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

PubMed

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

2011-03-31

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

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

PubMed Central

2011-01-01

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

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

PubMed

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

2013-03-01

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

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

NASA Astrophysics Data System (ADS)

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

2015-09-01

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

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

NASA Astrophysics Data System (ADS)

Terblanche, Deon; Jalkanen, Liisa

2013-04-01

counterparts. The urban environment also provides numerous opportunities. One example being the better use of weather and environmental predictions to proactively optimize the functioning of the urban environment in terms of the use of energy, goods and services. Another is the providing of air quality forecasting services to benefit the health of the population. To address the challenges and opportunities facing megacities and large urban complexes, WMO has established the Global Atmosphere Watch (GAW) Urban Research Meteorology and Environment (GURME). Air pollution questions in urban areas, in particular megacities, is the main focus, building observational and modelling capabilities in developing countries through pilot projects and transfer of scientific expertise. GURME contributes to improving capabilities to handle meteorological and related features of air pollution by addressing end-to-end aspects of air quality, linking observational capabilities with the needs of chemical weather prediction, with the goal of providing high quality air quality services. Using examples from around the world but with specific reference to Africa, the unique challenges and opportunities related to megacities and large urban complexes, as perceived by the World Meteorological Organization (WMO) are highlighted.

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

PubMed Central

2014-01-01

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

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

PubMed

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

2014-04-15

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

Addressing practical challenges in utility optimization of mobile wireless sensor networks

NASA Astrophysics Data System (ADS)

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

2008-04-01

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

Scaling up to address data science challenges

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

Wendelberger, Joanne R.

Statistics and Data Science provide a variety of perspectives and technical approaches for exploring and understanding Big Data. Partnerships between scientists from different fields such as statistics, machine learning, computer science, and applied mathematics can lead to innovative approaches for addressing problems involving increasingly large amounts of data in a rigorous and effective manner that takes advantage of advances in computing. Here, this article will explore various challenges in Data Science and will highlight statistical approaches that can facilitate analysis of large-scale data including sampling and data reduction methods, techniques for effective analysis and visualization of large-scale simulations, and algorithmsmore » and procedures for efficient processing.« less

Scaling up to address data science challenges

DOE PAGES

Wendelberger, Joanne R.

2017-04-27

Statistics and Data Science provide a variety of perspectives and technical approaches for exploring and understanding Big Data. Partnerships between scientists from different fields such as statistics, machine learning, computer science, and applied mathematics can lead to innovative approaches for addressing problems involving increasingly large amounts of data in a rigorous and effective manner that takes advantage of advances in computing. Here, this article will explore various challenges in Data Science and will highlight statistical approaches that can facilitate analysis of large-scale data including sampling and data reduction methods, techniques for effective analysis and visualization of large-scale simulations, and algorithmsmore » and procedures for efficient processing.« less

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

ERIC Educational Resources Information Center

Petersen, Christina I.; Gorman, Kristen S.

2014-01-01

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

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

PubMed

Catenacci, Daniel V T

2015-05-01

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

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

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

Atun, R.

2015-06-15

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

Energy-Intensive Processes Portfolio: Addressing Key Energy Challenges Across U.S. Industry

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

None

AMO is developing advanced technologies that cut energy use and carbon emissions in some of the most energy-intensive processes within U.S. manufacturing. The brochure describes the AMO R&D projects that address these challenges.

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

PubMed

Johnston, Lee M; Finegood, Diane T

2015-03-18

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

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

PubMed

Feeley, Kathleen M; Jones, Emily A

2006-09-01

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

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

PubMed Central

2013-01-01

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

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

ERIC Educational Resources Information Center

Alkaher, Iris; Tal, Tali

2016-01-01

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

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

NASA Technical Reports Server (NTRS)

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

2016-01-01

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

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

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

Coleman, N.

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

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

PubMed

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

2015-01-22

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

Addressing challenges for youths with mobility devices in winter conditions.

PubMed

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

2018-01-01

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

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

NASA Astrophysics Data System (ADS)

Bonet-García, Francisco; Materia, Paola; Kutsch, Werner; de Lucas, Jesús Marco; Tjulin, Anders

2016-04-01

During the Anthropocene, mankind will face several global environmental challenges. One of the first and more successful responses provided by Science to these challenges is the collecting of long-term series of biophysical variables in order to improve our knowledge of natural systems. The huge amount of information gathered during the last decades by Research Infrastructures (RIs) has helped to understand the structure and functioning of natural systems at local and regional scales. But how can we address the global cross-scale and cross-disciplinary challenges posed by the global environment change? We believe that it will be necessary to observe, model better and understand the whole biosphere using long term data generated by international RIs. RIs play a key role on many of the last advances and discoveries in science, from the observation of the Higgs Boson at CERN to the exploration of the Universe by the telescopes of the European Southern Observatory in Chile. The scale of complexity, instrumentation, computing resources, technological advances, and also of the investments, and the size of research collaborations, do not have precedents in Science. RIs in environmental field are developing fast, but the corresponding communities need yet to further reflect the need for a wider global collaboration because the challenges to tackle are in essence of global nature. This contribution describes how COOP+ project (EU Horizon 2020 Coordination and Support Action) will promote the cooperation among RIs at a global scale to address global environmental challenges. Our project evolves from the experience of the sucessful FP7 COOPEUS project (see http://www.coopeus.eu), which explored the use and access to data from RIs in environmental research in Europe and USA. The general goal of COOP+ is to strengthen the links and coordination of the ESFRI RIs related to Marine Science (EMSO), Arctic and Atmospheric Research (EISCAT), Carbon Observation (ICOS) and Biodiversity

Challenges in Diabetes Care: Can Digital Health Help Address Them?

PubMed Central

Close, Kelly

2016-01-01

In Brief There is great enthusiasm for the potential of digital health solutions in medicine and diabetes to address key care challenges: patient and provider burden, lack of data to inform therapeutic decision-making, poor access to care, and costs. However, the field is still in its nascent days; many patients and providers do not currently engage with digital health tools, and for those who do, the burden is still often high. Over time, digital health has excellent potential to collect data more seamlessly, make collected data more useful, and drive better outcomes at lower costs in less time. But there is still much to prove. This review offers key background information on the current state of digital health in diabetes, six of the most promising digital health technologies and services, and the challenges that remain. PMID:27621530

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

PubMed

Ben-Porath, Yossef S

2012-11-01

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

Localization of antigen-specific lymphocytes following lymph node challenge.

PubMed Central

Liu, H; Splitter, G A

1986-01-01

The effect of subcutaneous injections of Brucella abortus strain 19 antigen on the specific localization of autologous lymphocytes in the regional nodes of calves was analysed by fluorescent labelling and flow cytometry. Both in vitro and in vivo FITC labelling of lymphocytes indicated the preferential migration of lymphocytes from a previously challenged lymph node to a recently challenged lymph node. However, lymphocytes from a lymph node challenged with B. abortus failed to localize preferentially in a lymph node challenged with a control antigen, Listeria monocytogenes. Lymph node cells, enriched for T lymphocytes and isolated from primary stimulated or secondary challenged B. abortus lymph nodes, could proliferate when cultured with autologous antigen-pulsed macrophages. The kinetics of [3H]thymidine incorporation in lymphocytes from secondarily challenged lymph nodes occurred earlier and to a greater extent when compared with lymphocytes from primary challenged lymph nodes. Our data show that the accumulation of B. abortus-specific lymphocytes in secondarily challenged lymph nodes is increased by the presence of the specific antigen. Images Figure 4 PMID:2426183

Addressing the Mathematics-Specific Needs of Beginning Mathematics Teachers

ERIC Educational Resources Information Center

Britton, Edward

2012-01-01

Beginning mathematics teachers at the secondary level (middle and high school grades) have mathematics-specific needs that induction programs should address more substantially. However, a number of issues in how programs can accomplish this are more complex than often framed in discussions occurring in the induction programs and the field of…

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

PubMed

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

2015-12-01

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

[Continuous challenges in Japanese forensic toxicology practice: strategy to address specific goals].

PubMed

Kageura, Mitsuyoshi

2002-09-01

In this paper, the status quo of forensic toxicology in Japan and the West is surveyed and a strategy to address future goals of Japanese forensic toxicology is proposed. Forensic toxicology in the West consists of three main areas--post-mortem forensic toxicology, human-performance forensic toxicology and forensic urine drug testing. In Japan, post-mortem forensic toxicology is practiced in university forensic medicine departments while most of the human-performance forensic toxicology is carried out in police laboratories. However, at least at present, strictly controlled workplace urine drug testing is not being performed, despite the abuse of drugs even by uniformed members of the National Defence Forces and police. For several years, the author has been introducing Western forensic toxicology guidelines and recommendations, translated into Japanese with the help of Western forensic toxicologists, to Japanese forensic toxicologists. Western forensic toxicology practice is at an advanced stage, whereas Japanese practice is in a critical condition and holds many problems awaiting solution, as exemplified by the urine drug testing in police laboratories. There is never any sample left for re-examination by the defence in all cases, though the initial volume of the urine sample available for examination is 30-50 ml. Only one organisation carries out everything from sampling to reporting and, in addition, the parent drug and its metabolites are not quantified. It is clear that the police laboratories do not work within good laboratory practice guidelines, nor do they have quality manuals or standard operating procedures manuals. A basic change in Japanese forensic toxicology practice is now essential. The author strongly recommends that, first of all, Japanese toxicologists should prepare forensic toxicology guidelines based on the Western models. The guidelines would progress the following objectives for forensic toxicology laboratories: 1) to have documented good

46 CFR 107.317 - Addresses for submittal of plans, specifications, and calculations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Addresses for submittal of plans, specifications, and calculations. 107.317 Section 107.317 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Plan Approval § 107.317 Addresses for...

46 CFR 107.317 - Addresses for submittal of plans, specifications, and calculations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Addresses for submittal of plans, specifications, and calculations. 107.317 Section 107.317 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Plan Approval § 107.317 Addresses for...

46 CFR 107.317 - Addresses for submittal of plans, specifications, and calculations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Addresses for submittal of plans, specifications, and calculations. 107.317 Section 107.317 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Plan Approval § 107.317 Addresses for...

46 CFR 107.317 - Addresses for submittal of plans, specifications, and calculations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Addresses for submittal of plans, specifications, and calculations. 107.317 Section 107.317 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Plan Approval § 107.317 Addresses for...

46 CFR 107.317 - Addresses for submittal of plans, specifications, and calculations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Addresses for submittal of plans, specifications, and calculations. 107.317 Section 107.317 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Plan Approval § 107.317 Addresses for...

Addressing Earth Science Data Access Challenges through User Experience Research

NASA Astrophysics Data System (ADS)

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

2013-12-01

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

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

PubMed

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

2017-10-16

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

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

PubMed

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

2016-06-08

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

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

PubMed Central

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

2016-01-01

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

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

PubMed Central

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

2016-01-01

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

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

PubMed Central

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

2016-01-01

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

Interweaving Knowledge Resources to Address Complex Environmental Health Challenges

PubMed Central

Anderson, Beth Ellen; Suk, William A.

2015-01-01

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

Interweaving Knowledge Resources to Address Complex Environmental Health Challenges.

PubMed

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

2015-11-01

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

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

DTIC Science & Technology

2016-03-16

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

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

PubMed

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

2015-09-08

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

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

ERIC Educational Resources Information Center

Harris, Jessica C.; Patton, Lori D.

2017-01-01

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

Strategies to Address English Language Writing Challenges Faced by International Graduate Students in the US

ERIC Educational Resources Information Center

Ravichandran, Swathi; Kretovics, Mark; Kirby, Kara; Ghosh, Ankita

2017-01-01

Since 2000, there has been a 72% increase in the number of international students attending US institutions of higher education. The increase, specifically of international graduate students, has brought to light the writing challenges experienced by this population of students. This study explored specific writing challenges experienced by…

Addressing Psychosocial Factors with Library Mentoring

ERIC Educational Resources Information Center

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

2017-01-01

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

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

PubMed

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

2018-04-06

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

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

DTIC Science & Technology

2016-04-01

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

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

PubMed

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

2016-04-01

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

Addressing global change challenges for Central Asian socio-ecosystems

NASA Astrophysics Data System (ADS)

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

2012-06-01

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

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

PubMed Central

2010-01-01

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

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

ERIC Educational Resources Information Center

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

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

Addressing Open Water Data Challenges in the Bureau of Reclamation

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

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

PubMed

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

2016-12-01

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

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

PubMed Central

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

2017-01-01

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

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

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

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

2009-05-01

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

Consensus Statement on Electronic Health Predictive Analytics: A Guiding Framework to Address Challenges

PubMed Central

Amarasingham, Ruben; Audet, Anne-Marie J.; Bates, David W.; Glenn Cohen, I.; Entwistle, Martin; Escobar, G. J.; Liu, Vincent; Etheredge, Lynn; Lo, Bernard; Ohno-Machado, Lucila; Ram, Sudha; Saria, Suchi; Schilling, Lisa M.; Shahi, Anand; Stewart, Walter F.; Steyerberg, Ewout W.; Xie, Bin

2016-01-01

Context: The recent explosion in available electronic health record (EHR) data is motivating a rapid expansion of electronic health care predictive analytic (e-HPA) applications, defined as the use of electronic algorithms that forecast clinical events in real time with the intent to improve patient outcomes and reduce costs. There is an urgent need for a systematic framework to guide the development and application of e-HPA to ensure that the field develops in a scientifically sound, ethical, and efficient manner. Objectives: Building upon earlier frameworks of model development and utilization, we identify the emerging opportunities and challenges of e-HPA, propose a framework that enables us to realize these opportunities, address these challenges, and motivate e-HPA stakeholders to both adopt and continuously refine the framework as the applications of e-HPA emerge. Methods: To achieve these objectives, 17 experts with diverse expertise including methodology, ethics, legal, regulation, and health care delivery systems were assembled to identify emerging opportunities and challenges of e-HPA and to propose a framework to guide the development and application of e-HPA. Findings: The framework proposed by the panel includes three key domains where e-HPA differs qualitatively from earlier generations of models and algorithms (Data Barriers, Transparency, and Ethics) and areas where current frameworks are insufficient to address the emerging opportunities and challenges of e-HPA (Regulation and Certification; and Education and Training). The following list of recommendations summarizes the key points of the framework: Data Barriers: Establish mechanisms within the scientific community to support data sharing for predictive model development and testing.Transparency: Set standards around e-HPA validation based on principles of scientific transparency and reproducibility.Ethics: Develop both individual-centered and society-centered risk-benefit approaches to evaluate

Consensus Statement on Electronic Health Predictive Analytics: A Guiding Framework to Address Challenges.

PubMed

Amarasingham, Ruben; Audet, Anne-Marie J; Bates, David W; Glenn Cohen, I; Entwistle, Martin; Escobar, G J; Liu, Vincent; Etheredge, Lynn; Lo, Bernard; Ohno-Machado, Lucila; Ram, Sudha; Saria, Suchi; Schilling, Lisa M; Shahi, Anand; Stewart, Walter F; Steyerberg, Ewout W; Xie, Bin

2016-01-01

The recent explosion in available electronic health record (EHR) data is motivating a rapid expansion of electronic health care predictive analytic (e-HPA) applications, defined as the use of electronic algorithms that forecast clinical events in real time with the intent to improve patient outcomes and reduce costs. There is an urgent need for a systematic framework to guide the development and application of e-HPA to ensure that the field develops in a scientifically sound, ethical, and efficient manner. Building upon earlier frameworks of model development and utilization, we identify the emerging opportunities and challenges of e-HPA, propose a framework that enables us to realize these opportunities, address these challenges, and motivate e-HPA stakeholders to both adopt and continuously refine the framework as the applications of e-HPA emerge. To achieve these objectives, 17 experts with diverse expertise including methodology, ethics, legal, regulation, and health care delivery systems were assembled to identify emerging opportunities and challenges of e-HPA and to propose a framework to guide the development and application of e-HPA. The framework proposed by the panel includes three key domains where e-HPA differs qualitatively from earlier generations of models and algorithms (Data Barriers, Transparency, and ETHICS) and areas where current frameworks are insufficient to address the emerging opportunities and challenges of e-HPA (Regulation and Certification; and Education and Training). The following list of recommendations summarizes the key points of the framework: Data Barriers: Establish mechanisms within the scientific community to support data sharing for predictive model development and testing.Transparency: Set standards around e-HPA validation based on principles of scientific transparency and reproducibility. Develop both individual-centered and society-centered risk-benefit approaches to evaluate e-HPA.Regulation and Certification: Construct a

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

ERIC Educational Resources Information Center

DeMatthews, David; Mawhinney, Hanne

2014-01-01

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

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

ERIC Educational Resources Information Center

Morrison, Stephaney; Bryan, Julia

2014-01-01

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

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

PubMed

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

2017-06-14

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

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

PubMed

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

2018-05-01

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

The next organizational challenge: finding and addressing diagnostic error.

PubMed

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

2014-03-01

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

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

ERIC Educational Resources Information Center

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

2017-01-01

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

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

PubMed Central

Hankins, Catherine A.

2016-01-01

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

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

PubMed

Hankins, Catherine A

2016-01-01

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

Ethical challenges in resuscitation.

PubMed

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

2018-06-01

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

Ethical Challenges in the Teaching of Multicultural Course Work

ERIC Educational Resources Information Center

Fier, Elizabeth Boyer; Ramsey, MaryLou

2005-01-01

The authors explore the ethical issues and challenges frequently encountered by counselor educators of multicultural course work. Existing ethics codes are examined, and the need for greater specificity with regard to teaching courses of multicultural content is addressed. Options for revising existing codes to better address the challenges of…

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2018-03-22

Multinational clinical trials are logistically complex and require close coordination between various stakeholders. They must comply with global clinical standards and are accountable to multiple regulatory and ethical bodies. In resource-limited settings, it is challenging to understand how to apply global clinical standards to international, national, and local factors in clinical trials, making multiple-level stakeholder engagement an important element in the successful conduct of these clinical trials. During the planning and implementation of a large multinational clinical trial for intermittent preventive treatment of malaria in pregnancy in resource-limited areas of sub-Saharan Africa, we encountered numerous challenges, which required implementation of a range of engagement measures to ensure compliance with global clinical and regulatory standards. These challenges included coordination with ongoing global malaria efforts, heterogeneity in national regulatory structures, sub-optimal healthcare infrastructure, local practices and beliefs, and perspectives that view healthcare providers with undue trust or suspicion. In addition to engagement with international bodies, such as the World Health Organization, the Malaria in Pregnancy Consortium, the Steve Biko Centre for Bioethics, and the London School of Hygiene and Tropical Medicine, in order to address the challenges just described, Pfizer Inc. and Medicines for Malaria Venture (the "Sponsoring Entities" for these studies) and investigators liaised with national- and district-level stakeholders such as health ministers and regional/local community health workers. Community engagement measures undertaken by investigators included local meetings with community leaders to explain the research aims and answer questions and concerns voiced by the community. The investigators also engaged with family members of prospective trial participants in order to be sensitive to local practices and beliefs. Engagement

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

PubMed

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

2014-02-03

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

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

PubMed Central

2014-01-01

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

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

ERIC Educational Resources Information Center

Moreno, Gerardo; Bullock, Lyndal M.

2011-01-01

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

Visualisation and interaction design solutions to address specific demands in shared home care.

PubMed

Scandurra, Isabella; Hägglund, Maria; Koch, Sabine

2006-01-01

When care professionals from different organisations are involved in patient care, their different views on the care process may not be meaningfully integrated. To use visualisation and interaction design solutions addressing the specific demands of shared care in order to support a collaborative work process. Participatory design, comprising interdisciplinary seminar series with real users and iterative prototyping, was applied. A set of interaction and visualisation design solutions to address care professionals' requirements in shared home care is presented, introducing support for identifying origin of information, holistic presentation of information, user group specific visualisation, avoiding cognitive overload, coordination of work and planning, and quick overviews. The design solutions are implemented in an integrated virtual health record system supporting cooperation and coordination in shared home care for the elderly. The described requirements are, however, generalized to comprise all shared care work. The presented design considerations allow healthcare professionals in different organizations to share patient data on mobile devices. Visualization and interaction design facilitates specific work situations and assists in handling specific demands in shared care. The user interface is adapted to different user groups with similar yet distinct needs. Consequently different views supporting cooperative work and presenting shared information in holistic overviews are developed.

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

PubMed

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

2015-06-05

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

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

PubMed

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

2017-04-01

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

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

PubMed

Bosomworth, Karyn; Owen, Christine; Curnin, Steven

2017-04-01

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

Addressing Physics Grand Challenges Using the Jefferson Lab FEL

NASA Astrophysics Data System (ADS)

Williams, Gwyn P.

2006-11-01

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

Recent Approaches to Estimate Associations Between Source-Specific Air Pollution and Health.

PubMed

Krall, Jenna R; Strickland, Matthew J

2017-03-01

Estimating health effects associated with source-specific exposure is important for better understanding how pollution impacts health and for developing policies to better protect public health. Although epidemiologic studies of sources can be informative, these studies are challenging to conduct because source-specific exposures (e.g., particulate matter from vehicles) often are not directly observed and must be estimated. We reviewed recent studies that estimated associations between pollution sources and health to identify methodological developments designed to address important challenges. Notable advances in epidemiologic studies of sources include approaches for (1) propagating uncertainty in source estimation into health effect estimates, (2) assessing regional and seasonal variability in emissions sources and source-specific health effects, and (3) addressing potential confounding in estimated health effects. Novel methodological approaches to address challenges in studies of pollution sources, particularly evaluation of source-specific health effects, are important for determining how source-specific exposure impacts health.

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

PubMed

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

2010-10-01

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

Online Learning: Addressing Challenges and Seizing Opportunities. Oregon

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

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

Online Learning: Addressing Challenges and Seizing Opportunities. Minnesota

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

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

Online Learning: Addressing Challenges and Seizing Opportunities. Hawaii

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

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

Online Learning: Addressing Challenges and Seizing Opportunities. Idaho

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

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

Online Learning: Addressing Challenges and Seizing Opportunities. Wisconsin

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

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

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

PubMed

Colpitts, Che C; Baumert, Thomas F

2016-08-16

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

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

PubMed

Podlog, Leslie; Dionigi, Rylee

2010-09-01

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

A Holistic Approach towards Information and Communication Technology (ICT) for Addressing Education Challenges in Asia and the Pacific

ERIC Educational Resources Information Center

Ra, Sungsup; Chin, Brian; Lim, Cher Ping

2016-01-01

Information and Communication Technology (ICT) offers opportunities for governments to address key education challenges of quality, equity, and efficiency. While governments and educational institutions in developed countries may have taken up these opportunities, many developing countries in Asia and the Pacific region have often missed them out.…

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

ERIC Educational Resources Information Center

Christ, Tanya; Wang, X. Christine

2013-01-01

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

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

DTIC Science & Technology

2016-09-01

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

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

NASA Astrophysics Data System (ADS)

Mateo-Marti, Eva

2014-08-01

The study of planetary environments of astrobiological interest has become a major challenge. Because of the obvious technical and economical limitations on in situ planetary exploration, laboratory simulations are one of the most feasible research options to make advances both in planetary science and in developing a consistent description of the origin of life. With this objective in mind, we applied vacuum technology to the design of versatile vacuum chambers devoted to the simulation of planetary atmospheres' conditions. These vacuum chambers are able to simulate atmospheres and surface temperatures representative of the majority of planetary objects, and they are especially appropriate for studying the physical, chemical and biological changes induced in a particular sample by in situ irradiation or physical parameters in a controlled environment. Vacuum chambers are a promising potential tool in several scientific and technological fields, such as engineering, chemistry, geology and biology. They also offer the possibility of discriminating between the effects of individual physical parameters and selected combinations thereof. The implementation of our vacuum chambers in combination with analytical techniques was specifically developed to make feasible the in situ physico-chemical characterization of samples. Many wide-ranging applications in astrobiology are detailed herein to provide an understanding of the potential and flexibility of these experimental systems. Instruments and engineering technology for space applications could take advantage of our environment-simulation chambers for sensor calibration. Our systems also provide the opportunity to gain a greater understanding of the chemical reactivity of molecules on surfaces under different environments, thereby leading to a greater understanding of interface processes in prebiotic chemical reactions and facilitating studies of UV photostability and photochemistry on surfaces. Furthermore, the

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

PubMed

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

2015-02-01

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

Final Report from The University of Texas at Austin for DEGAS: Dynamic Global Address Space programming environments

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

Erez, Mattan; Yelick, Katherine; Sarkar, Vivek

The Dynamic, Exascale Global Address Space programming environment (DEGAS) project will develop the next generation of programming models and runtime systems to meet the challenges of Exascale computing. Our approach is to provide an efficient and scalable programming model that can be adapted to application needs through the use of dynamic runtime features and domain-specific languages for computational kernels. We address the following technical challenges: Programmability: Rich set of programming constructs based on a Hierarchical Partitioned Global Address Space (HPGAS) model, demonstrated in UPC++. Scalability: Hierarchical locality control, lightweight communication (extended GASNet), and ef- ficient synchronization mechanisms (Phasers). Performance Portability:more » Just-in-time specialization (SEJITS) for generating hardware-specific code and scheduling libraries for domain-specific adaptive runtimes (Habanero). Energy Efficiency: Communication-optimal code generation to optimize energy efficiency by re- ducing data movement. Resilience: Containment Domains for flexible, domain-specific resilience, using state capture mechanisms and lightweight, asynchronous recovery mechanisms. Interoperability: Runtime and language interoperability with MPI and OpenMP to encourage broad adoption.« less

Improving the Curriculum with Ethics: Gaps between Perceived Ethical Challenges of Practitioners and Educators

ERIC Educational Resources Information Center

Dolezel, Diane M.; Morrison, Eileen E.

2017-01-01

Health information management (HIM) professionals must address ethical challenges in their role as guardians of patients' personal information and organizations' proprietary information. Because of this need, HIM educators strive prepare their students to address these challenges. Unfortunately, little evidence exists about specific areas of…

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

NASA Astrophysics Data System (ADS)

Ramamurthy, Mohan; Fisher, Ward

2017-04-01

Data are not only the lifeblood of the geosciences but they have become the currency of the modern world in science and society. Rapid advances in computing, communi¬cations, and observational technologies — along with concomitant advances in high-resolution modeling, ensemble and coupled-systems predictions of the Earth system — are revolutionizing nearly every aspect of our field. Modern data volumes from high-resolution ensemble prediction/projection/simulation systems and next-generation remote-sensing systems like hyper-spectral satellite sensors and phased-array radars are staggering. For example, CMIP efforts alone will generate many petabytes of climate projection data for use in assessments of climate change. And NOAA's National Climatic Data Center projects that it will archive over 350 petabytes by 2030. For researchers and educators, this deluge and the increasing complexity of data brings challenges along with the opportunities for discovery and scientific breakthroughs. The potential for big data to transform the geosciences is enormous, but realizing the next frontier depends on effectively managing, analyzing, and exploiting these heterogeneous data sources, extracting knowledge and useful information from heterogeneous data sources in ways that were previously impossible, to enable discoveries and gain new insights. At the same time, there is a growing focus on the area of "Reproducibility or Replicability in Science" that has implications for Open Science. The advent of cloud computing has opened new avenues for not only addressing both big data and Open Science challenges to accelerate scientific discoveries. However, to successfully leverage the enormous potential of cloud technologies, it will require the data providers and the scientific communities to develop new paradigms to enable next-generation workflows and transform the conduct of science. Making data readily available is a necessary but not a sufficient condition. Data providers

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2014-08-13

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

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

PubMed

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

2017-04-01

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

Prenatal stress challenge impairs fetal lung development and asthma severity sex-specifically in mice.

PubMed

Zazara, Dimitra E; Perani, Clara V; Solano, María E; Arck, Petra C

2018-02-01

Allergic asthma is an increasing health problem worldwide. Interestingly, prenatal challenges such as stress have been associated with an increased risk for asthma during childhood. The underlying pathogenesis of how prenatal stress increases the risk for asthma still remains unclear. Potential targets could be that the fetal immune ontogeny or fetal lung development are compromised by prenatal challenges. Here, we aimed to identify whether prenatal stress challenge affects fetal lung development in mice. C57BL/6 pregnant mice were challenged with sound stress and fetal lung development was assessed histologically. Whilst prenatal stress challenge did not profoundly affect lung development in male fetuses, it resulted in less extensive terminal sacs, surrounded by thicker mesenchymal tissue in female fetuses. Thus, prenatal stress disrupted fetal lung development sex-specifically. Interestingly, upon prenatal stress challenge, the airway hyperresponsiveness and eosinophilic inflammation- two hallmarks of asthma - were significantly increased in adult female offspring, whilst regulatory CD4+ T cells were reduced. These findings strongly underpin the sex-specific association between s challenged fetal development and a sex-specific altered severity of asthma in adult offspring. Our model now allows to identify maternal markers through which the risk for asthma and possible other diseases is vertically transferred before birth in response to challenges. Such identification then opens avenues for primary disease prevention. Copyright © 2017 Elsevier B.V. All rights reserved.

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

NASA Astrophysics Data System (ADS)

Macklin, Thomas; Mathews, Joseph

2017-05-01

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

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

PubMed

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

2017-01-01

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

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

PubMed

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

2017-12-19

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

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

PubMed

Smith, B R

2009-01-01

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

Online Learning: Addressing Challenges and Seizing Opportunities. New Mexico

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

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

Online Learning: Addressing Challenges and Seizing Opportunities. New Hampshire

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

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

Multi-Institution Research Centers: Planning and Management Challenges

ERIC Educational Resources Information Center

Spooner, Catherine; Lavey, Lisa; Mukuka, Chilandu; Eames-Brown, Rosslyn

2016-01-01

Funding multi-institution centers of research excellence (CREs) has become a common means of supporting collaborative partnerships to address specific research topics. However, there is little guidance for those planning or managing a multi-institution CRE, which faces specific challenges not faced by single-institution research centers. We…

Building Connections: Strategies to Address Rurality and Accessibility Challenges

ERIC Educational Resources Information Center

Hartman, Sara; Hines-Bergmeier, Jennifer

2015-01-01

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

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

PubMed Central

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

2015-01-01

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

Sesame allergy: role of specific IgE and skin-prick testing in predicting food challenge results.

PubMed

Permaul, Perdita; Stutius, Lisa M; Sheehan, William J; Rangsithienchai, Pitud; Walter, Jolan E; Twarog, Frank J; Young, Michael C; Scott, Jordan E; Schneider, Lynda C; Phipatanakul, Wanda

2009-01-01

There are conflicting data regarding the diagnostic value of sesame-specific IgE and sesame skin test. Currently, there are no established thresholds that predict clinical reactivity. We examined the correlation of sesame ImmunoCAP and skin-prick test (SPT) results with oral challenge outcomes in children suspected of having a sesame food allergy. We conducted a retrospective chart review of children, aged 2-12 years, receiving a sesame ImmunoCAP level, SPT, and food challenge from January 2004 to August 2008 at Children's Hospital Boston and affiliated allergy clinics. Food challenges were conducted in cases of questionable clinical history or a negative ImmunoCAP and/or negative SPT despite a convincing history. Thirty-three oral sesame challenges were conducted. Of the 33 challenges performed, 21% (n = 7) failed and 79% (n = 26) passed. A sesame-specific IgE level of > or = 7 kU(A)/L showed specificity of >90%. An SPT wheal size of > or = 6 mm showed specificity of >90%. Receiver operator characteristic (ROC) curve analysis for sesame-specific IgE revealed an area under the curve (AUC) of 0.56. ROC curve analysis for SPT wheal size revealed an AUC of 0.67. To our knowledge, this study represents the largest number of sesame challenges performed to evaluate the diagnostic value of both sesame-specific IgE and SPT. Based on our sample, both tests are not good predictors of true sesame allergy as determined by an oral challenge. We were unable to establish a threshold with a 95% positive predictive value for both sesame-specific IgE and SPT.

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

PubMed Central

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

2014-01-01

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

Ability of institutions to address new challenges

Treesearch

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

2010-01-01

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

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

NASA Astrophysics Data System (ADS)

Smith, P., II

2015-12-01

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

Carrington Mission and Beyond - What are the Challenges to be Scientifically and Operationally Addressed?

NASA Astrophysics Data System (ADS)

Gibbs, M.

2016-12-01

The proposed Carrington mission to L5 will bring many benefits of space weather forecasting, some of them glimpsed from the NASA STEREO Mission. How can any new data from L5 be used to maximum benefit? But what about other areas of potential space weather impacts. I'll address future needs and requirements from our Government Stakeholder view, protecting Critical National Infrastructure and key sectors. What are their needs and how can the global space weather enterprise (research & development and operations) begin to tackle these challenges. What new observations will we need (space borne or ground based), what models need developing and how will we use them to best effect? I will explore the key issues without delving deep into the science required.

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

PubMed

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

2018-03-21

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

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

PubMed Central

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

2018-01-01

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

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

PubMed

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

2018-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2016-12-01

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

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

PubMed

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

2014-06-23

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

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

PubMed Central

2014-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2016-12-01

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

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

PubMed

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

2010-07-01

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

ADDRESSING ENVIRONMENTAL ENGINEERING CHALLENGES WITH COMPUTATIONAL FLUID DYNAMICS

EPA Science Inventory

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

Specific inhalation challenge in the diagnosis of occupational asthma: consensus statement.

PubMed

Vandenplas, Olivier; Suojalehto, Hille; Aasen, Tor B; Baur, Xaver; Burge, P Sherwood; de Blay, Frederic; Fishwick, David; Hoyle, Jennifer; Maestrelli, Piero; Muñoz, Xavier; Moscato, Gianna; Sastre, Joaquin; Sigsgaard, Torben; Suuronen, Katri; Walusiak-Skorupa, Jolanta; Cullinan, Paul

2014-06-01

This consensus statement provides practical recommendations for specific inhalation challenge (SIC) in the diagnosis of occupational asthma. They are derived from a systematic literature search, a census of active European centres, a Delphi conference and expert consensus. This article details each step of a SIC, including safety requirements, techniques for delivering agents, and methods for assessing and interpreting bronchial responses. The limitations of the procedure are also discussed. Testing should only be carried out in hospitals where physicians and healthcare professionals have appropriate expertise. Tests should always include a control challenge, a gradual increase of exposure to the suspected agent, and close monitoring of the patient during the challenge and for at least 6 h afterwards. In expert centres, excessive reactions provoked by SIC are rare. A positive response is defined by a fall in forced expiratory volume in 1 s ≥ 15% from baseline. Equivocal reactions can sometimes be clarified by finding changes in nonspecific bronchial responsiveness, sputum eosinophils or exhaled nitric oxide. The sensitivity and specificity of SIC are high but not easily quantified, as the method is usually used as the reference standard for the diagnosis of occupational asthma. ©ERS 2014.

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

PubMed

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

2012-09-01

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

How Can eHealth Technology Address Challenges Related to Multimorbidity? Perspectives from Patients with Multiple Chronic Conditions.

PubMed

Zulman, Donna M; Jenchura, Emily C; Cohen, Danielle M; Lewis, Eleanor T; Houston, Thomas K; Asch, Steven M

2015-08-01

Patient eHealth technology offers potential support for disease self-management, but the value of existing applications for patients with multiple chronic conditions (MCCs) is unclear. To understand self-management and health care navigation challenges that patients face due to MCCs and to identify opportunities to support these patients through new and enhanced eHealth technology. After administering a screening survey, we conducted 10 focus groups of 3-8 patients grouped by age, sex, and common chronic conditions. Patients discussed challenges associated with having MCCs and their use of (and desires from) technology to support self-management. Three investigators used standard content analysis methods to code the focus group transcripts. Emergent themes were reviewed with all collaborators, and final themes and representative quotes were validated with a sample of participants. Fifty-three individuals with ≥3 chronic conditions and experience using technology for health-related purposes. Focus group participants had an average of five chronic conditions. Participants reported using technology most frequently to search for health information (96%), communicate with health care providers (92%), track medical information (83%), track medications (77%), and support decision-making about treatment (55%). Three themes emerged to guide eHealth technology development: (1) Patients with MCCs manage a high volume of information, visits, and self-care tasks; (2) they need to coordinate, synthesize, and reconcile health information from multiple providers and about different conditions; (3) their unique position at the hub of multiple health issues requires self-advocacy and expertise. Focus groups identified desirable eHealth resources and tools that reflect these themes. Although patients with multiple health issues use eHealth technology to support self-care for specific conditions, they also desire tools that transcend disease boundaries. By addressing the holistic

GEOSS: Addressing Big Data Challenges

NASA Astrophysics Data System (ADS)

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

2014-12-01

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

Peripheral erythrocytes decrease upon specific respiratory challenge with grass pollen allergen in sensitized mice and in human subjects.

