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.

Atomic Oxygen Task

NASA Technical Reports Server (NTRS)

Hadaway, James B.

1997-01-01

This report details work performed by the Center for Applied Optics (CAO) at the University of Alabama in Huntsville (UAH) on the contract entitled 'Atomic Oxygen Task' for NASA's Marshall Space Flight Center (contract NAS8-38609, Delivery Order 109, modification number 1). Atomic oxygen effects on exposed materials remain a critical concern in designing spacecraft to withstand exposure in the Low Earth Orbit (LEO) environment. The basic objective of atomic oxygen research in NASA's Materials & Processes (M&P) Laboratory is to provide the solutions to material problems facing present and future space missions. The objective of this work was to provide the necessary research for the design of specialized experimental test configurations and development of techniques for evaluating in-situ space environmental effects, including the effects of atomic oxygen and electromagnetic radiation on candidate materials. Specific tasks were performed to address materials issues concerning accelerated environmental testing as well as specifically addressing materials issues of particular concern for LDEF analysis and Space Station materials selection.

Brief Report: Attitudes about Responding to Survey Questions Concerning Childhood Sexual Abuse by Hispanic Female College Students

ERIC Educational Resources Information Center

Ernst, Frederick A.; Salinas, Nancy I.; Perez, Natalie

2009-01-01

In no studies have research participants been asked how they feel about answering questions concerning childhood sexual abuse. We have performed searches from two different search engines again and have found nothing published which specifically addresses this question in the way we have. A questionnaire about childhood sexual abuse was…

Thoughts About Advancement of the Discipline: Dark Clouds and Bright Lights.

PubMed

Turkel, Marian; Fawcett, Jacqueline; Chinn, Peggy L; Eustace, Rosemary; Hansell, Phyllis Shanley; Smith, Marlaine C; Watson, Jean; Zahourek, Rothlyn

2018-01-01

In this essay, several nurse scholars who are particularly concerned about the contemporary state of nursing science present their specific concerns (dark clouds) about the advancement of our discipline and the ways in which the concerns have been addressed (bright lights). This essay is the first of two essays that were catalyzed by Barrett's paper, "Again, What Is Nursing Science?" The second essay will be published in the next issue Nursing Science Quarterly.

Gender and Perceived Illness Severity: Differential Indicators of Employment Concerns for Adults with Multiple Sclerosis?

ERIC Educational Resources Information Center

Roessler, Richard T.; Turner, Ronna C.; Robertson, Judith L.; Rumrill,Phillip D.

2005-01-01

Although research has indicated a link between gender and perceived illness severity and the employment status of people with multiple sclerosis (MS), it has not addressed questions regarding the relationship between those variables and specific types of employment concerns. In this study, a sample of 1,310 adults with MS replied to a mail survey…

7 CFR 1466.20 - Application for contracts and selecting applications.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Committee or local working group, may establish ranking pools to address a specific resource concern..., such as the location of the conservation practice, the extent of natural resource degradation, and the...

7 CFR 1466.20 - Application for contracts and selecting applications.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Committee or local working group, may establish ranking pools to address a specific resource concern..., such as the location of the conservation practice, the extent of natural resource degradation, and the...

Solution-focused conversations: a new therapeutic strategy in well child health nursing telephone consultations.

PubMed

Polaschek, Linda; Polaschek, Nick

2007-07-01

This paper is a report of a study to explore well child nurses' perceptions of outcomes resulting from the use of solution-focused conversations in their telephone consultations with clients. Well child nurses (health visitors) in some services provide a separate telephone consultation service for parents who need immediate advice or are unable to visit the clinic. As well as purely physical issues suggesting infant pathology, these consultations address a range of other concerns relating to parenting and child behaviour. The standard problem-solving approach used to address physical issues is less effective for various non-physical concerns, where different communication strategies may be helpful. In this qualitative, action-oriented study, a small group of well child telenurses in New Zealand was introduced to a specific communication strategy, called 'solution-focused conversations', during 2005. They applied this approach in their practice and then reflected together on their experiences in focus groups. The nurses considered that the solution-focused conversations enabled clients to: recognize the nature of the parenting issue of concern that had motivated their call; identify more effective parenting practices to address specific issues with their child; increase their confidence in their own parenting capabilities. This study suggested the value of learning a specific communication strategy for the practice of a group of well child telenurses. Solution-focused conversation is a suitable approach for the single, relatively short, interactions involved in telephone nursing. Other communication strategies could be appropriate for nurses in different clinical situations.

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

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

None, None

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

Ethical issues in research and publication.

PubMed

Iammarino, N K; O'Rourke, T W; Pigg, R M; Weinberg, A D

1989-03-01

Ethical considerations inherent in the process of research and publication represent one issue of particular concern to professionals. Members of a profession usually are guided by a code of ethics that specifies standards for practice. However, rarely do professional preparation programs sufficiently prepare students to deal with the concerns associated with research and professional publication. The authors address three specific areas of concern for health educators: the student-professor relationship, joint authorship, and ethics in publishing. Potential problems are discussed, and implications for the profession are cited.

Skincare Bootcamp: The Evolving Role of Skincare.

PubMed

Rodan, Katie; Fields, Kathy; Majewski, George; Falla, Timothy

2016-12-01

Although cosmetic procedures have a significant impact on certain aspects of aging, such as deep, wrinkling, sagging, and volume loss, they fail to address the overall quality of the skin. Daily skincare routines potentially can have a significant long-term impact on the overall quality of a person's complexion. By expanding our product knowledge, we can help our patients individualize their at-home skincare routine using effective products and ingredients designed to address their specific skin concern and support the professional care we deliver. Here, we discuss the types of products and ingredients suitable for the most common dermatologic concerns, from wrinkling to skin sensitivity, acne to sun damage.

Potential of Organic Matrix Composites for Liquid Oxygen Tank

NASA Technical Reports Server (NTRS)

Davis, Samuel E.; Herald, Stephen D.; Stolzfus, Joel M.; Engel, Carl D.; Bohlen, James W.; Palm, Tod; Robinson, Michael J.

2005-01-01

Composite materials are being considered for the tankage of cryogenic propellants in access to space because of potentially lower structural weights. A major hurdle for composites is an inherent concern about the safety of using flammable structural materials in contact with liquid and gaseous oxygen. A hazards analysis approach addresses a series of specific concerns that must be addressed based upon test data. Under the 2nd Generation Reusable Launch Vehicle contracts, testing was begun for a variety of organic matrix composite materials both to aid in the selection of materials and to provide needed test data to support hazards analyses. The work has continued at NASA MSFC and the NASA WSTF to provide information on the potential for using composite materials in oxygen systems. Appropriate methods for oxygen compatibility testing of structural materials and data for a range of composite materials from impact, friction, flammability and electrostatic discharge testing are presented. Remaining concerns and conclusions about composite tank structures, and recommendations for additional testing are discussed. Requirements for system specific hazards analysis are identified.

Testing key predictions of the associative account of mirror neurons in humans using multivariate pattern analysis.

PubMed

Oosterhof, Nikolaas N; Wiggett, Alison J; Cross, Emily S

2014-04-01

Cook et al. overstate the evidence supporting their associative account of mirror neurons in humans: most studies do not address a key property, action-specificity that generalizes across the visual and motor domains. Multivariate pattern analysis (MVPA) of neuroimaging data can address this concern, and we illustrate how MVPA can be used to test key predictions of their account.

Communication between office-based primary care providers and nurses working within patients' homes: an analysis of process data from CAPABLE.

PubMed

Smith, Patrick D; Boyd, Cynthia; Bellantoni, Julia; Roth, Jill; Becker, Kathleen L; Savage, Jessica; Nkimbeng, Manka; Szanton, Sarah L

2016-02-01

To examine themes of communication between office-based primary care providers and nurses working in private residences; to assess which methods of communication elicit fruitful responses to nurses' concerns. Lack of effective communication between home health care nurses and primary care providers contributes to clinical errors, inefficient care delivery and decreased patient safety. Few studies have described best practices related to frequency, methods and reasons for communication between community-based nurses and primary care providers. Secondary analysis of process data from 'Community Aging in Place: Advancing Better Living for Elders (CAPABLE)'. Independent reviewers analysed nurse documentation of communication (phone calls, letters and client coaching) initiated for 70 patients and analysed 45 letters to primary care providers to identify common concerns and recommendations raised by CAPABLE nurses. Primary care providers responded to 86% of phone calls, 56% of letters and 50% of client coaching efforts. Primary care providers addressed 86% of concerns communicated by phone, 34% of concerns communicated by letter and 41% of client-raised concerns. Nurses' letters addressed five key concerns: medication safety, pain, change in activities of daily living, fall safety and mental health. In letters, CAPABLE nurses recommended 58 interventions: medication change; referral to a specialist; patient education; and further diagnostic evaluation. Effective communication between home-based nurses and primary care providers enhances care coordination and improves outcomes for home-dwelling elders. Various methods of contact show promise for addressing specific communication needs. Nurses practicing within patients' homes can improve care coordination by using phone calls to address minor matters and written letters for detailed communication. Future research should explore implementation of Situation, Background, Assessment and Recommendation in home care to promote safe and efficient communication. Nurses should empower patients to address concerns directly with providers through use of devices including health passports. © 2016 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.

Applications manual for logit modes of express bus-fringe parking choices.

DOT National Transportation Integrated Search

1976-01-01

Manual computations and computerized applications of logit models are described. The models demonstrated reflect travel behavior concerning express bus-fringe parking transit. The specific travel issues addressed include the basic automobile vs. expr...

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.

Electronic Medical Record Documentation of Driving Safety for Veterans with Diagnosed Dementia.

PubMed

Vair, Christina L; King, Paul R; Gass, Julie; Eaker, April; Kusche, Anna; Wray, Laura O

2018-01-01

Many older adults continue to drive following dementia diagnosis, with medical providers increasingly likely to be involved in addressing such safety concerns. This study examined electronic medical record (EMR) documentation of driving safety for veterans with dementia (N = 118) seen in Veterans Affairs primary care and interdisciplinary geriatrics clinics in one geographic region over a 10-year period. Qualitative directed content analysis of retrospective EMR data. Assessment of known risk factors or subjective concerns for unsafe driving were documented in fewer than half of observed cases; specific recommendations for driving safety were evident for a minority of patients, with formal driving evaluation the most frequently documented recommendation by providers. Utilizing data from actual clinical encounters provides a unique snapshot of how driving risk and safety concerns are addressed for veterans with dementia. This information provides a meaningful frame of reference for understanding potential strengths and possible gaps in how this important topic area is being addressed in the course of clinical care. The EMR is an important forum for interprofessional communication, with documentation of driving risk and safety concerns an essential element for continuity of care and ensuring consistency of information delivered to patients and caregivers.

Trends in public health policies addressing violence against women.

PubMed

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

2014-08-01

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

Trends in public health policies addressing violence against women

PubMed Central

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

2014-01-01

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

Certification Testing Approach for Propulsion System Design

NASA Technical Reports Server (NTRS)

Rodriguez, Henry; Popp, Chris

2005-01-01

The Certification of Propulsion Systems is costly and complex which involves development and qualification testing. The desire of the certification process is to assure all requirements can be demonstrated to be compliant. The purpose of this paper is to address the technical design concerns of certifying a system for flight. The authors of this paper have experience the lessons learned from supporting the Shuttle Program for Main Propulsion and On Orbit Propulsions Systems. They have collaborated design concerns for certifying propulsion systems. Presented are Pressurization, Tankage, Feed System and Combustion Instability concerns. Propulsion System Engineers are challenged with the dilemma for testing new systems to specific levels to reduce risk yet maintain budgetary targets. A methodical approach is presented to define the types of test suitable to address the technical issues for qualifying systems for retiring the risk levels.

78 FR 46374 - Minority Depository Institution Preservation Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-31

... in preserving the economic viability of their institutions. These benefits include facilitating... goals and objectives related to credit union viability and access. Specifically, the program is...) Economic Development Specialist assistance in addressing examination concerns or topics of interest; (3...

Analysis of a Multi Disciplinary Approach to Gun Misuse and the Need for a Paradigm Shift in Terminology

DTIC Science & Technology

2016-12-01

may pave the way for addressing other issues of common interdisciplinary concern. 14. SUBJECT TERMS interdisciplinary approach integration ...for some degree of integration of these disciplinary approaches. Specifically, this thesis addresses the following five questions: • Do commonly held...for evaluating the integration of the various disciplinary approaches to gun misuse is apparently still lacking within the reviewed literature. The

Perceptions of climate-related risk among water sector professionals in Africa-Insights from the 2016 African Water Association Congress.

PubMed

Connolly, Katherine; Mbutu, Mwaura; Bartram, Jamie; Fuente, David

2018-06-01

The ability of water and wastewater utilities to provide safe and reliable water and sanitation services now and in the future will be determined, in part, by their resilience to climate change. Investment in infrastructure, planning, and operational practices that increase resilience are affected, in turn, by how water sector professionals perceive the risks posed to utilities by climate change and its related impacts. We surveyed water sector professionals at the 2016 African Water Association's Congress in Nairobi, Kenya to assess their perceptions of climate-specific and general risks that may disrupt utility service. We find that water sector professionals are most concerned about climate-specific and general risks that affect utility water supplies (quantity), followed by adequacy of utility infrastructure. We also find that professionals tend to rank climate-specific risks as less concerning than general risks facing utilities. Furthermore, non-utility professionals are more concerned about climate-specific risks and climate change in general than utility professionals. These findings highlight the multiple, competing risks utilities face and the need for adaptation strategies that simultaneously address climate-specific and general concerns of utilities. Copyright © 2018 Elsevier GmbH. All rights reserved.

Skincare Bootcamp: The Evolving Role of Skincare

PubMed Central

Rodan, Katie; Fields, Kathy; Majewski, George

2016-01-01

Background: Although cosmetic procedures have a significant impact on certain aspects of aging, such as deep, wrinkling, sagging, and volume loss, they fail to address the overall quality of the skin. Methods: Daily skincare routines potentially can have a significant long-term impact on the overall quality of a person’s complexion. Results: By expanding our product knowledge, we can help our patients individualize their at-home skincare routine using effective products and ingredients designed to address their specific skin concern and support the professional care we deliver. Conclusions: Here, we discuss the types of products and ingredients suitable for the most common dermatologic concerns, from wrinkling to skin sensitivity, acne to sun damage. PMID:28018771

Does anxiety sensitivity predict symptoms of panic, depression, and social anxiety?

PubMed

Grant, DeMond M; Beck, J Gayle; Davila, Joanne

2007-09-01

This study examined whether the lower-order factors of the Anxiety Sensitivity Index (ASI) exhibited specificity in predicting symptoms of panic, depression, and social anxiety prospectively. This question was addressed using a sample of undergraduates stratified to represent low, medium, and high levels of anxiety sensitivity (AS). It was hypothesized that the physical concerns, mental concerns, and social concerns subscales of the ASI would predict increases in panic, depression, and social anxiety symptoms, respectively, one year later. Results found that the physical concerns subscale predicted increases in both panic and depressive symptoms. Neither the mental concerns nor the social concerns subscales predicted significant variance in any of the Time 2 symptoms. Theoretical implications of these data for AS are discussed.

The Exchange Visitor Program: Options for Review and Revision. A Position Paper Prepared by NAFSA: Association of International Educators for the Task Force on Regulatory Reform, United States Information Agency.

ERIC Educational Resources Information Center

National Association for Foreign Student Affairs, Washington, DC.

This position paper addresses four general areas of concern relating to the Exchange Visitor Program (EVP) and discusses specific proposals and related foreign policy implications. The areas of concern are as follows: (1) the role of the Immigration and Naturalization Service in EVP; (2) the relationship between the United States Information…

Professional concerns of beginning teachers of deaf and hard of hearing students.

PubMed

Guteng, Simon I

2005-01-01

The professional concerns of beginning teachers of students who are deaf or hard of hearing were examined. Five first-year teachers of deaf and hard of hearing students served as participants. Two of the participants were itinerant teachers; three taught in self-contained classrooms. Participants were selected from programs serving deaf and hard of hearing students in rural and urban areas of the midwestern and southwestern United States. To interview the study participants, the researcher used an in-depth phenomenological method employing semi-structured questions and guided by a constructivist paradigm. Data were analyzed using qualitative analysis strategies (Bogdan & Biklen, 1992; Miles & Huberman, 1994). Results showed that concerns of beginning teachers of deaf and hard of hearing students are specific to service delivery models and geography. Participants provided specific recommendations for addressing the concerns of beginning teachers of deaf and hard of hearing students.

Spacecraft applications of advanced global positioning system technology

NASA Technical Reports Server (NTRS)

Huth, Gaylord; Dodds, James; Udalov, Sergei; Austin, Richard; Loomis, Peter; Duboraw, I. Newton, III

1988-01-01

The purpose of this study was to evaluate potential uses of Global Positioning System (GPS) in spacecraft applications in the following areas: attitude control and tracking; structural control; traffic control; and time base definition (synchronization). Each of these functions are addressed. Also addressed are the hardware related issues concerning the application of GPS technology and comparisons are provided with alternative instrumentation methods for specific functions required for an advanced low earth orbit spacecraft.

Multicultural Issues and Concerns in Library Education.

ERIC Educational Resources Information Center

Freiband, Susan J.

1992-01-01

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

25 CFR 900.236 - May an Indian tribe elect to negotiate contract provisions on conflict of interest to take the...

Code of Federal Regulations, 2011 CFR

2011-04-01

... BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR, AND INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND... provisions, concerning either personal or organizational conflicts, that address the issues specific to the...

25 CFR 900.236 - May an Indian tribe elect to negotiate contract provisions on conflict of interest to take the...

Code of Federal Regulations, 2010 CFR

2010-04-01

... BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR, AND INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND... provisions, concerning either personal or organizational conflicts, that address the issues specific to the...

The Torrance Phenomenon.

ERIC Educational Resources Information Center

Magyari-Beck, Istvan

1996-01-01

Addresses issues concerned with the investigation of creativity across various human cultures, including data collection from a limited cultural base, a three-level approach to cross-cultural studies of creativity, identification of basic cultural paradigms characteristic of a specific culture, and barriers to mature cross-cultural relativism. (DB)

Rights and Wrongs...

ERIC Educational Resources Information Center

Update on the Courts, 1996

1996-01-01

This serial issue concerns itself with several conflicts between individual rights and allegedly wrongful acts that the Supreme Court has not considered previously. The articles on these topics illuminate the constitutional issues of equal protection, due process, and freedom of expression. Specific issues addressed include: (1) equal educational…

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

PubMed

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

2008-01-01

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

Alternative-Specific and Case-Specific Factors Involved in the Decisions of Islamic School Teachers Affecting Teacher Retention: A Discrete Choice Experiment

ERIC Educational Resources Information Center

Abd-El-Hafez, Alaa Karem

2015-01-01

Teacher retention is a concern in all educational sectors in America. It is of special importance to Islamic schools, which tend to lack the resources necessary in recruiting and training new teachers. This dissertation addressed this problem in full-time Islamic schools in New York State by conducting a discrete choice experiment, which reflects…

One Head Start Classroom's Experience: Computers and Young Children's Development.

ERIC Educational Resources Information Center

Fischer, Melissa Anne; Gillespie, Catherine Wilson

2003-01-01

Contends that early childhood educators need to understand how exposure to computers and constructive computer programs affects the development of children. Specifically examines: (1) research on children's technology experiences; (2) determining best practices; and (3) addressing educators' concerns about computers replacing other developmentally…

Workers' Education in Industrialised Countries and Its Specific Problems in Relation to Development.

ERIC Educational Resources Information Center

Labour Education, 1986

1986-01-01

Examines several problems that need to be addressed concerning world crisis: war, poverty, unemployment, overpopulation, environmental issues, and housing; developed versus developing countries; and social justice. The task for workers' education in relation to these problems is discussed. (CT)

Rehabilitation of cheatgrass-infested rangelands: management

USDA-ARS?s Scientific Manuscript database

This is the final part of a three part series specifically addressing lessons learned concerning the management of rehabilitated cheatgrass-infested rangelands. Steve Novak and Richard Mack reported in 2003 that they found no evidence of outcrossing in 2,000 cheatgrass seedlings from 60 North Americ...

Enhancing blood donation intentions using multimedia donor education materials.

PubMed

France, Christopher R; France, Janis L; Wissel, Mary Ellen; Kowalsky, Jennifer M; Bolinger, Elizabeth M; Huckins, Jamie L

2011-08-01

Prior research has shown that education materials that directly address prospective donor concerns and provide specific coping suggestions are particularly effective at enhancing donation attitudes and intentions to give blood. This study compared the effect of donor coping materials, provided in written and audiovisual formats, as potential tools to enhance recruitment of prospective blood donors. The role of initial attitudes toward blood donation on responses to these materials was also considered. Young adults (62% female; mean [SD] age=19.1 [1.4]; mean [range] prior blood donations=1.32 [0-13]) were randomly assigned to 1) read a brochure addressing common blood donor concerns and suggesting specific coping strategies, 2) view a video addressing blood donor concerns and illustrating coping techniques, 3) read the brochure and view the video, or 4) read a control brochure on healthy eating and exercise. Measures of blood donation attitudes, anxiety, confidence, and intentions to give blood were completed before and after the intervention. Relative to the control brochure, all the intervention groups showed larger reductions in anxiety, more positive changes in attitude, and greater increases in donation confidence and intentions. The combination of the brochure and video outperformed either intervention alone in further improving donation attitudes among participants with high initial donation attitudes. Blood donation coping materials, presented in either written or audiovisual formats, significantly enhance willingness to donate blood among young adults regardless of their initial attitudes toward blood donation. © 2011 American Association of Blood Banks.

Cancer screening in the older adult: issues and concerns.

PubMed

Craft, Melissa

2014-06-01

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

Time-Varying, Multi-Scale Adaptive System Reliability Analysis of Lifeline Infrastructure Networks

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

Gearhart, Jared Lee; Kurtz, Nolan Scot

2014-09-01

The majority of current societal and economic needs world-wide are met by the existing networked, civil infrastructure. Because the cost of managing such infrastructure is high and increases with time, risk-informed decision making is essential for those with management responsibilities for these systems. To address such concerns, a methodology that accounts for new information, deterioration, component models, component importance, group importance, network reliability, hierarchical structure organization, and efficiency concerns has been developed. This methodology analyzes the use of new information through the lens of adaptive Importance Sampling for structural reliability problems. Deterioration, multi-scale bridge models, and time-variant component importance aremore » investigated for a specific network. Furthermore, both bridge and pipeline networks are studied for group and component importance, as well as for hierarchical structures in the context of specific networks. Efficiency is the primary driver throughout this study. With this risk-informed approach, those responsible for management can address deteriorating infrastructure networks in an organized manner.« less

Testing the usability of two automated home-based patient-management systems.

PubMed

Farzanfar, Ramesh; Finkelstein, Joseph; Friedman, Robert H

2004-04-01

To explore to what extent observation and semistructured in-depth interviews provide effective tools for usability testing of two automated home-based systems aimed at monitoring patients' health status at home and improving self-care. Telephone-Linked Care for Diet Adherence in Dyslipidemia (TLC-DietAid) used computer telephony to interact with users and Home Asthma Telemonitoring System (HAT System) used a combination of Personal Digital Assistant (palmtops) and the Internet for similar purposes. Both systems were evaluated in two separate pilot studies. Our pilot studies uncovered "medium-specific" and "content-specific" issues that addressed either the process of the interaction or its content. The results demonstrated that patient-users tended to evaluate each system on the basis of how it fit into everyday life and corresponded to personal preferences. The methodology also allowed the system designers to understand users' concerns and the context of adoption in order to introduce necessary changes to the design to address such concerns.

Field Manual of Wildlife Diseases

USGS Publications Warehouse

Franson, J. Christian; Friend, Milton; Gibbs, Samantha E.J.; Wild, Margaret A.

2015-01-01

We begin this new manual with introductory contextual and historical background about the convergence of wildlife disease with wildlife management as a wildlife conservation concern (section A, chap. 1). The remainder of the publication is focused on pragmatic information and considerations for addressing various aspects of wildlife disease. Section B focuses on concepts associated with disease surveillance and response to outbreaks, and section C deals with specific techniques for disease surveillance and investigation. Section D, “Diseases of Wild Birds,” and others that follow will address diseases of concern in various species groups. Electronic links facilitate timely access to a wide variety of supplemental information and processes relevant to content in this new version of the “Field Manual of Wildlife Diseases.”

Safety evaluation report on Tennessee Valley Authority: Browns Ferry nuclear performance plan

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

Not Available

1989-10-01

This safety evaluation report (SER) on the information submitted by the Tennessee Valley Authority (TVA) in its Nuclear Performance Plan, through Revision 2, for the Browns Ferry Nuclear Plant and in supporting documents has been prepared by the US Nuclear Regulatory commission staff. The Browns Ferry Nuclear Plant consists of three boiling-water reactors at a site in Limestone County, Alabama. The plan addresses the plant-specific concerns requiring resolution before the startup of Unit 2. The staff will inspect implementation of those TVA programs that address these concerns. Where systems are common to Units 1 and 2 or to Units 2more » and 3, the staff safety evaluations of those systems are included herein. 85 refs.« less

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

PubMed

Robinson, Jeffrey D; Heritage, John

2016-01-01

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

Trends in personal motor vehicle ownership and use : evidence from the Nationwide Personal Transportation Survey

DOT National Transportation Integrated Search

1998-04-23

This paper addresses three related subject areas. The first is the total volume of personal motor vehicle travel, its recent growth, and the sources of its growth. The second subject concerns vehicle ownership, specifically, the number, types, and ag...

Indicators of Welfare Dependence: Annual Report to Congress.

ERIC Educational Resources Information Center

Department of Health and Human Services, Washington, DC.

This report addresses questions concerning the extent to which U.S. families depend on income from welfare programs, offering updated data on measures of welfare recipiency, dependency, and predictors of welfare dependence developed for previous reports. Chapter 1, "Introduction," reviews specific summary measures of welfare dependence…

Research pressure instrumentation for NASA Space Shuttle main engine, modification no. 5

NASA Technical Reports Server (NTRS)

Anderson, P. J.; Nussbaum, P.; Gustafson, G.

1984-01-01

Research concerning the development of pressure instrumentation for the space shuttle main engine is reported. The following specific topics were addressed: (1) transducer design and materials, (2) silicon piezoresistor characterization at cryogenic temperatures, (3) chip mounting characterization, and (4) frequency response optimization.

Stanley Cavell in Conversation with Paul Standish

ERIC Educational Resources Information Center

Journal of Philosophy of Education, 2012

2012-01-01

Having acknowledged the recurrent theme of education in Stanley Cavell's work, the discussion addresses the topic of scepticism, especially as this emerges in the interpretation of Wittgenstein. Questions concerning rule-following, language and society are then turned towards political philosophy, specifically with regard to John Rawls. The…

The Use of Technology for Enhancing the Learning Experiences of Undergraduate Students: From Online Education to the Use of Mobile Devices and Web-Based Programs

ERIC Educational Resources Information Center

Hochstrasser, Jeffrey L.

2014-01-01

This three article dissertation is the culminating requirement for the Professional Practices Doctorate, resulting in a terminal Ed.D. degree at the University of Idaho. As such, it consists of three articles specifically relating to educational concerns at Brigham Young University-Idaho. The goal was to address specific situations or needs…

Teaching and physics education research: bridging the gap.

PubMed

Fraser, James M; Timan, Anneke L; Miller, Kelly; Dowd, Jason E; Tucker, Laura; Mazur, Eric

2014-03-01

Physics faculty, experts in evidence-based research, often rely on anecdotal experience to guide their teaching practices. Adoption of research-based instructional strategies is surprisingly low, despite the large body of physics education research (PER) and strong dissemination effort of PER researchers and innovators. Evidence-based PER has validated specific non-traditional teaching practices, but many faculty raise valuable concerns toward their applicability. We address these concerns and identify future studies required to overcome the gap between research and practice.

Digital Social Media, Youth, and Nonmedical Use of Prescription Drugs: The Need for Reform

PubMed Central

Liang, Bryan A; Strathdee, Steffanie A

2013-01-01

The tragic death of 18-year-old Ryan Haight highlighted the ethical, public health, and youth patient safety concerns posed by illicit online nonmedical use of prescription drugs (NUPM) sourcing, leading to a federal law in an effort to address this concern. Yet despite the tragedy and resulting law, the NUPM epidemic in the United States has continued to escalate and represents a dangerous and growing trend among youth and adolescents. A critical point of access associated with youth NUPM is the Internet. Internet use among this vulnerable patient group is ubiquitous and includes new, emerging, and rapidly developing technologies—particularly social media networking (eg, Facebook and Twitter). These unregulated technologies may pose a potential risk for enabling youth NUPM behavior. In order to address limitations of current regulations and promote online safety, we advocate for legislative reform to specifically address NUPM promotion via social media and other new online platforms. Using more comprehensive and modernized federal legislation that anticipates future online developments is critical in substantively addressing youth NUPM behavior occurring through the Internet. PMID:23892156

Using technology to support HIV self-testing among MSM.

PubMed

LeGrand, Sara; Muessig, Kathryn E; Horvath, Keith J; Rosengren, Anna L; Hightow-Weidman, Lisa B

2017-09-01

Technology-based HIV self-testing (HST) interventions have the potential to improve access to HIV testing among gay, bisexual, and other MSM, as well as address concerns about HST use, including challenges with linkage to appropriate follow-up services. This review examines studies that use technology-based platforms to increase or improve the experience of HST among MSM. Seven published studies and eight funded studies were included in this review. Comprehensive prevention interventions with free HST kit distribution and interventions that provide free HST kits and support the HST process address a greater number of barriers (e.g., access, correct use of testing kits, and correct interpretation of results) than studies that only distribute free HST kits through technology-based platforms. By addressing HIV-testing barriers and specific HST concerns, these interventions address a critical need to improve first time and repeat testing rates among MSM. Additional research is needed to determine the efficacy of recent formative HST interventions. If proven efficacious, scale-up of these strategies have the potential to increase HIV testing among MSM via expanded HST uptake.

Eating Disorders: The School Counselor's Role.

ERIC Educational Resources Information Center

Omizo, Sharon A.; Omizo, Michael M.

1992-01-01

Discusses role of school counselor in providing assistance to students who may be at risk for developing anorexia nervosa and bulimia and students who already display behaviors and physical symptoms of either of these illnesses. Addresses specific concerns regarding intervention strategies used by the school counselor in the student's recovery…

HIV liability & disability services providers: an introduction to tort principles.

PubMed

Harvey, D C; Decker, C L

1991-08-01

Mental health and developmental disability services providers are concerned that liability issues regarding worker and client exposure to HIV have not been adequately addressed. By developing policy specifically in the areas of education, infection control practices, and confidentiality, providers may minimize findings of liability and protect patient rights.

Designing "Interaction": How Do Interaction Design Students Address Interaction?

ERIC Educational Resources Information Center

Karlgren, Klas; Ramberg, Robert; Artman, Henrik

2016-01-01

Interaction design is usually described as being concerned with interactions with and through artifacts but independent of a specific implementation. Design work has been characterized as a conversation between the designer and the situation and this conversation poses a particular challenge for interaction design as interactions can be elusive…

Migration and Adult Education

ERIC Educational Resources Information Center

Gois, William

2007-01-01

The objective of this paper is to highlight the role of adult education as a tool in addressing labour migration issues, specifically those concerning the protection of migrant workers' rights and the transformation of the impact of migration into positive holistic developmental gains. The view of labour migration as a means to forge the economic…

Adolescent Behavior and Health in Cross-Cultural Context

ERIC Educational Resources Information Center

Demetrovics, Zsolt

2012-01-01

Specific behavioral problems appear during early adolescence, and they become more pronounced. Although these problems are universal in many aspects, cultural differences are also conspicuous. The author, in addition to analyzing the five studies in the Special Issue, addresses questions concerning the cross-cultural context. The analysis reveals…

Internationalizing Career Counseling: Emptying Our Cups and Learning from Each Other

ERIC Educational Resources Information Center

Hartung, Paul J.

2005-01-01

The symposium International Perspectives on Career Development included a plenary session that addressed career counseling in a world of limited resources. Panelists representing diverse areas of the world shared their perspectives on career counseling in their countries and the specific problems they faced. They identified common concerns and…

Sheltered and Supported Work Comparison: A Response to Wehman's Comments.

ERIC Educational Resources Information Center

Lam, Chow S.

1987-01-01

Responds to comments made by Wehman, Hill, Kregel, and Moon (1987) concerning the results of Lam's 1986 study comparing supported and sheltered employment programs for persons with mental retardation. Addresses specific questions raised by Wehman and his colleagues and discusses research issues on sample comparability. (Author/NB)

Academic Intellectual Property in a New Technological and Industrial Context.

ERIC Educational Resources Information Center

Spearritt, Peter; Thomas, Julian

1996-01-01

Practical and policy questions concerning intellectual property are considered in the context of advancing information technology and expanding international exchange of ideas, and specifically as they are or need to be addressed by Australian copyright and patent law. A 1995 discussion paper by the Australian Vice-Chancellors' Committee is…

Research pressure instrumentation for NASA Space Shuttle main engine, modification no. 6

NASA Technical Reports Server (NTRS)

Anderson, P. J.; Johnson, R. L.

1984-01-01

Research concerning the utilization of silicon piezoresistive strain sensing technology for space shuttle main engine applications is reported. The following specific topics were addressed: (1) transducer design and materials, (2) silicon piezoresistor characterization at cryogenic temperatures, (3) chip mounting characterization, and (4) frequency response optimization.

Gas alternatives to carbon dioxide for euthanasia: A piglet perspective

USDA-ARS?s Scientific Manuscript database

The identification and validation of a humane method to euthanize piglets is critical to address concern that current methods are not acceptable. This research sought to: 1) identify a method of scientifically determining if pigs find a specific euthanasia method aversive, and 2) develop an innovati...

Compulsive Internet Use among Adolescents: Bidirectional Parent-Child Relationships

ERIC Educational Resources Information Center

van den Eijnden, Regina J. J. M.; Spijkerman, Renske; Vermulst, Ad A.; van Rooij, Tony J.; Engels, Rutger C. M. E.

2010-01-01

Although parents experience growing concerns about their children's excessive internet use, little is known about the role parents can play to prevent their children from developing Compulsive Internet Use (CIU). The present study addresses associations between internet-specific parenting practices and CIU among adolescents, as well as the…

77 FR 12107 - Reports, Forms and Recordkeeping Requirements; Agency Information Collection Activity Under OMB...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-28

..., and transportation service providers to identify their specific plans, investment strategies, and perspectives concerning market trends, which are a critical part of the subject Study. Finally, the Maritime... (or will be developed) to address the potential impacts on their costs and routing strategies as a...

The Art Association/Higher Education Partnership: Implementing Residential Professional Development

ERIC Educational Resources Information Center

Charland, William

2006-01-01

In-service professional development in education began informally in the early nineteenth-century as a means of disseminating classroom management techniques, specifically addressing ways in which corporal punishment could be delivered to a child without inflicting serious injury. This initial effort paralleled a concern regarding children's…

Mobility and Young Children.

ERIC Educational Resources Information Center

Bernard van Leer Foundation Newsletter, 1994

1994-01-01

This newsletter theme issue deals with the phenomenon of mobility or transience in India, Kenya, Greece, Ireland, Malaysia, Thailand and Israel. The primary focus is on mobility's effect on young children, specifically their health and education; some of the broader concerns also addressed by the newsletter are the causes of mobility and its…

Evaluation of an Educational Program for Adolescents with Asthma

ERIC Educational Resources Information Center

Berg, Jill; Tichacek, Mary J.; Theodorakis, Renee

2004-01-01

In addition to challenges of adolescence itself, teens with asthma face demands of asthma management and risks of asthma sequelae, including fatalities. Few asthma educational programs specifically address their needs. In response to school nurse concern, this pilot study evaluated an adolescent asthma education program, the "Power Breathing[TM]…

Supporting Source Code Comprehension during Software Evolution and Maintenance

ERIC Educational Resources Information Center

Alhindawi, Nouh

2013-01-01

This dissertation addresses the problems of program comprehension to support the evolution of large-scale software systems. The research concerns how software engineers locate features and concepts along with categorizing changes within very large bodies of source code along with their versioned histories. More specifically, advanced Information…

Comparing Three Methods of Geometrical Approach in Visualizing Differential Equations

ERIC Educational Resources Information Center

KarimiFardinpour, Younes; Gooya, Zahra

2018-01-01

This paper concerns "planes-coordination" and "long-term-prediction" difficulties. These are specifically the case when students attempt to visualize solution curves of autonomous differential equations for predicting the long-term behavior of various initial conditions. To address these issues, a study was conducted in which…

Land-Use-Planning Writing Assignment for an Environmental-Geology Course.

ERIC Educational Resources Information Center

Carson, Robert James; Sadd, James Lester

1991-01-01

Describes writing environmental impact statement concerning land use as assignment in geology courses. Students select area, propose land-use project, analyze available literature, choose specific site within map area for project, and write report addressing site access, water supply, liquid and solid waste disposal, mitigation of environmental…

Transnational architecting for homeland defense

NASA Astrophysics Data System (ADS)

O'Brien, Thomas W.

2002-07-01

The homeland security interests of a many nations are being increasingly threatened by the proliferation of weapons of mass destruction, drug trafficking, mass migration, global terrorism, environmental concerns, international crime and other global issues. This paper presents the case for development of such a transnational ballistic missile defense architecture for homeland defense and specifically addresses the architecture methodology and process, as well as the potential benefits and the top-level architecture trade issues that would have to be addressed if the community should decide to seriously pursue such an approach.

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.

Analyzing Patterns of Community Interest at a Legacy Mining Waste Site to Assess and Inform Environmental Health Literacy Efforts

PubMed Central

Ramirez-Andreotta, Monica D.; Lothrop, Nathan; Wilkinson, Sarah T.; Root, Robert A.; Artiola, Janick F.; Klimecki, Walter; Loh, Miranda

2015-01-01

Understanding a community’s concerns and informational needs is crucial to conducting and improving environmental health research and literacy initiatives. We hypothesized that analysis of community inquiries over time at a legacy mining site would be an effective method for assessing environmental health literacy efforts and determining whether community concerns were thoroughly addressed. Through a qualitative analysis, we determined community concerns at the time of being listed as a Superfund site. We analyzed how community concerns changed from this starting point over the subsequent years, and whether: 1) communication materials produced by the USEPA and other media were aligned with community concerns; and 2) these changes demonstrated a progression of the community’s understanding resulting from community involvement and engaged research efforts. We observed that when the Superfund site was first listed, community members were most concerned with USEPA management, remediation, site-specific issues, health effects, and environmental monitoring efforts related to air/dust and water. Over the next five years, community inquiries shifted significantly to include exposure assessment and reduction methods and issues unrelated to the site, particularly the local public water supply and home water treatment systems. Such documentation of community inquiries over time at contaminated sites is a novel method to assess environmental health literacy efforts and determine whether community concerns were thoroughly addressed. PMID:27595054

Moving Beyond the Theoretical: Medical Students' Desire for Practical, Role-Specific Ethics Training.

PubMed

Stites, Shana D; Clapp, Justin; Gallagher, Stefanie; Fiester, Autumn

2018-05-04

Background It has been widely reported that medical trainees experience situations with profound ethical implications during their clinical rotations. To address this most U.S. medical schools include ethics curricula in their undergraduate programs. However, the content of these curricula vary substantially. Our pilot study aimed to discover, from the students' perspective, how ethics pedagogy prepares medical students for clerkship and what gaps might remain. This qualitative study organized focus groups of third- and fourth-year medical students. Participants recounted ethical concerns encountered during clerkship rotations and reflected on how their medical school ethics curriculum informed their responses to these scenarios. Transcripts of the focus group sessions were analyzed using a grounded theory approach to identify common themes that characterized the students' experiences. While students' accounts demonstrated a solid grasp of ethical theory and attunement to ethical concerns presented in the clinic, they also consistently evinced an inability to act on these issues given clerks' particular position in a complex learning hierarchy. Students felt they received too little training in the role-specific application of medical ethics as clinical trainees. We found a desire among trainees for enhanced practical ethics training in preparation for the clerkship phase of medical education. We recommend several strategies that can begin to address these findings. The use of roleplaying with standardized patients can enable students to practice engagement with ethical issues. Conventional ethics courses can focus more on action-based pedagogy and instruction in conflict management techniques. Finally, clear structures for reporting and seeking advice and support for addressing ethical issues can lessen students' apprehension to act on ethical concerns.

Dementia in Ontario: Prevalence and Health Services Utilization

ERIC Educational Resources Information Center

Tranmer, J. E.; Croxford, R.; Coyte, P. C.

2003-01-01

To understand the impact of ongoing reform of mental health and dementia care in Ontario, an examination of prevalence and health services utilization rates is needed. However, there exists a gap in current prevalence and health services research specific to dementia care in Ontario. The objective of this study was to address these concerns using…

Reconsidering Learning Difficulties and Misconceptions in Chemistry: Emergence in Chemistry and Its Implications for Chemical Education

ERIC Educational Resources Information Center

Tümay, Halil

2016-01-01

Identifying students' misconceptions and learning difficulties and finding effective ways of addressing them has been one of the major concerns in chemistry education. However, the chemistry education community has paid little attention to determining discipline-specific aspects of chemistry that can lead to learning difficulties and…

Teaching New Dogs Old Tricks.

ERIC Educational Resources Information Center

Goldberg, Judy Hiller; Laurin, Mark Alfred

For the new two-year college instructor, gaining information that specifically addresses his/her problems and concerns, and establishing the network to generate the flow of quality information can be a problem. How the instructor deals with this problem is a function of his/her stage of growth. In the neophyte stage, the new faculty member is…

Readiness for Work, Readiness for Life.

ERIC Educational Resources Information Center

Bennett, William J.

1985-01-01

The author addresses the need for a balanced education. In addition to training students in specific fields, we must concern ourselves with inculcating virtue as well. As the liberal arts play an important part in the formation of character, students can learn from them to commit themselves to a certain task and ultimately to their professions.…

Before You Decide: What Families Would Like Policy Makers to Know.

ERIC Educational Resources Information Center

Clark, Marsha J.; Kendrick, Martie; Chamberlain, Linda; Chesley, Esther; Clement, Stacie; Cummings, Dawn; Henri-Mackenzie, Sue; Labbe, Tonya; MacDonald, Janice; McNally, Diana; Niles, Nancy; Raymond, Roberta; Russell, Candice

This booklet, developed by parents of children with developmental disabilities, is intended to help policy makers understand major parental concerns about raising a child with a disability. The specific issues addressed are: (1) the special needs of families with a disabled child; (2) the right to community integration; (3) the continuing…

Future networking and cooperation summary of discussion

Treesearch

Roger R. Bay

1993-01-01

At the end of the workshop, I led a lightly structured and informal discussion concerning methods of continuing and improving communications and cooperation among workshop participants. The group specifically ad-dressed three areas: maintaining informal one-on-one direct contacts, improving the use of the ADAP computer system for mail, and the desirability of starting...

"The L Pack": Addressing the Sexual Health Needs of Young Lesbians

ERIC Educational Resources Information Center

McAlister, Siobhan; Neill, Gail

2009-01-01

Concerns about the sexual health of women who identify as other than heterosexual have been highlighted in numerous research reports, yet access to information, advice and services remains limited within Northern Ireland. In response to this, a group of young women have produced a sexual health resource ("The L Pack") specifically for…

The Role of Education and Rehabilitation Specialists in the Comprehensive Low Vision Care Process.

ERIC Educational Resources Information Center

Lueck, A. H.

1997-01-01

Outlines the contributions of education and rehabilitation specialists in maximizing specific skills, self-esteem, and quality of life of individuals with low vision. The role of these specialists in evaluating functional vision, teaching methods to compensate for impaired vision, and addressing psychosocial concerns are discussed. (Author/CR)

Professional Development Implementation: Perceptions of Elementary and Middle-School Teachers and Administrators

ERIC Educational Resources Information Center

Topley, Brenda M.

2010-01-01

In a Midwestern school district, teachers and administrators have specific concerns and opinions about professional development (PD) related to differentiated instruction. Carol Ann Tomlinson, the guru of differentiated instruction (DI), refers to DI as meeting the needs of students by adjusting instruction in order to address how they learn…

An Overview on Evaluation of E-Learning/Training Response Time Considering Artificial Neural Networks Modeling

ERIC Educational Resources Information Center

Mustafa, Hassan M. H.; Tourkia, Fadhel Ben; Ramadan, Ramadan Mohamed

2017-01-01

The objective of this piece of research is to interpret and investigate systematically an observed brain functional phenomenon which is associated with proceeding of e-learning processes. More specifically, this work addresses an interesting and challenging educational issue concerned with dynamical evaluation of elearning performance considering…

Aesthetic Creativity: Insights from Classical Literary Theory on Creative Learning

ERIC Educational Resources Information Center

Hellstrom, Tomas Georg

2011-01-01

This paper addresses the subject of textual creativity by drawing on work done in classical literary theory and criticism, specifically new criticism, structuralism and early poststructuralism. The question of how readers and writers engage creatively with the text is closely related to educational concerns, though they are often thought of as…

Using the Millon College Counseling Inventory to Assess Student Mental Health Needs

ERIC Educational Resources Information Center

Millon, Theodore; Strack, Stephen; Millon-Niedbala, Carolyn M.; Grossman, Seth D.

2008-01-01

Students visiting college counseling centers experience a broad range of complex and sometimes severe concerns that are often not adequately addressed by existing clinical measures. In response, the Millon College Counseling Inventory (MCCI;T. Millon, S. N. Strack, C. Millon, & S. Grossman, 2006) was specifically designed for use with…

Youth Environmental Science Outreach in the Mushkegowuk Territory of Subarctic Ontario, Canada

ERIC Educational Resources Information Center

Karagatzides, Jim D.; Kozlovic, Daniel R.; De Iuliis, Gerry; Liberda, Eric N.; General, Zachariah; Liedtke, Jeff; McCarthy, Daniel D.; Gomez, Natalya; Metatawabin, Daniel; Tsuji, Leonard J. S.

2011-01-01

We connected youth of the Mushkegowuk Territory (specifically Fort Albany First Nation) with environmental science and technology mentors in an outreach program contextualized to subarctic Ontario that addressed some of the environmental concerns identified by members of Fort Albany First Nation. Most activities were community-based centering on…

Preparing for High Technology: 30 Steps to Implementation. Research & Development Series No. 232.

