Sample records for address concerns identified

  1. Addressing a community's cancer cluster concerns

    PubMed Central

    Gavin, AT; Catney, D

    2006-01-01

    The felling of a telecommunications mast highlighted a community's concern regarding an alleged cancer cluster of eleven cases in a small rural area of Northern Ireland. At the request of the Local District Council, the Northern Ireland Cancer Registry (NICR) undertook an investigation. After extensive searching and contact with the community, only 6 of the alleged cases could be identified. Of these six, two did not have cancer and one had a non-malignant tumour. In addition to the three confirmed cancer cases, a search of the NICR database identified a further 17 cancers of mixed types in keeping with the population pattern of cancers. Standardised incidence and mortality rates were within, or lower than, the expected level. The results were presented to the local community at an open meeting. Despite extensive media interest when the issue of the alleged cluster was first raised, the negative findings received only local media attention. This study illustrates the value of an accurate population cancer registry in addressing cancer cluster concerns. PMID:16964811

  2. Addressing concerns about the inclusion of premenstrual dysphoric disorder in DSM-5.

    PubMed

    Hartlage, S Ann; Breaux, Cynthia A; Yonkers, Kimberly A

    2014-01-01

    Inclusion of premenstrual dysphoric disorder (PMDD) into the main text of the DSM has been a point of controversy for many years. The purpose of this article is to address the main concerns raised by opponents to its inclusion. Concerns are presented and countered in turn. To identify the most prevalent arguments against inclusion of PMDD, we searched MEDLINE (1966-2012), PsycINFO (1930-2012), the Internet, and reference lists of identified articles during September 1-17, 2012, using the keywords PMDD, premenstrual syndrome (PMS), DSM, DSM-5, concerns, controversy, women, political power, workforce, courts, and history. The search was restricted to English-language publications. A total of 55 articles were identified and included. The most pressing arguments against inclusion were grouped by similarity and addressed if they were reported 5 or more times. Our review of the sources yielded 38 concerns regarding PMDD; 6 concerns were reported at least 5 times and are addressed in this article. Evidence culled from historical and legal trends does not support the alleged societal use of PMS to harm women (eg, keeping women out of the workforce or using PMS against women in child custody disputes). Further, current epidemiologic research has answered all of the methodology criticisms of opponents. Studies have confirmed the existence of PMDD worldwide. The involvement of pharmaceutical companies in research has been questioned. However, irrespective of the level of association with industry, current research on PMDD has consistent results: PMDD exists in a minority of women. Historically, the pain and suffering of women have been dismissed, minimized, and negated. Similarly, women with PMDD have often had their experience invalidated. With the preponderance of evidence in its favor, PMDD has been placed in the main text of the DSM-5, opening the door for affected women to receive the attention full diagnostic status provides. © Copyright 2014 Physicians Postgraduate

  3. Concerns of early career agricultural science teachers and the perceived effectiveness of educator preparation programs in addressing those concerns

    NASA Astrophysics Data System (ADS)

    Pearson, Camilla E.

    Little is known about the concerns and needs of early career agricultural teachers associated with the various routes to certification and how these routes address those concerns. The purpose of this study is to determine how selected early career agriculture teachers perceive their teacher preparation program and how effective their programs were at addressing these concerns during their first year of teaching. The sample consisted of secondary agricultural teachers in Texas FFA Areas V and VI, who self-identified themselves as an early career agricultural teacher in their first 3 years of teaching. The first phase included a web-based survey administered to assess the concerns of early career agricultural teachers. Two Likert-type scales were used, and these were used to assess the perceived importance of problems faced by early career agricultural teachers and the frequency in which they encounter those problems. The second phase included a qualitative interview to better understand the perceived relationship between participants' undergraduate preparation, experiences in agriculture and related organizations, and other related activities in preparing them as agriculture science teachers. The teachers interviewed in this study indicated that overall, they were pleased with their preparation. Teacher educators from both programs should address the concerns presented from all teachers to further prepare them for issues faced by early career teachers because it is evident that these issues are not going away.

  4. Safety huddles to proactively identify and address electronic health record safety

    PubMed Central

    Menon, Shailaja; Singh, Hardeep; Giardina, Traber D; Rayburn, William L; Davis, Brenda P; Russo, Elise M

    2017-01-01

    Objective: Methods to identify and study safety risks of electronic health records (EHRs) are underdeveloped and largely depend on limited end-user reports. “Safety huddles” have been found useful in creating a sense of collective situational awareness that increases an organization’s capacity to respond to safety concerns. We explored the use of safety huddles for identifying and learning about EHR-related safety concerns. Design: Data were obtained from daily safety huddle briefing notes recorded at a single midsized tertiary-care hospital in the United States over 1 year. Huddles were attended by key administrative, clinical, and information technology staff. We conducted a content analysis of huddle notes to identify what EHR-related safety concerns were discussed. We expanded a previously developed EHR-related error taxonomy to categorize types of EHR-related safety concerns recorded in the notes. Results: On review of daily huddle notes spanning 249 days, we identified 245 EHR-related safety concerns. For our analysis, we defined EHR technology to include a specific EHR functionality, an entire clinical software application, or the hardware system. Most concerns (41.6%) involved “EHR technology working incorrectly,” followed by 25.7% involving “EHR technology not working at all.” Concerns related to “EHR technology missing or absent” accounted for 16.7%, whereas 15.9% were linked to “user errors.” Conclusions: Safety huddles promoted discussion of several technology-related issues at the organization level and can serve as a promising technique to identify and address EHR-related safety concerns. Based on our findings, we recommend that health care organizations consider huddles as a strategy to promote understanding and improvement of EHR safety. PMID:28031286

  5. Addressing the Health Concerns of VA Women with Sexual Trauma

    DTIC Science & Technology

    2017-10-01

    AWARD NUMBER: W81XWH-14-1-0368 TITLE: Addressing the Health Concerns of VA Women with Sexual Trauma PRINCIPAL INVESTIGATOR: Caron Zlotnick, PhD...develop and assess a computer-delivered intervention (Safety and Health Experiences Program; SHE) that will provide a screening and brief behavior...intervention for women veterans with any lifetime ST. More specifically, the intervention, SHE, will address interrelated health concerns for women

  6. Interventional studies in childhood dystonia do not address the concerns of children and their carers.

    PubMed

    Lumsden, Daniel E; Gimeno, Hortensia; Tustin, Kylee; Kaminska, Margaret; Lin, Jean-Pierre

    2015-05-01

    This study aimed to determine the main concerns/priorities of the parents and carers of children with dystonia referred to our service and whether medical interventional studies addressed these concerns. Records of children assessed by our service from June 2005-December 2012 were reviewed and expressed parental/carer concerns at initial assessment categorized using the International Classification of Functioning (ICF) Framework. Medline, CINAHL and Embase databases were searched for outcome measures of medical and surgical interventional studies in childhood dystonia. Data was collected from 273 children and young people with dystonia. The most commonly expressed concerns were: pain (104/273, 38.1%); difficulties in delivering activities of daily-living (66/273, 24.2%), difficulties with hand-use (59/273, 21.6%) and seating (41/273, 15.0%). Literature review identified 70 interventional studies, 46 neurosurgical and 24 pharmacological. The majority of neurosurgical studies (34/46) used impairment scales to measure change, with pharmacological studies typically reporting more subjective changes in motor symptoms. Only a minority of studies used assessments or scales capable of objectively addressing the concerns reported by our cohort. Existing interventional studies in childhood dystonia poorly address the main concerns of children with dystonia and their carers, limiting the conclusions which may be drawn as to true impact of these interventions in childhood. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  7. Addressing semen loss concerns: towards culturally appropriate HIV/AIDS interventions in Gujarat, India.

    PubMed

    Lakhani, A; Gandhi, K; Collumbien, M

    2001-11-01

    A situation analysis of sexual networking and sexual health in an industrial area of Gujarat, India, identified anxiety about masturbation and other semen loss concerns as major preoccupations among young men. This paper describes how the Deepak Charitable Trust addressed these concerns in their HIV prevention programme for young men aged 15 to 30. Flowcharts were used as participatory learning tools and to obtain data on the perceived consequences of masturbation, both before and after intervention activities. Research was also done on the relation between semen-related anxieties and sexual risk behaviour by DCT and two other NGOs among young men engaging in unsafe sexual behaviour. DCT advocates addressing masturbation and other semen loss concerns in all sexual health campaigns in South Asia, based on the magnitude of these concerns, their potential to confound syndromic management of STIs and their significance as an idiom of psychosocial distress. Masturbation and associated anxieties about sexual performance are seen as health issues and discussed as such by the programme. There is immediate identification among young men, whether or not they are already sexually active, and it provides an excellent entry point for sexual health and safer sex education. The community response to these efforts has been entirely positive.

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

    PubMed

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

    2012-05-08

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

  9. Addressing EO-1 Spacecraft Pulsed Plasma Thruster EMI Concerns

    NASA Technical Reports Server (NTRS)

    Zakrzwski, C. M.; Davis, Mitch; Sarmiento, Charles; Bauer, Frank H. (Technical Monitor)

    2001-01-01

    The Pulsed Plasma Thruster (PPT) Experiment on the Earth Observing One (EO-1) spacecraft has been designed to demonstrate the capability of a new generation PPT to perform spacecraft attitude control. Results from PPT unit level radiated electromagnetic interference (EMI) tests led to concerns about potential interference problems with other spacecraft subsystems. Initial plans to address these concerns included firing the PPT at the spacecraft level both in atmosphere, with special ground support equipment. and in vacuum. During the spacecraft level tests, additional concerns where raised about potential harm to the Advanced Land Imager (ALI). The inadequacy of standard radiated emission test protocol to address pulsed electromagnetic discharges and the lack of resources required to perform compatibility tests between the PPT and an ALI test unit led to changes in the spacecraft level validation plan. An EMI shield box for the PPT was constructed and validated for spacecraft level ambient testing. Spacecraft level vacuum tests of the PPT were deleted. Implementation of the shield box allowed for successful spacecraft level testing of the PPT while eliminating any risk to the ALI. The ALI demonstration will precede the PPT demonstration to eliminate any possible risk of damage of ALI from PPT operation.

  10. Framework for Identifying Key Environmental Concerns in Marine Renewable Energy Projects- Appendices

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

    Kramer, Sharon; Previsic, Mirko; Nelson, Peter

    2010-06-17

    Marine wave and tidal energy technology could interact with marine resources in ways that are not well understood. As wave and tidal energy conversion projects are planned, tested, and deployed, a wide range of stakeholders will be engaged; these include developers, state and federal regulatory agencies, environmental groups, tribal governments, recreational and commercial fishermen, and local communities. Identifying stakeholders’ environmental concerns in the early stages of the industry’s development will help developers address and minimize potential environmental effects. Identifying important concerns will also assist with streamlining siting and associated permitting processes, which are considered key hurdles by the industry inmore » the U.S. today. In September 2008, RE Vision consulting, LLC was selected by the Department of Energy (DoE) to conduct a scenario-based evaluation of emerging hydrokinetic technologies. The purpose of this evaluation is to identify and characterize environmental impacts that are likely to occur, demonstrate a process for analyzing these impacts, identify the “key” environmental concerns for each scenario, identify areas of uncertainty, and describe studies that could address that uncertainty. This process is intended to provide an objective and transparent tool to assist in decision-making for siting and selection of technology for wave and tidal energy development. RE Vision worked with H. T. Harvey & Associates, to develop a framework for identifying key environmental concerns with marine renewable technology. This report describes the results of this study. This framework was applied to varying wave and tidal power conversion technologies, scales, and locations. The following wave and tidal energy scenarios were considered: 4 wave energy generation technologies 3 tidal energy generation technologies 3 sites: Humboldt coast, California (wave); Makapu’u Point, Oahu, Hawaii (wave); and the Tacoma Narrows, Washington

  11. Identifying veterinary students' capacity for moral behavior concerning animal ethics issues.

    PubMed

    Verrinder, Joy M; Phillips, Clive J C

    2014-01-01

    Veterinarians face unique animal ethics challenges as practitioners and policy advisors to government and industry. Changing societal attitudes, cultural diversity, and the often conflicting needs and interests of patients and clients contribute to moral distress. Yet little has been done to identify veterinarians' capacity to address these animal ethics issues. In this study, first-year and final-year veterinary students in an Australian university were surveyed to explore moral sensitivity, moral motivation, and moral character and their relationship with moral reasoning. The majority of students were concerned about animal ethics issues and had experienced moral distress in relation to the treatment of animals. Most believed that veterinarians should address the wider social issues of animal protection and that veterinary medicine should require a commitment to animals' interests over owners'/caregivers' interests. There was less agreement that the veterinary profession was sufficiently involved in addressing animal ethics issues. The principal motivators for studying veterinary medicine were, in declining importance, enjoyment in working with animals, helping sick and injured animals, and improving the way animals are treated. However, most students had taken little or no action to address animal ethics issues. These results suggest that both first- and fifth-year veterinary students are sensitive to animal ethics issues and are motivated to prioritize the interests of animals but have little experience in taking action to address these issues. Further research is needed to determine ways to identify and assess these moral behavior components in veterinary education to develop veterinarians' capacity to address animal ethics issues.

  12. NCI Think Tank Concerning the Identifiability of Biospecimens and “-Omic” Data

    PubMed Central

    Weil, Carol J.; Mechanic, Leah E.; Green, Tiffany; Kinsinger, Christopher; Lockhart, Nicole C.; Nelson, Stefanie A.; Rodriguez, Laura L.; Buccini, Laura D.

    2014-01-01

    On June 11 and 12, 2012, the National Cancer Institute (NCI) hosted a think tank concerning the identifiability of biospecimens and “omic” Data in order to explore challenges surrounding this complex and multifaceted topic. The think tank brought together forty-six leaders from several fields, including cancer genomics, bioinformatics, human subject protection, patient advocacy, and commercial genetics. The first day involved presentations regarding the state of the science of re-identification; current and proposed regulatory frameworks for assessing identifiability; developments in law, industry and biotechnology; and the expectations of patients and research participants. The second day was spent by think tank participants in small break-out groups designed to address specific sub-topics under the umbrella issue of identifiability, including considerations for the development of best practices for data sharing and consent, and targeted opportunities for further empirical research. We describe the outcomes of this two day meeting, including two complimentary themes that emerged from moderated discussions following the presentations on Day 1, and ideas presented for further empirical research to discern the preferences and concerns of research participants about data sharing and individual identifiability. PMID:23579437

  13. Addressing Parental Vaccine Concerns: Engagement, Balance, and Timing

    PubMed Central

    Glanz, Jason M.; Kraus, Courtney R.; Daley, Matthew F.

    2015-01-01

    The recent United States measles epidemic has sparked another contentious national discussion about childhood vaccination. A growing number of parents are expressing concerns about the safety of vaccines, often fueled by misinformation from the internet, books, and other nonmedical sources. Many of these concerned parents are choosing to refuse or delay childhood vaccines, placing their children and surrounding communities at risk for serious diseases that are nearly 100% preventable with vaccination. Between 10% and 15% of parents are asking physicians to space out the timing of vaccines, which often poses an ethical dilemma for physicians. This trend reflects a tension between personal liberty and public health, as parents fight to control the decisions that affect the health of their children and public health officials strive to maintain high immunization rates to prevent outbreaks of vaccine-preventable diseases. Interventions to address this emerging public health issue are needed. We describe a framework by which web-based interventions can be used to help parents make evidence-based decisions about childhood vaccinations. PMID:26252770

  14. Addressing the Health Concerns of VA Women With Sexual Trauma

    DTIC Science & Technology

    2016-10-01

    SUPPLEMENTARY NOTES 14. ABSTRACT Lifetime ST disproportionately affects women veterans and can threaten their health and wellbeing. PTSD, IPV, and...alcohol use are closely interrelated and significant concerns for women veterans with lifetime ST . Providing effective and low-cost interventions to...address ST -related risks among women veterans with lifetime ST would advance clinical care for these women in an important area. 15. SUBJECT TERMS

  15. Identifying and prioritizing gaming workers' health and safety concerns using mapping for data collection.

    PubMed

    Keith, M M; Cann, B; Brophy, J T; Hellyer, D; Day, M; Egan, S; Mayville, K; Watterson, A

    2001-01-01

    This research was prompted by the clinical presentation of workers from a variety of gaming occupations with injuries and illnesses and multiple health and safety concerns. Using participatory action research principles, 51 gaming workers in Ontario and 20 gaming workers in Manitoba were consulted during a series of focus group sessions. Mapping exercises were used to survey the participants about their health concerns, perceived occupational hazards and the impact of working conditions on their personal lives. Participants were then asked to prioritize their concerns and make recommendations for improvements. Gaming workers from both provinces identified similar health, hazard and psycho-social concerns. They prioritized the issues of stress, ergonomics, indoor air quality (including second-hand smoke and temperature), biological hazards, physical hazards and noise. This study points to a need to more fully investigate and address health and safety issues in the gaming industry. It also demonstrates the effectiveness of a worker-driven, participatory consultation. Copyright 2001 Wiley-Liss, Inc.

  16. 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.

  17. Barriers to Mental Health Service Use and Preferences for Addressing Emotional Concerns among Lung Cancer Patients

    PubMed Central

    Mosher, Catherine E.; Winger, Joseph G.; Hanna, Nasser; Jalal, Shadia I.; Fakiris, Achilles J.; Einhorn, Lawrence H.; Birdas, Thomas J.; Kesler, Kenneth A.; Champion, Victoria L.

    2014-01-01

    Objective This study examined barriers to mental health service use and preferences for addressing emotional concerns among lung cancer patients (N=165) at two medical centers in the midwestern United States. Methods Lung cancer patients completed an assessment of anxiety and depressive symptoms, mental health service use, barriers to using these services, and preferences for addressing emotional concerns. Results Only 45% of distressed patients received mental health care since their lung cancer diagnosis. The most prevalent patient-reported barriers to mental health service use among non-users of these services (n=110) included the desire to independently manage emotional concerns (58%) and inadequate knowledge of services (19%). In addition, 57% of distressed patients who did not access mental health services did not perceive the need for help. Seventy-five percent of respondents (123/164) preferred to talk to a primary care physician if they were to have an emotional concern. Preferences for counseling, psychiatric medication, peer support, spiritual care, or independently managing emotional concerns also were endorsed by many patients (range=40%–50%). Older age was associated with a lower likelihood of preferring to see a counselor. Conclusions Findings suggest that many distressed lung cancer patients underuse mental health services and do not perceive the need for such services. Efforts to increase appropriate use of services should address patients' desire for autonomy and lack of awareness of services. PMID:24493634

  18. Addressing Common Concerns about Online Student Ratings of Instruction: A Research-Informed Approach

    ERIC Educational Resources Information Center

    Winer, Laura; DiGenova, Lina; Costopoulos, Andre

    2016-01-01

    Concerns over the usefulness and validity of student ratings of instruction (SRI) have continued to grow with online processes. This paper presents seven common and persistent concerns identified and tested during the development and implementation of a revised SRI policy at a Canadian research-intensive university. These concerns include bias due…

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

    PubMed

    Moore, C W; Rauch, P K

    2006-12-01

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

  20. A Latina/o Campus Community's Readiness to Address Lesbian, Gay, and Bisexual Concerns

    ERIC Educational Resources Information Center

    Rivera-Ramos, Zully A.; Oswald, Ramona F.; Buki, Lydia P.

    2015-01-01

    In response to the call for new and innovative methods of assessing campus climate (Worthington, 2008), the current study is the first to examine the readiness of a Latina/o campus community to address lesbian, gay, and bisexual (LGB) concerns. Using the Community Readiness Model, data were collected through individual interviews with a total of…

  1. Writing Centre Tutoring Sessions: Addressing Students' Concerns

    ERIC Educational Resources Information Center

    Winder, Roger; Kathpalia, Sujata S.; Koo, Swit Ling

    2016-01-01

    The guiding principle behind university writing centres is to focus on the process of writing rather than the finished product, prioritising higher order concerns related to organisation and argumentation of texts rather than lower order concerns of grammar and punctuation. Using survey-based data, this paper examines students' concerns regarding…

  2. 13 CFR 121.109 - What must a concern do in order to be identified as a small business concern in any Federal...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... be identified as a small business concern in any Federal procurement databases? 121.109 Section 121... order to be identified as a small business concern in any Federal procurement databases? (a) In order to be identified as a small business concern in the System for Award Management (SAM) database (or any...

  3. Addressing Male Facial Skin Concerns: Clinical Efficacy of a Topical Skincare Treatment Product for Men.

    PubMed

    Makino, Elizabeth T; Jiang, Lily I; Tan, Priscilla; Cheng, Tsing; Mehta, Rahul C

    2018-03-01

    The growing male skincare market reflects the increased interest of men in addressing facial aging concerns and maintaining a healthy youthful appearance. Because of differences in skin structure and aging as well as in lifestyle and behavior, male facial skin presents unique challenges that may result in different priorities or treatment strategies compared to female skin. A clinical study was conducted to assess clinical efficacy and tolerability of a topical skincare treatment product that was developed to address several male facial skin concerns related to skin quality, skin aging, and shaving. The treatment product provided significant improvements in all clinical efficacy parameters including overall photodamage, tactile roughness, fine line/wrinkles, and coarse lines/wrinkles. Furthermore, significant improvements in erythema as well as dryness/scaling were observed. Subject self-assessment questionnaires showed that the treatment product was highly rated in both self-perceived efficacy as well as product attributes. Use of skincare treatment products that tackle specific male facial skin concerns could further optimize skin quality and support healthy and youthful looking skin in men.

    J Drugs Dermatol. 2018;17(3):301-306.

    .

  4. Followup Audit: DLA Officials Took Appropriate Actions to Address Concerns With Repair Parts for the High Mobility Multipurpose Wheeled Vehicle

    DTIC Science & Technology

    2016-04-29

    Followup Audit : DLA Officials Took Appropriate Actions to Address Concerns With Repair Parts for the High Mobility Multipurpose Wheeled Vehicle A P R I L...Results in Brief Followup Audit : DLA Officials Took Appropriate Actions to Address Concerns With Repair Parts for the High Mobility Multipurpose Wheeled...and Maritime Paid Too Much for High Mobility Multipurpose Wheeled Vehicle Repair Parts,” (HMMWV) was issued on April 4, 2014. The audit

  5. States Address Concerns about Concussions in Youth Sports

    ERIC Educational Resources Information Center

    Kreck, Carol

    2014-01-01

    Education Commission of the States (ECS) reviewed legislation in the 50 states to see how state leaders are responding to concerns about concussions in youth sports. This report reviews state responses to concussion concerns, and provides examples of provisions put in place by California, Connecticut, and Texas. Three emerging innovations are…

  6. 24 CFR 1000.508 - If the recipient monitoring identifies programmatic concerns, what happens?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... concerns, what happens? If the recipient's monitoring activities identify areas of concerns, the recipient... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false If the recipient monitoring... INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient...

  7. 24 CFR 1000.508 - If the recipient monitoring identifies programmatic concerns, what happens?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... concerns, what happens? If the recipient's monitoring activities identify areas of concerns, the recipient... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false If the recipient monitoring... INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient...

  8. 24 CFR 1000.508 - If the recipient monitoring identifies programmatic concerns, what happens?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... concerns, what happens? If the recipient's monitoring activities identify areas of concerns, the recipient... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false If the recipient monitoring... INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient...

  9. 24 CFR 1000.508 - If the recipient monitoring identifies programmatic concerns, what happens?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... concerns, what happens? If the recipient's monitoring activities identify areas of concerns, the recipient... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false If the recipient monitoring... INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient...

  10. 24 CFR 1000.508 - If the recipient monitoring identifies programmatic concerns, what happens?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... concerns, what happens? If the recipient's monitoring activities identify areas of concerns, the recipient... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false If the recipient monitoring... INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient...

  11. Parents' evaluation of developmental status: how well do parents' concerns identify children with behavioral and emotional problems?

    PubMed

    Glascoe, Frances Page

    2003-03-01

    This study was undertaken to determine which parental concerns are most associated with significant behavioral/emotional problems and the extent to which parents' concerns can be depended on in the detection of mental health problems. An additional goal is to view how well a recently published screening test relying on parents' concerns, Parents' Evaluation of Developmental Status (PEDS), detects behavioral and emotional problems. Subjects were a national sample of 472 parents and their children (21 months to 8 years old) who were participants in 1 of 2 test standardization and validation studies. Sites included various pediatric settings, public schools, and Head Start programs in 5 diverse geographic locations. Subjects were representative of U.S. demographics in terms of ethnicity, parental level of education, gender, and socioeconomic status. At each site, psychological examiners, educational diagnosticians, or school psychologists recruited families, and obtained informed consent. Examiners disseminated a demographics questionnaire (in English or Spanish) and a developmental screening test that relies on parents' concerns (PEDS). Examiners were blinded to PEDS' scoring and interpretation administered either by interview or in writing, the Eyberg Child Behavior Inventory (ECBI) or the Possible Problems Checklist (PPC), a subtest of the Child Development Inventory that includes items measuring emotional well-being and behavioral self-control. PEDS was used to sort children into risk for developmental disabilities according to various types of parental concern. Those identified as having high or moderate risk were nominated for diagnostic testing or screening followed by developmental and mental health services when indicated. Because their emotional and behavioral needs would have been identified and addressed, these groups were removed from the analysis (N = 177). Of the 295 children who would not have been nominated for further scrutiny on PEDS due to their

  12. Identifying and addressing student difficulties with the ideal gas law

    NASA Astrophysics Data System (ADS)

    Kautz, Christian Hans

    This dissertation reports on an in-depth investigation of student understanding of the ideal gas law. The research and curriculum development were mostly conducted in the context of algebra- and calculus-based introductory physics courses and a sophomore-level thermal physics course. Research methods included individual demonstration interviews and written questions. Student difficulties with the quantities: pressure, volume, temperature, and the number of moles were identified. Data suggest that students' incorrect and incomplete microscopic models about gases contribute to the difficulties they have in answering questions posed in macroscopic terms. In addition, evidence for general reasoning difficulties is presented. These research results have guided the development of curriculum to address the student difficulties that have been identified.

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

    NASA Astrophysics Data System (ADS)

    Marshman, Margaret

    2017-03-01

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

  14. Workplace-based assessment: a review of user perceptions and strategies to address the identified shortcomings.

    PubMed

    Massie, Jonathan; Ali, Jason M

    2016-05-01

    Workplace based assessments (WBAs) are now commonplace in postgraduate medical training. User acceptability and engagement is essential to the success of any medical education innovation. To this end, possessing an insight into trainee and trainer perceptions towards WBAs will help identify the major problems, permitting strategies to be introduced to improve WBA implementation. A review of literature was performed to identify studies examining trainee and trainer perceptions towards WBAs. Studies were excluded if non-English or sampling a non-medical/dental population. The identified literature was synthesised for the purpose of this critical narrative review. It is clear that there is widespread negativity towards WBAs in the workplace. This has negatively impacted on the effectiveness of WBA tools as learning aids. This negativity exists in trainees but also to an extent in their trainers. Insight gained from the literature reveals three dominant problems with WBA implementation: poor understanding as to the purpose of WBAs; insufficient time available for undertaking these assessments; and inadequate training of trainers. Approaches to addressing these three problems with WBA implementation are discussed. It is likely that a variety of solutions will be required. The prevalence of negativity towards WBAs is substantial in both trainees and trainers, eroding the effectiveness of learning that is consequent upon them. The educational community must now listen to the concerns being raised by the users and consider the range of strategies being proposed to improve the experiences of trainees, and their trainers.

  15. Identifying and addressing the support needs of family caregivers of people with motor neurone disease using the Carer Support Needs Assessment Tool.

    PubMed

    Aoun, Samar M; Deas, Kathleen; Kristjanson, Linda J; Kissane, David W

    2017-02-01

    Family caregivers of people with motor neurone disease (MND) experience adverse health outcomes as a result of their caregiving experience. This may be alleviated if their support needs are identified and addressed in a systematic and timely manner. The objective of the present study was to assess the feasibility and relevance of the Carer Support Needs Assessment Tool (CSNAT) in home-based care during the period of caregiving from the perspectives of the family caregivers of people with MND and their service providers. The study was conducted during 2014 in Western Australia. Some 30 family caregivers and 4 care advisors participated in trialing the CSNAT intervention, which involved two visits from care advisors (6-8 weeks apart) to identify and address support needs. The feedback from family caregivers was obtained via telephone interviews and that of care advisors via a self-administered questionnaire. A total of 24 caregivers completed the study (80% completion rate) and identified the highest support priorities as "knowing what to expect in the future," "knowing who to contact if concerned," and "equipment to help care." The majority found that this assessment process adequately addressed their needs and gave them a sense of validation, reassurance, and empowerment. Care advisors advocated the CSNAT approach as an improvement over standard practice, allowing them to more clearly assess needs, to offer a more structured follow-up, and to focus on the caregiver and family. The CSNAT approach for identifying and addressing family caregivers' support needs was found to be relevant and feasible by MND family caregivers and care advisors. The tool provided a formal structure to facilitate discussions with family caregivers and thus enable needs to be addressed. Such discussions can also inform an evidence base for the ongoing development of services, ensuring that new and improved services are designed to meet the explicit needs of the family caregivers of people

  16. Interpersonal interactions on online forums addressing eating concerns.

    PubMed

    Ransom, Danielle C; La Guardia, Jennifer G; Woody, Erik Z; Boyd, Jennifer L

    2010-03-01

    Although some research suggests that online eating disorder forums promote "pro-eating-disorder" lifestyles and discourage recovery, other research suggests that such forums are an important source of interpersonal support. The current study extends this research by exploring the positive and negative behaviors encouraged on these forums and by comparing forum members' perceptions of support received from online and offline relationships to support received in relationships of age-matched controls. In a survey of 60 forum members, we assessed information exchanged and support provided on eating disorder forums. Further, we assessed perceptions of social support for general and specific life concerns in this group of forum members as well as 64 age-matched university controls. Results show that both adaptive and maladaptive behaviors are encouraged on the forums, and that this encouragement has some influence on forum members trying out these behaviors. Overall, forum members reported receiving less support for their eating concerns as compared to their general life stressors, and they perceived less support for both their general concerns and eating concerns in their offline relationships as compared to their online forum relationships. Moreover, forum members reported receiving less support from their offline relationships as compared to support received in relationships by age-matched controls. Forum members perceive less support in their important relationships than other peers do, and they seek out and participate in forums as a means of attaining greater social support. However, our research suggests that these forums also encourage dysregulated eating behaviors. Implications of online forum support and its impact on recovery are discussed further.

  17. Special nutritional concerns for the female athlete.

    PubMed

    Gabel, Kathe A

    2006-06-01

    Inadequate dietary intake is the primary nutritional concern of today's female athlete. As these athletes fail to consume enough energy to support the physical demands of training, they become at risk for disordered eating, amenorrhea, and osteoporosis, conditions collectively identified as the female athlete triad. This review addresses nutritional concerns of the female athlete, identification of those at risk, relationship of energy intake to menstrual irregularities, and recently identified chronic diseases associated with the female athlete triad. Strategies are offered to prevent harmful behaviors leading to the comorbidities associated with inadequate dietary intakes.

  18. Systematic reviews addressing identified health policy priorities in Eastern Mediterranean countries: a situational analysis.

    PubMed

    El-Jardali, Fadi; Akl, Elie A; Karroum, Lama Bou; Kdouh, Ola; Akik, Chaza; Fadlallah, Racha; Hammoud, Rawan

    2014-08-20

    Systematic reviews can offer policymakers and stakeholders concise, transparent, and relevant evidence pertaining to pressing policy priorities to help inform the decision-making process. The production and the use of systematic reviews are specifically limited in the Eastern Mediterranean region. The extent to which published systematic reviews address policy priorities in the region is still unknown. This situational analysis exercise aims at assessing the extent to which published systematic reviews address policy priorities identified by policymakers and stakeholders in Eastern Mediterranean region countries. It also provides an overview about the state of systematic review production in the region and identifies knowledge gaps. We conducted a systematic search of the Health System Evidence database to identify published systematic reviews on policy-relevant priorities pertaining to the following themes: human resources for health, health financing, the role of the non-state sector, and access to medicine. Priorities were identified from two priority-setting exercises conducted in the region. We described the distribution of these systematic reviews across themes, sub-themes, authors' affiliations, and countries where included primary studies were conducted. Out of the 1,045 systematic reviews identified in Health System Evidence on selected themes, a total of 200 systematic reviews (19.1%) addressed the priorities from the Eastern Mediterranean region. The theme with the largest number of systematic reviews included was human resources for health (115) followed by health financing (33), access to medicine (27), and role of the non-state sector (25). Authors based in the region produced only three systematic reviews addressing regional priorities (1.5%). Furthermore, no systematic review focused on the Eastern Mediterranean region. Primary studies from the region had limited contribution to systematic reviews; 17 systematic reviews (8.5%) included primary

  19. Systematic reviews addressing identified health policy priorities in Eastern Mediterranean countries: a situational analysis

    PubMed Central

    2014-01-01

    Background Systematic reviews can offer policymakers and stakeholders concise, transparent, and relevant evidence pertaining to pressing policy priorities to help inform the decision-making process. The production and the use of systematic reviews are specifically limited in the Eastern Mediterranean region. The extent to which published systematic reviews address policy priorities in the region is still unknown. This situational analysis exercise aims at assessing the extent to which published systematic reviews address policy priorities identified by policymakers and stakeholders in Eastern Mediterranean region countries. It also provides an overview about the state of systematic review production in the region and identifies knowledge gaps. Methods We conducted a systematic search of the Health System Evidence database to identify published systematic reviews on policy-relevant priorities pertaining to the following themes: human resources for health, health financing, the role of the non-state sector, and access to medicine. Priorities were identified from two priority-setting exercises conducted in the region. We described the distribution of these systematic reviews across themes, sub-themes, authors’ affiliations, and countries where included primary studies were conducted. Results Out of the 1,045 systematic reviews identified in Health System Evidence on selected themes, a total of 200 systematic reviews (19.1%) addressed the priorities from the Eastern Mediterranean region. The theme with the largest number of systematic reviews included was human resources for health (115) followed by health financing (33), access to medicine (27), and role of the non-state sector (25). Authors based in the region produced only three systematic reviews addressing regional priorities (1.5%). Furthermore, no systematic review focused on the Eastern Mediterranean region. Primary studies from the region had limited contribution to systematic reviews; 17 systematic reviews

  20. Identifying chemicals of concern in hydraulic fracturing fluids used for oil production.

    PubMed

    Stringfellow, William T; Camarillo, Mary Kay; Domen, Jeremy K; Sandelin, Whitney L; Varadharajan, Charuleka; Jordan, Preston D; Reagan, Matthew T; Cooley, Heather; Heberger, Matthew G; Birkholzer, Jens T

    2017-01-01

    Chemical additives used for hydraulic fracturing and matrix acidizing of oil reservoirs were reviewed and priority chemicals of concern needing further environmental risk assessment, treatment demonstration, or evaluation of occupational hazards were identified. We evaluated chemical additives used for well stimulation in California, the third largest oil producing state in the USA, by the mass and frequency of use, as well as toxicity. The most frequently used chemical additives in oil development were gelling agents, cross-linkers, breakers, clay control agents, iron and scale control agents, corrosion inhibitors, biocides, and various impurities and product stabilizers used as part of commercial mixtures. Hydrochloric and hydrofluoric acids, used for matrix acidizing and other purposes, were reported infrequently. A large number and mass of solvents and surface active agents were used, including quaternary ammonia compounds (QACs) and nonionic surfactants. Acute toxicity was evaluated and many chemicals with low hazard to mammals were identified as potentially hazardous to aquatic environments. Based on an analysis of quantities used, toxicity, and lack of adequate hazard evaluation, QACs, biocides, and corrosion inhibitors were identified as priority chemicals of concern that deserve further investigation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Addressing concerns of pregnant and lactating women after the 2005 hurricanes: the OTIS response.

    PubMed

    Quinn, Dorothy; Lavigne, Sharon Voyer; Chambers, Christina; Wolfe, Lori; Chipman, Hope; Cragan, Janet D; Rasmussen, Sonja A

    2008-01-01

    Natural disasters are devastating for anyone affected, but pregnant and breastfeeding women often have specific concerns about the effects of certain exposures (such as infections, chemicals, medications, and stress) on their fetus or breastfed child. For this reason, the Organization of Teratology Information Specialists (OTIS) and the National Center on Birth Defects and Developmental Disabilities at the Centers for Disease Control and Prevention partnered to provide information for women and healthcare professionals about the effects of exposures on pregnancy and breastfeeding after the hurricanes of 2005. This service expanded on OTIS's existing telephone counseling and fact sheets. Through this project, fact sheets were created to address specific potential concerns regarding exposures after the hurricanes. The OTIS national toll-free telephone number also was modified to accommodate questions regarding hurricane-related exposures, and several strategies were used to publicize this number as a resource for obtaining hurricane-related exposure information related to pregnancy and breastfeeding. This article describes OTIS's response after the 2005 hurricanes, the challenges encountered in implementing the response, and lessons learned that might be useful to improve the response to the unique needs of this special population after any disaster or public health emergency.

  2. A Simulation Model that Decreases Faculty Concerns about Adopting Web-Based Instruction

    ERIC Educational Resources Information Center

    Song, Hae-Deok; Wang, Wei-Tsong; Liu, Chao-Yueh

    2011-01-01

    Faculty members have different concerns as they integrate new technology into their teaching practices. The integration of Web-Based Instruction in higher-education settings will not be successful if these faculty concerns are not addressed. Four main stages of faculty concern (information, personal, management, and impact) were identified based…

  3. Aliens in the promised land? Keynote address for the 1986 National Gathering of the United Church of Christ's Coalition for Lesbian/Gay Concerns.

    PubMed

    Comstock, G D

    The following article is a condensed version of the keynote address given at the 1986 National Gathering of the Lesbian/Gay Coalition of the United Church of Christ (UCC). Problems encountered by lesbians and gay men in organized religion, especially within the liberal tradition, are identified by a method of inquiry developed by Christian educator John Westerhoff for assessing egalitarianism within institutions. The story of Queen Vashti from the Book of Esther in Hebrew scripture, and the emerging tradition of coming-out experiences by lesbians and gay men; provide the norm and model for declaring independence from denominations that neglect the concerns of lesbians and gay men and for constructing religious alternatives.

  4. Concerns among first year midwifery students: towards addressing attrition rates.

    PubMed

    Carolan, Mary C; Kruger, Gina B

    2011-01-01

    Since 2000, there has been a shift to undergraduate midwifery education in Australia. Midwifery students are generally highly motivated, however attrition rates remain high among first-year students. This study was undertaken in one Australian University against a background of high course demand and high student attrition. Thirty-two first-year midwifery students completed a demographic questionnaire and wrote a reflection in response to the question: What if anything, would make your experience as a first year student better? Data were subjected to thematic content analysis. Findings indicated a need for: greater opportunities to prepare; for more time to study; for greater student supports; and outlined difficulties such as financial and childcare. In conclusion, undergraduate midwifery courses and local conditions vary among institutions. Student feedback is a useful way of identifying local concerns that may impact on student completion rates. This is a necessary first step to the provision of meaningful student support.

  5. An innovative approach to using both cellphones and the radio to identify young people's sexual concerns in Kinshasa, Democratic Republic of Congo.

    PubMed

    Nsakala, Gabriel Vodiena; Coppieters, Yves; Kayembe, Patrick Kalambayi

    2014-01-01

    As teenagers have easy access to both radio programs and cell phones, the current study used these tools so that young people could anonymously identify questions about sex and other related concerns in the urban environment of the Democratic Republic of Congo. The purpose of this healthcare intervention was to identify and address concerns raised by young people, which are related to sexual health, and which promote youth health. This healthcare intervention was conducted over a six month period and consisted of a survey carried out in Kinshasa. This focused on 14 to 24 old young people using phone calls on a radio program raising concerns related to sexuality. The radio program was jointly run by a journalist and a health professional who were required to reply immediately to questions from young people. All sexual health concerns were recorded and analyzed. Forty programs were broadcast in six months and 1,250 messages and calls were recorded: 880 (70%) from girls and 370 (30%) from boys, which represents an average of 32 interventions (of which 10 calls and 22 messages) per broadcast. Most questions came from 15-19- and 20-24-year-old girls and boys. Focus of girls' questions: menstrual cycle calculation and related concerns accounted for the majority (24%); sexual practices (16%), love relationships (15%) and virginity (14%). Boys' concerns are masturbation (and its consequences) (22%), sexual practices (19%), love relationships (18%) and worries about penis size (10%). Infections (genital and STI) and topics regarding HIV represent 9% and 4% of the questions asked by girls against 7% and 10% by boys. Concerns were mainly related to knowledge, attitudes and competences to be developed. Concerns and sexual practices raised by teens about their sexual and emotional life have inspired the design of a practical guide for youth self-training and have steered the second phase of this interactive program towards supporting their responsible sexuality.

  6. 40 CFR Table 5 to Subpart Jj of... - List of VHAP of Potential Concern Identified by Industry

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 10 2010-07-01 2010-07-01 false List of VHAP of Potential Concern Identified by Industry 5 Table 5 to Subpart JJ of Part 63 Protection of Environment ENVIRONMENTAL PROTECTION.... 63, Subpt. JJ, Table 5 Table 5 to Subpart JJ of Part 63—List of VHAP of Potential Concern Identified...

  7. Medical-Legal Partnership: Collaborating with Lawyers to Identify and Address Health Disparities

    PubMed Central

    Cohen, Ellen; Fullerton, Danya Fortess; Retkin, Randye; Weintraub, Dana; Tames, Pamela; Brandfield, Julie

    2010-01-01

    Introduction Medical-legal partnerships (MLPs) bring together medical professionals and lawyers to address social causes of health disparities, including access to adequate food, housing and income. Setting Eighty-one MLPs offer legal services for patients whose basic needs are not being met. Program Description Besides providing legal help to patients and working on policy advocacy, MLPs educate residents (29 residency programs), health care providers (160 clinics and hospitals) and medical students (25 medical schools) about how social conditions affect health and screening for unmet basic needs, and how these needs can often be impacted by enforcing federal and state laws. These curricula include medical school courses, noon conferences, advocacy electives and CME courses. Program Evaluation Four example programs are described in this paper. Established MLPs have changed knowledge (MLP | Boston—97% reported screening for two unmet needs), attitudes (Stanford reported reduced concern about making patients “nervous” with legal questions from 38% to 21%) and behavior (NY LegalHealth reported increasing resident referrals from 15% to 54%) after trainings. One developing MLP found doctors experienced difficulty addressing social issues (NJ LAMP—67% of residents felt uncomfortable). Discussion MLPs train residents, students and other health care providers to tackle socially caused health disparities. PMID:20352508

  8. Concerns with AED conversion: comparison of patient and physician perspectives.

    PubMed

    Smith, Brien J; St Louis, Erik K; Stern, John M; Green, Chad; Bramley, Thomas

    2009-06-01

    When discussing AED conversion in the clinic, both the patient and physician perspectives on the goals and risks of this change are important to consider. To identify patient-reported and clinician-perceived concerns, a panel of epilepsy specialists was questioned about the topics discussed with patients and the clinician's perspective of patient concerns. Findings of a literature review of articles that report patient-expressed concerns regarding their epilepsy and treatment were also reviewed. Results showed that the specialist panel appropriately identified patient-reported concerns of driving ability, medication cost, seizure control, and medication side effects. Additionally, patient-reported concerns of independence, employment issues, social stigma, medication dependence, and undesirable cognitive effects are important to address when considering and initiating AED conversion.

  9. An innovative approach to using both cellphones and the radio to identify young people’s sexual concerns in Kinshasa, Democratic Republic of Congo

    PubMed Central

    2014-01-01

    Background As teenagers have easy access to both radio programs and cell phones, the current study used these tools so that young people could anonymously identify questions about sex and other related concerns in the urban environment of the Democratic Republic of Congo. The purpose of this healthcare intervention was to identify and address concerns raised by young people, which are related to sexual health, and which promote youth health. Methods This healthcare intervention was conducted over a six month period and consisted of a survey carried out in Kinshasa. This focused on 14 to 24 old young people using phone calls on a radio program raising concerns related to sexuality. The radio program was jointly run by a journalist and a health professional who were required to reply immediately to questions from young people. All sexual health concerns were recorded and analyzed. Results Forty programs were broadcast in six months and 1,250 messages and calls were recorded: 880 (70%) from girls and 370 (30%) from boys, which represents an average of 32 interventions (of which 10 calls and 22 messages) per broadcast. Most questions came from 15-19- and 20-24-year-old girls and boys. Focus of girls’ questions: menstrual cycle calculation and related concerns accounted for the majority (24%); sexual practices (16%), love relationships (15%) and virginity (14%). Boys’ concerns are masturbation (and its consequences) (22%), sexual practices (19%), love relationships (18%) and worries about penis size (10%). Infections (genital and STI) and topics regarding HIV represent 9% and 4% of the questions asked by girls against 7% and 10% by boys. Concerns were mainly related to knowledge, attitudes and competences to be developed. Conclusions Concerns and sexual practices raised by teens about their sexual and emotional life have inspired the design of a practical guide for youth self-training and have steered the second phase of this interactive program towards supporting

  10. Modelling categorical data to identify factors influencing concern for the natural environment in Iran.

    PubMed

    Parizanganeh, Abdolhossein; Lakhan, V Chris; Yazdani, Mahmoud; Ahmad, Sajid R

    2011-10-01

    Loglinear modelling techniques were used to identify the interactions and interrelationships underlying categorical environmental concern data collected from 9062 respondents in Iran. After fitting various loglinear models to the data, the most parsimonious model highlighted that a combination of interacting factors, namely educational attainment, age, gender, and residential location were responsible for influencing personal concern for the environment. Although high educational attainment had a close correspondence with high concern for the environment the loglinear results, when visualized with a geographical information system, demonstrated wide spatial variations in educational attainment and concern for the environment. Nearly two-thirds of the respondents were not highly educated, and were therefore not highly concerned for the environment. The finding that both rural and urban male and female respondents in the 15-24 years age category, with 10-12 years of education, had the strongest interaction with personal concern for the environment could be beneficial for policy planners to utilize education as the primary instrument to enhance environmental governance and prospects for sustainable development. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. What fosters concern for inequality among American adolescents?

    PubMed

    Cech, Erin A

    2017-01-01

    Understanding cultural beliefs about social and economic inequality is vital to discerning the roadblocks and pathways to addressing that inequality. The foundation of concern for inequality is laid during adolescence, yet scholars understand little about the factors that influence whether and how adolescents come to express such concern. Arguing that structural and cultural contexts are just as consequential as whether adolescents themselves are members of disadvantaged groups, I draw on four theoretical perspectives to identify factors that influence adolescents' concern for addressing inequality: the underdog thesis, intergroup contact theory, the education enlightens thesis, and ideological buttressing. Using representative restricted-use Educational Longitudinal Survey data, I find that 12th-graders' beliefs are indeed influenced by more than their own demography: the diversity of their social milieu, the content of education in and out of the classroom, and ideological buttressing via political region and entertainment all influence whether they express concern for addressing inequality. These findings suggest extensions and amendments to the four theoretical perspectives and underscore the importance of studying structural and cultural factors that shape beliefs about inequality. The results also point to several interventions that may increase students' concern for inequality: involvement in civic-oriented extracurricular activities, more education in academic subjects that consider inequality, nurturing of cross-race friendships, and increased leisure reading. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. 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.

  13. Identifying and Addressing Student Difficulties and Misconceptions: Examples from Physics and from Materials Science and Engineering

    ERIC Educational Resources Information Center

    Rosenblatt, Rebecca

    2012-01-01

    Here I present my work identifying and addressing student difficulties with several materials science and physics topics. In the first part of this thesis, I present my work identifying student difficulties and misconceptions about the directional relationships between net force, velocity, and acceleration in one dimension. This is accomplished…

  14. Can We Identify Parents Who Do Not Verbally Share Concerns for Their Children's Development?

    PubMed

    Eremita, Matthew; Semancik, Eileen; Lerer, Trudy; Dworkin, Paul H

    2017-04-01

    We aimed to identify characteristics of parents who do not voice developmental concerns when prompted by their children's nurse and/or primary care provider (PCP), despite reporting concerns on parent-completed questionnaires. We reviewed 376 medical records of children seen for a 9-month well-child visit in an urban pediatric clinic between September 2011 and December 2012 for sociodemographic variables hypothesized to affect parents' sharing of developmental concerns: the child's birth order and gender; parents' education level, employment, relationship status, and primary language; and family size and racial/ethnic background. The target population was parents who reported concerns on the Parents' Evaluation of Developmental Status (PEDS), a routinely administered, parent-completed screening questionnaire. We subdivided parents who reported concerns on the PEDS (N = 86) based on whether they voiced developmental concerns when prompted by their children's nurse and/or PCP. Two-sided Fisher's exact tests and logistic regression evaluated the relationship between sociodemographic variables and parents' voicing of developmental concerns. Only parent education approached significance, as parents with less than a high school education (concerns for their children's development than parents with at least a high school degree or equivalent (≥HS) (63% compared to 35%, p = .056). Univariate logistic regression analysis showed that parents with concerns than those with ≥HS. Parents with low educational attainment may be more likely to not verbally share their developmental concerns. For children of such parents, early detection of developmental delay may be strengthened by use of written questionnaires.

  15. Adolescent Social Issues: Using Media to Address Crucial Concerns.

    ERIC Educational Resources Information Center

    Sokoloff, Michele

    1987-01-01

    This article describes media resources available to help adolescents deal with a variety of social concerns, including substance abuse, dropouts, Acquired Immune Deficiency Syndrome (AIDS), suicide, and pregnancy. A list of 56 companies that provide resources dealing with social issues is also provided. (LRW)

  16. 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.

  17. Building public trust in uses of Health Insurance Portability and Accountability Act de-identified data.

    PubMed

    McGraw, Deven

    2013-01-01

    The aim of this paper is to summarize concerns with the de-identification standard and methodologies established under the Health Insurance Portability and Accountability Act (HIPAA) regulations, and report some potential policies to address those concerns that were discussed at a recent workshop attended by industry, consumer, academic and research stakeholders. The target audience includes researchers, industry stakeholders, policy makers and consumer advocates concerned about preserving the ability to use HIPAA de-identified data for a range of important secondary uses. HIPAA sets forth methodologies for de-identifying health data; once such data are de-identified, they are no longer subject to HIPAA regulations and can be used for any purpose. Concerns have been raised about the sufficiency of HIPAA de-identification methodologies, the lack of legal accountability for unauthorized re-identification of de-identified data, and insufficient public transparency about de-identified data uses. Although there is little published evidence of the re-identification of properly de-identified datasets, such concerns appear to be increasing. This article discusses policy proposals intended to address de-identification concerns while maintaining de-identification as an effective tool for protecting privacy and preserving the ability to leverage health data for secondary purposes.

  18. Detecting and addressing adolescent issues and concerns: evaluating the efficacy of a primary care previsit questionnaire.

    PubMed

    Lewin, Warren; Knäuper, Bärbel; Roseman, Michelle; Adler, Perry; Malus, Michael

    2009-07-01

    To assess the efficacy of a previsit questionnaire (PVQ), implemented without formal training, that was designed to screen for biomedical and psychosocial health issues and concerns among adolescent patients in a hospital-based primary care clinic, and to examine the subsequent action taken for health issues and concerns identified with the PVQ. Retrospective review of adolescent medical charts, using a pre-post design. An outpatient primary care clinic located in an urban teaching hospital in Montreal, Que. A total of 210 adolescent patients aged 13 to 19 who visited the clinic between 2000 and 2004. The type (medical vs psychosocial) and number of issues detected and actions taken by physicians in one-to-one consultations with adolescent patients 2 years before (2000-2002) and 2 years after (2002-2004) PVQ implementation, as noted in the patients' medical charts. In total, 105 charts were reviewed for each group. An increase in the number of psychosocial issues was detected following the introduction of the PVQ. An increase in the frequency of action taken for psychosocial concerns and a decrease in the frequency of medical action taken by physicians were found after PVQ implementation. More notations related to psychosocial concerns were also found in the adolescents' charts after introduction of the PVQ. A PVQ is an effective strategy to improve adolescent screening for psychosocial issues and concerns. Implementing such a questionnaire requires no training and can therefore be easily incorporated into clinical practice.

  19. Identifying the key concerns of Irish persons with intellectual disability.

    PubMed

    García Iriarte, Edurne; O'Brien, Patricia; McConkey, Roy; Wolfe, Marie; O'Doherty, Siobhain

    2014-11-01

    Internationally, people with intellectual disability are socially marginalized, and their rights under the United Nations Convention for the Rights of Persons with Disabilities (CRPD) are often ignored. This paper aims to define the key concerns of adults with an intellectual disability in relation to their participation in society using an inclusive research strategy for both data gathering and data analysis. A national study involving 23 focus groups and 168 persons was conducted on the island of Ireland with people with intellectual disability as co-facilitators. A thematic content analysis was undertaken of the verbatim transcripts initially by university co-researchers, and 19 themes were identified. Co-researchers with intellectual disability joined in identifying the eight core themes. These were as follows: living options, employment, relationships, citizenship, leisure time, money management, self-advocacy, and communication. The concerns are discussed within the framework of the CRPD, and implications for transforming service policy are drawn. Why we did the research In many countries, people with intellectual disability have difficulties doing things other people without disabilities do, for example to study, to get a job or to live independently. They also find that their rights are not respected under the Convention on the Rights of Persons with Disabilities (the Convention). We did this study to Learn what are the main issues for adults with intellectual disability in Ireland. Do research with people with intellectual disability. How we did the research People with intellectual disability and their supporters worked with university researchers to plan and do the research. We met with people in groups and 168 people told us about things important to them. What we found out We found that there were very important things that people talked about in the groups. We chose the most important: living options, employment, relationships, rights, leisure, money

  20. An analysis of the utilization of e-mail by physicians and patients: defining benefits, addressing concerns and forecasting implications on the doctor-patient relationship.

    PubMed

    Lang, Kirk T; Kiel, Joan M

    2008-01-01

    Though e-mail is ubiquitous in everyday life, it has not been the preferred mode of communication between physicians and patients. Several factors, including privacy and security, reimbursement and legal concerns, have been seen as barriers toward increased utilization. This article examines effect of e-mail on the doctor-patient relationship. It also addresses concerns expressed by providers and patients, and explores technology- and policy-based solutions to many of these issues.

  1. Using Discipline Data within SWPBIS to Identify and Address Disproportionality: A Guide for School Teams

    ERIC Educational Resources Information Center

    McIntosh, Kent; Barnes, Aaron; Eliason, Bert; Morris, Kelsey

    2014-01-01

    The problem of racial and ethnic discipline disproportionality is both long-standing and widespread. Educators must address this issue by identifying rates of discipline disproportionality, taking steps to reduce it, and monitoring the effects of intervention on disproportionality. The purpose of this guide is to provide a reference for…

  2. Building public trust in uses of Health Insurance Portability and Accountability Act de-identified data

    PubMed Central

    2013-01-01

    Objectives The aim of this paper is to summarize concerns with the de-identification standard and methodologies established under the Health Insurance Portability and Accountability Act (HIPAA) regulations, and report some potential policies to address those concerns that were discussed at a recent workshop attended by industry, consumer, academic and research stakeholders. Target audience The target audience includes researchers, industry stakeholders, policy makers and consumer advocates concerned about preserving the ability to use HIPAA de-identified data for a range of important secondary uses. Scope HIPAA sets forth methodologies for de-identifying health data; once such data are de-identified, they are no longer subject to HIPAA regulations and can be used for any purpose. Concerns have been raised about the sufficiency of HIPAA de-identification methodologies, the lack of legal accountability for unauthorized re-identification of de-identified data, and insufficient public transparency about de-identified data uses. Although there is little published evidence of the re-identification of properly de-identified datasets, such concerns appear to be increasing. This article discusses policy proposals intended to address de-identification concerns while maintaining de-identification as an effective tool for protecting privacy and preserving the ability to leverage health data for secondary purposes. PMID:22735615

  3. Some Issues of Particular Concern to Sociologists as Academic Administrators

    ERIC Educational Resources Information Center

    Wong, Paul

    2008-01-01

    As a sociologist who has served in deanships and other university administrative positions in the past 15 years, the author has been particularly concerned with race/class/gender issues in academia. This paper identified some of the issues and discussed the relevance of sociological training in addressing them.