PubMed

Jordakieva, Galateja; Wallmann, Julia; Schmutz, René; Lemell, Patrick; Wegmann, Michael; Nittke, Thomas; Mittlböck, Martina; Fehrenbach, Heinz; Godnic-Cvar, Jasminka; Zieglmayer, René; Jensen-Jarolim, Erika

2014-01-01

Specific hyper-responsiveness towards an allergen and non-specific airway hyperreactivity both impair quality of life in patients with respiratory allergic diseases. We aimed to investigate cellular responses following specific and non-specific airway challenges locally and systemically in i) sensitized BALB/c mice challenged with grass pollen allergen Phl p 5, and in ii) grass pollen sensitized allergic rhinitis subjects undergoing specific airway challenge in the Vienna Challenge Chamber (VCC). BALB/c mice (n = 20) were intraperitoneally immunized with grass pollen allergen Phl p 5 and afterwards aerosol challenged with either the specific allergen Phl p 5 (n = 10) or the non-specific antigen ovalbumin (OVA) (n = 10). A protocol for inducing allergic asthma as well as allergic rhinitis, according to the united airway concept, was used. Both groups of exposed mice showed significantly reduced physical activity after airway challenge. Specific airway challenge further resulted in goblet cell hyperplasia, enhanced mucous secretion, intrapulmonary leukocyte infiltration and lymphoid follicle formation, associated with significant expression of IL-4, IL-5 and IL-13 in splenocytes and also partially in lung tissue. Concerning circulating blood cell dynamics, we observed a significant drop of erythrocyte counts, hemoglobin and hematocrit levels in both mouse groups, challenged with allergen or OVA. A significant decrease in circulating erythrocytes and hematocrit levels after airway challenges with grass pollen allergen was also found in grass pollen sensitized human rhinitis subjects (n = 42) at the VCC. The effects on peripheral leukocyte counts in mice and humans however were opposed, possibly due to the different primary inflammation sites. Our data revealed that, besides significant leukocyte dynamics, particularly erythrocytes are involved in acute hypersensitivity reactions to respiratory allergens. A rapid recruitment of erythrocytes to the lungs to compensate

Rethinking Environmental Protection: Meeting the Challenges of a Changing World.

PubMed

Burke, Thomas A; Cascio, Wayne E; Costa, Daniel L; Deener, Kacee; Fontaine, Thomas D; Fulk, Florence A; Jackson, Laura E; Munns, Wayne R; Orme-Zavaleta, Jennifer; Slimak, Michael W; Zartarian, Valerie G

2017-03-01

From climate change to hydraulic fracturing, and from drinking water safety to wildfires, environmental challenges are changing. The United States has made substantial environmental protection progress based on media-specific and single pollutant risk-based frameworks. However, today’s environmental problems are increasingly complex and new scientific approaches and tools are needed to achieve sustainable solutions to protect the environment and public health. In this article, we present examples of today’s environmental challenges and offer an integrated systems approach to address them. We provide a strategic framework and recommendations for advancing the application of science for protecting the environment and public health. We posit that addressing 21st century challenges requires transdisciplinary and systems approaches, new data sources, and stakeholder partnerships. To address these challenges, we outline a process driven by problem formulation with the following steps: a ) formulate the problem holistically, b ) gather and synthesize diverse information, c ) develop and assess options, and d ) implement sustainable solutions. This process will require new skills and education in systems science, with an emphasis on science translation. A systems-based approach can transcend media- and receptor-specific bounds, integrate diverse information, and recognize the inextricable link between ecology and human health.

Rethinking Environmental Protection: Meeting the Challenges of a Changing World

PubMed Central

Burke, Thomas A.; Cascio, Wayne E.; Costa, Daniel L.; Deener, Kacee; Fontaine, Thomas D.; Fulk, Florence A.; Jackson, Laura E.; Munns, Wayne R.; Orme-Zavaleta, Jennifer; Slimak, Michael W.; Zartarian, Valerie G.

2017-01-01

Summary: From climate change to hydraulic fracturing, and from drinking water safety to wildfires, environmental challenges are changing. The United States has made substantial environmental protection progress based on media-specific and single pollutant risk-based frameworks. However, today’s environmental problems are increasingly complex and new scientific approaches and tools are needed to achieve sustainable solutions to protect the environment and public health. In this article, we present examples of today’s environmental challenges and offer an integrated systems approach to address them. We provide a strategic framework and recommendations for advancing the application of science for protecting the environment and public health. We posit that addressing 21st century challenges requires transdisciplinary and systems approaches, new data sources, and stakeholder partnerships. To address these challenges, we outline a process driven by problem formulation with the following steps: a) formulate the problem holistically, b) gather and synthesize diverse information, c) develop and assess options, and d) implement sustainable solutions. This process will require new skills and education in systems science, with an emphasis on science translation. A systems-based approach can transcend media- and receptor-specific bounds, integrate diverse information, and recognize the inextricable link between ecology and human health. PMID:28248180

Prediction of challenge test results by flour-specific IgE and skin prick test in symptomatic bakers.

PubMed

van Kampen, V; Rabstein, S; Sander, I; Merget, R; Brüning, T; Broding, H C; Keller, C; Müsken, H; Overlack, A; Schultze-Werninghaus, G; Walusiak, J; Raulf-Heimsoth, M

2008-07-01

Wheat and rye flours are among the most important allergens causing occupational asthma. Usually, the diagnosis of baker's asthma is based on inhalation challenge tests with flours. To evaluate the relevance of flour-specific serum immunoglobulin E (IgE) and skin prick test (SPT) in the diagnosis of baker's asthma and to define flour-specific IgE concentrations and wheal sizes that allow a prediction of the outcome of challenge testing. Bronchial and nasal challenge tests with wheat (rye) flour were performed in 71 (95) symptomatic bakers. Determinations of flour-specific IgE as well as SPTs were performed in all subjects. Analyses included the calculation of sensitivity, specificity, positive (PPV) and negative predictive values (NPV) at different IgE concentrations and different wheal sizes, and receiver-operating characteristics (ROC) plots with the challenge result as gold standard. Thirty-seven bakers were positive in the challenge with wheat flour, while 63 were positive with rye flour. Depending on the flour-specific IgE concentrations (wheal size), PPV was 74-100% (74-100%) for wheat and 82-100% (91-100%) for rye flour, respectively. The minimal cut-off values with a PPV of 100% were 2.32 kU/l (5.0 mm) for wheat flour and 9.64 kU/l (4.5 mm) for rye flour. The shapes of the ROC plots were similar for wheat and rye flour. High concentrations of flour-specific IgE and clear SPT results in symptomatic bakers are good predictors for a positive challenge test. Challenge tests with flours may be avoided in strongly sensitized bakers.

Challenges and Strategies for Prevention of Multidrug-Resistant Organism Transmission in Nursing Homes.

PubMed

Dumyati, Ghinwa; Stone, Nimalie D; Nace, David A; Crnich, Christopher J; Jump, Robin L P

2017-04-01

Nursing home residents are at high risk for colonization and infection with bacterial pathogens that are multidrug-resistant organisms (MDROs). We discuss challenges and potential solutions to support implementing effective infection prevention and control practices in nursing homes. Challenges include a paucity of evidence that addresses MDRO transmission during the care of nursing home residents, limited staff resources in nursing homes, insufficient infection prevention education in nursing homes, and perceptions by nursing home staff that isolation and contact precautions negatively influence the well being of their residents. A small number of studies provide evidence that specifically address these challenges. Their outcomes support a paradigm shift that moves infection prevention and control practices away from a pathogen-specific approach and toward one that focuses on resident risk factors.

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

PubMed

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

2017-03-01

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

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.

Analysis of Transportation and Logistics Challenges Affecting the Deployment of Larger Wind Turbines: Summary of Results

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

J. Cotrell, T. Stehly, J. Johnson, J. O. Roberts, Z. Parker, G. Scott, and D. Heimiller

The objectives of this study were to identify the transportation and logistics challenges, assess the associated impacts, and provide recommendations for strategies and specific actions to address the challenges.

Addressing dual agency: getting specific about the expectations of professionalism.

PubMed

Tilburt, Jon C

2014-01-01

Professionalism requires that physicians uphold the best interests of patients while simultaneously insuring just use of health care resources. Current articulations of these obligations like the American Board of Internal Medicine (ABIM) Foundation's Physician Charter do not reconcile how these obligations fit together when they conflict. This is the problem of dual agency. The most common ways of dealing with dual agency: "bunkering"--physicians act as though societal cost issues are not their problem; "bailing"--physicians assume that they are merely agents of society and deliver care typically based on a strongly consequentialist public health ethic; or "balancing"--a vaguely specified attempt to uphold both patient welfare and societal need for judicious resource use simultaneously--all fail. Here I propose how the problem of dual agency might begin to be addressed with rigor and consistency. Without dealing with the dual agency problem and getting more specific about how to reconcile its norms when they conflict, the expectations of professionalism risk being written off as cute, nonbinding aphorisms from the medical profession.

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

NASA Astrophysics Data System (ADS)

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

2015-04-01

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

Role of specific IgE and skin-prick testing in predicting food challenge results to baked egg

PubMed Central

Cortot, Catherine F.; Sheehan, William J.; Permaul, Perdita; Friedlander, James L.; Baxi, Sachin N.; Gaffin, Jonathan M.; Dioun, Anahita F.; Hoffman, Elaine B.; Schneider, Lynda C.

2012-01-01

Previous studies suggest that children with egg allergy may be able to tolerate baked egg. Reliable predictors of a successful baked egg challenge are not well established. We examined egg white–specific IgE levels, skin-prick test (SPT) results, and age as predictors of baked egg oral food challenge (OFC) outcomes. We conducted a retrospective chart review of children, aged 2–18 years, receiving an egg white–specific IgE level, SPT, and OFC to baked egg from 2008 to 2010. Fifty-two oral baked egg challenges were conducted. Of the 52 challenges, 83% (n = 43) passed and 17% (n = 9) failed, including 2 having anaphylaxis. Median SPT wheal size was 12 mm (range, 0–35 mm) for passed challenges and 17 mm (range, 10–30 mm) for failed challenges (p = 0.091). The negative predictive value for passing the OFC was 100% (9 of 9) if SPT wheal size was <10 mm. Median egg white–specific IgE was 2.02 kU/L (range, <0.35–13.00 kU/L) for passed challenges and 1.52 kU/L (range, 0.51–6.10 kU/L) for failed challenges (p = 0.660). Receiver operating characteristic (ROC) curve analysis for SPT revealed an area under the curve (AUC) of 0.64. ROC curve analysis for egg white–specific IgE revealed an AUC of 0.63. There was no significant difference in age between patients who failed and those who passed (median = 8.8 years versus 7.0 years; p = 0.721). Based on our sample, SPT, egg white–specific IgE and age are not good predictors of passing a baked egg challenge. However, there was a trend for more predictability with SPT wheal size. PMID:22584194

Role of specific IgE and skin-prick testing in predicting food challenge results to baked egg.

PubMed

Cortot, Catherine F; Sheehan, William J; Permaul, Perdita; Friedlander, James L; Baxi, Sachin N; Gaffin, Jonathan M; Dioun, Anahita F; Hoffman, Elaine B; Schneider, Lynda C; Phipatanakul, Wanda

2012-01-01

Previous studies suggest that children with egg allergy may be able to tolerate baked egg. Reliable predictors of a successful baked egg challenge are not well established. We examined egg white-specific IgE levels, skin-prick test (SPT) results, and age as predictors of baked egg oral food challenge (OFC) outcomes. We conducted a retrospective chart review of children, aged 2-18 years, receiving an egg white-specific IgE level, SPT, and OFC to baked egg from 2008 to 2010. Fifty-two oral baked egg challenges were conducted. Of the 52 challenges, 83% (n = 43) passed and 17% (n = 9) failed, including 2 having anaphylaxis. Median SPT wheal size was 12 mm (range, 0-35 mm) for passed challenges and 17 mm (range, 10-30 mm) for failed challenges (p = 0.091). The negative predictive value for passing the OFC was 100% (9 of 9) if SPT wheal size was <10 mm. Median egg white-specific IgE was 2.02 kU/L (range, <0.35-13.00 kU/L) for passed challenges and 1.52 kU/L (range, 0.51-6.10 kU/L) for failed challenges (p = 0.660). Receiver operating characteristic (ROC) curve analysis for SPT revealed an area under the curve (AUC) of 0.64. ROC curve analysis for egg white-specific IgE revealed an AUC of 0.63. There was no significant difference in age between patients who failed and those who passed (median = 8.8 years versus 7.0 years; p = 0.721). Based on our sample, SPT, egg white-specific IgE and age are not good predictors of passing a baked egg challenge. However, there was a trend for more predictability with SPT wheal size.

Addressing climate challenges in developing countries

NASA Astrophysics Data System (ADS)

Tilmes, Simone; Monaghan, Andrew; Done, James

2012-04-01

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

Nonclinical safety testing of biopharmaceuticals--Addressing current challenges of these novel and emerging therapies.

PubMed

Brennan, Frank R; Baumann, Andreas; Blaich, Guenter; de Haan, Lolke; Fagg, Rajni; Kiessling, Andrea; Kronenberg, Sven; Locher, Mathias; Milton, Mark; Tibbitts, Jay; Ulrich, Peter; Weir, Lucinda

2015-10-01

Non-clinical safety testing of biopharmaceuticals can present significant challenges to human risk assessment with these often innovative and complex drugs. Hot Topics in this field were discussed recently at the 4th Annual European Biosafe General Membership meeting. In this feature article, the presentations and subsequent discussions from the main sessions are summarized. The topics covered include: (i) wanted versus unwanted immune activation, (ii) bi-specific protein scaffolds, (iii) use of Pharmacokinetic (PK)/Pharmacodynamic (PD) data to impact/optimize toxicology study design, (iv) cytokine release and challenges to human translation (v) safety testing of cell and gene therapies including chimeric antigen receptor T (CAR-T) cells and retroviral vectors and (vi) biopharmaceutical development strategies encompassing a range of diverse topics including optimizing entry of monoclonal antibodies (mAbs) into the brain, safety testing of therapeutic vaccines, non-clinical testing of biosimilars, infection in toxicology studies with immunomodulators and challenges to human risk assessment, maternal and infant anti-drug antibody (ADA) development and impact in non-human primate (NHP) developmental toxicity studies, and a summary of an NC3Rs workshop on the future vision for non-clinical safety assessment of biopharmaceuticals. Copyright © 2015 Elsevier Inc. All rights reserved.

Freight transportation : strategies needed to address planning and financing limitations

DOT National Transportation Integrated Search

2003-12-01

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

Cultural Sensitivity and Challenges in Management of the Transgender Patient With ESRD in Transplantation.

PubMed

Hoch, Deborah Ann; Bulman, Maya; McMahon, Dorn W

2016-03-01

Transgender patients with end-stage renal disease (ESRD) present with specific challenges during the transplant evaluation, perioperative management, and postoperative phase of care. Demographic information, health-care records, chosen name, and gender identity along with documentation of specific health-care needs can become a challenge when gender assigned at birth is incongruent with the patients gender identity. Medical care involves addressing the end-organ disease as well as addressing those aspects of care specific to the transgender patient. This review article provides information on defining transgender, the impact of ESRD, and transgender in the transplant process and considerations in the throughout phases of care. Current recommendations for management of this unique population are provided. © 2016, NATCO.

Thinking clearly about the FIRST trial: addressing ethical challenges in cluster randomised trials of policy interventions involving health providers.

PubMed

Horn, Austin R; Weijer, Charles; Hey, Spencer Phillips; Brehaut, Jamie; Fergusson, Dean A; Goldstein, Cory E; Grimshaw, Jeremy; Taljaard, Monica

2018-04-27

The ethics of the Flexibility In duty hour Requirements for Surgical Trainees (FIRST) trial have been vehemently debated. Views on the ethics of the FIRST trial range from it being completely unethical to wholly unproblematic. The FIRST trial illustrates the complex ethical challenges posed by cluster randomised trials (CRTs) of policy interventions involving healthcare professionals. In what follows, we have three objectives. First, we critically review the FIRST trial controversy, finding that commentators have failed to sufficiently identify and address many of the relevant ethical issues. The 2012 Ottawa Statement on the Ethical Design and Conduct of Cluster Randomized Trials provides researchers and research ethics committees with specific guidance for the ethical design and conduct of CRTs. Second, we aim to demonstrate how the Ottawa Statement provides much-needed clarity to the ethical issues in the FIRST trial, including: research participant identification; consent requirements; gatekeeper roles; benefit-harm analysis and identification of vulnerable participants. We nonetheless also find that the FIRST trial raises ethical issues not adequately addressed by the Ottawa Statement. Hence, third and finally, we raise important questions requiring further ethical analysis and guidance, including: Does clinical equipoise apply to policy interventions with little or no evidence-base? Do healthcare providers have an obligation to participate in research? Does the power-differential in certain healthcare settings render healthcare providers vulnerable to duress and coercion to participant in research? If so, what safeguards might be implemented to protect providers, while allowing important research to proceed? © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Using a Participatory Culture-Specific Model to Increase the Effectiveness of Social Justice Courses in School Psychology

ERIC Educational Resources Information Center

Graybill, Emily C.; Varjas, Kris; Meyers, Joel; Greenberg, Daphne; Roach, Andrew T.

2013-01-01

The Participatory Culture-Specific Model of Course Development (PCSMCD), adapted from the Participatory Culture-Specific Intervention Model, is a proposed framework to address challenges to social justice education by addressing the following four course variables: instructor characteristics, instructor experiences, student characteristics, and…

Research on U.S. Military Women: Recruitment and Retention Challenges and Strategies.

PubMed

Braun, Lisa A; Kennedy, Holly P; Sadler, Lois S; Dixon, Jane

2015-12-01

To examine literature on recruitment and retention of military women in research studies as an underrepresented, and potentially marginalized, population. A literature search was conducted to examine challenges, identify potential barriers and facilitators, and to inform strategies for recruitment and retention of military women in research studies. This search was supplemented by findings in military-specific databases and discussions with Military Women's Health Research Interest Group subject matter experts. Ten articles addressed research recruitment and retention challenges and strategies in marginalized/underrepresented populations, providing an effective context to inform research recruitment and retention in military settings. Research with military women is often challenged by logistical, cultural, social, ethical, and methodological issues, which may hinder exploration of potentially sensitive issues. Researchers must consider military-specific challenges to conducting research that include lengthy deployments, unpredictable military exercises, and foreign assignments, in accessing research participants. A case example shows strategies used in a military cervical cancer screening study. There are few published articles specific to research recruitment and retention in female military populations. Available resources broadly address recruitment challenges for Veterans, marginalized, hard-to-access, and transient research participants, which may provide guidance and strategies for success when applied to military populations. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Addressing Challenges to the Design & Test of Operational Lighting Environments for the International Space Station

NASA Technical Reports Server (NTRS)

Clark, Toni A.

2014-01-01

In our day to day lives, the availability of light, with which to see our environment, is often taken for granted. The designers of land based lighting systems use sunlight and artificial light as their toolset. The availability of power, quantity of light sources, and variety of design options are often unlimited. The accessibility of most land based lighting systems makes it easy for the architect and engineer to verify and validate their design ideas. Failures with an implementation, while sometimes costly, can easily be addressed by renovation. Consider now, an architectural facility orbiting in space, 260 miles above the surface of the earth. This human rated architectural facility, the International Space Station (ISS) must maintain operations every day, including life support and appropriate human comforts without fail. The facility must also handle logistics of regular shipments of cargo, including new passengers. The ISS requires accommodations necessary for human control of machine systems. Additionally, the ISS is a research facility and supports investigations performed inside and outside its livable volume. Finally, the facility must support remote operations and observations by ground controllers. All of these architectural needs require a functional, safe, and even an aesthetic lighting environment. At Johnson Space Center, our Habitability and Human Factors team assists our diverse customers with their lighting environment challenges, via physical test and computer based analysis. Because of the complexity of ISS operational environment, our team has learned and developed processes that help ISS operate safely. Because of the dynamic exterior lighting environment, uses computational modeling to predict the lighting environment. The ISS' orbit exposes it to a sunrise every 90 minutes, causing work surfaces to quickly change from direct sunlight to earthshine to total darkness. Proper planning of vehicle approaches, robotics operations, and crewed

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

ERIC Educational Resources Information Center

Texas State Comptroller of Public Accounts, Austin.

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

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

PubMed

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

2017-09-01

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

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

ERIC Educational Resources Information Center

College Board, New York, NY.

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

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

PubMed

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

2012-12-01

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

Observational studies of the association between glucose-lowering medications and cardiovascular outcomes: addressing methodological limitations.

PubMed

Patorno, Elisabetta; Patrick, Amanda R; Garry, Elizabeth M; Schneeweiss, Sebastian; Gillet, Victoria G; Bartels, Dorothee B; Masso-Gonzalez, Elvira; Seeger, John D

2014-11-01

Recent years have witnessed a growing body of observational literature on the association between glucose-lowering treatments and cardiovascular disease. However, many of the studies are based on designs or analyses that inadequately address the methodological challenges involved. We reviewed recent observational literature on the association between glucose-lowering medications and cardiovascular outcomes and assessed the design and analysis methods used, with a focus on their ability to address specific methodological challenges. We describe and illustrate these methodological issues and their impact on observed associations, providing examples from the reviewed literature. We suggest approaches that may be employed to manage these methodological challenges. From the evaluation of 81 publications of observational investigations assessing the association between glucose-lowering treatments and cardiovascular outcomes, we identified the following methodological challenges: 1) handling of temporality in administrative databases; 2) handling of risks that vary with time and treatment duration; 3) definitions of the exposure risk window; 4) handling of exposures that change over time; and 5) handling of confounding by indication. Most of these methodological challenges may be suitably addressed through application of appropriate methods. Observational research plays an increasingly important role in the evaluation of the clinical effects of diabetes treatment. Implementation of appropriate research methods holds the promise of reducing the potential for spurious findings and the risk that the spurious findings will mislead the medical community about risks and benefits of diabetes medications.

The diagnosis of Brazil nut allergy using history, skin prick tests, serum-specific immunoglobulin E and food challenges.

PubMed

Ridout, S; Matthews, S; Gant, C; Twiselton, R; Dean, T; Arshad, S H

2006-02-01

Allergy to Brazil nut is a relatively common nut allergy and can be fatal. However, the evidence is lacking regarding the best approach to its diagnosis. We sought to determine the relative merits of history, skin prick testing, measurement of serum-specific IgE and challenge in the diagnosis of Brazil nut allergy. Fifty-six children and adults with a history of an allergic reaction to Brazil nut or evidence of sensitization were investigated by questionnaire (n=56), skin prick tests (SPTs) (n=53), measurement of serum-specific IgE to Brazil nut (n=54) and double-blind, placebo-controlled labial, and if necessary oral, challenges (n=19). Brazil nut allergy occurred in highly atopic individuals of any age with a strong family history of atopy. In 24 of 56 (43%), the history of an immediate reaction was sufficient to make a diagnosis with confidence and an oral challenge was considered unsafe. Of the 19 subjects undertaking the 'gold standard' test of a double-blind, placebo-controlled, food challenge, all six subjects with a SPT of at least 6 mm had a positive challenge and all three subjects with a SPT of 0 mm had a negative challenge. In the remaining 10 (53%) subjects, where SPT was between 1 and 5 mm and serum-specific IgE was less than 3.5 kU/L, an oral challenge was performed resulting in three positive and seven negative challenges. A combination of history, SPT and serum-specific IgE was adequate in achieving a diagnosis in the majority (77%) patients with suspected Brazil nut allergy. However, a doubtful history with SPT between 1 and 5 mm, or a serum-specific IgE less than 3.5 kU/L may require an oral challenge to help determine the risk of a Brazil nut allergic reaction.

Strategies to address management challenges in larger intensive care units.

PubMed

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

2015-10-01

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

Gender-specific Regulatory Challenges to Product Approval: A Panel Discussion

PubMed Central

McGregor, Alyson J.; Barr, Helen; Greenberg, Marna Rayl; Safdar, Basmah; Wildgoose, Peter; Wright, David W.; Hollander, Judd E.

2015-01-01

On May 13, 2014, a 1-hour panel discussion session titled “Gender-Specific Regulatory Challenges to Product Approval” was held during the Academic Emergency Medicine consensus conference, “Gender-Specific Research in Emergency Medicine: Investigate, Understand, and Translate How Gender Affects Patient Outcomes.” The session sought to bring together leaders in emergency medicine (EM) research, authors, and reviewers in EM research publications, as well as faculty, fellows, residents, and students engaged in research and clinical practice. A panel was convened involving a representative from the Office of Women’s Health of the U.S. Food and Drug Administration, two pharmaceutical executives, and a clinical EM researcher. The moderated discussion also involved audience members who contributed significantly to the dialogue. Historical background leading up to the session along with the main themes of the discussion are reproduced in this article. These revolve around sex- and gender-specific research, statistical analysis of sex and gender, clinical practice, financial costs associated with pharmaceutical development, adaptive design, and specific recommendations on the regulatory process as it affects the specialty of EM. PMID:25443664

Rehabilitation-specific challenges and advantages in the integration of migrant physicians in Germany: a multiperspective qualitative interview study in rehabilitative settings.

PubMed

Jansen, E; Hänel, P; Klingler, C

2018-07-01

In Germany, rehabilitative healthcare institutions increasingly rely on migrant physicians to meet their staffing needs. Yet until now, research on the integration of migrant physicians has focussed entirely on the acute care setting. This study is the first to address the specific advantages and challenges to integration in the field of rehabilitative medicine where a high number of migrant physicians work. From the experiences of migrant physicians and their colleagues, we provide actionable suggestions to counteract potential sources of conflict and thereby improve the integration of migrant physicians in the German workforce. We conducted a qualitative interview study. We conducted 23 interviews with a total of 26 participants occupying a variety of roles in two different rehabilitation centres (maximum variation sampling). Interviews were recorded, transcribed verbatim and parsed through thematic analysis. Our research revealed advantages and challenges to integration in three distinct areas: rehabilitative care institutions, competencies of migrant professionals and interpersonal relations. The first set of issues hinges on the work processes within rehabilitative hospitals, professional prospects there and the location of the institutions themselves. Second, migrant physicians may encounter difficulties because of limited linguistic skills and country-specific knowledge. And finally, aspects of their interactions with care teams and patients may constitute barriers to integration. Some of the factors influencing the integration of migrant physicians are the same in both rehabilitative and acute medicine, but the rehabilitative setting presents distinct advantages and challenges that are worthy of study in their own right. We outline several measures which could help overcome challenges to the integration of migrant physicians, including those associated with professional relationships. Further research is needed to develop concrete support programmes

In silico regenerative medicine: how computational tools allow regulatory and financial challenges to be addressed in a volatile market

PubMed Central

Geris, L.; Guyot, Y.; Schrooten, J.; Papantoniou, I.

2016-01-01

The cell therapy market is a highly volatile one, due to the use of disruptive technologies, the current economic situation and the small size of the market. In such a market, companies as well as academic research institutes are in need of tools to advance their understanding and, at the same time, reduce their R&D costs, increase product quality and productivity, and reduce the time to market. An additional difficulty is the regulatory path that needs to be followed, which is challenging in the case of cell-based therapeutic products and should rely on the implementation of quality by design (QbD) principles. In silico modelling is a tool that allows the above-mentioned challenges to be addressed in the field of regenerative medicine. This review discusses such in silico models and focuses more specifically on the bioprocess. Three (clusters of) examples related to this subject are discussed. The first example comes from the pharmaceutical engineering field where QbD principles and their implementation through the use of in silico models are both a regulatory and economic necessity. The second example is related to the production of red blood cells. The described in silico model is mainly used to investigate the manufacturing process of the cell-therapeutic product, and pays special attention to the economic viability of the process. Finally, we describe the set-up of a model capturing essential events in the development of a tissue-engineered combination product in the context of bone tissue engineering. For each of the examples, a short introduction to some economic aspects is given, followed by a description of the in silico tool or tools that have been developed to allow the implementation of QbD principles and optimal design. PMID:27051516

In silico regenerative medicine: how computational tools allow regulatory and financial challenges to be addressed in a volatile market.

PubMed

Geris, L; Guyot, Y; Schrooten, J; Papantoniou, I

2016-04-06

The cell therapy market is a highly volatile one, due to the use of disruptive technologies, the current economic situation and the small size of the market. In such a market, companies as well as academic research institutes are in need of tools to advance their understanding and, at the same time, reduce their R&D costs, increase product quality and productivity, and reduce the time to market. An additional difficulty is the regulatory path that needs to be followed, which is challenging in the case of cell-based therapeutic products and should rely on the implementation of quality by design (QbD) principles. In silico modelling is a tool that allows the above-mentioned challenges to be addressed in the field of regenerative medicine. This review discusses such in silico models and focuses more specifically on the bioprocess. Three (clusters of) examples related to this subject are discussed. The first example comes from the pharmaceutical engineering field where QbD principles and their implementation through the use of in silico models are both a regulatory and economic necessity. The second example is related to the production of red blood cells. The described in silico model is mainly used to investigate the manufacturing process of the cell-therapeutic product, and pays special attention to the economic viability of the process. Finally, we describe the set-up of a model capturing essential events in the development of a tissue-engineered combination product in the context of bone tissue engineering. For each of the examples, a short introduction to some economic aspects is given, followed by a description of the in silico tool or tools that have been developed to allow the implementation of QbD principles and optimal design.

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

PubMed

Mburu, Grace; George, Gavin

2017-07-31

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

Lessons Learned and Challenges in Building a Filipino Health Coalition

PubMed Central

Aguilar, David E.; Abesamis-Mendoza, Noilyn; Ursua, Rhodora; Divino, Lily Ann M.; Cadag, Kara; Gavin, Nicholas P.

2010-01-01

In recent years, community-based coalitions have become an effective channel to addressing various health problems within specific ethnic communities. The purpose of this article is twofold: (a) to describe the process involved in building the Kalusugan Coalition (KC), a Filipino American health coalition based in New York City, and (b) to highlight the lessons learned and the challenges from this collaborative venture. The challenges described also offer insights on how the coalition development process can be greatly affected by the partnership with an academic institution on a community-based research project. Because each cultural group has unique issues and concerns, the theoretical framework used by KC offers creative alternatives to address some of the challenges regarding coalition infrastructures, leadership development, unexpected change of coalition dynamics, and cultural nuances. PMID:19098260

Metagenomic Assembly: Overview, Challenges and Applications

PubMed Central

Ghurye, Jay S.; Cepeda-Espinoza, Victoria; Pop, Mihai

2016-01-01

Advances in sequencing technologies have led to the increased use of high throughput sequencing in characterizing the microbial communities associated with our bodies and our environment. Critical to the analysis of the resulting data are sequence assembly algorithms able to reconstruct genes and organisms from complex mixtures. Metagenomic assembly involves new computational challenges due to the specific characteristics of the metagenomic data. In this survey, we focus on major algorithmic approaches for genome and metagenome assembly, and discuss the new challenges and opportunities afforded by this new field. We also review several applications of metagenome assembly in addressing interesting biological problems. PMID:27698619

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

PubMed

Murray, Amanda L; Sischo, William M

2007-01-01

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

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

PubMed Central

2011-01-01

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

Strategies to Address Challenging Behaviour in Young Children with Down Syndrome

ERIC Educational Resources Information Center

Feeley, Kathleen; Jones, Emily

2008-01-01

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

A strategy to address the nursing faculty shortage.

PubMed

Ganley, Barbara J; Sheets, Ingrid

2009-07-01

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

Gender-specific Regulatory Challenges to Product Approval: a panel discussion.

PubMed

McGregor, Alyson J; Barr, Helen; Greenberg, Marna R; Safdar, Basmah; Wildgoose, Peter; Wright, David W; Hollander, Judd E

2014-12-01

On May 13, 2014, a 1-hour panel discussion session titled "Gender-specific Regulatory Challenges to Product Approval" was held during the Academic Emergency Medicine consensus conference, "Gender-specific Research in Emergency Medicine: Investigate, Understand, and Translate How Gender Affects Patient Outcomes." The session sought to bring together leaders in emergency medicine (EM) research, authors, and reviewers in EM research publications, as well as faculty, fellows, residents, and students engaged in research and clinical practice. A panel was convened involving a representative from the Office of Women's Health of the U.S. Food and Drug Administration, two pharmaceutical executives, and a clinical EM researcher. The moderated discussion also involved audience members who contributed significantly to the dialogue. Historical background leading up to the session along with the main themes of the discussion are reproduced in this article. These revolve around sex- and gender-specific research, statistical analysis of sex and gender, clinical practice, financial costs associated with pharmaceutical development, adaptive design, and specific recommendations on the regulatory process as it affects the specialty of EM. © 2014 by the Society for Academic Emergency Medicine.

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

PubMed Central

2017-01-01

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

Strain-Specific Changes in Locomotor Behavior in Larval Zebrafish Elicited by Cholinergic Challenge

EPA Science Inventory

Some studies have compared the baseline behavior of different strains of larval zebrafish (Danio rerio), but there is sparse information on strain-specific responses to chemical challenges. The following study examines both the basal activity and response to a pharmacological cha...

Challenges in an Aging Society: Presidential Address to APPAM

ERIC Educational Resources Information Center

Swartz, Katherine

2010-01-01

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

Addressing the Challenges of a Quarter Century of Giscience Education: A Flexible Higher Education Curriculum Framework

NASA Astrophysics Data System (ADS)

Veenendaal, B.

2014-04-01

A wide range of geographic information science (GIScience) educational programs currently exist, the oldest now over 25 years. Offerings vary from those specifically focussed on geographic information science, to those that utilise geographic information systems in various applications and disciplines. Over the past two decades, there have been a number of initiatives to design curricula for GIScience, including the NCGIA Core Curriculum, GIS&T Body of Knowledge and the Geospatial Technology Competency Model developments. The rapid developments in geospatial technology, applications and organisations have added to the challenges that higher educational institutions face in order to ensure that GIScience education is relevant and responsive to the changing needs of students and industry. This paper discusses some of the challenges being faced in higher education in general, and GIScience education in particular, and outlines a flexible higher education curriculum framework for GIScience.

Preventing Challenging Behaviors in Preschool: Effective Strategies for Classroom Teachers

ERIC Educational Resources Information Center

Coleman, Janelle C.; Crosby, Megan G.; Irwin, Heather K.; Dennis, Lindsay R.; Simpson, Cynthia G.; Rose, Chad A.

2013-01-01

This article provides practical strategies and techniques that early childhood educators can implement in their classrooms to effectively manage challenging behaviors. The specific strategies addressed fall under the following categories: (a) classroom management, (b) reinforcement, and (c) communication. Suggestions are made for how parents can…

Big Data Science: Opportunities and Challenges to Address Minority Health and Health Disparities in the 21st Century

PubMed Central

Zhang, Xinzhi; Pérez-Stable, Eliseo J.; Bourne, Philip E.; Peprah, Emmanuel; Duru, O. Kenrik; Breen, Nancy; Berrigan, David; Wood, Fred; Jackson, James S.; Wong, David W.S.; Denny, Joshua

2017-01-01

Addressing minority health and health disparities has been a missing piece of the puzzle in Big Data science. This article focuses on three priority opportunities that Big Data science may offer to the reduction of health and health care disparities. One opportunity is to incorporate standardized information on demographic and social determinants in electronic health records in order to target ways to improve quality of care for the most disadvantaged populations over time. A second opportunity is to enhance public health surveillance by linking geographical variables and social determinants of health for geographically defined populations to clinical data and health outcomes. Third and most importantly, Big Data science may lead to a better understanding of the etiology of health disparities and understanding of minority health in order to guide intervention development. However, the promise of Big Data needs to be considered in light of significant challenges that threaten to widen health disparities. Care must be taken to incorporate diverse populations to realize the potential benefits. Specific recommendations include investing in data collection on small sample populations, building a diverse workforce pipeline for data science, actively seeking to reduce digital divides, developing novel ways to assure digital data privacy for small populations, and promoting widespread data sharing to benefit under-resourced minority-serving institutions and minority researchers. With deliberate efforts, Big Data presents a dramatic opportunity for reducing health disparities but without active engagement, it risks further widening them. PMID:28439179

Big Data Science: Opportunities and Challenges to Address Minority Health and Health Disparities in the 21st Century.