ERIC Educational Resources Information Center

Abram, Robert; And Others

This planning guide is one of three that addresses the concerns of postsecondary college administrators and planners regarding the planning and implementation of technician training programs in high technology areas. It specifically focuses on a 30-step planning process that is generalizable to various high technology areas. (The other two…

Addressing Plagiarism in Online Programmes at a Health Sciences University: A Case Study

ERIC Educational Resources Information Center

Ewing, Helen; Anast, Ade; Roehling, Tamara

2016-01-01

Plagiarism continues to be a concern for all educational institutions. To build a solid foundation for high academic standards and best practices at a graduate university, aspects of plagiarism were reviewed to develop better management processes for reducing plagiarism. Specifically, the prevalence of plagiarism and software programmes for…

Seeking Evidence for "Curricular Relevancy" within Undergraduate, Liberal Arts Chemistry Textbooks

ERIC Educational Resources Information Center

Naughton, Wendy; Schreck, James; Heikkinen, Henry

2008-01-01

Interviews with representatives of nine municipal agencies involved in air-quality education were analyzed for concepts and skills perceived as important for citizens in addressing air-quality concerns. Interviewees focused mainly on general air quality-related understandings (60.2%), although cognitive skills (22.0%) and specific concepts (17.8%)…

Achievement Unlocked: Effective Curriculum Interventions with Low-Income Students

ERIC Educational Resources Information Center

VanTassel-Baska, Joyce

2018-01-01

This article explores the world of curriculum intervention for gifted students from low-income and culturally diverse backgrounds. It delineates both general and specific approaches to practices that can be used in classrooms and beyond. Affective and conative concerns are addressed as they have an impact on motivation and learning. Efforts toward…

Improving Human Services: Methods for Systematic Planning, Evaluation, and Staff Development.

ERIC Educational Resources Information Center

Jones, G. Brian; And Others

This monograph speaks to the basic problems confronting human services programs, and offers suggestions for improving guidance services. Specific concerns addressed are: (1) the need for more systematic program planning and evaluation; (2) an approach to effective planning and evaluation; (3) development of staff skills for use in the…

Fixation patterns, not clinical diagnosis, predict body size over-estimation in eating disordered women and healthy controls.

PubMed

Cornelissen, Katri K; Cornelissen, Piers L; Hancock, Peter J B; Tovée, Martin J

2016-05-01

A core feature of anorexia nervosa (AN) is an over-estimation of body size. Women with AN have a different pattern of eye-movements when judging bodies, but it is unclear whether this is specific to their diagnosis or whether it is found in anyone over-estimating body size. To address this question, we compared the eye movement patterns from three participant groups while they carried out a body size estimation task: (i) 20 women with recovering/recovered anorexia (rAN) who had concerns about body shape and weight and who over-estimated body size, (ii) 20 healthy controls who had normative levels of concern about body shape and who estimated body size accurately (iii) 20 healthy controls who had normative levels of concern about body shape but who did over-estimate body size. Comparisons between the three groups showed that: (i) accurate body size estimators tended to look more in the waist region, and this was independent of clinical diagnosis; (ii) there is a pattern of looking at images of bodies, particularly viewing the upper parts of the torso and face, which is specific to participants with rAN but which is independent of accuracy in body size estimation. Since the over-estimating controls did not share the same body image concerns that women with rAN report, their over-estimation cannot be explained by attitudinal concerns about body shape and weight. These results suggest that a distributed fixation pattern is associated with over-estimation of body size and should be addressed in treatment programs. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:507-518). © 2016 The Authors. International Journal of Eating Disorders published by Wiley Periodicals, Inc.

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

PubMed

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

2016-02-08

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

Low Levels of Empathic Concern Predict Utilitarian Moral Judgment

PubMed Central

Gleichgerrcht, Ezequiel; Young, Liane

2013-01-01

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

Low levels of empathic concern predict utilitarian moral judgment.

PubMed

Gleichgerrcht, Ezequiel; Young, Liane

2013-01-01

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

An Examination of Poetry for the People: A Decolonizing Holistic Approach to Arts Education

ERIC Educational Resources Information Center

Rangel, Nicole

2016-01-01

This article is concerned with the epidemic of alienation created by colonization and the ideologies that maintain systems of domination. More specifically, it argues that a decolonizing holistic pedagogy can help address the root of our individual and collective alienation to facilitate healing. This position is supported by the findings of an…

Turbine Engine Hot Section Technology (HOST)

NASA Technical Reports Server (NTRS)

1982-01-01

Research and plans concerning aircraft gas turbine engine hot section durability problems were discussed. Under the topics of structural analysis, fatigue and fracture, surface protective coatings, combustion, turbine heat transfer, and instrumentation specific points addressed were the thermal and fluid environment around liners, blades, and vanes, material coatings, constitutive behavior, stress-strain response, and life prediction methods for the three components.

American Indians and the Urban Experience. Contemporary Native American Communities 5.

ERIC Educational Resources Information Center

Lobo, Susan, Ed.; Peters, Kurt, Ed.

Over half of all American Indian people living in the United States now live in urban areas, but few books and little research have addressed urban Indian themes. This book compiles research, scholarly writing, poetry, prose, and artwork concerned with the Native urban experience. Of specific educational interest are chapters on the role of…

Educational Standards, Teacher Preparation, and Metacognition Instruction for Elementary Students: Studies in Pre-College Engineering Education

ERIC Educational Resources Information Center

Carr, Ronald L.

2013-01-01

This dissertation is a compilation of three separate works representing a wide range of issues related to pre-college engineering. Each work addresses multiple levels of concern for educators from national policy to specific classroom intervention. Although presenting different styles of writing--due to different journals requirements--and various…

Needles in the Haystack: Finding Content Worth Preparing for Workplace Learning with the KEP Model

ERIC Educational Resources Information Center

Thalmann, Stefan; Maier, Ronald

2017-01-01

Knowledge transfer between employees is a primary concern in organizations. Employees create or acquire content that partially represents knowledge. These knowledge elements are specific to the context in and for which they are created and rarely address the learning needs of other employees in other work situations. Organizations therefore need…

Water use assessments supporting company-specific growth and sustainability goals

Treesearch

John Beebe

2016-01-01

In areas with increasing demand for water, addressing water use objectives has long been a primary environmental objective and key concern among industrial water users including paper mills and other forest product companies. However, in recent years, water use metrics and related information (including population change, climate information, and land use...

"Not in the Middle Ages"?: Alan Garner's "The Owl Service" and the Literature of Adolescence.

ERIC Educational Resources Information Center

Hardwick, Paul

2000-01-01

Discusses connecting with the Middle Ages in adolescent fiction. Discusses how, in "The Owl Service," Garner addresses a relationship between adolescence in the late twentieth century and an aspect of the past--specifically the Middle Ages. Considers how "The Owl Service" is a story energized by myth, concerning the…

Teacher Empowerment in the Implementation of Response to Intervention: A Case Study

ERIC Educational Resources Information Center

Barge, Evie Taff

2012-01-01

Response to Intervention (RtI) is a data-driven process that supports the academic needs of students through targeted interventions to address specific identified areas of weakness. When implemented effectively, RtI aids students at the onset of learning concerns and can remediate learning problems which have, in the past, led to students being…

76 FR 72725 - Draft License Renewal Interim Staff Guidance LR-ISG-2011-05: Ongoing Review of Operating Experience

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-25

... Experience.'' This LR-ISG provides guidance and clarification concerning ongoing review of plant-specific and... plants. As noticed on September 20, 2011 (76 FR 58311), the public comment period was extended and, as of... to communicate insights and lessons learned and to address emergent issues not covered in license...

Area Specific Self-Esteem, Values, and Adolescent Substance Use

ERIC Educational Resources Information Center

Donnelly, Joseph; Young, Michael; Pearson, Rebecca; Penhollow, Tina M.; Hernandez, Aida

2008-01-01

The use of illicit and licit drugs continues to be a major public health concern. Many prevention and drug education programs address this issue by attempting to enhance self-esteem. The idea is that increased levels of self-esteem will serve as a protective factor in decreasing the motivation and increasing the resistance to use drugs. This study…

Watershed concerns and recent policy formulations in Sri Lanka and Australia

Treesearch

Rohan Ekanayake

1991-01-01

Addressing the problems associated with watersheds in both countries is the aim of this paper as well as assessing the respective watershed policies. Attention has been drawn to specific economic, environmental and sociocultural considerations in the recent past. An interesting feature of the most recent policy developments is the tendency to follow a balanced approach...

Implementation of the Biosphere Compatibility Principle in Urban Planning: How to Train Next-Generation Specialists

ERIC Educational Resources Information Center

Ivanova, Zinaida Ilyinichna; Yudenkova, Olga Valeryevna; Ishkov, Aleksandr Dmitrievich; Shnyrenkov, Evgeny Anatolyevich

2015-01-01

The co-authors address the relevant issues concerning the need to implement the principle of the biosphere compatibility as the core prerequisite for the symbiotic co-existence of man and nature. Caring treatment of the biosphere, termination of its excessive exploitation, analysis of the ratio between the biospheric potential of specific areas…

Implications of Bilingual Development for Specific Language Impairments in Turkey

ERIC Educational Resources Information Center

Topbas, Seyhun

2011-01-01

The potential impact of bilingualism on children's language development has emerged as a crucial concern for Turkey, but so far it has not been addressed from the point of view of language disorders. This short review examines the potential impact of bilingual language development for language impairments in Turkey, with special emphasis on the…

Parent and family stress factors predict health-related quality in pediatric patients with new-onset epilepsy.

PubMed

Wu, Yelena P; Follansbee-Junger, Katherine; Rausch, Joseph; Modi, Avani

2014-06-01

To examine the influence of parent and family general and epilepsy-related stress on longitudinal generic and epilepsy-specific health-related quality of life (HRQOL) for children with new-onset epilepsy, while controlling for demographic characteristics, disease factors, and antiepileptic drug (AED) adherence. This prospective, longitudinal study included 124 children with new-onset epilepsy (mean age 7.2 years, standard deviation [SD] 2.9 years). Parents completed questionnaires on parenting stress, perceived stigma, fears and concerns, and HRQOL at 1, 13, and 25 months after diagnosis. Adherence to AEDs was assessed using electronic monitors. A medical chart review was conducted at each visit to obtain seizure and side effect data. Higher levels of general and epilepsy-specific parent and family stress, fears and concerns, and perceived stigma negatively affected child generic and epilepsy-specific HRQOL, above and beyond disease and demographic factors. General parenting and family stress affected child generic and epilepsy-specific HRQOL more in the first year of disease management than at 2 years after diagnosis. Higher fears and concerns predicted higher epilepsy-specific HRQOL at 13 months postdiagnosis, whereas 2 years postdiagnosis, higher fears and concerns predicted lower epilepsy-specific HRQOL. Several demographic (i.e., age) and disease-related variables (i.e., side effects and AED adherence) influenced child generic and epilepsy-specific HRQOL. Although some findings were consistent across generic and epilepsy-specific HRQOL measures, others were unique. Modifiable parent factors (i.e., general and disease-specific parent and family stress, perceived stigma) impact HRQOL for children with new-onset epilepsy differently over the first 2 years postdiagnosis. Psychosocial interventions to improve HRQOL within the first year postdiagnosis should address parenting and family stress, overall coping, and anticipatory guidance on managing epilepsy. Interventions targeting adherence, perceived stigma, and fears and concerns could improve HRQOL. Promoting parent management of stress, fears/concerns, and perceived stigma may lead to improved child HRQOL outcomes. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

Identifying Health Promotion Needs Among Dominican-American Adolescents.

PubMed

Champion, Jane Dimmitt; Roye, Carol F

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

Scoping Meeting Summary, Kaunakakai, Moloka'i, March 12, 1992, 2 PM Session

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

Quinby-Hunt, Mary S.

The meeting began with presentations by the facilitator, Mr. Spiegel, and Dr. Lewis, the program manager from DOE. The facilitator introduced those on the podium. He then described the general structure of the meeting and its purpose: to hear the issues and concerns of those present regarding the proposed Hawaiian Geothermal Project. He described his role as assuring the impartiality and fairness of the meeting. Dr. Lewis of DOE further defined the scope of the project, introduced members of the EIS team, and briefly described.the EIS process. The overwhelming concerns of the meeting were Native Hawaiian issues. The presenters [moremore » than 70%, most of whom addressed no other issue] want the EIS to respect Native Hawaiian religion, race, rights, language, and culture, noting that they believe that geothermal development is a desecration of Pele [{approx}60% of all presenters]. They expressed concern that their ancestors and burials should not be desecrated. The EIS should address Native Hawaiian concerns that the HGP would negatively impact Native Hawaiian fisheries, subsistence lifestyles, and religious practices. Virtually all the speakers expressed frustration with government. Most (> 70%) of the speakers voiced concern and frustration regarding lack of consideration for Native Hawaiians by government and lack of trust in government. One commenter requested that the EIS should consider the international implications of the U.S allowing their rainforests to be cleared, when the U.S. government asks other nations to preserve theirs. Nearly 30% of the commenters want the EIS to address the concern that people on Moloka'i will bear major environmental consequences of the HGP, but not gain from it. The commenters question whether it is right for Moloka'i to pay for benefits to Oahu, particularly using an unproven technology. After questioning the reliability and feasibility of the marine cable:, nearly 30% of the presenters were concerned about the impacts of the submarine cable. In specific, they suggested that the EIS investigate the impacts the cable would have on fisheries and marine life due to electromagnetic fields, dredging, and oil-release. The EIS should study the impacts of the HGP on the humpback whale and other marine species, particularly their birthing grounds, noting whales' hypersensitivity to emf and sound. One commenter suggested that the EIS examine the economics of the cable, including the need to build specialized ships to lay it, harbour(s), and the cable itself. One commenter was concerned about the future uses of the cable suggesting that the EIS should address the impacts that would result if the cable connecting Moloka'i to Oahu is used to transmit power from large coal or other types of power generation facilities constructed on Moloka'i. Commenters questioned the reliability of geothermal development in a region that is both seismically and volcanically active. One suggested that the EIS examine the merits of projects that conserve energy. With respect to land use, commenters asked that the EIS examine the propriety of using Native Hawaiian homelands and ceded lands for the HGP, questioning specifically the land exchange in Puna [Campbell Estate for Wao Kele o Puna]. The commenters want the EIS to address the issue of air, water and sail quality preservation. More than 20% of the commenters asked that the EIS examine concerns about the environmental consequences of the HGP to the rainforest, including possible species extinction. In particular, the EIS should address the impacts of roads associated with the HGP in the rainforest, including the resulting importation of exotic species (for example banana poko), which successfully compete against native species; and the effects of noise and fumes which negatively impact plants, birds, animals, and insects.« less

Ethical considerations and potential threats to validity for three methods commonly used to collect geographic information in studies among people who use drugs.

PubMed

Rudolph, Abby E; Bazzi, Angela Robertson; Fish, Sue

2016-10-01

Analyses with geographic data can be used to identify "hot spots" and "health service deserts", examine associations between proximity to services and their use, and link contextual factors with individual-level data to better understand how environmental factors influence behaviors. Technological advancements in methods for collecting this information can improve the accuracy of contextually-relevant information; however, they have outpaced the development of ethical standards and guidance, particularly for research involving populations engaging in illicit/stigmatized behaviors. Thematic analysis identified ethical considerations for collecting geographic data using different methods and the extent to which these concerns could influence study compliance and data validity. In-depth interviews with 15 Baltimore residents (6 recruited via flyers and 9 via peer-referral) reporting recent drug use explored comfort with and ethics of three methods for collecting geographic information: (1) surveys collecting self-reported addresses/cross-streets, (2) surveys using web-based maps to find/confirm locations, and (3) geographical momentary assessments (GMA), which collect spatiotemporally referenced behavioral data. Survey methods for collecting geographic data (i.e., addresses/cross-streets and web-based maps) were generally acceptable; however, participants raised confidentiality concerns regarding exact addresses for illicit/stigmatized behaviors. Concerns specific to GMA included burden of carrying/safeguarding phones and responding to survey prompts, confidentiality, discomfort with being tracked, and noncompliance with study procedures. Overall, many felt that confidentiality concerns could influence the accuracy of location information collected for sensitive behaviors and study compliance. Concerns raised by participants could result in differential study participation and/or study compliance and questionable accuracy/validity of location data for sensitive behaviors. Copyright © 2016 Elsevier Ltd. All rights reserved.

Park-Use Behavior and Perceptions by Race, Hispanic Origin, and Immigrant Status in Minneapolis, MN: Implications on Park Strategies for Addressing Health Disparities.

PubMed

Das, Kirti V; Fan, Yingling; French, Simone A

2017-04-01

The study examines the connections between minority status, park use behavior, and park-related perceptions using recent survey data from three low-income neighborhoods in Minneapolis, MN. Blacks and foreign-born residents are found to underutilize parks. Blacks, Asians, and American Indians perceive fewer health benefits of parks than whites, including the benefits of parks for providing exercise/relaxation opportunities and family gathering spaces. Foreign-born residents, blacks, and Hispanics perceive greater and unique barriers to park use in terms of not feeling welcome, cultural and language restrictions, program schedule and pricing concerns, and/or facility maintenance and mismatch concerns. When designing park strategies for addressing health disparities, we recommend to focus the efforts on increasing awareness of park-related health benefits and removing specific park use barriers among minority and foreign-born communities.

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

Engels, J.

The Environmental Restoration (ER) Program was established for the investigation and remediation of inactive US Department of Energy (DOE) sites and facilities that have been declared surplus in terms of their previous uses. The purpose of this document is to Specify ER requirements for quality control (QC) of analytical data. Activities throughout all phases of the investigation may affect the quality of the final data product, thus are subject to control specifications. Laboratory control is emphasized in this document, and field concerns will be addressed in a companion document Energy Systems, in its role of technical coordinator and at themore » request of DOE-OR, extends the application of these requirements to all participants in ER activities. Because every instance and concern may not be addressed in this document, participants are encouraged to discuss any questions with the ER Quality Assurance (QA) Office, the Analytical Environmental Support Group (AESG), or the Analytical Project Office (APO).« less

Cultural competency, autonomy, and spiritual conflicts related to Reiki/CAM therapies: Should patients be informed?

PubMed Central

Arvonio, Maria Marra

2014-01-01

The use of complementary and alternative medicines (CAM) such as Reiki is on the rise in healthcare centers. Reiki is associated with a spirituality that conflicts with some belief systems. Catholic healthcare facilities are restricted from offering this therapy because it conflicts with the teachings of the Catholic Church. However, hospitals are offering it without disclosing the spiritual aspects of it to patients. This article will address the ethical concerns and possible legal implications associated with the present process of offering Reiki. It will address these concerns based on the Joint Commission's Standard of Cultural Competency and the ethical principles of autonomy and informed consent. A proposal will also be introduced identifying specific information which Reiki/CAM practitioners should offer to their patients out of respect of their autonomy as well as their cultural, spiritual, and religious beliefs. PMID:24899738

National trends in ozone injury to forest plants: 16 years of biomonitoring

Treesearch

Gretchen Smith

2013-01-01

The ozone indicator, an important research component of the Forest Health Monitoring (FHM) Program of the Forest Service, U.S. Department of Agriculture, was developed and implemented to address specific concerns about the negative effects of ground-level ozone pollution on forest health and productivity. Ozone is a highly toxic air contaminant that has been shown...

A Long Road to Travel: Narratives of African American Male Preservice Educators' Journeys through a Graduate Teacher Education Program

ERIC Educational Resources Information Center

Jones, Shawn

2011-01-01

The ongoing research concerning African American males enrolled in teacher education programs is essential for a number of reasons. Research specifically addressing preservice teaching, teacher education, and the African American male student is needed to promote the well-being of any school of education. According to McCray, Sindelar, Kilgore,…

Numerical Procedures in the Optimal Grouping of Students for Instructional Purposes. Technical Report No. 399 (Parts 1 and 2).

ERIC Educational Resources Information Center

Lawrence, Brian F.

The study was concerned with the formation of grouPs of students and specifically addressed the problem: Can a computerized Procedure be developed which assigns students to instructional groups, which maximizes the homogeneity of these groups when this homogeneity is based on relevent student learning characteristics, and which takes account of…

Focus on Infants & Toddlers (Ages 0-3): A Quarterly Newsletter for the Education Community, 2000-2001.

ERIC Educational Resources Information Center

Barry, Virginia M., Ed.; Cantor, Patricia, Ed.

2001-01-01

These four quarterly newsletter issues address various topics of interest to child caregivers. Each issue includes articles on a specific theme, along with regular news or a column by an AECI Executive Board vice president. The Fall 2000 issue focuses on the special features and unique concerns of employer-sponsored child care, with one article…

77 FR 37961 - Hazardous Materials: Incorporating Rail Special Permits Into the Hazardous Materials Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-25

... of safety. This rulemaking will also respond to two petitions for rulemaking, P-1497, concerning the... addressed two petitions for rulemaking in the NPRM: P-1497 and P-1567. P-1497 pertains to the use of... Transportation (DOT) Specification 110A500W multi-unit tank car tank; (d) Permit alternative start-to-discharge...

Using PROMs to guide patients and practitioners through the head and neck cancer journey

PubMed Central

Rogers, Simon N; Barber, Brittany

2017-01-01

The measurement of patient-reported outcome measures (PROMs) following head and neck cancer (HNC) has the capacity to substantially enhance the care of patients and their care-givers following the diagnosis and treatment of HNC. Literature concerning PROMs has increased exponentially in the past 2 decades, producing a vast array of data upon which the multidisciplinary team can reflect. For this review, “Handle On QOL” has been used as a source of references to illustrate the points raised. PROMs are contextualized by considering the clinically-distinct key stages that cancer patients endure: diagnosis, treatment, acute toxicity, early recovery, late effects, recurrence, and palliation. The PROMs are considered in six main categories: 1) those addressing cornucopia of issues not specific to cancer; 2) those addressing issues common to all cancers; 3) questionnaires with items specific to HNC; 4) questionnaires that focus on a particular aspect of head and neck function; 5) those measuring psychological concerns, such as depression, anxiety, or self-esteem; and 6) item prompt lists. Potential benefits of PROMs in clinical practice are discussed, as are barriers to use. The way forward in integrating PROMs into routine HNC care is discussed with an emphasis on information technology. PMID:29184455

Value propositions of mHealth projects.

PubMed

Gorski, Irena; Bram, Joshua T; Sutermaster, Staci; Eckman, Molly; Mehta, Khanjan

While mHealth holds great potential for addressing global health disparities, a majority of the initiatives never proceed beyond the pilot stage. One fundamental concern is that mHealth projects are seldom designed from the customer's perspective to address their specific problems and/or create appreciable value. A customer-centric view, where direct tangible benefits of interventions are identified and communicated effectively, can drive customer engagement and advance projects toward self-sustaining business models. This article reviews the business models of 234 mHealth projects to identify nine distinct value propositions that solve specific problems for customers. Each of these value propositions is discussed with real-world examples, analyses of their design approaches and business strategies, and common enablers as well as hurdles to surviving past the pilot stage. Furthermore, a deeper analysis of 42 mHealth ventures that have achieved self-sustainability through project revenue provides a host of practical and poignant insights into the design of systems that can fulfil mHealth's promise to address healthcare challenges in the long term.

Current Status of Research in Teaching and Learning Evolution: II. Pedagogical Issues

NASA Astrophysics Data System (ADS)

Smith, Mike U.

2010-06-01

This is the second of two articles that address recent scholarship about teaching and learning about evolution. This second review seeks to summarize this state of affairs and address the implications of this work for the classroom by addressing four basic questions: (1) What is evolution?/What components of the theory are important at the introductory level? (2) Why do students and members of the public at large need to understand evolution? (3) What makes evolution difficult to teach and learn? and (4) What promising instructional approaches have been developed and tested? The paper will also focus on concerns about both the research designs and the measures used in this work. Based on this review, I will then propose a set of pedagogical implications and recommendations for the classroom instructor and call for studies to address specific gaps identified.

Safety huddles to proactively identify and address electronic health record safety

PubMed Central

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

2017-01-01

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

Geospatial cryptography: enabling researchers to access private, spatially referenced, human subjects data for cancer control and prevention.

PubMed

Jacquez, Geoffrey M; Essex, Aleksander; Curtis, Andrew; Kohler, Betsy; Sherman, Recinda; Emam, Khaled El; Shi, Chen; Kaufmann, Andy; Beale, Linda; Cusick, Thomas; Goldberg, Daniel; Goovaerts, Pierre

2017-07-01

As the volume, accuracy and precision of digital geographic information have increased, concerns regarding individual privacy and confidentiality have come to the forefront. Not only do these challenge a basic tenet underlying the advancement of science by posing substantial obstacles to the sharing of data to validate research results, but they are obstacles to conducting certain research projects in the first place. Geospatial cryptography involves the specification, design, implementation and application of cryptographic techniques to address privacy, confidentiality and security concerns for geographically referenced data. This article defines geospatial cryptography and demonstrates its application in cancer control and surveillance. Four use cases are considered: (1) national-level de-duplication among state or province-based cancer registries; (2) sharing of confidential data across cancer registries to support case aggregation across administrative geographies; (3) secure data linkage; and (4) cancer cluster investigation and surveillance. A secure multi-party system for geospatial cryptography is developed. Solutions under geospatial cryptography are presented and computation time is calculated. As services provided by cancer registries to the research community, de-duplication, case aggregation across administrative geographies and secure data linkage are often time-consuming and in some instances precluded by confidentiality and security concerns. Geospatial cryptography provides secure solutions that hold significant promise for addressing these concerns and for accelerating the pace of research with human subjects data residing in our nation's cancer registries. Pursuit of the research directions posed herein conceivably would lead to a geospatially encrypted geographic information system (GEGIS) designed specifically to promote the sharing and spatial analysis of confidential data. Geospatial cryptography holds substantial promise for accelerating the pace of research with spatially referenced human subjects data.

Variations Among Pilots from Different Flight Operations in Party Line Information Requirements for Situation Awareness

NASA Technical Reports Server (NTRS)

Pritchett, Amy; Hansman, John

1997-01-01

Current air traffic control communications use shared VHF voice frequencies from which pilots can obtain 'party line' information (PLI) by overhearing communications addressed to other aircraft. Previous studies have shown that pilots perceive PLI to be important. There is concern that some critical PLI may be lost in the proposed data link environment, where communications will be discretely addressed. Different types of flight operations will be equipped with data link equipment at different times, generating a mixed environment in which some pilots will rely on PLI, while others will receive their information by data link. To research the importance, availability, and accuracy of PLI and to query pilots on the information they feel is necessary for global situation awareness, a survey was distributed to pilots. The pilots were selected from four flight operation groups to study the variations in PLI requirements in the mixed data link environment. Pilots perceived PLI to be important overall, with specific traffic and weather information elements identified as critical. Most PLI elements followed a pattern of higher perceived importance during terminal area operations, final approach, and landing. Pilots from the different flight operation groups identified some elements as particularly important. In a free-response question designed to identify the information requirements for global situation awareness, pilots frequently indicated a need for traffic and weather information. The results of this survey reveal specific concerns to be addressed when implementing data link communications.

Defining adolescent and young adult (AYA) exercise and nutrition needs: concerns communicated in an online cancer support community.

PubMed

Love, Brad; Moskowitz, Michal C; Crook, Brittani; Thompson, Charee M; Donovan-Kicken, Erin; Stegenga, Kristin; Macpherson, Catherine Fiona; Johnson, Rebecca H

2013-07-01

To describe topics, needs, and concerns related to nutrition and exercise that adolescents and young adults affected by a serious illness (cancer) discuss online. Investigators conducted a qualitative content analysis of messages related to nutrition and exercise posted on an online young adult cancer forum. AYAs described several functions achieved through nutrition and exercise, such as fighting cancer, losing weight, obtaining nutrients despite side effects of treatment, promoting general health, enjoyment, and promoting mental/emotional health. AYAs also discussed several problems that interfere with nutrition and exercise goals, such as side effects of steroids, physiological problems with eating, safety concerns or physical limitations due to treatment, poor follow through with behavioral change, stress, and low energy. AYAs discuss specific ways nutrition and exercise help achieve a variety of functions that may be physical or psychological, cancer-specific or general. AYAs describe several concerns and barriers that impede their nutrition and exercise goals. Clinicians should also consider relevant medical and personal variables that partly determine nutrition and exercise concerns. Clinicians can anticipate barriers to desired nutrition/exercise change and develop interventions that address these barriers in appropriately tailored ways, including using digital media. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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

PubMed Central

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

2007-01-01

Context In primary, acute-care visits, patients frequently present with more than 1 concern. Various visit factors prevent additional concerns from being articulated and addressed. Objective To test an intervention to reduce patients’ unmet concerns. Design Cross-sectional comparison of 2 experimental questions, with videotaping of office visits and pre and postvisit surveys. Setting Twenty outpatient offices of community-based physicians equally divided between Los Angeles County and a midsized town in Pennsylvania. Participants A volunteer sample of 20 family physicians (participation rate = 80%) and 224 patients approached consecutively within physicians (participation rate = 73%; approximately 11 participating for each enrolled physician) seeking care for an acute condition. Intervention After seeing 4 nonintervention patients, physicians were randomly assigned to solicit additional concerns by asking 1 of the following 2 questions after patients presented their chief concern: “Is there anything else you want to address in the visit today?” (ANY condition) and “Is there something else you want to address in the visit today?” (SOME condition). Main Outcome Measures Patients’ unmet concerns: concerns listed on previsit surveys but not addressed during visits, visit time, unanticipated concerns: concerns that were addressed during the visit but not listed on previsit surveys. Results Relative to nonintervention cases, the implemented SOME intervention eliminated 78% of unmet concerns (odds ratio (OR) = .154, p = .001). The ANY intervention could not be significantly distinguished from the control condition (p = .122). Neither intervention affected visit length, or patients’; expression of unanticipated concerns not listed in previsit surveys. Conclusions Patients’ unmet concerns can be dramatically reduced by a simple inquiry framed in the SOME form. Both the learning and implementation of the intervention require very little time. PMID:17674111

Qualification testing and electrical measurement experience: A manufacturer's view

NASA Astrophysics Data System (ADS)

Arnett, J. C.; Cooley, J. E.; Wingert, T. L.

1983-11-01

ARCO Solar's experiences as a participant in an industry-utility-government environmental qualification team examining photovoltaic devices are discussed. Included is an assessment of the applicability, completeness and appropriateness of the testing procedures and of the acceptance criteria for megawatt-sized procurements for utilities. Like the stand-alone users, the utility industry is interested in obtaining low costs, but additional concerns exist related to reliability and durability, safety, grounding and overall system criteria including performance prediction (related to output power acceptance testing), power quality and dispatchability. For purposes of this first major purchase of photovoltaic modules and panels by the utility industry, there was a carry-over of the JPL specifications. The need exists for futher development, assessement, and selection of qualification and testing standards and evaluation criteria specifically addressing these additional concerns for utility-connected PV power-plant applications.

Qualification testing and electrical measurement experience: A manufacturer's view

NASA Technical Reports Server (NTRS)

Arnett, J. C.; Cooley, J. E.; Wingert, T. L.

1983-01-01

ARCO Solar's experiences as a participant in an industry-utility-government environmental qualification team examining photovoltaic devices are discussed. Included is an assessment of the applicability, completeness and appropriateness of the testing procedures and of the acceptance criteria for megawatt-sized procurements for utilities. Like the stand-alone users, the utility industry is interested in obtaining low costs, but additional concerns exist related to reliability and durability, safety, grounding and overall system criteria including performance prediction (related to output power acceptance testing), power quality and dispatchability. For purposes of this first major purchase of photovoltaic modules and panels by the utility industry, there was a carry-over of the JPL specifications. The need exists for futher development, assessement, and selection of qualification and testing standards and evaluation criteria specifically addressing these additional concerns for utility-connected PV power-plant applications.

Tobacco cessation with patients recovering from alcohol and other substance abuse.

PubMed

McIlvain, H E; Bobo, J K

1999-09-01

This article focuses on the problem of tobacco cessation in the patient recovering from alcohol or other substance abuse. The authors review the epidemiology of the problem, specific health risks to this population from continued tobacco use, and recent research findings that address previous treatment concerns. Recommendations for counseling by physicians are made. These include an algorithm for determining the patient's stage of readiness for making a quit attempt, specific counseling tasks based on the patients stage, and motivational counseling strategies aimed at increasing the patients motivation to quit.

A Hermeneutical Study of Older Korean Graduate Students' Experiences in American Higher Education: From Confucianism to Western Educational Values

ERIC Educational Resources Information Center

Seo, Seonjin; Koro-Ljungberg, Mirka

2005-01-01

In this hermeneutical study, the authors focus on understanding the experiences of older Korean students who have come to the United States to pursue academic degrees at American universities. The purpose of this study is to describe the critical events related to their adjustment processes as well as to address some of the specific concerns of…

Esophageal motor function: technical aspects of manometry.

PubMed

Gyawali, C Prakash; Patel, Amit

2014-10-01

High-resolution manometry (HRM) has advanced the understanding of esophageal peristaltic mechanisms and has simplified esophageal motor testing. In this article the technical aspects of HRM are addressed, focusing on test protocols, in addition to concerns and pitfalls in performing esophageal motor studies. Specifically, catheter positioning, equipment-related artifacts, basal data acquisition, adequate swallows, and provocative maneuvers are discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

"They Never Really Tried to Reach out to Us": Examining Identities and Confronting the Emotional Distance between Urban Youth and Urban Schools

ERIC Educational Resources Information Center

McKnight, Andrew N.

2015-01-01

This paper looks at the perspectives of 22 young adults concerning their upbringings and life experiences, experiences in inner city and suburban schools, after leaving school, and later in a privately funded urban GED preparation facility in a large southern city. Specifically it addresses the conceptions students have about school and their…

Hammam Al Alil Division Training Center Mosul, Iraq

DTIC Science & Technology

2010-01-07

displacement of the concrete slab. The SOW required translucent material for the cladding and provided specific details for windows inserted in the...of poor curing practice; however, SIGIR did not observe any significant cracking or displacement of the concrete slab. The SOW required translucent ...Documentation that addressed the safety concerns of removing the overhead baffles was not available. In addition, the contractor used precast concrete planks

Head Start Substance Abuse Guide: A Resource Handbook for Head Start Grantees and Other Collaborating Community Programs.

ERIC Educational Resources Information Center

Collins, Raymond C.; Anderson, Penny R.

The purpose of this guide is to amplify the specific issues concerning substance abuse which Head Start grantees need to address, and to suggest resources and strategies to respond to these issues. The guide consists of five chapters, a bibliography, and two appendixes. An introduction (chapter I) discusses the problem of substance abuse and the…

New Trends in English Education: Selected Addresses Delivered at the Conference on English Education (4th, Carnegie Institute of Technology, March 31, April 1, 2, 1966).

ERIC Educational Resources Information Center

Stryker, David, Ed.

Special concerns in English education are explored in 11 papers from the 1966 Conference on English Education. Following an introduction by David Stryker, Lindley Stiles discusses important overall trends in teacher education. James Squire points out existing weaknesses in the preparation of English teachers and calls for specific curriculum…

Integrating standard operating procedures and industry notebook standards to evaluate students in laboratory courses.

PubMed

Wallert, Mark A; Provost, Joseph J

2014-01-01

To enhance the preparedness of graduates from the Biochemistry and Biotechnology (BCBT) Major at Minnesota State University Moorhead for employment in the bioscience industry we have developed a new Industry certificate program. The BCBT Industry Certificate was developed to address specific skill sets that local, regional, and national industry experts identified as lacking in new B.S. and B.A. biochemistry graduates. The industry certificate addresses concerns related to working in a regulated industry such as Good Laboratory Practices, Good Manufacturing Practices, and working in a Quality System. In this article we specifically describe how we developed a validation course that uses Standard Operating Procedures to describe grading policy and laboratory notebook requirements in an effort to better prepare students to transition into industry careers. © 2013 by The International Union of Biochemistry and Molecular Biology.

Aerospace Safety Advisory Panel

NASA Technical Reports Server (NTRS)

1992-01-01

The results of the Panel's activities are presented in a set of findings and recommendations. Highlighted here are both improvements in NASA's safety and reliability activities and specific areas where additional gains might be realized. One area of particular concern involves the curtailment or elimination of Space Shuttle safety and reliability enhancements. Several findings and recommendations address this area of concern, reflecting the opinion that safety and reliability enhancements are essential to the continued successful operation of the Space Shuttle. It is recommended that a comprehensive and continuing program of safety and reliability improvements in all areas of Space Shuttle hardware/software be considered an inherent component of ongoing Space Shuttle operations.

Communicating in context: a priority for gene therapy researchers.

PubMed

Robillard, Julie M

2015-03-01

History shows that public opinion of emerging biotechnologies has the potential to impact the research process through mechanisms such as funding and advocacy. It is critical, therefore, to consider public attitudes towards modern biotechnology such as gene therapy and more specifically towards the ethics of gene therapy, alongside advances in basic and clinical research. Research conducted through social media recently assessed how online users view the ethics of gene therapy and showed that while acceptability is high, significant ethical concerns remain. To address these concerns, the development of effective and evidence-based communication strategies that engage a wide range of stakeholders should be a priority for researchers.

Patient Perceptions About Data Sharing & Privacy: Insights from ActionADE.

PubMed

Small, Serena S; Peddie, David; Ackerley, Christine; Hohl, Corinne M; Balka, Ellen

2017-01-01

Information communication technologies (ICTs) may improve health delivery by enhancing informational continuity of care and enabling secondary use of health data including public health surveillance and research. ICTs also introduce concerns related to privacy. In this paper, we examine and address this tension in the context of the development and implementation of a novel platform that will enable the documentation and communication of patient-specific ADE information, titled ActionADE. We explored privacy concerns qualitatively from the perspective of patients. Our findings will inform a series of recommendations for system design that seek to balance the need to both share and protect personal health information.

48 CFR 19.1201 - General.

Code of Federal Regulations, 2010 CFR

2010-10-01

... addresses the evaluation of the extent of participation of small disadvantaged business (SDB) concerns in... are addressed in this subpart— (a) An evaluation factor or subfactor for the participation of SDB concerns in performance of the contract; and (b) An incentive subcontracting program for SDB concerns. [63...

48 CFR 19.1201 - General.

Code of Federal Regulations, 2014 CFR

2014-10-01

... addresses the evaluation of the extent of participation of small disadvantaged business (SDB) concerns in... are addressed in this subpart— (a) An evaluation factor or subfactor for the participation of SDB concerns in performance of the contract; and (b) An incentive subcontracting program for SDB concerns. [63...

48 CFR 19.1201 - General.

Code of Federal Regulations, 2013 CFR

2013-10-01

... addresses the evaluation of the extent of participation of small disadvantaged business (SDB) concerns in... are addressed in this subpart— (a) An evaluation factor or subfactor for the participation of SDB concerns in performance of the contract; and (b) An incentive subcontracting program for SDB concerns. [63...

48 CFR 19.1201 - General.

Code of Federal Regulations, 2012 CFR

2012-10-01

... addresses the evaluation of the extent of participation of small disadvantaged business (SDB) concerns in... are addressed in this subpart— (a) An evaluation factor or subfactor for the participation of SDB concerns in performance of the contract; and (b) An incentive subcontracting program for SDB concerns. [63...

48 CFR 19.1201 - General.

Code of Federal Regulations, 2011 CFR

2011-10-01

... addresses the evaluation of the extent of participation of small disadvantaged business (SDB) concerns in... are addressed in this subpart— (a) An evaluation factor or subfactor for the participation of SDB concerns in performance of the contract; and (b) An incentive subcontracting program for SDB concerns. [63...

Supervision of the certified occupational therapy assistant.

PubMed

Puccetti, D

1988-01-01

As current trends in health care continue to develop, manpower demands within the profession of occupational therapy will continue to rise. Creative partnerships and collaborative efforts between therapists and assistants are rapidly becoming a necessity to provide cost-effective patient care within a variety of treatment settings. Several documents and resources concerning role delinieation and supervision of assistants are available within the literature; however, few resources have been compiled to address supervision and supervision strategies for the assistant. This paper addresses supervison of the assistant in a fairly broad and generic sense, and includes specific strategies that my be introduced to enhance the supervisory process.

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.

Examining anxiety sensitivity as a mediator of the association between PTSD symptoms and suicide risk among women firefighters.

PubMed

Stanley, Ian H; Hom, Melanie A; Spencer-Thomas, Sally; Joiner, Thomas E

2017-08-01

Posttraumatic stress disorder (PTSD) symptoms are associated with increased suicide risk. Anxiety sensitivity (AS)-the fear of anxiety-related sensations-is both a vulnerability factor for and consequence of PTSD symptoms. AS also predicts suicide risk. To our knowledge, no study has examined whether AS concerns account for the association between PTSD symptoms and suicide risk. A total of 254 women firefighters completed a web-based mental health survey. The Life Events Checklist for DSM-5 (LEC-5) was administered as a prelude to the PTSD Checklist for DSM-5 (PCL-5) to assess for exposure to a Criterion A event. The PCL-5, Anxiety Sensitivity Index-3 (ASI-3), and Suicidal Behaviors Questionnaire-Revised (SBQ-R) were utilized to assess PTSD symptoms, AS concerns, and suicide risk, respectively. Bootstrap mediation analyses were conducted, controlling for depression symptoms as measured by the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R). Global and cognitive AS concerns, but neither physical nor social AS concerns, were statistically significant mediators of the relationship between PTSD symptoms (total score, re-experiencing and numbing clusters) and suicide risk. Alternate mediation models testing PTSD symptoms as a mediator of the relationship between AS concerns and suicide risk were not statistically significant, supporting the specificity of our proposed model. Anxiety sensitivity concerns-specifically, cognitive AS concerns-account for the link between PTSD symptoms and suicide risk among women firefighters. Among firefighters with elevated PTSD symptoms, interventions that address cognitive AS concerns may thwart the trajectory to suicidal thoughts and behaviors. Copyright © 2017 Elsevier Ltd. All rights reserved.

On the Path to SunShot. Utility Regulatory and Business Model Reforms for Addressing the Financial Impacts of Distributed Solar on Utilities

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

Barbose, Galen; Miller, John; Sigrin, Ben

Net-energy metering (NEM) has helped drive the rapid growth of distributed PV (DPV) but has raised concerns about electricity cost shifts, utility financial losses, and inefficient resource allocation. These concerns have motivated real and proposed reforms to utility regulatory and business models. This report explores the challenges and opportunities associated with such reforms in the context of the U.S. Department of Energy's SunShot Initiative. Most of the reforms to date address NEM concerns by reducing the benefits provided to DPV customers and thus constraining DPV deployment. Eliminating NEM nationwide, by compensating exports of PV electricity at wholesale rather than retailmore » rates, could cut cumulative DPV deployment by 20% in 2050 compared with a continuation of current policies. This would slow the PV cost reductions that arise from larger scale and market certainty. It could also thwart achievement of the SunShot deployment goals even if the initiative's cost targets are achieved. This undesirable prospect is stimulating the development of alternative reform strategies that address concerns about distributed PV compensation without inordinately harming PV economics and growth. These alternatives fall into the categories of facilitating higher-value DPV deployment, broadening customer access to solar, and aligning utility profits and earnings with DPV. Specific strategies include utility ownership and financing of DPV, community solar, distribution network operators, services-driven utilities, performance-based incentives, enhanced utility system planning, pricing structures that incentivize high-value DPV configurations, and decoupling and other ratemaking reforms that reduce regulatory lag. These approaches represent near- and long-term solutions for preserving the legacy of the SunShot Initiative.« less

The Influence of the Breast on Sport and Exercise Participation in School Girls in the United Kingdom.

PubMed

Scurr, Joanna; Brown, Nicola; Smith, Jenny; Brasher, Amanda; Risius, Debbie; Marczyk, Anna

2016-02-01

Emerging evidence suggests that breasts may be a barrier to physical activity for adult females. With only 12% of the UK 14-year-old girls achieving exercise guidelines, to understand deterrents to exercise in this population, we should consider whether breasts may also influence sport and exercise participation in school girls. This survey-based study investigated the influence of the breast on sport and exercise participation and breast-specific concerns in the UK school girls. A survey was developed to assess demographics, breast characteristics, breast-specific concerns in sports, breast knowledge, views on breast education, and sport participation. Chi-squared tests assessed associations between participation and breast size, sports bra use, and breast concerns. Two thousand eighty-nine school girls aged 11-18 years completed the survey, for 97 their breasts had begun developing and 96% reported wearing breast support. Forty-six percent of girls reported that their breasts had some effect on their participation in compulsory sports and exercise, which was more prevalent in girls aged 13-14 years (51%) and in larger-breasted girls (63%). More than 50% reported never wearing a sports bra during sports. Breast concerns were high with 73% reporting ≥1 breast-specific concern in sports; with breast bounce being most prevalent (38%). As most of the breast concerns raised in this survey could be addressed via education and 87% of girls wanted to know more about breasts, this study demonstrates a need for breast education for school girls, which may reduce the influence of the breast on sport and exercise participation. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

The Role of Close Relationships in Terror Management: A Systematic Review and Research Agenda.

PubMed

Plusnin, Nicholas; Pepping, Christopher A; Kashima, Emiko S

2018-02-01

Terror management theory outlines how humans seek self-esteem and worldview validation to manage death-related anxiety. Accumulating evidence reveals that close relationships serve a similar role. However, to date, there has been no synthesis of the literature that delineates when close relationships buffer mortality concerns, under what conditions, on which specific outcomes, and for whom. This systematic review presents over two decades of research to address these questions. Findings from 73 reviewed studies revealed that close relationships serve an important role in buffering death-related anxiety. A range of dispositional and situational moderating factors influence either the activation or inhibition of relational strivings to manage heightened death awareness, the most influential being attachment, gender, and relationship-contingent self-esteem. These findings were integrated into an overarching model that highlights some of the conditions under which mortality salience (MS) influences relational outcomes. We conclude by highlighting a range of theoretical and methodological concerns to be addressed by future research.

The impact of marijuana policies on youth: clinical, research, and legal update.

PubMed

Ammerman, Seth; Ryan, Sheryl; Adelman, William P

2015-03-01

This technical report updates the 2004 American Academy of Pediatrics technical report on the legalization of marijuana. Current epidemiology of marijuana use is presented, as are definitions and biology of marijuana compounds, side effects of marijuana use, and effects of use on adolescent brain development. Issues concerning medical marijuana specifically are also addressed. Concerning legalization of marijuana, 4 different approaches in the United States are discussed: legalization of marijuana solely for medical purposes, decriminalization of recreational use of marijuana, legalization of recreational use of marijuana, and criminal prosecution of recreational (and medical) use of marijuana. These approaches are compared, and the latest available data are presented to aid in forming public policy. The effects on youth of criminal penalties for marijuana use and possession are also addressed, as are the effects or potential effects of the other 3 policy approaches on adolescent marijuana use. Recommendations are included in the accompanying policy statement. Copyright © 2015 by the American Academy of Pediatrics.

Productivity, Slack, and Time Theft in the Soviet Economy: Evidence from the Soviet Interview Project

DTIC Science & Technology

1985-09-01

enterprise, changes in personal living standards, tightness of enterprise targets, and so on. The natural question is how these perceptions affect...microeconomic working arrangements, and respondent-specific questions concerning their own personal experiences and impressions. These two types of responses...directly to speak about personal workplace experiences, so there is less dznger of second-hand generalizatIons. The slack questions address

District of Columbia: D.C. Public Schools' Modernization Program Faces Major Challenges. Testimony before the Subcommittee on the District of Columbia, Committee on Appropriations, House of Representatives.