  4. Investigating the role of state permitting and agriculture agencies in addressing public health concerns related to industrial food animal production.

    PubMed

    Fry, Jillian P; Laestadius, Linnea I; Grechis, Clare; Nachman, Keeve E; Neff, Roni A

    2014-01-01

    Industrial food animal production (IFAP) operations adversely impact environmental public health through air, water, and soil contamination. We sought to determine how state permitting and agriculture agencies respond to these public health concerns. We conducted semi-structured qualitative interviews with staff at 12 state agencies in seven states, which were chosen based on high numbers or rapid increase of IFAP operations. The interviews served to gather information regarding agency involvement in regulating IFAP operations, the frequency and type of contacts received about public health concerns, how the agency responds to such contacts, and barriers to additional involvement. Permitting and agriculture agencies' responses to health-based IFAP concerns are constrained by significant barriers including narrow regulations, a lack of public health expertise within the agencies, and limited resources. State agencies with jurisdiction over IFAP operations are unable to adequately address relevant public health concerns due to multiple factors. Combining these results with previously published findings on barriers facing local and state health departments in the same states reveals significant gaps between these agencies regarding public health and IFAP. There is a clear need for regulations to protect public health and for public health professionals to provide complementary expertise to agencies responsible for regulating IFAP operations.

  5. Farmers' Concerns: A Qualitative Assessment to Plan Rural Medical Education

    ERIC Educational Resources Information Center

    Anderson, Brittney T.; Johnson, Gwendolyn J.; Wheat, John R.; Wofford, Amina S.; Wiggins, O. Sam; Downey, Laura H.

    2012-01-01

    Abstract Context: Limited research suggests that translational approaches are needed to decrease the distance, physical and cultural, between farmers and health care. Purpose: This study seeks to identify special concerns of farmers in Alabama and explore the need for a medical education program tailored to prepare physicians to address those…

  6. Addressing Special Education Inequity through Systemic Change: Contributions of Ecologically Based Organizational Consultation

    ERIC Educational Resources Information Center

    Sullivan, Amanda L.; Artiles, Alfredo J.; Hernandez-Saca, David I.

    2015-01-01

    Since the inception of special education, scholars and practitioners have been concerned about the disproportionate representation of students from culturally and linguistically diverse backgrounds among students identified with disabilities. Professional efforts to address this disproportionality have encompassed a range of targets, but scholars…

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

    DTIC Science & Technology

    2016-09-01

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

  8. Risk factors for peri-traumatic distress and appearance concerns in burn-injured inpatients identified by a screening tool

    PubMed Central

    Oaie, Ecaterina; Piepenstock, Emma; Williams, Lisa

    2018-01-01

    Introduction: Psychosocial screening of burn-injured patients is a National Burn Care Guideline and is increasingly used to identify individuals most in need of support. It can also generate data that can inform our understanding of patient reported concerns following a burn injury. Method: As part of routine care, 461 patients admitted to a burns unit were screened soon after admission using a psychosocial screen designed by the service. The questionnaire included items on pre-existing social support, coping, emotional and psychological difficulties, as well as current trauma symptoms and current level of concern about changed appearance following the burn. Results: Overall, patients reported low levels of appearance concerns (mean 3.7/10) and trauma symptoms (18% reporting flashbacks) in the initial days following a burn injury. In those who did report concerns, there were some significant associations with demographic and other variables. Patients who experienced flashbacks were younger and had a larger total body surface area (TBSA) burn. Higher levels of appearance concern were associated with younger women, larger TBSA and facial burns. However, the relationships found were weak and frequently confounded by other factors. Conclusion: Overall, the findings indicate that initial trauma symptoms and appearance concerns are not inevitable in this group and there is no substitute for screening in identifying who is most at risk. PMID:29873338

  9. Identifying and Addressing Student Difficulties with the Millikan Oil Drop Experiment

    NASA Astrophysics Data System (ADS)

    Klassen, Stephen

    2009-05-01

    The Millikan oil drop experiment has been characterized as one of the ‘most beautiful’ physics experiments of all time and, certainly, as one of the most frustrating of all the exercises in the undergraduate physics laboratory. A literature review reveals that work done on addressing student difficulties in performing the oil drop experiment has, to date, not achieved a significant measure of success. The historical background of the oil drop experiment is well established in the literature from the perspective of historians of science, but not so from the perspective of teachers and students of science. A summary of historical details surrounding the original experiment suitable for use in revising the instructional approach is presented. Both Millikan and his graduate student, Fletcher, are featured with the view to emphasizing details that humanize the protagonists and that are likely to raise student interest. The issue of the necessary reliance on presuppositions in doing speculative research is raised, both from the historical account and from the insights of university physics students who heard the historical account and performed the experiment. Difficulties current students have in performing the experiment are discussed from the perspective of Hodson (Stud Sci Educ 22:85-142, 1993) framework and the students’ own observations. Last, further historical materials are outlined that may be used to encourage student insight into the fundamental nature of electricity. It is proposed that these aspects are essential as a basis for identifying and addressing student difficulties with the Millikan oil drop experiment.

  10. 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

  11. Addressing the Concerns of Conservatoire Students about School Music Teaching

    ERIC Educational Resources Information Center

    Mills, Janet

    2005-01-01

    While most of the students who graduate each year from the Royal College of Music (RCM) in London build performance-based portfolio careers that include some teaching, very few of them enter secondary school class music teaching. This article describes how young musicians' concerns about the career of secondary class music teacher develop as they…

  12. Intake Procedures as a Factor in Identifying and Addressing Barriers to Attendance of Adult Education Students.

    ERIC Educational Resources Information Center

    Hubble, Judy Hafley

    A study explored the nature of intake procedures of Texas adult education programs. Research on barriers to attendance and strategies for retention were reviewed, and the current use of intake procedures to identify and address barriers to attendance was summarized through a survey of 374 Literacy, Even Start Family Literacy, Adult Basic Education…

  13. Where To Get Resource Materials To Address Barriers to Learning. A Resource Packet.

    ERIC Educational Resources Information Center

    California Univ., Los Angeles. Center for Mental Health in Schools.

    This resource aid is designed to provide a sampling of organizations and publishers that offer a variety of materials relevant to addressing students' psychosocial and mental concerns. Included is information about resources available upon request and/or purchase. The packet is divided into three sections. Section 1 identifies national…

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

    PubMed Central

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

    2017-01-01

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

  15. 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.

  16. Adolescent athletes: psychosocial challenges and clinical concerns.

    PubMed

    Tamminen, Katherine A; Holt, Nicholas L; Crocker, Peter R E

    2012-07-01

    To review the recent literature (over the past 18 months) regarding psychosocial challenges and clinical concerns among adolescent athletes, and to address the advances made in understanding adolescent athletes' coping processes. Coping research has moved from identifying discrete stressors and coping strategies to examining the processes of coping over time. Parents and coaches play an important role in young athletes' sport experiences and athletes' use and development of coping strategies. In terms of clinical concerns, findings regarding the prevalence of disordered eating have been equivocal. However, disordered eating may be of greater concern among athletes participating in 'leanness' sports. Sport participation may contribute to increased alcohol consumption among adolescent athletes but decreased use of drugs and smoking cigarettes, while steroid use appears to be relatively rare compared with athletes' use of alcohol and cigarettes. The reviewed studies have implications for future research by identifying opportunities for intervention and education regarding clinical and nonclinical psychosocial challenges. Researchers have emphasized the importance of athletes' social context and relationships in coping with psychosocial challenges in sport. One concern is that adolescent athletes' disordered eating and substance use may reflect maladaptive coping. Experimental and intervention research is limited; however, incorporating members of athletes' social network into future research and interventions may be a practical avenue to achieving positive outcomes among adolescent athletes.

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

    ERIC Educational Resources Information Center

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

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

  18. Factors influencing nurses' decisions to raise concerns about care quality.

    PubMed

    Attree, Moira

    2007-05-01

    To explore factors that influence nurses' decisions to raise concerns about standards of practice. Health care practitioners have a key role in monitoring care quality. Nurses are required by their professional body to raise concerns about standards; however, under-reporting is the norm. Grounded theory was used to collect and analyse data from semi-structured interviews with 142 practising nurses, theoretically sampled from three Acute NHS Trusts in England. Fear of repercussions, retribution, labelling and blame for raising concerns, about which they predicted nothing would be done, were identified as disincentives to raising concerns. Reporting was perceived as a high-risk:low-benefit action. Nurses lacked confidence in reporting systems. Disincentives to reporting need to be addressed if an open culture, which promotes quality, safety and learning, is to be developed. Findings give cause for concern and indicate a need to review organizational and professional guidelines, and organizational reporting systems.

  19. 78 FR 58608 - Proposed Collection; Comment Request: Furnishing Identifying Number of Tax Return Preparer

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-24

    ...: Furnishing Identifying Number of Tax Return Preparer AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... IRS is soliciting comments concerning furnishing identifying number of tax return preparer. DATES.... ADDRESSES: Direct all written comments to Yvette Lawrence, Internal Revenue Service, Room 6129, 1111...

  20. Common menstrual concerns of adolescents

    PubMed Central

    Sacks, Diane

    1998-01-01

    Symptoms associated with menstruation are among the most common concerns of adolescent women. However, the factual information that adolescent women need is not always available to them. Physicians can do much to correct the myths and misinformation that the teenager may have concerning her menstrual cycle. This paper addresses clinical office concerns about normal menstruation, dysmenorrhea, amenorrhea and dysfunctional uterine bleeding. PMID:20401253

  1. "Is it still safe to eat traditional food?" Addressing traditional food safety concerns in aboriginal communities.

    PubMed

    Bordeleau, Serge; Asselin, Hugo; Mazerolle, Marc J; Imbeau, Louis

    2016-09-15

    Food insecurity is a growing concern for indigenous communities worldwide. While the risk of heavy metal contamination associated to wild food consumption has been extensively studied in the Arctic, data are scarce for the Boreal zone. This study addressed the concerns over possible heavy metal exposure through consumption of traditional food in four Anishnaabeg communities living in the Eastern North American boreal forest. Liver and meat samples were obtained from 196 snowshoe hares (Lepus americanus) trapped during winter 2012 across the traditional lands of the participating communities and within 56-156km of a copper smelter. Interviews were conducted with 78 household heads to assess traditional food habits, focusing on snowshoe hare consumption. Concentrations in most meat and liver samples were below the detection limit for As, Co, Cr, Ni and Pb. Very few meat samples had detectable Cd and Hg concentrations, but liver samples had mean dry weight concentrations of 3.79mg/kg and 0.15mg/kg respectively. Distance and orientation from the smelter did not explain the variability between samples, but percent deciduous and mixed forest cover had a marginal negative effect on liver Cd, Cu and Zn concentrations. The estimated exposition risk from snowshoe hare consumption was low, although heavy consumers could slightly exceed recommended Hg doses. In accordance with the holistic perspective commonly adopted by indigenous people, the nutritional and sociocultural importance of traditional food must be considered in risk assessment. Traditional food plays a significant role in reducing and preventing serious health issues disproportionately affecting First Nations, such as obesity, diabetes, and cardiovascular diseases. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Engagement studios: students and communities working to address the determinants of health.

    PubMed

    Bainbridge, Lesley; Grossman, Susan; Dharamsi, Shafik; Porter, Jill; Wood, Victoria

    2014-01-01

    This article presents an innovative model for interprofessional community-oriented learning. The Engagement Studios model involves a partnership between community organizations and students as equal partners in conversations and activities aimed at addressing issues of common concern as they relate to the social determinants of health. Interprofessional teams of students from health and non-health disciplines work with community partners to identify priority community issues and explore potential solutions. The student teams work with a particular community organization, combining their unique disciplinary perspectives to develop a project proposal, which addresses the community issues that have been jointly identified. Approved proposals receive a small budget to implement the project. In this paper we present the Engagement Studios model and share lessons learned from a pilot of this educational initiative.

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

    PubMed Central

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

    2011-01-01

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

  4. Identifying Evidence-Based Practices for Behavior: Analysis of Studies Reviewed by the What Works Clearinghouse

    ERIC Educational Resources Information Center

    LeRoy, Adam Scott

    2017-01-01

    Prior concerns have been raised about the ability of schools to access evidence-based practices, however, these practices are instrumental for addressing behavior concerns. This is particularly true at the secondary level, where students are more likely to be disproportionately identified for school removal. This review investigates studies of…

  5. Maternal concerns about children overeating among low-income children

    PubMed Central

    Pesch, Megan H.; Rizk, Monika; Appugliese, Danielle P.; Rosenblum, Katherine L.; Miller, Alison; Lumeng, Julie C.

    2016-01-01

    Addressing overeating is essential to obesity treatment and prevention. The objectives of this study were to investigate maternal concern for child overeating, to identify associated participant characteristics and to determine if concern for child overeating is associated with maternal feeding practices. Low-income mothers (N = 289) of children (mean age 70.8 months) participated in a semi-structured interview. Themes of maternal concern for child overeating were identified and a coding scheme was reliably applied. Maternal feeding practices were measured by questionnaire and videotaped eating interactions. Logistic regressions were used to test the associations of participant characteristics with the presence of each theme, and bivariate analyses were used to test the associations of the presence of each theme with feeding practices. Three themes were identified: 1) mothers worry that their child does overeat, 2) mothers acknowledge that their child may overeat but indicate that it is not problematic because they manage their child’s eating behavior, and 3) mothers acknowledge that their child may overeat but indicate that it is not problematic because of characteristics inherent to the child. Child obesity predicted the themes; mothers of obese and overweight children are more likely to be concerned about overeating. Themes were associated with lower levels of observed pressure to eat. Only Theme 2 was associated with greater restrictive feeding practices. Interventions that provide parents practical, healthy ways to prevent child overeating may be helpful. PMID:27010491

  6. Maternal concerns about children overeating among low-income children.

    PubMed

    Pesch, Megan H; Rizk, Monika; Appugliese, Danielle P; Rosenblum, Katherine L; Miller, Alison; Lumeng, Julie C

    2016-04-01

    Addressing overeating is essential to obesity treatment and prevention. The objectives of this study were to investigate maternal concern for child overeating, to identify associated participant characteristics and to determine if concern for child overeating is associated with maternal feeding practices. Low-income mothers (N=289) of children (mean age 70.8months) participated in a semi-structured interview. Themes of maternal concern for child overeating were identified and a coding scheme was reliably applied. Maternal feeding practices were measured by questionnaire and videotaped eating interactions. Logistic regressions were used to test the associations of participant characteristics with the presence of each theme, and bivariate analyses were used to test the associations of the presence of each theme with feeding practices. Three themes were identified: 1) mothers worry that their child does overeat, 2) mothers acknowledge that their child may overeat but indicate that it is not problematic because they manage their child's eating behavior, and 3) mothers acknowledge that their child may overeat but indicate that it is not problematic because of characteristics inherent to the child. Child obesity predicted the themes; mothers of obese and overweight children are more likely to be concerned about overeating. Themes were associated with lower levels of observed pressure to eat. Only Theme 2 was associated with greater restrictive feeding practices. Interventions that provide parents' practical, healthy ways to prevent child overeating may be helpful. Copyright © 2016. Published by Elsevier Ltd.

  7. A Review of Radiolysis Concerns for Water Shielding in Fission Surface Power Applications

    NASA Technical Reports Server (NTRS)

    Schoenfeld, Michael P.

    2008-01-01

    This paper presents an overview of radiolysis concerns with regard to water shields for fission surface power. A review of the radiolysis process is presented and key parameters and trends are identified. From this understanding of the radiolytic decomposition of water, shield pressurization and corrosion are identified as the primary concerns. Existing experimental and modeling data addressing concerns are summarized. It was found that radiolysis of pure water in a closed volume results in minimal, if any net decomposition, and therefore reduces the potential for shield pressurization and corrosion. With the space program focus m emphasize more on permanent return to the Moon and eventually manned exploration of Mars, there has been a renewed look at fission power to meet the difficult technical & design challenges associated with this effort. This is due to the ability of fission power to provide a power rich environment that is insensitive to solar intensity and related aspects such as duration of night, dusty environments, and distance from the sun, etc. One critical aspect in the utilization of fission power for these applications of manned exploration is shielding. Although not typically considered for space applications, water shields have been identified as one potential option due to benefits in mass savings and reduced development cost and technical risk (Poston, 2006). However, the water shield option requires demonstration of its ability to meet key technical challenges including such things as adequate natural circulation for thermal management and capability for operational periods up to 8 years. Thermal management concerns have begun to be addressed and are not expected to be a problem (Pearson, 2007). One significant concern remaining is the ability to maintain the shield integrity through its operational lifetime. Shield integrity could be compromised through shield pressurization and corrosion resulting from the radiolytic decomposition of water.

  8. 40 CFR Table 5 to Subpart Jj of... - List of VHAP of Potential Concern Identified by Industry

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 11 2014-07-01 2014-07-01 false List of VHAP of Potential Concern Identified by Industry 5 Table 5 to Subpart JJ of Part 63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National...

  9. 40 CFR Table 5 to Subpart Jj of... - List of VHAP of Potential Concern Identified by Industry

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 11 2012-07-01 2012-07-01 false List of VHAP of Potential Concern Identified by Industry 5 Table 5 to Subpart JJ of Part 63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National...

  10. 40 CFR Table 5 to Subpart Jj of... - List of VHAP of Potential Concern Identified by Industry

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 11 2013-07-01 2013-07-01 false List of VHAP of Potential Concern Identified by Industry 5 Table 5 to Subpart JJ of Part 63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National...

  11. 40 CFR Table 5 to Subpart Jj of... - List of VHAP of Potential Concern Identified by Industry

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 10 2011-07-01 2011-07-01 false List of VHAP of Potential Concern Identified by Industry 5 Table 5 to Subpart JJ of Part 63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National...

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

    PubMed

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

    2018-06-01

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

  13. Addressing Parents' Vaccine Concerns: A Randomized Trial of a Social Media Intervention.

    PubMed

    Daley, Matthew F; Narwaney, Komal J; Shoup, Jo Ann; Wagner, Nicole M; Glanz, Jason M

    2018-05-08

    Successful strategies are needed to address parental vaccine hesitancy, a significant public health issue. The study objective was to assess whether an Internet-based platform with vaccine information and interactive social media components improved parents' vaccine-related attitudes. A three-arm RCT. The study was conducted in a large Colorado integrated healthcare organization. Parents were enrolled during September 2013 through October 2015 and followed through November 2016; data were analyzed in 2017. Parents, recruited during pregnancy, were given a survey about vaccine-related attitudes at enrollment (i.e., baseline) and when their child was aged 3-5 months and 12-15 months (Timepoints 1 and 2, respectively). Parental vaccine hesitancy was assessed at baseline. Study participants were randomized to the following: a study website with vaccine information and social media components (VSM arm); a website with vaccine information only (VI); or usual care. Change in parental vaccine attitudes over time by baseline degree of vaccine hesitancy. Among 1,093 study participants, 945 (86.5%) completed all three surveys. Comparing baseline with Timepoint 1 among vaccine-hesitant parents, the VSM and VI arms were associated with significant improvements in attitudes regarding vaccination benefits compared to usual care (VSM mean change 0.23 on a 5-point scale, 95% CI=0.05, 0.40, VI mean change 0.22, 95% CI=0.04, 0.40). Comparing baseline with Timepoint 2 among hesitant parents, the VSM and VI arms were also associated with significant reductions in parental concerns about vaccination risks compared to usual care (VSM mean change -0.37, 95% CI= -0.60, -0.14, VI mean change -0.31, 95% CI= -0.55, -0.07). Self-efficacy around vaccine decision making also improved among vaccine-hesitant parents. No intervention effect was observed among parents not vaccine-hesitant at baseline. Among vaccine-hesitant parents, an Internet-based intervention improved parents' attitudes about

  14. Online discourse on fibromyalgia: text-mining to identify clinical distinction and patient concerns.

    PubMed

    Park, Jungsik; Ryu, Young Uk

    2014-10-07

    The purpose of this study was to evaluate the possibility of using text-mining to identify clinical distinctions and patient concerns in online memoires posted by patients with fibromyalgia (FM). A total of 399 memoirs were collected from an FM group website. The unstructured data of memoirs associated with FM were collected through a crawling process and converted into structured data with a concordance, parts of speech tagging, and word frequency. We also conducted a lexical analysis and phrase pattern identification. After examining the data, a set of FM-related keywords were obtained and phrase net relationships were set through a web-based visualization tool. The clinical distinction of FM was verified. Pain is the biggest issue to the FM patients. The pains were affecting body parts including 'muscles,' 'leg,' 'neck,' 'back,' 'joints,' and 'shoulders' with accompanying symptoms such as 'spasms,' 'stiffness,' and 'aching,' and were described as 'sever,' 'chronic,' and 'constant.' This study also demonstrated that it was possible to understand the interests and concerns of FM patients through text-mining. FM patients wanted to escape from the pain and symptoms, so they were interested in medical treatment and help. Also, they seemed to have interest in their work and occupation, and hope to continue to live life through the relationships with the people around them. This research shows the potential for extracting keywords to confirm the clinical distinction of a certain disease, and text-mining can help objectively understand the concerns of patients by generalizing their large number of subjective illness experiences. However, it is believed that there are limitations to the processes and methods for organizing and classifying large amounts of text, so these limits have to be considered when analyzing the results. The development of research methodology to overcome these limitations is greatly needed.

  15. Clinical strategies to address patients' concerns in osteoporosis management with bisphosphonates.

    PubMed

    Cole, Raymond E

    2011-03-01

    Approximately 44 million Americans either have, or are at risk of developing, osteoporosis, a disease associated with an increased risk of fracture and, consequently, morbidity and mortality. Osteoporosis affects 20% to 30% of postmenopausal women, and resulting fractures pose a major economic burden, with estimated annual direct costs ranging from $17 billion to $19 billion. Hip fractures account for the majority of costs (~60%) because they often require costly long-term follow-up care in addition to the direct costs of initial treatment. Screening, diagnosis, and disease management are of paramount importance when treating patients at risk for osteoporosis. The National Osteoporosis Foundation recommends that all postmenopausal women be evaluated for osteoporosis risk factors and that all women aged ≥ 65 years undergo bone mineral density testing. Once the primary care physician has identified a patient at risk for osteoporosis-related fracture, the physician must decide whether and how to treat the patient (ie, nonpharmacologic or pharmacologic options). Bisphosphonates are the first-line pharmacologic treatment for women aged ≥ 50 years with postmenopausal osteoporosis. Bisphosphonates-which have a favorable safety and tolerability profile in clinical trials-have shown efficacy in reducing fractures. However, achieved real world effectiveness is very much dependent on good treatment adherence by the patient. Media attention to rare adverse events has motivated some patients to deliberate nonadherence. Physicians should screen patients for contraindications and adverse event risk factors, educate them on the risks of fracture and benefits and risks of treatment, and monitor them during therapy. To assist primary care physicians in clinical decision making for women at risk for or with confirmed osteoporosis, this article presents a review of the guidelines for the diagnosis and treatment of postmenopausal osteoporosis, recent long-term efficacy data for

  16. Misconceptions Concerning the Clinical Use of Hypnosis in Dentistry.

    DTIC Science & Technology

    1981-02-17

    I AD-A095 1473 ARMY INST OF DENTAL RESEARCH WASHINGTON DC F/G 6/S MISONCEPTIONS CONCERNING THE CLINICAL USE OF HYPNOSIS IN OITI-CTCiU) I FEB A1 W F...ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT. PROJECT, TASK ’ US Amy Institute of Dental Research AE&OKUI UJB Walter Reed Army Medical Center...Hypnosis in dentistry C:) 12ABSTR ACT (Cinttinzt am revenn afif N nacweaay md identify by block num ber) ?the vast majority of dental practitioners

  17. 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.

  18. 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.

  19. Parent Concern and Enrollment in Intervention Services for Young Children with Developmental Delays: 2007 National Survey of Children's Health

    ERIC Educational Resources Information Center

    Marshall, Jennifer; Kirby, Russell S.; Gorski, Peter A.

    2016-01-01

    This study sought to address underenrollment and late entry to early intervention by identifying factors associated with parental concern and services for developmental delays. The authors analyzed responses from 27,566 parents of children from birth to age 5 from the 2007 National Survey of Children's Health to quantify and to identify factors…

  20. 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…

  1. Identifying and Addressing Themes of Job Dissatisfaction for Secondary Principals

    ERIC Educational Resources Information Center

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

    2017-01-01

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

  2. Medical and pharmacy student concerns about participating on international service-learning trips.

    PubMed

    Chuang, Chih; Khatri, Siddique H; Gill, Manpal S; Trehan, Naveen; Masineni, Silpa; Chikkam, Vineela; Farah, Guillaume G; Khan, Amber; Levine, Diane L

    2015-12-23

    International Service Learning Trips (ISLT) provide health professional students the opportunity to provide healthcare, under the direction of trained faculty, to underserved populations in developing countries. Despite recent increases in international service learning trips, there is scant literature addressing concerns students have prior to attending such trips. This study focuses on identifying concerns before and after attending an ISLT and their impact on students. A survey comprised of closed and open-ended questions was developed to elucidate student concerns prior to attending an ISLT and experiences which might influence concerns. A five-point Likert-scale (extremely concerned = 1, minimally concerned = 5) was used to rate apprehension and satisfaction. Paired t-test was used to compare pre- and post-trip concerns; Chi-Square test was used to compare groups. Thirty-five students (27 medical, 8 pharmacy) attended ISLTs in December 2013. All completed pre and post-trip surveys. Significant decreases were seen in concerns related to cultural barriers (4.14 vs 4.46, P = .047), disease/epidemics (3.34 vs 4.60, P < .001), natural disasters (3.94 vs 4.94, P < .001), terrorism (4.34 vs 4.94, P < .001), travel (3.86 vs 4.51, P < .001) monetary issues (3.80 vs 4.60, P < .001), hospitality (3.94 vs 4.74, P = .001) and food (3.83 vs 4.60, P < .001). Language and group dynamics remained concerns post-trip. On open-ended questions, students described benefits of attending an ISLT. Students had multiple concerns prior to attending an ISLT. Most decreased upon return. Addressing concerns has the potential to decrease student apprehension. The results of this study highlight the benefits of providing ISLTs and supporting development of a curriculum incorporating trip-related concerns.

  3. Addressing social resistance in emerging security technologies

    PubMed Central

    Mitchener-Nissen, Timothy

    2013-01-01

    In their efforts to enhance the safety and security of citizens, governments and law enforcement agencies look to scientists and engineers to produce modern methods for preventing, detecting, and prosecuting criminal activities. Whole body scanners, lie detection technologies, biometrics, etc., are all being developed for incorporation into the criminal justice apparatus.1 Yet despite their purported security benefits these technologies often evoke social resistance. Concerns over privacy, ethics, and function-creep appear repeatedly in analyses of these technologies. It is argued here that scientists and engineers continue to pay insufficient attention to this resistance; acknowledging the presence of these social concerns yet failing to meaningfully address them. In so doing they place at risk the very technologies and techniques they are seeking to develop, for socially controversial security technologies face restrictions and in some cases outright banning. By identifying sources of potential social resistance early in the research and design process, scientists can both engage with the public in meaningful debate and modify their security technologies before deployment so as to minimize social resistance and enhance uptake. PMID:23970863

  4. Synthesis of common management concerns associated with dam removal

    USGS Publications Warehouse

    Tullos, Desiree D.; Collins, Mathias J.; Bellmore, J. Ryan; Bountry, Jennifer A.; Connolly, Patrick J.; Shafroth, Patrick B.; Wilcox, Andrew C.

    2016-01-01

    Managers make decisions regarding if and how to remove dams in spite of uncertainty surrounding physical and ecological responses, and stakeholders often raise concerns about certain negative effects, regardless of whether or not these concerns are warranted at a particular site. We used a dam-removal science database supplemented with other information sources to explore seven frequently-raised concerns, herein Common Management Concerns (CMCs). We investigate the occurrence of these concerns and the contributing biophysical controls. The CMCs addressed are: degree and rate of reservoir sediment erosion, excessive channel incision upstream of reservoirs, downstream sediment aggradation, elevated downstream turbidity, drawdown impacts on local water infrastructure, colonization of reservoir sediments by non-native plants, and expansion of invasive fish. Biophysical controls emerged for some of the concerns, providing managers with information to assess whether a given concern is likely to occur at a site. To fully assess CMC risk, managers should concurrently evaluate site conditions and identify the ecosystem or human uses that will be negatively affected if the biophysical phenomenon producing the CMC occurs. We show how many CMCs have one or more controls in common, facilitating the identification of multiple risks at a site, and demonstrate why CMC risks should be considered in the context of other factors like natural watershed variability and disturbance history.

  5. Reflections on Ways Forward for Addressing Ethical Concerns in Mobile Learning Research

    ERIC Educational Resources Information Center

    Wishart, Jocelyn

    2016-01-01

    This paper reflects on a decade of discussions about the range of ethical issues arising in mobile learning research. Research into the educational potential of mobile, handheld technologies to enhance teaching and learning has been regularly frustrated by lecturers' and teachers' concerns about how their students might use such devices. At other…

  6. Hispanic Women's Expectations of Campus-Based Health Clinics Addressing Sexual Health Concerns

    ERIC Educational Resources Information Center

    Stephens, Dionne P.; Thomas, Tami L.

    2011-01-01

    Although the number of Hispanic women attending postsecondary institutions has significantly increased in the past decade, knowledge about their use of campus health services to address sexuality-related issues remains low. Increased information about this population is crucial given that sexual health indicators have shown Hispanic women in…

  7. Mothers' Concerns for Personal Safety and Privacy While Breastfeeding: An Unexplored Phenomenon.

    PubMed

    Rosen-Carole, Casey; Allen, Katherine; Fagnano, Maria; Dozier, Ann; Halterman, Jill

    2018-04-01

    Preliminary qualitative research in upstate NY shows new mothers are worried about safety while breastfeeding. Little is known regarding prevalence of these concerns and their effect on breastfeeding outcomes. (1) Determine frequency of breastfeeding safety and privacy concerns; (2) Explore their association with breastfeeding outcomes. Mothers were surveyed immediately and 1-month postpartum about breastfeeding goals; both surveys addressed privacy and safety concerns at home, work, and in public. Outcome data included breastfeeding intent, exclusivity, and duration. Breastfeeding/non-breastfeeding mothers were compared using Chi-square and multivariate analyses. A total of 279 women enrolled. Of these 82.8% initiated breastfeeding; at 1-month 72% provided any breast milk, and 44% were exclusively breastfeeding. About 99% felt safe breastfeeding at home; 25% reported privacy concerns; and 5% felt "vulnerable or unsafe" while breastfeeding. At 1-month, 49% agreed there was a safe place to breastfeed/express milk at work (20% unsure). Non-breastfeeding mothers expressed more safety concerns outside home/at work: 18% breastfeeding versus 28% non-breastfeeding outside home; 27% breastfeeding versus 40% non-breastfeeding at work. Nearly 54% who reported feeling vulnerable/unsafe with breastfeeding initiated breastfeeding, compared with 86% not reporting this concern (p = 0.008). Fewer women initiating breastfeeding reported vulnerability/safety (3% breastfeeding versus 14% non-breastfeeding, p = 0.008) or privacy (22% breastfeeding versus 40% non-breastfeeding, p = 0.19) concerns. Associations held after controlling for age, race, parity, insurance, geography, and marital-status. Significant associations between initiation, privacy, and safety concerns did not extend to duration or exclusivity. Many breastfeeding women reported safety and privacy concerns, especially outside the home and at work, which may influence breastfeeding initiation. Further study

  8. Exploring the relationship between parental concern and the management of childhood obesity.

    PubMed

    Moore, Lucas C; Harris, Carole V; Bradlyn, Andrew S

    2012-05-01

    Parental concern about child weight has been identified as a factor in parental monitoring and regulation of child diet. However, little is known about factors that influence parental concern or about how concern may influence parent management of child physical activity. The objectives of the current study were to identify the factors associated with parental concern about child weight and determine if parental concern is associated with specific actions to improve diet and increase physical activity. A stratified random sample of 1,500 parents of children in kindergarten, 2nd, 4th, 5th, 7th, and 9th grade were interviewed. Interviews addressed: (a) child and parent physical activity, (b) child and family nutrition, (c) child and parent BMI weight category, (d) interactions with health care providers, (e) parent obesity knowledge, (f) school assessment of BMI, and (g) parent perception of and concern about child weight. Child gender, weight status, and parent perception of child weight were significant predictors of parental concern. Parents were significantly more likely to report concern if their child was female, they believed their child to be overweight/obese, or their child was overweight/obese as indicated by BMI percentile. Concerned parents were significantly more likely to limit child screen time, take steps to improve child diet, and increase child physical activity than were parents who reported no concern. Treatment and prevention efforts should emphasize parental concern and awareness about child weight by providing accurate feedback on child weight status and education regarding the health risks associated with childhood overweight and obesity. Schools can play an important role in this process through the incorporation of BMI screenings.

  9. Glaucoma Patient-Reported Concerns and Associated Factors.

    PubMed

    Mogil, Rachel S; Tirsi, Andrew; Lee, Jung Min; Tello, Celso; Park, Sung Chul

    2017-06-01

    To assess the character and degree of concerns of glaucoma patients and identify demographic/clinical factors affecting the concerns. Prospective cross-sectional study. A questionnaire that addressed patients' concerns was administered to consecutive glaucoma patients. Severity of concern was scored with a scale of 0-5 in order of increasing severity. Age, sex, intraocular pressure, visual field (VF) mean deviation (MD), number of antiglaucoma medications, history of glaucoma surgery, and employment status were recorded. Questionnaire results of 152 patients (mean VF MD, -8.03 ± 7.86 dB [better eye] and -16.06 ± 10.22 dB [worse eye]; mean age, 69 ± 14 years) were analyzed. Severity of concern was greatest for general eyesight (2.92/5.00) and visual symptoms (2.78/5.00), followed by activities (2.20/5.00) and socioeconomic factors (2.13/5.00), and then ocular symptoms (1.69/5.00) (P < .001). The most common concerns within each domain were blurry vision (32%), reading small print (34%), medical costs (26%), and dryness (32%). Concern about visual symptoms correlated with VF MD of the better eye (r = -0.258; P = .001) and worse eye (r = -0.233; P = .004). Concern about activities correlated with history of glaucoma surgery (r = 0.148; P = .023) and VF MD of the better eye (r = -0.284; P < .001) and worse eye (r = -0.295; P < .001). Concern about socioeconomic factors correlated with VF MD of the better eye (r = -0.245; P = .003) and age (r = -0.260; P = .001). Glaucoma patients reported varied degrees of concern regarding items associated with quality of life. Certain items may be more concerning than others. Severity of some concerns increased with more severe VF loss, prior glaucoma surgery, or younger age. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Global surveillance for chemical incidents of international public health concern.

    PubMed Central

    Olowokure, B.; Pooransingh, S.; Tempowski, J.; Palmer, S.; Meredith, T.

    2005-01-01

    OBJECTIVE: In December 2001, an expert consultation convened by WHO identified strengthening national and global chemical incident preparedness and response as a priority. WHO is working towards this objective by developing a surveillance and response system for chemical incidents. This report describes the frequency, nature and geographical location of acute chemical incidents of potential international concern from August 2002 to December 2003. METHODS: Acute chemical incidents were actively identified through several informal (e.g. Internet-based resources) and formal (e.g. various networks of organizations) sources and assessed against criteria for public health emergencies of international concern using the then proposed revised International Health Regulations (IHR). WHO regional and country offices were contacted to obtain additional information regarding identified incidents. FINDINGS: Altogether, 35 chemical incidents from 26 countries met one or more of the IHR criteria. The WHO European Region accounted for 43% (15/35) of reports. The WHO Regions for Africa, Eastern Mediterranean and Western Pacific each accounted for 14% (5/35); South-East Asia and the Americas accounted for 9% (3/35) and 6% (2/35), respectively. Twenty-three (66%) events were identified within 24 hours of their occurrence. CONCLUSION: To our knowledge this is the first global surveillance system for chemical incidents of potential international concern. Limitations such as geographical and language bias associated with the current system are being addressed. Nevertheless, the system has shown that it can provide early detection of important events, as well as information on the magnitude and geographical distribution of such incidents. It can therefore contribute to improving global public health preparedness. PMID:16462985

  11. Identifying the Key Concerns of Irish Persons with Intellectual Disability

    ERIC Educational Resources Information Center

    García Iriarte, Edurne; O'Brien, Patricia; McConkey, Roy; Wolfe, Marie; O'Doherty, Siobhain

    2014-01-01

    Background: Internationally, people with intellectual disability are socially marginalized, and their rights under the United Nations Convention for the Rights of Persons with Disabilities (CRPD) are often ignored. Aims: This paper aims to define the key concerns of adults with an intellectual disability in relation to their participation in…

  12. Addressing Parental Vaccination Questions in the School Setting

    ERIC Educational Resources Information Center

    Luthy, Karlen E.; Burningham, Jana; Eden, Lacey M.; Macintosh, Janelle L. B.; Beckstrand, Renea L.

    2016-01-01

    School nurses work in a unique environment with key opportunities to address parental concerns and questions regarding their child's health. A common concern for parents during school enrollment is childhood vaccination safety and efficacy. As public health leaders, school nurses are well respected among parents, therefore school nurses are in a…

  13. Radiation and Reliability Concerns for Modern Nonvolatile Memory Technology

    NASA Technical Reports Server (NTRS)

    Oldham, Timothy R.; Friendlich, Mark R.; Kim, Hak S.; Berg, Melanie D.; LaBel, Kenneth A.; Buchner, S. P.; McMorrow, D.; Mavis, D. G.; Eaton, P. H.; Castillo, J.

    2011-01-01

    Commercial nonvolatile memory technology is attractive for space applications, but radiation issues are serious concerns. In addition, we discuss combined radiation/reliability concerns which are only beginning to be addressed.

  14. Goals, beliefs, and concerns of urban caregivers of middle and older adolescents with asthma.

    PubMed

    Gibson-Scipio, Wanda; Krouse, Helene J

    2013-04-01

    Caregiver goals, an integral part of a partnership for asthma management, have been found to influence asthma outcomes in children. These goals are likely to change during the transitional period of adolescence to address the needs of teenagers as they mature and assume greater responsibilities for their own care. Little is known about the goals, beliefs, and concerns of caregivers as they begin to shift responsibilities for asthma management to teens. This study sought to identify the asthma management goals, beliefs, and concerns of primarily African American caregivers of urban middle and older adolescents. Fourteen caregivers of urban African American adolescents aged 14-18 years with asthma participated in a focus group session. An iterative process was used to identify themes from the session related to asthma management goals, concerns, and beliefs of caregivers. Caregivers identified goals that related to supporting their teens' progress toward independent asthma self-management. They described significant concerns related to the teens' ability to implement asthma self-management, especially in school settings. Caregivers also revealed beliefs that represented knowledge deficits related to asthma medications and factors that improved or worsened asthma. Most caregivers identified grave concerns about school policies regarding asthma medication administration and the lack of knowledge and support provided by teachers and staff for their teen. Caregivers are an invaluable resource in the care of adolescents with asthma. An opportunity exists to improve caregiver understanding of asthma medications and to provide support through improvements in asthma care for adolescents in school-based settings.

  15. 'Hesitant compliers': Qualitative analysis of concerned fully-vaccinating parents.

    PubMed

    Enkel, Stephanie L; Attwell, Katie; Snelling, Thomas L; Christian, Hayley E

    2017-10-11

    Some parents are hesitant about vaccines and yet still vaccinate their children. Vaccine behaviours are not fixed and parents who are concerned but nonetheless adherent to standard schedules could switch to an unconventional schedule, delaying or cherry-picking vaccines. There is a need to better understand vaccine hesitancy in specific contexts, acknowledging cultural and geographical variation, to ensure interventions targeting hesitancy are well directed and received. To identify the behaviours, knowledge and attitudes of 'hesitant compliers' in Perth, Western Australia, nine one-on-one in-depth interviews were conducted with vaccinating parents of children (<5 years) who were identified as being hesitant. Interview transcripts were analysed qualitatively and themes developed inductively, following a constructivist paradigm. Parents saw vaccination as important for themselves and their community, despite their limited knowledge of vaccine preventable diseases. Parents reported concerns about potential side effects, and worried about the safety of the measles-mumps-rubella (MMR) and seasonal influenza vaccines. Concerned about the role of anti-vaccination information in the community, some sought to isolate themselves from parents who did not vaccinate, although others were concerned that this could entrench non-vaccinators' behaviours. Parents' views were all underlaid by two pivotal 'vaccine-related events' that had occurred in the community: the severe injury of a baby from seasonal influenza vaccination in 2010, and the death of a baby from whooping cough in 2015. Parents interpreted pivotal vaccine-related events in the community as requiring them to take personal responsibility for vaccine decisions. Their reports of continued vaccine fears (evident in international studies in recent decades) demonstrate that vaccine scares have long lasting effects. With vaccine rates high and stable, current strategies appear to be have little impact on addressing

  16. Report: Inconsistencies With EPA Policy Identified in Region 10's Biweekly Pay Cap Waiver Process

    EPA Pesticide Factsheets

    Report #18-P-0068, January 12, 2018. We identified issues with documentation and review of biweekly pay cap waivers at Region 10, resulting from a lack of an internal policy or process. Region 10 recently issued a new procedure that addresses our concerns.

  17. 13 CFR 124.1016 - What must a concern do in order to be identified as a SDB in any Federal procurement database?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false What must a concern do in order to be identified as a SDB in any Federal procurement database? 124.1016 Section 124.1016 Business Credit... procurement database? (a) In order to be identified as a SDB in the System for Award Management (SAM) database...

  18. Reducing Patients’ Unmet Concerns in Primary Care: the Difference One Word Can Make

    PubMed Central

    Robinson, Jeffrey D.; Elliott, Marc N.; Beckett, Megan; Wilkes, Michael

    2007-01-01

    Context In primary, acute-care visits, patients frequently present with more than 1 concern. Various visit factors prevent additional concerns from being articulated and addressed. Objective To test an intervention to reduce patients’ unmet concerns. Design Cross-sectional comparison of 2 experimental questions, with videotaping of office visits and pre and postvisit surveys. Setting Twenty outpatient offices of community-based physicians equally divided between Los Angeles County and a midsized town in Pennsylvania. Participants A volunteer sample of 20 family physicians (participation rate = 80%) and 224 patients approached consecutively within physicians (participation rate = 73%; approximately 11 participating for each enrolled physician) seeking care for an acute condition. Intervention After seeing 4 nonintervention patients, physicians were randomly assigned to solicit additional concerns by asking 1 of the following 2 questions after patients presented their chief concern: “Is there anything else you want to address in the visit today?” (ANY condition) and “Is there something else you want to address in the visit today?” (SOME condition). Main Outcome Measures Patients’ unmet concerns: concerns listed on previsit surveys but not addressed during visits, visit time, unanticipated concerns: concerns that were addressed during the visit but not listed on previsit surveys. Results Relative to nonintervention cases, the implemented SOME intervention eliminated 78% of unmet concerns (odds ratio (OR) = .154, p = .001). The ANY intervention could not be significantly distinguished from the control condition (p = .122). Neither intervention affected visit length, or patients’; expression of unanticipated concerns not listed in previsit surveys. Conclusions Patients’ unmet concerns can be dramatically reduced by a simple inquiry framed in the SOME form. Both the learning and implementation of the intervention require very little

  19. Characteristics and Concerns of Caregivers of Adults With Traumatic Brain Injury.

    PubMed

    Powell, Janet M; Wise, Elizabeth K; Brockway, Jo Ann; Fraser, Robert; Temkin, Nancy; Bell, Kathleen R

    To describe the characteristics of caregivers of adults with traumatic brain injury (TBI) and their concerns in the first months after community discharge of the TBI survivor. Secondary analysis of data collected during a parallel-group randomized controlled trial. Community. A total of 153 consecutively enrolled caregivers of adults with moderate to severe TBI discharged to the community following acute and/or rehabilitation care at a Level I trauma center with 71 caregivers in the treatment group identifying concerns as part of the intervention procedures. Caregiver demographics, caregiver-survivor relationship characteristics, caregiver activity changes, and concerns targeted by caregivers for education and problem-solving via biweekly phone calls. Thirty-nine percent of caregivers were spouses and 35% parents. Sixty-five percent lived in the same house as the survivor preinjury with 86% in touch daily to several times per week. Concerns targeted by more than one-third of caregivers related to managing their emotional adjustment, strategies for getting things done, managing survivor emotions and behaviors, and engaging in healthful habits. Caregivers of TBI survivors targeted personal concerns relating to their own emotional adjustment and participation as well as concerns relating to symptoms and recovery of the TBI survivor to address through education and problem-solving.

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

    PubMed

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

    2011-02-01

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

  1. Addressing Vermont's concerns on climate change on many levels

    NASA Astrophysics Data System (ADS)

    Betts, A. K.

    2016-12-01

    As a climate scientist, I realized about 12 years ago that one of my responsibilities was to help Vermont understand and adapt to climate change. My road-map has four components: 1) Newspaper articles, radio and TV interviews to explain climate issues and how to deal with them in plain English (about 100 so far) 2) Public talks across the state to schools, professional, business and citizens groups, the legislature and state government - in fact to anyone that asked - with a willingness to honestly and clearly address all issues raised (230 so far). 3) Specific research on how the climate and seasonal cycle of Vermont have changed in the past, and are likely to change in the future, exploring the unknowns. 4) A personal web-site to make all my writings, talks and research open access (http://alanbetts.com). Because Vermont is a small state with a rural and environmental ethos and a strong desire to understand, I have been able to reach across the state in a decade. In parallel, Vermont has put in place an ambitious renewable energy policy, which is well underway. My multi-faceted strategy is open, clear and transparently honest, aimed at helping society understand and deal with this critical issue. This is in sharp contrast with the secret, deceptive multifaceted strategy to discredit climate science by well-funded right-wing groups (see Dark Money by Jane Mayer), in support of their political and economic agenda, which has found little support in Vermont.

  2. Access to Essential Medicines in Pakistan: Policy and Health Systems Research Concerns

    PubMed Central

    Zaidi, Shehla; Bigdeli, Maryam; Aleem, Noureen; Rashidian, Arash

    2013-01-01

    Introduction Inadequate access to essential medicines is a common issue within developing countries. Policy response is constrained, amongst other factors, by a dearth of in-depth country level evidence. We share here i) gaps related to access to essential medicine in Pakistan; and ii) prioritization of emerging policy and research concerns. Methods An exploratory research was carried out using a health systems perspective and applying the WHO Framework for Equitable Access to Essential Medicine. Methods involved key informant interviews with policy makers, providers, industry, NGOs, experts and development partners, review of published and grey literature, and consultative prioritization in stakeholder’s Roundtable. Findings A synthesis of evidence found major gaps in essential medicine access in Pakistan driven by weaknesses in the health care system as well as weak pharmaceutical regulation. 7 major policy concerns and 11 emerging research concerns were identified through consultative Roundtable. These related to weaknesses in medicine registration and quality assurance systems, unclear and counterproductive pricing policies, irrational prescribing and sub-optimal drug availability. Available research, both locally and globally, fails to target most of the identified policy concerns, tending to concentrate on irrational prescriptions. It overlooks trans-disciplinary areas of policy effectiveness surveillance, consumer behavior, operational pilots and pricing interventions review. Conclusion Experience from Pakistan shows that policy concerns related to essential medicine access need integrated responses across various components of the health systems, are poorly addressed by existing evidence, and require an expanded health systems research agenda. PMID:23717442

  3. Policy Concerns Raised by the Growing U.S. Population Aging with Disability

    PubMed Central

    Iezzoni, Lisa I.

    2014-01-01

    Narrative Summary The number of Americans aging with disabilities will grow substantially in coming decades. Promulgating policies and practices to improve their independent functioning within communities and participation in daily life is therefore imperative, but the most effective approaches for meeting various needs are generally unknown. Historically, research addressing approaches targeting elderly individuals have differed in important ways (e.g., underlying models of disability) from studies involving younger persons aging with disabilities. Participants in a conference addressing this discordance identified six major areas requiring study: (1) resources to support independent living; (2) improving quality of life and participation in daily activities; (3) performing activities of daily living (ADL) and instrumental ADLs; (4) role of families; (5) medical care; and (6) concerns transcending sectors. As these investigations move forward, bridging the divide between approaches addressing elderly individuals versus persons with disabilities will be critical. PMID:24456688

  4. How do Australian palliative care nurses address existential and spiritual concerns? Facilitators, barriers and strategies.

    PubMed

    Keall, Robyn; Clayton, Josephine M; Butow, Phyllis

    2014-11-01

    To investigate the facilitators, barriers and strategies that Australian palliative care nurses identify in providing existential and spiritual care for patients with life-limiting illnesses. Palliative care aims to be holistic, incorporating all domains of personhood, but spiritual/existential domain issues are often undertreated. Lack of time and skills and concerns for what you may uncover hamper care provision. A qualitative study through semistructured interviews. We interviewed 20 palliative care nurses from a cross section of area of work, place of work, years of experience, spiritual beliefs and importance of those beliefs within their lives. Questions focused on their current practices of existential and spiritual care, identification of facilitators of, barriers to and strategies for provision of that care. Their responses were transcribed and subjected to thematic analysis. The nurses' interviews yielded several themes including development of the nurse-patient relationship (14/20 nurses), good communication skills and examples of questions they use to 'create openings' to facilitate care. Barriers were identified as follows: lack of time (11/20 nurses), skills, privacy and fear of what you may uncover, unresolved symptoms and differences in culture or belief. Novel to our study, the nurses offered strategies that included the following: undertaking further education in this area, being self-aware and ensuring the setting is conducive to in-depth conversations and interactions and documentation and/or interdisciplinary sharing for continuity of care. Palliative care nurses are well placed to provide existential and spiritual care to patients with the primary facilitator being the nurse-patient relationship, the primary barrier being lack of time and the primary strategy being undertaking further education in this area. These findings could be used for nurse-support programmes, undergraduate or graduate studies or communication workshop for nurses.

  5. A Qualitative Analysis of Common Concerns about Challenges Facing Pharmacy Experiential Education Programs

    PubMed Central

    Craddick, Karen; Eccles, Dayl; Kwasnik, Abigail; O’Sullivan, Teresa A.

    2015-01-01

    Objective. To qualitatively analyze free-text responses gathered as part of a previously published survey in order to systematically identify common concerns facing pharmacy experiential education (EE) programs. Methods. In 2011, EE directors at all 118 accredited pharmacy schools in the US were asked in a survey to describe the most pressing issues facing their programs. Investigators performed qualitative, thematic analysis of responses and compared results against demographic data (institution type, class size, number of practice sites, number and type of EE faculty member/staff). Expert and novice investigators identified common themes via an iterative process. To check validity, additional expert and novice reviewers independently coded responses. The Cohen kappa coefficient was calculated and showed good agreement between investigators and reviewers. Results. Seventy-eight responses were received (66% response rate) representing 75% of publicly funded institutions and 71% of schools with class sizes 51-150. Themes identified as common concerns were site capacity, workload/financial support, quality assurance, preceptor development, preceptor stipends, assessment, onboarding, and support/recognition from administration. Good agreement (mean percent agreement 93%, ƙ range=0.59-0.92) was found between investigators and reviewers. Conclusion. Site capacity for student placements continues to be the foremost concern for many experiential education programs. New concerns about preceptor development and procedures for placing and orienting students at individual practice sites (ie, “onboarding”) have emerged and must be addressed as new accreditation standards are implemented. PMID:25741022

  6. Memory Loss, Alzheimer's Disease and General Anesthesia: A Preoperative Concern.

    PubMed

    Thaler, Adam; Siry, Read; Cai, Lufan; García, Paul S; Chen, Linda; Liu, Renyu

    2012-02-20

    The long-term cognitive effects of general anesthesia are under intense scrutiny. Here we present 5 cases from 2 academic institutions to analyze some common features where the patient's or the patient family member has made a request to address their concern on memory loss, Alzheimer's disease and general anesthesia before surgery. Records of anesthesia consultation separate from standard preoperative evaluation were retrieved to identify consultations related to memory loss and Alzheimer's disease from the patient and/or patient family members. The identified cases were extensively reviewed for features in common. We used Google® (http://www. google.com/) to identify available online information using "anesthesia memory loss" as a search phrase. Five cases were collected as a specific preoperative consultation related to memory loss, Alzheimer's disease and general anesthesia from two institutions. All of the individuals either had perceived memory impairment after a prior surgical procedure with general anesthesia or had a family member with Alzheimer's disease. They all accessed public media sources to find articles related to anesthesia and memory loss. On May 2 nd , 2011, searching "anesthesia memory loss" in Google yielded 764,000 hits. Only 3 of the 50 Google top hits were from peer-reviewed journals. Some of the lay media postings made a causal association between general anesthesia and memory loss and/or Alzheimer's disease without conclusive scientific literature support. The potential link between memory loss and Alzheimer's disease with general anesthesia is an important preoperative concern from patients and their family members. This concern arises from individuals who have had history of cognitive impairment or have had a family member with Alzheimer disease and have tried to obtain information from public media. Proper preoperative consultation with the awareness of the lay literature can be useful in reducing patient and patient family member

  7. 13 CFR 127.701 - What must a concern do in order to be identified as an EDWOSB or WOSB in any Federal procurement...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... be identified as an EDWOSB or WOSB in any Federal procurement databases? 127.701 Section 127.701... Federal procurement databases? (a) In order to be identified as an EDWOSB or WOSB in the System for Award Management (SAM) database (or any successor thereto), a concern must certify its EDWOSB or WOSB status in...

  8. Identifying and Addressing Student Difficulties with the Millikan Oil Drop Experiment

    ERIC Educational Resources Information Center

    Klassen, Stephen

    2009-01-01

    The Millikan oil drop experiment has been characterized as one of the "most beautiful" physics experiments of all time and, certainly, as one of the most frustrating of all the exercises in the undergraduate physics laboratory. A literature review reveals that work done on addressing student difficulties in performing the oil drop experiment has,…

  9. Exploring demands from the perspective of employees identified as being at risk of burnout

    PubMed Central

    Gauche, Cecile; de Beer, Leon T.; Brink, Lizelle

    2017-01-01

    ABSTRACT Purpose: Burnout has become an occupational health concern. However, little is known about the experiences of individuals identified as being at risk of burnout. This study aimed to address this gap by exploring employees’ experiences of well-being who were identified as burnout risks. Method: Interviews were conducted with 26 employees who agreed to participate in the study. A phenomenological approach was taken, with a case study design as the research strategy. Results: Three major themes were identified: job demands, life demands, and health concerns. It was evident that participants were experiencing demanding conditions in both their work and personal lives, indicating burnout to be a multi-domain phenomenon. Conclusions: Professionals and managers should take note of these results to assist and support employees who are identified as being at risk of burnout. PMID:28784048

  10. Ask Dr. Sue: Center Directors Express These Health Concerns.

    ERIC Educational Resources Information Center

    Aronson, Susan S.

    1991-01-01

    A physician addresses three health concerns of child care center directors. She provides information about the increasing number of children with asthma problems, the exclusion of ill children from child care settings, and the increasing concern about lead poisoning. (GLR)

  11. Identifying Health Promotion Needs Among Dominican-American Adolescents.

    PubMed

    Champion, Jane Dimmitt; Roye, Carol F

    Immigration from the Dominican Republic to the United States has grown rapidly. Yet, although adolescent pregnancy and obesity are common concerns among Hispanics, little is known specifically about Dominican adolescent health. This study was undertaken to assess Dominican-American adolescents' health concerns and their perceptions about their health promotion needs. Dominican-American adolescents (N=25) were recruited in a pediatric clinic in New York City which primarily serves a Dominican population. Eligibility criteria included age 13-21years, self-identifying as Dominican ethnicity, and able to speak and read English. They completed a questionnaire, with demographic questions and questions about their risk behaviors including sexual and substance use. After completing the questionnaire, they participated in a semi-structured interview addressing their health education experiences and suggestions for such programs. Quantitative data were analyzed using frequencies to provide a demographic and behavioral profile. Qualitative data were analyzed using thematic analysis. Twenty-five adolescents, ages 13-21years, (female N=19, male N=6) participated in the study. Most were in school (92%) and were sexually experienced (68%). Programmatic preferences included in-person programs rather than online. They spontaneously addressed the importance of cultural issues, and the need to address several issues in addition to sexuality, including obesity and substance use. Programming for this population should address a broad conceptualization of health, and incorporate Dominican cultural issues. Nurses working with adolescents of Dominican origin, should provide health education that incorporates the specific needs of this population, including culturally congruent face-to-face interventions. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Identifying and addressing specific student difficulties in advanced thermal physics

    NASA Astrophysics Data System (ADS)

    Smith, Trevor I.