PubMed

Zhang, Xinzhi; Pérez-Stable, Eliseo J; Bourne, Philip E; Peprah, Emmanuel; Duru, O Kenrik; Breen, Nancy; Berrigan, David; Wood, Fred; Jackson, James S; Wong, David W S; Denny, Joshua

2017-01-01

Addressing minority health and health disparities has been a missing piece of the puzzle in Big Data science. This article focuses on three priority opportunities that Big Data science may offer to the reduction of health and health care disparities. One opportunity is to incorporate standardized information on demographic and social determinants in electronic health records in order to target ways to improve quality of care for the most disadvantaged populations over time. A second opportunity is to enhance public health surveillance by linking geographical variables and social determinants of health for geographically defined populations to clinical data and health outcomes. Third and most importantly, Big Data science may lead to a better understanding of the etiology of health disparities and understanding of minority health in order to guide intervention development. However, the promise of Big Data needs to be considered in light of significant challenges that threaten to widen health disparities. Care must be taken to incorporate diverse populations to realize the potential benefits. Specific recommendations include investing in data collection on small sample populations, building a diverse workforce pipeline for data science, actively seeking to reduce digital divides, developing novel ways to assure digital data privacy for small populations, and promoting widespread data sharing to benefit under-resourced minority-serving institutions and minority researchers. With deliberate efforts, Big Data presents a dramatic opportunity for reducing health disparities but without active engagement, it risks further widening them.

A faith-based community partnership to address HIV/AIDS in the southern United States: implementation, challenges, and lessons learned.

PubMed

Abara, Winston; Coleman, Jason D; Fairchild, Amanda; Gaddist, Bambi; White, Jacob

2015-02-01

Though race and region are not by themselves risk factors for HIV infection, regional and racial disparities exist in the burden of HIV/AIDS in the US. Specifically, African Americans in the southern US appear to bear the brunt of this burden due to a complex set of upstream factors like structural and cultural influences that do not facilitate HIV/AIDS awareness, HIV testing, or sexual risk-reduction techniques while perpetuating HIV/AIDS-related stigma. Strategies proposed to mitigate the burden among this population have included establishing partnerships and collaborations with non-traditional entities like African American churches and other faith-based organizations. Though efforts to partner with the African American church are not necessarily novel, most of these efforts do not present a model that focuses on building the capacity of the African American church to address these upstream factors and sustain these interventions. This article will describe Project Fostering AIDS Initiatives That Heal (F.A.I.T.H), a faith-based model for successfully developing, implementing, and sustaining locally developed HIV/AIDS prevention interventions in African American churches in South Carolina. This was achieved by engaging the faith community and the provision of technical assistance, grant funding and training for project personnel. Elements of success, challenges, and lessons learned during this process will also be discussed.

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

PubMed

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

2014-06-01

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

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

PubMed Central

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

2018-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2017-11-01

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

Microbiome Therapeutics – Advances and Challenges

PubMed Central

Mimee, Mark; Citorik, Robert J.; Lu, Timothy K.

2016-01-01

The microbial community that lives on and in the human body exerts a major impact on human health, from metabolism to immunity. In order to leverage the close associations between microbes and their host, development of therapeutics targeting the microbiota has surged in recent years. Here, we discuss current additive and subtractive strategies to manipulate the microbiota, focusing on bacteria engineered to produce therapeutic payloads, consortia of natural organisms and selective antimicrobials. Further, we present challenges faced by the community in the development of microbiome therapeutics, including designing microbial therapies that are adapted for specific geographies in the body, stable colonization with microbial therapies, discovery of clinically relevant biosensors, robustness of engineered synthetic gene circuits and addressing safety and biocontainment concerns. Moving forward, collaboration between basic and applied researchers and clinicians to address these challenges will poise the field to herald an age of next-generation, cellular therapies that draw on novel findings in basic research to inform directed augmentation of the human microbiota. PMID:27158095

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

PubMed

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

2009-12-01

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

National health inequality monitoring: current challenges and opportunities.

PubMed

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

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

Microbiome therapeutics - Advances and challenges.

PubMed

Mimee, Mark; Citorik, Robert J; Lu, Timothy K

2016-10-01

The microbial community that lives on and in the human body exerts a major impact on human health, from metabolism to immunity. In order to leverage the close associations between microbes and their host, development of therapeutics targeting the microbiota has surged in recent years. Here, we discuss current additive and subtractive strategies to manipulate the microbiota, focusing on bacteria engineered to produce therapeutic payloads, consortia of natural organisms and selective antimicrobials. Further, we present challenges faced by the community in the development of microbiome therapeutics, including designing microbial therapies that are adapted for specific geographies in the body, stable colonization with microbial therapies, discovery of clinically relevant biosensors, robustness of engineered synthetic gene circuits and addressing safety and biocontainment concerns. Moving forward, collaboration between basic and applied researchers and clinicians to address these challenges will poise the field to herald an age of next-generation, cellular therapies that draw on novel findings in basic research to inform directed augmentation of the human microbiota. Copyright © 2016. Published by Elsevier B.V.

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

PubMed

Lu, Zhengwu

2010-01-01

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

Intervention Research with Youths at Elevated Risk for Suicide: Meeting the Ethical and Regulatory Challenges of Informed Consent and Assent

ERIC Educational Resources Information Center

King, Cheryl A.; Kramer, Anne C.

2008-01-01

Intervention research with youths at elevated risk for suicidal behavior and suicide--a vulnerable and high risk population--presents investigators with numerous ethical challenges. This report specifically addresses those challenges involving the informed consent and assent process with parents/guardians and youths. The challenges are delineated…

Prioritizing vulnerable children: why should we address inequity?

PubMed

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

2015-11-01

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

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

PubMed

Lange, Lene

2014-12-01

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

Emergency Medicine Gender-specific Education.

PubMed

Ashurst, John V; McGregor, Alyson J; Safdar, Basmah; Weaver, Kevin R; Quinn, Shawn M; Rosenau, Alex M; Goyke, Terrence E; Roth, Kevin R; Greenberg, Marna R

2014-12-01

The 2014 Academic Emergency Medicine consensus conference has taken the first step in identifying gender-specific care as an area of importance to both emergency medicine (EM) and research. To improve patient care, we need to address educational gaps in this area concurrent with research gaps. In this article, the authors highlight the need for sex- and gender-specific education in EM and propose guidelines for medical student, resident, and faculty education. Specific examples of incorporating this content into grand rounds, simulation, bedside teaching, and journal club sessions are reviewed. Future challenges and strategies to fill the gaps in the current education model are also described. © 2014 by the Society for Academic Emergency Medicine.

A Canadian Effort to Address Fractions Teaching and Learning Challenges

ERIC Educational Resources Information Center

Yearley, Shelley; Bruce, Catherine D.

2014-01-01

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

Current Challenges for HTCMC Aero-Propulsion Components

NASA Technical Reports Server (NTRS)

DiCarlo, James A.; Bansal, Narottam P.

2007-01-01

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

Challenges in pediatric ambulatory anesthesia: kids are different.

PubMed

Collins, Corey E; Everett, Lucinda L

2010-06-01

The care of the child having ambulatory surgery presents a specific set of challenges to the anesthesia provider. This review focuses on areas of clinical distinction that support the additional attention children often require, and on clinical controversies that require providers to have up-to-date information to guide practice and address parental concerns. These include perioperative risk; obstructive sleep apnea; obesity; postoperative nausea and vomiting; neurocognitive outcomes; and specific concerns regarding common ear, nose, and throat procedures. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Psychosocial challenges and strategies for coping with HIV among adolescents in Uganda: a qualitative study.

PubMed

Mutumba, Massy; Bauermeister, José A; Musiime, Victor; Byaruhanga, Judith; Francis, Kiweewa; Snow, Rachel C; Tsai, Alexander C

2015-02-01

Although more than 90% of youth perinatally infected with HIV live in sub-Saharan Africa, little is known about the psychosocial factors that impact their wellbeing, or how these youth cope with these challenges. The purpose of this study was to identify the psychosocial challenges and coping strategies among perinatal HIV-infected adolescents in Uganda. In-depth interviews were conducted with a purposive sample of 38 HIV-infected adolescents aged 12-19 years at a large HIV treatment center in Kampala. Data were analyzed thematically to identify themes and domains related to stressors and specific coping strategies. Psychosocial challenges included stigma/discrimination, relationship challenges such as HIV status disclosure, and medication difficulties. Coping strategies included medication adherence, concealment or limited disclosure of HIV status, treatment optimism, social support, rationalizing, social comparison, spirituality/religiosity, avoidance, and distraction. Age and gender differences also emerged: younger participants generally lacked specific coping strategies; compared to females, male adolescents reported greater use of avoidance/distraction techniques. Findings underscore the need to address stigma within homes and schools, and to equip adolescents with the comprehensive knowledge and skills to address their varied challenges.

Insect anaphylaxis: addressing clinical challenges.

PubMed

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

2011-08-01

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

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

PubMed

de Groot, Lisette C P G M

2016-05-01

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

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

PubMed

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

2016-01-01

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

Teaching Digital Natives: Promoting Information Literacy and Addressing Instructional Challenges

ERIC Educational Resources Information Center

Neumann, Crystal

2016-01-01

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

Oral health in Libya: addressing the future challenges.

PubMed

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

2014-01-01

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

Oral health in Libya: addressing the future challenges

PubMed Central

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

2014-01-01

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

Research strategies for addressing uncertainties

USGS Publications Warehouse

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

2013-01-01

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

Activation of Salmonella Typhi-specific regulatory T cells in typhoid disease in a wild-type S. Typhi challenge model.

PubMed

McArthur, Monica A; Fresnay, Stephanie; Magder, Laurence S; Darton, Thomas C; Jones, Claire; Waddington, Claire S; Blohmke, Christoph J; Dougan, Gordon; Angus, Brian; Levine, Myron M; Pollard, Andrew J; Sztein, Marcelo B

2015-05-01

Salmonella Typhi (S. Typhi), the causative agent of typhoid fever, causes significant morbidity and mortality worldwide. Currently available vaccines are moderately efficacious, and identification of immunological responses associated with protection or disease will facilitate the development of improved vaccines. We investigated S. Typhi-specific modulation of activation and homing potential of circulating regulatory T cells (Treg) by flow and mass cytometry using specimens obtained from a human challenge study. Peripheral blood mononuclear cells were obtained from volunteers pre- and at multiple time-points post-challenge with wild-type S. Typhi. We identified differing patterns of S. Typhi-specific modulation of the homing potential of circulating Treg between volunteers diagnosed with typhoid (TD) and those who were not (No TD). TD volunteers demonstrated up-regulation of the gut homing molecule integrin α4ß7 pre-challenge, followed by a significant down-regulation post-challenge consistent with Treg homing to the gut. Additionally, S. Typhi-specific Treg from TD volunteers exhibited up-regulation of activation molecules post-challenge (e.g., HLA-DR, LFA-1). We further demonstrate that depletion of Treg results in increased S. Typhi-specific cytokine production by CD8+ TEM in vitro. These results suggest that the tissue distribution of activated Treg, their characteristics and activation status may play a pivotal role in typhoid fever, possibly through suppression of S. Typhi-specific effector T cell responses. These studies provide important novel insights into the regulation of immune responses that are likely to be critical in protection against typhoid and other enteric infectious diseases.

A specific nanomanufacturing challenge

NASA Astrophysics Data System (ADS)

Kelly, M. J.; Dean, M. C.

2016-03-01

For a science to become a technology, a certain level of control has to have been established over the way items are fabricated for manufacture and use. Here we first consider the challenge of making and using a LEGO® brick scaled down by a factor of 10 n for n = 0-6 in each spatial dimension, i.e. from millimetres to nanometres. We consider both the manufacture and the subsequent properties of the nanobricks that pertain to their use in constructing and dismantling structures. As n increases, the ability to use fails first, to manufacture fails second and to fabricate fails last. Applied to the vast literature in nanoscience, this process emphasises the unmanufacturability of most nanoscale artefacts.

A systematic review of challenging behaviors in children exposed prenatally to substances of abuse.

PubMed

Dixon, Dennis R; Kurtz, Patricia F; Chin, Michelle D

2008-01-01

A review of the existing literature on the occurrence of challenging behavior among children with prenatal drug exposure was conducted. While a large number of studies were identified that evaluated various outcomes of prenatal drug exposure, only 37 were found that directly evaluated challenging behaviors. Of the 37 studies, 23 focused on prenatal cocaine exposure, and 14 focused on prenatal alcohol exposure; most studies relied on broadband measures such as the CBCL for the assessment of challenging behavior. Among the 37 studies, a clear role for the postnatal environment on developing challenging behaviors was evident; however, prenatal alcohol exposure showed a much clearer independent effect upon challenging behaviors than was noted in the prenatal cocaine studies. Additionally, only 3 of the 37 studies addressed interventions for challenging behaviors, each of which showed an improvement in child behavior or parent-child interactions. As researchers have continued to show the importance of the postnatal environment, it is likely that interventions addressing specific environmental risk factors will be helpful to reduce or prevent challenging behaviors among this population.

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

PubMed

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

2017-11-01

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

Reading handprinted addresses on IRS tax forms

NASA Astrophysics Data System (ADS)

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

1996-03-01

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

Addressing Reticence: The Challenge of Engaging Reluctant Adult ESL Students

ERIC Educational Resources Information Center

Carter, Steven J.; Henrichsen, Lynn E.

2015-01-01

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

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

ERIC Educational Resources Information Center

Carmel, Sara; Lowenstein, Ariela

2007-01-01

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

Laser pattern generator challenges in airborne molecular contamination protection

NASA Astrophysics Data System (ADS)

Ekberg, Mats; Skotte, Per-Uno; Utterback, Tomas; Paul, Swaraj; Kishkovich, Oleg P.; Hudzik, James S.

2003-08-01

The introduction of photomask laser pattern generators presents new challenges to system designers and manufacturers. One of the laser pattern generator's environmental operating challenges is Airborne Molecular Contamination (AMC), which affects both chemically amplified resists (CAResist) and laser optics. Similar challenges in CAResist protection have already been addressed in semiconductor wafer lithography with reasonable solutions and experience gained by all those involved. However, photomask and photomask equipment manufacturers have not previously had a comparable experience, and some photomask AMC issues differ from those seen in semiconductor wafer lithography. Culminating years of AMC experience, the authors discuss specific requirements of Photomask AMC. Air sampling and material of construction analysis were performed to understand these particular AMC challenges and used to develop an appropriate filtration specification for different classes of contaminates. The authors portray the importance of cooperation between tool designers and AMC experts early in the design stage to assure goal attainment to maximize both process stability and machine productivity in advanced mask making. In conclusion, the authors provide valuable recommendations to both laser tool users and other equipment manufacturers.

The challenges of studying visual expertise in medical image diagnosis.

PubMed

Gegenfurtner, Andreas; Kok, Ellen; van Geel, Koos; de Bruin, Anique; Jarodzka, Halszka; Szulewski, Adam; van Merriënboer, Jeroen Jg

2017-01-01

Visual expertise is the superior visual skill shown when executing domain-specific visual tasks. Understanding visual expertise is important in order to understand how the interpretation of medical images may be best learned and taught. In the context of this article, we focus on the visual skill of medical image diagnosis and, more specifically, on the methodological set-ups routinely used in visual expertise research. We offer a critique of commonly used methods and propose three challenges for future research to open up new avenues for studying characteristics of visual expertise in medical image diagnosis. The first challenge addresses theory development. Novel prospects in modelling visual expertise can emerge when we reflect on cognitive and socio-cultural epistemologies in visual expertise research, when we engage in statistical validations of existing theoretical assumptions and when we include social and socio-cultural processes in expertise development. The second challenge addresses the recording and analysis of longitudinal data. If we assume that the development of expertise is a long-term phenomenon, then it follows that future research can engage in advanced statistical modelling of longitudinal expertise data that extends the routine use of cross-sectional material through, for example, animations and dynamic visualisations of developmental data. The third challenge addresses the combination of methods. Alternatives to current practices can integrate qualitative and quantitative approaches in mixed-method designs, embrace relevant yet underused data sources and understand the need for multidisciplinary research teams. Embracing alternative epistemological and methodological approaches for studying visual expertise can lead to a more balanced and robust future for understanding superior visual skills in medical image diagnosis as well as other medical fields. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Promises and challenges in solid-state lighting

NASA Astrophysics Data System (ADS)

Schubert, Fred

2010-03-01

Lighting technologies based on semiconductor light-emitting diodes (LEDs) offer unprecedented promises that include three major benefits: (i) Gigantic energy savings enabled by efficient conversion of electrical energy to optical energy; (ii) Substantial positive contributions to sustainability through reduced emissions of global-warming gases, acid-rain gases, and toxic substances such as mercury; and (iii) The creation of new paradigms in lighting driven by the unique controllability of solid-state lighting sources. Due to the powerful nature of these benefits, the transition from conventional lighting sources to solid-state lighting is virtually assured. This presentation will illustrate the new world of lighting and illustrate the pervasive changes to be expected in lighting, displays, communications, and biotechnology. The presentation will also address the formidable challenges that must be addressed to continue the further advancement of solid-state lighting technology. These challenges offer opportunities for research and innovation. Specific challenges include light management, carrier transport, and optical design. We will present some innovative approaches in order to solve known technical challenges faced by solid-state lighting. These approaches include the demonstration and use of new optical thin-film materials with a continuously tunable refractive index. These approaches also include the use of polarization-matched structures that reduce the polarization fields in GaInN LEDs and the hotly debated efficiency droop, that is, the decreasing LED efficiency at high currents.

Addressing the empathy deficit: beliefs about the malleability of empathy predict effortful responses when empathy is challenging.

PubMed

Schumann, Karina; Zaki, Jamil; Dweck, Carol S

2014-09-01

Empathy is often thought to occur automatically. Yet, empathy frequently breaks down when it is difficult or distressing to relate to people in need, suggesting that empathy is often not felt reflexively. Indeed, the United States as a whole is said to be displaying an empathy deficit. When and why does empathy break down, and what predicts whether people will exert effort to experience empathy in challenging contexts? Across 7 studies, we found that people who held a malleable mindset about empathy (believing empathy can be developed) expended greater empathic effort in challenging contexts than did people who held a fixed theory (believing empathy cannot be developed). Specifically, a malleable theory of empathy--whether measured or experimentally induced--promoted (a) more self-reported effort to feel empathy when it is challenging (Study 1); (b) more empathically effortful responses to a person with conflicting views on personally important sociopolitical issues (Studies 2-4); (c) more time spent listening to the emotional personal story of a racial outgroup member (Study 5); and (d) greater willingness to help cancer patients in effortful, face-to-face ways (Study 6). Study 7 revealed a possible reason for this greater empathic effort in challenging contexts: a stronger interest in improving one's empathy. Together, these data suggest that people's mindsets powerfully affect whether they exert effort to empathize when it is needed most, and these data may represent a point of leverage in increasing empathic behaviors on a broad scale. 2014 APA, all rights reserved

Preventing and Addressing Challenging Behavior: Common Questions and Practical Strategies

ERIC Educational Resources Information Center

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

2012-01-01

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

Identifying and Addressing Challenges to Research in University Laboratory Preschools

ERIC Educational Resources Information Center

File, Nancy

2012-01-01

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

Photosensitive biosensor array system using optical addressing without an addressing circuit on array biochips

NASA Astrophysics Data System (ADS)

Ahn, Chang-Geun; Ah, Chil Seong; Kim, Tae-Youb; Park, Chan Woo; Yang, Jong-Heon; Kim, Ansoon; Sung, Gun Yong

2010-09-01

This paper introduces a photosensitive biosensor array system with a simple photodiode array that detects photocurrent changes caused by reactions between probe and target molecules. Using optical addressing, the addressing circuit on the array chip is removed for low-cost application, and real cell addressing is achieved using an externally located computer-controllable light-emitting diode array module. The fabricated biosensor array chip shows a good dynamic range of 1-100 ng/mL under prostate-specific antigen detection, with an on-chip resolution of roughly 1 ng/mL.

Determination of albumin adducts of 4,4'-methylenediphenyl diisocyanate after specific inhalative challenge tests in workers.

PubMed

Sabbioni, Gabriele; Dongari, Nagaraju; Kumar, Anoop; Baur, Xaver

2016-10-17

4,4'-Methylenediphenyl diisocyanate (MDI) is the most important isocyanate used in the industry. Lung sensitization with bronchial asthma is the main disorder in exposed workers. Albumin adducts of MDI might be involved in specific immunological reactions. MDI adducts with lysine (MDI-Lys) of albumin have been found in MDI-workers and construction workers. MDI-Lys is an isocyanate-specific adduct of MDI with albumin. In the present study, we report MDI-adducts in workers undergoing diagnostic MDI challenge tests. The workers were exposed for 2h to 5ppb of MDI. The adduct levels increase significantly after the exposure to MDI in the challenge chamber. About 0.6% of the dose was bound to albumin. So far, only urinary metabolites of MDI were measured to monitor isocyanate workers. However, such urinary metabolites are not isocyanate specific. Therefore, we propose to measure albumin adducts for monitoring MDI exposed subjects. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Addressing the Challenge of Molecular Change: An Interim Report

NASA Astrophysics Data System (ADS)

Levine, Raphael D.

2018-04-01

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

Addressing the Challenge of Molecular Change: An Interim Report.

PubMed

Levine, Raphael D

2018-04-20

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

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.

Progress and challenges of disaster health management in China: a scoping review

PubMed Central

Zhong, Shuang; Clark, Michele; Hou, Xiang-Yu; Zang, Yuli; FitzGerald, Gerard

2014-01-01

Background Despite the importance of an effective health system response to various disasters, relevant research is still in its infancy, especially in middle- and low-income countries. Objective This paper provides an overview of the status of disaster health management in China, with its aim to promote the effectiveness of the health response for reducing disaster-related mortality and morbidity. Design A scoping review method was used to address the recent progress of and challenges to disaster health management in China. Major health electronic databases were searched to identify English and Chinese literature that were relevant to the research aims. Results The review found that since 2003 considerable progress has been achieved in the health disaster response system in China. However, there remain challenges that hinder effective health disaster responses, including low standards of disaster-resistant infrastructure safety, the lack of specific disaster plans, poor emergency coordination between hospitals, lack of portable diagnostic equipment and underdeveloped triage skills, surge capacity, and psychological interventions. Additional challenges include the fragmentation of the emergency health service system, a lack of specific legislation for emergencies, disparities in the distribution of funding, and inadequate cost-effective considerations for disaster rescue. Conclusions One solution identified to address these challenges appears to be through corresponding policy strategies at multiple levels (e.g. community, hospital, and healthcare system level). PMID:25215910

Progress and challenges of disaster health management in China: a scoping review.

PubMed

Zhong, Shuang; Clark, Michele; Hou, Xiang-Yu; Zang, Yuli; FitzGerald, Gerard

2014-01-01

Despite the importance of an effective health system response to various disasters, relevant research is still in its infancy, especially in middle- and low-income countries. This paper provides an overview of the status of disaster health management in China, with its aim to promote the effectiveness of the health response for reducing disaster-related mortality and morbidity. A scoping review method was used to address the recent progress of and challenges to disaster health management in China. Major health electronic databases were searched to identify English and Chinese literature that were relevant to the research aims. The review found that since 2003 considerable progress has been achieved in the health disaster response system in China. However, there remain challenges that hinder effective health disaster responses, including low standards of disaster-resistant infrastructure safety, the lack of specific disaster plans, poor emergency coordination between hospitals, lack of portable diagnostic equipment and underdeveloped triage skills, surge capacity, and psychological interventions. Additional challenges include the fragmentation of the emergency health service system, a lack of specific legislation for emergencies, disparities in the distribution of funding, and inadequate cost-effective considerations for disaster rescue. One solution identified to address these challenges appears to be through corresponding policy strategies at multiple levels (e.g. community, hospital, and healthcare system level).

Addressing informatics challenges in Translational Research with workflow technology.

PubMed

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

2008-09-01

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

Coho salmon Oncorhynchus kisutch strain differences in disease resistance and non-specific immunity, following immersion challenges with Vibrio anguillarum

USGS Publications Warehouse

Balfry, Shannon K.; Maule, Alec G.; Iwama, George K.

2001-01-01

Two strains of freshwater-reared coho salmon Oncorhynchus kisutch were compared for differences in the activity of selected non-specific immune factors before and after lethal and non-lethal immersion challenges with the marine bacterial pathogen Vibrio anguillarum (Vang). Two disease challenge experiments were performed. The first experimental challenge resulted in no mortality; however, significant strain and challenge treatment effects were detected at Day 16 post-challenge. Strain differences in plasma lysozyme activity were found in pre-challenge samples. The second challenge experiment compared the same strains of coho salmon following immersion challenges in different doses of Vang. The fish were sampled at Days 0, 2, 7, and 18 post-challenge and mortality, plasma lysozyme, and anterior kidney phagocyte respiratory burst activity were compared. There were significant strain differences in mortality in the high dose group. The more disease-resistant strain was found to have higher levels of plasma lysozyme and anterior kidney phagocyte respiratory burst activity. These strain differences were detected at various times in the lethal (high dose) and non-lethal challenge groups. There was a clear relationship between the enhanced survival of the more disease-resistant strain and a more sustained, elevated non-specific immune response following the experimental disease challenges. The results of this study suggest that the basis for strain differences in innate disease resistance is related to the ability of the fish to respond quickly to the initial infection and to maintain the response until the infection is quelled.

Differentiated Pedagogy to Address Learner Diversity in Secondary Physical Education

ERIC Educational Resources Information Center

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

2017-01-01

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

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.

Addressing South Africa's Engineering Skills Gaps

ERIC Educational Resources Information Center

Hall, Jonathan; Sandelands, Eric

2009-01-01

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

Multivariate time series analysis of neuroscience data: some challenges and opportunities.

PubMed

Pourahmadi, Mohsen; Noorbaloochi, Siamak

2016-04-01

Neuroimaging data may be viewed as high-dimensional multivariate time series, and analyzed using techniques from regression analysis, time series analysis and spatiotemporal analysis. We discuss issues related to data quality, model specification, estimation, interpretation, dimensionality and causality. Some recent research areas addressing aspects of some recurring challenges are introduced. Copyright © 2015 Elsevier Ltd. All rights reserved.

Addressing Sexual Violence as Student Affairs Work

ERIC Educational Resources Information Center

Landreman, Lisa M.; Williamsen, Kaaren M.

2018-01-01

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

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

PubMed Central

Hurren, Emily; Stewart, Anna; Dennison, Susan

2017-01-01

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

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

PubMed

Hurren, Emily; Stewart, Anna; Dennison, Susan

2017-09-15

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

Taxonomy of Challenges for Digital Forensics.

PubMed

Karie, Nickson M; Venter, Hein S

2015-07-01

Since its inception, over a decade ago, the field of digital forensics has faced numerous challenges. Despite different researchers and digital forensic practitioners having studied and analysed various known digital forensic challenges, as of 2013, there still exists a need for a formal classification of these challenges. This article therefore reviews existing research literature and highlights the various challenges that digital forensics has faced for the last 10 years. In conducting this research study, however, it was difficult for the authors to review all the existing research literature in the digital forensic domain; hence, sampling and randomization techniques were employed to facilitate the review of the gathered literature. Taxonomy of the various challenges is subsequently proposed in this paper based on our review of the literature. The taxonomy classifies the large number of digital forensic challenges into four well-defined and easily understood categories. The proposed taxonomy can be useful, for example, in future developments of automated digital forensic tools by explicitly describing processes and procedures that focus on addressing specific challenges identified in this paper. However, it should also be noted that the purpose of this paper was not to propose any solutions to the individual challenges that digital forensics face, but to serve as a survey of the state of the art of the research area. © 2015 American Academy of Forensic Sciences.

Regional Seminars to Address Current Nuclear Export Control Issues

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

Killinger, Mark H.

2002-07-01

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

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

ERIC Educational Resources Information Center

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

2014-01-01

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

2010 Panel on the Biomaterials Grand Challenges

PubMed Central

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

2014-01-01

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

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

ERIC Educational Resources Information Center

Pook, Katja

2011-01-01

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

Address tracing for parallel machines

NASA Technical Reports Server (NTRS)

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

1991-01-01

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

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

PubMed

Poston, John W

2005-11-01

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

16 CFR 0.2 - Official address.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Official address. 0.2 Section 0.2 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.2... 20580, unless otherwise specifically directed. The Commission's Web site address is www.ftc.gov. [63 FR...

16 CFR 0.2 - Official address.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Official address. 0.2 Section 0.2 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.2... 20580, unless otherwise specifically directed. The Commission's Web site address is www.ftc.gov. [63 FR...

Trafficking receptor signatures define blood plasmablasts responding to tissue-specific immune challenge

PubMed Central

Seong, Yekyung; Lazarus, Nicole H.; Sutherland, Lusijah; Habtezion, Aida; Abramson, Tzvia; He, Xiao-Song; Greenberg, Harry B.

2017-01-01

Antibody-secreting cells are generated in regional lymphoid tissues and traffic as plasmablasts (PBs) via lymph and blood to target sites for local immunity. We used multiparameter flow cytometry to define PB trafficking programs (TPs, combinations of adhesion molecules and chemoattractant receptors) and their imprinting in patients in response to localized infection or immune insults. TPs enriched after infection or autoimmune inflammation of mucosae correlate with sites of immune response or symptoms, with different TPs imprinted during small intestinal, colon, throat, and upper respiratory immune challenge. PBs induced after intramuscular or intradermal influenza vaccination, including flu-specific antibody–secreting cells, display TPs characterized by the lack of mucosal homing receptors. PBs of healthy donors display diverse mucosa-associated TPs, consistent with homeostatic immune activity. Identification of TP signatures of PBs may facilitate noninvasive monitoring of organ-specific immune responses. PMID:28352656

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

ERIC Educational Resources Information Center

Chai, Zhen; Lieberman-Betz, Rebecca

2016-01-01

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

Addressing uncertainty in atomistic machine learning.

PubMed

Peterson, Andrew A; Christensen, Rune; Khorshidi, Alireza

2017-05-10

Machine-learning regression has been demonstrated to precisely emulate the potential energy and forces that are output from more expensive electronic-structure calculations. However, to predict new regions of the potential energy surface, an assessment must be made of the credibility of the predictions. In this perspective, we address the types of errors that might arise in atomistic machine learning, the unique aspects of atomistic simulations that make machine-learning challenging, and highlight how uncertainty analysis can be used to assess the validity of machine-learning predictions. We suggest this will allow researchers to more fully use machine learning for the routine acceleration of large, high-accuracy, or extended-time simulations. In our demonstrations, we use a bootstrap ensemble of neural network-based calculators, and show that the width of the ensemble can provide an estimate of the uncertainty when the width is comparable to that in the training data. Intriguingly, we also show that the uncertainty can be localized to specific atoms in the simulation, which may offer hints for the generation of training data to strategically improve the machine-learned representation.

Customizing NASA's Earth Science Research Products for addressing MENA Water Challenges

NASA Technical Reports Server (NTRS)

Habib, Shahid

2012-01-01

As projected by IPCC 2007 report, by the end of this century the Middle East North Mrica (MENA) region is projected to experience an increase of 3 C to 5 C rise in mean temperatures and a 20% decline in precipitation. This poses a serious problem for this geographic zone especially when majority of the hydrological consumption is for the agriculture sector and the remaining amount is for domestic consumption. In late 2011, the World Bank, USAID and NASA have joined hands to establishing integrated, modem, up to date NASA developed capabilities for various countries in the MENA region for addressing water resource issues and adapting to climate change impacts for improved decision making for societal benefits. The main focus of this undertaking is to address the most pressing societal issues which can be modeled and solved by utilizing NASA Earth Science remote sensing data products and hydrological models. The remote sensing data from space is one of the best ways to study such complex issues and further feed into the decision support systems. NASA's fleet of Earth Observing satellites offer a great vantage point from space to look at the globe and provide vital signs necessary to maintain healthy and sustainable ecosystem. NASA has over fifteen satellites and thirty instruments operating on these space borne platforms and generating over 2000 different science products on a daily basis. Some of these products are soil moisture, global precipitation, aerosols, cloud cover, normalized difference vegetation index, land cover/use, ocean altimetry, ocean salinity, sea surface winds, sea surface temperature, ozone and atmospheric gasses, ice and snow measurements, and many more. All of the data products, models and research results are distributed via the Internet freely through out the world. This project will utilize several NASA models such as global Land Data Assimilation System (LDAS) to generate hydrological states and fluxes in near real time. These LDAS products

Diagnosis of penicillin allergy revisited: the value of case history, skin testing, specific IgE and prolonged challenge.

PubMed

Hjortlund, J; Mortz, C G; Skov, P S; Bindslev-Jensen, C

2013-08-01

Skin testing in duplicate, correlation between case history of immediate and nonimmediate reactions and challenge outcome and prolonged oral treatment with penicillin in the diagnostic evaluation of allergic reactions to β-lactam antibiotics, mimicking real-life situations, have only been addressed in few studies. A total of 342 patients suspected of having β-lactam allergy were investigated according to the European Network for Drug Allergy (ENDA) guidelines and patients found to be negative in the ENDA program were supplemented with a 7-day oral treatment with penicillin. Skin testing with penicillins was performed in duplicate. Patients with case histories of reactions to other β-lactams were also subsequently challenged with the culprit drug. Nineteen patients were IgE-sensitized to penicillin. Then, intracutaneous tests (ICTs) were performed, in which 35 patients tested positive for allergy, 21 with delayed and 14 with immediate reactions. Only three patients tested positive for the major (PPL) and/or minor (MDM) penicillin determinants, all being positive for penicillin G in ICT. The remaining 291 patients were challenged with penicillin: 10 tested positive in single-dose challenge and 23 tested positive in the 7-day challenge. A total of 17 of 78 patients with a negative penicillin challenge tested positive during challenges with other β-lactams. We found no correlation between case histories of immediate and nonimmediate reactions and reaction time during challenge. The data suggest that case history is often insufficient to discriminate between immediate reactors and nonimmediate reactors. A 7-day challenge with the culprit β-lactam may yield more positive reactions than the accepted one- or 2-day challenge. Interpretation of skin testing should be made with caution. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-17

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

Centennial Challenges

NASA Image and Video Library

2010-02-26

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

Domain Specific Language Support for Exascale

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

Sadayappan, Ponnuswamy

Domain-Specific Languages (DSLs) offer an attractive path to Exascale software since they provide expressive power through appropriate abstractions and enable domain-specific optimizations. But the advantages of a DSL compete with the difficulties of implementing a DSL, even for a narrowly defined domain. The DTEC project addresses how a variety of DSLs can be easily implemented to leverage existing compiler analysis and transformation capabilities within the ROSE open source compiler as part of a research program focusing on Exascale challenges. The OSU contributions to the DTEC project are in the area of code generation from high-level DSL descriptions, as well asmore » verification of the automatically-generated code.« less

Challenges and strategies for coping with scleroderma: implications for a scleroderma-specific self-management program.

