter adolescents who are at risk for a pregnancy. In 2010, 34.2/1000 15–19 year old teens had a live birth in the United States, many more will seek care for a pregnancy scare or options counseling. Teen mothers are also at risk for a second or higher order pregnancy during adolescence. This paper provides clinicians with adolescent-friendly clinical and counseling strategies for pregnancy prevention, pre- and post-pregnancy test counseling, pregnancy-related care, and a review of the developmental challenges encountered by teens in the transition to parenthood. Clinicians are in a better position to approach the developmental, health and mental health needs of adolescents related to pregnancy if they understand and appreciate the obstacles adolescents may face negotiating the health care system. In addition, when clinical services are specially tailored to the needs of the adolescent, fewer opportunities will be lost to prevent unintended pregnancies, assist teens into timely prenatal services, and improve outcomes for their pregnancies and the transition to parenthood. PMID:23522339

Addressing Mental Health Needs in Our Schools: Supporting the Role of School Counselors

ERIC Educational Resources Information Center

Collins, Traci P.

2014-01-01

School counselors are a well-positioned resource to reach the significant number of children and adolescents with mental health problems. In this special school counseling issue of "The Professional Counselor," some articles focus on systemic, top-down advocacy efforts as the point of intervention for addressing child and adolescent…

Meditation acutely improves psychomotor vigilance, and may decrease sleep need

PubMed Central

2010-01-01

Background A number of benefits from meditation have been claimed by those who practice various traditions, but few have been well tested in scientifically controlled studies. Among these claims are improved performance and decreased sleep need. Therefore, in these studies we assess whether meditation leads to an immediate performance improvement on a well validated psychomotor vigilance task (PVT), and second, whether longer bouts of meditation may alter sleep need. Methods The primary study assessed PVT reaction times before and after 40 minute periods of mediation, nap, or a control activity using a within subject cross-over design. This study utilized novice meditators who were current university students (n = 10). Novice meditators completed 40 minutes of meditation, nap, or control activities on six different days (two separate days for each condition), plus one night of total sleep deprivation on a different night, followed by 40 minutes of meditation. A second study examined sleep times in long term experienced meditators (n = 7) vs. non-meditators (n = 23). Experienced meditators and controls were age and sex matched and living in the Delhi region of India at the time of the study. Both groups continued their normal activities while monitoring their sleep and meditation times. Results Novice meditators were tested on the PVT before each activity, 10 minutes after each activity and one hour later. All ten novice meditators improved their PVT reaction times immediately following periods of meditation, and all but one got worse immediately following naps. Sleep deprivation produced a slower baseline reaction time (RT) on the PVT that still improved significantly following a period of meditation. In experiments with long-term experienced meditators, sleep duration was measured using both sleep journals and actigraphy. Sleep duration in these subjects was lower than control non-meditators and general population norms, with no apparent decrements in PVT scores

Shrinking Sea Ice, Thawing Permafrost, Bigger Storms, and Extremely Limited Data - Addressing Information Needs of Stakeholders in Western Alaska Through Participatory Decisions and Collaborative Science.

NASA Astrophysics Data System (ADS)

Murphy, K. A.; Reynolds, J.

2015-12-01

Communities, Tribes, and decision makers in coastal western Alaska are being impacted by declining sea ice, sea level rise, changing storm patterns and intensities, and increased rates of coastal erosion. Relative to their counterparts in the contiguous USA, their ability to plan for and respond to these changes is constrained by the region's generally meager or non-existent information base. Further, the information needs and logistic challenges are of a scale that perhaps can be addressed only through strong, strategic collaboration. Landscape Conservation Cooperatives (LCCs) are fundamentally about applied science and collaboration, especially collaborative decision making. The Western Alaska LCC has established a process of participatory decision making that brings together researchers, agency managers, local experts from Tribes and field specialists to identify and prioritize shared information needs; develop a course of action to address them by using the LCC's limited resources to catalyze engagement, overcome barriers to progress, and build momentum; then ensure products are delivered in a manner that meets decision makers' needs. We briefly review the LCC's activities & outcomes from the stages of (i) collaborative needs assessment (joint with the Alaska Climate Science Center and the Alaska Ocean Observing System), (ii) strategic science activities, and (iii) product refinement and delivery. We discuss lessons learned, in the context of our recent program focused on 'Changes in Coastal Storms and Their Impacts' and current collaborative efforts focused on delivery of Coastal Resiliency planning tools and results from applied science projects. Emphasis is given to the various key interactions between scientists and decision makers / managers that have been promoted by this process to ensure alignment of final products to decision maker needs.

Chemical Weapons Disposal: Improvements Needed in Program Accountability and Financial Management

DTIC Science & Technology

2000-05-01

United States General Accounting Office PAQ Report to Congressional Committees May 2000 CHEMICAL WEAPONS DISPOSAL Improvements Needed in Program...warfare materiel, and former production facilities and identify and locate buried chemical warfare materiel. Alternative Technologies and Approaches...production facilities, and buried chemical warfare materiel. These items are described in table 1. Table 1: Nonstockpile Chemical Materiel Category

Assessing what to address in science communication.

PubMed

Bruine de Bruin, Wändi; Bostrom, Ann

2013-08-20

As members of a democratic society, individuals face complex decisions about whether to support climate change mitigation, vaccinations, genetically modified food, nanotechnology, geoengineering, and so on. To inform people's decisions and public debate, scientific experts at government agencies, nongovernmental organizations, and other organizations aim to provide understandable and scientifically accurate communication materials. Such communications aim to improve people's understanding of the decision-relevant issues, and if needed, promote behavior change. Unfortunately, existing communications sometimes fail when scientific experts lack information about what people need to know to make more informed decisions or what wording people use to describe relevant concepts. We provide an introduction for scientific experts about how to use mental models research with intended audience members to inform their communication efforts. Specifically, we describe how to conduct interviews to characterize people's decision-relevant beliefs or mental models of the topic under consideration, identify gaps and misconceptions in their knowledge, and reveal their preferred wording. We also describe methods for designing follow-up surveys with larger samples to examine the prevalence of beliefs as well as the relationships of beliefs with behaviors. Finally, we discuss how findings from these interviews and surveys can be used to design communications that effectively address gaps and misconceptions in people's mental models in wording that they understand. We present applications to different scientific domains, showing that this approach leads to communications that improve recipients' understanding and ability to make informed decisions.

44 CFR 206.119 - Financial assistance to address other needs.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) established under the National Flood Insurance Program (NFIP) regulations at 44 CFR 61.17. (1) The premium for... this portion of the Other Needs award and provide it to the NFIP on behalf of individuals and... established under section 408 of the Stafford Act. (2) FEMA or the State IHP staff shall provide the NFIP with...

44 CFR 206.119 - Financial assistance to address other needs.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) established under the National Flood Insurance Program (NFIP) regulations at 44 CFR 61.17. (1) The premium for... this portion of the Other Needs award and provide it to the NFIP on behalf of individuals and... established under section 408 of the Stafford Act. (2) FEMA or the State IHP staff shall provide the NFIP with...

44 CFR 206.119 - Financial assistance to address other needs.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) established under the National Flood Insurance Program (NFIP) regulations at 44 CFR 61.17. (1) The premium for... this portion of the Other Needs award and provide it to the NFIP on behalf of individuals and... established under section 408 of the Stafford Act. (2) FEMA or the State IHP staff shall provide the NFIP with...

Helping Social Workers Address the Educational Needs of Foster Children

ERIC Educational Resources Information Center

Zetlin, A.G.; Weinberg, L.A.; Kimm, C.

2005-01-01

Objective:: The main aim was to evaluate the effectiveness of the Education Initiative, an intervention program in one of the largest urban counties in the US seeking to increase the responsiveness of social workers to the educational needs of foster children. Method:: A pre-post test control group design was used. Data from case files and social…

Integrating qualitative research methods into care improvement efforts within a learning health system: addressing antibiotic overuse.

PubMed

Munoz-Plaza, Corrine E; Parry, Carla; Hahn, Erin E; Tang, Tania; Nguyen, Huong Q; Gould, Michael K; Kanter, Michael H; Sharp, Adam L

2016-08-15

Despite reports advocating for integration of research into healthcare delivery, scant literature exists describing how this can be accomplished. Examples highlighting application of qualitative research methods embedded into a healthcare system are particularly needed. This article describes the process and value of embedding qualitative research as the second phase of an explanatory, sequential, mixed methods study to improve antibiotic stewardship for acute sinusitis. Purposive sampling of providers for in-depth interviews improved understanding of unwarranted antibiotic prescribing and elicited stakeholder recommendations for improvement. Qualitative data collection, transcription and constant comparative analyses occurred iteratively. Emerging themes and sub-themes identified primary drivers of unwarranted antibiotic prescribing patterns and recommendations for improving practice. These findings informed the design of a health system intervention to improve antibiotic stewardship for acute sinusitis. Core components of the intervention are also described. Qualitative research can be effectively applied in learning healthcare systems to elucidate quantitative results and inform improvement efforts.

Health and household air pollution from solid fuel use: the need for improved exposure assessment.

PubMed

Clark, Maggie L; Peel, Jennifer L; Balakrishnan, Kalpana; Breysse, Patrick N; Chillrud, Steven N; Naeher, Luke P; Rodes, Charles E; Vette, Alan F; Balbus, John M

2013-10-01

Nearly 3 billion people worldwide rely on solid fuel combustion to meet basic household energy needs. The resulting exposure to air pollution causes an estimated 4.5% of the global burden of disease. Large variability and a lack of resources for research and development have resulted in highly uncertain exposure estimates. We sought to identify research priorities for exposure assessment that will more accurately and precisely define exposure-response relationships of household air pollution necessary to inform future cleaner-burning cookstove dissemination programs. As part of an international workshop in May 2011, an expert group characterized the state of the science and developed recommendations for exposure assessment of household air pollution. The following priority research areas were identified to explain variability and reduce uncertainty of household air pollution exposure measurements: improved characterization of spatial and temporal variability for studies examining both short- and long-term health effects; development and validation of measurement technology and approaches to conduct complex exposure assessments in resource-limited settings with a large range of pollutant concentrations; and development and validation of biomarkers for estimating dose. Addressing these priority research areas, which will inherently require an increased allocation of resources for cookstove research, will lead to better characterization of exposure-response relationships. Although the type and extent of exposure assessment will necessarily depend on the goal and design of the cookstove study, without improved understanding of exposure-response relationships, the level of air pollution reduction necessary to meet the health targets of cookstove interventions will remain uncertain.

Western Region: A Report Identifying and Addressing the Educational Needs

ERIC Educational Resources Information Center

US Department of Education, 2011

2011-01-01

During a four-week period (May 23, 2011-June 21, 2011), the Western Regional Advisory Committee (RAC) held a series of public meetings to solicit input and deliberate on key educational needs facing the four states in the region--Arizona, California, Nevada, and Utah. A two-day, face-to-face, public meeting was held May 23-24, 2011 in Arlington,…

Is food allergen analysis flawed? Health and supply chain risks and a proposed framework to address urgent analytical needs.

PubMed

Walker, M J; Burns, D T; Elliott, C T; Gowland, M H; Mills, E N Clare

2016-01-07

Food allergy is an increasing problem for those affected, their families or carers, the food industry and for regulators. The food supply chain is highly vulnerable to fraud involving food allergens, risking fatalities and severe reputational damage to the food industry. Many facets are being pursued to ameliorate the difficulties including better food labelling and the concept of thresholds of elicitation of allergy symptoms as risk management tools. These efforts depend to a high degree on the ability reliably to detect and quantify food allergens; yet all current analytical approaches exhibit severe deficiencies that jeopardise accurate results being produced particularly in terms of the risks of false positive and false negative reporting. If we fail to realise the promise of current risk assessment and risk management of food allergens through lack of the ability to measure food allergens reproducibly and with traceability to an international unit of measurement, the analytical community will have failed a significant societal challenge. Three distinct but interrelated areas of analytical work are urgently needed to address the substantial gaps identified: (a) a coordinated international programme for the production of properly characterised clinically relevant reference materials and calibrants for food allergen analysis; (b) an international programme to widen the scope of proteomics and genomics bioinformatics for the genera containing the major allergens to address problems in ELISA, MS and DNA methods; (c) the initiation of a coordinated international programme leading to reference methods for allergen proteins that provide results traceable to the SI. This article describes in more detail food allergy, the risks of inapplicable or flawed allergen analyses with examples and a proposed framework, including clinically relevant incurred allergen concentrations, to address the currently unmet and urgently required analytical requirements. Support for the

Addressing Uniqueness and Unison of Reliability and Safety for a Better Integration

NASA Technical Reports Server (NTRS)

Huang, Zhaofeng; Safie, Fayssal

2016-01-01

Over time, it has been observed that Safety and Reliability have not been clearly differentiated, which leads to confusion, inefficiency, and, sometimes, counter-productive practices in executing each of these two disciplines. It is imperative to address this situation to help Reliability and Safety disciplines improve their effectiveness and efficiency. The paper poses an important question to address, "Safety and Reliability - Are they unique or unisonous?" To answer the question, the paper reviewed several most commonly used analyses from each of the disciplines, namely, FMEA, reliability allocation and prediction, reliability design involvement, system safety hazard analysis, Fault Tree Analysis, and Probabilistic Risk Assessment. The paper pointed out uniqueness and unison of Safety and Reliability in their respective roles, requirements, approaches, and tools, and presented some suggestions for enhancing and improving the individual disciplines, as well as promoting the integration of the two. The paper concludes that Safety and Reliability are unique, but compensating each other in many aspects, and need to be integrated. Particularly, the individual roles of Safety and Reliability need to be differentiated, that is, Safety is to ensure and assure the product meets safety requirements, goals, or desires, and Reliability is to ensure and assure maximum achievability of intended design functions. With the integration of Safety and Reliability, personnel can be shared, tools and analyses have to be integrated, and skill sets can be possessed by the same person with the purpose of providing the best value to a product development.

Improving performance management for delivering appropriate care for patients no longer needing acute hospital care.

PubMed

Penney, Christine; Henry, Effie

2008-01-01

The public, providers and policy-makers are interested in a service continuum where care is provided in the appropriate place. Alternate level of care is used to define patients who no longer need acute care but remain in an acute care bed. Our aims were to determine how subacute care and convalescent care should be defined in British Columbia (BC); how these care levels should be aligned with existing legislation to provide more consistent service standards to patients and what reporting requirements were needed for system planning and performance management. A literature review was conducted to understand the international trends in performance management, care delivery models and change management. A Canada-wide survey was carried out to determine the directions of other provinces on the defined issues and a BC survey provided a current state analysis of programming within the five regional health authorities (HAs). A provincial policy framework for subacute and convalescent care has been developed to begin to address the concerns raised and provide a base for performance measurement. The policy has been approved and disseminated to BC HAs for implementation. An implementation plan has been developed and implementation activities have been integrated into the work of existing provincial committees. Evaluation will occur through performance measurement. The benefits anticipated include: clear policy guidance for programme development; improved comparability of performance information for system monitoring, planning and integrity of the national acute care Discharge Abstracting Database; improved efficiency in acute care bed use; and improved equity of access, insurability and quality for patients requiring subacute and convalescent care. While a national reporting system exists for acute care in Canada, this project raises questions about the implications for this system, given the shifting definition of acute care as other care levels emerge. Questions are also

Addressing cancer disparities through community engagement: improving breast health among Haitian women.

PubMed

Meade, Cathy D; Menard, Janelle; Thervil, Claudine; Rivera, Marlene

2009-11-01

To describe processes for fostering community engagement among Haitian women to facilitate breast health education and outreach that are consonant with Haitians' cultural values, literacy, and linguistic skills. Existing breast cancer education and outreach efforts for Haitian immigrant communities were reviewed. Local community partners were the primary source of information and guided efforts to create a series of health-promoting activities. The resultant partnership continues to be linked to a larger communitywide effort to reduce cancer disparities led by the Tampa Bay Community Cancer Network. A systematic framework known as the CLEAN (Culture, Literacy, Education, Assessment, and Networking) Look Checklist guided efforts for improved communications. Community engagement forms the foundation for the development and adaptation of sustainable breast education and outreach. Understanding and considering aspects of Haitian culture are important to the provision of competent and meaningful care. Nurses should expand their skills, knowledge, and competencies to better address the changing demographics of their communities. Nurses also can play a critical role in the development of outreach programs that are relevant to the culture and literacy of Haitian women by forming mutually beneficial partnerships that can decrease health disparities in communities.

What evidence and support do state-level public health practitioners need to address obesity prevention.

PubMed

Leeman, Jennifer; Teal, Randall; Jernigan, Jan; Reed, Jenica Huddleston; Farris, Rosanne; Ammerman, Alice

2014-01-01

Obesity has reached epidemic proportions. Public health practitioners are distinctly positioned to promote the environmental changes essential to addressing obesity. The Centers for Disease Control and Prevention (CDC) and other entities provide evidence and technical assistance to support this work, yet little is known about how practitioners use evidence and support as they intervene to prevent obesity. The study's purpose was to describe how practitioners and CDC project officers characterized the obesity prevention task, where practitioners accessed support and evidence, and what approaches to support and evidence they found most useful. APPROACH OR DESIGN: Mixed-methods, cross-sectional interviews, and survey. State-level public health obesity prevention programs. Public health practitioners and CDC project officers. We conducted 10 in-depth interviews with public health practitioners (n = 7) and project officers (n = 3) followed by an online survey completed by 62 practitioners (50% response rate). We applied content analysis to interview data and descriptive statistics to survey data. Practitioners characterized obesity prevention as uncertain and complex, involving interdependence among actors, multiple levels of activity, an excess of information, and a paucity of evidence. Survey findings provide further detail on the types of evidence and support practitioners used and valued. We recommend approaches to tailoring evidence and support to the needs of practitioners working on obesity prevention and other complex health problems.

A survey of the health needs of hospital staff: implications for health care managers.

PubMed

Jinks, Annette M; Lawson, Valerie; Daniels, Ruth

2003-09-01

Developing strategies to address the health needs of the National Health Services (NHS) workforce are of concern to many health care managers. Focal to the development of such strategies are of being in receipt of baseline information about employees expressed health needs and concerns. This article addresses obtaining such baseline information and presents the findings of a health needs survey of acute hospital staff in a trust in North Wales. The total population of trust employees were surveyed (n = 2300) and a 44% (n = 1021) response rate was achieved. A number of positive findings are given. Included are that the majority of those surveyed stated that their current health status is good, are motivated to improve their health further, do not smoke and their alcohol consumption is within recommended levels. There appears, however, to be a number of areas where trust managers can help its staff improve their health. Included are trust initiatives that focus on weight control and taking more exercise. In addition, there appears to be a reported lack of knowledge and positive health behaviour amongst the male respondents surveyed that would imply the trust needs to be more effective in promoting well man type issues. Finally there appears to be a general lack of pride in working for the trust and a pervasive feeling that the trust does not care about its employees that needs to be addressed. It is concluded that the findings of this survey have implications for management practices in the trust where the survey was conducted and also wider applicability to the management of health care professionals. For example, addressing work-related psychological and physical problems of employees are of importance to all health care managers. This is especially so when considering recruitment and retention issues.

How Can We Improve School Discipline?

ERIC Educational Resources Information Center

Osher, David; Bear, George G.; Sprague, Jeffrey R.; Doyle, Walter

2010-01-01

School discipline addresses schoolwide, classroom, and individual student needs through broad prevention, targeted intervention, and development of self-discipline. Schools often respond to disruptive students with exclusionary and punitive approaches that have limited value. This article surveys three approaches to improving school discipline…

The association of sociodemographic factors and needs of hemodialysis patients according to Maslow's hierarchy of needs.

PubMed

Shih, Chiung-Yu; Huang, Chiu-Ya; Huang, Mei-Lun; Chen, Chyong-Mei; Tang, Fu-In

2018-05-18

To explore the association between the sociodemographic factors and the needs of patients undergoing hemodialysis in Taiwan. Concomitant discomfort, including physical and mental aspects, affects the patients' quality of life and their willingness to undergo hemodialysis. Maslow's hierarchy of needs is a well-known tool to assess different levels of human needs. We conducted a small-scale cross-sectional observational study using a structured needs assessment questionnaire on 159 patients from the Taipei Veterans General Hospital hemodialysis unit. The overall mean scores of physical, mental, spiritual, other needs, and needs in relation to medical staff care were 4.0±0.8, 3.2±0.8, 2.7±1.0, 3.1±0.9, and 4.1±0.7, respectively. The results showed that the patients' highest need was in relation to medical staff care, followed by physical needs. Further analysis showed that patients who are still employed during the treatment process have higher mental, spiritual, and other needs. Patient who are financially supported by their family have higher physical needs. Patients taken cared of by paid caregivers have lower spiritual needs and other needs. This is also the same with patients who are religious as opposed to those who are non-religious. Patients who have attained tertiary education have higher other needs compared to patients who have only achieved up to primary or secondary education. The study is the first in Taiwan to identify and quantify the needs of patients undergoing hemodialysis. When the needs of the patients are identified in relation to their sociodemographic factors, the medical staff can give the appropriate treatment in order to meet the needs and improve the patients' well-being. Healthcare providers should not only focus on the patients' physiological needs, but should determine and address their other needs in various aspects in order to improve the quality and efficacy of the dialysis care process. This article is protected by copyright

Unmet Supportive Care Needs in U.S. Dialysis Centers and Lack of Knowledge of Available Resources to Address Them.

PubMed

Culp, Stacey; Lupu, Dale; Arenella, Cheryl; Armistead, Nancy; Moss, Alvin H

2016-04-01

Because of high symptom burden, numerous comorbidities, and shortened life expectancy, dialysis patients are increasingly recognized as appropriate candidates for early and continuous supportive care. The objectives of this study were to describe dialysis professionals' perceptions of the adequacy of supportive care in dialysis centers, barriers to providing it, suggestions for improving it, and familiarity with the existing evidence-based resources for supportive care of dialysis patients. The Coalition for Supportive Care of Kidney Patients conducted an online survey of dialysis professionals and administrators solicited through the 18 End-Stage Renal Disease Networks and the Renal Physicians Association. Only 4.5% of 487 respondents believed their dialysis centers were presently providing high-quality supportive care. They identified bereavement support, spiritual support, and end-of-life care discussions as the top three unmet needs. They reported that lack of a predictive algorithm for prognosis was the top barrier, and "guidelines to help with decision-making in seriously ill patients" was the top priority to improve supportive care. A majority of respondents were unaware that an evidence-based validated prognostic model and a clinical practice guideline to help with decision-making were already available. Dialysis professionals report significant unmet supportive care needs and barriers in their centers with only a small minority rating themselves as competently providing supportive care. There is an urgent need for education of dialysis professionals about available supportive care resources to provide quality supportive care to dialysis patients. Copyright © 2016. Published by Elsevier Inc.

Characteristics and quality of reporting of cluster randomized trials in children: reporting needs improvement.