    As part of an ongoing multi-university research study on student understanding of concepts in thermal physics at the upper division, I identified several student difficulties with topics related to heat engines (especially the Carnot cycle), as well as difficulties related to the Boltzmann factor. In an effort to address these difficulties, I developed two guided-inquiry worksheet activities (a.k.a. tutorials) for use in advanced undergraduate thermal physics courses. Both tutorials seek to improve student understanding of the utility and physical background of a particular mathematical expression. One tutorial focuses on a derivation of Carnot's theorem regarding the limit on thermodynamic efficiency, starting from the Second Law of Thermodynamics. The other tutorial helps students gain an appreciation for the origin of the Boltzmann factor and when it is applicable; focusing on the physical justification of its mathematical derivation, with emphasis on the connections between probability, multiplicity, entropy, and energy. Student understanding of the use and physical implications of Carnot's theorem and the Boltzmann factor was assessed using written surveys both before and after tutorial instruction within the advanced thermal physics courses at the University of Maine and at other institutions. Classroom tutorial sessions at the University of Maine were videotaped to allow in-depth scrutiny of student successes and failures following tutorial prompts. I also interviewed students on various topics related to the Boltzmann factor to gain a more complete picture of their understanding and inform tutorial revisions. Results from several implementations of my tutorials at the University of Maine indicate that students did not have a robust understanding of these physical principles after lectures alone, and that they gain a better understanding of relevant topics after tutorial instruction; Fisher's exact tests yield statistically significant improvement at the

  13. Addressing Community Concerns about Lead Contamination in Soil: Insights for Site Cleanup

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

    Finster, M.E.

    2008-07-01

    Health risks associated with contaminated sites are a key driver for cleanup decisions and determinations about alternate land use of areas released to the public, particularly in heavily populated metropolitan areas. To guide risk management and future use decisions at contaminated sites, insights can be gained from community-based research. These evaluations can also help ensure that assessments and decisions developed for urban sites consider input received from community members. In order to evaluate the potential risk due to consumption of plants home-grown in lead-contaminated soil, a pilot study was conducted over a period of two summers in a Chicago, ILmore » neighborhood. This survey included analyses of lead concentrations in a convenience sampling of edible fruits, vegetables, and herbs and also examined how the sample preparation method affected the lead concentrations detected in plant materials. A pattern of lead transfer from soil through the root to the stem and leaves of garden crops was found. This pattern is a concern particularly for plants in which the roots, stems, stalks, or leaves are consumed. Analyses of fruiting vegetables indicated that concentrations were below the limit of detection. Depending on the soil lead level and specific plant, the contamination found in some leafy vegetables and herbs may exceed the body's daily excretion rate and could contribute to the total body burden of lead, especially in children. Finally, washing edible portions did not necessarily eliminate the risk, indicating that the lead was located both on and in the plant tissue. This research was conducted in coordination with health experts from the community, and local citizens were involved in discussions on the research and implications for their health protection measures. In certain residential locations, identifying and understanding the potential source of lead contamination provides information for the community such that simple measures can be

  14. Childhood esotropia: child and parent concerns.

    PubMed

    Liebermann, Laura; Leske, David A; Castañeda, Yolanda S; Hatt, Sarah R; Wernimont, Suzanne M; Cheng, Christina S; Birch, Eileen E; Holmes, Jonathan M

    2016-08-01

    To identify specific health-related quality of life (HRQOL) concerns affecting children with esotropia as expressed by children or one of their parents (proxy) and concerns affecting the parents themselves. Sixty children with esotropia (0-17 years of age) and 1 parent for each child were prospectively enrolled. Individual semistructured interviews were conducted with children aged 5-17 years (n = 40) and 1 parent each for child ages 0-17 years. Transcripts of recorded interviews were evaluated using NVivo software. Specific concerns were identified from both child and parent interviews and coded. From these specific codes, broad themes were identified. Frequency of each theme was calculated, along with the frequency of specific codes within each theme. Regarding the child's experience 6 broad themes were identified: visual function (mentioned by 32 of 40 children (80%) and by 50 of 60 parents (proxy assessment of child, 83%), treatment (78% and 85%), emotions (65% and 67%), social (58% and 68%), physical (58% and 32%), and worry (45% and 7%). Regarding the parents' own experience, 5 broad themes were identified: treatment (59 of 60 parents, 98%), worry (97%), emotions (82%), compensation for condition (80%), and affects family (23%). A wide range of concerns were identified from interviews of children with esotropia and their parents. Concerns reflect the impact of esotropia in physical, emotional, and social domains, and specific concerns will be used for the development of questionnaires to quantify the effects of esotropia on children's and parents' quality of life. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  15. 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…

  16. 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.

  17. Consumer Concerns: Newcomer's Guide. 4.

    ERIC Educational Resources Information Center

    Michael, Jean

    A bilingual pamphlet containing practical law-related information for recent Russian Jewish immigrants to New York City, this document addresses consumer concerns. Following a brief description of the Newcomer series, 15 questions are listed, each followed by an answer. Questions asked include the meaning of the terms consumer and contract;…

  18. 75 FR 22127 - Notice of Data Availability Concerning 2010 CAIR NOX

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-27

    ... ENVIRONMENTAL PROTECTION AGENCY [FRL-9142-3] Notice of Data Availability Concerning 2010 CAIR NOX... viruses. FOR FURTHER INFORMATION CONTACT: Questions concerning this action should be addressed to Robert L... objection. However, objections may be submitted concerning whether EPA determined, in a manner consistent...

  19. Engineering Hematopoietic Cells for Cancer Immunotherapy: Strategies to Address Safety and Toxicity Concerns.

    PubMed

    Resetca, Diana; Neschadim, Anton; Medin, Jeffrey A

    2016-09-01

    Advances in cancer immunotherapies utilizing engineered hematopoietic cells have recently generated significant clinical successes. Of great promise are immunotherapies based on chimeric antigen receptor-engineered T (CAR-T) cells that are targeted toward malignant cells expressing defined tumor-associated antigens. CAR-T cells harness the effector function of the adaptive arm of the immune system and redirect it against cancer cells, overcoming the major challenges of immunotherapy, such as breaking tolerance to self-antigens and beating cancer immune system-evasion mechanisms. In early clinical trials, CAR-T cell-based therapies achieved complete and durable responses in a significant proportion of patients. Despite clinical successes and given the side effect profiles of immunotherapies based on engineered cells, potential concerns with the safety and toxicity of various therapeutic modalities remain. We discuss the concerns associated with the safety and stability of the gene delivery vehicles for cell engineering and with toxicities due to off-target and on-target, off-tumor effector functions of the engineered cells. We then overview the various strategies aimed at improving the safety of and resolving toxicities associated with cell-based immunotherapies. Integrating failsafe switches based on different suicide gene therapy systems into engineered cells engenders promising strategies toward ensuring the safety of cancer immunotherapies in the clinic.

  20. Screening and prioritisation of chemical risks from metal mining operations, identifying exposure media of concern.

    PubMed

    Pan, Jilang; Oates, Christopher J; Ihlenfeld, Christian; Plant, Jane A; Voulvoulis, Nikolaos

    2010-04-01

    Metals have been central to the development of human civilisation from the Bronze Age to modern times, although in the past, metal mining and smelting have been the cause of serious environmental pollution with the potential to harm human health. Despite problems from artisanal mining in some developing countries, modern mining to Western standards now uses the best available mining technology combined with environmental monitoring, mitigation and remediation measures to limit emissions to the environment. This paper develops risk screening and prioritisation methods previously used for contaminated land on military and civilian sites and engineering systems for the analysis and prioritisation of chemical risks from modern metal mining operations. It uses hierarchical holographic modelling and multi-criteria decision making to analyse and prioritise the risks from potentially hazardous inorganic chemical substances released by mining operations. A case study of an active platinum group metals mine in South Africa is used to demonstrate the potential of the method. This risk-based methodology for identifying, filtering and ranking mining-related environmental and human health risks can be used to identify exposure media of greatest concern to inform risk management. It also provides a practical decision-making tool for mine acquisition and helps to communicate risk to all members of mining operation teams.

  1. Towards a feminist global bioethics: addressing women's health concerns worldwide.

    PubMed

    Tong, R

    2001-01-01

    In this paper I argue that a global bioethics is possible. Specifically, I present the view that there are within feminist approaches to bioethics some conceptual and methodological tools necessary to forge a bioethics that embraces the health-related concerns of both developing and developed nations equally. To support my argument I discuss some of the challenges that have historically confronted feminists. If feminists accept the idea that women are entirely the same, then feminists present as fact the fiction of the essential "Woman." Not only does "Woman" not exist, -she" obscures important racial, ethnic, cultural, and class differences among women. However, if feminists stress women's differences too much, feminists lose the power to speak coherently and cogently about gender justice, women's rights, and sexual equality in general. Analyzing the ways in which the idea of difference as well as the idea of sameness have led feminists astray, I ask whether it is possible to avoid the Scylla of absolutism (imperialism, colonialism, hegemony) on the one hand and the Charybdis of relativism (postmodernism, fragmentation, Balkanization) on the other. Finally, after reflecting upon the work of Uma Narayan, Susan Muller Okin, and Martha Nussbaum, I conclude that there is a way out of this ethical bind. By focusing on women's, children's, and men's common human needs, it is possible to lay the foundation for a just and caring global bioethics.

  2. Investigating the Needs and Concerns of Lesbian, Gay, Bisexual, and Transgender Older Adults: The Use of Qualitative and Quantitative Methodology

    PubMed Central

    OREL, NANCY A.

    2014-01-01

    Extensive research on the specific needs and concerns of lesbian, gay, bisexual, and transgender (LGBT) older adults is lacking. This article describes the results of both quantitative studies (i.e., LGBT Elders Needs Assessment Scale) and qualitative studies (i.e., focus groups and in-depth interviews with lesbian, gay, or bisexual [LGB] older adults and LGB grandparents) that specifically sought to investigate the unique needs and concerns of LGBT elders. The results identified 7 areas (medical/health care, legal, institutional/housing, spiritual, family, mental health, and social) of concern and the recognition that the needs and concerns of LGBT older adults be addressed across multiple domains, rather than in isolation. PMID:24313253

  3. Delphi survey to identify topics to be addressed at the initial follow-up consultation after oesophageal cancer surgery.

    PubMed

    Jacobs, M; Henselmans, I; Macefield, R C; Blencowe, N S; Smets, E M A; de Haes, J C J M; Sprangers, M A G; Blazeby, J M; van Berge Henegouwen, M I

    2014-12-01

    There is no consensus among patients and healthcare professionals (HCPs) on the topics that need to be addressed after oesophageal cancer surgery. The aim of this study was to identify these topics, using a two-round Delphi survey. In round 1, patients and HCPs (surgeons, dieticians, nurses) were invited to rate the importance of 49 topics. The proportion of panellists that considered a topic to be of low, moderate or high importance was then calculated for each of these two groups. Based on these proportions and the i.q.r., topics were categorized as: 'consensus to be included', 'consensus to be excluded' and 'no consensus'. Only topics in the first category were included in the second round. In round 2, panellists were provided with individual and group feedback. To be included in the final list, topics had to meet criteria for consensus and stability. There were 108 patients and 77 HCPs in the round 2 analyses. In general, patients and HCPs considered the same topics important. The final list included 23 topics and revealed that it was most important to address: cancer removed/lymph nodes, the new oesophagus, eating and drinking, surgery, alarming new complaints and the recovery period. The study provides surgeons with a list of topics selected by patients and HCPs that may be addressed systematically at the initial follow-up consultation after oesophageal cancer surgery. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  4. Identifying Food Safety Concerns when Communication Barriers Exist

    ERIC Educational Resources Information Center

    Neal, Jack A.; Dawson, Mary; Madera, Juan M.

    2011-01-01

    Abstract: Students must be prepared to lead a diverse workforce. The objective of this study was to establish a teaching method that helps students identify barriers to food safety while working in a simulated environment with communication barriers. This study employed a perspective taking exercise based upon the principles of social learning…

  5. Teachers' Aides: Tasks and Concerns

    ERIC Educational Resources Information Center

    Balderson, James H.; Nixon, Mary

    1976-01-01

    Addresses three questions: (1) What tasks do aides perform? (2) Does training make a difference in the type of tasks aides perform? (3) What are the concerns of aides? (Available from the Department of Educational Administration, The University of Alberta, Edmonton, Alberta, Canada T6G 2G5; $0.50, single copy.) (Author/IRT)

  6. Environmental Concerns and the New Environmental Paradigm in Bulgaria

    ERIC Educational Resources Information Center

    Bostrom, Ann; Barke, Richard; Turaga, Rama Mohana R.; O'Connor, Robert E.

    2006-01-01

    Little is known about environmental concerns and attitudes among people in former Soviet bloc countries in Eastern Europe despite widespread perceptions of severe environmental problems. The authors addressed this gap by examining Bulgarians' environmental concerns with a focus on whether the new environmental paradigm (NEP) scale can reliably…

  7. Addressing Consumer Questions and Concerns

    USDA-ARS?s Scientific Manuscript database

    Food can be a touchy subject. It seems people either have very strong thoughts and opinions on food or they could care less as long as food is available to feed them and their families. With the current economic environment, many individuals are examining the food choices more closely to ensure t...

  8. Maternal concerns during early parenthood.

    PubMed

    Kaitz, M

    2007-11-01

    Most research on maternal concerns has focused on their assessment during pregnancy and the early post-partum period. The aim of this study was to identify primary concerns of mothers later in the first post-partum year, changes over time, and factors that were associated with relatively intense concerns, including infant (difficult) temperament, hours employed out of the home and obstetrical complications during pregnancy or childbirth. Data were obtained from 366 first-time (Israeli) mothers at 3 and 6 months post-partum by employing a new tool, the Mothers' Concern Questionnaire, along with standardized questionnaires, administered by phone. Analyses revealed six dimensions of concerns (Family Health, Return to Work, Mother's Well-being, Relationships/Support, Infant Care, and Spouse). Of these, issues related to returning to work and family health were of most concern, and ratings were higher at 3 months than at 6 months post-partum. Women with higher-than-average total concern scores perceived their infant as more difficult, were more likely to have experienced an obstetric complication, and worked more hours out of the house than women with lower-than-average scores. The findings afford a first look at the profile of normative maternal concerns outside of the immediate post-partum period and identify factors that predict more intense concerns. These findings extend what we know about the issues of new mothers and can guide birth educators and help couples prepare themselves for parenthood.

  9. [Identifying ways to address the crisis facing a medical specialty: a case study of general surgery].

    PubMed

    Nirel, Nurit; Hendin, Ayala; Rabau, Micha

    2012-03-01

    In a previous study we defined criteria for a medical specialty in crisis' and measures to assess the scale of the problem, and possible resolutions suggested based on experience abroad. This study seeks to gain further knowledge by exploring how front-line Israeli surgeons envisage the problems and possible solutions. To identify ways to address the workforce crisis in general surgery (GS) white focusing on issues that can be dealt with at the department and the hospital levels. An action study of GS conducted in two stages: (1) Semi-structured interviews with 180 GS residents. (2) The use of the retrospective method of "Learning from success" in five general surgical departments recognized as "successful" in attracting residents and integrating them into the departments while providing high-level training. The factors attracting medical students to specialize in GS are presented along with the problems perceived by residents during their residency. AdditionaLLy, 12 general principles identified in the study are presented, which can be transmitted to and implemented by other GS departments. They are related to three key topics: the mode and quality of residency training; work schedules, departmental organization of work and departmental atmosphere; and the comportment of senior physicians. The value of implementing these principles should be weighed in terms of being identified as constituting "leverage for change". Study findings will facilitate recommendations on internal organizational/professional factors of attracting and integrating residents to the specialty and the department. The study can serve as a basis for similar action research in other medical specialties.

  10. How Rhetorical Theories of Genre Address Common Core Writing Standards

    ERIC Educational Resources Information Center

    Collin, Ross

    2013-01-01

    This article begins with a review of the forms of writing promoted in the Common Core State Standards. Across content areas, Common Core encourages teachers to attune students' writing to rhetorical concerns of audience, purpose, task, and disciplinary thinking. To address these concerns, teachers might take a rhetorical approach to the study…

  11. Addressing the Global Burden of Breast Cancer

    Cancer.gov

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

  12. Epistemological beliefs in introductory biology: Addressing measurement concerns and exploring the relationship with strategy use

    NASA Astrophysics Data System (ADS)

    Holschuh, Jodi Lynn

    This study had two main purposes: to address measurement concerns about assessing students' epistemological beliefs and to explore the relationship between epistemological beliefs and deep and surface strategy use in an introductory biology classroom. The following research questions guided the study: (a) Are epistemological beliefs multidimensional? (b) Are the measures of epistemological beliefs correlated? (c) Are the measures of strategy use correlated? (d) Are epistemological beliefs correlated with deep and surface strategy use? (e) How much of the unique variance in Scholastic Aptitude Test (SAT) scores, grade point average (GPA), and course grade is accounted for by epistemological beliefs and strategy use? (f) To what extent does the content analysis of the open-ended questionnaire data support or refute the role of mature epistemological beliefs? and (g) To what extent does the content analysis of the open-ended questionnaire data support or refute the role of deep strategies? Participants (N = 518) were recruited from two sections of an introductory biology course. All participants completed five assessments including the Epistemological Questionnaire, the Epistemological Scenario, the Self-Regulated Learning Inventory, two strategy checklists, and an open-ended questionnaire. The factor analysis, which was used to answer the first question, indicated no clear loading of the hypothesized dimensions underlying epistemological beliefs as measured by the Epistemological Questionnaire. However, the factor analysis of the Epistemological Scenario indicated four factors underlying epistemological beliefs (i.e., certain knowledge, innate ability, quick learning, and simple knowledge). In addition, the correlation analyses, which were used to answer the second, third, and fourth questions, indicated a significant relationship between epistemological beliefs and strategy use. The multiple regression commonality analysis, which was used to answer the fifth

  13. Do newly diagnosed lung cancer patients feel their concerns are being met?

    PubMed

    Hill, K M; Amir, Z; Muers, M F; Connolly, C K; Round, C E

    2003-03-01

    Lung cancer is the leading cause of cancer death worldwide. It has a poor prognosis and the majority of those affected are elderly. Evidence suggests that providing clear, relevant information and addressing patients' concerns can make a worthwhile difference to patients. This study aimed to: explore the concerns of lung cancer patients shortly after diagnosis; and enquire whether these concerns had been discussed by their care teams. Eighty patients with a new diagnosis of primary lung cancer were interviewed 14-28 days after the date on which they were told the diagnosis. Interviews were conducted either in the hospital ward, outpatient clinic or at home. Participants were asked to rate 17 specific items of concern from 1 = 'not a worry' to 5 = 'extremely worried', plus one non-specific item. Patients rated at least two items as worrying them to some degree with a median of nine concerns being reported. Major concerns for patients were the illness itself; the future relating to the illness and concerns about the family. Overall, patients in the study felt that less than half of their concerns (43%) had been discussed by the care team. Although levels of concern about physical symptoms were relatively low, these had been more frequently addressed than the psychosocial issues, which were rated higher by patients. There were some differences in the number of concerns reported between males/females and younger/older age groups, but the pattern of concerns was similar. There were no differences in the level of concerns between treatment groups; the location of the interview nor in the interval between diagnosis and delivery of the checklist. This study supports previous findings that there is a need for health professionals to provide emotional support and respond to the psychosocial needs of patients by eliciting their concerns and attempting to address them in the early stages of the disease process.

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

    ERIC Educational Resources Information Center

    Center for Mental Health in Schools at UCLA, 2008

    2008-01-01

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

  15. An Inquiry into Teacher Concerns in Taiwan.

    ERIC Educational Resources Information Center

    Chen, Yih-fen; Reeves, Carolyn

    This study identified concerns of teachers in Taiwan and contrasted concerns of these teachers with the 56 concerns which comprise the Teacher Concerns Checklist (TCC), Form B, developed in the United States. A total of 294 teachers (155 preservice teachers and 139 inservice teachers) completed a Chinese version of the Survey of Teacher Concerns.…

  16. Extending Transition to Address Guardianship Alternatives: An Issue Concerning Students Who Have Intellectual Disability

    ERIC Educational Resources Information Center

    Millar, Dorothy Squatrito

    2014-01-01

    As students who have intellectual disability reach or have reached the age of majority, concerns regarding their competence to make informed decisions are often raised, as is the issue of adult guardianship. Guardianship refers to when a judge appoints an adult to be the guardian of another adult (ward) who has been determined to be unable to care…

  17. 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.

  18. "I Hate Group Work!": Addressing Students' Concerns about Small-Group Learning

    ERIC Educational Resources Information Center

    Allan, Elizabeth G.

    2016-01-01

    This article identifies the strategies used by architecture professors and their undergraduate students to mitigate common issues that students raise about group work. Based on participant-observation, interviews with students and faculty, and analysis of instructional materials and student work, this IRB-approved ethnographic case study…

  19. An examination of the disparity between self-identified versus legally identified rape victimization: A pilot study.

    PubMed

    Marsil, Dorothy F; McNamara, Corinne

    2016-07-01

    Researchers compared rape victimization based on self-identification to the current federal legal definition in a pilot study of college students. The sample was comprised of 1,648 (69.8% female; 30.2% male) college students who completed the Sexual Experiences Survey-Short Form Victimization (SES-SFV) online. Based on the current legal definition of rape, 9.4% (11.1% female; 5.2% male) of students had been raped since being enrolled, but only 2.9% of students self-identified as being raped. Moreover, 15.1% of students reported ever being raped, with females acknowledging higher rates (19.7%) than males (4.3%). Rape continues to be a major issue for colleges and universities. A serious concern is the disparity between the number of those who met the behavioral criteria for rape victimization based on the current legal definition, but who did not self-identify as a victim. Universities must address this disparity by using multiple measures to assess the prevalence of sexual violence on campus.

  20. Application of the Pareto principle to identify and address drug-therapy safety issues.

    PubMed

    Müller, Fabian; Dormann, Harald; Pfistermeister, Barbara; Sonst, Anja; Patapovas, Andrius; Vogler, Renate; Hartmann, Nina; Plank-Kiegele, Bettina; Kirchner, Melanie; Bürkle, Thomas; Maas, Renke

    2014-06-01

    Adverse drug events (ADE) and medication errors (ME) are common causes of morbidity in patients presenting at emergency departments (ED). Recognition of ADE as being drug related and prevention of ME are key to enhancing pharmacotherapy safety in ED. We assessed the applicability of the Pareto principle (~80 % of effects result from 20 % of causes) to address locally relevant problems of drug therapy. In 752 cases consecutively admitted to the nontraumatic ED of a major regional hospital, ADE, ME, contributing drugs, preventability, and detection rates of ADE by ED staff were investigated. Symptoms, errors, and drugs were sorted by frequency in order to apply the Pareto principle. In total, 242 ADE were observed, and 148 (61.2 %) were assessed as preventable. ADE contributed to 110 inpatient hospitalizations. The ten most frequent symptoms were causally involved in 88 (80.0 %) inpatient hospitalizations. Only 45 (18.6 %) ADE were recognized as drug-related problems until discharge from the ED. A limited set of 33 drugs accounted for 184 (76.0 %) ADE; ME contributed to 57 ADE. Frequency-based listing of ADE, ME, and drugs involved allowed identification of the most relevant problems and development of easily to implement safety measures, such as wall and pocket charts. The Pareto principle provides a method for identifying the locally most relevant ADE, ME, and involved drugs. This permits subsequent development of interventions to increase patient safety in the ED admission process that best suit local needs.

  1. Maternal Concern for Child Undereating.

    PubMed

    Brown, Callie L; Pesch, Megan H; Perrin, Eliana M; Appugliese, Danielle P; Miller, Alison L; Rosenblum, Katherine; Lumeng, Julie C

    To describe features of maternal concern for her child undereating; examine maternal and child correlates of maternal concern for undereating; and determine whether maternal concern for undereating is associated with feeding practices. This was a cross-sectional analysis of an observational study with 286 mother-child dyads (mean child age, 71 months). Maternal concern for undereating was assessed using a semistructured interview. Mothers completed questionnaires to assess picky eating, food neophobia, and feeding practices. Feeding practices were further assessed using videotaped mealtime observations. Logistic regression was used to assess the association of maternal and child characteristics with maternal concern for undereating. Regression was used to assess the association of maternal concern for undereating with feeding practices, controlling for covariates. Over a third of mothers (36.5%) expressed concern that their child does not eat enough. Correlates of concern for undereating included child body mass index z-score (BMIz; odds ratio [OR] = 0.58; 95% confidence interval [CI], 0.43-0.77) and picky eating (OR = 2.41; 95% CI, 1.26-4.59). Maternal concern for undereating was associated with greater reported pressure to eat (relative risk [RR] = 1.97; 95% CI, 1.55-2.50), greater observed bribery (OR = 2.63; 95% CI, 1.50-4.60), and higher observed pressure (OR = 1.90; 95% CI, 1.08-3.36) during mealtimes. Mothers of children who are picky eaters and have a lower BMIz are more likely to be concerned that their children do not eat enough, and maternal concern for undereating is associated with pressuring and bribing children to eat. Pediatricians might address maternal concern for undereating by advising feeding practices that do not involve pressure and bribery, particularly among healthy weight children. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  2. Maternal Concern for Child Undereating

    PubMed Central

    Brown, Callie L.; Pesch, Megan H.; Perrin, Eliana M.; Appugliese, Danielle P.; Miller, Alison L.; Rosenblum, Katherine; Lumeng, Julie C.

    2016-01-01

    OBJECTIVE To describe features of maternal concern for her child undereating; examine maternal and child correlates of maternal concern for undereating; and determine whether maternal concern for undereating is associated with feeding practices. METHODS This was a cross-sectional analysis of an observational study with 286 mother-child dyads (mean child age 71 months). Maternal concern for undereating was assessed using a semi-structured interview. Mothers completed questionnaires to assess picky eating, food neophobia, and feeding practices. Feeding practices were further assessed by videotaped mealtime observations. Logistic regression assessed the association of maternal and child characteristics with maternal concern for undereating. Regression assessed the association of maternal concern for undereating with feeding practices, controlling for covariates. RESULTS Over a third of mothers (36.5%) expressed concern that their child does not eat enough. Correlates of concern for undereating included child BMIz (OR 0.58, 95% CI 0.43–0.77) and picky eating (OR 2.41, 95% CI 1.26–4.59). Maternal concern for undereating was associated with greater reported pressure to eat (RR 1.97, 95% CI 1.55–2.50); and greater observed bribery (OR 2.63, 95% CI 1.50–4.60) and higher observed pressure (OR 1.90, 95% CI 1.08–3.36) during mealtimes. CONCLUSIONS Mothers of children who are picky eaters and have a lower BMIz are more likely to be concerned that their children do not eat enough, and maternal concern for undereating is associated with pressuring and bribing their children to eat. Pediatricians might address maternal concern for undereating by advising feeding practices that do not involve pressure and bribery, particularly among healthy weight children. PMID:27354196

  3. How can clinician-educator training programs be optimized to match clinician motivations and concerns?

    PubMed

    McCullough, Brendan; Marton, Gregory E; Ramnanan, Christopher J

    2015-01-01

    Several medical schools have implemented programs aimed at supporting clinician-educators with formal mentoring, training, and experience in undergraduate medical teaching. However, consensus program design has yet to be established, and the effectiveness of these programs in terms of producing quality clinician-educator teaching remains unclear. The goal of this study was to review the literature to identify motivations and perceived barriers to clinician-educators, which in turn will improve clinician-educator training programs to better align with clinician-educator needs and concerns. Review of medical education literature using the terms "attitudes", "motivations", "physicians", "teaching", and "undergraduate medical education" resulted in identification of key themes revealing the primary motivations and barriers involved in physicians teaching undergraduate medical students. A synthesis of articles revealed that physicians are primarily motivated to teach undergraduate students for intrinsic reasons. To a lesser extent, physicians are motivated to teach for extrinsic reasons, such as rewards or recognition. The key barriers deterring physicians from teaching medical students included: decreased productivity, lack of compensation, increased length of the working day, patient concerns/ethical issues, and lack of confidence in their own ability. Our findings suggest that optimization of clinician-educator training programs should address, amongst other factors, time management concerns, appropriate academic recognition for teaching service, and confidence in teaching ability. Addressing these issues may increase the retention of clinicians who are active and proficient in medical education.

  4. Senior military officers' educational concerns, motivators and barriers for healthful eating and regular exercise.

    PubMed

    Sigrist, Lori D; Anderson, Jennifer E; Auld, Garry W

    2005-10-01

    The increasing trend of overweight in the military, the high cost of health care associated with overweight, and the failure to meet some Healthy People 2000 objectives related to diet identify the need for more appropriate nutrition and fitness education for military personnel. The purpose of this study was to assess senior military officers' concerns on various health topics, educational preferences for nutrition and health topics, eating habits, and barriers and motivators for eating healthfully and exercising regularly. The survey was completed by 52 resident students at the U.S. Army War College. Fitness, weight, and blood cholesterol were top health concerns, and respondents wanted to know more about eating healthfully on the run. The primary barrier to eating healthfully and exercising regularly was lack of time, whereas health and appearance were top motivators. Health interventions for this population should include their topics of concern and should address perceived barriers and motivators.

  5. Ethical Concerns: Negotiating Truth and Trust

    ERIC Educational Resources Information Center

    McGarvey, Lynn M.; Sterenberg, Gladys

    2009-01-01

    Few studies in mathematics education explicitly address ethical issues arising from student interactions. The ethical concerns held by students are expressed in their words, actions, and interactions. The purpose of this article is to explore the ethical nature of copying as it arises in a mathematics classroom. We investigate the basis for…

  6. Effects of Recreation Participation and Tildenian Interpretation on Tourists' Environmental Concern

    ERIC Educational Resources Information Center

    Satchabut, Thitikan

    2013-01-01

    Evidence from correlational studies suggests outdoor recreation may enhance participants' environmental concern, but findings are inconclusive. Also, previous research has not systematically addressed the influence of interpretation services on environmental concern, and little research has been conducted in developing Eastern countries. Thus,…

  7. Regulatory approaches for addressing dissolved oxygen concerns at hydropower facilities

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

    Peterson, Mark J.; Cada, Glenn F.; Sale, Michael J.

    Low dissolved oxygen (DO) concentrations are a common water quality problem downstream of hydropower facilities. At some facilities, structural improvements (e.g. installation of weir dams or aerating turbines) or operational changes (e.g., spilling water over the dam) can be made to improve DO levels. In other cases, structural and operational approaches are too costly for the project to implement or are likely to be of limited effectiveness. Despite improvements in overall water quality below dams in recent years, many hydropower projects are unable to meet state water quality standards for DO. Regulatory agencies in the U.S. are considering or implementingmore » dramatic changes in their approach to protecting the quality of the Nation’s waters. New policies and initiatives have emphasized flexibility, increased collaboration and shared responsibility among all parties, and market-based, economic incentives. The use of new regulatory approaches may now be a viable option for addressing the DO problem at some hydropower facilities. This report summarizes some of the regulatory-related options available to hydropower projects, including negotiation of site-specific water quality criteria, use of biological monitoring, watershed-based strategies for the management of water quality, and watershed-based trading. Key decision points center on the health of the local biological communities and whether there are contributing impacts (i.e., other sources of low DO effluents) in the watershed. If the biological communities downstream of the hydropower project are healthy, negotiation for site-specific water quality standards or biocriteria (discharge performance criteria based on characteristics of the aquatic biota) might be pursued. If there are other effluent dischargers in the watershed that contribute to low DO problems, watershed-scale strategies and effluent trading may be effective. This report examines the value of regulatory approaches by reviewing their use

  8. Memory Loss, Alzheimer’s Disease and General Anesthesia: A Preoperative Concern

    PubMed Central

    Thaler, Adam; Siry, Read; Cai, Lufan; García, Paul S.; Chen, Linda; Liu, RenYu

    2012-01-01

    Background The long-term cognitive effects of general anesthesia are under intense scrutiny. Here we present 5 cases from 2 academic institutions to analyze some common features where the patient’s or the patient family member has made a request to address their concern on memory loss, Alzheimer’s disease and general anesthesia before surgery. Methods Records of anesthesia consultation separate from standard preoperative evaluation were retrieved to identify consultations related to memory loss and Alzheimer’s disease from the patient and/or patient family members. The identified cases were extensively reviewed for features in common. We used Google® (http://www. google.com/) to identify available online information using “anesthesia memory loss” as a search phrase. Results Five cases were collected as a specific preoperative consultation related to memory loss, Alzheimer’s disease and general anesthesia from two institutions. All of the individuals either had perceived memory impairment after a prior surgical procedure with general anesthesia or had a family member with Alzheimer’s disease. They all accessed public media sources to find articles related to anesthesia and memory loss. On May 2nd, 2011, searching “anesthesia memory loss” in Google yielded 764,000 hits. Only 3 of the 50 Google top hits were from peer-reviewed journals. Some of the lay media postings made a causal association between general anesthesia and memory loss and/or Alzheimer’s disease without conclusive scientific literature support. Conclusion The potential link between memory loss and Alzheimer’s disease with general anesthesia is an important preoperative concern from patients and their family members. This concern arises from individuals who have had history of cognitive impairment or have had a family member with Alzheimer disease and have tried to obtain information from public media. Proper preoperative consultation with the awareness of the lay literature can

  9. Concern that "EMF" magnetic fields from power lines cause cancer.

    PubMed

    Repacholi, Michael

    2012-06-01

    In 2002, the International Agency for Research on Cancer (IARC, 2002) categorized extremely low frequency (ELF) (including the power frequencies of 50 and 60 Hz) magnetic fields as "possibly carcinogenic to humans." That was based on pooled analyses of epidemiological research that reported an association between exposure to low-level magnetic fields and childhood leukemia. In 2007 a task group of scientific experts convened by the World Health Organization (WHO) acknowledged the IARC categorization but found that the laboratory studies and other research results did not support the association. Taking all evidence into account WHO reported that it could not confirm the existence of any health consequences from exposure to low-level magnetic fields. There remains continuing concern by some people that exposure to power frequency magnetic fields may cause adverse health effects, particularly childhood leukemia. Public health authorities need to fully understand the reasons for that ongoing concern and effective ways to address it. This paper describes what drives the concern, including how people perceive risks, how WHO and other public health authorities assess scientific research to determine whether health risks exist and the conclusions they have reached about power frequency magnetic fields. This paper also addresses the scientific basis of international exposure guidelines for power frequency magnetic fields and what precautionary measures are warranted to address the concern. Copyright © 2012. Published by Elsevier B.V.

  10. A rural/urban comparison of privacy and confidentiality concerns associated with providing sensitive location information in epidemiologic research involving persons who use drugs.

    PubMed

    Rudolph, Abby E; Young, April M; Havens, Jennifer R

    2017-11-01

    Analyses that link contextual factors with individual-level data can improve our understanding of the "risk environment"; however, the accuracy of information provided by participants about locations where illegal/stigmatized behaviors occur may be influenced by privacy/confidentiality concerns that may vary by setting and/or data collection approach. We recruited thirty-five persons who use drugs from a rural Appalachian town and a Mid-Atlantic city to participate in in-depth interviews. Through thematic analyses, we identified and compared privacy/confidentiality concerns associated with two survey methods that (1) collect self-reported addresses/cross-streets and (2) use an interactive web-based map to find/confirm locations in rural and urban settings. Concerns differed more by setting than between methods. For example, (1) rural participants valued interviewer rapport and protections provided by the Certificate of Confidentiality more; (2) locations considered to be sensitive differed in rural (i.e., others' homes) and urban (i.e., where drugs were used) settings; and (3) urban participants were more likely to view providing cross-streets as an acceptable alternative to providing exact addresses for sensitive locations and to prefer the web-based map approach. Rural-urban differences in privacy/confidentiality concerns reflect contextual differences (i.e., where drugs are used/purchased, population density, and prior drug-related arrests). Strategies to alleviate concerns include: (1) obtain a Certificate of Confidentiality, (2) collect geographic data at the scale necessary for proposed analyses, and (3) permit participants to provide intersections/landmarks in close proximity to actual locations rather than exact addresses or to skip questions where providing an intersection/landmark would not obfuscate the actual address. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. 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.

  12. Stereotype confirmation concerns predict dropout from cognitive behavioral therapy for social anxiety disorder.

    PubMed

    Johnson, Suzanne; Price, Matthew; Mehta, Natasha; Anderson, Page L

    2014-08-19

    There are high attrition rates observed in efficacy studies for social anxiety disorder, and research has not identified consistent nor theoretically meaningful predictors of dropout. Pre-treatment symptom severity and demographic factors, such as age and gender, are sometimes predictive of dropout. The current study examines a theoretically meaningful predictor of attrition based on experiences associated with social group membership rather than differences between social group categories--fear of confirming stereotypes. This is a secondary data analysis of a randomized controlled trial comparing two cognitive behavioral treatments for social anxiety disorder: virtual reality exposure therapy and exposure group therapy. Participants (N = 74) with a primary diagnosis of social anxiety disorder who were eligible to participate in the parent study and who self-identified as either "African American" (n = 31) or "Caucasian" (n = 43) completed standardized self-report measures of stereotype confirmation concerns (SCC) and social anxiety symptoms as part of a pre-treatment assessment battery. Hierarchical logistic regression showed that greater stereotype confirmation concerns were associated with higher dropout from therapy--race, age, gender, and pre-treatment symptom severity were not. Group treatment also was associated with higher dropout. These findings urge further research on theoretically meaningful predictors of attrition and highlight the importance of addressing cultural variables, such as the experience of stereotype confirmation concerns, during treatment of social anxiety to minimize dropout from therapy.

  13. 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.

  14. 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

  15. Behavior Analytic Consultation for Academic Referral Concerns

    ERIC Educational Resources Information Center

    Dufrene, Brad A.; Zoder-Martell, Kimberly A.; Dieringe, Shannon Titus; Labrot, Zachary

    2016-01-01

    Applied behavior analysis provides a technology of human behavior that demonstrates great potential for improving socially important outcomes for individuals. School-based consultation may provide a vehicle for delivering applied behavior analysis services in schools to address academic referral concerns. In this article, we propose that…

  16. Perceptions, motivations, and concerns about living organ donation among people living with HIV.

    PubMed

    Van Pilsum Rasmussen, Sarah E; Henderson, Macey L; Bollinger, Juli; Seaman, Shanti; Brown, Diane; Durand, Christine M; Segev, Dorry L; Sugarman, Jeremy

    2018-05-03

    Recent changes to United States law now permit people living with HIV (PLWH) to donate organs to HIV-infected (HIV+) recipients under research protocols. PLWH may have unique motivations for and concerns about living donation and understanding them is critical to ensuring the integrity of this novel approach to organ transplantation. We conducted in-depth interviews with PLWH from an urban HIV clinic who had previously indicated their willingness to be a living donor. Interviews elicited information on their motivations, perceived benefits, and concerns regarding living donation. Codes were identified inductively and then organized into themes and subthemes. Two coders independently analyzed the interviews and reconciled differences in coding by consensus. Thematic saturation was reached after 20 interviews. Motivations for living donation among PLWH included an altruistic desire to help others as well as HIV-specific motivations including solidarity with potential recipients and a desire to overcome HIV-related stigma. Perceived benefits of living donation included gratification from saving or improving the recipient's life and conferring a sense of normalcy for the HIV+ donor. Concerns about donation included the possibility of a prolonged recovery period, organ failure, and transmission of another strain of the virus to the recipients. PLWH had unique motivations, perceived benefits, and concerns about living donation in addition to those previously identified in the general population. These unique factors should be addressed in research protocols, informed consent processes, and the education and training of independent living donor advocates so that these endeavors are ethically sound.

  17. A Tailored Approach to Identifying and Addressing College Students' Online Health Information Literacy

    ERIC Educational Resources Information Center

    Banas, Jennifer

    2008-01-01

    Background: College students may fail to practice information literacy skills because they are unaware of their skill level or are not concerned with the risks. Purpose: In order to develop an effective message that motivates college students to learn online health information literacy skills, a better understanding of perceptions about such…

  18. Compassion and Vigilance: Investigators' Strategies To Manage Ethical Concerns in Palliative and End-of-Life Research

    PubMed Central

    Cartwright, Juliana C.; Nelson, Christine A.; Knafl, Kathleen

    2012-01-01

    Abstract Background Ethical concerns were identified as a potential barrier to advancing palliative and end-of-life science at the 2004 National Institutes of Health State of the Science Meeting. However, data are lacking about the nature of ethical concerns and strategies for balancing the need to advance science with human subjects protections. Methods A qualitative case-study design was used to follow 43 end-of-life studies from proposal development through the review process and implementation. Investigators participated in semi-structured telephone interviews and provided document data regarding their experiences with grant and IRB reviews. Using constant comparative analysis within and across cases, the investigators identified commonly encountered and unique concerns and strategies for managing these concerns. Findings Investigator strategies fell into two broad categories: 1) Recruitment and consent strategies related to subject identification and enrollment; and 2) Protocol-related strategies related to the process of data collection. These strategies shared the overarching meta-themes of compassion, as evidenced by a heightened sensitivity to the needs of the population, coupled with vigilance, as evidenced by close attention to the possible effects of study participation on the participants' well-being, clinical care, and the needs of research staff. Conclusions Ethical concerns have led to the development of compassionate and vigilant strategies designed to balance the potential for risk of harm with the need to advance the science of palliative and end-of-life care. These strategies can be used by investigators to address ethical concerns and minimize barriers to the development of palliative and end-of-life care science. PMID:22731516

  19. Compassion and vigilance: investigators' strategies to manage ethical concerns in palliative and end-of-life research.

    PubMed

    Hickman, Susan E; Cartwright, Juliana C; Nelson, Christine A; Knafl, Kathleen

    2012-08-01

    Ethical concerns were identified as a potential barrier to advancing palliative and end-of-life science at the 2004 National Institutes of Health State of the Science Meeting. However, data are lacking about the nature of ethical concerns and strategies for balancing the need to advance science with human subjects protections. A qualitative case-study design was used to follow 43 end-of-life studies from proposal development through the review process and implementation. Investigators participated in semi-structured telephone interviews and provided document data regarding their experiences with grant and IRB reviews. Using constant comparative analysis within and across cases, the investigators identified commonly encountered and unique concerns and strategies for managing these concerns. Investigator strategies fell into two broad categories: 1) Recruitment and consent strategies related to subject identification and enrollment; and 2) Protocol-related strategies related to the process of data collection. These strategies shared the overarching meta-themes of compassion, as evidenced by a heightened sensitivity to the needs of the population, coupled with vigilance, as evidenced by close attention to the possible effects of study participation on the participants' well-being, clinical care, and the needs of research staff. Ethical concerns have led to the development of compassionate and vigilant strategies designed to balance the potential for risk of harm with the need to advance the science of palliative and end-of-life care. These strategies can be used by investigators to address ethical concerns and minimize barriers to the development of palliative and end-of-life care science.

  20. Concerns and Responses for Integrating Health Systems Science Into Medical Education.

    PubMed

    Gonzalo, Jed D; Caverzagie, Kelly J; Hawkins, Richard E; Lawson, Luan; Wolpaw, Daniel R; Chang, Anna

    2018-06-01

    With the aim of improving the health of individuals and populations, medical schools are transforming curricula to ensure physician competence encompasses health systems science (HSS), which includes population health, health policy, high-value care, interprofessional teamwork, leadership, quality improvement, and patient safety. Large-scale, meaningful integration remains limited, however, and a major challenge in HSS curricular transformation efforts relates to the receptivity and engagement of students, educators, clinicians, scientists, and health system leaders. The authors identify several widely perceived challenges to integrating HSS into medical school curricula, respond to each concern, and provide potential strategies to address these concerns, based on their experiences designing and integrating HSS curricula. They identify two broad categories of concerns: the (1) relevance and importance of learning HSS-including the perception that there is inadequate urgency for change; HSS education is too complex and should occur in later years; early students would not be able to contribute, and the roles already exist; and the science is too nascent-and (2) logistics and practicality of teaching HSS-including limited curricular time, scarcity of faculty educators with expertise, lack of support from accreditation agencies and licensing boards, and unpreparedness of evolving health care systems to partner with schools with HSS curricula. The authors recommend the initiation and continuation of discussions between educators, clinicians, basic science faculty, health system leaders, and accrediting and regulatory bodies about the goals and priorities of medical education, as well as about the need to collaborate on new methods of education to reach these goals.

  1. How can clinician-educator training programs be optimized to match clinician motivations and concerns?

    PubMed Central

    McCullough, Brendan; Marton, Gregory E; Ramnanan, Christopher J

    2015-01-01

    Background Several medical schools have implemented programs aimed at supporting clinician-educators with formal mentoring, training, and experience in undergraduate medical teaching. However, consensus program design has yet to be established, and the effectiveness of these programs in terms of producing quality clinician-educator teaching remains unclear. The goal of this study was to review the literature to identify motivations and perceived barriers to clinician-educators, which in turn will improve clinician-educator training programs to better align with clinician-educator needs and concerns. Methods Review of medical education literature using the terms “attitudes”, “motivations”, “physicians”, “teaching”, and “undergraduate medical education” resulted in identification of key themes revealing the primary motivations and barriers involved in physicians teaching undergraduate medical students. Results A synthesis of articles revealed that physicians are primarily motivated to teach undergraduate students for intrinsic reasons. To a lesser extent, physicians are motivated to teach for extrinsic reasons, such as rewards or recognition. The key barriers deterring physicians from teaching medical students included: decreased productivity, lack of compensation, increased length of the working day, patient concerns/ethical issues, and lack of confidence in their own ability. Conclusion Our findings suggest that optimization of clinician-educator training programs should address, amongst other factors, time management concerns, appropriate academic recognition for teaching service, and confidence in teaching ability. Addressing these issues may increase the retention of clinicians who are active and proficient in medical education. PMID:25653570

  2. American Indians’ Family Health Concern on a Northern Plains Reservation: “Diabetes Runs Rampant Here”

    PubMed Central

    Martin, Donna; Yurkovich, Eleanor; Anderson, Kara

    2015-01-01

    Objectives The objective was to identify significant family health concerns from the perspective of adult tribal members residing in a reservation setting on the Northern Plains of the United States. Findings were used to co-create culturally appropriate strategies to address the most significant family health concern. Design and Sample A focused ethnography within a participatory framework was employed. An advisory council, comprised of seven tribal members, guided the research team. A purposive sampling technique with a snowball process was used. Twenty-one adult tribal members volunteered to participate. Measures Face-to-face, audio-recorded, semi-structured interviews were conducted and transcribed verbatim. Other data sources included field notes of approximately 100 hours of field work, windshield surveys, and a focus group. Data were analyzed using Spradley’s guidelines. Results The significant family health concern was “diabetes runs rampant here” with inter-related cognitive, emotional and behavioral responses. These responses were compounded by accumulated emotional trauma from witnessing premature deaths and severe comorbidities associated with diabetes. Contextual factors shaping “diabetes runs rampant here” were identified. Conclusion Holistic approaches are urgently needed in diabetes prevention and management programs. Implications for public health nurses are discussed and recommendations are provided for future research. PMID:26336881

  3. A history of the working group to address Los Alamos community health concerns - A case study of community involvement and risk communication

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

    Harry Otway; Jon Johnson

    2000-01-01

    In May 1991, at a Department of Energy (DOE) public hearing at Los Alamos, New Mexico, a local artist claimed there had been a recent brain tumor cluster in a small Los Alamos neighborhood. He suggested the cause was radiation from past operations of Los Alamos National Laboratory. Data from the Laboratory's extensive environmental monitoring program gave no reason to believe this charge to be true but also could not prove it false. These allegations, reported in the local and regional media, alarmed the community and revealed an unsuspected lack of trust in the Laboratory. Having no immediate and definitivemore » response, the Laboratory offered to collaborate with the community to address this concern. The Los Alamos community accepted this offer and a joint Community-Laboratory Working Group met for the first time 29 days later. The working group set as its primary goal the search for possible carcinogens in the local environment. Meanwhile, the DOE announced its intention to fund the New Mexico Department of Health to perform a separate and independent epidemiological study of all Los Alamos cancer rates. In early 1994, after commissioning 17 environmental studies and meeting 34 times, the working group decided that the public health concerns had been resolved to the satisfaction of the community and voted to disband. This paper tells the story of the artist and the working group, and how the media covered their story. It summarizes the environmental studies directed by the working group and briefly reviews the main findings of the epidemiology study. An epilogue records the present-day recollections of some of the key players in this environmental drama.« less

  4. Digital Textbooks: School Librarians' Stages of Concerns in Initial Implementation

    ERIC Educational Resources Information Center

    Kang, Ji Hei; Everhart, Nancy

    2014-01-01

    Introduction: A legislative mandate to adopt digital textbooks in Florida provides an opportunity to identify concerns school librarians have regarding digital textbook implementation. Method: The stages of concern questionnaire was used to identify stages of concern among Florida school librarians about their potential role in this…

  5. 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

  6. Stopping Antidepressants and Anxiolytics as Major Concerns Reported in Online Health Communities: A Text Mining Approach.

    PubMed

    Abbe, Adeline; Falissard, Bruno

    2017-10-23

    Internet is a particularly dynamic way to quickly capture the perceptions of a population in real time. Complementary to traditional face-to-face communication, online social networks help patients to improve self-esteem and self-help. The aim of this study was to use text mining on material from an online forum exploring patients' concerns about treatment (antidepressants and anxiolytics). Concerns about treatment were collected from discussion titles in patients' online community related to antidepressants and anxiolytics. To examine the content of these titles automatically, we used text mining methods, such as word frequency in a document-term matrix and co-occurrence of words using a network analysis. It was thus possible to identify topics discussed on the forum. The forum included 2415 discussions on antidepressants and anxiolytics over a period of 3 years. After a preprocessing step, the text mining algorithm identified the 99 most frequently occurring words in titles, among which were escitalopram, withdrawal, antidepressant, venlafaxine, paroxetine, and effect. Patients' concerns were related to antidepressant withdrawal, the need to share experience about symptoms, effects, and questions on weight gain with some drugs. Patients' expression on the Internet is a potential additional resource in addressing patients' concerns about treatment. Patient profiles are close to that of patients treated in psychiatry. ©Adeline Abbe, Bruno Falissard. Originally published in JMIR Mental Health (http://mental.jmir.org), 23.10.2017.

  7. Concerns and coping during cancer genetic risk assessment.

    PubMed

    Bennett, P; Phelps, C; Hilgart, J; Hood, K; Brain, K; Murray, A

    2012-06-01

    To gain an 'in-depth' understanding of patients' concerns and their related coping strategies during the genetic risk assessment process. Participants were the 'usual care' arm of a trial of a coping intervention targeted at men and women undergoing assessment of genetic risk for familial cancer. Participants completed questionnaires measuring the degree to which they experienced up to 11 concerns and which of 8 coping strategies they used to respond to each of them at entry into the programme and 1 month subsequently (before they received their risk information). A majority of participants were at least 'quite worried' about all the identified concerns, although the levels of concern fell over the waiting period. Participants used several strategies in response to their varying concerns - although a primary coping strategy for each concern was identifiable. The emotion-focused strategies of acceptance and positive appraisal were generally used in response to concerns they could not change, and seeking social support was used primarily to gain information, but not emotional support from their family. Cluster analysis identified three unique clusters of coping responses. Genetic risk assessment comprises a number of different stressors each of which is coped with using different strategies. Copyright © 2011 John Wiley & Sons, Ltd.

  8. Vitamin D: Moving Forward to Address Emerging Science

    PubMed Central

    Sempos, Christopher T.; Davis, Cindy D.; Brannon, Patsy M.

    2017-01-01

    The science surrounding vitamin D presents both challenges and opportunities. Although many uncertainties are associated with the understandings concerning vitamin D, including its physiological function, the effects of excessive intake, and its role in health, it is at the same time a major interest in the research and health communities. The approach to evaluating and interpreting the available evidence about vitamin D should be founded on the quality of the data and on the conclusions that take into account the totality of the evidence. In addition, these activities can be used to identify critical data gaps and to help structure future research. The Office of Dietary Supplements (ODS) at the National Institutes of Health has as part of its mission the goal of supporting research and dialogues for topics with uncertain data, including vitamin D. This review considers vitamin D in the context of systematically addressing the uncertainty and in identifying research needs through the filter of the work of ODS. The focus includes the role of systematic reviews, activities that encompass considerations of the totality of the evidence, and collaborative activities to clarify unknowns or to fix methodological problems, as well as a case study using the relationship between cancer and vitamin D. PMID:29194368

  9. Treatment-seeking college students with disabilities: Presenting concerns, protective factors, and academic distress.

    PubMed

    Fleming, Allison R; Edwin, Mary; Hayes, Jeffrey A; Locke, Benjamin D; Lockard, Allison J

    2018-02-01

    Students with disabilities are a growing population on college campuses and have unique challenges that put them at risk for early departure, creating complexity in efforts to address their personal and academic needs. The purpose was to explore academic and other sources of distress among college students with disabilities to identify possible areas where enhanced supports might benefit this population. Research Method and Design: Researchers analyzed cross-sectional data from the Center for Collegiate Mental Health to compare subsamples of students with (n = 1,774) and without disabilities (n = 1,774) on presenting concerns, and to determine significant predictors of academic distress among students with disabilities. Results indicated that students with disabilities have many similar treatment concerns with their peers, but showed greater concerns in depression and self-harm; academic performance; anxiety and obsessions/compulsions; and fewer concerns in relationship problems. Significant predictors of academic distress for students with disabilities included attention deficit-hyperactivity disorder (ADHD), depression and self-harm, trauma or victimization, stress and academic performance, and social support from family and peers. These results suggest the importance of several factors in understanding the presenting concerns of treatment-seeking students with disabilities and mitigating academic distress for this population. Additional areas for research are presented. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  10. Health concerns associated with unconventional gas mining in rural Australia.

    PubMed

    Haswell, Melissa R; Bethmont, Anna

    2016-01-01

    Many governments globally are investigating the benefits and risks associated with unconventional gas mining for shale, tight and coal seam gas (coalbed methane) to determine whether the industry should proceed in their jurisdiction. Most locations likely to be developed are in rural areas, with potential impact on farmers and small communities. Despite significant health concerns, public health knowledge and growing evidence are often overlooked in decision-making. It is difficult to gain a broad but accurate understanding of the health concerns for rural communities because the evidence has grown very recently and rapidly, is complex and largely based in the USA, where the industry is advanced. In 2016, a concerned South Australian beef and lamb farmer in an area targeted for potential unconventional gas development organised visits to homes in developed unconventional gas areas of Pennsylvania and forums with leading researchers and lawyers in Pennsylvania and New York. Guided by priorities identified during this trip, this communication concisely distils the research evidence on these key concerns, highlighting the Australian situation where evidence exists. It summarises key information of particular concern to rural regions, using Australia as an example, to assist rural health professionals to be better prepared to engage in decision-making and address the challenges associated with this new industry. Discussions with communities and experts, supported by the expanding research from the USA and Australia, revealed increasing health concerns in six key areas. These are absence of a safe solution to the toxic wastewater management problems, air pollution, land and water competition, mental health and psychosocial wellbeing risks, fugitive methane emissions and lack of proven regulatory regimes. Emerging epidemiological studies suggesting interference with foetal development and birth outcomes, and exacerbation of asthma conditions, are particularly concerning

  11. Bilateral childhood visual impairment: child and parent concerns.

    PubMed

    Liebermann, Laura; Leske, David A; Hatt, Sarah R; Castañeda, Yolanda S; Wernimont, Suzanne M; Cheng-Patel, Christina S; Birch, Eileen E; Holmes, Jonathan M

    2017-06-01

    To identify specific health-related quality of life and visual function concerns affecting children with bilateral visual impairment as expressed by children or one of their parents (proxy) and concerns affecting the parents themselves. A total of 37 children <16 years of age with visual impairment (visual acuity worse than 20/70 in the better eye) and one parent for each child were prospectively enrolled. Semistructured individual interviews were performed with children 5-15 years of age (n = 16) and with one parent for each child (ages 0-15 years, N = 37). Interview transcripts were analyzed using NVivo software. Categories of concern were identified from both child and parent interviews, from which broad themes were identified. The frequencies of the themes and specific categories of concerns were calculated. Regarding the child's experience, categories of concern were grouped into 6 themes: visual function (expressed by 13 of 16 children [81%] and 33 of 37 parents [89%]), treatment (63% and 54%), emotions (50% and 68%), social (50% and 70%), physical discomfort (50% and 22%), and worry (38% and 8%). Concerns expressed regarding the parents' own experience were grouped into 5 themes: worry (100%), compensate-adjust for condition (89%), treatment (84%), emotions (81%), and affects family (46%). Individual interviews identified a wide spectrum of concerns in children with visual impairment and their parents, affecting functional, emotional, social and physical domains. Specific concerns will be used to develop patient-derived questionnaires for quantifying the effects of visual impairment on children and parents in everyday life. Copyright © 2017 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  12. Hospital management of outpatient oncology treatment decisions: a survey to identify strategies and concerns.