PubMed

Milette, Katherine; Thombs, Brett D; Maiorino, Kristina; Nielson, Warren R; Körner, Annett; Peláez, Sandra

2018-05-09

The purpose of this study was to explore challenges faced by patients with systemic sclerosis, also called scleroderma, in coping with their disease and the strategies they used to face those challenges. Five focus groups were held with scleroderma patients (4 groups, n = 34) and health care professionals who have experience treating scleroderma (1 group, n = 8). Participants' discussions were recorded, transcribed and analyzed using thematic analysis. Participants reported challenges accessing information (e.g., knowledgeable specialists), dealing with negative emotions (e.g., stress due to misunderstandings with loved ones), and accessing resources (e.g., helpful products or devices). Strategies for overcoming challenges were also discussed (e.g., advocating for own needs). When faced with significant challenges while coping with scleroderma, patients develop strategies to manage better and improve their quality of life. To help them cope, patients would benefit from easier access to supportive interventions, including tailored scleroderma self-management programs. Although the challenges experienced by patients with scleroderma are unique, findings from this study might help better understand patients' perspectives regarding coping and disease management for other chronic diseases as well. Implications for Rehabilitation People living with rare diseases, including the rare autoimmune disease scleroderma, face unique challenges and often do not have access to disease-specific educational or other support resources. People with scleroderma report that they face challenges in accessing information, including knowledgeable healthcare providers; managing difficult social interactions and negative emotions; and accessing resources. Strategies employed by scleroderma patients to overcome these challenges include seeking connections to other people with scleroderma or scleroderma patient organizations, actively seeking out local resources, and learning to

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

PubMed

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

2014-03-01

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

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

PubMed

Greenberg, Caprice C

2017-11-01

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

Nuclear Explosion Monitoring Advances and Challenges

NASA Astrophysics Data System (ADS)

Baker, G. E.

2015-12-01

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

Epicutaneous challenge of orally immunized mice redirects antigen-specific gut-homing T cells to the skin.

PubMed

Oyoshi, Michiko K; Elkhal, Abdallah; Scott, Jordan E; Wurbel, Marc-Andre; Hornick, Jason L; Campbell, James J; Geha, Raif S

2011-06-01

Patients with atopic dermatitis (AD) often suffer from food allergy and develop flares upon skin contact with food allergens. However, it is unclear whether T cells sensitized to allergens in the gut promote this skin inflammation. To address this question, we orally immunized WT mice and mice lacking the skin-homing chemokine receptor Ccr4 (Ccr4-/- mice) with OVA and then challenged them epicutaneously with antigen. Allergic skin inflammation developed in the WT mice but not in the mutants and was characterized by epidermal thickening, dermal infiltration by eosinophils and CD4+ T cells, and upregulation of Th2 cytokines. T cells purified from mesenteric lymph nodes (MLNs) of orally immunized WT mice transferred allergic skin inflammation to naive recipients cutaneously challenged with antigen, but this effect was lost in T cells purified from Ccr4-/- mice. In addition, the ability of adoptively transferred OVA-activated T cells to home to the skin following cutaneous OVA challenge was ablated in mice that lacked lymph nodes. These results indicate that cutaneous exposure to food antigens can reprogram gut-homing effector T cells in LNs to express skin-homing receptors, eliciting skin lesions upon food allergen contact in orally sensitized AD patients.

Addressing Chronic Malnutrition through Multi-Sectoral, Sustainable Approaches: A Review of the Causes and Consequences

PubMed Central

Reinhardt, Kristina; Fanzo, Jessica

2014-01-01

Chronic malnutrition, including stunting, is an important example of a global challenge that spans multiple sectors, specifically health, agriculture, and the environment. The objective of this paper is to review current knowledge on the causes and consequences of chronic malnutrition and their relationship with multiple sectors. Understanding the causes includes approaching chronic malnutrition from the basic, underlying, and immediate levels. The causes reach from macro-level environmental influences to specific micronutrient intake. In order to effectively address stunting, it is important to understand the timing of stunting and the ability of individuals to catch up in terms of linear growth, cognitive ability, and immune function. The consequences of chronic malnutrition are transgenerational and they have an impact at the individual, community, and national level in the short- and long-term. There are still many gaps in knowledge regarding both the causes and consequences of chronic malnutrition, particularly when it comes to the interaction with agriculture and the environment, and understanding these gaps is important to addressing the burden of chronic malnutrition through evidence-based interventions. PMID:25988116

Identification of usual interstitial pneumonia pattern using RNA-Seq and machine learning: challenges and solutions.

PubMed

Choi, Yoonha; Liu, Tiffany Ting; Pankratz, Daniel G; Colby, Thomas V; Barth, Neil M; Lynch, David A; Walsh, P Sean; Raghu, Ganesh; Kennedy, Giulia C; Huang, Jing

2018-05-09

We developed a classifier using RNA sequencing data that identifies the usual interstitial pneumonia (UIP) pattern for the diagnosis of idiopathic pulmonary fibrosis. We addressed significant challenges, including limited sample size, biological and technical sample heterogeneity, and reagent and assay batch effects. We identified inter- and intra-patient heterogeneity, particularly within the non-UIP group. The models classified UIP on transbronchial biopsy samples with a receiver-operating characteristic area under the curve of ~ 0.9 in cross-validation. Using in silico mixed samples in training, we prospectively defined a decision boundary to optimize specificity at ≥85%. The penalized logistic regression model showed greater reproducibility across technical replicates and was chosen as the final model. The final model showed sensitivity of 70% and specificity of 88% in the test set. We demonstrated that the suggested methodologies appropriately addressed challenges of the sample size, disease heterogeneity and technical batch effects and developed a highly accurate and robust classifier leveraging RNA sequencing for the classification of UIP.

Narrative Research Addressing the Challenges of a Career in Professional Sports

ERIC Educational Resources Information Center

Frankl, Daniel

2013-01-01

The purpose of this article is to highlight the challenges that accomplished young athletes face as they aspire to become professional athletes. The data used in this study was derived from selected lived and told sport experiences of undergraduate and graduate kinesiology majors who were former competitive athletes. Additional data was derived…

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

PubMed

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

2016-01-01

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

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

PubMed Central

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

2016-01-01

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

Addressing Challenges in Web Accessibility for the Blind and Visually Impaired

ERIC Educational Resources Information Center

Guercio, Angela; Stirbens, Kathleen A.; Williams, Joseph; Haiber, Charles

2011-01-01

Searching for relevant information on the web is an important aspect of distance learning. This activity is a challenge for visually impaired distance learners. While sighted people have the ability to filter information in a fast and non sequential way, blind persons rely on tools that process the information in a sequential way. Learning is…

Validation of specific inhalation challenge for the diagnosis of occupational asthma due to persulphate salts

PubMed Central

Munoz, X; Cruz, M; Orriols, R; Torres, F; Espuga, M; Morell, F

2004-01-01

Background: The significant value of tests used to certify the diagnosis of occupational asthma due to persulphate salts remains uncertain. Aims: To validate the specific inhalation challenge (SIC) test for the diagnosis of occupational asthma. Methods: Eight patients with occupational asthma due to persulphate salts, eight patients with bronchial asthma who were never exposed to persulphate salts, and ten healthy subjects were studied. Clinical history taking, spirometry, bronchial challenge with methacholine, skin prick testing to common inhalant allergens and persulphate salts, total IgE levels, and SIC to potassium persulphate were carried out in all subjects. The SIC used increasing concentrations of potassium persulphate (5, 10, 15, and 30 g) mixed with 150 g of lactose. Patients tipped the mixture from one tray to another at a distance of 30 cm from the face for 10 minutes in a challenge booth. Results: The SIC was positive in all subjects with persulphate induced asthma and in one patient with bronchial asthma who had never been exposed to persulphate salts. Sensitivity was 100% (95% CI 67.6 to 100) and specificity was 87.5% (95% CI 52.9–97.8) when patients with occupational asthma due to persulphate salts were compared with those with bronchial asthma never exposed to persulphate salts. Conclusions: SIC to persulphate salts performed according to the protocol described appears to be useful for the diagnosis of occupational asthma secondary to inhalation of this substance. PMID:15377773

Centennial Challenges

NASA Image and Video Library

2010-02-26

NASA Administrator Charles Bolden, right, and Doug Comstock, left, stand with David Masten, of Masten Space Systems, during a ceremony for winners and participants of NASA’s 2009 Centennial Challenges, Friday, Feb. 26, 2010, at NASA Headquarters in Washington. The year-long competition addresses a range of technical challenges that support NASA's missions in aeronautics and space with a goal of encouraging novel solutions from non-traditional sources. Photo Credit: (NASA/Paul E. Alers)

Conversion of a Large, Urban High School to Small Schools: Leadership Challenges and Opportunities

ERIC Educational Resources Information Center

Nehring, James; Lohmeier, Jill H.; Colombo, Michaela

2009-01-01

This article reports findings from a study of the experiences of 11 school principals who are leading the conversion of a large, comprehensive, urban high school into six thematic small schools. Specifically, this study addresses the question, What do high school principals identify as the leadership challenges and opportunities embedded in the…

Challenging clinical learning environments: experiences of undergraduate nursing students.

PubMed

O'Mara, Linda; McDonald, Jane; Gillespie, Mary; Brown, Helen; Miles, Lynn

2014-03-01

Clinical learning is an essential component of becoming a nurse. However at times, students report experiencing challenging clinical learning environments (CCLE), raising questions regarding the nature of a challenging clinical learning environment, its impact on students' learning and how students might respond within a CCLE. Using an Interpretive Descriptive study design, researchers held focus groups with 54 students from two Canadian sites, who self-identified as having experienced a CCLE. Students defined a CCLE as affected by relationships in the clinical area and by the context of their learning experiences. CCLE decreased students' learning opportunities and impacted on them as persons. As students determined which relationships were challenging, they tapped other resources and they used strategies to rebuilt, reframe, redirect and/or retreat relative to the specific challenge. Relationships also acted as buffers to unsupportive practice cultures. Implications for practice and research are addressed. Copyright © 2013 Elsevier Ltd. All rights reserved.

Mars outpost - System and operations challenges

NASA Technical Reports Server (NTRS)

Roberts, Barney; Guerra, Lisa

1990-01-01

The paper addresses the challenges inherent in establishing an outpost on the planet Mars. For background purposes, the unique, remote Martian environment and the developmental phases of a settlement in such an environment are discussed. Challenges are identified in terms of surface systems and operations. Due to its importance to habitability, the life support system (LSS) is highlighted with various options identified. Operations for the Mars outpost, earth-based and local, are characterized by a decentralized concept. The challenge of integrating logistics analysis early in system design and operations strategy is also addressed. In order to understand and reduce the system and operations challenges, the application of terrestrial and lunar testbeds is explained.

Perceived benefits and challenges of coordinated approaches to chronic disease prevention in state health departments.

PubMed

Allen, Peg; Sequeira, Sonia; Best, Leslie; Jones, Ellen; Baker, Elizabeth A; Brownson, Ross C

2014-05-08

Chronic disease prevention efforts have historically been funded categorically according to disease or risk factor. Federal agencies are now progressively starting to fund combined programs to address common risk. The purpose of this study was to inform transitions to coordinated chronic disease prevention by learning views on perceived benefits and challenges of a coordinated approach to funding. A national survey on evidence-based public health was conducted from March through May 2013 among state health department employees working in chronic disease prevention (N = 865). Participants were asked to rank the top 3 benefits and top 3 challenges in coordinating chronic disease approaches from provided lists and could provide additional responses. Descriptive analyses, χ(2) tests, and analysis of variance were conducted. The most common perceived benefits of coordinated approaches to chronic disease prevention were improved health outcomes, common risk factors better addressed, and reduced duplication of program efforts. The most common perceived challenges were funding restrictions, such as disease-specific performance measures; competing priorities; lack of communication across programs; funding might be reduced; agency not structured for program coordination; and loss of disease-specific partner support. Rankings of benefits and challenges were similar across states and participant roles; the perceived challenges "lack of communication across programs" (P = .02) and "funding might be reduced" differed by program area (P < .001). Findings can be used by funding agencies and state health departments for planning, training, and technical assistance. The information on perceived challenges demonstrates the need to improve communication across programs, enhance organizational support for coordinated approaches, and create benefits for organizational partners.

Standards, Assessment, and Readiness: Addressing Postsecondary Transition Issues across State Lines

ERIC Educational Resources Information Center

Michelau, Demarée K.

2015-01-01

This brief describes major challenges ahead for states, institutions, and most importantly, students as the standards and assessments from the Common Core Standards (CCSS) are implemented. It also offers recommendations to create a network structure that would assist K-12 and higher education leaders in addressing those challenges. To begin the…

New challenges for text mining: mapping between text and manually curated pathways

PubMed Central

Oda, Kanae; Kim, Jin-Dong; Ohta, Tomoko; Okanohara, Daisuke; Matsuzaki, Takuya; Tateisi, Yuka; Tsujii, Jun'ichi

2008-01-01

Background Associating literature with pathways poses new challenges to the Text Mining (TM) community. There are three main challenges to this task: (1) the identification of the mapping position of a specific entity or reaction in a given pathway, (2) the recognition of the causal relationships among multiple reactions, and (3) the formulation and implementation of required inferences based on biological domain knowledge. Results To address these challenges, we constructed new resources to link the text with a model pathway; they are: the GENIA pathway corpus with event annotation and NF-kB pathway. Through their detailed analysis, we address the untapped resource, ‘bio-inference,’ as well as the differences between text and pathway representation. Here, we show the precise comparisons of their representations and the nine classes of ‘bio-inference’ schemes observed in the pathway corpus. Conclusions We believe that the creation of such rich resources and their detailed analysis is the significant first step for accelerating the research of the automatic construction of pathway from text. PMID:18426550

Predicting food challenge outcomes for baked milk: role of specific IgE and skin prick testing.

PubMed

Bartnikas, Lisa M; Sheehan, William J; Hoffman, Elaine B; Permaul, Perdita; Dioun, Anahita F; Friedlander, James; Baxi, Sachin N; Schneider, Lynda C; Phipatanakul, Wanda

2012-11-01

Cow's milk allergy is the most common food allergy in childhood. Many children with IgE-mediated cow's milk allergy may tolerate baked milk products, but few data exist on predictors of outcomes of baked milk challenges. To determine the relation of milk protein allergen specific IgE (sIgE) levels and skin prick test (SPT) wheal size with baked milk challenge outcomes. A retrospective medical record review was conducted of 35 baked milk challenges. SPT results, sIgE levels, demographic characteristics, and food challenge results were analyzed. Thirty-five children underwent open challenges to baked milk and 29 (83%) passed. Of those who failed, 3 (50%) passed the initial clinic challenge but developed symptoms to ongoing exposure at home, days to months later. One child who ultimately failed at home required epinephrine. Compared with those who passed, children who failed were younger (median age, 8.9 and 3.7 years, respectively; P = .02). Children with a milk SPT wheal less than 12 mm were more than 90% likely to pass a baked milk challenge, and no child with a milk SPT wheal less than 7 mm failed a baked milk challenge. We were also able to establish more than 90% predictive values for passing baked milk challenges with a casein SPT wheal of 9 mm, a milk sIgE level of 1.0 kU/L, and a casein sIgE level of 0.9 kU/L. Most children allergic to cow's milk tolerated baked milk. Milk protein SPT wheal may be more reliable than sIgE level in predicting outcomes of baked milk challenges. It is important to be aware of the possibility of late reactions to ongoing baked milk exposure. Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Addressing current challenges in cancer immunotherapy with mathematical and computational modelling.

PubMed

Konstorum, Anna; Vella, Anthony T; Adler, Adam J; Laubenbacher, Reinhard C

2017-06-01

The goal of cancer immunotherapy is to boost a patient's immune response to a tumour. Yet, the design of an effective immunotherapy is complicated by various factors, including a potentially immunosuppressive tumour microenvironment, immune-modulating effects of conventional treatments and therapy-related toxicities. These complexities can be incorporated into mathematical and computational models of cancer immunotherapy that can then be used to aid in rational therapy design. In this review, we survey modelling approaches under the umbrella of the major challenges facing immunotherapy development, which encompass tumour classification, optimal treatment scheduling and combination therapy design. Although overlapping, each challenge has presented unique opportunities for modellers to make contributions using analytical and numerical analysis of model outcomes, as well as optimization algorithms. We discuss several examples of models that have grown in complexity as more biological information has become available, showcasing how model development is a dynamic process interlinked with the rapid advances in tumour-immune biology. We conclude the review with recommendations for modellers both with respect to methodology and biological direction that might help keep modellers at the forefront of cancer immunotherapy development. © 2017 The Author(s).

An evaluation of the effectiveness of a case-specific approach to challenging behaviour associated with dementia.

PubMed

Bird, Michael; Llewellyn-Jones, Robert H; Korten, Ailsa

2009-01-01

Treatment of challenging behaviour in dementia using standardized psychopharmacological or psychosocial approaches remains problematical. A case-specific approach was trialled in this study, based on extensive evidence that each case is different in aetiology, the effects of the behaviour on others and what interventions are possible given the available resources. Forty-four consecutive referrals for challenging behaviour (two-thirds in residential care) were assessed across multiple causal domains. Both assessment and development of interventions were undertaken in collaboration with family carers and care staff. Measures of behaviour and associated carer distress, as well as medication and service use, were taken pre-intervention and at 2- and 5-month follow-ups. Psychotropic medication was used with a minority of participants but, overall, antipsychotic use was reduced. Psychosocial methods predominated, with 77% of cases judged as mainly or entirely psychosocial by an expert panel. There were significant mean improvements in behaviour and carer distress. Using conservative criteria there was a 65.9% clinical success rate. Results confirm those of other studies which have used multifaceted interventions tailored to the unique needs of each case. They compare favourably with results from trials of standardized psycho-pharmacological or psychosocial approaches. More trials are needed, necessarily involving further development of robust methodologies which reflect the case-specific nature of challenging behaviour associated with dementia.

Emerging Infections Program Efforts to Address Health Equity

PubMed Central

Vugia, Duc J.; Bennett, Nancy M.; Moore, Matthew R.

2015-01-01

The Emerging Infections Program (EIP), a collaboration between (currently) 10 state health departments, their academic center partners, and the Centers for Disease Control and Prevention, was established in 1995. The EIP performs active, population-based surveillance for important infectious diseases, addresses new problems as they arise, emphasizes projects that lead to prevention, and develops and evaluates public health practices. The EIP has increasingly addressed the health equity challenges posed by Healthy People 2020. These challenges include objectives to increase the proportion of Healthy People–specified conditions for which national data are available by race/ethnicity and socioeconomic status as a step toward first recognizing and subsequently eliminating health inequities. EIP has made substantial progress in moving from an initial focus on monitoring social determinants exclusively through collecting and analyzing data by race/ethnicity to identifying and piloting ways to conduct population-based surveillance by using area-based socioeconomic status measures. PMID:26291875

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

PubMed

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

2016-10-07

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

Addressing Wife Abuse in Mexican Immigrant Couples: Challenges for Family Social Workers

ERIC Educational Resources Information Center

Hancock, Tina

2006-01-01

This article addresses wife abuse in undocumented Mexican immigrant couples and suggests an ecosystems treatment approach that takes into consideration the structural forces of oppression and discrimination on abusive behaviors in the home and combines individual, family and community level interventions to help immigrant men stop the abuse.…

The Rise of International Relations Programs in the Brazilian Federal Universities: Curriculum Specificities and Current Challenges

ERIC Educational Resources Information Center

Ferreira, Marcos Alan S. V.

2016-01-01

The aim of this reflection is to study the new international relations (IR) programs introduced by Brazilian federal universities, looking comparatively at their curriculum specificities and current challenges. In recent years, Brazil has seen an increase of IR programs launched in several regions. Since 2003, the Ministry of Education is in the…

Addressing the hidden dimension in nursing education: promoting cultural competence.

PubMed

Carter, Kimberly F; Xu, Yu

2007-01-01

The authors describe a cultural competence quality enhancement process to address the retention challenge of students who speak English as second language and international students as part of a school of nursing's continuous program quality improvement to achieve excellence. The process, strategies, outcomes, and evaluation of the training program are detailed within the given geographical, institutional, and curriculum context. Lessons and continuing challenges are also specified.

Skin prick testing predicts peanut challenge outcome in previously allergic or sensitized children with low serum peanut-specific IgE antibody concentration.

PubMed

Nolan, Richard C; Richmond, Peter; Prescott, Susan L; Mallon, Dominic F; Gong, Grace; Franzmann, Annkathrin M; Naidoo, Rama; Loh, Richard K S

2007-05-01

Peanut allergy is transient in some children but it is not clear whether quantitating peanut-specific IgE by Skin Prick Test (SPT) adds additional information to fluorescent-enzyme immunoassay (FEIA) in discriminating between allergic and tolerant children. To investigate whether SPT with a commercial extract or fresh foods adds additional predictive information for peanut challenge in children with a low FEIA (<10 k UA/L) who were previously sensitized, or allergic to peanuts. Children from a hospital-based allergy service who were previously sensitized or allergic to peanuts were invited to undergo a peanut challenge unless they had a serum peanut-specific IgE>10 k UA/L, a previous severe reaction, or a recent reaction to peanuts (within two years). SPT with a commercial extract, raw and roasted saline soaked peanuts was performed immediately prior to open challenge in hospital with increasing quantity of peanuts until total of 26.7 g of peanut was consumed. A positive challenge consisted of an objective IgE mediated reaction occurring during the observation period. 54 children (median age of 6.3 years) were admitted for a challenge. Nineteen challenges were positive, 27 negative, five were indeterminate and three did not proceed after SPT. Commercial and fresh food extracts provided similar diagnostic information. A wheal diameter of >or=7 mm of the commercial extract predicted an allergic outcome with specificity 97%, positive predictive value 93% and sensitivity 83%. There was a tendency for an increase in SPT wheal since initial diagnosis in children who remained allergic to peanuts while it decreased in those with a negative challenge. The outcome of a peanut challenge in peanut sensitized or previously allergic children with a low FEIA can be predicted by SPT. In this cohort, not challenging children with a SPT wheal of >or=7 mm would have avoided 15 of 18 positive challenges and denied a challenge to one out of 27 tolerant children.

Challenges and opportunities in clinical translation of biomedical optical spectroscopy and imaging

NASA Astrophysics Data System (ADS)

Wilson, Brian C.; Jermyn, Michael; Leblond, Frederic

2018-03-01

Medical devices face many hurdles before they enter routine clinical practice to address unmet clinical needs. This is also the case for biomedical optical spectroscopy and imaging systems that are used here to illustrate the opportunities and challenges involved. Following initial concept, stages in clinical translation include instrument development, preclinical testing, clinical prototyping, clinical trials, prototype-to-product conversion, regulatory approval, commercialization, and finally clinical adoption and dissemination, all in the face of potentially competing technologies. Optical technologies face additional challenges from their being extremely diverse, often targeting entirely different diseases and having orders-of-magnitude differences in resolution and tissue penetration. However, these technologies can potentially address a wide variety of unmet clinical needs since they provide rich intrinsic biochemical and structural information, have high sensitivity and specificity for disease detection and localization, and are practical, safe (minimally invasive, nonionizing), and relatively affordable.

Optically addressed ultra-wideband phased antenna array

NASA Astrophysics Data System (ADS)

Bai, Jian

Demands for high data rate and multifunctional apertures from both civilian and military users have motivated development of ultra-wideband (UWB) electrically steered phased arrays. Meanwhile, the need for large contiguous frequency is pushing operation of radio systems into the millimeter-wave (mm-wave) range. Therefore, modern radio systems require UWB performance from VHF to mm-wave. However, traditional electronic systems suffer many challenges that make achieving these requirements difficult. Several examples includes: voltage controlled oscillators (VCO) cannot provide a tunable range of several octaves, distribution of wideband local oscillator signals undergo high loss and dispersion through RF transmission lines, and antennas have very limited bandwidth or bulky sizes. Recently, RF photonics technology has drawn considerable attention because of its advantages over traditional systems, with the capability of offering extreme power efficiency, information capacity, frequency agility, and spatial beam diversity. A hybrid RF photonic communication system utilizing optical links and an RF transducer at the antenna potentially provides ultra-wideband data transmission, i.e., over 100 GHz. A successful implementation of such an optically addressed phased array requires addressing several key challenges. Photonic generation of an RF source with over a seven-octave bandwidth has been demonstrated in the last few years. However, one challenge which still remains is how to convey phased optical signals to downconversion modules and antennas. Therefore, a feed network with phase sweeping capability and low excessive phase noise needs to be developed. Another key challenge is to develop an ultra-wideband array antenna. Modern frontends require antennas to be compact, planar, and low-profile in addition to possessing broad bandwidth, conforming to stringent space, weight, cost, and power constraints. To address these issues, I will study broadband and miniaturization

Addressing Methodological Challenges in Large Communication Datasets: Collecting and Coding Longitudinal Interactions in Home Hospice Cancer Care

PubMed Central

Reblin, Maija; Clayton, Margaret F; John, Kevin K; Ellington, Lee

2015-01-01

In this paper, we present strategies for collecting and coding a large longitudinal communication dataset collected across multiple sites, consisting of over 2000 hours of digital audio recordings from approximately 300 families. We describe our methods within the context of implementing a large-scale study of communication during cancer home hospice nurse visits, but this procedure could be adapted to communication datasets across a wide variety of settings. This research is the first study designed to capture home hospice nurse-caregiver communication, a highly understudied location and type of communication event. We present a detailed example protocol encompassing data collection in the home environment, large-scale, multi-site secure data management, the development of theoretically-based communication coding, and strategies for preventing coder drift and ensuring reliability of analyses. Although each of these challenges have the potential to undermine the utility of the data, reliability between coders is often the only issue consistently reported and addressed in the literature. Overall, our approach demonstrates rigor and provides a “how-to” example for managing large, digitally-recorded data sets from collection through analysis. These strategies can inform other large-scale health communication research. PMID:26580414

Addressing challenges of modulation transfer function measurement with fisheye lens cameras

NASA Astrophysics Data System (ADS)

Deegan, Brian M.; Denny, Patrick E.; Zlokolica, Vladimir; Dever, Barry; Russell, Laura

2015-03-01

Modulation transfer function (MTF) is a well defined and accepted method of measuring image sharpness. The slanted edge test, as defined in ISO12233 is a standard method of calculating MTF, and is widely used for lens alignment and auto-focus algorithm verification. However, there are a number of challenges which should be considered when measuring MTF in cameras with fisheye lenses. Due to trade-offs related Petzval curvature, planarity of the optical plane is difficult to achieve in fisheye lenses. It is therefore critical to have the ability to accurately measure sharpness throughout the entire image, particularly for lens alignment. One challenge for fisheye lenses is that, because of the radial distortion, the slanted edges will have different angles, depending on the location within the image and on the distortion profile of the lens. Previous work in the literature indicates that MTF measurements are robust for angles between 2 and 10 degrees. Outside of this range, MTF measurements become unreliable. Also, the slanted edge itself will be curved by the lens distortion, causing further measurement problems. This study summarises the difficulties in the use of MTF for sharpness measurement in fisheye lens cameras, and proposes mitigations and alternative methods.

Analysis of Transportation and Logistics Challenges Affecting the Deployment of Larger Wind Turbines: Summary of Results

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

Cotrell, J.; Stehly, T.; Johnson, J.

There is relatively little literature that characterizes transportation and logistics challenges and the associated effects on U.S. wind markets. The objectives of this study were to identify the transportation and logistics challenges, assess the associated impacts, and provide recommendations for strategies and specific actions to address the challenges. The authors primarily relied on interviews with wind industry project developers, original equipment manufacturers, and transportation and logistics companies to obtain the information and industry perspectives needed for this study. They also reviewed published literature on trends and developments in increasing wind turbine size, logistics, and transportation issues.

A Blueprint to Address Research Gaps in the Development of Biomarkers for Pediatric Tuberculosis

PubMed Central

Nicol, Mark Patrick; Gnanashanmugam, Devasena; Browning, Renee; Click, Eleanor S.; Cuevas, Luis E.; Detjen, Anne; Graham, Steve M.; Levin, Michael; Makhene, Mamodikoe; Nahid, Payam; Perez-Velez, Carlos M.; Reither, Klaus; Song, Rinn; Spiegel, Hans M. L.; Worrell, Carol; Zar, Heather J.; Walzl, Gerhard

2015-01-01

Childhood tuberculosis contributes significantly to the global tuberculosis disease burden but remains challenging to diagnose due to inadequate methods of pathogen detection in paucibacillary pediatric samples and lack of a child-specific host biomarker to identify disease. Accurately diagnosing tuberculosis in children is required to improve case detection, surveillance, healthcare delivery, and effective advocacy. In May 2014, the National Institutes of Health convened a workshop including researchers in the field to delineate priorities to address this research gap. This blueprint describes the consensus from the workshop, identifies critical research steps to advance this field, and aims to catalyze efforts toward harmonization and collaboration in this area. PMID:26409279

IDENTIFYING PERFORMANCE ASSURANCE CHALLENGES FOR SMART MANUFACTURING.

PubMed

Helu, Moneer; Morris, Katherine; Jung, Kiwook; Lyons, Kevin; Leong, Swee

2015-10-01

Smart manufacturing has the potential to address many of the challenges faced by industry. However, the manufacturing community often needs assistance to leverage available technologies to improve their systems. To assure the performance of these technologies, this paper proposes a shared knowledge base that collects problem areas, solutions, and best practices for manufacturing technology. An Implementation Risk Assessment Framework (IRAF) is also described to identify the primary weaknesses of technologies in specific manufacturing contexts. Such approaches have the potential to stimulate new ideas and drive standardization activities critical to scale up and deploy smart manufacturing technologies successfully and quickly.

IDENTIFYING PERFORMANCE ASSURANCE CHALLENGES FOR SMART MANUFACTURING

PubMed Central

Helu, Moneer; Morris, Katherine; Jung, Kiwook; Lyons, Kevin; Leong, Swee

2015-01-01

Smart manufacturing has the potential to address many of the challenges faced by industry. However, the manufacturing community often needs assistance to leverage available technologies to improve their systems. To assure the performance of these technologies, this paper proposes a shared knowledge base that collects problem areas, solutions, and best practices for manufacturing technology. An Implementation Risk Assessment Framework (IRAF) is also described to identify the primary weaknesses of technologies in specific manufacturing contexts. Such approaches have the potential to stimulate new ideas and drive standardization activities critical to scale up and deploy smart manufacturing technologies successfully and quickly. PMID:26783512

Current progress in patient-specific modeling

PubMed Central

2010-01-01

We present a survey of recent advancements in the emerging field of patient-specific modeling (PSM). Researchers in this field are currently simulating a wide variety of tissue and organ dynamics to address challenges in various clinical domains. The majority of this research employs three-dimensional, image-based modeling techniques. Recent PSM publications mostly represent feasibility or preliminary validation studies on modeling technologies, and these systems will require further clinical validation and usability testing before they can become a standard of care. We anticipate that with further testing and research, PSM-derived technologies will eventually become valuable, versatile clinical tools. PMID:19955236

Technology Challenges for Deep-Throttle Cryogenic Engines for Space Exploration

NASA Technical Reports Server (NTRS)

Brown, Kendall K.; Nelson, Karl W.

2005-01-01

requirements affect the engine system requirements and create system level technology challenges. An engine system architecture for multiple applications or a family of engines based upon a set of core technologies, design, and fabrication approaches may reduce overall programmatic cost and risk. The engine system discussion will also address the characterization of engine cycle figures of merit, configurations, and design approaches for some in-space vehicle alternatives under consideration. The second area evaluates the component-level technology challenges induced from the system requirements. Component technology issues are discussed addressing injector, thrust chamber, ignition system, turbopump assembly, and valve design for the challenging requirements of high reliability, robustness, fault tolerance, deep throttling, reasonable performance (with respect to weight and specific impulse).

Technology Challenges for Deep-Throttle Cryogenic Engines for Space Exploration

NASA Astrophysics Data System (ADS)

Brown, Kendall K.; Nelson, Karl W.

2005-02-01

requirements affect the engine system requirements and create system level technology challenges. An engine system architecture for multiple applications or a family of engines based upon a set of core technologies, design, and fabrication approaches may reduce overall programmatic cost and risk. The engine system discussion will also address the characterization of engine cycle figures of merit, configurations, and design approaches for some in-space vehicle alternatives under consideration. The second area evaluates the component-level technology challenges induced from the system requirements. Component technology issues are discussed addressing injector, thrust chamber, ignition system, turbopump assembly, and valve design for the challenging requirements of high reliability, robustness, fault tolerance, deep throttling, reasonable performance (with respect to weight and specific impulse).

Perceived Benefits and Challenges of Coordinated Approaches to Chronic Disease Prevention in State Health Departments

PubMed Central

Sequeira, Sonia; Best, Leslie; Jones, Ellen; Baker, Elizabeth A.; Brownson, Ross C.

2014-01-01

Introduction Chronic disease prevention efforts have historically been funded categorically according to disease or risk factor. Federal agencies are now progressively starting to fund combined programs to address common risk. The purpose of this study was to inform transitions to coordinated chronic disease prevention by learning views on perceived benefits and challenges of a coordinated approach to funding. Methods A national survey on evidence-based public health was conducted from March through May 2013 among state health department employees working in chronic disease prevention (N = 865). Participants were asked to rank the top 3 benefits and top 3 challenges in coordinating chronic disease approaches from provided lists and could provide additional responses. Descriptive analyses, χ2 tests, and analysis of variance were conducted. Results The most common perceived benefits of coordinated approaches to chronic disease prevention were improved health outcomes, common risk factors better addressed, and reduced duplication of program efforts. The most common perceived challenges were funding restrictions, such as disease-specific performance measures; competing priorities; lack of communication across programs; funding might be reduced; agency not structured for program coordination; and loss of disease-specific partner support. Rankings of benefits and challenges were similar across states and participant roles; the perceived challenges “lack of communication across programs” (P = .02) and “funding might be reduced” differed by program area (P < .001). Conclusion Findings can be used by funding agencies and state health departments for planning, training, and technical assistance. The information on perceived challenges demonstrates the need to improve communication across programs, enhance organizational support for coordinated approaches, and create benefits for organizational partners. PMID:24809362

Optically Addressable, Ferroelectric Memory With NDRO

NASA Technical Reports Server (NTRS)

Thakoor, Sarita

1994-01-01

For readout, memory cells addressed via on-chip semiconductor lasers. Proposed thin-film ferroelectric memory device features nonvolatile storage, optically addressable, nondestructive readout (NDRO) with fast access, and low vulnerability to damage by ionizing radiation. Polarization switched during recording and erasure, but not during readout. As result, readout would not destroy contents of memory, and operating life in specific "read-intensive" applications increased up to estimated 10 to the 16th power cycles.

A Promising Approach to Addressing America's Biggest Challenges. Needle-Moving Community Collaboratives

ERIC Educational Resources Information Center

Jolin, Michele; Schmitz, Paul; Seldon, Willa

2012-01-01

Communities face powerful challenges--a high-school dropout epidemic, youth unemployment, teen pregnancy--that require powerful solutions. In a climate of increasingly constrained resources, those solutions must help communities to achieve more with less. A new kind of community collaborative--an approach that aspires to significant,…

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

PubMed

Said, Maya; Zerhouni, Elias

2014-11-01

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

Research of future network with multi-layer IP address

NASA Astrophysics Data System (ADS)

Li, Guoling; Long, Zhaohua; Wei, Ziqiang

2018-04-01

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

Addressing current and future challenges for the NHS: the role of good leadership.

PubMed

Elton, Lotte

2016-10-03

Purpose This paper aims to describe and analyse some of the ways in which good leadership can enable those working within the National Health Service (NHS) to weather the changes and difficulties likely to arise in the coming years, and takes the format of an essay written by the prize-winner of the Faculty of Medical Leadership and Management's Student Prize. The Faculty of Medical Leadership and Management ran its inaugural Student Prize in 2015-2016, which aimed at medical students with an interest in medical leadership. In running the Prize, the Faculty hoped to foster an enthusiasm for and understanding of the importance of leadership in medicine. Design/methodology/approach The Faculty asked entrants to discuss the role of good leadership in addressing the current and future challenges faced by the NHS, making reference to the Leadership and Management Standards for Medical Professionals published by the Faculty in 2015. These standards were intended to help guide current and future leaders and were grouped into three categories, namely, self, team and corporate responsibility. Findings This paper highlights the political nature of health care in the UK and the increasing impetus on medical professionals to navigate debates on austerity measures and health-care costs, particularly given the projected deficit in NHS funding. It stresses the importance of building organisational cultures prizing transparency to prevent future breaches in standards of care and the value of patient-centred approaches in improving satisfaction for both patients and staff. Identification of opportunities for collaboration and partnership is emphasised as crucial to assuage the burden that lack of appropriate social care places on clinical services. Originality/value This paper offers a novel perspective - that of a medical student - on the complex issues faced by the NHS over the coming years and utilises a well-regarded set of standards in conceptualising the role that health

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

PubMed

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

2018-03-16

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

Barriers, Challenges, and Decision-Making in the Letter Writing Process for Gender Transition.

