Conflict of Interest Arises as Concern in Standards Push

ERIC Educational Resources Information Center

Zehr, Mary Ann

2009-01-01

A respected literacy-research organization is asking that a process be put in place to make more transparent potential conflicts of interest that writers of the common national academic standards might have, and to address them. The Literacy Research Association sent a letter Oct. 21 to the groups overseeing the development of common standards…

Optimizing study design for multi-species avian monitoring programmes

Treesearch

Jamie S. Sanderlin; William M. Block; Joseph L. Ganey

2014-01-01

Many monitoring programmes are successful at monitoring common species, whereas rare species, which are often of highest conservation concern, may be detected infrequently. Study designs that increase the probability of detecting rare species at least once over the study period, while collecting adequate data on common species, strengthen programme ability to address...

The Bridge of Language.

ERIC Educational Resources Information Center

Frye, Northrop

1981-01-01

A literary critic addresses science-oriented readers as an outsider and reviews the division between literature and the sciences. A common meeting point is seen in today's world in such broad concerns as environmental pollution. (MP)

Strengthening the Connection between School and Home. Essentials for Principals[TM].

ERIC Educational Resources Information Center

Caplan, Judith

This guide is intended for school leaders acting to involve families in the education of their children. A common concern is the amount and kinds of family involvement that lead to a positive school climate and higher student achievement. To address this concern, strategies are outlined to help school leaders in deciding upon the kinds of family…

Treatment and care of patients with metastatic breast cancer.

PubMed

Beaumont, T; Leadbeater, M

This article provides an overview of the treatment options available for patients diagnosed with metastatic breast cancer. The article focuses on the four common organ sites affected by metastatic breast cancer, including the bone, lungs, liver and brain. The implications for nursing care are addressed, highlighting common side effects of treatment and frequent areas of concern for patients.

The Foreign Language Classroom: New Techniques. Report of Central States Conference on the Teaching of Foreign Languages.

ERIC Educational Resources Information Center

Garfinkel, Alan, Ed.; And Others

The summary of the 1983 Central States Conference on the Teaching of Foreign Languages includes these papers: "A Look at Our Profession: Common Concerns, Common Dreams" (Mary Finocchiaro's keynote address to the 1982 Central States Conference); "Traversing the Language 'Gateway': The Passport Lesson" (Dana Carton); "Personal Growth Through…

Common Sense and the Uncommon Bacterium--Is "Life" Patentable?

ERIC Educational Resources Information Center

Kiley, Thomas D.

1978-01-01

The Supreme Court is faced with some difficult issues with a common origin in disagreement between the Patent and Trademark Office and the Court of Customs and Patent Appeals over the code that defines what things are and are not patentable. The patent concerns of the computer software and molecular biology fields are addressed. (JMD)

The Postmodernism of David Antin's "Tuning."

ERIC Educational Resources Information Center

Altieri, Charles

1986-01-01

Shows that Antin's talk poems satisfy basic needs. Discusses Antin's view on an art that addresses the concerns of "common life" and concentrates on feelings that do not depend on elaborate and evasively self-sustaining formal constructs. (EL)

Synthesis of common management concerns associated with dam removal

USGS Publications Warehouse

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

2016-01-01

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

Common Core State Standards for Mathematics: How Well Do the Textbook and Instructional Methods Align?

ERIC Educational Resources Information Center

Rawding, Denise M.

2016-01-01

The Common Core Math Standards were written to address concerns that the math curriculum in the United States was not focused and coherent. Based on national and international assessments, the United States math scores have remained stagnant, while other countries have seen significant growth in their scores. This study, designed as an action…

Surgical Management of Common Disorders of Feedlot Calves.

PubMed

Miesner, Matt D; Anderson, David E

2015-11-01

Procedures to improve animal and handler safety, shape production parameters, and directly address the prosperity of individuals in need of assistance are performed routinely. Techniques to accomplish these tasks have been described in many venues. Painful procedures are expected in feedlot practice. Assessing and managing pain and welfare for these procedures has strengthened significantly over the past decade to address increased public concerns and also to support the desires of the operators/managers to progress. Methods to perform common procedures are described, including evidence and techniques for managing the pain and distress while performing them. Published by Elsevier Inc.

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.

Impacts of marsh management on coastal-marsh bird habitats

USGS Publications Warehouse

Mitchell, L.R.; Gabrey, S.; Marra, P.P.; Erwin, R.M.

2006-01-01

The effects of habitat-management practices in coastal marshes have been poorly evaluated. We summarize the extant literature concerning whether these manipulations achieve their goals and the effects of these manipulations on target (i.e., waterfowl and waterfowl food plants) and non-target organisms (particularly coastal-marsh endemics). Although we focus on the effects of marsh management on birds, we also summarize the scant literature concerning the impacts of marsh manipulations on wildlife such as small mammals and invertebrates. We address three common forms of anthropogenic marsh disturbance: prescribed fire, structural marsh management, and open-marsh water management. We also address marsh perturbations by native and introduced vertebrates.

Vaccinating Your Preteen: Addressing Common Concerns

MedlinePlus

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

A strategic stakeholder approach for addressing further analysis requests in whole genome sequencing research.

PubMed

Thornock, Bradley Steven O

2016-01-01

Whole genome sequencing (WGS) can be a cost-effective and efficient means of diagnosis for some children, but it also raises a number of ethical concerns. One such concern is how researchers derive and communicate results from WGS, including future requests for further analysis of stored sequences. The purpose of this paper is to think about what is at stake, and for whom, in any solution that is developed to deal with such requests. To accomplish this task, this paper will utilize stakeholder theory, a common method used in business ethics. Several scenarios that connect stakeholder concerns and WGS will also posited and analyzed. This paper concludes by developing criteria composed of a series of questions that researchers can answer in order to more effectively address requests for further analysis of stored sequences.

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

Mechanisms and Permanence of Sequestered Pb and As in Soils: Impact on Human Bioavailability

DTIC Science & Technology

2016-12-01

Human health risk assessment ICP-MS Inductively coupled plasma - mass spectrometry ICP-OES Inductively coupled plasma – optical emission spectrometry...the most common contaminants of concern exceeding risk criteria because soil ingestion is the primary human health risk driver at many DoD sites...development activities must address to realize the use of bioavailability in human health risk assessment (HHRA). Our proposal addressed three of the

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.

IEP Common Talk. PAGE Bulletin.

ERIC Educational Resources Information Center

Pennsylvania Association for Gifted Education, Norristown.

This bulletin presents basic information for parents about identification and services for gifted students in Pennsylvania. Written in a question and answer format, the bulletin addresses the following concerns: the Individualized Education Program (IEP) required for all exceptional students in the state; the multi-disciplinary evaluation process;…

The opportunities for and challenges of common integrated electronics

NASA Astrophysics Data System (ADS)

Nelson, J. R.; Retterer, Bernard L.; Cloud, Harley A.

1994-02-01

This document summarizes a portion of IDA's work concerning common integrated electronics and the potential cost savings of using common electronic hardware and software. It addresses trends in avionics costs and recent experiences in applying common electronic standards to weapon programs as a way to reduce costs. The following essential elements of a program to acquire common integrated electronics are explored: (1) integrated system architecture; (2) advanced technology programs; (3) open system standards; (4) standard common modules; and (5) associated management and policies. The principal recommendation is that OSD support and coordinate such a-program by taking a strong leadership role and setting standards policy.

Medication education and consultation at a senior dining program for independently living seniors.

PubMed

Schmiedt, Dean; Ellingson, Jody

2010-08-01

To determine if pharmacist involvement within a senior dining program benefits diners by addressing their medication-related questions, using educational sessions, and providing individual consultations. Catholic Charities Senior Dining sites in central Minnesota. Pharmacists went to three senior dining sites, providing educational sessions and individual consultations to independently living senior diners. Pharmacists developed a program, in a nontraditional setting, that used educational sessions and individual consultations to assist seniors with their medication-related questions. The number of diner questions, significant issues raised, issues addressed, and level of diner satisfaction. Pharmacists made 36 visits from January to December 2009. During those visits they presented educational talks to 3,089 diners, and 12.4% of all diners spoke individually with pharmacists. Pharmacists addressed 581 questions or concerns from 384 diners. Significant issues were noted in 25.8% of individual consultations (144 questions). The most common significant issues included: adverse drug reactions (59), indications without treatment (27), and drug interactions (23). Nonopioid analgesics, antilipemics, and antihypertensive medications were most commonly involved in significant issues. Satisfaction surveys were strongly positive, with 97% indicating pharmacists had addressed their medication-related concern; only 3% did not reply. Almost half (42.7%) of satisfaction surveys indicated the diner would change something as a result of meeting with the pharmacist. Pharmacist availability in a nontraditional setting can assist seniors with addressing potentially significant medication-related issues. Independently living seniors will seek out information from a pharmacist in a convenient setting.

Depression, financial problems and other reasons for suspending medical studies, and requested support services: findings from a qualitative study.

PubMed

Soh, Nerissa; Ma, Colleen; Lampe, Lisa; Hunt, Glenn; Malhi, Gin; Walter, Garry

2012-12-01

This study aimed to qualitatively explore medical students' reasons for suspending, or thinking of suspending, their studies and the types of support services they request. Data were collected through an anonymous online survey. Medical students' responses to open-ended questions were analyzed thematically. Responses were received from 475 students. Financial problems, doubts as to whether medicine was the right vocation, and depression were the most commonly reported themes. Students endorsed a wide range of other pressures and concerns, barriers to obtaining assistance, and also suggested solutions and services to address their concerns. Medical students' financial concerns and potential depressive symptoms should be addressed by university and faculty support services. Government financial support mechanisms for students should also be reviewed. Students' suggestions of the types of services and their location must be borne in mind when allocating resources.

Callosobruchus maculatus: A Seed Beetle with a Future in Schools.

ERIC Educational Resources Information Center

Dockery, Michael

1997-01-01

Recommends the use of seed beetles for studying animal behavior and provides suggestions for practical and project assignments. Sources for obtaining the beetles and a list of the equipment needed for their study and maintenance are provided. Answers to common concerns are addressed. (DDR)

Addressing Sexuality and Pregnancy in Childbirth Education Classes

PubMed Central

Allen, Laura; Fountain, Lily

2007-01-01

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

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 valid are the common concerns raised against water birth? A focused review of the literature.

PubMed

Young, Kate; Kruske, Sue

2013-06-01

Women have birthed in water for many years, with researchers finding a number of benefits for mother and baby. Despite these benefits, many health institutions and clinicians are hesitant to support women's access to water immersion in birth for a number of reasons. As such, this paper aimed to (1) select five common concerns raised against water birth and (2) examine whether research supports these concerns as being evidence-based. A literature review was conducted to (1) select the concerns for review and to (2) review each selected concern as to whether they were supported by the current evidence. A recent review of women's access to, and uptake of, water immersion in Queensland, Australia, was also used to determine the concerns for review in order to better capture concerns relevant to Australian practice. Three clinical concerns were selected for review: water aspiration, neonatal and maternal infection, and neonatal and maternal thermo-regulation; and two concerns around the practice of water birth were selected: skills and education of workforce, and emergency procedures in case of maternal collapse. The three clinical concerns were not found to be supported by the available evidence and the two practice concerns can be addressed by appropriate policy, guidelines and practice. The reviewed common concerns against water birth are not evidence-based nor are they sufficient to prevent women from accessing the use of water in labour and birth. Health institutions and clinicians should ensure they take adequate precautions to enable women access to this valued and effective method of birth. Copyright © 2012 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Transforming the University Campus into a Sustainable Community

ERIC Educational Resources Information Center

Norton, Richard K.; Brix, Andrew; Brydon, Trevor; Davidian, Elijah; Dinse, Keely; Vidyarthi, Sanjeev

2007-01-01

This study addresses several common shortcomings of current university campus sustainability initiatives, including a lack of attention to integrative issues such as land use, housing, and transportation, and a generally reactive rather than proactive approach to sustainability. To engage these concerns, we develop a model for assessing the…

Unionizing: A Guide for Child Care Workers.

ERIC Educational Resources Information Center

Whitebook, Marcy; And Others

Including excerpts from contracts protecting unionized child care workers, this booklet explains basic terminology and facts about unionizing and addresses child care workers' concerns. Section 1 answers commonly asked questions about unions and offers advice about how to answer parents' questions about workers' attempts to organize. Section 2…

Neoliberalism and Justice in Education for Sustainable Development: A Call for Inclusive Pluralism

ERIC Educational Resources Information Center

Kopnina, Helen; Cherniak, Brett

2016-01-01

Commonly conceived, sustainable development is concerned with social and economic equity and maintenance of ecological stability for future generations. The Brundtland Report addresses the ethical principles of intragenerational and intergenerational equity as fundamental pillars of sustainable development. This equity is often defined in economic…

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…

Detection and characterization of gene-gene and gene-environment interactions in common human diseases and complex clinical endpoints

EPA Science Inventory

Biological organisms are complex systems that dynamically integrate inputs from a multitude of physiological and environmental factors. Therefore, in addressing questions concerning the etiology of complex health outcomes, it is essential that the systemic nature of biology be ta...

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

ERIC Educational Resources Information Center

Allan, Elizabeth G.

2016-01-01

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

Keys to Transition: The California Model.

ERIC Educational Resources Information Center

Kearly, Patt

This publication addresses basic issues related to the concept of transition as it is applied to students with disabilities in California. Following a pretest (and its answer key), the document uses a question and answer format to discuss common concerns about transition, normalization, the school role, the "Bridges" model developed by…

Participatory Action Research with Colombian Immigrants

ERIC Educational Resources Information Center

Balcazar, Fabricio E.; Garcia-Iriarte, Edurne; Suarez-Balcazar, Yolanda

2009-01-01

This article describes a participatory needs assessment process in which Colombian immigrants in Chicago collaborated with university researchers to identify their common concerns and implement self-help efforts to address some of their most pressing needs. A total of 261 Colombians completed a needs assessment survey, and 46 attended a public…

Ensuring the common for the goose: Implementing effective watershed policies

Treesearch

Hanna J. Cortner; Margaret A. Moote

2000-01-01

Addressing public and scientific concerns about human impacts on long-term ecological sustainability will require new approaches to resource management. These new approaches, which place considerable emphasis on management on the landscape or watershed scale, stress holistic and integrated science, meaningful public involvement to reflect changing social goals and...

Cultural Pluralism in Japan: A Sociolinguistic Outline.

ERIC Educational Resources Information Center

Honna, Nobuyuki

1980-01-01

Addressing the common misconception that Japan is a mono-ethnic, mono-cultural, and monolingual society, this article focuses on several areas of sociolinguistic concern. It discusses: (1) the bimodalism of the Japanese deaf population between Japanese Sign Language as native language and Japanese Spoken Language as acquired second language; (2)…

Classroom Instructional Ecology and School-Wide Positive Behavior Support

ERIC Educational Resources Information Center

Algozzine, Kate; Algozzine, Bob

2007-01-01

Addressing increasing levels of disruptive behavior and improving discipline is a national matter. The challenge is intensified by teachers' concerns about the growing inclusion of students with emotional and behavioral problems in general education classrooms and the general levels of diversity common in America's schools. Removing children with…

An automated curation procedure for addressing chemical errors and inconsistencies in public datasets used in QSAR modeling

EPA Science Inventory

Increasing availability of large collections of chemical structures and associated experimental data provides an opportunity to build robust QSAR models for applications in different fields. One common concern is the quality of both the chemical structure information and associat...

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.

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

PubMed Central

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

2015-01-01

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

A Thermal Paradox: Which Gets Warmer?

ERIC Educational Resources Information Center

Salazar, Agustin; Apinaniz, Estibaliz; Mendioroz, Arantza; Oleaga, Alberto

2010-01-01

In this paper we address a common misconception concerning the thermal behaviour of matter, namely that the front surface of a very thin plate, uniformly illuminated by a constant light beam, reaches a higher temperature than the front surface of a very thick slab made out of the same material. We present analytical solutions for the temperature…

Sexuality Education in China: The Conflict between Reality and Ideology

ERIC Educational Resources Information Center

Li, Ling; King, Mark E.; Winter, Sam

2009-01-01

The December 2008 release of China's new "Guidelines for health education in primary and secondary schools" by the Ministry of Education addressed many of the concerns arising from the academic and popular discourse on Chinese adolescent sexuality and sexuality education. The focus of this reform, common with similar reforms elsewhere in…

Reading Picture Books and Learning Science: Engaging Young Children with Informational Text

ERIC Educational Resources Information Center

Mantzicopoulos, Panayota; Patrick, Helen

2011-01-01

The authors draw from the research literature and from their work with the Scientific Literacy Project (SLP) in kindergarten classrooms to address the inclusion of science picture books in the curriculum. They describe features and functions of informational texts, discuss teachers' common concerns about providing young children with experiences…

A GIS-BASED MULTI-SCALE APPROACH TO HABITAT MODEL FOR THE COMMON LOON, GAVIA IMMER, IN NEW HAMPSHIRE, USA.

EPA Science Inventory

The U.S. EPA National Health and Environmental Effects Research Laboratory's (NHEERL) Wildlife Research Strategy was developed to provide methods, models and data to address concerns related to toxic chemicals and habitat alteration in the context of wildlife risk assessment and ...

Retaining the Learning Disabled Adult. A Handbook for Adult Basic Education Instructors.

ERIC Educational Resources Information Center

Hawkins, Diane, Comp.

This handbook is designed to address teachers' most common concerns about learning disabilities (LDs) and teaching adults with LDs. Section 1 defines LDs by describing traits that adults with LDs share. Section 2 focuses on identification of students with LDs. LD characteristics are divided into eight categories: academics, speech/language, motor…

Mentoring in Sports Coaching: A Review of the Literature

ERIC Educational Resources Information Center

Jones, Robyn L.; Harris, Richard; Miles, Andrew

2009-01-01

Background: Despite criticism of its positive claims being largely unfounded and ill-clarified, the concept of mentoring has come into common use within sports coaching. Purpose: In an attempt to address these concerns, the purpose of this paper is to take better account of the researched evidence on mentoring in general before providing some…

Perceived Effectiveness of Classroom Management Interventions with Attention Deficit/Hyperactivity Disorder (ADHD) Students

ERIC Educational Resources Information Center

Conforti, Darlene

2012-01-01

Many teachers are concerned about their ability to work effectively with students who have attention deficit/ hyperactivity disorder (ADHD). The purpose of this quantitative, descriptive study was to determine the perceived efficacy of common interventions used to address negative ADHD behaviors in the elementary and middle school classrooms. The…

Comparability of Fidelity Measures for Assessing Tier 1 School-Wide Positive Behavioral Interventions and Supports

ERIC Educational Resources Information Center

Mercer, Sterett H.; McIntosh, Kent; Hoselton, Robert

2017-01-01

Several reliable and valid fidelity surveys are commonly used to assess Tier 1 implementation in School-Wide Positive Behavioral Interventions and Supports (SWPBIS); however, differences across surveys complicate consequential decisions regarding school implementation status when multiple measures are compared. To address this concern, the current…

The Importance of Minority Teachers: Student Perceptions of Minority versus White Teachers

ERIC Educational Resources Information Center

Cherng, Hua-Yu Sebastian; Halpin, Peter F.

2016-01-01

The demographic divide between teachers and students is of growing public concern. However, few studies have explicitly addressed the common argument that students, and particularly minority students, have more favorable perceptions of minority versus White teachers. Using data from the Measure of Effective Teaching study, we find that students…

WhatsApp in Stroke Systems: Current Use and Regulatory Concerns.

PubMed

Calleja-Castillo, Juan M; Gonzalez-Calderon, Gina

2018-01-01

Smartphone use is extremely common. Applications such as WhatsApp have billions of users and physicians are no exception. Stroke Medicine is a field where instant communication among fairly large groups is essential. In developing countries, economic limitations preclude the possibility of acquiring proper communication platforms. Thus, WhatsApp has been used as an organizational tool, for sharing clinical data, and for real time guidance of clinical care decisions. It has evolved into a cheap, accessible tool for telemedicine. Nevertheless, regulatory and privacy issues must be addressed. Some countries have implemented legislation to address this issue, while others lag behind. In this article, we present an overview on the different roles WhatsApp has acquired as a clinical tool in stroke systems and the potential privacy concerns of its use.

WhatsApp in Stroke Systems: Current Use and Regulatory Concerns

PubMed Central

Calleja-Castillo, Juan M.; Gonzalez-Calderon, Gina

2018-01-01

Smartphone use is extremely common. Applications such as WhatsApp have billions of users and physicians are no exception. Stroke Medicine is a field where instant communication among fairly large groups is essential. In developing countries, economic limitations preclude the possibility of acquiring proper communication platforms. Thus, WhatsApp has been used as an organizational tool, for sharing clinical data, and for real time guidance of clinical care decisions. It has evolved into a cheap, accessible tool for telemedicine. Nevertheless, regulatory and privacy issues must be addressed. Some countries have implemented legislation to address this issue, while others lag behind. In this article, we present an overview on the different roles WhatsApp has acquired as a clinical tool in stroke systems and the potential privacy concerns of its use. PMID:29904369

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.

Guiding the Development and Use of Cost-Effectiveness Analysis in Education

ERIC Educational Resources Information Center

Levin, Henry M.; Belfield, Clive

2015-01-01

Cost-effectiveness analysis is rarely used in education. When it is used, it often fails to meet methodological standards, especially with regard to cost measurement. Although there are occasional criticisms of these failings, we believe that it is useful to provide a listing of the more common concerns and how they might be addressed. Based upon…

Practical Solutions to Practically Every Problem: The Early Childhood Teacher's Manual.

ERIC Educational Resources Information Center

Saifer, Steffen

This book is designed to help early childhood teachers deal with common problems that arise in all aspects of their work. Part one addresses daily dilemmas such as schedule planning, meal and nap times, art, and outdoor play. Part two covers classroom concerns such as the physical environment, curriculum, individual student needs, field trips,…

National Aeronautics and Space Administration: Guidance for Improving Customer Satisfaction.

DTIC Science & Technology

1994-04-01

Logistics Management Institute National Aeronautics and Space Administration Guidance for Improving Customer Satisfaction NS302RD1 Lawrence... Management Institute (LMI) has been engaged to provide a common approach for planning, conducting, and analyzing customer satisfaction surveys. LMI...groups and formal surveys) (2) Process definition provides the understanding for addressing customer concerns (3) Management and employee

The Need to Address Mobile Device Security in the Higher Education IT Curriculum

ERIC Educational Resources Information Center

Patten, Karen P.; Harris, Mark A.

2013-01-01

Mobile devices, including smartphones and tablets, enable users to access corporate data from anywhere. In 2013, people will purchase 1.2 billion mobile devices, surpassing personal computers as the most common method for accessing the Internet. However, security of these mobile devices is a major concern for organizations. The two leading…

Parental Mental Illness. Building Community Systems for Young Children.

ERIC Educational Resources Information Center

Hendrick, Victoria; Daly, Kathleen

Families are the principal influence on development in the first years of life, so the mental health of parents is an issue that affects every child in California. The most common mental health concerns facing parents involve stress and anxiety. These needs can be addressed through public health messages that de-stigmatize mental illness and…

Genetic horoscopes: is it all in the genes? Points for regulatory control of direct-to-consumer genetic testing

PubMed Central

Patch, Christine; Sequeiros, Jorge; Cornel, Martina C

2009-01-01

The development of tests for genetic susceptibility to common complex diseases has raised concerns. These concerns relate to evaluation of the scientific and clinical validity and utility of the tests, quality assurance of laboratories and testing services, advice and protection for the consumer and the appropriate regulatory and policy response. How these concerns are interpreted and addressed is an ongoing debate. If the possibility of using the discoveries from genomic science to improve health is to be realised without losing public confidence, then improvements in the evaluation and mechanisms for control of supply of tests may be as important as the science itself. PMID:19259126

Genetic horoscopes: is it all in the genes? Points for regulatory control of direct-to-consumer genetic testing.

PubMed

Patch, Christine; Sequeiros, Jorge; Cornel, Martina C

2009-07-01

The development of tests for genetic susceptibility to common complex diseases has raised concerns. These concerns relate to evaluation of the scientific and clinical validity and utility of the tests, quality assurance of laboratories and testing services, advice and protection for the consumer and the appropriate regulatory and policy response. How these concerns are interpreted and addressed is an ongoing debate. If the possibility of using the discoveries from genomic science to improve health is to be realised without losing public confidence, then improvements in the evaluation and mechanisms for control of supply of tests may be as important as the science itself.

Dignity, Health, and Membership: Who Counts as One of Us?

PubMed Central

Pilkington, Bryan C.

2016-01-01

This essay serves as an introduction to this issue of the Journal of Medicine and Philosophy. The five articles in this issue address a range of topics from the human embryo and substantial change to conceptions of disability. They engage claims of moral status, defense of our humanity, and argue for an accurate and just classification of persons of different communities within a healthcare system. I argue in this essay that though their concerns are diverse, the authors in this issue help to answer a common question: “Who counts as one of us?” Reading these articles through the lens of membership and the themes of dignity illustrates this commonality and bears fruit for further reflection on many of the challenging issues addressed in the subsequent papers. PMID:26868673

Understanding social complexity within the wildland urban interface: A new species of human habitation? Environmental Management

Treesearch

Travis B. Paveglio; Pamela J. Jakes; Matthew S. Carroll; Daniel R. Williams

2009-01-01

The lack of knowledge regarding social diversity in the Wildland Urban Interface (WUI) or an in-depth understanding of the ways people living there interact to address common problems is concerning, perhaps even dangerous, given that community action is necessary for successful wildland fire preparedness and natural resource management activities. In this article, we...

What Do I Do When... The Answer Book on Placement under the IDEA and Section 504.

ERIC Educational Resources Information Center

Pitasky, Vicki M.

Formatted in a question-and-answer style, this book is intended to provide a survey and overview of the federal law governing the placement of students with disabilities. It explores the procedural and substantive requirements of the placement process and addresses the most common concerns that arise in this area of special education law. The…

School Social Workers' Perceptions of School Safety and Security in Today's Schools: A Survey of Practitioners across the United States

ERIC Educational Resources Information Center

Cuellar, Matthew J.; Elswick, Susan E.; Theriot, Matthew T.

2018-01-01

To understand the effects of school safety practices and strategies on the school environment, researchers have consistently investigated the perceptions of students and various school personnel concerning school safety. Yet school social workers, professionals commonly employed in today's schools to address the mental health needs of students,…

Cognition and the menopause transition.

PubMed

Maki, Pauline M; Henderson, Victor W

2016-07-01

Complaints about forgetfulness, "brain fog," and difficulty concentrating are common in women transitioning through menopause. Women with these cognitive complaints often express concern about whether these problems are normal, related to menopause, or represent a symptom of Alzheimer disease or another serious cognitive disorder. In this Practice Pearl, we provide a brief summary of the scientific literature on the frequency of cognitive complaints in midlife women, the validity of complaints in relation to performance on standardized cognitive tests, and the influence of menopause on cognitive performance. We then offer recommendations for healthcare providers and women to address cognitive concerns.

Medicalized Female Genital Mutilation/Cutting: Contentious Practices and Persistent Debates.

PubMed

Kimani, Samuel; Shell-Duncan, Bettina

2018-01-01

Female genital cutting/mutilation (FGM/C) performed by health care professionals (medicalization) and reduced severity of cutting have been advanced as strategies for minimizing health risks, sparking acrimonious ongoing debates. This study summarizes key debates and critically assesses supporting evidence. While medicalization is concentrated in Africa, health professionals worldwide have faced requests to perform FGM/C. Whether medicalization is hindering the decline of FGM/C is unclear. Factors motivating medicalization include, but are not limited to, safety concerns. Involvement of health professionals in advocacy to end FGM/C can address both the supply and demand side of medicalization, but raises ethical concerns regarding dual loyalty. Ongoing debates need to address competing rights claims. Polarizing debates have brought little resolution. We call for a focus on common goals of protecting the health and welfare of girls living in communities where FGM/C is upheld and encourage more informed and open dialog.

Maintaining Sexual Health throughout Gynecologic Cancer Survivorship: A Comprehensive Review and Clinical Guide

PubMed Central

Huffman, Laura B.; Hartenbach, Ellen M.; Carter, Jeanne; Rash, Joanne K.; Kushner, David M.

2016-01-01

Objective The diagnosis and treatment of gynecologic cancer can cause short- and long-term negative effects on sexual health and quality of life (QoL). The aim of this article is to present a comprehensive overview of the sexual health concerns of gynecologic cancer survivors and discuss evidence-based treatment options for commonly encountered sexual health issues. Methods A comprehensive literature search of English language studies on sexual health in gynecologic cancer survivors and the treatment of sexual dysfunction was conducted in MEDLINE databases. Relevant data are presented in this review. Additionally, personal and institutional practices are incorporated where relevant. Results Sexual dysfunction is prevalent among gynecologic cancer survivors as a result of surgery, radiation, and chemotherapy--negatively impacting QoL. Many patients expect their healthcare providers to address sexual health concerns, but most have never discussed sex-related issues with their physician. Lubricants, moisturizers, and dilators are effective, simple, non-hormonal interventions that can alleviate the morbidity of vaginal atrophy, stenosis, and pain. Pelvic floor physical therapy can be an additional tool to address dyspareunia. Cognitive behavioral therapy has been shown to be beneficial to patients reporting problems with sexual interest, arousal, and orgasm. Conclusion Oncology providers can make a significant impact on the QoL of gynecologic cancer survivors by addressing sexual health concerns. Simple strategies can be implemented into clinical practice to discuss and treat many sexual issues. Referral to specialized sexual health providers may be needed to address more complex problems. PMID:26556768

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.

Development of a replacement AMLCD used on multiple platforms

NASA Astrophysics Data System (ADS)

Walsh, Kevin L.; Gobron, Robert

2002-08-01

A goal of military display users and manufacturers is commonality: to utilize a given display on as many platforms as possible. The often-addressed concern of obsolescence of commercial AMLCDs used on military programs becomes a key issue, though, with regard to commonality. Obsolescence occurs as the tools used in the manufacture of an AMLCD age and as new and improved materials and processes are developed. The LCD manufacturer, at some point, decides to cease the manufacture of a particular AMLCD. The users of that AMLCD then have two choices: make a lifetime buy of LCDs, or find a replacement. For a display which has achieved some degree of commonality, this choice must be faced by a number of different users on a number of platforms. This paper addresses some of the problems encountered when such a choice is made, as an SVGA display made by one manufacturer is replaced by an XGA display made by a different manufacturer.

Biobanking and Privacy in India.

PubMed

Chaturvedi, Sachin; Srinivas, Krishna Ravi; Muthuswamy, Vasantha

2016-03-01

Biobank-based research is not specifically addressed in Indian statutory law and therefore Indian Council for Medical Research guidelines are the primary regulators of biobank research in India. The guidelines allow for broad consent and for any level of identification of specimens. Although privacy is a fundamental right under the Indian Constitution, courts have limited this right when it conflicts with other rights or with the public interest. Furthermore, there is no established privacy test or actionable privacy right in the common law of India. In order to facilitate biobank-based research, both of these lacunae should be addressed by statutory law specifically addressing biobanking and more directly addressing the accompanying privacy concerns. A biobank-specific law should be written with international guidelines in mind, but harmonization with other laws should not be attempted until after India has created a law addressing biobank research within the unique legal and cultural environment of India. © 2016 American Society of Law, Medicine & Ethics.

Reassessment of Self-Reported Behavioral Health Habits and Other Issues Among Distributed Common Ground System Intelligence Operators and Non-Combatant Support Personnel

DTIC Science & Technology

2017-10-28

9 4.2 Sleep and Physical Exercise Health Behaviors...excess caffeine, nicotine, and alcohol use, and a deficit in physical fitness activity can further contribute to reduction in overall health . Since...to address key physical and psychological health concerns and to promote resiliency among their designated remote warrior workforces. The purpose

Guia para Padres: Acceso a los Grupos de Padres (Accessing Parent Groups: A Parent's Guide).

ERIC Educational Resources Information Center

Interstate Research Associates, McLean, VA.

This guide, in Spanish, notes the value of parent groups for parents of children with disabilities, as they offer parents a place and a means to share information, give and receive emotional support, and work as a team to address common concerns. Typical activities of a parent group are listed, and ways of identifying parent groups that exist…

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.

Mental health concerns among Canadian physicians: results from the 2007-2008 Canadian Physician Health Study.