    PubMed

    Li, Edward; Schleif, Ron; Edelen, Bruce

    2013-09-01

    Historically, hospitals did not actively restrict or manage outpatient oncology drug use, because treatment options were few, and reimbursement was generous. Recent growth of novel agents coupled with reimbursement challenges may require a strategy change. The extent of hospital engagement in controlling outpatient oncology drug use is currently unknown. Our objective was to describe the extent of hospital outpatient oncology drug management, management strategies employed, and specific drugs/tumor types of most concern for inappropriate use and cost. A multiple choice-question survey assessed management strategies and the drugs/tumors of greatest concern in US hospitals that dispense outpatient chemotherapy. From June to July 2011, the survey was distributed electronically to members of the Hematology-Oncology Pharmacy Association, representing 281 institutions. The survey was completed by 93 respondents (33% institutional response rate). Most institutions (99%) use at least one form of control to manage outpatient oncology drug therapy; 89% establish preferred therapies, and most use a multidisciplinary management team consisting of oncologists, pharmacists, nurses, and other practitioners. Tumor types of most concern for inappropriate drug use and cost were: prostate, breast, non-small-cell lung, melanoma, and colorectal. Fifty-five percent were concerned about drugs used in supportive care management. Drugs most restricted were: cetuximab, bevacizumab, eribulin, panitumumab, and trastuzumab. There is active control, management, and restriction of outpatient oncology drugs by hospitals. A majority of these institutions use a multidisciplinary team with active involvement by an oncologist. Future evaluations of hospital programs should consider monitoring the evolution of how institutions manage outpatient oncology services.

  13. Sleep concerns in children and young people with cerebral palsy in their home setting.

    PubMed

    McCabe, Susan M; Blackmore, A Marie; Abbiss, Chris R; Langdon, Katherine; Elliott, Catherine

    2015-12-01

    The aims were to identify in-home concerns about sleep in children and young people with cerebral palsy (CP) across age and Gross Motor Function Classification Scale (GMFCS) levels. This was a retrospective review of clinical notes of 154 children and young people with CP, aged 1-18 years (M = 7.8; standard deviation = 5.4) who received a home-based sleep service. Reported concerns were synthesised, for analysis according to age groups (1-5, 6-13, 14-18) and GMFCS levels. Sixteen factors of concern were derived from the home-based assessment reports. Most children and young people had multiple factors of concern. These varied across age groups and GMFCS levels. Body position was of concern across all age groups, for over 90% at GMFCS levels IV and V, and for 10% at GMFCS level I. Settling routines were of concern for more than 90% at GMFCS levels I and II, but for less than 50% at GMFCS levels IV and V. Settling routines were of concern to over 65% of those under 6 years but less than 25% of those over 14 years. Conversely, pain and pressure care concerned less than 10% of children under 6, and more than 35% of those over 14 years. Concerns about sleep vary across ages and GMFCS levels of children and young people with CP. Concerns relate to impairment of body structure and function, activity, environment, and personal supports. Multi-disciplinary, home-based assessment and interventions are recommended to address these concerns. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  14. Inquiry of Pre-Service Teachers' Concern about Integrating Web 2.0 into Instruction

    ERIC Educational Resources Information Center

    Hao, Yungwei; Lee, Kathryn S.

    2017-01-01

    To promote technology integration, it is essential to address pre-service teacher (PST) concerns about facilitating technology-enhanced learning environments. This study adopted the Concerns-Based Adoption Model to investigate PST concern on Web 2.0 integration. Four hundred and eighty-nine PSTs in a teacher education university in north Taiwan…

  15. The Growing Concerns Regarding School Resource Officers

    ERIC Educational Resources Information Center

    Ryan, Joseph B.; Katsiyannis, Antonis; Counts, Jennifer M.; Shelnut, Jill C.

    2018-01-01

    There have been an increasing number of incidents in which school resource officers (SRO) have been used to manage student disciplinary issues with disastrous results. Court cases brought by parents and advocacy groups claim SROs have traumatized and injured students. This article addresses several critical issues concerning SROs being used to…

  16. 75 FR 52940 - Final Notice of Data Availability Concerning 2010 CAIR NOX

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-30

    ... ENVIRONMENTAL PROTECTION AGENCY [FRL-9194-6] Final Notice of Data Availability Concerning 2010 CAIR NO X Annual Trading Program New Unit Set-Aside Allowance Allocations Under the Clean Air....153(e). FOR FURTHER INFORMATION CONTACT: Questions concerning this action should be addressed to...

  17. Fall concern about older persons shifts to carers as changing health policy focuses on family, home-based care.

    PubMed

    Ang, Seng Giap Marcus; O'Brien, Anthony Paul; Wilson, Amanda

    2018-01-01

    With the Singaporean population ageing at an exponential rate, home carers are increasingly becoming essential partners in fall prevention and care delivery for older persons living at home and in the community. Singapore, like other Asian countries, regards the family as the main support structure for the older person, and national policies have been implemented to support this cultural expectation. Family carers experience similar concerns as older persons with regard to fall risk, and identifying and addressing these concerns can potentially lower fall risk and improve fall prevention for older persons. It is timely to remind ourselves - as concern about falls in older persons begins to shift to carers - to incorporate the influence of Asian cultural values and unique family dynamics of outsourcing family caregiving, in the management of older persons' fall risk in the community. Copyright: © Singapore Medical Association.

  18. 76 FR 42055 - Data Availability Concerning Transport Rule Allowance Allocations to Existing Units

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-18

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 97 [FRL-9435-6] Data Availability Concerning Transport... concerning this action should be addressed to Brian Fisher, telephone (202) 343-9633, and e- mail fisher.... 97.411(a)(2), 97.511(a)(2), 97.611(a)(2), and 97.711(a)(2) (concerning termination of allocations of...

  19. Identifying environmental health priorities in underserved populations: a study of rural versus urban communities

    PubMed Central

    Bernhard, M.C.; Evans, M.B.; Kent, S.T.; Johnson, E.; Threadgill, S.L.; Tyson, S.; Becker, S.M.; Gohlke, J.M.

    2013-01-01

    Objectives Understanding and effectively addressing persistent health disparities in minority communities requires a clear picture of members’ concerns and priorities. This study was intended to engage residents in urban and rural communities in order to identify environmental health priorities. Specific emphasis was placed on how the communities defined the term environment, their perceptions of environmental exposures as affecting their health, specific priorities in their communities, and differences in urban versus rural populations. Study design A community-engaged approach was used to develop and implement focus groups and compare environmental health priorities in urban versus rural communities. Methods A total of eight focus groups were conducted: four in rural and four in urban communities. Topics included defining the term environment, how the environment may affect health, and environmental priorities within their communities, using both open discussion and a predefined list. Data were analysed both qualitatively and quantitatively to identify patterns and trends. Results There were important areas of overlap in priorities between urban and rural communities; both emphasized the importance of the social environment and shared a concern over air pollution from industrial sources. In contrast, for urban focus groups, abandoned houses and their social and physical sequelae were a high priority while concerns about adequate sewer and water services and road maintenance were high priorities in rural communities. Conclusions This study was able to identify environmental health priorities in urban versus rural minority communities. In contrast to some previous risk perception research, the results of this study suggest prioritization of tangible, known risks in everyday life instead of rare, disaster-related events, even in communities that have recently experienced devastating damage from tornadoes. The findings can help inform future efforts to study

  20. Ebola vaccine development plan: ethics, concerns and proposed measures.

    PubMed

    Folayan, Morenike Oluwatoyin; Yakubu, Aminu; Haire, Bridget; Peterson, Kristin

    2016-02-08

    The global interest in developing therapies for Ebola infection management and its prevention is laudable. However the plan to conduct an emergency immunization program specifically for healthcare workers using experimental vaccines raises some ethical concerns. This paper shares perspectives on these concerns and suggests how some of them may best be addressed. The recruitment of healthcare workers for Ebola vaccine research has challenges. It could result in coercion of initially dissenting healthcare workers to assist in the management of EVD infected persons due to mistaken beliefs that the vaccine offers protection. It could also affect equity and justice. For example, where people who are not skilled health care professionals but who provide care to patients infected with Ebola (such as in home care settings) are not prioritized for vaccination. The possibility of study participants contracting Ebola infection despite the use of experimental vaccine, and the standard of care they would receive, needs to be addressed clearly, transparently and formalized as part of the ethics review process. Future access to study products in view of current status of the TRIPS agreement needs to be addressed. Finally, broad stakeholder engagement at local, regional and international levels needs to be promoted using available communication channels to engage local, regional and international support. These same concerns are applicable for current and future epidemics. Successful Ebola vaccine development research requires concerted efforts at public dialogue to address misconceptions, equity and justice in participant selection, and honest discussions about risks, benefits and future access. Public dialogue about Ebola vaccine research plans is crucial and should be conducted by trusted locals and negotiated between communities, researchers and ethics committees in research study sites.

  1. 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…

  2. 75 FR 36654 - Final Notice of Data Availability Concerning 2010 CAIR NOX

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-28

    ... ENVIRONMENTAL PROTECTION AGENCY [FRL-9168-6] Final Notice of Data Availability Concerning 2010 CAIR NOX Ozone Season Trading Program New Unit Set-Aside Allowance Allocations Under the Clean Air... INFORMATION CONTACT: Questions concerning this action should be addressed to Robert L. Miller, U.S...

  3. Adaptation of a Counseling Intervention to Address Multiple Cancer Risk Factors Among Overweight/Obese Latino Smokers

    PubMed Central

    Castro, Yessenia; Fernández, Maria E.; Strong, Larkin L.; Stewart, Diana W.; Krasny, Sarah; Robles, Eden Hernandez; Heredia, Natalia; Spears, Claire A.; Correa-Fernández, Virmarie; Eakin, Elizabeth; Resnicow, Ken; Basen-Engquist, Karen; Wetter, David W.

    2015-01-01

    More than 60% of cancer-related deaths in the United States are attributable to tobacco use, poor nutrition, and physical inactivity, and these risk factors tend to cluster together. Thus, strategies for cancer risk reduction would benefit from addressing multiple health risk behaviors. We adapted an evidence-based intervention grounded in social cognitive theory and principles of motivational interviewing originally developed for smoking cessation to also address physical activity and fruit/vegetable consumption among Latinos exhibiting multiple health risk behaviors. Literature reviews, focus groups, expert consultation, pretesting, and pilot testing were used to inform adaptation decisions. We identified common mechanisms underlying change in smoking, physical activity, and diet used as treatment targets; identified practical models of patient-centered cross-cultural service provision; and identified that family preferences and support as particularly strong concerns among the priority population. Adaptations made to the original intervention are described. The current study is a practical example of how an intervention can be adapted to maximize relevance and acceptability and also maintain the core elements of the original evidence-based intervention. The intervention has significant potential to influence cancer prevention efforts among Latinos in the United States and is being evaluated in a sample of 400 Latino overweight/obese smokers. PMID:25527143

  4. Salient concerns in using analgesia for cancer pain among outpatients: A cluster analysis study.

    PubMed

    Meghani, Salimah H; Knafl, George J

    2017-02-10

    To identify unique clusters of patients based on their concerns in using analgesia for cancer pain and predictors of the cluster membership. This was a 3-mo prospective observational study ( n = 207). Patients were included if they were adults (≥ 18 years), diagnosed with solid tumors or multiple myelomas, and had at least one prescription of around-the-clock pain medication for cancer or cancer-treatment-related pain. Patients were recruited from two outpatient medical oncology clinics within a large health system in Philadelphia. A choice-based conjoint (CBC) analysis experiment was used to elicit analgesic treatment preferences (utilities). Patients employed trade-offs based on five analgesic attributes (percent relief from analgesics, type of analgesic, type of side-effects, severity of side-effects, out of pocket cost). Patients were clustered based on CBC utilities using novel adaptive statistical methods. Multiple logistic regression was used to identify predictors of cluster membership. The analyses found 4 unique clusters: Most patients made trade-offs based on the expectation of pain relief (cluster 1, 41%). For a subset, the main underlying concern was type of analgesic prescribed, i.e ., opioid vs non-opioid (cluster 2, 11%) and type of analgesic side effects (cluster 4, 21%), respectively. About one in four made trade-offs based on multiple concerns simultaneously including pain relief, type of side effects, and severity of side effects (cluster 3, 28%). In multivariable analysis, to identify predictors of cluster membership, clinical and socioeconomic factors (education, health literacy, income, social support) rather than analgesic attitudes and beliefs were found important; only the belief, i.e ., pain medications can mask changes in health or keep you from knowing what is going on in your body was found significant in predicting two of the four clusters [cluster 1 (-); cluster 4 (+)]. Most patients appear to be driven by a single salient concern

  5. A pushing chronic care forward in Abu Dhabi by identifying priorities and addressing barriers: a modified Delphi technique

    PubMed Central

    Loney, Tom; Lapão, Luis V

    2018-01-01

    Objective This study aimed to elucidate the top five key priorities and barriers to chronic care in the health system of Abu Dhabi, United Arab Emirates (UAE). Design A modified Delphi study was performed to reach consensus on priority areas and barriers to the development of the Chronic Care Model in the health system of Abu Dhabi. Individual wireless audience response devices (keypads) linked to a computer were used to reduce 28 priorities and 20 barriers to the top five during three iterative rounds over three consecutive days. Setting Chronic care services for patients with diabetes, cardiovascular diseases and cancer, in both private and publicly funded healthcare services in the emirate of Abu Dhabi. Participants A purposive sample of 20 health systems’ experts were recruited. They were front-line healthcare workers from the public and private sector working in the delivery of care for patients with diabetes, cardiovascular diseases and cancer. Results The ‘overall organizational leadership in chronic illness care’ was ranked as the most important priority to address (26.3%) and ‘patient compliance’ was ranked as the most important barrier (36.8%) to the development of the Chronic Care Model. Conclusions This study has identified the current priorities and barriers to improving chronic care within Abu Dhabi’s healthcare system. Our paper addresses the UAE’s 2021 Agenda of achieving a world-class healthcare system, and findings may help inform strategic changes required to achieve this mission. PMID:29866724

  6. On the Path to SunShot - Utility Regulatory Business Model Reforms forAddressing the Financial Impacts of Distributed Solar on Utilities

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

    None, None

    Net-energy metering (NEM) with volumetric retail electricity pricing has enabled rapid proliferation of distributed photovoltaics (DPV) in the United States. However, this transformation is raising concerns about the potential for higher electricity rates and cost-shifting to non-solar customers, reduced utility shareholder profitability, reduced utility earnings opportunities, and inefficient resource allocation. Although DPV deployment in most utility territories remains too low to produce significant impacts, these concerns have motivated real and proposed reforms to utility regulatory and business models, with profound implications for future DPV deployment. This report explores the challenges and opportunities associated with such reforms in the context ofmore » the U.S. Department of Energy’s SunShot Initiative. As such, the report focuses on a subset of a broader range of reforms underway in the electric utility sector. Drawing on original analysis and existing literature, we analyze the significance of DPV’s financial impacts on utilities and non-solar ratepayers under current NEM rules and rate designs, the projected effects of proposed NEM and rate reforms on DPV deployment, and alternative reforms that could address utility and ratepayer concerns while supporting continued DPV growth. We categorize reforms into one or more of four conceptual strategies. Understanding how specific reforms map onto these general strategies can help decision makers identify and prioritize options for addressing specific DPV concerns that balance stakeholder interests.« less

  7. 1986 Division 17 Presidential Address: Crossroads for Counseling Psychology.

    ERIC Educational Resources Information Center

    Gazda, George M.

    1987-01-01

    Addresses the American Psychological Association (APA) reorganization plans developed by the Task Force on the Structure of APA, and their impact on Division 17, the Division of Counseling Psychology. Discusses accreditation, specialization, model guidelines for state licensure and graduate education. Expresses concern regarding the Assemblies'…

  8. Using the patients concerns inventory for distress screening in post-treatment head and neck cancer survivors.

    PubMed

    Ghazali, Naseem; Roe, Brenda; Lowe, Derek; Tandon, Sank; Jones, Terry; Shaw, Richard; Risk, Janet; Rogers, Simon N

    2017-10-01

    Cancer patients can experience significant distress during their cancer trajectory, which impacts upon clinical outcomes and quality of life. Screening for distress using holistic assessments can help identify and address unmet concerns/needs. The purpose of this study was to evaluate the relationship between concerns and distress, and the impact of distress on clinic outcomes in post-treatment head and neck cancer patients. 170 patients attending routine follow-up clinics were prospectively recruited. All patients completed the Patient Concerns Inventory (PCI) and the Distress thermometer (DT) at preconsultation. The rate of significant distress (i.e. DT cut-off score ≥4) was 36% (62/170). Significantly distressed patients selected more items overall than patients without distress (mean, median (QR) of 5.40, 5 (2-8) vs 2.61, 2 (0-4), p < 0.001). Significant distress was most strongly associated with Physical and Functional well-being (p < 0.001) and Psychological and Emotional well-being domains (p = 0.001). On balance, very little difference was noted between cut-off points of either ≥4 or ≥5 PCI items of concern selected. Both cut-off points demonstrated an acceptable level of sensitivity, specificity and predictive values for significant distress. Consultations were longer with increasing numbers of concerns. Just over one-third of patients are significantly distressed. They were more likely to express a higher number of concerns. A cutoff score ≥4 or ≥5 PCI items selected can identify those at risk of significant distress. Concerns causing significant distress were related to emotional/psychological issues and physical function. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  9. For telehealth to succeed, privacy and security risks must be identified and addressed.

    PubMed

    Hall, Joseph L; McGraw, Deven

    2014-02-01

    The success of telehealth could be undermined if serious privacy and security risks are not addressed. For example, sensors that are located in a patient's home or that interface with the patient's body to detect safety issues or medical emergencies may inadvertently transmit sensitive information about household activities. Similarly, routine data transmissions from an app or medical device, such as an insulin pump, may be shared with third-party advertisers. Without adequate security and privacy protections for underlying telehealth data and systems, providers and patients will lack trust in the use of telehealth solutions. Although some federal and state guidelines for telehealth security and privacy have been established, many gaps remain. No federal agency currently has authority to enact privacy and security requirements to cover the telehealth ecosystem. This article examines privacy risks and security threats to telehealth applications and summarizes the extent to which technical controls and federal law adequately address these risks. We argue for a comprehensive federal regulatory framework for telehealth, developed and enforced by a single federal entity, the Federal Trade Commission, to bolster trust and fully realize the benefits of telehealth.

  10. Assessing public concern for landscape quality: a potential model to identify visual thresholds

    Treesearch

    Arthur W. Magill

    1990-01-01

    Considerable public criticism and sometimes legal obstructions have been directed toward landscape management in relation to the extraction of natural resources. Many managers do not understand public concerns for visually attractive resources. Managers need to know when landscape alterations, like clearcuts, attract public attention and become visually objectionable....

  11. Vaccinating Your Preteen: Addressing Common Concerns

    MedlinePlus

    ... to sit for 15 minutes after getting any​ shot in case your child faints (syncope). Staying seated for 15 ... mild side effects that can occur after receiving shots. Why is more than one dose of vaccine needed? HPV vaccine: It is ...

  12. Cultural neuroscience and global mental health: addressing grand challenges

    PubMed Central

    Chiao, Joan Y.; Li, Shu-Chen; Turner, Robert; Lee-Tauler, Su Yeon; Pringle, Beverly A.

    2016-01-01

    Mental, neurological and substance-use (MNS) disorders comprise approximately 13% of the global burden of disease. The Grand Challenges in Global Mental Health Initiative has recently identified research priorities for the next decade to address prevention and treatment of MNS disorders. One main research priority is to identify the root causes, risks and protective factors associated with global mental health. Recent advances in cultural neuroscience have identified theoretical, methodological, and empirical methods of identifying biomarkers associated with mental health disorders across nations. Here we review empirical research in cultural neuroscience that address meeting the grand challenges in global mental health. PMID:28642836

  13. Distributed photovoltaic systems - Addressing the utility interface issues

    NASA Astrophysics Data System (ADS)

    Firstman, S. I.; Vachtsevanos, G. J.

    This paper reviews work conducted in the United States on the impact of dispersed photovoltaic sources upon utility operations. The photovoltaic (PV) arrays are roof-mounted on residential houses and connected, via appropriate power conditioning equipment, to the utility grid. The presence of such small (4-6 Kw) dispersed generators on the distribution network raises questions of a technical, economic and institutional nature. After a brief identification of utility interface issues, the paper addresses such technical concerns as protection of equipment and personnel safety, power quality and utility operational stability. A combination of experimental and analytical approaches has been adopted to arrive at solutions to these problems. Problem areas, under various PV system penetration scenarios, are identified and conceptual designs of protection and control equipment and operating policies are developed so that system reliability is maintained while minimizing capital costs. It is hoped that the resolution of balance-of-system and grid interface questions will ascertain the economic viability of photovoltaic systems and assist in their widespread utilization in the future.

  14. Career Concerns for People Living with HIV/AIDS.

    ERIC Educational Resources Information Center

    Hunt, Brandon; Jaques, Jodi; Niles, Spencer G.; Wierzalis, Edward

    2003-01-01

    Study seeks to identify the career concerns of people living with HIV/AIDS. Used qualitative research methodology to ask participants to discuss the impact their diagnosis has had on their career development concerns and their career goals. Responses classified participants' concerns as relating to career or workplace issues, medical issues, or…

  15. Status of neotropical migrant landbirds in the Midwest: identifying species of management concern

    Treesearch

    Frank R. Thompson; Stephen J. Lewis; Janet D. Green; David N. Ewert

    1993-01-01

    We ranked species of neotropical migrant landbirds by decreasing management concern for their viability in the Midwest. This was part of a coordinated effort by regional working groups of the Partners In Flight Program, an interagency program for the conservation of neotropical migratory birds (NTMBs). Species were ranked by seven criteria, developed by working group...

  16. Addressing Problem Behavior at Recess Using Peer Praise Notes

    ERIC Educational Resources Information Center

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

    2017-01-01

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

  17. Factors influencing African-American mothers' concerns about immunization safety: a summary of focus group findings.

    PubMed Central

    Shui, Irene; Kennedy, Allison; Wooten, Karen; Schwartz, Benjamin; Gust, Deborah

    2005-01-01

    OBJECTIVE: To examine the vaccine safety concerns of African-American mothers who, despite concerns, have their children immunized. METHODS: Six focus groups of Atlanta-area African-American mothers who were very concerned about vaccine safety but whose children were fully vaccinated were conducted. RESULTS: Major factors influencing participants' concerns about immunizations included: lack of information and mistrust of the medical community and government. Factors that convinced parents to have their child immunized despite their concerns included social norms and/or laws supporting immunization and fear of the consequences of not immunizing. Suggestions given to reduce concerns included improving available information that addressed their concerns and provider-patient communication. CONCLUSIONS: Addressing mothers' concerns about immunization is important both from an ethical perspective, in assuring that they are fully informed of the risks and benefits of immunizations, as well as from a practical one, in reducing the possibility that they will decide not to immunize their child. Changes in the childhood immunization process should be made to reduce parental concern about vaccine safety. Some changes that may be considered include improved provider communication about immunizations and additional tailored information about the necessity and safety of vaccines. PMID:15926642

  18. 78 FR 44438 - Notice of Organization Name and Address Change

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-24

    ... POSTAL SERVICE 39 CFR Part 501 Notice of Organization Name and Address Change AGENCY: Postal Service\\TM\\. ACTION: Final rule. SUMMARY: The Postal Service is revising the rules concerning... is the Office of Payment Technology (PT) or successor organization. All submissions to the Postal...

  19. Perceived Competence in Addressing Student Substance Abuse: A National Survey of Middle School Counselors

    ERIC Educational Resources Information Center

    Burrow-Sanchez, Jason J.; Lopez, Adriana L.; Slagle, Clark P.

    2008-01-01

    Background: Student substance abuse is a serious concern for middle school personnel. School counselors are most likely to deliver mental health services, including substance abuse, in school settings. However, limited research is available on the perceived competence of middle school counselors for addressing student substance abuse concerns. The…

  20. Sexual Health Concerns Among Cancer Survivors: Testing a Novel Information-Need Measure Among Breast and Prostate Cancer Patients.

    PubMed

    Crowley, Sheila A; Foley, Sallie M; Wittmann, Daniela; Jagielski, Christina H; Dunn, Rodney L; Clark, Patricia M; Griggs, Jennifer J; Peterson, Catherine; Leonard, Marcia; An, Lawrence C; Wei, John T; Montie, James E; Janz, Nancy K

    2016-09-01

    While it is recognized that cancer treatment can contribute to problems in sexual function, much less is currently known about the specific sexual health concerns and information needs of cancer survivors. This study tested a new instrument to measure cancer survivors' sexual health concerns and needs for sexual information after cancer treatment. The Information on Sexual Health: Your Needs after Cancer (InSYNC), developed by a multidisciplinary team of experts, is a novel 12-item questionnaire to measure sexual health concerns and information needs of cancer survivors. We tested the measure with a sample of breast and prostate cancer survivors. A convenience sample of 114 cancer survivors (58 breast, 56 prostate) was enrolled. Results of the InSYNC questionnaire showed high levels of sexual concern among cancer survivors. Areas of concern differed by cancer type. Prostate cancer survivors were most concerned about being able to satisfy their partners (57 %) while breast cancer survivors were most concerned with changes in how their bodies worked sexually (46 %). Approximately 35 % of all cancer survivors wanted more information about sexual health. Sexual health concerns and unmet information needs are common among breast and prostate cancer survivors, varying in some aspects by type of cancer. Routine screening for sexual health concerns should be included in comprehensive cancer survivorship care to appropriately address health care needs. The InSYNC questionnaire is one tool that may help clinicians identify concerns facing their patients.

  1. Using eHealth Technologies: Interests, Preferences, and Concerns of Older Adults

    PubMed Central

    Ware, Patrick; Bartlett, Susan J; Paré, Guy; Symeonidis, Iphigenia; Tannenbaum, Cara; Bartlett, Gillian; Poissant, Lise

    2017-01-01

    Background The Internet and eHealth technologies represent new opportunities for managing health. Age, sex, socioeconomic status, and current technology use are some of the known factors that influence individuals’ uptake of eHealth; however, relatively little is known about facilitators and barriers to eHealth uptake specific to older adults, particularly as they relate to their experiences in accessing health care. Objective The aim of our study was to explore the interests, preferences, and concerns of older adults in using the Internet and eHealth technologies for managing their health in relation to their experiences with the current health care system. Methods Two focus groups (n=15) were conducted with adults aged 50+ years. Pragmatic thematic analysis using an inductive approach was conducted to identify the interests, preferences, and concerns of using the Internet and eHealth technologies. Results Five themes emerged that include (1) Difficulty in identifying credible and relevant sources of information on the Web; (2) Ownership, access, and responsibility for medical information; (3) Peer communication and support; (4) Opportunities to enhance health care interactions; and (5) Privacy concerns. These findings support the potential value older adults perceive in eHealth technologies, particularly in their ability to provide access to personal health information and facilitate communication between providers and peers living with similar conditions. However, in order to foster acceptance, these technologies will need to provide personal and general health information that is secure, readily accessible, and easily understood. Conclusions Older adults have diverse needs and preferences that, in part, are driven by their experiences and frustrations with the health care system. Results can help inform the design and implementation of technologies to address gaps in care and access to health information for older adults with chronic conditions who may

  2. Qualitative evaluation of pretreatment patient concerns in orthodontics.

    PubMed

    Twigge, Eugene; Roberts, Rachel M; Jamieson, Lisa; Dreyer, Craig W; Sampson, Wayne J

    2016-07-01

    A discrepancy exists between objective and subjective measures of orthodontic treatment need, highlighting the importance of patients' perceptions. Limited qualitative information is available regarding patients' perceptions and orthodontic concerns. For the first time, patient facial images and qualitative methodology were used to assess patients' orthodontic concerns, which are incorporated into and are important in treatment planning and consent. An interview-based, cross-sectional study of adolescent patients eligible to receive orthodontic treatment in a public dental hospital was conducted with 105 adolescents (42 boys, 63 girls) aged between 12 and 17 years. Each patient's face was video recorded, and 3 images were selected from each recording to assess the patient's orthodontic concerns. The initial chief concerns were compared with concerns articulated after the patients assessed their facial images. In addition, patient concerns were compared with occlusal features visible on smiling using the Dental Aesthetic Index and patient study casts. For 37% of the adolescent patients, smiling images helped to identify additional concerns. For 87%, their smiling images helped them to describe their concerns in more detail. In addition, a few patients did not articulate any concern about features measurable on the Dental Aesthetic Index that were visible on smiling. Showing adolescent patients images of their face and smile helped them to identify and better describe their concerns. Adolescents are not always overly concerned about visible and quantifiable malocclusion features. This might influence orthodontic treatment planning and consent. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  3. Parents' concern about their children's weight.

    PubMed

    Lampard, Amy M; Byrne, Susan M; Zubrick, Stephen R; Davis, Elizabeth A

    2008-01-01

    Firstly, to investigate the degree of concern parents feel about their children's weight (parental concern). Secondly, to identify factors that influence this concern, and to test a model of parental concern using structural equation modeling. A total of 347 non-overweight, overweight, and obese children (aged 6-13; Mean = 9.5, SD = 1.8) and their parents. Children and their parents attended an assessment session during which they were weighed and measured. Parents were administered a structured interview, which included the Eating Disorder Examination, and completed the Pediatric Quality of Life Inventory (parent proxy), and the Children's Body Image Scale. Eighty-two percent of parents of overweight children, and 18% of parents of obese children reported little parental concern. Higher parental concern was associated with higher child Body Mass Index, less parental underestimation of child body size, and lower child health-related quality of life. Interventions targeting childhood obesity should aim to optimise parental concern by reducing parents' underestimation of child body size and increasing their awareness of the effects of overweight and obesity on children's health and quality of life.

  4. Addressing health concerns of pregnant African American women using the lens of complexity theory.

    PubMed

    Sims, Traci

    2014-01-01

    Pregnant African American women are at higher risk for multiple complex health issues, including depression, than their European American counterparts (Canady, Bullen, Holzman, Broman, & Tian, 2008; Martin et al, 2011; Mathews & MacDorman, 2007; Orr, Blazer, & James, 2006; Segre, Losch, & O'Hara, 2006). Various strategies must be used to address depression through preventive care and promotion of access to appropriate mental health services. Nurses and other health care providers need to examine the relationships between the multifactorial problems to improve the health and well-being of pregnant African American women and their unborn children. This article presents a case study demonstrating the use of complexity science theory to understand and prevent poor health outcomes for pregnant African American women with depression and their unborn children.

  5. 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…

  6. Sexual concerns among kidney transplant recipients.

    PubMed

    Muehrer, Rebecca J; Lanuza, Dorothy M; Brown, Roger L; Djamali, Arjang

    2014-11-01

    Little is known about the specific sexual concerns of kidney transplant (KTx) recipients. The primary objectives of this study were to: (i) describe the importance of sexuality to KTx recipients; (ii) investigate the sexual concerns of KTx recipients; and (iii) examine the relationship between sexual concerns and quality of life (QOL). A secondary objective was to examine potential sexual concern differences by gender, pre-transplant dialysis status, and donor type. This study employed a cross-sectional, descriptive, correlational design. Sexual concerns were identified using the Sexual Concerns Questionnaire, which contains seven subscales. QOL was measured with the SF-8 and the QOL Uniscale. Nearly 73% of subjects rated sexuality as important. Subscales indicating highest area of sexual concerns were communication with healthcare providers about sexuality (Mean (M) = 2.70) and sexual pleasure concerns (M = 2.45). Higher concern ratings regarding health consequences of sexual activity, quality of sexual relationship, sexual pleasure, sexual functioning problems, and pessimistic beliefs about treatment were significantly, inversely related to QOL. Women had significantly higher scores on the Sexual Pleasure and Communication with Healthcare Providers subscales than men. This study reports the sexual concerns of KTx recipients' who are an average of four yr since surgery, and the relationship of these concerns to QOL. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. How well do websites concerning children's anxiety answer parents' questions about treatment choices?

    PubMed

    Reynolds, Kristin A; Walker, John R; Walsh, Kate

    2015-10-01

    The goals of this study were to evaluate the quality of information concerning anxiety disorders in children that is available on the Internet and to evaluate changes in the quality of website information over time. The authors identified websites addressing child anxiety disorders (N = 26) using a Google search and recommendations from an expert in child anxiety. Each website was evaluated on the extent to which it addressed questions that parents consider important, the quality of information, and the reading level. All websites provided adequate information describing treatment options; however, fewer websites had information addressing many questions that are important to parents, including the duration of treatment, what happens when treatment stops, and the benefits and risks of various treatments. Many websites provided inadequate information on pharmacological treatment. Most websites were of moderate quality and had more difficult reading levels than is recommended. Five years after the initial assessment, authors re-analyzed the websites in order to investigate changes in content over time. The content of only six websites had been updated since the original analysis, the majority of which improved on the three aforementioned areas of evaluation. Websites could be strengthened by providing important information that would support parent decision-making. © The Author(s) 2014.

  8. Contextual influences on environmental concerns cross-nationally: A multilevel investigation.

    PubMed

    Marquart-Pyatt, Sandra T

    2012-09-01

    Environmental issues continue to grow in international prominence, as environmental conditions are recognized as some of the most important problems facing the world. Research examining this globalization of environmental concern shown in public opinion surveys emphasizes the importance of context yet is currently underspecified. To address this gap, this research uses a multi-level, cross-national study to examine individual-level and country-level influences on three measures of environmental concern: environmental threat awareness, environmental efficacy, and willingness to pay. At the individual level, education, age, and gender affect environmental concerns. At the national level, economic, political, and environmental factors affect environmental concerns. Importantly, contextual factors differ in their effects depending on the dimension of environmental concern measured. Results from cross-level interactions for education confirm these complexities across these measures, supporting a dimensionality argument. The importance of the measurement of environmental concern shown in this research is emphasized for future cross-national scholarship. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Identifying geoscience knowledge likely to affect foreign policy

    NASA Astrophysics Data System (ADS)

    Kelmelis, J. A.

    2006-12-01

    The earth sciences play an important role in foreign policy and have done so throughout history. Whether it is access to resources, knowledge of weather or other earth system conditions, planning for or responding to disasters, protecting the environment, facilitating transportation and communication, or any of a number of other important topics, the geosciences continue to inform our decision making. The importance of science, technology, and health (STH) is being increasingly recognized in the foreign policy community. The National Research Council (NRC) recommended that the Department of State (State) expand its scientific base to address the importance of STH issues. In part, this consists of increasing the number of scientists within State. Another important aspect is not only identifying the STH issues that are of current concern, but also the issues that will be of importance in the future. A number of studies funded by the U.S. Government have identified some important STH areas of concern at a high level. These provide a basis for more in-depth investigations. However, there are additional phenomena, beyond those identified in the studies, which have foreign policy implications. The scientific findings may be well known to scientists but their foreign policy importance is not always obvious. The scientific and foreign policy communities could improve their dialog to better develop strategies for foreign policy and future scientific research. One way to help facilitate that is to ease identification of scientific issues with potential significance to foreign policy and to clarify uncertainties around those issues. A qualitative method relating the likelihood that the scientific finding has foreign policy importance to the potential level of foreign policy importance has been used to clarify the significance of a variety of scientific findings including Arctic warming, methane hydrates, atmospheric dust, disease, and natural hazards. From a foreign policy

  10. Addressing Sexuality and Pregnancy in Childbirth Education Classes

    PubMed Central

    Allen, Laura; Fountain, Lily

    2007-01-01

    A positive, nonjudgmental, and informed approach to sexual health during pregnancy promotes acceptance of the normal functioning of women's bodies. It also encourages the development of close and supportive relationships that are so essential during pregnancy and birth. Common concerns do not need to become problems. Concerns include issues of libido, positioning, and preterm labor or fetal health, as well as myths and cultural attitudes. Childbirth educators can use tools such as the PLISSIT model to approach the topic of sexuality during pregnancy. In addition, opportunities are available in every childbirth class to acknowledge or ignore sexual issues. Perinatal educators who take responsibility for addressing this often-taboo topic can enhance women's feelings of safety and their confidence in normal birth. PMID:18408809

  11. Bioethicists Can and Should Contribute to Addressing Racism

    PubMed Central

    Danis, Marion; Wilson, Yolonda; White, Amina

    2016-01-01

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

  12. Bioethicists Can and Should Contribute to Addressing Racism.

    PubMed

    Danis, Marion; Wilson, Yolonda; White, Amina

    2016-01-01

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

  13. Low levels of empathic concern predict utilitarian moral judgment.

    PubMed

    Gleichgerrcht, Ezequiel; Young, Liane

    2013-01-01

    Is it permissible to harm one to save many? Classic moral dilemmas are often defined by the conflict between a putatively rational response to maximize aggregate welfare (i.e., the utilitarian judgment) and an emotional aversion to harm (i.e., the non-utilitarian judgment). Here, we address two questions. First, what specific aspect of emotional responding is relevant for these judgments? Second, is this aspect of emotional responding selectively reduced in utilitarians or enhanced in non-utilitarians? The results reveal a key relationship between moral judgment and empathic concern in particular (i.e., feelings of warmth and compassion in response to someone in distress). Utilitarian participants showed significantly reduced empathic concern on an independent empathy measure. These findings therefore reveal diminished empathic concern in utilitarian moral judges.

  14. Beating the Odds: Preparing Graduates to Address Gambling-Related Problems

    ERIC Educational Resources Information Center

    Engel, Rafael J.; Bechtold, Jody; Kim, Yoonmi; Mulvaney, Elizabeth

    2012-01-01

    As gambling opportunities proliferate, social workers are likely to see clients with gambling-related problems, but they often lack the expertise to address these concerns. This descriptive study assessed the inclusion of content on gambling-related problems in graduate social work curricula. Responses to an online survey from 86 (43.7%) of the…

  15. Addressing Gender Imbalance in Nigeria's Higher Education through Institutional Framework

    ERIC Educational Resources Information Center

    Okeke, Emeka Paul

    2013-01-01

    This paper examined the gender imbalance among students in Nigeria's higher education and the possible ways to addressing them. The poor access of female gender to higher education in Nigeria has become a thing of great concern to all stakeholders such as School authorities, Government, International agencies and employers of labor. The paper…

  16. Directory of National Organizations Concerned With Land Pollution Control.

    ERIC Educational Resources Information Center

    Freed Publishing Co., New York, NY.

    Included in this directory are 133 national organizations, agencies, institutes and/or private groups concerned with the reduction or prevention of land pollution. Arranged in alphabetical order, each annotation gives the complete name of the organization, its address, telephone number, person to contact, and a short description of the scope of…

  17. Views of Classroom Teachers Concerning Students with Reading Difficulties

    ERIC Educational Resources Information Center

    Kayabasi, Zehra Esra Ketenoglu

    2017-01-01

    This study aimed to try to understand the views and attitudes of classroom teachers concerning students with reading difficulties. Data was collected using the semi-structured interview technique, which is among the qualitative data collection techniques. The researcher prepared a semi-structured interview with 5 questions to be addressed to…

  18. Folic Acid Food Fortification—Its History, Effect, Concerns, and Future Directions

    PubMed Central

    Crider, Krista S.; Bailey, Lynn B.; Berry, Robert J.

    2011-01-01

    Periconceptional intake of folic acid is known to reduce a woman’s risk of having an infant affected by a neural tube birth defect (NTD). National programs to mandate fortification of food with folic acid have reduced the prevalence of NTDs worldwide. Uncertainty surrounding possible unintended consequences has led to concerns about higher folic acid intake and food fortification programs. This uncertainty emphasizes the need to continually monitor fortification programs for accurate measures of their effect and the ability to address concerns as they arise. This review highlights the history, effect, concerns, and future directions of folic acid food fortification programs. PMID:22254102

  19. General practitioners' knowledge and concern about electromagnetic fields.

    PubMed

    Berg-Beckhoff, Gabriele; Breckenkamp, Jürgen; Larsen, Pia Veldt; Kowall, Bernd

    2014-12-01

    Our aim is to explore general practitioners' (GPs') knowledge about EMF, and to assess whether different knowledge structures are related to the GPs' concern about EMF. Random samples were drawn from lists of GPs in Germany in 2008. Knowledge about EMF was assessed by seven items. A latent class analysis was conducted to identify latent structures in GPs' knowledge. Further, the GPs' concern about EMF health risk was measured using a score comprising six items. The association between GPs' concern about EMF and their knowledge was analysed using multiple linear regression. In total 435 (response rate 23.3%) GPs participated in the study. Four groups were identified by the latent class analysis: 43.1% of the GPs gave mainly correct answers; 23.7% of the GPs answered low frequency EMF questions correctly; 19.2% answered only the questions relating EMF with health risks, and 14.0% answered mostly "don't know". There was no association between GPs' latent knowledge classes or between the number of correct answers given by the GPs and their EMF concern, whereas the number of incorrect answers was associated with EMF concern. Greater EMF concern in subjects with more incorrect answers suggests paying particular attention to misconceptions regarding EMF in risk communication.

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

    ERIC Educational Resources Information Center

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

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

  1. When Others' Performance Just Isn't Good Enough: Educational Leaders' Framing of Concerns in Private and Public

    ERIC Educational Resources Information Center

    Sinnema, Claire E. L.; Le Fevre, Deidre; Robinson, Viviane M. J.; Pope, Denyse

    2013-01-01

    Effective instructional leadership demands that leaders address the inevitable problems and concerns that exist in any educational organization. Unfortunately, much evidence suggests that many important concerns, including teacher performance issues, continue to be unaddressed and unresolved. This article portrays the nature of concerns facing 77…

  2. 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

  3. Low Levels of Empathic Concern Predict Utilitarian Moral Judgment

    PubMed Central

    Gleichgerrcht, Ezequiel; Young, Liane

    2013-01-01

    Is it permissible to harm one to save many? Classic moral dilemmas are often defined by the conflict between a putatively rational response to maximize aggregate welfare (i.e., the utilitarian judgment) and an emotional aversion to harm (i.e., the non-utilitarian judgment). Here, we address two questions. First, what specific aspect of emotional responding is relevant for these judgments? Second, is this aspect of emotional responding selectively reduced in utilitarians or enhanced in non-utilitarians? The results reveal a key relationship between moral judgment and empathic concern in particular (i.e., feelings of warmth and compassion in response to someone in distress). Utilitarian participants showed significantly reduced empathic concern on an independent empathy measure. These findings therefore reveal diminished empathic concern in utilitarian moral judges. PMID:23593213

  4. Identifying problem and compulsive gamblers.

    PubMed Central

    van Es, R.

    2000-01-01

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

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

    DOE PAGES

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

    2012-02-01

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

  6. Extended Care Programs in Catholic Schools: Some Legal Concerns.

    ERIC Educational Resources Information Center

    Shaughnessy, Mary Angela

    This publication addresses issues concerning the application of the law to extended-day Catholic schools. The first chapter provides an overview of extended care. In the second chapter, sources of the law that are applied to extended care programs are described. Canon law affects Catholic schools. Catholic schools are also subject to four types of…

  7. Methods to identify and address the ethical issues associated with managed care.

    PubMed

    Lundy, Courtnee

    2006-01-01

    There are many benefits of managed care, such as its focus on disease prevention and health promotion, its integration of healthcare services to minimize inefficiencies, and its ability to restrict healthcare costs; however, there are also some ethical concerns that arise from managing care. In the context of managed care, ethics is a method for examining conflicts of values and obligations where there are competing interests, each of which presents a reasonably justified position. The principles of procedural, commutative, and general justice are particularly applicable to the ethical issues associated with managed care. Through a review of relevant literature, this paper will examine different methods and principles of justice to consider in establishing an ethical managed care organization and it will offer some examples of plans that have established policies to meet their ethical goals. By setting common goals, plans and enrollees can minimize ethical conflicts and collaborate to ensure that plans consistently use just procedures to ensure that quality care is available.

  8. Empathic concern drives costly altruism

    PubMed Central

    FeldmanHall, Oriel; Dalgleish, Tim; Evans, Davy; Mobbs, Dean

    2015-01-01

    Why do we self-sacrifice to help others in distress? Two competing theories have emerged, one suggesting that prosocial behavior is primarily motivated by feelings of empathic other-oriented concern, the other that we help mainly because we are egoistically focused on reducing our own discomfort. Here we explore the relationship between costly altruism and these two sub-processes of empathy, specifically drawing on the caregiving model to test the theory that trait empathic concern (e.g. general tendency to have sympathy for another) and trait personal distress (e.g. predisposition to experiencing aversive arousal states) may differentially drive altruistic behavior. We find that trait empathic concern – and not trait personal distress – motivates costly altruism, and this relationship is supported by activity in the ventral tegmental area, caudate and subgenual anterior cingulate, key regions for promoting social attachment and caregiving. Together, this data helps identify the behavioral and neural mechanisms motivating costly altruism, while demonstrating that individual differences in empathic concern-related brain responses can predict real prosocial choice. PMID:25462694

  9. E-books: nurse faculty use and concerns.

    PubMed

    Abell, Cathy H; Garrett-Wright, Dawn

    2014-01-01

    The purpose of this study was to identify nurse educators' stage of concern regarding e-books and examine relationships between stage of concern and demographic variables. The use of e-books is growing, and nursing faculty must be prepared to use this evolving technology. A descriptive design was used with a convenience sample of 50 nurse educators attending a professional conference. Data were collected using a demographic questionnaire and the Stages of Concern (SoC) questionnaire. Sixty-four percent of participants' first high stage was Stage 0 (awareness); 22 percent had a first high stage of Stage 1 (informational). Using ordinal regression, no statistical significance was noted with the highest Stage of Concern and age (p = .431) or experience as a nurse educator (p = .893). Findings indicate low usage, faculty concerns, and the need for ongoing education regarding e-books.

  10. Staff Concerns in Schools Planning for and Implementing School-Wide Positive Behavior Interventions and Supports

    ERIC Educational Resources Information Center

    Tyre, Ashli D.; Feuerborn, Laura L.; Woods, Leslie

    2018-01-01

    Understanding staff concerns about a systemic change effort allows leadership teams to better anticipate and address staff needs for professional development and support. In this study, staff concerns in nine schools planning for or implementing School-Wide Positive Behavior Interventions and Supports (SWPBIS) were explored using the…

  11. The Partnership for Cancer Prevention: Addressing Access to Cervical Cancer Screening among Latinas in South Carolina

    PubMed Central

    Parra-Medina, Deborah; Hilfinger Messias, DeAnne K.; Fore, Elizabeth; Mayo, Rachel; Petry, Denyse; Das, Irene Prabhu

    2015-01-01

    Background Cancer is a leading cause of morbidity and morality among Hispanics, the fastest growing population group in South Carolina (SC). The Partnership for Cancer Prevention (PCP) was established to build partnerships and community capacity to address cervical cancer early detection and control among the growing Latina population in SC. In this paper we report on the initial PCP community-based participatory research (CBPR) project. Methods PCP members engaged in a multi-method, participatory research project to assess cervical cancer related resources and needs among Latinas and healthcare providers. To explore attitudes and behaviors related to women's health in general and more specifically, female cancer, PCP members conducted 8 focus group sessions with 38 Spanish-speaking women. To assess the availability and perceived importance of culturally and linguistically appropriate services, PCP members conducted a survey of providers (n=46) and support personnel (n=30) at 14 clinical sites that provide cancer screening services. Results Health care access issues were Latinas' main concerns. For information and assistance in accessing and navigating the health care system, they relied on informal social networks and community outreach workers. Latina participants voiced misunderstandings about cancer risk and most appeared to lack a prevention orientation. Practitioners’ concerns included the assessment and documentation of patients' language preference and ability, provision of language assistance for limited-English-proficient (LEP) patients, and bilingual staff. Conclusions Building on the findings of this participatory research initiative, PCP members identified the following action strategies to promote cervical cancer screening among Latinas in SC: culturally appropriate cervical cancer awareness messages and outreach strategies geared towards increasing participation in cervical cancer screening and follow-up; maintenance of active community

  12. Addressing Research and Development Gaps for Plasma-Material Interactions with Linear Plasma Devices

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

    Rapp, Juergen

    Plasma-material interactions in future fusion reactors have been identified as a knowledge gap to be dealt with before any next step device past ITER can be built. The challenges are manifold. They are related to power dissipation so that the heat fluxes to the plasma-facing components can be kept at technologically feasible levels; maximization of the lifetime of divertor plasma-facing components that allow for steadystate operation in a reactor to reach the neutron fluence required; the tritium inventory (storage) in the plasma-facing components, which can lead to potential safety concerns and reduction in the fuel efficiency; and it is relatedmore » to the technology of the plasma-facing components itself, which should demonstrate structural integrity under the high temperatures and high neutron fluence. While the dissipation of power exhaust can and should be addressed in high power toroidal devices, the interaction of the plasma with the materials can be best addressed in dedicated linear devices due to their cost effectiveness and ability to address urgent research and development gaps more timely. However, new linear plasma devices are needed to investigate the PMI under fusion reactor conditions and test novel plasma-facing components. Existing linear devices are limited either in their flux, their reactor-relevant plasma transport regimes in front of the target, their fluence, or their ability to test material samples a priori exposed to high neutron fluence. The proposed Material Plasma Exposure eXperiment (MPEX) is meant to address those deficiencies and will be designed to fulfill the fusion reactor-relevant plasma parameters as well as the ability to expose a priori neutron activated materials to plasmas.« less

  13. Contaminants of Emerging Concern - Methods Documents

    EPA Pesticide Factsheets

    Analytical methods developed by EPA to identify and measure certain contaminants of emerging concern. These methods are not approved under 40 CFR Part 136, but may be of interest to regulated entities, permitting authorities, and the public.

  14. Environmental concerns of supply chain sustainability (SCS)

    NASA Astrophysics Data System (ADS)

    Mokhtar, Mohd Faiz; Omar, Badrul; Nor, Nik Hisyamudin Muhd; Pauzi, Nur Fazlinda Mohd; Hasan, Sulaiman; Mohamed, W. A. Wan

    2017-04-01

    Environment concern is one important aspect for supply chain sustainability (SCS). Nowadays, company's activities give a lot of impact on the environment. Through these activities, there are other SCS issue of environment were identified. In this paper, the proposed SCS issue of environmental concern will be determined from Corporate Sustainability Report (CSR). Using a total weightage of 0.333 (after dividing into three aspects of sustainability), each proposed issues will be classified according to the company activities in order to determined weightage for each issue. Those weightages then will be used in developing of score metric for SCS in design phase. Result shows that the carbon footprint is the major concern for SCS of environment while environmental management system is a lowest concern for SCS environment.

  15. Family characteristics and parents' and children's health behaviour are associated with public health nurses' concerns at children's health examinations.

    PubMed

    Poutiainen, Hannele; Hakulinen, Tuovi; Mäki, Päivi; Laatikainen, Tiina

    2016-12-01

    The study aimed to establish whether family characteristics and the health behaviour and illnesses of parents and children are associated with public health nurses' (PHNs') concerns about children's physical health and psychosocial development in the context of health examinations. Factors affecting children's health and well-being should be identified as early as possible to provide children and families appropriate support. In 2007-2009, a cross-sectional study in Finland collected information about PHNs' concerns, children's health and well-being as well as the background factors affecting them during health examinations of preschool-age children and school-aged children (n = 4795). Associations between family characteristics, parents' and children's behaviour and diseases, and PHNs' concerns were assessed using logistic regression analysis. Overweight in children, the long-term illnesses of both children and parents, and parental smoking were the factors most strongly associated with PHNs' concerns about a child's physical health whereas non-nuclear family types, the father's low educational level and unemployment, the child's lack of sleep, and bullying were associated with concerns about the child's psychosocial development. The connections found demonstrate that health examinations should address factors that affect the whole family's well-being so as to comprehensively promote children's health, growth and development. © 2016 John Wiley & Sons Australia, Ltd.

  16. Cancer patients' expressions of emotional cues and concerns and oncology nurses' responses, in an online patient-nurse communication service.

    PubMed

    Grimsbø, Gro Hjelmeland; Ruland, Cornelia M; Finset, Arnstein

    2012-07-01

    To (1) investigate emotional cues and concerns (C&C) of cancer patients expressed in e-mail communication with oncology nurses in an online patient-nurse communication service (OPNC), and (2) explore how nurses responded to patients' C&C. 283 e-messages sent from 38 breast and 22 prostate cancer patients and 286 e-responses from five oncology nurses were coded with the Verona Coding Definitions of Emotional Sequences. We identified 102 cues and 33 concerns expressed in patients' messages. Cues indicating expression of uncertainty or hope, occurred most frequently (in 38.5% of messages), followed by concerns (in 24.4% of messages). Nurses responded to 85.2% of patients' C&Cs; more than half of patients' C&Cs were met with a mixture of information giving and empathic responses. Patients with breast and prostate cancer express many C&C in e-mail communications with oncology nurses, who demonstrated satisfactory sensitivity to patients' emotions in their responses to patients. Offering e-communication with oncology nurses to cancer patients is a promising and feasible supplement to usual care to address and relieve patients' concerns and emotional distress during illness and recovery. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  17. Unfinished business: efforts to define dual-use research of bioterrorism concern.

    PubMed

    Zmorzynska, Anna; Suk, Jonathan E; Biederbick, Walter; Maidhof, Heinrich; Sasse, Julia; Semenza, Jan C; Hunger, Iris

    2011-12-01

    Biotechnological research poses a special security problem because of the duality between beneficial use and misuse. In order to find a balance between regulating potentially dangerous research and assuring scientific advancement, a number of assessments have tried to define which types of research are especially open to misuse and should therefore be considered dual-use research of special concern requiring rigorous oversight. So far, there has been no common understanding of what such activities are. Here we present a review of 27 assessments focusing on biological dual-use issues published between 1997 and 2008. Dual-use research activities identified by these assessments as being of special concern were compiled and compared. Moreover, from these 27 assessments, the primary research publications explicitly identified as examples of concerning research activities were extracted and analyzed. We extracted a core list of 11 activities of special concern and show that this list does not match with the reasons why primary research publications were identified as being of special concern. Additionally, we note that the 11 activities identified are not easily conducted or replicated, and therefore the likelihood of their being used in a high-tech mass casualty bioterrorism event should be reevaluated. © Mary Ann Liebert, Inc.

  18. Directory of National Organizations Concerned with Land Pollution Control, 1971.

    ERIC Educational Resources Information Center

    Freed Publishing Co., New York, NY.

    Included in this directory are 204 national organizations, agencies, institutes, and/or private groups concerned with the reduction or prevention of land pollution. Arranged in alphabetical order, each annotation gives the complete name of the organization, its address, telephone number, person to contact, and a short description of the scope of…

  19. Addressing women concerns. Philippines. The Hague Forum.

    PubMed

    Medalla, F M

    1999-01-01

    Since the 1994 International Conference on Population and Development (ICPD), the Philippine government has worked closely with nongovernmental and peoples' organizations to push reforms which promote development which is broad-based, sustainable, and focused upon human resources. These initiatives recognized the important role of population and human development, and try to achieve rapid economic growth while protecting the environment. The government worked closely with civil society to draft a medium-term development plan for 1993-98 to improve the quality of life for all Filipinos. Reproductive health will be an important component of the Medium-Term Philippine Development Plan for 1999-2004. However, the necessary resources must be mobilized to carry out all elements of the program of action. Since the ICPD, total funding for reproductive health and family planning reached Philippine P 1 billion, of which 58% was provided by the foreign donor community. So far, the Philippine government has been blocked by the Catholic Church from allocating more public funds for contraception. Local government units need to take a more direct and active role in implementing rural health programs in general and reproductive health programs in particular.