PubMed

Walleser, Silke; Hill, Suzanne R; Bero, Lisa A

2011-12-01

To describe the characteristics and quality of reporting of cluster randomized trials (CRTs) in children published from 2004 to 2010. Four databases were searched for reports of CRTs in children (0-18 years). Characteristics of the studies were summarized and the quality of reporting assessed using consolidated standards of reporting trial-CRT (CONSORT-CRT). Of 1,949 identified references, 106 were included. The number of published CRTs in children increased since 2004. The greatest proportion of CRTs was undertaken in Europe (29%), whereas 40% was conducted in low- and middle-income countries. Most studies were of complex rather than simple interventions (83%); were preventive rather than treatment interventions (76%); and most frequently addressed infectious disease (21%), diet/physical activity interventions (19%), health-risk behaviors (15%), and undernutrition (13%). The majority used schools as units of randomization (72%) and enrolled 1,000-10,000 children per study (51%). Reporting was generally poor, with 34% of CRTs inadequately reporting on more than half of the CONSORT-CRT criteria. Although 85% of CRTs reported that they had ethics approval for the study, consent or assent was not obtained from children in most studies. Children-specific elements of reporting are needed to improve the quality of reporting of CRTs and consequently their planning and implementation. Copyright © 2011 Elsevier Inc. All rights reserved.

Coast Guard: Continued Improvements Needed to Address Potential Barriers to Equal Employment Opportunity

DTIC Science & Technology

2011-12-01

antidiscrimination statutes and EEOC regulations and directives, USCG’s policy provides that military equal opportunity policies are generally based upon...Legal Compliance. Agency head or designee is to certify to the EEOC that the agency is in full compliance with EEO laws, regulations , policy...followed EEO instructions regarding EEOC orders, regulations , and directives. For example, EEOC credited USCG for posting Notification and Federal

DOD Financial Management: Significant Improvements Needed in Efforts to Address Improper Payment Requirements

DTIC Science & Technology

2013-05-01

Agenda RAA Recovery Auditing Act SBR Statement of Budgetary Resources TMA TRICARE Management Activity USACE United States Army Corps of Engineers...Defense Authorization Act for Fiscal Year 2002 included the provisions commonly referred to as the Recovery Auditing Act ( RAA ).12...Administration, and Social Security Administration. The RAA required, among other things, that all executive branch agencies entering into contracts

DOD Business Systems Modernization: Further Actions Needed to Address Challenges and Improve Accountability

DTIC Science & Technology

2013-05-01

to Lack Adequate Validation Page 35 GAO-13-557 DOD Business Systems Modernization provided a compliance dashboard to document BEA...campaigns, execute marketing campaigns, and measure and evaluate the performance of marketing campaigns. Order-to- Cash Accept and process customer... dashboards reflected related GAO reports. In addition, the department’s fiscal year 2014 investment management guidance issued by the Office of the

The Magnitude of a Community's Health Needs and Nonprofit Hospitals' Progress in Meeting Those Needs: Are We Faced With a Paradox?

PubMed

Singh, Simone R; Cramer, Geri R; Young, Gary J

Although most nonprofit hospitals are required to conduct periodic community health needs assessments (CHNAs), such assessments arguably are most critical for communities with substantial health needs. The objective of this study was to describe differences in progress in conducting CHNAs between hospitals located in communities with the greatest compared with the fewest health needs. We used data on CHNA activity from the 2013 tax filings of 1331 US hospitals combined with data on community health needs from the County Health Rankings. We used bivariate and multivariate analyses to examine differences in hospitals' progress in implementing comprehensive CHNAs using 4 activities: (1) strategies to address identified needs, (2) participation in developing community-wide plans, (3) including CHNA into a hospital's operational plan, and (4) developing a budget to address identified needs. We compared progress in communities with the greatest and the fewest health needs using a comprehensive indicator comprising a community's socioeconomic factors, health behaviors, access to medical care, and physical environment. In 2013, nonprofit hospitals serving communities with the greatest health needs conducted an average of 2.5 of the 4 CHNA activities, whereas hospitals serving communities with the fewest health needs conducted an average of 2.7 activities. Multivariate analysis, however, showed a negative but not significant relationship between the magnitude of a community's health needs and a hospital's progress in implementing comprehensive CHNAs. Hospitals serving communities with the greatest health needs face high demand for free and reduced-cost care, which may limit their ability to invest more of their community benefit dollars in initiatives aimed at improving the health of the community.

Addressing religion and spirituality in the intensive care unit: A survey of clinicians.

PubMed

Choi, Philip J; Curlin, Farr A; Cox, Christopher E

2018-04-30

Studies have shown that when religious and spiritual concerns are addressed by the medical team, patients are more satisfied with their care and have lower healthcare costs. However, little is known about how intensive care unit (ICU) clinicians address these concerns. The objective of this study was to determine how ICU clinicians address the religious and spiritual needs of patients and families. We performed a cross-sectional survey study of ICU physicians, nurses, and advance practice providers (APPs) to understand their attitudes and beliefs about addressing the religious and spiritual needs of ICU patients and families. Each question was designed on a 4- to 5-point Likert scale. A total of 219 surveys were collected over a 4-month period.ResultA majority of clinicians agreed that it is their responsibility to address the religious/spiritual needs of patients. A total of 79% of attendings, 74% of fellows, 89% of nurses, and 83% of APPs agreed with this statement. ICU clinicians also feel comfortable talking to patients about their religious/spiritual concerns. In practice, few clinicians frequently address religious/spiritual concerns. Only 14% of attendings, 3% of fellows, 26% of nurses, and 17% of APPs say they frequently ask patients about their religious/spiritual needs.Significance of resultsThis study shows that ICU clinicians see it as their role to address the religious and spiritual needs of their patients, and report feeling comfortable talking about these issues. Despite this, a minority of clinicians regularly address religious and spiritual needs in clinical practice. This highlights a potential deficit in comprehensive critical care as outlined by many national guidelines.

Development and Face Validation of Strategies for Improving Consultation Skills

ERIC Educational Resources Information Center

Lefroy, Janet; Thomas, Adam; Harrison, Chris; Williams, Stephen; O'Mahony, Fidelma; Gay, Simon; Kinston, Ruth; McKinley, R. K.

2014-01-01

While formative workplace based assessment can improve learners' skills, it often does not because the procedures used do not facilitate feedback which is sufficiently specific to scaffold improvement. Provision of pre-formulated strategies to address predicted learning needs has potential to improve the quality and automate the provision of…

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.

Addressing the leadership gap in medicine: residents' need for systematic leadership development training.

PubMed

Blumenthal, Daniel M; Bernard, Ken; Bohnen, Jordan; Bohmer, Richard

2012-04-01

All clinicians take on leadership responsibilities when delivering care. Evidence suggests that effective clinical leadership yields superior clinical outcomes. However, few residency programs systematically teach all residents how to lead, and many clinicians are inadequately prepared to meet their day-to-day clinical leadership responsibilities. The purpose of this article is twofold: first, to make the case for the need to refocus residency education around the development of outstanding "frontline" clinical leaders and, second, to provide an evidence-based framework for designing formal leadership development programs for residents. The authors first present a definition of clinical leadership and highlight evidence that effective frontline clinical leadership improves both clinical outcomes and satisfaction for patients and providers. The authors then discuss the health care "leadership gap" and describe barriers to implementing leadership development training in health care. Next, they present evidence that leaders are not just "born" but, rather, can be "made," and offer a set of best practices to facilitate the design of leadership development programs. Finally, the authors suggest approaches to mitigating barriers to implementing leadership development programs and highlight the major reasons why health care delivery organizations, residency programs, and national accreditation bodies must make comprehensive leadership education an explicit goal of residency training.

Children and Their Basic Needs.

ERIC Educational Resources Information Center

Prince, Debra Lindsey; Howard, Esther M.

2002-01-01

Describes obstacles presented by poverty in the fulfillment of the basic needs of children. Individually addresses Maslow's five basic needs with regard to children reared in poverty: (1) physiological needs; (2) safety needs; (3) belonging and love needs; (4) self-esteem needs; and (5) self-actualization needs. (Author/SD)

Social and custodial needs of older adults in prison.

PubMed

Hayes, Adrian J; Burns, Alistair; Turnbull, Pauline; Shaw, Jenny J

2013-09-01

older prisoners are a fast-growing group but there is limited evidence for how well their needs are being met. to quantify the social and custodial needs of older prisoners and suggest improvements for service provision. cross-sectional study. twelve prisons holding adult males in North West England. two hundred and sixty-two prisoners; 97 aged between 50 and 59, 165 aged 60 and over. interview and case-note review for issues of social and custodial need and quality of life in prison, including Forensic Camberwell Assessment of Need and Lubben Scale for social networks. many had problems mixing with younger prisoners, accommodation and activities, and limited contact with friends and family. A small group had personal care needs which were not well managed in prison. older prisoners have distinct social and custodial needs which need to be addressed by a national strategy for their care and management.

Optimizing the Office Visit for Adolescents with Special Health Care Needs.

PubMed

Nathawad, Rita; Hanks, Christopher

2017-08-01

Youth with special health care needs (YSHCN) experience health care disparities and often need additional support to receive optimal medical care, particularly in adolescence as they prepare to transition to adult care. Many medical practices struggle to address their needs. Here, we discuss approaches to improve medical care in office-based settings for YSHCN. Office visits can be optimized by training staff in developmentally appropriate care and ensuring that the physical office space facilitates care. Participating in previsit preparation, including managing patient registries of YSHCN, engaging in regular team huddles, and incorporating previsit planning, can improve preparation and ensure that important needs are not overlooked. Additionally, approaches to improve patient and medical provider comfort with office visits with YSHCN, including approaches to measuring vital signs, examining patients, and communicating with patients with various disabilities, are reviewed. Finally, we discuss methods of supporting adolescents with special health care needs in developing self-management skills that will allow them to be better prepared to enter adult health care settings when appropriate. Although YSHCN can present challenges to medical teams, their care can be improved by developing office-based changes and processes to support improved care for these patients. This may help overcome the health care disparities they experience and increase comfort for all members of the medical team. Copyright © 2017. Published by Elsevier Inc.

Integrating unmet needs into dementia health-related quality of life research and care: Introduction of the Hierarchy Model of Needs in Dementia.

PubMed

Scholzel-Dorenbos, Carla J M; Meeuwsen, Els J; Olde Rikkert, Marcel G M

2010-01-01

To make an inventory of needs assessment instruments in dementia, to explore the interaction between unmet needs and health-related quality of life (HRQoL) and to relate these to the conceptual model of Maslow's Hierarchy of needs in order to design a dementia-specific model. Narrative review of literature on (measures of) needs of patients and caregivers and HRQoL determinants important in dementia. Relating these needs to individual goal setting instruments and Maslow's Hierarchy of needs model. The Camberwell Assessment of Needs for the Elderly (CANE) turns out to be a valid tool to assess needs of dementia patients, suitable for research and clinical use. The Carers' Needs Assessment for Dementia (CNA-D) is a valid instrument to assess needs of caregivers. Patients identified significantly fewer needs than (in)formal caregivers. The most important needs, that also determine large part of HRQoL, are need for information; support with regard to symptoms of dementia; social contact and company; and for health monitoring and safety. Goal attainment scaling in dementia is an important but not yet valid outcome measure, with only few data on feasibility in dementia patients. There are several instruments to assess needs of dementia patients and caregivers. Domains of unmet needs and HRQoL overlap. The Hierarchy Model of Needs in Dementia (HMND) offers a new theoretical framework to address the interplay between meeting of needs and improvement of HRQoL in dementia. By identifying unmet needs in dementia-research and focussing on unmet needs in dementia-care, much can be done to improve HRQoL.

Social Entrepreneurship in Religious Congregations’ Efforts to Address Health Needs

PubMed Central

Werber, Laura; Mendel, Peter J.; Derose, Kathryn Pitkin

2013-01-01

Purpose Examine how religious congregations engage in social entrepreneurship as they strive to meet health-related needs in their communities. Design Multiple case studies. Setting Los Angeles County, California. Participants Purposive sample of 14 congregations representing diverse races-ethnicities (African American, Latino, and white) and faith traditions (Jewish and various Christian). Method Congregations were recruited based on screening data and consultation of a community advisory board. In each congregation, researchers conducted interviews with clergy and lay leaders (n=57); administered a congregational questionnaire; observed health activities, worship services, and neighborhood context; and reviewed archival information. Interviews were analyzed using a qualitative, code-based approach. Results Congregations’ health-related activities tended to be episodic, small in scale, and local in scope. Trust and social capital played important roles in congregations’ health initiatives, providing a safe, confidential environment and leveraging resources from – and for – faith-based and secular organizations in their community networks. Congregations also served as “incubators” for members to engage in social entrepreneurship. Conclusion Although the small scale of congregations’ health initiatives suggest they may not have the capacity to provide the main infrastructure for service provision, congregations can complement the efforts of health and social providers with their unique strengths. Specifically, congregations are distinctive in their ability to identify unmet local needs, and congregations’ position in their communities permit them to network in productive ways. PMID:23875986

Social entrepreneurship in religious congregations' efforts to address health needs.

PubMed

Werber, Laura; Mendel, Peter J; Derose, Kathryn Pitkin

2014-01-01

Examine how religious congregations engage in social entrepreneurship as they strive to meet health-related needs in their communities. Multiple case studies. Los Angeles County, California. Purposive sample of 14 congregations representing diverse races/ethnicities (African-American, Latino, and white) and faith traditions (Jewish and various Christian). Congregations were recruited based on screening data and consultation of a community advisory board. In each congregation, researchers conducted interviews with clergy and lay leaders (n = 57); administered a congregational questionnaire; observed health activities, worship services, and neighborhood context; and reviewed archival information. Interviews were analyzed by using a qualitative, code-based approach. Congregations' health-related activities tended to be episodic, small in scale, and local in scope. Trust and social capital played important roles in congregations' health initiatives, providing a safe, confidential environment and leveraging resources from-and for-faith-based and secular organizations in their community networks. Congregations also served as "incubators" for members to engage in social entrepreneurship. Although the small scale of congregations' health initiatives suggest they may not have the capacity to provide the main infrastructure for service provision, congregations can complement the efforts of health and social providers with their unique strengths. Specifically, congregations are distinctive in their ability to identify unmet local needs, and congregations' position in their communities permit them to network in productive ways.

Information adaptive system of NEEDS. [of NASA End to End Data System

NASA Technical Reports Server (NTRS)

Howle, W. M., Jr.; Kelly, W. L.

1979-01-01

The NASA End-to-End Data System (NEEDS) program was initiated by NASA to improve significantly the state of the art in acquisition, processing, and distribution of space-acquired data for the mid-1980s and beyond. The information adaptive system (IAS) is a program element under NEEDS Phase II which addresses sensor specific processing on board the spacecraft. The IAS program is a logical first step toward smart sensors, and IAS developments - particularly the system components and key technology improvements - are applicable to future smart efforts. The paper describes the design goals and functional elements of the IAS. In addition, the schedule for IAS development and demonstration is discussed.

Every Other Day. Keynote Address.

ERIC Educational Resources Information Center

Tiller, Tom

Schools need to be reoriented and restructured so that what is taught and learned, and the way in which it is taught and learned, are better integrated with young people's real-world experiences. Many indicators suggest that the meaningful aspects of school have been lost in the encounter with modern times. The title of this address--"Every…

Surgical education to improve the quality of patient care: the role of practice-based learning and improvement.

PubMed

Sachdeva, Ajit K

2007-11-01

Health care is going through immense change, and concerns regarding the quality of patient care and patient safety continue to be expressed in many national forums. A variety of stakeholders are demanding greater accountability from the health care profession. Education is key to supporting surgeons' efforts to provide high-quality patient care during these challenging times. Educational programs for surgeons should be founded on principles of continuous professional development (CPD) and practice-based learning and improvement (PBLI). CPD focuses on the specific needs of individual surgeons and involves lifelong learning throughout a surgeon's career. It needs to form the basis of PBLI efforts. PBLI involves a cycle of four steps--identifying areas for improvement, engaging in learning, applying new knowledge and skills to practice, and checking for improvement. Ongoing involvement in PBLI activities to address specific learning needs should positively impact a surgeon's practice and improve outcomes of surgical care.

The Need for Systematic Reviews of Reasons

PubMed Central

Sofaer, Neema; Strech, Daniel

2012-01-01

There are many ethical decisions in the practice of health research and care, and in the creation of policy and guidelines. We argue that those charged with making such decisions need a new genre of review. The new genre is an application of the systematic review, which was developed over decades to inform medical decision-makers about what the totality of studies that investigate links between smoking and cancer, for example, implies about whether smoking causes cancer. We argue that there is a need for similarly inclusive and rigorous reviews of reason-based bioethics, which uses reasoning to address ethical questions. After presenting a brief history of the systematic review, we reject the only existing model for writing a systematic review of reason-based bioethics, which holds that such a review should address an ethical question. We argue that such a systematic review may mislead decision-makers when a literature is incomplete, or when there are mutually incompatible but individually reasonable answers to the ethical question. Furthermore, such a review can be written without identifying all the reasons given when the ethical questions are discussed, their alleged implications for the ethical question, and the attitudes taken to the reasons. The reviews we propose address instead the empirical question of which reasons have been given when addressing a specified ethical question, and present such detailed information on the reasons. We argue that this information is likely to improve decision-making, both directly and indirectly, and also the academic literature. We explain the limitations of our alternative model for systematic reviews. PMID:21521251

National Institute of Justice (NIJ): improving the effectiveness of law enforcement via homeland security technology improvements (Keynote Address)

NASA Astrophysics Data System (ADS)

Morgan, John S.

2005-05-01

Law enforcement agencies play a key role in protecting the nation from and responding to terrorist attacks. Preventing terrorism and promoting the nation"s security is the Department of Justice"s number one strategic priority. This is reflected in its technology development efforts, as well as its operational focus. The National Institute of Justice (NIJ) is the national focal point for the research, development, test and evaluation of technology for law enforcement. In addition to its responsibilities in supporting day-to-day criminal justice needs in areas such as less lethal weapons and forensic science, NIJ also provides critical support for counter-terrorism capacity improvements in state and local law enforcement in several areas. The most important of these areas are bomb response, concealed weapons detection, communications and information technology, which together offer the greatest potential benefit with respect to improving the ability to law enforcement agencies to respond to all types of crime including terrorist acts. NIJ coordinates its activities with several other key federal partners, including the Department of Homeland Security"s Science and Technology Directorate, the Technical Support Working Group, and the Department of Defense.

On Adopting Solutions to Improve Population Health: Do We Have the Political Will?

ERIC Educational Resources Information Center

Galea, Sandro

2016-01-01

In this column, Sandro Galea addresses what would be required to identify and implement solutions that can improve the health of populations. Galea suggests that two perspectives need to inform solutions that might prove successful. First, solutions that aim to improve the health of populations need to be grounded in clarity of purpose, aiming to…

Research needs for an improved primary care response to chronic non-communicable diseases in Africa.

PubMed

Maher, D; Sekajugo, J; Harries, A D; Grosskurth, H

2010-02-01

With non-communicable diseases (NCDs) projected to become leading causes of morbidity and mortality in developing countries, research is needed to improve the primary care response, especially in sub-Saharan Africa. This region has a particularly high double burden of communicable diseases and NCDs and the least resources for an effective response. There is a lack of good quality epidemiological data from diverse settings on chronic NCD burden in sub-Saharan Africa, and the approach to primary care of people with chronic NCDs is currently often unstructured. The main primary care research needs are therefore firstly, epidemiological research to document the burden of chronic NCDs, and secondly, health system research to deliver the structured, programmatic, public health approach that has been proposed for the primary care of people with chronic NCDs. Documentation of the burden and trends of chronic NCDs and associated risk factors in different settings and different population groups is needed to enable health system planning for an improved primary care response. Key research issues in implementing the programmatic framework for an improved primary care response are how to (i) integrate screening and prevention within health delivery; (ii) validate the use of standard diagnostic protocols for NCD case-finding among patients presenting to the local health facilities; (iii) improve the procurement and provision of standardised treatment and (iv) develop and implement a data collection system for standardised monitoring and evaluation of patient outcomes. Important research considerations include the following: selection of research sites and the particular NCDs targeted; research methodology; local research capacity; research collaborations; ethical issues; translating research findings into policy and practice and funding. Meeting the research needs for an improved health system response is crucial to deliver effective, affordable and equitable care for the

A review on effectiveness of best management practices in improving hydrology and water quality: Needs and opportunities.

PubMed

Liu, Yaoze; Engel, Bernard A; Flanagan, Dennis C; Gitau, Margaret W; McMillan, Sara K; Chaubey, Indrajeet

2017-12-01

Best management practices (BMPs) have been widely used to address hydrology and water quality issues in both agricultural and urban areas. Increasing numbers of BMPs have been studied in research projects and implemented in watershed management projects, but a gap remains in quantifying their effectiveness through time. In this paper, we review the current knowledge about BMP efficiencies, which indicates that most empirical studies have focused on short-term efficiencies, while few have explored long-term efficiencies. Most simulation efforts that consider BMPs assume constant performance irrespective of ages of the practices, generally based on anticipated maintenance activities or the expected performance over the life of the BMP(s). However, efficiencies of BMPs likely change over time irrespective of maintenance due to factors such as degradation of structures and accumulation of pollutants. Generally, the impacts of BMPs implemented in water quality protection programs at watershed levels have not been as rapid or large as expected, possibly due to overly high expectations for practice long-term efficiency, with BMPs even being sources of pollutants under some conditions and during some time periods. The review of available datasets reveals that current data are limited regarding both short-term and long-term BMP efficiency. Based on this review, this paper provides suggestions regarding needs and opportunities. Existing practice efficiency data need to be compiled. New data on BMP efficiencies that consider important factors, such as maintenance activities, also need to be collected. Then, the existing and new data need to be analyzed. Further research is needed to create a framework, as well as modeling approaches built on the framework, to simulate changes in BMP efficiencies with time. The research community needs to work together in addressing these needs and opportunities, which will assist decision makers in formulating better decisions regarding BMP

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

Addressing Inequities in Urban Health: Do Decision-Makers Have the Data They Need? Report from the Urban Health Data Special Session at International Conference on Urban Health Dhaka 2015.

PubMed

Elsey, H; Thomson, D R; Lin, R Y; Maharjan, U; Agarwal, S; Newell, J

2016-06-01

Rapid and uncontrolled urbanisation across low and middle-income countries is leading to ever expanding numbers of urban poor, defined here as slum dwellers and the homeless. It is estimated that 828 million people are currently living in slum conditions. If governments, donors and NGOs are to respond to these growing inequities they need data that adequately represents the needs of the urban poorest as well as others across the socio-economic spectrum.We report on the findings of a special session held at the International Conference on Urban Health, Dhaka 2015. We present an overview of the need for data on urban health for planning and allocating resources to address urban inequities. Such data needs to provide information on differences between urban and rural areas nationally, between and within urban communities. We discuss the limitations of data most commonly available to national and municipality level government, donor and NGO staff. In particular we assess, with reference to the WHO's Urban HEART tool, the challenges in the design of household surveys in understanding urban health inequities.We then present two novel approaches aimed at improving the information on the health of the urban poorest. The first uses gridded population sampling techniques within the design and implementation of household surveys and the second adapts Urban HEART into a participatory approach which enables slum residents to assess indicators whilst simultaneously planning the response. We argue that if progress is to be made towards inclusive, safe, resilient and sustainable cities, as articulated in Sustainable Development Goal 11, then understanding urban health inequities is a vital pre-requisite to an effective response by governments, donors, NGOs and communities.