PubMed

Compton, Michael T; Frank, Erica

2011-01-01

In light of prior reports on the prevalence of stress, depression, and other mental health problems among physicians in training and practice, we examined the mental health concerns of Canadian physicians using data from the 2007-2008 Canadian Physician Health Study. Among 3213 respondents, 5 variables (depressive symptoms during the past year, anhedonia in the past year, mental health concerns making it difficult to handle one's workload in the past month, problems with work-life balance, and poor awareness of resources for mental health problems) were examined in relation to sex, specialty, practice type (solo practice vs group or other practice settings), and practice setting (inner city, urban/suburban, or rural/small town/remote). Nearly one quarter of physicians reported a 2-week period of depressed mood, and depression was more common among female physicians and general practitioners/family physicians. Anhedonia was reported by one fifth; anesthesiologists were most likely to report anhedonia, followed by general practitioners/family physicians. More than one quarter reported mental health concerns making it difficult to handle their workload, which was more common among female physicians and general practitioners/family physicians and psychiatrists. Nearly one quarter reported poor work-life balance. Lack of familiarity with mental health resources was problematic, which was more prominent among female physicians and specialists outside of general practice/family medicine or psychiatry. Mental health concerns are relatively common among Canadian physicians. Training programs and programmatic/policy enhancements should redouble efforts to address depression and other mental health concerns among physicians for the benefit of the workforce and patients served by Canadian physicians. Copyright © 2011 Elsevier Inc. All rights reserved.

Childhood injury: a status report, part 2.

PubMed

Crawley-Coha, Teri

2002-04-01

The October issue of The Journal of Pediatric Nursing carried the first of two parts on childhood injury. That article reviewed the importance of prevention, the short- and long-term effects of injury on the child and the family, and how to incorporate prevention strategies at home and at work. Also reviewed were three of the most common mechanisms of injury, motor vehicle crashes, bicycle crashes, and pool drowning, and prevention measures. In this second part, the remaining primary areas of concern for common pediatric injuries are addressed: poisoning, fires and burns, and firearms. Copyright 2002, Elsevier Science (USA). All rights reserved.

Self-medication for cough and the common cold: information needs of consumers.

PubMed

Kloosterboer, Sanne Maartje; McGuire, Treasure; Deckx, Laura; Moses, Geraldine; Verheij, Theo; van Driel, Mieke L

2015-07-01

Despite the high use of over-the-counter (OTC) cough and cold medicines, little is known about Australia's cough and cold medicines information needs. The aim of this study was to identify gaps in consumers' perceived knowledge and concerns, to better target consumer medicines information and improve quality use of medicines. We analysed cough-and-cold related enquiries from consumers who contacted an Australian national medicine call centre between September 2002 and June 2010. Of 5503 cough and cold calls, female callers made up 86% of the calls and 33% were related to children. Questions most frequently related to drug-drug interactions (29%). An analysis of narratives over an 18-month period (248 calls) revealed 20% of the calls concerned potentially clinically relevant interactions, particularly those involving psychotropic agents. The potential for interactions with cough and cold medicines purchased OTC is recognised by consumers. Patient information should address their concerns. Doctors should be aware of the common cough and cold interactions and communicate likely clinical symptoms to patients when prescribing medication to prevent potential harm.

Data collection challenges in community settings: Insights from two field studies of patients with chronic disease

PubMed Central

Holden, Richard J.; McDougald Scott, Amanda M.; Hoonakker, Peter L.T.; Hundt, Ann S.; Carayon, Pascale

2014-01-01

Purpose Collecting information about health and disease directly from patients can be fruitfully accomplished using contextual approaches, ones that combine more and less structured methods in home and community settings. This paper's purpose is to describe and illustrate a framework of the challenges of contextual data collection. Methods A framework is presented based on prior work in community-based participatory research and organizational science, comprised of ten types of challenges across four broader categories. Illustrations of challenges and suggestions for addressing them are drawn from two mixed-method, contextual studies of patients with chronic disease in two regions of the US. Results The first major category of challenges was concerned with the researcher-participant partnership, for example, the initial lack of mutual trust and understanding between researchers, patients, and family members. The second category concerned patient characteristics such as cognitive limitations and a busy personal schedule that created barriers to successful data collection. The third concerned research logistics and procedures such as recruitment, travel distances, and compensation. The fourth concerned scientific quality and interpretation, including issues of validity, reliability, and combining data from multiple sources. The two illustrative studies faced both common and diverse research challenges and used many different strategies to address them. Conclusion Collecting less structured data from patients and others in the community is potentially very productive but requires the anticipation, avoidance, or negotiation of various challenges. Future work is necessary to better understand these challenges across different methods and settings, as well as to test and identify strategies to address them. PMID:25154464

Clinical practice: vocal nodules in dysphonic children.

PubMed

Martins, Regina Helena Garcia; Branco, Anete; Tavares, Elaine Lara Mendes; Gramuglia, Andrea Cristina Jóia

2013-09-01

Common among children, vocal symptoms are a cause of concern for parents who seek elucidation of their diagnosis and treatment. Vocal nodules are the major cause of dysphonias in children and are related to vocal abuse. We conducted a literature review considering clinical, physiopathological, epidemiological, and histological aspects of vocal nodules, as well as diagnostic methods, highlighting the main studies addressing this issue. The controversial points of treatments were also discussed.

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

PubMed

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

2014-01-01

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

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.

Impact of Alternative Rate Structures on Distributed Solar Customer Electricity Bills

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

McLaren, Joyce A

Electric utilities are increasingly proposing changes to residential rate structures, in order to address concerns about their inability to recover fixed system costs from customers with grid connected distributed generation. The most common proposals have been to increase fixed charges, set minimum bills or instigate residential demand charges. This presentation provides results of an analysis to explore how these rate design alternatives impact electricity bills for PV and non-PV customers.

Burden of socio-legal concerns among vulnerable patients seeking cancer care services at an urban safety-net hospital: a cross-sectional survey.

PubMed

Ko, Naomi Yu; Battaglia, Tracy A; Gupta-Lawrence, Rebecca; Schiller, Jessica; Gunn, Christine; Festa, Kate; Nelson, Kerrie; Flacks, JoHanna; Morton, Samantha J; Rosen, Jennifer E

2016-06-14

Social and economic conditions that affect one's ability to satisfy life's most basic needs such as lack of affordable housing, restricted access to education and employment, or inadequate income are increasingly well-documented barriers to optimal health. The burden of these challenges among vulnerable patients accessing cancer care services is unknown. We conducted a cross-sectional survey of patients presenting for ambulatory cancer care services (screening and treatment) at an urban safety-net hospital to assess socio-legal concerns (social problems related to meeting life's basic needs supported by public policy or programming and potentially remedied through legal advocacy/action). Among 104 respondents, 80 (77 %) reported concerns with one or more socio-legal needs in the past month, with a mean of 5.75 concerns per participant. The most common socio-legal concerns related to income supports, housing, and employment/education. Our findings support the need for innovations in cancer care delivery to address socio-legal concerns of a vulnerable patient population.

Acceptability of delivery of dietary advice in the dentistry setting to address obesity in pre-school children: a case study of the Common Risk Factor Approach.

PubMed

Henderson, Emily J

2015-07-01

The Common Risk Factor Approach proposes that public health efforts can be improved by multiple agencies working together on a shared risk factor. The present study aimed to assess the acceptability to parents, dental practice staff and commissioners of the delivery of dietary advice in the dentistry setting in order to address obesity. Semi-structured focus groups with dental practice staff and one-to-one interviews with parents of pre-school children and public health commissioners involved in an oral health promotion initiative delivering dietary advice in dental surgeries. Data were analysed using the Framework Approach. General dental practice surgeries and pre-schools in areas of high deprivation in north-east England. Parents (n 4), dental practice staff (n 23) and one commissioner. All participants found acceptable the concept of delivering public health messages in non-conventional settings. Dental practice staff were concerned about the potential for conflicting messages and deprioritisation of oral health advice, and they identified practical barriers to delivery, such as lack of training. Parents were very apprehensive about the potential of such approaches to stigmatise overweight children, including bullying. Uncertainty over the causes of obesity led to confusion about its solutions and the roles of public health and health care. Major concerns about the implementation of the Common Risk Factor Approach were raised by parents and dental practice staff. Specific dietary guidance for both oral health and healthy weight, as well as further research into issues of suitability, feasibility and stigmatisation, are needed.

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.

Existence of equilibria in articulated bearings

NASA Astrophysics Data System (ADS)

Buscaglia, G.; Ciuperca, I.; Hafidi, I.; Jai, M.

2007-04-01

The existence of equilibrium solutions for a lubricated system consisting of an articulated body sliding over a flat plate is considered. Though this configuration is very common (it corresponds to the popular tilting-pad thrust bearings), the existence problem has only been addressed in extremely simplified cases, such as planar sliders of infinite width. Our results show the existence of at least one equilibrium for a quite general class of (nonplanar) slider shapes. We also extend previous results concerning planar sliders.

NASA Space Rocket Logistics Challenges

NASA Technical Reports Server (NTRS)

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

2014-01-01

The Space Launch System (SLS) is the new NASA heavy lift launch vehicle and is scheduled for its first mission in 2017. The goal of the first mission, which will be uncrewed, is to demonstrate the integrated system performance of the SLS rocket and spacecraft before a crewed flight in 2021. SLS has many of the same logistics challenges as any other large scale program. Common logistics concerns for SLS include integration of discreet programs geographically separated, multiple prime contractors with distinct and different goals, schedule pressures and funding constraints. However, SLS also faces unique challenges. The new program is a confluence of new hardware and heritage, with heritage hardware constituting seventy-five percent of the program. This unique approach to design makes logistics concerns such as commonality especially problematic. Additionally, a very low manifest rate of one flight every four years makes logistics comparatively expensive. That, along with the SLS architecture being developed using a block upgrade evolutionary approach, exacerbates long-range planning for supportability considerations. These common and unique logistics challenges must be clearly identified and tackled to allow SLS to have a successful program. This paper will address the common and unique challenges facing the SLS programs, along with the analysis and decisions the NASA Logistics engineers are making to mitigate the threats posed by each.

Moral experience and ethical challenges in an emergency department in Pakistan: emergency physicians' perspectives.

PubMed

Zafar, Waleed

2015-04-01

Emergency departments (ED) are often stressful environments posing unique ethical challenges-issues that primarily raise moral rather than clinical concerns-in patient care. Despite this, there are very few reports of what emergency physicians find ethically challenging in their everyday work. Emergency medicine (EM) is a relatively young but rapidly growing specialty that is gaining acceptance worldwide. The aim of this study was to explore the perspectives of EM residents and physicians regarding the common ethical challenges they face during patient care in one of only two academic EM departments in Pakistan. These challenges could then be addressed in residents' training and departmental practice guidelines. A qualitative research design was employed and in-depth interviews were conducted with ED physicians. Participants were encouraged to think of specific examples from their work, to highlight the particular ethical concerns raised and to describe in detail the process by which those concerns were addressed or left unresolved. Transcripts were analysed using grounded theory methods. Thirteen participants were interviewed and they described four key challenges: how to provide highest quality care with limited resources; how to be truthful to patients; what to do when it is not possible to provide or continue treatment to patients; and when (and when not) to offer life-sustaining treatments. Participants' accounts provided important insights into how physicians tried to resolve these challenges in the 'local moral world' of an ED in Pakistan. The study highlights the need for developing systematic and contextually appropriate mechanisms for resolving common ethical challenges in the EDs and for training residents in moral problem solving. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

PubMed Central

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

2014-01-01

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

College Student Attitudes Towards "Smart" Guns: Results from a Nationwide Survey.

PubMed

Wallace, Lacey N; Dunn, Kaylin C

2018-02-01

Existing studies focusing on "smart" guns, weapons that can only be fired by an authorized user, have focused largely on overall views towards the topic. Little is known about how views differ within key demographics or why Americans feel positively or negatively towards smart guns. This study used data from a nationwide web survey of 520 college students to address these concerns. Multinomial regression was used to identify patterns of smart gun preference in quantitative data. Respondents' open-ended reasoning for their views was examined through common themes and descriptive statistics. About half of the sample preferred smart guns over traditional firearms, with support more likely among females and liberals. Those with more advanced academic standing were more likely to have a traditional gun preference. The sample did not rank cost as a significant concern. Child protection was a much less prominent theme than concerns over (un)authorized users.

Clinical Management of Psychosocial Concerns Related to Food Allergy.

PubMed

Herbert, Linda; Shemesh, Eyal; Bender, Bruce

2016-01-01

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

Biological fate of low-calorie sweeteners.

PubMed

Magnuson, Bernadene A; Carakostas, Michael C; Moore, Nadia H; Poulos, Sylvia P; Renwick, Andrew G

2016-11-01

With continued efforts to find solutions to rising rates of obesity and diabetes, there is increased interest in the potential health benefits of the use of low- and no-calorie sweeteners (LNCSs). Concerns about safety often deter the use of LNCSs as a tool in helping control caloric intake, even though the safety of LNCS use has been affirmed by regulatory agencies worldwide. In many cases, an understanding of the biological fate of the different LNSCs can help health professionals to address safety concerns. The objectives of this review are to compare the similarities and differences in the chemistry, regulatory status, and biological fate (including absorption, distribution, metabolism, and excretion) of the commonly used LNCSs: acesulfame potassium, aspartame, saccharin, stevia leaf extract (steviol glycoside), and sucralose. Understanding the biological fate of the different LNCSs is helpful in evaluating whether reports of biological effects in animal studies or in humans are indicative of possible safety concerns. Illustrations of the usefulness of this information to address questions about LNCSs include discussion of systemic exposure to LNCSs, the use of sweetener combinations, and the potential for effects of LNCSs on the gut microflora. © The Author(s) 2016. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

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

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.

Oily Skin: A review of Treatment Options

PubMed Central

Miller, Richard A.

2017-01-01

One of the most common dermatologic concerns is oily skin, and the demand for effective treatment options is ever apparent. This review article addresses numerous topical treatment options such as retinoids, olumacostat glasaretil, and various cosmeceutical agents. several systemic and procedural techniques that incorporate isotretinoin, spironolactone, oral contraceptives, botulinum toxin, photodynamic therapy, and lasers are reviewed as well. Each treatment option is analyzed in terms of the proposed mechanism of action, efficacy reported in the literature, and potential adverse effects. PMID:28979664

Contracting Officer's Technical Representatives

NASA Technical Reports Server (NTRS)

Brisbin, Steve

1997-01-01

The Breakout Session is a traditional conference instrument used by the NASA Occupational Health Program (OHP) as a method to convene people with common interests. Typically these sessions provide discussion of current topics of high priority and currency and allow multiple views and opinions to be shared and evaluated by all participants. Since the Contracting Officer's Technical Representatives (COTRs) occupy the technical focus of support contract management, this particular group, attended by 20 representatives, addressed issues and topics at the forefront of operational concerns.

Environmental Resource Management in Borderlands: Evolution from Competing Interests to Common Aversions

PubMed Central

Buckley, Patrick Henry; Belec, John; Levy, Jason

2015-01-01

Great enthusiasm is attached to the emergence of cross-border regions (CBRs) as a new institutional arrangement for dealing with local cross-border environmental resource management and other issues that remain too distant from national capitals and/or too expensive to be addressed in the traditional topocratic manner requiring instead local adhocratic methods. This study briefly discusses the perceived value of CBRs and necessary and sufficient conditions for the successful and sustainable development of such places. Then, assuming that necessary conditions can be met, the study investigates an intriguing hypothesis concerning the catalyzing of sustainable consensus for cross-border resource management based on a game theoretical approach that employs the use of dilemma of common aversion rather than the more traditional dilemma of competing common interests. Using this lens to investigate a series of events on the Pacific northwestern Canadian-American border in a part of the Fraser Lowland, we look for evidence of the emergence of an active and sustainable CBR to address local trans-border resource management issues. Although our micro-level scale fails to conclusively demonstrate such evidence, it does demonstrate the value of using this approach and suggests a number of avenues for further research. PMID:26154660

Sex: a sensitive issue.

PubMed

1997-01-01

Health care workers and educators may need to improve their skills in discussing sensitive issues in order to elicit and understand what influences people's attitudes toward sex. While the health worker may be bent upon preventing HIV infection, advising on family planning, or teaching youth about sexual relationships, his or her audience may have other priorities. A good counselor/teacher must learn what people's concerns are and discuss sexual health within that context. It can be difficult talking about sex because sex is a private concern and many people are embarrassed discussing it. Even sex partners often find it difficult to talk to each other about sex. Appropriate communication techniques vary depending upon the situation. It depends upon whether one is addressing people on an individual basis or in groups, which people are being addressed, which organization one is representing, and what one's role is. Good communication is a two-way sharing of information. The different stages of life, common beliefs and myths, culture and religion, relationships between men and women, reasons for having sex, and sex practices are discussed.

Holistic risk-based environmental decision making: a Native perspective.

PubMed Central

Arquette, Mary; Cole, Maxine; Cook, Katsi; LaFrance, Brenda; Peters, Margaret; Ransom, James; Sargent, Elvera; Smoke, Vivian; Stairs, Arlene

2002-01-01

Native American Nations have become increasingly concerned about the impacts of toxic substances. Although risk assessment and risk management processes have been used by government agencies to help estimate and manage risks associated with exposure to toxicants, these tools have many inadequacies and as a result have not served Native people well. In addition, resources have not always been adequate to address the concerns of Native Nations, and involvement of Native decision makers on a government-to-government basis in discussions regarding risk has only recently become common. Finally, because the definitions of health used by Native people are strikingly different from that of risk assessors, there is also a need to expand current definitions and incorporate traditional knowledge into decision making. Examples are discussed from the First Environment Restoration Initiative, a project that is working to address toxicant issues facing the Mohawk territory of Akwesasne. This project is developing a community-defined model in which health is protected at the same time that traditional cultural practices, which have long been the key to individual and community health, are maintained and restored. PMID:11929736

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.

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

Addressing the Health Concerns of VA Women with Sexual Trauma

DTIC Science & Technology

2017-10-01

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

Experiments in Neural-Network Control of a Free-Flying Space Robot

NASA Technical Reports Server (NTRS)

Wilson, Edward

1995-01-01

Four important generic issues are identified and addressed in some depth in this thesis as part of the development of an adaptive neural network based control system for an experimental free flying space robot prototype. The first issue concerns the importance of true system level design of the control system. A new hybrid strategy is developed here, in depth, for the beneficial integration of neural networks into the total control system. A second important issue in neural network control concerns incorporating a priori knowledge into the neural network. In many applications, it is possible to get a reasonably accurate controller using conventional means. If this prior information is used purposefully to provide a starting point for the optimizing capabilities of the neural network, it can provide much faster initial learning. In a step towards addressing this issue, a new generic Fully Connected Architecture (FCA) is developed for use with backpropagation. A third issue is that neural networks are commonly trained using a gradient based optimization method such as backpropagation; but many real world systems have Discrete Valued Functions (DVFs) that do not permit gradient based optimization. One example is the on-off thrusters that are common on spacecraft. A new technique is developed here that now extends backpropagation learning for use with DVFs. The fourth issue is that the speed of adaptation is often a limiting factor in the implementation of a neural network control system. This issue has been strongly resolved in the research by drawing on the above new contributions.

Understanding the Reasons Why Mothers Do or Do Not Have Their Adolescent Daughters Vaccinated Against Human Papillomavirus

PubMed Central

DEMPSEY, AMANDA F.; ABRAHAM, LEAH M.; DALTON, VANESSA; RUFFIN, MACK

2010-01-01

PURPOSE The objective of this study was to compare the reasons why mothers do or do not have their adolescent daughters vaccinated against HPV. METHODS Mothers of vaccinated and unvaccinated 11- to 17-year-old girls seen during preventive care visits in outpatient family medicine or pediatric clinics underwent an audiotaped structured telephone interview that used open-ended questions to assess the reasons underlying maternal decisions about HPV vaccination. Qualitative methods categorized maternal responses into themes. RESULTS Interviews of 52 mothers (19 declining vaccination, 33 accepting) identified several distinct factors underlying their decisions about HPV vaccination. Lack of knowledge about HPV, age-related concerns, and low perceived risk of infection were commonly cited reasons for declining vaccination. Desire to prevent illness, physician recommendation, and a high perceived risk of infection were commonly identified motivating factors. Both groups of mothers had significant concerns about vaccine safety. Locus of control (e.g., mother or daughter) of health-related decisions arose as a novel factor influencing this decision that had not been previously described in the context of HPV vaccination. CONCLUSIONS Addressing safety concerns, educating parents about the age-specific risk of HPV infection, and promoting strong physician recommendation for vaccination may be the most useful targets for future interventions to increase HPV vaccine utilization. PMID:19394865

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.

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...

Reaching a consensus. "Global issues, including environmental ones, are things to be solved with the cooperation of developed and developing countries".

PubMed

Hiraiwa, G

1998-01-01

This article is an excerpt of a speech given by the Honorary Chairman of the Japan Federation of Economic Organizations at the Common Agenda Roundtable meeting in February 1996. The Common Agenda is a bilateral cooperative effort between the US and Japan, which was established in July 1993, to address common concerns through a public-private partnership. The roundtable membership includes about 50 persons who have a range of expertise and professions including scholars, journalists, civil society organizations, and businesses. There have been about 10 Roundtable meetings over the past 2 years. Each meeting includes a report by the deputy minister of foreign affairs on progress made under the Common Agenda. Members exchange views in lively debate and meet with senior government officials. The US-Japan Partnerships on Environmental Awareness and Education were held in April 1997, in Tokyo. The February 1998 meeting with 60 participants was held in Washington, DC, on the Global Context of Civil Society. The workshops focused on the ways that cooperation with civil society organizations, businesses, and governments can be reinforced in the areas of population, health, and the environment. The workshop resulted in effective proposals. This speaker urges that the US and Japan reach as many agreements as possible; that some of the agreements result quickly in Common Agenda projects; and that each country will produce a private sector organization to support the Common Agenda. This effort is moving in new directions and offers a consensus of concerns for the environment.

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.

Behavioral medicine interventions for adult primary care settings: A review.

PubMed

Funderburk, Jennifer S; Shepardson, Robyn L; Wray, Jennifer; Acker, John; Beehler, Gregory P; Possemato, Kyle; Wray, Laura O; Maisto, Stephen A

2018-06-07

Health care organizations are embracing integrated primary care (IPC), in which mental health and behavioral health are addressed as part of routine care within primary care settings. Behavioral medicine concerns, which include health behavior change and coping with medical conditions, are common in primary care populations. Although there are evidence-based behavioral interventions that target a variety of behavioral medicine concerns, integrated behavioral health providers need interventions that are sufficiently brief (i.e., ≤6 appointments) to be compatible with IPC. We conducted a literature review of published studies examining behavioral interventions that target prevalent behavioral medicine concerns and can feasibly be employed by IPC providers in adult primary care settings. A total of 67 published articles representing 63 original studies met eligibility criteria. We extracted data on the behavioral interventions employed, results comparing the active intervention to a comparison group, general fit with IPC, and methodological quality. The vast majority of studies examined brief interventions targeting sleep difficulties and physical activity. The most commonly employed interventions were derived from cognitive-behavioral therapy and motivational interviewing. Outcomes were generally statistically significantly in favor of the active intervention relative to comparison, with highly variable methodological quality ratings (range = 0-5; M = 2.0). Results are discussed in relation to the need for further evidence for brief behavioral interventions targeting other behavioral medicine concerns beyond sleep and physical activity, as well as for more specificity regarding the compatibility of such interventions with IPC practice. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Cultural considerations for treatment of childhood obesity.

PubMed

Davis, S P; Northington, L; Kolar, K

2000-01-01

Childhood obesity has become one of the most common health problems facing children in America. Results from the Third National Health and Nutrition Examination Survey reveal that ethnic minority children in the United States are at particular risk for development of cardiovascular disease due to their disproportionate levels of obesity. In treating childhood obesity among ethnic minorities, practitioners need to be mindful of the cultural norms surrounding body size. Additional concerns that must be addressed include the effects of target marketing of unhealthy foods toward ethnic minorities and environmental deterrents to outside physical activities, to name a few. Strategies given to address the problem of childhood obesity among ethnic minorities include, increasing the child's physical activity, reducing television viewing and the adoption and maintenance of healthy lifestyle practices for the entire family.

Refugees in and out North Africa: a study of the Choucha refugee camp in Tunisia.

PubMed

Dourgnon, Paul; Kassar, Hassène

2014-08-01

In recent years, North African (NA) countries ceased to be emigration-only countries and are now on the verge of becoming immigration as well as transit countries for economic migrants and refugees. Contextual as well as structural long-term factors are driving these changes. The ongoing crises in Africa and the Middle East are prompting strong outflows of refugees, which are likely to induce NA countries to share some common public policy and public health concerns with European countries in a near future. This article highlights some aspects of these changes, from the study of the consequences of the 2011 Libyan crisis in Tunisia. It addresses individual trajectories and health concerns of refugees in and out North Africa from a study of the Choucha camp in Tunisia. The camp opened to immigrants from Libya during the 2011 crisis and accommodated the bulk of the refugees flow to Tunisia until July 2012. The study includes a monographic approach and a qualitative survey in the Choucha camp refugees. We describe the crisis history and the health response with a focus on the camp. We then address refugees' trajectories, and health needs and concerns from the interviews we collected in the camp in April 2012. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Implementing interprofessional education and practice: Lessons from a resource-constrained university.

PubMed

Frantz, J M; Rhoda, A J

2017-03-01

Interprofessional education is seen as a vehicle to facilitate collaborative practice and, therefore, address the complex health needs of populations. A number of concerns have, however, been raised with the implementation of interprofessional education. The three core concerns raised in the literature and addressed in the article include the lack of an explicit framework, challenges operationalising interprofessional education and practice, and the lack of critical mass in terms of human resources to drive activities related to interprofessional education and practice. This article aims to present lessons learnt when attempting to overcome the main challenges and implementing interprofessional education activities in a resource-constrained higher education setting in South Africa. Boyer's model of scholarship, which incorporates research, teaching integration, and application, was used to address the challenge of a lack of a framework in which to conceptualise the activities of interprofressional education. In addition, a scaffolding approach to teaching activities within a curriculum was used to operationalise interprofessional education and practice. Faculty development initiatives were additionally used to develop a critical mass that focused on driving interprofessional education. Lessons learnt highlighted that if a conceptual model is agreed upon by all, it allows for a more focused approach, and both human and financial resources may be channelled towards a common goal which may assist resource-constrained institutions in successfully implementing interprofessional activities.

Implementation of health risk assessments with family health history: barriers and benefits.

PubMed

Wu, R Ryanne; Orlando, Lori A

2015-09-01

Health risk assessments provide an opportunity to emphasise health promotion and disease prevention for individuals and populations at large. A key component of health risk assessments is the detailed collection of family health history information. This information is helpful in determining risk both for common chronic conditions and more rare diseases as well. While the concept of health risk assessments has been around since the Framingham Heart Study was launched in the 1950s, and such assessments are commonly performed in the workplace today, the US healthcare system has been slow to embrace them and the emphasis on prevention that they represent. Before wider implementation of health risk assessments within healthcare can be seen, several concerns must be addressed: (1) provider impact, (2) patient impact, (3) validity of patient-entered data and (4) health outcomes effect. Here, we describe recent developments in health risk assessment design that are helping to address these issues. 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.

The challenge of comorbidity in clinical trials for multiple sclerosis.

PubMed

Marrie, Ruth Ann; Miller, Aaron; Sormani, Maria Pia; Thompson, Alan; Waubant, Emmanuelle; Trojano, Maria; O'Connor, Paul; Reingold, Stephen; Cohen, Jeffrey A

2016-04-12

We aimed to provide recommendations for addressing comorbidity in clinical trial design and conduct in multiple sclerosis (MS). We held an international workshop, informed by a systematic review of the incidence and prevalence of comorbidity in MS and an international survey about research priorities for studying comorbidity including their relation to clinical trials in MS. We recommend establishing age- and sex-specific incidence estimates for comorbidities in the MS population, including those that commonly raise concern in clinical trials of immunomodulatory agents; shifting phase III clinical trials of new therapies from explanatory to more pragmatic trials; describing comorbidity status of the enrolled population in publications reporting clinical trials; evaluating treatment response, tolerability, and safety in clinical trials according to comorbidity status; and considering comorbidity status in the design of pharmacovigilance strategies. Our recommendations will help address knowledge gaps regarding comorbidity that interfere with the ability to interpret safety in monitored trials and will enhance the generalizability of findings from clinical trials to "real world" settings where the MS population commonly has comorbid conditions. © 2016 American Academy of Neurology.

The challenge of comorbidity in clinical trials for multiple sclerosis

PubMed Central

Miller, Aaron; Sormani, Maria Pia; Thompson, Alan; Waubant, Emmanuelle; Trojano, Maria; O'Connor, Paul; Reingold, Stephen; Cohen, Jeffrey A.

2016-01-01

Objective: We aimed to provide recommendations for addressing comorbidity in clinical trial design and conduct in multiple sclerosis (MS). Methods: We held an international workshop, informed by a systematic review of the incidence and prevalence of comorbidity in MS and an international survey about research priorities for studying comorbidity including their relation to clinical trials in MS. Results: We recommend establishing age- and sex-specific incidence estimates for comorbidities in the MS population, including those that commonly raise concern in clinical trials of immunomodulatory agents; shifting phase III clinical trials of new therapies from explanatory to more pragmatic trials; describing comorbidity status of the enrolled population in publications reporting clinical trials; evaluating treatment response, tolerability, and safety in clinical trials according to comorbidity status; and considering comorbidity status in the design of pharmacovigilance strategies. Conclusion: Our recommendations will help address knowledge gaps regarding comorbidity that interfere with the ability to interpret safety in monitored trials and will enhance the generalizability of findings from clinical trials to “real world” settings where the MS population commonly has comorbid conditions. PMID:26888986

Methods Used and Topics Addressed in Quantitative Health Research on Gay, Bisexual and Other Men Who Have Sex With Men: A Systematic Review of the Literature.

PubMed

Brennan, David J; Bauer, Greta R; Bradley, Kaitlin; Tran, Oth Vilaythong

2017-01-01

Research on sexual minority men (gay, bisexual, and other men who have sex with men) was examined with regard to the measures of sexual orientation used, the methods of research, and the main health outcomes under study. A systematic review of English-language quantitative studies was conducted focused on the health of sexual minority men published in 2010 (n = 250). The results provide a snapshot of the literature and revealed that research on sexual minority men overwhelmingly focused on HIV, STIs, and sexual health for which sexual orientation was most commonly defined behaviorally. For topics of mental health or body/fitness outcomes, sexual orientation was most commonly defined by identity. Most study samples were venue-based, and only 8.8% of published papers drew data from population-based samples. The findings suggest that there exists a need for research on sexual minority men's health beyond STIs and HIV that will examine mental and physical health outcomes beyond sexual risk, uses probability-based samples, and addresses intersectional concerns related to race/ethnicity and age.

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

PubMed

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

2014-07-01

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

Engineering education in research-intensive universities

NASA Astrophysics Data System (ADS)

Alpay, E.; Jones, M. E.

2012-12-01

The strengths and weaknesses of engineering education in research-intensive institutions are reported and key areas for developmental focus identified. The work is based on a questionnaire and session summaries used during a two-day international conference held at Imperial College London. The findings highlight several common concerns, such as the need to improve faculty motivation towards teaching, broaden the workplace skills of students, widen employer engagement in teaching and raise the relevance and value of scholarly activity in the discipline of engineering education. Examples of good practice used to address such issues are reported.

Sexual adjustment counseling for women with chronic pelvic pain.

PubMed

Howard, Heather S

2012-01-01

Sexual concerns are common in women with chronic pelvic pain and often remain unresolved when pain improves. Therefore, to restore pelvic function, treatment should address sexuality in addition to pain. In this article, I describe sexual challenges experienced by women with chronic pelvic pain, introduce a modified sexuality counseling model, and suggest sexuality resources and training for gynecologic nurses and other health care providers who are ideally positioned to offer sexuality counseling to this population. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

The role of job strain in understanding midlife common mental disorder: a national birth cohort study.