  20. Geoengineering: A humanitarian concern

    NASA Astrophysics Data System (ADS)

    Suarez, Pablo; van Aalst, Maarten K.

    2017-02-01

    The humanitarian sector is active at the global frontline of climate impacts, and has a track record in influencing the climate change policy agenda. Geoengineering is a humanitarian concern: the potential for deliberate large-scale intervention in the Earth's climate system has major implications in terms of impacts on the most vulnerable. Yet, so far the humanitarian community has largely been absent from geoengineering deliberations. Geoengineering may be perceived as too theoretical, too complex, and not imminent enough to merit attention. However, early engagement by the sector is imperative to ensure that humanitarian considerations are integrated into policy decisions. Those who can suffer the worst outcomes need to be involved; especially given the plausibility of "predatory geoengineering" where recklessly self-concerned actions may result in harmful consequences to others. This paper explores the humanitarian dimensions of geoengineering, specifically relating to solar radiation management (SRM). Drawing from the engagement of the Red Cross Red Crescent Climate Centre in SRM discussions, we discuss how to improve linkages between science, policy and humanitarian practice. We further propose the creation of a geoengineering risk management framework to ensure that the interests of the most vulnerable are considered and addressed - including the voices of all stakeholders.

  1. Addressing uncertainty in vulnerability assessments [Chapter 5

    Treesearch

    Linda Joyce; Molly Cross; Evan Girvatz

    2011-01-01

    This chapter addresses issues and approaches for dealing with uncertainty specifically within the context of conducting climate change vulnerability assessments (i.e., uncertainties related to identifying and modeling the sensitivities, levels of exposure, and adaptive capacity of the assessment targets).

  2. Predictors of parental perceptions and concerns about child weight

    PubMed Central

    Keller, Kathleen L.; Olsen, Annemarie; Kuilema, Laura; Meyermann, Karol; van Belle, Christopher

    2012-01-01

    Appropriate levels of parental perception and concern about child weight are important components of successful obesity treatment, but the factors that contribute to these attitudes need clarification. The aim of this study was to identify child and parent characteristics that best predict parental perceptions and concerns about child weight. A cross-sectional design was used to assess characteristics of parents (e.g. age, income, and feeding attitudes) and children (e.g. body composition, ad libitum intake, and reported physical activity). Results are reported for 75, 4–6 year-olds from diverse ethnicities. Perceived child weight and concern were measured with the Child Feeding Questionnaire (CFQ). Multiple linear regression was used to identify the best models for perceived child weight and concern. For perceived child weight, the best model included parent age, children’s laboratory intake of sugar-sweetened beverages (SSB) and palatable buffet items, and two measures of child body composition (ratio of trunk fat-to-total fat and ratio of leg fat-to-total fat). For concern, child android/gynoid fat ratio explained the largest amount of variance, followed by restrictive feeding and SSB intake. Parental perceptions and concerns about child weight are best explained by models that account for children’s eating behavior and body fat distribution. PMID:23207190

  3. Concerns of parents and teachers of children with autism in elementary school

    PubMed Central

    Azad, Gazi; Mandell, David S

    2015-01-01

    Many consensus guidelines encourage parents and teachers to openly communicate about their concerns regarding their children. These guidelines attest to the importance of achieving consensus about what issues are most critical and how to address them. The purpose of this study was to examine whether parents and teachers (1) agree about their concerns for their children with autism and (2) when given the opportunity, whether they discussed these concerns. Participants were 39 parent–teacher dyads of children with autism in kindergarten-through-fifth grade autism support classrooms. Each parent and teacher was interviewed separately about their concerns and then observed together in a discussion about the child. Parents and teachers generally agreed about their primary and secondary concerns. When given an opportunity to communicate their concerns, 49% of the parent–teacher dyads discussed problems that neither reported as their primary concern, and 31% discussed problems that neither reported as their primary or secondary concern. These findings suggest that interventions should target parent–teacher communication, rather than agreement, to facilitate home–school collaboration. PMID:26069200

  4. Concerns of parents and teachers of children with autism in elementary school.

    PubMed

    Azad, Gazi; Mandell, David S

    2016-05-01

    Many consensus guidelines encourage parents and teachers to openly communicate about their concerns regarding their children. These guidelines attest to the importance of achieving consensus about what issues are most critical and how to address them. The purpose of this study was to examine whether parents and teachers (1) agree about their concerns for their children with autism and (2) when given the opportunity, whether they discussed these concerns. Participants were 39 parent-teacher dyads of children with autism in kindergarten-through-fifth grade autism support classrooms. Each parent and teacher was interviewed separately about their concerns and then observed together in a discussion about the child. Parents and teachers generally agreed about their primary and secondary concerns. When given an opportunity to communicate their concerns, 49% of the parent-teacher dyads discussed problems that neither reported as their primary concern, and 31% discussed problems that neither reported as their primary or secondary concern. These findings suggest that interventions should target parent-teacher communication, rather than agreement, to facilitate home-school collaboration. © The Author(s) 2015.

  5. ED accreditation update. Physicians, medical staff may report safety concerns without fear of disciplinary action.

    PubMed

    2007-11-01

    Educating your staff about The Joint Commission's requirements for concerns about hospital safety and quality of care requires the ED manager to set a tone of openness and cooperation, while at the same time emphasizing your department's role in addressing such concerns: * The ED should be the first place that staff members communicate quality and safety concerns. It is only when a problem is not addressed that they should take the issue to hospital administration and, if necessary, The Joint Commission. * A single event should not trigger a report to The Joint Commission, unless it is unusually serious. Otherwise, only a series of events should trigger a report. * Reassure your staff that you care about what is reported and will act quickly on it. Educate your staff about the reporting forms, and follow up with random audits to ensure compliance.

  6. Concerns of patients actively contemplating total knee replacement: differences by race and gender.

    PubMed

    Chang, Huan J; Mehta, Priya S; Rosenberg, Aaron; Scrimshaw, Susan C

    2004-02-15

    To examine differences by race/ethnicity and gender in patients' concerns regarding total knee replacement (TKR). Focus groups of patients actively considering TKR were conducted. Discussion included patients' questions and concerns regarding TKR. The software ATLAS.ti was used to tabulate themes by race/ethnicity and gender. Concerns raised by focus group participants were compared with thematic content from patient joint replacement information materials. This comparison used patient literature from 3 high-volume academic TKR centers, the Arthritis Foundation, and the American Academy of Orthopedic Surgeons. All groups shared similar concerns. However, some issues were more prevalent among certain gender and racial groups. For instance, concerns regarding anesthesia were more important to white Americans and concerns regarding recovery were more important to women. Some of these concerns were not addressed in the available patient literature. Different gender and racial subgroups focus on different concerns when considering TKR. These differences may contribute to gender and race/ethnicity disparity seen in TKR use.

  7. Psychosocial Correlates of Shape and Weight Concerns in Overweight Pre-Adolescents

    PubMed Central

    Sinton, Meghan M.; Goldschmidt, Andrea B.; Aspen, Vandana; Theim, Kelly R.; Stein, Richard I.; Saelens, Brian E.; Epstein, Leonard H.; Wilfley, Denise E.

    2013-01-01

    Shape and weight concerns among overweight pre-adolescents heighten risk for eating disorders and weight gain. Treatment and prevention efforts require consideration of psychosocial factors that co-occur with these concerns. This study involved 200 overweight pre-adolescents, aged 7–12 years (M age = 9.8; SD = 1.4), presenting for family-based weight control treatment. Hierarchical regression was used to examine the influence of pre-adolescents’ individual characteristics and social experiences, and their parents’ psychological symptoms, on shape and weight concerns as assessed by the Child Eating Disorder Examination. Findings revealed that higher levels of dietary restraint, greater feelings of loneliness, elevated experiences with weight-related teasing, and higher levels of parents’ eating disorder symptoms predicted higher shape and weight concerns among overweight pre-adolescents. Interventions addressing overweight pre-adolescents’ disordered eating behaviors and social functioning, as well as their parents’ disordered eating behaviors and attitudes, may be indicated for those endorsing shape and weight concerns. PMID:21695562

  8. Dimensions of the epilepsy foundation concerns index.

    PubMed

    Loring, David W; Larrabee, Glenn J; Meador, Kimford J; Lee, Gregory P

    2005-05-01

    We performed principal component analysis (PCA) of the Epilepsy Foundation Concerns Index scale in 189 patients undergoing evaluation for epilepsy surgery. We identified a five-factor solution in which there were no varimax-rotated factors consisting of fewer than two questions. Factor 1 reflects affective impact on enjoyment of life, Factor 2 reflects general autonomy concerns, Factor 3 reflects fear of seizure recurrence, Factor 4 reflects concern of being a burden to one's family, and Factor 5 reflects a perceived lack of understanding by others. Multiple regression using the Quality of Life in Epilepsy--89 question version; Minnesota Multiphasic Personality Inventory--2; Wechsler Adult Intelligence Scale--third edition; and verbal and visual memory tests as predictors demonstrated a different pattern of association with the factor and summary scores. We conclude that the Epilepsy Foundation Concerns Index is multidimensional, and using a global score based on all items may mask specific concerns that may be relevant when applied to individual patients.

  9. Addressing health workforce distribution concerns: a discrete choice experiment to develop rural retention strategies in Cameroon

    PubMed Central

    Robyn, Paul Jacob; Shroff, Zubin; Zang, Omer Ramses; Kingue, Samuel; Djienouassi, Sebastien; Kouontchou, Christian; Sorgho, Gaston

    2015-01-01

    Background: Nearly every nation in the world faces shortages of health workers in remote areas. Cameroon is no exception to this. The Ministry of Public Health (MoPH) is currently considering several rural retention strategies to motivate qualified health personnel to practice in remote rural areas. Methods: To better calibrate these mechanisms and to develop evidence-based retention strategies that are attractive and motivating to health workers, a Discrete Choice Experiment (DCE) was conducted to examine what job attributes are most attractive and important to health workers when considering postings in remote areas. The study was carried out between July and August 2012 among 351 medical students, nursing students and health workers in Cameroon. Mixed logit models were used to analyze the data. Results: Among medical and nursing students a rural retention bonus of 75% of base salary (aOR= 8.27, 95% CI: 5.28-12.96, P< 0.001) and improved health facility infrastructure (aOR= 3.54, 95% CI: 2.73-4.58) respectively were the attributes with the largest effect sizes. Among medical doctors and nurse aides, a rural retention bonus of 75% of base salary was the attribute with the largest effect size (medical doctors aOR= 5.60, 95% CI: 4.12-7.61, P< 0.001; nurse aides aOR= 4.29, 95% CI: 3.11-5.93, P< 0.001). On the other hand, improved health facility infrastructure (aOR= 3.56, 95% CI: 2.75-4.60, P< 0.001), was the attribute with the largest effect size among the state registered nurses surveyed. Willingness-to-Pay (WTP) estimates were generated for each health worker cadre for all the attributes. Preference impact measurements were also estimated to identify combination of incentives that health workers would find most attractive. Conclusion: Based on these findings, the study recommends the introduction of a system of substantial monetary bonuses for rural service along with ensuring adequate and functional equipment and uninterrupted supplies. By focusing on the

  10. Safety in the veterinary medical workplace environment. Common issues and concerns.

    PubMed

    Brody, M D

    1993-09-01

    This article addresses some of the major areas of concern related to safety in the veterinary workplace. Some practical guidance is offered for setting up programs in areas such as medical waste, hazard communication, general occupational safety and health requirements, shipments of etiologic agents, and pesticides.

  11. Environmental Concerns, Environmental Policy and Green Investment.

    PubMed

    Gao, Xuexian; Zheng, Haidong

    2017-12-13

    Environmental regulators often use environmental policy to induce green investment by firms. However, if an environmental policy fails to exert a long-run effect on regulating the economic agents' behavior, it may be more reasonable to think of the firm as the leader in the game, since the investment in green technology is usually a strategic decision. In this paper, we consider a three-stage Stackelberg game to address the interaction between a profit-maximizing firm (Stackelberg leader) facing emission-dependent demand, and the environmental regulator (Stackelberg follower). The firm decides on the green technology level in the first stage of the game based on its understanding of the regulator's profits function, especially an environmental concern that is introduced as an exogenous variable. In the current research, we show that high levels of the regulator's environmental concerns do not necessarily lead to the choice of green technology by the firm, and green investment level depends on the combined effects of the market and operational factors for a given level of the regulator's environmental concerns. The result also shows that increasing environmental awareness amongst the consumers is an effective way to drive the firm's green investment.

  12. Falling short: how state laws can address health information exchange barriers and enablers.

    PubMed

    Schmit, Cason D; Wetter, Sarah A; Kash, Bita A

    2018-06-01

    Research on the implementation of health information exchange (HIE) organizations has identified both positive and negative effects of laws relating to governance, incentives, mandates, sustainability, stakeholder participation, patient engagement, privacy, confidentiality, and security. We fill a substantial research gap by describing whether comprehensive state and territorial HIE legal frameworks address identified legal facilitators and barriers. We used the Westlaw database to identify state and territorial laws relating to HIEs in effect on June 7, 2016 (53 jurisdictions). We blind-coded all laws and addressed coding discrepancies in peer-review meetings. We recorded a consensus code for each law in a master database. We compared 20 HIE legal attributes with identified barriers to and enablers of HIE activity in the literature. Forty-two states, the District of Columbia, and 2 territories have laws relating to HIEs. On average, jurisdictions address 8.32 of the 20 criteria selected in statutes and regulations. Twenty jurisdictions unambiguously address ≤5 criteria in statutes and regulations. None of the significant legal criteria are unambiguously addressed in >60% of the 53 jurisdictions. Laws can be barriers to or enablers of HIEs. However, jurisdictions are not addressing many significant issues identified by researchers. Consequently, there is a substantial risk that existing legal frameworks are not adequately supporting HIEs. The current evidence base is insufficient for comparative assessments or impact rankings of the various factors. However, the detailed Centers for Disease Control and Prevention dataset of HIE laws could enable investigations into the types of laws that promote or impede HIEs.

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

    PubMed

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

    2014-02-03

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

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

    PubMed Central

    2014-01-01

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

  15. Summary of Tiger Team Assessment and Technical Safety Appraisal recurring concerns in the Maintenance Area

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

    Not Available

    1993-01-01

    Tiger Team Assessments and Technical Safety Appraisals (TSA) were reviewed and evaluated for concerns in the Maintenance Area (MA). Two hundred and thirty one (231) maintenance concerns were identified by the Tiger Team Assessments and TSA reports. These recurring concerns appear below. A summary of the Noteworthy Practices that were identified and a compilation of the maintenance concerns for each performance objective that were not considered as recurring are also included. Where the Tiger Team Assessment and TSA identified the operating contractor or facility by name, the concern has been modified to remove the name while retaining the intent ofmore » the comment.« less

  16. Beyond the Dialectics and Polemics: Canadian Catholic Schools Addressing LGBT Youth Issues

    ERIC Educational Resources Information Center

    Liboro, Renato M.; Travers, Robb; St. John, Alex

    2015-01-01

    In 2012, Canadian media coverage on Bill 13--an Ontario legislative proposal to require all publicly funded schools to support Gay-Straight Alliances as a means of addressing issues concerning bullied lesbian, gay, bisexual, and transgender (LGBT) students--instigated a divisive exchange among representatives of the Ontario Catholic school sector.…

  17. Concerns for Minority Groups in Communication Disorders. ASHA Reports No. 16.

    ERIC Educational Resources Information Center

    Bess, Fred H., Ed.; And Others

    This monograph addresses topical issues in training, service delivery, and research for minorities in communication disorders. It presents extended versions of papers that were delivered at the conference, "Concerns for Minority Groups in Communication Disorders," held in Nashville, Tennessee on September 17-19, 1984. Papers include: "The First…

  18. Self-reported skin concerns: An epidemiological study of community-dwelling older people.

    PubMed

    Cowdell, Fiona; Dyson, Judith; Long, Judith; Macleod, Una

    2018-03-25

    To identify the frequency and impact of self-reported skin concerns in community-dwelling older people. Globally, the population is getting older and it is essential to develop effective interventions to promote healthy ageing. Skin change with age is inevitable and renders this often neglected organ more vulnerable to damage and breakdown; this can be costly to individuals and society. Maintenance of skin health in older people presents a health challenge that has yet to be fully understood or addressed. Cross-sectional, self-reported questionnaire survey in England. Patients registered with participating general practices (n = 3), aged ≥70 years, living in their own homes and able to give informed consent (n = 3,359) were sent a letter of invitation to a free health and care assessment, and 1116 responded. When asked "do you have any concerns about your skin?", 16.5% (n = 183) said yes. Of this group, the most common concerns were dry skin 80.7% (n = 146), itching 56.9% (n = 103) and aged appearance 61% (n = 113). Itch, dry skin and inflammation were rated as most bothersome. There was a significant association between the dry skin and itch χ 2 (1) = 6.9, p < .05. Many community-dwelling older people suffer from skin concerns predominantly dry skin and itching that is often bothersome. Skin health assessment is often absent in routine consultations with community-dwelling older people. Dry, itchy skin is prevalent and can be simply managed with low-cost interventions. This has the potential to reduce suffering and maintain or improve skin barrier function. Nurses and other health professionals should therefore routinely assess and advise on skin health care for this population. © 2018 John Wiley & Sons Ltd.

  19. Beyond pills and tests: addressing the social determinants of tuberculosis.

    PubMed

    Wingfield, Tom; Tovar, Marco A; Huff, Doug; Boccia, Delia; Saunders, Matthew J; Datta, Sumona; Montoya, Rosario; Ramos, Eric; Lewis, James J; Gilman, Robert H; Evans, Carlton

    2016-12-01

    Poverty drives tuberculosis (TB) rates but the approach to TB control has been disproportionately biomedical. In 2015, the World Health Organization's End TB Strategy explicitly identified the need to address the social determinants of TB through socio-economic interventions. However, evidence concerning poverty reduction and cost mitigation strategies is limited. The research described in this article, based on the 2016 Royal College of Physicians Linacre Lecture, aimed to address this knowledge gap. The research was divided into two phases: the first phase was an analysis of a cohort study identifying TB-related costs of TB-affected households and creating a clinically relevant threshold above which those costs became catastrophic; the second was the design, implementation and evaluation of a household randomised controlled evaluation of socio-economic support to improve access to preventive therapy, increase TB cure, and mitigate the effects of catastrophic costs. The first phase showed TB remains a disease of people living in poverty - 'free' TB care was unaffordable for impoverished TB-affected households and incurring catastrophic costs was associated with as many adverse TB treatment outcomes (including death, failure of treatment, lost to follow-up and TB recurrence) as multidrug resistant (MDR) TB. The second phase showed that, in TB-affected households receiving socio-economic support, household contacts were more likely to start and adhere to TB preventive therapy, TB patients were more likely to be cured and households were less likely to incur catastrophic costs. In impoverished Peruvian shantytowns, poverty remains inextricably linked with TB and incurring catastrophic costs predicted adverse TB treatment outcome. A novel socio-economic support intervention increased TB preventive therapy uptake, improved TB treatment success and reduced catastrophic costs. The impact of the intervention on TB control is currently being evaluated by the Community

  20. 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.

  1. Faculty Attitudes toward Addressing Mental Health Conditions and Substance Abuse among College Students

    ERIC Educational Resources Information Center

    O'Connor-Merrigan, Mary L.

    2013-01-01

    The continued prevalence of mental health conditions and substance abuse among students enrolled in institutions of higher education is a significant and progressing concern, with marked impact on retention, academic success, graduation rate, and alarming personal consequences. Yet, many institutions struggle with successfully addressing these…

  2. Concerns of anophthalmic patients-a comparison between cryolite glass and polymethyl methacrylate prosthetic eye wearers.

    PubMed

    Rokohl, Alexander C; Koch, Konrad R; Adler, Werner; Trester, Marc; Trester, Wolfgang; Pine, Nicola S; Pine, Keith R; Heindl, Ludwig M

    2018-06-01

    To compare the concerns of experienced cryolite glass and (poly)methyl methacrylate (PMMA) prosthetic eye wearers. One hundred six experienced cryolite glass and 63 experienced PMMA prosthetic eye wearers completed an anonymous questionnaire regarding general and specific prosthetic eye concerns at least 2 years after natural eye loss. From these independent anophthalmic populations, we identified 34 case-control pairs matched for the known influencing demographic variables of gender, occupation, age, and time since natural eye loss. The levels of concern were significantly lower in the cryolite glass group than those in the PMMA group for the following: loss of balance (p < 0.001), phantom sight vision (p < 0.001), pain (p < 0.001), receiving good advice (p = 0.001), fullness of orbit (p = 0.001), size (p = 0.007), direction of gaze relative to the healthy fellow eye (p = 0.005), eye lid contour (p = 0.037), comfort of the prosthetic eye (p < 0.001), colour relative to the healthy fellow eye (p < 0.001), and retention of the prosthetic eye (p < 0.001). Concerns about watering, crusting, discharge, visual perception, appearance, movement of the prosthetic eye, and health of the remaining eye were not significantly different between both groups. The results of this study showed that many general and specific levels of concern were significantly lower for cryolite glass prosthetic eye wearers than for PMMA prosthetic eye wearers. The question of why there are significant differences and to what extent the material of the prosthesis (cryolite glass or PMMA) has an impact on various concerns remains unanswered and should be addressed in a prospective comparative multicentre trial.

  3. A menu with prices: Annual per person costs of programs addressing community integration.

    PubMed

    Leff, H Stephen; Cichocki, Ben; Chow, Clifton; Salzer, Mark; Wieman, Dow

    2016-02-01

    Information on costs of programs addressing community integration for persons with serious mental illness in the United States, essential for program planning and evaluation, is largely lacking. To address this knowledge gap, community integration programs identified through directories and snowball sampling were sent an online survey addressing program costs and organizational attributes. 64 Responses were received for which annual per person costs (APPC) could be computed. Programs were categorized by type of services provided. Program types differed in median APPCs, though median APPCs identified were consistent with the ranges identified in the limited literature available. Multiple regression was used to identify organizational variables underlying APPCs such as psychosocial rehabilitation program type, provision of EBPs, number of volunteers, and percentage of budget spent on direct care staff, though effects sizes were moderate at best. This study adds tentative prices to the menu of community integration programs, and the implications of these findings for choosing, designing and evaluating programs addressing community integration are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Quality of life and functional vision concerns of children with cataracts and their parents.

    PubMed

    Castañeda, Y S; Cheng-Patel, C S; Leske, D A; Wernimont, S M; Hatt, S R; Liebermann, L; Birch, E E; Holmes, J M

    2016-09-01

    PurposeTo identify specific health-related quality of life (HRQOL) and functional vision concerns affecting children with cataracts and common associated conditions as expressed by children or one of their parents (proxy), and HRQOL concerns affecting the parents themselves.MethodsIndividual semi-structured interviews were conducted with parents of children with cataracts (N=31) and with the children themselves (ages 5-17 years; N=16). Transcripts of recorded interviews were evaluated using NVivo software. Specific concerns were identified and coded, and broad themes were identified. The frequency of each theme was calculated, with the frequency of specific concerns within each theme.ResultsRegarding the child's experience, 6 themes were identified: Visual Function (mentioned by 16 of 16 children (100%) and by 26 of 31 parents (84%), Social (94 and 65%), Treatment (81 and 90%), Worry (75 and 10%), Emotions (63 and 68%), and Physical Discomfort (63 and 26%). Worry showed the largest discrepancy between child and their parent; although 75% children reported Worry, only 6% of parents reported that their child experienced Worry (P=0.0009). Regarding the parents' own experience, 5 themes were identified: Worry (100%), Compensation for Condition (100%), Treatment (94%), Emotions (90%), and Affects Family (52%).ConclusionsA wide range of concerns were identified from interviews of children with cataracts and their parents. Concerns reflect the impact of cataracts in physical, emotional, and social domains, and specific concerns will be used for the development of questionnaires to quantify the quality of life and functional vision effects of cataracts.

  5. Quality of life and functional vision concerns of children with cataracts and their parents

    PubMed Central

    Castañeda, Y S; Cheng-Patel, C S; Leske, D A; Wernimont, S M; Hatt, S R; Liebermann, L; Birch, E E; Holmes, J M

    2016-01-01

    Purpose To identify specific health-related quality of life (HRQOL) and functional vision concerns affecting children with cataracts and common associated conditions as expressed by children or one of their parents (proxy), and HRQOL concerns affecting the parents themselves. Methods Individual semi-structured interviews were conducted with parents of children with cataracts (N=31) and with the children themselves (ages 5–17 years; N=16). Transcripts of recorded interviews were evaluated using NVivo software. Specific concerns were identified and coded, and broad themes were identified. The frequency of each theme was calculated, with the frequency of specific concerns within each theme. Results Regarding the child's experience, 6 themes were identified: Visual Function (mentioned by 16 of 16 children (100%) and by 26 of 31 parents (84%), Social (94 and 65%), Treatment (81 and 90%), Worry (75 and 10%), Emotions (63 and 68%), and Physical Discomfort (63 and 26%). Worry showed the largest discrepancy between child and their parent; although 75% children reported Worry, only 6% of parents reported that their child experienced Worry (P=0.0009). Regarding the parents' own experience, 5 themes were identified: Worry (100%), Compensation for Condition (100%), Treatment (94%), Emotions (90%), and Affects Family (52%). Conclusions A wide range of concerns were identified from interviews of children with cataracts and their parents. Concerns reflect the impact of cataracts in physical, emotional, and social domains, and specific concerns will be used for the development of questionnaires to quantify the quality of life and functional vision effects of cataracts. PMID:27391939

  6. Trends in public health policies addressing violence against women.

    PubMed

    Loría, Kattia Rojas; Rosado, Teresa Gutiérrez; Espinosa, Leonor María Cantera; Marrochi, Leda María Marenco; Sánchez, Anna Fernández

    2014-08-01

    To analyze the content of policies and action plans within the public healthcare system that addresses the issue of violence against women. A descriptive and comparative study was conducted on the health policies and plans in Catalonia and Costa Rica from 2005 to 2011. It uses a qualitative methodology with documentary analysis. It is classified by topics that describe and interpret the contents. We considered dimensions, such as principles, strategies, concepts concerning violence against women, health trends, and evaluations. Thirteen public policy documents were analyzed. In both countries' contexts, we have provided an overview of violence against women as a problem whose roots are in gender inequality. The strategies of gender policies that address violence against women are cultural exchange and institutional action within the public healthcare system. The actions of the healthcare sector are expanded into specific plans. The priorities and specificity of actions in healthcare plans were the distinguishing features between the two countries. The common features of the healthcare plans in both the counties include violence against women, use of protocols, detection tasks, care and recovery for women, and professional self-care. Catalonia does not consider healthcare actions with aggressors. Costa Rica has a lower specificity in conceptualization and protocol patterns, as well as a lack of updates concerning health standards in Catalonia.

  7. Trends in public health policies addressing violence against women

    PubMed Central

    Loría, Kattia Rojas; Rosado, Teresa Gutiérrez; Espinosa, Leonor María Cantera; Marrochi, Leda María Marenco; Sánchez, Anna Fernández

    2014-01-01

    OBJECTIVE To analyze the content of policies and action plans within the public healthcare system that addresses the issue of violence against women. METHODS A descriptive and comparative study was conducted on the health policies and plans in Catalonia and Costa Rica from 2005 to 2011. It uses a qualitative methodology with documentary analysis. It is classified by topics that describe and interpret the contents. We considered dimensions, such as principles, strategies, concepts concerning violence against women, health trends, and evaluations. RESULTS Thirteen public policy documents were analyzed. In both countries’ contexts, we have provided an overview of violence against women as a problem whose roots are in gender inequality. The strategies of gender policies that address violence against women are cultural exchange and institutional action within the public healthcare system. The actions of the healthcare sector are expanded into specific plans. The priorities and specificity of actions in healthcare plans were the distinguishing features between the two countries. CONCLUSIONS The common features of the healthcare plans in both the counties include violence against women, use of protocols, detection tasks, care and recovery for women, and professional self-care. Catalonia does not consider healthcare actions with aggressors. Costa Rica has a lower specificity in conceptualization and protocol patterns, as well as a lack of updates concerning health standards in Catalonia. PMID:25210820

  8. Social and Economic Concern of Supply Chain Sustainability (SCS)

    NASA Astrophysics Data System (ADS)

    Faiz Mokhtar, Mohd; Omar, Badrul; Hisyamudin Muhd Nor, Nik; Fazlinda Mohd Pauzi, Nur; Hassan, Sulaiman; Mohamed, W. A. Wan

    2016-11-01

    Sustainability issues will provide impact on the environment, social and economy. The importance of these three aspects of sustainability must be look at in tandem. Some issues of these three pillars getting more attention by companies since they are more interested to identify issues that may affect performances related to their people or profit. Through CSRs report released by various international companies, this paper identified the value which companies place for social and economic sustainability. Result shows that human right and, occupational and safety have highest concern by companies while Product Utilities is less concern from other social issues. From an economic aspect, sales and net profit are the most influencing factors of sustainability while the raw material cost is shown as of the least concern. Based on the results, companies should consider the issues on social and economic aspects following these priorities.

  9. Using citizen science data to identify the sensitivity of species to human land use.

    PubMed

    Todd, Brian D; Rose, Jonathan P; Price, Steven J; Dorcas, Michael E

    2016-12-01

    Conservation practitioners must contend with an increasing array of threats that affect biodiversity. Citizen scientists can provide timely and expansive information for addressing these threats across large scales, but their data may contain sampling biases. We used randomization procedures to account for possible sampling biases in opportunistically reported citizen science data to identify species' sensitivities to human land use. We analyzed 21,044 records of 143 native reptile and amphibian species reported to the Carolina Herp Atlas from North Carolina and South Carolina between 1 January 1990 and 12 July 2014. Sensitive species significantly associated with natural landscapes were 3.4 times more likely to be legally protected or treated as of conservation concern by state resource agencies than less sensitive species significantly associated with human-dominated landscapes. Many of the species significantly associated with natural landscapes occurred primarily in habitats that had been nearly eradicated or otherwise altered in the Carolinas, including isolated wetlands, longleaf pine savannas, and Appalachian forests. Rare species with few reports were more likely to be associated with natural landscapes and 3.2 times more likely to be legally protected or treated as of conservation concern than species with at least 20 reported occurrences. Our results suggest that opportunistically reported citizen science data can be used to identify sensitive species and that species currently restricted primarily to natural landscapes are likely at greatest risk of decline from future losses of natural habitat. Our approach demonstrates the usefulness of citizen science data in prioritizing conservation and in helping practitioners address species declines and extinctions at large extents. © 2016 Society for Conservation Biology.

  10. 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.

  11. Identifying pain-related concerns in routine follow-up clinics following oral and oropharyngeal cancer.

    PubMed

    Rogers, Simon N; Cleator, Alexander J; Lowe, Derek; Ghazali, Naseem

    2012-08-10

    To describe clinical characteristics of head and neck cancer (HNC) patients with pain and those wishing to discuss pain concerns during consultation. Cross-sectional, questionnaire study using University of Washington Quality of Life, version 4 (UW-QOL) and the Patients Concerns Inventory (PCI) in disease-free, post-treatment HNC cohort. Significant pain on UW-QOL and indicating "Pain in head and neck" and "Pain elsewhere" on PCI. One hundred and seventy-seven patients completed UW-QOL and PCI. The prevalence of self-reported pain issues was 38% (67/177) comprising 25% (44/177) with significant problems despite medications and 13% (23/177) with lesser or no problems but wishing to discuss pain. Patients aged under 65 years and patients having treatment involving radiotherapy were more likely to have pain issues. Just over half, 55% (24/44) of patients with significant pain did not express a need to discuss this. Those with significant pain or others wanting to discuss pain in clinic had greater problems in physical and social-emotional functioning, reported suboptimal QOL, and also had more additional PCI items to discuss in clinic compared to those without significant pain and not wishing to discuss pain. Significant HNC-related pain is prevalent in the disease-free, posttreatment cohort. Onward referral to a specialist pain team may be beneficial. The UW-QOL and PCI package is a valuable tool that may routinely screen for significant pain in outpatient clinics.

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

    PubMed

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

    2018-06-15

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

  13. Why has Not There been More Research of Concern?

    PubMed

    Rappert, Brian

    2014-01-01

    Amid the renewed concern in the last several years about the potential for life science research to facilitate the spread of disease, a central plank of the policy response has been to enact processes for assessing the risks and benefits of "research of concern." The recent controversy regarding a proposed redaction of work on the modification of a H5N1 avian influenza virus is perhaps the most prominent such instance. And yet, a noteworthy feature of this case is its exceptionalness. In the last 10 years, life science publishers, funders, and labs have rarely identified any research as "of concern," let alone proposed censors. This article takes this experience with risk assessment as an invitation for reflection. Reasons for the low number of instances of concern are related to how the biosecurity dimensions of the life sciences are identified, how they are described, how the assessments of benefits and risks are undertaken, how value considerations do and do not enter into assessments, as well as the lack of information on the outcomes of reviews. This argument builds on such considerations to examine the limitations and implications of the risk-benefit experiment of concern framing, the politics of expertise as well as the prospects for alternative responses.

  14. Why has Not There been More Research of Concern?

    PubMed Central

    Rappert, Brian

    2014-01-01

    Amid the renewed concern in the last several years about the potential for life science research to facilitate the spread of disease, a central plank of the policy response has been to enact processes for assessing the risks and benefits of “research of concern.” The recent controversy regarding a proposed redaction of work on the modification of a H5N1 avian influenza virus is perhaps the most prominent such instance. And yet, a noteworthy feature of this case is its exceptionalness. In the last 10 years, life science publishers, funders, and labs have rarely identified any research as “of concern,” let alone proposed censors. This article takes this experience with risk assessment as an invitation for reflection. Reasons for the low number of instances of concern are related to how the biosecurity dimensions of the life sciences are identified, how they are described, how the assessments of benefits and risks are undertaken, how value considerations do and do not enter into assessments, as well as the lack of information on the outcomes of reviews. This argument builds on such considerations to examine the limitations and implications of the risk–benefit experiment of concern framing, the politics of expertise as well as the prospects for alternative responses. PMID:25101254

  15. Employer Concerns Regarding Workers with Disabilities.

    ERIC Educational Resources Information Center

    Greenwood, Reed; Johnson, Virginia Anne

    More than 90 surveys conducted during the past 40 years covering a variety of disabling conditions and employers' concerns regarding workers with these conditions were reviewed. The goal of this review is to identify, develop, test, and disseminate interventions for rehabilitation practitioners to use in job development and placement. The review…

  16. Background and overview on the contribution of dairy nutrition to addressing environmental concerns in Wisconsin: nitrogen, phosphorus, and methane

    USDA-ARS?s Scientific Manuscript database

    During the last part of the 20th century, public concern increased over non-point source pollution originating primarily from agricultural practices. Two chemical elements, nitrogen and phosphorus, which are important to the growth and development of crops and livestock, have been associated with no...

  17. Addressing unwarranted clinical variation: A rapid review of current evidence.

    PubMed

    Harrison, Reema; Manias, Elizabeth; Mears, Stephen; Heslop, David; Hinchcliff, Reece; Hay, Liz

    2018-05-15

    Unwarranted clinical variation (UCV) can be described as variation that can only be explained by differences in health system performance. There is a lack of clarity regarding how to define and identify UCV and, once identified, to determine whether it is sufficiently problematic to warrant action. As such, the implementation of systemic approaches to reducing UCV is challenging. A review of approaches to understand, identify, and address UCV was undertaken to determine how conceptual and theoretical frameworks currently attempt to define UCV, the approaches used to identify UCV, and the evidence of their effectiveness. Rapid evidence assessment (REA) methodology was used. A range of text words, synonyms, and subject headings were developed for the major concepts of unwarranted clinical variation, standards (and deviation from these standards), and health care environment. Two electronic databases (Medline and Pubmed) were searched from January 2006 to April 2017, in addition to hand searching of relevant journals, reference lists, and grey literature. Results were merged using reference-management software (Endnote) and duplicates removed. Inclusion criteria were independently applied to potentially relevant articles by 3 reviewers. Findings were presented in a narrative synthesis to highlight key concepts addressed in the published literature. A total of 48 relevant publications were included in the review; 21 articles were identified as eligible from the database search, 4 from hand searching published work and 23 from the grey literature. The search process highlighted the voluminous literature reporting clinical variation internationally; yet, there is a dearth of evidence regarding systematic approaches to identifying or addressing UCV. Wennberg's classification framework is commonly cited in relation to classifying variation, but no single approach is agreed upon to systematically explore and address UCV. The instances of UCV that warrant investigation and

  18. 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

  19. 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

  20. How patients understand physicians' solicitations of additional concerns: implications for up-front agenda setting in primary care.

    PubMed

    Robinson, Jeffrey D; Heritage, John

    2016-01-01

    In the more than 1 billion primary-care visits each year in the United States, the majority of patients bring more than one distinct concern, yet many leave with "unmet" concerns (i.e., ones not addressed during visits). Unmet concerns have potentially negative consequences for patients' health, and may pose utilization-based financial burdens to health care systems if patients return to deal with such concerns. One solution to the problem of unmet concerns is the communication skill known as up-front agenda setting, where physicians (after soliciting patients' chief concerns) continue to solicit patients' concerns to "exhaustion" with questions such as "Are there some other issues you'd like to address?" Although this skill is trainable and efficacious, it is not yet a panacea. This article uses conversation analysis to demonstrate that patients understand up-front agenda-setting questions in ways that hamper their effectiveness. Specifically, we demonstrate that up-front agenda-setting questions are understood as making relevant "new problems" (i.e., concerns that are either totally new or "new since last visit," and in need of diagnosis), and consequently bias answers away from "non-new problems" (i.e., issues related to previously diagnosed concerns, including much of chronic care). Suggestions are made for why this might be so, and for improving up-front agenda setting. Data are 144 videotapes of community-based, acute, primary-care, outpatient visits collected in the United States between adult patients and 20 family-practice physicians.

  1. Policy Framework for Addressing Personal Security Issues Concerning Women and Girls. National Strategy on Community Safety and Crime Prevention.

    ERIC Educational Resources Information Center

    National Crime Prevention Centre, Ottawa (Ontario).

    This document presents a policy framework for improving the personal security of women and girls. The document includes: (1) "Introduction"; (2) "Policy Background" (the concept of personal security, the societal context of women's personal security, consequences of violence for women and girls, long-term policy concern, and…

  2. Ethical concerns related to grateful patient philanthropy: the physician's perspective.

    PubMed

    Wright, Scott M; Wolfe, Leah; Stewart, Rosalyn; Flynn, John A; Paisner, Richard; Rum, Steve; Parson, Gregory; Carrese, Joseph

    2013-05-01

    Philanthropic contributions to academic medical centers from grateful patients support research, patient care, education, and capital projects. The goal of this study was to identify the ethical concerns associated with philanthropic gifts from grateful patients. A qualitative study design was selected. Investigators conducted in-depth semi-structured interviews with 20 Department of Medicine physicians at Johns Hopkins who were identified by Development Office staff as experienced and successful in this realm-those having relationships with multiple patients who have made philanthropic contributions. Interview transcripts were independently coded by two investigators. Content analysis identified several themes related to ethical concerns. Eighteen informants (90 %) were Associate Professors or Professors; two (10 %) were females. Four thematic domains emerged related to ethical concerns associated with philanthropy from grateful patients: (i) impact of gift on the doctor-patient relationship; (ii) gift acquisition considered beyond the physician's professional role; (iii) justice and fairness; and (iv) vulnerability of patients. Despite acknowledging at least one of the aforementioned concerns, eleven physician informants (55 %) expressed the view that there were no ethical issues involved with grateful patient philanthropy. In this paper, we report that physicians involved in grateful patient philanthropy are aware of, and in some cases troubled by, the ethical concerns related to this activity. Further studies could examine how best to prepare faculty for the challenges that may accompany these gifts so as to help them maintain expected professional and ethical standards when accepting grateful patient philanthropy.

  3. Systematic reviews addressing microsurgical head and neck reconstruction.

    PubMed

    Momeni, Arash; Jacobson, Joshua Y; Lee, Gordon K

    2015-01-01

    Systematic reviews frequently form the basis for clinical decision making and guideline development. Yet, the quality of systematic reviews has been variable, thus raising concerns about the validity of their conclusions. In the current study, a quality analysis of systematic reviews was performed, addressing microsurgical head and neck reconstruction. A PubMed search was performed to identify all systematic reviews published up to and including December 2012 in 12 surgical journals. Two authors independently reviewed the literature and extracted data from the included reviews. Discrepancies were resolved by consensus. Quality assessment was performed using AMSTAR. The initial search retrieved 1020 articles. After screening titles and abstracts, 987 articles were excluded. Full-text review of the remaining 33 articles resulted in further exclusion of 18 articles, leaving 15 systematic reviews for final analysis. A marked increase in the number of published systematic reviews over time was noted (P = 0.07). The median AMSTAR score was 5, thus reflecting a "fair" quality. No evidence for improvement in methodological quality over time was noted. The trend to publish more systematic reviews in microsurgical head and neck reconstruction is encouraging. However, efforts are indicated to improve the methodological quality of systematic reviews. Familiarity with criteria of methodological quality is critical to ensure future improvements in the quality of systematic reviews conducted in microsurgery.

  4. Changes in Aleut concerns following the stakeholder-driven Amchitka independent science assessment.

    PubMed

    Burger, Joanna; Gochfeld, Michael

    2009-08-01

    There is widespread agreement that stakeholders should be included in the problem-formulation phase of addressing environment problems and, more recently, there have been attempts to include stakeholders in other phases of environmental research. However, there are few studies that evaluate the effects of including stakeholders in all phases of research aimed at solving environmental problems. Three underground nuclear blasts were detonated on Amchitka Island from 1965 to 1971. Considerable controversy developed when the Department of Energy (DOE) decided to "close" Amchitka. Concerns were voiced by subsistence Aleuts living in the region, resource trustees, and the State of Alaska, among others. This article evaluates perceptions of residents of three Aleutian village before (2003) and after (2005) the Consortium for Risk Evaluation with Stakeholder Participation's (CRESP) Amchitka Independent Science Assessment (AISA). The CRESP AISA provided technical information on radionuclide levels in biota to inform questions of seafood safety and food chain health. CRESP used the questions asked at public meetings in the Aleut communities of Atka, Nikolski, and Unalaska to evaluate attitudes and perceptions before and after the AISA. Major concerns before the AISA were credibility/trust of CRESP and the DOE, and information about biological methodology of the study. Following the AISA, people were most concerned about health effects and risk reduction, and trust issues with CRESP declined while those for the DOE remained stable. People's relative concerns about radionuclides declined, while their concerns about mercury (not addressed in the AISA) increased, and interest in ecological issues (population changes of local species) and the future (continued biomonitoring) increased from 2003 to 2005. These results suggest that questions posed at public meetings can be used to evaluate changes in attitudes and perceptions following environmental research, and the results are

  5. Changes in Aleut Concerns Following the Stakeholder-Driven Amchitka Independent Science Assessment

    PubMed Central

    Burger, Joanna; Gochfeld, Michael

    2014-01-01

    There is widespread agreement that stakeholders should be included in the problem-formulation phase of addressing environment problems and, more recently, there have been attempts to include stakeholders in other phases of environmental research. However, there are few studies that evaluate the effects of including stakeholders in all phases of research aimed at solving environmental problems. Three underground nuclear blasts were detonated on Amchitka Island from 1965 to 1971. Considerable controversy developed when the Department of Energy (DOE) decided to “close” Amchitka. Concerns were voiced by subsistence Aleuts living in the region, resource trustees, and the State of Alaska, among others. This article evaluates perceptions of residents of three Aleutian village before (2003) and after (2005) the Consortium for Risk Evaluation with Stakeholder Participation’s (CRESP) Amchitka Independent Science Assessment (AISA). The CRESP AISA provided technical information on radionuclide levels in biota to inform questions of seafood safety and food chain health. CRESP used the questions asked at public meetings in the Aleut communities of Atka, Nikolski, and Unalaska to evaluate attitudes and perceptions before and after the AISA. Major concerns before the AISA were credibility/trust of CRESP and the DOE, and information about biological methodology of the study. Following the AISA, people were most concerned about health effects and risk reduction, and trust issues with CRESP declined while those for the DOE remained stable. People’s relative concerns about radionuclides declined, while their concerns about mercury (not addressed in the AISA) increased, and interest in ecological issues (population changes of local species) and the future (continued biomonitoring) increased from 2003 to 2005. These results suggest that questions posed at public meetings can be used to evaluate changes in attitudes and perceptions following environmental research, and the

  6. Examining weight concern and delay discounting in adolescent females.

    PubMed

    Thamotharan, Sneha; Lange, Krista; Ramos, Ashley; Fields, Sherecce

    2016-04-01

    Pediatric obesity is a growing public health concern that contributes to high rates of negative long-term physical and mental health outcomes. Research focused on identifying risk for pediatric obesity has linked delay discounting, or an inclination for immediate rewards, as well as weight concern to individuals with greater Body Mass Index (BMI). The current study seeks to fill a void in the literature by examining how these two variables interact to promote higher BMI in female adolescents. Adolescent (n=60) females between the ages of 13-19years (mage=17.45, SD=1.74) of age completed the Eating Disorder Examination Questionnaire (EDE-Q) and the Delay Discounting Questionnaire. A mediation model examined whether delay discounting accounted for the relationship between weight concern and BMI. Results indicate that in the current study weight concern was negatively related to delay discounting and delay discounting was negatively related to BMI. The overall model revealed that a partial mediation occurred [b=1.28, t(60)=4.92, p<0.01]. These results suggest that while impulsivity is an important factor to consider, other constructs may also be influential in how weight concerns contribute to greater BMI. Nevertheless, the results indicate that prevention and interventions should identify females with high levels of both weight concern and impulsivity as an increased risk for experiencing pediatric obesity and long-term negative health outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Applying genotoxicology tools to identify environmental stressors in support of river management.

    PubMed

    Oberholster, Paul J; Hill, Liesl; Jappie, Shaamiela; Truter, Johannes C; Botha, Anna-Maria

    2016-02-01

    Although bioassay approaches are useful for identifying chemicals of potential concern, they provide little understanding of the mechanisms of chemical toxicity. Without this understanding, it is difficult to address some of the key challenges that currently face aquatic ecotoxicology. To overcome this, the toxicity potential of the water samples was assessed and surviving organisms (Physa acuta) were used for protein activity measurements and gene expression profiling by making use of complementary DNA amplified fragment length polymorphism (cDNA-AFLP) analysis. From the data it was evident that the impacts of specific pollutants (e.g. sewage) on organisms at the cellular level could be identified, and that the expressed stressor genes can be used as bioindicators/markers/genetic signatures or fingerprints during identification of point source pollution. From an ecosystem management point of view these insights could assist with the forecasting and reduction of environmental risks on catchment level by implementing suitable management interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Environmental Concerns, Environmental Policy and Green Investment

    PubMed Central

    Gao, Xuexian; Zheng, Haidong

    2017-01-01

    Environmental regulators often use environmental policy to induce green investment by firms. However, if an environmental policy fails to exert a long-run effect on regulating the economic agents’ behavior, it may be more reasonable to think of the firm as the leader in the game, since the investment in green technology is usually a strategic decision. In this paper, we consider a three-stage Stackelberg game to address the interaction between a profit-maximizing firm (Stackelberg leader) facing emission-dependent demand, and the environmental regulator (Stackelberg follower). The firm decides on the green technology level in the first stage of the game based on its understanding of the regulator’s profits function, especially an environmental concern that is introduced as an exogenous variable. In the current research, we show that high levels of the regulator’s environmental concerns do not necessarily lead to the choice of green technology by the firm, and green investment level depends on the combined effects of the market and operational factors for a given level of the regulator’s environmental concerns. The result also shows that increasing environmental awareness amongst the consumers is an effective way to drive the firm’s green investment. PMID:29236072

  9. Towards achieving Abuja targets: identifying and addressing barriers to access and use of insecticides treated nets among the poorest populations in Kenya.

    PubMed

    Chuma, Jane; Okungu, Vincent; Ntwiga, Janet; Molyneux, Catherine

    2010-03-16

    Ensuring that the poor and vulnerable population benefit from malaria control interventions remains a challenge for malaria endemic countries. Until recently, ownership and use of insecticides treated nets (ITNs) in most countries was low and inequitable, although coverage has increased in countries where free ITN distribution is integrated into mass vaccination campaigns. In Kenya, free ITNs were distributed to children aged below five years in 2006 through two mass campaigns. High and equitable coverage were reported after the campaigns in some districts, although national level coverage remained low, suggesting that understanding barriers to access remains important. This study was conducted to explore barriers to ownership and use of ITNs among the poorest populations before and after the mass campaigns, to identify strategies for improving coverage, and to make recommendations on how increased coverage levels can be sustained. The study was conducted in the poorest areas of four malaria endemic districts in Kenya. Multiple data collection methods were applied including: cross-sectional surveys (n = 708 households), 24 focus group discussions and semi-structured interviews with 70 ITN suppliers. Affordability was reported as a major barrier to access but non-financial barriers were also shown to be important determinants. On the demand side key barriers to access included: mismatch between the types of ITNs supplied through interventions and community preferences; perceptions and beliefs on illness causes; physical location of suppliers and; distrust in free delivery and in the distribution agencies. Key barriers on the supply side included: distance from manufacturers; limited acceptability of ITNs provided through interventions; crowding out of the commercial sector and the price. Infrastructure, information and communication played a central role in promoting or hindering access. Significant resources have been directed towards addressing affordability

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

    NASA Astrophysics Data System (ADS)

    Nordin, Tom; Matsuda, Richard

    2016-07-01

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

  11. Cancer screening in the older adult: issues and concerns.

    PubMed

    Craft, Melissa

    2014-06-01

    Making individual recommendations for cancer screening in older adult patients may be difficult and time consuming, because of the need to incorporate complex issues of life expectancy, health status, risks and benefits, and individual values and wishes. In this article, current recommendations and related risks and benefits are summarized. Specific issues and concerns are addressed, with suggestions for strategies to assist older adults in making screening decisions. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. 24 CFR 1000.510 - What happens if tribal monitoring identifies compliance concerns?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false What happens if tribal monitoring... HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring, Oversight and Accountability § 1000.510 What happens if tribal monitoring identifies compliance...

  13. 24 CFR 1000.510 - What happens if tribal monitoring identifies compliance concerns?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What happens if tribal monitoring... HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring, Oversight and Accountability § 1000.510 What happens if tribal monitoring identifies compliance...

  14. 24 CFR 1000.510 - What happens if tribal monitoring identifies compliance concerns?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false What happens if tribal monitoring... HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring, Oversight and Accountability § 1000.510 What happens if tribal monitoring identifies compliance...

  15. 24 CFR 1000.510 - What happens if tribal monitoring identifies compliance concerns?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false What happens if tribal monitoring... HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring, Oversight and Accountability § 1000.510 What happens if tribal monitoring identifies compliance...

  16. 24 CFR 1000.510 - What happens if tribal monitoring identifies compliance concerns?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false What happens if tribal monitoring... HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring, Oversight and Accountability § 1000.510 What happens if tribal monitoring identifies compliance...

  17. Identifying and reducing risk factors related to trainee-client sexual misconduct.

    PubMed

    Hamilton, J C; Spruill, J

    1999-06-01

    Sexual misconduct involving therapists-in-training and their clients is addressed. Personal and situational factors that may constitute risk factors for the development of inappropriate sexual activity between trainees and their clients are identified. Although there may be certain characteristics that put particular students at risk for such involvement, the authors believe this risk is more strongly related to systemic, programmatic, and pedagogic characteristics of the environments in which students train. Examples include, respectively, the decline of concern over transference and countertransference, failure to include education about client-therapist sexual attraction and the consequences of sexual misconduct in graduate psychology curricula, and the reluctance of supervisors to deal straightforwardly with trainees' sexual feelings. Suggestions for reducing risks for client-therapist sexual misconduct are directed toward these situational factors.

  18. Public attitudes toward health information exchange: perceived benefits and concerns.

    PubMed

    Dimitropoulos, Linda; Patel, Vaishali; Scheffler, Scott A; Posnack, Steve

    2011-12-01

    To characterize consumers' attitudes regarding the perceived benefits of electronic health information exchange (HIE), potential HIE privacy and security concerns, and to analyze the intersection of these concerns with perceived benefits. A cross-sectional study. A random-digit-dial telephone survey of English-speaking adults was conducted in 2010. Multivariate logistic regression models examined the association between consumer characteristics and concerns related to the security of electronic health records (EHRs) and HIE. A majority of the 1847 respondents reported they were either "very" or "somewhat" concerned about privacy of HIE (70%), security of HIE (75%), or security of EHRs (82%). Concerns were significantly higher (P <.05) among employed individuals 40 to 64 years old and minorities. Many believed that HIE would confer benefits such as improved coordination of care (89%). Overall, 75% agreed that the benefits of EHRs outweighed risks to privacy and security, and 60% would permit HIE for treatment purposes even if the physician might not be able to protect their privacy all of the time. Over half (52%) wanted to choose which providers access and share their data. Greater participation by consumers in determining how HIE takes place could engender a higher degree of trust among all demographic groups, regardless of their varying levels of privacy and security concerns. Addressing the specific privacy and security concerns of minorities, individuals 40 to 64 years old, and employed individuals will be critical to ensuring widespread consumer participation in HIE.

  19. Ethics in Community-University-Artist Partnered Research: Tensions, Contradictions and Gaps Identified in an 'Arts for Social Change' Project.

    PubMed

    Yassi, Annalee; Spiegel, Jennifer Beth; Lockhart, Karen; Fels, Lynn; Boydell, Katherine; Marcuse, Judith

    Academics from diverse disciplines are recognizing not only the procedural ethical issues involved in research, but also the complexity of everyday "micro" ethical issues that arise. While ethical guidelines are being developed for research in aboriginal populations and low-and-middle-income countries, multi-partnered research initiatives examining arts-based interventions to promote social change pose a unique set of ethical dilemmas not yet fully explored. Our research team, comprising health, education, and social scientists, critical theorists, artists and community-activists launched a five-year research partnership on arts-for-social change. Funded by the Social Science and Humanities Research Council in Canada and based in six universities, including over 40 community-based collaborators, and informed by five main field projects (circus with street youth, theatre by people with disabilities, dance for people with Parkinson's disease, participatory theatre with refugees and artsinfused dialogue), we set out to synthesize existing knowledge and lessons we learned. We summarized these learnings into 12 key points for reflection, grouped into three categories: community-university partnership concerns ( n  = 3), dilemmas related to the arts ( n  = 5), and team issues ( n  = 4). In addition to addressing previous concerns outlined in the literature (e.g., related to consent, anonymity, dangerous emotional terrain, etc.), we identified power dynamics (visible and hidden) hindering meaningful participation of community partners and university-based teams that need to be addressed within a reflective critical framework of ethical practice. We present how our team has been addressing these issues, as examples of how such concerns could be approached in community-university partnerships in arts for social change.

  20. Exploring functional concerns in help-seeking youth: a qualitative study.

    PubMed

    Cairns, Alice; Dark, Frances; Kavanagh, David; McPhail, Steven

    2015-06-01

    This study aimed to explore the functional concerns of help-seeking young people 12-25 years of age. Semistructured interviews with n = 10 young people seeking help from a youth mental health clinic were conducted. Data were transcribed verbatim and analysed using content analysis. Results were verified by member checking. Participants identified reasons for seeking help, with the main themes being relationships, emotional management, risk-taking behaviour and difficulties with employment. There appeared to be a difference between the concerns of the older, post-school-age group and the younger participants. Young people are able to identify their functional concerns and reasons for seeking help from mental health services. Understanding the concerns of these young people provides weight to the model of youth-specific mental health services. Future work examining concerns of 12-25 year olds should ensure adequate representation of the older group as their needs and concerns seem to differ from those of younger participants in this study. Post-school-age youth seem to be under-represented in existing literature in this field. However, a limitation with this study is the small sample sizes once the cohort is divided by age. Future studies with a larger, more detailed examination of the needs and concerns of this population are warranted to inform service delivery advancements and clarify the difference in needs between the post-school and current school attendee groups. © 2013 Wiley Publishing Asia Pty Ltd.