The Role Of Nonprofit Hospitals In Identifying And Addressing Health Inequities In Cities.

PubMed

Carroll-Scott, Amy; Henson, Rosie Mae; Kolker, Jennifer; Purtle, Jonathan

2017-06-01

For nonprofit hospitals to maintain their tax-exempt status, the Affordable Care Act requires them to conduct a community health needs assessment, in which they evaluate the health needs of the community they serve, and to create an implementation strategy, in which they propose ways to address these needs. We explored the extent to which nonprofit urban hospitals identified equity among the health needs of their communities and proposed health equity strategies to address this need. We conducted a content analysis of publicly available community health needs assessments and implementation strategies from 179 hospitals in twenty-eight US cities in the period August-December 2016. All of the needs assessments included at least one implicit health equity term (such as disparities , disadvantage , poor , or minorities ), while 65 percent included at least one explicit health equity term ( equity , health equity , inequity , or health inequity ). Thirty-five percent of implementation strategies included one or more explicit health equity terms, but only 9 percent included an explicit activity to promote health equity. While needs assessment reporting requirements have the potential to encourage urban nonprofit hospitals to address health inequities in their communities, hospitals need incentives and additional capacity to invest in strategies that address the underlying structural social and economic conditions that cause health inequities. Project HOPE—The People-to-People Health Foundation, Inc.

A nursing response to the needs of the elderly.

PubMed

Koff, S Z; Koff, H V

1997-01-01

The aging phenomenon, a mark of contemporary society, has underscored the need to maintain and improve the health status of the elderly as well as their quality of life and to prevent their institutionalization. In a response to this need, the Foundation of the New York State Nurses Association has designed a unique and comprehensive health promotion program based on the cooperative efforts of volunteer nurses and consumers which is addressed to the well and frail elderly living in the community. This article discusses the various facets of the initial establishment of the process. More specifically, it focuses on the needs of the target population, the structure of the program, its curriculum, an evaluation comparing this effort with others, and the advantages accruing to the nursing profession.

Design and Implementation of High Performance Content-Addressable Memories.

DTIC Science & Technology

1985-12-01

content addressability and two basic implementations of content addressing. The need and application of hardware CAM is presented to motivate the " topic...3r Pass 4th Ps4 Pass Figure 2.15 Maximum SearchUsing All-Parallel CAM - left-most position (the most significant bit) and the other IF bits are zeros

Visitor or Inhabitant? Addressing the Needs of Undergraduate Transnational Medical Students

ERIC Educational Resources Information Center

Lindley, Jennifer; McCall, Louise; Abu-Arab, Adela

2013-01-01

This study was conducted to identify key issues for students in an undergraduate medical course with cross border delivery and the impact of these issues on the students' ability to learn. Data relating to the student experience and perceived student needs were collected from transnational students and teaching staff from Australia and Malaysia.…

Addressing Needs of Rural Health Care Providers via Distance Learning. Draft.

ERIC Educational Resources Information Center

Adeyemi, Gloria; And Others

This document describes a distance learning program designed to meet the needs of rural health care providers. The program allows students to complete an Associate of Applied Science (AS) in the Meramec Physical Therapist Assistant (PTA) program through St. Louis Community College (SLCC). The first section of the document provides a draft of the…

Addressing Student Debt in the Classroom

ERIC Educational Resources Information Center

Perkins, David; Johnston, Tim; Lytle, Rick

2016-01-01

Student debt is a national concern. The authors address debt in the classroom to enhance students' understanding of the consequences of debt and the need for caution when financing their education. However, student feedback indicates this understanding has a delayed effect on borrowing behavior and underscores the importance of making difficult…

Reading Comprehension Deficits in Adolescents: Addressing Underlying Language Abilities.

PubMed

Nippold, Marilyn A

2017-04-20

The purpose of this article is to discuss reading comprehension deficits in adolescents in relation to their word reading skills and lexical and syntactic development. Although reading comprehension strategies (e.g., "Find the main idea") are often recommended, it is argued that before these can be effective, students' underlying language deficits should be addressed. Data from a longitudinal study are analyzed to determine the relationship between reading comprehension, word reading, and lexical and syntactic development in adolescents. The findings indicate that poor reading comprehension in adolescents is predicted by concurrent deficits in word reading ability, lexical development, and syntactic development. When poor comprehension is accompanied by deficits in word reading ability and/or lexical and syntactic development, intervention should target the underlying areas of deficiency. Studies designed to improve reading comprehension in adolescents are needed.

Addressing Social Determinants of Health in a Clinic Setting: The WellRx Pilot in Albuquerque, New Mexico.

PubMed

Page-Reeves, Janet; Kaufman, Will; Bleecker, Molly; Norris, Jeffrey; McCalmont, Kate; Ianakieva, Veneta; Ianakieva, Dessislava; Kaufman, Arthur

2016-01-01

Although it is known that the social determinants of health have a larger influence on health outcomes than health care, there currently is no structured way for primary care providers to identify and address nonmedical social needs experienced by patients seen in a clinic setting. We developed and piloted WellRx, an 11-question instrument used to screen 3048 patients for social determinants in 3 family medicine clinics over a 90-day period. Results showed that 46% of patients screened positive for at least 1 area of social need, and 63% of those had multiple needs. Most of these needs were previously unknown to the clinicians. Medical assistants and community health workers then offered to connect patients with appropriate services and resources to address the identified needs. The WellRx pilot demonstrated that it is feasible for a clinic to implement such an assessment system, that the assessment can reveal important information, and that having information about patients' social needs improves provider ease of practice. Demonstrated feasibility and favorable outcomes led to institutionalization of the WellRx process at a university teaching hospital and influenced the state department of health to require managed care organizations to have community health workers available to care for Medicaid patients. © Copyright 2016 by the American Board of Family Medicine.

Climate Change and Water Working Group - User Needs to Manage Hydrclimatic Risk from Days to Decades

NASA Astrophysics Data System (ADS)

Raff, D. A.; Brekke, L. D.; Werner, K.; Wood, A.; White, K. D.

2012-12-01

The Federal Climate Change Water Working Group (CCAWWG) provides engineering and scientific collaborations in support of water management. CCAWWG objectives include building working relationships across federal science and water management agencies, provide a forum to share expertise and leverage resources, develop education and training forums, to work with water managers to understand scientific needs and to foster collaborative efforts across the Federal and non-Federal water management and science communities to address those needs. Identifying and addressing water management needs has been categorized across two major time scales: days to a decade and multi-decadal, respectively. These two time periods are termed "Short-Term" and "Long-Term" in terms of the types of water management decisions they support where Short-Term roughly correlates to water management operations and Long-Term roughly correlates to planning activities. This presentation will focus on portraying the identified water management user needs across these two time periods. User Needs for Long-Term planning were identified in the 2011 Reclamation and USACE "Addressing Climate Change in Long-Term Water Resources Planning and Management: User Needs for Improving Tools and Information." User needs for Long-Term planning are identified across eight major categories: Summarize Relevant Literature, Obtain Climate Change Information, Make Decisions About How to Use the Climate Change Information, Assess Natural Systems Response, Assess Socioeconomic and Institutional Response, Assess System Risks and Evaluate Alternatives, Assess and Characterize Uncertainties, and Communicating Results and Uncertainties to Decisionmakers. User Needs for Short-Term operations are focused on needs relative to available or desired monitoring and forecast products from the hydroclimatic community. These needs are presenting in the 2012 USACE, Reclamation, and NOAA - NWS "Short-Term Water Management Decisions: User

Addressing the needs of first-time fathers in Tasmania: A qualitative study of father-only antenatal groups.

PubMed

Nash, Meredith

2018-04-01

To examine how first-time fathers in rural Tasmania experienced father-only antenatal support/education groups. Semistructured interviews with expectant fathers were used for this study. Purposive sampling was used to recruit fathers in 2014. Participants were recruited face-to-face via email through a government health service and not-for-profit organisation that runs a state-wide fatherhood program. Several participants were recruited through a company that holds antenatal education classes for men in a pub. Data were analysed thematically. Three rural Tasmanian areas (South, Central Coast and Northern Midlands) PARTICIPANTS: Twenty-five men from three rural areas of Tasmania, ≥18 years, about to become first-time father with partner at least 20 weeks pregnant. Semistructured interviews explored men's experiences of father-only antenatal education groups. Four themes emerged from the thematic analysis: (i) motivations for attending antenatal groups; (ii) the effect of the group setting on men's experiences; (iii) masculine stereotypes in antenatal groups; and (iv) strategies to support fathers. Data show men wanted to join the groups and learn about being an involved father. They often felt uncomfortable sharing experiences in discussion-based groups. They tended to prefer information-based groups which were not premised on sharing emotions. Men offered strategies to improve father-only antenatal education groups. Tasmanian antenatal education/support programs need improvement. Providing men with multiple opportunities to connect with other fathers is critical to improving support. Groups can be improved by accounting for multiple and complex constructions of masculinity, increasing the number of sessions offered and altering the structure. © 2017 National Rural Health Alliance Inc.

Addressing Obesity in the Workplace: The Role of Employers

PubMed Central

Heinen, Luann; Darling, Helen

2009-01-01

Context: Employers have pursued many strategies over the years to control health care costs and improve care. Disappointed by efforts to manage costs through the use of insurance-related techniques (e.g., prior authorization, restricted provider networks), employers have also begun to try to manage health by addressing their employees' key lifestyle risks. Reducing obesity (along with tobacco use and inactivity) is a priority for employers seeking to lower the incidence and severity of chronic illness and the associated demand for health services. Methods: This article describes the employer's perspective on the cost impact of obesity, discusses current practices in employer-sponsored wellness and weight management programs, provides examples from U.S. companies illustrating key points of employers' leverage and opportunities, and suggests policy directions to support the expansion of employers' initiatives, especially for smaller employers. Findings: Researchers and policymakers often overlook the extensive efforts and considerable impact of employer-sponsored wellness and health improvement programs. Greater focus on opportunities in the workplace is merited, however, for the evidence base supporting the economic and health impacts of employer-sponsored health promotion and wellness is growing, although not as quickly as the experience base of large employers. Conclusions: Public and private employers can serve their own economic interests by addressing obesity. Health care organizations, particularly hospitals, as well as public employers can be important role models. Policy development is needed to accelerate change, especially for smaller employers (those with fewer than 500 employees), which represent the majority of U.S. employers and are far less likely to offer health promotion programs. PMID:19298417

Addressing obesity in the workplace: the role of employers.

PubMed

Heinen, LuAnn; Darling, Helen

2009-03-01

Employers have pursued many strategies over the years to control health care costs and improve care. Disappointed by efforts to manage costs through the use of insurance-related techniques (e.g., prior authorization, restricted provider networks), employers have also begun to try to manage health by addressing their employees' key lifestyle risks. Reducing obesity (along with tobacco use and inactivity) is a priority for employers seeking to lower the incidence and severity of chronic illness and the associated demand for health services. This article describes the employer's perspective on the cost impact of obesity, discusses current practices in employer-sponsored wellness and weight management programs, provides examples from U.S. companies illustrating key points of employers' leverage and opportunities, and suggests policy directions to support the expansion of employers' initiatives, especially for smaller employers. Researchers and policymakers often overlook the extensive efforts and considerable impact of employer-sponsored wellness and health improvement programs. Greater focus on opportunities in the workplace is merited, however, for the evidence base supporting the economic and health impacts of employer-sponsored health promotion and wellness is growing, although not as quickly as the experience base of large employers. Public and private employers can serve their own economic interests by addressing obesity. Health care organizations, particularly hospitals, as well as public employers can be important role models. Policy development is needed to accelerate change, especially for smaller employers (those with fewer than 500 employees), which represent the majority of U.S. employers and are far less likely to offer health promotion programs.

Building Capacity of Occupational Therapy Practitioners to Address the Mental Health Needs of Children and Youth: A Mixed-Methods Study of Knowledge Translation.

PubMed

Bazyk, Susan; Demirjian, Louise; LaGuardia, Teri; Thompson-Repas, Karen; Conway, Carol; Michaud, Paula

2015-01-01

We explored the meaning and outcomes of a 6-mo building capacity process designed to promote knowledge translation of a public health approach to mental health among pediatric occupational therapy practitioners participating in a Community of Practice. A one-group (N = 117) mixed-methods design using a pretest-posttest survey and qualitative analysis of written reflections was used to explore the meaning and outcomes of the building capacity process. Statistically significant improvements (p < .02) in pretest-posttest scores of knowledge, beliefs, and actions related to a public health approach to mental health were found. Qualitative findings suggest that participation resulted in a renewed commitment to addressing children's mental health. The building capacity process expanded practitioner knowledge, renewed energy, and promoted confidence, resulting in change leaders empowered to articulate, advocate for, and implement practice changes reflecting occupational therapy's role in addressing children's mental health. Copyright © 2015 by the American Occupational Therapy Association, Inc.

Building Capacity of Occupational Therapy Practitioners to Address the Mental Health Needs of Children and Youth: A Mixed-Methods Study of Knowledge Translation

PubMed Central

Demirjian, Louise; LaGuardia, Teri; Thompson-Repas, Karen; Conway, Carol; Michaud, Paula

2015-01-01

PURPOSE. We explored the meaning and outcomes of a 6-mo building capacity process designed to promote knowledge translation of a public health approach to mental health among pediatric occupational therapy practitioners participating in a Community of Practice. METHOD. A one-group (N = 117) mixed-methods design using a pretest–posttest survey and qualitative analysis of written reflections was used to explore the meaning and outcomes of the building capacity process. RESULTS. Statistically significant improvements (p < .02) in pretest–posttest scores of knowledge, beliefs, and actions related to a public health approach to mental health were found. Qualitative findings suggest that participation resulted in a renewed commitment to addressing children’s mental health. CONCLUSION. The building capacity process expanded practitioner knowledge, renewed energy, and promoted confidence, resulting in change leaders empowered to articulate, advocate for, and implement practice changes reflecting occupational therapy’s role in addressing children’s mental health. PMID:26565099

Preparation of name and address data for record linkage using hidden Markov models

PubMed Central

Churches, Tim; Christen, Peter; Lim, Kim; Zhu, Justin Xi

2002-01-01

Background Record linkage refers to the process of joining records that relate to the same entity or event in one or more data collections. In the absence of a shared, unique key, record linkage involves the comparison of ensembles of partially-identifying, non-unique data items between pairs of records. Data items with variable formats, such as names and addresses, need to be transformed and normalised in order to validly carry out these comparisons. Traditionally, deterministic rule-based data processing systems have been used to carry out this pre-processing, which is commonly referred to as "standardisation". This paper describes an alternative approach to standardisation, using a combination of lexicon-based tokenisation and probabilistic hidden Markov models (HMMs). Methods HMMs were trained to standardise typical Australian name and address data drawn from a range of health data collections. The accuracy of the results was compared to that produced by rule-based systems. Results Training of HMMs was found to be quick and did not require any specialised skills. For addresses, HMMs produced equal or better standardisation accuracy than a widely-used rule-based system. However, acccuracy was worse when used with simpler name data. Possible reasons for this poorer performance are discussed. Conclusion Lexicon-based tokenisation and HMMs provide a viable and effort-effective alternative to rule-based systems for pre-processing more complex variably formatted data such as addresses. Further work is required to improve the performance of this approach with simpler data such as names. Software which implements the methods described in this paper is freely available under an open source license for other researchers to use and improve. PMID:12482326

Automatic address validation and health record review to identify homeless Social Security disability applicants.

PubMed

Erickson, Jennifer; Abbott, Kenneth; Susienka, Lucinda

2018-06-01

Homeless patients face a variety of obstacles in pursuit of basic social services. Acknowledging this, the Social Security Administration directs employees to prioritize homeless patients and handle their disability claims with special care. However, under existing manual processes for identification of homelessness, many homeless patients never receive the special service to which they are entitled. In this paper, we explore address validation and automatic annotation of electronic health records to improve identification of homeless patients. We developed a sample of claims containing medical records at the moment of arrival in a single office. Using address validation software, we reconciled patient addresses with public directories of homeless shelters, veterans' hospitals and clinics, and correctional facilities. Other tools annotated electronic health records. We trained random forests to identify homeless patients and validated each model with 10-fold cross validation. For our finished model, the area under the receiver operating characteristic curve was 0.942. The random forest improved sensitivity from 0.067 to 0.879 but decreased positive predictive value to 0.382. Presumed false positive classifications bore many characteristics of homelessness. Organizations could use these methods to prompt early collection of information necessary to avoid labor-intensive attempts to reestablish contact with homeless individuals. Annually, such methods could benefit tens of thousands of patients who are homeless, destitute, and in urgent need of assistance. We were able to identify many more homeless patients through a combination of automatic address validation and natural language processing of unstructured electronic health records. Copyright © 2018. Published by Elsevier Inc.

A Need for a Competency Based Teacher Education for Native Americans. Position Paper.

ERIC Educational Resources Information Center

Miller, Louise

This paper addresses: (a) problems in the education of native Americans caused by prejudice and the coercive assimilation policy of the federal government, and (b) the need for improvement of education for Indians. The prime requisites for change must be generated in a climate of willingness on the part of educational institutions to assume…

Contradictions as Drivers for Improving Inclusion in Teaching Pupils with Special Educational Needs

ERIC Educational Resources Information Center

Paju, Birgit; Kajamaa, Anu; Pirttimaa, Raija; Kontu, Elina

2018-01-01

The aim of this paper is to enhance understanding of the contradictions that arise in the drive to improve teaching practices among pupils with special educational needs (SENs). A questionnaire was administrated to 167 classroom teachers, subject teachers, special education teachers and teaching assistants in Finland. The analysis, based on…

Transformation in Higher Education: A Learner-Needs Segmentation Leads to Improved Learner Satisfaction

ERIC Educational Resources Information Center

Rogers, Gayla; Finley, Donna S.; Patterson, Margaret

2006-01-01

Segmentation is a marketing concept that can be applied in a post-secondary context. This article delineates the outcome of applying a learner-needs segmentation that resulted in significantly improved learner satisfaction scores in a professional faculty at a large public university. Our original work described the purpose and value of…

Frequency addressable beams for land mobile communications

NASA Technical Reports Server (NTRS)

Thompson, J. D.; Dubellay, G. G.

1988-01-01

Satellites used for mobile communications need to serve large numbers of small, low cost terminals. The most important parameters affecting the capacity of such systems are the satellite equivalent isotropically radiated power (EIRP) and gain to noise temperature ratio (G/T) and available bandwidth. Satellites using frequency addressed beams provide high EIRP and G/T with high-gain antenna beams that also permit frequency reuse over the composite coverage area. Frequency addressing is easy to implement and compatible with low-cost terminals and offers higher capacity than alternative approaches.

Resources from the NASA SMD Astrophysics Forum: Addressing the needs of the higher education community (Invited)

NASA Astrophysics Data System (ADS)

Meinke, B. K.; Schultz, G. R.; Smith, D.; Bianchi, L.; Blair, W. P.; Fraknoi, A.

2013-12-01

Four NASA Science Mission Directorate (SMD) Science Education and Public Outreach Forums organize individual SMD-funded E/PO projects and their teams into a coordinated effort. The Forums assist scientists and educators with becoming involved in SMD E/PO and make SMD E/PO resources and expertise accessible to the science and education communities. The Astrophysics Forum and the Astrophysics E/PO community have focused efforts to support and engage the higher education community on enhancing awareness of the resources available to them. To ensure Astrophysics higher education efforts are grounded in audience needs, we held informal conversations with instructors of introductory astronomy courses, convened sessions with higher education faculty and E/PO professionals at conferences, and examined existing literature and findings of the SMD Higher Education Working Group. This work indicates that most Astronomy 101 instructors are not specialists in areas of astrophysics where rapid progress is being made, older textbooks are out of date, and ideas are challenging for students. Instructors are seeking resources and training that support them in effectively teaching the latest science and are in need both basic material and information on new results. In this session, we will discuss our efforts to address these expressed needs, namely through Resource Guides and Slide Sets, and how these are applicable to topics in Heliophysics and Planetary Science. We have collaborated with the Astrophysics E/PO community, researchers, and Astronomy 101 instructors to create two Resource Guides on the topics of cosmology and exoplanets. These fields are ripe with scientific developments that college instructors have told us they find challenging to stay current. Each guide includes a wide variety of sources of background information, links to animations/simulations, classroom activities, and references on teaching each topic. Feedback from Astronomy 101 instructors indicated that the

Military Personnel: Actions Needed to Address Sexual Assaults of Male Servicemembers

DTIC Science & Technology

2015-03-01

providers we interviewed said that these same traditional gender stereotypes can make it particularly difficult for males to report that they were...develop a plan for using its data to inform program development; systematically evaluate whether male victims have gender - specific medical and...not systematically identified whether male victims have any gender -specific needs. DOD sexual assault policies specify that care be sensitive to gender

Improving access to supportive cancer care through an eHealth application: a qualitative needs assessment among cancer survivors.

PubMed

Lubberding, Sanne; van Uden-Kraan, Cornelia F; Te Velde, Elisabeth A; Cuijpers, Pim; Leemans, C René; Verdonck-de Leeuw, Irma M

2015-05-01

To gain insight into cancer survivors' needs towards an eHealth application monitoring quality of life and targeting personalised access to supportive care. Supportive care in cancer addresses survivors' concerns and needs. However, many survivors are not taking advantage of supportive care provided. To enable cancer survivors to benefit, survivors' needs must be identified timely and effectively. An eHealth application could be a solution to meet patients' individual supportive care needs. A qualitative approach. Thirty cancer survivors (15 head and neck and 15 breast cancer survivors) participated. The majority were female (n = 20·67%). The mean age was 60 (SD 8·8) years. Mean time interval since treatment was 13·5 months (SD 10·5). All interviews were audio-recorded and transcribed verbatim. During the interviews, participants were asked about their unmet needs during follow-up care and a potential eHealth application. Data were analyzed independently by two coders and coded into key issues and themes. Cancer survivors commented that they felt unprepared for the post-treatment period and that their symptoms often remained unknown to care providers. Survivors also mentioned a suboptimal referral pattern to supportive care services. Mentioned advantages of an eHealth application were as follows: insight into the course of symptoms by monitoring, availability of information among follow-up appointments, receiving personalised advice and tailored supportive care. Cancer survivors identified several unmet needs during follow-up care. Most survivors were positive towards the proposed eHealth application and expressed that it could be a valuable addition to follow-up cancer care. Study results provide care providers with insight into barriers that impede survivors from obtaining optimal supportive care. This study also provides insight into the characteristics needed to design, build and implement an eHealth application targeting personalised access to supportive

Patient handover in orthopaedics, improving safety using Information Technology.

PubMed

Pearkes, Tim

2015-01-01

Good inpatient handover ensures patient safety and continuity of care. An adjunct to this is the patient list which is routinely managed by junior doctors. These lists are routinely created and managed within Microsoft Excel or Word. Following the merger of two orthopaedic departments into a single service in a new hospital, it was felt that a number of safety issues within the handover process needed to be addressed. This quality improvement project addressed these issues through the creation and implementation of a new patient database which spanned the department, allowing trouble free, safe, and comprehensive handover. Feedback demonstrated an improved user experience, greater reliability, continuity within the lists and a subsequent improvement in patient safety.