PubMed

Harvey, Samuel B; Sellahewa, Dilan A; Wang, Min-Jung; Milligan-Saville, Josie; Bryan, Bridget T; Henderson, Max; Hatch, Stephani L; Mykletun, Arnstein

2018-06-01

Long-standing concerns exist about reverse causation and residual confounding in the prospective association between job strain and risk of future common mental disorders. We aimed to address these concerns through analysis of data collected in the UK National Child Development Study, a large British cohort study. Data from the National Child Development Study (n=6870) were analysed by use of multivariate logistic regression to investigate the prospective association between job strain variables at age 45 years and risk of future common mental disorders at age 50 years, controlling for lifetime psychiatric history and a range of other possible confounding variables across the lifecourse. Population attributable fractions were calculated to estimate the public health effect of job strain on midlife mental health. In the final model, adjusted for all measured confounders, high job demands (odds ratio 1·70, 95% CI 1·25-2·32; p=0·0008), low job control (1·89, 1·29-2·77; p=0·0010), and high job strain (2·22, 1·59-3·09; p<0·0001) remained significant independent predictors of future onset of common mental disorder. If causality is assumed, our findings suggest that 14% of new cases of common mental disorder could have been prevented through elimination of high job strain (population attributable fraction 0·14, 0·06-0·20). High job strain appears to independently affect the risk of future common mental disorders in midlife. These findings suggest that modifiable work-related risk factors might be an important target in efforts to reduce the prevalence of common mental disorders. iCare Foundation and Mental Health Branch, NSW Health. Copyright © 2018 Elsevier Ltd. All rights reserved.

A review of return to sport concerns following injury rehabilitation: practitioner strategies for enhancing recovery outcomes.

PubMed

Podlog, Leslie; Dimmock, James; Miller, John

2011-02-01

Evidence suggests that competitive athletes returning to sport following injury rehabilitation may experience a range of psychosocial concerns. The purpose of this paper is to review some of the psychosocial stresses common among returning athletes and to provide practitioner strategies for enhancing recovery outcomes. Findings are based on a database search of Sport Discus, Psychinfo, and Medline using sport injury, fear of re-injury, return to full activity. Salient apprehensions among athletes' returning to sport following injury were found to include: anxieties associated with re-injury; concerns about an inability to perform to pre-injury standards; feelings of isolation, a lack of athletic identity and insufficient social support; pressures to return to sport; and finally, self-presentational concerns about the prospect of appearing unfit, or lacking in skill in relation to competitors. The results suggest that athletes returning to sport from injury may experience concerns related to their sense of competence, autonomy and relatedness. Given its focus on competence, autonomy and relatedness issues, self-determination theory (SDT) is offered as a framework for understanding athlete concerns in the return to sport from injury. Practical suggestions for sport medicine practitioners, researchers and applied sport psychology specialists seeking to address athlete issues are provided using an SDT perspective. Copyright © 2010 Elsevier Ltd. All rights reserved.

Crew Factors in Flight Operations. 11; A Survey of Fatigue Factors in Regional Airline Operations

NASA Technical Reports Server (NTRS)

Co, Elizabeth L.; Gregory, Kevin B.; Johnson, Julie M.; Rosekind, Mark R.

1999-01-01

This report is the eleventh in a series on the physiological effects of flight operations on flight crews. A 119-question survey was completed by 1,424 flight crewmembers from 26 regional carriers to identify factors contributing to fatigue in regional airline operations. Eighty-nine percent of crewmembers identified fatigue as a moderate or serious concern with 88% reporting that it was a common occurrence and 92% reporting that, when it occurs, fatigue represents a moderate or serious safety issue. However, 86% reported they received no company training addressing fatigue issues. Identified fatigue factors included multiple flight segments, scheduling considerations, varying regulations, and others. The two most commonly cited fatigue factors regarded flying multiple (more than four) segments. Scheduling factors accounted for nine of the ten most common recommendations to reduce fatigue in regional operations. Differing requirements among regulations were cited as contributing to fatigue. Other identified factors were the flight deck environment, automation, and diet. The data suggested specific recommendations, including education of industry personnel about fatigue issues and examination of scheduling practices. Education plays a critical role in any effort to address fatigue. Analyzing scheduling practices and identifying potential improvements may result in reduced fatigue as well as other benefits to operations.

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.

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.

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.

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.

Patient adherence in COPD.

PubMed

Bourbeau, J; Bartlett, S J

2008-09-01

Patient adherence to treatment in chronic obstructive pulmonary disease (COPD) is essential to optimise disease management. As with other chronic diseases, poor adherence is common and results in increased rates of morbidity, healthcare expenditures, hospitalisations and possibly mortality, as well as unnecessary escalation of therapy and reduced quality of life. Examples include overuse, underuse, and alteration of schedule and doses of medication, continued smoking and lack of exercise. Adherence is affected by patients' perception of their disease, type of treatment or medication, the quality of patient provider communication and the social environment. Patients are more likely to adhere to treatment when they believe it will improve disease management or control, or anticipate serious consequences related to non-adherence. Providers play a critical role in helping patients understand the nature of the disease, potential benefits of treatment, addressing concerns regarding potential adverse effects and events, and encouraging patients to develop self-management skills. For clinicians, it is important to explore patients' beliefs and concerns about the safety and benefits of the treatment, as many patients harbour unspoken fears. Complex regimens and polytherapy also contribute to suboptimal adherence. This review addresses adherence related issues in COPD, assesses current efforts to improve adherence and highlights opportunities to improve adherence for both providers and patients.

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

Ethical issues faced by field primatologists: asking the relevant questions.

PubMed

Fedigan, Linda Marie

2010-09-01

Field primatologists face unusual ethical issues. We study animals rather than people and receive research approval from animal care rather than ethics committees. However, animal care evaluation forms are developed from concerns about laboratory animal research and are based on the "Three R's" for humane treatment of captive experimental subjects (replacement, reduction and refinement), which are only debatably relevant to field research. Scientists who study wild, free-ranging primates in host countries experience many ethical dilemmas seldom dealt with in animal care forms. This paper reviews the ethical issues many field primatologists say they face and how these might be better addressed by animal care forms. The ethical issues arising for field researchers are divided into three categories: "Presence, Protocols and People" and for each the most frequent issues are described. The most commonly mentioned ethical concern arising from our presence in the field is the possibility of disease transmission. Although most primate field studies employ only observational protocols, the practice of habituating our study animals to close human presence is an ethical concern for many since it can lessen the animals' fear of all humans, thereby facilitating undesirable behaviors (e.g., crop-raiding) and rendering them vulnerable to harm. Field primatologists who work in host countries must observe national laws and local traditions. As conservationists, primatologists must often negotiate between the resource needs and cultural practices of local people and the interests of the nonhuman primates. Many say they face more ethical dilemmas arising from human interactions than from research on the animals per se. This review concludes with suggestions for relevant questions to ask on animal care forms, and actions that field primatologists can take to better inform animal care committees about the common ethical issues we experience as well as how to develop guidelines for addressing them. (c) 2010 Wiley-Liss, Inc.

Resourcefulness, Desperation, Shame, Gratitude and Powerlessness: Common Themes Emerging from A Study of Food Bank Use in Northeast Scotland.

PubMed

Douglas, Flora; Sapko, Jennifer; Kiezebrink, Kirsty; Kyle, Janet

2015-01-01

There is growing policy maker and public concern about current trends in food bank use in Scotland. Yet little is known about the experiences of those seeking help from food banks in this country. This research aimed to address this issue by studying the use and operation of a food bank situated in a rich northeast city during January and June 2014. The study aimed to establish who was seeking help from the food bank, their reasons for doing so, and what those who did thought of, and dealt with the food they received from it. Consequently, an audit of the food bank's client database, four months of participant observation based in the food bank, and seven face-to-face interviews with current and former food bank clients were conducted. The audit revealed that clients came from a range of socio-economic backgrounds, with men more likely to access it compared to women. Debt and social security benefit delays were cited as the main reasons for doing so. Qualitative data confirmed that sudden and unanticipated loss of income was a key driver of use. Resourcefulness in making donated food last as long as possible, keeping fuel costs low, and concern to minimise food waste were commonly described by participants. Desperation, gratitude, shame and powerlessness were also prevalent themes. Furthermore, clients were reluctant to ask for food they normally ate, as they were acutely aware that the food bank had little control over what it was able offer. Insights from this study suggest that recent UK policy proposals to address food poverty may have limited impact, without concomitant effort to address material disadvantage. Research is urgently required to determine the precise nature and extent of household level food insecurity in Scotland, and to consider monitoring for adverse physical and mental health outcomes for those affected by it.

Resourcefulness, Desperation, Shame, Gratitude and Powerlessness: Common Themes Emerging from A Study of Food Bank Use in Northeast Scotland

PubMed Central

Douglas, Flora; Sapko, Jennifer; Kiezebrink, Kirsty; Kyle, Janet

2015-01-01

There is growing policy maker and public concern about current trends in food bank use in Scotland. Yet little is known about the experiences of those seeking help from food banks in this country. This research aimed to address this issue by studying the use and operation of a food bank situated in a rich northeast city during January and June 2014. The study aimed to establish who was seeking help from the food bank, their reasons for doing so, and what those who did thought of, and dealt with the food they received from it. Consequently, an audit of the food bank's client database, four months of participant observation based in the food bank, and seven face-to-face interviews with current and former food bank clients were conducted. The audit revealed that clients came from a range of socio-economic backgrounds, with men more likely to access it compared to women. Debt and social security benefit delays were cited as the main reasons for doing so. Qualitative data confirmed that sudden and unanticipated loss of income was a key driver of use. Resourcefulness in making donated food last as long as possible, keeping fuel costs low, and concern to minimise food waste were commonly described by participants. Desperation, gratitude, shame and powerlessness were also prevalent themes. Furthermore, clients were reluctant to ask for food they normally ate, as they were acutely aware that the food bank had little control over what it was able offer. Insights from this study suggest that recent UK policy proposals to address food poverty may have limited impact, without concomitant effort to address material disadvantage. Research is urgently required to determine the precise nature and extent of household level food insecurity in Scotland, and to consider monitoring for adverse physical and mental health outcomes for those affected by it. PMID:29546112

Group Parent Training with Immigrant Chinese Families: Enhancing Engagement and Augmenting Skills Training

PubMed Central

Lau, Anna S.; Fung, Joey J.; Yung, Vanda

2013-01-01

Parent training (PT) is a well supported treatment for reducing and preventing child conduct problems and abusive parenting. However, questions have been raised about the dissemination of PT to culturally diverse families who hold different views on childrearing and family structure. This article describes the application of group PT in two Chinese immigrant families to illustrate dual strategies for addressing potential cultural barriers. The Incredible Years program builds in many therapeutic process elements to address cultural concerns about PT skills to enhance parental engagement. In addition, augmenting basic PT with additional skills training can help parents manage stressors common in immigrant families in order to facilitate uptake of new parenting skills. Our implementation experience suggests that high risk immigrant Chinese parents can be effectively engaged in group PT even when they are not in treatment voluntarily. PMID:20564684

Population attitudes towards research use of health care registries: a population-based survey in Finland.

PubMed

Eloranta, Katariina; Auvinen, Anssi

2015-07-17

Register-based research can provide important and valuable contributions to public health research, but involves ethical issues concerning the balance of public health benefits and individual autonomy. This study aimed to describe the opinions of the Finnish public about these issues. Mail survey questionnaire sent to a random sample of 1000 Finns. Participation proportion was 42%, with 258 women and 160 men. The majority of the participants (61%) were willing to provide their identifiable health information for research. Almost half of the participants (48%) would, nevertheless, like to be informed when their information is used. A third (30%) indicated no need for informed consent in register-based research, a similar proportion felt it should be obtained for every study, and 40% thought it necessary in some situations, such as studies addressing a sensitive study topic. As for the best policy for obtaining consent, the majority (86%) favoured broader consent methods: one consent covering a certain register or a research topic. Half of the participants (55%) desired a required ethical evaluation from register-based research addressing a sensitive issue. Privacy protection was the most common concern for register-based research. More than half of the participants were either content with the current Finnish laws concerning register-based research or wanted to liberalize them to advance research. The Finnish public is supportive of register-based research, but the requirement for informed consent divides opinions and many would at least like to be informed of the research use of their information.

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…

Examining the prevalence, role and impact of evidence regarding Antisocial Personality, sociopathy and psychopathy in capital cases: a survey of defense team members.

PubMed

Edens, John F; Cox, Jennifer

2012-01-01

Although anecdotal case accounts suggest that evidence concerning Antisocial Personality Disorder (APD), sociopathy and psychopathy is frequently introduced by the prosecution in capital murder trials, to date there has been no systematic research to determine the actual prevalence, role, or perceived impact of such evidence in these cases. Survey data collected from attendees at a national capital mitigation conference (n=41) indicated that prosecution evidence concerning APD was quite prevalent, with "sociopath" and "psychopath" labels being introduced less frequently. Evidence concerning these disorders, which were assessed primarily via DSM criteria and self-report personality inventories, was most often introduced by the prosecution in the sentencing phase to address a defendant's ostensible risk of future dangerousness and/or to rebut mitigating evidence-although it was also introduced frequently in the guilt/innocence phase of these trials to rebut mental health evidence offered by the defense. Survey respondents believed that evidence concerning APD, sociopathy, and psychopathy had a considerable impact on trial outcomes. Also, although defense objections were common, such evidence was rarely ruled to be inadmissible in these cases. Copyright © 2012 John Wiley & Sons, Ltd.

Crowdfunding FOR MEDICAL CARE: Ethical Issues in an Emerging Health Care Funding Practice.

PubMed

Snyder, Jeremy

2016-11-01

Crowdfunding websites allow users to post a public appeal for funding for a range of activities, including adoption, travel, research, participation in sports, and many others. One common form of crowdfunding is for expenses related to medical care. Medical crowdfunding appeals serve as a means of addressing gaps in medical and employment insurance, both in countries without universal health insurance, like the United States, and countries with universal coverage limited to essential medical needs, like Canada. For example, as of 2012, the website Gofundme had been used to raise a total of 8.8 million dollars (U.S.) for seventy-six hundred campaigns, the majority of which were health related. This money can make an important difference in the lives of crowdfunding users, as the costs of unexpected or uninsured medical needs can be staggering. In this article, I offer an overview of the benefits of medical crowdfunding websites and the ethical concerns they raise. I argue that medical crowdfunding is a symptom and cause of, rather than a solution to, health system injustices and that policy-makers should work to address the injustices motivating the use of crowdfunding sites for essential medical services. Despite the sites' ethical problems, individual users and donors need not refrain from using them, but they bear a political responsibility to address the inequities encouraged by these sites. I conclude by suggesting some responses to these concerns and future directions for research. © 2016 The Hastings Center.

A simulation and video-based training program to address adverse childhood experiences.

PubMed

Wen, Frances K; Miller-Cribbs, Julie E; Coon, Kim A; Jelley, Martina J; Foulks-Rodriguez, Kristin A

2017-05-01

Adverse childhood experiences (ACEs) are 10 categories of childhood abuse and maltreatment, which have a dose-response relationship with common adult health concerns seen in primary care including health risk behaviors, chronic disease, and mental illness. Many of the ACEs-associated biopsychosocial risk factors are modifiable. However, physicians may not address these issues for fear of opening "Pandora's Box", that is, a source of extensive problems for which they are not sufficiently prepared with training, resources, or time. Residents need training in how to conduct trauma-focused conversations within the limited scope of an office visit. To address this need, a 4-hour simulation and video-based training program was developed for primary care residents about how to conduct brief interventions connecting their patients' current health concerns with their experiences of ACEs. Resident participants have evaluated this program as preparatory for real-life encounters and as being designed to allow for educational mastery. This article describes a workshop presenting this training program which was given at the 37th Annual Behavioral Science Forum in Family Medicine. Five skills targeted in the program were presented and a demonstration was made of the components, that is, didactics, provider and patient videos, simulated patient encounters, trainee feedback, and facilitated discussion that encompasses targeted skills, clinical implementation, and self-care. Companion tools were shared, including the syllabus, evaluation rubric, and provider and patient resources. Participants practiced trainee feedback and discussed the challenges in implementation.

A CONTENT ANALYSIS OF MILITARY COMMANDER MESSAGES ABOUT TOBACCO AND OTHER HEALTH ISSUES IN MILITARY INSTALLATION NEWSPAPERS: WHAT DO MILITARY COMMANDERS SAY ABOUT TOBACCO?

PubMed Central

Poston, Walker S.C.; Haddock, Christopher K.; Jahnke, Sara A.; Hyder, Melissa L.; Jitnarin, Nattinee

2014-01-01

Military installation newspapers are a primary means used by military commanders to communicate information about topics important to military personnel including leadership, training issues, installation events, safety concerns, and vital health issues. We conducted a content analysis of military commanders’ messages about health issues that were published in online military installation newspapers/newsfeeds. We identified a total of 75 publicly accessible installation newspapers/newsfeeds with commanders’ messages (n=39 Air Force, n=19 Army, n=7 Navy, n=1 Marine, and n=9 Joint Bases). Commander messages published between January 2012–December 2012 were collected, screened, and coded. Coder inter-rater reliability was 98.9%. Among the 2,479 coded commanders’ messages, 132 (5.3%) addressed a health topic as the primary focus. There were no significant differences between service branches in the percentage of health-oriented messages (χ2=5.019, p=0.285). The most commonly addressed health topics were exercise/fitness (23.5%), other mental health concerns (19.7%), alcohol/DUI (13.6%), and suicide (12.1%). Tobacco use was directly addressed as a primary health aim in only two commanders’ messages (1.5%). Health topics, and particularly tobacco-related content, are rarely written about by military commanders. The absence of tobacco-related health messages from line leadership contributes to the perception that tobacco control is a low priority. PMID:26032388

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.

Overview of proteomics studies in obstructive sleep apnea

PubMed Central

Feliciano, Amélia; Torres, Vukosava Milic; Vaz, Fátima; Carvalho, Ana Sofia; Matthiesen, Rune; Pinto, Paula; Malhotra, Atul; Bárbara, Cristina; Penque, Deborah

2015-01-01

Obstructive sleep apnea (OSA) is an underdiagnosed common public health concern causing deleterious effects on metabolic and cardiovascular health. Although much has been learned regarding the pathophysiology and consequences of OSA in the past decades, the molecular mechanisms associated with such processes remain poorly defined. The advanced high-throughput proteomics-based technologies have become a fundamental approach for identifying novel disease mediators as potential diagnostic and therapeutic targets for many diseases, including OSA. Here, we briefly review OSA pathophysiology and the technological advances in proteomics and the first results of its application to address critical issues in the OSA field. PMID:25770042

European health systems and the internal market: reshaping ideology?

PubMed

da Costa Leite Borges, Danielle

2011-12-01

Departing from theories of distributive justice and their relation with the distribution of health care within society, especially egalitarianism and libertarianism, this paper aims at demonstrating that the approach taken by the European Court of Justice regarding the application of the Internal Market principles (or the market freedoms) to the field of health care services has introduced new values which are more concerned with a libertarian view of health care. Moreover, the paper also addresses the question of how these new values introduced by the Court may affect common principles of European health systems, such as equity and accessibility.

Planning and implementing an interdisciplinary diabetes workshop for healthcare professionals.

PubMed

Valdez, Gloria M; Dadich, Karen A; Boswell, Carol; Cannon, Sharon; Irons, Brian K; Vickers, Patricia; Esperat, Christina

2007-01-01

A diabetes education program for healthcare professionals evolved out of a series of discussions among healthcare providers. This group realized the importance and the necessity of developing a current knowledge base for themselves, their clients, and their clients' families. The target audiences for this program were physicians, nurses, pharmacists, and dietitians who could be eligible to work toward becoming a certified diabetes educator. This article discusses the process used to develop and conduct these workshops. The lessons learned during this project are provided for consideration by others seeking to address common concerns and challenges in other areas of clinical practice.

Information Virtulization in Virtual Environments

NASA Technical Reports Server (NTRS)

Bryson, Steve; Kwak, Dochan (Technical Monitor)

2001-01-01

Virtual Environments provide a natural setting for a wide range of information visualization applications, particularly wlieit the information to be visualized is defined on a three-dimensional domain (Bryson, 1996). This chapter provides an overview of the issues that arise when designing and implementing an information visualization application in a virtual environment. Many design issues that arise, such as, e.g., issues of display, user tracking are common to any application of virtual environments. In this chapter we focus on those issues that are special to information visualization applications, as issues of wider concern are addressed elsewhere in this book.

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.

Are facial injuries really different? An observational cohort study comparing appearance concern and psychological distress in facial trauma and non-facial trauma patients.

PubMed

Rahtz, Emmylou; Bhui, Kamaldeep; Hutchison, Iain; Korszun, Ania

2018-01-01

Facial injuries are widely assumed to lead to stigma and significant psychosocial burden. Experimental studies of face perception support this idea, but there is very little empirical evidence to guide treatment. This study sought to address the gap. Data were collected from 193 patients admitted to hospital following facial or other trauma. Ninety (90) participants were successfully followed up 8 months later. Participants completed measures of appearance concern and psychological distress (post-traumatic stress symptoms (PTSS), depressive symptoms, anxiety symptoms). Participants were classified by site of injury (facial or non-facial injury). The overall levels of appearance concern were comparable to those of the general population, and there was no evidence of more appearance concern among people with facial injuries. Women and younger people were significantly more likely to experience appearance concern at baseline. Baseline and 8-month psychological distress, although common in the sample, did not differ according to the site of injury. Changes in appearance concern were, however, strongly associated with psychological distress at follow-up. We conclude that although appearance concern is severe among some people with facial injury, it is not especially different to those with non-facial injuries or the general public; changes in appearance concern, however, appear to correlate with psychological distress. We therefore suggest that interventions might focus on those with heightened appearance concern and should target cognitive bias and psychological distress. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Arsenic and dichlorvos: Possible interaction between two environmental contaminants.

PubMed

Flora, Swaran J S

2016-05-01

Metals are ubiquitously present in the environment and pesticides are widely used throughout the world. Environmental and occupational exposure to metal along with pesticide is an area of great concern to both the public and regulatory authorities. Our major concern is that combination of these toxicant present in environment may elicit toxicity either due to additive or synergistic interactions or 'joint toxic actions' among these toxicants. It poses a rising threat to human health. Water contamination particularly ground water contamination with arsenic is a serious problem in today's scenario since arsenic is associated with several kinds of health problems, such arsenic associated health anomalies are commonly called as 'Arsenism'. Uncontrolled use and spillage of pesticides into the environment has resulted in alarming situation. Moreover serious concerns are being addressed due to their persistence in the environmental matrices such as air, soil and surface water runoff resulting in continuous exposure of these harmful chemicals to human beings and animals. Bio-availability of these environmental toxicants has been enhanced much due to anthropological activities. Dreadfully very few studies are available on combined exposures to these toxicants on the animal or human system. Studies on the acute and chronic exposure to arsenic and DDVP are well reported and well defined. Arsenic is a common global ground water contaminant while dichlorvos is one of the most commonly and widely employed organophosphate based insecticide used in agriculture, horticulture etc. There is thus a real situation where a human may get exposed to these toxicants while working in a field. This review highlights the individual and combined exposure to arsenic and dichlorvos on health. Copyright © 2016 Elsevier GmbH. All rights reserved.

What do consumers want to know about antibiotics? Analysis of a medicines call centre database.

PubMed

Hawke, Kate L; McGuire, Treasure M; Ranmuthugala, Geetha; van Driel, Mieke L

2016-02-01

Australia is one of the highest users of antibiotics in the developed world. This study aimed to identify consumer antibiotic information needs to improve targeting of medicines information. We conducted a retrospective, mixed-method study of consumers' antibiotic-related calls to Australia's National Prescribing Service (NPS) Medicines Line from September 2002 to June 2010. Demographic and question data were analysed, and the most common enquiry type in each age group was explored for key narrative themes. Relative antibiotic call frequencies were determined by comparing number of calls to antibiotic utilization in Australian Statistics on Medicines (ASM) data. Between 2002 and 2010, consumers made 8696 antibiotic calls to Medicines Line. The most common reason was questions about the role of their medicine (22.4%). Patient age groups differed in enquiry pattern, with more questions about lactation in the 0- to 4-year age group (33.6%), administration (5-14 years: 32.4%), interactions (15-24 years: 33.4% and 25-54 years: 23.3%) and role of the medicine (55 years and over: 26.6%). Key themes were identified for each age group. Relative to use in the community, antibiotics most likely to attract consumer calls were ciprofloxacin (18.0 calls/100,000 ASM prescriptions) and metronidazole (12.9 calls/100,000 ASM prescriptions), with higher call rates than the most commonly prescribed antibiotic amoxicillin (3.9 calls/100,000 ASM prescriptions). Consumers' knowledge gaps and concerns about antibiotics vary with age, and certain antibiotics generate greater concern relative to their usage. Clinicians should target medicines information to proactively address consumer concerns. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Community health workers leading the charge on workforce development: lessons from New Orleans.

PubMed

Wennerstrom, Ashley; Johnson, Liljana; Gibson, Kristina; Batta, Sarah E; Springgate, Benjamin F

2014-12-01

Academic institutions and community organizations engaged community health workers (CHWs) in creating a community-appropriate CHW workforce capacity-building program in an area without a previously established CHW professional group. From 2009 to 2010, we solicited New Orleans-based CHWs' opinions about CHW professional development through a survey, a community conference, and workgroup meetings. Throughout 2011 and 2012, we created and implemented a responsive 80-h workforce development program that used popular education techniques. We interviewed CHWs 6 months post-training to assess impressions of the course and application of skills and knowledge to practice. CHWs requested training to develop nationally-recognized core competencies including community advocacy, addresses issues unique to New Orleans, and mitigate common professional challenges. Thirty-five people completed the course. Among 25 interviewees, common themes included positive impressions of the course, application of skills and community-specific information to practice, understanding of CHWs' historical roles as community advocates, and ongoing professional challenges. Engaging CHW participation in workforce development programs is possible in areas lacking organized CHW groups. CHW insight supports development of training that addresses unique local concerns. Trained CHWs require ongoing professional support.

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.

The Comparative Study of Metacognition: Sharper Paradigms, Safer Inferences

PubMed Central

Smith, J. David; Beran, Michael J.; Couchman, Justin J.; Coutinho, Mariana V. C.

2015-01-01

Results that point to animals’ metacognitive capacity bear a heavy burden given the potential for competing behavioral descriptions. This article uses formal models to evaluate the force of these descriptions. One example is that many existing studies have directly rewarded so-called “uncertainty” responses. Modeling confirms that this practice is an interpretative danger because it supports associative processes and encourages simpler interpretations. Another example is that existing studies raise the concern that animals avoid difficult stimuli not because of uncertainty monitored but because of aversion given error-causing or reinforcement-lean stimuli. Modeling also justifies this concern and shows that this problem is not addressed by the common practice of comparing performance on Chosen and Forced trials. The models and related discussion have utility for metacognition researchers and theorists broadly because they specify the experimental operations that will best indicate a metacognitive capacity in humans or animals by eliminating alternative behavioral accounts. PMID:18792496

Review paper: Organ transplants: ethical, social, and religious issues in a multicultural society.

PubMed

Robson, Noor Zurani Md Haris; Razack, Azad Hassan; Dublin, Norman

2010-07-01

Recent advances in the fields of organ donation and organ transplant have introduced new hope for the treatment of serious diseases. However, this promise has been accompanied by several issues. The most common issue raised is ethical implications, but in a multicultural society like Malaysia, additional concerns arise pertaining to social and religious issues. These concerns needs to be addressed as attitudes toward and acceptability of organ donation varies according to social, culture, and religion. The diverse cultural, religious, and traditional concepts pertaining to organ donation may hamper its acceptability and cause a lack of willingness to donate organs. The purpose of this article is to briefly explore the ethical issues involved in organ transplant and the various religious opinions on organ donation. It is hoped that this knowledge and understanding may benefit both health care providers and patients in a multicultural society like Malaysia.

Impacts of weatherization on indoor air quality: A field study of 514 homes.

PubMed

Pigg, S; Cautley, D; Francisco, P W

2018-03-01

Residential energy efficiency retrofits continue to be common in the United States, especially through governmental and utility programs. Because of the potential for reduced air exchange, there have been concerns raised regarding the potential for negative impacts on health and safety of residents when air sealing occurs. To address this concern, a study was undertaken in 2009-2010 to evaluate the indoor air quality impacts of weatherization performed through the U.S. Department of Energy's Weatherization Assistance Program. Testing was conducted on 514 homes throughout the United States. The results show that weatherization, as performed at the time of the study, could result in small but statistically significant increases in some indoor contaminants such as radon and humidity, while also reducing exposures to elevated carbon monoxide in some homes. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The adoption and implementation of RFID technologies in healthcare: a literature review.

PubMed

Yao, Wen; Chu, Chao-Hsien; Li, Zang

2012-12-01

Radio Frequency Identification (RFID) technology not only offers tracking capability to locate equipment, supplies and people in real time, but also provides efficient and accurate access to medical data for health professionals. However, the reality of RFID adoption in healthcare is far behind earlier expectation. This study reviews literature on the use of RFID in healthcare/hospitals following a formal innovation-decision framework. We aim to identify the common applications, potential benefits, barriers, and critical success factors. Our study facilitates quick assessment and provides guidance for researchers and practitioners in adopting RFID in medical arenas. Many earlier adopters in healthcare found RFID to be functional and useful in such areas as asset tracking and patient identification. Major barriers to adoption include technological limitations, interference concerns, prohibitive costs, lack of global standards and privacy concerns. Better designed RFID systems with low cost and privacy issues addressed are needed to increase acceptance of RFID in healthcare.

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

"At this point now": older workers' reflections on their current employment experiences.

PubMed

Noonan, Anne E

2005-01-01

Despite the frequently referenced graying of the U.S. workforce, we know relatively little about the work-related concerns and experiences of older workers--those aged 55+. This qualitative study addresses that gap by examining the current employment situations of a purposive sample of 37 older workers. Thematic content analysis revealed a vast diversity in the concerns and experiences of contemporary older workers, with participants being actively involved in all of the traditional stages of work-life development. Findings suggest a deepened or more nuanced view of the principal meanings of work--in particular, identity and social interaction--and highlight several negative aspects of later-life employment such as pension insecurity, unemployment, age discrimination, not having found one's "niche," and chronic interpersonal difficulties with co-workers. Findings are discussed against the backdrop of a rapidly changing workplace and dramatically shifting work-retirement trajectories in which job stability and predictable retirement are less common.

Facilitating consumer participation: an approach to finding the 'right' consumer.

PubMed

Happell, Brenda

2010-01-01

Contemporary health care increasingly dictates that consumers of services should become active participants in the health care system. This has placed responsibility on administrators, managers and clinicians to include consumers in key strategic and decision making initiatives. However, this direction has not been accompanied by clear policies or guidelines. Consequently confusion about selecting consumers able to provide valuable input is identified as a barrier to active consumer involvement. The purpose of this paper is to address some concerns raised in the quest to find the "right" consumer, including: finding a consumer without an axe to grind; ensuring the consumer is representative of broader views; health professionals as consumer representatives. While these concerns are common they have not yet been extensively debated and discussed in the broader Literature. Strategies necessary to support consumers in participatory roles are also considered and the controversial subject of financial remuneration for consumers is also explored.

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.

Parental help-seeking in primary care for child and adolescent mental health concerns: qualitative study.

PubMed

Sayal, Kapil; Tischler, Victoria; Coope, Caroline; Robotham, Sarah; Ashworth, Mark; Day, Crispin; Tylee, Andre; Simonoff, Emily

2010-12-01

Child and adolescent mental health problems are common in primary care. However, few parents of children with mental health problems express concerns about these problems during consultations. To explore the factors influencing parental help-seeking for children with emotional or behavioural difficulties. Focus group discussions with 34 parents from non-specialist community settings who had concerns about their child's mental health. All groups were followed by validation groups or semi-structured interviews. Most children had clinically significant mental health symptoms or associated impairment in function. Appointment systems were a key barrier, as many parents felt that short appointments did not allow sufficient time to address their child's difficulties. Continuity of care and trusting relationships with general practitioners (GPs) who validated their concerns were perceived to facilitate help-seeking. Parents valued GPs who showed an interest in their child and family situation. Barriers to seeking help included embarrassment, stigma of mental health problems, and concerns about being labelled or receiving a diagnosis. Some parents were concerned about being judged a poor parent and their child being removed from the family should they seek help. Primary healthcare is a key resource for children and young people with emotional and behavioural difficulties and their families. Primary care services should be able to provide ready access to health professionals with an interest in children and families and appointments of sufficient length so that parents feel able to discuss their mental health concerns.