ERIC Educational Resources Information Center

Cooper, David E.

This Congressional testimony focuses on the challenges faced by the District of Columbia in modernizing its public schools. Specifically, it addresses: (1) increases in the cost of modernizing the schools; (2) delays in completing the schools; (3) quality inspection problems; and (4) concerns about managing asbestos hazards. The testimony…

Overcoming Degraded Communications under A2AD: A Doctrinal Solution

DTIC Science & Technology

2014-05-15

against an A2AD challenge. 3 While retaining the counterinsurgency expertise paid for in blood over the last decade, the U.S. military must refine and...We now carry with us invaluable new lessons paid for in blood and treasure concerning counterinsurgency and stability operations. But we may also...attempting to address the competency shortfall. It specifically identifies capability gaps regarding operations in a potential stressed -communications

A Model for Effective Organization and Communication of Homeland Security Activity at the State Level

DTIC Science & Technology

2007-03-01

whether managing the functional segments of a major corporation, i.e. sourcing, product development, inbound/ outbound logistics , or after-market services...homeland security concerns. While none specifically addresses the mechanics or logistics of the reorganization of state governments, it does assert...and around casino and hotels . Respond to all threats and hazards. Admit lawful bettors and visitors. Promote legal gaming.41 Department of

Patient communication in hormone therapy.

PubMed

Schnare, S M

2001-01-01

Common regimens of HRT therapy are reviewed, including common routes of hormone administration. Inconsistent patterns of HRT use are discussed, including the reasons women most often give for discontinuing hormone therapies. Specific issues related to misperceptions and fears regarding HRT are clarified, and specific, focused patient education formats are discussed to address women's common concerns about HRT. Obstacles to HRT use are elucidated, with suggestions for clinicians about how to communicate more effectively with women: clinicians must focus on emotional and physical aspects of HRT choices and tailor therapies to the individual patient. Discussing frankly the very serious concerns of women regarding the association between lobular breast cancer and endometrial cancer is important; discussing and preparing women for possible side effects helps patients cope better if and when side effects occur. Finally, offering a wide variety of HRT therapies provides women with a broader choice if an initial regimen is unsuccessful.

Lesbian, gay, bisexual, transgendered, or intersexed content for nursing curricula.

PubMed

Brennan, Ann Marie Walsh; Barnsteiner, Jane; Siantz, Mary Lou de Leon; Cotter, Valeri T; Everett, Janine

2012-01-01

There has been limited identification of core lesbian, gay, bisexual, transgendered, or intersexed (LGBTI) experience concepts that should be included in the nursing curricula. This article addresses the gap in the literature. To move nursing toward the goals of health equity and cultural humility in practice, education, and research, nursing curricula must integrate core LGBTI concepts, experiences, and needs related to health and illness. This article reviews LGBTI health care literature to address the attitudes, knowledge, and skills needed to address curricular gaps and provide content suggestions for inclusion in nursing curricula. Also considered is the need to expand nursing students' definition of diversity before discussing the interplay between nurses' attitudes and culturally competent care provided to persons who are LGBTI. Knowledge needed includes a life span perspective that addresses developmental needs and their impact on health concerns throughout the life course; health promotion and disease prevention with an articulation of unique health issues for this population; mental health concerns; specific health needs of transgender and intersex individuals; barriers to health care; interventions and resources including Internet sites; and legal and policy issues. Particular assessment and communication skills for LGBTI patients are identified. Finally, there is a discussion of didactic, simulation, and clinical strategies for incorporating this content into nursing curricula at the undergraduate and graduate levels. Copyright © 2012 Elsevier Inc. All rights reserved.

Uncorrected and corrected refractive error experiences of Nepalese adults: a qualitative study.

PubMed

Kandel, Himal; Khadka, Jyoti; Shrestha, Mohan Krishna; Sharma, Sadhana; Neupane Kandel, Sandhya; Dhungana, Purushottam; Pradhan, Kishore; Nepal, Bhagavat P; Thapa, Suman; Pesudovs, Konrad

2018-04-01

The aim of this study was to explore the impact of corrected and uncorrected refractive error (URE) on Nepalese people's quality of life (QoL), and to compare the QoL status between refractive error subgroups. Participants were recruited from Tilganga Institute of Ophthalmology and Dhulikhel Hospital, Nepal. Semi-structured in-depth interviews were conducted with 101 people with refractive error. Thematic analysis was used with matrices produced to compare the occurrence of themes and categories across participants. Themes were identified using an inductive approach. Seven major themes emerged that determined refractive error-specific QoL: activity limitation, inconvenience, health concerns, psycho-social impact, economic impact, general and ocular comfort symptoms, and visual symptoms. Activity limitation, economic impact, and symptoms were the most important themes for the participants with URE, whereas inconvenience associated with wearing glasses was the most important issue in glasses wearers. Similarly, possibilities of having side effects or complications were the major concerns for participants wearing contact lens. In general, refractive surgery addressed socio-emotional impact of wearing glasses or contact lens. However, the surgery participants had concerns such as possibility of having to wear glasses again due to relapse of refractive error. Impact of refractive error on people's QoL is multifaceted. Significance of the identified themes varies by refractive error subgroups. Refractive correction may not always address QoL impact of URE but often add unique QoL issues. This study findings also provide content for developing an item-bank for quantitatively measuring refractive error-specific QoL in developing country setting.

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

DTIC Science & Technology

2016-04-29

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

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

PubMed

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

2016-05-01

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

IDC Re-Engineering Phase 2 System Specification Document Version 1.5

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

Satpathi, Meara Allena; Burns, John F.; Harris, James M.

This document contains the system specifications derived to satisfy the system requirements found in the IDC System Requirements Document for the IDC Re-Engineering Phase 2 project. This System Specification Document (SSD) defines waveform data processing requirements for the International Data Centre (IDC) of the Comprehensive Nuclear Test Ban Treaty Organization (CTBTO). The routine processing includes characterization of events with the objective of screening out events considered to be consistent with natural phenomena or non-nuclear, man-made phenomena. This document does not address requirements concerning acquisition, processing and analysis of radionuclide data but does include requirements for the dissemination of radionuclide datamore » and products.« less

Status Report of the Pacific Lamprey (Lampetra Trzdentata) in the Columbia River Basin.

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

Close, David A.; Parker, Blaine; James, gary

1995-07-01

The widespread decline of Pacific lamprey (Lampetra tridentata) in the Pacific Northwest, especially in the Columbia River system has led to concerns and questions from a number of regional agencies, Native American tribes, and the public. To address these concerns, new research efforts must focus on specific problems associated with this understudied species. The preservation and restoration of this species is critical for a number of reasons, including its importance to the tribes and its importance as an indicator of ecosystem health. Historically lamprey have been labeled a pest species due to the problems associated with the exotic sea lamprey,more » (Petromyzon marinus), invading the Great Lakes.« less

Evaluation of accountability measurements

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

Cacic, C.G.

The New Brunswick Laboratory (NBL) is programmatically responsible to the U.S. Department of Energy (DOE) Office of Safeguards and Security (OSS) for providing independent review and evaluation of accountability measurement technology in DOE nuclear facilities. This function is addressed in part through the NBL Safegaurds Measurement Evaluation (SME) Program. The SME Program utilizes both on-site review of measurement methods along with material-specific measurement evaluation studies to provide information concerning the adequacy of subject accountability measurements. This paper reviews SME Program activities for the 1986-87 time period, with emphasis on noted improvements in measurement capabilities. Continued evolution of the SME Programmore » to respond to changing safeguards concerns is discussed.« less

Veterans’ Health Care: Limited Progress Made to Address Concerns That Led to High Risk Designation

DTIC Science & Technology

2017-03-15

partially meet two of the five criteria GAO uses to assess removal from the High-Risk List ( leadership commitment and an action plan), but it has not met...the other three (agency capacity, monitoring efforts, and demonstrated progress). Specifically, VA officials have taken leadership actions such as...high-risk designation, additional actions are required of VA, including: (1) demonstrating stronger leadership support as it continues its

Guidelines for the Clinical Use of Electronic Mail with Patients

PubMed Central

Kane, Beverley; Sands, Daniel Z.

1998-01-01

Guidelines regarding patient—provider electronic mail are presented. The intent is to provide guidance concerning computer-based communications between clinicians and patients within a contractual relationship in which the health-care provider has taken on an explicit measure of responsibility for the client's care. The guidelines address two interrelated aspects: effective interaction between the clinician and patient, and observance of medicolegal prudence. Recommendations for site-specific policy formulation are included. PMID:9452989

Exploring Intercultural Awareness in the Primary Modern Language Classroom: The Potential of the New Model of European Language Portfolio Developed by the Irish Modern Languages in Primary Schools Initiative (MLPSI)

ERIC Educational Resources Information Center

Rantz, Frederique; Horan, Pascaline

2005-01-01

This paper reflects a key concern for teacher trainers: how can primary language teachers promote the development of intercultural awareness among their pupils? It addresses the concept of intercultural awareness as it applies to young learners and refers more specifically to the context of the Irish primary classroom and its curriculum. It argues…

Using Biodata to Select Air Traffic Controllers

DTIC Science & Technology

2014-10-01

training success (Collins et al., 1990). In fact, in a study designed specifically to address the impact of education on controller suc- cess, defined...examination of adverse impact in controller selection for certain protected groups in controller selection. The concern was the use of the AT-SAT in...Broach et al., 2013). The issue is how to reduce adverse impact in controller hiring and still maintain a valid process for selecting the best

Transforming Traditional Practices of Teacher Preparation to Meet Changing Needs of Digital Learners: A First Step Intervention by Assessing and Addressing Needs of Pre-Service Teachers in a Dual Learning Environment

ERIC Educational Resources Information Center

Poyo, Susan Ricke

2016-01-01

Changes in the field of education require teachers' acquisition of specific knowledge of technology and the skills of its effective use in the classroom. With the expansion of the traditional classroom to include virtual learning environments, concern still exists regarding characteristics necessary for quality teaching and learning. This research…

U.S. Transportation Command Needs Further Improvements to Address Performance Concerns Over the Global Privately Owned Vehicle Contract 3

DTIC Science & Technology

2016-02-03

required vehicles be covered, locked , and stored in accordance with standard commercial practices. Specifically, numerous leaks were present...Vehicle Processing Center and storage facility, Dallas , Texas; • Vehicle Processing Center, St. Louis, Missouri; • Vehicle Processing Center, Charleston...vehicles did not require covers and were not required to be locked based on authorized directives from the contracting officer. He also stated that

Sexual information needs of Arab-Muslim patients with cardiac problems.

PubMed

Akhu-Zaheya, Laila M; Masadeh, Arwa B

2015-12-01

Cardiac diseases have direct and indirect effects on sexuality. Health care providers, especially nurses, have a major responsibility in addressing and discussing sexual concerns and providing sexual counseling needs for patients with cardiac diseases. Discussing sexual issues in Arabic Muslim countries is considered a taboo. Lack of information about sexual life can affect the quality of life for patients with cardiac diseases. In this study, concerns regarding counseling needs and sexual information pertaining to Jordanian patients with cardiac diseases are addressed. Non-experimental, cross-sectional, descriptive designs were employed, accompanied by a self-report questionnaire, as well as a structured interview using the Steinke Sexual Concerns and Sexual Activity questionnaires for cardiac patients. A convenient sample of Jordanian male and female patients with cardiac problems was recruited. Results revealed that only 11% of the participants with cardiac diseases reported receiving information regarding sexual life following cardiac-related events. Most patients (71%, F=81) preferred cardiologists to provide them with sexual information, and almost two-thirds of them (62%, F=75) considered nurses' gender to be a barrier, preventing them from inquiring about their sexual life. Patients with cardiac diseases had sexual concerns, but none of incredible importance. However, most patients (76%, F=94) reported changes in sexual activities following cardiac-related events. Cardiac patients had sexual concerns and sexual counseling needs that they would not discuss. Health care professionals should arrange sexual counseling plans with the patient; as every patient has individual, specific, and unique sexual counseling needs, dependent upon their lifestyle, health conditions, and their type of cardiac disease. © The European Society of Cardiology 2015.

Skin exposure: Assessing the hazard in the workplace

NASA Technical Reports Server (NTRS)

Cummins, Kevin

1994-01-01

An outline of the Occupational Safety and Health Agency's concerns of skin exposure to hazardous chemicals is presented, followed by the corresponding slide narrations. Specifically, dermatitis and skin absorption as compared to lung absorption are addressed. Lung versus skin exposure is examined for glycol ethers and acrylamide. Examples of skin exposure include PBC's in transformers, toluene and xylene from autobody work, polynuclear aromatics (PNA's) among Coke oven workers, toluene diisocyanate (TDI), and occupational chemical exposures in an academic medical center. Permeation through gloves in the semiconductor industry is addressed as evidence for the need to assess the effectiveness of PPE (Personal Protective Equipment). This leads to the revisions of the PPE standard and the Safety and Health Program standard.

Predictors of burden among lower socioeconomic status caregivers of persons with chronic mental illness.

PubMed

Biegel, D E; Milligan, S E; Putnam, P L; Song, L Y

1994-10-01

This study uses a stress-coping-support framework to examine the predictors of caregiver burden with a sample of 103 lower social class family caregivers of persons with chronic mental illness. Results of multiple regression analyses show that the greater the frequency of client behavioral symptoms and the lower the amount of perceived support from family members, the higher the level of overall caregiver burden. Examination of the predictors of specific types of burden-family disruption, stigma, strain, and dependency-reveal that different constellations of variables predict different types of burden. The need for mental health agencies to address caregiver and client concerns is addressed. Implications are presented for practice and future research.

Research- and community-based clinicians' attitudes on treatment manuals.

PubMed

Barry, Declan T; Fulgieri, Melissa D; Lavery, Meaghan E; Chawarski, Marek C; Najavits, Lisa M; Schottenfeld, Richard S; Pantalon, Michael V

2008-01-01

We assessed the attitudes of 18 research- and 22 community-based substance abuse clinicians on treatment manuals. Research and community clinicians exhibited favorable attitudes toward manuals, and the majority (72% and 77%, respectively) reported an interest in learning more about substance use disorder (SUD) treatment manuals. Among community clinicians, greater years of experience was significantly associated with less favorable attitudes toward treatment manuals. Research clinicians endorsed significantly higher ratings for the importance attached to "theoretical rationale/overview" and "main session points to address" than community clinicians. Findings suggest that community SUD clinicians are already familiar with and have positive attitudes toward manuals, but specific subgroups have concerns that should be addressed.

Lack of genotoxicity in vivo for food color additive Allura Red AC.

PubMed

Bastaki, Maria; Farrell, Thomas; Bhusari, Sachin; Pant, Kamala; Kulkarni, Rohan

2017-07-01

Allura Red AC is an approved food color additive internationally with INS number 129, in the United States as food color subject to batch certification "Food, Drug, and Cosmetic" (FD&C) Red No. 40, and in Europe as food color additive with E number 129. In their evaluation of the color (2013), the European Food Safety Authority (EFSA) expressed concerns of potential genotoxicity, based primarily on one genotoxicity study that was not conducted according to Guidelines. The present in vivo genotoxicity study was conducted according to OECD Guidelines in response to EFSA's request for additional data. The animal species and strain, and the tissues examined were selected specifically to address the previously reported findings. The results show clear absence of genotoxic activity for Allura Red AC, in the bone marrow micronucleus assay and the Comet assay in the liver, stomach, and colon. These data addressed EFSA's concerns for genotoxicity. The Joint WHO/FAO Committee on Food Additives (JECFA) (2016) also reviewed the study and concluded that there is no genotoxicity concern for Allura Red AC. Negative findings in parallel genotoxicity studies on Tartrazine and Ponceau 4R (published separately) are consistent with lack of genotoxicity for azo dyes used as food colors. Copyright © 2017 Elsevier Ltd. All rights reserved.

Lack of genotoxicity in vivo for food color additive Tartrazine.

PubMed

Bastaki, Maria; Farrell, Thomas; Bhusari, Sachin; Pant, Kamala; Kulkarni, Rohan

2017-07-01

Tartrazine is approved as a food color additive internationally with INS number 102, in the United States as food color subject to batch certification "Food, Drug, and Cosmetic" (FD&C) Yellow No. 5, and in Europe as food color additive with E number 102. In their evaluation of the color (2013), the European Food Safety Authority (EFSA) expressed concerns of potential genotoxicity, based primarily on one genotoxicity study that was not conducted according to Guidelines. The present in vivo genotoxicity study was conducted according to OECD Guidelines in response to EFSA's request for additional data. The animal species and strain, and the tissues examined were selected specifically to address the previously reported findings. The results of this study show clear absence of genotoxic activity for Tartrazine, in the bone marrow micronucleus assay and the Comet assay in the liver, stomach, and colon. These data addressed EFSA's concerns for genotoxicity. The Joint WHO/FAO Committee on Food Additives (JECFA) (2016) also reviewed these data and concluded that there is no genotoxicity concern for Tartrazine. Negative findings in parallel genotoxicity studies on Allura Red AC and Ponceau 4R (published separately) are consistent with lack of genotoxicity for azo dyes used as food colors. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparative analysis of dietary guidelines in the Spanish-Speaking Caribbean.

PubMed

Fuster, Melissa

2016-03-01

Dietary guidelines are important education and policy tools to address local nutrition concerns. The current paper presents a comparative analysis of nutrition messages from three Spanish-speaking Caribbean countries (Cuba, Puerto Rico and Dominican Republic) to explore how these dietary guidelines address common public health nutrition concerns, contextualized in different changing food environments and food culture similarities. Qualitative, comparative analysis of current dietary guideline documents and key recommendations. Key recommendations were categorized into sixteen themes (two diet-based, ten food-based and four 'other'). Only the Cuban dietary guidelines included diet-based key recommendations. Of the ten food-based key recommendations, only four themes overlapped across the three dietary guidelines (the encouragement of fruits and vegetables, addressing protein sources and fat). Other overlaps were found between dietary guideline pairs, except between Cuba and Puerto Rico. Further analysis revealed differences in levels of specificity and acknowledgement of local dietary patterns and issues, as well as the need to revise the guidelines to account for current scientific advances. The present study underscored the importance of context in the framing of dietary advice and the influence of national socio-economic and political situations on nutrition policy and education efforts. The results contribute to inform efforts to improve nutrition communication in the region and among migrant communities.

Costs, Substitution, and Material Use: The Case of Rare Earth Magnets.

PubMed

Smith, Braeton J; Eggert, Roderick G

2018-03-20

Environmental technologies depend on raw materials, some of which are subject to volatile costs and availability concerns. One way to address these concerns is through substitution, of which there are many types. An important form of substitution in the short term is adopting an alternative production process, yielding a material with the same functional properties with less material input. In effect, technology substitutes for material. This study elucidates the role increased and uncertain material costs play in inducing different substitution types in the short to medium term. Specifically, this paper uses an expert survey to determine the relative importance of eight specific industry responses taken by magnet and wind turbine manufacturers in response to the 2010/2011 rare-earth price spike through 2016. Statistical tests show adopting an existing production process for magnets was the most important response, followed by cost passthrough, using an alternate magnet grade in a redesigned generator system, and using alternate systems altogether. The paper also provides specific findings for the magnet and wind turbine industries with respect to each substitution type.

Country-Specific Effects of Climate Variability on Human Migration.

PubMed

Gray, Clark; Wise, Erika

2016-04-01

Involuntary human migration is among the social outcomes of greatest concern in the current era of global climate change. Responding to this concern, a growing number of studies have investigated the consequences of short to medium-term climate variability for human migration using demographic and econometric approaches. These studies have provided important insights, but at the same time have been significantly limited by lack of expertise in the use of climate data, access to cross-national data on migration, and attention to model specification. To address these limitations, we link data on internal and international migration over a 6-year period from 9,812 origin households in Kenya, Uganda, Nigeria, Burkina Faso and Senegal to high-resolution gridded climate data from both station and satellite sources. Analyses of these data using several plausible specifications reveal that climate variability has country-specific effects on migration: Migration tends to increase with temperature anomalies in Uganda, tends to decrease with temperature anomalies in Kenya and Burkina Faso, and shows no consistent relationship with temperature in Nigeria and Senegal. Consistent with previous studies, precipitation shows weak and inconsistent relationships with migration across countries. These results challenge generalizing narratives that foresee a consistent migratory response to climate change across the globe.

Common usage of cardiologic anatomical terminology: critical analysis and a trilingual discussion proposal.

PubMed

Werneck, Alexandre Lins; Batigália, Fernando

2009-01-01

Terminology and Lexicography have been especially addressed to the Allied Health Sciences regarding discussion of case reports or concerning publication of scientific articles. The knowledge of Human Anatomy enables the understanding of medical terms and the refinement of Medical Terminology makes possible a better anatomicomedical communication in a highly technical level. Most of the scientific publications in both Anatomy and Medicine are found only in English and most of dictionaries or search resources available do not have specificity enough to explain anatomicomedical, terminological, or lexicographical occurrences. To design and produce a multilingual terminological dictionary (Latin-English-Portuguese-Spanish) containing a list of English anatomicomedical terms in common usage in cardiology subspecialties addressed to medical students and professionals, to other allied health sciences professionals, and to translators working in this specific field. Terms, semantical and grammatical components were selected to compose an anatomicocardiological corpus. The adequacy to the thematic terminological research requests and the translation reliability level will be settled from the terminology specificity in contrast to the semantics, as well as from a peer survey of the main terms used by national and international experts in specialized journals, Internet sites, and from text-books on Anatomy and Cardiology. The inclusion criteria will be the terms included in the English, Portuguese, and Spanish Terminologia Anatomica - the official terminology of the anatomical sciences; nonofficial technical commonly used terms which lead to terminology or translation misunderstanding often being a source of confusion. A table with a sample of the 508 most used anatomical cardiologic terms in English language peer-reviewed journals of cardiology and (pediatric and adult) thoracic surgery is shown. The working up of a multilingual terminological dictionary reduces the risk of ambiguities, inconsistencies, inutilities, and repetitions concerning the Nomenclature addressed to the Allied Health Sciences by prioritizing the inclusion of official technical terms and a judicious selection of commonly used terms. Efforts to standardize lists of structures in Humana Anatomy lead to both opportunities of scientific update and conceptual enlightenment.

Beyond barriers: fundamental 'disconnects' underlying the treatment of breast cancer patients' sexual health.

PubMed

Halley, Meghan C; May, Suepattra G; Rendle, Katharine A S; Frosch, Dominick L; Kurian, Allison W

2014-01-01

Sexual health concerns represent one of the most frequently experienced and longest-lasting effects of breast cancer treatment, but research suggests that service providers rarely discuss sexual health with their patients. Existing research examining barriers to addressing patients' sexual health concerns has focused on discrete characteristics of the provider-patient interaction without considering the broader context in which these interactions occur. Drawing on the experiences of 21 breast cancer survivors, this paper explores three ways in which fundamental cultural and structural characteristics of the cancer care system in the USA may prevent breast cancer survivors from addressing their sexual health concerns, including: (1) when patients discussed sexual health with their providers, their providers approached sexuality as primarily physical, while participants experienced complex, multidimensional sexual health concerns; (2) specialisation within cancer care services made it difficult for patients to identify the appropriate provider to address their concerns; and (3) the structure of cancer care literally disconnects patients from the healthcare system at the time when sexual side effects commonly emerged. These data suggest that addressing breast cancer survivors' sexual health concerns requires a multifaceted approach to health systems change.

Perceived obstacles to career success for women in academic surgery.

PubMed

Colletti, L M; Mulholland, M W; Sonnad, S S

2000-08-01

We conducted this study to determine whether concerns expressed by male and female surgeons at 1 academic center are generally reflective of broader concerns for academic surgery and academic medicine. We reviewed published studies concerning women in academic surgery within the context of reporting the results of a survey of both male and female surgeons at 1 academic center. We developed a survey that included demographic information, work experience, and social issues. The survey was distributed to the entire faculty. For key questions, we compared answers between male and female faculty. Additional data came from the published literature. We reviewed all available studies identified by a MEDLINE search with key words women and academic and medicine or physician. Included studies contained either data collection or editorial comment concerning women in academic medicine. Data and opinions from all included studies paralleling survey questions were extracted from each article. Male and female faculty members reported different experiences and perceptions, specifically relating to relationships between family and professional life and perceptions of subtle sex-related biases. Both men and women reported insufficient mentoring and difficulties in balancing personal and professional responsibilities. Attitudes, behaviors, and traditions surrounding how we structure work and evaluate participation in academic surgery are more difficult to change than just addressing obvious inequities in support for female surgeons. However, attempting the deeper changes is worthwhile, because addressing obstacles faced by female faculty, many of which also affect men, will allow progress toward environments that attract and retain the best physicians, regardless of sex.

Don't Fear the Cyborg: Toward Embracing Posthuman and Feminist Cyborg Discourses in Teacher Education and Educational Technology Research

ERIC Educational Resources Information Center

Gleason, Shannon C.

2014-01-01

I argue that larger cultural concerns about human-technology interactions are seldom addressed in teacher education. This article seeks to trace cultural anxieties about technology by addressing the long-standing trope of human versus machine; examine how these concerns are manifested and addressed (or not) in popular culture, educational…

An Assessment of the Issues and Concerns Associated with the Analysis of Ice-bearing Samples by the 2009 Mars Science Laboratory

NASA Technical Reports Server (NTRS)

Beaty, D. W.; Miller, S. L.; Bada, J. L.; Bearman, G. H.; Black, P. B.; Bruno, R. J.; Carsey, F. D.; Conrad, P. G.; Daly, M.; Fisher, D.

2003-01-01

In early 2003, the Mars Icy Sample Team (MIST) was formed to address several questions related to the acquisition and analysis of ice-bearing samples on the surface of Mars by a robotic mission. These questions were specifically framed in the context of planning for the 2009 Mars Science Laboratory (MSL) lander, but the answers will also also have value in planning other future landed investigations.

Structural empowerment, Magnet hospital characteristics, and patient safety culture: making the link.

PubMed

Armstrong, Kevin J; Laschinger, Heather

2006-01-01

Nurse managers are seeking ways to improve patient safety in their organizations. At the same time, they struggle to address nurse recruitment and retention concerns by focusing on the quality of nurses' work environment. This exploratory study tested a theoretical model, linking the quality of the nursing practice environments to a culture of patient safety. Specific strategies to increase nurses' access to empowerment structures and thereby increase the culture of patient safety are suggested.

USGS Colorado Water Science Center bookmark

USGS Publications Warehouse

,

2016-12-05

The U.S. Geological Survey Colorado Water Science Center conducts its water-resources activities primarily in Colorado in cooperation with more than 125 different entities. These activities include extensive data-collection efforts and studies of streamflow, water quality, and groundwater to address many specific issues of concern to Colorado water-management entities and citizens. The collected data are provided in the National Water Information System, and study results are documented in reports and information served on the Internet.

Management options for recycling radioactive scrap metals

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

Dehmel, J.C.; MacKinney, J.; Bartlett, J.

1997-02-01

The feasibility and advantages of recycling radioactive scrap metals (RSM) have yet to be assessed, given the unique technical, regulatory, safety, and cost-benefit issues that have already been raised by a concerned recycling industry. As is known, this industry has been repeatedly involved with the accidental recycling of radioactive sources and, in some cases, with costly consequences. If recycling were deemed to be a viable option, it might have to be implemented with regulatory monitoring and controls. Its implementation may have to consider various and complex issues and address the requirements and concerns of distinctly different industries. There are threemore » basic options for the recycling of such scraps. They are: (1) recycling through the existing network of metal-scrap dealers and brokers, (2) recycling directly and only with specific steelmills, or (3) recycling through regional processing centers. Under the first option, scrap dealers and brokers would receive material from RSM generators and determine at which steelmills such scraps would be recycled. For the second option, RSM generators would deal directly with selected steelmills under specific agreements. For the third option, generators would ship scraps only to regional centers for processing and shipment to participating steelmills. This paper addresses the potential advantages of each option, identifies the types of arrangements that would need to be secured among all parties, and attempts to assess the receptivity of the recycling industry to each option.« less

Legislation on direct-to-consumer genetic testing in seven European countries.

PubMed

Borry, Pascal; van Hellemondt, Rachel E; Sprumont, Dominique; Jales, Camilla Fittipaldi Duarte; Rial-Sebbag, Emmanuelle; Spranger, Tade Matthias; Curren, Liam; Kaye, Jane; Nys, Herman; Howard, Heidi

2012-07-01

An increasing number of private companies are now offering direct-to-consumer (DTC) genetic testing services. Although a lot of attention has been devoted to the regulatory framework of DTC genetic testing services in the USA, only limited information about the regulatory framework in Europe is available. We will report on the situation with regard to the national legislation on DTC genetic testing in seven European countries (Belgium, the Netherlands, Switzerland, Portugal, France, Germany, the United Kingdom). The paper will address whether these countries have legislation that specifically address the issue of DTC genetic testing or have relevant laws that is pertinent to the regulatory control of these services in their countries. The findings show that France, Germany, Portugal and Switzerland have specific legislation that defines that genetic tests can only be carried out by a medical doctor after the provision of sufficient information concerning the nature, meaning and consequences of the genetic test and after the consent of the person concerned. In the Netherlands, some DTC genetic tests could fall under legislation that provides the Minister the right to refuse to provide a license to operate if a test is scientifically unsound, not in accordance with the professional medical practice standards or if the expected benefit is not in balance with the (potential) health risks. Belgium and the United Kingdom allow the provision of DTC genetic tests.

Legislation on direct-to-consumer genetic testing in seven European countries

PubMed Central

Borry, Pascal; van Hellemondt, Rachel E; Sprumont, Dominique; Jales, Camilla Fittipaldi Duarte; Rial-Sebbag, Emmanuelle; Spranger, Tade Matthias; Curren, Liam; Kaye, Jane; Nys, Herman; Howard, Heidi

2012-01-01

An increasing number of private companies are now offering direct-to-consumer (DTC) genetic testing services. Although a lot of attention has been devoted to the regulatory framework of DTC genetic testing services in the USA, only limited information about the regulatory framework in Europe is available. We will report on the situation with regard to the national legislation on DTC genetic testing in seven European countries (Belgium, the Netherlands, Switzerland, Portugal, France, Germany, the United Kingdom). The paper will address whether these countries have legislation that specifically address the issue of DTC genetic testing or have relevant laws that is pertinent to the regulatory control of these services in their countries. The findings show that France, Germany, Portugal and Switzerland have specific legislation that defines that genetic tests can only be carried out by a medical doctor after the provision of sufficient information concerning the nature, meaning and consequences of the genetic test and after the consent of the person concerned. In the Netherlands, some DTC genetic tests could fall under legislation that provides the Minister the right to refuse to provide a license to operate if a test is scientifically unsound, not in accordance with the professional medical practice standards or if the expected benefit is not in balance with the (potential) health risks. Belgium and the United Kingdom allow the provision of DTC genetic tests. PMID:22274578

Safety management and risk assessment in chemical laboratories.

PubMed

Marendaz, Jean-Luc; Friedrich, Kirstin; Meyer, Thierry

2011-01-01

The present paper highlights a new safety management program, MICE (Management, Information, Control and Emergency), which has been specifically adapted for the academic environment. The process starts with an exhaustive hazard inventory supported by a platform assembling specific hazards encountered in laboratories and their subsequent classification. A proof of concept is given by a series of implementations in the domain of chemistry targeting workplace health protection. The methodology is expressed through three examples to illustrate how the MICE program can be used to address safety concerns regarding chemicals, strong magnetic fields and nanoparticles in research laboratories. A comprehensive chemical management program is also depicted.

Variations in Party Line Information Requirements for Flight Crew Situation Awareness in the Datalink Environment

NASA Technical Reports Server (NTRS)

Pritchett, Amy R.; Hansman, R. John

1994-01-01

Current Air Traffic Control communications use shared very high frequency (VHF) voice frequencies from which pilots can obtain 'Party Line' Information (PLI) by overhearing communications addressed to other aircraft. A prior study has shown pilots perceive this PLI to be important. There is concern that some critical PLI may be lost in the proposed datalink environment where communications will be discretely addressed. Different types of flight operations will be, equipped with datalink equipment at different times, generating a 'mixed environment' where some pilots may rely on PLI while others will receive their information by datalink. To research the importance, availability and accuracy of PLI and to query pilots on the information they feel is necessary, a survey was distributed to pilots. The pilots were selected from four flight operation groups to study the variations in PLI requirements in the mixed datalink environment. Pilots perceived PLI to be important overall. Specific information elements pertaining to traffic and weather information were identified as Critical. Most PLI elements followed a pattern of higher perceived importance during terminal area operations, final approach and landing. Pilots from the different flight operation groups identified some elements as particularly important. Pilots perceived PLI to be only moderately available and accurate overall. Several PLI elements received very low availability and accuracy ratings but are perceived as important. In a free response question designed to find the information requirements for global situation awareness, pilots frequently indicated a need for traffic and weather information. These elements were also frequently cited by them as information that could be presented by a datalink system. The results of this survey identify specific concerns to be addressed when implementing datalink communications.

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

PubMed

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

2018-06-01

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

Toward accommodating physicians' conscientious objections: an argument for public disclosure.

PubMed

Harter, Thomas D

2015-03-01

This paper aims to demonstrate how public disclosure can be used to balance physicians' conscientious objections with their professional obligations to patients--specifically respect for patient autonomy and informed consent. It is argued here that physicians should be permitted to exercise conscientious objections, but that they have a professional obligation to provide advance notification to patients about those objections. It is further argued here that public disclosure is an appropriate and ethically justifiable limit to the principle of advance notification. The argument for publicly disclosing physicians' conscientious objections is made in this paper by discussing three practical benefits of public disclosure in medicine, and then addressing how publicly disclosing physicians' conscientious objections is not an undue invasion of privacy. Three additional concerns with public disclosure of physicians' conscientious objections are briefly addressed--potential harassment of physicians, workplace discrimination, and mischaracterising physicians' professional aptitude--concluding that each of these concerns requires further deliberation in the realm of business ethics. 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.

Ethical questions must be considered for electronic health records.

PubMed

Spriggs, Merle; Arnold, Michael V; Pearce, Christopher M; Fry, Craig

2012-09-01

National electronic health record initiatives are in progress in many countries around the world but the debate about the ethical issues and how they are to be addressed remains overshadowed by other issues. The discourse to which all others are answerable is a technical discourse, even where matters of privacy and consent are concerned. Yet a focus on technical issues and a failure to think about ethics are cited as factors in the failure of the UK health record system. In this paper, while the prime concern is the Australian Personally Controlled Electronic Health Record (PCEHR), the discussion is relevant to and informed by the international context. The authors draw attention to ethical and conceptual issues that have implications for the success or failure of electronic health records systems. Important ethical issues to consider as Australia moves towards a PCEHR system include: issues of equity that arise in the context of personal control, who benefits and who should pay, what are the legitimate uses of PCEHRs, and how we should implement privacy. The authors identify specific questions that need addressing.

Problems associated with the utilization of algae in bioregenerative life support systems

NASA Technical Reports Server (NTRS)

Averner, M. M.; Karel, M.; Radmer, R.

1984-01-01

A workshop was conducted to identify the potential problems associated with the use of microalgae in biorregenerative life support systems, and to identify algae rlated research issues that must be addressed through space flight experimentation. Major questions to be resolved relate to the choice of algal species for inclusion in a bioregenerative life support system, their long term behavior in the space environment, and the nature of the techniques required for the continuous growth of algae on the scale required. Consideration was given to the problems associated with the conversion of algal biomass into edible components. Specific concerns were addressed and alternative transformation processes identified and compared. The workshop identified the following major areas to be addressed by space flight experimentation: (1) long term culture stability, (2) optimal design of algal growth reactors, and (3) post growth harvesting and processing in the space environment.

Knowledge and Beliefs about Reproductive Anatomy and Physiology among Mexican-Origin Women in the U.S.A: Implications for Effective Oral Contraceptive Use

PubMed Central

Amastae, Jon; Potter, Joseph E.; Hopkins, Kristine; Grossman, Daniel

2013-01-01

Inherent in many reproductive health and family planning programmes is the problematic assumption that the body, its processes, and modifications to it are universally experienced in the same way. This paper addresses contraceptive knowledge and beliefs among Mexican-origin women, based upon data gathered by the qualitative component of the Border Contraceptive Access Study. Open-ended interviews explored the perceived mechanism of action of the pill, side effects, non-contraceptive benefits, and general knowledge of contraception. Findings revealed complex connections between traditional and scientific information. Use of medical terms (“hormone”) illustrated attempts to integrate new information with existing knowledge and belief systems. Conclusions address concerns that existing information and services may not be sufficient if population-specific knowledge and beliefs are not assessed and addressed. Findings can contribute to the development of effective education, screening, and reproductive health services. PMID:23464742

The origin and evolution of religious prosociality.

PubMed

Norenzayan, Ara; Shariff, Azim F

2008-10-03

We examine empirical evidence for religious prosociality, the hypothesis that religions facilitate costly behaviors that benefit other people. Although sociological surveys reveal an association between self-reports of religiosity and prosociality, experiments measuring religiosity and actual prosocial behavior suggest that this association emerges primarily in contexts where reputational concerns are heightened. Experimentally induced religious thoughts reduce rates of cheating and increase altruistic behavior among anonymous strangers. Experiments demonstrate an association between apparent profession of religious devotion and greater trust. Cross-cultural evidence suggests an association between the cultural presence of morally concerned deities and large group size in humans. We synthesize converging evidence from various fields for religious prosociality, address its specific boundary conditions, and point to unresolved questions and novel predictions.

Concerns about aging and caregiving among middle-aged and older lesbian and gay adults.

PubMed

Czaja, Sara J; Sabbag, Samir; Lee, Chin Chin; Schulz, Richard; Lang, Samantha; Vlahovic, Tatiana; Jaret, Adrienne; Thurston, Catherine

2016-11-01

Despite the increasing number of lesbian and gay older adults, research geared towards health and well-being of this population is limited. Many lesbian and gay seniors experience health disparities and are at risk for poor health outcomes. The aims of this study were to gather in-depth information on the concerns of lesbian and gay elders with respect to aging and care needs. The sample included 124 gay men and lesbian women aged 50+ years. Data were gathered via focus groups and questionnaires. The focus groups addressed: (1) concerns about aging in the LGBT community, (2) barriers to needed support and services, (3) concerns about caregiving and (4) needed programs for lesbian and gay seniors. Concerns expressed about aging included: lack of financial security, lack of family or social support, fears about the lack of someone to provide needed care, and discrimination in healthcare or service communities. Participants also indicated concerns about being alone and vulnerable and a need for resources and support programs, specifically for lesbian and gay older adults and for lesbian and gay caregivers. These findings suggest needed areas of support and programs for older gay men and lesbian women. They also suggest that healthcare professionals might need more training regarding the particular needs and concerns of this community.

Auf gute Nachbarschaft!. Verantwortungsübernahme durch Unternehmen für die Stadtteilentwicklung - Haniel und Grillo in Duisburg

NASA Astrophysics Data System (ADS)

Kleine-König, Christiane; Hohn, Uta

2016-03-01

Companies' community involvement turns out to be spatially relevant and-in many cases-to be focused on the near surroundings of the place of business. Some companies strategically align their involvement in order to systematically address local challenges. The essay at hand addresses the subject of corporate social responsibility from a local development perspective. Using the example of two family-owned enterprises based in Duisburg, Haniel and Grillo, it illustrates how socially committed companies can get involved with their local community by acting as good neighbours. Furthermore, it argues that socially committed companies can function as producers of space concerning matters of urban and local development. The specific local settings as well as the economic conditions of the local community serve as an explanatory background of the companies' involvement. The cases presented in this paper prove the firms' specific knowledge of local development needs and possibilities. This makes them qualified partners for local government actors and civil society actors. Thus, in the future, it is worth addressing corporate local responsibility from a governance point of view both in theory and in practice.

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

NASA Astrophysics Data System (ADS)

Pearson, Camilla E.

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

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

PubMed

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

2015-05-01

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

Androgens and Androgen Derivatives: Science, Myths, and Theories: Explored From a Special Operations Perspective.

PubMed

Givens, Melissa L; Deuster, Patricia

2015-01-01

Androgen use outside of legitimate medical therapy is a perceived concern that is drawing attention across military and specifically Special Operations Forces (SOF) communities. For leadership and the medical community to properly address the issue and relate to those individuals who are using or considering use, it will be crucial to understand the scope of the problem. Limited data suggest that the prevalence of androgen use may be increasing, and inferences made from the scientific literature suggest that SOF may be a population of concern. While risks of androgen use are well known, there are little data specific to military performance that can be applied to a rigorous risk:benefit analysis, allowing myths and poorly supported theories to perpetuate within the community. Further efforts to define the potential benefits balanced against the short- and long-term risks should be undertaken. Providers within the SOF community should arm themselves with information to engage androgen users and leadership in meaningful discussion regarding androgen use. 2015.

Home intravenous therapy: Part I--Issues.

PubMed

McAbee, R R; Grupp, K; Horn, B

1991-01-01

Concerns related to providing home intravenous therapy were among the top ten clinical problems identified by Northwest Medicare-certified home care agencies in a 1986 survey. This paper addresses issues related to home intravenous therapy and provides lists of resources for the development of home intravenous therapy programs. Part I of the paper covers concerns related to intravenous therapy as expressed by home care agencies in the Northwest and synthesized the literature about home intravenous therapies. Survey results are presented, followed by a discussion of client and caregiver concerns. These include: discharge planning, client admission criteria and client and caregiver education. Standards, staffing, and staff education issues are discussed followed by sections on economics, marketing regulations and legal and ethical concerns. Finally, there is a discussion of issues related to specific types of intravenous therapies: parenteral nutrition, antibiotic therapy; chemotherapy; blood and blood component therapy and other less frequently used types of intravenous therapies. Each therapy is discussed with regard to complications, client and caregiver instruction and financial considerations. Part II of the paper is a resource guide which lists resources that agencies may use to develop a home intravenous therapy program. In the first section, national organizations and journals and books concerned with intravenous therapy are listed as well as journal articles, guidelines and guidebooks and client and provider educational materials. National and regional product and service representatives of intravenous therapy related companies are also listed. In the second section, addresses for the State Boards of Nursing are given for Alaska, Idaho, Montana, Oregon and Washington. Each state section includes a list of those agencies who indicated in the 1988 survey that they would be willing to share materials. In addition, product and service vendors of intravenous therapy supplies and equipment are listed for the State of Washington.

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

PubMed

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

2016-09-01

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

Export Control Requirements for Tritium Processing Design and R&D

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

Hollis, William Kirk; Maynard, Sarah-Jane Wadsworth

This document will address requirements of export control associated with tritium plant design and processes. Los Alamos National Laboratory has been working in the area of tritium plant system design and research and development (R&D) since the early 1970’s at the Tritium Systems Test Assembly (TSTA). This work has continued to the current date with projects associated with the ITER project and other Office of Science Fusion Energy Science (OS-FES) funded programs. ITER is currently the highest funding area for the DOE OS-FES. Although export control issues have been integrated into these projects in the past a general guidance documentmore » has not been available for reference in this area. To address concerns with currently funded tritium plant programs and assist future projects for FES, this document will identify the key reference documents and specific sections within related to tritium research. Guidance as to the application of these sections will be discussed with specific detail to publications and work with foreign nationals.« less

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

Palomar, J.; Wyman, R.

This document provides recommendations to guide reviewers in the application of Programmable Logic Controllers (PLCS) to the control, monitoring and protection of nuclear reactors. The first topics addressed are system-level design issues, specifically including safety. The document then discusses concerns about the PLC manufacturing organization and the protection system engineering organization. Supplementing this document are two appendices. Appendix A summarizes PLC characteristics. Specifically addressed are those characteristics that make the PLC more suitable for emergency shutdown systems than other electrical/electronic-based systems, as well as characteristics that improve reliability of a system. Also covered are PLC characteristics that may create anmore » unsafe operating environment. Appendix B provides an overview of the use of programmable logic controllers in emergency shutdown systems. The intent is to familiarize the reader with the design, development, test, and maintenance phases of applying a PLC to an ESD system. Each phase is described in detail and information pertinent to the application of a PLC is pointed out.« less

Export Control Requirements for Tritium Processing Design and R&D

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

Hollis, William Kirk; Maynard, Sarah-Jane Wadsworth

2015-10-30

This document will address requirements of export control associated with tritium plant design and processes. Los Alamos National Laboratory has been working in the area of tritium plant system design and research and development (R&D) since the early 1970’s at the Tritium Systems Test Assembly (TSTA). This work has continued to the current date with projects associated with the ITER project and other Office of Science Fusion Energy Science (OS-FES) funded programs. ITER is currently the highest funding area for the DOE OS-FES. Although export control issues have been integrated into these projects in the past a general guidance documentmore » has not been available for reference in this area. To address concerns with currently funded tritium plant programs and assist future projects for FES, this document will identify the key reference documents and specific sections within related to tritium research. Guidance as to the application of these sections will be discussed with specific detail to publications and work with foreign nationals.« less

Balancing entrepreneurship and business practices for e-collaboration: responsible information sharing in academic research.

PubMed

Porter, Mark W; Porter, Mark William; Milley, David; Oliveti, Kristyn; Ladd, Allen; O'Hara, Ryan J; Desai, Bimal R; White, Peter S

2008-11-06

Flexible, highly accessible collaboration tools can inherently conflict with controls placed on information sharing by offices charged with privacy protection, compliance, and maintenance of the general business environment. Our implementation of a commercial enterprise wiki within the academic research environment addresses concerns of all involved through the development of a robust user training program, a suite of software customizations that enhance security elements, a robust auditing program, allowance for inter-institutional wiki collaboration, and wiki-specific governance.

African-American Congregational Care and Counseling: Transcending Universal and Culturally-Specific Barriers.

PubMed

Armstrong, Tonya D

2016-06-01

This article addresses two major African-American congregational care needs: (1) helping suffering people to access sustained mental health care, particularly in a large/mega-church; and (2) helping suffering people with multi-layered challenges to access appropriate, skilled care that transcends traditional barriers and is consistent with their faith. One model of congregational care is presented with concrete examples of how cultural, theological, and strategic concerns are discussed, with broad implications for diverse faith communities. © The Author(s) 2016.

Workforce Investment Act: Labor has Made Progress in Addressing Areas of Concern, but More Focus Needed on Understanding What Works and What Doesn't. Testimony Before the Subcommittee on Higher Education, Lifelong Learning, and Competitiveness, Committee on Education and Labor, House of Representatives. GAO-09-396T

ERIC Educational Resources Information Center

Scott, George A.