PubMed

Budge, Stephanie L; Dickey, Lore M

2017-03-01

This article addresses the challenges that clinicians face in writing letters of support for transgender and gender-diverse clients. It addresses common but challenging clinical representations to help the reader understand the nuances associated with writing letters. Three cases are presented. The first addresses systemic challenges, the second addresses management of care, and the third addresses co-occurring mental health concerns. Recommendations for practice are provided based on the experiences included within the 3 case examples. Copyright © 2016 Elsevier Inc. All rights reserved.

An Elegant Biosensor Molecular Beacon Probe: Challenges and Recent Solutions

PubMed Central

Kolpashchikov, Dmitry M.

2012-01-01

Molecular beacon (MB) probes are fluorophore- and quencher-labeled short synthetic DNAs folded in a stem-loop shape. Since the first report by Tyagi and Kramer, it has become a widely accepted tool for nucleic acid analysis and triggered a cascade of related developments in the field of molecular sensing. The unprecedented success of MB probes stems from their ability to detect specific DNA or RNA sequences immediately after hybridization with no need to wash out the unbound probe (instantaneous format). Importantly, the hairpin structure of the probe is responsible for both the low fluorescent background and improved selectivity. Furthermore, the signal is generated in a reversible manner; thus, if the analyte is removed, the signal is reduced to the background. This paper highlights the advantages of MB probes and discusses the approaches that address the challenges in MB probe design. Variations of MB-based assays tackle the problem of stem invasion, improve SNP genotyping and signal-to-noise ratio, as well as address the challenges of detecting folded RNA and DNA. PMID:24278758

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

ERIC Educational Resources Information Center

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

2007-01-01

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

NASA Space Rocket Logistics Challenges

NASA Technical Reports Server (NTRS)

Bramon, Chris; Neeley, James R.; Jones, James V.; Watson, Michael D.; Inman, Sharon K.; Tuttle, Loraine

2014-01-01

The Space Launch System (SLS) is the new NASA heavy lift launch vehicle in development and is scheduled for its first mission in 2017. SLS has many of the same logistics challenges as any other large scale program. However, SLS also faces unique challenges. This presentation will address the SLS challenges, along with the analysis and decisions to mitigate the threats posed by each.

Addressing Household Food Insecurity in Canada - Position Statement and Recommendations - Dietitians of Canada.

PubMed

2016-09-01

POSITION STATEMENT It is the position of Dietitians of Canada that household food insecurity is a serious public health issue with profound effects on physical and mental health and social well-being. All households in Canada must have sufficient income for secure access to nutritious food after paying for other basic necessities. Given the alarming prevalence, severity and impact of household food insecurity in Canada, Dietitians of Canada calls for a pan-Canadian, government-led strategy to specifically reduce food insecurity at the household level, including policies that address the unique challenges of household food insecurity among Indigenous Peoples. Regular monitoring of the prevalence and severity of household food insecurity across all of Canada is required. Research must continue to address gaps in knowledge about household vulnerability to food insecurity and to evaluate the impact of policies developed to eliminate household food insecurity in Canada. Dietitians of Canada recommends: Development and implementation of a pan-Canadian government-led strategy that includes coordinated policies and programs, to ensure all households have consistent and sufficient income to be able to pay for basic needs, including food. Implementation of a federally-supported strategy to comprehensively address the additional and unique challenges related to household food insecurity among Indigenous Peoples, including assurance of food sovereignty, with access to lands and resources, for acquiring traditional/country foods, as well as improved access to more affordable and healthy store-bought/market foods in First Nation reserves and northern and remote communities. Commitment to mandatory, annual monitoring and reporting of the prevalence of marginal, moderate and severe household food insecurity in each province and territory across Canada, including among vulnerable populations, as well as regular evaluation of the impact of poverty reduction and protocols for

Proteome labelling and protein identification in specific tissues and at specific developmental stages in an animal

PubMed Central

Elliott, Thomas S.; Townsley, Fiona M.; Bianco, Ambra; Ernst, Russell J.; Sachdeva, Amit; Elsässer, Simon J.; Davis, Lloyd; Lang, Kathrin; Pisa, Rudolf; Greiss, Sebastian.; Lilley, Kathryn S.; Chin, Jason W.

2014-01-01

Identifying the proteins synthesized in defined cells at specific times in an animal will facilitate the study of cellular functions and dynamic processes. Here we introduce stochastic orthogonal recoding of translation with chemoselective modification (SORT-M) to address this challenge. SORT-M involves modifying cells to express an orthogonal aminoacyl-tRNA synthetase/tRNA pair to enable the incorporation of chemically modifiable analogs of amino acids at diverse sense codons in cells in rich media. We apply SORT-M to Drosophila melanogaster fed standard food to label and image proteins in specific tissues at precise developmental stages with diverse chemistries, including cyclopropene-tetrazine inverse electron demand Diels-Alder cycloaddition reactions. We also use SORT-M to identify proteins synthesized in germ cells of the fly ovary without dissection. SORT-M will facilitate the definition of proteins synthesized in specific sets of cells to study development, and learning and memory in flies, and may be extended to other animals. PMID:24727715

A Model Driven Framework to Address Challenges in a Mobile Learning Environment

ERIC Educational Resources Information Center

Khaddage, Ferial; Christensen, Rhonda; Lai, Wing; Knezek, Gerald; Norris, Cathie; Soloway, Elliot

2015-01-01

In this paper a review of the pedagogical, technological, policy and research challenges and concepts underlying mobile learning is presented, followed by a brief description of categories of implementations. A model Mobile learning framework and dynamic criteria for mobile learning implementations are proposed, along with a case study of one site…

Therapeutic Self-Disclosure within DBT, Schema Therapy, and CBASP: Opportunities and Challenges.

PubMed

Köhler, Stephan; Guhn, Anne; Betzler, Felix; Stiglmayr, Christian; Brakemeier, Eva-Lotta; Sterzer, Philipp

2017-01-01

In recent years, various therapeutic interventions have been established that extended behavior and cognitive behavior therapy (CBT) by so-called "third-wave" strategies. In order to address specific therapeutic challenges in certain subgroups of patients who do not sufficiently respond to "classical CBT," some of these third-wave strategies put particular emphasis on therapist self-disclosure. This article highlights therapeutic self-disclosure as a means to address interpersonal problems by comparing three third-wave strategies: (a) acceptance and change strategies as used in Dialectical Behavioral Therapy (DBT), (b) the concept of "limited reparenting" as used in Schema Therapy (ST), and (c) disciplined personal involvement as used in the Cognitive Behavioral Analysis System of Psychotherapy (CBASP). On the basis of a critical discussion on opportunities and challenges within these three concepts, self-disclosure is proposed to be a promising therapeutic tool that is worth to be investigated in more depth in future studies.

Therapeutic Self-Disclosure within DBT, Schema Therapy, and CBASP: Opportunities and Challenges

PubMed Central

Köhler, Stephan; Guhn, Anne; Betzler, Felix; Stiglmayr, Christian; Brakemeier, Eva-Lotta; Sterzer, Philipp

2017-01-01

In recent years, various therapeutic interventions have been established that extended behavior and cognitive behavior therapy (CBT) by so-called “third-wave” strategies. In order to address specific therapeutic challenges in certain subgroups of patients who do not sufficiently respond to “classical CBT,” some of these third-wave strategies put particular emphasis on therapist self-disclosure. This article highlights therapeutic self-disclosure as a means to address interpersonal problems by comparing three third-wave strategies: (a) acceptance and change strategies as used in Dialectical Behavioral Therapy (DBT), (b) the concept of “limited reparenting” as used in Schema Therapy (ST), and (c) disciplined personal involvement as used in the Cognitive Behavioral Analysis System of Psychotherapy (CBASP). On the basis of a critical discussion on opportunities and challenges within these three concepts, self-disclosure is proposed to be a promising therapeutic tool that is worth to be investigated in more depth in future studies. PMID:29238317

Student Leadership: Challenges and Possibilities

ERIC Educational Resources Information Center

Nel, Willy

2016-01-01

In my attempt to adhere to the request that I provide an interpretation of the theme for the session, "Critical Engagement, Innovation and Inclusivity", and cognisant of the primary audience, I weave student leadership responsibilities, challenges and possibilities into the address. Events since the plenary address have however…

Addressable-Matrix Integrated-Circuit Test Structure

NASA Technical Reports Server (NTRS)

Sayah, Hoshyar R.; Buehler, Martin G.

1991-01-01

Method of quality control based on use of row- and column-addressable test structure speeds collection of data on widths of resistor lines and coverage of steps in integrated circuits. By use of straightforward mathematical model, line widths and step coverages deduced from measurements of electrical resistances in each of various combinations of lines, steps, and bridges addressable in test structure. Intended for use in evaluating processes and equipment used in manufacture of application-specific integrated circuits.

Stream specificity and asymmetries in feature binding and content-addressable access in visual encoding and memory.

PubMed

Huynh, Duong L; Tripathy, Srimant P; Bedell, Harold E; Ögmen, Haluk

2015-01-01

Human memory is content addressable-i.e., contents of the memory can be accessed using partial information about the bound features of a stored item. In this study, we used a cross-feature cuing technique to examine how the human visual system encodes, binds, and retains information about multiple stimulus features within a set of moving objects. We sought to characterize the roles of three different features (position, color, and direction of motion, the latter two of which are processed preferentially within the ventral and dorsal visual streams, respectively) in the construction and maintenance of object representations. We investigated the extent to which these features are bound together across the following processing stages: during stimulus encoding, sensory (iconic) memory, and visual short-term memory. Whereas all features examined here can serve as cues for addressing content, their effectiveness shows asymmetries and varies according to cue-report pairings and the stage of information processing and storage. Position-based indexing theories predict that position should be more effective as a cue compared to other features. While we found a privileged role for position as a cue at the stimulus-encoding stage, position was not the privileged cue at the sensory and visual short-term memory stages. Instead, the pattern that emerged from our findings is one that mirrors the parallel processing streams in the visual system. This stream-specific binding and cuing effectiveness manifests itself in all three stages of information processing examined here. Finally, we find that the Leaky Flask model proposed in our previous study is applicable to all three features.

The Impact of Hurricanes Katrina and Rita on People with Disabilities: A Look Back and Remaining Challenges

ERIC Educational Resources Information Center

Powell, Robyn; Gilbert, Sheldon

2006-01-01

This paper focuses on the effects of the hurricanes on people with all types of disabilities. The National Council on Disability (NCD) released another report that addressed in detail the specific challenges for people with psychiatric disabilities. Please refer to "The Needs of People with Psychiatric Disabilities During and After Hurricanes…

Green ergonomics: challenges and opportunities.

PubMed

Hanson, Margaret A

2013-01-01

Addressing the causes and consequences of environmental degradation presents significant challenges for humankind. This paper considers what ergonomics/human factors (E/HF) professionals can contribute to understanding and tackling some of the issues that arise through the movement towards a more environmentally sustainable economy. These issues are considered in relation to work in green industries (specifically, sustainable energy production, recycling and organic food production), and there is a need to ensure that these jobs are safe and healthy; the design of products and systems that are 'environmentally friendly' to facilitate their acceptability and use and how E/HF professionals can contribute to understanding and promoting behavioural change relating to environmental choices. The activities of some international organisations in this area are identified and the potential for E/HF involvement is considered. The implications for the E/HF profession are discussed. This paper considers how ergonomics/human factors professionals can contribute to the movement towards more sustainable and 'environmentally friendly' design and work. Potential challenges and opportunities are discussed in relation to jobs in green industries, products and systems and behaviour change.

Transsphenoidal surgery in patients with acromegaly: operative strategies for overcoming technically challenging anatomical variations.

PubMed

Zada, Gabriel; Cavallo, Luigi M; Esposito, Felice; Fernandez-Jimenez, Julio Cesar; Tasiou, Anastasia; De Angelis, Michelangelo; Cafiero, Tullio; Cappabianca, Paolo; Laws, Edward R

2010-10-01

, distinct patterns of tumor extension and bony invasion, and anatomical variations in the caliber and course of the internal carotid artery. Specific operative techniques for addressing each of these intraoperative challenges are discussed. Transsphenoidal surgery in patients with longstanding acromegaly frequently poses greater challenges than operations for other types of sellar lesions, yet these challenges may be safely and effectively overcome with the anticipation of specific issues and implementation of various intraoperative techniques.

Challenges in Fingertip Replantation

PubMed Central

Kim, Jin-Soo; Yang, Jae-Won; Lee, Dong-Chul; Ki, Sae-Hwi; Roh, Si-Young

2013-01-01

Fingertip amputation is a challenging injury to manage. Among various reconstructive procedures, replantation results in superior outcome, but is seldom considered in many institutions. From the identification of vessel ends to reanastomosis of the submillimeter vessels, fingertip's highly specialized anatomy requires technical excellence. By addressing these anatomic challenges, fingertip replantation can be a routine reconstructive option for microvascular surgeons. PMID:24872765

Addressing Challenges to Enhance the Bioactives of Withania somnifera through Organ, Tissue, and Cell Culture Based Approaches

PubMed Central

Singh, Pritika; Guleri, Rupam; Angurala, Amrita; Kaur, Kuldeep; Kaur, Kulwinder; Kaul, Sunil C.; Wadhwa, Renu

2017-01-01

Withania somnifera is a highly valued medicinal plant in traditional home medicine and is known for a wide range of bioactivities. Its commercial cultivation is adversely affected by poor seed viability and germination. Infestation by various pests and pathogens, survival under unfavourable environmental conditions, narrow genetic base, and meager information regarding biosynthesis of secondary metabolites are some of the other existing challenges in the crop. Biotechnological interventions through organ, tissue, and cell culture provide promising options for addressing some of these issues. In vitro propagation facilitates conservation and sustainable utilization of the existing germplasms and broadening the genetic base. It would also provide means for efficient and rapid mass propagation of elite chemotypes and generating uniform plant material round the year for experimentation and industrial applications. The potential of in vitro cell/organ cultures for the production of therapeutically valuable compounds and their large-scale production in bioreactors has received significant attention in recent years. In vitro culture system further provides distinct advantage for studying various cellular and molecular processes leading to secondary metabolite accumulation and their regulation. Engineering plants through genetic transformation and development of hairy root culture system are powerful strategies for modulation of secondary metabolites. The present review highlights the developments and sketches current scenario in this field. PMID:28299323

Strengthening health information systems to address health equity challenges.

PubMed Central

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

2005-01-01

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

To What Extent Is Criminal Justice Content Specifically Addressed in MSW Programs?

ERIC Educational Resources Information Center

Epperson, Matthew W.; Roberts, Leslie E.; Ivanoff, Andre; Tripodi, Stephen J.; Gilmer, Christy N.

2013-01-01

This study examined the extent to which criminal justice content is addressed in all CSWE-accredited MSW programs in the United States ("N"?=?192). Criminal justice content was measured in three areas: (1) dual or joint degree programs, (2) concentrations or specializations, and (3) coursework. Excluding social work and law classes, 22%…

Blood-Injection-Injury (B-I-I) Specific Phobia Affects the Outcome of Hypoxic Challenge Testing.

PubMed

Spurling, Kristofer J; McGoldrick, Veronica P

2017-05-01

Blood-injection-injury (B-I-I) phobia is capable of producing inaccurate hypoxic challenge testing results due to anxiety-induced hyperventilation. A 69-yr-old woman with a history of hypersensitivity pneumonitis, restrictive spirometry, exercise desaturation requiring supplementary oxygen on mobilizing, reduced DLco, and B-I-I phobia was referred for hypoxic challenge testing (HCT) to assess in-flight oxygen requirements. HCT was performed by breathing a 15% FIo2 gas mixture, simulating the available oxygen in ambient air onboard aircraft pressurized to an equivalent altitude of 8000 ft. Spo2 fell to a nadir value of 81% during HCT, although it rapidly increased to 89% during the first of two attempts at blood gas sampling. A resultant blood gas sample showed an acceptable Po2 outside the criteria for recommending in-flight oxygen and a reduced Pco2. Entering the nadir Spo2 value into the Severinghaus equation gives an estimated arterial Po2 of 6 kPa (45 mmHg), which was felt to be more representative of resting values during HCT, and in-flight oxygen was recommended. While hyperventilation is an expected response to hypoxia, transient rises in Spo2 coinciding with threat of injury are likely to be attributable to emotional stress-induced hyperventilation, characteristic of B-I-I specific phobia and expected during the anticipation of exteroceptive threat, even in normal subjects. In summary, should excessive hyperventilation be detected during HCT and coincide with transient increases in Spo2, HCT should be repeated using Spo2 only as a guide to the level of hypoxemia, and Spo2 maintained using supplementary oxygen in accordance with alternative methods described in guidelines.Spurling KJ, McGoldrick VP. Blood-injection-injury (B-I-I) specific phobia affects the outcome of hypoxic challenge testing. Aerosp Med Hum Perform. 2017; 88(5):503-506.

Addressing governance challenges in the provision of animal health services: A review of the literature and empirical application transaction cost theory.

PubMed

Ilukor, John; Birner, Regina; Nielsen, Thea

2015-11-01

Providing adequate animal health services to smallholder farmers in developing countries has remained a challenge, in spite of various reform efforts during the past decades. The focuses of the past reforms were on market failures to decide what the public sector, the private sector, and the "third sector" (the community-based sector) should do with regard to providing animal health services. However, such frameworks have paid limited attention to the governance challenges inherent in the provision of animal health services. This paper presents a framework for analyzing institutional arrangements for providing animal health services that focus not only on market failures, but also on governance challenges, such as elite capture, and absenteeism of staff. As an analytical basis, Williamson's discriminating alignment hypothesis is applied to assess the cost-effectiveness of different institutional arrangements for animal health services in view of both market failures and governance challenges. This framework is used to generate testable hypotheses on the appropriateness of different institutional arrangements for providing animal health services, depending on context-specific circumstances. Data from Uganda and Kenya on clinical veterinary services is used to provide an empirical test of these hypotheses and to demonstrate application of Williamson's transaction cost theory to veterinary service delivery. The paper concludes that strong public sector involvement, especially in building and strengthening a synergistic relation-based referral arrangement between paraprofessionals and veterinarians is imperative in improving animal health service delivery in developing countries. Copyright © 2015 Elsevier B.V. All rights reserved.

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

ERIC Educational Resources Information Center

Nelson, Tenneisha; Squires, Vicki

2017-01-01

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

Addressing the challenges of standalone multi-core simulations in molecular dynamics

NASA Astrophysics Data System (ADS)

Ocaya, R. O.; Terblans, J. J.

2017-07-01

Computational modelling in material science involves mathematical abstractions of force fields between particles with the aim to postulate, develop and understand materials by simulation. The aggregated pairwise interactions of the material's particles lead to a deduction of its macroscopic behaviours. For practically meaningful macroscopic scales, a large amount of data are generated, leading to vast execution times. Simulation times of hours, days or weeks for moderately sized problems are not uncommon. The reduction of simulation times, improved result accuracy and the associated software and hardware engineering challenges are the main motivations for many of the ongoing researches in the computational sciences. This contribution is concerned mainly with simulations that can be done on a "standalone" computer based on Message Passing Interfaces (MPI), parallel code running on hardware platforms with wide specifications, such as single/multi- processor, multi-core machines with minimal reconfiguration for upward scaling of computational power. The widely available, documented and standardized MPI library provides this functionality through the MPI_Comm_size (), MPI_Comm_rank () and MPI_Reduce () functions. A survey of the literature shows that relatively little is written with respect to the efficient extraction of the inherent computational power in a cluster. In this work, we discuss the main avenues available to tap into this extra power without compromising computational accuracy. We also present methods to overcome the high inertia encountered in single-node-based computational molecular dynamics. We begin by surveying the current state of the art and discuss what it takes to achieve parallelism, efficiency and enhanced computational accuracy through program threads and message passing interfaces. Several code illustrations are given. The pros and cons of writing raw code as opposed to using heuristic, third-party code are also discussed. The growing trend

Females have stronger neurogenic response than males after non-specific nasal challenge in patients with seasonal allergic rhinitis.

PubMed

Tomljenovic, Dejan; Baudoin, Tomislav; Megla, Zeljka Bukovec; Geber, Goran; Scadding, Glenis; Kalogjera, Livije

2018-07-01

Epidemiological studies show female predominance in the prevalence of non- allergic rhinitis (NAR) and local allergic rhinitis (LAR). Experimental studies show female patients with allergic rhinitis (AR) demonstrate higher levels of sensitivity to irritants and airway hyperresponsiveness than males. Bronchial asthma shows female predominance in post-puberty patients, and gender interaction with severe asthma endotypes. Fibromyalgia, chronic fatigue syndrome, migraine and chronic cough, syndromes, which are commonly related to neurokinin substance P (SP) in the literature, also show strong female predominance. Studies have demonstrated that sex hormones, primarily oestrogens, affect mast cell activation. Mast cell proteases can amplify neurogenic inflammatory responses including the release of SP. Based on human epidemiological data and animal experimental data we hypothesized that female patients have different interaction between mast cell activation and neurogenic inflammation, i.e. substance P release, resulting in a different nasal symptom profile. To test the hypothesis we performed allergen and non-specific nasal challenges in patients with seasonal allergic rhinitis (SAR) out of season and looked for gender differences in subjective and objective responses. The interaction between subjective and objective reactivity was evaluated through the comparison of subjective symptom scores, concentrations of neurokinin substance P (SP) and cellular markers in nasal lavages after low doses of nasal allergen challenges. Female allergic subjects tended to have higher substance P (SP) concentrations both before and after non-specific challenges. The difference between post-allergen and post - hypertonic saline (HTS) challenge was highly significant in female patients (p = 0.001), while insignificant in male subjects (p = 0.14). Female patients had significantly stronger burning sensation after HTS challenge than male. These data indicate difference in the

Family Connections: Addressing Behavior Issues--Practical Tips for Parents

ERIC Educational Resources Information Center

LaCaze, Donna; Kirylo, James D.

2012-01-01

When parents get together, the subject of appropriately addressing the behavior of their children often comes to the forefront of conversations. Parents share various challenges they face with their children, including issues associated with listening, eating vegetables, doing chores, and a host of other discipline-related situations. The plethora…

Addressing Methodological Challenges in Large Communication Data Sets: Collecting and Coding Longitudinal Interactions in Home Hospice Cancer Care.

PubMed

Reblin, Maija; Clayton, Margaret F; John, Kevin K; Ellington, Lee

2016-07-01

In this article, we present strategies for collecting and coding a large longitudinal communication data set collected across multiple sites, consisting of more than 2000 hours of digital audio recordings from approximately 300 families. We describe our methods within the context of implementing a large-scale study of communication during cancer home hospice nurse visits, but this procedure could be adapted to communication data sets across a wide variety of settings. This research is the first study designed to capture home hospice nurse-caregiver communication, a highly understudied location and type of communication event. We present a detailed example protocol encompassing data collection in the home environment, large-scale, multisite secure data management, the development of theoretically-based communication coding, and strategies for preventing coder drift and ensuring reliability of analyses. Although each of these challenges has the potential to undermine the utility of the data, reliability between coders is often the only issue consistently reported and addressed in the literature. Overall, our approach demonstrates rigor and provides a "how-to" example for managing large, digitally recorded data sets from collection through analysis. These strategies can inform other large-scale health communication research.

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

NASA Astrophysics Data System (ADS)

Buttery, Richard

2013-08-01

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

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.

Summoning compassion to address the challenges of conservation.

PubMed

Wallach, Arian D; Bekoff, Marc; Batavia, Chelsea; Nelson, Michael P; Ramp, Daniel

2018-04-27

Conservation practice is informed by science, but also reflects ethical beliefs about how we ought to value and interact with the Earth's biota. As human activities continue to drive extinctions and diminish critical life-sustaining ecosystem processes, achieving conservation goals becomes increasingly urgent. In our determination to react decisively, conservation challenges can be handled without due deliberation, particularly when wildlife individuals are sacrificed "for the greater good" of wildlife collectives (populations, species, ecosystems). With growing recognition of the widespread sentience and sapience of many nonhuman animals, standard conservation practices that categorically prioritize collectives without due consideration for the wellbeing of individuals are ethically untenable. Here we highlight three overarching ethical orientations characterizing current and historical practices in conservation that suppress compassion: instrumentalism, collectivism, and nativism. We illustrate how establishing a commitment to compassion could re-orient conservation in more ethically expansive directions, which incorporate recognition of the intrinsic value of wildlife, the sentience of nonhuman animals, and the values of novel ecosystems, introduced species and their members. A compassionate conservation approach allays practices that intentionally and unnecessarily harm wildlife individuals, while aligning with critical conservation goals. Although the urgency of achieving effective outcomes for solving major conservation problems may enhance the appeal of quick and harsh measures, the costs are too high. Continuing to justify moral indifference when causing the suffering of wildlife individuals, particularly those who possess sophisticated capacities for emotion, consciousness, and sociality, risks estranging conservation practice from prevailing, and appropriate, social values. As conservationists and compassionate beings, we must demonstrate concern for both

The (Im)possibility of the Project: Radford Address

ERIC Educational Resources Information Center

Green, Bill

2010-01-01

In this address, the author engages both with the possibility "and" the impossibility of the educational project--and suggests something of what it means to say this. His presentation is specifically addressed to the theme of the (im)possibility of the educational project. He draws from philosophy, literature, psychoanalysis and history,…

Teaching Climate Change to Future Teachers Using 'Real' Data: Challenges and Opportunities (Invited)

NASA Astrophysics Data System (ADS)

Petcovic, H. L.; Barone, S.; Fulford, J.

2013-12-01

A climate-literate public is essential to resolving pressing problems related to global change. Future elementary teachers are a critical audience in climate and climate change education, as they will introduce children in early grades (USA grades K-8, children ages 5-14) to fundamentals of the climate system, natural and anthropogenic drivers of climate change, and impacts of global change on human and natural systems. Here we describe challenges we have encountered in teaching topics of the carbon cycle, greenhouse gases, past climate, recent anthropogenic change, and carbon footprints to future elementary teachers. We also describe how we have met (to varying degrees of success) these challenges in an introductory earth science course that is specifically designed for this audience. Two prominent challenges we have encountered are: the complex nature of the scientific content of climate change, and robust misconceptions held by our students about these topics. To address the first challenge, we attempt to adjust the scientific content to a level appropriate for future K-8 teachers, without sacrificing too much accuracy or critical detail. To address the second challenge, we explicitly discuss alternate conceptions of each topic. The use of authentic data sets can also address both of these challenges. Yet incorporating 'real' climate and paleoclimate data into the classroom poses still an additional challenge of instructional design. We use a variety of teaching approaches in our laboratory-based course including student-designed experiments, computer simulations, physical models, and authentic data sets. We have found that students strongly prefer the physical models and experiments, because these are 'hands-on' and perceived as easily adaptable to the K-8 classroom. Students often express dislike for activities that use authentic data sets (for example, an activity using graphs of CO2 and methane concentrations in Vostok ice cores), in particular because they

The Challenge of the Deanship.

ERIC Educational Resources Information Center

Montez, Joni; Wolverton, Mimi

This paper addresses the evolution of the kinds of challenges that deans have met over time and examines perceptions of today's deans concerning their ability to deal effectively with current challenges. A sample of deans (n=695) in the colleges of education, business, liberal arts, and nursing at 360 public and private institutions was surveyed…

Challenges and limitations of patient-specific vascular phantom fabrication using 3D Polyjet printing.

PubMed

Ionita, Ciprian N; Mokin, Maxim; Varble, Nicole; Bednarek, Daniel R; Xiang, Jianping; Snyder, Kenneth V; Siddiqui, Adnan H; Levy, Elad I; Meng, Hui; Rudin, Stephen

2014-03-13

Additive manufacturing (3D printing) technology offers a great opportunity towards development of patient-specific vascular anatomic models, for medical device testing and physiological condition evaluation. However, the development process is not yet well established and there are various limitations depending on the printing materials, the technology and the printer resolution. Patient-specific neuro-vascular anatomy was acquired from computed tomography angiography and rotational digital subtraction angiography (DSA). The volumes were imported into a Vitrea 3D workstation (Vital Images Inc.) and the vascular lumen of various vessels and pathologies were segmented using a "marching cubes" algorithm. The results were exported as Stereo Lithographic (STL) files and were further processed by smoothing, trimming, and wall extrusion (to add a custom wall to the model). The models were printed using a Polyjet printer, Eden 260V (Objet-Stratasys). To verify the phantom geometry accuracy, the phantom was reimaged using rotational DSA, and the new data was compared with the initial patient data. The most challenging part of the phantom manufacturing was removal of support material. This aspect could be a serious hurdle in building very tortuous phantoms or small vessels. The accuracy of the printed models was very good: distance analysis showed average differences of 120 μm between the patient and the phantom reconstructed volume dimensions. Most errors were due to residual support material left in the lumen of the phantom. Despite the post-printing challenges experienced during the support cleaning, this technology could be a tremendous benefit to medical research such as in device development and testing.

Challenges and limitations of patient-specific vascular phantom fabrication using 3D Polyjet printing

NASA Astrophysics Data System (ADS)

Ionita, Ciprian N.; Mokin, Maxim; Varble, Nicole; Bednarek, Daniel R.; Xiang, Jianping; Snyder, Kenneth V.; Siddiqui, Adnan H.; Levy, Elad I.; Meng, Hui; Rudin, Stephen

2014-03-01

Additive manufacturing (3D printing) technology offers a great opportunity towards development of patient-specific vascular anatomic models, for medical device testing and physiological condition evaluation. However, the development process is not yet well established and there are various limitations depending on the printing materials, the technology and the printer resolution. Patient-specific neuro-vascular anatomy was acquired from computed tomography angiography and rotational digital subtraction angiography (DSA). The volumes were imported into a Vitrea 3D workstation (Vital Images Inc.) and the vascular lumen of various vessels and pathologies were segmented using a "marching cubes" algorithm. The results were exported as Stereo Lithographic (STL) files and were further processed by smoothing, trimming, and wall extrusion (to add a custom wall to the model). The models were printed using a Polyjet printer, Eden 260V (Objet-Stratasys). To verify the phantom geometry accuracy, the phantom was reimaged using rotational DSA, and the new data was compared with the initial patient data. The most challenging part of the phantom manufacturing was removal of support material. This aspect could be a serious hurdle in building very tortuous phantoms or small vessels. The accuracy of the printed models was very good: distance analysis showed average differences of 120 μm between the patient and the phantom reconstructed volume dimensions. Most errors were due to residual support material left in the lumen of the phantom. Despite the post-printing challenges experienced during the support cleaning, this technology could be a tremendous benefit to medical research such as in device development and testing.

Back to the basics: Identifying and addressing underlying challenges in achieving high quality and relevant health statistics for indigenous populations in Canada

PubMed Central

Smylie, Janet; Firestone, Michelle

2015-01-01

Canada is known internationally for excellence in both the quality and public policy relevance of its health and social statistics. There is a double standard however with respect to the relevance and quality of statistics for Indigenous populations in Canada. Indigenous specific health and social statistics gathering is informed by unique ethical, rights-based, policy and practice imperatives regarding the need for Indigenous participation and leadership in Indigenous data processes throughout the spectrum of indicator development, data collection, management, analysis and use. We demonstrate how current Indigenous data quality challenges including misclassification errors and non-response bias systematically contribute to a significant underestimate of inequities in health determinants, health status, and health care access between Indigenous and non-Indigenous people in Canada. The major quality challenge underlying these errors and biases is the lack of Indigenous specific identifiers that are consistent and relevant in major health and social data sources. The recent removal of an Indigenous identity question from the Canadian census has resulted in further deterioration of an already suboptimal system. A revision of core health data sources to include relevant, consistent, and inclusive Indigenous self-identification is urgently required. These changes need to be carried out in partnership with Indigenous peoples and their representative and governing organizations. PMID:26793283

Negative specific heat of black-holes from fluid-gravity correspondence

NASA Astrophysics Data System (ADS)

Bhattacharya, Swastik; Shankaranarayanan, S.

2017-04-01

Black holes in asymptotically flat space-times have negative specific heat—they get hotter as they loose energy. A clear statistical mechanical understanding of this has remained a challenge. In this work, we address this issue using fluid-gravity correspondence which aims to associate fluid degrees of freedom to the horizon. Using linear response theory and the teleological nature of event horizon, we show explicitly that the fluctuations of the horizon-fluid lead to negative specific heat for a Schwarzschild black Hole. We also point out how the specific heat can be positive for Kerr-Newman or AdS black holes. Our approach constitutes an important advance as it allows us to apply the canonical ensemble approach to study thermodynamics of asymptotically flat black hole space-times.

What do we know about the needs and challenges of health systems? A scoping review of the international literature.

PubMed

Roncarolo, Federico; Boivin, Antoine; Denis, Jean-Louis; Hébert, Rejean; Lehoux, Pascale

2017-09-08

While there is an extensive literature on Health System (HS) strengthening and on the performance of specific HSs, there are few exhaustive syntheses of the challenges HSs are facing worldwide. This paper reports the findings of a scoping review aiming to classify the challenges of HSs investigated in the scientific literature. Specifically, it determines the kind of research conducted on HS challenges, where it was performed, in which health sectors and on which populations. It also identifies the types of challenge described the most and how they varied across countries. We searched 8 databases to identify scientific papers published in English, French and Italian between January 2000 and April 2016 that addressed HS needs and challenges. The challenges reported in the articles were classified using van Olmen et al.'s dynamic HS framework. Countries were classified using the Human Development Index (HDI). Our analyses relied on descriptive statistics and qualitative content analysis. 292 articles were included in our scoping review. 33.6% of these articles were empirical studies and 60.1% were specific to countries falling within the very high HDI category, in particular the United States. The most frequently researched sectors were mental health (41%), infectious diseases (12%) and primary care (11%). The most frequently studied target populations included elderly people (23%), people living in remote or poor areas (21%), visible or ethnic minorities (15%), and children and adolescents (15%). The most frequently reported challenges related to human resources (22%), leadership and governance (21%) and health service delivery (24%). While health service delivery challenges were more often examined in countries within the very high HDI category, human resources challenges attracted more attention within the low HDI category. This scoping review provides a quantitative description of the available evidence on HS challenges and a qualitative exploration of the

Ethical challenges in pain management post-surgery.

PubMed

Rejeh, Nahid; Ahmadi, Fazlollah; Mohamadi, Eesa; Anoosheh, Moniereh; Kazemnejad, Anooshirvan

2009-03-01

This qualitative study describes ethical challenges faced by Iranian nurses in the process of pain management in surgical units. To address this issue, semistructured interviews were conducted with 26 nurses working in surgery units in three large university hospitals in Tehran. An analysis of the transcripts revealed three main categories: institutional limitations; nurses' proximity to and involvement with pain and suffering; and nurses' fallibility. Specific themes identified within the categories were: insufficient resources, medical hierarchy; difficulties with believing patients' complaints regarding pain and suffering; and experiencing the consequences of poor judgments. Our findings lead us to conclude that, as nurses are much closer to patients' pain and suffering than other health professionals, being aware of their ethical problems, and being able to reflect on them and discuss and learn from them, will reduce the burden of the ethical challenges faced. The findings will help nurses in other countries to devise suitable ways to reduce the ethical burdens they bear in their daily practice.