  1. Ancillary Care in South African HIV Vaccine Trials: Addressing Needs, Drafting Protocols, and Engaging Community

    PubMed Central

    Slack, Catherine M.

    2014-01-01

    There has been debate about sponsor-investigator ethical responsibilities to address participants’ medical needs in trials in resource-constrained contexts. Certain ethical guidelines make detailed recommendations. This study explored whether ethical guideline recommendations for care in HIV vaccine trials were being met, and whether stakeholders were facing difficulties addressed by guidelines. It sampled key stakeholders involved in two trials across five sites in South Africa, and reviewed relevant documentation. It concluded that sites were largely meeting guideline recommendations for addressing needs, with some exceeding these. Recommendations for writing protocols were only partially achieved. Recommendations for engaging participating community were mostly met, except for “moral negotiation” recommendations. Suggestions are made to strengthen practices, and to improve guidelines so they address empirical concerns. PMID:24572086

  2. Ancillary care in South African HIV vaccine trials: addressing needs, drafting protocols, and engaging community.

    PubMed

    Slack, Catherine M

    2014-02-01

    There has been debate about sponsor-investigator ethical responsibilities to address participants' medical needs in trials in resource-constrained contexts. Certain ethical guidelines make detailed recommendations. This study explored whether ethical guideline recommendations for care in HIV vaccine trials were being met, and whether stakeholders were facing difficulties addressed by guidelines. It sampled key stakeholders involved in two trials across five sites in South Africa, and reviewed relevant documentation. It concluded that sites were largely meeting guideline recommendations for addressing needs, with some exceeding these. Recommendations for writing protocols were only partially achieved. Recommendations for engaging participating community were mostly met, except for "moral negotiation" recommendations. Suggestions are made to strengthen practices, and to improve guidelines so they address empirical concerns.

  3. 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.

  4. Association between congenital toxoplasmosis and parent-reported developmental outcomes, concerns, and impairments, in 3 year old children

    PubMed Central

    Freeman, Katherine; Salt, Alison; Prusa, Andrea; Malm, Gunilla; Ferret, Nicole; Buffolano, Wilma; Schmidt, Dorthe; Tan, Hooi Kuan; Gilbert, Ruth E

    2005-01-01

    Background Information is lacking on the effects of congenital toxoplasmosis on development, behavior, and impairment in later childhood, as well as on parental concerns and anxiety. This information is important for counselling parents about the prognosis for an infected child and for policy decisions on screening. Methods We prospectively studied a cohort of children identified by screening for toxoplasmosis in pregnant women or neonates between 1996 and 2000 in ten European centers. At 3 years of age, parents of children with and without congenital toxoplasmosis were surveyed about their child's development, behavior, and impairment, and about parental concerns and anxiety, using a postal questionnaire. Results Parents of 178/223 (80%) infected, and 527/821 (64%) uninfected children responded. We found no evidence that impaired development or behavior were more common in infected children, or that any potential effect of congenital toxoplasmosis was masked by prenatal treatment. Parents of infected children were significantly more anxious and reported more visual problems in their children. Conclusion On average, children aged three to four years with congenital toxoplasmosis identified by screening and treated during infancy in this European setting had risks of abnormal development and behavior similar to uninfected children. Parental anxiety about infected children needs to be addressed by clinicians. Future studies with longer follow up and clinician-administered assessments may be better able to detect any subtle differences in child outcomes. PMID:16014166

  5. Will you accept the government's friend request? Social networks and privacy concerns.

    PubMed

    Siegel, David A

    2013-01-01

    Participating in social network websites entails voluntarily sharing private information, and the explosive growth of social network websites over the last decade suggests shifting views on privacy. Concurrently, new anti-terrorism laws, such as the USA Patriot Act, ask citizens to surrender substantial claim to privacy in the name of greater security. I address two important questions regarding individuals' views on privacy raised by these trends. First, how does prompting individuals to consider security concerns affect their views on government actions that jeopardize privacy? Second, does the use of social network websites alter the effect of prompted security concerns? I posit that prompting individuals to consider security concerns does lead to an increased willingness to accept government actions that jeopardize privacy, but that frequent users of websites like Facebook are less likely to be swayed by prompted security concerns. An embedded survey experiment provides support for both parts of my claim.

  6. Persistence of Latino Students in Community Colleges: An Empowerment Model Addressing Acculturative Stress

    ERIC Educational Resources Information Center

    Wilson, Judy C.

    2012-01-01

    College student persistence has been a concern of researchers and practitioners since the early 1960s. Traditional models have addressed the need for students to be integrated into the academic and social domains of the college campus. Recently, critical theorists and researchers have been questioning the relevance of the traditional models for…

  7. Persistent Identifiers Implementation in EOSDIS

    NASA Technical Reports Server (NTRS)

    Ramapriyan, H. K. " Rama"

    2016-01-01

    This presentation provides the motivation for and status of implementation of persistent identifiers in NASA's Earth Observation System Data and Information System (EOSDIS). The motivation is provided from the point of view of long-term preservation of datasets such that a number of questions raised by current and future users can be answered easily and precisely. A number of artifacts need to be preserved along with datasets to make this possible, especially when the authors of datasets are no longer available to address users questions. The artifacts and datasets need to be uniquely and persistently identified and linked with each other for full traceability, understandability and scientific reproducibility. Current work in the Earth Science Data and Information System (ESDIS) Project and the Distributed Active Archive Centers (DAACs) in assigning Digital Object Identifiers (DOI) is discussed as well as challenges that remain to be addressed in the future.

  8. Promoting Interdisciplinary Collaboration: Trainees Addressing Siloed Medical Education

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  9. Addressing the Concerns Surrounding Continuous Deep Sedation in Singapore and Southeast Asia: A Palliative Care Approach.

    PubMed

    Krishna, Lalit Kumar Radha

    2015-09-01

    The application of continuous deep sedation (CDS) in the treatment of intractable suffering at the end of life continues to be tied to a number of concerns that have negated its use in palliative care. Part of the resistance towards use of this treatment option of last resort has been the continued association of CDS with physician-associated suicide and/or euthanasia (PAS/E), which is compounded by a lack clinical guidelines and a failure to cite this treatment under the aegis of a palliative care approach. I argue that reinstituting a palliative care-inspired approach that includes a holistic review of the patient's situation and the engagement of a multidisciplinary team (MDT) guided by clearly defined practice requirements that have been lacking amongst many prevailing guidelines will overcome prevailing objections to this practice and allow for the legitimization of this process.

  10. "So What if My Students Misbehave?" Addressing Misbehavior in a Task-Involving Motivational Climate

    ERIC Educational Resources Information Center

    Model, Eric D.; Todorovich, John R.; Largo-Wight, Erin

    2005-01-01

    This article describes factors that teachers can use to create a task-involving motivational climate, discusses behavioral practices for increasing student compliance, and provides specific recommendations for addressing behavior concerns in the physical education setting. A good teaching philosophy built upon established principles is the best…

  11. EMPOWER: An Intervention to Address Barriers to Pain Management in Hospice

    PubMed Central

    Cagle, John G.; Zimmerman, Sheryl; Cohen, Lauren W.; Porter, Laura S.; Hanson, Laura C.; Reed, David

    2017-01-01

    Context Concerns about pain medications are major barriers to pain management in hospice, but few studies have focused on systematic methods to address these concerns. Objective We conducted a pilot cluster randomized controlled trial with four hospices to test preliminary efficacy of the EMPOWER intervention which included: hospice staff education; staff screening of barriers to pain management at admission; and discussion about misunderstandings regarding pain management with family caregivers and patients. Methods 126 family caregivers (55 intervention; 71 control) were interviewed at two weeks post-admission. If patients survived three months post-admission, caregivers were re-interviewed. Results At two weeks, caregivers in the intervention group reported better knowledge about pain management (p=.001), fewer concerns about pain and pain medications (p=.008), and lower patient pain over the past week (p=.014); and trended toward improvement in most other areas under study. Exploratory analyses suggest EMPOWER had a greater effect for Black subjects (vs. Whites) on reducing concern about stigma. At three months, the intervention group trended better on most study outcomes. Conclusion EMPOWER is a promising model to reduce barriers to pain management in hospice. PMID:24880000

  12. Existential concerns about death: a qualitative study of dying patients in a Danish hospice.

    PubMed

    Moestrup, Lene; Hansen, Helle Ploug

    2015-06-01

    Research suggests that addressing dying patients' existential concerns can improve their quality of life. We aimed to illuminate dying patients' existential concerns about the impending death through a descriptive analysis of semistructured interviews with 17 patients in Danish hospices. The main findings demonstrated how the patients faced the imminent death without being anxious of death but sorrowful about leaving life. Some patients expressed that they avoided thinking about death. They wished to focus on positive aspects in their daily life. We argue that the patients' existential concerns could not be fully captured by Yalom's existential psychology or by Kübler-Ross's theory about death stages. Patients' complex concerns could be more fully explained taking an outset in Heidegger's phenomenological thinking. © The Author(s) 2014.

  13. Addressing safety liabilities of TfR bispecific antibodies that cross the blood-brain barrier.

    PubMed

    Couch, Jessica A; Yu, Y Joy; Zhang, Yin; Tarrant, Jacqueline M; Fuji, Reina N; Meilandt, William J; Solanoy, Hilda; Tong, Raymond K; Hoyte, Kwame; Luk, Wilman; Lu, Yanmei; Gadkar, Kapil; Prabhu, Saileta; Ordonia, Benjamin A; Nguyen, Quyen; Lin, Yuwen; Lin, Zhonghua; Balazs, Mercedesz; Scearce-Levie, Kimberly; Ernst, James A; Dennis, Mark S; Watts, Ryan J

    2013-05-01

    Bispecific antibodies using the transferrin receptor (TfR) have shown promise for boosting antibody uptake in brain. Nevertheless, there are limited data on the therapeutic properties including safety liabilities that will enable successful development of TfR-based therapeutics. We evaluate TfR/BACE1 bispecific antibody variants in mouse and show that reducing TfR binding affinity improves not only brain uptake but also peripheral exposure and the safety profile of these antibodies. We identify and seek to address liabilities of targeting TfR with antibodies, namely, acute clinical signs and decreased circulating reticulocytes observed after dosing. By eliminating Fc effector function, we ameliorated the acute clinical signs and partially rescued a reduction in reticulocytes. Furthermore, we show that complement mediates a residual decrease in reticulocytes observed after Fc effector function is eliminated. These data raise important safety concerns and potential mitigation strategies for the development of TfR-based therapies that are designed to cross the blood-brain barrier.

  14. Do systematic reviews address community healthcare professionals' wound care uncertainties? Results from evidence mapping in wound care.

    PubMed

    Christie, Janice; Gray, Trish A; Dumville, Jo C; Cullum, Nicky A

    2018-01-01

    Complex wounds such as leg and foot ulcers are common, resource intensive and have negative impacts on patients' wellbeing. Evidence-based decision-making, substantiated by high quality evidence such as from systematic reviews, is widely advocated for improving patient care and healthcare efficiency. Consequently, we set out to classify and map the extent to which up-to-date systematic reviews containing robust evidence exist for wound care uncertainties prioritised by community-based healthcare professionals. We asked healthcare professionals to prioritise uncertainties based on complex wound care decisions, and then classified 28 uncertainties according to the type and level of decision. For each uncertainty, we searched for relevant systematic reviews. Two independent reviewers screened abstracts and full texts of reviews against the following criteria: meeting an a priori definition of a systematic review, sufficiently addressing the uncertainty, published during or after 2012, and identifying high quality research evidence. The most common uncertainty type was 'interventions' 24/28 (85%); the majority concerned wound level decisions 15/28 (53%) however, service delivery level decisions (10/28) were given highest priority. Overall, we found 162 potentially relevant reviews of which 57 (35%) were not systematic reviews. Of 106 systematic reviews, only 28 were relevant to an uncertainty and 18 of these were published within the preceding five years; none identified high quality research evidence. Despite the growing volume of published primary research, healthcare professionals delivering wound care have important clinical uncertainties which are not addressed by up-to-date systematic reviews containing high certainty evidence. These are high priority topics requiring new research and systematic reviews which are regularly updated. To reduce clinical and research waste, we recommend systematic reviewers and researchers make greater efforts to ensure that research

  15. A risk-based approach for identifying constituents of concern in oil sands process-affected water from the Athabasca Oil Sands region.

    PubMed

    McQueen, Andrew D; Kinley, Ciera M; Hendrikse, Maas; Gaspari, Daniel P; Calomeni, Alyssa J; Iwinski, Kyla J; Castle, James W; Haakensen, Monique C; Peru, Kerry M; Headley, John V; Rodgers, John H

    2017-04-01

    Mining leases in the Athabasca Oil Sands (AOS) region produce large volumes of oil sands process-affected water (OSPW) containing constituents that limit beneficial uses and discharge into receiving systems. The aim of this research is to identify constituents of concern (COCs) in OSPW sourced from an active settling basin with the goal of providing a sound rational for developing mitigation strategies for using constructed treatment wetlands for COCs contained in OSPW. COCs were identified through several lines of evidence: 1) chemical and physical characterization of OSPW and comparisons with numeric water quality guidelines and toxicity endpoints, 2) measuring toxicity of OSPW using a taxonomic range of sentinel organisms (i.e. fish, aquatic invertebrates, and a macrophyte), 3) conducting process-based manipulations (PBMs) of OSPW to alter toxicity and inform treatment processes, and 4) discerning potential treatment pathways to mitigate ecological risks of OSPW based on identification of COCs, toxicological analyses, and PBM results. COCs identified in OSPW included organics (naphthenic acids [NAs], oil and grease [O/G]), metals/metalloids, and suspended solids. In terms of species sensitivities to undiluted OSPW, fish ≥ aquatic invertebrates > macrophytes. Bench-scale manipulations of the organic fractions of OSPW via PBMs (i.e. H 2 O 2 +UV 254 and granular activated charcoal treatments) eliminated toxicity to Ceriodaphnia dubia (7-8 d), in terms of mortality and reproduction. Results from this study provide critical information to inform mitigation strategies using passive or semi-passive treatment processes (e.g., constructed treatment wetlands) to mitigate ecological risks of OSPW to aquatic organisms. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Words that make pills easier to swallow: a communication typology to address practical and perceptual barriers to medication intake behavior

    PubMed Central

    Linn, Annemiek J; van Weert, Julia CM; Schouten, Barbara C; Smit, Edith G; van Bodegraven, Ad A; van Dijk, Liset

    2012-01-01

    Purpose The barriers to patients’ successful medication intake behavior could be reduced through tailored communication about these barriers. The aim of this study is therefore (1) to develop a new communication typology to address these barriers to successful medication intake behavior, and (2) to examine the relationship between the use of the typology and the reduction of the barriers to successful medication intake behavior. Patients and methods Based on a literature review, the practical and perceptual barriers to successful medication intake behavior typology (PPB-typology) was developed. The PPB-typology addresses four potential types of barriers that can be either practical (memory and daily routine barriers) or perceptual (concern and necessity barriers). The typology describes tailored communication strategies that are organized according to barriers and communication strategies that are organized according to provider and patient roles. Eighty consultations concerning first-time medication use between nurses and inflammatory bowel disease patients were videotaped. The verbal content of the consultations was analyzed using a coding system based on the PPB-typology. The Medication Understanding and Use Self-efficacy Scale and the Beliefs about Medicine Questionnaire Scale were used as indicators of patients’ barriers and correlated with PPB-related scores. Results The results showed that nurses generally did not communicate with patients according to the typology. However, when they did, fewer barriers to successful medication intake behavior were identified. A significant association was found between nurses who encouraged question-asking behavior and memory barriers (r = −0.228, P = 0.042) and between nurses who summarized information (r = −0.254, P = 0.023) or used cartoons or pictures (r = −0.249, P = 0.026) and concern barriers. Moreover, a significant relationship between patients’ emotional cues about side effects and perceived concern

  17. Multicultural Issues and Concerns in Library Education.

    ERIC Educational Resources Information Center

    Freiband, Susan J.

    1992-01-01

    Identifies multilingual and multicultural issues relevant to library and information science curricula today and outlines the skills, knowledge, and attitudes needed by graduates to address these issues. Aspects of the curriculum, specific programs, and activities on which to focus are discussed. (13 references) (EA)

  18. 26 CFR 1.6109-1 - Identifying numbers.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 13 2010-04-01 2010-04-01 false Identifying numbers. 1.6109-1 Section 1.6109-1...) INCOME TAXES Miscellaneous Provisions § 1.6109-1 Identifying numbers. (a) Information to be furnished after April 15, 1974. For provisions concerning the requesting and furnishing of identifying numbers...

  19. Pre-Service Teachers' Attitudes, Concerns and Sentiments about Inclusive Education: An International Comparison of Novice Pre-Service Teachers

    ERIC Educational Resources Information Center

    Sharma, Umesh; Forlin, Chris; Loreman, Tim; Earle, Chris

    2006-01-01

    This study investigates the nature of concerns and attitudes held by pre-service teachers regarding inclusive education and their degree of comfort on interaction with people with disabilities. Pre-service training may be the optimal time to address educators' concerns and alter any negative attitudes about inclusive education. This paper reports…

  20. Elementary Teachers' and Principals' Concerns in the Implementation of Inclusion in a South Texas School District

    ERIC Educational Resources Information Center

    Arce, Lauren Y.

    2017-01-01

    This study addressed the in-depth concerns that elementary regular education teachers, elementary special education teachers, and campus administrators in one South Texas school district have for the use or non-use of inclusionary practices as a means of educating students with special needs. These concerns that teachers and campus administrators…

  1. Concerns of Parents and Teachers of Children with Autism in Elementary School

    ERIC Educational Resources Information Center

    Azad, Gazi; Mandell, David S.

    2016-01-01

    Many consensus guidelines encourage parents and teachers to openly communicate about their concerns regarding their children. These guidelines attest to the importance of achieving consensus about what issues are most critical and how to address them. The purpose of this study was to examine whether parents and teachers (1) agree about their…

  2. Searching for resilience: addressing the impacts of changing disturbance regimes on forest ecosystem services

    Treesearch

    Rupert Seidl; Thomas A. Spies; David L. Peterson; Scott L. Stephens; Jeffrey A. Hicke

    2015-01-01

    Summary 1. The provisioning of ecosystem services to society is increasingly under pressure from global change. Changing disturbance regimes are of particular concern in this context due to their high potential impact on ecosystem structure, function and composition. Resiliencebased stewardship is advocated to address these changes in ecosystem management,...

  3. Comic Relief: Graduate Students Address Multiple Meanings for Technology Integration with Digital Comic Creation

    ERIC Educational Resources Information Center

    Sockman, Beth Rajan; Sutton, Rhonda; Herrmann, Michele

    2016-01-01

    This study determined the usefulness of digital comic creation with 77 graduate students in a teacher technology course. Students completed an assigned reading and created digital comics that addressed technology integration concerns in the schools and society. Using practical action research, 77 student-created comics were analyzed. The findings…

  4. Improving Access to Essential Medicines: How Health Concerns can be Prioritised in the Global Governance System

    PubMed Central

    Sridhar, Devi

    2008-01-01

    This paper discusses the politics of access to essential medicines and identifies ‘space’ in the current system where health concerns can be strengthened relative to trade. This issue is addressed from a global governance perspective focusing on the main actors who can have the greatest impact. These include developing country coalitions and citizens in developed countries though participation in civil society organisations. These actors have combined forces to tackle this issue successfully, resulting in the 2001 Doha Declaration on Public Health. The collaboration has been so powerful due to the assistance of the media as well as the decision to compromise with pharmaceutical companies and their host countries. To improve access to essential medicines, six C's are needed: coalitions, civil society, citizenship, compromise, communication and collaboration. PMID:19461853

  5. Major concerns regarding lung injury and related health conditions caused by the use of humidifier disinfectant

    PubMed Central

    2016-01-01

    A total of 221 patients were evaluated to be humidifier disinfectant associated with lung injury (HDLI) through two rounds of programs through April 2015. The humidifier disinfectant (HD) brands most often associated with HDLI were found to be Oxy (n=151, 68 %) and Cefu (n=26, 17 %). Polyhexamethylene guanidine used for disinfectant for four types of HD brands including Oxy was found to be associated with the highest number of HDLI cases (n=188). Further programs are operating to identify various health effects including lung injury which may be associated with the use of HD. Not only national agencies, but also pertinent environmental health societies should cooperate in the necessary investigations so that this tragedy can be properly addressed and future incidents concerning chemicals and chemical-containing products can be prevented. PMID:27431912

  6. Concerns about identity and services among people with autism and Asperger's regarding DSM-5 changes.

    PubMed

    Spillers, Jessica L H; Sensui, Leonard M; Linton, Kristen F

    2014-01-01

    The Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-5]; American Psychiatric Association, 2012 ) now includes a new autism spectrum diagnosis (ASD) with previous separate diagnoses of autism removed. This study explores the concerns of people with Asperger's syndrome (AS) and autistic disorder (AD). Discussion forum data of people with AS and AD (N = 76) were analyzed using phenomenological, inductive-content analysis to gather qualitative data about the concerns of people with AS and AD regarding the changes in the DSM-5. People with AS and AD were concerned about identity, community, the cure movement, and services. They also discussed using advocacy and solidarity to address their concerns.

  7. Structured identification of response options to address environmental health risks at the Agbogbloshie electronic waste site.

    PubMed

    Cazabon, Danielle; Fobil, Julius N; Essegbey, George; Basu, Niladri

    2017-11-01

    Electronic waste (e-waste) is a growing problem across low- and middle-income countries. Agbogbloshie (Accra, Ghana) is among the world's largest and most notorious e-waste sites, with an increasing number of studies documenting a range of environmental health risks. The present study aimed to provide national, regional, and international stakeholders with a summary of expert opinion on the most pressing problems arising from e-waste activities at Agbogbloshie, as well as suggested solutions to address these problems. Structured interviews were performed between April and September 2015 that used a Logical Framework Approach as a scoping exercise to gauge problems and benefits of e-waste recycling, and the Delphi methodology to identify response options. Stakeholders (n = 19) from 15 institutions were interviewed with 2 rounds of a Delphi Poll: open-ended interviews followed by an electronic questionnaire in which experts ranked various proposed response options based on health, environmental, social, and economic benefit and feasibility. The goal was to prioritize potential interventions that would address identified problems at Agbogbloshie. Experts identified the most beneficial and feasible options in decreasing rank order as follows and prefaced by the statement "it is recommended that": 1) there be further research on the health effects; 2) e-waste workers be given appropriate personal protective equipment; 3) the Ministry of the Environment, Science, Technology and Innovation re-visit Ghana's Hazardous Waste Bill; 4) e-waste workers be involved in the planning process of interventions and are be kept informed of any results; and 5) there be increased education and sensitization on hazards related to e-waste for both workers and the general public. These solutions are discussed in relation to ongoing dialogue at the international level concerning e-waste recycling interventions, with strengths and weaknesses examined for the Ghanaian context. Integr

  8. Psychological Symptoms and Concerns Experienced by International Students: Outreach Implications for Counseling Centers

    ERIC Educational Resources Information Center

    Poyrazli, Senel

    2015-01-01

    This study examines psychological symptoms and concerns experienced by international students. Participants identified with a variety of psychological symptoms and concerns. The top three were related to academics (71%), career (60%), and stress (43%). In addition, 34% of the participants indicated being concerned about depression and/or anxiety.…

  9. Will You Accept the Government's Friend Request? Social Networks and Privacy Concerns

    PubMed Central

    Siegel, David A.

    2013-01-01

    Participating in social network websites entails voluntarily sharing private information, and the explosive growth of social network websites over the last decade suggests shifting views on privacy. Concurrently, new anti-terrorism laws, such as the USA Patriot Act, ask citizens to surrender substantial claim to privacy in the name of greater security. I address two important questions regarding individuals' views on privacy raised by these trends. First, how does prompting individuals to consider security concerns affect their views on government actions that jeopardize privacy? Second, does the use of social network websites alter the effect of prompted security concerns? I posit that prompting individuals to consider security concerns does lead to an increased willingness to accept government actions that jeopardize privacy, but that frequent users of websites like Facebook are less likely to be swayed by prompted security concerns. An embedded survey experiment provides support for both parts of my claim. PMID:24312236

  10. Concerns of nursing students beginning clinical courses: A descriptive study.

    PubMed

    Cowen, Kay J; Hubbard, Lori J; Hancock, Debbie Croome

    2016-08-01

    Students harbor fears related to the clinical environment that influence their participation and learning. Some studies have addressed general anxieties in undergraduate nursing students, but few have asked students to report their fears and concerns prior to entering the clinical environment. Therefore, this study examined the fears and concerns of undergraduate nursing students beginning clinical courses as well as their continued concerns upon completion of the first year of instruction. The study also assessed their confidence in physical assessment skills. Ninety-six junior nursing students enrolled in a generic baccalaureate nursing program completed a survey, two items of which asked about their fears and concerns related to beginning clinical experiences and their confidence in physical assessment. A follow up survey was completed at the end of the junior year by 72 students. Making a mistake, lack of course success, and not knowing how to do something were students' major concerns prior to the start of clinical experiences. Bad experiences with a nurse or instructor, freezing up, and uncomfortable patient/family experiences were also concerns. Not knowing how to do something persisted as a concern at the completion of the first year. Fears about being/feeling left alone in a clinical setting as well as concern about the senior year also emerged on the post survey. Confidence in physical assessment was a mean of 60.46 on a scale of 0-100 at the beginning of clinical instruction and 71.28 at the end of the junior year. Faculty should structure learning activities that decrease anxiety and enhance students' confidence prior to initial clinical experiences. Opportunities might include in-depth orientation to clinical settings and various simulations that allow practice of skills and communication. Awareness of predominant student fears and concerns can also guide staff nurses to provide a welcoming environment and enhance learning. Copyright © 2016 Elsevier

  11. Canadian In-Service Teachers' Concerns, Efficacy, and Attitudes about Inclusive Teaching

    ERIC Educational Resources Information Center

    Sokal, Laura; Sharma, Umesh

    2014-01-01

    The study examined concerns, attitudes, and teacher efficacy of 131 in-service, Kindergarten to Grade 8 teachers in three school divisions in Manitoba, Canada. Analyses were conducted to identify the relationships between teachers' back-ground variables, their attitudes and concerns about teaching in inclusive classrooms, and their efficacy for…

  12. Health concerns and hazardous waste

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

    Yassi, A.; Weeks, J.; Kraut, A.

    1990-01-01

    This report discusses health effects of hazardous waste and emphasizes human health concerns related to establishing a hazardous waste management facility. The study reviewed world epidemiological and public health literature to identify cases of suspected or substantiated claims of public health impacts associated with hazardous waste management facilities and potential products or emissions from such facilities, and placed them into perspective, including possible routes and consequences of exposure, risk assessment, and the toxicity of selected organic and inorganic compounds.

  13. Barriers to addressing substance abuse in domestic violence court.

    PubMed

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

    2014-03-01

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

  14. Addressing Thermal Model Run Time Concerns of the Wide Field Infrared Survey Telescope using Astrophysics Focused Telescope Assets (WFIRST-AFTA)

    NASA Technical Reports Server (NTRS)

    Peabody, Hume; Guerrero, Sergio; Hawk, John; Rodriguez, Juan; McDonald, Carson; Jackson, Cliff

    2016-01-01

    The Wide Field Infrared Survey Telescope using Astrophysics Focused Telescope Assets (WFIRST-AFTA) utilizes an existing 2.4 m diameter Hubble sized telescope donated from elsewhere in the federal government for near-infrared sky surveys and Exoplanet searches to answer crucial questions about the universe and dark energy. The WFIRST design continues to increase in maturity, detail, and complexity with each design cycle leading to a Mission Concept Review and entrance to the Mission Formulation Phase. Each cycle has required a Structural-Thermal-Optical-Performance (STOP) analysis to ensure the design can meet the stringent pointing and stability requirements. As such, the models have also grown in size and complexity leading to increased model run time. This paper addresses efforts to reduce the run time while still maintaining sufficient accuracy for STOP analyses. A technique was developed to identify slews between observing orientations that were sufficiently different to warrant recalculation of the environmental fluxes to reduce the total number of radiation calculation points. The inclusion of a cryocooler fluid loop in the model also forced smaller time-steps than desired, which greatly increases the overall run time. The analysis of this fluid model required mitigation to drive the run time down by solving portions of the model at different time scales. Lastly, investigations were made into the impact of the removal of small radiation couplings on run time and accuracy. Use of these techniques allowed the models to produce meaningful results within reasonable run times to meet project schedule deadlines.

  15. A systematic review to identify areas of enhancements of pandemic simulation models for operational use at provincial and local levels

    PubMed Central

    2012-01-01

    Background In recent years, computer simulation models have supported development of pandemic influenza preparedness policies. However, U.S. policymakers have raised several concerns about the practical use of these models. In this review paper, we examine the extent to which the current literature already addresses these concerns and identify means of enhancing the current models for higher operational use. Methods We surveyed PubMed and other sources for published research literature on simulation models for influenza pandemic preparedness. We identified 23 models published between 1990 and 2010 that consider single-region (e.g., country, province, city) outbreaks and multi-pronged mitigation strategies. We developed a plan for examination of the literature based on the concerns raised by the policymakers. Results While examining the concerns about the adequacy and validity of data, we found that though the epidemiological data supporting the models appears to be adequate, it should be validated through as many updates as possible during an outbreak. Demographical data must improve its interfaces for access, retrieval, and translation into model parameters. Regarding the concern about credibility and validity of modeling assumptions, we found that the models often simplify reality to reduce computational burden. Such simplifications may be permissible if they do not interfere with the performance assessment of the mitigation strategies. We also agreed with the concern that social behavior is inadequately represented in pandemic influenza models. Our review showed that the models consider only a few social-behavioral aspects including contact rates, withdrawal from work or school due to symptoms appearance or to care for sick relatives, and compliance to social distancing, vaccination, and antiviral prophylaxis. The concern about the degree of accessibility of the models is palpable, since we found three models that are currently accessible by the public while

  16. Clinical Management of Psychosocial Concerns Related to Food Allergy.

    PubMed

    Herbert, Linda; Shemesh, Eyal; Bender, Bruce

    2016-01-01

    Current estimates indicate that 4% to 8% of children in the United States are diagnosed with food allergy, and more than 40% of US children with food allergy experience severe allergic reactions. Families trying to avoid foods that may trigger an allergic reaction and ensure adequate treatment of allergic reactions that do occur face numerous challenges. The rise in the number of children diagnosed with food allergies underscores the importance of food allergy-related interventions to address elevated psychosocial concerns, such as parenting stress, anxiety, and worries about bullying. This review provides an overview of common psychosocial concerns among children with food allergy and their families across the developmental spectrum, and offers guidance to medical providers regarding the identification and treatment of food allergy-related psychosocial challenges. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  17. Addressing Concerns About the Major Investment Study Requirements

    DOT National Transportation Integrated Search

    2011-12-01

    With funding and support from the USDOT RITA and direction from the FHWA Road Weather Management Program, NCAR is developing a Vehicle Data Translator (VDT) software system that incorporates vehicle-based measurements of the road and surrounding atmo...

  18. Addressing Pediatric Health Concerns through School-Based Consultation

    ERIC Educational Resources Information Center

    Truscott, Stephen D.; Albritton, Kizzy

    2011-01-01

    In schools, the term "consultation" has multiple meanings. Often it is used to describe a quick, informal process of advice giving between teachers and/or school specialists. As a formal discipline, School-Based Consultation (SBC) is an indirect service delivery model that involves two or more parties working together to benefit students. Most…

  19. Knowledge with Wisdom in Postgraduate Studies and Supervision: Epistemological and Institutional Concerns and Challenges

    ERIC Educational Resources Information Center

    Bitzer, E. M.

    2011-01-01

    Publications about postgraduate studies and the supervision address issues and concerns such as supervisory orientations and strategies, ways to handle postgraduate students, challenging postgraduate education practices, factors related to success in postgraduate studies, the benefits of advanced studies, transition to independent research and…

  20. Community College Faculty Attitudes and Concerns about Student Learning Outcomes Assessment

    ERIC Educational Resources Information Center

    Fontenot, Janet Smith

    2012-01-01

    The purpose of this study was to identify the attitudes and concerns community college faculty have about student learning outcomes assessment and to further explore the relationship between these factors and faculty levels of involvement in assessment activities. Combining the conceptual frameworks of the concerns-based adoption Model (CBAM) and…

  1. Explicating perceived barriers to mammography for the USCREEN project: concerns about breast implants, faith violations, and perceived recommendations.

    PubMed

    Jensen, Jakob D; Ratcliff, Chelsea; Weaver, Jeremy; Krakow, Melinda M; Payton, William; Loewen, Sherrie

    2015-11-01

    In line with the health belief model, perceived barriers have proven to be a key determinant of intentions to screen for breast cancer. The standard measure of perceived barriers to breast cancer screening is an 11 item scale developed by Victoria Champion. However, perceived barriers emerge and change over time, and Champion's perceived barriers scale was last revised in 1999. Moreover, the original scale did not address barriers which may be more pronounced in particular populations, such as congruity of action with faith. As part of the Utah Screening Project, a sample of women 40-74 (N = 341, Mage = 51.19, SD = 8.11) were recruited from four Utah counties in 2014 to complete a survey. The results revealed that the four new perceived barrier items explained 6.4 % of intentions to screen, above and beyond other predictors. In addition to barriers identified in past research, the current study identified several novel barriers including (a) concerns about negative effects to breast implants, (b) perceived conflict with faith, and the (c) perception that mammography is no longer recommended. The new perceived barriers items are useful to researchers interested in exploring barriers not addressed by the original instrument. The barriers also suggest potential belief-based targets and channels (e.g., plastic surgery clinics, faith-based interventions) for delivering mammography interventions.

  2. Physician privacy concerns when disclosing patient data for public health purposes during a pandemic influenza outbreak

    PubMed Central

    2011-01-01

    Background Privacy concerns by providers have been a barrier to disclosing patient information for public health purposes. This is the case even for mandated notifiable disease reporting. In the context of a pandemic it has been argued that the public good should supersede an individual's right to privacy. The precise nature of these provider privacy concerns, and whether they are diluted in the context of a pandemic are not known. Our objective was to understand the privacy barriers which could potentially influence family physicians' reporting of patient-level surveillance data to public health agencies during the Fall 2009 pandemic H1N1 influenza outbreak. Methods Thirty seven family doctors participated in a series of five focus groups between October 29-31 2009. They also completed a survey about the data they were willing to disclose to public health units. Descriptive statistics were used to summarize the amount of patient detail the participants were willing to disclose, factors that would facilitate data disclosure, and the consensus on those factors. The analysis of the qualitative data was based on grounded theory. Results The family doctors were reluctant to disclose patient data to public health units. This was due to concerns about the extent to which public health agencies are dependable to protect health information (trusting beliefs), and the possibility of loss due to disclosing health information (risk beliefs). We identified six specific actions that public health units can take which would affect these beliefs, and potentially increase the willingness to disclose patient information for public health purposes. Conclusions The uncertainty surrounding a pandemic of a new strain of influenza has not changed the privacy concerns of physicians about disclosing patient data. It is important to address these concerns to ensure reliable reporting during future outbreaks. PMID:21658256

  3. Physician privacy concerns when disclosing patient data for public health purposes during a pandemic influenza outbreak.

    PubMed

    El Emam, Khaled; Mercer, Jay; Moreau, Katherine; Grava-Gubins, Inese; Buckeridge, David; Jonker, Elizabeth

    2011-06-09

    Privacy concerns by providers have been a barrier to disclosing patient information for public health purposes. This is the case even for mandated notifiable disease reporting. In the context of a pandemic it has been argued that the public good should supersede an individual's right to privacy. The precise nature of these provider privacy concerns, and whether they are diluted in the context of a pandemic are not known. Our objective was to understand the privacy barriers which could potentially influence family physicians' reporting of patient-level surveillance data to public health agencies during the Fall 2009 pandemic H1N1 influenza outbreak. Thirty seven family doctors participated in a series of five focus groups between October 29-31 2009. They also completed a survey about the data they were willing to disclose to public health units. Descriptive statistics were used to summarize the amount of patient detail the participants were willing to disclose, factors that would facilitate data disclosure, and the consensus on those factors. The analysis of the qualitative data was based on grounded theory. The family doctors were reluctant to disclose patient data to public health units. This was due to concerns about the extent to which public health agencies are dependable to protect health information (trusting beliefs), and the possibility of loss due to disclosing health information (risk beliefs). We identified six specific actions that public health units can take which would affect these beliefs, and potentially increase the willingness to disclose patient information for public health purposes. The uncertainty surrounding a pandemic of a new strain of influenza has not changed the privacy concerns of physicians about disclosing patient data. It is important to address these concerns to ensure reliable reporting during future outbreaks.

  4. Parental vaccine concerns, information source, and choice of alternative immunization schedules.

    PubMed

    Wheeler, Marissa; Buttenheim, Alison M

    2013-08-01

    Alternative immunization schedules increase the time a child is unvaccinated and require greater resources from providers. Understanding what drives interest in alternative immunization schedules can potentially inform the design of effective, targeted messages that help to reduce time spent counseling and decrease requests for alternative immunization schedules. This study used the Theory of Planned Behavior to explore associations between sources of vaccine information, parental vaccine concerns, peer norms for vaccine behavior and intentions to follow an alternative immunization schedule. We performed logistic regression using medical record data from a private pediatric practice in a large northeastern city. Routine data were recorded in the EMR by the pediatrician during an initial vaccine counseling conversation with the parent(s). Parents who received vaccine information from doctors were less likely to have immunization concerns while parents who got vaccine information from friends and family or from books were more likely to report specific vaccine concerns. Our multivariate analysis shows that number of reported vaccine concerns and concerns about the utility or necessity of vaccines are strongly associated with alternative immunization intentions. We also find a direct relationship between sources of information about vaccines and alternative immunization intentions. Our results suggest that vaccine concerns and non-physician information sources play an important role in alternative immunization intentions while communication from physicians may play an important role in addressing vaccine concerns and promoting adherence to the ACIP immunization schedule.

  5. External Quality Assurance in Higher Education: How Can It Address Corruption and Other Malpractices?

    ERIC Educational Resources Information Center

    Martin, Michaela

    2016-01-01

    Corruption and malpractices in higher education are today a major concern in nearly all higher education systems worldwide. It is a multifaceted phenomenon and has become particularly visible in the academic domain. This paper represents an exploration of the possible role that quality assurance can play in addressing corruption and malpractices.…

  6. Healthy me: A gender-specific program to address body image concerns and risk factors among preadolescents.

    PubMed

    McCabe, Marita P; Connaughton, Catherine; Tatangelo, Gemma; Mellor, David; Busija, Lucy

    2017-03-01

    This study evaluated a gender-specific, school-based program to promote positive body image and address risk factors for body dissatisfaction. In total, 652 children aged 8-10 years participated (335 intervention, 317 wait-list control). Children participated in four 60min sessions and a recap session at three months post-intervention. The broad content areas were body image, peer relationships, media awareness, healthy diet, and exercise. The activities and examples for each session were gender specific. The recap session was an overview of the four sessions. Assessment measures were completed at pre-intervention, post-intervention, and after the recap. Boys and girls in the intervention demonstrated higher muscle esteem and vegetable intake at post-intervention, compared to children in the control condition. Boys and girls demonstrated higher body esteem, muscle esteem and fruit and vegetable intake at the recap. Boys in the intervention demonstrated less investment in masculine gender norms at post-intervention and at recap. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Development of the role of public health nurses in addressing child and family poverty: a framework for action.

    PubMed

    Cohen, Benita E; Reutter, Linda

    2007-10-01

    The purpose of this paper is to invite dialogue about how public health nurses could best address child and family poverty. Their current role is reviewed and a framework for expanding this role is presented. The negative health consequences of poverty for children are well-documented worldwide. The high levels of children living in poverty in wealthy industrialized countries such as Canada should be of concern to the health sector. What role(s) can public health nurses play in addressing child and family poverty? A review of scholarly literature from Canada, the United States of America and the United Kingdom was conducted to ascertain support for public health nurses' roles in reducing poverty and its effects. We then reviewed professional standards and competencies for nursing practice in Canada. The data were collected between 2005 and 2006. Numerous nursing scholars have called for public health nurses to address the causes and consequences of poverty through policy advocacy. However, this role was less likely to be identified in professional standards and competencies, and we found little empirical evidence documenting Canadian public health nurses' efforts to engage in this role. Public health nurses' roles in relation to poverty focus primarily on assisting families living in poverty to access appropriate services rather than directing efforts at the policy level. Factors associated with this limited involvement are identified. We suggest that the conceptual framework developed by Blackburn in the United Kingdom offers direction for a more fully developed public health nursing role. Prerequisites to engaging in the strategies articulated in the framework are discussed. Given more organizational support and enhanced knowledge and skills, public health nurses could be playing a greater role in working with others to make child and family poverty history.

  8. A strategic stakeholder approach for addressing further analysis requests in whole genome sequencing research.

    PubMed

    Thornock, Bradley Steven O

    2016-01-01

    Whole genome sequencing (WGS) can be a cost-effective and efficient means of diagnosis for some children, but it also raises a number of ethical concerns. One such concern is how researchers derive and communicate results from WGS, including future requests for further analysis of stored sequences. The purpose of this paper is to think about what is at stake, and for whom, in any solution that is developed to deal with such requests. To accomplish this task, this paper will utilize stakeholder theory, a common method used in business ethics. Several scenarios that connect stakeholder concerns and WGS will also posited and analyzed. This paper concludes by developing criteria composed of a series of questions that researchers can answer in order to more effectively address requests for further analysis of stored sequences.

  9. Addressing Consent Issues in Donation After Circulatory Determination of Death.

    PubMed

    Overby, Kim J; Weinstein, Michael S; Fiester, Autumn

    2015-01-01

    Given the widening gap between the number of individuals on transplant waiting lists and the availability of donated organs, as well as the recent plateau in donations based on neurological criteria (i.e., brain death), there has been a growing interest in expanding donation after circulatory determination of death. While the prevalence of this form of organ donation continues to increase, many thorny ethical issues remain, often creating moral distress in both clinicians and families. In this article, we address one of these issues, namely, the challenges surrounding patient and surrogate informed consent for donation after circulatory determination of death. First we discuss several general concerns regarding consent related to this form of organ donation, and then we address additional issues that are unique to three different patient categories: adult patients with medical decision-making capacity or potential capacity, adult patients who lack capacity, and pediatric patients.

  10. Ethical Concerns About Human Genetic Enhancement in the Malay Science Fiction Novels.

    PubMed

    Isa, Noor Munirah; Hj Safian Shuri, Muhammad Fakhruddin

    2018-02-01

    Advancements in science and technology have not only brought hope to humankind to produce disease-free offspring, but also offer possibilities to genetically enhance the next generation's traits and capacities. Human genetic enhancement, however, raises complex ethical questions, such as to what extent should it be allowed? It has been a great challenge for humankind to develop robust ethical guidelines for human genetic enhancement that address both public concerns and needs. We believe that research about public concerns is necessary prior to developing such guidelines, yet the issues have not been thoroughly investigated in many countries, including Malaysia. Since the novel often functions as a medium for the public to express their concerns, this paper explores ethical concerns about human genetic enhancement expressed in four Malay science fiction novels namely Klon, Leksikon Ledang, Transgenesis Bisikan Rimba and Transgenik Sifar. Religion has a strong influence on the worldview of the Malays therefore some concerns such as playing God are obviously religious. Association of the negative image of scientists as well as the private research companies with the research on human genetic enhancement reflects the authors' concerns about the main motivations for conducting such research and the extent to which such research will benefit society.

  11. A Conceptual Framework to Address Stress-Associated Human Health Effects of Ecosystem Services Degraded by Disasters

    EPA Science Inventory

    Chronic stress leads to a variety of mental and physiological disorders, and stress effects are the primary concern after traumatic injury and exposure to infectious diseases or toxic agents from disaster events. We developed a conceptual model to address the question of whether...

  12. WhatsApp in Stroke Systems: Current Use and Regulatory Concerns.

    PubMed

    Calleja-Castillo, Juan M; Gonzalez-Calderon, Gina

    2018-01-01

    Smartphone use is extremely common. Applications such as WhatsApp have billions of users and physicians are no exception. Stroke Medicine is a field where instant communication among fairly large groups is essential. In developing countries, economic limitations preclude the possibility of acquiring proper communication platforms. Thus, WhatsApp has been used as an organizational tool, for sharing clinical data, and for real time guidance of clinical care decisions. It has evolved into a cheap, accessible tool for telemedicine. Nevertheless, regulatory and privacy issues must be addressed. Some countries have implemented legislation to address this issue, while others lag behind. In this article, we present an overview on the different roles WhatsApp has acquired as a clinical tool in stroke systems and the potential privacy concerns of its use.

  13. WhatsApp in Stroke Systems: Current Use and Regulatory Concerns

    PubMed Central

    Calleja-Castillo, Juan M.; Gonzalez-Calderon, Gina

    2018-01-01

    Smartphone use is extremely common. Applications such as WhatsApp have billions of users and physicians are no exception. Stroke Medicine is a field where instant communication among fairly large groups is essential. In developing countries, economic limitations preclude the possibility of acquiring proper communication platforms. Thus, WhatsApp has been used as an organizational tool, for sharing clinical data, and for real time guidance of clinical care decisions. It has evolved into a cheap, accessible tool for telemedicine. Nevertheless, regulatory and privacy issues must be addressed. Some countries have implemented legislation to address this issue, while others lag behind. In this article, we present an overview on the different roles WhatsApp has acquired as a clinical tool in stroke systems and the potential privacy concerns of its use. PMID:29904369

  14. What Assessment Knowledge and Skills Do Initial Teacher Education Programs Address? A Western Canadian Perspective

    ERIC Educational Resources Information Center

    Poth, Cheryl-Anne

    2012-01-01

    Teacher education programs play a crucial role in preparing teachers for their future assessment roles and responsibilities, yet many beginning teachers feel unprepared to assess their students' performances (Mertler, 2009). To address concerns related to the relevancy of pre-service assessment education, this study examined 57 syllabi from…

  15. Gender differences and demographic influences in perceived concern for driver safety and support for impaired driving countermeasures.

    PubMed

    Butters, Jennifer; Mann, Robert E; Wickens, Christine M; Boase, Paul

    2012-12-01

    Driving safety, impaired driving, and legislation to address these concerns remain important issues. It is imperative countermeasures be targeted toward the most appropriate groups. This paper explores the potential relationship between gender and driving attitudes toward safety issues and impaired-driving countermeasures. The data are from the 2007 Impaired Driving Survey commissioned by Transport Canada and Mothers Against Drunk Driving (MADD) Canada. The survey is a, stratified by region, telephone survey of 1,514 Canadian drivers 18years of age and older with a valid driver's license who had driven within the past 30days. The findings illustrate a consistent impact of gender on these issues. Other variables were also identified as relevant factors although less consistently. Current findings suggest that strategies for building support for interventions, or for changing risk perception/concern for risky driving behaviors should be tailored by gender to maximize the potential for behavior change. This information may assist program and policy developers through the identification of more or less receptive target groups. Future research directions are also presented. Copyright © 2012 National Safety Council and Elsevier Ltd. All rights reserved.

  16. Comparing mothers' postpartum concerns in two clinical trials 18 years apart.

    PubMed

    Hannan, Jean; Brooten, Dorothy; Youngblut, JoAnne M; Galindo, Ali Marie

    2016-11-01

    To determine if U.S. women's postpartum concerns have changed over time. Mothers' postpartum concerns were compared in two clinical trials: 1997 (high-risk pregnancy) and 2015 (first-time mothers). Advanced practice nurses (APNs) provided care through 8 weeks postpartum and recorded interactions in clinical logs. Content analysis of logs was used for identifying concerns. Ninety-five percent of 58 1997 mothers were African American; 64% of 62 2015 mothers were Hispanic. The number of infant concerns (129 vs. 144) was similar to four of the top five infant concerns; infant feeding was the top concern for both groups. The 1997 mothers were concerned with body changes, birth control, breastfeeding, maternal health problems, and had more concerns about their health (142 vs. 43); the 2015 mothers were concerned with not having help, fatigue, finding things hard. Both groups had postpartum pain concerns and problems accessing mother/infant governmental programs. Mothers' concerns regarding infant care were essentially the same over the two time periods with infant feeding as the top concern. Maternal concerns in common were postpartum pain and needing help accessing government programs. Women who had high-risk pregnancies had more health concerns. Results provide guidance for helping minority mothers in the postpartum period. ©2016 American Association of Nurse Practitioners.

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

    PubMed

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

    2012-01-01

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

  18. Health care voluntourism: addressing ethical concerns of undergraduate student participation in global health volunteer work.

    PubMed

    McCall, Daniel; Iltis, Ana S

    2014-12-01

    The popularity and availability of global health experiences has increased, with organizations helping groups plan service trips and companies specializing in "voluntourism," health care professionals volunteering their services through different organizations, and medical students participating in global health electives. Much has been written about global health experiences in resource poor settings, but the literature focuses primarily on the work of health care professionals and medical students. This paper focuses on undergraduate student involvement in short term medical volunteer work in resource poor countries, a practice that has become popular among pre-health professions students. We argue that the participation of undergraduate students in global health experiences raises many of the ethical concerns associated with voluntourism and global health experiences for medical students. Some of these may be exacerbated by or emerge in unique ways when undergraduates volunteer. Guidelines and curricula for medical student engagement in global health experiences have been developed. Guidelines specific to undergraduate involvement in such trips and pre-departure curricula to prepare students should be developed and such training should be required of volunteers. We propose a framework for such guidelines and curricula, argue that universities should be the primary point of delivery even when universities are not organizing the trips, and recommend that curricula should be developed in light of additional data.

  19. Elderly patients' and GPs' perspectives of patient-GP communication concerning polypharmacy: a qualitative interview study.

    PubMed

    Schöpf, Andrea C; von Hirschhausen, Maike; Farin, Erik; Maun, Andy

    2017-12-26

    Aim The aim of this study was to explore elderly patients' and general practitioners' (GPs') perceptions of communication about polypharmacy, medication safety and approaches for empowerment. To manage polypharmacy, GPs need to know patients' real medication consumption. However, previous research has shown that patients do not always volunteer all information about their medication regimen, for example, such as the intake of over-the-counter medication or the alteration or discontinuation of prescribed medication. A qualitative interview study including patients of at least 65 years old with polypharmacy (⩾5 medications) and their GPs in a German Primary Healthcare Centre. The transcripts from the semi-structured interviews (n=6 with patients; n=3 with GPs) were analysed using a framework analytical approach. Findings We identified three themes: differing medication plans: causes?; dialogue concerning medication: whose responsibility?; supporting patients' engagement: how? While GPs stated that patients do not always report or might even conceal information, all patients reported that they could speak openly about everything with their GPs. In this context, trust might act as a double-edged sword, as it can promote open communication but also prevent patients from asking questions. Both GPs and patients could name very few ways in which patients could be supported to become more informed and active in communication concerning polypharmacy and medication safety. This study shows that patients' awareness of the significance of their active role in addressing polypharmacy needs to be increased. This includes understanding that trusting the doctor does not preclude asking questions or seeking more information. Thus, interventions which improve patients' communication skills and address specific issues of polypharmacy, particularly in elderly patients, should be designed. GPs might support patients by 'inviting' their contribution.

  20. Teachers' Understanding of and Concerns about Mathematical Modeling in the Common Core Standards

    ERIC Educational Resources Information Center

    Wolf, Nancy Butler

    2013-01-01

    Educational reform is most likely to be successful when teachers are knowledgeable about the intended reform, and when their concerns about the reform are understood and addressed. The Common Core State Standards (CCSS) is an effort to establish a set of nationwide expectations for students and teachers. This study examined teacher understanding…

  1. Lack of Cost-Effectiveness Analyses to Address Healthy People 2020 Priority Areas.

    PubMed

    Neumann, Peter J; Farquhar, Megan; Wilkinson, Colby L; Lowry, Mackenzie; Gold, Marthe

    2016-12-01

    To examine the extent to which recently published cost-utility analyses (cost-effectiveness analyses using quality-adjusted life-years to measure health benefits) have covered the leading health concerns in the US Department of Health and Human Services Healthy People 2020 report. We examined data in the Tufts Medical Center Cost-Effectiveness Analysis Registry, a database containing 5000 published cost-utility analyses published in the MEDLINE literature through 2014. We focused on US-based cost-utility analyses published from 2011 through 2014 (n = 687). Two reviewers scanned abstracts and met for a consensus on categorization of cost-utility analyses that addressed the specific priorities listed in the 12 Healthy People 2020 areas (n = 120). Although 7.3% of recently published cost-utility analyses addressed key clinical preventive services, only about 2% of recently published cost-utility analyses covered each of the following Healthy People 2020 topics: reproductive and sexual health, nutrition/physical activity/obesity, maternal and infant health, and tobacco. Fewer than 1% addressed priorities such as injuries and violence, mental health or substance abuse, environmental quality, and oral health. Few cost-utility analyses have addressed Healthy People 2020 priority areas.

  2. An assessment of the level of concern among hospital-based health-care workers regarding MERS outbreaks in Saudi Arabia.

    PubMed

    Abolfotouh, Mostafa A; AlQarni, Ali A; Al-Ghamdi, Suliman M; Salam, Mahmoud; Al-Assiri, Mohammed H; Balkhy, Hanan H

    2017-01-03

    Middle East Respiratory Syndrome (MERS) is caused by MERS coronavirus (MERS-CoV). More than 80% of reported cases have occurred in Saudi Arabia, with a mortality exceeding 50%. Health-care workers (HCWs) are at risk of acquiring and transmitting this virus, so the concerns of HCWs in Saudi Arabia regarding MERS were evaluated. An anonymous, self-administered, previously validated questionnaire was given to 1031 HCWs at three tertiary hospitals in Saudi Arabia from October to December, 2014. Concerns regarding the disease, its severity and governmental efforts to contain it, as well as disease outcomes were assessed using 31 concern statements in five distinct domains. A total concern score was calculated for each HCW. Multiple regression analyses were used to identify predictors of high concern scores. The average age of participants was 37.1 ± 9.0 years, 65.8% were married and 59.1% were nurses. The majority of respondents (70.4%) felt at risk of contracting a MERS-CoV infection at work, 69.1% felt threatened if a colleague contracted MERS-CoV, 60.9% felt obliged to care for patients infected with MERS-CoV and 87.8% did not feel safe at work using standard precautions. In addition, 87.7% believed that the government should isolate patients with MERS in specialized hospitals, 73.7% agreed with travel restriction to and from areas affected by MERS and 65.3% agreed with avoiding inviting expatriates from such areas. After adjustment for covariates, high concern scores were significantly associated with being a Saudi national (p < 0.001), a non-physician (p < 0.001) and working in the central region (p < 0.001). The majority of respondents reported concern regarding MERS-CoV infection from exposure at work. The overall level of concern may be influenced by previous experience of MERS outbreaks and related cultural issues. The concerns of HCWs may affect their overall effectiveness in an outbreak and should be addressed by incorporating management

  3. Teaching Design in Middle-School: Instructors' Concerns and Scaffolding Strategies

    NASA Astrophysics Data System (ADS)

    Bamberger, Yael M.; Cahill, Clara S.

    2013-04-01

    This study deals with engineering education in the middle-school level. Its focus is instructors' concerns in teaching design, as well as scaffolding strategies that can help teachers deal with these concerns. Through participatory action research, nine instructors engaged in a process of development and instruction of a curriculum about energy along with engineering design. A 50-h curriculum was piloted during a summer camp for 38 middle-school students. Data was collected through instructors' materials: observation field notes, daily reflections and post-camp discussions. In addition, students' artifacts and planning graphical models were collected in order to explore how instructors' concerns were aligned with students' learning. Findings indicate three main tensions that reflect instructors' main concerns: how to provide sufficient scaffolding yet encourage creativity, how to scaffold hands-on experiences that promote mindful planning, and how to scaffold students' modeling practices. Pedagogical strategies for teaching design that developed through this work are described, as well as the ways they address the National Research Council (A framework for K-12 science education: practices, crosscutting concepts, and core ideas. National Academies Press, Washington, DC, 2011) core ideas of engineering education and the International Technological Literacy standards (ITEA in Standards for technological literacy, 3rd edn. International Technology education Association, Reston, VA, 2007).