2009-01-01

Since the Workforce Investment Act's (WIA) enactment in 1998, GAO has issued numerous reports that included recommendations regarding many aspects of WIA. These aspects include performance measures and accountability, funding formulas and spending, one-stop centers, and training, as well as services provided to specific populations, such as…

Voting Rights Act: Bilingual Education, Expert Witness Fees, and Presley. Hearings before the Subcommittee on Civil and Constitutional Rights of the Committee to the Judiciary. House of Representatives, One Hundred Second Congress, Second Session (April 1, 2, and 8, 1992).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on the Judiciary.

Testimony concerning amendments to the Voting Rights Act of 1965 addresses, specifically, the provisions for language assistance for Alaskan native, Asian-American, Hispanic, and Native American citizens in order that they be able to exercise effectively their right to vote. The proposed legislation would extend coverage of Section 203 of the…

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

PubMed

Wheeler, Marissa; Buttenheim, Alison M

2013-08-01

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

Understanding safety and production risks in rail engineering planning and protection.

PubMed

Wilson, John R; Ryan, Brendan; Schock, Alex; Ferreira, Pedro; Smith, Stuart; Pitsopoulos, Julia

2009-07-01

Much of the published human factors work on risk is to do with safety and within this is concerned with prediction and analysis of human error and with human reliability assessment. Less has been published on human factors contributions to understanding and managing project, business, engineering and other forms of risk and still less jointly assessing risk to do with broad issues of 'safety' and broad issues of 'production' or 'performance'. This paper contains a general commentary on human factors and assessment of risk of various kinds, in the context of the aims of ergonomics and concerns about being too risk averse. The paper then describes a specific project, in rail engineering, where the notion of a human factors case has been employed to analyse engineering functions and related human factors issues. A human factors issues register for potential system disturbances has been developed, prior to a human factors risk assessment, which jointly covers safety and production (engineering delivery) concerns. The paper concludes with a commentary on the potential relevance of a resilience engineering perspective to understanding rail engineering systems risk. Design, planning and management of complex systems will increasingly have to address the issue of making trade-offs between safety and production, and ergonomics should be central to this. The paper addresses the relevant issues and does so in an under-published domain - rail systems engineering work.

What do health consumers want to know about childhood vaccination? An evaluation of data from an Australian medicines call centre.

PubMed

Mus, Marnix; Kreijkamp-Kaspers, Sanne; McGuire, Treasure; Deckx, Laura; van Driel, Mieke

2017-02-01

Immunisation is crucial to population health. This study aimed to identify the information needs and concerns of health consumers regarding childhood vaccination. We analysed 1,342 calls concerning childhood vaccination to an Australian pharmacist-operated medicines call centre (MCC). Data were available from September 2002 until June 2010. We identified key themes and compared these for callers from high and low immunisation coverage areas. Most calls related to safety concerns (60.4%), with many questions about vaccine constituents (31.6%). In low immunisation areas, a higher level of concern persisted about vaccine preservatives (mercury and thiomersal) despite their removal from vaccines in 2000. Of specific vaccines, the measles, mumps and rubella vaccine raised most questions (29.9%). Common motivations to call the MCC were 'inadequate information' (54%), 'second opinion' (21%) 'conflicting information' (9%) and 'worrying symptom' (6%). The consistent number of vaccine-related calls, particularly about safety, demonstrates an information gap that can contribute to vaccination hesitancy. Health professionals need to know their local immunisation rate and associated carer concerns, to proactively address these information-related barriers to vaccination. © 2016 The Authors.

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

Porse, Sean L.; Wade, Sarah; Hovorka, Susan D.

Risk communication literature suggests that for a number of reasons, the public may perceive a risk to be greater than indicated by its statistical probability. Public concern over risk can lead to significant and costly delays in project permitting and operations. Considering these theories, media coverage of CO₂-related well blowouts in 2013 gave rise to the questions: What is the risk of CO₂ well blowouts associated with CCUS through CO₂ EOR? What is the potential public perception of those risks? What information could be used to respond to public concern? To address these questions, this study aims to: 1) providemore » a framework for understanding the nature of onshore well blowouts, 2) quantify the incidence of such events for three specific geographic regions of Texas, 3) relate this data to CCUS and findings from other studies, and 4) explore the potential implications for public perception of this risk associated with CCUS projects. While quantifying answers to these questions proved to be challenging, the results from this study suggest that (1) the perceived risk of CO₂ well blowouts may exceed the statistical risk and (2) information that could be used to address this gap could be made more readily available to the greater benefit of industry and stakeholders who support the development of CCUS as an option for addressing anthropogenic CO₂ emissions. The study also suggests approaches to best conduct such data inquiries.« less

ICESat-2 simulated data from airborne altimetery

NASA Astrophysics Data System (ADS)

Brunt, K. M.; Neumann, T.; Markus, T.; Brenner, A. C.; Barbieri, K.; Field, C.; Sirota, M.

2010-12-01

Ice, Cloud, and land Elevation Satellite-2 (ICESat-2) is scheduled to launch in 2015 and will carry onboard the Advanced Topographic Laser Altimeter System (ATLAS), which represents a new approach to spaceborne determination of surface elevations. Specifically, the current ATLAS design is for a micropulse, multibeam, photon-counting laser altimeter with lower energy, a shorter pulse width, and a higher repetition rate relative to the Geoscience Laser Altimeter (GLAS), the instrument that was onboard ICESat. Given the new and untested technology associated with ATLAS, airborne altimetry data is necessary (1) to test the proposed ATLAS instrument geometry, (2) to validate instrument models, and (3) to assess the atmospheric effects on multibeam altimeters. We present an overview of the airborne instruments and datasets intended to address the ATLAS instrument concept, including data collected over Greenland (July 2009) using an airborne SBIR prototype 100 channel, photon-counting, terrain mapping altimeter, which addresses the first of these 3 scientific concerns. Additionally, we present the plan for further simulator data collection over vegetated and ice covered regions using Multiple Altimeter Beam Experimental Lidar (MABEL), intended to address the latter two scientific concerns. As the ICESAT-2 project is in the design phase, the particular configuration of the ATLAS instrument may change. However, we expect this work to be relevant as long as ATLAS pursues a photon-counting approach.

Addressing Parental Vaccination Questions in the School Setting

ERIC Educational Resources Information Center

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

2016-01-01

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

Specific issues, exact locations: case study of a community mapping project to improve safety in a disadvantaged community.

PubMed

Qummouh, Rana; Rose, Vanessa; Hall, Pat

2012-12-01

Safety is a health issue and a significant concern in disadvantaged communities. This paper describes an example of community-initiated action to address perceptions of fear and safety in a suburb in south-west Sydney which led to the development of a local, community-driven research project. As a first step in developing community capacity to take action on issues of safety, a joint resident-agency group implemented a community safety mapping project to identify the extent of safety issues in the community and their exact geographical location. Two aerial maps of the suburb, measuring one metre by two metres, were placed on display at different locations for four months. Residents used coloured stickers to identify specific issues and exact locations where crime and safety were a concern. Residents identified 294 specific safety issues in the suburb, 41.9% (n=123) associated with public infrastructure, such as poor lighting and pathways, and 31.9% (n=94) associated with drug-related issues such as drug activity and discarded syringes. Good health promotion practice reflects community need. In a very practical sense, this project responded to community calls for action by mapping resident knowledge on specific safety issues and exact locations and presenting these maps to local decision makers for further action.

Country-Specific Effects of Climate Variability on Human Migration

PubMed Central

Gray, Clark; Wise, Erika

2016-01-01

Involuntary human migration is among the social outcomes of greatest concern in the current era of global climate change. Responding to this concern, a growing number of studies have investigated the consequences of short to medium-term climate variability for human migration using demographic and econometric approaches. These studies have provided important insights, but at the same time have been significantly limited by lack of expertise in the use of climate data, access to cross-national data on migration, and attention to model specification. To address these limitations, we link data on internal and international migration over a 6-year period from 9,812 origin households in Kenya, Uganda, Nigeria, Burkina Faso and Senegal to high-resolution gridded climate data from both station and satellite sources. Analyses of these data using several plausible specifications reveal that climate variability has country-specific effects on migration: Migration tends to increase with temperature anomalies in Uganda, tends to decrease with temperature anomalies in Kenya and Burkina Faso, and shows no consistent relationship with temperature in Nigeria and Senegal. Consistent with previous studies, precipitation shows weak and inconsistent relationships with migration across countries. These results challenge generalizing narratives that foresee a consistent migratory response to climate change across the globe. PMID:27092012

Perceived Risks Associated with Contraceptive Method Use among Men and Women in Ibadan and Kaduna, Nigeria.

PubMed

Schwandt, Hilary M; Skinner, Joanna; Hebert, Luciana E; Saad, Abdulmumin

2015-12-01

Research shows that side effects are often the most common reason for contraceptive non-use in Nigeria; however, research to date has not explored the underlying factors that influence risk and benefit perceptions associated with specific contraceptive methods in Nigeria. A qualitative study design using focus group discussions was used to explore social attitudes and beliefs about family planning methods in Ibadan and Kaduna, Nigeria. A total of 26 focus group discussions were held in 2010 with men and women of reproductive age, disaggregated by city, sex, age, marital status, neighborhood socioeconomic status, and--for women only--family planning experience. A discussion guide was used that included specific questions about the perceived risks and benefits associated with the use of six different family planning methods. A thematic content analytic approach guided the analysis. Participants identified a spectrum of risks encompassing perceived threats to health (both real and fictitious) and social concerns, as well as benefits associated with each method. By exploring Nigerian perspectives on the risks and benefits associated with specific family planning methods, programs aiming to increase contraceptive use in Nigeria can be better equipped to highlight recognized benefits, address specific concerns, and work to dispel misperceptions associated with each family planning method.

A Nationwide Study of Pharmacists' Perception of the Impact of Medicare Part D on the Pharmacist-Patient Relationship.

PubMed

Spooner, Joshua J; Spotts, Harlan; Khan, Shamima

2017-10-01

Medicare Part D was implemented in 2006, introducing change to the community pharmacy marketplace, with profound disruption to independent pharmacy operations across the United States. To understand pharmacist perceptions about Part D and their perceived obligation to address Part D issues on behalf of their beneficiaries. A nationwide, cross-sectional survey of pharmacists was conducted between April and July 2013. The 43-item online survey collected information about demographics, implications of Part D on community pharmacy and patients, and beliefs about ideal pharmacy practice. Pharmacists reported more responsibility to address prior authorization issues (55.3% strongly agree or agree) than dispensing preferred medications (43.5%) or addressing patient copayment issues (38.1%). Predictors of the perceived responsibility to assist patients varied and included practice site, pharmacist age, pharmacy prescription volume, and pharmacy financial performance. Financial concerns continue to be the most significant issue following Part D implementation. The degree to which pharmacists feel responsible for addressing patient Part D concerns is variable and dependent on a variety of factors. Pharmacists who felt a personal responsibility to address patient copayment issues reported a better pharmacy financial performance, a larger increase in prescription volume, and a better pharmacist-patient relationship since Part D implementation. Nationwide, Part D financial concerns remain significant. Pharmacists can assist patients with managing cost issues, which can help alleviate pharmacy financial concerns. Many pharmacists practicing at independent locations do not feel responsible for addressing patient cost concerns, which may inadvertently impart a negative financial effect upon their pharmacy.

A historical perspective on the "fish tumors or other deformities" beneficial use impairment at Great Lakes Areas of Concern

USGS Publications Warehouse

Rafferty, S.D.; Blazer, V.S.; Pinkney, A.E.; Grazio, J.L.; Obert, E.C.; Boughton, L.

2009-01-01

The Great Lakes Water Quality Agreement defines Areas of Concern as geographic areas that fail to meet the general or specific objectives of the agreement where such failure has caused or is likely to cause impairment of beneficial use of the area's ability to support aquatic life. One of the beneficial use impairments, fish tumors or other deformities, is defined by the International Joint Commission to occur when the incidence rate of fish tumors and other deformities exceeds rates at unimpacted or control sites, or when survey data confirm the presence of neoplastic or preneoplastic liver tumors in bullhead or suckers. Brown bullhead, a benthic species with a limited home range, have frequently been used as indicator species in U.S. Areas of Concern. While there is strong field evidence for an association between PAH exposure and hepatic neoplasia in brown bullhead, laboratory investigations would strengthen the association. There is less evidence linking specific classes of chemicals in the environment to orocutaneous neoplasia in brown bullhead. Studies on orocutaneous neoplasia of brown bullhead should focus on assessing the presence or absence of viruses and on epidermal exposure to specific chemicals and chemical mixtures. Lastly, the effects of covariates such as length, age, and gender on the prevalence of liver and skin neoplasms should be investigated. This paper reviews the state of science on the fish tumors or other deformities beneficial use impairment. Subsequent papers address specific issues related to this impairment and provide recommendations for standardized criteria.

Measuring and improving patient safety through health information technology: The Health IT Safety Framework

PubMed Central

Singh, Hardeep

2016-01-01

Health information technology (health IT) has potential to improve patient safety but its implementation and use has led to unintended consequences and new safety concerns. A key challenge to improving safety in health IT-enabled healthcare systems is to develop valid, feasible strategies to measure safety concerns at the intersection of health IT and patient safety. In response to the fundamental conceptual and methodological gaps related to both defining and measuring health IT-related patient safety, we propose a new framework, the Health IT Safety (HITS) measurement framework, to provide a conceptual foundation for health IT-related patient safety measurement, monitoring, and improvement. The HITS framework follows both Continuous Quality Improvement (CQI) and sociotechnical approaches and calls for new measures and measurement activities to address safety concerns in three related domains: 1) concerns that are unique and specific to technology (e.g., to address unsafe health IT related to unavailable or malfunctioning hardware or software); 2) concerns created by the failure to use health IT appropriately or by misuse of health IT (e.g. to reduce nuisance alerts in the electronic health record (EHR)), and 3) the use of health IT to monitor risks, health care processes and outcomes and identify potential safety concerns before they can harm patients (e.g. use EHR-based algorithms to identify patients at risk for medication errors or care delays). The framework proposes to integrate both retrospective and prospective measurement of HIT safety with an organization's existing clinical risk management and safety programs. It aims to facilitate organizational learning, comprehensive 360 degree assessment of HIT safety that includes vendor involvement, refinement of measurement tools and strategies, and shared responsibility to identify problems and implement solutions. A long term framework goal is to enable rigorous measurement that helps achieve the safety benefits of health IT in real-world clinical settings. PMID:26369894

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

PubMed

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

2018-04-30

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

Fire Safety for the Oral and Maxillofacial Surgeon and Surgical Staff.

PubMed

Di Pasquale, LisaMarie; Ferneini, Elie M

2017-05-01

Fire in the operating room is a life-threatening emergency that demands quick, efficient intervention. Because the circumstances surrounding fires are generally well-understood, virtually every operating room fire is preventable. Before every operating room case, thorough preprocedure "time outs" should address each team members' awareness of specific fire risks and agreement regarding fire concerns and emergency actions. Fire prevention centers on 3 constituent parts of the fire triad necessary for fire formation. Regular fire drills should guide policies and procedures to prevent surgical fires. Delivering optimal patient care in emergent situations requires surgical team training, practicing emergency roles, and specific actions. Copyright © 2016 Elsevier Inc. All rights reserved.

Engaging with Faith Councils to Develop Stoma-specific Fatawās: A Novel Approach to the Healthcare Needs of Muslim Colorectal Patients.

PubMed

Iqbal, Fareed; Zaman, Shafquat; Karandikar, Sharad; Hendrickse, Charles; Bowley, Douglas M

2016-06-01

Intestinal stomas are common. Muslims report significantly lower quality of life following stoma surgery compared to non-Muslims. A fatwā is a ruling on a point of Islamic law according to a recognised religious authority. The use of fatawās to guide health-related decision-making has becoming an increasingly popular practice amongst Muslims, regardless of geographic location. This project aimed to improve the quality of life of Muslim ostomates by addressing faith-specific stoma concerns. Through close collaboration with Muslim ostomates, a series of 10 faith-related questions were generated, which were posed to invited local faith leaders during a stoma educational event. Faith leaders received education concerning the realities of stoma care before generating their fatawās. The event lead to the formulation of a series of stoma-specific fatawās representing Hanafi and Salafi scholarship, providing faith-based guidance for Muslim ostomates and their carers. Enhanced communication between healthcare providers and Islamic faith leaders allows for the delivery of informed fatawās that directly benefit Muslim patients and may represent an efficient method of improving health outcomes in this faith group.

Alternative Exercise Traditions in Cancer Rehabilitation.

PubMed

Ruddy, Kathryn J; Stan, Daniela L; Bhagra, Anjali; Jurisson, Mary; Cheville, Andrea L

2017-02-01

Alternative exercise traditions (AETs) such as Pilates, yoga, Tai Chi Chuan, Qigong, and various forms of dance offer the potential to improve diverse outcomes among cancer survivors by reducing adverse symptoms and mood disorders, and by enhancing function. Additionally AETs have emerged as a potential means to address deficits in current disease-focused care delivery models which are marked by prevalent under-treatment of symptoms and physical impairments. Relative to therapeutic exercise in allopathic models, many AETs are comparatively affordable and accessible. AETs have the further potential to simultaneously address needs spanning multiple domains including social, physical, and psycho-emotional. AETs additionally offer the salient benefits of promoting integrated whole body movement and concurrently enhancing strength, coordination, balance, posture, flexibility, and kinesthetic awareness. Despite AETs' benefits, compelling concerns leave many clinicians ambivalent and reluctant to endorse or even discuss them. One issue is the extensive heterogeneity across and even within specific AETs. An additional concern is that the one-size-fits-many nature of AET group classes undermines an instructor's capacity to individualize dose, type, frequency, and intensity, which are cornerstones of effective therapeutic exercise. Inconsistencies in AET practitioner expertise and certification, as well as the extent of practitioner familiarity with vulnerabilities unique to cancer populations, may also be problematic. At this juncture, an extensive literature of inconsistent quality that spans diverse cancer populations frustrates efforts to precisely determine the effect size of any specific AET in improving a specific outcome; Although systematic reviews and meta-analyses have concluded that AETs have beneficial effects, they consistently identify a high risk of bias in a majority of trials related to a lack of blinding, poor allocation concealment, small sample sizes, and incomplete outcome data. Copyright © 2016 Elsevier Inc. All rights reserved.

A development perspective on adolescent drug abuse.

PubMed

Baumrind, D; Moselle, K A

1985-01-01

Adolescent drug use is placed in an historical and developmental perspective. Existing evidence concerning causes and consequences of adolescent drug use is inconclusive. In the absence of conclusive empirical evidence and cogent theories, we present a prima facie case against early adolescent drug use by defending six propositions which posit specific cognitive, conative, and affective negative consequences including impairment of attention and memory; developmental lag imposing categorical limitations on the level of maximum functioning available to the user in cognitive, moral and psychosocial domains; amotivational syndrome; consolidation of diffuse or negative identity; and social alienation and estrangement. We call for a program of research which could provide credible evidence to support or rebut these propositions, and thus address the factual claims underlying the sociomoral concerns of social policy planners.

Mishap risk control for advanced aerospace/composite materials

NASA Technical Reports Server (NTRS)

Olson, John M.

1994-01-01

Although advanced aerospace materials and advanced composites provide outstanding performance, they also present several unique post-mishap environmental, safety, and health concerns. The purpose of this paper is to provide information on some of the unique hazards and concerns associated with these materials when damaged by fire, explosion, or high-energy impact. Additionally, recommended procedures and precautions are addressed as they pertain to all phases of a composite aircraft mishap response, including fire-fighting, investigation, recovery, clean-up, and guidelines are general in nature and not application-specific. The goal of this project is to provide factual and realistic information which can be used to develop consistent and effective procedures and policies to minimize the potential environmental, safety, and health impacts of a composite aircraft mishap response effort.

Citizen expectations of 'academic entrepreneurship' in health research: public science, practical benefit.

PubMed

Miller, Fiona A; Painter-Main, Michael; Axler, Renata; Lehoux, Pascale; Giacomini, Mita; Slater, Barbara

2015-12-01

Responsiveness to citizens as users of technological innovation helps motivate translational research and commercial engagement among academics. Yet, retaining citizen trust and support for research encourages caution in pursuit of commercial science. We explore citizen expectations of the specifically academic nature of commercial science [i.e. academic entrepreneurship (AE)] and the influence of conflict of interest concerns, hopes about practical benefits and general beliefs. We conducted a cross-sectional national opinion survey of 1002 Canadians online in 2010. Approval of AE was moderate (mean 3.2/5, SD 0.84), but varied by entrepreneurial activity. Concern about conflict of interests (COI) was moderate (mean 2.9/5, SD 0.86) and varied by type of concern. An ordinary least-squares regression showed that expectations of practical benefits informed support for AE, specifically that academic-industry collaboration can better address real-world problems; conflict of interest concerns were insignificant. These findings suggest that citizens support AE for its potential to produce practical benefits, but enthusiasm varies and is reduced for activities that may prioritize private over public interests. Further, support exists despite concern about COI, perhaps due to trust in the academic research context. For user engagement in research priority setting, these findings suggest the need to attend to the commercial nature of translational science. For research policy, they suggest the need for governance arrangements for responsible innovation, which can sustain public trust in academic research, and realize the practical benefits that inform public support for AE. © 2014 John Wiley & Sons Ltd.

Nanotechnology in cosmetics.

PubMed

Katz, Linda M; Dewan, Kapal; Bronaugh, Robert L

2015-11-01

Nanomaterials are being used in cosmetic products for various effects. However, their use also raises potential safety concerns. Some of these concerns can be addressed by determining the type of nanomaterials used, as well as stability, potential for skin absorption, route of exposure, and how they are formulated in cosmetic products. There has been considerable effort internationally to harmonize approaches in order to address definitional issues and safety concerns related to the use of nanomaterials in cosmetic products. Published by Elsevier Ltd.

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

PubMed Central

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

2014-01-01

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

Lack of Cost-Effectiveness Analyses to Address Healthy People 2020 Priority Areas.

PubMed

Neumann, Peter J; Farquhar, Megan; Wilkinson, Colby L; Lowry, Mackenzie; Gold, Marthe

2016-12-01

To examine the extent to which recently published cost-utility analyses (cost-effectiveness analyses using quality-adjusted life-years to measure health benefits) have covered the leading health concerns in the US Department of Health and Human Services Healthy People 2020 report. We examined data in the Tufts Medical Center Cost-Effectiveness Analysis Registry, a database containing 5000 published cost-utility analyses published in the MEDLINE literature through 2014. We focused on US-based cost-utility analyses published from 2011 through 2014 (n = 687). Two reviewers scanned abstracts and met for a consensus on categorization of cost-utility analyses that addressed the specific priorities listed in the 12 Healthy People 2020 areas (n = 120). Although 7.3% of recently published cost-utility analyses addressed key clinical preventive services, only about 2% of recently published cost-utility analyses covered each of the following Healthy People 2020 topics: reproductive and sexual health, nutrition/physical activity/obesity, maternal and infant health, and tobacco. Fewer than 1% addressed priorities such as injuries and violence, mental health or substance abuse, environmental quality, and oral health. Few cost-utility analyses have addressed Healthy People 2020 priority areas.

Xenotransplantation-theological-ethical considerations in an interdisciplinary symposium.

PubMed

Sautermeister, Jochen; Mathieu, Richard; Bogner, Veronika

2015-01-01

Unlike allotransplantation, reflections on xenotransplantation are infrequent in theological literature. However, xenotransplantation poses questions specifically concerning ethical and theological aspects that are imperative to address, such as personal identity between the poles of body, soul, and mind, the relationship between humans and animals, as well as challenges regarding specific issues of medical and social ethics. This study summarizes the lectures of the symposium on "Xenotransplantation-a challenge to theological ethics," which took place in Munich from September 30 until October 2, 2013, and analyses the implications of xenotransplantation from the perspectives of Christian theological ethics, biblical theology, and systematic theology. Furthermore, the issue of xenotransplantation is addressed from the perspectives of Judaism and Islam. Beyond these theological deliberations, the metaphorical and religious meaning of the human heart, which may have an impact on the societal acceptability of xenotransplantation, as well as the Christian notion of compassion regarding animals, is analyzed from the perspective of historical sciences. According to the perspectives of Christianity, Judaism, and Islam, there are no specifically religious fundamental and generally binding reasons to prohibit xenotransplantation as a means of treating grave and life-threatening organ insufficiencies. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Enabling comparative effectiveness research with informatics: show me the data!

PubMed

Safdar, Nabile M; Siegel, Eliot; Erickson, Bradley J; Nagy, Paul

2011-09-01

Both outcomes researchers and informaticians are concerned with information and data. As such, some of the central challenges to conducting successful comparative effectiveness research can be addressed with informatics solutions. Specific informatics solutions which address how data in comparative effectiveness research are enriched, stored, shared, and analyzed are reviewed. Imaging data can be made more quantitative, uniform, and structured for researchers through the use of lexicons and structured reporting. Secure and scalable storage of research data is enabled through data warehouses and cloud services. There are a number of national efforts to help researchers share research data and analysis tools. There is a diverse arsenal of informatics tools designed to meet the needs of comparative effective researchers. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

Moving Forward: Breaking the Cycle of Mistrust Between American Indians and Researchers

PubMed Central

Daley, Sean M.; Brown, Travis; Filippi, Melissa; Greiner, K. Allen; Daley, Christine M.

2013-01-01

American Indians (AIs) have some of the poorest documented health outcomes of any racial/ethnic group. Research plays a vital role in addressing these health disparities. Historical and recent instances of unethical research, specifically the Havasupai diabetes project, have generated mistrust in AI communities. To address the concerns about unethical research held by some AIs in the Heartland (Midwest), the Center for American Indian Community Health (CAICH) has launched a series of efforts to inform AIs about research participants’ rights. CAICH educates health researchers about the importance of learning and respecting a community’s history, culture, values, and wishes when engaging in research with that community. Through community-based participatory research, CAICH is also empowering AIs to assert their rights as research participants. PMID:24134368

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

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 addressed through complex/resource-demanding interventions. Such actions require support by ongoing/future research.

Assessing Medical Students' Awareness of and Sensitivity to Diverse Health Beliefs Using a Standardized Patient Station.

ERIC Educational Resources Information Center

Robins, Lynne S.; White, Casey B.; Alexander, Gwen L.; Gruppen, Larry D.; Grum, Cyril M.

2001-01-01

Assessed students' competence in addressing the health beliefs and cultural concerns of a standardized patient, an African American woman with diabetes, during a clinical interview. Found that minority students displayed greater competence in addressing the patient's concerns about altering culturally-based dietary behaviors; white students…

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

ERIC Educational Resources Information Center

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

2008-01-01

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

How Rhetorical Theories of Genre Address Common Core Writing Standards

ERIC Educational Resources Information Center

Collin, Ross

2013-01-01

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

Is there a place for extended assessments in addressing child sexual abuse allegations? How sensitivity and specificity impact professional perspectives.

PubMed

Williams, Javonda; Nelson-Gardell, Debra; Coulborn Faller, Kathleen; Tishelman, Amy; Cordisco-Steele, Linda

2014-01-01

Using data from a survey of perceptions of 932 child welfare professionals about the utility of extended assessments, the researchers constructed a scale to measure respondents' views about sensitivity (ensuring sexually abused children are correctly identified) and specificity (ensuring nonabused children are correctly identified) in child sexual abuse evaluations. On average, respondents scored high (valuing sensitivity) on the sensitivity versus specificity scale. Next, the researchers undertook bivariate analyses to identify independent variables significantly associated with the sensitivity versus specificity scale. Then those variables were entered into a multiple regression. Four independent variables were significantly related to higher sensitivity scores: encountering cases requiring extended assessments, valuing extended assessments among scarce resources, less concern about proving cases in court, and viewing the goal of extended assessments as understanding needs of child and family (adjusted R2 = .34).

Expanding Access to Malaria Diagnosis through Retail Shops in Western Kenya: What Do Shop Workers Think?

PubMed

Rusk, Andria; Goodman, Catherine; Naanyu, Violet; Koech, Beatrice; Obala, Andrew; O'Meara, Wendy Prudhomme

2013-01-01

Background. The common symptoms of malaria reduce the specificity of clinical diagnosis. Presumptive treatment is conventional but can lead to overdiagnosis of malaria, delay of appropriate treatment, overprescription of antimalarials, and drug resistance. Routine use of diagnostic tests can address many of these concerns. Though treatment is often procured from retailers, there is low availability of rapid diagnostic tests for malaria (MRDTs), a simple, inexpensive, and accurate diagnostic solution. We know little about the challenges to expanding access to diagnostics through these outlets. Methods. To understand the perceptions of the benefits and challenges to selling rapid diagnostic tests for malaria, we conducted focus group discussions with antimalarial retailers who serve the residents of the Webuye Health and Demographic Surveillance Site in western Kenya. Results. Medicine retailers perceived MRDTs to be beneficial to their customers and businesses but also included cost, fear of the tests, risks of self-treatment, and regulatory concerns among the challenges to using and selling MRDTs. Conclusion. MRDTs represent a viable approach to increase access to malaria diagnostic testing. Medicine retailers are eager for MRDTs to be made available to them. However, certain challenges remain to implementation in retail outlets and should be addressed in advance.

Over my fake body: body ownership illusions for studying the multisensory basis of own-body perception

PubMed Central

Kilteni, Konstantina; Maselli, Antonella; Kording, Konrad P.; Slater, Mel

2015-01-01

Which is my body and how do I distinguish it from the bodies of others, or from objects in the surrounding environment? The perception of our own body and more particularly our sense of body ownership is taken for granted. Nevertheless, experimental findings from body ownership illusions (BOIs), show that under specific multisensory conditions, we can experience artificial body parts or fake bodies as our own body parts or body, respectively. The aim of the present paper is to discuss how and why BOIs are induced. We review several experimental findings concerning the spatial, temporal, and semantic principles of crossmodal stimuli that have been applied to induce BOIs. On the basis of these principles, we discuss theoretical approaches concerning the underlying mechanism of BOIs. We propose a conceptualization based on Bayesian causal inference for addressing how our nervous system could infer whether an object belongs to our own body, using multisensory, sensorimotor, and semantic information, and we discuss how this can account for several experimental findings. Finally, we point to neural network models as an implementational framework within which the computational problem behind BOIs could be addressed in the future. PMID:25852524

A Question of Control? Examining the Role of Control Conditions in Experimental Psychopathology using the Example of Cognitive Bias Modification Research.

PubMed

Blackwell, Simon E; Woud, Marcella L; MacLeod, Colin

2017-10-26

While control conditions are vitally important in research, selecting the optimal control condition can be challenging. Problems are likely to arise when the choice of control condition is not tightly guided by the specific question that a given study aims to address. Such problems have become increasingly apparent in experimental psychopathology research investigating the experimental modification of cognitive biases, particularly as the focus of this research has shifted from theoretical questions concerning mechanistic aspects of the association between cognitive bias and emotional vulnerability, to questions that instead concern the clinical efficacy of 'cognitive bias modification' (CBM) procedures. We discuss the kinds of control conditions that have typically been employed in CBM research, illustrating how difficulties can arise when changes in the types of research questions asked are not accompanied by changes in the control conditions employed. Crucially, claims made on the basis of comparing active and control conditions within CBM studies should be restricted to those conclusions allowed by the specific control condition employed. CBM studies aiming to establish clinical utility are likely to require quite different control conditions from CBM studies aiming to illuminate mechanisms. Further, conclusions concerning the clinical utility of CBM interventions cannot necessarily be drawn from studies in which the control condition has been chosen to answer questions concerning mechanisms. Appreciating the need to appropriately alter control conditions in the transition from basic mechanisms-focussed investigations to applied clinical research could greatly facilitate the translational process.

SSME - Materials and Methods for Addressing High-Pressure Hydrogen Embrittlement

NASA Technical Reports Server (NTRS)

Matejczk, Daniel; Russell, Dale; Frandsen, Jon; Swanson, Greg

2010-01-01

From the humid, corrosion-friendly atmosphere of KSC, to the extreme heat of ascent, to the cold vacuum of space, the Space Shuttle faced one hostile environment after another. One of those harsh environments the hydrogen environment existed within the shuttle itself. Liquid hydrogen was the fuel that powered the shuttle s complex, powerful, and reusable main engine. Hydrogen provided the high specific impulse the bang per pound of fuel needed to perform the shuttle s heavy lifting duties. Hydrogen, however, was also a potential threat to the very metal of the propulsion system that used it. The diffusion of hydrogen atoms into a metal can make it more brittle and prone to cracking a process called hydrogen embrittlement. This effect can reduce the toughness of carefully selected and prepared materials. A concern that exposure to hydrogen might encourage crack growth was present from the beginning of the Space Shuttle Program, but the rationale for using hydrogen was compelling. This paper outlines the material characterization, anomaly resolution, and path to understanding of hydrogen embrittlement on superalloys through the course of the SSME program. Specific examples of nickel alloy turbine housings and single crystal turbine blades are addressed. The evolution of fracture mechanics analytical methods is also addressed.

Provision of integrated psychosocial services for cancer survivors post-treatment

PubMed Central

Recklitis, Christopher J; Syrjala, Karen L

2018-01-01

Meeting the psychosocial needs of patients with cancer has been recognised as a priority within oncology care for several decades. Many approaches that address these needs have been developed and described; however, until recently much of this work had focused on patients during treatment and end-of-life care. With continued improvement in therapies, the population of cancer survivors who can expect to live for 5 or more years after cancer diagnosis has increased dramatically, as have associated concerns about how to meet their medical, psychosocial, and health behaviour needs after treatment. Guidelines and models for general survivorship care routinely address psychosocial needs, and similar guidelines for psychosocial care of patients with cancer are being extended to address the needs of survivors. In this Series paper, we summarise the existing recommendations for the provision of routine psychosocial care to survivors, as well as the challenges present in providing this care. We make specific recommendations for the integration of psychosocial services into survivorship care. PMID:28049576

Merging spatially variant physical process models under an optimized systems dynamics framework.

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

Cain, William O.; Lowry, Thomas Stephen; Pierce, Suzanne A.

The complexity of water resource issues, its interconnectedness to other systems, and the involvement of competing stakeholders often overwhelm decision-makers and inhibit the creation of clear management strategies. While a range of modeling tools and procedures exist to address these problems, they tend to be case specific and generally emphasize either a quantitative and overly analytic approach or present a qualitative dialogue-based approach lacking the ability to fully explore consequences of different policy decisions. The integration of these two approaches is needed to drive toward final decisions and engender effective outcomes. Given these limitations, the Computer Assisted Dispute Resolution systemmore » (CADRe) was developed to aid in stakeholder inclusive resource planning. This modeling and negotiation system uniquely addresses resource concerns by developing a spatially varying system dynamics model as well as innovative global optimization search techniques to maximize outcomes from participatory dialogues. Ultimately, the core system architecture of CADRe also serves as the cornerstone upon which key scientific innovation and challenges can be addressed.« less

Information technology developments within the national biological information infrastructure

USGS Publications Warehouse

Cotter, G.; Frame, M.T.

2000-01-01

Looking out an office window or exploring a community park, one can easily see the tremendous challenges that biological information presents the computer science community. Biological information varies in format and content depending whether or not it is information pertaining to a particular species (i.e. Brown Tree Snake), or a specific ecosystem, which often includes multiple species, land use characteristics, and geospatially referenced information. The complexity and uniqueness of each individual species or ecosystem do not easily lend themselves to today's computer science tools and applications. To address the challenges that the biological enterprise presents the National Biological Information Infrastructure (NBII) (http://www.nbii.gov) was established in 1993. The NBII is designed to address these issues on a National scale within the United States, and through international partnerships abroad. This paper discusses current computer science efforts within the National Biological Information Infrastructure Program and future computer science research endeavors that are needed to address the ever-growing issues related to our Nation's biological concerns.

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

PubMed

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

2011-12-01

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

Radiation and Reliability Concerns for Modern Nonvolatile Memory Technology

NASA Technical Reports Server (NTRS)

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

2011-01-01

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

Best practices in OR suite layout and equipment choices to reduce slips, trips, and falls.

PubMed

Brogmus, George; Leone, William; Butler, Lorraine; Hernandez, Edward

2007-09-01

Slips, trips, and falls (STFs) account for about 20% of lost-time injuries for health care personnel. Although the effect that OR layout and equipment choices have on STF risk has not been specifically addressed in the literature, STFs in the perioperative suite are of particular concern because of their potential to cause adverse patient consequences. Increased renovation of ORs to include equipment for minimally invasive procedures intensifies the importance of examining best practices in OR layout and equipment choices to reduce the potential for STFs.

Simulation: A Complementary Method for Teaching Health Services Strategic Management

PubMed Central

Reddick, W. T.

1990-01-01

Rapid change in the health care environment mandates a more comprehensive approach to the education of future health administrators. The area of consideration in this study is that of health care strategic management. A comprehensive literature review suggests microcomputer-based simulation as an appropriate vehicle for addressing the needs of both educators and students. Seven strategic management software packages are reviewed and rated with an instrument adapted from the Infoworld review format. The author concludes that a primary concern is the paucity of health care specific strategic management simulations.

Controlled Ecological Life Support Systems: CELSS '89 Workshop

NASA Technical Reports Server (NTRS)

Macelroy, Robert D. (Editor)

1990-01-01

Topics discussed at NASA's Controlled Ecological Life Support Systems (CELSS) workshop concerned the production of edible biomass. Specific areas of interest ranged from the efficiency of plant growth, to the conversion of inedible plant material to edible food, to the use of plant culture techniques. Models of plant growth and whole CELSS systems are included. The use of algae to supplement and improve dietary requirements is addressed. Flight experimentation is covered in topics ranging from a Salad Machine for use on the Space Station Freedom to conceptual designs for a lunar base CELSS.

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

ERIC Educational Resources Information Center

Center for Mental Health in Schools at UCLA, 2008

2008-01-01

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

76 FR 20571 - Bidding by Affiliates in Open Seasons for Pipeline Capacity

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-13

... time value of money to determine the present value of a time series of discounted cash flows.\\6\\ The... addressing yesterday's concerns may not address tomorrow's concerns. Over time, however, experience in...:30 a.m. to 5 p.m. Eastern time) at 888 First Street, NE., Room 2A, Washington, DC 20426. 27. From...

Class Size Reduction: Lessons Learned from Experience. Policy Brief No. Twenty-Three.

ERIC Educational Resources Information Center

McRobbie, Joan; Finn, Jeremy D.; Harman, Patrick

New federal proposals have fueled national interest in class-size reduction (CSR). However, CSR raises numerous concerns, some of which are addressed in this policy brief. The text draws on the experiences of states and districts that have implemented CSR. The brief addresses the following 15 concerns: Do small classes in and of themselves affect…

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

PubMed

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

2012-05-01

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

Physical Protection of Spent Fuel Shipments: Resolution of Stakeholder Concerns Through Rulemaking - 12284

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

Ballard, James D.; Halstead, Robert J.; Dilger, Fred

2012-07-01

In 1999, the State of Nevada brought its concerns about physical protection of current spent nuclear fuel (SNF) shipments, and future SNF shipments to a federal repository, before the NRC in a 1999 petition for rulemaking (PRM-73-10). In October 2010, the NRC published a rulemaking decision which would significantly strengthen physical protection of SNF in transit. The newest articulation of the rule (10 CFR 73.37) incorporates regulatory clarifications and security enhancements requested in Nevada's 1999 petition for rulemaking, codifies the findings of the Nuclear NRC and DOE consequence analyses into policy guidance documents and brings forward into regulations the agencymore » and licensee experience gained since the terrorist attacks of September 11, 2001. Although at present DOE SNF shipments would continue to be exempt from these NRC regulations, Nevada considers the rule to constitute a largely satisfactory resolution to stakeholder concerns raised in the original petition and in subsequent comments submitted to the NRC. This paper reviews the process of regulatory changes, assesses the specific improvements contained in the new rules and briefly describes the significance of the new rule in the context of a future national nuclear waste management program. Nevada's petition for rulemaking led to a generally satisfactory resolution of the State's concerns. The decade plus timeframe from petition to rulemaking conclusion saw a sea change in many aspects of the relevant issues - perhaps most importantly the attacks on 9/11 led to the recognition by regulatory bodies that a new threat environment exists wherein shipments of SNF and HLW pose a viable target for human initiated events. The State of Nevada has always considered security a critical concern for the transport of these highly radioactive materials. This was one of the primary reasons for the original rulemaking petition and subsequent advocacy by Nevada on related issues. NRC decisions on the majority of the concerns expressed in the petition, additional developments by other regulatory bodies and the change in how the United States sees threats to the homeland - all of these produced a satisfactory resolution through the rulemaking process. While not all of the concerns expressed by Nevada were addressed in the proposed rule and significant challenges face any programmatic shipment campaign in the future, the lesson learned on this occasion is that stakeholder concerns can be resolved through rulemaking. If DOE would engage with stakeholders on its role in transport of SNF and HLW under the NWPA, these concerns would be better addressed. Specifically the attempts by DOE to resist transportation and security regulations now considered necessary by the NRC for the adequate protection of the shipments of highly radioactive materials, these DOE efforts seem ill advised. One clear lesson learned from this successful rulemaking petition process is that the system of stakeholder input can work to better the regulatory environment. (authors)« less

Ethical and Legal Implications of the Methodological Crisis in Neuroimaging.

PubMed

Kellmeyer, Philipp

2017-10-01

Currently, many scientific fields such as psychology or biomedicine face a methodological crisis concerning the reproducibility, replicability, and validity of their research. In neuroimaging, similar methodological concerns have taken hold of the field, and researchers are working frantically toward finding solutions for the methodological problems specific to neuroimaging. This article examines some ethical and legal implications of this methodological crisis in neuroimaging. With respect to ethical challenges, the article discusses the impact of flawed methods in neuroimaging research in cognitive and clinical neuroscience, particularly with respect to faulty brain-based models of human cognition, behavior, and personality. Specifically examined is whether such faulty models, when they are applied to neurological or psychiatric diseases, could put patients at risk, and whether this places special obligations on researchers using neuroimaging. In the legal domain, the actual use of neuroimaging as evidence in United States courtrooms is surveyed, followed by an examination of ways that the methodological problems may create challenges for the criminal justice system. Finally, the article reviews and promotes some promising ideas and initiatives from within the neuroimaging community for addressing the methodological problems.

Recognition and management of stroke in young adults and adolescents

PubMed Central

Biller, José; Elkind, Mitchell S.; Fullerton, Heather J.; Jauch, Edward C.; Kittner, Steven J.; Levine, Deborah A.; Levine, Steven R.

2013-01-01

Approximately 15% of all ischemic strokes (IS) occur in young adults and adolescents. To date, only limited prior public health and research efforts have specifically addressed stroke in the young. Early diagnosis remains challenging because of the lack of awareness and the relative infrequency of stroke compared with stroke mimics. Moreover, the causes of IS in the young are heterogeneous and can be relatively uncommon, resulting in uncertainties about diagnostic evaluation and cause-specific management. Emerging data have raised public health concerns about the increasing prevalence of traditional vascular risk factors in young individuals, and their potential role in increasing the risk of IS, stroke recurrence, and poststroke mortality. These issues make it important to formulate and enact strategies to increase both awareness and access to resources for young stroke patients, their caregivers and families, and health care professionals. The American Academy of Neurology recently convened an expert panel to develop a consensus document concerning the recognition, evaluation, and management of IS in young adults and adolescents. The report of the consensus panel is presented herein. PMID:23946297

Recognition and management of stroke in young adults and adolescents.

PubMed

Singhal, Aneesh B; Biller, José; Elkind, Mitchell S; Fullerton, Heather J; Jauch, Edward C; Kittner, Steven J; Levine, Deborah A; Levine, Steven R

2013-09-17

Approximately 15% of all ischemic strokes (IS) occur in young adults and adolescents. To date, only limited prior public health and research efforts have specifically addressed stroke in the young. Early diagnosis remains challenging because of the lack of awareness and the relative infrequency of stroke compared with stroke mimics. Moreover, the causes of IS in the young are heterogeneous and can be relatively uncommon, resulting in uncertainties about diagnostic evaluation and cause-specific management. Emerging data have raised public health concerns about the increasing prevalence of traditional vascular risk factors in young individuals, and their potential role in increasing the risk of IS, stroke recurrence, and poststroke mortality. These issues make it important to formulate and enact strategies to increase both awareness and access to resources for young stroke patients, their caregivers and families, and health care professionals. The American Academy of Neurology recently convened an expert panel to develop a consensus document concerning the recognition, evaluation, and management of IS in young adults and adolescents. The report of the consensus panel is presented herein.

Analysing how negative emotions emerge and are addressed in veterinary consultations, using the Verona Coding Definitions of Emotional Sequences (VR-CoDES).

PubMed

Vijfhuizen, Malou; Bok, Harold; Matthew, Susan M; Del Piccolo, Lidia; McArthur, Michelle

2017-04-01

To explore the applicability, need for modifications and reliability of the VR-CoDES in a veterinary setting while also gaining a deeper understanding of clients' expressions of negative emotion and how they are addressed by veterinarians. The Verona Coding Definitions of Emotional Sequences for client cues and concerns (VR-CoDES-CC) and health provider responses (VR-CoDES-P) were used to analyse 20 audiotaped veterinary consultations. Inter-rater reliability was established. The applicability of definitions of the VR-CoDES was identified, together with the need for specific modifications to suit veterinary consultations. The VR-CoDES-CC and VR-CoDES-P generally applied to veterinary consultations. Cue and concern reliability was found satisfactory for most types of cues, but not for concerns. Response reliability was satisfactory for explicitness, and for providing and reducing space for further disclosure. Modifications to the original coding system were necessary to accurately reflect the veterinary context and included minor additions to the VR-CoDES-CC. Using minor additions to the VR-CoDES including guilt, reassurance and cost discussions it can be reliably adopted to assess clients' implicit expressions of negative emotion and veterinarians' responses. The modified VR-CoDES could be of great value when combined with existing frameworks used for teaching and researching veterinary communication. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Possibilities for global governance of converging technologies

NASA Astrophysics Data System (ADS)

Roco, Mihail C.

2008-01-01

The convergence of nanotechnology, modern biology, the digital revolution and cognitive sciences will bring about tremendous improvements in transformative tools, generate new products and services, enable opportunities to meet and enhance human potential and social achievements, and in time reshape societal relationships. This paper focuses on the progress made in governance of such converging, emerging technologies and suggests possibilities for a global approach. Specifically, this paper suggests creating a multidisciplinary forum or a consultative coordinating group with members from various countries to address globally governance of converging, emerging technologies. The proposed framework for governance of converging technologies calls for four key functions: supporting the transformative impact of the new technologies; advancing responsible development that includes health, safety and ethical concerns; encouraging national and global partnerships; and establishing commitments to long-term planning and investments centered on human development. Principles of good governance guiding these functions include participation of all those who are forging or affected by the new technologies, transparency of governance strategies, responsibility of each participating stakeholder, and effective strategic planning. Introduction and management of converging technologies must be done with respect for immediate concerns, such as privacy, access to medical advancements, and potential human health effects. At the same time, introduction and management should also be done with respect for longer-term concerns, such as preserving human integrity, dignity and welfare. The suggested governance functions apply to four levels of governance: (a) adapting existing regulations and organizations; (b) establishing new programs, regulations and organizations specifically to handle converging technologies; (c) building capacity for addressing these issues into national policies and institutions; and (d) making international agreements and partnerships. Several possibilities for improving the governance of converging technologies in the global self-regulating ecosystem are recommended: using open-source and incentive-based models, establishing corresponding science and engineering platforms, empowering the stakeholders and promoting partnerships among them, implementing long-term planning that includes international perspectives, and institute voluntary and science-based measures for risk management.