Using Just in Time Teaching in a Global Climate Change Course to Address Misconceptions

NASA Astrophysics Data System (ADS)

Schuenemann, K. C.

2013-12-01

Just in Time Teaching (JiTT) is employed in an introductory Global Climate Change college course with the intention of addressing common misconceptions and climate myths. Students enter the course with a variety of prior knowledge and opinions on global warming, and JiTT can be used as a constructivist pedagogical approach to make use of this prior knowledge. Students are asked to watch a short video or do a reading, sometimes screen capture videos created by the professor as review of material from the previous class, a video available on the web from NASA or NOAA, for example, or a reading from an online article or their textbook. After the video or reading, students answer a question carefully designed to pry at a common misconception, or simply are asked for the 'muddiest point' that remains on the concept. This assignment is done the night before class using a web program. The program aggregates the answers in an organized way so the professor can use the answers to design the day's lesson to address common misconceptions or concerns students displayed in their answers, as well as quickly assign participation credit to students who completed the assignment. On the other hand, if students display that they have already mastered the material, the professor can confidently move on to the next concept. The JiTT pedagogical method personalizes each lecture period to the students in that particular class for maximum efficiency while catching and fixing misconceptions in a timely manner. This technique requires students to spend time with the material outside of class, acts as review of important concepts, and increases engagement in class due to the personalization of the course. Evaluation results from use of this technique will be presented. Examples of successful JiTT videos, questions, student answers, and techniques for addressing misconceptions during lecture will also be presented with the intention that instructors can easily apply this technique to their next course.

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.

Nanomedicine – challenge and perspectives

PubMed Central

Riehemann, Kristina; Schneider, Stefan W.; Luger, Thomas A.; Godin, Biana; Ferrari, Mauro; Fuchs, Harald

2014-01-01

Nanomedicine introduces nanotechnology concepts into medicine and thus joins two large cross disciplinary fields with an unprecedented societal and economical potential arising from the natural combination of specific achievements in the respective fields. The common basis evolves from the molecular scale properties relevant in the two fields. Nanoanalytical tools such as local probes and molecular imaging techniques, allow us to characterize surface and interface properties at a nanometer scale at predefined locations, while elaborated chemical approaches offer the opportunity for the control and addressing of surfaces e. g. for targeted drug delivery, enhanced biocompatibility and neuroprosthetic purposes. This commonality opens a wide variety of economic fields both of industrial and clinical interests. However, concerns arise in this cross disciplinary area about toxicological aspects and ethical implications. This review gives an overview of selected recent developments of nanotechnology applied on medical objectives. PMID:19142939

Creating a data resource: what will it take to build a medical information commons?

PubMed

Deverka, Patricia A; Majumder, Mary A; Villanueva, Angela G; Anderson, Margaret; Bakker, Annette C; Bardill, Jessica; Boerwinkle, Eric; Bubela, Tania; Evans, Barbara J; Garrison, Nanibaa' A; Gibbs, Richard A; Gentleman, Robert; Glazer, David; Goldstein, Melissa M; Greely, Hank; Harris, Crane; Knoppers, Bartha M; Koenig, Barbara A; Kohane, Isaac S; La Rosa, Salvatore; Mattison, John; O'Donnell, Christopher J; Rai, Arti K; Rehm, Heidi L; Rodriguez, Laura L; Shelton, Robert; Simoncelli, Tania; Terry, Sharon F; Watson, Michael S; Wilbanks, John; Cook-Deegan, Robert; McGuire, Amy L

2017-09-22

National and international public-private partnerships, consortia, and government initiatives are underway to collect and share genomic, personal, and healthcare data on a massive scale. Ideally, these efforts will contribute to the creation of a medical information commons (MIC), a comprehensive data resource that is widely available for both research and clinical uses. Stakeholder participation is essential in clarifying goals, deepening understanding of areas of complexity, and addressing long-standing policy concerns such as privacy and security and data ownership. This article describes eight core principles proposed by a diverse group of expert stakeholders to guide the formation of a successful, sustainable MIC. These principles promote formation of an ethically sound, inclusive, participant-centric MIC and provide a framework for advancing the policy response to data-sharing opportunities and challenges.

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

PubMed

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

2012-05-08

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

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

Widergren, Steven E.; Knight, Mark R.; Melton, Ronald B.

The Interoperability Strategic Vision whitepaper aims to promote a common understanding of the meaning and characteristics of interoperability and to provide a strategy to advance the state of interoperability as applied to integration challenges facing grid modernization. This includes addressing the quality of integrating devices and systems and the discipline to improve the process of successfully integrating these components as business models and information technology improve over time. The strategic vision for interoperability described in this document applies throughout the electric energy generation, delivery, and end-use supply chain. Its scope includes interactive technologies and business processes from bulk energy levelsmore » to lower voltage level equipment and the millions of appliances that are becoming equipped with processing power and communication interfaces. A transformational aspect of a vision for interoperability in the future electric system is the coordinated operation of intelligent devices and systems at the edges of grid infrastructure. This challenge offers an example for addressing interoperability concerns throughout the electric system.« less

Experimentally Building a Qualitative Understanding of Newton's Second Law

NASA Astrophysics Data System (ADS)

Gates, Joshua

2014-12-01

Newton's second law is one of the cornerstones of the introductory physics curriculum, but it can still trouble a large number of students well after its introduction, hobbling their ability to apply the concept to problem solving1 and to related concepts, such as momentum, circular motion, and orbits. While there are several possibilities for lab activities addressing the functional relationship among net force, mass, and acceleration, the qualitative understanding of the connection between forces and acceleration can still be lacking,2 leading to poor performance in problem solving and in assessments such as the Force Concept Inventory3 and Force and Motion Conceptual Evaluation.4 There is a need for strong conceptual understanding of the relationships between net force and acceleration and between acceleration and velocity in order to effectively address common force-motion misconceptions;5 there is a large literature concerning student understanding of force and motion.6

Towards agreement on best practice for publishing raw clinical trial data.

PubMed

Hrynaszkiewicz, Iain; Altman, Douglas G

2009-03-18

Many research-funding agencies now require open access to the results of research they have funded, and some also require that researchers make available the raw data generated from that research. Similarly, the journal Trials aims to address inadequate reporting in randomised controlled trials, and in order to fulfil this objective, the journal is working with the scientific and publishing communities to try to establish best practice for publishing raw data from clinical trials in peer-reviewed biomedical journals. Common issues encountered when considering raw data for publication include patient privacy - unless explicit consent for publication is obtained - and ownership, but agreed-upon policies for tackling these concerns do not appear to be addressed in the guidance or mandates currently established. Potential next steps for journal editors and publishers, ethics committees, research-funding agencies, and researchers are proposed, and alternatives to journal publication, such as restricted access repositories, are outlined.

Cognitive Sequelae of Blast-Induced Traumatic Brain Injury: Recovery and Rehabilitation

PubMed Central

Bogdanova, Yelena; Verfaellie, Mieke

2015-01-01

Blast-related traumatic brain injury (bTBI) poses a significant concern for military personnel engaged in Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF). Given the highly stressful context in which such injury occurs, psychiatric comorbidities are common. This paper provides an overview of mild bTBI and discusses the cognitive sequelae and course of recovery typical of mild TBI (mTBI). Complicating factors that arise in the context of co-morbid posttraumatic stress disorder (PTSD) are considered with regard to diagnosis and treatment. Relatively few studies have evaluated the efficacy of cognitive rehabilitation in civilian mTBI, but we discuss cognitive training approaches that hold promise for addressing mild impairments in executive function and memory, akin to those seen in OEF/OIF veterans with bTBI and PTSD. Further research is needed to address the patient and environmental characteristics associated with optimal treatment outcome. PMID:22350691

Medical Malpractice in Dermatology-Part I: Reducing the Risks of a Lawsuit.

PubMed

Shah, Vidhi V; Kapp, Marshall B; Wolverton, Stephen E

2016-12-01

Malpractice risk is a common source of concern for the practicing physician. Dermatologists experience fewer lawsuits than most other specialists in medicine, but the risk is not negligible. All physicians should familiarize themselves with areas of potential risk and avoid medico-legal pitfalls. We present Part I of a two-part series addressing medico-legal questions common to most practitioners that cause a great deal of anxiety. Part I will focus upon risk management and prevention of future malpractice lawsuits, and Part II deals with suggestions and guidance once a lawsuit occurs. Herein, we discuss the primary sources of malpractice lawsuits delivered against healthcare practitioners including issues with informed consent, patient noncompliance, medical negligence, and inappropriate documentation, including use of electronic medical records. The overall goal is to effectively avoid these common sources of litigation. The risk management strategies discussed in this paper are relevant to the everyday practitioner and may offer physicians some degree of protection from potential liability.

Do Online Privacy Concerns Predict Selfie Behavior among Adolescents, Young Adults and Adults?

PubMed Central

Dhir, Amandeep; Torsheim, Torbjørn; Pallesen, Ståle; Andreassen, Cecilie S.

2017-01-01

Selfies, or self-portraits, are often taken and shared on social media for online self-presentation reasons, which are considered essential for the psychosocial development and well-being of people in today’s culture. Despite the growing popularity and widespread sharing of selfies in the online space, little is known about how privacy concerns moderate selfie behavior. In addition to this, it is also not known whether privacy concerns across age and gender groups influence selfie behavior. To address this timely issue, a survey assessing common selfie behaviors, that is, frequency of taking (individual and group selfies), editing (cropping and filtering), and posting selfies online, and social media privacy concerns (over personal data being accessed and misused by third parties) was conducted. The web-survey was administered to 3,763 Norwegian social media users, ranging from 13 to 50 years, with a preponderance of women (n = 2,509, 66.7%). The present study investigated the impact of privacy concerns on selfie behaviors across gender and age groups (adolescent, young adult, and adult) by use of the structural equation modeling approach. The results suggest that young adults have greater privacy concerns compared to adolescents and adults. Females have greater privacy concerns than males. Greater privacy concerns among female social media users were linked to lower engagement in selfie behavior, but privacy concerns did not influence selfie behavior in the case of male adolescents and young adults. Overall, privacy concerns were more consistently and inversely related to selfie behavior (taking and posting) among females than males. The study results have theoretical as well as practical implications for both researchers and policy makers. PMID:28588530

Do Online Privacy Concerns Predict Selfie Behavior among Adolescents, Young Adults and Adults?

PubMed

Dhir, Amandeep; Torsheim, Torbjørn; Pallesen, Ståle; Andreassen, Cecilie S

2017-01-01

Selfies, or self-portraits, are often taken and shared on social media for online self-presentation reasons, which are considered essential for the psychosocial development and well-being of people in today's culture. Despite the growing popularity and widespread sharing of selfies in the online space, little is known about how privacy concerns moderate selfie behavior. In addition to this, it is also not known whether privacy concerns across age and gender groups influence selfie behavior. To address this timely issue, a survey assessing common selfie behaviors, that is, frequency of taking (individual and group selfies), editing (cropping and filtering), and posting selfies online, and social media privacy concerns (over personal data being accessed and misused by third parties) was conducted. The web-survey was administered to 3,763 Norwegian social media users, ranging from 13 to 50 years, with a preponderance of women ( n = 2,509, 66.7%). The present study investigated the impact of privacy concerns on selfie behaviors across gender and age groups (adolescent, young adult, and adult) by use of the structural equation modeling approach. The results suggest that young adults have greater privacy concerns compared to adolescents and adults. Females have greater privacy concerns than males. Greater privacy concerns among female social media users were linked to lower engagement in selfie behavior, but privacy concerns did not influence selfie behavior in the case of male adolescents and young adults. Overall, privacy concerns were more consistently and inversely related to selfie behavior (taking and posting) among females than males. The study results have theoretical as well as practical implications for both researchers and policy makers.

The Environment in Pediatric Practice: A Study of New York Pediatricians’ Attitudes, Beliefs, and Practices towards Children’s Environmental Health

PubMed Central

Boscarino, Joseph; Graber, Nathan; Falk, Raphael; Schechter, Clyde; Galvez, Maida; Dunkel, George; Geslani, Jessica; Moline, Jacqueline; Kaplan-Liss, Evonne; Miller, Richard K.; Korfmacher, Katrina; Carpenter, David; Forman, Joel; Balk, Sophie J.; Laraque, Danielle; Frumkin, Howard; Landrigan, Philip

2006-01-01

Chronic diseases of environmental origin are a significant and increasing public health problem among the children of New York State, yet few resources exist to address this growing burden. To assess New York State pediatricians self-perceived competency in dealing with common environmental exposures and diseases of environmental origin in children, we assessed their attitudes and beliefs about the role of the environment in children’s health. A four-page survey was sent to 1,500 randomly selected members of the New York State American Academy of Pediatrics in February 2004. We obtained a 20.3% response rate after one follow-up mailing; respondents and nonrespondents did not differ in years of licensure or county of residence. Respondents agreed that the role of environment in children’s health is significant (mean 4.44 ± 0.72 on 1–5 Likert scale). They voiced high self-efficacy in dealing with lead exposure (mean 4.16–4.24 ± 0.90–1.05), but their confidence in their skills for addressing pesticides, mercury and mold was much lower (means 2.51–3.21 ± 0.90–1.23; p < 0.001). About 93.8% would send patients to a clinic “where pediatricians could refer patients for clinical evaluation and treatment of their environmental health concerns.” These findings indicate that New York pediatricians agree that children are suffering preventable illnesses of environmental origin but feel ill-equipped to educate families about common exposures. Significant demand exists for specialized centers of excellence that can evaluate environmental health concerns, and for educational opportunities. PMID:16736113

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.

What do first-time mothers worry about? A study of usage patterns and content of calls made to a postpartum support telephone hotline.

PubMed

Osman, Hibah; Chaaya, Monique; El Zein, Lama; Naassan, Georges; Wick, Livia

2010-10-15

Telephone hotlines designed to address common concerns in the early postpartum could be a useful resource for parents. Our aim was to test the feasibility of using a telephone as an intervention in a randomized controlled trial. We also aimed to test to use of algorithms to address parental concerns through a telephone hotline. Healthy first-time mothers were recruited from postpartum wards of hospitals throughout Lebanon. Participants were given the number of a 24-hour telephone hotline that they could access for the first four months after delivery. Calls were answered by a midwife using algorithms developed by the study team whenever possible. Callers with medical complaints were referred to their physicians. Call patterns and content were recorded and analyzed. Eighty-four of the 353 women enrolled (24%) used the hotline. Sixty percent of the women who used the service called more than once, and all callers reported they were satisfied with the service. The midwife received an average of three calls per day and most calls occurred during the first four weeks postpartum. Our algorithms were used to answer questions in 62.8% of calls and 18.6% of calls required referral to a physician. Of the questions related to mothers, 66% were about breastfeeding. Sixty percent of questions related to the infant were about routine care and 23% were about excessive crying. Utilization of a telephone hotline service for postpartum support is highest in the first four weeks postpartum. Most questions are related to breastfeeding, routine newborn care, and management of a fussy infant. It is feasible to test a telephone hotline as an intervention in a randomized controlled trial. Algorithms can be developed to provide standardized answers to the most common questions.

Understanding Vaccine Hesitancy in Canada: Results of a Consultation Study by the Canadian Immunization Research Network

PubMed Central

Dubé, Eve; Gagnon, Dominique; Ouakki, Manale; Bettinger, Julie A.; Guay, Maryse; Halperin, Scott; Wilson, Kumanan; Graham, Janice; Witteman, Holly O.; MacDonald, Shannon; Fisher, William; Monnais, Laurence; Tran, Dat; Gagneur, Arnaud; Guichon, Juliet; Saini, Vineet; Heffernan, Jane M.; Meyer, Samantha; Driedger, S. Michelle; Greenberg, Joshua; MacDougall, Heather

2016-01-01

“Vaccine hesitancy” is a concept now frequently used in vaccination discourse. The increased popularity of this concept in both academic and public health circles is challenging previously held perspectives that individual vaccination attitudes and behaviours are a simple dichotomy of accept or reject. A consultation study was designed to assess the opinions of experts and health professionals concerning the definition, scope, and causes of vaccine hesitancy in Canada. We sent online surveys to two panels (1- vaccination experts and 2- front-line vaccine providers). Two questionnaires were completed by each panel, with data from the first questionnaire informing the development of questions for the second. Our participants defined vaccine hesitancy as an attitude (doubts, concerns) as well as a behaviour (refusing some / many vaccines, delaying vaccination). Our findings also indicate that both vaccine experts and front-line vaccine providers have the perception that vaccine rates have been declining and consider vaccine hesitancy an important issue to address in Canada. Diffusion of negative information online and lack of knowledge about vaccines were identified as the key causes of vaccine hesitancy by the participants. A common understanding of vaccine hesitancy among researchers, public health experts, policymakers and health care providers will better guide interventions that can more effectively address vaccine hesitancy within Canada. PMID:27257809

Academic retainer medicine: an innovative business model for cross-subsidizing primary care.

PubMed

Lucier, David J; Frisch, Nicholas B; Cohen, Brian J; Wagner, Michael; Salem, Deeb; Fairchild, David G

2010-06-01

Retainer-medicine primary care practices, commonly referred to as "luxury" or "concierge" practices, provide enhanced services to patients beyond those available in traditional practices for a yearly retainer fee. Adoption of retainer practices has been largely absent in academic health centers (AHCs). Reasons for this trend stem primarily from ethical concerns, such as the potential for patient abandonment when physicians downsize from larger, traditional practices to smaller, retainer-medicine practices.In 2004, the Department of Medicine at Tufts Medical Center developed an academic retainer-medicine primary care practice within the Division of General Medicine that not only generates financial support for the division but also incorporates a clinical and business model that is aligned with the mission and ethics of an academic institution.In contrast to private retainer-medicine practices, this unique business model addresses several of the ethical issues associated with traditional retainer practices-it does not restrict net access to care and it neutralizes concerns about patient abandonment. Addressing the growing primary care shortage, the model also presents the opportunity for a retainer practice to cross-subsidize the expansion of general medicine in an academic medical setting. The authors elucidate the benefits, as well as the inherent challenges, of embedding an academic retainer-medicine practice within an AHC.

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

Medically unexplained conditions considered by patients in general practice.

PubMed

Tschudi-Madsen, Hedda; Kjeldsberg, Mona; Natvig, Bård; Ihlebaek, Camilla; Straand, Jørund; Bruusgaard, Dag

2014-04-01

Patients frequently present with multiple and 'unexplained' symptoms, often resulting in complex consultations. To better understand these patients is a challenge to health care professionals, in general, and GPs, in particular. In our research on symptom reporting, we wanted to explore whether patients consider that they may suffer from conditions commonly regarded as unexplained, and we explored associations between these concerns and symptom load, life stressors and socio-demographic factors. Consecutive, unselected patients in general practice completed questionnaires addressing eight conditions commonly regarded as unexplained (amalgam poisoning, Candida syndrome, fibromyalgia, food intolerance, electromagnetic hypersensitivity, burnout syndrome, chronic fatigue syndrome and irritable bowel syndrome). With logistic regression, we analysed associations with symptom load, burden of life stressors with negative impact on present health and socio-demographic variables. Out of the 909 respondents (response rate = 88.8%), 863 had complete data. In total, 39.6% of patients had considered that they may suffer from one or more unexplained conditions (UCs). These concerns were strongly and positively associated with recent symptom load and number of life stressors. If we excluded burnout and food intolerance, corresponding associations were found. Patients frequently considered that they may suffer from UCs. The likelihood of such concerns strongly increased with an increasing symptom load and with the number of life stressors with negative impact on present health. Hence, the number of symptoms may be a strong indicator of whether patients consider their symptoms part of such often controversial multisymptom conditions.

A population-based survey in Australia of men's and women's perceptions of genetic risk and predictive genetic testing and implications for primary care.

PubMed

Taylor, S

2011-01-01

Community attitudes research regarding genetic issues is important when contemplating the potential value and utilisation of predictive testing for common diseases in mainstream health services. This article aims to report population-based attitudes and discuss their relevance to integrating genetic services in primary health contexts. Men's and women's attitudes were investigated via population-based omnibus telephone survey in Queensland, Australia. Randomly selected adults (n = 1,230) with a mean age of 48.8 years were interviewed regarding perceptions of genetic determinants of health; benefits of genetic testing that predict 'certain' versus 'probable' future illness; and concern, if any, regarding potential misuse of genetic test information. Most (75%) respondents believed genetic factors significantly influenced health status; 85% regarded genetic testing positively although attitudes varied with age. Risk-based information was less valued than certainty-based information, but women valued risk information significantly more highly than men. Respondents reported 'concern' (44%) and 'no concern' (47%) regarding potential misuse of genetic information. This study contributes important population-based data as most research has involved selected individuals closely impacted by genetic disorders. While community attitudes were positive regarding genetic testing, genetic literacy is important to establish. The nature of gender differences regarding risk perception merits further study and has policy and service implications. Community concern about potential genetic discrimination must be addressed if health benefits of testing are to be maximised. Larger questions remain in scientific, policy, service delivery, and professional practice domains before predictive testing for common disorders is efficacious in mainstream health care. Copyright © 2011 S. Karger AG, Basel.

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.

Somatic symptoms and psychological concerns in a general adolescent population: Exploring the relevance of DSM-5 somatic symptom disorder.

PubMed

van Geelen, Stefan M; Rydelius, Per-Anders; Hagquist, Curt

2015-10-01

DSM-5 somatic symptom disorder (SSD) constitutes a major change for psychosomatic medicine and psychiatry, as well as for epidemiological research in these fields. This study investigates somatic symptoms and psychological concerns among adolescents in order to systematically explore the relevance of SSD for general adolescent populations. A cross-sectional population-based design, with a symptoms-based strategy and a symptom-and-psychological-concern-based strategy, was used to estimate the prevalence of somatic symptoms and psychological concerns in a general adolescent population (n=2476, mean age=16years, 49% boys, 51% girls). Somatic symptoms and psychological concerns in relation to gender, and self-reported medical and psychiatric conditions were investigated. The association between somatic symptoms, psychological concerns, and functional impairment in school-, family-, peer- and physical activities was studied. Reporting 3+ persistent distressing somatic symptoms was significantly more common than reporting one or more persistent distressing somatic symptom(s) combined with serious psychological concern. The prevalence of such complaints was significantly higher in girls. The proportion of medical and psychiatric conditions was highest in the group reporting 3+ persistent distressing somatic symptoms combined with serious psychological concern. Belonging to this group most significantly increased odds ratios for functional impairment. For large-scale studies on SSD, results suggest the use of measures based on multiple somatic items in combination with psychological concerns, and a methodologically sound standardized measure of functional impairment. To further enhance clinical decision-making, the relation of symptoms to functional impairment, and the substantial overlap of SSD with medical and psychiatric conditions during adolescence should be addressed. Copyright © 2015 Elsevier Inc. All rights reserved.

Depression longitudinally mediates the association of appearance concerns to ART non-adherence in HIV-infected individuals with a history of injection drug use.

PubMed

Blashill, Aaron J; Gordon, Janna R; Safren, Steven A

2014-02-01

Appearance concerns are common among HIV-infected individuals, and previous cross-sectional and longitudinal data indicate that these concerns are associated with antiretroviral therapy (ART) non-adherence. However, to date, no known prospective data have explored the mechanism behind this relationship. Thus, the aim of the current study was to test depression severity as a prospective mediator of the relationship between appearance concerns and ART non-adherence in HIV-infected individuals with a history of injection drug use (IDU). Participants were 89 HIV-infected individuals with a history of IDU who participated in a prospective, randomized controlled trial of cognitive behavioral therapy for depression and medication adherence. Clinician-administered measures of depression severity and appearance concerns, along with electronic monitoring of ART non-adherence were included. Data were analyzed using longitudinal linear mixed-level modeling, and mediation was tested via the Monte Carlo Method of Assessing Mediation. Appearance concerns were predictive of depression severity, γ = .31, SE = .076, 95 % CI [.16, .46], t = 4.1, p = .0001, and depression severity was predictive of ART non-adherence, γ = 3.3, SE = 1.3, 95 % CI [.8, 5.8], t = 2.6, p = .01. The effect of appearance concerns on ART non-adherence, however, was significantly mediated by depression severity, γ = 1.02, 95 % CI [.21, 2.1]. Appearance concerns are associated with depression severity, which in turn is associated with ART non-adherence. Integrative interventions addressing appearance concerns, depression and ART adherence are needed, as this is one potential pathway towards worse health outcomes in HIV-infected individuals.

A patient-centered approach to counseling patients with head and neck cancer undergoing human papillomavirus testing: a clinician's guide.

PubMed

Chu, Amy; Genden, Eric; Posner, Marshall; Sikora, Andrew

2013-01-01

The International Agency for Research on Cancer and the National Cancer Institute have acknowledged human papillomavirus (HPV)-16 as an independent risk factor for oropharyngeal cancer (OPC). HPV-positive oropharyngeal cancer (HPVOPC) is a sexually transmitted entity that is on the rise; within the next 10 years, the annual number of HPV-associated OPC cases is projected to exceed the annual number of cervical cancer cases in the United States. Recognition of HPV status in OPC has broad implications beyond the traditional oncological concerns of timely diagnosis, accurate staging, and appropriate treatment of cancer patients. The National Comprehensive Cancer Network recommends testing the tumor site for HPV-status during OPC management; it is likely this will become a standard component of care for patients with high-probability tumors of the oropharynx. As the practice of HPV testing becomes more common, it behooves providers to be able to adequately address the concerns of patients with HPVOPC. Although there are currently few relevant studies focusing on this population, existing literature on HPV-infected women and patients with cervical cancer strongly supports the concept that patients with HPVOPC need education to optimally address concerns such as self-blame, guilt, intimacy, and interpersonal relationships. When HPV testing is done, it should be accompanied by evidence-driven and patient-centered counseling to best minimize negative psychosocial outcomes and ensure optimum health promotion. Based on the current state of the literature, this article is intended to be a reference for physicians to effectively manage psychosocial outcomes when diagnosing patients with HPV-associated OPC.

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.

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

PubMed Central

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

2013-01-01

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

Video-assisted segmentation of speech and audio track

NASA Astrophysics Data System (ADS)

Pandit, Medha; Yusoff, Yusseri; Kittler, Josef; Christmas, William J.; Chilton, E. H. S.

1999-08-01

Video database research is commonly concerned with the storage and retrieval of visual information invovling sequence segmentation, shot representation and video clip retrieval. In multimedia applications, video sequences are usually accompanied by a sound track. The sound track contains potential cues to aid shot segmentation such as different speakers, background music, singing and distinctive sounds. These different acoustic categories can be modeled to allow for an effective database retrieval. In this paper, we address the problem of automatic segmentation of audio track of multimedia material. This audio based segmentation can be combined with video scene shot detection in order to achieve partitioning of the multimedia material into semantically significant segments.

Maori responsiveness in health and medical research: key issues for researchers (part 1).

PubMed

Sporle, Andrew; Koea, Jonathan

2004-08-06

Application for contestable government-research funding and ethical approval requires researchers to outline how their intended research project contributes to Maori development or advancement. When formulating their research proposals, the key issues for researchers are research utility, defining Maori, informed consent, confidentiality, issues with human tissues and genetic material, participant remuneration and recognition (koha), intellectual property, and involvement of local Maori health or social services. The most common Maori responsiveness issues in research applications can be readily approached by researchers who address straightforward methodological concerns, by working through precedents established by peers and colleagues, as well as by working with end-users of their research.

The state of the art of thin-film photovoltaics

NASA Astrophysics Data System (ADS)

Surek, T.

1993-10-01

Thin-film photovoltaic technologies, based on materials such as amorphous or polycrystalline silicon, copper indium diselenide, cadmium telluride, and gallium arsenide, offer the potential for significantly reducing the cost of electricity generated by photovoltaics. The significant progress in the technologies, from the laboratory to the marketplace, is reviewed. The common concerns and questions raised about thin films are addressed. Based on the progress to date and the potential of these technologies, along with continuing investments by the private sector to commercialize the technologies, one can conclude that thin-film PV will provide a competitive alternative for large-scale power generation in the future.

Myths and misperceptions about ingredients used in commercial pet foods.

PubMed

Laflamme, Dottie; Izquierdo, Oscar; Eirmann, Laura; Binder, Stephen

2014-07-01

Information and misinformation about pet nutrition and pet foods, including ingredients used in pet foods, is widely available through various sources. Often, this "information" raises questions or concerns among pet owners. Many pet owners will turn to their veterinarian for answers to these questions. One of the challenges that veterinarians have is keeping up with the volume of misinformation about pet foods and sorting out fact from fiction. The goal of this article is to provide facts regarding some common myths about ingredients used in commercial pet foods so as to better prepare veterinarians to address their client's questions. Copyright © 2014 Elsevier Inc. All rights reserved.

Hydrodynamics of sailing of the Portuguese man-of-war Physalia physalis

PubMed Central

Iosilevskii, G.; Weihs, D.

2008-01-01

Physalia physalis, commonly known as the Portuguese man-of-war (PMW), is a peculiar looking colony of specialized polyps. The most conspicuous members of this colony are the gas-filled sail-like float and the long tentacles, budding asymmetrically beneath the float. This study addresses the sailing of the PMW, and, in particular, the hydrodynamics of its trailing tentacles, the interaction between the tentacles and the float and the actual sailing performance. This paper attempts to provide answers for two of the many open questions concerning P. physalis: why does it need a sail? and how does it harness the sail? PMID:19091687

Bringing Person- and Family-Centred Care Alive in Home, Community and Long-Term Care Organizations.

PubMed

Bender, Danielle; Holyoke, Paul

2016-01-01

It is now more important than ever for person- and family-centred care (PFCC) to be at the forefront of program and service design and delivery; yet, to date, very little guidance is available to assist home, community and long-term care (LTC) organizations to operationalize this concept and overcome inherent challenges. This article provides a list of practical strategies for healthcare leaders to promote and support a culture shift towards PFCC in their organizations and identifies and addresses five common concerns. The unique opportunities and challenges for practicing PFCC in home, community and LTC settings are also discussed.

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

Lamorgese, Lydia, E-mail: lydial@tin.it; Geneletti, Davide, E-mail: davide.geneletti@unitn.it

This paper presents a framework for analysing the degree of consideration of sustainability principles in Strategic environmental assessment (SEA), and demonstrates its application to a sample of SEA of Italian urban plans. The framework is based on Gibson's (2006) sustainability principles, which are linked to a number of guidance criteria and eventually to review questions, resulting from an extensive literature review. A total of 71 questions are included in the framework, which gives particular emphasis to key concepts, such as intragenerational and intergenerational equity. The framework was applied to review the Environmental Report of the urban plans of 15 majormore » Italian cities. The results of this review show that, even if sustainability is commonly considered as a pivotal concept, there is still work to be done in order to effectively integrate sustainability principles into SEA. In particular, most of the attention is given to mitigation and compensation measures, rather than to actual attempts to propose more sustainable planning decisions in the first place. Concerning the proposed framework of analysis, further research is required to clarify equity concerns and particularly to identify suitable indicators for operationalizing the concepts of intra/inter-generational equity in decision-making. -- Highlights: ► A framework was developed in order to evaluate planning against sustainability criteria. ► The framework was applied to analyse how sustainable principles are addressed in 15 Italian SEA reports. ► Over 85% of the reports addressed, to some extent, at least 40% of the framework questions. ► Criteria explicitly linked to intra and inter-generational equity are rarely addressed.« less

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

Glaucoma Patient-Reported Concerns and Associated Factors.