  4. Parental concerns towards children and adolescents with epilepsy in Sri Lanka--Qualitative study.

    PubMed

    Murugupillai, Roshini; Wanigasinghe, Jithangi; Muniyandi, Ravi; Arambepola, Carukshi

    2016-01-01

    Social, cultural, psychological and many other factors significantly impact the lives of epileptic children and their families. Parental concerns towards their children are less known in south Asian children with epilepsy. We aimed to identify the parental concerns regarding their children and adolescents with epilepsy in Sri Lanka. We carried out qualitative study in 3 districts of Sri Lanka, comprising 16 in-depth interviews with parents of children and adolescents with epilepsy and 3 focus group discussions with primary caregivers of epileptic children and key informants (schoolteachers, public health staffs). Content analysis of the interview data was performed. Parental concerns were spread among seven themes that emerged from the content analysis. These concerns were about the child's functioning in areas such as physical, behavioural, psychological and social, education, concerns related to anti-epileptic therapy and epilepsy as a disease. Parents were more concerned about their child's safety, educational achievements and future prospects in terms of employment and marriage. Unpredictability of seizures, fear of stigma and unawareness of epilepsy were the main reasons voiced by the parents for having such concerns. Increased concern and perception of vulnerability was seen among parents whose children had epilepsy and co-morbid illness. Parental concerns towards their children and adolescents show a multidimensional construct. Unpredictability of seizures, fear of stigma and unawareness of epilepsy were identified as key influential factors in moulding the parental concerns. Copyright © 2015. Published by Elsevier Ltd.

  5. Addressing Medical Errors in Hand Surgery

    PubMed Central

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

    2014-01-01

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

  6. Geochemistry and mercury contamination in receiving environments of artisanal mining wastes and identified concerns for food safety

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

    Reichelt-Brushett, Amanda J., E-mail: amanda.reich

    Artisanal small-scale gold mining (ASGM) using mercury (Hg) amalgamation has been occurring on Buru Island, Indonesia since early 2012, and has caused rapid accumulation of high Hg concentrations in river, estuary and marine sediments. In this study, sediment samples were collected from several sites downstream of the Mount Botak ASGM site, as well as in the vicinity of the more recently established site at Gogrea where no sampling had previously been completed. All sediment samples had total Hg (THg) concentrations exceeding Indonesian sediment quality guidelines and were up to 82 times this limit at one estuary site. The geochemistry ofmore » sediments in receiving environments indicates the potential for Hg-methylation to form highly bioavailable Hg species. To assess the current contamination threat from consumption of local seafood, samples of fish, molluscs and crustaceans were collected from the Namlea fish market and analysed for THg concentrations. The majority of edible tissue samples had elevated THg concentrations, which raises concerns for food safety. This study shows that river, estuary and marine ecosystems downstream of ASGM operations on Buru Island are exposed to dangerously high Hg concentrations, which are impacting aquatic food chains, and fisheries resources. Considering the high dietary dependence on marine protein in the associated community and across the Mollucas Province, and the short time period since ASGM operations commenced in this region, the results warrant urgent further investigation, risk mitigation, and community education. - Highlights: • Mercury contamination of sediments and seafood due to artisanal gold mining. • Considerable risks to human and ecosystem health are identified. • Results emphasise the urgent need for risk mitigation and community education.« less

  7. Identifying unproven cancer treatments on the health web: addressing accuracy, generalizability and scalability.

    PubMed

    Aphinyanaphongs, Yin; Fu, Lawrence D; Aliferis, Constantin F

    2013-01-01

    Building machine learning models that identify unproven cancer treatments on the Health Web is a promising approach for dealing with the dissemination of false and dangerous information to vulnerable health consumers. Aside from the obvious requirement of accuracy, two issues are of practical importance in deploying these models in real world applications. (a) Generalizability: The models must generalize to all treatments (not just the ones used in the training of the models). (b) Scalability: The models can be applied efficiently to billions of documents on the Health Web. First, we provide methods and related empirical data demonstrating strong accuracy and generalizability. Second, by combining the MapReduce distributed architecture and high dimensionality compression via Markov Boundary feature selection, we show how to scale the application of the models to WWW-scale corpora. The present work provides evidence that (a) a very small subset of unproven cancer treatments is sufficient to build a model to identify unproven treatments on the web; (b) unproven treatments use distinct language to market their claims and this language is learnable; (c) through distributed parallelization and state of the art feature selection, it is possible to prepare the corpora and build and apply models with large scalability.

  8. 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.

  9. Comparing Mothers' Postpartum Concerns in 2 Clinical Trials 18 Years Apart

    PubMed Central

    Hannan, Jean; Brooten, Dorothy; Youngblut, JoAnne M.; Galindo, Ali Marie

    2016-01-01

    Background/purpose To determine if US women's postpartum concerns have changed overtime. Methods Mothers' postpartum concerns were compared in 2 clinical trials: 1997 (High Risk Pregnancy); 2015 (First Time Mothers). Advanced Practice Nurses (APNs) provided care through 8 weeks postpartum and recorded interactions in clinical logs. Content analysis of logs was used to identify concerns. Results 95% of 58 1997 mothers were African American; 64% of 62 2015 mothers were Hispanic. Number of infant concerns (129 vs 144) was similar as were 4 of top 5; infant feeding was the top concern for both. 1997 mothers were concerned with body changes, birth control, breastfeeding, maternal health problems and had more concerns about their health (142 vs. 43); 2015 mothers were concerned with not having help, fatigue, finding things hard. Both groups had postpartum pain concerns and problems accessing mother/infant governmental programs. Conclusions Mother's concerns regarding infant care were essentially the same over the 2 time periods with infant feeding as the top concern. Maternal concerns in common were postpartum pain and needing help accessing government programs. Women who had high risk pregnancies had more health concerns. Implications for Practice Results provide guidance for helping minority mothers in the postpartum period. PMID:27273192

  10. Addressing Escape-Maintained Behavior for Students with Developmental Disabilities: A Systematic Review of School-Based Interventions

    ERIC Educational Resources Information Center

    Dart, Evan H.; Radley, Keith C.; Mason, Benjamin A.; Allen, Justin P.

    2018-01-01

    Students with developmental disabilities have been found to exhibit higher rates of problem behavior in the classroom than their typically developing peers. Effectively addressing these students' behavior concerns requires the identification of interventions that can be implemented in an educational setting. Furthermore, matching intervention…

  11. The experiences and support needs of people with intellectual disabilities who identify as LGBT: A review of the literature.

    PubMed

    McCann, Edward; Lee, Regina; Brown, Michael

    2016-10-01

    People who identify as lesbian, gay, bisexual and transgender (LGBT) can face many challenges in society including accessing education, care and support appropriate to individual needs. However, there is a growing and evolving evidence base about the specific needs of people with intellectual disabilities (ID) in this regard. The aim of this review was to explore the experiences of people with ID who identified as LGBT through an examination of studies that addressed their views and highlighted specific issues, concerns and service responses. A comprehensive search of relevant databases from February 1995 to February 2015 was conducted. Studies were identified that met specific criteria that included: empirical peer reviewed studies, the use of recognised research methods and focused on people with ID whom identified as LGBT. The search yielded 161 papers in total. The search was narrowed and 37 papers were screened using rigorous inclusion and exclusion criteria. Finally, 14 papers were considered suitable for the review. The data were analysed and key themes identified that included accessing health services, gender and sexual identity, attitudes of people with ID regarding their LGBT status, and education, supports and therapeutic interventions. There is a need for service providers and carers to be more responsive to the concerns of people with ID who identify as LGBT to improve their health and well-being by reducing stigma and discrimination and by increasing awareness of their care and support needs. The implications are discussed in terms of policy, education, research and practice developments. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Quality of life concerns and depression among hematopoietic stem cell transplant survivors.

    PubMed

    Mosher, Catherine E; DuHamel, Katherine N; Rini, Christine; Corner, Geoffrey; Lam, Joanne; Redd, William H

    2011-09-01

    This study examined quality of life, transplant-related concerns, and depressive symptoms and their demographic and medical correlates at 1 to 3 years following hematopoietic stem cell transplantation (HSCT). HSCT survivors (N=406) completed telephone-administered questionnaires that assessed demographic variables, functional status, quality of life, transplant-related concerns, and depressive symptoms. The most prevalent concerns among HSCT survivors included physical symptoms (e.g., fatigue and pain), maintaining current health status and employment, changes in appearance, and lack of sexual interest and satisfaction. In addition, almost one-third (32%) of survivors age 40 years and younger reported concern about their ability to have children. Unemployed survivors and those with lower incomes and worse functional status were more likely to experience poorer quality of life in multiple domains. Fifteen percent of the sample reported moderate to severe depressive symptoms, and these symptoms were higher among allogeneic transplant recipients and those with lower functional status. Results suggest that interventions are needed to address physical symptoms, coping with an uncertain future, infertility, and sexual issues during the early phase of HSCT survivorship.

  13. Supporting practice teachers to identify failing students.

    PubMed

    Skingley, Ann; Arnott, J; Greaves, J; Nabb, J

    2007-01-01

    The subject of identifying and supporting failing students in community nursing education programmes has been largely overlooked in the literature, yet is of great concern to practice teachers. This article discusses the views on the topic of a group of practice teachers in the light of existing, related research and proposes a number of indicators for good practice. It is suggested that of central importance is the need for higher education institutions and practice teachers to work together in identifying students causing concern at an early stage in their studies, based on both objective and subjective observations, and to have in place documented procedures to be followed when such situations arise.

  14. DDT and Malaria Prevention: Addressing the Paradox

    PubMed Central

    Bouwman, Hindrik; van den Berg, Henk; Kylin, Henrik

    2011-01-01

    Background The debate regarding dichlorodiphenyltrichloroethane (DDT) in malaria prevention and human health is polarized and can be classified into three positions: anti-DDT, centrist-DDT, pro-DDT. Objective We attempted to arrive at a synthesis by matching a series of questions on the use of DDT for indoor residual spraying (IRS) with literature and insights, and to identify options and opportunities. Discussion Overall, community health is significantly improved through all available malaria control measures, which include IRS with DDT. Is DDT “good”? Yes, because it has saved many lives. Is DDT safe as used in IRS? Recent publications have increasingly raised concerns about the health implications of DDT. Therefore, an unqualified statement that DDT used in IRS is safe is untenable. Are inhabitants and applicators exposed? Yes, and to high levels. Should DDT be used? The fact that DDT is “good” because it saves lives, and “not safe” because it has health and environmental consequences, raises ethical issues. The evidence of adverse human health effects due to DDT is mounting. However, under certain circumstances, malaria control using DDT cannot yet be halted. Therefore, the continued use of DDT poses a paradox recognized by a centrist-DDT position. At the very least, it is now time to invoke precaution. Precautionary actions could include use and exposure reduction. Conclusions There are situations where DDT will provide the best achievable health benefit, but maintaining that DDT is safe ignores the cumulative indications of many studies. In such situations, addressing the paradox from a centrist-DDT position and invoking precaution will help design choices for healthier lives. PMID:21245017

  15. Developing a strategy for understanding adolescent nutrition concerns.

    PubMed

    Amos, R J; Pingree, S; Ashbrook, S; Betts, N M; Fox, H M; Newell, K; Ries, C P; Terry, R D; Tinsley, A; Voichick, J

    1989-01-01

    Disseminating nutrition information that adolescents will incorporate into their lives has been a difficult challenge for nutrition educators. The communication of such information has often been a "one-way street"; adolescents are given information that educators feel they need to have. Researchers contend that a more effective way to communicate is for adolescents to describe what they need to know in order to relate nutrition messages to their own worlds. A research model based on Brenda Dervin's work with the "sense-making" theory of communication was used to better determine adolescents' perceived nutrition concerns. Adolescents aged 14 to 16 across six states were interviewed to record personal situations they experienced concerning food, nutrition, and/or eating. Situation "movement states" were identified to determine the qualitative ways in which the adolescents perceived themselves as dealing with the situations they described. Data indicate that this theoretical base may be used by nutrition educators to identify adolescents' nutrition needs and to design appropriate education materials.

  16. Workplace Safety Concerns among Co-workers of Responder Returning from Ebola-Affected Country

    PubMed Central

    Daly, Elizabeth R.; Talbot, Elizabeth A.

    2015-01-01

    We surveyed public health co-workers regarding attitudes toward a physician who returned to New Hampshire after volunteering in the West African Ebola outbreak. An unexpectedly large (18.0%) proportion of staff expressed discomfort with the Ebola responder returning to work. Employers should take proactive steps to address employee fears and concerns. PMID:26488494

  17. Security and health research databases: the stakeholders and questions to be addressed.

    PubMed

    Stewart, Sara

    2006-01-01

    Health research database security issues abound. Issues include subject confidentiality, data ownership, data integrity and data accessibility. There are also various stakeholders in database security. Each of these stakeholders has a different set of concerns and responsibilities when dealing with security issues. There is an obvious need for training in security issues, so that these issues may be addressed and health research will move on without added obstacles based on misunderstanding security methods and technologies.

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

    PubMed

    Angel, Sanne; Frederiksen, Kirsten Norup

    2015-09-01

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

  19. Feeding and Mealtime Correlates of Maternal Concern About Children's Weight.

    PubMed

    Branch, Jacqueline M; Appugliese, Danielle P; Rosenblum, Katherine L; Miller, Alison L; Lumeng, Julie C; Bauer, Katherine W

    2017-06-01

    To examine associations between maternal concern regarding their children becoming overweight and two domains of weight-related parenting; child feeding practices and family meal characteristics. Cross-sectional study. Low-income mothers (n = 264; 67% non-Hispanic white) and their children (51.5% male, aged 4.02-8.06 years). Maternal concern and feeding practices, using the Child Feeding Questionnaire. Meal characteristics were assessed using video-recorded meals and meal information collected from mothers. The authors used MANOVA and logistic regression to identify differences in maternal feeding practices and family meal characteristics across levels of maternal concern (none, some, and high). Approximately half of mothers were not concerned about their child becoming overweight, 28.4% reported some concern, and 19.0% had high concern. Mothers reporting no concern described lower restrictive feeding compared with mothers who reported some or high concern (mean [SE], none = 3.1 [0.1]; some = 3.5 [0.1]; and high = 3.6 [0.1]; P = .004). No differences in other feeding practices or family meal characteristics were observed by level of concern. Concern regarding children becoming overweight was common. However, concern rarely translated into healthier feeding practices or family meal characteristics. Maternal concern alone may not be sufficient to motivate action to reduce children's risk of obesity. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  20. 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.

  1. Professional concerns of beginning teachers of deaf and hard of hearing students.

    PubMed

    Guteng, Simon I

    2005-01-01

    The professional concerns of beginning teachers of students who are deaf or hard of hearing were examined. Five first-year teachers of deaf and hard of hearing students served as participants. Two of the participants were itinerant teachers; three taught in self-contained classrooms. Participants were selected from programs serving deaf and hard of hearing students in rural and urban areas of the midwestern and southwestern United States. To interview the study participants, the researcher used an in-depth phenomenological method employing semi-structured questions and guided by a constructivist paradigm. Data were analyzed using qualitative analysis strategies (Bogdan & Biklen, 1992; Miles & Huberman, 1994). Results showed that concerns of beginning teachers of deaf and hard of hearing students are specific to service delivery models and geography. Participants provided specific recommendations for addressing the concerns of beginning teachers of deaf and hard of hearing students.

  2. Global paradigm shift in medical education: issues of concern for Africa.

    PubMed

    Gukas, Isaac D

    2007-11-01

    When medical education became established in Africa, many curricula were adopted from the West so as to achieve comparable standards in training. Over the last half a century however, major global pedagogical shifts have occurred in medical education without African keeping pace. This article reviews key pedagogical changes and other innovations in medical education that have occurred over the last half a century as reported in the literature and identifies some of the issues that need to be addressed in Africa. Socioeconomic and political instability, failure to rapidly overcome the inertia for change by substituting the old curriculum with a more problem, system and student-based one and redefining the goals of medical education are some of the issues of concern for Africa, and its ability to keep up in the dynamic world of medical education. There are only few faculty and school managers with effective medical education backgrounds to initiate, evaluate and sustain these changes. African medical academics, national governments and the international community need to come together to assist Africa to rise up to these challenges to ensure attainment and sustenance of global standards in medical training.

  3. Parents' beliefs about the healthfulness of sugary drink options: opportunities to address misperceptions.

    PubMed

    Munsell, Christina R; Harris, Jennifer L; Sarda, Vishnudas; Schwartz, Marlene B

    2016-01-01

    To assess potential misperceptions among parents regarding the healthfulness of sugary drinks for their children. Online survey of parents. Participants identified the categories and specific brands of sugary drinks they provided for their children. They also indicated their perceptions of sugary drink categories and brands as healthy options for children, perceived importance of on-package claims in purchase decisions and their concerns about common sugary drink ingredients. Online market research panel. Parents (n 982) of 2- to 17-year-olds, 46 % non-white or Hispanic. Ninety-six per cent of parents provided on average 2·9 different categories of sugary drinks for their children in the past month. Flavoured waters, fruit drinks and sports drinks were rated as the healthiest sugary drink categories. Across all categories and brands, parents who purchased specific products rated them as significantly healthier than those who did not (P<0·05). Over half of parents reported concern about caffeine, sugar and artificial sweeteners in sugary drinks that their children consume and approximately one-third reported that on-package ingredient claims were important in their purchase decisions. Nearly all parents provide sugary drinks for their children and many believe that some sugary drinks are healthy options for children, particularly flavoured waters, fruit drinks and sports drinks. Furthermore, many parents rely upon on-package claims in their purchase decisions. Given excessive consumption of added sugar by children in the home, there is a continuing need to address parents' misperceptions about the healthfulness of many sugary drink products.

  4. The Concerns about Counseling Racial Minority Clients Scale

    ERIC Educational Resources Information Center

    Wei, Meifen; Chao, Ruth Chu-Lien; Tsai, Pei-Chun; Botello-Zamarron, Raquel

    2012-01-01

    The purpose of this study was to develop and validate the Concerns about Counseling Racial Minority Clients (CCRMC) scale among counselor trainees. Sample 1 was used for an exploratory factor analysis and confirmatory factor analysis. Four factors were identified, Managing Cultural Differences ([alpha] = 0.82), Offending or Hurting Clients…

  5. Identifying and addressing potential conflict of interest: a professional medical organization's code of ethics.

    PubMed

    Heim, Lori

    2010-01-01

    The new Consumer Alliance agreement between the American Academy of Family Physicians (AAFP) and The Coca-Cola Company provides a valuable opportunity to illustrate AAFP's adherence to its ethical foundation, demonstrate the AAFP's commitment to serving physicians and the public, and maintain the trust Americans put in their family physicians and the organization that represents them. Throughout the development of this program, as well as in all business interactions, the AAFP consistently addresses possible conflict of interest openly and directly, sharing with our members and the public exactly what measures we take to ensure that, in fact, no unethical conduct or breach of trust would--or will in the future--occur. In this case, the AAFP saw a public health and education need that was both unmet and undermined by the barrage of marketing messages and confusing information, and acted to fill that need. In so doing, the AAFP hewed to its high ethical standards, its core values, and its mission in the decisions made and the actions that followed.

  6. Animating Research with Counseling Values: A Training Model to Address the Research-to-Practice Gap

    ERIC Educational Resources Information Center

    Lee, Kristi A.; Dewell, John A.; Holmes, Courtney M.

    2014-01-01

    The persistent research-to-practice gap poses a problem for counselor education. The gap may be caused by conflicts between the humanistic values that guide much of counseling and the values that guide research training. In this article, the authors address historical concerns regarding research training for students and the conducting of research…

  7. "Back-Stage" Dissent: Student Twitter Use Addressing Instructor Ideology

    ERIC Educational Resources Information Center

    Linvill, Darren L.; Boatwright, Brandon C.; Grant, Will J.

    2018-01-01

    In this content analysis, we explored how students address instructor ideology in the university classroom through the social media platform Twitter. We employed Boolean search operators through Salesforce Marketing Cloud Radian6 software to gather tweets and identified English language tweets by how students referenced their instructor's…

  8. 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…

  9. Fitness-to-practice concerns in rural undergraduate medical education: a qualitative study.

    PubMed

    Snow, Pamela Claire; Harvey, Pamela Jane; Cocking, Kylie Lynette

    2014-09-19

    Since July 2010, new reporting requirements have applied to registered Australian health practitioners who have a reasonable belief that a practitioner or student (of any registered discipline) is exhibiting "notifiable conduct". A study of healthcare complaints reported that a small number of practitioners are over-represented in the majority of formal complaints brought against doctors. The impetus for conducting this research was a recognition that identifying and responding to particular behaviours early may prevent issues requiring mandatory reporting later on. As a first step, a better understanding of how fitness-to-practice (FTP) concerns are viewed was sought from stakeholders in a rural medical school. This qualitative project used purposive and snowballing sampling. Thirteen participants from an Australian rural medical school were interviewed for the study about FTP concerns. Seven were university staff, including clinical educators, program co-ordinators and academic faculty. Six were medical students in the middle of their final year. Their de-identified interview transcripts were independently coded into themes and emergent data categories were refined through comparative analysis between the authors. Data collection ceased after theoretical saturation was achieved. Although students and faculty staff responded similarly in their recognition of FTP concerns, they varied in their assessment of their frequency, with students indicating that concerns were rare. Students and staff expressed reluctance to formally report students or colleagues with FTP concerns because of the complexity and uncertainty of medical practice. Both groups considered early recognition of problems and implementation of supportive mechanisms as important, but students generally did not want to contact the university about concerns for fear of stigmatisation. Education providers need to have clear processes for identifying and responding to FTP concerns in the pre-service years

  10. Early Warning Program to Detect and Identify Contaminants of Emerging Concern and Their Effects to Fish and Wildlife

    EPA Science Inventory

    The Great Lakes basin provides an opportunity to investigate impacts to fish and wildlife from various natural and anthropogenic influences, particularly within Areas of Concern (AOC). While AOC beneficial use impairments related to chemical pollution largely encompass legacy con...

  11. EMPOWER: an intervention to address barriers to pain management in hospice.

    PubMed

    Cagle, John G; Zimmerman, Sheryl; Cohen, Lauren W; Porter, Laura S; Hanson, Laura C; Reed, David

    2015-01-01

    Concerns about pain medications are major barriers to pain management in hospice, but few studies have focused on systematic methods to address these concerns. The objective of this study was to test the preliminary efficacy of the Effective Management of Pain: Overcoming Worries to Enable Relief (EMPOWER) intervention, which included hospice staff education, staff screening of barriers to pain management at admission, and discussion about misunderstandings regarding pain management with family caregivers and patients. We conducted a pilot, cluster randomized, controlled trial with four hospices. One hundred twenty-six family caregivers (55 interventions and 71 controls) were interviewed at two weeks after admission. If patients survived three months after admission, caregivers were reinterviewed. At two weeks, caregivers in the intervention group reported better knowledge about pain management (P = 0.001), fewer concerns about pain and pain medications (P = 0.008), and lower patient pain over the past week (P = 0.014) and trended toward improvement in most other areas under study. Exploratory analyses suggest that EMPOWER had a greater effect for black subjects (vs. whites) on reducing concern about stigma. At three months, the intervention group trended better on most study outcomes. EMPOWER is a promising model to reduce barriers to pain management in hospice. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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

    PubMed

    de Groot, Lisette C P G M

    2016-05-01

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

  13. Experiencing reproductive concerns as a female cancer survivor is associated with depression.

    PubMed

    Gorman, Jessica R; Su, H Irene; Roberts, Samantha C; Dominick, Sally A; Malcarne, Vanessa L

    2015-03-15

    Young adult female cancer survivors have unmet reproductive concerns and informational needs that are associated with poorer quality of life. The purpose of this study was to examine the association between current reproductive concerns and moderate to severe depression among young survivors. This cross-sectional study included 200 female cancer survivors between the ages of 18 and 35 years who completed a Web-based survey measuring reproductive history, parenthood desires, reproductive concerns after cancer, and quality-of-life indicators. The mean age of the participants was 28 years (standard deviation, 4.4 years), and almost two-thirds were diagnosed within 5 years of survey completion. A multivariate logistic regression analysis controlling for education, duration of survivorship, and social support revealed an association between experiencing reproductive concerns and moderate to severe depression (odds ratio for each 5-unit increase in the Reproductive Concerns After Cancer [RCAC] score, 1.30; 95% confidence interval, 1.06-1.60). Among those with moderate to severe depression, 23% had high RCAC scores, whereas 6% of those with minimal to mild depression did (P < .001). A higher level of reproductive concerns was associated with greater odds of experiencing moderate to severe depression. Almost a quarter of survivors in this sample reported moderate to severe depression, and addressing reproductive concerns represents one potential area of intervention for improving the psychosocial health of young survivors. © 2014 American Cancer Society.

  14. URISA Address Standard

    EPA Pesticide Factsheets

    The Urban and Regional Information Systems Association (URISA) standard for addresses. The document covers thoroughfare, landmark, and postal addresses within the United States, including its outlying territories and possessions.

  15. THE FUKUSHIMA RADIOLOGICAL EMERGENCY AND CHALLENGES IDENTIFIED FOR FUTURE PUBLIC HEALTH RESPONSES

    PubMed Central

    Miller, Charles W.

    2015-01-01

    On 11 March 2011, northern Japan was rocked by first a magnitude 9.0 earthquake off the eastern coast and then an ensuing tsunami. The Fukushima Daiichi Nuclear Power Plant complex was hit by these twin disasters, and a cascade of events was initiated that led to radionuclide releases causing widespread radioactive contamination of residential areas, agricultural land, and coastal waters. Radioactive material from Japan was subsequently transmitted to locations around the globe, including the U.S. The levels of radioactive material that arrived in the U.S. were never large enough to be a concern for health effects, but the presence of this material in the environment was enough to create a public health emergency in the U.S. The radiation safety and public health communities in the U.S. are identifying challenges they faced in responding to this incident. This paper discusses three of those challenges: (1) The growing shortage of trained radiation subject matter experts in the field of environmental transport and dosimetry of radionuclides; (2) the need to begin expressing all radiation-related quantities in terms of the International System of Units; and (3) the need to define when a radiation dose is or is not one of “public health concern.” This list represents only a small subset of the list of challenges being identified by public health agencies that responded to the Fukushima incident. However, these three challenges are fundamental to any radiological emergency response. Addressing them will have a significant positive impact on how the U.S. responds to the next radiological emergency. PMID:22469934

  16. The Fukushima radiological emergency and challenges identified for future public health responses.

    PubMed

    Miller, Charles W

    2012-05-01

    On 11 March 2011, northern Japan was rocked by first a magnitude 9.0 earthquake off the eastern coast and then an ensuing tsunami. The Fukushima Daiichi Nuclear Power Plant complex was hit by these twin disasters, and a cascade of events was initiated that led to radionuclide releases causing widespread radioactive contamination of residential areas, agricultural land, and coastal waters. Radioactive material from Japan was subsequently transmitted to locations around the globe, including the U.S. The levels of radioactive material that arrived in the U.S. were never large enough to be a concern for health effects, but the presence of this material in the environment was enough to create a public health emergency in the U.S. The radiation safety and public health communities in the U.S. are identifying challenges they faced in responding to this incident. This paper discusses three of those challenges: (1) The growing shortage of trained radiation subject matter experts in the field of environmental transport and dosimetry of radionuclides; (2) the need to begin expressing all radiation-related quantities in terms of the International System of Units; and (3) the need to define when a radiation dose is or is not one of "public health concern." This list represents only a small subset of the list of challenges being identified by public health agencies that responded to the Fukushima incident. However, these three challenges are fundamental to any radiological emergency response. Addressing them will have a significant positive impact on how the U.S. responds to the next radiological emergency.

  17. Experiencing reproductive concerns as a female cancer survivor is associated with depression

    PubMed Central

    Gorman, Jessica R.; Su, H. Irene; Roberts, Samantha C.; Dominick, Sally A.; Malcarne, Vanessa L.

    2014-01-01

    Background Young adult female cancer survivors have unmet reproductive concerns and informational needs that are associated with poorer quality of life. The purpose of this study was to examine the association between current reproductive concerns and moderate to severe depression among young survivors. Methods This cross-sectional study includes 200 female cancer survivors between the ages of 18 and 35 years who completed a web-based survey measuring reproductive history, parenthood desires, reproductive concerns after cancer, and quality of life indicators. Results The mean age of participants was 28 years (SD = 4.4) and almost two-thirds were diagnosed within 5 years of completing the survey. Multivariable logistic regression analysis controlling for education, duration of survivorship, and social support revealed an association between experiencing reproductive concerns and moderate to severe depression (OR = 1.30, 95% CI = 1.06–1.60 for each 5 unit increase in RCAC score). Of those with moderate to severe depression, 23% had high RCAC scores as compared to 6% of those with minimal to mild depression (p < 0.001). Conclusion A higher level of reproductive concerns was associated with greater odds of experiencing moderate to severe depression. Almost a quarter of survivors in this sample reported moderate to severe depression, and addressing reproductive concerns represents one potential area of intervention to improve the psychosocial health of young survivors. PMID:25377593

  18. Potential of low-temperature anaerobic digestion to address current environmental concerns on swine production.

    PubMed

    Massé, D I; Masse, L; Xia, Y; Gilbert, Y

    2010-04-01

    Environmental issues associated with swine production are becoming a major concern among the general public and are thus an important challenge for the swine industry. There is now a renewed interest in environmental biotechnologies that can minimize the impact of swine production and add value to livestock by-products. An anaerobic biotechnology called psychrophilic anaerobic digestion (PAD) in sequencing batch reactors (SBR) has been developed at Agriculture and Agri-Food Canada. This very stable biotechnology recovers usable energy, stabilizes and deodorizes manure, and increases the availability of plant nutrients. Experimental results indicated that PAD of swine manure slurry at 15 to 25 degrees C in intermittently fed SBR reduces the pollution potential of manure by removing up to 90% of the soluble chemical oxygen demand. The process performs well under intermittent feeding, once to 3 times a week, and without external mixing. Bioreactor feeding activities can thus be easily integrated into the routine manure removal procedures in the barn, with minimal interference with other farm operations and use of existing manure-handling equipment. Process stability was not affected by the presence of antibiotics in manure. The PAD process was efficient in eliminating populations of zoonotic pathogens and parasites present in raw livestock manure slurries. Psychrophilic anaerobic digestion in SBR could also be used for swine mortality disposal. The addition of swine carcasses, at loading rates representing up to 8 times the normal mortality rates on commercial farms, did not affect the stability of SBR. No operational problems were related to the formation of foam and scum. The biotechnology was successfully operated at semi-industrial and full commercial scales. Biogas production rate exceeded 0.20 L of methane per gram of total chemical oxygen demand fed to the SBR. The biogas was of excellent quality, with a methane concentration ranging from 70 to 80%. The

  19. Addressing environmental justice under the National Environment Policy Act at Sandia National Laboratories/New Mexico

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

    Cohen, T.M.; Bleakly, D.R.

    1997-04-01

    Under Executive Order 12898, Federal Actions to Address Environmental Justice in Minority Populations and Low-Income Populations, the Department of Energy (DOE) and Sandia National Laboratories New Mexico (SNL) are required to identify and address, as appropriate, disproportionately high, adverse human health or environmental effects of their activities on minority and low-income populations. The National Environmental Policy Act (NEPA) also requires that environmental justice issues be identified and addressed. This presents a challenge for SNL because it is located in a culturally diverse area. Successfully addressing potential impacts is contingent upon accurately identifying them through objective analysis of demographic information. However,more » an effective public participation process, which is necessarily subjective, is also needed to understand the subtle nuances of diverse populations that can contribute to a potential impact, yet are not always accounted for in a strict demographic profile. Typically, there is little or no coordination between these two disparate processes. This report proposes a five-step method for reconciling these processes and uses a hypothetical case study to illustrate the method. A demographic analysis and community profile of the population within 50 miles of SNL were developed to support the environmental justice analysis process and enhance SNL`s NEPA and public involvement programs. This report focuses on developing a methodology for identifying potentially impacted populations. Environmental justice issues related to worker exposures associated with SNL activities will be addressed in a separate report.« less

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

    PubMed

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

    2016-05-01

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

  1. Bulimia: Issues a University Counseling Center Needs To Address.

    ERIC Educational Resources Information Center

    Whitner, Phillip A.; Shetterly, Arminta

    The eating disorder known as bulimia is a relatively new and baffling phenomenon. This paper raises questions that college and university counseling center professionals need to address regarding this phenomenon. The first section focuses on defining the term "bulimia" and its evolution. The second section identifies numerous symptoms that need to…

  2. Culture X: addressing barriers to physical activity in Samoa.

    PubMed

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

    2017-08-01

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

  3. The impact of educational interventions on the empathic concern of health professional students: A literature review.

    PubMed

    Everson, Naleya; Levett-Jones, Tracy; Pitt, Victoria

    2018-05-24

    This review aimed to identify programs that promote health professional students' empathic concern. Empathic concern is a key mediator of important outcomes for both patients and health professionals. However the empathic concern of health professional students tends to decline over the course of their studies. To date studies that have evaluated the impact of educational programs on empathic concern have not been reviewed. The databases ProQuest, CINAHL and Ovid were searched for studies that had evaluated educational programs for health professional students using a validated psychometric measure of empathic concern. Studies were graded using The Quality Assessment Tool for Quantitative Studies. Of 2977 identified studies, fifteen met inclusion criteria. Seven studies separately reported empathic concern scores. Four of the fifteen studies reported increased empathy scale scores after students took part in a program. Two studies received a strong quality rating, six a moderate rating and seven a weak rating. This review did not identify any studies that clearly demonstrated an increase in students' empathic concern after taking part in an educational program. Mindfulness based stress reduction, providing empathy content at each stage of a degree, programs that incorporate the film Wit, and Balint groups, may promote empathic concern. In light of the significant impact of health professionals' levels of empathic concern on outcomes for patients and health professionals, further robustly designed research using appropriate psychometric scales is needed to inform the development of education programs in this area. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Living donation decision making: recipients' concerns and educational needs.

    PubMed

    Waterman, Amy D; Stanley, Sara L; Covelli, Tonie; Hazel, Erik; Hong, Barry A; Brennan, Daniel C

    2006-03-01

    Despite the advantages of living donor transplantation, evidence suggests that some potential recipients with living donors have psychological concerns that prevent them from pursuing living donation. Addressing these concerns through education may increase the rates of living donation. To understand the psychological barriers and educational needs of potential kidney recipients regarding living donation. Qualitative focus group study of kidney transplant recipients, donors, and family members to explore their assessment of the advantages of dialysis and deceased donor transplantation over living donation, their concerns about living donation, and what types of living donation education would be most helpful. Kidney recipients reported that they might not pursue living donation because they felt guilty and indebted to the donor, did not want to harm or inconvenience the donor, did not want to accept a kidney that a family member might need later, and did not want to disappoint the donor if the kidney failed. Recipients were generally unaware that donors could personally benefit from donating and would rather wait for donor volunteers than ask anyone directly. Both donors and recipients thought that training on how to make the donation request and education about living donors' motivations for donation and transplant experience could help more renal patients pursue living donation.

  5. THE VARIED INFLUENCE OF SES ON ENVIRONMENTAL CONCERN

    PubMed Central

    Pampel, Fred C.

    2013-01-01

    Objective Cross-national studies have found positive relationships of socioeconomic status (SES) with environmental concern at the individual level but have not systematically examined how the relationships may differ across nations. Such comparisons have relevance to identifying the generality of theories of postmaterialism, affluence, and global environmentalism. Methods This study specifies how the individual-level influence of SES varies across national contexts and tests predictions using four waves of the World Values Survey on up to 96 nations. Results The results show that SES is associated only weakly with environmental concern in lower income nations with poor environmental conditions but is associated strongly and positively in higher income nations with better environmental conditions. Conclusion SES has a contingent relationship with environmental concern such that the global environmentalism theory receives support for lower income nations, while the postmaterialism and affluence theories receive support for higher income nations. PMID:24678128

  6. Fertility concerns among breast cancer patients in Mexico.

    PubMed

    Villarreal-Garza, Cynthia; Martinez-Cannon, Bertha Alejandra; Platas, Alejandra; Mohar, Alejandro; Partridge, Ann H; Gil-Moran, Arnoldo; Fonseca, Alan; Vega, Yoatzin; Bargallo-Rocha, Enrique; Cardona-Huerta, Servando; Lopez-Aguirre, Yadira Estefany; Barragan-Carrillo, Regina; Castro-Sanchez, Andrea

    2017-06-01

    Young women represent a high proportion of the total number of breast cancer (BC) patients in Mexico; however, no previous studies addressing their attitudes regarding the risk of chemotherapy-induced infertility and its contributing factors are available. The aim of this study was to evaluate the concerns of young women with BC towards the risk of infertility in two referral centers in Mexico with access to public health services. A cross-sectional study including women with newly or previously detected BC aged 40 years or younger at diagnosis was conducted. Variables regarding concerns about fertility were collected from an adapted version of the Fertility Issues Survey. 134 consecutive eligible women responded to the in-person paper survey. 55% were partnered, 35.1% had no children, and 48% reported willingness to have children prior to BC diagnosis. Only 3% of patients considered to be able to afford extra expenses. At diagnosis, 44% of women expressed some level of concern about infertility risk. The only factor significantly associated with fertility concern was the desire of having children prior to diagnosis (OR 11.83, p = 0.006). Only 30.6% patients recalled having received information regarding infertility risk from their physicians. A minority of young women with breast cancer in Mexico is informed about the risk of BC treatment-induced infertility, despite substantial interest. Informing all patients about infertility risk and available options for fertility preservation should be an essential aspect of the supportive care of young women with BC, even in low-middle income countries such as Mexico. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Designing Interactive Multimedia Instruction to Address Soldiers’ Learning Needs

    DTIC Science & Technology

    2014-12-01

    A point of need design seeks to identify and meet specific learning needs. It does so by focusing on the learning needs of an identified group ...instructional design and tailored training techniques to address the Army Learning Model (ALM) point of need concept. The point of need concept focuses both on ...developing six IMI exemplars focused on point of need training, including three variations of needs-focused designs : familiarization, core, and tailored

  8. Accessing local knowledge to identify where species of conservation concern occur in a tropical forest landscape.

    PubMed

    Padmanaba, Michael; Sheil, Douglas; Basuki, Imam; Liswanti, Nining

    2013-08-01

    Conventional biodiversity surveys play an important role in ensuring good conservation friendly management in tropical forest regions but are demanding in terms of expertise, time, and budget. Can local people help? Here, we illustrate how local knowledge can support low cost conservation surveys. We worked in the Malinau watershed, East Kalimantan, Indonesia, an area currently at risk of extensive forest loss. We selected eight species of regional conservation interest: rafflesia (Rafflesia spp.), black orchid (Coelogyne pandurata), sun bear (Helarctos malayanus), tarsier (Tarsius bancanus), slow loris (Nycticebus coucang), proboscis monkey (Nasalis larvatus), clouded leopard (Neofelis diardi/N. nebulosa), and orang-utan (Pongo pygmaeus). We asked 52 informants in seven villages if, where and when they had observed these species. We used maps, based on both geo-referenced and sketched features, to record these observations. Verification concerns and related issues are discussed. Evaluations suggest our local information is reliable. Our study took 6 weeks and cost about USD 5000. Extensive expert based field surveys across the same region would cost one or two orders of magnitude more. The records extend the known distribution for sun bear, tarsier, slow loris, and clouded leopard. Reports of rafflesia, proboscis monkey, and orang-utan are of immediate conservation significance. While quality concerns should never be abandoned, we conclude that local people can help expand our knowledge of large areas in an effective, reliable, and low cost manner and thus contribute to improved management.

  9. Optically addressed and submillisecond response phase only liquid crystal spatial light modulator

    NASA Astrophysics Data System (ADS)

    Zhao, Xiangjie; Duan, Jiazhu; Zhang, Dayong; Luo, Yongquan

    2014-10-01

    Liquid crystal based phase only spatial light modulator has attracted many research interests since last decades because of its superior advantage. Until now the liquid crystal spatial light modulator has been applied in many fields, but the response speed of nematic LC limited its further application. In this paper, an optically addressed phase only LC spatial light modulator was proposed based on polymer network liquid crystal. Morphology effect on the light scattering of PNLC was studied, which was mainly consisted of fiber and fiber bundles. The morphology nearly determined the light scattering and electro-optical property. Due to the high threshold voltage, to address the PNLC phase modulator was also concerned. Optical addressing method was proposed, in which BSO crystal was selected to replace one of the glass substrate. The response speed of PNLC was so fast that the reorientation of liquid crystal director will follow the change of effective voltage applied on LC layer, which was related with the voltage signal and especially with electron transport of photo-induced carriers due to diffusion and drift. The on state dynamic response of phase change was investigated. Based on this device, beam steering was also achieved by loading 488nm laser strip on the optical addressed phase only spatial light modulator.

  10. Feeding and mealtime correlates of maternal concern about children’s weight

    PubMed Central

    Branch, Jacqueline M.; Appugliese, Danielle P.; Rosenblum, Katherine L.; Miller, Alison L.; Lumeng, Julie C.; Bauer, Katherine W.

    2017-01-01

    Objective Examine differences within two domains of weight-related parenting: child feeding practices and family meal characteristics, among mothers of young children by concern about children becoming overweight. Design Cross-sectional study Participants Low-income mothers (N=264, 67% non-Hispanic white) and their children (51.5% male, age range: 4.02 – 8.06 years). Variables measured Maternal concern and feeding practices were measured using the Child Feeding Questionnaire (CFQ). Meal characteristics were assessed using video-recorded meals and meal information collected from mothers. Analysis MANOVA and logistic regression were used to identify differences in maternal feeding practices and family meal characteristics across levels of maternal concern (none, some, and high). Results Approximately half of mothers were not concerned about their child becoming overweight, 28.4% reported some concern and 19.0% high concern. Mothers reporting no concern reported lower restrictive feeding versus mothers who reported some or high concern (None: 3.1(0.1), Some: 3.5(0.1), High: 3.6(0.1), p=.004). No differences in other feeding practices or family meal characteristics were observed by level of concern. Conclusions and Implications Concern regarding children becoming overweight was common. However, concern rarely translated into healthier feeding practices or family meal characteristics. Maternal concern alone may not be sufficient to motivate action to reduce children’s risk of obesity. (200) PMID:28457715

  11. Employee Concerns and Counselor Role: A Factor Analysis.

    ERIC Educational Resources Information Center

    Mazer, Gilbert E.

    A significant step in the direction of improving employee counselor services in an industrial setting is offered. The research combined survey and factor analytic methodology to empirically identify sources of employee concerns or stress and to measure the tendency of employees to use counseling services in connection with these problem areas. The…

  12. The Perceptions of Superintendents and Emergency Responders Concerning the Usefulness of Geographical Information Systems in Illinois School District's Crisis Response Procedures

    ERIC Educational Resources Information Center

    Roundcount, Travis R.

    2010-01-01

    Across the United States, many communities are concerned with the prevention and response to school violence. To address their concerns, school districts and emergency responders (law enforcement) have increased their use of technological information when planning for and responding to a crisis event. There are many different types of security…

  13. Trade-Off Analysis between Concerns Based on Aspect-Oriented Requirements Engineering

    NASA Astrophysics Data System (ADS)

    Laurito, Abelyn Methanie R.; Takada, Shingo

    The identification of functional and non-functional concerns is an important activity during requirements analysis. However, there may be conflicts between the identified concerns, and they must be discovered and resolved through trade-off analysis. Aspect-Oriented Requirements Engineering (AORE) has trade-off analysis as one of its goals, but most AORE approaches do not actually offer support for trade-off analysis; they focus on describing concerns and generating their composition. This paper proposes an approach for trade-off analysis based on AORE using use cases and the Requirements Conflict Matrix (RCM) to represent compositions. RCM shows the positive or negative effect of non-functional concerns over use cases and other non-functional concerns. Our approach is implemented within a tool called E-UCEd (Extended Use Case Editor). We also show the results of evaluating our tool.

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

    PubMed

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

    2010-04-01

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

  15. 'Poisonous, filthy, loathsome, damnable stuff': the rhetorical ecology of vaccination concern.

    PubMed

    Hausman, Bernice L; Ghebremichael, Mecal; Hayek, Philip; Mack, Erin

    2014-12-01

    In this article, we analyze newspaper articles and advertisements mentioning vaccination from 1915 to 1922 and refer to historical studies of vaccination practices and attitudes in the early 20th century in order to assess historical continuities and discontinuities in vaccination concern. In the Progressive Era period, there were a number of themes or features that resonated with contemporary issues and circumstances: 1) fears of vaccine contamination; 2) distrust of medical professionals; 3) resistance to compulsory vaccination; and 4) the local nature of vaccination concern. Such observations help scholars and practitioners understand vaccine skepticism as longstanding, locally situated, and linked to the sociocultural contexts in which vaccination occurs and is mandated for particular segments of the population. A rhetorical approach offers a way to understand how discourses are engaged and mobilized for particular purposes in historical contexts. Historically situating vaccine hesitancy and addressing its articulation with a particular rhetorical ecology offers scholars and practitioners a robust understanding of vaccination concerns that can, and should, influence current approaches to vaccination skepticism.

  16. A biopsychosocial model of body image concerns and disordered eating in early adolescent girls.

    PubMed

    Rodgers, Rachel F; Paxton, Susan J; McLean, Siân A

    2014-05-01

    Body image and eating concerns are prevalent among early adolescent girls, and associated with biological, psychological and sociocultural risk factors. To date, explorations of biopsychosocial models of body image concerns and disordered eating in early adolescent girls are lacking. A sample of 488 early adolescent girls, mean age = 12.35 years (SD = 0.53), completed a questionnaire assessing depressive symptoms, self-esteem, body mass index (BMI), sociocultural appearance pressures, thin-ideal internalization, appearance comparison, body image concerns and disordered eating. Structural equation modelling was conducted to test a hypothetical model in which internalization and comparison were mediators of the effect of both negative affect and sociocultural influences on body image concerns and disordered eating. In addition, the model proposed that BMI would impact body image concerns. Although the initial model was a poor fit to the data, the fit was improved after the addition of a direct pathway between negative affect and bulimic symptoms. The final model explained a large to moderate proportion of the variance in body image and eating concerns. This study supports the role of negative affect in biopsychosocial models of the development of body image concerns and disordered eating in early adolescent girls. Interventions including strategies to address negative affect as well as sociocultural appearance pressures may help decrease the risk for body image concerns and disordered eating among this age group.

  17. Actions, Objectives & Concerns. Human Parameters for Architectural Design.

    ERIC Educational Resources Information Center

    Lasswell, Thomas E.; And Others

    An experiment conducted at California State College, Los Angeles, to test the value of social-psychological research in defining building needs is described. The problems of how to identify and synthesize the disparate objectives, concerns and actions of the groups who use or otherwise have an interest in large and complex buildings is discussed.…

  18. Revisiting the Democratic Paradox of Environmental and Sustainability Education: Sustainability Issues as Matters of Concern

    ERIC Educational Resources Information Center

    Van Poeck, Katrien; Goeminne, Gert; Vandenabeele, Joke

    2016-01-01

    In this article, we address the democratic paradox in environmental and sustainability education (ESE) by drawing on Bruno Latour's conceptual distinction between "matters of fact" and "matters of concern" and the notion of attachments that goes with it. We present an analysis of three cases (nature excursions, workshops that…

  19. Public Concern with Farm-Animal Welfare: Religion, Politics, and Human Disadvantage in the Food Sector

    ERIC Educational Resources Information Center

    Deemer, Danielle R.; Lobao, Linda M.

    2011-01-01

    The welfare of farm animals has become a continuing source of controversy as states seek greater regulation over the livestock industry. However, empirical studies addressing the determinants of public concern for farm-animal welfare are limited. Religion and politics, two institutional bases of attitudes, are rarely explored. Nor have…

  20. Zoonoses: an occupational hazard for livestock workers and a public health concern for rural communities.

    PubMed

    LeJeune, J; Kersting, A

    2010-07-01

    Farming employs one of the most diverse work forces, while at the same time it is one of the most dangerous occupations in the U.S. Individuals associated with the livestock industry face an additional risk: zoonotic diseases. In an effort to improve the overall well-being of the farming community, this review addresses zoonoses as a health concern for the farming community. The discussion of agriculturally acquired zoonoses includes infections naturally transmitted from vertebrate animals to man (e.g., rabies) and those common to animals and man (e.g., Salmonella). Special consideration is given to identifying individuals potentially at higher risk for developing disease. Case reports and epidemiological studies are reviewed from published veterinary and human-health literature to illustrate exposure scenarios and associated health outcomes. Additionally, key livestock zoonoses in the U.S. are summarized, and an overview of prevention and control strategies is provided. Findings show that livestock can transmit many zoonoses directly and indirectly, and human health can be significantly impacted, but the number of people adversely impacted is largely unknown. This review concludes that more education about zoonosis transmission and prevention is needed, and healthcare providers serving rural communities are a critical link in providing this information. In order for healthcare providers to address the educational gap, we recommend greater collaboration with veterinary specialists schooled in population medicine, zoonosis prevention and control, and animal production.

  1. Biological, chemical, and nuclear terrorism readiness: major concerns and preparedness of future nurses.

    PubMed

    Young, Charlotte F; Persell, Deborah J

    2004-01-01

    The nursing profession is developing educational resources to improve their response to victims of nuclear, biological, and chemical terrorism. Future nurses may differ from practicing nurses in their perspective of what is critical information. The purpose of this study was to identify student nurses' major concerns in relation to working with victims of terrorism. A descriptive study was used to identify how future nurses might practice as caregivers for victims of terrorism. The study population consisted of a convenience sample of 95 junior and senior baccalaureate nursing students at a mid-south state university. The students were given an anonymous questionnaire regarding their concerns and how their lives had changed after September 11, 2001. The questionnaire consisted of 19 major items that identified demographics and perceptions and concerns regarding preparedness, willingness to work, expectation of future terrorism events, effect on lifestyle, and other fears related to terrorism or caring for victims of terrorism. A Cronbach alpha coefficient of reliability on standardized items was .745. Students' primary concern was for the safety of themselves and their families. They were primarily concerned about having adequate protection for all types of terrorist agents and indicated they would not be willing to care for victims if there was a lack of protection for both themselves and family. Although the nursing school faculty had provided self-education information about terrorism, students did not demonstrate an accurate understanding of the pathogenic nature of many agents.

  2. The American Competitiveness Initiative: Addressing the STEM Teacher Shortage and Improving Student Academic Readiness. BHEF Issue Brief

    ERIC Educational Resources Information Center

    Business-Higher Education Forum (NJ1), 2006

    2006-01-01

    America's leaders are increasingly concerned about U.S. competitiveness in a rapidly globalizing world. In response, during the 2006 State of the Union Address, President Bush introduced the American Competitiveness Initiative (ACI) to promote policy that bolsters student achievement in the areas of science, technology, engineering, and…

  3. Identifying research priorities for public health research to address health inequalities: use of Delphi-like survey methods.

    PubMed

    Turner, S; Ollerhead, E; Cook, A

    2017-10-09

    In the funding of health research and public health research it is vital that research questions posed are important and that funded research meets a research need or a gap in evidence. Many methods are used in the identification of research priorities, however, these can be resource intensive, costly and logistically challenging. Identifying such research priorities can be particularly challenging for complex public health problems as there is a need to consult a number of experts across disciplines and with a range of expertise. This study investigated the use of Delphi-like survey methods in identifying important research priorities relating to health inequalities and framing tractable research questions for topic areas identified. The study was conducted in two phases, both using Delphi-like survey methods. Firstly, public health professionals with an interest in health inequalities were asked to identify research priorities. Secondly academic researchers were asked to frame tractable research questions relating to the priorities identified. These research priorities identified using Delphi-like survey methods were subsequently compared to those identified using different methods. A total of 52 public health professionals and 21 academics across the United Kingdom agreed to take part. The response rates were high, from public health professionals across three survey rounds (69%, 50% and 40%) and from academics across one round (52%), indicating that participants were receptive to the method and motivated to respond. The themes identified as encompassing the most important research priorities were mental health, healthy environment and health behaviours. Within these themes, the topic areas that emerged most strongly included community interventions for prevention of mental health problems and the food and alcohol environment. Some responses received from academic researchers were (as requested) in the form of tractable research questions, whereas others

  4. How Do Contextual Factors Influence Implementation and Receipt of Positive Youth Development Programs Addressing Substance Use and Violence? A Qualitative Meta-Synthesis of Process Evaluations.

    PubMed

    Dickson, Kelly; Melendez-Torres, G J; Fletcher, Adam; Hinds, Kate; Thomas, James; Stansfield, Claire; Murphy, Simon; Campbell, Rona; Bonell, Chris

    2018-05-01

    Positive youth development (PYD) often aims to prevent tobacco, alcohol, and drugs use and violence. We systematically reviewed PYD interventions, synthesizing process, and outcomes evidence. Synthesis of outcomes, published elsewhere, found no overall evidence of reducing substance use or violence but notable variability of fidelity. Our synthesis of process evaluations examined how implementation varied and was influenced by context. Process evaluations of PYD aiming to reduce substance use and violence. Study Inclusion Criteria: Overall review published since 1985; written in English; focused on youth aged 11 to 18 years; focused on interventions addressing multiple positive assets; reported on theory, process, or outcomes; and concerned with reducing substance use or violence. Synthesis of process evaluations examined how implementation varies with or is influenced by context. Two reviewers in parallel. Thematic synthesis. We identified 12 reports. Community engagement enhanced program appeal. Collaboration with other agencies could broaden the activities offered. Calm but authoritative staff increased acceptability. Staff continuity underpinned diverse activities and durable relationships. Empowering participants were sometimes in tension with requiring them to engage in diverse activities. Our systematic review identified factors that might help improve the fidelity and acceptability of PYD interventions. Addressing these might enable PYD to fulfill its potential as a means of promoting health.

  5. Psychosocial concerns of cancer patients in Singapore.

    PubMed

    Mahendran, Rathi; Lim, Haikel A; Chua, Joanne; Lim, Siew Eng; Kua, Ee Heok

    2017-04-01

    Psychosocial needs are high among cancer patients, and screening for these is recognized as integral to quality cancer care. This study identified the psychosocial needs of cancer patients at their first visit at a hematology-oncology clinic. Fifty-four new consecutive patients completed the Distress Thermometer and the Problem List, the Hospital Anxiety and Depression Scale, and the EuroQol Quality of Life Scale at their first visit to plan for chemotherapy. Data were analyzed with SPSS. Analyses revealed that participants had an average of 2.8 ± 2.3 problems, with 82% having psychosocial needs. Emotional concerns formed the top four psychosocial needs of the cohort (worry 46%, fears 26%, nervousness 26%, sadness 24%), with the fifth being a practical concern (insurance/finance 22%). The former were more frequent among 41- to 50-year-olds and significantly correlated with distress scores. Practical concerns were significantly correlated with depressive symptoms. Family concerns were more significant in women. The overall score on the Problem List correlated with distress, anxious symptomatology and poorer quality of life scores. Distress and psychosocial needs are high in cancer patients even at an early stage prior to chemotherapy. Attention to these needs is crucial as they cause significant distress and affect the patient's quality of life. © 2015 Wiley Publishing Asia Pty Ltd.