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

PubMed Central

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

2013-01-01

Objectives Understanding and effectively addressing persistent health disparities in minority communities requires a clear picture of members’ concerns and priorities. This study was intended to engage residents in urban and rural communities in order to identify environmental health priorities. Specific emphasis was placed on how the communities defined the term environment, their perceptions of environmental exposures as affecting their health, specific priorities in their communities, and differences in urban versus rural populations. Study design A community-engaged approach was used to develop and implement focus groups and compare environmental health priorities in urban versus rural communities. Methods A total of eight focus groups were conducted: four in rural and four in urban communities. Topics included defining the term environment, how the environment may affect health, and environmental priorities within their communities, using both open discussion and a predefined list. Data were analysed both qualitatively and quantitatively to identify patterns and trends. Results There were important areas of overlap in priorities between urban and rural communities; both emphasized the importance of the social environment and shared a concern over air pollution from industrial sources. In contrast, for urban focus groups, abandoned houses and their social and physical sequelae were a high priority while concerns about adequate sewer and water services and road maintenance were high priorities in rural communities. Conclusions This study was able to identify environmental health priorities in urban versus rural minority communities. In contrast to some previous risk perception research, the results of this study suggest prioritization of tangible, known risks in everyday life instead of rare, disaster-related events, even in communities that have recently experienced devastating damage from tornadoes. The findings can help inform future efforts to study, understand and effectively address environmental issues, and are particularly relevant to developing effective community-based strategies in vulnerable populations. PMID:24239281

A 'user friendly' geographic information system in a color interactive digital image processing system environment

NASA Technical Reports Server (NTRS)

Campbell, W. J.; Goldberg, M.

1982-01-01

NASA's Eastern Regional Remote Sensing Applications Center (ERRSAC) has recognized the need to accommodate spatial analysis techniques in its remote sensing technology transfer program. A computerized Geographic Information System to incorporate remotely sensed data, specifically Landsat, with other relevant data was considered a realistic approach to address a given resource problem. Questions arose concerning the selection of a suitable available software system to demonstrate, train, and undertake demonstration projects with ERRSAC's user community. The very specific requirements for such a system are discussed. The solution found involved the addition of geographic information processing functions to the Interactive Digital Image Manipulation System (IDIMS). Details regarding the functions of the new integrated system are examined along with the characteristics of the software.

An application specific integrated circuit based multi-anode microchannel array readout system

NASA Technical Reports Server (NTRS)

Smeins, Larry G.; Stechman, John M.; Cole, Edward H.

1991-01-01

Size reduction of two new multi-anode microchannel array (MAMA) readout systems is described. The systems are based on two analog and one digital application specific integrated circuits (ASICs). The new readout systems reduce volume over previous discrete designs by 80 percent while improving electrical performance on virtually every significant parameter. Emphasis is made on the packaging used to achieve the volume reduction. Surface mount technology (SMT) is combined with modular construction for the analog portion of the readout. SMT reliability concerns and the board area impact of MIL SPEC SMT components is addressed. Package selection for the analog ASIC is discussed. Future sytems will require even denser packaging and the volume reduction progression is shown.

Can we treat CO₂ well blowouts like routine plumbing problems? A study of the incidence, impact, and perception of loss of well control

DOE PAGES

Porse, Sean L.; Wade, Sarah; Hovorka, Susan D.

2014-12-31

Risk communication literature suggests that for a number of reasons, the public may perceive a risk to be greater than indicated by its statistical probability. Public concern over risk can lead to significant and costly delays in project permitting and operations. Considering these theories, media coverage of CO₂-related well blowouts in 2013 gave rise to the questions: What is the risk of CO₂ well blowouts associated with CCUS through CO₂ EOR? What is the potential public perception of those risks? What information could be used to respond to public concern? To address these questions, this study aims to: 1) providemore » a framework for understanding the nature of onshore well blowouts, 2) quantify the incidence of such events for three specific geographic regions of Texas, 3) relate this data to CCUS and findings from other studies, and 4) explore the potential implications for public perception of this risk associated with CCUS projects. While quantifying answers to these questions proved to be challenging, the results from this study suggest that (1) the perceived risk of CO₂ well blowouts may exceed the statistical risk and (2) information that could be used to address this gap could be made more readily available to the greater benefit of industry and stakeholders who support the development of CCUS as an option for addressing anthropogenic CO₂ emissions. The study also suggests approaches to best conduct such data inquiries.« less

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

PubMed

Lang, Kirk T; Kiel, Joan M

2008-01-01

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

Concern-driven integrated approaches to nanomaterial testing and assessment – report of the NanoSafety Cluster Working Group 10

PubMed Central

Oomen, Agnes G.; Bos, Peter M. J.; Fernandes, Teresa F.; Hund-Rinke, Kerstin; Boraschi, Diana; Byrne, Hugh J.; Aschberger, Karin; Gottardo, Stefania; von der Kammer, Frank; Kühnel, Dana; Hristozov, Danail; Marcomini, Antonio; Migliore, Lucia; Scott-Fordsmand, Janeck; Wick, Peter

2014-01-01

Bringing together topic-related European Union (EU)-funded projects, the so-called “NanoSafety Cluster” aims at identifying key areas for further research on risk assessment procedures for nanomaterials (NM). The outcome of NanoSafety Cluster Working Group 10, this commentary presents a vision for concern-driven integrated approaches for the (eco-)toxicological testing and assessment (IATA) of NM. Such approaches should start out by determining concerns, i.e., specific information needs for a given NM based on realistic exposure scenarios. Recognised concerns can be addressed in a set of tiers using standardised protocols for NM preparation and testing. Tier 1 includes determining physico-chemical properties, non-testing (e.g., structure–activity relationships) and evaluating existing data. In tier 2, a limited set of in vitro and in vivo tests are performed that can either indicate that the risk of the specific concern is sufficiently known or indicate the need for further testing, including details for such testing. Ecotoxicological testing begins with representative test organisms followed by complex test systems. After each tier, it is evaluated whether the information gained permits assessing the safety of the NM so that further testing can be waived. By effectively exploiting all available information, IATA allow accelerating the risk assessment process and reducing testing costs and animal use (in line with the 3Rs principle implemented in EU Directive 2010/63/EU). Combining material properties, exposure, biokinetics and hazard data, information gained with IATA can be used to recognise groups of NM based upon similar modes of action. Grouping of substances in return should form integral part of the IATA themselves. PMID:23641967

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

ERIC Educational Resources Information Center

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

2015-01-01

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

Teaching Writing: Some Perennial Questions and Some Possible Answers. Occasional Paper No. 85.

ERIC Educational Resources Information Center

Florio-Ruane, Susan; Dunn, Saundra

Based on the premise that writing research will be useful to educators only to the extent that it offers them conceptual tools to use in framing and solving their own problems, this paper reviews studies that address educators' perennial concerns about writing instruction. Among the questions addressed in the paper are those concerning (1) the…

Rurality and Rural Education: Discourses Underpinning Rurality and Rural Education Research in South African Postgraduate Education Research 1994-2004

ERIC Educational Resources Information Center

Nkambule, T.; Balfour, R. J.; Pillay, G.; Moletsane, R.

2011-01-01

Historically, rurality and rural education have been marginalised bodies of knowledge in South Africa. The post-1994 era has seen an emerging government concern to address the continuing interplay between poverty, HIV/AIDS, underdevelopment, and underachievement in schools categorised as rural. To address these concerns, scholars in South African…

Simulation to Support Local Search in Trajectory Optimization Planning

NASA Technical Reports Server (NTRS)

Morris, Robert A.; Venable, K. Brent; Lindsey, James

2012-01-01

NASA and the international community are investing in the development of a commercial transportation infrastructure that includes the increased use of rotorcraft, specifically helicopters and civil tilt rotors. However, there is significant concern over the impact of noise on the communities surrounding the transportation facilities. One way to address the rotorcraft noise problem is by exploiting powerful search techniques coming from artificial intelligence coupled with simulation and field tests to design low-noise flight profiles which can be tested in simulation or through field tests. This paper investigates the use of simulation based on predictive physical models to facilitate the search for low-noise trajectories using a class of automated search algorithms called local search. A novel feature of this approach is the ability to incorporate constraints directly into the problem formulation that addresses passenger safety and comfort.

Trainee experiences of intellectual disability psychiatry and an innovative leaderless support group: a qualitative study

PubMed Central

Spackman, Ross; Toogood, Hannah; Kerridge, Jayne; Nash, Jon; Anderson, Elizabeth; Rai, Dheeraj

2017-01-01

Aims and method There is very little research into the challenges of training in intellectual disability psychiatry or into interventions which may address these challenges. Using focus groups, we explored the experiences of intellectual disability psychiatry trainees, and evaluated a leaderless trainee support group developed in Bristol. Results Five distinct themes were identified via framework analysis: that trainees felt unprepared for the difference from previous posts; the need for support; the value of the group; that trainees were concerned about judgement in supervision; that the group structure was valued. Clinical implications Our findings highlight the support needs specific to intellectual disability psychiatry trainees. Leaderless peer support groups may be a valued resource to address such issues, and may be a useful model to be considered by other training schemes. PMID:28811919

Raman spectroscopic signature of vaginal fluid and its potential application in forensic body fluid identification.

PubMed

Sikirzhytskaya, Aliaksandra; Sikirzhytski, Vitali; Lednev, Igor K

2012-03-10

Traces of human body fluids, such as blood, saliva, sweat, semen and vaginal fluid, play an increasingly important role in forensic investigations. However, a nondestructive, easy and rapid identification of body fluid traces at the scene of a crime has not yet been developed. The obstacles have recently been addressed in our studies, which demonstrated the considerable potential of Raman spectroscopy. In this study, we continued to build a full library of body fluid spectroscopic signatures. The problems concerning vaginal fluid stain identification were addressed using Raman spectroscopy coupled with advanced statistical analysis. Calculated characteristic Raman and fluorescent spectral components were used to build a multidimensional spectroscopic signature of vaginal fluid, which demonstrated good specificity and was able to handle heterogeneous samples from different donors. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Senior residents' perceived need of and preferences for "smart home" sensor technologies.

PubMed

Demiris, George; Hensel, Brian K; Skubic, Marjorie; Rantz, Marilyn

2008-01-01

The goal of meeting the desire of older adults to remain independent in their home setting while controlling healthcare costs has led to the conceptualization of "smart homes." A smart home is a residence equipped with technology that enhances safety of residents and monitors their health conditions. The study aim is to assess older adults' perceptions of specific smart home technologies (i.e., a bed sensor, gait monitor, stove sensor, motion sensor, and video sensor). The study setting is TigerPlace, a retirement community designed according to the Aging in Place model. Focus group sessions with fourteen residents were conducted to assess perceived advantages and concerns associated with specific applications, and preferences for recipients of sensor-generated information pertaining to residents' activity levels, sleep patterns and potential emergencies. Sessions were audio-taped; tapes were transcribed, and a content analysis was performed. A total of fourteen older adults over the age of 65 participated in three focus group sessions Most applications were perceived as useful, and participants would agree to their installation in their own home. Preference for specific sensors related to sensors' appearance and residents' own level of frailty and perceived need. Specific concerns about privacy were raised. The findings indicate an overall positive attitude toward sensor technologies for nonobtrusive monitoring. Researchers and practitioners are called upon to address ethical and technical challenges in this emerging domain.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-27

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

Person-centred communication for emotional support in district nursing: SAGE and THYME model.

PubMed

Griffiths, Jane

2017-12-02

Patients on district nursing caseloads have multiple physical morbidities, and related emotional concerns. District nurses are ideally placed to assess and meet patients' emotional needs but in increasingly stretched workplaces, it is difficult to find time. There is also evidence that district nurses sometimes believe they lack skills to address patients' concerns. Traditional communication skills training is useful for encouraging patients to open up about their concerns, but less helpful at finding workable solutions. District nurses can be afraid to open a 'can of worms' of concerns that they are unable to deal with. SAGE and THYME is a person-centred, evidence-based communication skills model that addresses district nurses' concerns about time and skills. It provides a structure for conversations about concerns, and empowers patients to work with district nurses to find solutions. Research suggests that it is a promising model for district nursing practice.

A demonstration of the instream flow incremental methodology, Shenandoah River

USGS Publications Warehouse

Zappia, Humbert; Hayes, Donald C.

1998-01-01

Current and projected demands on the water resources of the Shenandoah River have increased concerns for the potential effect of these demands on the natural integrity of the Shenandoah River system. The Instream Flow Incremental Method (IFIM) process attempts to integrate concepts of water-supply planning, analytical hydraulic engineering models, and empirically derived habitat versus flow functions to address water-use and instream-flow issues and questions concerning life-stage specific effects on selected species and the general well being of aquatic biological populations.The demonstration project also sets the stage for the identification and compilation of the major instream-flow issues in the Shenandoah River Basin, development of the required multidisciplinary technical team to conduct more detailed studies, and development of basin specific habitat and flow requirements for fish species, species assemblages, and various water uses in the Shenandoah River Basin. This report presents the results of an IFIM demonstration project, conducted on the main stem Shenandoah River in Virginia, during 1996 and 1997, using the Physical Habitat Simulation System (PHABSIM) model.Output from PHABSIM is used to address the general flow requirements for water supply and recreation and habitat for selected life stages of several fish species. The model output is only a small part of the information necessary for effective decision making and management of river resources. The information by itself is usually insufficient for formulation of recommendations regarding instream-flow requirements. Additional information, for example, can be obtained by analysis of habitat time-series data, habitat duration data, and habitat bottlenecks. Alternative-flow analysis and habitat-duration curves are presented.

Reflect before you act: providing structure to the evaluation of rehabilitation programmes.

PubMed

Velema, Johan P; Cornielje, Huib

2003-11-18

This paper is concerned with understanding and evaluating potentially diverse rehabilitation programmes. It helps evaluators and programme managers to focus attention on specific aspects of the rehabilitation process and select evaluation questions relevant to each. Distinction is made between the rehabilitation programme itself, the programme environment and the relationships between the two. For each of these areas, evaluation questions have been formulated. For services offered to individual clients, questions address whether the status of clients has improved, what interventions are offered and who benefit from them, the relationships between the service providers and the clients, and who may be involved in the rehabilitation process besides the client. To assess the programme environment, questions address the epidemiology of disability, the resources available to persons with disabilities, the inclusiveness of education and employment and a number of eco-social variables. Relationships between the programme and its environment concern the support of the community for the programme, the way the programme seeks to influence the community, the referral of clients to other services available in the community and the extent to which the programme is a learning organization. Lists of evaluation questions are presented from which the evaluator can select those most relevant to the programme to be evaluated. This provides a framework for the evaluation and for the information to be gathered. Rather than providing a blue print, this framework permits flexibility to adapt to the specific situation of the programme to be evaluated. This paper presents a useful guideline that stimulates the thinking of those preparing for the evaluation of rehabilitation programmes.

Parents' beliefs about the healthfulness of sugary drink options: opportunities to address misperceptions.

PubMed

Munsell, Christina R; Harris, Jennifer L; Sarda, Vishnudas; Schwartz, Marlene B

2016-01-01

To assess potential misperceptions among parents regarding the healthfulness of sugary drinks for their children. Online survey of parents. Participants identified the categories and specific brands of sugary drinks they provided for their children. They also indicated their perceptions of sugary drink categories and brands as healthy options for children, perceived importance of on-package claims in purchase decisions and their concerns about common sugary drink ingredients. Online market research panel. Parents (n 982) of 2- to 17-year-olds, 46 % non-white or Hispanic. Ninety-six per cent of parents provided on average 2·9 different categories of sugary drinks for their children in the past month. Flavoured waters, fruit drinks and sports drinks were rated as the healthiest sugary drink categories. Across all categories and brands, parents who purchased specific products rated them as significantly healthier than those who did not (P<0·05). Over half of parents reported concern about caffeine, sugar and artificial sweeteners in sugary drinks that their children consume and approximately one-third reported that on-package ingredient claims were important in their purchase decisions. Nearly all parents provide sugary drinks for their children and many believe that some sugary drinks are healthy options for children, particularly flavoured waters, fruit drinks and sports drinks. Furthermore, many parents rely upon on-package claims in their purchase decisions. Given excessive consumption of added sugar by children in the home, there is a continuing need to address parents' misperceptions about the healthfulness of many sugary drink products.

Writing Centre Tutoring Sessions: Addressing Students' Concerns

ERIC Educational Resources Information Center

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

2016-01-01

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

Why Do International Students Avoid Communicating with Americans?

ERIC Educational Resources Information Center

Wang, I-Ching; Ahn, Janet N.; Kim, Hyojin J.; Lin-Siegler, Xiaodong

2017-01-01

We explore how the communication concerns of non-native English speakers (NNS) and Americans relate to their perceptions of each other and decisions to interact. NNS identified their concerns in communicating with Americans, the perceived causes of their concerns, and the strategies they would employ to address these concerns. Americans noted…

Addressing the Health Concerns of VA Women With Sexual Trauma

DTIC Science & Technology

2016-10-01

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

An urban survey of paediatric environmental health concerns: Perceptions of parents, guardians and health care professionals

PubMed Central

Buka, Irena; Rogers, W Todd; Osornio-Vargas, Alvaro R; Hoffman, Harold; Pearce, Marni; Li, Yuen Yee

2006-01-01

OBJECTIVES To conduct a survey in Edmonton, Alberta, to gather information regarding concerns about the influence of environmental factors on children’s health and to use the information to set an agenda for the resources of the Paediatric Environmental Health Specialty Unit at Misericordia Hospital (Edmonton, Alberta). METHODS Two questionnaires with 28 closed-ended questions were developed to examine parents’, guardians’ and health care professionals’ concerns. They comprised items about six environmental factors (air, water and food quality; household supplies; radiation; and waste disposal). Health care professionals were also asked four questions about their knowledge of and their needs in Paediatric Environmental Health. Parents and guardians attending the public health centres and nurses working therein received questionnaires. Physicians were surveyed by e-mail. RESULTS After verification, the questionnaire data from 400 parents or guardians and 152 health care professionals were used for analyses. Results from contingency table, Hotelling’s T2 and effect size analyses revealed similarities in the levels of concern in both groups, and the results were combined. The greatest concern of both groups was with environmental tobacco smoke, followed by pesticides in water. Concerns about six additional environmental elements were also expressed. The health care professionals showed a high level of concern about the need for resources, specific training and public education regarding paediatric environmental health. CONCLUSION A significant level of concern was consistently found between the two groups studied, regardless of professional training. The highest level of concern was with a well-documented topic (ie, environmental tobacco smoke). Less concern associated with decreased documentation calls for increasing the knowledge of society, including health care professionals, to address the adverse effects of environmental factors on children. PMID:19030279

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

PubMed Central

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

2005-01-01

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

Measuring and improving patient safety through health information technology: The Health IT Safety Framework.

PubMed

Singh, Hardeep; Sittig, Dean F

2016-04-01

Health information technology (health IT) has potential to improve patient safety but its implementation and use has led to unintended consequences and new safety concerns. A key challenge to improving safety in health IT-enabled healthcare systems is to develop valid, feasible strategies to measure safety concerns at the intersection of health IT and patient safety. In response to the fundamental conceptual and methodological gaps related to both defining and measuring health IT-related patient safety, we propose a new framework, the Health IT Safety (HITS) measurement framework, to provide a conceptual foundation for health IT-related patient safety measurement, monitoring, and improvement. The HITS framework follows both Continuous Quality Improvement (CQI) and sociotechnical approaches and calls for new measures and measurement activities to address safety concerns in three related domains: 1) concerns that are unique and specific to technology (e.g., to address unsafe health IT related to unavailable or malfunctioning hardware or software); 2) concerns created by the failure to use health IT appropriately or by misuse of health IT (e.g. to reduce nuisance alerts in the electronic health record (EHR)), and 3) the use of health IT to monitor risks, health care processes and outcomes and identify potential safety concerns before they can harm patients (e.g. use EHR-based algorithms to identify patients at risk for medication errors or care delays). The framework proposes to integrate both retrospective and prospective measurement of HIT safety with an organization's existing clinical risk management and safety programs. It aims to facilitate organizational learning, comprehensive 360 degree assessment of HIT safety that includes vendor involvement, refinement of measurement tools and strategies, and shared responsibility to identify problems and implement solutions. A long term framework goal is to enable rigorous measurement that helps achieve the safety benefits of health IT in real-world clinical settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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

PubMed Central

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

2015-01-01

Background Cancer is a leading cause of morbidity and morality among Hispanics, the fastest growing population group in South Carolina (SC). The Partnership for Cancer Prevention (PCP) was established to build partnerships and community capacity to address cervical cancer early detection and control among the growing Latina population in SC. In this paper we report on the initial PCP community-based participatory research (CBPR) project. Methods PCP members engaged in a multi-method, participatory research project to assess cervical cancer related resources and needs among Latinas and healthcare providers. To explore attitudes and behaviors related to women's health in general and more specifically, female cancer, PCP members conducted 8 focus group sessions with 38 Spanish-speaking women. To assess the availability and perceived importance of culturally and linguistically appropriate services, PCP members conducted a survey of providers (n=46) and support personnel (n=30) at 14 clinical sites that provide cancer screening services. Results Health care access issues were Latinas' main concerns. For information and assistance in accessing and navigating the health care system, they relied on informal social networks and community outreach workers. Latina participants voiced misunderstandings about cancer risk and most appeared to lack a prevention orientation. Practitioners’ concerns included the assessment and documentation of patients' language preference and ability, provision of language assistance for limited-English-proficient (LEP) patients, and bilingual staff. Conclusions Building on the findings of this participatory research initiative, PCP members identified the following action strategies to promote cervical cancer screening among Latinas in SC: culturally appropriate cervical cancer awareness messages and outreach strategies geared towards increasing participation in cervical cancer screening and follow-up; maintenance of active community partnerships for health promotion, cancer risk reduction, and improved access to care; and increasing the capacity of the health care systems in SC to address Hispanic health concerns. PMID:20108722

Engineered inorganic nanoparticles and cosmetics: facts, issues, knowledge gaps and challenges.

PubMed

Wiechers, Johann W; Musee, Ndeke

2010-10-01

The cosmetic industry is among the first adaptors of nanotechnology through the use of engineered nanoparticles (ENPs) to enhance the performance of their products and meet the customers' needs. Recently, there have been increasing concerns from different societal stakeholders (e.g., governments, environmental activist pressure groups, scientists, general public, etc.) concerning the safety and environmental impact of ENPs used in cosmetics. This review paper seeks to address the twin concerns of the safety of cosmetics and the potential environmental impacts due to the constituent chemicals-the ENPs. The safety aspect is addressed by examining recently published scientific data on the possibility of ENPs penetrating human skin. Data indicates that although particular types of ENPs can penetrate into the skin, until now no penetration has been detected beyond the stratum corneum of the ENPs used in cosmetics. Yet, important lessons can be learned from the more recent studies that identify the characteristics of ENPs penetrating into and permeating through human skin. On the part of the environmental impact, the scientific literature has very limited or none existent specific articles addressing the environmental impacts of ENPs owing to the cosmetic products. Therefore, general ecotoxicological data on risk assessment of ENPs has been applied to ascertain if there are potential environmental impacts from cosmetics. Results include some of the first studies on the qualitative and quantitative risk assessment of ENPs from cosmetics and suggest that further research is required as the knowledge is incomplete to make definitive conclusions as is the case with skin penetration. The authors conclude that the cosmetic industry should be more transparent in its use of nanotechnology in cosmetic products to facilitate realistic risk assessments as well as scientists and pressure groups being accurate in their conclusions on the general applicability of their findings. Transparency in cosmetics needs nanotechnology, but nanotechnology in cosmetics also needs transparency...

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

ERIC Educational Resources Information Center

Aronson, Susan S.

1991-01-01

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

Health Sector Evolution Plan in Iran; Equity and Sustainability Concerns.

PubMed

Moradi-Lakeh, Maziar; Vosoogh-Moghaddam, Abbas

2015-08-31

In 2014, a series of reforms, called as the Health Sector Evolution Plan (HSEP), was launched in the health system of Iran in a stepwise process. HSEP was mainly based on the fifth 5-year health development national strategies (2011-2016). It included different interventions to: increase population coverage of basic health insurance, increase quality of care in the Ministry of Health and Medical Education (MoHME) affiliated hospitals, reduce out-of-pocket (OOP) payments for inpatient services, increase quality of primary healthcare, launch updated relative value units (RVUs) of clinical services, and update tariffs to more realistic values. The reforms resulted in extensive social reaction and different professional feedback. The official monitoring program shows general public satisfaction. However, there are some concerns for sustainability of the programs and equity of financing. Securing financial sources and fairness of the financial contribution to the new programs are the main concerns of policy-makers. Healthcare providers' concerns (as powerful and influential stakeholders) potentially threat the sustainability and efficiency of HSEP. Previous experiences on extending health insurance coverage show that they can lead to a regressive healthcare financing and threat financial equity. To secure financial sources and to increase fairness, the contributions of people to new interventions should be progressive by their income and wealth. A specific progressive tax would be the best source, however, since it is not immediately feasible, a stepwise increase in the progressivity of financing must be followed. Technical concerns of healthcare providers (such as nonplausible RVUs for specific procedures or nonefficient insurance-provider processes) should be addressed through proper revision(s) while nontechnical concerns (which are derived from conflicting interests) must be responded through clarification and providing transparent information. The requirements of HSEP and especially the key element of progressive tax should be considered properly in the coming sixth national development plan (2016-2021). © 2015 by Kerman University of Medical Sciences.

Predictors of non-use of intrauterine contraception among women aged 18-49 years in a general practice setting in the UK.

PubMed

Walker, Susan H; Newton, Victoria L; Hoggart, Lesley; Parker, Mike J

2016-01-01

Our research examined the barriers to the uptake of intrauterine contraception (IUC) by women in a general practice (GP) setting in the UK. This study reports predictors of non-use of IUC in this context. We used a mixed method Qual/Quant approach in which the initial qualitative research provides a framework for subsequent larger quantitative surveys. Utilizing findings derived from 30 qualitative interviews, a quantitative survey was developed and distributed to a pragmatic sample of 1,195 women, aged 18-49 years, who were recruited through 32 participating GP practices in an area of England, UK. Outcome measures were percentage of attributes or responses in the sample and use or non-use of IUC. Results were analyzed using descriptive statistical analysis and binary logistic regression, using use/non-use as a binary response variable. Attitudinal variables, which were the strongest predictors of non-use of IUC, were an adverse opinion on long-acting aspect of IUC (odds ratio [OR]=8.34), disliking the thought of IUC inside the body (OR=3.138), concerns about IUC causing difficulties becoming pregnant in the future (OR=2.587), concerns about womb damage (OR=2.224), having heard adverse opinions about levonorgestrel-releasing intrauterine system (Mirena ® ) (OR=2.551), having an adverse opinion of having light, irregular periods (OR=2.382) and, having an adverse opinion of having no periods (OR=2.018). Concerns about the long-acting nature of IUC and persisting concerns about the safety of IUC may act as barriers to its use. Information for women, tailored to specifically address these concerns, is needed. Clinicians should provide more reassurance and information to potential users of IUC to increase their confidence about the possibility of removing IUC early or on request. They should also specifically seek to alleviate concerns about internal damage, damage to the womb, or damage to future fertility from using the methods.

Health Sector Evolution Plan in Iran; Equity and Sustainability Concerns

PubMed Central

Moradi-Lakeh, Maziar; Vosoogh-Moghaddam, Abbas

2015-01-01

In 2014, a series of reforms, called as the Health Sector Evolution Plan (HSEP), was launched in the health system of Iran in a stepwise process. HSEP was mainly based on the fifth 5-year health development national strategies (2011-2016). It included different interventions to: increase population coverage of basic health insurance, increase quality of care in the Ministry of Health and Medical Education (MoHME) affiliated hospitals, reduce out-of-pocket (OOP) payments for inpatient services, increase quality of primary healthcare, launch updated relative value units (RVUs) of clinical services, and update tariffs to more realistic values. The reforms resulted in extensive social reaction and different professional feedback. The official monitoring program shows general public satisfaction. However, there are some concerns for sustainability of the programs and equity of financing. Securing financial sources and fairness of the financial contribution to the new programs are the main concerns of policy-makers. Healthcare providers’ concerns (as powerful and influential stakeholders) potentially threat the sustainability and efficiency of HSEP. Previous experiences on extending health insurance coverage show that they can lead to a regressive healthcare financing and threat financial equity. To secure financial sources and to increase fairness, the contributions of people to new interventions should be progressive by their income and wealth. A specific progressive tax would be the best source, however, since it is not immediately feasible, a stepwise increase in the progressivity of financing must be followed. Technical concerns of healthcare providers (such as nonplausible RVUs for specific procedures or nonefficient insurance-provider processes) should be addressed through proper revision(s) while nontechnical concerns (which are derived from conflicting interests) must be responded through clarification and providing transparent information. The requirements of HSEP and especially the key element of progressive tax should be considered properly in the coming sixth national development plan (2016-2021). PMID:26673172

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

ERIC Educational Resources Information Center

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

2011-01-01

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

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

ERIC Educational Resources Information Center

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

2013-01-01

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

Categorization and reasoning among tree experts: do all roads lead to Rome?

PubMed

Medin, D L; Lynch, E B; Coley, J D; Atran, S

1997-02-01

To what degree do conceptual systems reflect universal patterns of featural covariation in the world (similarity) or universal organizing principles of mind, and to what degree do they reflect specific goals, theories, and beliefs of the categorizer? This question was addressed in experiments concerned with categorization and reasoning among different types of tree experts (e.g., taxonomists, landscape workers, parks maintenance personnel). The results show an intriguing pattern of similarities and differences. Differences in sorting between taxonomists and maintenance workers reflect differences in weighting of morphological features. Landscape workers, in contrast, sort trees into goal-derived categories based on utilitarian concerns. These sorting patterns carry over into category-based reasoning for the taxonomists and maintenance personnel but not the landscape workers. These generalizations interact with taxonomic rank and suggest that the genus (or folk generic) level is relatively and in some cases absolutely privileged. Implications of these findings for theories of categorization are discussed.

Fire Signatures of Materials Used in Spacecraft Construction

NASA Technical Reports Server (NTRS)

Taylor, Christina

2003-01-01

The focus of my work this summer was fire safety, specifically determining fire signatures from the combustion of materials commonly found in the construction of spacecraft. This project was undertaken with the aim of addressing concerns for health and safety onboard spacecraft. Under certain conditions, burning electronics produce surprisingly large amounts of acrid smoke, release fine airborne particles and expel condensable aerosols. Similarly, some wire insulation and packing material evolves smoke when in contact with a hot surface. In the limited, enclosed space available on spacecraft, these combustion products may pose a nuisance at the very least - at worst, a hazard to health or equipment. There is also a concern for fire safety in early detection on spacecraft. Our goal for the summer was to determine the most effective methods to test the materials, develop a protocol for sampling, and generate samples for analysis. We restricted our testing to electronic components, packaging and insulation materials, and wire insulation materials.

Participatory action research: considerations for ethical review.

PubMed

Khanlou, N; Peter, E

2005-05-01

This paper addresses the distinctive nature of participatory action research (PAR) in relation to ethical review requirements. As a framework for conducting research and reducing health disparities, PAR is gaining increased attention in community and public health research. As a result, PAR researchers and members of Research Ethics Boards could benefit from an increased understanding of the array of ethical concerns that can arise. We discuss these concerns in light of commonly held ethical requirements for clinical research (social or scientific value, scientific validity, fair subject/participant selection, favourable risk-benefit ratio, independent review, informed consent, and respect for potential and enrolled participants) and refer to guidelines specifically developed for participatory research in health promotion. We draw from our community-based experiences in mental health promotion research with immigrant and culturally diverse youth to illustrate the ethical advantages and challenges of applying a PAR approach. We conclude with process suggestions for Research Ethics Boards.

Integration of deliberate practice and peer mentoring to enhance students' mastery and retention of essential skills.

PubMed

Ross, Jennifer Gunberg; Bruderle, Elizabeth; Meakim, Colleen

2015-03-01

Faculty in a 4-year baccalaureate nursing program were concerned with students' failure to retain the patient care skills of vital signs, breath sounds, and heart sounds learned in freshman and sophomore courses and consequent inability to transfer these high-frequency skills into the clinical setting. Because nursing is a practice profession, new graduates must be prepared to demonstrate specific competencies that are designed to improve practice. To address faculty concerns, support more positive learning outcomes, and engage in evidence-based nursing education, faculty developed and implemented an assignment that incorporated deliberate practice and peer mentoring into a sophomore course on the essentials of nursing practice. The purpose of this article is to describe the rationale, development and implementation, and feedback for a deliberate practice and peer mentoring assignment designed to enhance skill mastery and retention. Copyright 2015, SLACK Incorporated.

Mixtures and their risk assessment in toxicology.

PubMed

Mumtaz, Moiz M; Hansen, Hugh; Pohl, Hana R

2011-01-01

For communities generally and for persons living in the vicinity of waste sites specifically, potential exposures to chemical mixtures are genuine concerns. Such concerns often arise from perceptions of a site's higher than anticipated toxicity due to synergistic interactions among chemicals. This chapter outlines some historical approaches to mixtures risk assessment. It also outlines ATSDR's current approach to toxicity risk assessment. The ATSDR's joint toxicity assessment guidance for chemical mixtures addresses interactions among components of chemical mixtures. The guidance recommends a series of steps that include simple calculations for a systematic analysis of data leading to conclusions regarding any hazards chemical mixtures might pose. These conclusions can, in turn, lead to recommendations such as targeted research to fill data gaps, development of new methods using current science, and health education to raise awareness of residents and health care providers. The chapter also provides examples of future trends in chemical mixtures assessment.

Systematic Assessment of the Hemolysis Index: Pros and Cons.

PubMed

Lippi, Giuseppe

2015-01-01

Preanalytical quality is as important as the analytical and postanalytical quality in laboratory diagnostics. After decades of visual inspection to establish whether or not a diagnostic sample may be suitable for testing, automated assessment of hemolysis index (HI) has now become available in a large number of laboratory analyzers. Although most national and international guidelines support systematic assessment of sample quality via HI, there is widespread perception that this indication has not been thoughtfully acknowledged. Potential explanations include concern of increased specimen rejection rate, poor harmonization of analytical techniques, lack of standardized units of measure, differences in instrument-specific cutoff, negative impact on throughput, organization and laboratory economics, and lack of a reliable quality control system. Many of these concerns have been addressed. Evidence now supports automated HI in improving quality and patient safety. These will be discussed. © 2015 Elsevier Inc. All rights reserved.

Wireless power using magnetic resonance coupling for neural sensing applications

NASA Astrophysics Data System (ADS)

Yoon, Hargsoon; Kim, Hyunjung; Choi, Sang H.; Sanford, Larry D.; Geddis, Demetris; Lee, Kunik; Kim, Jaehwan; Song, Kyo D.

2012-04-01

Various wireless power transfer systems based on electromagnetic coupling have been investigated and applied in many biomedical applications including functional electrical stimulation systems and physiological sensing in humans and animals. By integrating wireless power transfer modules with wireless communication devices, electronic systems can deliver data and control system operation in untethered freely-moving conditions without requiring access through the skin, a potential source of infection. In this presentation, we will discuss a wireless power transfer module using magnetic resonance coupling that is specifically designed for neural sensing systems and in-vivo animal models. This research presents simple experimental set-ups and circuit models of magnetic resonance coupling modules and discusses advantages and concerns involved in positioning and sizing of source and receiver coils compared to conventional inductive coupling devices. Furthermore, the potential concern of tissue heating in the brain during operation of the wireless power transfer systems will also be addressed.

A Comparison of Participant and Practitioner Beliefs About Evaluation

PubMed Central

Whitehall, Anna K.; Hill, Laura G.; Koehler, Christian R.

2014-01-01

The move to build capacity for internal evaluation is a common organizational theme in social service delivery, and in many settings, the evaluator is also the practitioner who delivers the service. The goal of the present study was to extend our limited knowledge of practitioner evaluation. Specifically, the authors examined practitioner concerns about administering pretest and posttest evaluations within the context of a multisite 7-week family strengthening program and compared those concerns with self-reported attitudes of the parents who completed evaluations. The authors found that program participants (n = 105) were significantly less likely to find the evaluation process intrusive, and more likely to hold positive beliefs about the evaluation process, than practitioners (n = 140) expected. Results of the study may address a potential barrier to effective practitioner evaluation—the belief that having to administer evaluations interferes with establishing a good relationship with program participants. PMID:25328379

Defining Scenarios: Linking Integrated Models, Regional Concerns, and Stakeholders

NASA Astrophysics Data System (ADS)

Hartmann, H. C.; Stewart, S.; Liu, Y.; Mahmoud, M.

2007-05-01

Scenarios are important tools for long-term planning, and there is great interest in using integrated models in scenario studies. However, scenario definition and assessment are creative, as well as scientific, efforts. Using facilitated creative processes, we have worked with stakeholders to define regionally significant scenarios that encompass a broad range of hydroclimatic, socioeconomic, and institutional dimensions. The regional scenarios subsequently inform the definition of local scenarios that work with context-specific integrated models that, individually, can address only a subset of overall regional complexity. Based on concerns of stakeholders in the semi-arid US Southwest, we prioritized three dimensions that are especially important, yet highly uncertain, for long-term planning: hydroclimatic conditions (increased variability, persistent drought), development patterns (urban consolidation, distributed rural development), and the nature of public institutions (stressed, proactive). Linking across real-world decision contexts and integrated modeling efforts poses challenges of creatively connecting the conceptual models held by both the research and stakeholder communities.

Incorporating feminist theory and insights into a restorative justice response to sex offenses.

PubMed

Hopkins, C Quince; Koss, Mary P

2005-05-01

Sex offenses, particularly nonpenetration sex offenses and acquaintance sexual assault, are all too common. Because these crimes reinforce women's fear of crime and restrict spatial and social freedom, it is paramount for the justice system to act affirmatively; however, it does not. This article identifies several failures in the current response to these sex offenses. We describe the research demonstration project, RESTORE, operating in Pima County, Arizona, which uses a restorative justice response as a way of remedying some of those failures. Identifying central feminist insights that guided the development of that project, the article addresses concerns raised by feminists about the use of restorative justice for gendered violence. We conclude that most if not all of these concerns apply to cases of on going domestic violence--cases specifically excluded from the RESTORE program--rather than to cases of acquaintance sexual assault or nonpenetration sex offenses.

Field Testing of Environmentally Friendly Drilling System

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

David Burnett

2009-05-31

The Environmentally Friendly Drilling (EFD) program addresses new low-impact technology that reduces the footprint of drilling activities, integrates light weight drilling rigs with reduced emission engine packages, addresses on-site waste management, optimizes the systems to fit the needs of a specific development sites and provides stewardship of the environment. In addition, the program includes industry, the public, environmental organizations, and elected officials in a collaboration that addresses concerns on development of unconventional natural gas resources in environmentally sensitive areas. The EFD program provides the fundamentals to result in greater access, reasonable regulatory controls, lower development cost and reduction of themore » environmental footprint associated with operations for unconventional natural gas. Industry Sponsors have supported the program with significant financial and technical support. This final report compendium is organized into segments corresponding directly with the DOE approved scope of work for the term 2005-2009 (10 Sections). Each specific project is defined by (a) its goals, (b) its deliverable, and (c) its future direction. A web site has been established that contains all of these detailed engineering reports produced with their efforts. The goals of the project are to (1) identify critical enabling technologies for a prototype low-impact drilling system, (2) test the prototype systems in field laboratories, and (3) demonstrate the advanced technology to show how these practices would benefit the environment.« less

Storytelling as part of cancer rehabilitation to support cancer patients and their relatives.

PubMed

la Cour, Karen; Ledderer, Loni; Hansen, Helle Ploug

2016-01-01

Previous research on psychosocial support for cancer-related concerns has primarily focused on either patients or their relatives, although limited research is available on how patients and their relatives can be supported together. The aim of this article is to explore the use of storytelling as a part of a residential cancer rehabilitation intervention for patients together with their relatives, with a specific focus on their management of cancer-related concerns. Ten pairs participated in the intervention and data were generated through ethnographic fieldwork, including participant observations, informal conversations and follow-up interviews conducted one month after completing the intervention. Analysis was performed drawing on narrative theory combined with social practice theory. The results demonstrate that the use of storytelling and metaphors intertwined with other course activities, such as dancing and arts & crafts, provided the patients and their relatives with strategies to manage cancer-related concerns, which they were later able to apply in their everyday lives. The study results may be useful to other professionals in clinical practice for rehabilitation purposes for addressing issues of fear and worry.

Reproducibility and replicability of rodent phenotyping in preclinical studies.

PubMed

Kafkafi, Neri; Agassi, Joseph; Chesler, Elissa J; Crabbe, John C; Crusio, Wim E; Eilam, David; Gerlai, Robert; Golani, Ilan; Gomez-Marin, Alex; Heller, Ruth; Iraqi, Fuad; Jaljuli, Iman; Karp, Natasha A; Morgan, Hugh; Nicholson, George; Pfaff, Donald W; Richter, S Helene; Stark, Philip B; Stiedl, Oliver; Stodden, Victoria; Tarantino, Lisa M; Tucci, Valter; Valdar, William; Williams, Robert W; Würbel, Hanno; Benjamini, Yoav

2018-04-01

The scientific community is increasingly concerned with the proportion of published "discoveries" that are not replicated in subsequent studies. The field of rodent behavioral phenotyping was one of the first to raise this concern, and to relate it to other methodological issues: the complex interaction between genotype and environment; the definitions of behavioral constructs; and the use of laboratory mice and rats as model species for investigating human health and disease mechanisms. In January 2015, researchers from various disciplines gathered at Tel Aviv University to discuss these issues. The general consensus was that the issue is prevalent and of concern, and should be addressed at the statistical, methodological and policy levels, but is not so severe as to call into question the validity and the usefulness of model organisms as a whole. Well-organized community efforts, coupled with improved data and metadata sharing, have a key role in identifying specific problems and promoting effective solutions. Replicability is closely related to validity, may affect generalizability and translation of findings, and has important ethical implications. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Expanding Access to Malaria Diagnosis through Retail Shops in Western Kenya: What Do Shop Workers Think?

PubMed Central

Koech, Beatrice; Obala, Andrew; O'Meara, Wendy Prudhomme

2013-01-01

Background. The common symptoms of malaria reduce the specificity of clinical diagnosis. Presumptive treatment is conventional but can lead to overdiagnosis of malaria, delay of appropriate treatment, overprescription of antimalarials, and drug resistance. Routine use of diagnostic tests can address many of these concerns. Though treatment is often procured from retailers, there is low availability of rapid diagnostic tests for malaria (MRDTs), a simple, inexpensive, and accurate diagnostic solution. We know little about the challenges to expanding access to diagnostics through these outlets. Methods. To understand the perceptions of the benefits and challenges to selling rapid diagnostic tests for malaria, we conducted focus group discussions with antimalarial retailers who serve the residents of the Webuye Health and Demographic Surveillance Site in western Kenya. Results. Medicine retailers perceived MRDTs to be beneficial to their customers and businesses but also included cost, fear of the tests, risks of self-treatment, and regulatory concerns among the challenges to using and selling MRDTs. Conclusion. MRDTs represent a viable approach to increase access to malaria diagnostic testing. Medicine retailers are eager for MRDTs to be made available to them. However, certain challenges remain to implementation in retail outlets and should be addressed in advance. PMID:23766923

Priapism: new concepts in medical and surgical management.

PubMed

Burnett, Arthur L; Bivalacqua, Trinity J

2011-05-01

Advances have recently been made in both medical and surgical management of priapism, and these offer improvements in the level of care afforded such patients. Further developments can be expected based on ongoing progress, particularly in the area of molecular science, which is the primary source for driving novel therapeutic approaches. Continued action to address the health care administrative concerns of those most commonly affected by priapism, specifically individuals with sickle cell disease, is also appropriate. All successes in these arenas ensure that afflicted individuals avoid the health burdens of priapism and preserve sexual function. 2011 Elsevier Inc. All rights reserved.

Successful commercialization of nanophotonic technology

NASA Astrophysics Data System (ADS)

Jaiswal, Supriya L.; Clarke, Roger B. M.; Hyde, Sam C. W.

2006-08-01

The exploitation of nanotechnology from proof of principle to realizable commercial applications encounters considerable challenges in regards to high volume, large scale, low cost manufacturability and social ethics. This has led to concerns over converting powerful intellectual property into realizable, industry attractive technologies. At The Technology Partnership we specifically address the issue of successful integration of nanophotonics into industry in markets such as biomedical, ophthalmic, energy, telecommunications, and packaging. In this paper we draw on a few examples where we have either developed industrial scale nanophotonic technology or engineering platforms which may be used to fortify nano/microphotonic technologies and enhance their commercial viability.

A systematic mapping study of process mining

NASA Astrophysics Data System (ADS)

Maita, Ana Rocío Cárdenas; Martins, Lucas Corrêa; López Paz, Carlos Ramón; Rafferty, Laura; Hung, Patrick C. K.; Peres, Sarajane Marques; Fantinato, Marcelo

2018-05-01

This study systematically assesses the process mining scenario from 2005 to 2014. The analysis of 705 papers evidenced 'discovery' (71%) as the main type of process mining addressed and 'categorical prediction' (25%) as the main mining task solved. The most applied traditional technique is the 'graph structure-based' ones (38%). Specifically concerning computational intelligence and machine learning techniques, we concluded that little relevance has been given to them. The most applied are 'evolutionary computation' (9%) and 'decision tree' (6%), respectively. Process mining challenges, such as balancing among robustness, simplicity, accuracy and generalization, could benefit from a larger use of such techniques.

Constellation's Command, Control, Communications and Information (C3I) Architecture

NASA Technical Reports Server (NTRS)

Breidenthal, Julian C.

2007-01-01

Operations concepts are highly effective for: 1) Developing consensus; 2) Discovering stakeholder needs, goals, objectives; 3) Defining behavior of system components (especially emergent behaviors). An interoperability standard can provide an excellent lever to define the capabilities needed for system evolution. Two categories of architectures are needed in a program of this size are: 1) Generic - Needed for planning, design and construction standards; 2) Specific - Needed for detailed requirement allocations, interface specs. A wide variety of architectural views are needed to address stakeholder concerns, including: 1) Physical; 2) Information (structure, flow, evolution); 3) Processes (design, manufacturing, operations); 4) Performance; 5) Risk.