PubMed

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

2017-06-01

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

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

PubMed

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

2012-02-20

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

Human Research Program Human Health Countermeasures Element Extravehicular Activity (EVA) Risk Standing Review Panel (SRP)

NASA Technical Reports Server (NTRS)

Norfleet, William; Harris, Bernard

2009-01-01

The Extravehicular Activity (EVA) Risk Standing Review Panel (SRP) was favorably impressed by the operational risk management approach taken by the Human Research Program (HRP) Integrated Research Plan (IRP) to address the stated life sciences issues. The life sciences community at the Johnson Space Center (JSC) seems to be focused on operational risk management. This approach is more likely to provide risk managers with the information they need at the time they need it. Concerning the information provided to the SRP by the EVA Physiology, Systems, and Performance Project (EPSP), it is obvious that a great deal of productive activity is under way. Evaluation of this information was hampered by the fact that it often was not organized in a fashion that reflects the "Gaps and Tasks" approach of the overall Human Health Countermeasures (HHC) effort, and that a substantial proportion of the briefing concerned subjects that, while interesting, are not part of the HHC Element (e.g., the pressurized rover presentation). Additionally, no information was provided on several of the tasks or how they related to work underway or already accomplished. This situation left the SRP having to guess at the efforts and relationship to other elements, and made it hard to easily map the EVA Project efforts currently underway, and the data collected thus far, to the gaps and tasks in the IRP. It seems that integration of the EPSP project into the HHC Element could be improved. Along these lines, we were concerned that our SRP was split off from the other participating SRPs at an early stage in the overall agenda for the meeting. In reality, the concerns of EPSP and other projects share much common ground. For example, the commonality of the concerns of the EVA and exercise physiology groups is obvious, both in terms of what reduced exercise capacity can do to EVA capability, and how the exercise performed during an EVA could contribute to an overall exercise countermeasure prescription.

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

PubMed Central

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

2012-01-01

Background The long-term cognitive effects of general anesthesia are under intense scrutiny. Here we present 5 cases from 2 academic institutions to analyze some common features where the patient’s or the patient family member has made a request to address their concern on memory loss, Alzheimer’s disease and general anesthesia before surgery. Methods Records of anesthesia consultation separate from standard preoperative evaluation were retrieved to identify consultations related to memory loss and Alzheimer’s disease from the patient and/or patient family members. The identified cases were extensively reviewed for features in common. We used Google® (http://www. google.com/) to identify available online information using “anesthesia memory loss” as a search phrase. Results Five cases were collected as a specific preoperative consultation related to memory loss, Alzheimer’s disease and general anesthesia from two institutions. All of the individuals either had perceived memory impairment after a prior surgical procedure with general anesthesia or had a family member with Alzheimer’s disease. They all accessed public media sources to find articles related to anesthesia and memory loss. On May 2nd, 2011, searching “anesthesia memory loss” in Google yielded 764,000 hits. Only 3 of the 50 Google top hits were from peer-reviewed journals. Some of the lay media postings made a causal association between general anesthesia and memory loss and/or Alzheimer’s disease without conclusive scientific literature support. Conclusion The potential link between memory loss and Alzheimer’s disease with general anesthesia is an important preoperative concern from patients and their family members. This concern arises from individuals who have had history of cognitive impairment or have had a family member with Alzheimer disease and have tried to obtain information from public media. Proper preoperative consultation with the awareness of the lay literature can be useful in reducing patient and patient family member’s preoperative anxiety related to this concern. PMID:23853740

Concern and Helplessness: Citizens' Assessments of Individual and Collective Action on the Provision of Environmental Public Goods in a Coastal City at Risk of Inundation.

PubMed

Bunyan, Sabrina; Collins, Alan; Duffy, David

2016-09-01

Survey data from a representative sample of 1005 households in the UK coastal city of Portsmouth are examined to discern commonalities and contrasts in their assessment of actions to address the related environmental threats of climate change and flooding. The city of Portsmouth is at risk of inundation from rising sea levels and the city has recent experience of flooding. A simple local and global public good framework is used to organize the understanding of reported attitudes and their determinants. The findings show that it is not always the same individuals who express concern about both climate change and flooding. Investigation into perceptions of helplessness in tackling climate change indicates that individuals more often perceived themselves to be helpless in tackling climate but perceived local collective action to be more effective. Individuals considered local collective action to be more effective in tackling climate change. Perceptions of individual helplessness are in turn related to reported concern. Several socioeconomic characteristics of individuals are shown to be useful in explaining the determinants of concern and perceptions of helplessness among respondents. As other cities face climate change-related challenges, the empirical findings, based upon attitudes from an alert urban population, are informative to policy design.

Concern and Helplessness: Citizens' Assessments of Individual and Collective Action on the Provision of Environmental Public Goods in a Coastal City at Risk of Inundation

NASA Astrophysics Data System (ADS)

Bunyan, Sabrina; Collins, Alan; Duffy, David

2016-09-01

Survey data from a representative sample of 1005 households in the UK coastal city of Portsmouth are examined to discern commonalities and contrasts in their assessment of actions to address the related environmental threats of climate change and flooding. The city of Portsmouth is at risk of inundation from rising sea levels and the city has recent experience of flooding. A simple local and global public good framework is used to organize the understanding of reported attitudes and their determinants. The findings show that it is not always the same individuals who express concern about both climate change and flooding. Investigation into perceptions of helplessness in tackling climate change indicates that individuals more often perceived themselves to be helpless in tackling climate but perceived local collective action to be more effective. Individuals considered local collective action to be more effective in tackling climate change. Perceptions of individual helplessness are in turn related to reported concern. Several socioeconomic characteristics of individuals are shown to be useful in explaining the determinants of concern and perceptions of helplessness among respondents. As other cities face climate change-related challenges, the empirical findings, based upon attitudes from an alert urban population, are informative to policy design.

Lead, Arsenic, and Manganese Metal Mixture Exposures: Focus on Biomarkers of Effect.

PubMed

Andrade, V M; Mateus, M L; Batoréu, M C; Aschner, M; Marreilha dos Santos, A P

2015-07-01

The increasing exposure of human populations to excessive levels of metals continues to represent a matter of public health concern. Several biomarkers have been studied and proposed for the detection of adverse health effects induced by lead (Pb), arsenic (As), and manganese (Mn); however, these studies have relied on exposures to each single metal, which fails to replicate real-life exposure scenarios. These three metals are commonly detected in different environmental, occupational, and food contexts and they share common neurotoxic effects, which are progressive and once clinically apparent may be irreversible. Thus, chronic exposure to low levels of a mixture of these metals may represent an additive risk of toxicity. Building upon their shared mechanisms of toxicity, such as oxidative stress, interference with neurotransmitters, and effects on the hematopoietic system, we address putative biomarkers, which may assist in assessing the onset of neurological diseases associated with exposure to this metal mixture.

Toward customer-centric organizational science: A common language effect size indicator for multiple linear regressions and regressions with higher-order terms.

PubMed

Krasikova, Dina V; Le, Huy; Bachura, Eric

2018-06-01

To address a long-standing concern regarding a gap between organizational science and practice, scholars called for more intuitive and meaningful ways of communicating research results to users of academic research. In this article, we develop a common language effect size index (CLβ) that can help translate research results to practice. We demonstrate how CLβ can be computed and used to interpret the effects of continuous and categorical predictors in multiple linear regression models. We also elaborate on how the proposed CLβ index is computed and used to interpret interactions and nonlinear effects in regression models. In addition, we test the robustness of the proposed index to violations of normality and provide means for computing standard errors and constructing confidence intervals around its estimates. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Hydrophobic Organic Hole Transporters for Improved Moisture Resistance in Metal Halide Perovskite Solar Cells.

PubMed

Leijtens, Tomas; Giovenzana, Tommaso; Habisreutinger, Severin N; Tinkham, Jonathan S; Noel, Nakita K; Kamino, Brett A; Sadoughi, Golnaz; Sellinger, Alan; Snaith, Henry J

2016-03-09

Solar cells based on organic-inorganic perovskite semiconductor materials have recently made rapid improvements in performance, with the best cells performing at over 20% efficiency. With such rapid progress, questions such as cost and solar cell stability are becoming increasingly important to address if this new technology is to reach commercial deployment. The moisture sensitivity of commonly used organic-inorganic metal halide perovskites has especially raised concerns. Here, we demonstrate that the hygroscopic lithium salt commonly used as a dopant for the hole transport material in perovskite solar cells makes the top layer of the devices hydrophilic and causes the solar cells to rapidly degrade in the presence of moisture. By using novel, low cost, and hydrophobic hole transporters in conjunction with a doping method incorporating a preoxidized salt of the respective hole transporters, we are able to prepare efficient perovskite solar cells with greatly enhanced water resistance.

Lead, arsenic and manganese metal mixture exposures: focus on biomarkers of effect

PubMed Central

Andrade, VL; Mateus, ML; Batoréu, MC; Aschner, M; Marreilha dos Santos, AP

2015-01-01

Summary The increasing exposure of human populations to excessive levels of metals continues to represent a matter of public health concern. Several biomarkers have been studied and proposed for the detection of adverse health effects induced by lead (Pb), arsenic (As) and manganese (Mn); however, these studies have relied on exposures to each single metal, which fails to replicate real-life exposure scenarios. These 3 metals are commonly detected in different environmental, occupational and food contexts and they share common neurotoxic effects, which are progressive and once clinically apparent may be irreversible. Thus, chronic exposure to low levels of a mixture of these metals represents an additive risk of toxicity. Building upon their shared mechanisms of toxicity, such as oxidative stress, interference with neurotransmitters and effects on hematopoietic system, we address putative biomarkers, which may be assist in assessing onset of neurological diseases associated with exposure to this metal mixture. PMID:25693681

Conscientious Classification: A Data Scientist's Guide to Discrimination-Aware Classification.

PubMed

d'Alessandro, Brian; O'Neil, Cathy; LaGatta, Tom

2017-06-01

Recent research has helped to cultivate growing awareness that machine-learning systems fueled by big data can create or exacerbate troubling disparities in society. Much of this research comes from outside of the practicing data science community, leaving its members with little concrete guidance to proactively address these concerns. This article introduces issues of discrimination to the data science community on its own terms. In it, we tour the familiar data-mining process while providing a taxonomy of common practices that have the potential to produce unintended discrimination. We also survey how discrimination is commonly measured, and suggest how familiar development processes can be augmented to mitigate systems' discriminatory potential. We advocate that data scientists should be intentional about modeling and reducing discriminatory outcomes. Without doing so, their efforts will result in perpetuating any systemic discrimination that may exist, but under a misleading veil of data-driven objectivity.

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

PubMed Central

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

2012-01-01

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

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

PubMed

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

2012-08-01

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

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…

Operational Considerations for Oxygen Flammability Risks: Concentrated Oxygen Diffusion and Permeation Behaviors

NASA Technical Reports Server (NTRS)

Harper, Susana; Smith, Sarah; Juarez, Alfredo; Hirsch, David

2010-01-01

Increased human spaceflight operations utilize oxygen concentrations that are frequently varied with use of concentrations up to 100 percent oxygen. Even after exiting a higher percentage oxygen environment, high oxygen concentrations can still be maintained due to material saturation and oxygen entrapment between barrier materials. This paper examines the material flammability concerns that arise from changing oxygen environments during spaceflight operations. We examine the time required for common spacecraft and spacesuit materials exposed to oxygen to return to reduced ignitability and flammability once removed from the increased concentration. Various common spacecraft materials were considered: spacecraft cabin environment foams, Extra Vehicular Mobility Unit materials and foams, Advanced Crew Escape Suit materials, and other materials of interest such as Cotton, Nomex^ HT90-40, and Tiburon Surgical Drape. This paper presents calculated diffusion coefficients derived from experimentally obtained oxygen transmission rates for the tested materials and the analytically derived times necessary for reduced flammability to be achieved based on NASA flammability criteria. Oxygen material saturation and entrapment scenarios are examined. Experimental verification data on oxygen diffusion in saturation scenarios are also presented and discussed. We examine how to use obtained data to address flammability concerns during operational planning to reduce the likelihood of fires while improving efficiency for procedures.

Communication at an online infertility expert forum: provider responses to patients' emotional and informational cues.

PubMed

Aarts, J W M; van Oers, A M; Faber, M J; Cohlen, B J; Nelen, W L D M; Kremer, J A M; van Dulmen, A M

2015-01-01

Online patient-provider communication has become increasingly popular in fertility care. However, it is not known to what extent patients express cues or concerns and how providers respond. In this study, we investigated cues and responses that occur in online patient-provider communication at an infertility-specific expert forum. We extracted 106 threads from the multidisciplinary expert forum of two Dutch IVF clinics. We performed the following analyses: (1) thematic analysis of patients' questions; and (2) rating patients' emotional and informational cues and subsequent professionals' responses using an adaptation of the validated Medical Interview Aural Rating Scale. Frequencies of themes, frequencies of cues and responses, and sequences (what cue is followed by what response) were extracted. Sixty-five infertile patients and 19 providers participated. The most common themes included medication and lifestyle. Patients gave more informational than emotional cues (106 versus 64). Responses to informational cues were mostly adequate (61%). The most common response to emotional cues was empathic acknowledgment (72%). Results indicate that an online expert forum could have a positive effect on patient outcomes, which should guide future research. Offering infertile patients an expert forum to communicate with providers can be a promising supplement to usual care in both providing information and addressing patients' concerns.

Unpacking the Barriers to Reproductive Health Services in Ghana: HIV/STI Testing, Abortion and Contraception.

PubMed

Thatte, Nandita; Bingenheimer, Jeffrey B; Ndiaye, Khadidiatou; Rimal, Rajiv N

2016-06-01

Youth report embarrassment, cost, and poor access as barriers to sexual and reproductive health (SRH) services. Interventions to address barriers like youth friendly services have yet to conclusively demonstrate impact on protective behaviours like condom or contraceptive use. SRH encompasses a range of services so we aimed to assess how perceived barriers differed depending on the service being sought between common services accessed by young people: HIV/STI testing, abortion, and contraception. 1203 Ghanaian youth were interviewed. Data was analysed to identify barriers by service type, demographics, and between high and low HIV prevalence communities. Being embarrassed or shy was the most commonly reported barrier across services. Overall being embarrassed or shy, fear of safety, fear of family finding out and cost were the most reported barriers across all services. Further analysis by service indicated that being embarrassed was a significantly greater barrier for HIV/STI testing and contraception when compared with abortion (p<0.001) and safety concerns and cost were significantly greater barriers for abortion and contraception compared with HIV/STI testing (p<0.001). Efforts to develop interventions that consider the service being sought may help address the range of barriers faced by youth with diverse SRH needs.

Community-based counselors' interventions for elementary school-age children coping with trauma.

PubMed

Nabors, Laura; Baker-Phibbs, Christina; Woodson, Kenneth

2016-01-01

Child trauma is a mental health concern and more information is needed about treatment in community mental health settings. This article presents results of a focus group and member checking sessions held with counselors who provided therapy for children experiencing posttraumatic stress disorder in a community-based setting. Results indicated that play and art techniques were commonly used during individual child therapy sessions. Sessions were child-directed and allowed children to review trauma experiences in a "safe" setting with an "expert" guide. Several themes were commonly addressed in sessions including opportunities to re-experience, release, and reorganize the trauma, building resilience or self-esteem for the child, promoting safety, and helping the child to regulate emotional reactions and behavior problems. Counselors focused on discussing ways to interact with the child to promote healing and there was a belief that children would return to a positive developmental trajectory after coping with traumatic experiences. Future research needs to address what works for whom, in terms of what interventions are useful in child-directed counseling sessions for children who have experienced specific types of trauma, such as sexual and physical abuse or witnessing domestic violence. Integration of knowledge from evidence-based treatments will also further inform clinical practice with children who have experienced traumatic events.

Alternative Method to Simulate a Sub-idle Engine Operation in Order to Synthesize Its Control System

NASA Astrophysics Data System (ADS)

Sukhovii, Sergii I.; Sirenko, Feliks F.; Yepifanov, Sergiy V.; Loboda, Igor

2016-09-01

The steady-state and transient engine performances in control systems are usually evaluated by applying thermodynamic engine models. Most models operate between the idle and maximum power points, only recently, they sometimes address a sub-idle operating range. The lack of information about the component maps at the sub-idle modes presents a challenging problem. A common method to cope with the problem is to extrapolate the component performances to the sub-idle range. Precise extrapolation is also a challenge. As a rule, many scientists concern only particular aspects of the problem such as the lighting combustion chamber or the turbine operation under the turned-off conditions of the combustion chamber. However, there are no reports about a model that considers all of these aspects and simulates the engine starting. The proposed paper addresses a new method to simulate the starting. The method substitutes the non-linear thermodynamic model with a linear dynamic model, which is supplemented with a simplified static model. The latter model is the set of direct relations between parameters that are used in the control algorithms instead of commonly used component performances. Specifically, this model consists of simplified relations between the gas path parameters and the corrected rotational speed.

The management of young people who self-harm by New Zealand Infant, Child and Adolescent Mental Health Services: cutting-edge or cutting corners?

PubMed

Thabrew, Hiran; Gandeza, Ernest; Bahr, Giselle; Bettany, David; Bampton, Chris; Cooney, Emily; Coleman, Nikki; Tiatia-Seath, Jemaima

2018-04-01

Self-harm is common in New Zealand (NZ) young people and can have short-term and long-term consequences, including suicide. This study was undertaken to examine the extent to which evidence-based approaches for addressing self-harm are offered by Infant, Child and Adolescent Mental Health Services (ICAMHS). A national survey of ICAMHS practitioners working with young people who self-harm was undertaken between May and July 2016. Responses from 23 out of 30 ICAMHS confirmed self-harm was a familiar presentation and most commonly associated with diagnoses of depression, anxiety and borderline personality disorder. Cognitive behavioural therapy (47.1%, n = 8), dialectical behaviour therapy (47.1%, n = 8) and acceptance and commitment therapy (5.9%, n = 1) were the treatments of choice, but variably delivered. There were significant training gaps for all types of therapy. Although it is reassuring that many ICAMHS are using evidence-based approaches to address self-harm in young people, there is concerning variability in the way these therapies are delivered. Improvement in training in key modalities, further research into therapist performance and continuous evaluation of workforce development are needed to maximise the effectiveness of proven interventions and provide NZ young people with the state-of-the-art service they deserve.

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.

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…

Quality of service management framework for dynamic chaining of geographic information services

NASA Astrophysics Data System (ADS)

Onchaga, Richard

2006-06-01

Dynamic chaining of geographic information services (geo-services) is gaining popularity as a new paradigm for evolving flexible geo-information systems and for providing on-demand access to geo-information. In dynamic chaining, disparate geo-services are discovered and composed at run time to yield more elaborate functionality and create value-added geo-information. Common approaches to service chaining discover and compose disparate geo-services based on the functional capability of individual geo-services. The primary concern of common approaches is thus the emergent behavior of the resulting composite geo-service. However, as geo-services become mundane and take on a greater and more strategic role in mission critical processes, deliverable quality of service (QoS) becomes an important concern. QoS concerns operational characteristics of a service that determine its utility in an application context. To address pertinent QoS requirements, a new approach to service chaining becomes necessary. In this paper we propose a QoS-aware chaining approach in which geo-services are discovered, composed and executed considering both functional and QoS requirements. We prescribe a QoS management framework that defines fundamental principles, concepts and mechanisms which can be applied to evolve an effective distributed computing platform for QoS-aware chaining of geo-services - the so-called geo-service infrastructure. The paper also defines an extensible QoS model for services delivered by dynamic compositions of geo-services. The process of orthophoto generation is used to demonstrate the applicability of the prescribed framework to service-oriented geographic information processing.

Patterns of drugs prescribed for dental outpatients in Nigeria: findings and implications.

PubMed

Fadare, Joseph O; Oshikoya, Kazeem A; Obimakinde, Obitade S; Sijuade, Abayomi O; Afolayan, Jide M; Adeleke, Adeyinka A; Godman, Brian; Ojumu, Damilola O

2017-10-01

There are concerns with inappropriate prescribing of medicines among dentists especially antimicrobials. It is more concerning if this increases resistance rates. This study aimed to address this by assessing patterns of drugs prescribed for outpatients attending a hospital dental clinic in Nigeria. The findings will be used to plan future interventions, particularly around antimicrobial prescribing, where there are concerns. Medical records of patients attending the dental clinic of a leading teaching hospital in Nigeria were evaluated. Patients referred for admission, without a prescription, or prescribed medicines without a documented diagnosis were excluded. Overall, 607 prescriptions were analysed, 314 (51.7%) were for females. Periodontal and gum diseases (414; 68.1%) were the most frequent diagnoses, followed by pulpitis (49; 8.2%), and dentoalveolar abscess (43; 7.1%). A total of 1798 medicines were prescribed for all patients with a mean of 3.0 ± 0.48 medicines per prescription. Antimicrobials (1178; 65.5%) and analgesics (620; 34.5%) were the two drug classes prescribed. Ascorbic acid and vitamin B complex were prescribed for 361 (59.5%) patients. Among antimicrobials, amoxicillin (564; 95.1%) either alone or combined with clavulanic acid was the most frequently prescribed, followed by metronidazole (561; 94.6%). Brand name prescribing was also appreciably higher than WHO recommendations. Polypharmacy, brand name prescriptions, and the frequent prescription of antimicrobials were common practices at the dental clinic of this teaching hospital in Nigeria. We suggest a review of the current standard treatment guidelines in Nigeria to guide dentists on current knowledge- and evidence-based treatment of common oral diseases.

Zoonoses: an occupational hazard for livestock workers and a public health concern for rural communities.

PubMed

LeJeune, J; Kersting, A

2010-07-01

Farming employs one of the most diverse work forces, while at the same time it is one of the most dangerous occupations in the U.S. Individuals associated with the livestock industry face an additional risk: zoonotic diseases. In an effort to improve the overall well-being of the farming community, this review addresses zoonoses as a health concern for the farming community. The discussion of agriculturally acquired zoonoses includes infections naturally transmitted from vertebrate animals to man (e.g., rabies) and those common to animals and man (e.g., Salmonella). Special consideration is given to identifying individuals potentially at higher risk for developing disease. Case reports and epidemiological studies are reviewed from published veterinary and human-health literature to illustrate exposure scenarios and associated health outcomes. Additionally, key livestock zoonoses in the U.S. are summarized, and an overview of prevention and control strategies is provided. Findings show that livestock can transmit many zoonoses directly and indirectly, and human health can be significantly impacted, but the number of people adversely impacted is largely unknown. This review concludes that more education about zoonosis transmission and prevention is needed, and healthcare providers serving rural communities are a critical link in providing this information. In order for healthcare providers to address the educational gap, we recommend greater collaboration with veterinary specialists schooled in population medicine, zoonosis prevention and control, and animal production.

A paramagnetic implant containing lithium naphthalocyanine microcrystals for high-resolution biological oximetry

PubMed Central

Meenakshisundaram, Guruguhan; Pandian, Ramasamy P.; Eteshola, Edward; Lee, Stephen C.; Kuppusamy, Periannan

2009-01-01

Lithium naphthalocyanine (LiNc) is a microcrystalline EPR oximetry probe with high sensitivity to oxygen (Pandian et al. J. Mater. Chem., 19, 4138, 2009). However, direct implantation of the crystals in the tissue for in vivo oxygen measurements may be hindered by concerns associated with their direct contact with the tissue/cells and loss of EPR signal due to particle migration in the tissue. In order to address these concerns, we have developed encapsulations (chips) of LiNc microcrystals in polydimethyl siloxane (PDMS), an oxygen-permeable, bioinert polymer. Oximetry evaluation of the fabricated chips revealed that the oxygen sensitivity of the crystals was unaffected by encapsulation in PDMS. Chips were stable against sterilization procedures or treatment with common biological oxidoreductants. In vivo oxygen measurements established the ability of the chips to provide reliable and repeated measurements of tissue oxygenation. This study establishes PDMS-encapsulated LiNc as a potential probe for long-term and repeated measurements of tissue oxygenation. PMID:20006529

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.

Genetic aspects of population policy.

PubMed

Morton, N E

1999-08-01

Every science begins in folklore and matures as it reacts against dogma and myth. Astronomy developed in the Neolithic, but it did not outgrow astrology until the sixteenth century. Chemistry discarded alchemy at about the same time. On the contrary, the short history of genetics has been concurrent with the pseudo-science of eugenics, which, at times, has been widely accepted and incorporated in population policy and directive genetic counselling, with rare opposition by geneticists. Societal pressures are likely to increase with the power of genetic technology, the fear it generates and the perception that population growth threatens human welfare. Without a pertinent ethical code, geneticists are vulnerable to both temptation and opprobrium. The intrusion of eugenics into genetic counselling has been a recent source of concern to societies and congresses of genetics. This review traces the causes of this concern and the manner of its expression in the absence of an international voice for genetics that could address ethical and other common interests.

Metabolic, autonomic and immune markers for cardiovascular disease in posttraumatic stress disorder

PubMed Central

Kibler, Jeffrey L; Tursich, Mischa; Ma, Mindy; Malcolm, Lydia; Greenbarg, Rachel

2014-01-01

Posttraumatic stress disorder (PTSD) has been associated with significantly greater incidence of heart disease. Numerous studies have indicated that health problems for individuals with PTSD occur earlier in life than in the general population. Multiple mechanistic pathways have been suggested to explain cardiovascular disese (CVD) risk in PTSD, including neurochemical, behavioral, and immunological changes. The present paper is a review of recent research that examines cardiovascular and immune risk profiles of individuals with PTSD. First, we address the relatively new evidence that the constellation of risk factors commonly experienced in PTSD fits the profile of metabolic syndrome. Next we examine the findings concerning hypertension/blood pressure in particular. The literature on sympathetic and parasympathetic responsivity in PTSD is reviewed. Last, we discuss recent findings concerning immune functioning in PTSD that may have a bearing on the high rates of CVD and other illnesses. Our primary goal is to synthesize the existing literature by examining factors that overlap mechanistically to increase the risk of developing CVD in PTSD. PMID:24976918

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.

'Am I covered?': an analysis of a national enquiry database on scope of practice.

PubMed

Brady, Anne-Marie; Fealy, Gerard; Casey, Mary; Hegarty, Josephine; Kennedy, Catriona; McNamara, Martin; O'Reilly, Pauline; Prizeman, Geraldine; Rohde, Daniela

2015-10-01

Analysis of a national database of enquiries to a professional body pertaining to the scope of nursing and midwifery practice. Against a backdrop of healthcare reform is a demand for flexibility in nursing and midwifery roles with unprecedented redefinition of role boundaries and/or expansion. Guidance from professional regulatory bodies is being sought around issues of concern that are arising in practice. Qualitative thematic analysis. The database of telephone enquiries (n = 9818) made by Registered Nurses and midwives to a national regulatory body (2001-2013) was subjected to a cleaning process and examined to detect those concerns that pertained to scope of practice. A total of 978 enquiries were subjected to thematic analysis. Enquiries were concerned with three main areas: medication management, changing and evolving scope of practice and professional role boundaries. The context was service developments, staff shortages and uncertainty about role expansion and professional accountability. Other concerns related to expectations around responsibility and accountability for other support staff. Efforts by employers to maximize the skill mix of their staff and optimally deploy staff to meet service needs and/or address gaps in service represented the primary service context from which many enquiries arose. The greatest concern for nurses arises around medication management but innovation in healthcare delivery and the demands of service are also creating challenges for nurses and midwives. Maintaining and developing competence is a concern among nurses and midwives particularly in an environment of limited resources and where re-deployment is common. © 2015 John Wiley & Sons Ltd.

Parental concerns on disclosure of HIV status to children living with HIV: children's perspective.

PubMed

Sanjeeva, G N; Pavithra, H B; Chaitanya, S; Sunil Kumar, D R; Rewari, B B

2016-11-01

Disclosure is an important component of comprehensive management of children living with HIV infection (CLHIV). Many parental concerns are barriers for disclosure in children and only few studies addresses children's perspective on these concerns. Our study aims to understand children's perspective on parental concerns for disclosure and assess the knowledge of HIV. A questionnaire-based cross-sectional study involving CLHIV between 10 and 18 years attending HIV clinic in southern India, was conducted. Data were collected by directly interviewing only the children after obtaining consent from parents/caregivers. Initial open-ended questions were asked to assess the disclosure status and only fully disclosed children were included. Out of 362 enrolled eligible children, the prevalence of full and partial disclosure was 36.7% and 24%, respectively. The mean age of disclosure was 10.4 years (SD ± 2.6) and non-parental family members in an informal setting were the most common source of disclosure (38.3%). Forty-six percentages of parents were unaware of their child's disclosure status. Only 2% had disclosed their status to others who were not part of their care. Among disclosed children, 33.8% became upset or sad upon knowing their status, 12% faced discrimination and 41.4% had complete knowledge about their illness. Though the prevalence of disclosure among CLHIV was high, a majority of them had incomplete knowledge about HIV infection. The parental concerns as reported in literature like the child is too young to disclose, concerns about coping, fear of stigma and discrimination and child disclosing to others were not expressed by children.

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…

The Culture of Academic Medicine: Faculty Behaviors Impacting the Learning Environment.

PubMed

Moutier, Christine; Wingard, Deborah; Gudea, Monica; Jeste, Dilip; Goodman, Seneca; Reznik, Vivian

2016-12-01

The culture of academic medical institutions impacts trainee education, among many other faculty and patient outcomes. Disrespectful behavior by faculty is one of the most challenging and common problems that, left unattended, disrupts healthy work and learning environments. Conversely, a respectful environment facilitates learning, creates a sense of safety, and rewards professionalism. The authors developed surveys and an intervention in an effort to better understand and improve climate concerns among health sciences faculty at the University of California, San Diego (UCSD), a research-intense, public, academic medical center. An online "climate survey" of all UC San Diego health sciences faculty was conducted in 2011-2012. A strategic campaign to address the behavioral issues identified in the initial survey was subsequently launched. In 2015, the climate was re-evaluated in order to assess the effectiveness of the intervention. A total of 478 faculty members (223 women, 235 men, 35 % of faculty) completed the baseline survey, reporting relatively low levels of observed sexual harassment (7 %). However, faculty reported concerning rates of other disruptive behaviors: derogatory comments (29 %), anger outbursts (25 %), and hostile communication (25 %). Women and mid-level faculty were more likely to report these behavioral concerns than men and junior or senior colleagues. Three years after an institutional strategy was initiated, 729 faculty members (50 % of the faculty) completed a follow-up survey. The 2015 survey results indicate significant improvement in numerous climate factors, including overall respectful behaviors, as well as behaviors related to gender. In order to enhance a culture of respect in the learning environment, institutions can effectively engage academic leaders and faculty at all levels to address disruptive behavior and enhance positive climate factors.

[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.

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

PubMed

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

2016-09-15

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

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/.

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.

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

Lodhia, P.; Antonious, A.; Esat, I.

There has been much recent interest in the application of artificial intelligence systems to real world problems. Substantial interest has been shown in their application to investment markets. Artificial Neural Networks are the most common technique here. This paper is concerned with the use of ANNs in forecasting exchange rates. Much research has been carried out in currency markets. However, many of the studies use end of day or average quotes for currencies as a basis for prediction. A growing school of thought propose that markets are non-random in the short-term and can be shown to follow patterns. This short-termmore » time span can be described as being a period when the markets are inefficient at price adjustments. The use of intraday data is an ideal testing ground for ANNs based research. This paper aims to study the intraday forecasting of the US Dollar/German Deutschmark and to address the question of whether ANNs can make acceptable predictions. The problems of forecasting in such a complex environment will be addressed.« less

Addressing Criticisms of Large-Scale Marine Protected Areas.

PubMed

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

2018-05-01

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

Barriers to Implementing a Reporting and Learning Patient Safety System: Pediatric Chiropractic Perspective.

PubMed

Pohlman, Katherine A; Carroll, Linda; Hartling, Lisa; Tsuyuki, Ross T; Vohra, Sunita

2016-04-01

A reporting and learning system is a method of monitoring the occurrence of incidents that affect patient safety. This cross-sectional survey asked pediatric chiropractors about factors that may limit their participation in such a system. The list of potential barriers for participation was developed using a systematic approach. All members of the 2 pediatric councils associated with US national chiropractic organizations were invited to complete the survey (N = 400). The cross-sectional survey was created using an online survey tool (REDCap) and sent directly to member emails addressed by the respective executive committees. Of the 400 potential respondents, 81 responded (20.3%). The most common limitations to participating were identified as time pressure (96%) and patient concerns (81%). Reporting and learning systems have been utilized to increase safety awareness in many high-risk industries. To be successful, future patient safety studies with pediatric chiropractors need to ensure these barriers are understood and addressed. © The Author(s) 2015.

Addressing Criticisms of Large-Scale Marine Protected Areas

PubMed Central

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

2018-01-01

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

The cancer experience map: an approach to including the patient voice in supportive care solutions.