Aviation rulemaking : further reform is needed to address long-standing problems

DOT National Transportation Integrated Search

2001-07-01

The U.S. General Accounting Office (GAO) was requested to conduct a review of the Federal Aviation Administration's (FAA's) rulemaking process in order to identify ways to improve its efficiency. GAO established 3 research questions: (1) What are the...

Addressing Point of Need in Interactive Multimedia Instruction: A Conceptual Review and Evaluation

DTIC Science & Technology

2013-11-01

classroom setting, ability grouping refers to the practice of putting students into groups on the basis of individual group members’ ability levels...presentation of elaborated/basic vs. advanced material, color cuing, pretesting and modifying learning presentation based on performance) ...learners’ points of need. The point of need concept is focused both on the accessibility of information to support the learning process as well as

Stakeholder-Driven Quality Improvement: A Compelling Force for Clinical Practice Guidelines.

PubMed

Rosenfeld, Richard M; Wyer, Peter C

2018-01-01

Clinical practice guideline development should be driven by rigorous methodology, but what is less clear is where quality improvement enters the process: should it be a priority-guiding force, or should it enter only after recommendations are formulated? We argue for a stakeholder-driven approach to guideline development, with an overriding goal of quality improvement based on stakeholder perceptions of needs, uncertainties, and knowledge gaps. In contrast, the widely used topic-driven approach, which often makes recommendations based only on randomized controlled trials, is driven by epidemiologic purity and evidence rigor, with quality improvement a downstream consideration. The advantages of a stakeholder-driven versus a topic-driven approach are highlighted by comparisons of guidelines for otitis media with effusion, thyroid nodules, sepsis, and acute bacterial rhinosinusitis. These comparisons show that stakeholder-driven guidelines are more likely to address the quality improvement needs and pressing concerns of clinicians and patients, including understudied populations and patients with multiple chronic conditions. Conversely, a topic-driven approach often addresses "typical" patients, based on research that may not reflect the needs of high-risk groups excluded from studies because of ethical issues or a desire for purity of research design.

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.

Addressing Younger Workers' Needs: The Promoting U through Safety and Health (PUSH) Trial Outcomes.

PubMed

Rohlman, Diane S; Parish, Megan; Elliot, Diane L; Hanson, Ginger; Perrin, Nancy

2016-08-10

Most younger workers, less than 25 years old, receive no training in worker safety. We report the feasibility and outcomes of a randomized controlled trial of an electronically delivered safety and health curriculum for younger workers entitled, PUSH (Promoting U through Safety and Health). All younger workers (14-24 years old) hired for summer work at a large parks and recreation organization were invited to participate in an evaluation of an online training and randomized into an intervention or control condition. Baseline and end-of-summer online instruments assessed acceptability, knowledge, and self-reported attitudes and behaviors. One-hundred and forty participants (mean age 17.9 years) completed the study. The innovative training was feasible and acceptable to participants and the organization. Durable increases in safety and health knowledge were achieved by intervention workers (p < 0.001, effect size (Cohen's d) 0.4). However, self-reported safety and health attitudes did not improve with this one-time training. These results indicate the potential utility of online training for younger workers and underscore the limitations of a single training interaction to change behaviors. Interventions may need to be delivered over a longer period of time and/or include environmental components to effectively alter behavior.

Addressing Younger Workers’ Needs: The Promoting U through Safety and Health (PUSH) Trial Outcomes

PubMed Central

Rohlman, Diane S.; Parish, Megan; Elliot, Diane L.; Hanson, Ginger; Perrin, Nancy

2016-01-01

Most younger workers, less than 25 years old, receive no training in worker safety. We report the feasibility and outcomes of a randomized controlled trial of an electronically delivered safety and health curriculum for younger workers entitled, PUSH (Promoting U through Safety and Health). All younger workers (14–24 years old) hired for summer work at a large parks and recreation organization were invited to participate in an evaluation of an online training and randomized into an intervention or control condition. Baseline and end-of-summer online instruments assessed acceptability, knowledge, and self-reported attitudes and behaviors. One-hundred and forty participants (mean age 17.9 years) completed the study. The innovative training was feasible and acceptable to participants and the organization. Durable increases in safety and health knowledge were achieved by intervention workers (p < 0.001, effect size (Cohen’s d) 0.4). However, self-reported safety and health attitudes did not improve with this one-time training. These results indicate the potential utility of online training for younger workers and underscore the limitations of a single training interaction to change behaviors. Interventions may need to be delivered over a longer period of time and/or include environmental components to effectively alter behavior. PMID:27517968

Tissue is alive: New technologies are needed to address the problems of protein biomarker pre-analytical variability.

PubMed

Espina, Virginia; Mueller, Claudius; Edmiston, Kirsten; Sciro, Manuela; Petricoin, Emanuel F; Liotta, Lance A

2009-08-01

Instability of tissue protein biomarkers is a critical issue for molecular profiling. Pre-analytical variables during tissue procurement, such as time delays during which the tissue remains stored at room temperature, can cause significant variability and bias in downstream molecular analysis. Living tissue, ex vivo, goes through a defined stage of reactive changes that begin with oxidative, hypoxic and metabolic stress, and culminate in apoptosis. Depending on the delay time ex vivo, and reactive stage, protein biomarkers, such as signal pathway phosphoproteins will be elevated or suppressed in a manner which does not represent the biomarker levels at the time of excision. Proteomic data documenting reactive tissue protein changes post collection indicate the need to recognize and address tissue stability, preservation of post-translational modifications, and preservation of morphologic features for molecular analysis. Based on the analysis of phosphoproteins, one of the most labile tissue protein biomarkers, we set forth tissue procurement guidelines for clinical research. We propose technical solutions for (i) assessing the state of protein analyte preservation and specimen quality via identification of a panel of natural proteins (surrogate stability markers), and (ii) using multi-purpose fixative solution designed to stabilize, preserve and maintain proteins, nucleic acids, and tissue architecture.

Tissue is alive: New technologies are needed to address the problems of protein biomarker pre-analytical variability

PubMed Central

Espina, Virginia; Mueller, Claudius; Edmiston, Kirsten; Sciro, Manuela; Petricoin, Emanuel F.; Liotta, Lance A.

2010-01-01

Instability of tissue protein biomarkers is a critical issue for molecular profiling. Pre-analytical variables during tissue procurement, such as time delays during which the tissue remains stored at room temperature, can cause significant variability and bias in downstream molecular analysis. Living tissue, ex vivo, goes through a defined stage of reactive changes that begin with oxidative, hypoxic and metabolic stress, and culminate in apoptosis. Depending on the delay time ex vivo, and reactive stage, protein biomarkers, such as signal pathway phosphoproteins will be elevated or suppressed in a manner which does not represent the biomarker levels at the time of excision. Proteomic data documenting reactive tissue protein changes post collection indicate the need to recognize and address tissue stability, preservation of post-translational modifications, and preservation of morphologic features for molecular analysis. Based on the analysis of phosphoproteins, one of the most labile tissue protein biomarkers, we set forth tissue procurement guidelines for clinical research. We propose technical solutions for (i) assessing the state of protein analyte preservation and specimen quality via identification of a panel of natural proteins (surrogate stability markers), and (ii) using multi-purpose fixative solution designed to stabilize, preserve and maintain proteins, nucleic acids, and tissue architecture. PMID:20871745

Improving data collection, documentation, and workflow in a dementia screening study.

PubMed

Read, Kevin B; LaPolla, Fred Willie Zametkin; Tolea, Magdalena I; Galvin, James E; Surkis, Alisa

2017-04-01

A clinical study team performing three multicultural dementia screening studies identified the need to improve data management practices and facilitate data sharing. A collaboration was initiated with librarians as part of the National Library of Medicine (NLM) informationist supplement program. The librarians identified areas for improvement in the studies' data collection, entry, and processing workflows. The librarians' role in this project was to meet needs expressed by the study team around improving data collection and processing workflows to increase study efficiency and ensure data quality. The librarians addressed the data collection, entry, and processing weaknesses through standardizing and renaming variables, creating an electronic data capture system using REDCap, and developing well-documented, reproducible data processing workflows. NLM informationist supplements provide librarians with valuable experience in collaborating with study teams to address their data needs. For this project, the librarians gained skills in project management, REDCap, and understanding of the challenges and specifics of a clinical research study. However, the time and effort required to provide targeted and intensive support for one study team was not scalable to the library's broader user community.

Recommendations for sexual expression management in long-term care: a qualitative needs assessment

PubMed Central

Syme, Maggie L.; Lichtenberg, Peter; Moye, Jennifer

2017-01-01

Aims To conduct a qualitative needs assessment of Directors of Nursing regarding challenges and recommendations for addressing sexual expression and consent. Background Sexual expression management among long-term care residents is a complex issue for nursing home staff. Little guidance is available for those wanting to follow a person-centred approach. Policies and procedures are needed, and must be usable across long-term care settings. Design Qualitative design for in-depth exploration. Methods Semi-structured interviews were conducted with 20 Directors of Nursing in the spring and summer of 2013, representing a range of regions, facility sizes and resident populations. Interview questions prompted them to identify recommendations that address challenges to improving sexual expression management in long-term care settings. Results Comparative thematic analysis resulted in several codes, which were grouped into eight overall categories. Recommendation categories that addressed key challenges included: address the issue, make environmental changes, identify staff expertise, provide education and training, assess sexuality initially and recurrently, establish policies/procedures for sexual expression management, develop assessment tools for sexual expression and consent, and clarify legal issues. The recommendation to develop national guidelines was observed across categories. Discussion Directors of Nursing report several challenges to sexual expression management in their facilities, and perceive their current methods to be ad hoc. A proactive approach to policy and procedure development is needed. PMID:27188413

Addressable droplet microarrays for single cell protein analysis.

PubMed

Salehi-Reyhani, Ali; Burgin, Edward; Ces, Oscar; Willison, Keith R; Klug, David R

2014-11-07

Addressable droplet microarrays are potentially attractive as a way to achieve miniaturised, reduced volume, high sensitivity analyses without the need to fabricate microfluidic devices or small volume chambers. We report a practical method for producing oil-encapsulated addressable droplet microarrays which can be used for such analyses. To demonstrate their utility, we undertake a series of single cell analyses, to determine the variation in copy number of p53 proteins in cells of a human cancer cell line.

Sexual health needs and the LGBT community.

PubMed

Campbell, Sue

Lesbian, gay, bisexual and trans (LGBT) individuals have particular vulnerabilities to sexually transmitted infections and HIV infection. Globally, reasons for this include physiological factors, discrimination and poor understanding of their sexual health needs. In many countries LGBT individuals are not able to exercise fully their rights to health care. This raises public health concerns for the LGBT community and the wider population. This article explores these issues, and makes recommendations for the healthcare profession to address health inequalities and promote improved health outcomes for LGBT populations. This article aims to promote an evidence-based approach that focuses on rights and public health issues.

Utilizing findings from a gender-based analysis to address chronic disease prevention and management among African-American women in a Michigan community.

PubMed

Lombard, Wendy; Burke, Jodi; Waddell, Sandra; Franke, Arthur

2015-08-01

This research note underscores the importance of including strategies to address gender-based disparities when planning and implementing community health improvement programs. Working in collaboration with the Inkster Partnership for a Healthier Community (IPHC), the National Kidney Foundation of Michigan conducted a gender-based analysis as part of its broader community health needs assessment efforts in Inkster, MI. The findings from these studies revealed significant challenges impacting women that were not being adequately addressed within the community. In response to these findings, the IPHC created a strategic action plan to respond to the highest priority needs by increasing community awareness of and linkages to resources that provide supportive services for low-income African-American women. Copyright © 2014 Elsevier Ltd. All rights reserved.

Reading Comprehension Deficits in Adolescents: Addressing Underlying Language Abilities

PubMed Central

2017-01-01

Purpose The purpose of this article is to discuss reading comprehension deficits in adolescents in relation to their word reading skills and lexical and syntactic development. Although reading comprehension strategies (e.g., “Find the main idea”) are often recommended, it is argued that before these can be effective, students' underlying language deficits should be addressed. Method Data from a longitudinal study are analyzed to determine the relationship between reading comprehension, word reading, and lexical and syntactic development in adolescents. Results The findings indicate that poor reading comprehension in adolescents is predicted by concurrent deficits in word reading ability, lexical development, and syntactic development. Conclusion When poor comprehension is accompanied by deficits in word reading ability and/or lexical and syntactic development, intervention should target the underlying areas of deficiency. Studies designed to improve reading comprehension in adolescents are needed. PMID:28384784

Addressing software security risk mitigations in the life cycle

NASA Technical Reports Server (NTRS)

Gilliam, David; Powell, John; Haugh, Eric; Bishop, Matt

2003-01-01

The NASA Office of Safety and Mission Assurance (OSMA) has funded the Jet Propulsion Laboratory (JPL) with a Center Initiative, 'Reducing Software Security Risk through an Integrated Approach' (RSSR), to address this need. The Initiative is a formal approach to addressing software security in the life cycle through the instantiation of a Software Security Assessment Instrument (SSAI) for the development and maintenance life cycles.

Continuous Improvement in State Funded Preschool Programs

ERIC Educational Resources Information Center

Jackson, Sarah L.

2012-01-01

State funded preschool programs were constantly faced with the need to change in order to address internal and external demands. As programs engaged in efforts towards change, minimal research was available on how to support continuous improvement efforts within the context unique to state funded preschool programs. Guidance available had…

Translating Research Into E/PO That Addresses Real Needs in K-12 Classrooms

NASA Astrophysics Data System (ADS)

van der Veen, Wil E.; Belbruno, E. A.; Roelofsen Moody, T.

2009-01-01

One of the challenges in NASA ROSES E/PO is translating cutting edge research into products for which there is a demonstrated need. Rather than working from the premise that the "research is so cool’ that K-12 students or the public should learn about it, it is key to consult with the target audience to identify what their needs really are. The partnership between NJACE, Innovative Orbital Design, Inc., and Princeton offered a unique opportunity to translate intriguing but theoretical and mathematical research related to low energy orbits into a valuable education product. NJACE worked with educators to identify several needs with an intellectual link to this research: 1) Understanding of Gravity and Newton's Laws, 2) Understanding of Energy and Energy Transformations, 3) Integration of the sciences with math and technology, and 4) Knowledge of NASA's past accomplishments (such as the moon landings). Based on these identified needs, two science units were developed for students in grades 5-12 that integrate astronomy, physics, and the life sciences with math and technology. In addition an engaging public lecture was developed that tells a personal story of the quest for more economic space travel. In the past year, the workshops have been presented on three occasions, reaching over 75 teachers and demand exceeded available space with numerous teachers on waiting lists. The lecture has been presented numerous times at planetariums, museums, amateur astronomy and other clubs. We hope that our partnership will serve as a useful example of how to translate cutting edge research into valuable education products with an identified need. We will provide handouts with links to a website where the products and training can be downloaded in hope that others will help disseminate our product.

A Scoping Review to Address the Culture of Concussion in Youth and High School Sports.

PubMed

Sarmiento, Kelly; Donnell, Zoe; Hoffman, Rosanne

2017-10-01

In 2013, the National Academy of Sciences emphasized the need to develop, implement, and evaluate effective large-scale educational strategies to improve the culture of concussion in youth and high school sports. In support of this recommendation, in this article we summarize research on factors that contribute to the culture of concussion. We conducted the literature search using 7 electronic databases. We used a scoping review method to identify studies that addressed knowledge, attitudes, behaviors, use of educational resources, and interventions related to concussion among young athletes, coaches, and parents. Of the 33 articles identified, most focused on concussion education (N = 15), followed by knowledge (N = 13), behaviors (N = 13), and attitudes (N = 5). Three studies addressed multiple study populations. The rapid spread of concussion education and awareness efforts has outpaced research on effective strategies to improve knowledge, attitudes, and behaviors that contribute to the culture of concussion. Further research is critical to inform the development and implementation of large-scale educational efforts. This research should incorporate rigorous study designs; be inclusive of diverse ages, socioeconomic status, and racial/ethnic groups; and examine opportunities to improve behavioral outcomes around concussion prevention, reporting, and management. © 2017, American School Health Association.

Physics and biophysics experiments needed for improved risk assessment in space

NASA Astrophysics Data System (ADS)

Sihver, L.

To improve the risk assessment of radiation carcinogenesis, late degenerative tissue effects, acute syndromes, synergistic effects of radiation and microgravity or other spacecraft factors, and hereditary effects, on future LEO and interplanetary space missions, the radiobiological effects of cosmic radiation before and after shielding must be well understood. However, cosmic radiation is very complex and includes low and high LET components of many different neutral and charged particles. The understanding of the radiobiology of the heavy ions, from GCRs and SPEs, is still a subject of great concern due to the complicated dependence of their biological effects on the type of ion and energy, and its interaction with various targets both outside and within the spacecraft and the human body. In order to estimate the biological effects of cosmic radiation, accurate knowledge of the physics of the interactions of both charged and non-charged high-LET particles is necessary. Since it is practically impossible to measure all primary and secondary particles from all projectile-target-energy combinations needed for a correct risk assessment in space, accurate particle and heavy ion transport codes might be a helpful instrument to overcome those difficulties. These codes have to be carefully validated to make sure they fulfill preset accuracy criteria, e.g. to be able to predict particle fluence and energy distributions within a certain accuracy. When validating the accuracy of the transport codes, both space and ground-based accelerator experiments are needed. In this paper current and future physics and biophysics experiments needed for improved risk assessment in space will be discussed. The cyclotron HIRFL (heavy ion research facility in Lanzhou) and the new synchrotron CSR (cooling storage ring), which can be used to provide ion beams for space related experiments at the Institute of Modern Physics, Chinese Academy of Sciences (IMP-CAS), will be presented together with

Improving state Medicaid contracts and plan practices for children with special needs.

PubMed

Fox, H B; McManus, M A

1998-01-01

The rapid transition of state Medicaid beneficiaries into fully capitated managed care plans requires a special focus on children with chronic or disabling conditions, who often depend on numerous pediatric physicians and other specialty services for health care and related services. Because managed care arrangements for this population are growing in popularity nationwide, it is important that states craft managed care contracts to address the unique needs of children with complex physical, developmental, and mental health problems. Based on the research reported in this article, in-depth interviews with state Medicaid agency staff, interviews with medical directors and administrators of managed care plans serving Medicaid recipients, and input from experts in pediatrics and managed care, a set of recommendations is made for tailoring managed care contracts to meet the needs of this vulnerable group of children. Six contracting elements that should be adopted by state Medicaid agencies include (1) clarifying the specificity of pediatric benefits, (2) defining appropriate pediatric provider capacity requirements, (3) developing a medical necessity standard specific to children, (4) identifying pediatric quality-of-care measures, (5) setting appropriate pediatric capitation rates, and (6) creating incentives for high-quality pediatric care. Nine approaches that should be adopted by managed care practices interested in providing high-quality care for children with special needs also are identified. These include (1) ensuring that assigned primary care providers have appropriate training and experience, (2) offering support systems for primary care practices, (3) providing specialty consultation for primary care providers, (4) establishing arrangements for the comanagement of primary and specialty pediatric services, (5) arranging for comprehensive care coordination, (6) establishing flexible service authorization policies, (7) implementing provider profiling systems

Status and Needs of Power Electronics for Photovoltaic Inverters: Summary Document

NASA Astrophysics Data System (ADS)

West, R.; Mauch, K.; Qin, Y. C.; Mohan, N.; Bonn, R.

2002-05-01

Photovoltaic inverters are the most mature of any DER inverter, and their mean time to first failure (MTFF) is about five years. This is an unacceptable MTFF and will inhibit the rapid expansion of PV. With all DER technologies, (solar, wind, fuel cells, and microturbines) the inverter is still an immature product that will result in reliability problems in fielded systems. The increasing need for all of these technologies to have a reliable inverter provides a unique opportunity to address these needs with focused R&D development projects. The requirements for these inverters are so similar that modular designs with universal features are obviously the best solution for a 'next generation' inverter. A 'next generation' inverter will have improved performance, higher reliability, and improved profitability. Sandia National Laboratories has estimated that the development of a 'next generation' inverter could require approximately 20 man-years of work over an 18- to 24-month time frame, and that a government-industry partnership will greatly improve the chances of success.

The Boys in Schools Bulletin: Practical Initiatives Addressing Boys' Needs, 1999.

ERIC Educational Resources Information Center

Fletcher, Richard, Ed.; Browne, Rollo, Ed.

1999-01-01

This document is comprised of volume 2 of a quarterly bulletin for educators in Australia providing a practical focus to improving boys' schooling. The April 1999 issue focuses on the role of school executives, or administrators, on supporting educational initiatives. This issue includes articles describing the development of a program-based…

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…

The need for monetary information within corporate water accounting.

PubMed

Burritt, Roger L; Christ, Katherine L

2017-10-01

A conceptual discussion is provided about the need to add monetary data to water accounting initiatives and how best to achieve this if companies are to become aware of the water crisis and to take actions to improve water management. Analysis of current water accounting initiatives reveals the monetary business case for companies to improve water management is rarely considered, there being a focus on physical information about water use. Three possibilities emerge for mainstreaming the integration of monetization into water accounting: add-on to existing water accounting frameworks and tools, develop new tools which include physical and monetary information from the start, and develop environmental management accounting (EMA) into a water-specific application and set of tools. The paper appraises these three alternatives and concludes that development of EMA would be the best way forward. Suggestions for further research include the need to examine the use of a transdisciplinary method to address the complexities of water accounting. Copyright © 2017 Elsevier Ltd. All rights reserved.

Addressing Children's Oral Health in the New Millennium: Trends in the Dental Workforce

PubMed Central

Mertz, Elizabeth; Mouradian, Wendy

2009-01-01

The Surgeon General's Report on Oral Health (SGROH) and the Call to Action to Promote Oral Health outlined the need to increase the diversity, capacity and flexibility of the dental workforce to reduce oral health disparities. This paper provides an update on dental workforce trends since the SGROH in the context of children's oral health needs. Major challenges remain to ensure a workforce that is adequate to address the needs of all children. The dentist to population ratio is declining, while mal-distribution of dentists continues for rural and underserved communities. The diversity of the dental workforce has only improved slightly, while the diversity of the pediatric population has increased substantially. More pediatric dentists have been trained, and dental educational programs are preparing students for practice in underserved areas, but the impact of these efforts on underserved children is uncertain. Other workforce developments with the potential to improve children's oral health include: enhanced training in children's oral health for general dentists; expanded scope of practice for allied dental health professionals; new dental practitioners including the dental health aid therapist; and increased engagement of pediatricians and other medical practitioners in children's oral health. The evidence for increasing caries experience in young children points to the need for continued efforts to bolster the oral health workforce. However, workforce strategies alone will not be sufficient to change this situation. Requisite policy changes, educational efforts and strong partnerships with communities will be needed to effect substantive changes in children's oral health. PMID:19854121

Addressing children's oral health in the new millennium: trends in the dental workforce.