Restoration of Function With Acupuncture Following Severe Traumatic Brain Injury: A Case Report.

PubMed

Wolf, Jacob; Sparks, Linda; Deng, Yong; Langland, Jeffrey

2015-11-01

This case report illustrates the improvement of an acupuncture-treated patient who incurred a severe traumatic brain injury (TBI) from a snowboarding accident. Over 4 years, the patient progressed from initially not being able to walk, having difficulty with speech, and suffering from poor eyesight to where he has now regained significant motor function, speech, and vision and has returned to snowboarding. A core acupuncture protocol plus specific points added to address the patient's ongoing concerns was used. This case adds to the medical literature by demonstrating the potential role of acupuncture in TBI treatment.

Reply to the comment by J.C. Carracedo et al. on 'Geoarchaeological and chronometrical evidence…'

NASA Astrophysics Data System (ADS)

Zöller, Ludwig; von Suchodoletz, Hans; Blanchard, Henrik; Faust, Dominik; Hambach, Ulrich

2004-10-01

We would like to thank Carracedo et al. for their response to our earlier article, and shall do our best to respond to both their queries and the various other communications we have received. We would like to commence by stating that we maintain our earlier stance concerning various as-yet unexplored inconsistencies in current interpretations of Lanzarote's Quaternary geological profile and occupational history. This paper is structured to address Carracedo et al.'s specific comments; however, we would firstly like to clarify some issues that appear to have been misunderstood by the authors.

Primary data collection in health technology assessment.

PubMed

McIsaac, Michelle L; Goeree, Ron; Brophy, James M

2007-01-01

This study discusses the value of primary data collection as part of health technology assessment (HTA). Primary data collection can help reduce uncertainty in HTA and better inform evidence-based decision making. However, methodological issues such as choosing appropriate study design and practical concerns such as the value of collecting additional information need to be addressed. The authors emphasize the conditions required for successful primary data collection in HTA: experienced researchers, sufficient funding, and coordination among stakeholders, government, and researchers. The authors conclude that, under specific conditions, primary data collection is a worthwhile endeavor in the HTA process.

Safety Evaluation Report on Tennessee Valley Authority: Browns Ferry Nuclear Performance Plan: Browns Ferry Unit 2 restart

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

Not Available

1989-04-01

This safety evaluation report (SER) on the information submitted by the Tennessee Valley Authority (TVA) in its Nuclear Performance Plan, through Revision 2, for the Browns Ferry Nuclear Power Station and in supporting documents has been prepared by the US Nuclear Regulatory Commission staff. The plan addresses the plant-specific concerns requiring resolution before startup of Unit 2. The staff will inspect implementation of those programs. Where systems are common to Units 1 and 2 or to Units 2 and 3, the staff safety evaluations of those systems are included herein. 3 refs.

Pharmacologic Therapy in Men's Health: Hypogonadism, Erectile Dysfunction, and Benign Prostatic Hyperplasia.

PubMed

Berkseth, Kathryn E; Thirumalai, Arthi; Amory, John K

2016-07-01

This article reviews current pharmacologic treatment options for 3 common men's health concerns: hypogonadism, erectile dysfunction (ED), and benign prostatic hyperplasia (BPH). Specific topics addressed include: management of male hypogonadism using testosterone replacement therapy, use of oral phosphodiesterase inhibitors as first-line therapy for men with ED and the utility of intraurethral and intrapenile alprostadil injections for patients who do not respond to oral medications, and the role of alpha1-adrenergic antagonists, 5-alpha-reductase inhibitors, anticholinergic agents, and herbal therapies in the management of BPH. Copyright © 2016 Elsevier Inc. All rights reserved.

On thermomechanical testing in support of constitutive equation development for high temperature alloys

NASA Technical Reports Server (NTRS)

Robinson, D. N.

1985-01-01

Three major categories of testing are identified that are necessary to provide support for the development of constitutive equations for high temperature alloys. These are exploratory, charactrization and verification tests. Each category is addressed and specific examples of each are given. An extensive, but not exhaustive, set of references is provided concerning pertinent experimental results and their relationships to theoretical development. This guide to formulating a meaningful testing effort in support of consitutive equation development can also aid in defining the necessary testing equipment and instrumentation for the establishment of a deformation and structures testing laboratory.

Principles of management of thoracolumbar fractures.

PubMed

Dai, Li-yang

2012-05-01

There is little consensus on treatment of thoracolumbar fractures, which are one of the most controversial areas in spine surgery. The great variations in clinical decision making may come from differences in evaluation of spine stability with these fractures. Few high-quality studies concerning optimal treatment of thoracolumbar fractures have been conducted. This article reviews the conflicting results and recommendations for management of thoracolumbar fractures of currently published reports. Specifically, it addresses issues regarding evaluation of stability, indications for operative treatment, timing of surgery, surgical approach, and fusion length. © 2012 Tianjin Hospital and Blackwell Publishing Asia Pty Ltd.

Formal Validation of Aerospace Software

NASA Astrophysics Data System (ADS)

Lesens, David; Moy, Yannick; Kanig, Johannes

2013-08-01

Any single error in critical software can have catastrophic consequences. Even though failures are usually not advertised, some software bugs have become famous, such as the error in the MIM-104 Patriot. For space systems, experience shows that software errors are a serious concern: more than half of all satellite failures from 2000 to 2003 involved software. To address this concern, this paper addresses the use of formal verification of software developed in Ada.

16S rRNA beacons for bacterial monitoring during human space missions.

PubMed

Larios-Sanz, Maia; Kourentzi, Katerina D; Warmflash, David; Jones, Jeffrey; Pierson, Duane L; Willson, Richard C; Fox, George E

2007-04-01

Microorganisms are unavoidable in space environments and their presence has, at times, been a source of problems. Concerns about disease during human space missions are particularly important considering the significant changes the immune system incurs during spaceflight and the history of microbial contamination aboard the Mir space station. Additionally, these contaminants may have adverse effects on instrumentation and life-support systems. A sensitive, highly specific system to detect, characterize, and monitor these microbial populations is essential. Herein we describe a monitoring approach that uses 16S rRNA targeted molecular beacons to successfully detect several specific bacterial groupings. This methodology will greatly simplify in-flight monitoring by minimizing sample handling and processing. We also address and provide solutions to target accessibility problems encountered in hybridizations that target 16S rRNA.

Construction of optimal 3-node plate bending triangles by templates

NASA Astrophysics Data System (ADS)

Felippa, C. A.; Militello, C.

A finite element template is a parametrized algebraic form that reduces to specific finite elements by setting numerical values to the free parameters. The present study concerns Kirchhoff Plate-Bending Triangles (KPT) with 3 nodes and 9 degrees of freedom. A 37-parameter template is constructed using the Assumed Natural Deviatoric Strain (ANDES). Specialization of this template includes well known elements such as DKT and HCT. The question addressed here is: can these parameters be selected to produce high performance elements? The study is carried out by staged application of constraints on the free parameters. The first stage produces element families satisfying invariance and aspect ratio insensitivity conditions. Application of energy balance constraints produces specific elements. The performance of such elements in benchmark tests is presently under study.

Career and Retirement Theories: Relevance for Older Workers Across Cultures

PubMed Central

Lytle, Megan C.; Foley, Pamela F.; Cotter, Elizabeth W.

2015-01-01

This paper reviews selected career development theories as well as theories specifically focused on retirement, with an emphasis on their application to retirement decisions and vocational behavior in multicultural populations. Theories are evaluated based on whether: (a) retirement was considered a stage of working life, (b) work satisfaction, motivation, and other work variables at retirement age were addressed, (c) work choices at retirement age were included, and (d) cultural and other minority status issues were either directly considered in the work/retirement decision or if the model could be reasonably applied to retirement across cultures. We provide specific recommendations for research and practice with the aim of helping practitioners and scholars conceptualize the current concerns older adults face in their working lives and during retirement planning. PMID:26101455

Epigenomic Adaptation to Low Dose Radiation

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

Gould, Michael N.

2015-06-30

The overall hypothesis of this grant application is that the adaptive responses elicited by low dose ionizing radiation (LDIR) result in part from heritable DNA methylation changes in the epigenome. In the final budget period at the University of Wisconsin-Madison, we will specifically address this hypothesis by determining if the epigenetically labile, differentially methylated regions (DMRs) that regulate parental-specific expression of imprinted genes are deregulated in agouti mice by low dose radiation exposure during gestation. This information is particularly important to ascertain given the 1) increased human exposure to medical sources of radiation; 2) increased number of people predicted tomore » live and work in space; and 3) enhanced citizen concern about radiation exposure from nuclear power plant accidents and terrorist ‘dirty bombs.’« less

Career and Retirement Theories: Relevance for Older Workers Across Cultures.

PubMed

Lytle, Megan C; Foley, Pamela F; Cotter, Elizabeth W

2015-06-01

This paper reviews selected career development theories as well as theories specifically focused on retirement, with an emphasis on their application to retirement decisions and vocational behavior in multicultural populations. Theories are evaluated based on whether: (a) retirement was considered a stage of working life, (b) work satisfaction, motivation, and other work variables at retirement age were addressed, (c) work choices at retirement age were included, and (d) cultural and other minority status issues were either directly considered in the work/retirement decision or if the model could be reasonably applied to retirement across cultures. We provide specific recommendations for research and practice with the aim of helping practitioners and scholars conceptualize the current concerns older adults face in their working lives and during retirement planning.

Deriving a Set of Privacy Specific Heuristics for the Assessment of PHRs (Personal Health Records).

PubMed

Furano, Riccardo F; Kushniruk, Andre; Barnett, Jeff

2017-01-01

With the emergence of personal health record (PHR) platforms becoming more widely available, this research focused on the development of privacy heuristics to assess PHRs regarding privacy. Existing sets of heuristics are typically not application specific and do not address patient-centric privacy as a main concern prior to undergoing PHR procurement. A set of privacy specific heuristics were developed based on a scoping review of the literature. An internet-based commercially available, vendor specific PHR application was evaluated using the derived set of privacy specific heuristics. The proposed set of privacy specific derived heuristics is explored in detail in relation to ISO 29100. The assessment of the internet-based commercially available, vendor specific PHR application indicated numerous violations. These violations were noted within the study. It is argued that the new derived privacy heuristics should be used in addition to Nielsen's well-established set of heuristics. Privacy specific heuristics could be used to assess PHR portal system-level privacy mechanisms in the procurement process of a PHR application and may prove to be a beneficial form of assessment to prevent the selection of a PHR platform with a poor privacy specific interface design.

Toward a domain-specific approach to the study of parental psychological control: distinguishing between dependency-oriented and achievement-oriented psychological control.

PubMed

Soenens, Bart; Vansteenkiste, Maarten; Luyten, Patrick

2010-02-01

Theory and research suggest that psychologically controlling parenting can be driven by parental concerns in two different domains, that is, interpersonal closeness and achievement. Three studies addressing this hypothesis are presented. Study 1 provides evidence for the validity of the Dependency-Oriented and Achievement-Oriented Psychological Control Scale (DAPCS), a new measure assessing psychological control in these two domains. Study 2 showed that dependency-oriented and achievement-oriented psychological control were related in expected ways to parental separation anxiety and perfectionism in a sample of mothers and fathers. Finally, Study 3 showed that dependency-oriented and achievement-oriented psychological control were differentially related to middle adolescent dependency and self-criticism and that these personality features act as specific intervening variables between the domain-specific expressions of psychological control and depressive symptoms. It is argued that the distinction between two domain-specific expressions of psychological control may allow for a more intricate analysis of the processes involved in intrusive parenting.

Information Science Panel joint meeting with Imaging Science Panel

NASA Technical Reports Server (NTRS)

1982-01-01

Specific activity in information extraction science (taken to include data handling) is needed to: help identify the bounds of practical missions; identify potential data handling and analysis scenarios; identify the required enabling technology; and identify the requirements for a design data base to be used by the disciplines in determining potential parameters for future missions. It was defined that specific analysis topics were a function of the discipline involved, and therefore no attempt was made to define any specific analysis developments required. Rather, it was recognized that a number of generic data handling requirements exist whose solutions cannot be typically supported by the disciplines. The areas of concern were therefore defined as: data handling aspects of system design considerations; enabling technology for data handling, with specific attention to rectification and registration; and enabling technology for analysis. Within each of these areas, the following topics were addressed: state of the art (current status and contributing factors); critical issues; and recommendations for research and/or development.

Identification of 2-phenylethanol with a rose-like odor from anal sac secretions of the small Indian mongoose (Herpestes auropunctatus).

PubMed

Miyazaki, Tamako; Nakata, Katsushi; Nishimura, Takashi; Abe, Shintaro; Yamashita, Tetsuro; Miyazaki, Masao

2018-02-01

The small Indian mongoose (Herpestes auropunctatus) is an invasive species in Okinawa and Amami-Oshima, Japan. Major strategies for their eradication have been the use of baited traps, which suffer from decreasing efficiency with declining populations and the bycatch of native animals. To address these concerns, mongoose-specific lures are required. In this study, we aimed to identify species- and/or sex-specific compounds from anal sac secretions of small Indian mongooses. Volatile compounds emitted from male and female mongoose anal sac secretions were analyzed by thermal desorption-gas chromatography-mass spectrometry. In addition to several fatty acids, 2-phenylethanol was identified as a minor compound, which is uncommon in mammalian secretions but a dominant odorant in roses. Female samples emitted higher levels of 2-phenylethanol than male samples did. These findings indicate that 2-phenylethanol is a female-specific volatile compound of anal sac secretions in small Indian mongooses, and it may be useful as an ingredient of mongoose-specific scent lures.

Marine record of late quaternary glacial-interglacial fluctuations in the Ross Sea and evidence for rapid, episodic sea level change due to marine ice sheet collapse

NASA Technical Reports Server (NTRS)

Anderson, John B.

1991-01-01

Some of the questions to be addressed by SeaRISE include: (1) what was the configuration of the West Antarctic ice sheet during the last glacial maximum; (2) What is its configuration during a glacial minimum; and (3) has it, or any marine ice sheet, undergone episodic rapid mass wasting. These questions are addressed in terms of what is known about the history of the marine ice sheet, specifically in Ross Sea, and what further studies are required to resolve these problems. A second question concerns the extent to which disintegration of marine ice sheets may result in rises in sea level that are episodic in nature and extremely rapid, as suggested by several glaciologists. Evidence that rapid, episodic sea level changes have occurred during the Holocene is also reviewed.

What's the bottom line payback for TQM?

NASA Technical Reports Server (NTRS)

Usilaner, Brian

1992-01-01

The purpose of this article is to explore in detail TQM's impact on improving organization performance and how effective TQM strategies are designed and implemented. Both of these issues are addressed primarily by a discussion of a recent study of TQM efforts conducted by the U.S. General Accounting Office (GAO). The GAO study examines the impact of formal TQM improvement strategies on the performance of selected U.S. companies. The study grew out of a concern by a number of U.S. Congressmen that little is known about the impact of various quality-related efforts many companies have adopted to remain viable and profitable in an increasingly competitive world marketplace. Specifically, the study addresses: what has been the performance impact of adopting TQM improvement strategies, how has improved quality been achieved, and what lessons may be applicable to U.S. companies in general. A number of other studies are also used to expand upon the GAO data.

Retracted: Design Education in the Global Era

NASA Astrophysics Data System (ADS)

de Lobo, Theresa

The aim of this paper is to show the collaboration of design disciplines to instill a broader sense of design for students through intercultural service learning projects. While there are programs that are reinventing their curriculum, there are still several that follow the classic structure of a first year art foundation program with the final years concentrating on the desired discipline. The interactions at a global scale, has heightened the need for graduates to learn to interact more effectively with people from different cultures. This approach combines the concern of addressing a need for design in a real world situation, with learning how to understand culture, place, and experience through a collaborative project. Referencing a specific international service learning project, and drawing from literature on internationalization of education, this paper explores key concepts, learning objectives, methods, and challenges faced in addressing the need to prepare students for practice in an increasingly integrated workplace.

NIOSH comments to DOL on the occupational safety and health advance notice of proposed rulemaking: Occupational exposure to methylene chloride by R. A. Lemen, February 25, 1987

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

Not Available

1987-02-25

The testimony addressed the concerns of NIOSH regarding the advance notice of proposed rulemaking (ANPR) dealing with occupational exposure to methylene-chloride (75092) (MC). Specifically the testimony addressed the studies that OSHA should consider in its assessment of the potential health risks, especially the carcinogenic, chronic neurological, encephalopathic, teratogenic, and mutagenic effects of MC; the dermal absorption studies available and the extent of the potential adverse health effects resulting from dermal exposure; studies or evidence indicating the combined effects of inhalation and dermal exposures; how OSHA should estimate the significance of risk at the current exposure limits; what the permissible exposuremore » levels should be; production and control systems; substitution availability; protective equipment and clothing; worker exposure and monitoring; worker training; and medical surveillance.« less

Using CREAM and CEMonitor for job submission and management in the gLite middleware

NASA Astrophysics Data System (ADS)

Aiftimiei, C.; Andreetto, P.; Bertocco, S.; Dalla Fina, S.; Dorigo, A.; Frizziero, E.; Gianelle, A.; Marzolla, M.; Mazzucato, M.; Mendez Lorenzo, P.; Miccio, V.; Sgaravatto, M.; Traldi, S.; Zangrando, L.

2010-04-01

In this paper we describe the use of CREAM and CEMonitor services for job submission and management within the gLite Grid middleware. Both CREAM and CEMonitor address one of the most fundamental operations of a Grid middleware, that is job submission and management. Specifically, CREAM is a job management service used for submitting, managing and monitoring computational jobs. CEMonitor is an event notification framework, which can be coupled with CREAM to provide the users with asynchronous job status change notifications. Both components have been integrated in the gLite Workload Management System by means of ICE (Interface to CREAM Environment). These software components have been released for production in the EGEE Grid infrastructure and, for what concerns the CEMonitor service, also in the OSG Grid. In this paper we report the current status of these services, the achieved results, and the issues that still have to be addressed.

Teaching undergraduate nursing students about environmental health: addressing public health issues through simulation.

PubMed

Stanley, Mary Jo; Rojas, Deb

2014-01-01

Schools of nursing are challenged to find clinical placements in public health settings. Use of simulation can address situations unique to public health, with attention to specific concerns, such as environmental health. Environmental health is an integral part of public health nursing and is a standard of professional practice. Current simulations focus on acute care situations, offering limited scenarios with a public health perspective and excluding environmental health. This study's simulation scenario was created to enhance nursing students' understanding of public health concepts within an environmental health context. Outcomes from the simulation include the need for integration of environmental issues in public health teaching. Students stated that this scenario provided a broader understanding of the environmental influences that can affect the client's and family's health. This scenario fills a void in simulation content, while providing an interactive teaching and learning strategy to help students to apply knowledge to practice. Copyright 2014, SLACK Incorporated.

ASIME 2016 White Paper: Answers to Questions from the Asteroid Miners

NASA Astrophysics Data System (ADS)

Galache, Jl; Graps, A. L.; Asime 2016 Contributors, 30

2017-09-01

The aim of the Asteroid Science Intersections with In-Space Mine Engineering (ASIME) 2016 conference on September 21-22, 2016 in Luxembourg City was to provide an environment for the detailed discussion of the specific properties of asteroids, with the engineering needs of space missions that utilise asteroids. The ASIME 2016 Conference produced a layered record of discussions from the asteroid scientists and the asteroid miners to understand each other's key concerns and to address key scientific questions from the asteroid mining companies: Planetary Resources, Deep Space Industries and TransAstra. These Questions were the focus of the two-day conference, were addressed by scientists inside and outside of the ASIME 2016 Conference and were the focus of this White Paper. The answers in this White Paper point to the Science Knowledge Gaps (SKGs) for advancing the asteroid in-space resource utilisation domain.

Personality disorders in DSM-5: emerging research on the alternative model.

PubMed

Morey, Leslie C; Benson, Kathryn T; Busch, Alexander J; Skodol, Andrew E

2015-04-01

The current categorical classification of personality disorders, originally introduced in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), has been found to suffer from numerous shortcomings that hamper its usefulness for research and for clinical application. The Personality and Personality Disorders Work Group for DSM-5 was charged with developing an alternative model that would address many of these concerns. The developed model involved a hybrid dimensional/categorical model that represented personality disorders as combinations of core impairments in personality functioning with specific configurations of problematic personality traits. The Board of Trustees of the American Psychiatric Association did not accept the Task Force recommendation to implement this novel approach, and thus this alternative model was included in Sect. III of the DSM-5 among concepts requiring additional study. This review provides an overview of the emerging research on this alternative model, addressing each of the primary components of the model.

What's the bottom line payback for TQM?

NASA Astrophysics Data System (ADS)

Usilaner, Brian

The purpose of this article is to explore in detail TQM's impact on improving organization performance and how effective TQM strategies are designed and implemented. Both of these issues are addressed primarily by a discussion of a recent study of TQM efforts conducted by the U.S. General Accounting Office (GAO). The GAO study examines the impact of formal TQM improvement strategies on the performance of selected U.S. companies. The study grew out of a concern by a number of U.S. Congressmen that little is known about the impact of various quality-related efforts many companies have adopted to remain viable and profitable in an increasingly competitive world marketplace. Specifically, the study addresses: what has been the performance impact of adopting TQM improvement strategies, how has improved quality been achieved, and what lessons may be applicable to U.S. companies in general. A number of other studies are also used to expand upon the GAO data.

Examining Data Repository Guidelines for Qualitative Data Sharing.

PubMed

Antes, Alison L; Walsh, Heidi A; Strait, Michelle; Hudson-Vitale, Cynthia R; DuBois, James M

2018-02-01

Qualitative data provide rich information on research questions in diverse fields. Recent calls for increased transparency and openness in research emphasize data sharing. However, qualitative data sharing has yet to become the norm internationally and is particularly uncommon in the United States. Guidance for archiving and secondary use of qualitative data is required for progress in this regard. In this study, we review the benefits and concerns associated with qualitative data sharing and then describe the results of a content analysis of guidelines from international repositories that archive qualitative data. A minority of repositories provide qualitative data sharing guidelines. Of the guidelines available, there is substantial variation in whether specific topics are addressed. Some topics, such as removing direct identifiers, are consistently addressed, while others, such as providing an anonymization log, are not. We discuss the implications of our study for education, best practices, and future research.

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

PubMed

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

2017-11-01

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

Do prominent quality measurement surveys capture the concerns of persons with disability?

PubMed

Iezzoni, Lisa I; Marsella, Sarah A; Lopinsky, Tiffany; Heaphy, Dennis; Warsett, Kimberley S

2017-04-01

Demonstration programs nationwide aim to control costs and improve care for people dually-eligible for Medicare and Medicaid, including many persons with disability. Ensuring these initiatives maintain or improve care quality requires comprehensive evaluation of quality of care. To examine whether the common quality measures being used to evaluate the Massachusetts One Care duals demonstration program comprehensively address the concerns of persons with disability. Drawing upon existing conceptual frameworks, we developed a model of interrelationships of personal, health care, and environmental factors for achieving wellness for persons with disability. Based on this model, we specified a scheme to code individual quality measurement items and coded the items contained in 12 measures being used to assess Massachusetts One Care, which exclusively enrolls non-elderly adults with disability. Across these 12 measures, we assigned 376 codes to 302 items; some items received two codes. Taken together, the 12 measures contain items addressing most factors in our conceptual model that affect health care quality for persons with disability, including long-term services and supports. Some important gaps exist. No items examine sexual or reproductive health care, peer support, housing security, disability stigmatization, and specific services obtained outside the home like adult day care. Certain key concepts are covered only by a single or several of the 12 quality measures. Common quality metrics cover most - although not all-health care quality concerns of persons with disability. However, multiple different quality measures are required for this comprehensive coverage, raising questions about respondent burden. Copyright © 2017 Elsevier Inc. All rights reserved.

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

NASA Technical Reports Server (NTRS)

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

2001-01-01

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

Reducing stigma in healthcare and law enforcement: a novel approach to service provision for street level sex workers.

PubMed

Bodkin, Kate; Delahunty-Pike, Alannah; O'Shea, Tim

2015-04-09

Providing services for street level sex workers requires a multidisciplinary approach, addressing both health and safety concerns typical of their age and gender and those that arise specific to their line of work. Despite being a diverse population, studies have identified some specific health needs for sex workers including addictions treatment, mental health. Additionally, studies have shown a higher risk of physical and sexual assault for this population. The Persons at Risk program (PAR) in London, Ontario, Canada was started in 2005 to address the specific needs of street level sex workers by using a harm-reduction model for policing and healthcare provision. This qualitative study evaluated this model of care in terms of improving access to healthcare and essential police services for street level sex workers. A total of 14 semi-structured interviews were conducted with current and former female street level sex workers enrolled in the PAR program. In addition, 3 semi-structured interviews were conducted with health and law enforcement professionals. The research team then analyzed and coded the transcripts using qualitative description to identify key themes in the data. Results indicated that participants represent a vulnerable population with increased safety concerns and healthcare needs relating to addictions, mental health and infectious disease. Despite this, participants reported avoiding healthcare workers and police officers in the past because of fear of stigma or repercussions. All participants identified the harm reduction approach of the PAR program as being essential to their continued engagement with the program. Other important aspects included flexible hours, the location of the clinic, streamlined access to mental health and addictions treatment and the female gender of the police and healthcare worker. The PAR program provides sex workers access to much needed primary healthcare that is flexible and without judgment. In addition, they are provided with a direct avenue to access law enforcement. We feel a similar model of care could be applicable to many cities across Canada.

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

ERIC Educational Resources Information Center

Winer, Laura; DiGenova, Lina; Costopoulos, Andre

2016-01-01

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

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

ERIC Educational Resources Information Center

Hao, Yungwei; Lee, Kathryn S.

2017-01-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-18

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

What fosters concern for inequality among American adolescents?

PubMed

Cech, Erin A

2017-01-01

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

Distributed health data networks: a practical and preferred approach to multi-institutional evaluations of comparative effectiveness, safety, and quality of care.

PubMed

Brown, Jeffrey S; Holmes, John H; Shah, Kiran; Hall, Ken; Lazarus, Ross; Platt, Richard

2010-06-01

Comparative effectiveness research, medical product safety evaluation, and quality measurement will require the ability to use electronic health data held by multiple organizations. There is no consensus about whether to create regional or national combined (eg, "all payer") databases for these purposes, or distributed data networks that leave most Protected Health Information and proprietary data in the possession of the original data holders. Demonstrate functions of a distributed research network that supports research needs and also address data holders concerns about participation. Key design functions included strong local control of data uses and a centralized web-based querying interface. We implemented a pilot distributed research network and evaluated the design considerations, utility for research, and the acceptability to data holders of methods for menu-driven querying. We developed and tested a central, web-based interface with supporting network software. Specific functions assessed include query formation and distribution, query execution and review, and aggregation of results. This pilot successfully evaluated temporal trends in medication use and diagnoses at 5 separate sites, demonstrating some of the possibilities of using a distributed research network. The pilot demonstrated the potential utility of the design, which addressed the major concerns of both users and data holders. No serious obstacles were identified that would prevent development of a fully functional, scalable network. Distributed networks are capable of addressing nearly all anticipated uses of routinely collected electronic healthcare data. Distributed networks would obviate the need for centralized databases, thus avoiding numerous obstacles.

Maternal intuitive eating as a moderator of the association between concern about child weight and restrictive child feeding.

PubMed

Tylka, Tracy L; Lumeng, Julie C; Eneli, Ihuoma U

2015-12-01

Mothers who are concerned about their young child's weight are more likely to use restrictive feeding, which has been associated with increased food seeking behaviors, emotional eating, and overeating in young children across multiple prospective and experimental studies. In the present study, we examined whether mothers' intuitive eating behaviors would moderate the association between their concern about their child's weight and their use of restrictive feeding. In a sample of 180 mothers of young children, two maternal intuitive eating behaviors (i.e., eating for physical reasons, trust in hunger and satiety cues) moderated this association after controlling for maternal age, body mass index, years of education, race/ethnicity, awareness of hunger and satiety cues and perceptions of child weight. More specifically, concern about child weight was unrelated to restrictive feeding for mothers with higher levels of eating for physical reasons and trust in hunger and satiety cues. However, concern about child weight was positively related to restrictive feeding among mothers with lower or average levels of eating for physical reasons and trust in hunger and satiety cues. These findings indicate that it may be important address maternal intuitive eating within interventions designed to improve self-regulated eating in children, as mothers who attend these interventions tend to be highly concerned about their child's weight and, if also low in intuitive eating, may be at risk for using restrictive feeding behaviors that interfere with children's self-regulated eating. Copyright © 2015 Elsevier Ltd. All rights reserved.

Maternal Intuitive Eating as a Moderator of the Association between Concern about Child Weight and Restrictive Child Feeding

PubMed Central

Tylka, Tracy L.; Lumeng, Julie C.; Eneli, Ihuoma U.

2015-01-01

Mothers who are concerned about their young child's weight are more likely to use restrictive feeding, which has been associated with increased food seeking behaviors, emotional eating, and overeating in young children across multiple prospective studies. In the present study, we examined whether mothers' intuitive eating behaviors would moderate the association between their concern about their child's weight and their use of restrictive feeding. In a sample of 180 mothers of young children, two maternal intuitive eating behaviors (i.e., eating for physical reasons, trust in hunger and satiety cues) moderated this association after controlling for maternal age, body mass index, years of education, race/ethnicity, awareness of hunger and satiety cues and perceptions of child weight. More specifically, concern about child weight was unrelated to restrictive feeding for mothers with higher levels of eating for physical reasons and trust in hunger and satiety cues. However, concern about child weight was positively related to restrictive feeding among mothers with lower or average levels of eating for physical reasons and trust in hunger and satiety cues. These findings indicate that it may be important address maternal intuitive eating within interventions designed to improve self-regulated eating in children, as mothers who attend these interventions tend to be highly concerned about their child's weight and, if also low in intuitive eating, may be at risk for using restrictive feeding behaviors that interfere with children's self-regulated eating. PMID:26145275

Multichannel/Multisensor Signal Processing In Uncertain Environments With Application To Multitarget Tracking.

DTIC Science & Technology

1998-05-22

NUMBER PR-98-1 T. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) Office of Naval Research Ballston Center Tower One One North Quincy...unlimited. 12 b. DISTRIBUTION CODE 19980601 082 13. ABSTRACT (Maximum 200 words) This research project is concerned with two distinct aspects of analysis...Environments With Application To Multitarget Tracking This research project is concerned with two distinct aspects of analysis and processing of sig

Barriers to treatment adherence among African American and white women with systemic lupus erythematosus.

PubMed

Mosley-Williams, Angelia; Lumley, Mark A; Gillis, Mazy; Leisen, James; Guice, Deena

2002-12-15

To determine whether African Americans with systemic lupus erythematosus (SLE) have poorer treatment adherence than whites, and to determine ethnic group differences in barriers to adherence, and how barriers affect adherence. We compared 68 African American and 54 white women with SLE on 19 potential barriers, on 2 adherence behaviors during the past year, and on how the potential barriers relate to each nonadherence behavior. African Americans and whites were similar on most barriers, although African Americans were more likely to rely on religion and were more concerned about long-term medication effects. The 2 ethnic groups were comparable on medication nonadherence, but whites tended to have poorer clinic appointment adherence than African Americans. Finally, we found that barriers related to negative affect (depression, medication concerns, physical symptoms) as well as short-term memory problems and the need for child or elder care were associated with nonadherence among African Americans, whereas perceived treatment inefficacy and lacking trust in physicians were associated with nonadherence among whites. Relationships between adherence barriers and nonadherence may be ethnicity specific, suggesting that interventions to address barriers should be targeted to specific groups.

UK guidance on the management of personal dosimetry systems for healthcare staff working at multiple organizations.

PubMed

Rogers, Andy; Chapple, Claire-Louise; Murray, Maria; Platton, David; Saunderson, John

2017-11-01

There has been concern expressed by the UK regulator, the Health & Safety Executive, regarding the management of occupation dose for healthcare radiation workers who work across multiple organizations. In response to this concern, the British Institute of Radiology led a working group of relevant professional bodies to develop guidance in this area. The guidance addresses issues of general system management that would apply to all personal dosimetry systems, regardless of whether or not the workers within that system work across organizational boundaries, along with exploring efficient strategies to comply with legislation where those workers do indeed work across organizational boundaries. For those specific instances, the guidance discusses both system requirements to enable organizations to co-operate (Ionising Radiation Regulations 1999 Regulation 15), as well as specific instances of staff exposure. This is broken down into three categories-low, medium and high risk. A suggested approach to each is given to guide employers and their radiation advisers in adopting sensible strategies for the monitoring of their staff and the subsequent sharing of dosimetry data to ensure overall compliance with both dose limits and optimization requirements.

Ethical guidance in the era of managed care: an analysis of the American College of Healthcare Executives' Code of Ethics.

PubMed

Higgins, W

2000-01-01

Market competition and the rise of managed care are transforming the healthcare system from a physician-dominated cottage industry into a manager-dominated corporate enterprise. The managed care revolution is also undermining the safe-guards offered by medical ethics and raising serious public concerns. These trends highlight the growing importance of ethical standards for managers. The most comprehensive ethical guidance for health service managers is contained in the American College of Healthcare Executives' (ACHE) Code of Ethics. An analysis of the ACHE Code suggests that it does not adequately address several ethical concerns associated with managed care. The ACHE may wish to develop a supplemental statement regarding ethical issues in managed care. A supplemental statement that provides more specific guidance in the areas of financial incentives to reduce utilization, social mission, consumer/patient information, and the health service manager's responsibility to patients could be extremely valuable in today's complex and rapidly changing environment. More specific ethical guidelines would not ensure individual or organizational compliance. However, they would provide professional standards that could guide decision making and help managers evaluate performance in managed care settings.

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

ERIC Educational Resources Information Center

Satchabut, Thitikan

2013-01-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-30

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

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

ERIC Educational Resources Information Center

McCorvey, Zamecia J.

2013-01-01

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

Outbound medical tourism from Mongolia: a qualitative examination of proposed domestic health system and policy responses to this trend.

PubMed

Snyder, Jeremy; Byambaa, Tsogtbaatar; Johnston, Rory; Crooks, Valorie A; Janes, Craig; Ewan, Melanie

2015-05-03

Medical tourism is the practice of traveling across international boundaries in order to access medical care. Residents of low-to-middle income countries with strained or inadequate health systems have long traveled to other countries in order to access procedures not available in their home countries and to take advantage of higher quality care elsewhere. In Mongolia, for example, residents are traveling to China, Japan, Thailand, South Korea, and other countries for care. As a result of this practice, there are concerns that travel abroad from Mongolia and other countries risks impoverishing patients and their families. In this paper, we present findings from 15 interviews with Mongolian medical tourism stakeholders about the impacts of, causes of, and responses to outbound medical tourism. These findings were developed using a case study methodology that also relied on tours of health care facilities and informal discussions with citizens and other stakeholders during April, 2012. Based on these findings, health policy changes are needed to address the outflow of Mongolian medical tourists. Key areas for reform include increasing funding for the Mongolian health system and enhancing the efficient use of these funds, improving training opportunities and incentives for health workers, altering the local culture of care to be more supportive of patients, and addressing concerns of corruption and favouritism in the health system. While these findings are specific to the Mongolian health system, other low-to-middle income countries experiencing outbound medical tourism will benefit from consideration of how these findings apply to their own contexts. As medical tourism is increasing in visibility globally, continued research on its impacts and context-specific policy responses are needed.

The REFLECT statement: reporting guidelines for randomized controlled trials in livestock and food safety: explanation and elaboration.

PubMed

Sargeant, J M; O'Connor, A M; Gardner, I A; Dickson, J S; Torrence, M E; Dohoo, I R; Lefebvre, S L; Morley, P S; Ramirez, A; Snedeker, K

2010-03-01

Concerns about the completeness and accuracy of reporting of randomized clinical trials (RCTs) and the impact of poor reporting on decision-making have been documented in the medical field over the past several decades. Experience from RCTs in human medicine would suggest that failure to report critical trial features can be associated with biased estimated effect measures, and there is evidence to suggest similar biases occur in RCTs conducted in livestock populations. In response to these concerns, standardized guidelines for reporting RCTs were developed and implemented in human medicine. The Consolidated Standards of Reporting Trials (CONSORT) statement was first published in 1996 with a revised edition published in 2001. The CONSORT statement consists of a 22-item checklist for reporting a RCT and a flow diagram to follow the number of participants at each stage of a trial. An explanation and elaboration document not only defines and discusses the importance of each of the items, but also provides examples of how this information could be supplied in a publication. Differences between human and livestock populations necessitate modifications to the CONSORT statement to maximize its usefulness for RCTs involving livestock. These have been addressed in an extension of the CONSORT statement titled the REFLECT statement: Methods and processes of creating reporting guidelines for randomized control trials for livestock and food safety. The modifications made for livestock trials specifically addressed the common use of group housing and group allocation to intervention in livestock studies, the use of a deliberate challenge model in some trials, and common use of non-clinical outcomes, such as contamination with a foodborne pathogen. In addition, the REFLECT statement for RCTs in livestock populations proposed specific terms or further clarified terms as they pertained to livestock studies.

The REFLECT statement: reporting guidelines for Randomized Controlled Trials in livestock and food safety: explanation and elaboration.

PubMed

Sargeant, J M; O'Connor, A M; Gardner, I A; Dickson, J S; Torrence, M E

2010-03-01

Concerns about the completeness and accuracy of reporting of randomized clinical trials (RCTs) and the impact of poor reporting on decision making have been documented in the medical field over the past several decades. Experience from RCTs in human medicine would suggest that failure to report critical trial features can be associated with biased estimated effect measures, and there is evidence to suggest that similar biases occur in RCTs conducted in livestock populations. In response to these concerns, standardized guidelines for reporting RCTs were developed and implemented in human medicine. The Consolidated Standards of Reporting Trials (CONSORT) statement was first published in 1996, with a revised edition published in 2001. The CONSORT statement consists of a 22-item checklist for reporting a RCT and a flow diagram to follow the number of participants at each stage of a trial. An explanation and elaboration document not only defines and discusses the importance of each of the items, but also provides examples of how this information could be supplied in a publication. Differences between human and livestock populations necessitate modifications to the CONSORT statement to maximize its usefulness for RCTs involving livestock. These have been addressed in an extension of the CONSORT statement titled the REFLECT statement: Methods and processes of creating reporting guidelines for randomized control trials for livestock and food safety. The modifications made for livestock trials specifically addressed the common use of group housing and group allocation to intervention in livestock studies; the use of deliberate challenge models in some trials and the common use of non-clinical outcomes, such as contamination with a foodborne pathogen. In addition, the REFLECT statement for RCTs in livestock populations proposed specific terms or further clarified terms as they pertained to livestock studies.

NIOSH comments to DOL on MSHA's advance notice of proposed rulemaking (ANPR) metal and nonmetal mine safety and health, radiation standards by J. D. Millar, March 18, 1985

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

Not Available

1985-03-18

The testimony presents the views of NIOSH with regard to specific issues raised by MSHA in a proposed rulemaking affecting metal and nonmetal mine safety and health, radiation standards. Results are included from epidemiological studies in which the relationship between lung cancer and exposure to radon daughters was examined. A quantitative risk assessment is also noted which will be considered in the development of a NIOSH recommended exposure limit for radon daughters. Specific issues addressed include risk assessment, particularly the relationship and the associated uncertainty between cumulative lifetime radon daughters exposure at or below 120 working level months and themore » lifetime risk of lung cancer or other biological response, and themethodology used to arrive at the risk relationship. The use of a nonthreshold model extrapolating from elevated exposure levels is considered along with modification of the risk relationship to account for cell repair or other factors. Questions concerning the latency period, cigarette smoking, exposure to thoron daughters, exposure to gamma radiation, and exposure to ore dusts are also addressed.« less

78 FR 3319 - Amendments to Existing Validated End User Authorizations: Advanced Micro Devices China, Inc., Lam...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-16

...In this rule, the Bureau of Industry and Security (BIS) amends the Export Administration Regulations (EAR) to revise the existing Authorization Validated End-User (VEU) listings for four VEUs in the People's Republic of China (PRC). Specifically, BIS amends Supplement No. 7 to part 748 of the EAR to update VEU Advanced Micro Devices China Inc.'s (AMD China) current list of eligible destinations. BIS also amends the authorization of VEU Lam Research Corporation (Lam) by updating the addresses of ten eligible destinations and reformatting the list of Lam's existing eligible destinations into groups associated with specific eligible items. BIS also updates the EAR to amend the addresses and lists of eligible items for VEUs SK hynix Semiconductor (China) Ltd. and SK hynix Semiconductor (Wuxi) Ltd. Finally, BIS amends Supplement No. 7 to part 748 of the EAR to include language reminding exporters that the language in the Supplement does not supersede other requirements in the EAR. These amendments to the authorizations of the named VEUs are not the result of activities of concern. The respective changes were prompted by factors arising from the companies' normal course of business or are being done at the request of the companies.

Measuring vaccine confidence: analysis of data obtained by a media surveillance system used to analyse public concerns about vaccines.

PubMed

Larson, Heidi J; Smith, David M D; Paterson, Pauline; Cumming, Melissa; Eckersberger, Elisabeth; Freifeld, Clark C; Ghinai, Isaac; Jarrett, Caitlin; Paushter, Louisa; Brownstein, John S; Madoff, Lawrence C

2013-07-01

The intensity, spread, and effects of public opinion about vaccines are growing as new modes of communication speed up information sharing, contributing to vaccine hesitancy, refusals, and disease outbreaks. We aimed to develop a new application of existing surveillance systems to detect and characterise early signs of vaccine issues. We also aimed to develop a typology of concerns and a way to assess the priority of each concern. Following preliminary research by The Vaccine Confidence Project, media reports (eg, online articles, blogs, government reports) were obtained using the HealthMap automated data collection system, adapted to monitor online reports about vaccines, vaccination programmes, and vaccine-preventable diseases. Any reports that did not meet the inclusion criteria--any reference to a human vaccine or vaccination campaign or programme that was accessible online--were removed from analysis. Reports were manually analysed for content and categorised by concerns, vaccine, disease, location, and source of report, and overall positive or negative sentiment towards vaccines. They were then given a priority level depending on the seriousness of the reported event and time of event occurrence. We used descriptive statistics to analyse the data collected during a period of 1 year, after refinements to the search terms and processes had been made. We analysed data from 10,380 reports (from 144 countries) obtained between May 1, 2011, and April 30, 2012. 7171 (69%) contained positive or neutral content and 3209 (31%) contained negative content. Of the negative reports, 1977 (24%) were associated with impacts on vaccine programmes and disease outbreaks; 1726 (21%) with beliefs, awareness, and perceptions; 1371 (16%) with vaccine safety; and 1336 (16%) with vaccine delivery programmes. We were able to disaggregate the data by country and vaccine type, and monitor evolution of events over time and location in specific regions where vaccine concerns were high. Real-time monitoring and analysis of vaccine concerns over time and location could help immunisation programmes to tailor more effective and timely strategies to address specific public concerns. Bill & Melinda Gates Foundation. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

PubMed

Lakhani, A; Gandhi, K; Collumbien, M

2001-11-01

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

Case history: improved maxillary growth and development following digit sucking elimination and orofacial myofunctional therapy.

PubMed

Green, Shari

2013-11-01

Orofacial myologists are frequently called upon to address retained oral habit concerns. During this process, current I.A.O.M. recommended treatment includes addressing tongue, lip, and jaw rest posture concerns. Following digit sucking remediation, we may also be called upon to address these rest posture issues, and tongue thrust more aggressively together. In this process, facial growth and development and jaw structure may coincidentally improve as a result of 'nature taking its course' by addressing both swallow AND rest posture. In a select subset of clients, dramatic improvements may occur if the timing is right. This article discusses one such case that appears to have yielded a significant improvement in oral postures influencing improved facial and oral growth and development.

Common menstrual concerns of adolescents

PubMed Central

Sacks, Diane

1998-01-01

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

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 provides examples of how guideline developers perceive and approach the issue of implementation during the development and early launch of prevention guidelines. Models for guideline development could benefit from an initial assessment of how the guideline topic, its target context and stakeholders will affect the upcoming implementation.

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

PubMed

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

2017-10-01

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

Student Teacher Thinking: A Comparative Study of Elementary and Secondary Student Teachers.

ERIC Educational Resources Information Center

Galluzzo, Gary L.; Minix, Nancy A.

1992-01-01

Using videotaped simulated recall interviews, researchers assessed elementary and secondary student teachers' thoughts and concerns. Both groups considered pupil learning the greatest concern. There were consistent differences in how the groups perceived classroom interactions. Both groups addressed a narrower range of concerns regarding teaching…

States Address Concerns about Concussions in Youth Sports

ERIC Educational Resources Information Center

Kreck, Carol

2014-01-01

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

Environmental Concerns and the New Environmental Paradigm in Bulgaria

ERIC Educational Resources Information Center

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

2006-01-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-28

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

Understanding product specificity of protein lysine methyltransferases from QM/MM molecular dynamics and free energy simulations: the effects of mutation on SET7/9 beyond the Tyr/Phe switch.

PubMed

Yao, Jianzhuang; Chu, Yuzhuo; An, Ran; Guo, Hong

2012-02-27

The results of hybrid quantum mechanical/molecular mechanical (QM/MM) free energy (potential of mean force) simulations for methyl-transfer processes in SET7/9 and its Y245A mutant are compared to address the question concerning the change of the product specificity as well as catalytic efficiency due to the mutation. One of the key questions is whether or not the free energy profiles of methyl transfers may be used to predict the change of the product specificity as a result of the mutations for the residues that are not located at the Tyr/Phe switch position. The simulations show that while the wild-type SET7/9 is a monomethylase, the Y245→A mutation increases the ability of the enzyme to add more methyl groups on the target lysine (i.e., acting as a trimethylase). However, the first methyl-transfer process seems to become less efficient in the mutant compared to that in wild-type. All these results are consistent with experimental observations concerning the effects of the mutation on the product specificity and catalytic efficiency. Thus, the previous suggestion that the energetics of the methyl-transfer reactions may determine the product specificity, at least in some cases, is confirmed by the present work. Moreover, the dynamic information of the reactant complexes obtained from the QM/MM molecular dynamics simulations shows that the ability of the reactant complexes to form the reactive transition-state-like configurations may be used as an important indicator for the prediction of the product specificity of PKMTs, consistent with previous computational studies.

Vaccine hesitancy among healthcare workers in Europe: A qualitative study.