PubMed

Hall, Leslie Kelly; Kunz, Breanne F; Davis, Elizabeth V; Dawson, Rose I; Powers, Ryan S

2015-05-28

The perspective of the patient, also called the "patient voice", is an essential element in materials created for cancer supportive care. Identifying that voice, however, can be a challenge for researchers and developers. A multidisciplinary team at a health information company tasked with addressing this issue created a representational model they call the "cancer experience map". This map, designed as a tool for content developers, offers a window into the complex perspectives inside the cancer experience. Informed by actual patient quotes, the map shows common overall themes for cancer patients, concerns at key treatment points, strategies for patient engagement, and targeted behavioral goals. In this article, the team members share the process by which they created the map as well as its first use as a resource for cancer support videos. The article also addresses the broader policy implications of including the patient voice in supportive cancer content, particularly with regard to mHealth apps.

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

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

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...

Consumer acceptance of cultured meat: A systematic review.

PubMed

Bryant, Christopher; Barnett, Julie

2018-09-01

Cultured meat grown in-vitro from animal cells is being developed as a way of addressing many of the ethical and environmental concerns associated with conventional meat production. As commercialisation of this technology appears increasingly feasible, there is growing interest in the research on consumer acceptance of cultured meat. We present a systematic review of the peer-reviewed literature, and synthesize and analyse the findings of 14 empirical studies. We highlight demographic variations in consumer acceptance, factors influencing acceptance, common consumer objections, perceived benefits, and areas of uncertainty. We conclude by evaluating the most important objections and benefits to consumers, as well as highlighting areas for future research. Copyright © 2018 Elsevier Ltd. All rights reserved.

Suicide among police in a federal force.

PubMed

Loo, R

1986-01-01

Suicide among police has gained the attention of numerous police forces over the past two decades. The great variation in reported police suicide rates and caveats concerning such statistics are addressed. The paper reports the results of a study of suicide among members (n = 35) of the Royal Canadian Mounted Police (RMCP) between 1960 and 1983. The average annual rate (14.1 per 100,000) of suicide in this force was approximately half that of the comparable general population, and the most common means of suicide was by service revolver (77% of cases). Recommendations are made for suicide prevention and postvention actions in police forces. Finally, the need for reliable, long-term police suicide data bases is stressed.

Restoration of impaired ecosystems: An ounce of prevention or a pound of cure? introduction, overview, and key messages from a SETAC-SER workshop

USGS Publications Warehouse

Farag, Aïda M.; Hull, Ruth N.; Clements, Will H.; Glomb, Steve; Larson, Diane L.; Stahl, Ralph G.; Stauber, Jenny

2016-01-01

A workshop on Restoration of Impaired Ecosystems was held in Jackson, Wyoming, in June 2014. Experts from Australia, Canada, Mexico, the United Kingdom, and the United States in ecotoxicology, restoration, and related fields from both the Society of Environmental Toxicology and Chemistry and the Society for Ecological Restoration convened to advance the practice of restoring ecosystems that have been contaminated or impaired from industrial activities. The overall goal of this workshop was to provide a forum for ecotoxicologists and restoration ecologists to define the best scientific practices to achieve ecological restoration while addressing contaminant concerns. To meet this goal, participants addressed 5 areas: 1) links between ecological risk assessment and ecological restoration, 2) restoration goals, 3) restoration design, 4) monitoring for restoration effectiveness and 5) recognizing opportunities and challenges. Definitions are provided to establish a common language across the varied disciplines. The current practice for addressing restoration of impaired ecosystems tends to be done sequentially to remediate contaminants, then to restore ecological structure and function. A better approach would anticipate or plan for restoration throughout the process. By bringing goals to the forefront, we may avoid intrusive remediation activities that close off options for the desired restoration. Participants realized that perceived limitations in the site assessment process hinder consideration of restoration goals; contaminant presence will influence restoration goal choices; social, economic, and cultural concerns can factor into goal setting; restoration options and design should be considered early during site assessment and management; restoration of both structure and function is encouraged; creative solutions can overcome limitations; a regional focus is imperative; monitoring must occur throughout the restoration process; and reciprocal transfer of knowledge is needed among theorists, practitioners, and stakeholders and among varied disciplines.

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.

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

PubMed

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

2003-03-01

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

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…

A Relational Ethics Framework for Advancing Practice with Children with Complex Health Care Needs and Their Parents.

PubMed

Carnevale, Franco A; Teachman, Gail; Bogossian, Aline

2017-12-01

Children with complex health care needs are an emerging population that commonly requires long-term supportive services. A growing body of evidence has highlighted that these children and their families experience significant challenges. Many of these challenges involve ethical concerns that have been under-recognized. In this article, we (a) outline ethical concerns that arise in clinical practice with children with complex health care needs and their families (e.g.: exclusion of children's voices in discussions and decisions that affect them; difficulties in defining their best interests; clashes across the array of social roles that parents manage; limited recognition of the ethical significance of parents' and other family members' interests) and (b) propose a relational ethics framework for addressing these concerns. Our framework draws on hermeneutical interpretation and moral experience as foundational orientations, recognizing children with complex health care needs as relationally embedded agents, who while dependent and entitled to protection, are simultaneously agential. Children's and parents' interests are relationally intertwined and interdependent. Families are recognized as significant social microcosms for the cultivation and transmission of intergenerational cultural heritage, narratives, and outlooks. We describe strategies for (a) conducting a relational ethics inquiry and (b) reconciliation of identified ethical concerns through a process of rapprochement. A relational ethics framework can promote clinical practices that are ethically attuned to the complexity of this population's needs.

Conceptual measurement framework for help-seeking for mental health problems

PubMed Central

Rickwood, Debra; Thomas, Kerry

2012-01-01

Background Despite a high level of research, policy, and practice interest in help-seeking for mental health problems and mental disorders, there is currently no agreed and commonly used definition or conceptual measurement framework for help-seeking. Methods A systematic review of research activity in the field was undertaken to investigate how help-seeking has been conceptualized and measured. Common elements were used to develop a proposed conceptual measurement framework. Results The database search revealed a very high level of research activity and confirmed that there is no commonly applied definition of help-seeking and no psychometrically sound measures that are routinely used. The most common element in the help-seeking research was a focus on formal help-seeking sources, rather than informal sources, although studies did not assess a consistent set of professional sources; rather, each study addressed an idiosyncratic range of sources of professional health and community care. Similarly, the studies considered help-seeking for a range of mental health problems and no consistent terminology was applied. The most common mental health problem investigated was depression, followed by use of generic terms, such as mental health problem, psychological distress, or emotional problem. Major gaps in the consistent measurement of help-seeking were identified. Conclusion It is evident that an agreed definition that supports the comparable measurement of help-seeking is lacking. Therefore, a conceptual measurement framework is proposed to fill this gap. The framework maintains that the essential elements for measurement are: the part of the help-seeking process to be investigated and respective time frame, the source and type of assistance, and the type of mental health concern. It is argued that adopting this framework will facilitate progress in the field by providing much needed conceptual consistency. Results will then be able to be compared across studies and population groups, and this will significantly benefit understanding of policy and practice initiatives aimed at improving access to and engagement with services for people with mental health concerns. PMID:23248576

Packet flow monitoring tool and method

DOEpatents

Thiede, David R [Richland, WA

2009-07-14

A system and method for converting packet streams into session summaries. Session summaries are a group of packets each having a common source and destination internet protocol (IP) address, and, if present in the packets, common ports. The system first captures packets from a transport layer of a network of computer systems, then decodes the packets captured to determine the destination IP address and the source IP address. The system then identifies packets having common destination IP addresses and source IP addresses, then writes the decoded packets to an allocated memory structure as session summaries in a queue.

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

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

Online Technologies for Health Information and Education: A literature review.

PubMed

Gill, Harkiran K; Gill, Navkiranjit; Young, Sean D

2013-04-01

There is a growing body of research focused on the use of social media and Internet technologies for health education and information sharing. The authors reviewed literature on this topic, with a specific focus on the benefits and concerns associated with using online social technologies as health education and communication tools. Studies suggest that social media technologies have the potential to safely and effectively deliver health education, if privacy concerns are addressed. Utility of social media-based health education and communication will improve as technology developers and public health officials determine ways to improve information accuracy and address privacy concerns.

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)

The Environment: The Tie That Binds.

ERIC Educational Resources Information Center

Lichtenstein, Elissa C.

1997-01-01

Articulates the need for international cooperation concerning environmental issues and the promotion of sustainable development. Discusses several international treaties and conventions addressing specific environmental concerns. Lists a number of worldwide environmental concerns, including fresh water, arable land, air pollution, oceans, forests,…

1What do first-time mothers worry about? A study of usage patterns and content of calls made to a postpartum support telephone hotline

PubMed Central

2010-01-01

Background Telephone hotlines designed to address common concerns in the early postpartum could be a useful resource for parents. Our aim was to test the feasibility of using a telephone as an intervention in a randomized controlled trial. We also aimed to test to use of algorithms to address parental concerns through a telephone hotline. Methods Healthy first-time mothers were recruited from postpartum wards of hospitals throughout Lebanon. Participants were given the number of a 24-hour telephone hotline that they could access for the first four months after delivery. Calls were answered by a midwife using algorithms developed by the study team whenever possible. Callers with medical complaints were referred to their physicians. Call patterns and content were recorded and analyzed. Results Eighty-four of the 353 women enrolled (24%) used the hotline. Sixty percent of the women who used the service called more than once, and all callers reported they were satisfied with the service. The midwife received an average of three calls per day and most calls occurred during the first four weeks postpartum. Our algorithms were used to answer questions in 62.8% of calls and 18.6% of calls required referral to a physician. Of the questions related to mothers, 66% were about breastfeeding. Sixty percent of questions related to the infant were about routine care and 23% were about excessive crying. Conclusions Utilization of a telephone hotline service for postpartum support is highest in the first four weeks postpartum. Most questions are related to breastfeeding, routine newborn care, and management of a fussy infant. It is feasible to test a telephone hotline as an intervention in a randomized controlled trial. Algorithms can be developed to provide standardized answers to the most common questions. PMID:20946690

The Global Online Sexuality Survey (GOSS): the United States of America in 2011 chapter II: phosphodiesterase inhibitors utilization among English speakers.

PubMed

Shaeer, Osama

2013-02-01

Utility of phosphodiesterase inhibitors (PDEi's) for the treatment of erectile dysfunction (ED) has been the focus of experimental and clinical studies. However, public preferences, attitudes, and experiences with PDEi's are rarely addressed from a population/epidemiology viewpoint. The Global Online Sexuality Survey (GOSS) is a worldwide epidemiologic study of sexuality and sexual disorders, first launched in the Middle East in 2010, followed by the United States in 2011. To describe the utilization rates, trends, and attitudes toward PDEi's in the United States in the year 2011. GOSS was randomly deployed to English-speaking male Web surfers in the United States via paid advertising on Facebook®, comprising 146 questions. Utilization rates and preferences for PDEi's by brand. Six hundred three subjects participated; mean age 53.43 years ± 13.9. Twenty-three point seven percent used PDEi's on more consistent basis, 37.5% of those with ED vs. 15.6% of those without ED (recreational users). Unrealistic safety concerns including habituation were pronounced. Seventy-nine point six percent of utilization was on prescription basis. PDEi's were purchased through pharmacies (5.3% without prescription) and in 16.5% over the Internet (68% without prescription). Nine point six percent nonprescription users suffered coronary heart disease. Prescription use was inclined toward sildenafil, generally, and particularly in severe cases, and shifted toward tadalafil in moderate ED and for recreational use, followed by vardenafil. Nonprescription utilization trends were similar, except in recreational use where sildenafil came first. In the United States unrealistic safety concerns over PDEi's utility exist and should be addressed. Preference for particular PDEi's over the others is primarily dictated by health-care providers, despite lack of guidelines that govern physician choice. Online and over-the-counter sales of PDEi's are common, and can expose a subset of users to health risks. Recreational use of PDEi's is common, and could be driven by undiagnosed premature ejaculation. © 2012 International Society for Sexual Medicine.

Using the Internet as source of information during pregnancy - a descriptive cross-sectional study among fathers-to-be in Sweden.

PubMed

Oscarsson, Marie Gunnel; Medin, Erica; Holmström, Ida; Lendahls, Lena

2018-07-01

The aim of this study was to identify how fathers-to-be used the Internet as a source of information during their partners' pregnancy and how it affected them. A descriptive cross-sectional study was conducted. Data were collected through a questionnaire and distributed at a maternity clinic in south of Sweden. The data were analysed descriptively. Ninety-two Swedish fathers participated in the study, and the response rate was 98.9%. Of all the fathers-to-be, 76% sought pregnancy-related information on the Internet. One sought information on a daily basis, 40.6% every week and 58% every month or more rarely. The fathers-to-be who participated at all/most visits at antenatal care searched for information on the Internet more often than those who only attended few/no visits (p = 0.012). A total of 33.4% of fathers-to-be had been recommended a web page by the midwife at the antenatal care. The main reason for using the Internet was to find information about pregnancy related subjects and read about people in similar situations. More than half of the fathers-to-be (61.8%) had at some point been worried by something they read online. These concerns were commonly addressed by asking the midwife at their next appointment (33.9%). Almost 26% of the fathers-to-be chose not to take any action at all to address their concerns. The majority of all fathers-to-be searched for information on the Internet, and more than half of the fathers were, at some point, worried about the information they read on the Internet. One way to address questions and concerns could be for the fathers-to-be to ask and discuss with the midwives what they read online so that midwives can recommend appropriate and credible websites. To achieve this, there must be opportunities for midwives to gain knowledge on how best to use the Internet as a tool. Copyright © 2018 Elsevier Ltd. All rights reserved.

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…

Techniques to evaluate the importance of common cause degradation on reliability and safety of nuclear weapons.

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

Darby, John L.

2011-05-01

As the nuclear weapon stockpile ages, there is increased concern about common degradation ultimately leading to common cause failure of multiple weapons that could significantly impact reliability or safety. Current acceptable limits for the reliability and safety of a weapon are based on upper limits on the probability of failure of an individual item, assuming that failures among items are independent. We expanded the current acceptable limits to apply to situations with common cause failure. Then, we developed a simple screening process to quickly assess the importance of observed common degradation for both reliability and safety to determine if furthermore » action is necessary. The screening process conservatively assumes that common degradation is common cause failure. For a population with between 100 and 5000 items we applied the screening process and conclude the following. In general, for a reliability requirement specified in the Military Characteristics (MCs) for a specific weapon system, common degradation is of concern if more than 100(1-x)% of the weapons are susceptible to common degradation, where x is the required reliability expressed as a fraction. Common degradation is of concern for the safety of a weapon subsystem if more than 0.1% of the population is susceptible to common degradation. Common degradation is of concern for the safety of a weapon component or overall weapon system if two or more components/weapons in the population are susceptible to degradation. Finally, we developed a technique for detailed evaluation of common degradation leading to common cause failure for situations that are determined to be of concern using the screening process. The detailed evaluation requires that best estimates of common cause and independent failure probabilities be produced. Using these techniques, observed common degradation can be evaluated for effects on reliability and safety.« less

Nonpharmacologic, nonherbal management of menopause-associated vasomotor symptoms: an umbrella systematic review (protocol).

PubMed

Goldstein, Karen M; McDuffie, Jennifer R; Shepherd-Banigan, Megan; Befus, Deanna; Coeytaux, Remy R; Van Noord, Megan G; Goode, Adam P; Masilamani, Varsha; Adam, Soheir; Nagi, Avishek; Williams, John W

2016-04-07

Vasomotor symptoms such as hot flashes and night sweats are a common concern of perimenopausal and postmenopausal women and are associated with a decreased quality of life. These symptoms can be effectively managed with hormone therapy, but safety concerns limit its use. Thus, understanding the effectiveness of nonpharmacologic therapies such as acupuncture or yoga is critical to managing these common symptoms in older women. Our review seeks to address the following question: In women with menopause-associated vasomotor symptoms, what are the effects on health-related quality of life, vasomotor symptoms, and adverse events of the following nonpharmacologic, nonherbal interventions as compared with any inactive control or active comparator: (a) acupuncture, (b) yoga, tai chi, and qigong, (c) structured exercise, and (d) meditation, mindfulness-based practices, and relaxation? We describe a protocol for an umbrella review approach, supplemented by evaluating randomized controlled trials (RCTs) published after the most recent good-quality systematic review for each of the eligible interventions. Specific interventions were chosen based on current literature and with input from a technical expert panel and organizational stakeholders. We will conduct a thorough literature search and perform a quality assessment of potentially included systematic reviews and RCTs. Our umbrella review, supplemented by an additional search for eligible RCTs, aims to synthesize existing evidence on the use of nonpharmacologic, nonherbal interventions to manage bothersome vasomotor symptoms in perimenopausal and postmenopausal women. PROSPERO CRD42016029335.

Canadian 24-Hour Movement Guidelines for Children and Youth: Exploring the perceptions of stakeholders regarding their acceptability, barriers to uptake, and dissemination.

PubMed

Faulkner, Guy; White, Lauren; Riazi, Negin; Latimer-Cheung, Amy E; Tremblay, Mark S

2016-06-01

Engaging stakeholders in the development of guidelines and plans for implementation is vital. The purpose of this study was to examine stakeholders' (parents, teachers, exercise professionals, paediatricians, and youth) perceptions of the Canadian 24-Hour Movement Behaviour Guidelines for Children and Youth ("Movement Guidelines"). Stakeholders (n = 104) engaged in semi-structured focus groups or interviews to discuss the perceived acceptability of the guidelines, potential barriers to implementation, and preferred methods and messengers of dissemination. A thematic analysis was conducted. Overall, there was consistent support across all stakeholder groups, with the exception of youth participants, for the Movement Guidelines. Stakeholders identified a range of barriers to the uptake of the guidelines including concerns with accurately defining key terms such as "recreational" screen time; everyday challenges such as financial and time constraints; and the possibility of the Movement Guidelines becoming just another source of stress and guilt for already busy and overwhelmed parents. Participants identified a range of recommended methods and messengers for future dissemination. School and medical settings were the most commonly recommended settings through which dissemination efforts should be delivered. Overall, participants representing a range of stakeholder groups were receptive to the new Movement Guidelines and endorsed their value. In complementing the Movement Guidelines, messaging and resources will need to be developed that address common concerns participants had regarding their dissemination and implementation.

SegAuth: A Segment-based Approach to Behavioral Biometric Authentication

PubMed Central

Li, Yanyan; Xie, Mengjun; Bian, Jiang

2016-01-01

Many studies have been conducted to apply behavioral biometric authentication on/with mobile devices and they have shown promising results. However, the concern about the verification accuracy of behavioral biometrics is still common given the dynamic nature of behavioral biometrics. In this paper, we address the accuracy concern from a new perspective—behavior segments, that is, segments of a gesture instead of the whole gesture as the basic building block for behavioral biometric authentication. With this unique perspective, we propose a new behavioral biometric authentication method called SegAuth, which can be applied to various gesture or motion based authentication scenarios. SegAuth can achieve high accuracy by focusing on each user’s distinctive gesture segments that frequently appear across his or her gestures. In SegAuth, a time series derived from a gesture/motion is first partitioned into segments and then transformed into a set of string tokens in which the tokens representing distinctive, repetitive segments are associated with higher genuine probabilities than those tokens that are common across users. An overall genuine score calculated from all the tokens derived from a gesture is used to determine the user’s authenticity. We have assessed the effectiveness of SegAuth using 4 different datasets. Our experimental results demonstrate that SegAuth can achieve higher accuracy consistently than existing popular methods on the evaluation datasets. PMID:28573214

SegAuth: A Segment-based Approach to Behavioral Biometric Authentication.

PubMed

Li, Yanyan; Xie, Mengjun; Bian, Jiang

2016-10-01

Many studies have been conducted to apply behavioral biometric authentication on/with mobile devices and they have shown promising results. However, the concern about the verification accuracy of behavioral biometrics is still common given the dynamic nature of behavioral biometrics. In this paper, we address the accuracy concern from a new perspective-behavior segments, that is, segments of a gesture instead of the whole gesture as the basic building block for behavioral biometric authentication. With this unique perspective, we propose a new behavioral biometric authentication method called SegAuth, which can be applied to various gesture or motion based authentication scenarios. SegAuth can achieve high accuracy by focusing on each user's distinctive gesture segments that frequently appear across his or her gestures. In SegAuth, a time series derived from a gesture/motion is first partitioned into segments and then transformed into a set of string tokens in which the tokens representing distinctive, repetitive segments are associated with higher genuine probabilities than those tokens that are common across users. An overall genuine score calculated from all the tokens derived from a gesture is used to determine the user's authenticity. We have assessed the effectiveness of SegAuth using 4 different datasets. Our experimental results demonstrate that SegAuth can achieve higher accuracy consistently than existing popular methods on the evaluation datasets.

Factors influencing older black women’s sexual functioning and their disclosure of sexual concerns

PubMed Central

White, T; Laganá, L

2014-01-01

Introduction The study of older women’s sexual health has been very limited. Most of the available research in this area is on Caucasian older women; a few studies have targeted the sexuality of older Black women. There could be several reasons for this and for the common reluctance of these women to disclose information on their sexual health. The aim of this review was to discuss factors influencing older black women’s sexual functioning and their disclosure of sexual concerns. Discussion In this article, we first briefly reviewed the literature on sexual health among older women, then covered historical and social issues that are likely to influence older Black women’s sexuality as well as their common reluctance to disclose intimate details of their lives to their health providers. This information could be important for researchers as well as healthcare professionals. Specific groups of clinicians potentially interested in this discussion are sexual health professionals, couples’ counsellors as well as other professionals attempting to address older patients’ problems such as relationship, intimacy and sex challenges. Without knowledge of critical issues such as the potentially traumatizing historical events and the multiple societal pressures that are likely to impact these women’s sexuality and disclosure of sexual concerns, it would be difficult for researchers and clinicians to get an accurate account of older Black women’s sexual needs. Conclusion Older Black women’s sexuality is a very delicate and complex topic. We encourage interested professionals to make an effort to become more aware of what is potentially holding back older Black women from disclosing their sexual concerns to them, and have provided some historical information and research suggestions to guide professionals interested in investigating older African American women’s sexuality in a more tactful and culturally-sensitive way. PMID:25598985

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.

The Virtual Physiological Human ToolKit.

PubMed

Cooper, Jonathan; Cervenansky, Frederic; De Fabritiis, Gianni; Fenner, John; Friboulet, Denis; Giorgino, Toni; Manos, Steven; Martelli, Yves; Villà-Freixa, Jordi; Zasada, Stefan; Lloyd, Sharon; McCormack, Keith; Coveney, Peter V

2010-08-28

The Virtual Physiological Human (VPH) is a major European e-Science initiative intended to support the development of patient-specific computer models and their application in personalized and predictive healthcare. The VPH Network of Excellence (VPH-NoE) project is tasked with facilitating interaction between the various VPH projects and addressing issues of common concern. A key deliverable is the 'VPH ToolKit'--a collection of tools, methodologies and services to support and enable VPH research, integrating and extending existing work across Europe towards greater interoperability and sustainability. Owing to the diverse nature of the field, a single monolithic 'toolkit' is incapable of addressing the needs of the VPH. Rather, the VPH ToolKit should be considered more as a 'toolbox' of relevant technologies, interacting around a common set of standards. The latter apply to the information used by tools, including any data and the VPH models themselves, and also to the naming and categorizing of entities and concepts involved. Furthermore, the technologies and methodologies available need to be widely disseminated, and relevant tools and services easily found by researchers. The VPH-NoE has thus created an online resource for the VPH community to meet this need. It consists of a database of tools, methods and services for VPH research, with a Web front-end. This has facilities for searching the database, for adding or updating entries, and for providing user feedback on entries. Anyone is welcome to contribute.

Fish tapeworm Khawia sinensis: an indicator of environmental microcystins?

PubMed

Palikova, Miroslava; Adamovsky, Ondrej; Blaha, Ludek; Mares, Jan; Kopp, Radovan; Navratil, Stanislav; Cutakova, Zdenka; Soukupova, Zdenka; Pikula, Jiri

2013-01-01

Parasites have recently been recognized as accumulation indicators that take up and bio-concentrate substances from environmental pollution. Interestingly, helminths of fish are known to accumulate metals from the ambient environment and to contain several orders of magnitude higher concentrations than hosts. While the majority of reports mention inorganic toxin accumulation in parasites, studies concerning effects of organic pollution are infrequent and little is known about the potential of parasites to bio-accumulate microcystins. The parasite-host system of tapeworm Khawia sinensis and common carp (Cyprinus carpio) was used to address this issue. Both the tapeworms and livers were dissected from experimental carps orally exposed to cyanobacterial biomass for 20 days. The total dose of microcystins amounted to 27 mg/kg of feed, i.e., 0.4 mg/kg of fish mass a day. Microcystin concentrations in tapeworms and carp liver tissues were measured using the LC-MS/MS method. Considering the three measured microcystin variants LR, YR and RR, only MC-RR was detected and its concentrations in tapeworms and carp liver tissue amounted to 5.78±3.78 ng/g and 2.11±0.74 ng/g fresh weight (p<0.05), respectively. Here we show accumulation of microcystin MC-RR in the tapeworm Khawia sinensis, a parasite of common carp (Cyprinus carpio). As this is the first report addressing this issue, further studies will be necessary to examine this specific parasite-host system.

The case for randomized controlled trials to assess the impact of clinical information systems.

PubMed

Liu, Joseph L Y; Wyatt, Jeremy C

2011-01-01

There is a persistent view of a significant minority in the medical informatics community that the randomized controlled trial (RCT) has a limited role to play in evaluating clinical information systems. A common reason voiced by skeptics is that these systems are fundamentally different from drug interventions, so the RCT is irrelevant. There is an urgent need to promote the use of RCTs, given the shift to evidence-based policy and the need to demonstrate cost-effectiveness of these systems. The authors suggest returning to first principles and argue that what is required is clarity about how to match methods to evaluation questions. The authors address common concerns about RCTs, and the extent to which they are fallacious, and also discuss the challenges of conducting RCTs in informatics and alternative study designs when randomized trials are infeasible. While neither a perfect nor universal evaluation method, RCTs form an important part of an evaluator's toolkit.

The case for randomized controlled trials to assess the impact of clinical information systems

PubMed Central

Wyatt, Jeremy C

2011-01-01

There is a persistent view of a significant minority in the medical informatics community that the randomized controlled trial (RCT) has a limited role to play in evaluating clinical information systems. A common reason voiced by skeptics is that these systems are fundamentally different from drug interventions, so the RCT is irrelevant. There is an urgent need to promote the use of RCTs, given the shift to evidence-based policy and the need to demonstrate cost-effectiveness of these systems. The authors suggest returning to first principles and argue that what is required is clarity about how to match methods to evaluation questions. The authors address common concerns about RCTs, and the extent to which they are fallacious, and also discuss the challenges of conducting RCTs in informatics and alternative study designs when randomized trials are infeasible. While neither a perfect nor universal evaluation method, RCTs form an important part of an evaluator's toolkit. PMID:21270132

Genetics and Personal Insurance: the Perspectives of Canadian Cancer Genetic Counselors.

PubMed

Lane, Michelle; Ngueng Feze, Ida; Joly, Yann

2015-12-01

Genetic discrimination in the context of genetic testing has been identified as a concern for symptomatic and asymptomatic individuals for more than three decades. Genetic counselors are often the health care professionals who discuss risks and benefits of genetic testing with patients, thereby making them most appropriate to address patient concerns about genetics and personal insurance (i.e., life, life as related to mortgage or group insurance, disability, critical illness and travel). A pilot study was conducted to ascertain the current practices of Canadian cancer genetic counselors in regard to their discussions with patients about genetic testing and access to personal insurance. Among the 36 counselors surveyed, 100 % reported discussing the issue of genetic testing and personal insurance with their patients. Several factors influenced the content, depth and length of these discussions including age, cancer status, family members, and patients' current and future insurance needs. Counselors reported discussing with patients the possible impact of genetic test results on access to personal insurance, possible access and use of patient genetic information by insurance companies, and whom patients should contact if they have additional questions. The most commonly reported inquiries from patients included questions about the possible impact of genetic testing on their ability to obtain insurance, and the insurability of family members. While 28 % of counselors reported having been contacted by an insurer requesting access to patient information, only one counselor was aware of or could recall the outcome of such a request. This pilot study revealed that issues concerning genetics and personal insurance are commonly discussed in Canadian cancer genetic counseling sessions. Counselors furthermore expressed a need for additional educational resources on the topic of genetics and personal insurance for themselves and their patients.

Occupational health risks and intervention strategies for US taxi drivers.

PubMed

Murray, Kate E; Buul, Abdimalik; Aden, Rasheed; Cavanaugh, Alyson M; Kidane, Luwam; Hussein, Mikaiil; Eastman, Amelia; Checkoway, Harvey

2017-12-02

Research has shown that taxi drivers are at risk for numerous health concerns, such as low back and leg pain, linked to their highly sedentary occupation, long work hours and stressors related to the job (e.g. low income, safety threats). The goal of this study was to explore occupational health risks and opportunities for health interventions with taxi drivers using community-based participatory research (CBPR) methods. A mixed methods approach included first a convenience sample of 19 East African taxi drivers participating in focus group discussions. Second, a convenience sample of 75 current taxi drivers (M age = 45.7 years) and 25 non-driver comparison participants (M age = 40.3 years) were recruited to complete a structured self-reported questionnaire and objective measures of health. Health education was provided alongside the research to address common health concerns and to ensure mutual benefit and an action orientation. The focus groups described numerous health concerns that drivers attributed to their occupation, including chronic pain, sleep deprivation, cardiovascular disease, diabetes, kidney disease and eye problems, as the most common. Participants offered ideas for health interventions that include workplace reform and driver education. Quantitative data indicate that 44% of drivers reported their health as 'fair' or 'poor'. Drivers were more likely to report musculoskeletal pain, less sleep, more fatigue and less physical activity as compared to non-drivers. The majority of drivers reported financial and job dissatisfaction. The research provides data to inform targeted health interventions that support the health and safety of taxi drivers. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A Pilot Study Exploring the Role of Physical Therapists and Transition in Care of Pediatric Patients with Cystic Fibrosis to the Adult Setting

PubMed Central

Packel, Lora; Sood, Megha; Gormley, Michelle; Hayden, Rebecca

2013-01-01

Background Cystic fibrosis (CF) is a disease that requires intensive multidisciplinary care, including care by physical therapists (PTs). People with CF are now living well into adulthood, necessitating a transfer of care from the pediatric setting to an adult one. Physical therapists play a large role in the care of the person with CF; however, there is little known about the PT role in transition of care. Purpose To explore transition issues for people with CF from the perspective of PTs. Methods An 18-question online survey was sent to PTs via an electronic CF listserv. Questions were derived from an analysis of transition literature in CF and other chronic childhood conditions. Physical therapists who reported treating people with CF gave their opinions on issues impacting transition from their perspective as well as their perception of patient and parent concerns. Descriptive statistics were used for data analysis. Results A total of 26 PTs completed the survey. A majority, 61.5%, reported that there was a transition program at their facility, with 42.3% involving physical therapy. Common themes for patients and parents included feeling uncertain about: knowledge of the adult physician, acquiring pulmonary infections in the adult setting, and pace of the adult clinic. Physical therapists were concerned about adherence with airway clearance and exercise following transfer to the adult clinic. Conclusions The role of PT in transition programs is quite varied. Physical therapists should address common concerns of their patients and families to improve the transition process and possibly impact adherence to the PT plan of care. PMID:23754936

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.

Emotional, developmental, and behavioral health of American children and their families: a report from the 2003 National Survey of Children's Health.