PubMed

Mertz, Elizabeth; Mouradian, Wendy E

2009-01-01

Oral Health in America: A Report of the Surgeon General (SGROH) and National Call to Action to Promote Oral Health outlined the need to increase the diversity, capacity, and flexibility of the dental workforce to reduce oral health disparities. This paper provides an update on dental workforce trends since the SGROH in the context of children's oral health needs. Major challenges remain to ensure a workforce that is adequate to address the needs of all children. The dentist-to-population ratio is declining while shortages of dentists continue in rural and underserved communities. The diversity of the dental workforce has only improved slightly, and the the diversity of the pediatric population has increased substantially. More pediatric dentists have been trained, and dental educational programs are preparing students for practice in underserved areas, but the impact of these efforts on underserved children is uncertain. Other workforce developments with the potential to improve children's oral health include enhanced training in children's oral health for general dentists, expanded scope of practice for allied dental health professionals, new dental practitioners including the dental health aid therapist, and increased engagement of pediatricians and other medical practitioners in children's oral health. The evidence for increasing caries experience in young children points to the need for continued efforts to bolster the oral health workforce. However, workforce strategies alone will not be sufficient to change this situation. Requisite policy changes, educational efforts, and strong partnerships with communities will be needed to effect substantive changes in children's oral health.

Report: EPA Needs to Improve Physical Security at Its Offices in Las Vegas, Nevada

EPA Pesticide Factsheets

Report #10-P-0059, February 3, 2010. EPA needs to improve physical security at its Las Vegas facilities. The Las Vegas Finance Center’s (LVFC’s) server room and other key areas are susceptible to unauthorized access by personnel not a part of LVFC.

Phase-image-based content-addressable holographic data storage

NASA Astrophysics Data System (ADS)

John, Renu; Joseph, Joby; Singh, Kehar

2004-03-01

We propose and demonstrate the use of phase images for content-addressable holographic data storage. Use of binary phase-based data pages with 0 and π phase changes, produces uniform spectral distribution at the Fourier plane. The absence of strong DC component at the Fourier plane and more intensity of higher order spatial frequencies facilitate better recording of higher spatial frequencies, and improves the discrimination capability of the content-addressable memory. This improves the results of the associative recall in a holographic memory system, and can give low number of false hits even for small search arguments. The phase-modulated pixels also provide an opportunity of subtraction among data pixels leading to better discrimination between similar data pages.

Addressing Criticisms of Large-Scale Marine Protected Areas.

PubMed

O'Leary, Bethan C; Ban, Natalie C; Fernandez, Miriam; Friedlander, Alan M; García-Borboroglu, Pablo; Golbuu, Yimnang; Guidetti, Paolo; Harris, Jean M; Hawkins, Julie P; Langlois, Tim; McCauley, Douglas J; Pikitch, Ellen K; Richmond, Robert H; Roberts, Callum M

2018-05-01

Designated large-scale marine protected areas (LSMPAs, 100,000 or more square kilometers) constitute over two-thirds of the approximately 6.6% of the ocean and approximately 14.5% of the exclusive economic zones within marine protected areas. Although LSMPAs have received support among scientists and conservation bodies for wilderness protection, regional ecological connectivity, and improving resilience to climate change, there are also concerns. We identified 10 common criticisms of LSMPAs along three themes: (1) placement, governance, and management; (2) political expediency; and (3) social-ecological value and cost. Through critical evaluation of scientific evidence, we discuss the value, achievements, challenges, and potential of LSMPAs in these arenas. We conclude that although some criticisms are valid and need addressing, none pertain exclusively to LSMPAs, and many involve challenges ubiquitous in management. We argue that LSMPAs are an important component of a diversified management portfolio that tempers potential losses, hedges against uncertainty, and enhances the probability of achieving sustainably managed oceans.

Addressing Criticisms of Large-Scale Marine Protected Areas

PubMed Central

Ban, Natalie C; Fernandez, Miriam; Friedlander, Alan M; García-Borboroglu, Pablo; Golbuu, Yimnang; Guidetti, Paolo; Harris, Jean M; Hawkins, Julie P; Langlois, Tim; McCauley, Douglas J; Pikitch, Ellen K; Richmond, Robert H; Roberts, Callum M

2018-01-01

Abstract Designated large-scale marine protected areas (LSMPAs, 100,000 or more square kilometers) constitute over two-thirds of the approximately 6.6% of the ocean and approximately 14.5% of the exclusive economic zones within marine protected areas. Although LSMPAs have received support among scientists and conservation bodies for wilderness protection, regional ecological connectivity, and improving resilience to climate change, there are also concerns. We identified 10 common criticisms of LSMPAs along three themes: (1) placement, governance, and management; (2) political expediency; and (3) social–ecological value and cost. Through critical evaluation of scientific evidence, we discuss the value, achievements, challenges, and potential of LSMPAs in these arenas. We conclude that although some criticisms are valid and need addressing, none pertain exclusively to LSMPAs, and many involve challenges ubiquitous in management. We argue that LSMPAs are an important component of a diversified management portfolio that tempers potential losses, hedges against uncertainty, and enhances the probability of achieving sustainably managed oceans. PMID:29731514

The 2012 NCTE Presidential Address: Literacy, Rhetoric, Education, Democracy

ERIC Educational Resources Information Center

Gilyard, Keith

2013-01-01

This article presents the text of Keith Gilyard's presidential address, delivered at the National Council of Teachers of English (NCTE) Annual Convention in Las Vegas, Nevada, on November 18, 2012. In his address he proposes several core elements that he believes will instrumentally improve the education system in the United States: a rich…

Addressing Common Questions Encountered in the Diagnosis and Management of Cardiac Amyloidosis

PubMed Central

Maurer, Mathew S.; Elliott, Perry; Comenzo, Raymond; Semigran, Marc; Rapezzi, Claudio

2017-01-01

Advances in cardiac imaging have resulted in greater recognition of cardiac amyloidosis (CA) in everyday clinical practice, but the diagnosis continues to be made in patients with late stage disease, suggesting that more needs to be done to improve awareness of its clinical manifestations and the potential of therapeutic intervention to improve prognosis. Light chain CA (AL-CA) in particular, if recognized early and treated with targeted plasma cell therapy, can be managed very effectively. For patients with transthyretin amyloidosis, there are numerous therapies that are currently in late phase clinical trials. In this review we address common questions encountered in clinical practice regarding etiology, clinical presentation, diagnosis and management of cardiac amyloidosis, focusing on recent important developments in cardiac imaging and biochemical diagnosis. The aim is to show how a systematic approach to the evaluation of suspected CA can impact the prognosis of patients in the modern era. PMID:28373528

Improving outcomes for people with progressive cancer: interrupted time series trial of a needs assessment intervention.

PubMed

Waller, Amy; Girgis, Afaf; Johnson, Claire; Lecathelinais, Christophe; Sibbritt, David; Forstner, Dion; Liauw, Winston; Currow, David C

2012-03-01

Improving the effectiveness of cancer care delivery has become a major focus of research. This study assessed the uptake and impact of the Palliative Care Needs Assessment Guidelines and Needs Assessment Tool: Progressive Disease--Cancer (NAT: PD-C) on the outcomes of people with advanced cancer. Given widely varying survival in people with advanced cancer, an interrupted time series design was used, with data on unmet needs, depression, anxiety, and quality of life collected from 195 patients using telephone interviews every two months, for up to 18 months. Patients completed at least two baseline interviews before health professionals were academically detailed in the use of the Palliative Care Needs Assessment Guidelines and NAT: PD-C. Health professionals completed the NAT: PD-C with patients approximately monthly for the remainder of the study. Changes in patients' outcomes were compared prior to and following the introduction of the NAT: PD-C using general estimating equations. Moderate to high needs across all domains were frequently seen in the preintervention phase. The use of the NAT: PD-C was associated with a significant reduction in health system and information and patient care and support needs. These resources have the potential as an efficient and acceptable strategy for supporting needs-based cancer care. Further work is required to determine their unique contribution to improvements in patient outcomes. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

CIRM Alpha Stem Cell Clinics: Collaboratively Addressing Regenerative Medicine Challenges.

PubMed

Jamieson, Catriona H M; Millan, Maria T; Creasey, Abla A; Lomax, Geoff; Donohoe, Mary E; Walters, Mark C; Abedi, Mehrdad; Bota, Daniela A; Zaia, John A; Adams, John S

2018-06-01

The California Institute for Regenerative Medicine (CIRM) Alpha Stem Cell Clinic (ASCC) Network was launched in 2015 to address a compelling unmet medical need for rigorous, FDA-regulated, stem cell-related clinical trials for patients with challenging, incurable diseases. Here, we describe our multi-center experiences addressing current and future challenges. Copyright © 2018 Elsevier Inc. All rights reserved.

A qualitative and quantitative needs assessment of pain management for hospitalized orthopedic patients.

PubMed

Cordts, Grace A; Grant, Marian S; Brandt, Lynsey E; Mears, Simon C

2011-08-08

Despite advances in pain management, little formal teaching is given to practitioners and nurses in its use for postoperative orthopedic patients. The goal of our study was to determine the educational needs for orthopedic pain management of our residents, nurses, and physical therapists using a quantitative and qualitative assessment. The needs analysis was conducted in a 10-bed orthopedic unit at a teaching hospital and included a survey given to 20 orthopedic residents, 9 nurses, and 6 physical therapists, followed by focus groups addressing barriers to pain control and knowledge of pain management. Key challenges for nurses included not always having breakthrough pain medication orders and the gap in pain management between cessation of patient-controlled analgesia and ordering and administering oral medications. Key challenges for orthopedic residents included treating pain in patients with a history of substance abuse, assessing pain, and determining when to use long-acting vs short-acting opioids. Focus group assessments revealed a lack of training in pain management and the need for better coordination of care between nurses and practitioners and improved education about special needs groups (the elderly and those with substance abuse issues). This needs assessment showed that orthopedic residents and nurses receive little formal education on pain management, despite having to address pain on a daily basis. This information will be used to develop an educational program to improve pain management for postoperative orthopedic patients. An integrated educational program with orthopedic residents, nurses, and physical therapists would promote understanding of issues for each discipline. Copyright 2011, SLACK Incorporated.

Practice Facilitator Strategies for Addressing Electronic Health Record Data Challenges for Quality Improvement: EvidenceNOW.

PubMed

Hemler, Jennifer R; Hall, Jennifer D; Cholan, Raja A; Crabtree, Benjamin F; Damschroder, Laura J; Solberg, Leif I; Ono, Sarah S; Cohen, Deborah J

2018-01-01

Practice facilitators ("facilitators") can play an important role in supporting primary care practices in performing quality improvement (QI), but they need complete and accurate clinical performance data from practices' electronic health records (EHR) to help them set improvement priorities, guide clinical change, and monitor progress. Here, we describe the strategies facilitators use to help practices perform QI when complete or accurate performance data are not available. Seven regional cooperatives enrolled approximately 1500 small-to-medium-sized primary care practices and 136 facilitators in EvidenceNOW, the Agency for Healthcare Research and Quality's initiative to improve cardiovascular preventive services. The national evaluation team analyzed qualitative data from online diaries, site visit field notes, and interviews to discover how facilitators worked with practices on EHR data challenges to obtain and use data for QI. We found facilitators faced practice-level EHR data challenges, such as a lack of clinical performance data, partial or incomplete clinical performance data, and inaccurate clinical performance data. We found that facilitators responded to these challenges, respectively, by using other data sources or tools to fill in for missing data, approximating performance reports and generating patient lists, and teaching practices how to document care and confirm performance measures. In addition, facilitators helped practices communicate with EHR vendors or health systems in requesting data they needed. Overall, facilitators tailored strategies to fit the individual practice and helped build data skills and trust. Facilitators can use a range of strategies to help practices perform data-driven QI when performance data are inaccurate, incomplete, or missing. Support is necessary to help practices, particularly those with EHR data challenges, build their capacity for conducting data-driven QI that is required of them for participating in practice

Performance improvements of MOEMS-based diffractive arrays: address isolation and optical switching

NASA Astrophysics Data System (ADS)

Panaman, Ganesh; Madison, Seth; Sano, Michael; Castracane, James

2005-01-01

Micro-Opto-Electro-Mechanical Systems (MOEMS) have found a variety of applications in fields such as telecommunications, spectroscopy and display technology. MOEMS-based optical switching is currently under investigation for the increased flexibility that such devices provide for reconfiguration of the I/O network for inter-chip communication applications. This potential not only adds an additional degree of freedom for adjustment of transmitter/receiver links but also allows for fine alignment of individual channels in the network link. Further, this use of diffractive arrays for specific applications combines beam steering/adjustment capabilities with the inherent wavelength dependence of the diffractive approach for channel separation and de-multiplexing. Research and development has been concentrated on the progression from single MOEMS components to parallel arrays integrated with optical source arrays for a successful feasibility demonstration. Successful development of such an approach will have a major impact of the next generation communication protocols. This paper will focus on the current status of the MOEMS research program for Free Space Optical inter-chip communication at the College of NanoScale Science and Engineering, University at Albany-SUNY (CNSE). New versions of diffractive arrays stemming from the basic MEMS Compound Grating (MCG; patent #5,999,319) have been produced through various fabrication methods including the MUMPs process1. Most MEMS components relying on electrostatic actuation tend to require high actuation voltages (>20V) compared to the typical 5V levels prevalent in conventional integrated circuits. The specific goal is to yield improved performance while minimizing the power consumption of the components. Structural modifications through the variation in the ruling/electrode spacing distance and array wiring layout through individually addressable gratings have been studied to understand effects on the actuation voltage and

Report: EPA Needs to Improve Management Practices to Ensure a Successful Customer Technology Solutions Project

EPA Pesticide Factsheets

Report #10-P-0194, August 23, 2010. Although EPA indicated it could avoid spending more than $115.4 million over 8.5 years by consolidating the desktop computing environment, improved management practices are needed.

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

What is needed to deliver collaborative care to address comorbidity more effectively for adults with a severe mental illness?

PubMed

Lee, Stuart J; Crowther, Elizabeth; Keating, Charlotte; Kulkarni, Jayashri

2013-04-01

Innovative models of care for people with a severe mental illness have been developed across Australia to more effectively address comorbidity and disability by enhancing the collaboration between clinical and non-clinical services. In particular, this review paper focuses on collaboration that has occurred to address comorbidities affecting the following domains: homelessness; substance addiction; physical ill-health; unemployment; and forensic issues. The identification of relevant collaborative care models was facilitated by carrying out a review of the published peer-reviewed literature and policy or other published reports available on the Internet. Contact was also made with representatives of the mental health branches of each Australian state and territory health department to assist in identifying examples of innovative collaborative care models established within their jurisdiction. A number of nationally implemented and local examples of collaborative care models were identified that have successfully delivered enhanced integration of care between clinical and non-clinical services. Several key principles for effective collaboration were also identified. Governmental and organisational promotion of and incentives for cross-sector collaboration is needed along with education for staff about comorbidity and the capacity of cross-sector agencies to work in collaboration to support shared clients. Enhanced communication has been achieved through mechanisms such as the co-location of staff from different agencies to enhance sharing of expertise and interagency continuity of care, shared treatment plans and client records, and shared case review meetings. Promoting a 'housing first approach' with cross-sector services collaborating to stabilise housing as the basis for sustained clinical engagement has also been successful. Cross-sector collaboration is achievable and can result in significant benefits for mental health consumers and staff of collaborating

Designing a Clinical Data Warehouse Architecture to Support Quality Improvement Initiatives.

PubMed

Chelico, John D; Wilcox, Adam B; Vawdrey, David K; Kuperman, Gilad J

2016-01-01

Clinical data warehouses, initially directed towards clinical research or financial analyses, are evolving to support quality improvement efforts, and must now address the quality improvement life cycle. In addition, data that are needed for quality improvement often do not reside in a single database, requiring easier methods to query data across multiple disparate sources. We created a virtual data warehouse at NewYork Presbyterian Hospital that allowed us to bring together data from several source systems throughout the organization. We also created a framework to match the maturity of a data request in the quality improvement life cycle to proper tools needed for each request. As projects progress in the Define, Measure, Analyze, Improve, Control stages of quality improvement, there is a proper matching of resources the data needs at each step. We describe the analysis and design creating a robust model for applying clinical data warehousing to quality improvement.

Partnership 2000: Improving the Workforce through Partnerships. Monograph.

ERIC Educational Resources Information Center

Fujimoto, Jack

Partnership 2000 is a joint collaborative effort of labor, education, and industry in California created to address the needs of employees through vocational and technical education provided by community colleges and affiliated training institutions. Partnership 2000's long-range goals are to: (1) improve student access to vocational education…

From Exclusion to Inclusion: Ways of Responding in Schools to Students with Special Educational Needs

ERIC Educational Resources Information Center

Ainscow, Mel; Dyson, Alan; Weiner, Saira

2013-01-01

The idea that schools can impact positively on student outcomes is a crucial driver in the rise of interest in school improvement research and practice. This review focuses on "from exclusion to inclusion." With a specific focus on children with special educational needs (SEN), this review addresses the forms of classroom practice that…

Report: Some States Cannot Address Assessment Needs and Face Limitations in Meeting Future Superfund Cleanup Requirements

EPA Pesticide Factsheets

Report #2004-P-00027, September 1, 2004. The five States have established hazardous waste site cleanup programs that address contaminated sites posing human health and environmental risks ranging from low to high.

Report: Office of Research and Development Needs to Improve Its Method of Measuring Administrative Savings

EPA Pesticide Factsheets

Report #11-P-0333, July 14, 2011. ORD’s efforts to reduce its administrative costs are noteworthy, but ORD needs to improve its measurement mechanism for assessing the effectiveness of its initiatives to reduce administrative costs.

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

ERIC Educational Resources Information Center

McCorvey, Zamecia J.

2013-01-01

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

Northeast and Islands Region: A Report Identifying and Addressing the Educational Needs

ERIC Educational Resources Information Center

US Department of Education, 2011

2011-01-01

This report discusses the deliberations of the Northeast and Islands (NEI) Regional Advisory Committee (RAC), one of 10 RACs established by the U.S. Department of Education to solicit information about the educational needs of state and local educators, school officials, business leaders, state education agencies, parents, local communities, and…

Addressing Issues Related to Technology and Engineering

ERIC Educational Resources Information Center

Technology Teacher, 2008

2008-01-01

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

State Energy Data Needs Assessment

EIA Publications

2009-01-01

This report responds to Section 805(d) of the Energy Independence and Security Act of 2007 (EISA), Public Law 110-140, requiring the Energy Information Administration to assess State-level energy data needs and submit to Congress a plan to address those needs.

Need for Improved Methods to Collect and Present Spatial Epidemiologic Data for Vectorborne Diseases

PubMed Central

Eisen, Rebecca J.

2007-01-01

Improved methods for collection and presentation of spatial epidemiologic data are needed for vectorborne diseases in the United States. Lack of reliable data for probable pathogen exposure site has emerged as a major obstacle to the development of predictive spatial risk models. Although plague case investigations can serve as a model for how to ideally generate needed information, this comprehensive approach is cost-prohibitive for more common and less severe diseases. New methods are urgently needed to determine probable pathogen exposure sites that will yield reliable results while taking into account economic and time constraints of the public health system and attending physicians. Recent data demonstrate the need for a change from use of the county spatial unit for presentation of incidence of vectorborne diseases to more precise ZIP code or census tract scales. Such fine-scale spatial risk patterns can be communicated to the public and medical community through Web-mapping approaches. PMID:18258029

Need for improved methods to collect and present spatial epidemiologic data for vectorborne diseases.

PubMed

Eisen, Lars; Eisen, Rebecca J

2007-12-01

Improved methods for collection and presentation of spatial epidemiologic data are needed for vectorborne diseases in the United States. Lack of reliable data for probable pathogen exposure site has emerged as a major obstacle to the development of predictive spatial risk models. Although plague case investigations can serve as a model for how to ideally generate needed information, this comprehensive approach is cost-prohibitive for more common and less severe diseases. New methods are urgently needed to determine probable pathogen exposure sites that will yield reliable results while taking into account economic and time constraints of the public health system and attending physicians. Recent data demonstrate the need for a change from use of the county spatial unit for presentation of incidence of vectorborne diseases to more precise ZIP code or census tract scales. Such fine-scale spatial risk patterns can be communicated to the public and medical community through Web-mapping approaches.

How to Address the Volitional Dimension of the Engineer's Social Responsibility

ERIC Educational Resources Information Center

Heikkero, T.

2008-01-01

In this paper I argue that volitional aspects, i.e. ethos, attitude, pathos, will, underlying emotion, in engineering action need to be addressed when teaching social responsibility within the engineering curriculum. After presenting reasons for this claim, I look at two different, but not mutually exclusive, approaches to address volitional…

Improving data collection, documentation, and workflow in a dementia screening study

PubMed Central

Read, Kevin B.; LaPolla, Fred Willie Zametkin; Tolea, Magdalena I.; Galvin, James E.; Surkis, Alisa

2017-01-01

Background A clinical study team performing three multicultural dementia screening studies identified the need to improve data management practices and facilitate data sharing. A collaboration was initiated with librarians as part of the National Library of Medicine (NLM) informationist supplement program. The librarians identified areas for improvement in the studies’ data collection, entry, and processing workflows. Case Presentation The librarians’ role in this project was to meet needs expressed by the study team around improving data collection and processing workflows to increase study efficiency and ensure data quality. The librarians addressed the data collection, entry, and processing weaknesses through standardizing and renaming variables, creating an electronic data capture system using REDCap, and developing well-documented, reproducible data processing workflows. Conclusions NLM informationist supplements provide librarians with valuable experience in collaborating with study teams to address their data needs. For this project, the librarians gained skills in project management, REDCap, and understanding of the challenges and specifics of a clinical research study. However, the time and effort required to provide targeted and intensive support for one study team was not scalable to the library’s broader user community. PMID:28377680

Tempest: Tools for Addressing the Needs of Next-Generation Climate Models

NASA Astrophysics Data System (ADS)

Ullrich, P. A.; Guerra, J. E.; Pinheiro, M. C.; Fong, J.

2015-12-01

Tempest is a comprehensive simulation-to-science infrastructure that tackles the needs of next-generation, high-resolution, data intensive climate modeling activities. This project incorporates three key components: TempestDynamics, a global modeling framework for experimental numerical methods and high-performance computing; TempestRemap, a toolset for arbitrary-order conservative and consistent remapping between unstructured grids; and TempestExtremes, a suite of detection and characterization tools for identifying weather extremes in large climate datasets. In this presentation, the latest advances with the implementation of this framework will be discussed, and a number of projects now utilizing these tools will be featured.

Policy directions in urban health in developing countries--the slum improvement approach.

PubMed

Harpham, T; Stephens, C

1992-07-01

The urban development, or housing, sector has a longer experience of addressing the problems of the urban poor in developing countries than the health sector. In recent years the policy of 'slum improvement', which involves both sectors, has attracted the support of international donors. This article documents the development of the slum improvement approach and addresses key issues of the approach which have implications for health planning: covering the poorest dwellers; relocation; land tenure; gentrification; debt burdens and the impact on women. Questions about the approach which still need answering are defined and a summary of the constraints in slum improvement and potential solutions is presented.