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

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

Pierce, Eric M; Peterson, Mark J

Human activities have altered trace metal distributions globally. This is especially true for the trace metal mercury (Hg), a pervasive global pollutant that can be methylated to form highly toxic methylmercury (MeHg), which bioaccumulates in aquatic food webs, endangering humans and other biota. Currently there are more than 3,000 mercury-contaminated sites identified worldwide and the United Nations Environment Programme has recently highlighted the risk of this contamination to human health [1, 2]. The Oak Ridge Reservation (ORR) represents an example of one of these mercury-contaminated sites. Unlike other contaminants metals, radionuclides, and organic solvents that impact the Department of Energymore » Office of Environmental Management (DOE-EM) cleanup program at the ORR and other DOE sites, mercury has several unique characteristics that make environmental remediation of the Y-12 National Security Complex one of the most formidable challenges ever encountered. These distinctive physicochemical properties for mercury include the following: it is a liquid at ambient temperature and pressure; it is the only metal that biomagnifies; and it is the only contaminant transported as a cation, as a dissolved or gaseous elemental metal (similar to an organic solvent), or as both a cation and a dissolved or gaseous elemental metal under environmental conditions. Because of these complexities, implementing cost effective and sustainable solutions that reduce mercury flux from various primary and secondary contamination sources will require linking basic science understanding and applied research advancements into Oak Ridge Office of Environmental Management s (OREM) cleanup process. Currently, DOE is investing in mercury-related research through a variety of programs, including the Office of Science sponsored Critical Interfaces Science Focus Area, EM headquarters sponsored Applied Field Research Initiative, OREM-sponsored Lower East Fork Poplar Creek (LEFPC) Mercury

OpenTopography: Addressing Big Data Challenges Using Cloud Computing, HPC, and Data Analytics

NASA Astrophysics Data System (ADS)

Crosby, C. J.; Nandigam, V.; Phan, M.; Youn, C.; Baru, C.; Arrowsmith, R.

2014-12-01

OpenTopography (OT) is a geoinformatics-based data facility initiated in 2009 for democratizing access to high-resolution topographic data, derived products, and tools. Hosted at the San Diego Supercomputer Center (SDSC), OT utilizes cyberinfrastructure, including large-scale data management, high-performance computing, and service-oriented architectures to provide efficient Web based access to large, high-resolution topographic datasets. OT collocates data with processing tools to enable users to quickly access custom data and derived products for their application. OT's ongoing R&D efforts aim to solve emerging technical challenges associated with exponential growth in data, higher order data products, as well as user base. Optimization of data management strategies can be informed by a comprehensive set of OT user access metrics that allows us to better understand usage patterns with respect to the data. By analyzing the spatiotemporal access patterns within the datasets, we can map areas of the data archive that are highly active (hot) versus the ones that are rarely accessed (cold). This enables us to architect a tiered storage environment consisting of high performance disk storage (SSD) for the hot areas and less expensive slower disk for the cold ones, thereby optimizing price to performance. From a compute perspective, OT is looking at cloud based solutions such as the Microsoft Azure platform to handle sudden increases in load. An OT virtual machine image in Microsoft's VM Depot can be invoked and deployed quickly in response to increased system demand. OT has also integrated SDSC HPC systems like the Gordon supercomputer into our infrastructure tier to enable compute intensive workloads like parallel computation of hydrologic routing on high resolution topography. This capability also allows OT to scale to HPC resources during high loads to meet user demand and provide more efficient processing. With a growing user base and maturing scientific user

Teaching lesbian, gay, bisexual and transgender health in a South African health sciences faculty: addressing the gap.

PubMed

Müller, Alexandra

2013-12-27

People who identity as lesbian, gay, bisexual and transgender (LGBT) have specific health needs. Sexual orientation and gender identity are social determinants of health, as homophobia and heteronormativity persist as prejudices in society. LGBT patients often experience discrimination and prejudice in health care settings. While recent South African policies recognise the need for providing LGBT specific health care, no curricula for teaching about LGBT health related issues exist in South African health sciences faculties. This study aimed to determine the extent to which LGBT health related content is taught in the University of Cape Town's medical curriculum. A curriculum mapping exercise was conducted through an online survey of all academic staff at the UCT health sciences faculty, determining LGBT health related content, pedagogical methodology and assessment. 127 academics, across 31 divisions and research units in the Faculty of Health Sciences, responded to the survey, of which 93 completed the questionnaire. Ten taught some content related to LGBT health in the MBChB curriculum. No LGBT health related content was taught in the allied health sciences curricula. The MBChB curriculum provided no opportunity for students to challenge their own attitudes towards LGBT patients, and key LGBT health topics such as safer sex, mental health, substance abuse and adolescent health were not addressed. At present, UCTs health sciences curricula do not adequately address LGBT specific health issues. Where LGBT health related content is taught in the MBChB curriculum, it is largely discretionary, unsystematic and not incorporated into the overarching structure. Coordinated initiatives to integrate LGBT health related content into all health sciences curricula should be supported, and follow an approach that challenges students to develop professional attitudes and behaviour concerning care for patients from LGBT backgrounds, as well as providing them with specific LGBT

Teaching lesbian, gay, bisexual and transgender health in a South African health sciences faculty: addressing the gap

PubMed Central

2013-01-01

Background People who identity as lesbian, gay, bisexual and transgender (LGBT) have specific health needs. Sexual orientation and gender identity are social determinants of health, as homophobia and heteronormativity persist as prejudices in society. LGBT patients often experience discrimination and prejudice in health care settings. While recent South African policies recognise the need for providing LGBT specific health care, no curricula for teaching about LGBT health related issues exist in South African health sciences faculties. This study aimed to determine the extent to which LGBT health related content is taught in the University of Cape Town’s medical curriculum. Methods A curriculum mapping exercise was conducted through an online survey of all academic staff at the UCT health sciences faculty, determining LGBT health related content, pedagogical methodology and assessment. Results 127 academics, across 31 divisions and research units in the Faculty of Health Sciences, responded to the survey, of which 93 completed the questionnaire. Ten taught some content related to LGBT health in the MBChB curriculum. No LGBT health related content was taught in the allied health sciences curricula. The MBChB curriculum provided no opportunity for students to challenge their own attitudes towards LGBT patients, and key LGBT health topics such as safer sex, mental health, substance abuse and adolescent health were not addressed. Conclusion At present, UCTs health sciences curricula do not adequately address LGBT specific health issues. Where LGBT health related content is taught in the MBChB curriculum, it is largely discretionary, unsystematic and not incorporated into the overarching structure. Coordinated initiatives to integrate LGBT health related content into all health sciences curricula should be supported, and follow an approach that challenges students to develop professional attitudes and behaviour concerning care for patients from LGBT backgrounds, as

High-risk medical devices, children and the FDA: regulatory challenges facing pediatric mechanical circulatory support devices.

PubMed

Almond, Christopher S D; Chen, Eric A; Berman, Michael R; Less, Joanne R; Baldwin, J Timothy; Linde-Feucht, Sarah R; Hoke, Tracey R; Pearson, Gail D; Jenkins, Kathy; Duncan, Brian W; Zuckerman, Bram D

2007-01-01

Pediatric mechanical circulatory support is a critical unmet need in the United States. Infant- and child-sized ventricular assist devices are currently being developed largely through federal contracts and grants through the National Heart, Lung, and Blood Institute (NHLBI). Human testing and marketing of high-risk devices for children raises epidemiologic and regulatory issues that will need to be addressed. Leaders from the US Food and Drug Administration (FDA), NHLBI, academic pediatric community, and industry convened in January 2006 for the first FDA Workshop on the Regulatory Process for Pediatric Mechanical Circulatory Support Devices. The purpose was to provide the pediatric community with an overview of the federal regulatory process for high-risk medical devices and to review the challenges specific to the development and regulation of pediatric mechanical circulatory support devices. Pediatric mechanical circulatory support present significant epidemiologic, logistic, and financial challenges to industry, federal regulators, and the pediatric community. Early interactions with the FDA, shared appreciation of challenges, and careful planning will be critical to avoid unnecessary delays in making potentially life-saving devices available for children. Collaborative efforts to address these challenges are warranted.

Cell and Gene Therapies: European View on Challenges in Translation and How to Address Them

PubMed Central

Rousseau, Cécile F.; Mačiulaitis, Romaldas; Śladowski, Dariusz; Narayanan, Gopalan

2018-01-01

Advanced therapy medicinal products (ATMPs), i.e., cell and gene therapy products, is a rapidly evolving field of therapeutic development. A significant proportion of the products are being developed by academia or small/medium-sized enterprises (SMEs). The many challenges in translation posed by this class of products include aspects covering: manufacturing, non-clinical development plan as relevant to clinical trial, marketing authorization, and reimbursement. In this context, the term translation refers to the relevance of non-clinical data in relation to how it impacts on appropriate and efficient clinical development. In order to successfully overcome these challenges, a clear understanding of the requirements and expectations of all the stakeholders is critical. This article aims to cover the potential challenges related to such translation and suggested approaches to find solutions based on experience and learnings from the perspective of European Union. While commercial challenges have a significant impact on the ATMPs in general, it is considered outside the scope of this article. However, by adopting a strong scientific basis for translation as suggested in this article, it is likely such an approach would help rather than harm successful real world clinical use of ATMPs.

Influenza Vaccines: Challenges and Solutions

PubMed Central

Houser, Katherine; Subbarao, Kanta

2015-01-01

Vaccination is the best method for the prevention and control of influenza. Vaccination can reduce illness and lessen severity of infection. This review focuses on how currently licensed influenza vaccines are generated in the U.S., why the biology of influenza poses vaccine challenges, and vaccine approaches on the horizon that address these challenges. PMID:25766291

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

NASA Technical Reports Server (NTRS)

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

2011-01-01

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

Addressing Health Disparities through Multi-institutional, Multidisciplinary Collaboratories

PubMed Central

Fleming, Erik S.; Perkins, James; Easa, David; Conde, José G.; Baker, Richard S.; Southerland, William M.; Dottin, Robert; Benabe, Julio E.; Ofili, Elizabeth O.; Bond, Vincent C.; McClure, Shelia A.; Sayre, Michael H.; Beanan, Maureen J.; Norris, Keith C.

2009-01-01

The national research leadership has recently become aware of the tremendous potential of translational research as an approach to address health disparities. The Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) is a research network that supports multi-institutional, multidisciplinary collaboration with a focus on key diseases and conditions for which disproportionately adverse racial and ethnic health disparities exist. The RTRN is designed to facilitate the movement of scientific advances across the translational research spectrum by providing researchers at different institutions with the infrastructure and tools necessary to collaborate on interdisciplinary and transdisciplinary research projects relating to specific health outcomes for which major racial/ethnic disparities exist. In the past, the difficulty of overcoming the restrictions imposed by time and space have made it difficult to carry out this type of large-scale, multilevel collaboration efficiently. To address this formidable challenge, the RTRN will deploy a translational research cluster system that uses “cyber workspaces” to bring researchers with similar interests together by using online collaboratory technology. These virtual meeting environments will provide a number of tools, including videoconferences (seminars, works in progress, meetings); project management tools (WebCT, Microsoft Share Point); and posting areas for projects, concepts, and other research and educational activities. This technology will help enhance access to resources across institutions with a common mission, minimize many of the logistical hurdles that impede intellectual exchange, streamline the planning and implementation of innovative interdisciplinary research, and assess the use of protocols and practices to assist researchers in interacting across and within cyber workspaces. PMID:18646341

Addressing health disparities through multi-institutional, multidisciplinary collaboratories.

PubMed

Fleming, Erik S; Perkins, James; Easa, David; Conde, José G; Baker, Richard S; Southerland, William M; Dottin, Robert; Benabe, Julio E; Ofili, Elizabeth O; Bond, Vincent C; McClure, Shelia A; Sayre, Michael H; Beanan, Maureen J; Norris, Keith C

2008-01-01

The national research leadership has recently become aware of the tremendous potential of translational research as an approach to address health disparities. The Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) is a research network that supports multi-institutional, multidisciplinary collaboration with a focus on key diseases and conditions for which disproportionately adverse racial and ethnic health disparities exist. The RTRN is designed to facilitate the movement of scientific advances across the translational research spectrum by providing researchers at different institutions with the infrastructure and tools necessary to collaborate on interdisciplinary and transdisciplinary research projects relating to specific health outcomes for which major racial/ethnic disparities exist. In the past, the difficulty of overcoming the restrictions imposed by time and space have made it difficult to carry out this type of large-scale, multilevel collaboration efficiently. To address this formidable challenge, the RTRN will deploy a translational research cluster system that uses "cyber workspaces" to bring researchers with similar interests together by using online collaboratory technology. These virtual meeting environments will provide a number of tools, including videoconferences (seminars, works in progress, meetings); project management tools (WebCT, Microsoft Share Point); and posting areas for projects, concepts, and other research and educational activities. This technology will help enhance access to resources across institutions with a common mission, minimize many of the logistical hurdles that impede intellectual exchange, streamline the planning and implementation of innovative interdisciplinary research, and assess the use of protocols and practices to assist researchers in interacting across and within cyber workspaces.

Military Cooperation Frameworks: Effective Models to Address Transnational Security Challenges of the Asia-Pacific Region

DTIC Science & Technology

2011-05-04

evolving security challenges. Issues such as terrorism, proliferation of weapons of mass destruction, impacts of climate change , and the ever...impacts of climate change , and the ever-growing competition for valuable natural resources are a few of the these challenges. As an integral part...destruction, impacts of climate change , and the ever-growing competition for valuable natural resources have resulted in a new set of security

Rare cancers: Challenges & issues.

PubMed

Pillai, Raveendran K; Jayasree, K

2017-01-01

Rare cancers account for about 22 per cent of all cancers diagnosed worldwide, disproportionately affecting some demographic groups, with an occurrence of less than 6 per 100,000 individuals annually. Many rare cancers in adults, adolescents and children are not curable, and patients and care providers have little option to take therapeutic decisions. The epidemiology of rare cancers is a challenging area of study but is inadequately addressed. Despite efforts mainly in some European nations, a few improvements have been observed in the management of rare cancers. Reasons for this obvious stagnation are multifactorial and are mainly inherent to logistical difficulties in carrying out clinical trials in very small patient populations, hesitation of the pharmaceutical industry to spend in small markets and complexity in creating adequate information for the development of cost-effective drugs. Rare cancers also face specific challenges that include late and incorrect diagnosis, lack of clinical expertise and lack of research interest and development of new therapies. The utilization of nationally representative study findings for the patients' evaluation may possibly offer chances to find out pathogenesis and prevalence, and this will eventually lead to control and prevention. Currently, advancing targeted therapies offer a great opportunity for the better management of rare cancers. Conducting clinical trials with small patient population, innovative clinical trial approach, prevailing controlling obstacles for international cooperation and financial support for research are the present challenges for rare cancers. The International Rare Cancers Initiative functions as a main platform for achieving new international clinical trials in rare tumours. This review delineates the current challenges and issues in the interpretation, management and research scenarios of rare cancers.

Rare cancers: Challenges & issues

PubMed Central

Pillai, Raveendran K.; Jayasree, K.

2017-01-01

Rare cancers account for about 22 per cent of all cancers diagnosed worldwide, disproportionately affecting some demographic groups, with an occurrence of less than 6 per 100,000 individuals annually. Many rare cancers in adults, adolescents and children are not curable, and patients and care providers have little option to take therapeutic decisions. The epidemiology of rare cancers is a challenging area of study but is inadequately addressed. Despite efforts mainly in some European nations, a few improvements have been observed in the management of rare cancers. Reasons for this obvious stagnation are multifactorial and are mainly inherent to logistical difficulties in carrying out clinical trials in very small patient populations, hesitation of the pharmaceutical industry to spend in small markets and complexity in creating adequate information for the development of cost-effective drugs. Rare cancers also face specific challenges that include late and incorrect diagnosis, lack of clinical expertise and lack of research interest and development of new therapies. The utilization of nationally representative study findings for the patients’ evaluation may possibly offer chances to find out pathogenesis and prevalence, and this will eventually lead to control and prevention. Currently, advancing targeted therapies offer a great opportunity for the better management of rare cancers. Conducting clinical trials with small patient population, innovative clinical trial approach, prevailing controlling obstacles for international cooperation and financial support for research are the present challenges for rare cancers. The International Rare Cancers Initiative functions as a main platform for achieving new international clinical trials in rare tumours. This review delineates the current challenges and issues in the interpretation, management and research scenarios of rare cancers. PMID:28574010

Engineering the LISA Project: Systems Engineering Challenges

NASA Technical Reports Server (NTRS)

Evans, Jordan P.

2006-01-01

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

Design and manufacturing challenges of optogenetic neural interfaces: a review

NASA Astrophysics Data System (ADS)

Goncalves, S. B.; Ribeiro, J. F.; Silva, A. F.; Costa, R. M.; Correia, J. H.

2017-08-01

Optogenetics is a relatively new technology to achieve cell-type specific neuromodulation with millisecond-scale temporal precision. Optogenetic tools are being developed to address neuroscience challenges, and to improve the knowledge about brain networks, with the ultimate aim of catalyzing new treatments for brain disorders and diseases. To reach this ambitious goal the implementation of mature and reliable engineered tools is required. The success of optogenetics relies on optical tools that can deliver light into the neural tissue. Objective/Approach: Here, the design and manufacturing approaches available to the scientific community are reviewed, and current challenges to accomplish appropriate scalable, multimodal and wireless optical devices are discussed. Significance: Overall, this review aims at presenting a helpful guidance to the engineering and design of optical microsystems for optogenetic applications.

Skin prick testing and peanut-specific IgE can predict peanut challenge outcomes in preschoolchildren with peanut sensitization.

PubMed

Johannsen, H; Nolan, R; Pascoe, E M; Cuthbert, P; Noble, V; Corderoy, T; Franzmann, A; Loh, R; Prescott, S L

2011-07-01

The rise in peanut allergy is a source of considerable burden in the community. A growing number of preschoolchildren have been identified as peanut sensitized in the course of investigation of other allergic conditions. Although many have never knowingly ingested peanuts and their clinical reactivity is not known, it has been common practice to place these children on avoidance diets for many years. To determine the utility of skin prick tests (SPT) and fluorescent-enzyme immunoassays (FEIA) for identifying either peanut allergy or tolerance in preschoolchildren with peanut sensitization. Forty-nine preschoolchildren (<5 years of age) with peanut sensitization (SPT ≥ 2 mm or peanut-specific IgE ≥ 0.35 kU/L) but unknown clinical reactivity had graded open peanut challenges reaching a total of 11 g. A positive challenge was defined as an objective IgE-mediated reaction during challenge or the 2-h observation. Forty-nine percent (24/49) of children had positive challenges. An SPT of >7 mm on the day of challenge predicted a positive challenge with a sensitivity of 83% and a negative predictive value (NPV) of 84%. An FEIA of >2.0 kU/L showed a sensitivity of 79% and an NPV of 80%. Predicting challenge outcome from a combination of SPT and FEIA (SPT >7 and/or FEIA >2 is positive) increased sensitivity to 96% and NPV to 95%. At least half of preschoolchildren with peanut sensitization and no antecedent history of peanut ingestion can tolerate peanuts. A SPT<7 mm and FEIA<2 kU/L identify children most likely to tolerate peanut, with only a 5% likelihood of failing an oral challenge. This study assists clinicians considering challenges in very young peanut-sensitized children. © 2011 Blackwell Publishing Ltd.

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…

Addressing the Creationist Challenge.

ERIC Educational Resources Information Center

Seaford, H. Wade, Jr.

1990-01-01

Describes a method of contrasting "scientific creationism" and evolution, or pseudo-science and science, that was utilized in a freshman seminar at Dickinson College. Discusses how the seminar format fostered analytical thinking, research, and writing skills. Presents responses given by creationist students after the course. (JS)

Toward a Predictive Understanding of Earth's Microbiomes to Address 21st Century Challenges.

PubMed

Blaser, Martin J; Cardon, Zoe G; Cho, Mildred K; Dangl, Jeffrey L; Donohue, Timothy J; Green, Jessica L; Knight, Rob; Maxon, Mary E; Northen, Trent R; Pollard, Katherine S; Brodie, Eoin L

2016-05-13

Microorganisms have shaped our planet and its inhabitants for over 3.5 billion years. Humankind has had a profound influence on the biosphere, manifested as global climate and land use changes, and extensive urbanization in response to a growing population. The challenges we face to supply food, energy, and clean water while maintaining and improving the health of our population and ecosystems are significant. Given the extensive influence of microorganisms across our biosphere, we propose that a coordinated, cross-disciplinary effort is required to understand, predict, and harness microbiome function. From the parallelization of gene function testing to precision manipulation of genes, communities, and model ecosystems and development of novel analytical and simulation approaches, we outline strategies to move microbiome research into an era of causality. These efforts will improve prediction of ecosystem response and enable the development of new, responsible, microbiome-based solutions to significant challenges of our time. Copyright © 2016 Blaser et al.

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

ERIC Educational Resources Information Center

Jones, Joseph R.

2015-01-01

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

Practical guidelines addressing ethical issues pertaining to the curation of human locus-specific variation databases (LSDBs)

PubMed Central

Povey, Sue; Al Aqeel, Aida I; Cambon-Thomsen, Anne; Dalgleish, Raymond; den Dunnen, Johan T; Firth, Helen V; Greenblatt, Marc S; Barash, Carol Isaacson; Parker, Michael; Patrinos, George P; Savige, Judith; Sobrido, Maria-Jesus; Winship, Ingrid; Cotton, Richard GH

2010-01-01

More than 1,000 Web-based locus-specific variation databases (LSDBs) are listed on the Website of the Human Genetic Variation Society (HGVS). These individual efforts, which often relate phenotype to genotype, are a valuable source of information for clinicians, patients, and their families, as well as for basic research. The initiators of the Human Variome Project recently recognized that having access to some of the immense resources of unpublished information already present in diagnostic laboratories would provide critical data to help manage genetic disorders. However, there are significant ethical issues involved in sharing these data worldwide. An international working group presents second-generation guidelines addressing ethical issues relating to the curation of human LSDBs that provide information via a Web-based interface. It is intended that these should help current and future curators and may also inform the future decisions of ethics committees and legislators. These guidelines have been reviewed by the Ethics Committee of the Human Genome Organization (HUGO). Hum Mutat 31:–6, 2010. © 2010 Wiley-Liss, Inc. PMID:20683926

Playing it safe: addressing the emotional and physical health of lesbian and gay pupils in the U.K.

PubMed

Warwick, I; Aggleton, P; Douglas, N

2001-02-01

Compared to young people in general, young lesbians and gay men can face specific challenges to their physical and emotional well-being. These include discrimination, victimization, homophobic bullying and an elevated suicide risk. Relative to initiatives which attempt to address bullying in general, little has been done in schools in the U.K. to address physical and verbal homophobic bullying. This paper reports on an exploratory study to examine teachers' perceptions of homophobic bullying, the responses made to this form of bullying, and the factors which impact on the provision of education and support to lesbian and gay pupils. Findings suggested that teachers were aware of homophobic bullying but were confused, unable or unwilling to address the needs of lesbian and gay pupils. Implications for policy, practice and research are discussed. While current U.K. Government policy promoting Healthy Schools and Citizenship education offers hope for the future, much remains to be done to ensure that such initiatives are inclusive of all pupils. Copyright 2001 The Association for Professionals in Services for Adolescents.

Challenges facing European agriculture and possible biotechnological solutions.

PubMed

Ricroch, Agnès; Harwood, Wendy; Svobodová, Zdeňka; Sági, László; Hundleby, Penelope; Badea, Elena Marcela; Rosca, Ioan; Cruz, Gabriela; Salema Fevereiro, Manuel Pedro; Marfà Riera, Victoria; Jansson, Stefan; Morandini, Piero; Bojinov, Bojin; Cetiner, Selim; Custers, René; Schrader, Uwe; Jacobsen, Hans-Joerg; Martin-Laffon, Jacqueline; Boisron, Audrey; Kuntz, Marcel

2016-10-01

Agriculture faces many challenges to maximize yields while it is required to operate in an environmentally sustainable manner. In the present study, we analyze the major agricultural challenges identified by European farmers (primarily related to biotic stresses) in 13 countries, namely Belgium, Bulgaria, the Czech Republic, France, Germany, Hungary, Italy, Portugal, Romania, Spain, Sweden, UK and Turkey, for nine major crops (barley, beet, grapevine, maize, oilseed rape, olive, potato, sunflower and wheat). Most biotic stresses (BSs) are related to fungi or insects, but viral diseases, bacterial diseases and even parasitic plants have an important impact on yield and harvest quality. We examine how these challenges have been addressed by public and private research sectors, using either conventional breeding, marker-assisted selection, transgenesis, cisgenesis, RNAi technology or mutagenesis. Both national surveys and scientific literature analysis followed by text mining were employed to evaluate genetic engineering (GE) and non-GE approaches. This is the first report of text mining of the scientific literature on plant breeding and agricultural biotechnology research. For the nine major crops in Europe, 128 BS challenges were identified with 40% of these addressed neither in the scientific literature nor in recent European public research programs. We found evidence that the private sector was addressing only a few of these "neglected" challenges. Consequently, there are considerable gaps between farmer's needs and current breeding and biotechnology research. We also provide evidence that the current political situation in certain European countries is an impediment to GE research in order to address these agricultural challenges in the future. This study should also contribute to the decision-making process on future pertinent international consortia to fill the identified research gaps.

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

PubMed Central

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

2016-01-01

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

Challenges in obesity research.

PubMed

Palou, Andreu; Bonet, M Luisa

2013-09-01

Obesity is the main nutritional problem and one of the most important health problems in developed societies. Central to the challenge of obesity prevention and management is a thoroughly understanding of its determinants. Multiple socio-cultural, socio-economic, behavioural and biological factors--often interrelated and many of them still unknown or poorly understood--can contribute to the establishment and perpetuation of obese phenotypes. Here, we address current research challenges regarding basic aspects of obesity and emerging science for its control, including brown adipose tissue thermogenesis and browning of white fat as possible therapeutic targets for obesity, the influence of the microbioma, and genetics, epigenetics, nutrigenomics and nutrigenetics of obesity. We also highlight hot topics in relation to food and lifestyle as determinants of obesity, including the brain mechanisms underlying environmental motivation to eat, the biological control of spontaneous physical activity, the possible role of concrete foods and food components, and the importance of early life nutrition and environment. Challenges regarding the connections of obesity with other alterations and pathologies are also briefly addressed, as well as social and economical challenges in relation to healthy food production and lifestyle for the prevention of obesity, and technological challenges in obesity research and management. The objective is to give a panoramic of advances accomplished and still ahead relevant to the different stakeholders engaged in understanding and combating obesity. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

Challenges of Working in a Multicultural Environment.

ERIC Educational Resources Information Center

Howland, Joan S.

2001-01-01

Addresses challenges faced when working in a multicultural library setting and discusses the need for library administration to create supportive environments. Highlights include fluctuating power dynamics; merging diverse opinions and approaches; overcoming perceived lack of empathy; tokenism; accountability; and transforming challenges into…

The medical leadership challenge in healthcare is an identity challenge.

PubMed

Andersson, Thomas

2015-01-01

The purpose of this article is to describe and analyse the identity challenges that physicians with medical leadership positions face. Four qualitative case studies were performed to address the fact that identity is processual, relational and situational. Physicians with managerial roles were interviewed, as well as their peers, supervisors and subordinates. Furthermore, observations were made to understand how different identities are displayed in action. This study illustrates that medical leadership implies identity struggles when physicians have manager positions, because of the different characteristics of the social identities of managers and physicians. Major differences are related between physicians as autonomous individuals in a system and managers as subordinates to the organizational system. There are psychological mechanisms that evoke the physician identity more often than the managerial identity among physicians who are managers, which explains why physicians who are managers tend to remain foremost physicians. The implications of the findings, that there are major identity challenges by being both a physician and manager, suggest that managerial physicians might not be the best prerequisite for medical leadership, but instead, cooperative relationships between physicians and non-physician managers might be a less difficult way to support medical leadership. Acknowledging and addressing identity challenges can be important both in creating structures in organizations and designing the training for managers in healthcare (both physicians and non-physicians) to support medical leadership. Medical leadership is most often related to organizational structure and/or leadership skills, but this paper discusses identity requirements and challenges related to medical leadership.

Challenging behaviors in young children: the father's role.

PubMed

Burbach, Ann D; Fox, Robert A; Nicholson, Bonnie C

2004-06-01

In this study, the authors examined the parenting practices, developmental expectations, and stress levels of 136 fathers and the challenging and prosocial behaviors of their 1- to 5-year-old children. In addition, the authors systematically addressed fathers' qualitative concerns about their parenting. The authors divided the participants into 4 groups and controlled for family socioeconomic status (SES) and the focus child's gender. Results showed a significantly higher use of corporal and verbal punishment and parenting stress among lower income fathers. Secondary analyses demonstrated a significant effect of paternal disciplinary practices that emphasized the frequent use of corporal and verbal punishment on child behavior problems, regardless of SES level. On a positive note, fathers from both lower and higher SES groups had reasonable developmental expectations for their boys and girls, and they reported similar frequencies of their children's prosocial behavior. The authors discuss the need for early parent education programs that include fathers and that teach specific strategies to address child behavior problems.

The Benefits and Challenges of Becoming Cross-Culturally Competent Counseling Psychologists. Presidential Address

ERIC Educational Resources Information Center

Heppner, P. Paul

2006-01-01

The central thesis of this article is that focusing on cross-cultural competence will enhance both the science and the practice of counseling psychology. Developing cross-cultural competence is a lifelong journey, replete with many joys and challenges, that will (a) increase the sophistication of our research, (b) expand the utility and…

ADDRESSING HUMAN EXPOSURES TO AIR POLLUTANTS AROUND BUILDINGS IN URBAN AREAS WITH COMPUTATIONAL FLUID DYNAMICS MODELS

EPA Science Inventory

This paper discusses the status and application of Computational Fluid Dynamics (CFD) models to address challenges for modeling human exposures to air pollutants around urban building microenvironments. There are challenges for more detailed understanding of air pollutant sour...

21 CFR 20.119 - Lists of names and addresses.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Lists of names and addresses. 20.119 Section 20.119 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PUBLIC INFORMATION Availability of Specific Categories of Records § 20.119 Lists of names and addresses...

ORD-State Cooperation is Essential to Help States Address Contemporary Environmental Public Health Challenges

EPA Science Inventory

Dr. Cascio’s presentation “ORD-State Cooperation is Essential to Help States Address Contemporary Environmental Public Health Challenges” at ORD’s State Coordination Team Meeting will highlight the role that ORD science and technical expertise in helping t...

Internet and mobile technologies: addressing the mental health of trauma survivors in less resourced communities.

PubMed

Ruzek, J I; Yeager, C M

2017-01-01

Internet and mobile technologies offer potentially critical ways of delivering mental health support in low-resource settings. Much evidence indicates an enormous negative impact of mental health problems in low- and middle-income countries (LMICs), and many of these problems are caused, or worsened, by exposure to wars, conflicts, natural and human-caused disasters, and other traumatic events. Though specific mental health treatments have been found to be efficacious and cost-effective for low-resource settings, most individuals living in these areas do not have access to them. Low-intensity task-sharing interventions will help, but there is a limit to the scalability and sustainability of human resources in these settings. To address the needs of trauma survivors, it will be important to develop and implement Internet and mobile technology resources to help reduce the scarcity, inequity, and inefficiency of current mental health services in LMICs. Mobile and Internet resources are experiencing a rapid growth in LMICs and can help address time, stigma, and cost barriers and connect those who have been socially isolated by traumatic events. This review discusses current research in technological interventions in low-resource settings and outlines key issues and future challenges and opportunities. Though formidable challenges exist for large-scale deployment of mobile and Internet mental health technologies, work to date indicates that these technologies are indeed feasible to develop, evaluate, and deliver to those in need of mental health services, and that they can be effective.

Solar Sail Roadmap Mission GN and C Challenges

NASA Technical Reports Server (NTRS)

Heaton, Andrew F.

2005-01-01

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

Update on infection control challenges in special pediatric populations.

PubMed

Balkhy, Hanan H; Zingg, Walter

2014-08-01

Compared with adults, neonatal and pediatric populations are especially vulnerable patients who have specific diagnostic and therapeutic differences; therefore, the standard infection control practices designed for adults are sometimes not effective or need modifications to work. This review focuses on the recent literature addressing the challenges and successes in preventing healthcare-associated infections (HAIs) in children. Improving the implementation of pediatric versions of preventive bundles focusing on proper catheter insertion and maintenance, mainly as a part of a larger multimodal strategy, is effective in reducing the central-line-associated bloodstream infections in neonatal and pediatric populations including oncology patients. Appropriate feeding, antimicrobial stewardship, and infection control measures should be combined in reducing necrotizing enterocolitis in preterm neonates. Implementing a multimodal bundle strategy adapted for pediatric population is successful in preventing ventilator-associated pneumonia. Appropriate use of antimicrobial prophylaxis remains the cornerstone for preventing surgical-site infections irrespective of age, with few additional effective adjuvant preventive practices in specific pediatric patients. Several evidence-based practices are effective in reducing the incidence and the impact of HAIs in children; however, proper implementation remains a challenge. Additionally, several adult preventive practices are still unestablished in children and need further thorough examination.

Healthcare sustainability and the challenges of innovation to biopharmaceuticals in Canada.

PubMed

Rosenberg-Yunger, Zahava R S; Daar, Abdallah S; Singer, Peter A; Martin, Douglas K

2008-09-01

Governments around the world have focused on issues of sustainability, innovations and priority setting within their health systems. Tension exists between governments' desire to increase biotechnology innovation and the need to address health system sustainability. This commentary will: (1) review government initiatives in biotechnology in health innovation; (2) discuss how innovation, specifically biopharmaceuticals, challenges health system sustainability; and (3) explore how the tension between innovation and sustainability can be addressed using fairness and legitimacy. It is evident that a uni-jurisdictional approach may not be optimal in promoting innovation while ensuring a sustainable health system. Harmonization of biotechnology policies across the federal, provincial, and territorial governments will ensure consistent policies across all branches in order to circumvent the possibility of one governmental branch refusing to reimburse the very innovations other branches are promoting.

Addressing challenges of training a new generation of clinician-innovators through an interdisciplinary medical technology design program: Bench-to-Bedside.

PubMed

Loftus, Patrick D; Elder, Craig T; D'Ambrosio, Troy; Langell, John T

2015-01-01

Graduate medical education has traditionally focused on training future physicians to be outstanding clinicians with basic and clinical science research skills. This focus has resulted in substantial knowledge gains, but a modest return on investment based on direct improvements in clinical care. In today's shifting healthcare landscape, a number of important challenges must be overcome to not only improve the delivery of healthcare, but to prepare future physicians to think outside the box, focus on and create healthcare innovations, and navigate the complex legal, business and regulatory hurdles of bringing innovation to the bedside. We created an interdisciplinary and experiential medical technology design competition to address these challenges and train medical students interested in moving new and innovative clinical solutions to the forefront of medicine. Medical students were partnered with business, law, design and engineering students to form interdisciplinary teams focused on developing solutions to unmet clinical needs. Over the course of six months teams were provided access to clinical and industry mentors, $500 prototyping funds, development facilities, and non-mandatory didactic lectures in ideation, design, intellectual property, FDA regulatory requirements, prototyping, market analysis, business plan development and capital acquisition. After four years of implementation, the program has supported 396 participants, seen the development of 91 novel medical devices, and launched the formation of 24 new companies. From our perspective, medical education programs that develop innovation training programs and shift incentives from purely traditional basic and clinical science research to also include high-risk innovation will see increased student engagement in improving healthcare delivery and an increase in the quality and quantity of innovative solutions to medical problems being brought to market.

Key challenges of offshore wind power: Three essays addressing public acceptance, stakeholder conflict, and wildlife impacts

NASA Astrophysics Data System (ADS)

Bates, Alison Waterbury

Society is facing a pressing need to reduce greenhouse gas emissions to limit anthropogenic climate change, which has far reaching implications for humans and the environment. Transforming the energy infrastructure to carbon-free sources is one solution to curb greenhouse gas emissions, but this transformation has been slow to materialize in many places, such as the United States (U.S.). Offshore wind energy is one of the most promising renewable energy sources available, which can be deployed in large-scale developments in many parts of the world. Yet, offshore wind has faced many challenges, which are more social and regulatory than technical. This dissertation addresses social and regulatory issues surrounding offshore wind development through three stand-alone essays, which, in combination, address a decision-making framework of where to locate offshore wind turbines, by minimizing effects on people and wildlife. The challenges to offshore wind that are addressed by this dissertation include (1) understanding underlying factors that drive support for or opposition to offshore wind energy; (2) conflict with existing ocean uses and users; and (3) public concern and regulatory processes related to wildlife impacts. The first paper identifies unique factors that drive public opinion of proposed offshore wind projects in nearby coastal communities. Wind energy development on land has faced local opposition for reasons such as effects on cultural landscapes and wildlife, which can be instrumental in whether or not and the speed with which a project moves ahead toward completion. Factors leading to support for, or opposition to, offshore wind energy are not well known, particularly for developments that are near-shore and in-view of coastal communities. Results are presented from a survey of 699 residents (35.5% response rate) completed in 2013 in greater Atlantic City, New Jersey and coastal Delaware, United States, where near-shore wind demonstration projects had

Traversing myths and mountains: addressing socioeconomic inequities in the promotion of nutrition and physical activity behaviours.