PubMed

Blanchard, Laura T; Gurka, Matthew J; Blackman, James A

2006-06-01

Recent children's health surveys have documented a high prevalence of emotional, developmental, and behavioral problems among children. Data from the 2003 National Survey of Children's Health provide new insights into these problems and their association with family function and community participation. These issues have become a current focus of the World Health Organization. Answers to questions of interest from the 2003 National Survey of Children's Health were reported using estimates and SEs of rates. Statistical comparisons of rates with chi2 tests at the 0.05 level were made when relevant. The most commonly diagnosed problems among children 6-17 years of age were learning disabilities (11.5%), attention-deficit/hyperactivity disorder (8.8%), and behavioral problems (6.3%); among preschoolers, speech problems (5.8%) and developmental delay (3.2%) were most common. One in 200 children was diagnosed with autism. In contrast, rates of parental concerns about emotional, developmental, or behavioral problems were much higher; for example, 41% of parents had concerns about learning difficulties and 36% about depression or anxiety. Children with developmental problems had lower self-esteem, more depression and anxiety, more problems with learning, missed more school, and were less involved in sports and other community activities. Their families experienced more difficulty in the areas of childcare, employment, parent-child relationships, and caregiver burden. The most recent National Survey of Children's Health mirrored results of previous surveys regarding rates of diagnosed emotional, developmental, and behavioral problems, including an escalating diagnosis of autism among children. Reported rates of parental concerns about these problems were much higher, suggesting possible underdiagnosis of children's problems. Children with chronic problems had diminished family functioning, more school absences, and less participation in community activities compared with other children. Their parents experienced more difficulty with childcare, employment, and parenting skills. A change in treatment emphasis is needed, away from an exclusive focus on a child's developmental and behavioral problems to one that addresses the impacts of these problems on the family and community participation. A new approach to the way these issues are addressed and managed has the potential to enhance the quality of life for a child, as well as the parents, and to produce more meaningful and tangible solutions to these complex and increasingly evident problems.

Development of a remote spectroelectrochemical sensor for technetium as pertechnetate

NASA Astrophysics Data System (ADS)

Monk, David James

Subsurface contamination by technetium (Tc) is of particular concern in the monitoring, characterization, and remediation of underground nuclear waste storage tanks, processing areas, and associated surroundings at the Hanford Site and other U.S. DOE sites nationwide. The concern over this radioactive element arises for two reasons. First, its most common isotope, 99Tc, has an extremely long lifetime of 2.15 x 105 years. Second, it's most common chemical form in environmental conditions, pertechnetate (TcO4-), exhibits very fast migration through soils and readily presents itself to any nearby aquifer. Standard procedures of sampling and analysis in a laboratory prove to be slow and costly in the case of subsurface contamination by radioactive materials. It is highly desirable to develop sensors for these materials that possess the capability of either in-situ or on-site placement for continuous monitoring or immediate analysis of collected samples. These sensors need to possess adequate detection limit and selectivity, rapid response, reversibility (many measurements with one sensor), the ability to perform remotely, and ruggedness. This dissertation describes several areas of the continued work toward a sensor for 99Tc as TcO4-. Research initially focused on developing spectroelectrochemical instrumentation and a disposable sensing element, engineered to address the need to perform remote measurements. The instrument was then tested using samples containing 99Tc, resulting in the development of ancillary equipment and techniques to address concerns associated with performing experiments on radioactive materials. In these tests, the electrochemistry of TcO4 - was demonstrated to be irreversible. Electrochemical reduction of TcO4- on a bare or polymer modified electrode resulted in the continuous build up of technetium oxide (TcO2) on the electrode surface. This TcO2 formed in visual quantities in these films during electrochemistry, and proved to be non-ideal for spectroelectrochemical sensing. In the most recent work described, the development of metal templating techniques using complexes synthesized with rhenium (Re) was investigated as one means to circumvent this irreversibility. In an extension of the metal templating research, custom ligands were being designed which will impart structural rigidity and fluorescence to the template complexes, to facilitate selectivity and sensitivity at levels previously unprecedented for optical techniques.

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...

Dosing of antirheumatic drugs in renal disease and dialysis.

PubMed

Swarup, Areena; Sachdeva, Namita; Schumacher, H Ralph

2004-08-01

Many patients with rheumatic diseases have their management complicated by renal problems. Renal failure modifies the metabolism of many drugs, especially by retention. Questions often arise about the effects of renal failure on the handling of drugs commonly used in rheumatology. For which drugs must we be especially concerned about increased toxicity? Patients on chronic dialysis may also need a variety of drugs for rheumatic disease. How are our drugs dialyzed, and which of these can be safety used and how best to use them?Decisions about dosing of rheumatic drugs are often required for the patients with chronic renal insufficiency or on long-term dialysis, although many drugs have not been formally studied in these settings. Patients with renal insufficiency are excluded from most drug trials. Data for some of these drugs have to be extrapolated based on the information available about the pharmacokinetics of the drug.This review addresses dosing of commonly used drugs in rheumatology in patients with chronic renal insufficiency or failure. It is compiled from a MEDLINE search of papers dealing with renal handling of antirheumatic drugs and suggestions for dose adjustments for these drugs. Drugs reviewed include commonly used disease-modifying antirheumatic drugs (DMARDS), drugs used for treatment of gout, commonly used nonsteroidal antnflammatory drugs (NSAIDS) and the newer COX-2 inhibitors.

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

PubMed

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

2018-01-01

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

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.

Medical Malpractice in Dermatology-Part II: What To Do Once You Have Been Served with a Lawsuit.

PubMed

Shah, Vidhi V; Kapp, Marshall B; Wolverton, Stephen E

2016-12-01

Facing a malpractice lawsuit can be a daunting and traumatic experience for healthcare practitioners, with most clinicians naïve to the legal landscape. It is crucial for physicians to know and understand the malpractice system and his or her role once challenged with litigation. We present part II of a two-part series addressing the most common medicolegal questions that cause a great deal of anxiety. Part I focused upon risk-management strategies and prevention of malpractice lawsuits, whereas part II provides helpful suggestions and guidance for the physician who has been served with a lawsuit complaint. Herein, we address the best approach concerning what to do and what not to do after receipt of a legal claim, during the deposition, and during the trial phases. We also discuss routine concerns that may arise during the development of the case, including the personal, financial, and career implications of a malpractice lawsuit and how these can be best managed. The defense strategies discussed in this paper are not a guide separate from legal representation to winning a lawsuit, but may help physicians prepare for and cope with a medical malpractice lawsuit. This article is written from a US perspective, and therefore not all of the statements made herein will be applicable in other countries. Within the USA, medical practitioners must be familiar with their own state and local laws and should consult with their own legal counsel to obtain advice about specific questions.

A call to improve practice concerning cultural sensitivity in advance directives: a review of the literature.

PubMed

Zager, B Sue; Yancy, Margaret

2011-12-01

The Patient Self Determination Act of 1990 mandates healthcare providers (HCP) to speak with patients about end-of-life preferences and advance directives (AD). HCP work with patients of varying cultures, and standard ADs do not address cultural differences. In order to understand various cultural beliefs, cultural sensitivity is important especially when discussing advance care planning (ACP). Individuals from differing ethnic backgrounds are likely to turn to their traditional norms of practice when ill or treatment choices must be made. An AD that addresses varying cultural values and beliefs was sought. A comprehensive review of the literature was conducted. Articles selected for review included qualitative and quantitative studies. The evidence was evaluated and synthesized for information related to cultural sensitivity and ADs. Three common themes emerged related to ACP discussions and culture. Healthcare provider awareness, communication, and education concerning cultural differences and ACP assisted in meeting the needs for end-of-life planning in the current era of increased globalization. Education for HCP on cultural differences and how to lead discussions promoted ACP. ADs are an essential part of health care and promote patient-centered care. (HCP) should be able to recognize differing cultural values and beliefs in order to initiate conversations about end of life. Initiating conversations about ACP can be facilitated by using open-ended questions that respect the values and beliefs of various cultures. Copyright ©2011 Sigma Theta Tau International.

Ethical concerns: comparison of values from two cultures.

PubMed

Wros, Peggy L; Doutrich, Dawn; Izumi, Shigeko

2004-06-01

The present study was a secondary analysis of data from two phenomenological studies of nurses in the USA and Japan. The study incorporated hermeneutics and feminist methodologies to answer the following questions. Are there common values and ethical concerns and values within the nursing cultures of Japan and the USA? What are some commonalities and differences between Japanese nurses' ethical concerns and those of American nurses? Findings indicated that nurses from the USA and Japan share common values and ethical concerns as professional nurses, including competence, respect for the patient as a person, responsibility, relationship and connection, importance of the family, caring, good death, comfort, truth-telling, understanding the patient/situation, and anticipatory care. Although ethical concerns are similar, related background meanings and actions often look different between cultures; truth-telling is described as an example. Nurses in each country also hold unique values not found in the nursing practice of the other country. Understanding these commonalities and differences is critical for the development of global nursing ethics.

High school students' experiences of bullying and victimization and the association with school health center use.

PubMed

Lewis, Catherine; Deardorff, Julianna; Lahiff, Maureen; Soleimanpour, Samira; Sakashita, Kimi; Brindis, Claire D

2015-05-01

Bullying and victimization are ongoing concerns in schools. School health centers (SHCs) are well situated to support affected students because they provide crisis intervention, mental health care, and broader interventions to improve school climate. This study examined the association between urban adolescents' experiences of school-based bullying and victimization and their use of SHCs. Data was analyzed from 2063 high school students in 5 Northern California school districts using the 2009-2010 California Healthy Kids Survey. Chi-square tests and multivariate logistic regression were used to measure associations. Students who were bullied or victimized at school had significantly higher odds of using the SHCs compared with students who were not, and were also significantly more likely to report confidentiality concerns. The magnitude of associations was largest for Asian/Pacific Islander students, though this was likely due to greater statistical power. African American students reported victimization experiences at approximately the same rate as their peers, but were significantly less likely to indicate they experienced bullying. Findings suggest that SHCs may be an important place to address bullying and victimization at school, but confidentiality concerns are barriers that may be more common among bullied and victimized youth. © 2015, American School Health Association.

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

Thirty Years of Media Coverage on High Drug Prices in the United States--A Never-Ending Story or a Time for Change?

PubMed

Leopold, Christine; Chambers, James D; Wagner, Anita K

2016-01-01

In recent years drug prices have increasingly become a topic of debate for patients, providers, payers and policy makers. To place the current drug price debate into historical context, we searched the New York Times and Wall Street Journal from 1985 - 2015 and found that concerns about drug prices have commonly featured in the press over the study period with recently stronger calls for change. Price levels, types of innovations, stakeholder responses, and strategies to address high prices discussed in the media suggest that concerted efforts are required to enable affordable and high-value innovations. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

A CLINICIAN'S GUIDE TO X-LINKED HYPOPHOSPHATEMIA

PubMed Central

Carpenter, Thomas O.; Imel, Erik A.; Holm, Ingrid A.; Jan de Beur, Suzanne M.; Insogna, Karl L.

2011-01-01

X-linked hypophosphatemia (XLH) is the prototypic disorder of renal phosphate wasting, and the most common form of heritable rickets. Physicians, patients, and XLH support groups have all expressed concerns about the dearth of information about this disease and the lack of treatment guidelines which frequently lead to missed diagnoses or mismanagement. This perspective addresses the recommendation by conferees for the dissemination of concise and accessible treatment guidelines for clinicians arising from the “Advances in Rare Bone Diseases Scientific Conference,” held at the National Institutes of Health in October 2008. We briefly review the clinical and pathophysiologic features of the disorder, and offer this guide in response to the conference recommendation, base on our collective accumulated experience in the management of this complex disorder. PMID:21538511

Hui Malama o ke Kai: mobilizing to prevent youth violence and substance use with passion, common goals, and culture.

PubMed

Akeo, Nani P; Bunyan, Eric S; Burgess, Kaui N; Eckart, David R; Evensen, Shirley L; Hirose-Wong, Shannon M; Majit-Gorion, Sharon S; Takeshita, Carl K; Takeshita, Irene K; Vasconcellos, Carl G

2008-03-01

The goal of the Hui Malama o ke Kai project was the development of a community-based youth program that supported the prevention of youth violence and substance use among 5th- and 6th-grade students from a predominantly Hawaiian community. This program's development included engaging with a variety of community partners and mobilizing parents through the youths' cultural development. Recommendations for working with Hawaiians and other indigenous peoples include having program evaluators work more intimately with program participants and developing program components that address ethnic identity and family engagement. In doing so, youth programs with indigenous peoples can also galvanize small communities that are coping with destructive social concerns.

A Formal Basis for Safety Case Patterns

NASA Technical Reports Server (NTRS)

Denney, Ewen; Pai, Ganesh

2013-01-01

By capturing common structures of successful arguments, safety case patterns provide an approach for reusing strategies for reasoning about safety. In the current state of the practice, patterns exist as descriptive specifications with informal semantics, which not only offer little opportunity for more sophisticated usage such as automated instantiation, composition and manipulation, but also impede standardization efforts and tool interoperability. To address these concerns, this paper gives (i) a formal definition for safety case patterns, clarifying both restrictions on the usage of multiplicity and well-founded recursion in structural abstraction, (ii) formal semantics to patterns, and (iii) a generic data model and algorithm for pattern instantiation. We illustrate our contributions by application to a new pattern, the requirements breakdown pattern, which builds upon our previous work

Nanogenerators for Human Body Energy Harvesting.

PubMed

Proto, Antonino; Penhaker, Marek; Conforto, Silvia; Schmid, Maurizio

2017-07-01

Humans generate remarkable quantities of energy while performing daily activities, but this energy usually dissipates into the environment. Here, we address recent progress in the development of nanogenerators (NGs): devices that are able to harvest such body-produced biomechanical and thermal energies by exploiting piezoelectric, triboelectric, and thermoelectric physical effects. In designing NGs, the end-user's comfort is a primary concern. Therefore, we focus on recently developed materials giving flexibility and stretchability to NGs. In addition, we summarize common fabrics for NG design. Finally, the mid-2020s market forecasts for these promising technologies highlight the potential for the commercialization of NGs because they may help contribute to the route of innovation for developing self-powered systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

Managing pregnancy and delivery in women with sexual pain disorders.

PubMed

Rosenbaum, Talli Y; Padoa, Anna

2012-07-01

Vaginismus and dyspareunia most commonly affect women in their childbearing years, yet sexual function, and not childbirth, has been the focus of most research. The aim of this study is to discuss pregnancy and birth outcomes in women with sexual pain disorders (SPDs) and address practical concerns of patients and practitioners regarding management during pregnancy, pelvic examination, labor, and delivery. Review of the relevant literature and recommendations based on clinical expertise of the authors. A review of SPD, conception, and birth outcomes is provided as well as clinical recommendations for prenatal, labor, and delivery management of women with SPD. Practitioners involved in obstetrical care should be knowledgeable about SPD and provide appropriate modifications and interventions. © 2012 International Society for Sexual Medicine.

Online Technologies for Health Information and Education: A literature review

PubMed Central

Gill, Harkiran K.; Gill, Navkiranjit; Young, Sean D.

2014-01-01

There is a growing body of research focused on the use of social media and Internet technologies for health education and information sharing. The authors reviewed literature on this topic, with a specific focus on the benefits and concerns associated with using online social technologies as health education and communication tools. Studies suggest that social media technologies have the potential to safely and effectively deliver health education, if privacy concerns are addressed. Utility of social media-based health education and communication will improve as technology developers and public health officials determine ways to improve information accuracy and address privacy concerns. PMID:24465171

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…

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.

Breastfeeding FAQs: Some Common Concerns

MedlinePlus

... Staying Safe Videos for Educators Search English Español Breastfeeding FAQs: Some Common Concerns KidsHealth / For Parents / Breastfeeding ... breastfeeding is not necessary. My baby bites during breastfeeding. Can I stop it? Babies will often play ...

Is it possible to give scientific solutions to Grand Challenges? On the idea of grand challenges for life science research.

PubMed

Efstathiou, Sophia

2016-04-01

This paper argues that challenges that are grand in scope such as "lifelong health and wellbeing", "climate action", or "food security" cannot be addressed through scientific research only. Indeed scientific research could inhibit addressing such challenges if scientific analysis constrains the multiple possible understandings of these challenges into already available scientific categories and concepts without translating between these and everyday concerns. This argument builds on work in philosophy of science and race to postulate a process through which non-scientific notions become part of science. My aim is to make this process available to scrutiny: what I call founding everyday ideas in science is both culturally and epistemologically conditioned. Founding transforms a common idea into one or more scientifically relevant ones, which can be articulated into descriptively thicker and evaluatively deflated terms and enable operationalisation and measurement. The risk of founding however is that it can invisibilise or exclude from realms of scientific scrutiny interpretations that are deemed irrelevant, uninteresting or nonsensical in the domain in question-but which may remain salient for addressing grand-in-scope challenges. The paper considers concepts of "wellbeing" in development economics versus in gerontology to illustrate this process. Copyright © 2015 Elsevier Ltd. All rights reserved.

Media coverage of "wise" interventions can reduce concern for the disadvantaged.

PubMed

Ikizer, Elif G; Blanton, Hart

2016-06-01

Recent articulation of the "wise" approach to psychological intervention has drawn attention to the way small, seemingly trivial social psychological interventions can exert powerful, long-term effects. These interventions have been used to address such wide-ranging social issues as the racial achievement gap, environmental conservation, and the promotion of safer sex. Although there certainly are good reasons to seek easier as opposed to harder solutions to social problems, we examine a potentially undesirable effect that can result from common media portrayals of wise interventions. By emphasizing the ease with which interventions help address complex social problems, media reports might decrease sympathy for the individuals assisted by such efforts. Three studies provide evidence for this, showing that media coverage of wise interventions designed to address academic and health disparities increased endorsement of the view that the disadvantaged can solve their problems on their own, and the tendency to blame such individuals for their circumstances. Effects were strongest for interventions targeted at members of a historically disadvantaged group (African Americans as opposed to college students) and when the coverage was read by conservatives as opposed to liberals. Attempts to undermine this effect by introducing cautious language had mixed success. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Physician-patient communication about overactive bladder: Results of an observational sociolinguistic study.

PubMed

Hahn, Steven R; Bradt, Pamela; Hewett, Kathleen A; Ng, Daniel B

2017-01-01

Overactive bladder (OAB) and urinary incontinence are common problems that have significant impact on quality of life (QOL). Less than half of sufferers seek help from their physicians; many who do are dissatisfied with treatment and their physicians' understanding of their problems. Little is known about the sociolinguistic characteristics of physician-patient communication about OAB in community practice. An IRB-approved observational sociolinguistic study of dialogues between patients with OAB and treating physicians was conducted. Study design included semi-structured post-visit interviews, post-visit questionnaires, and follow-up phone calls. Conversations were analyzed using techniques from interactional sociolinguistics. Communication was physician- rather than patient-centered. Physicians spoke the majority of words and 83% of questions were closed-ended. The impact of OAB on QOL and concerns about and adherence to treatment were infrequently addressed by physicians, who were poorly aligned with patients in their understanding. These topics were addressed more frequently when open-ended questions successfully eliciting elaborated responses were used in ask-tell-ask or ask-tell sequences. Clinical dialogue around OAB is physician-centered; topics critical to managing OAB are infrequently and inadequately addressed. The use of patient-centered communication is correlated with more discussion of critical topics, and thus, more effective management of OAB.

Physician-patient communication about overactive bladder: Results of an observational sociolinguistic study

PubMed Central

Hahn, Steven R.; Bradt, Pamela; Hewett, Kathleen A.; Ng, Daniel B.

2017-01-01

Introduction Overactive bladder (OAB) and urinary incontinence are common problems that have significant impact on quality of life (QOL). Less than half of sufferers seek help from their physicians; many who do are dissatisfied with treatment and their physicians’ understanding of their problems. Little is known about the sociolinguistic characteristics of physician-patient communication about OAB in community practice. Methods An IRB-approved observational sociolinguistic study of dialogues between patients with OAB and treating physicians was conducted. Study design included semi-structured post-visit interviews, post-visit questionnaires, and follow-up phone calls. Conversations were analyzed using techniques from interactional sociolinguistics. Results Communication was physician- rather than patient-centered. Physicians spoke the majority of words and 83% of questions were closed-ended. The impact of OAB on QOL and concerns about and adherence to treatment were infrequently addressed by physicians, who were poorly aligned with patients in their understanding. These topics were addressed more frequently when open-ended questions successfully eliciting elaborated responses were used in ask-tell-ask or ask-tell sequences. Discussion Clinical dialogue around OAB is physician-centered; topics critical to managing OAB are infrequently and inadequately addressed. The use of patient-centered communication is correlated with more discussion of critical topics, and thus, more effective management of OAB. PMID:29140974

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

PubMed Central

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

2015-01-01

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

Physician attitude toward depression care interventions: Implications for implementation of quality improvement initiatives

PubMed Central

Henke, Rachel Mosher; Chou, Ann F; Chanin, Johann C; Zides, Amanda B; Scholle, Sarah Hudson

2008-01-01

Background Few individuals with depression treated in the primary care setting receive care consistent with clinical treatment guidelines. Interventions based on the chronic care model (CCM) have been promoted to address barriers and improve the quality of care. A current understanding of barriers to depression care and an awareness of whether physicians believe interventions effectively address those barriers is needed to enhance the success of future implementation. Methods We conducted semi-structured interviews with 23 primary care physicians across the US regarding their experience treating patients with depression, barriers to care, and commonly promoted CCM-based interventions. Themes were identified from interview transcripts using a grounded theory approach. Results Six barriers emerged from the interviews: difficulty diagnosing depression, patient resistance, fragmented mental health system, insurance coverage, lack of expertise, and competing demands and other responsibilities as a primary care provider. A number of interventions were seen as helpful in addressing these barriers – including care managers, mental health integration, and education – while others received mixed reviews. Mental health consultation models received the least endorsement. Two systems-related barriers, the fragmented mental health system and insurance coverage limitations, appeared incompletely addressed by the interventions. Conclusion CCM-based interventions, which include care managers, mental health integration, and patient education, are most likely to be implemented successfully because they effectively address several important barriers to care and are endorsed by physicians. Practices considering the adoption of interventions that received less support should educate physicians about the benefit of the interventions and attend to physician concerns prior to implementation. A focus on interventions that address systems-related barriers is needed to overcome all barriers to care. PMID:18826646

The health risks associated with energy efficient fluorescent, LEDs, and artificial lighting

NASA Astrophysics Data System (ADS)

Panahi, Allen

2014-09-01

With the phasing out of incandescent lamps in many countries, the introduction of new LED based light sources and luminaries sometimes raise the question of whether the spectral characteristics of the LED and other energy savings Fluorescent lights including the popular CFLs are suitable to replace the traditional incandescent lamps. These concerns are sometimes raised particularly for radiation emissions in the UV and Blue parts of the spectrum. This paper aims to address such concerns for the common `white light' sources typically used in household and other general lighting used in the work place. Recent studies have shown that women working the night shift have an increased probability of developing breast cancer. We like to report on the findings of many studies done by medical professionals, in particular the recent announcement of AMA in the US and many studies conducted in the UK, as well as the European community to increase public awareness on the long term health risks of the optical and opto-biological effects on the human health caused by artificial lighting.

Industry and government perspectives on First Nations' participation in the British Columbia environmental assessment process

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

Booth, Annie L., E-mail: annie@unbc.ca; Skelton, Norm W.

2011-04-15

Research was conducted with West Moberly First Nations, Halfway First Nation and the Treaty 8 Tribal Association (located in northeastern British Columbia, Canada) on effective engagement in environmental assessment processes. As part of this research, we examined the perspectives of a subset of resource industry proponents and their consultants, as well as staff from the British Columbia Environmental Assessment Office on their experiences with the requirement to consult with Canada's indigenous peoples. Research into the perspectives of industry proponents and consultants is almost non-existent, yet industry and governments are key participants within environmental assessments. This research found that industry proponentsmore » were disenfranchised by the British Columbia environmental assessment process and its mechanisms for consulting with First Nations, and that they sought changes to that process. Their concerns and their implications are documented and some recommendations are offered for addressing those concerns. Understanding industry and government views on First Nations engagement could suggest not only potential improvements in EA processes that facilitate all parties but provide common grounds for mutually engaging to resolve challenges.« less

Primary hypertension and special aspects of hypertension in older children and adolescents

PubMed Central

Ellis, Demetrius; Miyashita, Yosuke

2011-01-01

The prevalence of hypertension has increased at an accelerated rate in older children and adolescents. This has raised great concern about premature development of cardiovascular disease, which has major long-term health and financial implications. While obesity and sedentary habits largely explain this phenomenon, there are other social and cultural influences that may unmask genetic susceptibility to hypertension in the pediatric population. While it is essential to exclude numerous causes of secondary hypertension in every child, these disorders are not discussed in this review. Rather, the aim of this review is to familiarize pediatricians with casual and ambulatory blood pressure measurement, epidemiology, pathophysiology, and management of several common conditions that play a role in the development of hypertension in children and adolescents. Besides primary hypertension and obesity-related hypertension, emphasis is given to epidemiology, measurement of blood pressure, including ambulatory blood pressure monitoring, hypertension associated with drug use, teenage pregnancy, and video and computer games. Lastly, because pediatricians are increasingly confronted with special issues concerning the management of the hypertensive athlete, this topic is also addressed. PMID:24600275

Cervical Cancer Screening (Pap Testing) Behaviours and Acceptability of Human Papillomavirus Self-Testing among Lesbian and Bisexual Women Aged 21–26 Years in the USA

PubMed Central

Reiter, Paul L.; McRee, Annie-Laurie

2017-01-01

Objective Lesbian and bisexual women are at risk for human papillomavirus (HPV) infection and cervical disease. We examined Pap testing among these women and their acceptability of HPV self-testing at home, a potential cervical cancer screening strategy. Methods We analyzed data from a national sample of lesbian and bisexual women ages 21–26 who completed our online survey during Fall 2013 (n=418). Logistic regression identified correlates of: 1) receipt of a Pap test in the last three years; and 2) willingness to use an HPV self-test at home. Results About 70% of women had received a Pap test in the last three years. Pap testing was more common among women who had disclosed their sexual orientation to their healthcare provider (OR=2.01, 95% CI: 1.02–3.95) and less common among women who self-identified as lesbian (OR=0.48, 95% CI: 0.25–0.93). Just over half of women (51%) were willing to use an HPV self-test at home. Women were more willing to use an HPV self-test at home if they were older (OR=1.16, 95% CI: 1.03–1.30) or reported higher levels of worry about getting an HPV-related disease (OR=1.28, 95% CI: 1.01–1.63). The most common concerns about HPV self-testing at home were using the test incorrectly (70%) and test accuracy (64%). Conclusions Many young lesbian and bisexual women have not received a recent Pap test. HPV self-testing at home may be a promising future strategy for reaching and screening these women. Findings highlight beliefs and concerns that could be addressed by self-test programs. PMID:25385868

Examination of the association of sex and race/ethnicity with appearance concerns: a Scleroderma Patient-centered Intervention Network (SPIN) Cohort study.

PubMed

Jewett, Lisa R; Kwakkenbos, Linda; Carrier, Marie-Eve; Malcarne, Vanessa L; Bartlett, Susan J; Furst, Daniel E; Gottesman, Karen; Mayes, Maureen D; Assassi, Shervin; Harcourt, Diana; Williamson, Heidi; Johnson, Sindhu R; Körner, Annett; Steen, Virginia; Fox, Rina S; Gholizadeh, Shadi; Mills, Sarah D; Molnar, Jacqueline C; Rice, Danielle B; Thombs, Brett D

2016-01-01

Appearance concerns are common in systemic sclerosis (SSc) and have been linked to younger age and more severe disease. No study has examined their association with sex or race/ethnicity. SSc patients were sampled from the Scleroderma Patient-centered Intervention Network Cohort. Presence of appearance concerns was assessed with a single item, and medical and sociodemographic information were collected. Of 644 patients, appearance concerns were present in 72%, including 421 of 565 women (75%), 42 of 79 men (53%), 392 of 550 patients who identified as White (71%), 35 of 41 who identified as Black (85%), and 36 of 53 who identified as another race/ethnicity (68%). In multivariate analysis, women had significantly greater odds of reporting appearance concerns than men (odds ratio (OR)=2.97, 95% confidence interval (CI)=1.78-4.95, p<.001). Black patients had significantly greater odds of appearance concerns than White patients in unadjusted (OR=2.64, 95% CI=1.01-6.34, p=.030), but not multivariate analysis (OR=1.76, 95% CI=0.67-4.60, p=.250). Compared to a general population sample, appearance concerns were substantially more common in SSc, particularly for men across all age groups and for younger women. The most commonly reported features of concern were related to the face and head, followed by the hands and fingers; this did not differ by sex or race/ethnicity. Appearance concerns were common in SSc. Women were substantially more likely than men to have appearance concerns. Although non-significant in multivariate analysis, Black patients were more likely to have concerns than White patients, likely due to more severe changes in appearance.

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...

role of altruistic behavior, empathetic concern, and social responsibility motivation in blood donation behavior.

PubMed

Steele, Whitney Randolph; Schreiber, George B; Guiltinan, Anne; Nass, Catharie; Glynn, Simone A; Wright, David J; Kessler, Debra; Schlumpf, Karen S; Tu, Yongling; Smith, James W; Garratty, George

2008-01-01

Blood donation can be described as a prosocial behavior, and donors often cite prosocial reasons such as altruism, empathy, or social responsibility for their willingness to donate. Previous studies have not quantitatively evaluated these characteristics in donors or examined how they relate to donation frequency. As part of a donor motivation study, 12,064 current and lapsed donors answered questions used to create an altruistic behavior, empathetic concern, and social responsibility motivation score for each donor. Analysis of variance was used to compare mean scores by demographics and donor status and to determine the influence of each variable on the mean number of donations in the past 5 years. The mean score for each prosocial characteristic appeared high, with lower scores in male and younger donors. Higher altruistic behavior and social responsibility motivation scores were associated with increased past donation frequency, but the effects were minor. Empathetic concern was not associated with prior donation. The largest differences in prior donations were by age and donor status, with older and current donors having given more frequently. Most blood donors appear to have high levels of the primary prosocial characteristics (altruism, empathy, and social responsibility) commonly thought to be the main motivators for donation, but these factors do not appear to be the ones most strongly related to donation frequency. Traditional donor appeals based on these characteristics may need to be supplemented by approaches that address practical concerns like convenience, community safety, or personal benefit.

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...

Ageing and dementia in low and middle income countries-Using research to engage with public and policy makers.

PubMed

Prince, Martin; Acosta, Daisy; Albanese, Emiliano; Arizaga, Raul; Ferri, Cleusa P; Guerra, Mariella; Huang, Yueqin; Jacob, K S; Jimenez-Velazquez, Ivonne Z; Rodriguez, Juan Llibre; Salas, Aquiles; Sosa, Ana Luisa; Sousa, Renata; Uwakwe, Richard; van der Poel, Rikus; Williams, Joseph; Wortmann, Marc

2008-08-01

While two thirds of the 24 million people with dementia worldwide live in low and middle income countries, very little research has been conducted to support policy making in these regions. Among the non-communicable diseases, dementia (in common with other chronic NCDs linked more to long-term disability than to mortality) has been relatively under-prioritized. International agreements, plans and policy guidelines have called for an end to ageist discrimination and a focus upon reducing disadvantage arising from poverty and the consequences of ill health. Social protection, access to good quality age-appropriate healthcare and addressing the problem of disability are all key issues. However, as yet, little progress has been made in addressing these concerns. In this review we outline the current international policy agenda for older individuals, and its specific relevance to those with dementia and other disabling non-communicable diseases. We consider the potential for epidemiological research to raise awareness, refine the policy agenda, and promote action, using the example of the dissemination strategy developed by the 10/66 Dementia Research Group.

Human factors for a sustainable future.

PubMed

Thatcher, Andrew; Yeow, Paul H P

2016-11-01

Current human activities are seriously eroding the ability of natural and social systems to cope. Clearly we cannot continue along our current path without seriously damaging our own ability to survive as a species. This problem is usually framed as one of sustainability. As concerned professionals, citizens, and humans there is a strong collective will to address what we see as a failure to protect the natural and social environments that supports us. While acknowledging that we cannot do this alone, human factors and ergonomics needs to apply its relevant skills and knowledge to assist where it can in addressing the commonly identified problem areas. These problems include pollution, climate change, renewable energy, land transformation, and social unrest amongst numerous other emerging global problems. The issue of sustainability raises two fundamental questions for human factors and ergonomics: which system requires sustaining and what length of time is considered sustainable? In this paper we apply Wilson (2014) parent-sibling-child model to understanding what is required of an HFE sustainability response. This model is used to frame the papers that appear in this Special Issue. Copyright © 2016 Elsevier Ltd. All rights reserved.

Hitchhiker's Guide to Voltammetry: Acute and Chronic Electrodes for in Vivo Fast-Scan Cyclic Voltammetry.