Boomer Matters: Responding to Emotional Health Needs in an Aging Society.

PubMed

O'Connor, Deborah; Kelson, Elizabeth

2018-01-01

This study explores baby boomer-aged adults' experiences accessing an emotional health program (EHP) in a community-based seniors' center, examining differences between it and an older cohort of users. Data generation includes client-based surveys (n=118), in-depth qualitative interviews (n=20) with client users and professionally-trained counselors (n=2), and a focus group with peer support service worker (n=14). Key findings suggest EHPs as a preventative strategy to address familial abuse, the need for education and support on sexual health and dating, and the need to combat ageism to improve access. Community-based seniors' centers as a cost-effective approach to health promotion is also highlighted.

To Build or Not to Build: Addressing Facilities Needs While Controlling Costs

ERIC Educational Resources Information Center

Kadamus, James A.

2015-01-01

When trustees, presidents, and senior college administrators meet, one topic dominates the conversation: how to keep education quality high and costs down. To keep quality high, college leaders need to have strong faculties and state-of-the-art facilities for teaching and research. Quality counts but it also costs, and that is where the pressures…

Tools for Communication: Novel infrastructure to address patient-perceived gaps in oncology care
.

PubMed

McMullen, Suzanne; Szabo, Shelagh; Halbert, Ronald J; Lai, Catherine; Parikh, Aparna; Bunce, Mikele; Khoury, Raya; Small, Art; Masaquel, Anthony

2017-04-01

Healthcare providers (HCPs) and patient communication are integral to high-quality oncology care. The patient and HCP perspectives are needed to identify gaps in care and develop communication tools.
. This study aimed to understand patient- and HCP-perceived elements of and gaps in high-quality care to develop novel communication tools to improve care. 
. Qualitative interviews were conducted among 16 patients with cancer and 10 HCPs in the United States. Trained interviewers elicited patients' and HCPs' concerns, views, and perceived needs for communication tools. A thematic analysis was used to identify four quality of care domains, depicted in a conceptual model, and two draft communication tools were developed to address identified gaps.
. No patients reported previously using a communication tool, and gaps in communication regarding treatment aims and education were evident. Two tools were developed to assess patients' life and treatment goals and the importance of ongoing education.

New viruses for cancer therapy: meeting clinical needs

PubMed Central

Miest, Tanner S.; Cattaneo, Roberto

2014-01-01

Early-stage clinical trials of oncolytic virotherapy have reported the safety of several virus platforms, and viruses from three families have progressed to advanced efficacy trials. In addition, preclinical studies have established proof-of-principle for many new genetic engineering strategies. Thus, the virotherapy field now has available a diverse collection of viruses that are equipped to address unmet clinical needs owing to improved systemic administration, greater tumour specificity and enhanced oncolytic efficacy. The current key challenge for the field is to develop viruses that replicate with greater efficiency within tumours while achieving therapeutic synergy with currently available treatments. PMID:24292552

Confirming, Classifying, and Prioritizing Needed Over-the-Bed Table Improvements via Methodological Triangulation.

PubMed

Manganelli, Joe; Threatt, Anthony; Brooks, Johnell O; Healy, Stan; Merino, Jessica; Yanik, Paul; Walker, Ian; Green, Keith

2014-01-01

This article presents the results of a qualitative study that confirmed, classified, and prioritized user needs for the design of a more useful, usable, and actively assistive over-the-bed table. Manganelli et al. (2014) generated a list of 74 needs for use in developing an actively assistive over-the-bed table. This present study assesses the value and importance of those needs. Fourteen healthcare subject matter experts and eight research and design subject matter experts engaged in a participatory and iterative research and design process. A mixed methods qualitative approach used methodological triangulation to confirm the value of the findings and ratings to establish importance. Open and closed card sorts and a Delphi study were used. Data analysis methods included frequency analysis, content analysis, and a modified Kano analysis. A table demonstrating the needs that are of high importance to both groups of subject matter experts and classification of the design challenges each represents was produced. Through this process, the list of 74 needs was refined to the 37 most important need statements for both groups. Designing a more useful, usable, and actively assistive over-the-bed table is primarily about the ability to position it optimally with respect to the user for any task, as well as improving ease of use and usability. It is also important to make explicit and discuss the differences in priorities and perspectives demonstrated between research and design teams and their clients. © 2014 Vendome Group, LLC.

Military Justice: Oversight and Better Collaboration Needed for Sexual Assault Investigations and Adjudications

DTIC Science & Technology

2011-06-01

Coast Guard Academies Have Taken Steps to Address Incidents of Sexual Harassment and Assault, but Greater Federal Oversight Is Needed, GAO-08-296...provided through multiple sources and vary annually relative to other programmatic priorities. According to the Army Sexual Harassment /Assault...2.1 million it received from the Army’s Sexual Harassment /Assault Response and Prevention program in fiscal year 2010 for the improvement of sexual

Addressing Common Questions Encountered in the Diagnosis and Management of Cardiac Amyloidosis.

PubMed

Maurer, Mathew S; Elliott, Perry; Comenzo, Raymond; Semigran, Marc; Rapezzi, Claudio

2017-04-04

Advances in cardiac imaging have resulted in greater recognition of cardiac amyloidosis in everyday clinical practice, but the diagnosis continues to be made in patients with late-stage disease, suggesting that more needs to be done to improve awareness of its clinical manifestations and the potential of therapeutic intervention to improve prognosis. Light chain cardiac amyloidosis, in particular, if recognized early and treated with targeted plasma cell therapy, can be managed very effectively. For patients with transthyretin amyloidosis, there are numerous therapies that are currently in late-phase clinical trials. In this review, we address common questions encountered in clinical practice regarding etiology, clinical presentation, diagnosis, and management of cardiac amyloidosis, focusing on recent important developments in cardiac imaging and biochemical diagnosis. The aim is to show how a systematic approach to the evaluation of suspected cardiac amyloidosis can impact the prognosis of patients in the modern era. © 2017 American Heart Association, Inc.

Value for money of changing healthcare services? Economic evaluation of quality improvement

PubMed Central

Severens, J

2003-01-01



 There are many instances of perceived or real inefficiencies in health service delivery. Both healthcare providers and policy makers need to know the impact and cost of applying strategies to change the behaviour of individuals or organisations. Quality improvement or implementation research is concerned with evaluating the methods of behavioural change. Addressing inefficiencies in healthcare services raises a series of issues, beginning with how inefficiency itself should be defined. The basic concepts of cost analysis and economic evaluations are explained and a model for working through the economic issues of quality improvement is discussed. This model combines the costs and benefits of corrected inefficiency with the costs and degree of behavioural change achieved by a quality improvement method in the policy maker's locality. It shows why it may not always be cost effective for policy makers to address suboptimal behaviour. Both the interpretation of quality improvement research findings and their local application need careful consideration. The limited availability of applicable quality improvement research may make it difficult to provide robust advice on the value for money of many behavioural quality improvement strategies. PMID:14532369

Clinical decision support systems for addressing information needs of physicians.

PubMed

Denekamp, Yaron

2007-11-01

Clinicians routinely practice in a state of incomplete information--about the patient, and about medical knowledge pertaining to patients' care. Consequently, there is now growing interest in the use of CDSS to bring decision support to the point of care. CDSS can impact physician behavior in routine practice. Nonetheless, CDSSs are meant to support humans who are ultimately responsible for the clinical decisions, rather than replace them. Although the adoption of CDSS has proceeded at a slow pace, there is a widespread recognition that CDSSs are expected to play a crucial role in reducing medical errors and improving the quality and efficacy of health care. This will be facilitated by the gradual maturation of electronic health record systems and the emergence of standard terminologies and messaging standards for the exchange of clinical data.

Designing a Clinical Data Warehouse Architecture to Support Quality Improvement Initiatives

PubMed Central

Chelico, John D.; Wilcox, Adam B.; Vawdrey, David K.; Kuperman, Gilad J.

2016-01-01

Clinical data warehouses, initially directed towards clinical research or financial analyses, are evolving to support quality improvement efforts, and must now address the quality improvement life cycle. In addition, data that are needed for quality improvement often do not reside in a single database, requiring easier methods to query data across multiple disparate sources. We created a virtual data warehouse at NewYork Presbyterian Hospital that allowed us to bring together data from several source systems throughout the organization. We also created a framework to match the maturity of a data request in the quality improvement life cycle to proper tools needed for each request. As projects progress in the Define, Measure, Analyze, Improve, Control stages of quality improvement, there is a proper matching of resources the data needs at each step. We describe the analysis and design creating a robust model for applying clinical data warehousing to quality improvement. PMID:28269833

Translating Life Course Theory to Clinical Practice to Address Health Disparities

PubMed Central

Solomon, Barry S.

2013-01-01

Life Course Theory (LCT) is a framework that explains health and disease across populations and over time and in a powerful way, conceptualizes health and health disparities to guide improvements. It suggests a need to change priorities and paradigms in our healthcare delivery system. In “Rethinking Maternal and Child Health: The Life Course Model as an Organizing Framework,” Fine and Kotelchuck identify three areas of rethinking that have relevance to clinical care: (1) recognition of context and the “whole-person, whole-family, whole-community systems approach;” (2) longitudinal approach with “greater emphasis on early (“upstream”) determinants of health”; and (3) need for integration and “developing integrated, multi-sector service systems that become lifelong “pipelines” for healthy development”. This paper discusses promising clinical practice innovations in these three areas: addressing social influences on health in clinical practice, longitudinal and vertical integration of clinical services and horizontal integration with community services and resources. In addition, barriers and facilitators to implementation are reviewed. PMID:23677685

The Learning Needs of Older Adults.

ERIC Educational Resources Information Center

Purdie, Nola; Boulton-Lewis, Gillian

2003-01-01

Interviews with 17 older adults about learning needs and barriers resulted in a questionnaire completed by 160 elders. Most important needs were associated with transportation, health, and safety. Physical disabilities were the chief barrier. They felt most confident addressing health, safety, leisure, and transportation needs but not…

The urgent need for quality improvement in Russia.

PubMed

Ruevekamp, D

1994-01-01

Induced abortion became accepted as a legal method of family planning after the October Revolution of 1917 from which terminations were performed in state hospitals free of charge upon a woman's request. The procedure was made legal in response to then newly voiced egalitarian ideals and the increasing involvement of women in the labor market, as well as because of the rapidly deteriorating situation and post-Revolution period of famine. Administrators fully expected to reduce the incidence of abortion once living conditions improved. Little was done at the time to develop contraceptives. Stalin, however, in the 1920s and 1930s, lamented a falling birth rate in the face of manpower needed for labor and the military; abortion and contraceptives were banned, leading to post-abortion complications without really stimulating the birth rate. Abortion was relegalized in 1956, but the right to contraception was never fully restored. Seven million induced abortions were officially registered to have taken place in each of the last ten years in the former Soviet Union. A woman typically undergoes one abortion per year, or approximately twenty abortions during the childbearing period of her life. Lacking knowledge about contraception, contraceptives, and what many Western countries regard to be women's reproductive health rights, most Russian women, however, freely tolerate frequent repeated abortion as a normal method of fertility regulation. Lack of access to contraceptives along with the lack of domestic contraceptive method production facilities and lack of hard currency to secure quality supplies from abroad are contributing factors to this ongoing trend. Gynecologists also receive lucrative fees for illegal abortions and are unlikely to promote change. Plans to open twelve family planning centers in Moscow have been hampered by the inertia of bureaucracy, the lack of financial means, the lack of trained personnel, and people's suspicion of government bodies. Much needs

Foreign Affairs: Specific Action Plan Needed to Improve Response to Parental Child Abductions

DTIC Science & Technology

2000-03-01

the child or prejudice to interested parties; (3) secure the voluntary return of the child or to bring about an amicable resolution of the issues, and...FOREIGN AFFAIRS Specific Action Plan Needed to Improve Response to Parental Child Abductions DISTRIBUTION STATEMENT A Approved for Public Release...International Parental Child Abduction 17 Page 1 GAO/NSIAD-00-10 Parental Child Abduction Page 2 GAO/NSIAD-00-10 Parental Child Abduction GAP

Homeland Defense: Continued Actions Needed to Improve Management of Air Sovereignty Alert Operations

DTIC Science & Technology

2012-01-01

Better Outcomes, GAO-10-374T (Washington, D.C.: May 20, 2009); Aviation Security : DHS and TSA Have Researched, Developed and Begun Deploying Passenger... Security : TSA Has Made Progress, but Additional Efforts Are Needed to Improve Security. GAO-11-938T. Washington, D.C.: September 16, 2011. Aviation ...Washington, D.C.: October 23, 2009. Related GAO Products Homeland Defense DOD Tactical Aircraft Aviation Security Risk Management Related GAO

Aviation Safety: FAA Oversight of Repair Stations Needs Improvement

DOT National Transportation Integrated Search

1997-10-24

This report by the General Accounting Office examines the Federal Aviation : Administration's (FAA) oversight of the aviation repair station industry. : Specifically, this report addresses the following questions: (1) What is the : nature and scope o...

Conservation Research Is Not Happening Where It Is Most Needed.

PubMed

Wilson, Kerrie A; Auerbach, Nancy A; Sam, Katerina; Magini, Ariana G; Moss, Alexander St L; Langhans, Simone D; Budiharta, Sugeng; Terzano, Dilva; Meijaard, Erik

2016-03-01

Target 19, set by the Convention on Biological Diversity, seeks to improve the knowledge, science base, and technologies relating to biodiversity. We will fail to achieve this target unless prolific biases in the field of conservation science are addressed. We reveal that comparatively less research is undertaken in the world's most biodiverse countries, the science conducted in these countries is often not led by researchers based in-country, and these scientists are also underrepresented in important international fora. Mitigating these biases requires wide-ranging solutions: reforming open access publishing policies, enhancing science communication strategies, changing author attribution practices, improving representation in international processes, and strengthening infrastructure and human capacity for research in countries where it is most needed.

Housing First: exploring participants' early support needs.

PubMed

Stergiopoulos, Vicky; Gozdzik, Agnes; O'Campo, Patricia; Holtby, Alixandra R; Jeyaratnam, Jeyagobi; Tsemberis, Sam

2014-04-13

related to substance use and a need for life skills training and support. Additional strategies can help support Housing First participants in the early stages of program participation and address potential causes of early difficulties, including lack of life skills and social isolation. This study highlights the importance of early and ongoing evaluation, monitoring and program adaptations to address consumer support needs. Current Controlled Trials ISRCTN42520374.

Housing First: exploring participants’ early support needs

PubMed Central

2014-01-01

participants, as well as problems related to substance use and a need for life skills training and support. Conclusions Additional strategies can help support Housing First participants in the early stages of program participation and address potential causes of early difficulties, including lack of life skills and social isolation. This study highlights the importance of early and ongoing evaluation, monitoring and program adaptations to address consumer support needs. Trial registration Current Controlled Trials ISRCTN42520374 PMID:24725374

Conditions for addressing environmental determinants of health behavior in intersectoral policy networks: A fuzzy set Qualitative Comparative Analysis.

PubMed

Peters, D T J M; Verweij, S; Grêaux, K; Stronks, K; Harting, J

2017-12-01

Improving health requires changes in the social, physical, economic and political determinants of health behavior. For the realization of policies that address these environmental determinants, intersectoral policy networks are considered necessary for the pooling of resources to implement different policy instruments. However, such network diversity may increase network complexity and therefore hamper network performance. Network complexity may be reduced by network management and the provision of financial resources. This study examined whether network diversity - amidst the other conditions - is indeed needed to address environmental determinants of health behavior. We included 25 intersectoral policy networks in Dutch municipalities aimed at reducing overweight, smoking, and alcohol/drugs abuse. For our fuzzy set Qualitative Comparative Analysis we used data from three web-based surveys among (a) project leaders regarding network diversity and size (n = 38); (b) project leaders and project partners regarding management (n = 278); and (c) implementation professionals regarding types of environmental determinants addressed (n = 137). Data on budgets were retrieved from project application forms. Contrary to their intentions, most policy networks typically addressed personal determinants. If the environment was addressed too, it was mostly the social environment. To address environmental determinants of health behavior, network diversity (>50% of the actors are non-public health) was necessary in networks that were either small (<16 actors) or had small budgets (<€183,172), when both were intensively managed. Irrespective of network diversity, environmental determinants also were addressed by small networks with large budgets, and by large networks with small budgets, when both provided network management. We conclude that network diversity is important - although not necessary - for resource pooling to address environmental determinants of health behavior

Pulmonary specialty training to improve respiratory health in low- and middle-income countries. Needs and challenges.

PubMed

Chakaya, Jeremiah M; Carter, E Jane; Hopewell, Philip C

2015-04-01

It is estimated that 85% of the world's population lives in low- and middle-income countries (LMICs). Although economic conditions are improving in these countries, health expenditures have not kept pace with the overall economic growth, and health systems remain weak. These already inadequate systems are being further stressed by the epidemiologic transition that is taking place, characterized by a slow decrease in communicable diseases and an increase in noninfectious chronic diseases, resulting in a "double burden" of infectious and noninfectious diseases. Respiratory diseases comprise the largest category of illness within this combined burden of disease. Although there are chronic respiratory disease programs of proven effectiveness appropriate for LMICs, implementation has been greatly hampered by the lack of physicians who have special knowledge and skills in addressing the full spectrum of lung diseases. Thus, there is an urgent need to create training programs for specialists in respiratory diseases. Such programs should be developed and conducted by institutions in LMICs and tailored to fit the prevailing circumstances of the country. Existing curriculum blueprints may be used to guide training program development with appropriate modifications. Academic institutions and professional societies in high-income countries may be called upon to provide technical assistance in developing and implementing training programs. In order to better define the burden of respiratory diseases and identify effective interventions, research, moved forward by persons committed and specialized in this area of health, will be essential.

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

Project Responder: technology needs for local emergency response

NASA Astrophysics Data System (ADS)

Beakley, Guy; Garwin, Thomas; Pollard, Neal A.; Singley, George T., III; Tuohy, Robert V.; Lupo, Jasper

2003-09-01

Since April 2001, the Oklahoma City National Memorial Institute for the Prevention of Terrorism has funded an effort by Hicks &Associates, Inc. and the Terrorism Research Center, Inc., aimed ultimately at improving local, state, and federal emergency responders" capabilities for mitigating the effects of chemical, biological, radiological, nuclear or explosive/ incendiary (CBRNE) terrorism. This effort, titled "Project Responder," began by developing an understanding of how state and local responders view their current capabilities, shortfalls, and needs. This paper discusses some of the results of this first phase of the effort that has resulted in a comprehensive report titled "Emergency Responders" Needs, Goals, and Priorities." This paper addresses two of the capabilities from that report which we believe are of most interest to this conference. There are ten other capabilities discussed in the report, which may also be of interest.

Predictors of physicians' attitudes toward sharing information with patients and addressing psychosocial needs: a cross-sectional study in Greece.

PubMed

Tsimtsiou, Zoi; Benos, Alexios; Garyfallos, Alexandros A; Hatzichristou, Dimitrios

2012-01-01

Sharing information with patients and addressing their psychosocial needs are recognized as fundamental practices of patient-centered physicians. Our study explored predictors of physicians' patient-centered attitudes and yielded a better understanding of the relative influences of job satisfaction, employment status, specialty, previous communication skills training, and sociodemographic factors. Physicians who participated in 13 identical workshops offered throughout Greece were invited to complete a battery of anonymous questionnaires (demographics, job satisfaction scale, Patient-Practitioner Orientation Scale-Sharing subscale, and Physician Belief Scale). Prediction models were used to identify predictors of patient-centered attitudes. In total, 400 fully completed questionnaires were returned (response rate 79.8%). Job satisfaction, previous training in communication skills, younger age and lower socioeconomic status were predictors of positive attitudes toward sharing information with patients. Job satisfaction, previous training in communication skills, and stronger religious beliefs were predictors of higher psychosocial orientation. Job satisfaction and training in communication skills should be ensured in the effort to develop and maintain patient-centered attitudes in physicians. Religious beliefs, age, and socioeconomic status should be taken into consideration in the effort to help physicians become aware of their biases.

How can developing countries harness biotechnology to improve health?

PubMed Central

Daar, Abdallah S; Berndtson, Kathryn; Persad, Deepa L; Singer, Peter A

2007-01-01

Background The benefits of genomics and biotechnology are concentrated primarily in the industrialized world, while their potential to combat neglected diseases in the developing world has been largely untapped. Without building developing world biotechnology capacity to address local health needs, this disparity will only intensify. To assess the potential of genomics to address health needs in the developing world, the McLaughlin-Rotman Centre for Global Health, along with local partners, organized five courses on Genomics and Public Health Policy in the developing world. The overall objective of the courses was to collectively explore how to best harness genomics to improve health in each region. This article presents and analyzes the recommendations from all five courses. Discussion In this paper we analyze recommendations from 232 developing world experts from 58 countries who sought to answer how best to harness biotechnology to improve health in their regions. We divide their recommendations into four categories: science; finance; ethics, society and culture; and politics. Summary The Courses' recommendations can be summarized across the four categories listed above: Science - Collaborate through national, regional, and international networks - Survey and build capacity based on proven models through education, training, and needs assessments Finance - Develop regulatory and intellectual property frameworks for commercialization of biotechnology - Enhance funding and affordability of biotechnology - Improve the academic-industry interface and the role of small and medium enterprise Ethics, Society, Culture - Develop public engagement strategies to inform and educate the public about developments in genomics and biotechnology - Develop capacity to address ethical, social and cultural issues - Improve accessibility and equity Politics - Strengthen understanding, leadership and support at the political level for biotechnology - Develop policies outlining

How can developing countries harness biotechnology to improve health?

PubMed

Daar, Abdallah S; Berndtson, Kathryn; Persad, Deepa L; Singer, Peter A

2007-12-03

The benefits of genomics and biotechnology are concentrated primarily in the industrialized world, while their potential to combat neglected diseases in the developing world has been largely untapped. Without building developing world biotechnology capacity to address local health needs, this disparity will only intensify. To assess the potential of genomics to address health needs in the developing world, the McLaughlin-Rotman Centre for Global Health, along with local partners, organized five courses on Genomics and Public Health Policy in the developing world. The overall objective of the courses was to collectively explore how to best harness genomics to improve health in each region. This article presents and analyzes the recommendations from all five courses. In this paper we analyze recommendations from 232 developing world experts from 58 countries who sought to answer how best to harness biotechnology to improve health in their regions. We divide their recommendations into four categories: science; finance; ethics, society and culture; and politics. The Courses' recommendations can be summarized across the four categories listed above: SCIENCE: - Collaborate through national, regional, and international networks- Survey and build capacity based on proven models through education, training, and needs assessments FINANCE: - Develop regulatory and intellectual property frameworks for commercialization of biotechnology- Enhance funding and affordability of biotechnology- Improve the academic-industry interface and the role of small and medium enterprise ETHICS, SOCIETY, CULTURE: - Develop public engagement strategies to inform and educate the public about developments in genomics and biotechnology- Develop capacity to address ethical, social and cultural issues- Improve accessibility and equity POLITICS: - Strengthen understanding, leadership and support at the political level for biotechnology- Develop policies outlining national biotechnology strategy

A Web-Based Framework for Improving Geriatric Education

ERIC Educational Resources Information Center

Hirth, Victor A.; Hajjar, Ihab

2004-01-01

Despite the growth in the elderly population, physicians with special geriatric training and certification number only 9,000 out of 650,000 doctors in the United States. The flexibility and increasing availability of the Internet makes it an ideal avenue for addressing the educational needs of health care providers to improve the health and care…

Adaptive collective foraging in groups with conflicting nutritional needs

PubMed Central

Senior, Alistair M.; Lihoreau, Mathieu; Charleston, Michael A.; Buhl, Jerome; Raubenheimer, David; Simpson, Stephen J.