  6. Public awareness, concerns, and priorities about anthropogenic impacts on marine environments.

    PubMed

    Gelcich, Stefan; Buckley, Paul; Pinnegar, John K; Chilvers, Jason; Lorenzoni, Irene; Terry, Geraldine; Guerrero, Matias; Castilla, Juan Carlos; Valdebenito, Abel; Duarte, Carlos M

    2014-10-21

    Numerous international bodies have advocated the development of strategies to achieve the sustainability of marine environments. Typically, such strategies are based on information from expert groups about causes of degradation and policy options to address them, but these strategies rarely take into account assessed information about public awareness, concerns, and priorities. Here we report the results of a pan-European survey of public perceptions about marine environmental impacts as a way to inform the formation of science and policy priorities. On the basis of 10,106 responses to an online survey from people in 10 European nations, spanning a diversity of socioeconomic and geographical areas, we examine the public's informedness and concern regarding marine impacts, trust in different information sources, and priorities for policy and funding. Results show that the level of concern regarding marine impacts is closely associated with the level of informedness and that pollution and overfishing are two areas prioritized by the public for policy development. The level of trust varies greatly among different information sources and is highest for academics and scholarly publications but lower for government or industry scientists. Results suggest that the public perceives the immediacy of marine anthropogenic impacts and is highly concerned about ocean pollution, overfishing, and ocean acidification. Eliciting public awareness, concerns, and priorities can enable scientists and funders to understand how the public relates to marine environments, frame impacts, and align managerial and policy priorities with public demand.

  7. Public awareness, concerns, and priorities about anthropogenic impacts on marine environments

    PubMed Central

    Gelcich, Stefan; Buckley, Paul; Pinnegar, John K.; Chilvers, Jason; Lorenzoni, Irene; Terry, Geraldine; Guerrero, Matias; Castilla, Juan Carlos; Valdebenito, Abel; Duarte, Carlos M.

    2014-01-01

    Numerous international bodies have advocated the development of strategies to achieve the sustainability of marine environments. Typically, such strategies are based on information from expert groups about causes of degradation and policy options to address them, but these strategies rarely take into account assessed information about public awareness, concerns, and priorities. Here we report the results of a pan-European survey of public perceptions about marine environmental impacts as a way to inform the formation of science and policy priorities. On the basis of 10,106 responses to an online survey from people in 10 European nations, spanning a diversity of socioeconomic and geographical areas, we examine the public’s informedness and concern regarding marine impacts, trust in different information sources, and priorities for policy and funding. Results show that the level of concern regarding marine impacts is closely associated with the level of informedness and that pollution and overfishing are two areas prioritized by the public for policy development. The level of trust varies greatly among different information sources and is highest for academics and scholarly publications but lower for government or industry scientists. Results suggest that the public perceives the immediacy of marine anthropogenic impacts and is highly concerned about ocean pollution, overfishing, and ocean acidification. Eliciting public awareness, concerns, and priorities can enable scientists and funders to understand how the public relates to marine environments, frame impacts, and align managerial and policy priorities with public demand. PMID:25288740

  8. Identifying Barriers That Hinder Onsite Parental Involvement in a School-Based Health Promotion Program

    PubMed Central

    Garcia-Dominic, Oralia; Wray, Linda A.; Treviño, Roberto P.; Hernandez, Arthur E.; Yin, Zenong; Ulbrecht, Jan S.

    2009-01-01

    We investigated whether barriers to onsite parental involvement in the Bienestar Health Program Parent Component could be identified and whether participation rates could be increased by addressing these barriers. All nonparticipating parents of fourth-grade students of San Antonio Independent School District from 4 schools, which were selected randomly from 20 intervention schools in Bienestar, were invited to take part in this study. A total of 47 of 223 (21%) parents engaged in one of four focus groups offered. Parents identified barriers to their involvement in Bienestar that fit into five descriptive categories: (a) low value, (b) high cost, (c) competing family demands, (d) concerns about the program design, and (e) social role norms. The Bienestar Parent Component was then modified according to the focus group findings, which resulted in a marked increase in parental involvement from 17% to 37% overall. These findings suggest that even when parents are involved in the initial design of parent-friendly and culturally sensitive programs, as was the case for Bienestar, maximizing parental involvement may require additional assessment, identification, and remediation of barriers. PMID:19339644

  9. Rapid Assessment of Stakeholder Concerns about Public Health. An Introduction to a Fast and Inexpensive Approach Applied on Health Concerns about Intensive Animal Production Systems.

    PubMed

    Kraaij-Dirkzwager, Marleen; van der Ree, Joost; Lebret, Erik

    2017-12-11

    To effectively manage environmental health risks, stakeholders often need to act collectively. Stakeholders vary in their desire to act due to many factors, such as knowledge, risk perception, interests, and worldviews. Understanding their perceptions of the issues at stake is crucial to support the risk governance process. Even though concern assessment is a pivotal element of risk governance, few tools for rapid assessment are reported in the literature. We tested a rapid and relatively cheap approach, taking the Dutch debate on Intensive Animal Production Systems (IAPS) and health as an example. Dutch policy-oriented publications on IAPS and health and ten semi-structured in-depth interviews with a variety of stakeholders were analyzed to identify stakeholders and concerns involved in the Dutch debate about IAPS and health. Concerns were mapped and a stakeholder network was derived. Three classes of concerns were recognized in the discussions about IAPS and health: concerns related to health risks, concerns regarding the activity causing the risks (IAPS), and concerns about the process to control the risks. The notions of 'trust' and 'scientific uncertainty' appeared as important themes in the discussions. Argumentation based on concerns directly related to health risks, the activity causing the risk (IAPS), and its risk management can easily become muddled up in a societal debate, limiting the development of effective action perspectives. Acknowledging these multiple stakeholder concerns can clarify the positions taken by stakeholders and allow for more and other action perspectives to develop.

  10. Rapid Assessment of Stakeholder Concerns about Public Health. An Introduction to a Fast and Inexpensive Approach Applied on Health Concerns about Intensive Animal Production Systems

    PubMed Central

    van der Ree, Joost; Lebret, Erik

    2017-01-01

    To effectively manage environmental health risks, stakeholders often need to act collectively. Stakeholders vary in their desire to act due to many factors, such as knowledge, risk perception, interests, and worldviews. Understanding their perceptions of the issues at stake is crucial to support the risk governance process. Even though concern assessment is a pivotal element of risk governance, few tools for rapid assessment are reported in the literature. We tested a rapid and relatively cheap approach, taking the Dutch debate on Intensive Animal Production Systems (IAPS) and health as an example. Dutch policy-oriented publications on IAPS and health and ten semi-structured in-depth interviews with a variety of stakeholders were analyzed to identify stakeholders and concerns involved in the Dutch debate about IAPS and health. Concerns were mapped and a stakeholder network was derived. Three classes of concerns were recognized in the discussions about IAPS and health: concerns related to health risks, concerns regarding the activity causing the risks (IAPS), and concerns about the process to control the risks. The notions of ‘trust’ and ‘scientific uncertainty’ appeared as important themes in the discussions. Argumentation based on concerns directly related to health risks, the activity causing the risk (IAPS), and its risk management can easily become muddled up in a societal debate, limiting the development of effective action perspectives. Acknowledging these multiple stakeholder concerns can clarify the positions taken by stakeholders and allow for more and other action perspectives to develop. PMID:29232902

  11. Native Hawaiians Study Commission: Report on the Culture, Needs and Concerns of Native Hawaiians. Final Report. Volume II. Claims of Conscience: A Dissenting Study of the Culture, Needs and Concerns of Native Hawaiians.

    ERIC Educational Resources Information Center

    Department of the Interior, Washington, DC.

    Volume II of the final report of the Native Hawaiians Study Commission (NHSC) on the culture, needs, and concerns of native Hawaiians, this book contains a formal dissent to the conclusions and recommendations presented in Volume I made by three of the NHSC commissioners. Its principal criticism is that Volume I fails to address the underlying…

  12. Applying quantile regression for modeling equivalent property damage only crashes to identify accident blackspots.

    PubMed

    Washington, Simon; Haque, Md Mazharul; Oh, Jutaek; Lee, Dongmin

    2014-05-01

    Hot spot identification (HSID) aims to identify potential sites-roadway segments, intersections, crosswalks, interchanges, ramps, etc.-with disproportionately high crash risk relative to similar sites. An inefficient HSID methodology might result in either identifying a safe site as high risk (false positive) or a high risk site as safe (false negative), and consequently lead to the misuse the available public funds, to poor investment decisions, and to inefficient risk management practice. Current HSID methods suffer from issues like underreporting of minor injury and property damage only (PDO) crashes, challenges of accounting for crash severity into the methodology, and selection of a proper safety performance function to model crash data that is often heavily skewed by a preponderance of zeros. Addressing these challenges, this paper proposes a combination of a PDO equivalency calculation and quantile regression technique to identify hot spots in a transportation network. In particular, issues related to underreporting and crash severity are tackled by incorporating equivalent PDO crashes, whilst the concerns related to the non-count nature of equivalent PDO crashes and the skewness of crash data are addressed by the non-parametric quantile regression technique. The proposed method identifies covariate effects on various quantiles of a population, rather than the population mean like most methods in practice, which more closely corresponds with how black spots are identified in practice. The proposed methodology is illustrated using rural road segment data from Korea and compared against the traditional EB method with negative binomial regression. Application of a quantile regression model on equivalent PDO crashes enables identification of a set of high-risk sites that reflect the true safety costs to the society, simultaneously reduces the influence of under-reported PDO and minor injury crashes, and overcomes the limitation of traditional NB model in dealing

  13. 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…

  14. Motor carrier concerns about transportation problems in Oregon : final report.

    DOT National Transportation Integrated Search

    2004-03-01

    This report summarizes an analysis of data from a statewide survey of freight motor carrier firms, conducted by the Oregon Department of Transportation (ODOT) in the summer of 2001, to identify freight industry concerns about problems they encounter ...

  15. Remedial Action Plan for Deer Lake Area of Concern, 1987

    EPA Pesticide Factsheets

    Stage I document details Deer Lake’s history of mercury and other contamination, and describes sources of pollution and future remedial actions, to address beneficial use impairments identified by the Great Lakes Water Quality Board (WQB).

  16. Space resources. Volume 4: Social concerns

    NASA Technical Reports Server (NTRS)

    Mckay, Mary Fae (Editor); Mckay, David S. (Editor); Duke, Michael B. (Editor)

    1992-01-01

    Space resources must be used to support life on the Moon and exploration of Mars. This volume, Social Concerns, covers some of the most important issues which must be addressed in any major program for the human exploration of space. The volume begins with a consideration of the economics and management of large scale space activities. Then the legal aspects of these activities are discussed, particularly the interpretation of treaty law with respect to the Moon and asteroids. The social and cultural issues of moving people into space are considered in detail, and the eventual emergence of a space culture different from the existing culture is envisioned. The environmental issues raised by the development of space settlements are faced. Some innovative approaches are proposed to space communities and habitats and self-sufficiency is considered along with human safety at a lunar base or outpost.

  17. Alzheimer's Disease and Other Dementias: An Organizational Approach to Identifying and Addressing Practices and Learning Needs of Family Physicians

    ERIC Educational Resources Information Center

    Allen, Michael; Ferrier, Suzanne; Sargeant, Joan; Loney, Elaine; Bethune, Graeme; Murphy, Gerard

    2005-01-01

    Caring for patients with dementia is complex and demanding. Since family physicians (FPs) provide much of this care, we examined their practices, learning needs, and barriers to care concerning Alzheimer's disease and other dementias. We surveyed 392 (approximately 50%) Nova Scotia FPs and conducted focus groups and interviews with: FPs; staff of…

  18. Concerns about aging and caregiving among middle-aged and older lesbian and gay adults.

    PubMed

    Czaja, Sara J; Sabbag, Samir; Lee, Chin Chin; Schulz, Richard; Lang, Samantha; Vlahovic, Tatiana; Jaret, Adrienne; Thurston, Catherine

    2016-11-01

    Despite the increasing number of lesbian and gay older adults, research geared towards health and well-being of this population is limited. Many lesbian and gay seniors experience health disparities and are at risk for poor health outcomes. The aims of this study were to gather in-depth information on the concerns of lesbian and gay elders with respect to aging and care needs. The sample included 124 gay men and lesbian women aged 50+ years. Data were gathered via focus groups and questionnaires. The focus groups addressed: (1) concerns about aging in the LGBT community, (2) barriers to needed support and services, (3) concerns about caregiving and (4) needed programs for lesbian and gay seniors. Concerns expressed about aging included: lack of financial security, lack of family or social support, fears about the lack of someone to provide needed care, and discrimination in healthcare or service communities. Participants also indicated concerns about being alone and vulnerable and a need for resources and support programs, specifically for lesbian and gay older adults and for lesbian and gay caregivers. These findings suggest needed areas of support and programs for older gay men and lesbian women. They also suggest that healthcare professionals might need more training regarding the particular needs and concerns of this community.

  19. Do Online Privacy Concerns Predict Selfie Behavior among Adolescents, Young Adults and Adults?

    PubMed Central

    Dhir, Amandeep; Torsheim, Torbjørn; Pallesen, Ståle; Andreassen, Cecilie S.

    2017-01-01

    Selfies, or self-portraits, are often taken and shared on social media for online self-presentation reasons, which are considered essential for the psychosocial development and well-being of people in today’s culture. Despite the growing popularity and widespread sharing of selfies in the online space, little is known about how privacy concerns moderate selfie behavior. In addition to this, it is also not known whether privacy concerns across age and gender groups influence selfie behavior. To address this timely issue, a survey assessing common selfie behaviors, that is, frequency of taking (individual and group selfies), editing (cropping and filtering), and posting selfies online, and social media privacy concerns (over personal data being accessed and misused by third parties) was conducted. The web-survey was administered to 3,763 Norwegian social media users, ranging from 13 to 50 years, with a preponderance of women (n = 2,509, 66.7%). The present study investigated the impact of privacy concerns on selfie behaviors across gender and age groups (adolescent, young adult, and adult) by use of the structural equation modeling approach. The results suggest that young adults have greater privacy concerns compared to adolescents and adults. Females have greater privacy concerns than males. Greater privacy concerns among female social media users were linked to lower engagement in selfie behavior, but privacy concerns did not influence selfie behavior in the case of male adolescents and young adults. Overall, privacy concerns were more consistently and inversely related to selfie behavior (taking and posting) among females than males. The study results have theoretical as well as practical implications for both researchers and policy makers. PMID:28588530

  20. Do Online Privacy Concerns Predict Selfie Behavior among Adolescents, Young Adults and Adults?

    PubMed

    Dhir, Amandeep; Torsheim, Torbjørn; Pallesen, Ståle; Andreassen, Cecilie S

    2017-01-01

    Selfies, or self-portraits, are often taken and shared on social media for online self-presentation reasons, which are considered essential for the psychosocial development and well-being of people in today's culture. Despite the growing popularity and widespread sharing of selfies in the online space, little is known about how privacy concerns moderate selfie behavior. In addition to this, it is also not known whether privacy concerns across age and gender groups influence selfie behavior. To address this timely issue, a survey assessing common selfie behaviors, that is, frequency of taking (individual and group selfies), editing (cropping and filtering), and posting selfies online, and social media privacy concerns (over personal data being accessed and misused by third parties) was conducted. The web-survey was administered to 3,763 Norwegian social media users, ranging from 13 to 50 years, with a preponderance of women ( n = 2,509, 66.7%). The present study investigated the impact of privacy concerns on selfie behaviors across gender and age groups (adolescent, young adult, and adult) by use of the structural equation modeling approach. The results suggest that young adults have greater privacy concerns compared to adolescents and adults. Females have greater privacy concerns than males. Greater privacy concerns among female social media users were linked to lower engagement in selfie behavior, but privacy concerns did not influence selfie behavior in the case of male adolescents and young adults. Overall, privacy concerns were more consistently and inversely related to selfie behavior (taking and posting) among females than males. The study results have theoretical as well as practical implications for both researchers and policy makers.

  1. Methods That Matter in Addressing Cultural Diversity with Teacher Candidates

    ERIC Educational Resources Information Center

    Acquah, Emmanuel O.; Commins, Nancy L.

    2017-01-01

    Drawing on a combination of prior experience, theoretical stance, and intuition, along with pedagogical practices identified to be effective in addressing diversity with teacher candidates, a model for teaching multicultural education to teacher candidates was designed. This study examined how particular elements of this model were effective in…

  2. The differing privacy concerns regarding exchanging electronic medical records of internet users in Taiwan.

    PubMed

    Hwang, Hsin-Ginn; Han, Hwai-En; Kuo, Kuang-Ming; Liu, Chung-Feng

    2012-12-01

    This study explores whether Internet users have different privacy concerns regarding the information contained in electronic medical records (EMRs) according to gender, age, occupation, education, and EMR awareness. Based on the Concern for Information Privacy (CFIP) scale developed by Smith and colleagues in 1996, we conducted an online survey using 15 items in four dimensions, namely, collection, unauthorized access, secondary use, and errors, to investigate Internet users' concerns regarding the privacy of EMRs under health information exchanges (HIE). We retrieved 213 valid questionnaires. The results indicate that the respondents had substantial privacy concerns regarding EMRs and their educational level and EMR awareness significantly influenced their privacy concerns regarding unauthorized access and secondary use of EMRs. This study recommends that the Taiwanese government organizes a comprehensive EMR awareness campaign, emphasizing unauthorized access and secondary use of EMRs. Additionally, to cultivate the public's understanding of EMRs, the government should employ various media, especially Internet channels, to promote EMR awareness, thereby enabling the public to accept the concept and use of EMRs. People who are highly educated and have superior EMR awareness should be given a comprehensive explanation of how hospitals protect patients' EMRs from unauthorized access and secondary use to address their concerns. Thus, the public can comprehend, trust, and accept the use of EMRs, reducing their privacy concerns, which should facilitate the future implementation of HIE.

  3. Analysing how negative emotions emerge and are addressed in veterinary consultations, using the Verona Coding Definitions of Emotional Sequences (VR-CoDES).

    PubMed

    Vijfhuizen, Malou; Bok, Harold; Matthew, Susan M; Del Piccolo, Lidia; McArthur, Michelle

    2017-04-01

    To explore the applicability, need for modifications and reliability of the VR-CoDES in a veterinary setting while also gaining a deeper understanding of clients' expressions of negative emotion and how they are addressed by veterinarians. The Verona Coding Definitions of Emotional Sequences for client cues and concerns (VR-CoDES-CC) and health provider responses (VR-CoDES-P) were used to analyse 20 audiotaped veterinary consultations. Inter-rater reliability was established. The applicability of definitions of the VR-CoDES was identified, together with the need for specific modifications to suit veterinary consultations. The VR-CoDES-CC and VR-CoDES-P generally applied to veterinary consultations. Cue and concern reliability was found satisfactory for most types of cues, but not for concerns. Response reliability was satisfactory for explicitness, and for providing and reducing space for further disclosure. Modifications to the original coding system were necessary to accurately reflect the veterinary context and included minor additions to the VR-CoDES-CC. Using minor additions to the VR-CoDES including guilt, reassurance and cost discussions it can be reliably adopted to assess clients' implicit expressions of negative emotion and veterinarians' responses. The modified VR-CoDES could be of great value when combined with existing frameworks used for teaching and researching veterinary communication. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Health and fracking: should the medical profession be concerned?

    PubMed

    Mash, Rachel; Minnaar, Jolynn; Mash, Bob

    2014-02-26

    The use of natural gas that is obtained from high-volume hydraulic fracturing (fracking) may reduce carbon emissions relative to the use of coal and have substantial economic benefits for South Africa. However, concerns have been raised regarding the health and environmental impacts. The drilling and fracking processes use hundreds of chemicals as well as silica sand. Additional elements are either released from or formed in the shale during drilling. These substances can enter the environment in various ways: through failures in the well casing; via alternative underground pathways; as wastewater, spills and leaks on the wellpad; through transportation accidents; and as air pollution. Although many of these chemicals and elements have known adverse health effects, there is little evidence available on the health impacts of fracking. These health concerns have not yet been fully addressed in policy making, and the authors recommend that the voice of health professionals should be part of the public debate on fracking and that a full health impact assessment be required before companies are given the go-ahead to drill. 

  5. Methodological quality of systematic reviews addressing femoroacetabular impingement.

    PubMed

    Kowalczuk, Marcin; Adamich, John; Simunovic, Nicole; Farrokhyar, Forough; Ayeni, Olufemi R

    2015-09-01

    As the body of literature on femoroacetabular impingement (FAI) continues to grow, clinicians turn to systematic reviews to remain current with the best available evidence. The quality of systematic reviews in the FAI literature is currently unknown. The goal of this study was to assess the quality of the reporting of systematic reviews addressing FAI over the last 11 years (2003-2014) and to identify the specific methodological shortcomings and strengths. A search of the electronic databases, MEDLINE, EMBASE and PubMed, was performed to identify relevant systematic reviews. Methodological quality was assessed by two reviewers using the revised assessment of multiple systematic reviews (R-AMSTAR) scoring tool. An intraclass correlation coefficient (ICC) with 95 % confidence intervals (CI) was used to determine agreement between reviewers on R-AMSTAR quality scores. A total of 22 systematic reviews were assessed for methodological quality. The mean consensus R-AMSTAR score across all studies was 26.7 out of 40.0, indicating fair methodological quality. An ICC of 0.931, 95 % CI 0.843-0.971 indicated excellent agreement between reviewers during the scoring process. The systematic reviews addressing FAI are generally of fair methodological quality. Use of tools such as the R-AMSTAR score or PRISMA guidelines while designing future systematic reviews can assist in eliminating methodological shortcomings identified in this review. These shortcomings need to be kept in mind by clinicians when applying the current literature to their patient populations and making treatment decisions. Systematic reviews of highest methodological quality should be used by clinicians when possible to answer clinical questions.

  6. Investing in the Future: Addressing Work/Life Issues of Employees.

    ERIC Educational Resources Information Center

    Kutilek, Linda M.; Conklin, Nikki L.; Gunderson, Gail

    2002-01-01

    A national survey of Extension employees identified the most critical work/life challenges as a heavy workload, evening and weekend commitments, and lack of control or job autonomy. Only 40% were aware of benefits and programs offered concerning work/life balance. Recommendations included reducing the workload and time requirements of county-based…

  7. Minnesota Pharmacists and Medical Cannabis: A Survey of Knowledge, Concerns, and Interest Prior to Program Launch

    PubMed Central

    Hwang, Joy; Arneson, Tom; St. Peter, Wendy

    2016-01-01

    Objectives To assess Minnesota pharmacists’ preparedness for the state’s medical cannabis program in terms of professional competency in policies and regulations and in pharmacotherapy, as well as their concerns and perceptions about the impact on their practice. The secondary objective was to identify pharmacists’ perceptions about ways to reduce potential gaps in knowledge. Methods A Web-based 14-item questionnaire was distributed to all pharmacists whose email addresses were registered with the Minnesota Board of Pharmacy. Results Pharmacists reported limited knowledge of Minnesota state-level cannabis policies and regulations and felt that they were inadequately trained in cannabis pharmacotherapy. Most pharmacists were unprepared to counsel patients on medical cannabis and had many concerns regarding its availability and usage. Only a small proportion felt that the medical cannabis program would impact their practice. Pharmacists’ leading topics of interest for more education included Minnesota’s regulations on the medical cannabis program, cannabis pharmacotherapy, and the types and forms of cannabis products available for commercialization. Preferred modes of receiving information were electronic-based, including email and online continuing education credit. Since the survey’s completion, educational presentations have been provided to pharmacists and health professionals in Minnesota. Conclusion Pharmacists need more training and education on the regulatory and clinical aspects of cannabis in preparation for their work with patients in the medical cannabis program. PMID:27904305

  8. Four suggestions for addressing public concern regarding synthetic biology

    PubMed Central

    2010-01-01

    The following essay was written by Mr. Alex Hatch, a junior undergraduate student majoring in Biological Engineering at Utah State University. Mr. Hatch submitted a 1000-1200 word essay to the 5th Annual Bioethics Contest sponsored by the Institute of Biological Engineering (IBE). A group of professionals in Biological Engineering assessed and ranked the essays in a blinded process. Five semi-finalists were invited to present their essays at a session at the annual meeting of IBE in Cambridge, MA on March 6, 2010. Five judges scored all the presentations and selected Mr. Hatch's contribution as the overall winner (first place). PMID:20534150

  9. Four suggestions for addressing public concern regarding synthetic biology.

    PubMed

    Hatch, Alex David

    2010-06-09

    The following essay was written by Mr. Alex Hatch, a junior undergraduate student majoring in Biological Engineering at Utah State University. Mr. Hatch submitted a 1000-1200 word essay to the 5th Annual Bioethics Contest sponsored by the Institute of Biological Engineering (IBE). A group of professionals in Biological Engineering assessed and ranked the essays in a blinded process. Five semi-finalists were invited to present their essays at a session at the annual meeting of IBE in Cambridge, MA on March 6, 2010. Five judges scored all the presentations and selected Mr. Hatch's contribution as the overall winner (first place).

  10. Identity-driven differences in stakeholder concerns about hunting wolves.

    PubMed

    Lute, Michelle L; Bump, Adam; Gore, Meredith L

    2014-01-01

    Whereas past wolf management in the United States was restricted to recovery, managers must now contend with publicly contentious post-recovery issues including regulated hunting seasons. Understanding stakeholder concerns associated with hunting can inform stakeholder engagement, communication, and policy development and evaluation. Social identity theory (SIT) has been used to understand how groups interact, why they conflict, and how collaboration may be achieved. Applying SIT to stakeholder conflicts about wolf hunting may help delineate groups according to their concern about, support for or opposition to the policy choice of hunting wolves. Our objective was to assess concerns about hunting as a tool to resolve conflict in Michigan, using SIT as a framework. We used a mixed-modal sampling approach (e.g., paper, Internet) with wolf hunting-related public meeting participants in March 2013. Survey questions focused on 12 concerns previously identified as associated with hunting as a management tool to resolve conflict. Respondents (n  =  666) cared greatly about wolves but were divided over hunting wolves. Wolf conflicts, use of science in policy decisions, and maintaining a wolf population were the highest ranked concerns. Principle components analysis reduced concerns into three factors that explained 50.7% of total variance; concerns crystallized over justifications for hunting. General linear models revealed a lack of geographic influence on care, fear and support for hunting related to wolves. These findings challenge assumptions about regional differences and suggest a strong role for social identity in driving dichotomized public perceptions in wildlife management.

  11. Teaching Digital Natives: Promoting Information Literacy and Addressing Instructional Challenges

    ERIC Educational Resources Information Center

    Neumann, Crystal

    2016-01-01

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

  12. Graduate Education to Facilitate Interdisciplinary Research Collaboration: Identifying Individual Competencies and Developmental Activities

    ERIC Educational Resources Information Center

    Holt, Valerie Ciocca

    2013-01-01

    Interdisciplinary research collaborations (IDRC) are considered essential for addressing the most complex global community problems concerning science, health, education, energy, the environment, and society. In spite of technological advances, supportive funding, and even researcher proclivity to collaborate, these complex interdisciplinary…

  13. Problems identified by dual sensory impaired older adults in long-term care when using a self-management program: A qualitative study

    PubMed Central

    Zuidema, Sytse; Vernooij-Dassen, Myrra; Dees, Marianne; Hermsen, Pieter; Kempen, Gertrudis; Graff, Maud

    2017-01-01

    Objective To gain insights into the problems of dual sensory impaired older adults in long-term care. Insights into these problems are essential for developing adequate policies which address the needs of the increasing population of dual sensory impaired older adults in long-term care. Methods A qualitative study was conducted in parallel with a cluster randomized controlled trial. Dual sensory impaired older adults in the intervention group (n = 47, age range 82–98) were invited by a familiar nurse to identify the problems they wanted to address. Data were taken from the semi-structured intervention diaries in which nurses noted the older adults’ verbal responses during a five-month intervention period in 17 long-term care homes across the Netherlands. The data were analyzed using descriptive statistics and qualitative content analysis based on the Grounded Theory. Findings The 47 dual sensory impaired older adults identified a total of 122 problems. Qualitative content analysis showed that the older adults encountered participation problems and problems controlling what happens in their personal environment. Three categories of participation problems emerged: (1) existential concerns of not belonging or not being able to connect with other people, (2) lack of access to communication, information and mobility, and (3) the desire to be actively involved in care delivery. Two categories of control-in-personal-space problems emerged: (1) lack of control of their own physical belongings, and (2) lack of control regarding the behavior of nurses providing daily care in their personal environment. Conclusions The invasive problems identified indicate that dual sensory impaired older adults experience great existential pressures on their lives. Long-term care providers need to develop and implement policies that identify and address these problems, and be aware of adverse consequences of usual care, in order to improve dual sensory impaired residents’ autonomy and

  14. Problems identified by dual sensory impaired older adults in long-term care when using a self-management program: A qualitative study.

    PubMed

    Roets-Merken, Lieve; Zuidema, Sytse; Vernooij-Dassen, Myrra; Dees, Marianne; Hermsen, Pieter; Kempen, Gertrudis; Graff, Maud

    2017-01-01

    To gain insights into the problems of dual sensory impaired older adults in long-term care. Insights into these problems are essential for developing adequate policies which address the needs of the increasing population of dual sensory impaired older adults in long-term care. A qualitative study was conducted in parallel with a cluster randomized controlled trial. Dual sensory impaired older adults in the intervention group (n = 47, age range 82-98) were invited by a familiar nurse to identify the problems they wanted to address. Data were taken from the semi-structured intervention diaries in which nurses noted the older adults' verbal responses during a five-month intervention period in 17 long-term care homes across the Netherlands. The data were analyzed using descriptive statistics and qualitative content analysis based on the Grounded Theory. The 47 dual sensory impaired older adults identified a total of 122 problems. Qualitative content analysis showed that the older adults encountered participation problems and problems controlling what happens in their personal environment. Three categories of participation problems emerged: (1) existential concerns of not belonging or not being able to connect with other people, (2) lack of access to communication, information and mobility, and (3) the desire to be actively involved in care delivery. Two categories of control-in-personal-space problems emerged: (1) lack of control of their own physical belongings, and (2) lack of control regarding the behavior of nurses providing daily care in their personal environment. The invasive problems identified indicate that dual sensory impaired older adults experience great existential pressures on their lives. Long-term care providers need to develop and implement policies that identify and address these problems, and be aware of adverse consequences of usual care, in order to improve dual sensory impaired residents' autonomy and quality of life.

  15. Integrated agriculture programs to address malnutrition in northern Malawi.

    PubMed

    Kerr, Rachel Bezner; Chilanga, Emmanuel; Nyantakyi-Frimpong, Hanson; Luginaah, Isaac; Lupafya, Esther

    2016-11-28

    In countries where the majority of undernourished people are smallholder farmers, there has been interest in agricultural interventions to improve nutritional outcomes. Addressing gender inequality, however, is a key mechanism by which agriculture can improve nutrition, since women often play a crucial role in farming, food processing and child care, but have limited decision-making and control over agricultural resources. This study examines the approaches by which gender equity in agrarian, resource-poor settings can be improved using a case study in Malawi. A quasi-experimental design with qualitative methods was used to examine the effects of a participatory intervention on gender relations. Thirty married couple households in 19 villages with children under the age of 5 years were interviewed before and then after the intervention. An additional 7 interviews were conducted with key informants, and participant observation was carried out before, during the intervention and afterwards in the communities. The interviews were recorded and transcribed, and analysed qualitatively for key themes, concepts and contradictions. Several barriers were identified that undermine the quality of child care practices, many linked to gender constructions and norms. The dominant concepts of masculinity created shame and embarrassment if men deviated from these norms, by cooking or caring for their children. The study provided evidence that participatory education supported new masculinities through public performances that encouraged men to take on these new roles. Invoking men's family responsibilities, encouraging new social norms alongside providing new information about different healthy recipes were all pathways by which men developed new 'emergent' masculinities in which they were more involved in cooking and child care. The transformational approach, intergenerational and intra-gendered events, a focus on agriculture and food security, alongside involving male leaders

  16. "I Did Not Plan Ahead": Preservice Teachers' Concerns Integrating Print-Based Literacy Lessons with Computer Technology.

    ERIC Educational Resources Information Center

    Richards, Janet C.

    In order to determine preservice teachers' reflective thinking and concerns as they addressed the complexities of supporting and augmenting their students' literacy instruction through computer activities, a systematic qualitative inquiry was conducted. The study was conducted in three schools within the same school district in south Mississippi.…

  17. A simulation and video-based training program to address adverse childhood experiences.

    PubMed

    Wen, Frances K; Miller-Cribbs, Julie E; Coon, Kim A; Jelley, Martina J; Foulks-Rodriguez, Kristin A

    2017-05-01

    Adverse childhood experiences (ACEs) are 10 categories of childhood abuse and maltreatment, which have a dose-response relationship with common adult health concerns seen in primary care including health risk behaviors, chronic disease, and mental illness. Many of the ACEs-associated biopsychosocial risk factors are modifiable. However, physicians may not address these issues for fear of opening "Pandora's Box", that is, a source of extensive problems for which they are not sufficiently prepared with training, resources, or time. Residents need training in how to conduct trauma-focused conversations within the limited scope of an office visit. To address this need, a 4-hour simulation and video-based training program was developed for primary care residents about how to conduct brief interventions connecting their patients' current health concerns with their experiences of ACEs. Resident participants have evaluated this program as preparatory for real-life encounters and as being designed to allow for educational mastery. This article describes a workshop presenting this training program which was given at the 37th Annual Behavioral Science Forum in Family Medicine. Five skills targeted in the program were presented and a demonstration was made of the components, that is, didactics, provider and patient videos, simulated patient encounters, trainee feedback, and facilitated discussion that encompasses targeted skills, clinical implementation, and self-care. Companion tools were shared, including the syllabus, evaluation rubric, and provider and patient resources. Participants practiced trainee feedback and discussed the challenges in implementation.

  18. Gender and Perceived Illness Severity: Differential Indicators of Employment Concerns for Adults with Multiple Sclerosis?

    ERIC Educational Resources Information Center

    Roessler, Richard T.; Turner, Ronna C.; Robertson, Judith L.; Rumrill,Phillip D.

    2005-01-01

    Although research has indicated a link between gender and perceived illness severity and the employment status of people with multiple sclerosis (MS), it has not addressed questions regarding the relationship between those variables and specific types of employment concerns. In this study, a sample of 1,310 adults with MS replied to a mail survey…

  19. Family History, Gender, and Eating and Body Image Concerns in University Students Seeking Counseling Services

    ERIC Educational Resources Information Center

    Cavallini, Adriane Q.; Erekson, David M.; Steinberg, Rachel M.; Clayson, Rachelle A.; Albright, Dallin D.

    2018-01-01

    Family history events have been shown to be reliable predictors of eating and body image concerns; however, little is known regarding how family history events compare in a clinical sample, or if these events differ by gender. The current study addresses this paucity, focusing on 3,129 university students seeking clinical services. Having a family…

  20. Emerging Concerns in Reading; Highlights of the 21st Annual Reading Conference of Lehigh University.

    ERIC Educational Resources Information Center

    Kender, Joseph P., Ed.

    Addressing the question, "How can we teach all educable children to read effectively?" the papers in the first part of this volume look at several topical concerns in reading: "On Relocating the Reading Program: Finding a Better Barn for Our Sacred Cow,""The Transitional Open Classroom,""A Computer Program for Initial Screening of Problem…

  1. Needs and concerns of transgender individuals regarding interdisciplinary transgender healthcare: A non-clinical online survey

    PubMed Central

    Koehler, Andreas; Dekker, Arne; Sehner, Susanne; Nieder, Timo O.

    2017-01-01

    This study investigates the needs and concerns transgender (short: trans) individuals have concerning trans healthcare (THC) in interdisciplinary THC centres. Trans individuals’ gender does not (fully/constantly) match their sex assigned at birth. To be able to live in their gender role and to prevent or minimise gender dysphoria, they might require a multidisciplinary set of transition related healthcare services. The current shift from the traditionally highly regulated, hierarchical and pathologising approach to THC towards a more patient-centred approach has highlighted the importance of trans patients’ satisfaction with treatment processes and results. As the still influential regulations have a negative effect on patient satisfaction, and might also keep trans individuals from seeking transition related treatment, it is crucial to investigate what trans individuals, whether patients or not, need and fear regarding transition related healthcare. Against the backdrop of mixed reactions received from the local trans community regarding the foundation of the Interdisciplinary Transgender Healthcare Centre Hamburg (ITHCCH), Germany, this study seeks to determine what trans individuals need with respect to THC in order to guarantee for high quality service provision at the ITHCCH. To this end, an online questionnaire was developed. The researchers employed a participatory approach to questionnaire development by involving a working group consisting of local trans support group representatives and (THC) specialists (N = 4). The sample consisted of N = 415 trans-identified individuals aged between 16 and 76. Most of them were based in Germany. 85.2% (n = 382) reported experience with transition related healthcare and 72.5% (n = 301) had (additional) treatments planned. Analysis revealed a need for communication and feedback opportunities. Furthermore, during the treatment process, addressing individual needs was considered crucial by participants. They agreed

  2. ‘Poisonous, Filthy, Loathsome, Damnable Stuff’: The Rhetorical Ecology of Vaccination Concern

    PubMed Central

    Hausman, Bernice L.; Ghebremichael, Mecal; Hayek, Philip; Mack, Erin

    2014-01-01

    In this article, we analyze newspaper articles and advertisements mentioning vaccination from 1915 to 1922 and refer to historical studies of vaccination practices and attitudes in the early 20th century in order to assess historical continuities and discontinuities in vaccination concern. In the Progressive Era period, there were a number of themes or features that resonated with contemporary issues and circumstances: 1) fears of vaccine contamination; 2) distrust of medical professionals; 3) resistance to compulsory vaccination; and 4) the local nature of vaccination concern. Such observations help scholars and practitioners understand vaccine skepticism as longstanding, locally situated, and linked to the sociocultural contexts in which vaccination occurs and is mandated for particular segments of the population. A rhetorical approach offers a way to understand how discourses are engaged and mobilized for particular purposes in historical contexts. Historically situating vaccine hesitancy and addressing its articulation with a particular rhetorical ecology offers scholars and practitioners a robust understanding of vaccination concerns that can, and should, influence current approaches to vaccination skepticism. PMID:25506275

  3. Economic performance and public concerns about social class in twentieth-century books.

    PubMed

    Chen, Yunsong; Yan, Fei

    2016-09-01

    What is the association between macroeconomic conditions and public perceptions of social class? Applying a novel approach based on the Google Books N-gram corpus, this study addresses the relationship between public concerns about social class and economic conditions throughout the twentieth century. The usage of class-related words/phrases, or "literary references to class," in American English-language books is related to US economic performance and income inequality. The findings of this study demonstrate that economic conditions play a significant role in literary references to class throughout the century, whereas income inequality does not. Similar results are obtained from further analyses using alternative measures of class concerns as well as different corpora of English Fiction and the New York Times. We add to the social class literature by showing that the long-term temporal dynamics of an economy can be exhibited by aggregate class concerns. The application of massive culture-wide content analysis using data of unprecedented size also represents a contribution to the literature. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Mismatch between aspects of hearing impairment and hearing disability/handicap in adult/elderly Cantonese speakers: some hypotheses concerning cultural and linguistic influences.

    PubMed

    Doyle, J; Wong, L L

    1996-12-01

    This paper addresses the observation that some Cantonese-speaking adults do not perceive a hearing problem even when hearing screening identifies hearing loss. A sample of 49 Cantonese speakers was surveyed about their self-perceptions of hearing prior to a 25 dB HTL pure-tone screening test. All 49 persons failed the screening test, yet 34 (69.4%) reported that they had no problems hearing during conversations. Persons who admitted hearing difficulties tended to have mean hearing levels in excess of 45 dB HTL. A number of hypotheses concerning cultural and linguistic influences are proposed as explanations for the apparent lack of significance of auditory sensitivity loss for some Cantonese speakers. Ways in which these hypotheses might be tested are suggested.

  5. Identifying and Addressing Potential Conflict of Interest: A Professional Medical Organization’s Code of Ethics

    PubMed Central

    Heim, Lori

    2010-01-01

    The new Consumer Alliance agreement between the American Academy of Family Physicians (AAFP) and The Coca-Cola Company provides a valuable opportunity to illustrate AAFP’s adherence to its ethical foundation, demonstrate the AAFP’s commitment to serving physicians and the public, and maintain the trust Americans put in their family physicians and the organization that represents them. Throughout the development of this program, as well as in all business interactions, the AAFP consistently addresses possible conflict of interest openly and directly, sharing with our members and the public exactly what measures we take to ensure that, in fact, no unethical conduct or breach of trust would—or will in the future—occur. In this case, the AAFP saw a public health and education need that was both unmet and undermined by the barrage of marketing messages and confusing information, and acted to fill that need. In so doing, the AAFP hewed to its high ethical standards, its core values, and its mission in the decisions made and the actions that followed. PMID:20644192

  6. Defining Educational Research: A Perspective of/on Presidential Addresses and the Australian Association for Research in Education

    ERIC Educational Resources Information Center

    Lingard, Bob; Gale, Trevor

    2010-01-01

    This paper is concerned with the definition of the field of educational research and the changing and developing role of the Australian Association for Research in Education (AARE) in representing and constituting this field. The evidence for the argument is derived from AARE Presidential Addresses across its 40-year history. The paper documents…

  7. Gestational diabetes: women's concerns, mood state, quality of life and treatment satisfaction.

    PubMed

    Trutnovsky, Gerda; Panzitt, Thomas; Magnet, Eva; Stern, Christina; Lang, Uwe; Dorfer, Martha

    2012-11-01

    The aim of this observational cohort study was to explore concerns, mood state, quality of life (QoL) and treatment satisfaction of women treated for gestational diabetes (GDM). Twenty-seven diet-treated and 18 insulin-treated women participated in a semi-structured interview and completed a series of three different questionnaires. Qualitative analysis identified "the baby's health" as dominant concern, but also as main motivational treatment factor. Treatment satisfaction was generally high and further increased, whereas QoL and mood state significantly dropped over time. Acknowledgment of women's concerns and precise information may improve treatment compliance and outcome.

  8. Panel 2: anticipatory risk assessment: identifying, assessing, and mitigating exposure risks before they occur.

    PubMed

    Guidotti, Tee L; Pacha, Laura

    2011-07-01

    Health threats place the military mission and deployed service members at risk. A commander's focus is on preventing acute health risks, such as diarrhea, because these quickly compromise the mission. However, in recent conflicts chronic and long-term illness risks have emerged as concerns. Department of Defense and Joint Chiefs of Staff mandates require documentation of exposures and environmental conditions to reconstruct exposures and evaluate future health risks. Current processes for identifying and assessing hazards, including identification and assessment before deployment and in time to take action to prevent or reduce exposures, when followed, are generally adequate for known hazards. Identifying and addressing novel, unexpected risks remain challenges. Armed conflicts are associated with rapidly changing conditions, making ongoing hazard identification and assessment difficult. Therefore, surveillance of the environment for hazards and surveillance of personnel for morbidity must be practiced at all times. Communication of risk information to decision makers is critical but problematic. Preventive Medicine (PM) personnel should take responsibility for communicating this information to non-PM military medical people and to military commanders. Communication of risks identified and lessons learned between PM personnel of different military units is extremely important when one military unit replaces another in a deployed environment.

  9. Concern-driven integrated approaches to nanomaterial testing and assessment – report of the NanoSafety Cluster Working Group 10

    PubMed Central

    Oomen, Agnes G.; Bos, Peter M. J.; Fernandes, Teresa F.; Hund-Rinke, Kerstin; Boraschi, Diana; Byrne, Hugh J.; Aschberger, Karin; Gottardo, Stefania; von der Kammer, Frank; Kühnel, Dana; Hristozov, Danail; Marcomini, Antonio; Migliore, Lucia; Scott-Fordsmand, Janeck; Wick, Peter

    2014-01-01

    Bringing together topic-related European Union (EU)-funded projects, the so-called “NanoSafety Cluster” aims at identifying key areas for further research on risk assessment procedures for nanomaterials (NM). The outcome of NanoSafety Cluster Working Group 10, this commentary presents a vision for concern-driven integrated approaches for the (eco-)toxicological testing and assessment (IATA) of NM. Such approaches should start out by determining concerns, i.e., specific information needs for a given NM based on realistic exposure scenarios. Recognised concerns can be addressed in a set of tiers using standardised protocols for NM preparation and testing. Tier 1 includes determining physico-chemical properties, non-testing (e.g., structure–activity relationships) and evaluating existing data. In tier 2, a limited set of in vitro and in vivo tests are performed that can either indicate that the risk of the specific concern is sufficiently known or indicate the need for further testing, including details for such testing. Ecotoxicological testing begins with representative test organisms followed by complex test systems. After each tier, it is evaluated whether the information gained permits assessing the safety of the NM so that further testing can be waived. By effectively exploiting all available information, IATA allow accelerating the risk assessment process and reducing testing costs and animal use (in line with the 3Rs principle implemented in EU Directive 2010/63/EU). Combining material properties, exposure, biokinetics and hazard data, information gained with IATA can be used to recognise groups of NM based upon similar modes of action. Grouping of substances in return should form integral part of the IATA themselves. PMID:23641967

  10. Identifying new patient prospects: efficacy of usage segmentation. For some health care services, usage-based segmentation schemes can be wasteful and ineffective.

    PubMed

    Sarel, D; Marmorstein, H

    1996-01-01

    Even though there is intuitive appeal in identifying the user profile for a given service and then targeting similar nonusers, this approach can be very misleading when marketing health care services with low market penetration. If usage segmentation is employed without checking other indicators of latent demand and perceived barriers to use, significant misallocation of marketing resources is likely to occur. Confidentiality and embarrassment can be significant barriers to use by segments that are excellent patient prospects. In this study of mental and behavioral care, females and non-whites were found to be more concerned with confidentiality than were members of the user group. Lack of awareness can be a much bigger impediment to adoption than negative attitudes. Health care marketers need to design communications that not only increase awareness and familiarity for services with low market penetration, but also address other issues of concern to highly receptive segments.

  11. Awareness of technology-induced errors and processes for identifying and preventing such errors.

    PubMed

    Bellwood, Paule; Borycki, Elizabeth M; Kushniruk, Andre W

    2015-01-01

    There is a need to determine if organizations working with health information technology are aware of technology-induced errors and how they are addressing and preventing them. The purpose of this study was to: a) determine the degree of technology-induced error awareness in various Canadian healthcare organizations, and b) identify those processes and procedures that are currently in place to help address, manage, and prevent technology-induced errors. We identified a lack of technology-induced error awareness among participants. Participants identified there was a lack of well-defined procedures in place for reporting technology-induced errors, addressing them when they arise, and preventing them.

  12. What are patients' goals and concerns about breast reconstruction after mastectomy?

    PubMed

    Lee, Clara N; Hultman, Charles Scott; Sepucha, Karen

    2010-05-01

    Discussions about breast reconstruction should include factual information and consideration of the patient's personal concerns. Providers are familiar with the relevant facts but may not know which personal concerns are important to patients. Experience with breast cancer patients has found that providers frequently do not know their patients' treatment preferences. To help reconstructive surgeons discuss personal preferences with their patients, we sought to identify women's key concerns related to breast reconstruction. We employed a qualitative design and convened a sample of 65 women in 7 focus groups and 15 semi-structured interviews. Women with a recent history of early-stage breast cancer who had a mastectomy with or without reconstruction were included. A variety of backgrounds, including underserved populations, low education levels, and various ages were represented. Qualitative content analysis was performed, and key themes were identified. Five key themes emerged. (1) Magnitude of surgery and recovery. Many women reported that concerns over the number of operations, duration of recovery, and risk of complications strongly affected their decision-making. (2) Using one's own tissue. Several women felt comforted by the notion of using their own tissue for reconstruction. (3) Looking natural in clothing. Many women pointed out the difference between how they look in clothing versus how they look naked. (4) Avoiding an external prosthesis. Several women stressed practical concerns and framed the reconstruction decision in terms of not having to use prosthesis. (5) Considering others' opinions. A few women reported that their partners' opinion strongly influenced their decision. Many women stated that they ultimately followed their doctor's recommendation. Women considering reconstruction have some unmet emotional and physical needs as well as important goals and concerns that can affect their decisions about and experience with reconstruction. In particular

  13. Health concern, food choice motives, and attitudes toward healthy eating: the mediating role of food choice motives.

    PubMed

    Sun, Yu-Hua Christine

    2008-07-01

    This study addresses how various health concerns might influence not only consumers' food choice motives but also consumers' subsequent attitudes toward healthy eating. This study expects that those consumers with greater health concerns would have different food choice motives and better attitudes toward healthy eating. A self-completion questionnaire was used to gather information. Participants, a random sample of 500 undergraduate students from a national university in Taipei, Taiwan, provided a total of 456 usable questionnaires, representing a valid response rate of 91%. The average age of the respondents at the time of the survey was 21 years and 63% of respondents were females. The relationship between health concern and healthy eating attitudes was confirmed. The relationship between health concern of developing diseases and attitudes toward healthy eating was fully mediated by food choice motives. However, the relationship between calorie consumption health concern and healthy eating attitudes was only partially mediated by food choice motives. Implications of these findings are discussed.

  14. Ethnic differences in ecological concerns: Spanish-speaking Hispanics are more concerned than others

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

    Burger, Joanna; Greenberg, Michael; Edward J. Bloustein School of Planning and Public Policy, Rutgers University, 33 Livingston Avenue, New Brunswick, New Jersey 08901-1958

    We postulated that environmental concern encompasses a wide range of different issues, often lumping pollution with habitat loss (or land use) and ecological resources (fish and wildlife). In this paper, we compare perceptions about a range of environmental and ecological resource issues, and explore ethnic/racial differences. We surveyed 1513 residents of New Jersey about 'environmental concerns', using both general environmental questions (two questions: How serious are environmental problems in New Jersey? Are you concerned about the loss of open space?) and ecological resource questions (12 questions: e.g., how important is planting trees in your neighborhood, how concerned are you aboutmore » loss of breeding and feeding habitat for fish and birds?) in New Jersey. Not all concerns were rated equally. For the ecological questions, there were no ethnic differences in concerns over preserving areas around water supplies, loss of places to hunt and fish, and loss of places for quiet walks and cycling, but there were for the other 9 ecological concerns. For eight of these nine concerns, Spanish-speaking Hispanics were more concerned than others (including English-speaking Hispanics). We divided the ecological resources into three categories: ecological services (clean water and safety), ecological resources (fish and wildlife), and recreational services. The strongest correlates of people's association with enlarging and enhancing recreational services were Spanish-speaking Hispanics, who are supportive of regulations and believe local government is not doing enough for environmental problems. People concerned about the loss of ecological resources and open space believe the federal government and the state are not doing enough for the environment, were non-Hispanic White, want continued environmental regulations, were longer-term residents, were high school graduates, and were older (45-54 years). People interested in ecological services were college

  15. Overview of ORNL/NRC programs addressing durability of concrete structures

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

    Naus, D.J.; Oland, C.B.

    1994-06-01

    The role of reinforced concrete relative to its applications as either safety-related structures in nuclear power or engineered barriers of low-level radioactive waste disposal facilities is described. Factors that can affect the long-term durability of reinforced concrete are identified. Overviews are presented of the Structural Aging Program, which is addressing the aging management of safety-related concrete structures in nuclear power plants, and the Permeability Test Methods and Data Program, which is identifying pertinent data and information for use in performance assessments of engineered barriers for low-level radioactive waste disposal.

  16. The next organizational challenge: finding and addressing diagnostic error.

    PubMed

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

    2014-03-01

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

  17. Translating concerns into action: a detailed qualitative evaluation of an interdisciplinary intervention on medical wards

    PubMed Central

    Archer, Stephanie; Johnston, Maximillian J; Beveridge, Iain; Long, Susannah Jane; Athanasiou, Thanos; Sevdalis, Nick

    2017-01-01

    Objectives To understand how frontline reports of day-to-day care failings might be better translated into improvement. Design Qualitative evaluation of an interdisciplinary team intervention capitalising on the frontline experience of care delivery. Prospective clinical team surveillance (PCTS) involved structured interdisciplinary briefings to capture challenges in care delivery, facilitated organisational escalation of the issues they identified, and feedback. Eighteen months of ethnography and two focus groups were conducted with staff taking part in a trial of PCTS. Results PCTS fostered psychological safety—a confidence that the team would not embarrass or punish those who speak up. This was complemented by a hard edge of accountability, whereby team members would regulate their own behaviour in anticipation of future briefings. Frontline concerns were triaged to managers, or resolved autonomously by ward teams, reversing what had been well-established normalisations of deviance. Junior clinicians found a degree of catharsis in airing their concerns, and their teams became more proactive in addressing improvement opportunities. PCTS generated tangible organisational changes, and enabled managers to make a convincing case for investment. However, briefings were constrained by the need to preserve professional credibility, and staff found some comfort in avoiding accountability. At higher organisational levels, frontline concerns were subject to competition with other priorities, and their resolution was limited by the scale of the challenges they described. Conclusions Prospective safety strategies relying on staff-volunteered data produce acceptable, negotiated accounts, subject to the many interdisciplinary tensions that characterise ward work. Nonetheless, these strategies give managers access to the realities of frontline cares, and support frontline staff to make incremental changes in their daily work. These are goals for learning healthcare

  18. Health care professionals' concerns regarding in-hospital family-witnessed cardiopulmonary resuscitation implementation into clinical practice.

    PubMed

    Sak-Dankosky, Natalia; Andruszkiewicz, Paweł; Sherwood, Paula R; Kvist, Tarja

    2018-05-01

    In-hospital, family-witnessed cardiopulmonary resuscitation of adults has been found to help patients' family members deal with the short- and long-term emotional consequences of resuscitation. Because of its benefits, many national and international nursing and medical organizations officially recommend this practice. Research, however, shows that family-witnessed resuscitation is not widely implemented in clinical practice, and health care professionals generally do not favour this recommendation. To describe and provide an initial basis for understanding health care professionals' views and perspectives regarding the implementation of an in-hospital, family-witnessed adult resuscitation practice in two European countries. An inductive qualitative approach was used in this study. Finnish (n = 93) and Polish (n = 75) emergency and intensive care nurses and physicians provided written responses to queries regarding their personal observations, concerns and comments about in-hospital, family-witnessed resuscitation of an adult. Data were analysed using inductive thematic analysis. The study analysis yielded five themes characterizing health care professionals' main concerns regarding family-witnessed resuscitation: (1) family's horror, (2) disturbed workflow (3) no support for the family, (4) staff preparation and (5) situation-based decision. Despite existing evidence revealing the positive influence of family-witnessed resuscitation on patients, relatives and cardiopulmonary resuscitation process, Finnish and Polish health care providers cited a number of personal and organizational barriers against this practice. The results of this study begin to examine reasons why family-witnessed resuscitation has not been widely implemented in practice. In order to successfully apply current evidence-based resuscitation guidelines, provider concerns need to be addressed through educational and organizational changes. This study identified important implementation

  19. Concerns and Preferred Assistance Strategies of Beginning Middle and High School Teachers.

    ERIC Educational Resources Information Center

    Charnock, Barbara; Kiley, Margaret

    In attempting to identify causes of the high rates of attrition of beginning teachers and possible solutions to their exodus, this study identified what beginning high school and middle school teachers in the Baltimore County Public School system found were their most urgent concerns and most valuable types of assistance. A questionnaire was sent…

  20. Wireless Phone Threat Assessment and New Wireless Technology Concerns for Aircraft Navigation Radios

    NASA Technical Reports Server (NTRS)

    Ely, Jay J.; Nguyen, Truong X.; Koppen, Sandra V.; Beggs, John H.; Salud, Maria Theresa P.

    2003-01-01

    To address the concern for cellular phone electromagnetic interference to aircraft radios, a radiated emission measurement process was developed for two dominant digital standards of wireless handsets. Spurious radiated emissions were efficiently characterized from devices tested in either a semi-anechoic or reverberation chamber, in terms of effective radiated power. Eight representative handsets (four from each digital standard) were commanded to operate while varying their radio transmitter parameters (power, modulation, etc.). This report provides a detailed description of the measurement process and resulting data, which may subsequently be used by others as a basis of consistent evaluation of other portable transmitters using a variety of wireless transmission protocols. Aircraft interference path loss and navigation radio interference threshold data from numerous reference documents, standards, and NASA partnerships were compiled. Using these data, a preliminary risk assessment is provided for wireless phone interference to aircraft Localizer, Glideslope, Very High Frequency Omni directional Range, and Global Positioning Satellite radio receivers on typical transport airplanes. The report identifies where existing data for device emissions, interference path loss, and navigation radio interference thresholds need to be extended for an accurate risk assessment for wireless transmitters in aircraft.