PubMed

Ball, Kylie

2015-11-14

In developed countries, individuals experiencing socioeconomic disadvantage - whether a low education level, low income, low-status occupation, or living in a socioeconomically disadvantaged neighbourhood - are less likely than those more advantaged to engage in eating and physical activity behaviours conducive to optimal health. These socioeconomic inequities in nutrition and physical activity (and some sedentary) behaviours are graded, persistent, and evident across multiple populations and studies. They are concerning in that they mirror socioeconomic inequities in obesity and in health outcomes. Yet there remains a dearth of evidence of the most effective means of addressing these inequities. People experiencing disadvantage face multiple challenges to healthy behaviours that can appear insurmountable. With increasing recognition of the role of underlying structural and societal factors as determinants of nutrition and physical activity behaviours and inequities in these behaviours, and the limited success of behaviour change approaches in addressing these inequities, we might wonder whether there remains a role for behavioural scientists to tackle these challenges. This debate piece argues that behavioural scientists can play an important role in addressing socioeconomic inequities in nutrition, physical activity and sedentary behaviours, and that this will involve challenging myths and taking on new perspectives. There are successful models for doing so from which we can learn. Addressing socioeconomic inequities in eating, physical activity and sedentary behaviours is challenging. However, successful examples demonstrate that overcoming such challenges is possible, and provide guidance for doing so. Given the disproportionate burden of ill health carried by people experiencing socioeconomic disadvantage, all our nutrition and physical activity interventions, programs and policies should be designed to reach and positively impact these individuals at greatest

Realizing Benefits and Overcoming Challenges of Education Programs Associated with Scientific Research Programs

NASA Astrophysics Data System (ADS)

Morrow, C. A.

2005-12-01

This paper will frame the topic of the session and report on the analysis of additional data related to an ongoing research project that specifically addresses the benefits and challenges of educational programs associated with scientific research programs. In particular, the paper will present the results of a survey of professionals who lead education and public outreach programs inside NASA space science missions and programs. This survey was done in association with the NASA Scientist Communication & Involvement Working Group (SCIWG). The results of this new survey are compared to those of a similar survey of AGU session participants and presenters that was made in the fall of 2003. The fall 2003 data showed clear indications of educational benefits that were unique to having a close association with scientific research programs. The data also showed clear challenges, many of which are being addressed via the rise of the new profession of bridge-builders who endeavor to match the resources and opportunities of the research science community to genuine educational needs.

Balancing the benefits and risks of public-private partnerships to address the global double burden of malnutrition.

PubMed

Kraak, Vivica I; Harrigan, Paige B; Lawrence, Mark; Harrison, Paul J; Jackson, Michaela A; Swinburn, Boyd

2012-03-01

Transnational food, beverage and restaurant companies, and their corporate foundations, may be potential collaborators to help address complex public health nutrition challenges. While UN system guidelines are available for private-sector engagement, non-governmental organizations (NGO) have limited guidelines to navigate diverse opportunities and challenges presented by partnering with these companies through public-private partnerships (PPP) to address the global double burden of malnutrition. We conducted a search of electronic databases, UN system websites and grey literature to identify resources about partnerships used to address the global double burden of malnutrition. A narrative summary provides a synthesis of the interdisciplinary literature identified. We describe partnership opportunities, benefits and challenges; and tools and approaches to help NGO engage with the private sector to address global public health nutrition challenges. PPP benefits include: raising the visibility of nutrition and health on policy agendas; mobilizing funds and advocating for research; strengthening food-system processes and delivery systems; facilitating technology transfer; and expanding access to medications, vaccines, healthy food and beverage products, and nutrition assistance during humanitarian crises. PPP challenges include: balancing private commercial interests with public health interests; managing conflicts of interest; ensuring that co-branded activities support healthy products and healthy eating environments; complying with ethical codes of conduct; assessing partnership compatibility; and evaluating partnership outcomes. NGO should adopt a systematic and transparent approach using available tools and processes to maximize benefits and minimize risks of partnering with transnational food, beverage and restaurant companies to effectively target the global double burden of malnutrition.

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

PubMed

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

2018-01-01

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

Integration among databases and data sets to support productive nanotechnology: Challenges and recommendations

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

Karcher, Sandra; Willighagen, Egon L.; Rumble, John

Many groups within the broad field of nanoinformatics are already developing data repositories and analytical tools driven by their individual organizational goals. Integrating these data resources across disciplines and with non-nanotechnology resources can support multiple objectives by enabling the reuse of the same information. Integration can also serve as the impetus for novel scientific discoveries by providing the framework to support deeper data analyses. This article discusses current data integration practices in nanoinformatics and in comparable mature fields, and nanotechnology-specific challenges impacting data integration. Based on results from a nanoinformatics-community-wide survey, recommendations for achieving integration of existing operational nanotechnology resourcesmore » are presented. Nanotechnology-specific data integration challenges, if effectively resolved, can foster the application and validation of nanotechnology within and across disciplines. This paper is one of a series of articles by the Nanomaterial Data Curation Initiative that address data issues such as data curation workflows, data completeness and quality, curator responsibilities, and metadata.« less

How can we exploit above–belowground interactions to assist in addressing the challenges of food security?

PubMed Central

Orrell, Peter; Bennett, Alison E.

2013-01-01

Can above–belowground interactions help address issues of food security? We address this question in this manuscript, and review the intersection of above–belowground interactions and food security. We propose that above–belowground interactions could address two strategies identified by Godfray etal. (2010): reducing the Yield Gap, and Increasing Production Limits. In particular, to minimize the difference between potential and realized production (The Yield Gap) above–belowground interactions could be manipulated to reduce losses to pests and increase crop growth (and therefore yields). To Increase Production Limits we propose two mechanisms: utilizing intercropping (which uses multiple aspects of above–belowground interactions) and breeding for traits that promote beneficial above–belowground interactions, as well as breeding mutualistic organisms to improve their provided benefit. As a result, if they are managed correctly, there is great potential for above–belowground interactions to contribute to food security. PMID:24198821

Changing roles for primary-care physicians: addressing challenges and opportunities.

PubMed

McLaughlin, C P; Kaluzny, A D; Kibbe, D C; Tredway, R

2005-01-01

Direct-to-consumer advertising is but one example of a process called disintermediation that is directly affecting primary-care physicians and their patients. This paper examines the trends and the actors involved in disintermediation, which threatens the traditional patient-physician relationship. The paper outlines the social forces behind these threats and illustrates the resulting challenges and opportunities. A rationale and strategies are presented to rebuild, maintain and strengthen the patient-physician relationship in an era of growing disintermediation and anticipated advancements in cost-effective office-based information systems. Primary care--as we know it--is under siege from a number of trends in healthcare delivery, resulting in loss of physician autonomy, disrupted continuity of care and potential erosion of professional values (Rastegar 2004; Future of Family Medicine Project Leadership Committee 2004). The halcyon days of medicine as a craft guild with a monopoly on (1) technical knowledge and (2) the means of implementation, reached its zenith in the mid-twentieth century and has been under pressure ever since (Starr 1982; Schlesinger 2002). While this is a trend within the US health system, it is likely to affect other delivery systems in the years ahead.

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).

Anticipating and addressing event-specific alcohol consumption among adolescents.

PubMed

Pettigrew, Simone; Biagioni, Nicole; Jongenelis, Michelle I

2016-07-29

Various specific events and celebrations are associated with excessive alcohol consumption and related harms. End-of-school celebrations such as Schoolies in Australia are of particular concern given high levels of documented harm among underage and young drinkers. The present study investigated high school students' expectations of their Schoolies celebrations to inform future interventions to reduce adverse outcomes among members of this vulnerable group and other young people involved in similar rites of passage. A link to an online survey was distributed via high schools and Schoolies-related websites. The survey included qualitative questions that invited respondents to discuss (i) aspects of Schoolies they were looking forward to most and least and (ii) their perceptions of the likely consequences if they refrained from consuming alcohol during the event. In total, 435 students provided responses. Respondents discussed the role of Schoolies in marking their transition to adulthood. Their comments revealed a cross-temporal focus indicating that Schoolies is simultaneously symbolic of the past, present, and future. Through its ability to enhance social interaction, alcohol was perceived to have a vital role in realising the potential of this event to signify and facilitate this temporal progression. Results suggest interventions that treat Schoolies as an isolated event that occurs in specific locations may fail to appreciate the extent to which these events transcend time for those involved. Instead, harm reduction is likely to involve a reconceptualisation of the event among both participants and authority figures to facilitate the provision of alternative pastimes to drinking during Schoolies that yield similar social benefits.

Patient specific CFD models of nasal airflow: overview of methods and challenges.

PubMed

Kim, Sung Kyun; Na, Yang; Kim, Jee-In; Chung, Seung-Kyu

2013-01-18

Respiratory physiology and pathology are strongly dependent on the airflow inside the nasal cavity. However, the nasal anatomy, which is characterized by complex airway channels and significant individual differences, is difficult to analyze. Thus, commonly adopted diagnostic tools have yielded limited success. Nevertheless, with the rapid advances in computer resources, there have been more elaborate attempts to correlate airflow characteristics in human nasal airways with the symptoms and functions of the nose by computational fluid dynamics study. Furthermore, the computed nasal geometry can be virtually modified to reflect predicted results of the proposed surgical technique. In this article, several computational fluid mechanics (CFD) issues on patient-specific three dimensional (3D) modeling of nasal cavity and clinical applications were reviewed in relation to the cases of deviated nasal septum (decision for surgery), turbinectomy, and maxillary sinus ventilation (simulated- and post-surgery). Clinical relevance of fluid mechanical parameters, such as nasal resistance, flow allocation, wall shear stress, heat/humidity/NO gas distributions, to the symptoms and surgical outcome were discussed. Absolute values of such parameters reported by many research groups were different each other due to individual difference of nasal anatomy, the methodology for 3D modeling and numerical grid, laminar/turbulent flow model in CFD code. But, the correlation of these parameters to symptoms and surgery outcome seems to be obvious in each research group with subject-specific models and its variations (virtual- and post-surgery models). For the more reliable, patient-specific, and objective tools for diagnosis and outcomes of nasal surgery by using CFD, the future challenges will be the standardizations on the methodology for creating 3D airway models and the CFD procedures. Copyright © 2012 Elsevier Ltd. All rights reserved.

Valuable yet Vulnerable-A review of the challenges encountered by older nurses in the workplace.

PubMed

Ryan, C; Bergin, M; Wells, J S

2017-07-01

As the global nursing workforce ages, developing a comprehensive understanding of the experiences, needs and values specific to older nurses is increasingly significant. This paper reviews the evidence with regard to the specific challenges encountered by older nurses in the workplace. A scoping review of the published literature was conducted using the electronic databases Medline, CINAHL, PsycINFO, Science Direct and Google Scholar. A total of 20 papers were included in this review, most of which were qualitative (n=14). Three quantitative studies were identified (including one study which combined a physical exam with survey methods) as well as three mixed method studies. The challenges faced by older nurses in their practice are synthesised across three primary domains: Nursing and the ageing body; Recognition and support of the older nurse and Demands associated with middle-age. As older nurses form a substantial proportion of the healthcare workforce in many countries, the development and implementation of strategies to address these challenges is of utmost importance. Copyright © 2017 Elsevier Ltd. All rights reserved.

Brain Metastasis: Unique Challenges and Open Opportunities

PubMed Central

Lowery, Frank J.; Yu, Dihua

2016-01-01

The metastasis of cancer to the central nervous system (CNS) remains a devastating clinical reality, carrying an estimated survival time of less than one year in spite of recent therapeutic breakthroughs for other disease contexts. Advances in brain metastasis research are hindered by a number of reasons, including its complicated nature and the difficulty of modeling metastatic cancer growth in the unique brain microenvironment. In this review, we will discuss the clinical challenge, and compare the values and limitations of the available models for brain metastasis research. Additionally, we will specifically address current knowledge on how brain metastases take advantage of the unique brain environment to benefit their own growth. Finally, we will explore the distinctive metabolic and nutrient characteristics of the brain; how these paradoxically represent barriers to establishment of brain metastasis, but also provide ample supplies for metastatic cells’ growth in the brain. We envision that multi-disciplinary innovative approaches will open opportunities for the field to make breakthroughs in tackling unique challenges of brain metastasis. PMID:27939792

Quantifying Scheduling Challenges for Exascale System Software

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

Mondragon, Oscar; Bridges, Patrick G.; Jones, Terry R

2015-01-01

The move towards high-performance computing (HPC) ap- plications comprised of coupled codes and the need to dra- matically reduce data movement is leading to a reexami- nation of time-sharing vs. space-sharing in HPC systems. In this paper, we discuss and begin to quantify the perfor- mance impact of a move away from strict space-sharing of nodes for HPC applications. Specifically, we examine the po- tential performance cost of time-sharing nodes between ap- plication components, we determine whether a simple coor- dinated scheduling mechanism can address these problems, and we research how suitable simple constraint-based opti- mization techniques are for solvingmore » scheduling challenges in this regime. Our results demonstrate that current general- purpose HPC system software scheduling and resource al- location systems are subject to significant performance de- ciencies which we quantify for six representative applica- tions. Based on these results, we discuss areas in which ad- ditional research is needed to meet the scheduling challenges of next-generation HPC systems.« less

Developing a Watershed Challenge

ERIC Educational Resources Information Center

Roman, Harry T.

2010-01-01

This article presents a watershed challenge that gives students an opportunity to investigate the challenge of using a watershed area as a site for development, examining the many aspects of this multifaceted problem. This design challenge could work well in a team-based format, with students taking on specific aspects of the challenges and…

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

PubMed

Behrens, Sue A

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

Do we need to challenge thoughts in cognitive behavior therapy?

PubMed

Longmore, Richard J; Worrell, Michael

2007-03-01

Cognitive behavior therapy (CBT) emphasizes the primacy of cognition in mediating psychological disorder. It aims to alleviate distress by modifying cognitive content and process, realigning thinking with reality. Recently, various authors have questioned the need for CBT therapists to use logico-rational strategies to directly challenge maladaptive thoughts. Hayes [Hayes, S.C. (2004). Acceptance and commitment therapy and the new behavior therapies. In S.C. Hayes, V.M. Follette, & M.M. Linehan (Eds.), Mindfulness and acceptance: Expanding the cognitive behavioral tradition. (pp. 1-29). New York: Guilford] has identified three empirical anomalies in the research literature. Firstly, treatment component analyzes have failed to show that cognitive interventions provide significant added value to the therapy. Secondly, CBT treatments have been associated with a rapid symptomatic improvement prior to the introduction of specific cognitive interventions. Thirdly, there is a paucity of data that changes in cognitive mediators instigate symptomatic change. This paper critically reviews the empirical literature that addresses these significant challenges to CBT. A comprehensive review of component studies finds little evidence that specific cognitive interventions significantly increase the effectiveness of the therapy. Although evidence for the early rapid response phenomenon is lacking, there is little empirical support for the role of cognitive change as causal in the symptomatic improvements achieved in CBT. These findings are discussed with reference to the key question: Do we need to challenge thoughts in CBT?

The Challenges Encountered by Immigrant-Serving Agencies in Addressing the Health of Temporary Foreign Workers.

PubMed

Salami, Bukola; Kirova, Anna; Hegadoren, Kathleen; Meherali, Salima; Chiu, Yvonne; Nsaliwa, Christina

2016-01-01

This study sought to examine the challenges encountered by immigrant-serving agencies in meeting the health needs of temporary foreign workers and their families in one Canadian province. The authors interviewed 11 representatives of immigrant-serving agencies and two policy makers. Some of the challenges that agencies face in delivering programs and services for temporary foreign workers and their families include the time required to build trust with this population, temporary foreign workers' reluctance to use services due to fear that it will affect their immigration status, and the emotional labor associated with working with temporary foreign workers.

NASA Space Flight Vehicle Fault Isolation Challenges

NASA Technical Reports Server (NTRS)

Neeley, James R.; Jones, James V.; Bramon, Christopher J.; Inman, Sharon K.; Tuttle, Loraine

2016-01-01

The Space Launch System (SLS) is the new NASA heavy lift launch vehicle in development and is scheduled for its first mission in 2018.SLS has many of the same logistics challenges as any other large scale program. However, SLS also faces unique challenges related to testability. This presentation will address the SLS challenges for diagnostics and fault isolation, along with the analyses and decisions to mitigate risk..

Is it possible to give scientific solutions to Grand Challenges? On the idea of grand challenges for life science research.

PubMed

Efstathiou, Sophia

2016-04-01

This paper argues that challenges that are grand in scope such as "lifelong health and wellbeing", "climate action", or "food security" cannot be addressed through scientific research only. Indeed scientific research could inhibit addressing such challenges if scientific analysis constrains the multiple possible understandings of these challenges into already available scientific categories and concepts without translating between these and everyday concerns. This argument builds on work in philosophy of science and race to postulate a process through which non-scientific notions become part of science. My aim is to make this process available to scrutiny: what I call founding everyday ideas in science is both culturally and epistemologically conditioned. Founding transforms a common idea into one or more scientifically relevant ones, which can be articulated into descriptively thicker and evaluatively deflated terms and enable operationalisation and measurement. The risk of founding however is that it can invisibilise or exclude from realms of scientific scrutiny interpretations that are deemed irrelevant, uninteresting or nonsensical in the domain in question-but which may remain salient for addressing grand-in-scope challenges. The paper considers concepts of "wellbeing" in development economics versus in gerontology to illustrate this process. Copyright © 2015 Elsevier Ltd. All rights reserved.

Practical challenges in quantum key distribution

DOE PAGES

Diamanti, Eleni; Lo, Hoi -Kwong; Qi, Bing; ...

2016-11-08

Here, quantum key distribution (QKD) promises unconditional security in data communication and is currently being deployed in commercial applications. Nonetheless, before QKD can be widely adopted, it faces a number of important challenges such as secret key rate, distance, size, cost and practical security. Here, we survey those key challenges and the approaches that are currently being taken to address them.

Practical challenges in quantum key distribution

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

Diamanti, Eleni; Lo, Hoi -Kwong; Qi, Bing

Here, quantum key distribution (QKD) promises unconditional security in data communication and is currently being deployed in commercial applications. Nonetheless, before QKD can be widely adopted, it faces a number of important challenges such as secret key rate, distance, size, cost and practical security. Here, we survey those key challenges and the approaches that are currently being taken to address them.

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

PubMed

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

2012-01-01

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

Major Management Challenges and Program Risks: Department of Transportation

DOT National Transportation Integrated Search

2001-01-01

This report is part of a special series entitled the Performance and Accountability Series: Major Management Challenges and Program Risks. This report addresses the major performance and accountability challenges facing the Department of Transportati...

Progress and challenges to the global waste management system.

PubMed

Singh, Jagdeep; Laurenti, Rafael; Sinha, Rajib; Frostell, Björn

2014-09-01

Rapid economic growth, urbanization and increasing population have caused (materially intensive) resource consumption to increase, and consequently the release of large amounts of waste to the environment. From a global perspective, current waste and resource management lacks a holistic approach covering the whole chain of product design, raw material extraction, production, consumption, recycling and waste management. In this article, progress and different sustainability challenges facing the global waste management system are presented and discussed. The study leads to the conclusion that the current, rather isolated efforts, in different systems for waste management, waste reduction and resource management are indeed not sufficient in a long term sustainability perspective. In the future, to manage resources and wastes sustainably, waste management requires a more systems-oriented approach that addresses the root causes for the problems. A specific issue to address is the development of improved feedback information (statistics) on how waste generation is linked to consumption. © The Author(s) 2014.

Guidelines for reporting methodological challenges and evaluating potential bias in dementia research

PubMed Central

Weuve, Jennifer; Proust-Lima, Cécile; Power, Melinda C.; Gross, Alden L.; Hofer, Scott M.; Thiébaut, Rodolphe; Chêne, Geneviève; Glymour, M. Maria; Dufouil, Carole

2015-01-01

Clinical and population research on dementia and related neurologic conditions, including Alzheimer’s disease, faces several unique methodological challenges. Progress to identify preventive and therapeutic strategies rests on valid and rigorous analytic approaches, but the research literature reflects little consensus on “best practices.” We present findings from a large scientific working group on research methods for clinical and population studies of dementia, which identified five categories of methodological challenges as follows: (1) attrition/sample selection, including selective survival; (2) measurement, including uncertainty in diagnostic criteria, measurement error in neuropsychological assessments, and practice or retest effects; (3) specification of longitudinal models when participants are followed for months, years, or even decades; (4) time-varying measurements; and (5) high-dimensional data. We explain why each challenge is important in dementia research and how it could compromise the translation of research findings into effective prevention or care strategies. We advance a checklist of potential sources of bias that should be routinely addressed when reporting dementia research. PMID:26397878

Expanding the Annual Irrigation Maps (AIM) Product to the entire High Plains Aquifer (HPA): Addressing the Challenges of Cotton and Deficit-Irrigated Fields

NASA Astrophysics Data System (ADS)

Rapp, J. R.; Deines, J. M.; Kendall, A. D.; Hyndman, D. W.

2017-12-01

The High Plains Aquifer (HPA) is the most extensively irrigated aquifer in the continental United States and is the largest major aquifer in North America with an area of 500,000 km2. Increased demand for agricultural products has led to expanded irrigation extent, but brought with it declining groundwater levels that have made irrigation unsustainable in some locations. Understanding these irrigation dynamics and mapping irrigated areas through time are essential for future sustainable agricultural practices and hydrological modeling. Map products using remote sensing have only recently been able to track annual dynamics at relatively high spatial resolution (30 m) for a large portion of the northern HPA. However follow-on efforts to expand these maps to the entire HPA have met with difficulty due to the challenge of distinguishing irrigation in crop types that are commonly deficit- or partially-irrigated. Expanding these maps to the full HPA requires addressing unique features of partially irrigated fields and irrigated cotton, a major water user in the southern HPA. Working in Google Earth Engine, we used all available Landsat imagery to generate annual time series of vegetation indices. We combined this information with climate covariables, planting dates, and crop specific training data to algorithmically separate fully irrigated, partially irrigated, and non-irrigated field locations. The classification scheme was then applied to produce annual maps of irrigation across the entire HPA. The extensive use of ancillary data and the "greenness" time series for the algorithmic classification generally increased accuracy relative to previous efforts. High-accuracy, representative map products of irrigation extent capable of detecting crop type and irrigation intensity within aquifers will be an essential tool to monitor the sustainability of global aquifers and to provide a scientific bases for political and economic decisions affecting those aquifers.

Challenges in Implementing Strategies for Gender-Aware Teaching.

ERIC Educational Resources Information Center

Gilbert, Melissa C.; Gilbert, Lucia Albino

2002-01-01

Discusses the negative consequences of gender stereotyping in the mathematics classroom, especially for girls. Addresses possible challenges associated with creating a safe learning environment and combating gender stereotypes. Describes difficulties in various settings in the mathematics classroom and explores challenges associated with…

Developing Interdisciplinary Workforce to Meet Future Aerospace Challenges

NASA Technical Reports Server (NTRS)

Misra, Ajay

2017-01-01

The presentation will focus on the importance of interdisciplinary research for addressing future aerospace challenges. Examples of current research activities at NASA's Glenn Research Center will be provided to illustrate the importance of interdisciplinary research. Challenges with conducting interdisciplinary research will be discussed.

Estimating the Health Effects of Greenhouse Gas Mitigation Strategies: Addressing Parametric, Model, and Valuation Challenges

PubMed Central

Hess, Jeremy J.; Ebi, Kristie L.; Markandya, Anil; Balbus, John M.; Wilkinson, Paul; Haines, Andy; Chalabi, Zaid

2014-01-01

simultaneously improving health. Citation: Remais JV, Hess JJ, Ebi KL, Markandya A, Balbus JM, Wilkinson P, Haines A, Chalabi Z. 2014. Estimating the health effects of greenhouse gas mitigation strategies: addressing parametric, model, and valuation challenges. Environ Health Perspect 122:447–455; http://dx.doi.org/10.1289/ehp.1306744 PMID:24583270

STAT4 Deficiency Fails To Induce Lung Th2 or Th17 Immunity following Primary or Secondary Respiratory Syncytial Virus (RSV) Challenge but Enhances the Lung RSV-Specific CD8+ T Cell Immune Response to Secondary Challenge

PubMed Central

Dulek, Daniel E.; Newcomb, Dawn C.; Toki, Shinji; Goliniewska, Kasia; Cephus, Jacqueline; Reiss, Sara; Bates, John T.; Crowe, James E.; Boyd, Kelli L.; Moore, Martin L.; Zhou, Weisong

2014-01-01

ABSTRACT Immune-mediated lung injury is a hallmark of lower respiratory tract illness caused by respiratory syncytial virus (RSV). STAT4 plays a critical role in CD4+ Th1 lineage differentiation and gamma interferon (IFN-γ) protein expression by CD4+ T cells. As CD4+ Th1 differentiation is associated with negative regulation of CD4+ Th2 and Th17 differentiation, we hypothesized that RSV infection of STAT4−/− mice would result in enhanced lung Th2 and Th17 inflammation and impaired lung Th1 inflammation compared to wild-type (WT) mice. We performed primary and secondary RSV challenges in WT and STAT4−/− mice and used STAT1−/− mice as a positive control for the development of RSV-specific lung Th2 and Th17 inflammation during primary challenge. Primary RSV challenge of STAT4−/− mice resulted in decreased T-bet and IFN-γ expression levels in CD4+ T cells compared to those of WT mice. Lung Th2 and Th17 inflammation did not develop in primary RSV-challenged STAT4−/− mice. Decreased IFN-γ expression by NK cells, CD4+ T cells, and CD8+ T cells was associated with attenuated weight loss and enhanced viral clearance with primary challenge in STAT4−/− mice compared to WT mice. Following secondary challenge, WT and STAT4−/− mice also did not develop lung Th2 or Th17 inflammation. In contrast to primary challenge, secondary RSV challenge of STAT4−/− mice resulted in enhanced weight loss, an increased lung IFN-γ expression level, and an increased lung RSV-specific CD8+ T cell response compared to those of WT mice. These data demonstrate that STAT4 regulates the RSV-specific CD8+ T cell response to secondary infection but does not independently regulate lung Th2 or Th17 immune responses to RSV challenge. IMPORTANCE STAT4 is a protein critical for both innate and adaptive immune responses to viral infection. Our results show that STAT4 regulates the immune response to primary and secondary challenge with RSV but does not restrain RSV

Correlated Imaging – A Grand Challenge in Chemical Analysis

PubMed Central

Masyuko, Rachel; Lanni, Eric; Sweedler, Jonathan V.; Bohn, Paul W.

2013-01-01

Correlated chemical imaging is an emerging strategy for acquisition of images by combining information from multiplexed measurement platforms to track, visualize, and interpret in situ changes in the structure, organization, and activities of interesting chemical systems, frequently spanning multiple decades in space and time. Acquiring and correlating information from complementary imaging experiments has the potential to expose complex chemical behavior in ways that are simply not available from single methods applied in isolation, thereby greatly amplifying the information gathering power of imaging experiments. However, in order to correlate image information across platforms, a number of issues must be addressed. First, signals are obtained from disparate experiments with fundamentally different figures of merit, including pixel size, spatial resolution, dynamic range, and acquisition rates. In addition, images are often acquired on different instruments in different locations, so the sample must be registered spatially so that the same area of the sample landscape is addressed. The signals acquired must be correlated in both spatial and temporal domains, and the resulting information has to be presented in a way that is readily understood. These requirements pose special challenges for image cross-correlation that go well beyond those posed in single technique imaging approaches. The special opportunities and challenges that attend correlated imaging are explored by specific reference to correlated mass spectrometric and Raman imaging, a topic of substantial and growing interest. PMID:23431559

Can thermostable vaccines help address cold-chain challenges? Results from stakeholder interviews in six low- and middle-income countries.

PubMed

Kristensen, Debra D; Lorenson, Tina; Bartholomew, Kate; Villadiego, Shirley

2016-02-10

This study captures the perspectives of stakeholders at multiple levels of the vaccine supply chain regarding their assessment of challenges with storing vaccines within recommended temperature ranges and their perceptions on the benefits of having vaccines with improved stability, including the potential short-term storage and transport of vaccines in a controlled-temperature chain. Semi-structured interviews were undertaken with 158 immunization stakeholders in six countries. Interviewees included national decision-makers and advisors involved in vaccine purchasing decisions, national Expanded Programme on Immunization managers, and health and logistics personnel at national, subnational, and health facility levels. Challenges with both heat and freeze-exposure of vaccines were recognized in all countries, with heat-exposure being a greater concern. Conditions leading to freeze-exposure including ice build-up due to poor refrigerator performance and improper icepack conditioning were reported by 53% and 28% of participants, respectively. Respondents were interested in vaccine products with improved heat/freeze-stability characteristics. The majority of those involved in vaccine purchasing indicated they would be willing to pay a US$0.05 premium per dose for a freeze-stable pentavalent vaccine (68%) or a heat-stable rotavirus vaccine (59%), although most (53%) preferred not to pay the premium for a heat-stable pentavalent vaccine if the increased stability required changing from a liquid to a lyophilized product. Most respondents (73%) were also interested in vaccines labeled for short-term use in a controlled-temperature chain. The majority (115/158) recognized the flexibility this would provide during outreach or should cold-chain breaks occur. Respondents were also aware that possible confusion might arise and additional training would be required if handling conditions were changed for some, but not all vaccines. Participating immunization stakeholders

Can thermostable vaccines help address cold-chain challenges? Results from stakeholder interviews in six low- and middle-income countries

PubMed Central

Kristensen, Debra D.; Lorenson, Tina; Bartholomew, Kate; Villadiego, Shirley

2016-01-01

Introduction This study captures the perspectives of stakeholders at multiple levels of the vaccine supply chain regarding their assessment of challenges with storing vaccines within recommended temperature ranges and their perceptions on the benefits of having vaccines with improved stability, including the potential short-term storage and transport of vaccines in a controlled-temperature chain. Methods Semi-structured interviews were undertaken with 158 immunization stakeholders in six countries. Interviewees included national decision-makers and advisors involved in vaccine purchasing decisions, national Expanded Programme on Immunization managers, and health and logistics personnel at national, subnational, and health facility levels. Results Challenges with both heat and freeze-exposure of vaccines were recognized in all countries, with heat-exposure being a greater concern. Conditions leading to freeze-exposure including ice build-up due to poor refrigerator performance and improper icepack conditioning were reported by 53% and 28% of participants, respectively. Respondents were interested in vaccine products with improved heat/freeze-stability characteristics. The majority of those involved in vaccine purchasing indicated they would be willing to pay a US$0.05 premium per dose for a freeze-stable pentavalent vaccine (68%) or a heat-stable rotavirus vaccine (59%), although most (53%) preferred not to pay the premium for a heat-stable pentavalent vaccine if the increased stability required changing from a liquid to a lyophilized product. Most respondents (73%) were also interested in vaccines labeled for short-term use in a controlled-temperature chain. The majority (115/158) recognized the flexibility this would provide during outreach or should cold-chain breaks occur. Respondents were also aware that possible confusion might arise and additional training would be required if handling conditions were changed for some, but not all vaccines. Conclusion

Hitting the Moving Target: Challenges of Creating a Dynamic Curriculum Addressing the Ethical Dimensions of Geospatial Data

ERIC Educational Resources Information Center

Carr, John; Vallor, Shannon; Freundschuh, Scott; Gannon, William L.; Zandbergen, Paul

2014-01-01

While established ethical norms and core legal principles concerning the protection of privacy may be easily identified, applying these standards to rapidly evolving digital information technologies, markets for digital information and convulsive changes in social understandings of privacy is increasingly challenging. This challenge has been…

Moral experience and ethical challenges in an emergency department in Pakistan: emergency physicians' perspectives.

PubMed

Zafar, Waleed

2015-04-01

Emergency departments (ED) are often stressful environments posing unique ethical challenges-issues that primarily raise moral rather than clinical concerns-in patient care. Despite this, there are very few reports of what emergency physicians find ethically challenging in their everyday work. Emergency medicine (EM) is a relatively young but rapidly growing specialty that is gaining acceptance worldwide. The aim of this study was to explore the perspectives of EM residents and physicians regarding the common ethical challenges they face during patient care in one of only two academic EM departments in Pakistan. These challenges could then be addressed in residents' training and departmental practice guidelines. A qualitative research design was employed and in-depth interviews were conducted with ED physicians. Participants were encouraged to think of specific examples from their work, to highlight the particular ethical concerns raised and to describe in detail the process by which those concerns were addressed or left unresolved. Transcripts were analysed using grounded theory methods. Thirteen participants were interviewed and they described four key challenges: how to provide highest quality care with limited resources; how to be truthful to patients; what to do when it is not possible to provide or continue treatment to patients; and when (and when not) to offer life-sustaining treatments. Participants' accounts provided important insights into how physicians tried to resolve these challenges in the 'local moral world' of an ED in Pakistan. The study highlights the need for developing systematic and contextually appropriate mechanisms for resolving common ethical challenges in the EDs and for training residents in moral problem solving. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Toward a Predictive Understanding of Earth’s Microbiomes to Address 21st Century Challenges

PubMed Central

Blaser, Martin J.; Cardon, Zoe G.; Cho, Mildred K.; Dangl, Jeffrey L.; Green, Jessica L.; Knight, Rob; Maxon, Mary E.; Northen, Trent R.; Pollard, Katherine S.

2016-01-01

ABSTRACT Microorganisms have shaped our planet and its inhabitants for over 3.5 billion years. Humankind has had a profound influence on the biosphere, manifested as global climate and land use changes, and extensive urbanization in response to a growing population. The challenges we face to supply food, energy, and clean water while maintaining and improving the health of our population and ecosystems are significant. Given the extensive influence of microorganisms across our biosphere, we propose that a coordinated, cross-disciplinary effort is required to understand, predict, and harness microbiome function. From the parallelization of gene function testing to precision manipulation of genes, communities, and model ecosystems and development of novel analytical and simulation approaches, we outline strategies to move microbiome research into an era of causality. These efforts will improve prediction of ecosystem response and enable the development of new, responsible, microbiome-based solutions to significant challenges of our time. PMID:27178263

The challenges of being an insider in storytelling research.

PubMed

Blythe, Stacy; Wilkes, Lesley; Jackson, Debra; Halcomb, Elizabeth

2013-01-01

To describe the challenges related to being an 'insider' researcher in a study that uses a feminist-informed storytelling research design and to discuss practical strategies to manage these challenges. The positioning of the researcher in qualitative research has numerous methodological implications. Often, qualitative researchers share similar experiences or characteristics with their participants. Such an 'insider' position provides challenges for the researcher in conducting the research. Understanding these challenges and planning how to manage them is beneficial for the researcher and for the conduct of the project. This paper is based on the research team's experience of undertaking a feminist-informed storytelling study exploring the experiences of Australian women providing long-term foster care. This paper provides a discussion of the methodology used in the investigation. Four challenges resulting from the insider status of the primary researcher were identified as affecting the research: assumed understanding, ensuring analytic objectivity, dealing with emotions and participants' expectations. Strategies to address these challenges include: 'participant probing', 'researcher reflexivity', review by an 'outsider' researcher, identifying the risk, debriefing, making the aims and use of study outcomes clear, and acknowledging participants' expectations. Methods to implement these strategies are described. The use of an insider researcher was beneficial to our study design and helped with recruitment and rapport, enabling collaboration and the generation of stories rich in content. By identifying the challenges associated with insider research and using strategies to mitigate them, researchers can effectively use an insider position in conjunction with a storytelling research design. ImplicaTIONS FOR FUTURE RESEARCH/PRACTICE: Further investigation of the insider in different qualitative research designs would be useful in identifying challenges and benefits

Addressing multigenerational conflict: mutual respect and carefronting as strategy.