2016-01-01

Collective foraging, based on positive feedback and quorum responses, is believed to improve the foraging efficiency of animals. Nutritional models suggest that social information transfer increases the ability of foragers with closely aligned nutritional needs to find nutrients and maintain a balanced diet. However, whether or not collective foraging is adaptive in a heterogeneous group composed of individuals with differing nutritional needs is virtually unexplored. Here we develop an evolutionary agent-based model using concepts of nutritional ecology to address this knowledge gap. Our aim was to evaluate how collective foraging, mediated by social retention on foods, can improve nutrient balancing in individuals with different requirements. The model suggests that in groups where inter-individual nutritional needs are unimodally distributed, high levels of collective foraging yield optimal individual fitness by reducing search times that result from moving between nutritionally imbalanced foods. However, where nutritional needs are highly bimodal (e.g. where the requirements of males and females differ) collective foraging is selected against, leading to group fission. In this case, additional mechanisms such as assortative interactions can coevolve to allow collective foraging by subgroups of individuals with aligned requirements. Our findings indicate that collective foraging is an efficient strategy for nutrient regulation in animals inhabiting complex nutritional environments and exhibiting a range of social forms. PMID:27152206

Case Study of Science Teachers' Professional Development in Saudi Arabia: Challenges and Improvements

ERIC Educational Resources Information Center

Alshehry, Amel

2018-01-01

Professional development has a major role in addressing the skill gaps of teachers. Recently, much effort has been focused on improving teaching practices in Saudi Arabia. Here we aim to determine Saudi teachers professional development needs in the higher educational system. We also focus on skill needs, training programs, factors affecting…

Flexible Biomanufacturing Processes that Address the Needs of the Future.

PubMed

Diel, Bernhard; Manzke, Christian; Peuker, Thorsten

2014-01-01

: As the age of the blockbuster drug recedes, the business model for the biopharmaceutical industry is evolving at an ever-increasing pace. The personalization of medicine, the emergence of biosimilars and biobetters, and the need to provide vaccines globally are just some of the factors forcing biomanufacturers to rethink how future manufacturing capability is implemented. One thing is clear: the traditional manufacturing strategy of constructing large-scale, purpose-built, capital-intensive facilities will no longer meet the industry's emerging production and economic requirements. Therefore, the authors of this chapter describe the new approach for designing and implementing flexible production processes for monoclonal antibodies and focus on the points to consider as well as the lessons learned from past experience in engineering such systems. A conceptual integrated design is presented that can be used as a blueprint for next-generation biomanufacturing facilities. In addition, this chapter discusses the benefits of the new approach with respect to flexibility, cost, and schedule. The concept presented here can be applied to other biopharmaceutical manufacturing processes and facilities, including-but not limited to-vaccine manufacturing, multiproduct and/or multiprocess capability, clinical manufacturing, and so on.

Ethnographic process evaluation of a quality improvement project to improve transitions of care for older people

PubMed Central

Sutton, Elizabeth; Dixon-Woods, Mary; Tarrant, Carolyn

2016-01-01

Objectives Quality improvement projects to address transitions of care across care boundaries are increasingly common but meet with mixed success for reasons that are poorly understood. We aimed to characterise challenges in a project to improve transitions for older people between hospital and care homes. Design Independent process evaluation, using ethnographic observations and interviews, of a quality improvement project. Setting and participants An English hospital and two residential care homes for older people. Data 32 hours of non-participant observations and 12 semistructured interviews with project members, hospital and care home staff. Results A hospital-based improvement team sought to reduce unplanned readmissions from residential care homes using interventions including a community-based geriatric team that could be accessed directly by care homes and a communication tool intended to facilitate transfer of information between homes and hospital. Only very modest (if any) impacts of these interventions on readmission rates could be detected. The process evaluation identified multiple challenges in implementing interventions and securing improvement. Many of these arose because of lack of consensus on the nature of the problem and the proper solutions: while the hospital team was keen to reduce readmissions and saw the problems as lying in poor communication and lack of community-based support for care homes, the care home staff had different priorities. Care home staff were unconvinced that the improvement interventions were aligned with their needs or addressed their concerns, resulting in compromised implementation. Conclusions Process evaluations have a valuable role in quality improvement. Our study suggests that a key task for quality improvement projects aimed at transitions of care is that of developing a shared view of the problem to be addressed. A more participatory approach could help to surface assumptions, interpretations and interests

Improving Evaluation to Address the Unintended Consequences of Health Information Technology:. a Position Paper from the Working Group on Technology Assessment & Quality Development.

PubMed

Magrabi, F; Ammenwerth, E; Hyppönen, H; de Keizer, N; Nykänen, P; Rigby, M; Scott, P; Talmon, J; Georgiou, A

2016-11-10

With growing use of IT by healthcare professionals and patients, the opportunity for any unintended effects of technology to disrupt care health processes and outcomes is intensified. The objectives of this position paper by the IMIA Working Group (WG) on Technology Assessment and Quality Development are to highlight how our ongoing initiatives to enhance evaluation are also addressing the unintended consequences of health IT. Review of WG initiatives Results: We argue that an evidence-based approach underpinned by rigorous evaluation is fundamental to the safe and effective use of IT, and for detecting and addressing its unintended consequences in a timely manner. We provide an overview of our ongoing initiatives to strengthen study design, execution and reporting by using evaluation frameworks and guidelines which can enable better characterization and monitoring of unintended consequences, including the Good Evaluation Practice Guideline in Health Informatics (GEP-HI) and the Statement on Reporting of Evaluation Studies in Health Informatics (STARE-HI). Indicators to benchmark the adoption and impact of IT can similarly be used to monitor unintended effects on healthcare structures, processes and outcome. We have also developed EvalDB, a web-based database of evaluation studies to promulgate evidence about unintended effects and are developing the content for courses to improve training in health IT evaluation. Evaluation is an essential ingredient for the effective use of IT to improve healthcare quality and patient safety. WG resources and skills development initiatives can facilitate a proactive and evidence-based approach to detecting and addressing the unintended effects of health IT.

What Educators in Catholic Schools Might Expect when Addressing Gay and Lesbian Issues: A Study of Needs and Barriers

ERIC Educational Resources Information Center

Maher, Michael J.; Sever, Linda M.

2007-01-01

Previous research indicated that Catholic high schools in the United States were not addressing the topic of homosexuality in any significant and systematic way prior to the mid-1990s, though practitioners in Catholic high schools have begun to address the topic in recent years. This study, in sampling seven Catholic schools in the greater Chicago…

Child Support; Need to Improve Efforts to Identify Fathers and Obtain Support Orders.

DTIC Science & Technology

1987-04-01

34 Reduces the stigma of illegitimacy and helps give the child a sense of identity. • Increases the child’s opportunity to develop a close parental...A179 979 CHILD SUPPORT; NEED TO IMPROVE EFFORTS TO IDENTIFY 1/1 FATHERS AND OBTAIN SUPPORT ORDERS(U) GENERAL ACCOUNTING OFFICE WASHINGTON DC HUNAN...April 30, 1987 The Honorable Otis R. Bowen, M.D. The Secretary of Health and Human Services Dear Mr. Secretary: This report discusses child support

National Labor Relations Board: Action Needed to Improve Case-Processing Time at Headquarters

DTIC Science & Technology

1991-01-01

Board more than 2 years. The Board agreed with the report regarding (1) the disruptive impact of Board-member turnover and vacancies, (2) Board...establish) and the impact of lead case delays were signifi- cant factors that warrant the extent of discussion in the report. ’’A Staff Report on the...of course, too early to evaluate the final impact of the Draft Report’s recommendations on action needed to improve case-processing time at the five

Educational Needs for Improving Self-care in Heart Failure Patients with Diabetes

PubMed Central

Cha, Eun Seok; Clark, Patricia C.; Reilly, Carolyn Miller; Higgins, Melinda; Lobb, Maureen; Smith, Andrew L.; Dunbar, Sandra B.

2013-01-01

Purpose To explore the need for self-monitoring and self-care education in heart failure patients with diabetes (HF-DM patients) by describing cognitive and affective factors to provide guidance in developing effective self- management education. Method A cross-sectional correlation design was employed using baseline patient data from a study testing a 12 week patient and family dyad intervention to improve dietary and medication-taking self-management behaviors in HF patients. Data from 116 participants recruited from metropolitan Atlanta area were used. Demographic and co-morbidities, physical function, psychological distress, relationship with health care provider, self-efficacy (medication taking and low sodium diet), and behavioral outcomes (medications, dietary habits) were assessed. Descriptive statistics and a series of chi-square tests, t-tests or Mann Whitney tests were performed to compare HF patients with and without DM. Results HF-DM patients were older, heavier, had more co- morbidities, and took more daily medications than HF patients. High self-efficacy on medication and low sodium diet was reported in both groups with no significant difference. Although HF-DM patients took more daily medications than HF, both groups exhibited high HF medication taking behaviors. The HF-DM patients consumed significantly lower total sugar than HF patients, but clinically higher levels of sodium. Conclusions Diabetes educators need to be aware of potential conflicts of treatment regimens to manage two chronic diseases. Special and integrated diabetes self-management education programs which incorporate principles of HF self-management should be developed to improve self-management behavior in HF-DM patients. PMID:22722611

Educational needs for improving self-care in heart failure patients with diabetes.

PubMed

Cha, EunSeok; Clark, Patricia C; Reilly, Carolyn Miller; Higgins, Melinda; Lobb, Maureen; Smith, Andrew L; Dunbar, Sandra B

2012-01-01

To explore the need for self-monitoring and self-care education in heart failure patients with diabetes (HF- DM patients) by describing cognitive and affective factors to provide guidance in developing effective self-management education. A cross-sectional correlation design was employed using baseline patient data from a study testing a 12-week patient and family dyad intervention to improve dietary and medication-taking self-management behaviors in HF patients. Data from 116 participants recruited from metropolitan Atlanta area were used. Demographic and comorbidities, physical function, psychological distress, relationship with health care provider, self-efficacy (medication taking and low sodium diet), and behavioral outcomes (medications, dietary habits) were assessed. Descriptive statistics and a series of chi-square tests, t tests, or Mann-Whitney tests were performed to compare HF patients with and without DM. HF-DM patients were older and heavier, had more comorbidities, and took more daily medications than HF patients. High self-efficacy on medication and low-sodium diet was reported in both groups with no significant difference. Although HF-DM patients took more daily medications than HF, both groups exhibited high HF medication-taking behaviors. The HF-DM patients consumed significantly lower total sugar than HF patients but clinically higher levels of sodium. Diabetes educators need to be aware of potential conflicts of treatment regimens to manage 2 chronic diseases. Special and integrated diabetes self-management education programs that incorporate principles of HF self-management should be developed to improve self-management behavior in HF-DM patients.

Quantifying tropical dry forest type and succession: substantial improvement with LiDAR

Treesearch

Sebastian Martinuzzi; William A. Gould; Lee A. Vierling; Andrew T. Hudak; Ross F. Nelson; Jeffrey S. Evans

2012-01-01

Improved technologies are needed to advance our knowledge of the biophysical and human factors influencing tropical dry forests, one of the world’s most threatened ecosystems. We evaluated the use of light detection and ranging (LiDAR) data to address two major needs in remote sensing of tropical dry forests, i.e., classification of forest types and delineation of...

Determinants of unmet need for contraception among Chinese migrants: a worksite-based survey.

PubMed

Decat, Peter; Zhang, Wei-Hong; Moyer, Eileen; Cheng, Yimin; Wang, Zhi-Jin; Lu, Ci-Yong; Wu, Shi-Zhong; Nadisauskiene, Ruta Jolanta; Luchters, Stanley; Deveugele, Myriam; Temmerman, Marleen

2011-02-01

Considerable sexual and reproductive health (SRH) challenges have been reported among rural-to-urban migrants in China. Predictors thereof are urgently needed to develop targeted interventions. A cross-sectional study assessed determinants of unmet need for contraception using semi-structured interviews in two cities in China: Guangzhou and Qingdao. Between July and September 2008, 4867 female rural-to-urban migrants aged 18-29 years participated in the study. Of these, 2264 were married or cohabiting. Among sexually-active women (n = 2513), unmet need for contraception was reported by 36.8% and 51.2% of respondents in Qingdao and Guangzhou, respectively; it was associated with being unmarried, having no children, less schooling, poor SRH knowledge, working in non-food industry, and not being covered by health insurance. A substantial proportion of unmarried migrants reported they had sexual intercourse (16.6 % in Qingdao and 21.4% in Guangzhou) contrary to current sexual standards in China. The study emphasises the importance of improving the response to the needs of rural-to-urban migrants and recommends strategies to address the unmet need for contraception. These should enhance open communication on sexuality, increase the availability of condoms, and improve health insurance coverage.

Addressing cancer control needs of African-born immigrants in the US: a systematic literature review.

PubMed

Hurtado-de-Mendoza, Alejandra; Song, Minna; Kigen, Ocla; Jennings, Yvonne; Nwabukwu, Ify; Sheppard, Vanessa B

2014-10-01

Compared to non-Hispanic Whites, African immigrants have worse cancer outcomes. However, there is little research about cancer behaviors and/or interventions in this growing population as they are generally grouped with populations from America or the Caribbean. This systematic review examines cancer-related studies that included African-born participants. We searched PsycINFO, Ovid Medline, Pubmed, CINHAL, and Web of Science for articles focusing on any type of cancer that included African-born immigrant participants. Twenty articles met study inclusion criteria; only two were interventions. Most articles focused on one type of cancer (n=11) (e.g., breast cancer) and were conducted in disease-free populations (n=15). Studies included African participants mostly from Nigeria (n=8) and Somalia (n=6). However, many papers (n=7) did not specify nationality or had small percentages (<5%) of African immigrants (n=5). Studies found lower screening rates in African immigrants compared to other subpopulations (e.g. US-born). Awareness of screening practices was limited. Higher acculturation levels were associated with higher screening rates. Barriers to screening included access (e.g. insurance), pragmatic (e.g. transportation), and psychosocial barriers (e.g. shame). Interventions to improve cancer outcomes in African immigrants are needed. Research that includes larger samples with diverse African subgroups including cancer survivors is necessary to inform future directions. Copyright © 2014 Elsevier Inc. All rights reserved.

Addressing Cancer Control Needs of African-born Immigrants in the US: A Systematic Literature Review

PubMed Central

Hurtado-de-Mendoza, Alejandra; Song, Minna; Kigen, Ocla; Jennings, Yvonne; Nwabukwu, Ify; Sheppard, Vanessa B.

2014-01-01

Compared to non-Hispanic Whites, African immigrants have worse cancer outcomes. However, there is little research about cancer behaviors and/or interventions in this growing population as they are generally grouped with populations from America or the Caribbean. This systematic review examines cancer-related studies that included African-born participants. We searched PsychINFO, Ovid Medline, Pubmed, CINHAL, and Web of Science for articles focusing on any type of cancer that included African-born immigrant participants. Twenty articles met study inclusion criteria; only two were interventions. Most articles focused on one type of cancer (n=11) (e.g., breast cancer) and were conducted in disease-free populations (n=15). Studies included African participants mostly from Nigeria (n=8) and Somalia (n=6). However, many papers (n=7) did not specify nationality or had small percentages (<5%) of African immigrants (n=5). Studies found lower screening rates in African immigrants compared to other subpopulations (e.g. US born). Awareness of screening practices was limited. Higher acculturation levels were associated with higher screening rates. Barriers to screening included access (e.g. insurance), pragmatic (e.g. transportation), and psychosocial barriers (e.g. shame). Interventions to improve cancer outcomes in African immigrants are needed. Research that includes larger samples with diverse African subgroups including cancer survivors are necessary to inform future directions. PMID:25034729

VA Health Care: Improvements Needed in Monitoring Antidepressant Use for Major Depressive Disorder and in Increasing Accuracy of Suicide Data

DTIC Science & Technology

2014-11-01

VA HEALTH CARE Improvements Needed in Monitoring Antidepressant Use for Major Depressive Disorder and in Increasing...00-2014 4. TITLE AND SUBTITLE VA Health Care: Improvements Needed in Monitoring Antidepressant Use for Major Depressive Disorder and in Increasing...Use for Major Depressive Disorder and in Increasing Accuracy of Suicide Data Why GAO Did This Study In 2013, VA estimated that about 1.5 million

Addressing the Needs of Adolescents with Autism Spectrum Disorder: Considerations and Complexities for High School Interventions

ERIC Educational Resources Information Center

Kucharczyk, Suzanne; Reutebuch, Colleen K.; Carter, Erik W.; Hedges, Susan; El Zein, Farah; Gustafson, Jenny R.

2015-01-01

The outcomes of students with autism spectrum disorder (ASD) are driving the field to address how secondary education might be optimally designed and delivered. We conducted 28 focus groups across four states to explore the contexts, considerations, and complexities associated with delivering and combining evidence-based interventions to meet the…

Head Start: An Effective Program But the Fund Distribution Formula Needs Revision and Management Controls Need Improvement. Report to the Congress of the United States by the Comptroller General.

ERIC Educational Resources Information Center

Comptroller General of the U.S., Washington, DC.

This report from the Comptroller General to the United States Congress finds Head Start to be an effective program whose fund distribution formula needs revision and whose management controls need improvement. Head Start's funding for enrollment and operating costs increased significantly between 1977-81. However, these funding increases were not…

Helping Older Adults Improve Their Medication Experience (HOME) by Addressing Medication Regimen Complexity in Home Healthcare.

PubMed

Sheehan, Orla C; Kharrazi, Hadi; Carl, Kimberly J; Leff, Bruce; Wolff, Jennifer L; Roth, David L; Gabbard, Jennifer; Boyd, Cynthia M

In skilled home healthcare (SHHC), communication between nurses and physicians is often inadequate for medication reconciliation and needed changes to the medication regimens are rarely made. Fragmentation of electronic health record (EHR) systems, transitions of care, lack of physician-nurse in-person contact, and poor understanding of medications by patients and their families put patients at risk for serious adverse outcomes. The aim of this study was to develop and test the HOME tool, an informatics tool to improve communication about medication regimens, share the insights of home care nurses with physicians, and highlight to physicians and nurses the complexity of medication schedules. We used human computer interaction design and evaluation principles, automated extraction from standardized forms, and modification of existing EHR fields to highlight key medication-related insights that had arisen during the SHHC visit. Separate versions of the tool were developed for physicians/nurses and patients/caregivers. A pilot of the tool was conducted using 20 SHHC encounters. Home care nurses and physicians found the tool useful for communication. Home care nurses were able to implement the HOME tool into their clinical workflow and reported improved communication with physicians about medications. This simple and largely automated tool improves understanding and communication around medications in SHHC.

Participation needs of older adults having disabilities and receiving home care: met needs mainly concern daily activities, while unmet needs mostly involve social activities.

PubMed

Turcotte, Pier-Luc; Larivière, Nadine; Desrosiers, Johanne; Voyer, Philippe; Champoux, Nathalie; Carbonneau, Hélène; Carrier, Annie; Levasseur, Mélanie

2015-08-01

highlights the complexity of older adults' participation needs, involving daily as well as social activities. Properly assessing and addressing these needs is thus necessary to improve older adults' health and well-being. Discrepancies in the various actors' perceptions of participation needs must be further explored. Additional research would help better understand how to optimize the contribution of community organizations and caregivers.

Pneumococcal conjugate vaccine use in adults - Addressing an unmet medical need for non-bacteremic pneumococcal pneumonia.

PubMed

Sings, Heather L

2017-09-25

Streptococcus pneumoniae is a frequent cause of community acquired pneumonia (CAP), with the largest burden of disease attributed to non-bacteremic pneumonia. Due to the high persistent burden of disease, pneumococcal pneumonia, particularly non-bacteremic pneumococcal pneumonia, continues to be a major public health concern. There are currently two pneumococcal vaccines approved for use in adults in the United States (US) and other countries worldwide: a 23-valent pneumococcal simple polysaccharide vaccine (PPV23), and a 13-valent pneumococcal conjugate vaccine (PCV13). The capsular polysaccharides included in PPV23 induce antibodies primarily by a T-cell independent mechanism, thus the immune response is short lived and lacks the ability to elicit an anamnestic response. PCV13, on the other hand, has the bacterial polysaccharides covalently conjugated to an immunogenic carrier protein resulting in the formation of memory B lymphocytes, thus proving long-acting immunologic memory and an anamnestic response. Despite 30years of use, the question of PPV23 vaccine efficacy, particularly with respect to efficacy for non-bacteremic pneumonia, has been extensively debated and investigated; whereas PCV13 efficacy against vaccine-type pneumococcal CAP, both bacteremic and non-bacteremic, was confirmed in a large randomized controlled trial in older adults. PCV13 was approved under the US Food and Drug Administration's accelerated pathway, which allows for earlier approval of products that provide meaningful benefit over existing treatments - in this case, protection of adults from non-bacteremic pneumococcal pneumonia. Its use is now increasingly recommended globally. This article summarizes the history and use of PPV23 and PCV13 in adults and how vaccination of adults with PCV13 addresses an unmet medical need. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cerritos Community College: Improvements Needed in Aspects of Operating the District and Its Auxiliary Organization.

ERIC Educational Resources Information Center

California State Office of the Auditor General, Sacramento.

This audit report discusses the operation of the Enterprise Fund by Cerritos Community College District in California. In addition, the Cerritos College Foundation's conflict of interest policies, its relationship with the district, and its award of contracts for services was reviewed. It was found that the district needed improvement in its…

Multiple strategies are required to address the information and support needs of gay and bisexual men with hepatitis C in Australia.