PubMed

Karafillakis, Emilie; Dinca, Irina; Apfel, Franklin; Cecconi, Sabrina; Wűrz, Andrea; Takacs, Judit; Suk, Jonathan; Celentano, Lucia Pastore; Kramarz, Piotr; Larson, Heidi J

2016-09-22

Healthcare workers (HCWs) are often referred to as the most trusted source of vaccine-related information for their patients. However, the evidence suggests that a number of HCWs are vaccine-hesitant. This study consists of 65 semi-structured interviews with vaccine providers in Croatia, France, Greece, and Romania to investigate concerns HCWs might have about vaccination. The results revealed that vaccine hesitancy is present in all four countries among vaccine providers. The most important concern across all countries was the fear of vaccine side effects. New vaccines were singled out due to perceived lack of testing for vaccine safety and efficacy. Furthermore, while high trust in health authorities was expressed by HCWs, there was also strong mistrust of pharmaceutical companies due to perceived financial interests and lack of communication about side effects. The notion that it is a doctor's responsibility to respond to hesitant patients was reported in all countries. Concerns were also seen to be country- and context-specific. Strategies to improve confidence in vaccines should be adapted to the specific political, social, cultural and economic context of countries. Furthermore, while most interventions focus on education and improving information about vaccine safety, effectiveness, or the need for vaccines, concerns raised in this study identify other determinants of hesitancy that need addressing. The representativeness of the views of the interviewed HCWs must be interpreted with caution. This a qualitative study with a small sample size that included geographical areas where vaccination uptake was lower or where hesitancy was more prevalent and it reflects individual participants' beliefs and attitudes toward the topic. As HCWs have the potential of influencing patient vaccination uptake, it is crucial to improve their confidence in vaccination and engage them in activities targeting vaccine hesitancy among their patients. Copyright © 2016. Published by Elsevier Ltd.

Reasons for not vaccinating adolescents: National Immunization Survey of Teens, 2008-2010.

PubMed

Darden, Paul M; Thompson, David M; Roberts, James R; Hale, Jessica J; Pope, Charlene; Naifeh, Monique; Jacobson, Robert M

2013-04-01

To determine the reasons adolescents are not vaccinated for specific vaccines and how these reasons have changed over time. We analyzed the 2008-2010 National Immunization Survey of Teens examining reasons parents do not have their teens immunized. Parents whose teens were not up to date (Not-UTD) for Tdap/Td and MCV4 were asked the main reason they were not vaccinated. Parents of female teens Not-UTD for human papillomavirus vaccine (HPV) were asked their intent to give HPV, and those unlikely to get HPV were asked the main reason why not. The most frequent reasons for not vaccinating were the same for Tdap/Td and MCV4, including "Not recommended" and "Not needed or not necessary." For HPV, the most frequent reasons included those for the other vaccines as well as 4 others, including "Not sexually active" and "Safety concerns/Side effects." "Safety concerns/Side effects" increased from 4.5% in 2008 to 7.7% in 2009 to 16.4% in 2010 and, in 2010, approaching the most common reason "Not Needed or Not Necessary" at 17.4% (95% CI: 15.7-19.1). Although parents report that health care professionals increasingly recommend all vaccines, including HPV, the intent to not vaccinate for HPV increased from 39.8% in 2008 to 43.9% in 2010 (OR for trend 1.08, 95% CI: 1.04-1.13). Despite doctors increasingly recommending adolescent vaccines, parents increasingly intend not to vaccinate female teens with HPV. The concern about safety of HPV grew with each year. Addressing specific and growing parental concerns about HPV will require different considerations than those for the other vaccines.

14 CFR 189.3 - Kinds of messages accepted or relayed.

Code of Federal Regulations, 2012 CFR

2012-01-01

... address: (1) Distress messages and distress traffic. (2) Messages concerning the safety of human life. (3) Flight safety messages concerning— (i) Air traffic control, including— (A) Messages concerning aircraft...

Color Imaging management in film processing

NASA Astrophysics Data System (ADS)

Tremeau, Alain; Konik, Hubert; Colantoni, Philippe

2003-12-01

The latest research projects in the laboratory LIGIV concerns capture, processing, archiving and display of color images considering the trichromatic nature of the Human Vision System (HSV). Among these projects one addresses digital cinematographic film sequences of high resolution and dynamic range. This project aims to optimize the use of content for the post-production operators and for the end user. The studies presented in this paper address the use of metadata to optimise the consumption of video content on a device of user's choice independent of the nature of the equipment that captured the content. Optimising consumption includes enhancing the quality of image reconstruction on a display. Another part of this project addresses the content-based adaptation of image display. Main focus is on Regions of Interest (ROI) operations, based on the ROI concepts of MPEG-7. The aim of this second part is to characterize and ensure the conditions of display even if display device or display media changes. This requires firstly the definition of a reference color space and the definition of bi-directional color transformations for each peripheral device (camera, display, film recorder, etc.). The complicating factor is that different devices have different color gamuts, depending on the chromaticity of their primaries and the ambient illumination under which they are viewed. To match the displayed image to the aimed appearance, all kind of production metadata (camera specification, camera colour primaries, lighting conditions) should be associated to the film material. Metadata and content build together rich content. The author is assumed to specify conditions as known from digital graphics arts. To control image pre-processing and image post-processing, these specifications should be contained in the film's metadata. The specifications are related to the ICC profiles but need additionally consider mesopic viewing conditions.

When Is Safe, Safe Enough?

ERIC Educational Resources Information Center

Neil, Kirk

2002-01-01

Discusses events affecting parental school-safety concerns and what school districts can do to alleviate those concerns. Addresses post-September 11 crisis-management procedures, preventing sports-related student deaths, maintaining healthy indoor air quality. (PKP)

Site-specific DNA excision in transgenic rice with a cell-permeable cre recombinase.

PubMed

Cao, Ming-Xia; Huang, Jian-Qiu; Yao, Quan-Hong; Liu, Sheng-Jun; Wang, Cheng-Long; Wei, Zhi-Ming

2006-01-01

The removal of selected marker genes from transgenic plants is necessary to address biosafety concerns and to carry out further experiments with transgenic organisms. In the present study, the 12-amino-acid membrane translocation sequence (MTS) from the Kaposi fibroblast growth factor (FGF)-4 was used as a carrier to deliver enzymatically active Cre proteins into living plant cells, and to produce a site-specific DNA excision in transgenic rice plants. The process, which made cells permeable to Cre recombinase-mediated DNA recombination, circumvented the need to express Cre under spatiotemporal control and was proved to be a simple and efficient system to achieve marker-free transgenic plants. The ultimate aim of the present study is to develop commercial rice cultivars free from selected marker genes to hasten public acceptance of transgenic crops.

A Prospective Study of the Concordance of DSM-IV and DSM-5 Diagnostic Criteria for Autism Spectrum Disorder.

PubMed

Mazurek, Micah O; Lu, Frances; Symecko, Heather; Butter, Eric; Bing, Nicole M; Hundley, Rachel J; Poulsen, Marie; Kanne, Stephen M; Macklin, Eric A; Handen, Benjamin L

2017-09-01

The transition from DSM-IV to DSM-5 criteria for autism spectrum disorder (ASD) sparked considerable concern about the potential implications of these changes. This study was designed to address limitations of prior studies by prospectively examining the concordance of DSM-IV and final DSM-5 criteria on a consecutive sample of 439 children referred for autism diagnostic evaluations. Concordance and discordance were assessed using a consistent diagnostic battery. DSM-5 criteria demonstrated excellent overall specificity and good sensitivity relative to DSM-IV criteria. Sensitivity and specificity were strongest for children meeting DSM-IV criteria for autistic disorder, but poor for those meeting criteria for Asperger's disorder and pervasive developmental disorder. Higher IQ, older age, female sex, and less pronounced ASD symptoms were associated with greater discordance.

Physician perceptions about living organ donation in patients with Amyotrophic Lateral Sclerosis.

PubMed

Ansari, S; Bromberg, M B; Gibson, S B

2017-09-01

Patients with Amyotrophic Lateral Sclerosis (ALS) have expressed desire to become living organ donors but are unable to do so with current organ donation policies. Our objective is to assess ALS patient's interest in organ donation, and perceived concerns of this practice by ALS neurologists. An electronic survey was administered to ALS neurologists across the United States regarding living organ donation in ALS patients prior to respiratory failure. 52 complete responses were received from 121 invites. 67% (35/52) of neurologists expressed no concerns about living organ donation in ALS patients, and 33% had concerns. The concerns related to respiratory failure, anesthesia exposure and renal dysfunction. With their concerns addressed, 71% of neurologists reported that they would endorse living organ donation. 49% of neurologists reported being asked by a patient for information regarding living organ donation. ALS neurologists felt that 22.8% of ALS patients (median 19%) would be interested in learning more about organ donation, while only 6% of neurologists broach this subject with their patients. Our results indicate that 1 in every 4 ALS patients may be interested in exploring options for living organ donation, and this topic is not routinely addressed by ALS clinics. These results indicate an unexplored area of patient interest. To honor a patient's wishes to donate, the transplant community will have to accommodate living organ donation from terminally ill patients, and address neurologist concerns. Such a practice could benefit two groups of patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Safe use of electronic health records and health information technology systems: trust but verify.

PubMed

Denham, Charles R; Classen, David C; Swenson, Stephen J; Henderson, Michael J; Zeltner, Thomas; Bates, David W

2013-12-01

We will provide a context to health information technology systems (HIT) safety hazards discussions, describe how electronic health record-computer prescriber order entry (EHR-CPOE) simulation has already identified unrecognized hazards in HIT on a national scale, helping make EHR-CPOE systems safer, and we make the case for all stakeholders to leverage proven methods and teams in HIT performance verification. A national poll of safety, quality improvement, and health-care administrative leaders identified health information technology safety as the hazard of greatest concern for 2013. Quality, HIT, and safety leaders are very concerned about technology performance risks as addressed in the Health Information Technology and Patient Safety report of the Institute of Medicine; and these are being addressed by the Office of the National Coordinator of HIT of the U.S. Dept. of Human Services in their proposed plans. We describe the evolution of postdeployment testing of HIT performance, including the results of national deployment of Texas Medical Institute of Technology's electronic health record computer prescriber order entry (TMIT EHR-CPOE) Flight Simulator verification test that is addressed in these 2 reports, and the safety hazards of concern to leaders. A global webinar for health-care leaders addressed the top patient safety hazards in the areas of leadership, practices, and technologies. A poll of 76 of the 221 organizations participating in the webinar revealed that HIT hazards were the participants' greatest concern of all 30 hazards presented. Of those polled, 89% rated HIT patient/data mismatches in EHRs and HIT systems as a 9 or 10 on a scale of 1 to 10 as a hazard of great concern. Review of a key study of postdeployment testing of the safety performance of operational EHR systems with CPOE implemented in 62 hospitals, using the TMIT EHR-CPOE simulation tool, showed that only 53% of the medication orders that could have resulted in fatalities were detected. The study also showed significant variability in the performance of specific EHR vendor systems, with the same vendor product scoring as high as a 75% detection score in one health-care organization, and the same vendor system scoring below 10% in another health-care organization. HIT safety hazards should be taken very seriously, and the need for proven, robust, and regular postdeployment performance verification measurement of EHR system operations in every health-care organization is critical to ensure that these systems are safe for every patient. The TMIT EHR-CPOE flight simulator is a well-tested and scalable tool that can be used to identify performance gaps in EHR and other HIT systems. It is critical that suppliers, providers, and purchasers of health-care partner with HIT stakeholders and leverage the existing body of work, as well as expert teams and collaborative networks to make care safer; and public-private partnerships to accelerate safety in HIT. A global collaborative is already underway incorporating a "trust but verify" philosophy.

Alaskan resources, current development. Traditional cultural values, and the role of LANDSAT data in current and future land use management planning

NASA Technical Reports Server (NTRS)

Laperriere, A. J.

1975-01-01

Past, present, and proposed applications of LANDSAT data for renewable resource assessments in Alaska are described. Specific projects briefly discussed include: a feasibility investigation applying LANDSAT data to caribou habitat mapping in northeast Alaska, analysis of a native corporate region in southwest Alaska, analysis of a game management unit in interior Alaska, and two proposed analyses in northwest Alaska. These analyses principally address range evaluations concerning caribou, moose, and Dall sheep, but results have application to other renewable resource themes. Application of resource assessment results to a statewide land use management plan is discussed.

Animal Models of Substance Abuse and Addiction: Implications for Science, Animal Welfare, and Society

PubMed Central

Lynch, Wendy J; Nicholson, Katherine L; Dance, Mario E; Morgan, Richard W; Foley, Patricia L

2010-01-01

Substance abuse and addiction are well recognized public health concerns, with 2 NIH institutes (the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism) specifically targeting this societal problem. As such, this is an important area of research for which animal experiments play a critical role. This overview presents the importance of substance abuse and addiction in society; reviews the development and refinement of animal models that address crucial areas of biology, pathophysiology, clinical treatments, and drug screening for abuse liability; and discusses some of the unique veterinary, husbandry, and IACUC challenges associated with these models. PMID:20579432

Optimization of the convection volume in online post-dilution haemodiafiltration: practical and technical issues

PubMed Central

Chapdelaine, Isabelle; de Roij van Zuijdewijn, Camiel L.M.; Mostovaya, Ira M.; Lévesque, Renée; Davenport, Andrew; Blankestijn, Peter J.; Wanner, Christoph; Nubé, Menso J.; Grooteman, Muriel P.C.

2015-01-01

In post-dilution online haemodiafiltration (ol-HDF), a relationship has been demonstrated between the magnitude of the convection volume and survival. However, to achieve high convection volumes (>22 L per session) detailed notion of its determining factors is highly desirable. This manuscript summarizes practical problems and pitfalls that were encountered during the quest for high convection volumes. Specifically, it addresses issues such as type of vascular access, needles, blood flow rate, recirculation, filtration fraction, anticoagulation and dialysers. Finally, five of the main HDF systems in Europe are briefly described as far as HDF prescription and optimization of the convection volume is concerned. PMID:25815176

White-nose Syndrome management: Report on structured decision making initiative

USGS Publications Warehouse

Szymanski, Jennifer A.; Runge, Michael C.; Parkin, Mary J.; Armstrong, Mike

2009-01-01

This report describes an analysis undertaken to assist state and federal natural resources managers in addressing the following question: What management measures should be taken this year within a given area to control the spread and minimize the effects of white-nose syndrome (WNS) on hibernating bats at the individual and population levels? The answer depends upon specific characteristics of the bat species, the hibernacula, and the syndrome itself, all of which could vary across the geographic extent of WNS and change over time. It also depends on a large number of agency and societal judgments concerning how to balance disease management against other objectives.

Clinical translation of controlled protein delivery systems for tissue engineering.

PubMed

Spiller, Kara L; Vunjak-Novakovic, Gordana

2015-04-01

Strategies that utilize controlled release of drugs and proteins for tissue engineering have enormous potential to regenerate damaged organs and tissues. The multiple advantages of controlled release strategies merit overcoming the significant challenges to translation, including high costs and long, difficult regulatory pathways. This review highlights the potential of controlled release of proteins for tissue engineering and regenerative medicine. We specifically discuss treatment modalities that have reached preclinical and clinical trials, with emphasis on controlled release systems for bone tissue engineering, the most advanced application with several products already in clinic. Possible strategies to address translational and regulatory concerns are also discussed.

Animal models of substance abuse and addiction: implications for science, animal welfare, and society.

PubMed

Lynch, Wendy J; Nicholson, Katherine L; Dance, Mario E; Morgan, Richard W; Foley, Patricia L

2010-06-01

Substance abuse and addiction are well recognized public health concerns, with 2 NIH institutes (the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism) specifically targeting this societal problem. As such, this is an important area of research for which animal experiments play a critical role. This overview presents the importance of substance abuse and addiction in society; reviews the development and refinement of animal models that address crucial areas of biology, pathophysiology, clinical treatments, and drug screening for abuse liability; and discusses some of the unique veterinary, husbandry, and IACUC challenges associated with these models.

Cognitive versus stimulus-response theories of learning

PubMed Central

Holland, Peter C.

2010-01-01

In his 1948 address to the Division of Theoretical-Experimental Psychology of the American Psychological Association, Kenneth W. Spence discussed six distinctions between cognitive and stimulus-response (S-R) theories of learning. In this article I first review these six distinctions, and then focus on two of them in the context of my own research. This research concerns the specification of stimulus-stimulus associations in associative learning, and the characterization of neural systems underlying those associations. In the course of describing Spence's views and my research, I hope to communicate some of the richness of Spence's S-R psychology, and its currency within modern scientific analyses of behavior. PMID:18683467

Administrative automation in a scientific environment

NASA Technical Reports Server (NTRS)

Jarrett, J. R.

1984-01-01

Although the scientific personnel at GSFC were advanced in the development and use of hardware and software for scientific applications, resistance to the use of automation or purchase of terminals, software and services, specifically for administrative functions was widespread. The approach used to address problems and constraints and plans for administrative automation within the Space and Earth Sciences Directorate are delineated. Accomplishments thus far include reduction of paperwork and manual efforts; improved communications through telemail and committees; additional support staff; increased awareness at all levels on ergonomic concerns and the need for training; better equipment; improved ADP skills through experience; management commitment; and an overall strategy for automating.

Clinical translation of controlled protein delivery systems for tissue engineering

PubMed Central

Spiller, Kara L.; Vunjak-Novakovic, Gordana

2013-01-01

Strategies that utilize controlled release of drugs and proteins for tissue engineering have enormous potential to regenerate damaged organs and tissues. The multiple advantages of controlled release strategies merit overcoming the significant challenges to translation, including high costs and long, difficult regulatory pathways. This review highlights the potential of controlled release of proteins for tissue engineering and regenerative medicine. We specifically discuss treatment modalities that have reached preclinical and clinical trials, with emphasis on controlled release systems for bone tissue engineering, the most advanced application with several products already in clinic. Possible strategies to address translational and regulatory concerns are also discussed. PMID:25787736

‘It has saved thousands of lives, so why change it?’ Content analysis of objections to cervical screening programme changes in Australia

PubMed Central

Bonner, Carissa; Jansen, Jesse; McCaffery, Kirsten

2018-01-01

Objectives The incidence and mortality of cervical cancer have halved since introduction of the Australian cervical screening programme in 1991, involving 2-yearly Pap smears from ages 18–69 years. In 2017, the programme changed to 5- yearly primary human papillomavirus (HPV) testing for women aged 25–74 years. This study investigated reasons for opposition to the renewed screening programme within the open-ended comments of an online petition, ‘Stop May 1st Changes to Pap Smears—Save Women’s Lives’, opposing the changes, which received over 70 000 signatures and almost 20 000 comments. Methods Content analysis of a random sample of 2000 comments, reflecting 10% of the 19 633 comments posted in February–March 2017. Results Nineteen codes were identified, reflecting four themes: (1) valuing women’s health and rights, (2) political statements, (3) concerns about healthcare funding cuts and (4) opposition to specific components of the new screening programme. The most prevalent codes were: placing value on women’s health (33%), concerns about increasing screening intervals (17%) and opposition to the changes related to personal experiences with cervical cancer or cervical abnormalities (15%). Concern about the key change in technology (HPV testing instead of Pap smears) was expressed in less than 3% of comments, and some opposition to the changes from health professionals was noted. Conclusions Screening changes within this selected group were perceived as threatening women’s health, as a political policy created by male decision-makers and as a cost-cutting exercise. Many commenters were concerned about increased screening intervals and later screening onset, but little opposition was expressed regarding the testing technology itself. This analysis may inform public education and communication strategies for future changes to cervical screening programmes internationally, to pre-emptively address specific concerns about the changes. PMID:29440214

Community-based approaches and partnerships: innovations in health-service delivery in Bangladesh.

PubMed

El Arifeen, Shams; Christou, Aliki; Reichenbach, Laura; Osman, Ferdous Arfina; Azad, Kishwar; Islam, Khaled Shamsul; Ahmed, Faruque; Perry, Henry B; Peters, David H

2013-12-14

In Bangladesh, rapid advancements in coverage of many health interventions have coincided with impressive reductions in fertility and rates of maternal, infant, and childhood mortality. These advances, which have taken place despite such challenges as widespread poverty, political instability, and frequent natural disasters, warrant careful analysis of Bangladesh's approach to health-service delivery in the past four decades. With reference to success stories, we explore strategies in health-service delivery that have maximised reach and improved health outcomes. We identify three distinctive features that have enabled Bangladesh to improve health-service coverage and health outcomes: (1) experimentation with, and widespread application of, large-scale community-based approaches, especially investment in community health workers using a doorstep delivery approach; (2) experimentation with informal and contractual partnership arrangements that capitalise on the ability of non-governmental organisations to generate community trust, reach the most deprived populations, and address service gaps; and (3) rapid adoption of context-specific innovative technologies and policies that identify country-specific systems and mechanisms. Continued development of innovative, community-based strategies of health-service delivery, and adaptation of new technologies, are needed to address neglected and emerging health challenges, such as increasing access to skilled birth attendance, improvement of coverage of antenatal care and of nutritional status, the effects of climate change, and chronic disease. Past experience should guide future efforts to address rising public health concerns for Bangladesh and other underdeveloped countries. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

ERIC Educational Resources Information Center

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

2018-01-01

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

Addressing EO-1 Spacecraft Pulsed Plasma Thruster EMI Concerns

NASA Technical Reports Server (NTRS)

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

2001-01-01

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

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

Bogen, K T

A relatively simple, quantitative approach is proposed to address a specific, important gap in the appr approach recommended by the USEPA Guidelines for Cancer Risk Assessment to oach address uncertainty in carcinogenic mode of action of certain chemicals when risk is extrapolated from bioassay data. These Guidelines recognize that some chemical carcinogens may have a site-specific mode of action (MOA) that is dual, involving mutation in addition to cell-killing induced hyperplasia. Although genotoxicity may contribute to increased risk at all doses, the Guidelines imply that for dual MOA (DMOA) carcinogens, judgment be used to compare and assess results obtained usingmore » separate 'linear' (genotoxic) vs. 'nonlinear' (nongenotoxic) approaches to low low-level risk extrapolation. However, the Guidelines allow the latter approach to be used only when evidence is sufficient t to parameterize a biologically based model that reliably o extrapolates risk to low levels of concern. The Guidelines thus effectively prevent MOA uncertainty from being characterized and addressed when data are insufficient to parameterize such a model, but otherwise clearly support a DMOA. A bounding factor approach - similar to that used in reference dose procedures for classic toxicity endpoints - can address MOA uncertainty in a way that avoids explicit modeling of low low-dose risk as a function of administere administered or internal dose. Even when a 'nonlinear' toxicokinetic model cannot be fully validated, implications of DMOA uncertainty on low low-dose risk may be bounded with reasonable confidence when target tumor types happen to be extremely rare. This concept was i illustrated llustrated for a likely DMOA rodent carcinogen naphthalene, specifically to the issue of risk extrapolation from bioassay data on naphthalene naphthalene-induced nasal tumors in rats. Bioassay data, supplemental toxicokinetic data, and related physiologically based p pharmacokinetic and 2 harmacokinetic 2-stage stochastic carcinogenesis modeling results all clearly indicate that naphthalene is a DMOA carcinogen. Plausibility bounds on rat rat-tumor tumor-type specific DMOA DMOA-related uncertainty were obtained using a 2-stage model adapted to reflec reflect the empirical link between genotoxic and cytotoxic effects of t the most potent identified genotoxic naphthalene metabolites, 1,2 1,2- and 1,4 1,4-naphthoquinone. Bound Bound-specific 'adjustment' factors were then used to reduce naphthalene risk estimated by linear ex extrapolation (under the default genotoxic MOA assumption), to account for the DMOA trapolation exhibited by this compound.« less

A systematic literature review of individuals' perspectives on broad consent and data sharing in the United States.

PubMed

Garrison, Nanibaa' A; Sathe, Nila A; Antommaria, Armand H Matheny; Holm, Ingrid A; Sanderson, Saskia C; Smith, Maureen E; McPheeters, Melissa L; Clayton, Ellen W

2016-07-01

In 2011, an Advanced Notice of Proposed Rulemaking proposed that de-identified human data and specimens be included in biobanks only if patients provide consent. The National Institutes of Health Genomic Data Sharing policy went into effect in 2015, requiring broad consent from almost all research participants. We conducted a systematic literature review of attitudes toward biobanking, broad consent, and data sharing. Bibliographic databases included MEDLINE, Web of Science, EthxWeb, and GenETHX. Study screening was conducted using DistillerSR. The final 48 studies included surveys (n = 23), focus groups (n = 8), mixed methods (n = 14), interviews (n = 1), and consent form analyses (n = 2). Study quality was characterized as good (n = 19), fair (n = 27), and poor (n = 2). Although many participants objected, broad consent was often preferred over tiered or study-specific consent, particularly when broad consent was the only option, samples were de-identified, logistics of biobanks were communicated, and privacy was addressed. Willingness for data to be shared was high, but it was lower among individuals from under-represented minorities, individuals with privacy and confidentiality concerns, and when pharmaceutical companies had access to data. Additional research is needed to understand factors affecting willingness to give broad consent for biobank research and data sharing in order to address concerns to enhance acceptability.Genet Med 18 7, 663-671.

A pilot study on the effects of individually tailored education for MMR vaccine-hesitant parents on MMR vaccination intention

PubMed Central

Gowda, Charitha; Schaffer, Sarah E.; Kopec, Kristin; Markel, Arielle; Dempsey, Amanda F.

2013-01-01

Healthcare providers need strategies to better address the concerns of vaccine-hesitant parents. We studied whether individually tailored education was more effective than untailored education at improving vaccination intention among MMR vaccine-hesitant parents. In an intervention pilot study of parents (n = 77) of children < 6 y who screened as hesitant to vaccinate against MMR (first or second dose), parents were randomly assigned to receive either (1) educational web pages that were individually tailored to address their specific vaccine concerns; or (2) web pages similar in appearance to the intervention but containing untailored information. The main outcome, change in vaccination intention before and after the intervention, was assessed using an 11-pt scale (higher values indicated greater intent). We found that a greater proportion of parents in the tailored than untailored arm had positive vaccination intentions after viewing educational information (58% vs. 46%). Furthermore, parents in the tailored group had a greater magnitude of change in vaccination intention (1.08 vs. 0.49 points) than participants in the untailored group. However, neither of these results was statistically significant. From this pilot study we conclude message tailoring may be an effective way to improve vaccine compliance among vaccine hesitant parents. However, larger studies are warranted to further investigate the efficacy of providing tailored education for increasing vaccine acceptance among parents with diverse beliefs. PMID:23291937

Psychosocial Approaches for Sexual Health and Intimate Relationships Among Patients With Serious Mental Illness.

PubMed

Helu-Brown, Paula; Aranda, Maria

2016-01-01

The sexual health and behavior and the intimate relationships of patients diagnosed with a serious mental illness (SMI) have been described as ongoing and often ignored concerns in mental health treatment. Evidence-based psychosocial interventions have emerged as effective complimentary approaches to address symptoms of SMI in conjunction with psychopharmacology, yet rarely do they address sexual concerns in a targeted manner. This systematic review explores the scope and efficacy of psychosocial interventions designed to address sexual health and behavior and intimate relationship concerns in patients with SMI. The search was conducted in four targeted databases and identified 967 articles with four of those meeting inclusion criteria for this review. The data extracted included setting, study sample, study design, outcome measures, data analysis, and results. The measures utilized in the studies assess mental and sexual health-related outcomes. All four studies reported an improvement in sexual and mental health outcomes. Given the lack of psychosocial approaches and culturally sensitive adaptations, this review highlights a gap in literature that should be addressed, particularly emphasizing their combined treatment with psychotropic medication and efficacy testing with diverse populations. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

[Presidential address at the 20th Journees sur la Fertilite et l'Orthogenie].

PubMed

Dourlen-rollier, A M

1993-01-01

Recollections of the author's early experiences in French family planning and reflections on the ethical issues and legal status of new fertility technologies are the major topics of this address. The group that was to become le Mouvement francais pour le Planning Familial (MFPF) was founded in 1956 by the author and others and opened its first family planning center in 1961, before contraception became legal. Despite opposition from physicians and Catholic clergy, the MFPF operated 100 centers serving over 100,000 clients by 1965. In 1969 the MFPF began a study of abortion. Despite legalization, the controversy concerning the legitimacy of abortion has not subsided. More recently, the practices of artificial insemination with donor sperm, in vitro fertilization, surrogate mothers, and other medically assisted fertility technologies have raised moral, ethical, and legal questions for all societies. The questions range from the legitimacy of gamete donation to the status of unused embryos. The dissociation of different stages of the reproductive process affects concepts of filiation, paternity and maternity. In the absence of appropriate legislation, it has been left largely to the courts to create a new body of law at this frontier. The review of legislation in France, elsewhere in Europe, and in the U.S. concerning contested filiation in cases of artificial insemination, the legitimacy of insemination of a woman after the death of her spouse, the preservation and donation of embryos, surrogate motherhood, the child's rights to information about his biological parents, and other questions indicate that no consensus has yet emerged concerning the admissibility and legitimacy of specific practices. It would be highly desirable for the European countries to adopt a common legislation in these areas.

Building more effective sea level rise models for coastal management

NASA Astrophysics Data System (ADS)

Kidwell, D.; Buckel, C.; Collini, R.; Meckley, T.

2017-12-01

For over a decade, increased attention on coastal resilience and adaptation to sea level rise has resulted in a proliferation of predictive models and tools. This proliferation has enhanced our understanding of our vulnerability to sea level rise, but has also led to stakeholder fatigue in trying to realize the value of each advancement. These models vary in type and complexity ranging from GIS-based bathtub viewers to modeling systems that dynamically couple complex biophysical and geomorphic processes. These approaches and capabilities typically have the common purpose using scenarios of global and regional sea level change to inform adaptation and mitigation. In addition, stakeholders are often presented a plethora of options to address sea level rise issues from a variety of agencies, academics, and consulting firms. All of this can result in confusion, misapplication of a specific model/tool, and stakeholder feedback of "no more new science or tools, just help me understand which one to use". Concerns from stakeholders have led to the question; how do we move forward with sea level rise modeling? This presentation will provide a synthesis of the experiences and feedback derived from NOAA's Ecological Effects of Sea level Rise (EESLR) program to discuss the future of predictive sea level rise impact modeling. EESLR is an applied research program focused on the advancement of dynamic modeling capabilities in collaboration with local and regional stakeholders. Key concerns from stakeholder engagement include questions about model uncertainty, approaches for model validation, and a lack of cross-model comparisons. Effective communication of model/tool products, capabilities, and results is paramount to address these concerns. Looking forward, the most effective predictions of sea level rise impacts on our coast will be attained through a focus on coupled modeling systems, particularly those that connect natural processes and human response.

Attitudes to HPV vaccination among mothers in the British Jewish community: reasons for accepting or declining the vaccine.

PubMed

Gordon, Daniel; Waller, Jo; Marlow, Laura A V

2011-10-06

This study aimed to explore attitudes to human papillomavirus (HPV) vaccination and reasons for accepting or declining the vaccine in the British Jewish community. A qualitative approach was used to explore maternal attitudes towards HPV vaccination. Participants were mothers of girls who had been offered HPV vaccination and were purposively sampled through Jewish secondary schools. Face-to-face interviews were conducted with vaccine-accepting (n=10) and vaccine-declining (n=10) mothers. Interviews were transcribed verbatim and analysed using a framework approach. HPV and cervical cancer knowledge varied, with poor knowledge attributed to lack of contact with the disease. Although mothers thought HPV vaccination was a good idea in general, many did not perceive it as necessary for their daughter, citing Jewish religious laws governing family purity and abstinence until marriage as reasons for daughter's low susceptibility. These beliefs combined with concerns about the novelty of the vaccination were the main reasons given for declining the vaccine. Mothers who accepted the vaccine generally did so to protect their daughters health and because they felt unable to predict their daughters future behaviour and HPV susceptibility. Many mothers expressed a wish to wait until their daughter was older and the vaccine was more established before consenting. Among some mothers there was disappointment in the information they had received and a feeling that the concerns and questions of the Jewish community had not been addressed. Attitudes to HPV vaccine in religious communities may lead to reduced vaccine coverage. The development of community-specific information about the importance of the vaccine may help address concerns. Copyright © 2011 Elsevier Ltd. All rights reserved.

Communicating with parents about vaccination: a framework for health professionals.

PubMed

Leask, Julie; Kinnersley, Paul; Jackson, Cath; Cheater, Francine; Bedford, Helen; Rowles, Greg

2012-09-21

A critical factor shaping parental attitudes to vaccination is the parent's interactions with health professionals. An effective interaction can address the concerns of vaccine supportive parents and motivate a hesitant parent towards vaccine acceptance. Poor communication can contribute to rejection of vaccinations or dissatisfaction with care. We sought to provide a framework for health professionals when communicating with parents about vaccination. Literature review to identify a spectrum of parent attitudes or 'positions' on childhood vaccination with estimates of the proportion of each group based on population studies. Development of a framework related to each parental position with determination of key indicators, goals and strategies based on communication science, motivational interviewing and valid consent principles. Five distinct parental groups were identified: the 'unquestioning acceptor' (30-40%), the 'cautious acceptor' (25-35%); the 'hesitant' (20-30%); the 'late or selective vaccinator' (2-27%); and the 'refuser' of all vaccines (<2%). The goals of the encounter with each group will vary, depending on the parents' readiness to vaccinate. In all encounters, health professionals should build rapport, accept questions and concerns, and facilitate valid consent. For the hesitant, late or selective vaccinators, or refusers, strategies should include use of a guiding style and eliciting the parent's own motivations to vaccinate while, avoiding excessive persuasion and adversarial debates. It may be necessary to book another appointment or offer attendance at a specialised adverse events clinic. Good information resources should also be used. Health professionals have a central role in maintaining public trust in vaccination, including addressing parents' concerns. These recommendations are tailored to specific parental positions on vaccination and provide a structured approach to assist professionals. They advocate respectful interactions that aim to guide parents towards quality decisions.

Communicating with parents about vaccination: a framework for health professionals

PubMed Central

2012-01-01

Background A critical factor shaping parental attitudes to vaccination is the parent’s interactions with health professionals. An effective interaction can address the concerns of vaccine supportive parents and motivate a hesitant parent towards vaccine acceptance. Poor communication can contribute to rejection of vaccinations or dissatisfaction with care. We sought to provide a framework for health professionals when communicating with parents about vaccination. Methods Literature review to identify a spectrum of parent attitudes or ‘positions’ on childhood vaccination with estimates of the proportion of each group based on population studies. Development of a framework related to each parental position with determination of key indicators, goals and strategies based on communication science, motivational interviewing and valid consent principles. Results Five distinct parental groups were identified: the ‘unquestioning acceptor’ (30–40%), the ‘cautious acceptor’ (25–35%); the ‘hesitant’ (20–30%); the ‘late or selective vaccinator’ (2–27%); and the ‘refuser’ of all vaccines (<2%). The goals of the encounter with each group will vary, depending on the parents’ readiness to vaccinate. In all encounters, health professionals should build rapport, accept questions and concerns, and facilitate valid consent. For the hesitant, late or selective vaccinators, or refusers, strategies should include use of a guiding style and eliciting the parent’s own motivations to vaccinate while, avoiding excessive persuasion and adversarial debates. It may be necessary to book another appointment or offer attendance at a specialised adverse events clinic. Good information resources should also be used. Conclusions Health professionals have a central role in maintaining public trust in vaccination, including addressing parents’ concerns. These recommendations are tailored to specific parental positions on vaccination and provide a structured approach to assist professionals. They advocate respectful interactions that aim to guide parents towards quality decisions. PMID:22998654

Reducing the nicotine content of combusted tobacco products sold in New Zealand.

PubMed

Donny, Eric C; Walker, Natalie; Hatsukami, Dorothy; Bullen, Chris

2017-03-01

Large reductions in nicotine content could dramatically reduce reinforcement from and dependence on cigarettes. In this article, we summarise the potential benefits of reducing nicotine in combusted tobacco and address some of the common concerns. We focus specifically on New Zealand because it may be ideally situated to implement such a policy. The available data suggest that, in current smokers, very low nicotine content (VLNC) cigarettes decrease nicotine exposure, decrease cigarette dependence, reduce the number of cigarettes smoked per day and increase the likelihood of contemplating, making and succeeding at a quit attempt. New smokers would almost certainly be exposed to far less nicotine as a result of smoking VLNC cigarettes and, consequently, would probably be less likely to become chronic, dependent, smokers. Many of the concerns about reducing nicotine including compensatory smoking, an exacerbation of psychiatric symptoms, the perception that VLNC cigarettes are less harmful, and the potential for a black market are either not supported by the available data, likely mitigated by other factors including the availability of nicotine-containing e-cigarettes, or unlikely to offset the potential benefit to public health. Although not all concerns have been addressed or can be a priori, the magnitude of the potential benefits and the growing evidence of relatively few potential harms should make nicotine reduction one of the centrepieces for discussion of how to rapidly advance tobacco control. Policies that aim to render the most toxic tobacco products less addictive could help New Zealand attain their goal of becoming smokefree by 2025. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Elderly patients' and GPs' perspectives of patient-GP communication concerning polypharmacy: a qualitative interview study.

PubMed

Schöpf, Andrea C; von Hirschhausen, Maike; Farin, Erik; Maun, Andy

2017-12-26

Aim The aim of this study was to explore elderly patients' and general practitioners' (GPs') perceptions of communication about polypharmacy, medication safety and approaches for empowerment. To manage polypharmacy, GPs need to know patients' real medication consumption. However, previous research has shown that patients do not always volunteer all information about their medication regimen, for example, such as the intake of over-the-counter medication or the alteration or discontinuation of prescribed medication. A qualitative interview study including patients of at least 65 years old with polypharmacy (⩾5 medications) and their GPs in a German Primary Healthcare Centre. The transcripts from the semi-structured interviews (n=6 with patients; n=3 with GPs) were analysed using a framework analytical approach. Findings We identified three themes: differing medication plans: causes?; dialogue concerning medication: whose responsibility?; supporting patients' engagement: how? While GPs stated that patients do not always report or might even conceal information, all patients reported that they could speak openly about everything with their GPs. In this context, trust might act as a double-edged sword, as it can promote open communication but also prevent patients from asking questions. Both GPs and patients could name very few ways in which patients could be supported to become more informed and active in communication concerning polypharmacy and medication safety. This study shows that patients' awareness of the significance of their active role in addressing polypharmacy needs to be increased. This includes understanding that trusting the doctor does not preclude asking questions or seeking more information. Thus, interventions which improve patients' communication skills and address specific issues of polypharmacy, particularly in elderly patients, should be designed. GPs might support patients by 'inviting' their contribution.

Listen to the public and fulfil their information interests - translating vaccine communication research findings into guidance for regulators.

PubMed

Bahri, Priya; Castillon Melero, Mireia

2018-03-24

Regulatory authorities have a crucial role in communicating about the vaccines they license. In terms of content and timing, their communication to the public is usually driven by data on quality, safety and efficacy. However, concerns over safety and vaccine hesitancy have emerged in some communities in various countries, and this demands a new approach to communication, starting with listening to the public debate. Reviewing communication research findings, coming in particular from the cognitive, decision-making and media sciences, constitutes one mechanism of listening and has led the European Union (EU) regulatory network to developing guidance about which common concerns and information needs of the public to address through proactive and prepared communication. The guidance has been welcomed by EU and international fora. The current article summarizes the recommendations and shares the underlying research findings, as well as a proof of concept that communication research can be valuable for regulators. It is critical that regulators integrate the communication process with product risk assessment in the framework of pharmacovigilance, to ensure that public concerns are addressed in the assessments and that information about evidence and uncertainty relating to safety is provided to the public and vaccination policy makers in a specific, clear and accurate manner. Additionally, information from regulatory authorities should support healthcare professionals in their communication with patients. Meeting the information interests of the public is the principal prerequisite for informed decisions as well as safe and effective use of vaccines and medicines overall. This is also fundamental for trust in the authorities' commitment to patient and population health. © 2018 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.

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.

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 health knowledge. Educating health professions students on the health needs of LGBT people is essential to improving this population's health by providing competent and non-judgmental care.

Ethical issues in perinatal mental health research.

PubMed

Brandon, Anna R; Shivakumar, Geetha; Lee, Simon Craddock; Inrig, Stephen J; Sadler, John Z

2009-11-01

To review the background of current ethical standards for the conduct of perinatal mental health research and describe the ethical challenges in this research domain. Current literature reflects a growing sentiment in the scientific community that having no information regarding the impact of psychiatric treatment on the mother and developing fetus/infant poses dangers that may exceed the risks involved in research. However, without sufficient consensus across the scientific community, both regulatory bodies and perinatal researchers find themselves without a framework for decision making that satisfactorily limits the risks and facilitates the benefits of participation of pregnant and lactating women in clinical research. Psychiatric research in perinatal mental health is critically important as it enables clinicians and patients to participate in informed decision-making concerning treatment for psychiatric disorders. Specific areas of concern include fetal safety, maternal risk, the therapeutic misconception, commercial interests, forensic/legal issues, the informed consent process, and study design. Developing guidelines that address ethical challenges and include the views and concerns of multiple stakeholders could improve the access of perinatal women to the benefits of participation in mental health research in addition to providing evidence-based mental healthcare for this subpopulation.

Geoengineering: A humanitarian concern

NASA Astrophysics Data System (ADS)

Suarez, Pablo; van Aalst, Maarten K.

2017-02-01

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

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2014-01-01

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

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

PubMed

Repacholi, Michael

2012-06-01

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

Issues and Concerns Faced by Undergraduate Language Student Teachers during Teaching Practicum Experiences

ERIC Educational Resources Information Center

Ali, Mohd Sofi; Othman, Abdul Jalil; Karim, Abdul Faruk Abdul

2014-01-01

This study examined specific issues and concerns faced by Bachelor of Education student teachers majoring in Language and Literature during their 12-week teaching practicum experience. Specifically, three main areas of concerns were examined. They were: (1) specific issues and concerns related to the implementation of teaching practicum faced by…

Assisting persons living with HIV/AIDS to return to work: programmatic steps for AIDS service organizations.

PubMed

Brooks, R A; Klosinski, L E

1999-06-01

The objective of this study was to develop a comprehensive picture of the concerns and needs of persons living with HIV/AIDS who are interested in returning to work. To collect information in this new area, a series of focus groups was conducted with a random sample of clients from AIDS Project Los Angeles who were currently unemployed and expressed a desire to return to work. The results indicate a range of concerns among individuals with HIV/AIDS about returning to work, such as a loss of or change in medical benefits, the need for flexibility in employment to address ongoing medical needs, concerns regarding disclosure of their HIV/AIDS status, the possibility of job related discrimination, and the need to address the practical aspects of reentering the labor market after a prolonged absence. The findings suggest a series of action steps for AIDS service organizations and others to address the needs of persons with HIV/AIDS in this new area.

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

PubMed

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

2018-05-03

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

State of the art: nursing knowledge and electroconvulsive therapy.

PubMed

Froimson, L; Creed, P; Mathew, L

1995-09-01

Nursing services attempting to develop standards for their own facilities will find limited literature specific to nursing and electroconvulsive therapy (ECT) in American publications. From 1966 to December 1994, there were only 19 publications in American nursing journals that provide a specific focus on nursing and ECT. Only one of these articles reported research findings. Twenty-seven citations in Convulsive Therapy included nurse contributors. While the APA Task Force on the Practice of ECT has addressed educational needs of nursing and technical elements of the procedure, there do not currently exist specific standards for nursing practice in ECT. Concerns salient to nursing that have generated articles by nurses include instruction of patients, support to patients and families, safety of patients, assessment of clinical status, informed consent, and nurses' and patients' attitudes about ECT. Nurses are encouraged to join their physician-colleagues in developing and disseminating the information needed for the field of nursing to contribute its own expertise to the care of patients receiving ECT.

Design and Evaluation of a Medication Adherence Application with Communication for Seniors in Independent Living Communities.

PubMed

Dasgupta, Dipanwita; Johnson, Reid A; Chaudhry, Beenish; Reeves, Kimberly G; Willaert, Patty; Chawla, Nitesh V

2016-01-01

Medication non-adherence is a pressing concern among seniors, leading to a lower quality of life and higher healthcare costs. While mobile applications provide a viable medium for medication management, their utility can be limited without tackling the specific needs of seniors and facilitating the active involvement of care providers. To address these limitations, we are developing a tablet-based application designed specifically for seniors to track their medications and a web portal for their care providers to track medication adherence. In collaboration with a local Aging in Place program, we conducted a three-month study with sixteen participants from an independent living facility. Our study found that the application helped participants to effectively track their medications and improved their sense of wellbeing. Our findings highlight the importance of catering to the needs of seniors and of involving care providers in this process, with specific recommendations for the development of future medication management applications.

Cirrus clouds and climate feedback: Is the sky falling and should we go tell the king

NASA Technical Reports Server (NTRS)

Stephens, Graeme L.

1990-01-01

It is widely believed that thin cirrus clouds act to enhance the greenhouse effect owing to a particular combination of their optical properties. It is demonstrated how this effect is perhaps based on inadequate resolution of the physics of cirrus clouds and that the more likely impact of cirrus clouds to climate change remains somewhat elusive. These conclusions are developed within the context of a specific feedback mechanism incorporated into a simple mechanistic climate model. A specific scientific question addressed is whether or not the observed relationship between the ice water content and temperature of cirrus provides any significant feedback to the CO2 greenhouse warming. A related question also examined concerns the specific role of cloud microphysics and radiation in this feedback. This raises several pertinent issues about the understanding of cirrus clouds and their likely role in climate change as there presently exists a considerable uncertainty about the microphysics of these clouds (size and shape of ice crystals) and their radiative influences.

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

PubMed

2007-11-01

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

Trait liabilities and specific promotive processes in psychopathology: The example of suicidal behavior.

PubMed

Buchman-Schmitt, Jennifer M; Brislin, Sarah J; Venables, Noah C; Joiner, Thomas E; Patrick, Christopher J

2017-07-01

The RDoC matrix framework calls for investigation of mental health problems through analysis of core biobehavioral processes quantified and studied across multiple domains of measurement. Critics have raised concerns about RDoC, including overemphasis on biological concepts/measures and disregard for the principle of multifinality, which holds that identical biological predispositions can give rise to differing behavioral outcomes. The current work illustrates an ontogenetic process approach to addressing these concerns, focusing on biobehavioral traits corresponding to RDoC constructs as predictors, and suicidal behavior as the outcome variable. Data were collected from a young adult sample (N=105), preselected to enhance rates of suicidality. Participants completed self-report measures of traits (threat sensitivity, response inhibition) and suicide-specific processes. We show that previously reported associations for traits of threat sensitivity and weak inhibitory control with suicidal behavior are mediated by more specific suicide-promoting processes-namely, thwarted belongingness, perceived burdensomeness, and capability for suicide. The sample was relatively small and the data were cross-sectional, limiting conclusions that can be drawn from the mediation analyses. Given prior research documenting neurophysiological as well as psychological bases to these trait dispositions, the current work sets the stage for an intensive RDoC-oriented investigation of suicidal tendencies in which both traits and suicide-promoting processes are quantified using indicators from different domains of measurement. More broadly, this work illustrates how an RDoC research approach can contribute to a nuanced understanding of specific clinical problems, through consideration of how general biobehavioral liabilities interface with distinct problem-promoting processes. Copyright © 2016 Elsevier B.V. All rights reserved.