PubMed

Kupperschmidt, Betty R

2006-05-31

This article addresses the challenges faced by nurses as they work side-by-side with nurses from a variety of generational cohorts. First a brief overview of the generational characteristics of the four generational cohorts in today's workplace is presented. Next the importance of each nurse using respect and carefronting as antidotes to generational conflict is discussed. Finally the role of nursing leadership in facilitating respect and carefronting is noted.

Ukrainian prisoners and community reentry challenges: implications for transitional care

PubMed Central

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

2013-01-01

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

Multi-disciplinary interoperability challenges (Ian McHarg Medal Lecture)

NASA Astrophysics Data System (ADS)

Annoni, Alessandro

2013-04-01

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

Library outreach: overcoming health literacy challenges*

PubMed Central

Parker, Ruth; Kreps, Gary L.

2005-01-01

Objective: This paper examines the powerful influences of consumer health literacy on access to and use of relevant health information. Method: The paper describes how widespread problems with health literacy significantly limit effective dissemination of relevant health information in society, especially to many vulnerable populations where health literacy challenges are especially pervasive. Results: The paper examines strengths and weaknesses of different programs for addressing health literacy problems, including educational programs, message design programs, and strategic communication training and intervention programs. Implications: The paper evaluates strategies that can be implemented throughout the modern health care system to address problems of health literacy by improving health information access, processing, and understanding. It concludes by examining several strategies that libraries can adopt to overcome many health literacy challenges. PMID:16239962

Addressing defeatist beliefs in work rehabilitation

PubMed Central

Mervis, Joshua E.; Lysaker, Paul H.; Fiszdon, Joanna M.; Bell, Morris D.; Chue, Amanda E.; Pauls, Carol; Bisoglio, Joseph; Choi, Jimmy

2018-01-01

Background Adults with serious mental illness (SMI) may struggle with expectations of failure in vocational rehabilitation. These expectations can be global and trait-like or performance-specific and related to ability. Aims To date, it has not been examined whether global or performance-specific defeatist beliefs are related to functional outcomes. Method The Indianapolis Vocational Intervention Program (IVIP) is a CBT intervention used to address expectations of failure and improve work performance. We examined the relationships between defeatist beliefs, self-esteem, social functioning, and work behaviors in 54 adults with SMI who completed IVIP within a work therapy program. Results Baseline work-specific defeatist beliefs were related to baseline self-esteem, employment attitude, and work behaviors. Decline in work-specific defeatist beliefs was associated with better social functioning, self-esteem, and work behaviors. Decline in global defeatist beliefs was only associated with improvements in social functioning. Conclusions Performance-specific expectations about work may be an appropriate therapeutic target to enhance work outcome in SMI. PMID:26828824

Greatest Challenges of Rectal Cancer Survivors: Results of a Population-Based Survey

PubMed Central

McMullen, Carmit K.; Bulkley, Joanna E.; Altschuler, Andrea; Wendel, Christopher S.; Grant, Marcia; Hornbrook, Mark C.; Sun, Virginia; Krouse, Robert S.

2016-01-01

Background Eliciting cancer survivors’ priorities is essential to address the specific needs of cancer survivor subgroups. Objective To describe long-term rectal cancer survivors’ greatest challenges related to treatment. Design Observational study with cross-sectional survey. Setting Members of Kaiser Permanente, Northern California and Northwest health plans. Patients A survey was mailed to long-term (≥5 years post diagnosis) rectal cancer survivors who had an anastomosis, temporary ostomy, or permanent ostomy. Main Outcome Measures An open-ended question about the greatest challenge related to cancer surgery. We categorized responses using a grounded theory approach with double coding for reliability. Bonferroni-adjusted X2 values were used to assess differences in the proportions of subgroups who mentioned challenges within each response category. Results The survey completion rate was 61% (577/953); 76% (440/577) of participants responded to the greatest challenge question. Respondents’ greatest challenges were bowel/ostomy management (reported by 44%), negative psychosocial effects (37%), late effects of treatment (21%), comorbidities and aging (13%), postoperative recovery (5%), and negative health care experiences (5%). Survivors with temporary ostomy or anastomosis were more likely than survivors with permanent ostomy to report late effects (p<0.0001 and p=0.01, respectively). Survivors with anastomosis were less likely than survivors with permanent ostomy to report negative psychosocial impacts (p=0.0001). Conclusions Our results reveal the need for bowel/ostomy management, psychosocial services and surveillance for late effects in survivorship and supportive care services for all rectal cancer survivors, regardless of ostomy status. The perspective of long-term survivors with anastomosis reveals challenges that may not be anticipated during treatment decision-making. Limitations Generalizability is restricted by the lack of ethnically and

Major Management Challenges and Program Risks, Department of Education. Performance and Accountability Series.

ERIC Educational Resources Information Center

Comptroller General of the U.S., Washington, DC.

This report addresses the major performance and management challenges that have limited the effectiveness of the Department of Education in carrying out its mission. The booklet addresses corrective actions that Education has taken or initiated on these challenges--including a number of management initiatives to improve controls over the…

Big Data and Analytics in Higher Education: Opportunities and Challenges

ERIC Educational Resources Information Center

Daniel, Ben

2015-01-01

Institutions of higher education are operating in an increasingly complex and competitive environment. This paper identifies contemporary challenges facing institutions of higher education worldwide and explores the potential of Big Data in addressing these challenges. The paper then outlines a number of opportunities and challenges associated…

IPv6 Addressing Proxy: Mapping Native Addressing from Legacy Technologies and Devices to the Internet of Things (IPv6)

PubMed Central

Jara, Antonio J.; Moreno-Sanchez, Pedro; Skarmeta, Antonio F.; Varakliotis, Socrates; Kirstein, Peter

2013-01-01

Sensors utilize a large number of heterogeneous technologies for a varied set of application environments. The sheer number of devices involved requires that this Internet be the Future Internet, with a core network based on IPv6 and a higher scalability in order to be able to address all the devices, sensors and things located around us. This capability to connect through IPv6 devices, sensors and things is what is defining the so-called Internet of Things (IoT). IPv6 provides addressing space to reach this ubiquitous set of sensors, but legacy technologies, such as X10, European Installation Bus (EIB), Controller Area Network (CAN) and radio frequency ID (RFID) from the industrial, home automation and logistic application areas, do not support the IPv6 protocol. For that reason, a technique must be devised to map the sensor and identification technologies to IPv6, thus allowing homogeneous access via IPv6 features in the context of the IoT. This paper proposes a mapping between the native addressing of each technology and an IPv6 address following a set of rules that are discussed and proposed in this work. Specifically, the paper presents a technology-dependent IPv6 addressing proxy, which maps each device to the different subnetworks built under the IPv6 prefix addresses provided by the internet service provider for each home, building or user. The IPv6 addressing proxy offers a common addressing environment based on IPv6 for all the devices, regardless of the device technology. Thereby, this offers a scalable and homogeneous solution to interact with devices that do not support IPv6 addressing. The IPv6 addressing proxy has been implemented in a multi-protocol card and evaluated successfully its performance, scalability and interoperability through a protocol built over IPv6. PMID:23686145

IPv6 addressing proxy: mapping native addressing from legacy technologies and devices to the Internet of Things (IPv6).

PubMed

Jara, Antonio J; Moreno-Sanchez, Pedro; Skarmeta, Antonio F; Varakliotis, Socrates; Kirstein, Peter

2013-05-17

Sensors utilize a large number of heterogeneous technologies for a varied set of application environments. The sheer number of devices involved requires that this Internet be the Future Internet, with a core network based on IPv6 and a higher scalability in order to be able to address all the devices, sensors and things located around us. This capability to connect through IPv6 devices, sensors and things is what is defining the so-called Internet of Things (IoT). IPv6 provides addressing space to reach this ubiquitous set of sensors, but legacy technologies, such as X10, European Installation Bus (EIB), Controller Area Network (CAN) and radio frequency ID (RFID) from the industrial, home automation and logistic application areas, do not support the IPv6 protocol. For that reason, a technique must be devised to map the sensor and identification technologies to IPv6, thus allowing homogeneous access via IPv6 features in the context of the IoT. This paper proposes a mapping between the native addressing of each technology and an IPv6 address following a set of rules that are discussed and proposed in this work. Specifically, the paper presents a technology-dependent IPv6 addressing proxy, which maps each device to the different subnetworks built under the IPv6 prefix addresses provided by the internet service provider for each home, building or user. The IPv6 addressing proxy offers a common addressing environment based on IPv6 for all the devices, regardless of the device technology. Thereby, this offers a scalable and homogeneous solution to interact with devices that do not support IPv6 addressing. The IPv6 addressing proxy has been implemented in a multi-protocol Sensors 2013, 13 6688 card and evaluated successfully its performance, scalability and interoperability through a protocol built over IPv6.

Rational Rhymes for Addressing Common Childhood Issues

ERIC Educational Resources Information Center

Warren, Jeffrey M.

2011-01-01

Music-based interventions are valuable tools counselors can use when working with children. Specific types of music-based interventions, such as songs or rhymes, can be especially pertinent in addressing the thoughts, feelings, and behaviors of children. Rational-emotive behavior therapy (REBT) provides a therapeutic framework that encourages…

Preparing Engineers for the Challenges of Community Engagement

ERIC Educational Resources Information Center

Harsh, Matthew; Bernstein, Michael J.; Wetmore, Jameson; Cozzens, Susan; Woodson, Thomas; Castillo, Rafael

2017-01-01

Despite calls to address global challenges through community engagement, engineers are not formally prepared to engage with communities. Little research has been done on means to address this "engagement gap" in engineering education. We examine the efficacy of an intensive, two-day Community Engagement Workshop for engineers, designed…

Challenges in global ballast water management.

PubMed

Endresen, Øyvind; Lee Behrens, Hanna; Brynestad, Sigrid; Bjørn Andersen, Aage; Skjong, Rolf

2004-04-01

Ballast water management is a complex issue raising the challenge of merging international regulations, ship's specific configurations along with ecological conservation. This complexity is illustrated in this paper by considering ballast water volume, discharge frequency, ship safety and operational issues aligned with regional characteristics to address ecological risk for selected routes. A re-estimation of ballast water volumes gives a global annual level of 3500 Mton. Global ballast water volume discharged into open sea originating from ballast water exchange operations is estimated to approximately 2800 Mton. Risk based decision support systems coupled to databases for different ports and invasive species characteristics and distributions can allow for differentiated treatment levels while maintaining low risk levels. On certain routes, the risk is estimated to be unacceptable and some kind of ballast water treatment or management should be applied.

Leadership and Cultural Challenges in Operating the International Space Station

NASA Technical Reports Server (NTRS)

Clement, J. L.; Ritsher, J. B.; Saylor, S. A.; Kanas, N.

2006-01-01

Operating the International Space Station (ISS) involves an indefinite, continuous series of long-duration international missions, and this requires an unprecedented degree of cooperation across multiple sites, organizations, and nations. ISS flight controllers have had to find ways to maintain effective team performance in this challenging new context. The goal of this study was to systematically identify and evaluate the major leadership and cultural challenges faces by ISS flight controllers, and to highlight the approaches that they have found most effective to surmount these challenges. We conducted a qualitative survey using a semi-structured interview. Subjects included 14 senior NASA flight controllers who were chosen on the basis of having had substantial experience working with international partners. Data were content analyzed using an iterative process with multiple coders and consensus meetings to resolve discrepancies. To further explore the meaning of the interview findings, we also conducted some new analyses of data from a previous questionnaire study of Russian and American ISS mission control personnel. The interview data showed that respondents had substantial consensus on several leadership and cultural challenges and on key strategies for dealing with them, and they offered a wide range of specific tactics for implementing these strategies. Surprisingly few respondents offered strategies for addressing the challenge of working with team members whose native language is not American English. The questionnaire data showed that Americans think it is more important than Russians that mission control personnel speak the same dialect of one shared common language. Although specific to the ISS program, our results are consistent with recent management, cultural, and aerospace research. We aim to use our results to improve training for current and future ISS flight controllers.

Challenges for creating a site-specific groundwater-use record for the Ozark Plateaus aquifer system (central USA) from 1900 to 2010

NASA Astrophysics Data System (ADS)

Knierim, Katherine J.; Nottmeier, Anna M.; Worland, Scott; Westerman, Drew A.; Clark, Brian R.

2017-09-01

Hydrologic budgets to determine groundwater availability are important tools for water-resource managers. One challenging component for developing hydrologic budgets is quantifying water use through time because historical and site-specific water-use data can be sparse or poorly documented. This research developed a groundwater-use record for the Ozark Plateaus aquifer system (central USA) from 1900 to 2010 that related county-level aggregated water-use data to site-specific well locations and aquifer units. A simple population-based linear model, constrained to 0 million liters per day in 1900, provided the best means to extrapolate groundwater-withdrawal rates pre-1950s when there was a paucity of water-use data. To disaggregate county-level data to individual wells across a regional aquifer system, a programmatic hierarchical process was developed, based on the level of confidence that a well pumped groundwater for a specific use during a specific year. Statistical models tested on a subset of the best-available site-specific water-use data provided a mechanism to bracket historic groundwater use, such that groundwater-withdrawal rates ranged, on average, plus or minus 38% from modeled values. Groundwater withdrawn for public supply and domestic use accounted for between 48 and 74% of total groundwater use since 1901, highlighting that groundwater provides an important drinking-water resource. The compilation, analysis, and spatial and temporal extrapolation of water-use data remain a challenging task for water scientists, but is of paramount importance to better quantify groundwater use and availability.

Challenges for creating a site-specific groundwater-use record for the Ozark Plateaus aquifer system (central USA) from 1900 to 2010

USGS Publications Warehouse

Knierim, Katherine J.; Nottmeier, Anna M.; Worland, Scott C.; Westerman, Drew A.; Clark, Brian R.

2017-01-01

Hydrologic budgets to determine groundwater availability are important tools for water-resource managers. One challenging component for developing hydrologic budgets is quantifying water use through time because historical and site-specific water-use data can be sparse or poorly documented. This research developed a groundwater-use record for the Ozark Plateaus aquifer system (central USA) from 1900 to 2010 that related county-level aggregated water-use data to site-specific well locations and aquifer units. A simple population-based linear model, constrained to 0 million liters per day in 1900, provided the best means to extrapolate groundwater-withdrawal rates pre-1950s when there was a paucity of water-use data. To disaggregate county-level data to individual wells across a regional aquifer system, a programmatic hierarchical process was developed, based on the level of confidence that a well pumped groundwater for a specific use during a specific year. Statistical models tested on a subset of the best-available site-specific water-use data provided a mechanism to bracket historic groundwater use, such that groundwater-withdrawal rates ranged, on average, plus or minus 38% from modeled values. Groundwater withdrawn for public supply and domestic use accounted for between 48 and 74% of total groundwater use since 1901, highlighting that groundwater provides an important drinking-water resource. The compilation, analysis, and spatial and temporal extrapolation of water-use data remain a challenging task for water scientists, but is of paramount importance to better quantify groundwater use and availability.

A Blueprint to Address Research Gaps in the Development of Biomarkers for Pediatric Tuberculosis.

PubMed

Nicol, Mark Patrick; Gnanashanmugam, Devasena; Browning, Renee; Click, Eleanor S; Cuevas, Luis E; Detjen, Anne; Graham, Steve M; Levin, Michael; Makhene, Mamodikoe; Nahid, Payam; Perez-Velez, Carlos M; Reither, Klaus; Song, Rinn; Spiegel, Hans M L; Worrell, Carol; Zar, Heather J; Walzl, Gerhard

2015-10-15

Childhood tuberculosis contributes significantly to the global tuberculosis disease burden but remains challenging to diagnose due to inadequate methods of pathogen detection in paucibacillary pediatric samples and lack of a child-specific host biomarker to identify disease. Accurately diagnosing tuberculosis in children is required to improve case detection, surveillance, healthcare delivery, and effective advocacy. In May 2014, the National Institutes of Health convened a workshop including researchers in the field to delineate priorities to address this research gap. This blueprint describes the consensus from the workshop, identifies critical research steps to advance this field, and aims to catalyze efforts toward harmonization and collaboration in this area. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Computation and application of tissue-specific gene set weights.

PubMed

Frost, H Robert

2018-04-06

Gene set testing, or pathway analysis, has become a critical tool for the analysis of highdimensional genomic data. Although the function and activity of many genes and higher-level processes is tissue-specific, gene set testing is typically performed in a tissue agnostic fashion, which impacts statistical power and the interpretation and replication of results. To address this challenge, we have developed a bioinformatics approach to compute tissuespecific weights for individual gene sets using information on tissue-specific gene activity from the Human Protein Atlas (HPA). We used this approach to create a public repository of tissue-specific gene set weights for 37 different human tissue types from the HPA and all collections in the Molecular Signatures Database (MSigDB). To demonstrate the validity and utility of these weights, we explored three different applications: the functional characterization of human tissues, multi-tissue analysis for systemic diseases and tissue-specific gene set testing. All data used in the reported analyses is publicly available. An R implementation of the method and tissue-specific weights for MSigDB gene set collections can be downloaded at http://www.dartmouth.edu/∼hrfrost/TissueSpecificGeneSets. rob.frost@dartmouth.edu.

Communication Challenges in Neonatal Encephalopathy.

PubMed

Lemmon, Monica E; Donohue, Pamela K; Parkinson, Charlamaine; Northington, Frances J; Boss, Renee D

2016-09-01

Families must process complex information related to neonatal encephalopathy and therapeutic hypothermia. In this mixed methods study, semi-structured interviews were performed with parents whose infants were enrolled in an existing longitudinal cohort study of therapeutic hypothermia between 2011 and 2014. Thematic saturation was achieved after 20 interviews. Parental experience of communicating with clinicians was characterized by 3 principle themes. Theme 1 highlighted that a fragmented communication process mirrored the chaotic maternal and neonatal course. Parents often received key information about neonatal encephalopathy and therapeutic hypothermia from maternal clinicians. Infant medical information was often given to 1 family member (60%), who felt burdened by the responsibility to relay that information to others. Families universally valued the role of the bedside nurse, who was perceived as the primary source of communication for most (75%) families. Theme 2 encompassed the challenges of discussing the complex therapy of therapeutic hypothermia: families appreciated clinicians who used lay language and provided written material, and they often felt overwhelmed by technical information that made it hard to understand the "big picture" of their infant's medical course. Theme 3 involved the uncertain prognosis after neonatal encephalopathy. Parents appreciated specific expectations about their infant's long-term development, and experienced long-term distress about prognostic uncertainty. Communicating complex and large volumes of information in the midst of perinatal crisis presents inherent challenges for both clinicians and families. We identified an actionable set of communication challenges that can be addressed with targeted interventions. Copyright © 2016 by the American Academy of Pediatrics.

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.

The Challenges and Opportunities of Residence Hall Facilities.

ERIC Educational Resources Information Center

Thaler-Carter, Ruth E.

2001-01-01

Explores the challenges facing college and university residence hall facility managers and how different schools address these issues in diverse ways. Ongoing concerns involving funding needs and maintenance are examined followed by discussions on the new challenges in managing student life, health, and safety. Concluding comments reveal where…

Community Coordinated Modeling Center: Addressing Needs of Operational Space Weather Forecasting

NASA Technical Reports Server (NTRS)

Kuznetsova, M.; Maddox, M.; Pulkkinen, A.; Hesse, M.; Rastaetter, L.; Macneice, P.; Taktakishvili, A.; Berrios, D.; Chulaki, A.; Zheng, Y.;

Barriers to Addressing Adolescent Substance Use: Perceptions of New York School-Based Health Center Providers.

PubMed

Harris, Brett; Shaw, Benjamin; Lawson, Hal; Sherman, Barry

2016-02-01

Adolescent substance use is associated with chronic health conditions, accidents, injury, and school-related problems, including dropping out. Schools have the potential to provide students with substance use prevention and intervention services, albeit with confidentiality challenges. School-based health centers (SBHCs) provide confidentiality, positioning them as ideal settings to provide substance use prevention and intervention. This study identified program directors' and clinicians' barriers to addressing adolescent substance use in SBHCs. Between May and June 2013, an electronic survey was distributed to all 162 New York State SBHC program directors and clinicians serving middle and high school students. The most prevalent perceived barriers to discussing substance use with students were time constraints (43%), the belief that students are not honest about their use (43%), and clinicians' lack of training (28%). Both directors and clinicians identified challenges in getting students to return for additional sessions to address their use, and they also indicated that confidentiality was a treatment referral barrier. This study identified timely opportunities that may be leveraged and unique challenges that may be overcome with targeted dissemination, training, and technical assistance efforts to enable directors and clinicians to routinely address substance use in SBHCs. © 2016, American School Health Association.

Addressing the underperformance of faculty and staff.

PubMed

Kenner, Carole; Pressler, Jana L

2006-01-01

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

Leadership in Meeting Ethical Challenges.

ERIC Educational Resources Information Center

Jonsen, Albert R.

1987-01-01

The ethical challenge to academic medical centers is to find a balance between education and research, addressing such issues as serving the unsponsored patient, the cost of new technology, and balancing acute and primary care as well as educating future physicians. (MSE)

Challenges to Seventh-Day Adventist Tertiary Education in the Caribbean

ERIC Educational Resources Information Center

Gardner, Trevor George

2010-01-01

The article briefly summarizes seven challenges that faces the Seventh Day Adventist (SDA) tertiary institutions in the Caribbean. There is no exhaustive discussion of the challenges but each is clearly articulated. There is no attempt to address solution but the discussion of each challenge, however, provides opportunity for several inferences…

Education, Democratization, and Globalization: A Challenge for Comparative Education. Guest Editorial Essay and Presidential Address.

ERIC Educational Resources Information Center

McGinn, Noel F.

1996-01-01

Comparative education can contribute to democratization by addressing four issues: declining democratic practice and civic participation in the industrialized world, reasons why education does not resolve this problem, impact of economic globalization on education and on democratization, and the urgency for comparative research on cultural…

Nephron segment specific microRNA biomarkers of pre-clinical drug-induced renal toxicity: Opportunities and challenges

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

Nassirpour, Rounak, E-mail: Rounak.nassirpour@pfiz

Drug-induced nephrotoxicity is a common drug development complication for pharmaceutical companies. Sensitive, specific, translatable and non-invasive biomarkers of renal toxicity are urgently needed to diagnose nephron segment specific injury. The currently available gold standard biomarkers for nephrotoxicity are not kidney-specific, lack sensitivity for early detection, and are not suitable for renal damage localization (glomerular vs tubulointerstitial injury). MicroRNAs (miRNAs) are increasingly gaining momentum as promising biomarkers of various organ toxicities, including drug induced renal injury. This is mostly due to their stability in easily accessible biofluids, ease of developing nucleic acids detection compared to protein detection assays, as well asmore » their interspecies translatability. Increasing concordance of miRNA findings by standardizing methodology most suitable for their detection and quantitation, as well as characterization of their expression pattern in a cell type specific manner, will accelerate progress toward validation of these miRNAs as biomarkers in pre-clinical, and clinical settings. This review aims to highlight the current pre-clinical findings surrounding miRNAs as biomarkers in two important segments of the nephron, the glomerulus and tubules. - Highlights: • miRNAs are promising biomarkers of drug-induced kidney injury. • Summarized pre-clinical miRNA biomarkers of drug-induced nephrotoxicity. • Described the strengths and challenges associated with miRNAs as biomarkers.« less

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

PubMed

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

2018-04-01

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

Addressing challenges of heterogeneous tumor treatment through bispecific protein-mediated pretargeted drug delivery.

PubMed

Yang, Qi; Parker, Christina L; McCallen, Justin D; Lai, Samuel K

2015-12-28

Tumors are frequently characterized by genomically and phenotypically distinct cancer cell subpopulations within the same tumor or between tumor lesions, a phenomenon termed tumor heterogeneity. These diverse cancer cell populations pose a major challenge to targeted delivery of diagnostic and/or therapeutic agents, as the conventional approach of conjugating individual ligands to nanoparticles is often unable to facilitate intracellular delivery to the full spectrum of cancer cells present in a given tumor lesion or patient. As a result, many cancers are only partially suppressed, leading to eventual tumor regrowth and/or the development of drug-resistant tumors. Pretargeting (multistep targeting) approaches involving the administration of 1) a cocktail of bispecific proteins that can collectively bind to the entirety of a mixed tumor population followed by 2) nanoparticles containing therapeutic and/or diagnostic agents that can bind to the bispecific proteins accumulated on the surface of target cells offer the potential to overcome many of the challenges associated with drug delivery to heterogeneous tumors. Despite its considerable success in improving the efficacy of radioimmunotherapy, the pretargeting strategy remains underexplored for a majority of nanoparticle therapeutic applications, especially for targeted delivery to heterogeneous tumors. In this review, we will present concepts in tumor heterogeneity, the shortcomings of conventional targeted systems, lessons learned from pretargeted radioimmunotherapy, and important considerations for harnessing the pretargeting strategy to improve nanoparticle delivery to heterogeneous tumors. Copyright © 2015 Elsevier B.V. All rights reserved.

Challenges and needs in fire management: A landscape simulation modeling perspective [chapter 4

Treesearch

Robert E. Keane; Geoffrey J. Cary; Mike D. Flannigan

2011-01-01

Fire management will face many challenges in the future from global climate change to protecting people, communities, and values at risk. Simulation modeling will be a vital tool for addressing these challenges but the next generation of simulation models must be spatially explicit to address critical landscape ecology relationships and they must use mechanistic...

Beyond specific pathogen-free: biology and effect of common viruses in macaques.

PubMed

Lerche, Nicholas W; Simmons, Joe H

2008-02-01

Macaque models have contributed to key advances in our basic knowledge of behavior, anatomy, and physiology as well as to our understanding of a wide variety of human diseases. This issue of Comparative Medicine focuses on several of the viral agents (members of Retroviridae, Herpesviridae and 2 small DNA viruses) that can infect both nonhuman primates and humans as well as confound research studies. Featured articles also address the challenges of developing colonies of macaques and other nonhuman primates that are truly specific pathogen-free for these and other adventitious infectious agents.

Beyond Specific Pathogen-Free: Biology and Effect of Common Viruses in Macaques

PubMed Central

Lerche, Nicholas W; Simmons, Joe H

2008-01-01

Macaque models have contributed to key advances in our basic knowledge of behavior, anatomy, and physiology as well as to our understanding of a wide variety of human diseases. This issue of Comparative Medicine focuses on several of the viral agents (members of Retroviridae, Herpesviridae and 2 small DNA viruses) that can infect both nonhuman primates and humans as well as confound research studies. Featured articles also address the challenges of developing colonies of macaques and other nonhuman primates that are truly specific pathogen-free for these and other adventitious infectious agents. PMID:19793451

Addressing "Who Am I?" before "Who Are They?" when Facing Diversity

ERIC Educational Resources Information Center

Frank, Jan L. H.; Frank, Kerry D.

2006-01-01

Before we as teachers can even begin to address the question of "Who are our students?" we must first reflect on and analyze ourselves--who we are in terms of race, ethnicity, class, gender, culture, personality, and other important factors. Relating to our students, challenging their thinking and actions, and being voices for change all demand…

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

EPA Science Inventory

When the U.S. Environmental Protection Agency (EPA) was established nearly 50 years ago, the nation faced serious threats to its air, land, and water, which in turn impacted human health. These threats were effectively addressed by the creation of EPA (in 1970) and many subsequen...

Immunization with Outer Membrane Vesicles Displaying Designer Glycotopes Yields Class-Switched, Glycan-Specific Antibodies

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

Valentine, Jenny L.; Chen, Linxiao; Perregaux, Emily C.

The development of antibodies against specific glycan epitopes poses a significant challenge due to difficulties obtaining desired glycans at sufficient quantity and purity, and the fact that glycans are usually weakly immunogenic. To address this challenge, we leveraged the potent immunostimulatory activity of bacterial outer membrane vesicles (OMVs) to deliver designer glycan epitopes to the immune system. This approach involved heterologous expression of two clinically important glycans, namely polysialic acid (PSA) and Thomsen-Friedenreich antigen (T antigen) in hypervesiculating strains of non-pathogenic Escherichia coli. The resulting glycOMVs displayed structural mimics of PSA or T antigen on their surfaces, and induced highmore » titers of glycan-specific IgG antibodies following immunization in mice. In the case of PSA glycOMVs, serum antibodies potently killed Neisseria meningitidis serogroup B (MenB), whose outer capsule is PSA, in a serum bactericidal assay. These findings demonstrate the potential of glycOMVs for inducing class-switched, humoral immune responses against glycan antigens.« less

Immunization with Outer Membrane Vesicles Displaying Designer Glycotopes Yields Class-Switched, Glycan-Specific Antibodies

DOE PAGES

Valentine, Jenny L.; Chen, Linxiao; Perregaux, Emily C.; ...

2016-06-23

The development of antibodies against specific glycan epitopes poses a significant challenge due to difficulties obtaining desired glycans at sufficient quantity and purity, and the fact that glycans are usually weakly immunogenic. To address this challenge, we leveraged the potent immunostimulatory activity of bacterial outer membrane vesicles (OMVs) to deliver designer glycan epitopes to the immune system. This approach involved heterologous expression of two clinically important glycans, namely polysialic acid (PSA) and Thomsen-Friedenreich antigen (T antigen) in hypervesiculating strains of non-pathogenic Escherichia coli. The resulting glycOMVs displayed structural mimics of PSA or T antigen on their surfaces, and induced highmore » titers of glycan-specific IgG antibodies following immunization in mice. In the case of PSA glycOMVs, serum antibodies potently killed Neisseria meningitidis serogroup B (MenB), whose outer capsule is PSA, in a serum bactericidal assay. These findings demonstrate the potential of glycOMVs for inducing class-switched, humoral immune responses against glycan antigens.« less

ESSA, Equity of Opportunity, and Addressing Barriers to Learning. Research for School Improvement and Transformation. Policy Brief

ERIC Educational Resources Information Center

Center for Mental Health in Schools at UCLA, 2016

2016-01-01

The "Every Student Succeeds Act" (ESSA) recognizes that significant numbers of students require supports to successfully meet challenging state academic standards. This brief (1) analyzes the act to assess how it addresses the nature and scope of supports to address barriers to learning and re-engage disconnected students and (2)…

Has the biobank bubble burst? Withstanding the challenges for sustainable biobanking in the digital era.

PubMed

Chalmers, Don; Nicol, Dianne; Kaye, Jane; Bell, Jessica; Campbell, Alastair V; Ho, Calvin W L; Kato, Kazuto; Minari, Jusaku; Ho, Chih-Hsing; Mitchell, Colin; Molnár-Gábor, Fruzsina; Otlowski, Margaret; Thiel, Daniel; Fullerton, Stephanie M; Whitton, Tess

2016-07-12

Biobanks have been heralded as essential tools for translating biomedical research into practice, driving precision medicine to improve pathways for global healthcare treatment and services. Many nations have established specific governance systems to facilitate research and to address the complex ethical, legal and social challenges that they present, but this has not lead to uniformity across the world. Despite significant progress in responding to the ethical, legal and social implications of biobanking, operational, sustainability and funding challenges continue to emerge. No coherent strategy has yet been identified for addressing them. This has brought into question the overall viability and usefulness of biobanks in light of the significant resources required to keep them running. This review sets out the challenges that the biobanking community has had to overcome since their inception in the early 2000s. The first section provides a brief outline of the diversity in biobank and regulatory architecture in seven countries: Australia, Germany, Japan, Singapore, Taiwan, the UK, and the USA. The article then discusses four waves of responses to biobanking challenges. This article had its genesis in a discussion on biobanks during the Centre for Health, Law and Emerging Technologies (HeLEX) conference in Oxford UK, co-sponsored by the Centre for Law and Genetics (University of Tasmania). This article aims to provide a review of the issues associated with biobank practices and governance, with a view to informing the future course of both large-scale and smaller scale biobanks.

Veterans Affairs: Sustained Management Attention Needed to Address Numerous IT Challenges

DTIC Science & Technology

2016-06-22

territories and the Philippines. The department’s three major components—the Veterans Benefits Administration ( VBA ), the Veterans Health Administration...VHA), and the National Cemetery Administration (NCA)—are primarily responsible for carrying out its mission. More specifically, VBA provides a...used for the determination of benefits, benefits claims processing, patient admission to hospitals and clinics, and access to health records, among

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

DOT National Transportation Integrated Search

2009-12-23

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

FTP Extensions for Variable Protocol Specification

NASA Technical Reports Server (NTRS)

Allman, Mark; Ostermann, Shawn

2000-01-01

The specification for the File Transfer Protocol (FTP) assumes that the underlying network protocols use a 32-bit network address and a 16-bit transport address (specifically IP version 4 and TCP). With the deployment of version 6 of the Internet Protocol, network addresses will no longer be 32-bits. This paper species extensions to FTP that will allow the protocol to work over a variety of network and transport protocols.

Wasatch: An architecture-proof multiphysics development environment using a Domain Specific Language and graph theory

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

Saad, Tony; Sutherland, James C.

To address the coding and software challenges of modern hybrid architectures, we propose an approach to multiphysics code development for high-performance computing. This approach is based on using a Domain Specific Language (DSL) in tandem with a directed acyclic graph (DAG) representation of the problem to be solved that allows runtime algorithm generation. When coupled with a large-scale parallel framework, the result is a portable development framework capable of executing on hybrid platforms and handling the challenges of multiphysics applications. In addition, we share our experience developing a code in such an environment – an effort that spans an interdisciplinarymore » team of engineers and computer scientists.« less

Wasatch: An architecture-proof multiphysics development environment using a Domain Specific Language and graph theory

DOE PAGES

Saad, Tony; Sutherland, James C.

2016-05-04

To address the coding and software challenges of modern hybrid architectures, we propose an approach to multiphysics code development for high-performance computing. This approach is based on using a Domain Specific Language (DSL) in tandem with a directed acyclic graph (DAG) representation of the problem to be solved that allows runtime algorithm generation. When coupled with a large-scale parallel framework, the result is a portable development framework capable of executing on hybrid platforms and handling the challenges of multiphysics applications. In addition, we share our experience developing a code in such an environment – an effort that spans an interdisciplinarymore » team of engineers and computer scientists.« less

Rethinking Environmental Protection: Meeting the Challenges ...

EPA Pesticide Factsheets

Background: The U.S. Environmental Protection Agency (EPA) has made great progress in addressing some major environmental problems. These successes were framed within EPA’s statutory mandates which are largely media-specific and receptor-focused and follow a segmented risk-based construct. Today’s environmental problems are increasingly complex, and new approaches are needed to achieve sustainable solutions that protect the environment and public health. Objectives: We provide an overview of environmental protection at EPA and highlight today’s environmental challenges. We provide case examples of systems approaches that consider the links between environment and human health. We offer a strategic framework for tackling challenges so EPA can continue to protect the environment and public health.Discussion: Expanded approaches will be transdisciplinary, informed by vast new sources of data, and build upon new stakeholder partnerships. A systems approach to environmental protection looks at problems holistically, includes the drivers and stressors that impact the issue and the dimensions that frame it, and integrates various types of data from health, ecological, and social sciences, with the goal of formulating sustainable solutions to environmental issues. Conclusions: The natural environment and human health are inextricably linked, and human health, well-being, and economic prosperity depend on healthy ecosystems. EPA research is leading an evolution in

National Institutes of Health addresses the science of diversity.

PubMed

Valantine, Hannah A; Collins, Francis S

2015-10-06

The US biomedical research workforce does not currently mirror the nation's population demographically, despite numerous attempts to increase diversity. This imbalance is limiting the promise of our biomedical enterprise for building knowledge and improving the nation's health. Beyond ensuring fairness in scientific workforce representation, recruiting and retaining a diverse set of minds and approaches is vital to harnessing the complete intellectual capital of the nation. The complexity inherent in diversifying the research workforce underscores the need for a rigorous scientific approach, consistent with the ways we address the challenges of science discovery and translation to human health. Herein, we identify four cross-cutting diversity challenges ripe for scientific exploration and opportunity: research evidence for diversity's impact on the quality and outputs of science; evidence-based approaches to recruitment and training; individual and institutional barriers to workforce diversity; and a national strategy for eliminating barriers to career transition, with scientifically based approaches for scaling and dissemination. Evidence-based data for each of these challenges should provide an integrated, stepwise approach to programs that enhance diversity rapidly within the biomedical research workforce.

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

Optimizing perioperative care for children and adolescents with challenging behaviors.