PubMed

Hopwood, Max; Lea, Toby; Aggleton, Peter

2016-03-01

Hepatitis C virus (HCV) infection is increasingly reported among gay and bisexual men. However, little is known about the personal and social dimensions of HCV-related experience among these men in Australia. An online survey of 474 Australian gay and bisexual men was conducted from August to December 2013. A subsample of 48 HCV mono-infected and HIV/HCV co-infected men was analysed to explore HCV knowledge, sources of information, unmet information needs and use of HCV-related services. More than half of respondents in the subsample were unaware that HIV infection increases the risk of sexually acquired HCV and most wanted information about how to prevent the sexual transmission of HCV. A majority of respondents requested gay-specific HCV services, and approximately similar proportions of men indicated that they would like these services delivered by a hepatitis organization, a lesbian, gay, bisexual, transgender and intersex (LGBTI) organization and a HIV organization. Men in receipt of HIV antiretroviral treatments were most likely to request that gay-specific HCV information and support services be delivered by a LGBTI or HIV organization (OR = 8.63). These findings suggest that a variety of organizations are required to address the information and support needs of Australian gay and bisexual men with HCV. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Conservation Research Is Not Happening Where It Is Most Needed

PubMed Central

Wilson, Kerrie A.; Auerbach, Nancy A.; Sam, Katerina; Magini, Ariana G.; Moss, Alexander St. L.; Langhans, Simone D.; Budiharta, Sugeng; Terzano, Dilva; Meijaard, Erik

2016-01-01

Target 19, set by the Convention on Biological Diversity, seeks to improve the knowledge, science base, and technologies relating to biodiversity. We will fail to achieve this target unless prolific biases in the field of conservation science are addressed. We reveal that comparatively less research is undertaken in the world’s most biodiverse countries, the science conducted in these countries is often not led by researchers based in-country, and these scientists are also underrepresented in important international fora. Mitigating these biases requires wide-ranging solutions: reforming open access publishing policies, enhancing science communication strategies, changing author attribution practices, improving representation in international processes, and strengthening infrastructure and human capacity for research in countries where it is most needed. PMID:27023288

Are We Doing Enough to Address the Cancer Care Needs 
of the LGBT Community?

PubMed

Brown, Carlton; Mayer, Deborah K

2015-06-01

The 2011 film titled Gen Silent (http://gensilent.com) focuses on the needs and issues of six aging lesbian, gay, bisexual, and transgender (LGBT) people, at least two of whom had cancer. One of the issues made apparent in the film was the lack of trust in the healthcare system and the discrimination these individuals faced at a time when their needs were growing and they were increasingly vulnerable. It was sad and caused us to reflect on what we, as oncology nurses, are doing to meet the needs of LGBT individuals faced with a cancer diagnosis.
.

Patient priorities and needs for diabetes care among urban African American adults.

PubMed

Batts, M L; Gary, T L; Huss, K; Hill, M N; Bone, L; Brancati, F L

2001-01-01

This study was conducted to determine diabetes care priorities and needs in a group of urban African American adults with type 2 diabetes mellitus. One hundred nineteen African American adults with type 2 diabetes, aged 35 to 75, received behavioral/educational interventions from a nurse case manager, a community health worker, or both. Priorities and needs were assessed during 3 intervention visits. The most frequently reported priorities for diabetes care were glucose self-monitoring (61%), medication adherence (47%), and healthy eating (36%). The most frequently addressed diabetes needs were glucose self-monitoring and medication adherence. Most of the intervention visits (77%) addressed non-diabetes-related health issues such as cardiovascular disease (36%) and social issues such as family responsibilities (30%). Participants' self-reported priorities for diabetes care directly reflected the diabetes needs addressed. Needs beyond the focus of traditional diabetes care (social issues and insurance) are important to address in urban African Americans with type 2 diabetes. Interventions designed to address comprehensive health and social needs should be included in treatment and educational plans for this population.

Changing the paradigm of emergency response: The need for first-care providers.

PubMed

Bobko, Joshua P; Kamin, Richard

2015-01-01

There is a major gap in the security of the critical infrastructure - civilian medical response to atypical emergencies. Clear evidence demonstrates that, despite ongoing improvements to the first-responder system, there exists an inherent delay in the immediate medical care at the scene of an emergency. This delay can only be reduced through a societal shift in reliance on police and fire response and by extending the medical system into all communities. Additionally, through analysis of military data, it is known that immediately addressing the common injury patterns following a traumatic event will save lives. The predictable nature of these injuries, coupled with an unavoidable delay in the arrival of first responders, necessitates the need for immediate care on scene. Initial care is often rendered by bystanders, typically armed only with basic first-aid training based on medical emergencies and does not adequately address the traumatic injury patterns seen in disasters. Implementing an approach similar to the American Cardiac Arrest Act can improve outcomes to traumatic events. This paper analyses the latest data on active shooter incidents and proposes that the creation of a network of trauma-trained medic extenders would improve all communities' resilience to catastrophic disaster.

An investigation of the ways in which public health nutrition policy and practices can address climate change.

PubMed

Sulda, Heidi; Coveney, John; Bentley, Michael

2010-03-01

To develop a framework to guide action in the public health nutrition workforce to develop policies and practices addressing factors contributing to climate change. Action/consultative research. Interviews - South Australia, questionnaire - Australia. Interviews - key informants (n 6) were from various government, academic and non-government positions, invited through email. Questionnaire - participants were members of the public health nutrition workforce (n 186), recruited to the study through emails from public health nutrition contacts for each State in Australia (with the exception of South Australia). Support by participants for climate change as a valid role for dietitians and nutritionists was high (78 %). However, climate change was ranked low against other public health nutrition priorities. Support of participants to conduct programmes to address climate change from professional and work organisations was low. The final framework developed included elements of advocacy/lobbying, policy, professional recognition/support, organisational support, knowledge/skills, partnerships and programmes. This research demonstrates a need for public health nutrition to address climate change, which requires support by organisations, policy, improved knowledge and increased professional development opportunities.

National plan to enhance aviation safety through human factors improvements

NASA Technical Reports Server (NTRS)

Foushee, Clay

1990-01-01

The purpose of this section of the plan is to establish a development and implementation strategy plan for improving safety and efficiency in the Air Traffic Control (ATC) system. These improvements will be achieved through the proper applications of human factors considerations to the present and future systems. The program will have four basic goals: (1) prepare for the future system through proper hiring and training; (2) develop a controller work station team concept (managing human errors); (3) understand and address the human factors implications of negative system results; and (4) define the proper division of responsibilities and interactions between the human and the machine in ATC systems. This plan addresses six program elements which together address the overall purpose. The six program elements are: (1) determine principles of human-centered automation that will enhance aviation safety and the efficiency of the air traffic controller; (2) provide new and/or enhanced methods and techniques to measure, assess, and improve human performance in the ATC environment; (3) determine system needs and methods for information transfer between and within controller teams and between controller teams and the cockpit; (4) determine how new controller work station technology can optimally be applied and integrated to enhance safety and efficiency; (5) assess training needs and develop improved techniques and strategies for selection, training, and evaluation of controllers; and (6) develop standards, methods, and procedures for the certification and validation of human engineering in the design, testing, and implementation of any hardware or software system element which affects information flow to or from the human.

Improving medical graduates’ training in palliative care: advancing education and practice

PubMed Central

Head, Barbara A; Schapmire, Tara J; Earnshaw, Lori; Chenault, John; Pfeifer, Mark; Sawning, Susan; Shaw, Monica A

2016-01-01

The needs of an aging population and advancements in the treatment of both chronic and life-threatening diseases have resulted in increased demand for quality palliative care. The doctors of the future will need to be well prepared to provide expert symptom management and address the holistic needs (physical, psychosocial, and spiritual) of patients dealing with serious illness and the end of life. Such preparation begins with general medical education. It has been recommended that teaching and clinical experiences in palliative care be integrated throughout the medical school curriculum, yet such education has not become the norm in medical schools across the world. This article explores the current status of undergraduate medical education in palliative care as published in the English literature and makes recommendations for educational improvements which will prepare doctors to address the needs of seriously ill and dying patients. PMID:26955298

Enabling Curricula: The Development of a Teaching Observation Protocol to Address Students' Diverse Learning Needs

ERIC Educational Resources Information Center

Hayden, Sharon

2011-01-01

Diverse learning needs are students' learning needs in areas such as language, learning styles, background, disabilities, technology skills, motivation, engagement, and access. Teacher candidates must be aware of and plan to meet these needs. The Universal Design for Learning (UDL) provides guidelines that can increase the level of student…

Reshaping Rural Schools in the Northwest Region: Lessons from Federal School Improvement Grant Implementation. REL 2016-107

ERIC Educational Resources Information Center

Scott, Caitlin; Ostler, Nora

2016-01-01

The five states in the Regional Educational Laboratory (REL) Northwest Region have many rural schools that have been designated as in need of improvement. And all five states had rural schools in the first cohort of federal School Improvement Grant (SIG) recipients. To address school improvement, the majority of those schools implemented the…

The Role of Lean Process Improvement in Implementation of Evidence-Based Practices in Behavioral Health Care.

PubMed

Steinfeld, Bradley; Scott, Jennifer; Vilander, Gavin; Marx, Larry; Quirk, Michael; Lindberg, Julie; Koerner, Kelly

2015-10-01

To effectively implement evidence-based practices (EBP) in behavioral health care, an organization needs to have operating structures and processes that can address core EBP implementation factors and stages. Lean, a widely used quality improvement process, can potentially address the factors crucial to successful implementation of EBP. This article provides an overview of Lean and the relationship between Lean process improvement steps, and EBP implementation models. Examples of how Lean process improvement methodologies can be used to help plan and carry out implementation of EBP in mental health delivery systems are presented along with limitations and recommendations for future research and clinical application.

Tailoring Professional Development to Improve Literacy Instruction in Urban Schools

ERIC Educational Resources Information Center

De La Garza, Tammy Oberg

2011-01-01

To address the need for improving instructional practice in literacy, this paper examines whole school, teacher uptake of a professional development initiative over a four-year project. The study takes place in an urban, PK-6 school in a predominantly Mexican-American community. Measuring and analyzing teacher enactment of a professional…

Community Forays: Addressing Students' Functional Skills in Inclusive Settings.

ERIC Educational Resources Information Center

Burcroff, Teri L.; Radogna, Daniel M.; Wright, Erika H.

2003-01-01

This article describes how one inclusive middle school addressed needs of students with significant disabilities for functional community-referenced skills including clothing purchases, buying groceries, eating out, crossing the street, doing laundry, and using a microwave. Program development, program organization, and involvement of peers…

Assessment, Improvement, and Cooperation: The Challenge of Reform in Higher Education.

ERIC Educational Resources Information Center

Fincher, Cameron

This monograph contains a collection of six national commission reports that address the nation's need to improve undergraduate education. The reports present findings and recommendations that target policy (public and institutional), programs (college and university), and constructive changes in institutions of higher education, as well as their…

Workforce capacity to address obesity: a Western Australian cross-sectional study identifies the gap between health priority and human resources needed.

PubMed

Begley, Andrea; Pollard, Christina Mary

2016-08-25

generalists rather than specialists, which may reduce service effectiveness. Although conclusions from this research need to take into account the fact that the audit was conducted in 2004, the findings suggest that there was a need to equip health services with an adequately skilled workforce of sufficient capacity to deliver an effective public health response to the obesity epidemic, particularly addressing poor nutrition and physical inactivity.

Acquiring the Data Needed to Support Defense Transformation

DTIC Science & Technology

2010-04-01

PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Center for Technology and National Security Policy (CTNSP) National Defense University (NDU) Fort...Lesley J. McNair, Washington, DC USA 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR...makers (see Table 1 below), there is a need to collect and organize the data of interest. It is anticipated that all of the stakeholders will be

Recent advances to address European Union Health Security from cross border chemical health threats.

PubMed

Duarte-Davidson, R; Orford, R; Wyke, S; Griffiths, M; Amlôt, R; Chilcott, R

2014-11-01

The European Union (EU) Decision (1082/2013/EU) on serious cross border threats to health was adopted by the European Parliament in November 2013, in recognition of the need to strengthen the capacity of Member States to coordinate the public health response to cross border threats, whether from biological, chemical, environmental events or events which have an unknown origin. Although mechanisms have been in place for years for reporting cross border health threats from communicable diseases, this has not been the case for incidents involving chemicals and/or environmental events. A variety of collaborative EU projects have been funded over the past 10 years through the Health Programme to address gaps in knowledge on health security and to improve resilience and response to major incidents involving chemicals. This paper looks at the EU Health Programme that underpins recent research activities to address gaps in resilience, planning, responding to and recovering from a cross border chemical incident. It also looks at how the outputs from the research programme will contribute to improving public health management of transnational incidents that have the potential to overwhelm national capabilities, putting this into context with the new requirements as the Decision on serious cross border threats to health as well as highlighting areas for future development. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Addressing critical gaps in the treatment of eating disorders.

PubMed

Kazdin, Alan E; Fitzsimmons-Craft, Ellen E; Wilfley, Denise E

2017-03-01

Remarkable progress has been made in developing psychosocial interventions for eating disorders and other mental disorders. Two priorities in providing treatment consist of addressing the research-practice gap and the treatment gap. The research-practice gap pertains to the dissemination of evidence-based treatments from controlled settings to routine clinical care. Closing the gap between what is known about effective treatment and what is actually provided to patients who receive care is crucial in improving mental health care, particularly for conditions such as eating disorders. The treatment gap pertains to extending treatments in ways that will reach the large number of people in need of clinical care who currently receive nothing. Currently, in the United States (and worldwide), the vast majority of individuals in need of mental health services for eating disorders and other mental health problems do not receive treatment. This article discusses the approaches required to better ensure: (1) that more people who are receiving treatment obtain high-quality, evidence-based care, using such strategies as train-the-trainer, web-centered training, best-buy interventions, electronic support tools, higher-level support and policy; and (2) that a higher proportion of those who are currently underserved receive treatment, using such strategies as task shifting and disruptive innovations, including treatment delivery via telemedicine, the Internet, and mobile apps. © 2017 Wiley Periodicals, Inc.

An Outreach Program: Addressing the Needs of the Physically Impaired in Rural Communities.

ERIC Educational Resources Information Center

Moore, Elizabeth; Allen, Deborah

The paper describes a joint effort by the Easter Seal Society and the Arkansas State Department of Education to help rural districts provide appropriate services to orthopedically impaired students. The resulting outreach program provided on-site (school or home) evaluation of students' needs and practical guidelines in non-technical terms to meet…

The Value of Addressing Patient Preferences.

PubMed

Allen, Jeff D; Stewart, Mark D; Roberts, Samantha A; Sigal, Ellen V

2017-02-01

Recent scientific progress is, in some cases, leading to transformative new medicines for diseases that previously had marginal or even no treatment options. This offers great promise for people affected by these diseases, but it has also placed stress on the health care system in terms of the growing cost associated with some new interventions. Effort has been taken to create tools to help patients and health care providers assess the value of new medical innovations. These tools may also provide the basis for assessing the price associated with new medical products. Given the growing expenditures in health care, value frameworks present an opportunity to evaluate new therapeutic options in the context of other treatments and potentially lead to a more economically sustainable health care system. In summary, the contribution to meaningful improvements in health outcomes is the primary focus of any assessment of the value of a new intervention. A component of such evaluations, however, should factor in timely access to new products that address an unmet medical need, as well as the magnitude of that beneficial impact. To achieve these goals, value assessment tools should allow for flexibility in clinical end points and trial designs, incorporate patient preferences, and continually evolve as new evidence, practice patterns, and medical progress advance. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The Need for Formal Surgical Global Health Programs and Improved Mission Trip Coordination.

PubMed

Medoff, Sar; Freed, Jeffrey

There is a dire need for more surgical services as part of improving global health. Conditions treatable with surgery account for 11% of the global burden of disease, with a disproportionate burden affecting low- and middle-income countries (LMICs). Less than 6% of the world's operations are performed in LMICs, with relief organizations performing nearly 250,000 operations annually in LMICs in addition to each country's domestic surgical capacity. Currently, surgical needs are not adequately met by the existing patchwork of federal and nongovernmental organizations' surgical services and surgical mission trips. Improving coordination between mission trips may have synergistic benefits for maximizing the efficacy of the individual trips and improving the overall quality of care. To establish whether cooperation between surgical mission trips can lead to operational efficiency and to identify obstacles to cooperation. In order to establish the veracity of cooperation translating into efficiency and to identify obstacles that prevent cooperation, a 50-question survey was created (see Supplement 1). The survey was sent to surgical program directors of the 147 major surgical programs in the United States and Canada with a follow-up telephone survey of 18 randomly selected programs. The survey response rate was 14%. Although 90% of respondent programs mount at least 1 mission trip per year, only one-third confirmed the existence of global health or surgical global health programs at their institution (33%). There was significant interest in cooperating with programs at other institutions (80%). When asked why they do not communicate with humanitarian aid organizations doing similar work, 53% of respondents reported a "lack of knowledge of how to find similar organizations to mine doing similar work." An additional 21% of respondents were "unaware that coordination is possible." A minority of respondent surgery programs host formal, organized surgical global health

Towards Improving the Quality of Work Life in Education.

ERIC Educational Resources Information Center

Wood, J. M.

Addressing the need to consider ways in which the quality of educator work life can be improved, the author uses J. Walton's eight-point definition of the quality of work life as a framework for discussion. The eight points include (1) adequate and fair compensation, in which financial incentives are provided for advanced coursework; (2) safe and…

Addressing Mental Health Needs: Perspectives from African Americans Living in the Rural South

PubMed Central

Haynes, Tiffany F.; Cheney, Ann; Sullivan, Greer; Bryant, Keneshia; Curran, Geoffrey; Olson, Mary; Cottoms, Naomi; Reaves, Christina

2017-01-01

OBJECTIVE Rural African Americans are disproportionately impacted by social stressors that place them at risk of developing psychiatric disorders. This study aims to understand mental health from the perspective of rural African American residents and other stakeholders in order to devise culturally acceptable treatment approaches. METHODS Seven focus groups (N=50) were conducted with four stakeholder groups. A semi-structured interview guide was used to elicit perspectives of mental health, mental health treatment, and ways to improve mental health within rural African American communities. Inductive analysis was used to identify emergent themes and develop a conceptual model grounded in the textual data. RESULTS Stressful living environments (e.g. impoverished communities) and broader community held beliefs (e.g. religious beliefs and mental health stigma) impacted not only perceptions of mental health but also contributed to barriers that impede mental health seeking. Participants also identified community level strategies that can be utilized to improve emotional wellness in rural African American communities. CONCLUSION Rural African Americans experience several barriers that impede treatment use. Strategies that include conceptualizing mental illness as a normal reaction to stressful living environments, the use of community-based mental health services, and providing mental health education to the general public may improve use of services in this population. PMID:28142389

Beyond bankable dollars: establishing a business case for improving health care.

PubMed

Bailit, Michael; Dyer, Mary Beth

2004-09-01

To address widespread deficiencies in the quality of health care, the authors argue that health care organizations need to be able to make a "business case" for improving quality--a compelling rationale for financial investment in quality improvement programs. The authors' framework for such a business case is organized around three broad areas: direct financial considerations, strategic considerations, and internal organizational considerations. Within these categories, they offer a total of 10 specific business case arguments, with examples, for investing in quality improvement.

Information needs of survivors and families after childhood CNS tumor treatment: a population-based study.

PubMed

Hovén, Emma; Lannering, Birgitta; Gustafsson, Göran; Boman, Krister K

2018-05-01

This study examines information needs and satisfaction with provided information among childhood central nervous system (CNS) tumor survivors and their parents. In a population-based sample of 697 adult survivors in Sweden, 518 survivors and 551 parents provided data. Information needs and satisfaction with information were studied using a multi-dimensional standardized questionnaire addressing information-related issues. Overall, 52% of the survivors and 48% of the parents reported no, or only minor, satisfaction with the extent of provided information, and 51% of the survivors expressed a need for more information than provided. The information received was found useful (to some extent/very much) by 53%, while 47% did not find it useful, or to a minor degree only. Obtaining written material was associated with greater satisfaction and usefulness of information. Dissatisfaction with information was associated with longer time since diagnosis, poorer current health status and female sex. The survivors experienced unmet information needs vis-à-vis late effects, illness education, rehabilitation and psychological services. Overall, parents were more dissatisfied than the survivors. These findings have implications for improvements in information delivery. Information in childhood CNS tumor care and follow-up should specifically address issues where insufficiency was identified, and recognize persistent and with time changing needs at the successive stages of long-term survivorship.

Student Support in China: Addressing the Perceived Needs of Undergraduate English Department Students

ERIC Educational Resources Information Center

Schippers, Margriet

2008-01-01

As yet little research into the perspectives of Chinese students studying in mainland China's Higher Education Institutions has been undertaken. This paper explores the issue of students' support needs and presents the findings of a study carried out in 2005-2007 at a public university in North East China. The Action Research method used…

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

PubMed

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

2006-01-01

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

Addressing the Needs of Children With Disabilities Experiencing Disaster or Terrorism.

PubMed

Stough, Laura M; Ducy, Elizabeth McAdams; Kang, Donghyun

2017-04-01

This paper reviews the empirical literature on psychosocial factors relating to children with disabilities in the context of disaster or terrorism. Research indicates adults with disabilities experience increased exposure to hazards due to existing social disparities and barriers associated with disability status. However, studies on the psychological effects of disaster/terrorism on children with pre-existing disabilities are exceedingly few and empirical evidence of the effectiveness of trauma-focused therapies for this population is limited. Secondary adversities, including social stigma and health concerns, also compromise the recovery of these children post-disaster/terrorism. Schools and teachers appear to be particularly important in the recovery of children with disabilities from disaster. Disasters, terrorism, and war all contribute to increased incidence of disability, as well as disproportionately affect children with pre-existing disabilities. Disaster preparedness interventions and societal changes are needed to decrease the disproportionate environmental and social vulnerability of children with disabilities to disaster and terrorism.

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.

Improving Human Services: Methods for Systematic Planning, Evaluation, and Staff Development.

ERIC Educational Resources Information Center

Jones, G. Brian; And Others

This monograph speaks to the basic problems confronting human services programs, and offers suggestions for improving guidance services. Specific concerns addressed are: (1) the need for more systematic program planning and evaluation; (2) an approach to effective planning and evaluation; (3) development of staff skills for use in the…

PDC cutters improve drilling in harsh environments

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

Mensa-Wilmot, G.

2000-02-01

Improvements in polycrystalline diamond compact (PDC) cutter technology have contributed immensely to the industry's acceptance of PDC bits as effective drilling tools. These cutters are being engineered to address the needs and requirements of different drilling programs. Extensive research and developments efforts have been dedicated to the analysis of the diamond table/tungsten carbide interface. The paper describes PDC cutter development, operational challenges, offset performance, and field experiences.

Improvement attributes in healthcare: implications for integrated care.

PubMed

Harnett, Patrick John

2018-04-16

Purpose Healthcare quality improvement is a key concern for policy makers, regulators, carers and service users. Despite a contemporary consensus among policy makers that integrated care represents a means to substantially improve service outcomes, progress has been slow. Difficulties achieving sustained improvement at scale imply that methods employed are not sufficient and that healthcare improvement attributes may be different when compared to prior reference domains. The purpose of this paper is to examine and synthesise key improvement attributes relevant to a complex healthcare change process, specifically integrated care. Design/methodology/approach This study is based on an integrative literature review on systemic improvement in healthcare. Findings A central theme emerging from the literature review indicates that implementing systemic change needs to address the relationship between vision, methods and participant social dynamics. Practical implications Accommodating personal and professional network dynamics is required for systemic improvement, especially among high autonomy individuals. This reinforces the need to recognise the change process as taking place in a complex adaptive system where personal/professional purpose/meaning is central to the process. Originality/value Shared personal/professional narratives are insufficiently recognised as a powerful change force, under-represented in linear and rational empirical improvement approaches.