Patient-specific analysis of post-operative aortic hemodynamics: a focus on thoracic endovascular repair (TEVAR)

NASA Astrophysics Data System (ADS)

Auricchio, F.; Conti, M.; Lefieux, A.; Morganti, S.; Reali, A.; Sardanelli, F.; Secchi, F.; Trimarchi, S.; Veneziani, A.

2014-10-01

The purpose of this study is to quantitatively evaluate the impact of endovascular repair on aortic hemodynamics. The study addresses the assessment of post-operative hemodynamic conditions of a real clinical case through patient-specific analysis, combining accurate medical image analysis and advanced computational fluid-dynamics (CFD). Although the main clinical concern was firstly directed to the endoluminal protrusion of the prosthesis, the CFD simulations have demonstrated that there are two other important areas where the local hemodynamics is impaired and a disturbed blood flow is present: the first one is the ostium of the subclavian artery, which is partially closed by the graft; the second one is the stenosis of the distal thoracic aorta. Besides the clinical relevance of these specific findings, this study highlights how CFD analyses allow to observe important flow effects resulting from the specific features of patient vessel geometries. Consequently, our results demonstrate the potential impact of computational biomechanics not only on the basic knowledge of physiopathology, but also on the clinical practice, thanks to a quantitative extraction of knowledge made possible by merging medical data and mathematical models.

An Analysis of Persistence and Motivation in Public Research Institutions for Doctoral Completers

ERIC Educational Resources Information Center

Colbert, Marvette D.

2013-01-01

Doctoral student attrition is an issue of great concern among leaders in higher education (Gardner, 2009a). In response to concern for high attrition rates in doctoral programs, several studies (Lovitts, 2001; National Science Foundation, 2004; Nettles & Millett, 2006) investigated this issue aimed at gaining data to address this concern.…

Wind energy on the horizon in British Columbia. A review and evaluation of the British Columbia wind energy planning framework

NASA Astrophysics Data System (ADS)

Day, Jason

This study examines the wind energy planning frameworks from ten North American jurisdictions, drawing important lessons that British Columbia could use to build on its current model which has been criticized for its limited scope and restriction of local government powers. This study contributes to similar studies conducted by Kimrey (2006), Longston (2006), and Eriksen (2009). This study concludes that inclusion of wind resource zones delineated through strategic environmental assessment, programme assessment, and conducting research-oriented studies could improve the current British Columbia planning framework. The framework should also strengthen its bat impact assessment practices and incorporate habitat compensation. This research also builds upon Rosenberg's (2008) wind energy planning framework typologies. I conclude that the typology utilized in Texas should be employed in British Columbia in order to facilitate utilizing wind power. The only adaptation needed is the establishment of a cross-jurisdictional review committee for project assessment to address concerns about local involvement and site-specific environmental and social concerns.

Processing large remote sensing image data sets on Beowulf clusters

USGS Publications Warehouse

Steinwand, Daniel R.; Maddox, Brian; Beckmann, Tim; Schmidt, Gail

2003-01-01

High-performance computing is often concerned with the speed at which floating- point calculations can be performed. The architectures of many parallel computers and/or their network topologies are based on these investigations. Often, benchmarks resulting from these investigations are compiled with little regard to how a large dataset would move about in these systems. This part of the Beowulf study addresses that concern by looking at specific applications software and system-level modifications. Applications include an implementation of a smoothing filter for time-series data, a parallel implementation of the decision tree algorithm used in the Landcover Characterization project, a parallel Kriging algorithm used to fit point data collected in the field on invasive species to a regular grid, and modifications to the Beowulf project's resampling algorithm to handle larger, higher resolution datasets at a national scale. Systems-level investigations include a feasibility study on Flat Neighborhood Networks and modifications of that concept with Parallel File Systems.

Ethical aspects of clinical research with minors.

PubMed

Bos, Wendy; Tromp, Krista; Tibboel, Dick; Pinxten, Wim

2013-07-01

Over the past decades, clinical research has increasingly been subjected to ethical requirements and legal regulation. The specific focus of ethical and legal frameworks on competent adults (which serve as the paradigmatic research subject), however, has created an ambivalent attitude towards pediatric clinical research. On one hand, minors are regarded as a vulnerable population that deserves additional protection against the risks and burdens involved in clinical research. On the other hand, the population of minors should not be denied (or not get timely) access to the benefits of clinical research. In this paper, we will explore the legal regulation and ethical guidance that currently governs pediatric clinical research in the European Union and discuss the future challenges in this field. In addition, we will discuss major ethical concerns in pediatric clinical research, with a focus on the acceptability of research risks and the informed consent process. In the discussion, we will address key concerns in both regulating pediatric clinical research and implementing ethical and legal requirement in the actual pediatric research conduct.

Yellow Fever prevention strategies awareness among HIV-infected patients in São Paulo, Brazil.

PubMed

Avelino-Silva, Vivian Iida; Francelino, Hilario Sousa; Kallás, Esper Georges

2014-01-01

Vaccination is the main preventive strategy against Yellow Fever (YF), which is a public health concern in Brazil. However, HIV-infected patients might have insufficient knowledge regarding YF, YF prevention, and vaccines in general. In this questionnaire-based study, data from 158 HIV-infected individuals were addressed in three distinct outpatient clinics in São Paulo. Information was collected on demographic and clinical characteristics, as well as patients' knowledge of vaccines, YF and YF preventive strategies. In addition, individual YF vaccine recommendations and vaccine status were investigated. Although most participants adequately ascertain the vaccine as the main prevention strategy against YF, few participants were aware of the severity and lack of specific treatment for YF. Discrepancy in YF vaccine (patients who should have taken the vaccine, but did not) was observed in 18.8% of participants. YF is an important and preventable public health concern, and these results demonstrate that more information is necessary for the HIV-infected population.

Perspectives on academic misconduct: implications for education and practice.

PubMed

Klainberg, Marilyn B; McCrink, Andrea; Eckardt, Patricia; Schecter, Rose; Bongiorno, Anne; Sedhom, Laila

2014-01-01

From Harvard to high school, concern related to academic misconduct, specifically cheating and its impact on societal issues, has become a great concern for educational communities. While a significant number of studies on ethical behaviors in practice in other professions such as business have been published, little research exists on registered nurses in practice. Even fewer studies have, for registered nurses, addressed if there is an association between perceived academic misconduct as students and perceived unethical behaviors in the workplace. The purpose of this study was to determine the relationship between perceptions of registered professional nurses' (RNs) current workplace behaviors and the RNs' retrospective perceptions of their academic misconduct as students. A convenience sample of 1 66 RNs enrolled in master's degree programs at four university schools of nursing completed questionnaires regarding their beliefs and behaviors. The outcome of this study was significant. Results revealed a strong relationship between unethical behaviors of the RN in practice and their prior academic misconduct when they were students.

Physician retirement: a case for concern in Canadian hospitals.

PubMed Central

Gillies, J H; Ross, L C

1984-01-01

Mandatory retirement is being challenged on the basis of age discrimination, and physicians are not divorced from this social trend. In January 1982 legal precedent was set by the Manitoba Court of Appeal concerning the retirement policy for physicians in Canada. Currently, Canadian hospital bylaws include clauses that require a change in membership status once a physician reaches 65 years of age. The main arguments in favour of this change include easier physician manpower management, ensured public safety and, in some instances, greater productivity. The main arguments against this change include loss of income to physicians, loss of skilled manpower to the profession and adverse effects on the mental and physical health of retiring physicians. In an effort to resolve this conflict some Canadian hospitals are developing strategies for reviewing the specific privileges and responsibilities physicians will retain once they reach age 65. The medical staff of the Victoria General Hospital in Halifax, NS have addressed this issue through their annual reappointment process. PMID:6744174

Transmission of Bacterial Zoonotic Pathogens between Pets and Humans: The Role of Pet Food.

PubMed

Lambertini, Elisabetta; Buchanan, Robert L; Narrod, Clare; Pradhan, Abani K

2016-01-01

Recent Salmonella outbreaks associated with dry pet food and treats raised the level of concern for these products as vehicle of pathogen exposure for both pets and their owners. The need to characterize the microbiological and risk profiles of this class of products is currently not supported by sufficient specific data. This systematic review summarizes existing data on the main variables needed to support an ingredients-to-consumer quantitative risk model to (1) describe the microbial ecology of bacterial pathogens in the dry pet food production chain, (2) estimate pet exposure to pathogens through dry food consumption, and (3) assess human exposure and illness incidence due to contact with pet food and pets in the household. Risk models populated with the data here summarized will provide a tool to quantitatively address the emerging public health concerns associated with pet food and the effectiveness of mitigation measures. Results of such models can provide a basis for improvements in production processes, risk communication to consumers, and regulatory action.

Shelter strategies, humanitarian praxis and critical urban theory in post-crisis reconstruction.

PubMed

Fan, Lilianne

2012-07-01

The paper seeks to link contemporary thinking on urban shelter in the humanitarian sector to debates in the field of 'critical urban theory'. It argues that current humanitarian thinking on urban shelter shares many common concerns with critical urban theory, but that these concerns are rarely translated effectively into humanitarian practice. It attributes this disconnect not only to weaknesses in implementation capacity, but also to the need to reorient humanitarian action to address more definitively questions of power and justice. Humanitarian actors need to step back from product-delivery approaches and find ways of integrating into their analytical, planning, implementation and monitoring tools questions about access, exclusion and the historically specific ways in which these aspects converge in particular urban spaces. By doing so, the humanitarian community would benefit from a more explicit, systematic and sustained engagement with the catalytic theoretical resources that critical urban theory has to offer. © 2012 The Author(s). Journal compilation © Overseas Development Institute, 2012.

A "client perspective" helps improve services.

PubMed

1998-01-01

Egypt's Ministry of Health launched a campaign in 1992 to improve client satisfaction with family planning clinic services in the country. In the program, family planning clinic supervisors are being trained to use a checklist of 101 indicators to evaluate services, ranging from the availability of contraceptive commodities to the condition of facilities. Television messages and posters disseminated throughout communities instruct potential clients to look for gold stars on the doors of family planning clinics across the country, indicators of a clinic which meets quality service standards. This program is currently used by almost 4000 clinics nationwide. Family planning services worldwide have long focused upon increasing levels of contraceptive use. More recently, however, they are also focusing upon the quality of services provided. Frameworks for improving services tend to emphasize better ways to interact with clients, and often address how to approach specific management concerns, such as maintaining adequate contraceptive supplies. Client interaction, management concerns, and how quality makes a difference are discussed.

Food-chain contamination evaluations in ecological risk assessments

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

Linder, G.

Food-chain models have become increasingly important within the ecological risk assessment process. This is the case particularly when acute effects are not readily apparent, or the contaminants of concern are not readily detoxified, have a high likelihood for partitioning into lipids, or have specific target organs or tissues that may increase their significance in evaluating their potential adverse effects. An overview of food-chain models -- conceptual, theoretical, and empirical -- will be considered through a series of papers that will focus on their application within the ecological risk assessment process. Whether a food-chain evaluation is being developed to address relativelymore » simple questions related to chronic effects of toxicants on target populations, or whether a more complex food-web model is being developed to address questions related to multiple-trophic level transfers of toxicants, the elements within the food chain contamination evaluation can be generalized to address the mechanisms of toxicant accumulation in individual organisms. This can then be incorporated into more elaborate models that consider these organismal-level processes within the context of a species life-history or community-level responses that may be associated with long-term exposures.« less

Unilateral and Mild Bilateral Hearing Loss in Children: Past and Current Perspectives

PubMed Central

Tharpe, Anne Marie

2008-01-01

Since the early 1980s, audiologists have become increasingly aware of the potential effect of even mild degrees of hearing loss on the psychoeducational and psychosocial outcomes of children. This review describes some of the key research findings during the past several decades that have led us to our current thinking about unilateral and mild bilateral hearing loss in children. The first section addresses unilateral hearing loss. This is followed by a review of the literature on mild bilateral hearing loss. Specifically, the issues addressed include the significance of permanent mild degrees of hearing loss on children's psychoeducational and psychosocial development and the speech, language, and auditory characteristics of children with mild degrees of hearing loss. Finally, some recommendations regarding the direction of future research are offered. This review is followed by 2 articles summarizing the proceedings of a 2005 workshop convened by the Centers for Disease Control and Prevention (CDC), Early Hearing Detection and Intervention (EHDI) program, and the Marion Downs Hearing Center to address concerns about the underidentification of—and professionals' apparent lack of awareness of—permanent unilateral and minimal to mild hearing loss in children.56,57 PMID:18270174

HYPOTHESIS TESTING WITH THE SIMILARITY INDEX

EPA Science Inventory

Mulltilocus DNA fingerprinting methods have been used extensively to address genetic issues in wildlife populations. Hypotheses concerning population subdivision and differing levels of diversity can be addressed through the use of the similarity index (S), a band-sharing coeffic...

Issues and recent advances in optimal experimental design for site investigation (Invited)

NASA Astrophysics Data System (ADS)

Nowak, W.

2013-12-01

This presentation provides an overview over issues and recent advances in model-based experimental design for site exploration. The addressed issues and advances are (1) how to provide an adequate envelope to prior uncertainty, (2) how to define the information needs in a task-oriented manner, (3) how to measure the expected impact of a data set that it not yet available but only planned to be collected, and (4) how to perform best the optimization of the data collection plan. Among other shortcomings of the state-of-the-art, it is identified that there is a lack of demonstrator studies where exploration schemes based on expert judgment are compared to exploration schemes obtained by optimal experimental design. Such studies will be necessary do address the often voiced concern that experimental design is an academic exercise with little improvement potential over the well- trained gut feeling of field experts. When addressing this concern, a specific focus has to be given to uncertainty in model structure, parameterizations and parameter values, and to related surprises that data often bring about in field studies, but never in synthetic-data based studies. The background of this concern is that, initially, conceptual uncertainty may be so large that surprises are the rule rather than the exception. In such situations, field experts have a large body of experience in handling the surprises, and expert judgment may be good enough compared to meticulous optimization based on a model that is about to be falsified by the incoming data. In order to meet surprises accordingly and adapt to them, there needs to be a sufficient representation of conceptual uncertainty within the models used. Also, it is useless to optimize an entire design under this initial range of uncertainty. Thus, the goal setting of the optimization should include the objective to reduce conceptual uncertainty. A possible way out is to upgrade experimental design theory towards real-time interaction with the ongoing site investigation, such that surprises in the data are immediately accounted for to restrict the conceptual uncertainty and update the optimization of the plan.

Adapting the bioblitz to meet conservation needs.

PubMed

Parker, Sophie S; Pauly, Gregory B; Moore, James; Fraga, Naomi S; Knapp, John J; Principe, Zachary; Brown, Brian V; Randall, John M; Cohen, Brian S; Wake, Thomas A

2018-03-01

When conservation strategies require new, field-based information, practitioners must find the best ways to rapidly deliver high-quality survey data. To address this challenge, several rapid-assessment approaches have been developed since the early 1990s. These typically involve large areas, take many months to complete, and are not appropriate when conservation-relevant survey data are urgently needed for a specific locale. In contrast, bioblitzes are designed for quick collection of site-specific survey data. Although bioblitzes are commonly used to achieve educational or public-engagement goals, conservation practitioners are increasingly using a modified bioblitz approach to generate conservation-relevant data while simultaneously enhancing research capacity and building working partnerships focused on conservation concerns. We term these modified events expert bioblitzes. Several expert bioblitzes have taken place on lands of conservation concern in Southern California and have involved collaborative efforts of government agencies, nonprofit organizations, botanic gardens, museums, and universities. The results of expert bioblitzes directly informed on-the-ground conservation and decision-making; increased capacity for rapid deployment of expert bioblitzes in the future; and fostered collaboration and communication among taxonomically and institutionally diverse experts. As research and conservation funding becomes increasingly scarce, expert bioblitzes can play an increasingly important role in biodiversity conservation. © 2018 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

Perceived Academic Control and Academic Emotions Predict Undergraduate University Student Success: Examining Effects on Dropout Intention and Achievement.

PubMed

Respondek, Lisa; Seufert, Tina; Stupnisky, Robert; Nett, Ulrike E

2017-01-01

The present study addressed concerns over the high risk of university students' academic failure. It examined how perceived academic control and academic emotions predict undergraduate students' academic success, conceptualized as both low dropout intention and high achievement (indicated by GPA). A cross-sectional survey was administered to 883 undergraduate students across all disciplines of a German STEM orientated university. The study additionally compared freshman students ( N = 597) vs. second-year students ( N = 286). Using structural equation modeling, for the overall sample of undergraduate students we found that perceived academic control positively predicted enjoyment and achievement, as well as negatively predicted boredom and anxiety. The prediction of dropout intention by perceived academic control was fully mediated via anxiety. When taking perceived academic control into account, we found no specific impact of enjoyment or boredom on the intention to dropout and no specific impact of all three academic emotions on achievement. The multi-group analysis showed, however, that perceived academic control, enjoyment, and boredom among second-year students had a direct relationship with dropout intention. A major contribution of the present study was demonstrating the important roles of perceived academic control and anxiety in undergraduate students' academic success. Concerning corresponding institutional support and future research, the results suggested distinguishing incoming from advanced undergraduate students.

American and German attitudes towards cow-calf separation on dairy farms

PubMed Central

Busch, Gesa; Weary, Daniel M.; Spiller, Achim; von Keyserlingk, Marina A. G.

2017-01-01

Public concerns regarding the quality of life of farm animals are often focused on specific practices such as separating the cow and calf immediately after birth. The available scientific literature provides some evidence in support of this practice (including reduced acute responses to separation when it does occur), as well as evidence of disadvantages (such as increased risk of uterine disease in cows). The aim of this study is to systematically examine public views around this practice. Specifically, this study analyzes the views of American and German citizens to separation of cow and calf at birth using a quantitative segmentation approach. Although the majority of participants opposed early separation, a small proportion of our sample supported the practice. According to participants’ preference for early and later separation and their evaluation of different arguments for both practices, three clusters were identified. US participants were more likely to support early separation compared to German participants. The arguments presented for and against both practices caused different reactions in the three clusters, but did not appear to sway the opinions of most participants. The results show considerable opposition to the practice of early separation in large parts of the sample and suggest that the dairy industry should consider approaches to address this concern. PMID:28301604

A Community-Based Approach to Developing a Mobile Device for Measuring Ambient Air Exposure, Location, and Respiratory Health

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

Rohlman, Diana; Syron, Laura; Hobbie, Kevin

In west Eugene (Oregon), community research indicates residents are disproportionately exposed to industrial air pollution and exhibit increased asthma incidence. In Carroll County (Ohio), recent increases in unconventional natural gas drilling sparked air quality concerns. These community concerns led to the development of a prototype mobile device to measure personal chemical exposure, location, and respiratory function. Working directly with the environmental justice (EJ) communities, the prototype was developed to (1) meet the needs of the community and; (2) evaluate the use in EJ communities. The prototype was evaluated in 3 community focus groups (n=25) to obtain feedback on the prototypemore » and feasibility study design to evaluate the efficacy of the device to address community concerns. Focus groups were recorded and qualitatively analyzed with discrete feedback tabulated for further refinement. The prototype was improved by community feedback resulting in 8 alterations/additions to software and instructional materials. Overall, focus group participants were supportive of the device and believed it would be a useful environmental health tool. The use of focus groups ensured that community members were engaged in the research design and development of a novel environmental health tool. We found that community-based research strategies resulted in a refined device as well as relevant research questions, specific to the EJ community needs and concerns.« less

A Community-Based Approach to Developing a Mobile Device for Measuring Ambient Air Exposure, Location, and Respiratory Health

DOE PAGES

Rohlman, Diana; Syron, Laura; Hobbie, Kevin; ...

2015-08-15

In west Eugene (Oregon), community research indicates residents are disproportionately exposed to industrial air pollution and exhibit increased asthma incidence. In Carroll County (Ohio), recent increases in unconventional natural gas drilling sparked air quality concerns. These community concerns led to the development of a prototype mobile device to measure personal chemical exposure, location, and respiratory function. Working directly with the environmental justice (EJ) communities, the prototype was developed to (1) meet the needs of the community and; (2) evaluate the use in EJ communities. The prototype was evaluated in 3 community focus groups (n=25) to obtain feedback on the prototypemore » and feasibility study design to evaluate the efficacy of the device to address community concerns. Focus groups were recorded and qualitatively analyzed with discrete feedback tabulated for further refinement. The prototype was improved by community feedback resulting in 8 alterations/additions to software and instructional materials. Overall, focus group participants were supportive of the device and believed it would be a useful environmental health tool. The use of focus groups ensured that community members were engaged in the research design and development of a novel environmental health tool. We found that community-based research strategies resulted in a refined device as well as relevant research questions, specific to the EJ community needs and concerns.« less

Electromyogenic Artifacts and Electroencephalographic Inferences Revisited

PubMed Central

McMenamin, Brenton W.; Shackman, Alexander J.; Greischar, Lawrence L.; Davidson, Richard J.

2010-01-01

Recent years have witnessed a renewed interest in using oscillatory brain electrical activity to understand the neural bases of cognition and emotion. Electrical signals originating from pericranial muscles represent a profound threat to the validity of such research. Recently, McMenamin et al (2010) examined whether independent component analysis (ICA) provides a sensitive and specific means of correcting electromyogenic (EMG) artifacts. This report sparked the accompanying commentary (Olbrich, Jödicke, Sander, Himmerich & Hegerl, in press), and here we revisit the question of how EMG can alter inferences drawn from the EEG and what can be done to minimize its pernicious effects. Accordingly, we briefly summarize salient features of the EMG problem and review recent research investigating the utility of ICA for correcting EMG and other artifacts. We then directly address the key concerns articulated by Olbrich and provide a critique of their efforts at validating ICA. We conclude by identifying key areas for future methodological work and offer some practical recommendations for intelligently addressing EMG artifact. PMID:20981275

The Cool Hand Luke Effect: Failure to Communicate Effectively (Invited)

NASA Astrophysics Data System (ADS)

Davidson, M. A.

2010-12-01

There is a growing concern with the accelerating rate of local sea level change and its implications for local and regional planning and development. While there are a growing number of local governments that are beginning to seriously consider their adaptation options, the vast majority of local leaders have not yet developed confidence in the various scenarios that are currently available. To adequately address the range of possible impacts and options for addressing local sea level change, one must have more than high resolution data, model output and decision support tools. We need to have a better understandin of the range of likely impacts upon and the value of local ecosystem services as well as as understanding of the foundations of the local economies. A sound scientific foundation must exist to support 'decision making under uncertainty' but we also need to understand the very local specific cultural frameworks within which decision makers must work. This is why working with local civic organizations, NGOs and other boundary organizations is increasingly important.

Optimizing the health impacts of civil legal aid interventions: the public health framework of medical-legal partnerships.

PubMed

Lawton, Ellen; Tyler, Elizabeth Tobin

2013-07-01

Research documents the significance of the social determinants of health - the social and environmental conditions in which people live, work and play. A critical foundation of these social and environmental conditions are laws and regulations, which construct the environments in which individuals and populations live, influencing how and when people face disease. Increasingly, healthcare providers, public health professionals and lawyers concerned with social determinants are joining forces to form Medical-Legal Partnerships (MLPs) which offer a preventive approach to address the complex social, legal and systemic problems that affect the health of vulnerable populations. Now in more than 500 health and legal institutions across the country, including Rhode Island, MLP is a healthcare delivery model that integrates legal assistance as a vital component of healthcare. This article explores the many benefits of the MLP model for improving patient health, transforming medical and legal practice and institutions and generating policy changes that specifically address health disparities and social determinants.

[Measuring, evaluating and strategic development of community capacity and empowerment: introduction of a qualitative tool].

PubMed

Laverack, G

2008-12-01

This article addresses the questions of why some communities have more ability than others, why some communities are more capable at accessing resources, at influencing decision makers, are better organised and are better able at mobilising themselves towards empowerment. The difference in ability can be attributed to the level of knowledge, skills and competencies or capacity that a community has and which it can draw upon to address its concerns about the lives and health of its members. This article discusses a qualitative tool that has been extensively used in health promotion programmes to build community capacity and empowerment. The article defines the key concepts and unpacks capacity building into nine specific 'domains'. The article goes on to describe how the 'tool' can be implemented by practitioners to build and measure capacity and empowerment. The article provides an actual example from practice on the use of an innovative form of visual representation of the findings of the measurement.

Environmental implications of increased biomass energy use

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

Miles, T.R. Sr.; Miles, T.R. Jr.

1992-03-01

This study reviews the environmental implications of continued and increased use of biomass for energy to determine what concerns have been and need to be addressed and to establish some guidelines for developing future resources and technologies. Although renewable biomass energy is perceived as environmentally desirable compared with fossil fuels, the environmental impact of increased biomass use needs to be identified and recognized. Industries and utilities evaluating the potential to convert biomass to heat, electricity, and transportation fuels must consider whether the resource is reliable and abundant, and whether biomass production and conversion is environmentally preferred. A broad range ofmore » studies and events in the United States were reviewed to assess the inventory of forest, agricultural, and urban biomass fuels; characterize biomass fuel types, their occurrence, and their suitability; describe regulatory and environmental effects on the availability and use of biomass for energy; and identify areas for further study. The following sections address resource, environmental, and policy needs. Several specific actions are recommended for utilities, nonutility power generators, and public agencies.« less

Building the U.S. First Offshore Wind Farm-Applying EBM Approaches to Successfully Address Offshore Energy, Commercial Fisheries, and Recreational Boating interactions

NASA Astrophysics Data System (ADS)

Lipsky, A.

2016-12-01

In August 2015 construction commenced on the Block Island Wind Farm, the first offshore wind energy project in the U.S. This pilot-scale offshore energy project, located 18 miles offshore of the Rhode Island mainland, was sited through a comprehensive ocean planning process. As the project progressed into design and construction, our team utilized potent ecosystem based management approaches to great advantage to address the human and resource interactions that existed in the project area. These practices have included designing and executing collaborative long-term monitoring ventures to fill key science gaps and reconcile fisheries concerns, establishing effective industry to industry engagement, and developing durable multi-sector agreements. This presentation will describe the specific EBM approaches used after the planning process was completed to bring the project to construction; highlighting where key aspects of the National Ocean Policy goals and principles have been successfully applied.

Building the U.S. First Offshore Wind Farm-Applying EBM Approaches to Successfully Address Offshore Energy, Commercial Fisheries, and Recreational Boating interactions

NASA Astrophysics Data System (ADS)

Lipsky, A.

2016-02-01

In August 2015 construction commenced on the Block Island Wind Farm, the first offshore wind energy project in the U.S. This pilot-scale offshore energy project, located 18 miles offshore of the Rhode Island mainland, was sited through a comprehensive ocean planning process. As the project progressed into design and construction, our team utilized potent ecosystem based management approaches to great advantage to address the human and resource interactions that existed in the project area. These practices have included designing and executing collaborative long-term monitoring ventures to fill key science gaps and reconcile fisheries concerns, establishing effective industry to industry engagement, and developing durable multi-sector agreements. This presentation will describe the specific EBM approaches used after the planning process was completed to bring the project to construction; highlighting where key aspects of the National Ocean Policy goals and principles have been successfully applied.

The hopes and fears of in utero gene therapy for genetic disease--a review.

PubMed

Coutelle, C; Themis, M; Waddington, S; Gregory, L; Nivsarkar, M; Buckley, S; Cook, T; Rodeck, C; Peebles, D; David, A

2003-10-01

Somatic gene delivery in utero is a novel approach to gene therapy for genetic disease. It is based on the concept that application of gene therapy vectors to the fetus in utero may prevent the development of early disease related tissue damage, may allow targeting of otherwise inaccessible organs, tissues and still expanding stem cell populations and may also provide postnatal tolerance against the therapeutic transgenic protein. This review outlines the hypothesis and scientific background of in utero gene therapy and addresses some of the frequently expressed concerns raised by this still experimental, potentially preventive gene therapy approach. We describe and discuss the choice of vectors, of animal models and routes of administration to the fetus. We address potential risk factors of prenatal gene therapy such as vector toxicity, inadvertent germ line modification, developmental aberration and oncogenesis as well as specific risks of this procedure for the fetus and mother and discuss their ethical implications.

Alternative approaches to pollution control and waste management: Regulatory and economic instruments. Planteamientos alternos para el control de la contaminacion y el manejo de desechos: instrumentos regulatorios y economicos

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

Bernstein, J.D.

1993-01-01

The paper examines ways in which developed and developing countries control pollution and manage urban wastes. It addresses pollution issues of concern to local, provincial, and national governments, as well as nongovernmental organizations. Two approaches to pollution management are discussed: direct regulation and economic incentives. Direct regulation sets standards and enforces them through permits, licenses, and controls on land or water use. Economic incentives encourage polluters to adopt control measures and are more flexible and cost effective. Such incentives include charging fees to enterprises for pollution discharges or providing government subsidies for pollution control technology. The author tells how economicmore » incentives can supplement direct regulation and why such incentives, when properly used, offer advantages over direct regulation. The author discusses how governments have used economic incentives to deal with specific environmental issues and what factors policymakers must address when they plan pollution controls.« less

Memory Decline in Peri- and Post-menopausal Women: The Potential of Mind–Body Medicine to Improve Cognitive Performance

PubMed Central

Sliwinski, Jim R; Johnson, Aimee K; Elkins, Gary R

2014-01-01

Cognitive decline is a frequent complaint during the menopause transition and among post-menopausal women. Changes in memory correspond with diminished estrogen production. Further, many peri- and post-menopausal women report sleep concerns, depression, and hot flashes, and these factors may contribute to cognitive decline. Hormone therapy can increase estrogen but is contraindicated for many women. Mind–body medicine has been shown to have beneficial effects on sleep, mood, and hot flashes, among post-menopausal women. Further, mind–body medicine holds potential in addressing symptoms of cognitive decline post-menopause. This study proposes an initial framework for how mind–body interventions may improve cognitive performance and inform future research seeking to identify the common and specific factors associated with mind–body medicine for addressing memory decline in peri- and post-menopausal women. It is our hope that this article will eventually lead to a more holistic and integrative approach to the treatment of cognitive deficits in peri- and post-menopausal women. PMID:25125972

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.

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

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.

Iraq and Afghanistan Veterans: National Findings from VA Residential Treatment Programs

PubMed Central

Cook, Joan M.; Dinnen, Stephanie; O’Donnell, Casey; Bernardy, Nancy; Rosenheck, Robert; Desai, Rani

2013-01-01

A quality improvement effort was undertaken in Department of Veterans Affairs’ (VA) residential treatment programs for Posttraumatic Stress Disorder (PTSD) across the United States. Qualitative interviews were conducted with over 250 directors, providers, and staff during site visits of 38 programs. The aims of this report are to describe clinical issues and distinctive challenges in working with veterans from Iraq and Afghanistan and approaches to addressing their needs. Providers indicated that the most commonly reported problems were: acute PTSD symptomotology; other complex mental health symptom presentations; broad readjustment problems; and difficulty with time demands of and readiness for intensive treatment. Additional concerns included working with active duty personnel and mixing different eras in therapy. Programmatic solutions address structure (e.g., blended versus era-specific therapy), content (e.g., physical activity), and adaptations (e.g., inclusion of family; shortened length of stay). Clinical implications for VA managers and policy makers as well as non-VA health care systems and individual health care providers are noted. PMID:23458113

[Status of health psychology teaching in Chilean schools of medicine].

PubMed

Santander, Jaime T; Pinedo, José P; Repetto, Paula L

2012-07-01

Physicians should be exposed, during their training to basic concepts in psychology. To describe the current status of the formal teaching of health psychology or medical psychology in Chilean medical schools. We reviewed the programs of the courses including topics of Medical Psychology, Health Psychology and Behavioral Medicine at 18 medical schools in Chile, using a focused coding method. The contents and the time spent on these courses were considered and analyzed. Eighty three percent of medical schools have a Medical Psychology or related program, 56.3% are carried out during the first year of medical School teaching and the weekly load has an average of 4 hours. The contents are mixed and predominantly concerning general and developmental psychology, but also address specific issues of Medical Psychology in most cases. There is little clarity about the training issues to be addressed in medical psychology for medical students in Chile. It is necessary to define the minimum content that all medical graduates should learn.

The Challenges of Seeking Security While Respecting Privacy

NASA Astrophysics Data System (ADS)

Kantor, Paul B.; Lesk, Michael E.

Security is a concern for persons, organizations, and nations. For the individual members of organizations and nations, personal privacy is also a concern. The technologies for monitoring electronic communication are at the same time tools to protect security and threats to personal privacy. Participants in this workshop address the interrelation of personal privacy and national or societal security, from social, technical and legal perspectives. The participants represented industry, the academy and the United States Government. The issues addressed have become, if anything, even more pressing today than they were when the conference was held.

Behavioral Responses Of Fish To A Current-Based Hydrokinetic Turbine Under Mutlipe Operational Conditions: Final Report

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

Grippo, Mark A.; Shen, Haixue; Zydlewski, Gayle

There is significant interest in the interaction of aquatic organisms with current-based marine and hydrokinetic (MHK) technologies. Determining the potential impacts of MHK devices on fish behavior is critical to addressing the environmental concerns that could act as barriers to the permitting and deployment of MHK devices. To address these concerns, we use field monitoring and fish behavior models to characterize the behavioral responses of fish to MHK turbines and infer potential stimuli that may have elicited the observed behavioral changes.

Contributions of mobile technologies to addiction research.

PubMed

Swendsen, Joel

2016-06-01

Mobile technologies are revolutionizing the field of mental health, and particular progress has been made in their application to addiction research and treatment. The use of smartphones and other mobile devices has been shown to be feasible with individuals addicted to any of a wide range of substances, with few biases being observed concerning the repeated monitoring of daily life experiences, craving, or substance use. From a methodological point of view, the use of mobile technologies overcomes longstanding limitations of traditional clinical research protocols, including the more accurate assessment of temporal relationships among variables, as well as the reduction in both contextual constraints and discipline-specific methodological isolation. The present article presents a conceptual review of these advances while using illustrations of research applications that are capable of overcoming specific methodological barriers. Finally, a brief review of both the benefits and risks of mobile technology use for the treatment of patients will be addressed.

Advanced software development workstation. Comparison of two object-oriented development methodologies

NASA Technical Reports Server (NTRS)

Izygon, Michel E.

1992-01-01

This report is an attempt to clarify some of the concerns raised about the OMT method, specifically that OMT is weaker than the Booch method in a few key areas. This interim report specifically addresses the following issues: (1) is OMT object-oriented or only data-driven?; (2) can OMT be used as a front-end to implementation in C++?; (3) the inheritance concept in OMT is in contradiction with the 'pure and real' inheritance concept found in object-oriented (OO) design; (4) low support for software life-cycle issues, for project and risk management; (5) uselessness of functional modeling for the ROSE project; and (6) problems with event-driven and simulation systems. The conclusion of this report is that both Booch's method and Rumbaugh's method are good OO methods, each with strengths and weaknesses in different areas of the development process.

Evaluation of weapons' combustion products in armored vehicles. Final report, 30 September 1986-14 December 1988

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

Menzies, K.T.; Randel, M.A.; Quill, A.L.

1989-01-01

The U.S. Army Biomedical Research and Development Laboratory defined an extensive research program to address the generation of potentially toxic propellant combustion products in crew compartments of armored vehicles during weapons firing. The major objectives of the research were: (1) to determine the presence and concentration of propellant combustion products, (2) to determine potential crew exposure to these combustion products, and (3) to assess the efficacy of field monitoring in armored vehicles. To achieve these goals, air monitoring was conducted in selected armored vehicle types, i.e., M109, M60, M3, M1, at several Army installations. Auxiliary information concerning the specific munitionsmore » fired and the Training and Doctrine Command (TRADOC) or Forces Command (FORSCOM) firing scenarios was collected so that a comparison of pollutant concentrations generated by specific weapons both within vehicle types and between vehicle types could be made.« less

Health-related quality of life assessment among patients with inflammatory bowel diseases after surgery – review

PubMed Central

Formanowicz, Dorota; Gmerek, Łukasz; Krokowicz, Piotr

2016-01-01

Aim of the work was to review systematically the published literature addressing whether quality of life (QoL) and health-related QoL (HRQoL) are influenced by surgery among patients with inflammatory bowel disease (IBD). Electronic databases and published articles were searched to identify relevant studies published in the years 1990–2015. Then, a multistep selection was undertaken to identify articles that met specific selection criteria, such us specific key-words (IBD, HRQoL, ulcerative colitis (UC), Crohn’s disease (CD), and surgery), and the population was assessed (studies concerning patients < 18 years old were excluded). The review included 27 studies that were evaluated in the context of the influence of surgery on QoL and HRQoL. Concluding, with the increase in the incidence of IBD, monitoring of QoL is an important indicator of the health effects at each stage of the surgical treatment. PMID:28337230

Clean room survey and assessment, volume 5, appendix H

NASA Technical Reports Server (NTRS)

1991-01-01

The scope of this task is to perform a comparative analysis of the various Environmental Control Life Support System (ECLSS) options for different growth scenarios. The Space Station Freedom ECLSS design and existing ground-based clean room facilities are used as a baseline for comparison. Specifically addressed here are the ground based clean room facilities at the Marshall Space Flight Center (MSFC). Given here is an evaluation of the facilities, equipment, technologies, and procedures used to maintain specified environments in typical aerospace industrial areas. Twenty-five specific clean rooms are evaluated. The objectives were to collect, compare, and catalog data for each specified facility in the areas of engineering and design, construction materials, work stations, contamination control, particulate elimination, entry systems, and instrumentation, and to make recommendations concerning enhancements required to assure an efficient and orderly evolution of MSFC clean room environmental control facilities.

Morbid Obesity in Disasters: Bringing the “Conspicuously Invisible” into Focus

PubMed Central

Gray, Lesley; MacDonald, Carol

2016-01-01

It is a frightening reality for some people to be caught up in the midst of a disaster, alone and vulnerable due to their relative size, shape or weight. A literature search failed to find any empirical reports of data specific to body mass index (BMI) in disaster situations. A handful of largely anecdotal reports described situations in which people categorised as morbidly obese were negatively impacted in disasters because of their size and/or weight. While a small number of toolkits and training resources were found, there remains a paucity of research in relation to obesity and emergency planning or disaster risk reduction. This is somewhat surprising, considering the concern about increasing levels of obesity globally. Research is urgently needed to prioritise and address the specific considerations of people with morbid obesity and how communities plan, prepare, respond, and recover from disasters and public health emergencies. PMID:27775636

Use of convalescent plasma in Ebola virus infection.

PubMed

Garraud, Olivier

2017-02-01

The recent Ebola virus epidemics which threatened three West African countries (Dec.2014-Apr.2016) has urged global collaborative health organizations and countries to set up measures to stop the infection and to treat patients, near half of them being at risk of death. Convalescent plasma-recovered from rescued West Africans-was considered a feasible therapeutic option. Efficacy was difficult to evaluate because of numerous unknowns (especially evolution of neutralizing antibodies), prior to the cessation of active transmission. This raises a large body of questions spanning epidemiological, virological, immunological but also ethical, sociological and anthropological aspects, alongside with public health concerns, in order to be better prepared to the next outbreak. This essay summarizes efforts made by a large number of groups worldwide, and attempts to address still unanswered questions on the benefit of specific versus non-specific plasma on altered-leaking-vascular endothelia in Ebola infection. Copyright © 2016 Elsevier Ltd. All rights reserved.

Sterile-Insect Methods for Control of Mosquito-Borne Diseases: An Analysis

PubMed Central

Benedict, Mark; Bellini, Romeo; Clark, Gary G.; Dame, David A.; Service, Mike W.; Dobson, Stephen L.

2010-01-01

Abstract Effective vector control, and more specifically mosquito control, is a complex and difficult problem, as illustrated by the continuing prevalence (and spread) of mosquito-transmitted diseases. The sterile insect technique and similar methods control certain agricultural insect pest populations in a species-specific, environmentally sound, and effective manner; there is increased interest in applying this approach to vector control. Such an approach, like all others in use and development, is not a one-size-fits-all solution, and will be more appropriate in some situations than others. In addition, the proposed release of pest insects, and more so genetically modified pest insects, is bound to raise questions in the general public and the scientific community as to such a method's efficacy, safety, and sustainability. This article attempts to address these concerns and indicate where sterile-insect methods are likely to be useful for vector control. PMID:19725763

Integrating interface slicing into software engineering processes

NASA Technical Reports Server (NTRS)

Beck, Jon

1993-01-01

Interface slicing is a tool which was developed to facilitate software engineering. As previously presented, it was described in terms of its techniques and mechanisms. The integration of interface slicing into specific software engineering activities is considered by discussing a number of potential applications of interface slicing. The applications discussed specifically address the problems, issues, or concerns raised in a previous project. Because a complete interface slicer is still under development, these applications must be phrased in future tenses. Nonetheless, the interface slicing techniques which were presented can be implemented using current compiler and static analysis technology. Whether implemented as a standalone tool or as a module in an integrated development or reverse engineering environment, they require analysis no more complex than that required for current system development environments. By contrast, conventional slicing is a methodology which, while showing much promise and intuitive appeal, has yet to be fully implemented in a production language environment despite 12 years of development.

Contributions of mobile technologies to addiction research

PubMed Central

Swendsen, Joel

2016-01-01

Mobile technologies are revolutionizing the field of mental health, and particular progress has been made in their application to addiction research and treatment. The use of smartphones and other mobile devices has been shown to be feasible with individuals addicted to any of a wide range of substances, with few biases being observed concerning the repeated monitoring of daily life experiences, craving, or substance use. From a methodological point of view, the use of mobile technologies overcomes longstanding limitations of traditional clinical research protocols, including the more accurate assessment of temporal relationships among variables, as well as the reduction in both contextual constraints and discipline-specific methodological isolation. The present article presents a conceptual review of these advances while using illustrations of research applications that are capable of overcoming specific methodological barriers. Finally, a brief review of both the benefits and risks of mobile technology use for the treatment of patients will be addressed. PMID:27489461

Morbid Obesity in Disasters: Bringing the "Conspicuously Invisible" into Focus.

PubMed

Gray, Lesley; MacDonald, Carol

2016-10-20

It is a frightening reality for some people to be caught up in the midst of a disaster, alone and vulnerable due to their relative size, shape or weight. A literature search failed to find any empirical reports of data specific to body mass index (BMI) in disaster situations. A handful of largely anecdotal reports described situations in which people categorised as morbidly obese were negatively impacted in disasters because of their size and/or weight. While a small number of toolkits and training resources were found, there remains a paucity of research in relation to obesity and emergency planning or disaster risk reduction. This is somewhat surprising, considering the concern about increasing levels of obesity globally. Research is urgently needed to prioritise and address the specific considerations of people with morbid obesity and how communities plan, prepare, respond, and recover from disasters and public health emergencies.

Ketorolac as an analgesic agent for infants and children after cardiac surgery: safety profile and appropriate patient selection.

PubMed

Jalkut, Meredith K

2014-01-01

Ketorolac has been used safely as an analgesic agent for children following cardiac surgery in selected populations. Controversy exists among institutions about the risks involved with this medication in this patient group. This article reviews the current literature regarding the safety of ketorolac for postoperative pain management in children after cardiac surgery. Specifically, concerns about renal dysfunction and increased bleeding risk are addressed. Additionally, the article details pharmacokinetics and potential benefits of ketorolac, such as its opioid-sparing effect. The literature reflects that the use of this medication is not well studied in certain pediatric cardiac patients such as neonates and those with single-ventricle physiology, and the safety of this medication in regards to these special populations is reviewed. In conclusion, ketorolac can be used in specific pediatric patients after cardiac surgery with minimal risk of bleeding or renal dysfunction with appropriate dosing and duration of use.

Adaptation and readaptation medical concerns of a Mars trip

NASA Technical Reports Server (NTRS)

Johnson, Philip C.

1986-01-01

The ability of the human body to adapt to microgravity environments and to later readapt to a gravity environment was examined. Issues specifically relating to the effects of long duration space flight on the adaptation/readaptation process are discussed. The need for better health prediction techniques is stressed in order to be able to better anticipate crew health problems and to perform corrective actions. Several specific examples are discussed of latent diseases which could occur during a long duration space mission, even after having subjected the crew to thorough premission checkups. The need for learning how to prevent or ameliorate such problems as space adaptation syndrome, bone and muscle (and possibly tissue) atrophy, immune system atrophy, and heart arrythmias is also discussed. The implications of the age of the crew, the influence of an onboard low level gravity field, and drugs are briefly addressed as factors in the adaptation/readaptation process.

Healthy marriage initiatives: on the need for empiricism in policy implementation.

PubMed

Johnson, Matthew D

2012-01-01

The association between marriage and well-being has led to policies that promote marital interventions and discourage divorce. These include federal initiatives specifically targeting poor couples and couples of color. While there are many prospective studies on marriage that have informed some couple interventions, the studies that are included in this literature sampled predominantly White and middle-class couples. By comparison, far less is known about the longitudinal predictors of relationship satisfaction and status for poor couples and couples of color. Therefore, it is unsurprising that preliminary data on applying current interventions to the couples targeted by these federal initiatives have been disappointing. In this article, I detail three concerns with these initiatives, propose a course of psychological research to address deficits in what is known about poor couples and couples of color, and make specific recommendations to enhance the effectiveness of these initiatives.

Earth Observing System/Meteorological Satellite (EOS/METSAT). Advanced Microwave Sounding Unit-A (AMSU-A) Contamination Control Plan

NASA Technical Reports Server (NTRS)

Fay, M.

1998-01-01

This Contamination Control Plan is submitted in response the Contract Document requirements List (CDRL) 007 under contract NAS5-32314 for the Earth Observing System (EOS) Advanced Microwave Sounding Unit A (AMSU-A). In response to the CDRL instructions, this document defines the level of cleanliness and methods/procedures to be followed to achieve adequate cleanliness/contamination control, and defines the required approach to maintain cleanliness/contamination control through shipping, observatory integration, test, and flight. This plan is also applicable to the Meteorological Satellite (METSAT) except where requirements are identified as EOS-specific. This plan is based on two key factors: a. The EOS/METSAT AMSU-A Instruments are not highly contamination sensitive. b. Potential contamination of other EOS Instruments is a key concern as addressed in Section 9/0 of the Performance Assurance Requirements for EOS/METSAT Integrated Programs AMSU-A Instrument (MR) (NASA Specification S-480-79).

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

PubMed

Sachdeva, Ajit K

2007-11-01

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