PubMed

Rodeberg, Nathan T; Sandberg, Stefan G; Johnson, Justin A; Phillips, Paul E M; Wightman, R Mark

2017-02-15

Fast-scan cyclic voltammetry (FSCV) has been used for over 20 years to study rapid neurotransmission in awake and behaving animals. These experiments were first carried out with carbon-fiber microelectrodes (CFMs) encased in borosilicate glass, which can be inserted into the brain through micromanipulators and guide cannulas. More recently, chronically implantable CFMs constructed with small diameter fused-silica have been introduced. These electrodes can be affixed in the brain with minimal tissue response, which permits longitudinal measurements of neurotransmission in single recording locations during behavior. Both electrode designs have been used to make novel discoveries in the fields of neurobiology, behavioral neuroscience, and psychopharmacology. The purpose of this Review is to address important considerations for the use of FSCV to study neurotransmitters in awake and behaving animals, with a focus on measurements of striatal dopamine. Common issues concerning experimental design, data collection, and calibration are addressed. When necessary, differences between the two methodologies (acute vs chronic recordings) are discussed. The topics raised in this Review are particularly important as the field moves beyond dopamine toward new neurochemicals and brain regions.

Ageing and dementia in low and middle income countries - Using research to engage with public and policy makers

PubMed Central

Prince, Martin; Acosta, Daisy; Albanese, Emiliano; Arizaga, Raul; Ferri, Cleusa P.; Guerra, Mariella; Huang, Yueqin; Jacob, Ks; Jimenez-Velazquez, Ivonne Z.; Rodriguez, Juan Llibre; Salas, Aquiles; Sosa, Ana Luisa; Sousa, Renata; Uwakwe, Richard; Van Der Poel, Rikus; Williams, Joseph; Wortmann, Marc

2008-01-01

Abstract While two thirds of the 24 million people with dementia worldwide live in low and middle income countries, very little research has been conducted to support policy making in these regions. Among the non-communicable diseases, dementia (in common with other chronic NCDs linked more to long-term disability than to mortality) has been relatively under-prioritized. International agreements, plans and policy guidelines have called for an end to ageist discrimination and a focus upon reducing disadvantage arising from poverty and the consequences of ill health. Social protection, access to good quality age-appropriate healthcare and addressing the problem of disability are all key issues. However, as yet, little progress has been made in addressing these concerns. In this review we outline the current international policy agenda for older individuals, and its specific relevance to those with dementia and other disabling non-communicable diseases. We consider the potential for epidemiological research to raise awareness, refine the policy agenda, and promote action, using the example of the dissemination strategy developed by the 10/66 Dementia Research Group. PMID:18925482

A critical review of published research literature reviews on nursing and healthcare ageism.

PubMed

Wilson, Donna M; Nam, Mavis A; Murphy, Jill; Victorino, João P; Gondim, Ellen C; Low, Gail

2017-12-01

To establish how common and impactful nursing and healthcare ageism is and whether proven interventions or prevention methods exist. Ageism has been a concern since 1969 when it was first introduced as a concept for social reform. As ageism has been linked to lower quality health services and reduced health care access, it is imperative that healthcare and nursing ageism is prevented or identified and reduced or eliminated. A qualitative narrative review of published research literature reviews using a scoping design to map all published reviews was undertaken. The EBSCO Discovery Service (providing access to articles in 271 databases, including MEDLINE and CINAHL) and Directory of Open Access Journals (providing access to over 9,000 open access journals) were used to find review articles. Using predetermined inclusion and exclusion criteria, and limited by English language and peer-review publications, 12 eligible reviews were identified and information from them was systematically identified, assessed and synthesised. The 12 reviews did not provide clear and convincing information to determine how common and impactful nursing or healthcare ageism is, nor what can best be done to prevent or address it. Although each review had value since research literature was collected and discussed on nursing or healthcare ageism, the array of literature search and analysis methods, and diversity in conclusions reached about the evidence is highly problematic. Research literature reviews offering a more balanced perspective and demonstrating greater care in finding and using quality evidence are needed. At this point in time, there is no clear understanding of how widespread and impactful nursing or healthcare ageism is, and what can best be done to prevent or address it. Nurses need to be aware that ageism may be common and impactful, and guard against it. © 2017 John Wiley & Sons Ltd.

Addressing Low Colorectal Cancer Screening in African Americans: Using Focus Groups to Inform the Development of Effective Interventions.

PubMed

May, Folasade P; Whitman, Cynthia B; Varlyguina, Ksenia; Bromley, Erica G; Spiegel, Brennan M R

2016-09-01

African Americans have the highest burden of colorectal cancer (CRC) in the United States of America (USA) yet lower CRC screening rates than whites. Although poor screening has prompted efforts to increase screening uptake, there is a persistent need to develop public health interventions in partnership with the African American community. The aim of this study was to conduct focus groups with African Americans to determine preferences for the content and mode of dissemination of culturally tailored CRC screening interventions. In June 2013, 45-75-year-old African Americans were recruited through online advertisements and from an urban Veterans Affairs system to create four focus groups. A semi-structured interview script employing open-ended elicitation was used, and transcripts were analyzed using ATLAS.ti software to code and group data into a concept network. A total of 38 participants (mean age = 54) were enrolled, and 59 ATLAS.ti codes were generated. Commonly reported barriers to screening included perceived invasiveness of colonoscopy, fear of pain, and financial concerns. Facilitators included poor diet/health and desire to prevent CRC. Common sources of health information included media and medical providers. CRC screening information was commonly obtained from medical personnel or media. Participants suggested dissemination of CRC screening education through commercials, billboards, influential African American public figures, Internet, and radio. Participants suggested future interventions include culturally specific information, including details about increased risk, accessing care, and dispelling of myths. Public health interventions to improve CRC screening among African Americans should employ media outlets, emphasize increased risk among African Americans, and address race-specific barriers. Specific recommendations are presented for developing future interventions.

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)

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.

Environmental concern and cooperative-competitive behavior in a simulated commons dilemma.

PubMed

Smith, J M; Bell, P A

1992-08-01

Commons-dilemma simulation games are designed to examine behavior associated with preservation and destruction of slowly regenerating natural resources. In Experiment 1, 120 introductory psychology students in the United States were assigned to high- or low-environmental-concern conditions based on a median split of their scores from a pretest. They then played either a points game, in which they selected numerical points from a slowly regenerating pool, or a tree game, in which they harvested trees from a jointly managed forest. After the game, subjects were asked to sign a petition for an environmental cause, to participate in a litter pick-up, and to participate in a recycling drive. Neither environmental concern nor proenvironmental behaviors were related to commons dilemma performance. In Experiment 2, 57 other introductory psychology students were assessed on environmental concern and Machiavellian personality, size of other players' harvesting choices, and other players' altruistic choices, all correlated with subjects' outcomes in the game. Overall, cooperation and competition were more important than environmental concern in predicting behavior in the commons dilemma simulation game.

Learning from conservation planning for the U.S. National Wildlife Refuges.

PubMed

Meretsky, Vicky J; Fischman, Robert L

2014-10-01

The U.S. National Wildlife Refuge System has nearly completed its first round of unit-level, comprehensive conservation plans (CCPs) and will soon begin required revisions. Laws and policies governing refuge planning emphasize ecological integrity, landscape-scale conservation, and adaptive management. We evaluated 185 CCPs completed during 2005-2011, which cover 324 of 555 national wildlife refuges. We reviewed CCP prescriptions addressing 5 common conservation issues (habitat and game, nongame, imperiled, and invasive species) and 3 specialized topics (landscape-scale conservation, climate change, and environmental quality). Common conservation issues received prescriptions in >90% of CCPs. Specialized topics received more variable treatment. Prescriptions for aquatic connectivity, water quantity, and climate-change impacts increased over the study period. Except for climate change, direct actions were the most common type of management prescription, followed by plans or studies. Most CCPs stated a commitment to adaptive management and prescribed monitoring for common conservation objectives; other aspects of planning for adaptive management were often lacking, despite strong support for adaptive management in the conservation planning literature. To better address refuge-specific threats, we recommend that revised plans explicitly match identified refuge issues with prescriptions, particularly for under-represented concerns such as novel pests and pathogens. We recommend incorporating triggers into monitoring frameworks and specifying actions that will occur when threshold values are reached to improve support for adaptive management. Revised CCPs should better reflect work that refuges already undertake to extend conservation objectives beyond their borders and better engage with regional conservation efforts to continue this work. More thorough landscape-scale threat assessments and explicit prioritization of planned actions would further improve conservation effectiveness. Excellent examples of all recommended practices exist within the CCPs we examined; sharing best planning practices would improve planning efficiency within the refuge system. © 2014 The Authors. Conservation Biology published by Wiley Periodicals, Inc., on behalf of the Society for Conservation Biology.

Ethical dilemmas in community-based participatory research: recommendations for institutional review boards.

PubMed

Flicker, Sarah; Travers, Robb; Guta, Adrian; McDonald, Sean; Meagher, Aileen

2007-07-01

National and international codes of research conduct have been established in most industrialized nations to ensure greater adherence to ethical research practices. Despite these safeguards, however, traditional research approaches often continue to stigmatize marginalized and vulnerable communities. Community-based participatory research (CBPR) has evolved as an effective new research paradigm that attempts to make research a more inclusive and democratic process by fostering the development of partnerships between communities and academics to address community-relevant research priorities. As such, it attempts to redress ethical concerns that have emerged out of more traditional paradigms. Nevertheless, new and emerging ethical dilemmas are commonly associated with CBPR and are rarely addressed in traditional ethical reviews. We conducted a content analysis of forms and guidelines commonly used by institutional review boards (IRBs) in the USA and research ethics boards (REBs) in Canada. Our intent was to see if the forms used by boards reflected common CBPR experience. We drew our sample from affiliated members of the US-based Association of Schools of Public Health and from Canadian universities that offered graduate public health training. This convenience sample (n = 30) was garnered from programs where application forms were available online for download between July and August, 2004. Results show that ethical review forms and guidelines overwhelmingly operate within a biomedical framework that rarely takes into account common CBPR experience. They are primarily focused on the principle of assessing risk to individuals and not to communities and continue to perpetuate the notion that the domain of "knowledge production" is the sole right of academic researchers. Consequently, IRBs and REBs may be unintentionally placing communities at risk by continuing to use procedures inappropriate or unsuitable for CBPR. IRB/REB procedures require a new framework more suitable for CBPR, and we propose alternative questions and procedures that may be utilized when assessing the ethical appropriateness of CBPR.

Ethical Dilemmas in Community-Based Participatory Research: Recommendations for Institutional Review Boards

PubMed Central

Travers, Robb; Guta, Adrian; McDonald, Sean; Meagher, Aileen

2007-01-01

National and international codes of research conduct have been established in most industrialized nations to ensure greater adherence to ethical research practices. Despite these safeguards, however, traditional research approaches often continue to stigmatize marginalized and vulnerable communities. Community-based participatory research (CBPR) has evolved as an effective new research paradigm that attempts to make research a more inclusive and democratic process by fostering the development of partnerships between communities and academics to address community-relevant research priorities. As such, it attempts to redress ethical concerns that have emerged out of more traditional paradigms. Nevertheless, new and emerging ethical dilemmas are commonly associated with CBPR and are rarely addressed in traditional ethical reviews. We conducted a content analysis of forms and guidelines commonly used by institutional review boards (IRBs) in the USA and research ethics boards (REBs) in Canada. Our intent was to see if the forms used by boards reflected common CBPR experience. We drew our sample from affiliated members of the US-based Association of Schools of Public Health and from Canadian universities that offered graduate public health training. This convenience sample (n = 30) was garnered from programs where application forms were available online for download between July and August, 2004. Results show that ethical review forms and guidelines overwhelmingly operate within a biomedical framework that rarely takes into account common CBPR experience. They are primarily focused on the principle of assessing risk to individuals and not to communities and continue to perpetuate the notion that the domain of “knowledge production” is the sole right of academic researchers. Consequently, IRBs and REBs may be unintentionally placing communities at risk by continuing to use procedures inappropriate or unsuitable for CBPR. IRB/REB procedures require a new framework more suitable for CBPR, and we propose alternative questions and procedures that may be utilized when assessing the ethical appropriateness of CBPR. PMID:17436114

Scientists and Faith Communities in Dialogue - Finding Common Ground to Care for our Common Home

NASA Astrophysics Data System (ADS)

Jablonski, L. M.

2017-12-01

World-wide, faith communities are a key place for education and outreach to the general adult population. The sacred responsibility to care for the earth, living sustainability and concern for the poor are nearly universal priorities across faith communities. Scientists and people of faith share in common experiences of awe and wonder and ethical roles as citizens. The majority of faith communities have statements on climate changes, environmental justice, and stewardship, and respond with education, action plans and advocacy. People of faith are increasingly seeking science expertise to better understand the science and best solutions to implement. Transformation of point of view often requires heart-felt motivation (domain of religion) as well as knowledge (science). Scientists can participate in alleviating environmental justice by providing data and education to communities. Expert testimony is a critical service. Pope Francis' environmental encyclical Laudato si, engaged diverse scientists in its writing and outreach. Francis invites our continued dialogue with people of faith and goodwill of all societal sectors and fields to achieve an integral ecology that integrates science, economics, and impacts on the poor. For scientists to be most effective in sharing expertise, and building understanding and trust in scientific findings, skill- building is needed in: communication, finding common ground, intercultural competency, working with diverse populations and religious literacy. Educational initiatives bridging scientists and faith-communities will be highlighted including within: the Ecological Society of America, American Assn for Advancement of Sustainability in Higher Education, faith-based & Environmental Justice networks, Nature centers, Higher Education (including Seminary) Initiatives and the Hanley Sustainability Institute, and interfaith religious organizations engaged with scientists. Bridge-building and ongoing partnerships of scientists, EJ-impacted community members and people of faith are critical to addressing climate change and its impacts and countering environmental injustice. Such partnerships can help achieve the UN Sustainable Development Goals which address both human rights and environmental sustainability.

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 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.

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.

CONCEPTUAL AND METHODOLOGICAL ISSUES IN DESIGNING A RANDOMIZED CONTROLLED TREATMENT TRIAL FOR GERIATRIC BIPOLAR DISORDER: GERI-BD

PubMed Central

Young, Robert C.; Schulberg, Herbert C.; Gildengers, Ariel G.; Sajatovic, Martha; Mulsant, Benoit H.; Gyulai, Laszlo; Beyer, John; Marangell, Lauren; Kunik, Mark; Have, Thomas Ten; Bruce, Martha L.; Gur, Ruben; Marino, Patricia; Evans, Jovier D.; Reynolds, Charles F.; Alexopoulos, George S.

2010-01-01

Aim This report considers the conceptual and methodological concerns confronting clinical investigators seeking to generate knowledge regarding the tolerability and benefits of pharmacotherapy in geriatric bipolar (BP) patients. Method There is continuing need for evidence-based guidelines derived from randomized controlled trials that will enhance drug treatment of geriatric BP patients. We, therefore, present the complex conceptual and methodological choices encountered in designing a multi-site clinical trial and the decisions reached by the investigators with the intention that study findings are pertinent to, and can facilitate, routine treatment decisions. Results Guided by a literature review and input from peers, the tolerability and anti-manic effect of lithium and valproate were judged to be the key mood stabilizers to investigate with regard to treating BP I manic, mixed and hypomanic states. The patient selection criteria are intended to generate a sample that experiences common treatment needs but which also represents the variety of older patients seen in university-based clinical settings. The clinical protocol guides titratation of lithium and valproate to target serum concentrations, with lower levels allowed when necessitated by limited tolerability. The protocol emphasizes initial monotherapy. However, augmentation with risperidone is permitted after three weeks when indicated by operational criteria. Conclusions A randomized controlled trial that both investigates commonly prescribed mood stabilizers and maximizes patient participation can meaningfully address high priority clinical concerns directly relevant to the routine pharmacologic treatment of geriatric BP patients. PMID:20148867

Cultural beliefs that may discourage breastfeeding among Lebanese women: a qualitative analysis.

PubMed

Osman, Hibah; El Zein, Lama; Wick, Livia

2009-11-02

Although the health benefits of breastfeeding are well established, early introduction of formula remains a common practice. Cultural beliefs and practices can have an important impact on breastfeeding. This paper describes some common beliefs that may discourage breastfeeding in Lebanon. Participants were healthy first-time mothers recruited from hospitals throughout Lebanon to participate in a study on usage patterns of a telephone hotline for postpartum support. The hotline was available to mothers for the first four months postpartum and patterns of usage, as well as questions asked were recorded. Thematic analysis of the content of questions which referred to cultural beliefs and practices related to breastfeeding was conducted. Twenty four percent of the 353 women enrolled in the study called the hotline, and 50% of the calls included questions about breastfeeding. Mothers expressed concern about having adequate amounts of breast milk or the quality of their breast milk. Concerns that the mother could potentially harm her infant though breastfeeding were rooted in a number of cultural beliefs. Having an inherited inability to produce milk, having "bad milk", and transmission of abdominal cramps to infants through breast milk were among the beliefs that were expressed. Although the researchers live and work in Lebanon, they were not aware of many of the beliefs that are reported in this study. There are a number of cultural beliefs that could potentially discourage breastfeeding among Lebanese women. Understanding and addressing local beliefs and customs can help clinicians to provide more culturally appropriate counselling about breastfeeding.

Impact of WWII dumpsites on Saipan (CNMI): heavy metal status of soils and sediments.

PubMed

Denton, Gary R W; Emborski, Carmen A; Hachero, April A B; Masga, Ray S; Starmer, John A

2016-06-01

A number of dumpsites occur on the island of Saipan and in the surrounding coastal waters. Many of these sites date back to the immediate post WWII clean-up period and contain a variety of wartime wastes. Metallic debris is generally the most visible waste material and commonly includes bomb fragments, artillery shells, bullets, and other military hardware. In this investigation, we examined the heavy metal status of soils from around several of these dumpsites and in any obvious drainage pathways leading from them to the coast. Sediments were also taken for analysis from a number of coastal discharge points and three submerged sites. Metal enrichment was evident for one or more elements in deposits from two of the three submerged sites and 24 of the 32 land-based sites visited. Copper, Pb, and Zn were the most commonly encountered contaminant metals with levels well in excess of 1000 μg/g(-1) in several instances. Elevated Hg and Cd concentrations were also relatively widespread throughout the study area although levels of each element seldom exceeded 1.0 and 10.0 μg/g(-1), respectively. Silver, another element of toxicological concern, was only occasionally detected despite registering a high of 42 μg/g(-1) at one particular site. The metal data were weighed against established benchmarks formulated for the protection of human and ecological health. Implications of the findings and issues of primary concern are briefly addressed.

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.

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

ERIC Educational Resources Information Center

Petersen, Christina I.; Gorman, Kristen S.

2014-01-01

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

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.

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.

American Thyroid Association consensus review and statement regarding the anatomy, terminology, and rationale for lateral neck dissection in differentiated thyroid cancer.

PubMed

Stack, Brendan C; Ferris, Robert L; Goldenberg, David; Haymart, Megan; Shaha, Ashok; Sheth, Sheila; Sosa, Julie Ann; Tufano, Ralph P

2012-05-01

Cervical lymph node metastases from differentiated thyroid cancer (DTC) are common. Thirty to eighty percent of patients with papillary thyroid cancer harbor lymph node metastases, with the central neck being the most common compartment involved. The goals of this study were to: (1) identify appropriate methods for determining metastatic DTC in the lateral neck and (2) address the extent of lymph node dissection for the lateral neck necessary to control nodal disease balanced against known risks of surgery. A literature review followed by formulation of a consensus statement was performed. Four proposals regarding management of the lateral neck are made for consideration by organizations developing management guidelines for patients with thyroid nodules and DTC including the next iteration of management guidelines developed by the American Thyroid Association (ATA). Metastases to lateral neck nodes must be considered in the evaluation of the newly diagnosed thyroid cancer patient and for surveillance of the previously treated DTC patient. Lateral neck lymph nodes are a significant consideration in the surgical management of patients with DTC. When current guidelines formulated by the ATA and by other international medical societies are followed, initial evaluation of the DTC patient with ultrasound (or other modalities when indicated) will help to identify lateral neck lymph nodes of concern. These findings should be addressed using fine-needle aspiration biopsy. A comprehensive neck dissection of at least nodal levels IIa, III, IV, and Vb should be performed when indicated to optimize disease control.

“Group sex” parties and other risk patterns: A qualitative study about the perceptions of sexual behaviors and attitudes of adolescents in Soweto, South Africa

PubMed Central

Dietrich, Janan; Khunwane, Mamakiri; Laher, Fatima; de Bruyn, Guy; Sikkema, Kathleen J.; Gray, Glenda

2011-01-01

This study explored perceptions about sexual behaviors and attitudes of adolescents living in Soweto, Johannesburg, South Africa, from the perspective of parents, counselors and adolescents. A qualitative methodology was applied. Nine focus group discussions (FGDs) were held; three with parents of adolescents, two with counselors who work with adolescents, two with female adolescents aged 16-18 years and two with male adolescents aged 16-18 years. In total, 80 participants were recruited from in and around Soweto. FGDs were guided by a semi-structured interview guide, audio-recorded, transcribed verbatim and translated into English. Data were analyzed using Maxqda, a qualitative software analysis program. There were eight key themes related to adolescent sexuality and perceived attitudes towards relationships. Five themes were common to all participant groupings (parents, counselors and adolescents): (1) dating during adolescence, (2) adolescent females dating older males, (3) condom use amongst adolescents, (4) pregnancy and (5) homosexuality. (6) Sex as a regular and important activity among adolescents and (7) group sex practices among adolescents emerged as themes from adolescent and counselor FGDs. Lastly, (8) the role of the media as an influence on adolescent sexuality was common to adolescent and parent groups. Risky sexual behaviors continue among adolescents, with group sex parties a concerning emergent phenomenon that necessitates further study. HIV, other STIs and pregnancy prevention interventions should address multiple levels of influence to address context-specific influences. PMID:22844344

Implementation of ICU palliative care guidelines and procedures: a quality improvement initiative following an investigation of alleged euthanasia.

PubMed

Kuschner, Ware G; Gruenewald, David A; Clum, Nancy; Beal, Alice; Ezeji-Okoye, Stephen C

2009-01-01

Ethical conflicts are commonly encountered in the course of delivering end-of-life care in the ICU. Some ethical concerns have legal dimensions, including concerns about inappropriate hastening of death. Despite these concerns, many ICUs do not have explicit policies and procedures for withdrawal of life-sustaining treatments. We describe a US Office of Inspector General (OIG) investigation of end-of-life care practices in our ICU. The investigation focused on care delivered to four critically ill patients with terminal diseases and an ICU nurse's concern that the patients had been subjected to euthanasia. The OIG investigation also assessed the validity of allegations that patient flow in and out of our ICU was inappropriately influenced by scheduled surgeries and that end-of-life care policies in our ICU were not clear. Although the investigation did not substantiate the allegations of euthanasia or inappropriate ICU patient flow, it did find that the policies that discuss end-of-life care issues were not clear and allowed for wide-ranging interpretations. Acting on the OIG recommendations, we developed a quality improvement initiative addressing end-of-life care in our ICU, intended to enhance communication and understanding about palliative care practices in our ICU, to prevent ethical conflicts surrounding end-of-life care, and to improve patient care. The initiative included the introduction of newly developed ICU comfort care guidelines, a physician order set, and a physician template note. Additionally, we implemented an educational program for ICU staff. Staff feedback regarding the initiative has been highly favorable, and the nurse whose concerns led to the investigation was satisfied not only with the investigation but also the policies and procedures that were subsequently introduced in our ICU.

Potential exposures and risks from beryllium-containing products.

PubMed

Willis, Henry H; Florig, H Keith

2002-10-01

Beryllium is the strongest of the lightweight metals. Used primarily in military applications prior to the end of the Cold War, beryllium is finding new applications in many commercial products, including computers, telecommunication equipment, and consumer and automotive electronics. The use of beryllium in nondefense consumer applications is of concern because beryllium is toxic. Inhalation of beryllium dust or vapor causes a chronic lung disease in some individuals at concentrations as low as 0.01 microg/m3 in air. As beryllium enters wider commerce, it is prudent to ask what risks this might present to the general public and to workers downstream of the beryllium materials industry. We address this question by evaluating the potential for beryllium exposure from the manufacturing, use, recycle, and disposal of beryllium-containing products. Combining a market study with a qualitative exposure analysis, we determine which beryllium applications and life cycle phases have the largest exposure potential. Our analysis suggests that use and maintenance of the most common types of beryllium-containing products do not result in any obvious exposures of concern, and that maintenance activities result in greater exposures than product use. Product disposal has potential to present significant individual risks, but uncertainties concerning current and future routes of product disposal make it difficult to be definitive. Overall, additional exposure and dose-response data are needed to evaluate both the health significance of many exposure scenarios, and the adequacy of existing regulations to protect workers and the public. Although public exposures to beryllium and public awareness and concern regarding beryllium risks are currently low, beryllium risks have psychometric qualities that may lead to rapidly heightened public concern.

Recklessness as a hallmark of aggressive cancer.

PubMed

Noda, Makoto; Takahashi, Chiaki

2007-11-01

Cancer recurrence after surgical treatment is a major concern for patients and doctors. Understanding what makes tumors prone to recurrence would be an important step toward its prevention. Accumulating evidence indicates that the level of membrane-associated protease regulator reversion-inducing cysteine-rich protein with Kazal motifs (RECK) expressed in tumor tissue is a good prognostic indicator in several common cancers. Certain members of the matrix metalloproteinase family are often upregulated in advanced cancers and are known to play important roles in tumor angiogenesis, invasion and metastasis. RECK negatively regulates several matrix metalloproteinases. Therefore, RECK itself may well be considered a promising tool or target molecule to be activated in cancer therapy. Here we review the recent advances in RECK research and discuss some of the important issues to be addressed in future studies.

Introduction: U.S. Homophile Internationalism.

PubMed

Stein, Marc

2017-01-01

This article introduces "U.S. Homophile Internationalism," a special issue of the Journal of Homosexuality. The introduction provides a broad overview of the "U.S. Homophile Internationalism" archive and exhibit, which was published on the Outhistory Web site in 2015. The archive and exhibit consists of more than 800 U.S. homophile magazine articles, letters, and other items that referenced non-U.S. regions of the world from 1953 to 1964. The essays in the special issue focus on (1) Africa; (2) Asia and the Pacific; (3) Canada; (4) Latin America and the Caribbean; (5) the Middle East; and (6) Russia, the Soviet Union, and Eastern Europe. There is also an article that addresses the public history and digital humanities dimensions of the project. The introduction concludes by discussing the essays' common goals, themes, and concerns.

Children and refusal of medical treatment: in urgent need of reform.

PubMed

Lennings, Nicholas

2013-09-01

The ability of children to refuse medical treatment is far from certain. The New South Wales Law Reform Commission report on this topic, released in 2008, addressed a number of key concerns. As yet, no action on that report has been taken. Neither the present statutory nor common law regime provides sufficient guidance on this issue. The case of Gillick v West Norfolk and Wisbech Area Health Authority [1986] AC 112, while important, is not as far-reaching as it first appeared and has been subject to substantial limitations regarding refusals of treatment. Specifically, the position in relation to the assessment of competency, and the weight of a competent decision, remains outstanding. The ability of children to refuse medical treatment is in urgent need of attention and rectification.

Ethical framework for resource allocation during a drug supply shortage.

PubMed

Gibson, Jennifer L; Bean, Sally; Chidwick, Paula; Godkin, Dianne; Sibbald, Robert W; Wagner, Frank

2012-01-01

Drug supply shortages are common in health systems due to manufacturing and other delays. Frequently, shortages are successfully addressed through conservation and redistribution efforts, with limited impact on patient care. However, when Sandoz Canada Inc. announced in February 2012 that it was reducing production of a number of generic injectable drugs at its Quebec facility, the scope and magnitude of the drug supply shortage were unprecedented in Canada. The potential for an extreme scarcity of some drugs raised ethical concerns about patient care, including the need to limit access to some health services. In this article, the authors describe the development and implementation of an ethical framework to promote equitable access to drugs and healthcare services in the context of a drug supply shortage within and across health systems.

Method can improve efficiency of heli-portable seismic operations

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

Kingsbury, O.J.

1995-11-13

There are regions of the world where the only viable means of conducting a seismic survey on land must involve helicopters as a primary means of transport. The high operating cost of helicopters means that such heliportable work is expensive compared with the more common land and marine surveys. This article is addressed to exploration companies contemplating heliportable seismic surveys. Its aim is to show how these operations work and to enable a dramatic reduction in the cost and timescale of future operations compared with numerous operations this writer has witnessed and been involved with in recent years. The coremore » of this article concerns distinct designs of drilling machinery used in these activities and the most efficient ways of configuring this machinery in the field.« less

Investigation of preservice elementary teachers' thinking about science

NASA Astrophysics Data System (ADS)

Cobern, William W.; Loving, Cathleen C.

2002-12-01

It is not uncommon to find media reports on the failures of science education, nor uncommon to hear prestigious scientists publicly lament the rise of antiscience attitudes. Given the position elementary teachers have in influencing children, antiscience sentiment among them would be a significant concern. Hence, this article reports on an investigation in which preservice elementary teachers responded to the Thinking about Science survey instrument. This newly developed instrument addresses the broadrelationship of science to nine important areas of society and culture and is intended to reveal the extent of views being consistent with or disagreeing with a commonly held worldview of science portrayed in the media and in popular science and science education literature. Results indicate that elementary teachers discriminate with respect to different aspects of culture and science but they are not antiscience.

Health, human rights, and the conduct of clinical research within oppressed populations

PubMed Central

Mills, Edward J; Singh, Sonal

2007-01-01

Background Clinical trials evaluating interventions for infectious diseases require enrolling participants that are vulnerable to infection. As clinical trials are conducted in increasingly vulnerable populations, issues of protection of these populations become challenging. In settings where populations are forseeably oppressed, the conduct of research requires considerations that go beyond common ethical concerns and into issues of international human rights law. Discussion Using examples of HIV prevention trials in Thailand, hepatitis-E prevention trials in Nepal and malaria therapeutic trials in Burma (Myanmar), we address the inadequacies of current ethical guidelines when conducting research within oppressed populations. We review existing legislature in the United States and United Kingdom that may be used against foreign investigators if trial hardships exist. We conclude by making considerations for research conducted within oppressed populations. PMID:17996056

Integrating Competition for Food, Hosts, or Mates via Experimental Evolution.

PubMed

Rodrigues, Leonor R; Duncan, Alison B; Clemente, Salomé H; Moya-Laraño, Jordi; Magalhães, Sara

2016-02-01

Competitive interactions shape the evolution of organisms. However, often it is not clear whether competition is the driving force behind the patterns observed. The recent use of experimental evolution in competitive environments can help establish such causality. Unfortunately, this literature is scattered, as competition for food, mates, and hosts are subject areas that belong to different research fields. Here, we group these bodies of literature, extract common processes and patterns concerning the role of competition in shaping evolutionary trajectories, and suggest perspectives stemming from an integrative view of competition across these research fields. This review reinstates the power of experimental evolution in addressing the evolutionary consequences of competition, but highlights potential pitfalls in the design of such experiments. Copyright © 2015 Elsevier Ltd. All rights reserved.

What are narratives good for?

PubMed

Beatty, John

2016-08-01

Narratives may be easy to come by, but not everything is worth narrating. What merits a narrative? Here, I follow the lead of narratologists and literary theorists, and focus on one particular proposal concerning the elements of a story that make it narrative-worthy. These elements correspond to features of the natural world addressed by the historical sciences, where narratives figure so prominently. What matters is contingency. Narratives are especially good for representing contingency and accounting for contingent outcomes. This will be squared with a common view that narratives leave no room for chance. On the contrary, I will argue, tracing one path through a maze of alternative possibilities, and alluding to those possibilities along the way, is what a narrative does particularly well. Copyright © 2016 Elsevier Ltd. All rights reserved.

Future implications of eHealth interventions for chronic pain management in underserved populations.

PubMed

DeMonte, Colette M; DeMonte, William D; Thorn, Beverly E

2015-01-01

Many underserved communities, especially those in rural settings, face unique challenges that make high quality healthcare less accessible. The implementation of eHealth technologies has become a potentially valuable option to disseminate interventions. The authors' work in rural Alabama Federally Qualified Health Centers provide insights into the access to technology as well as the likelihood of utilizing eHealth technology in underserved communities. This paper will review current challenges related to digital dissemination of behavioral health interventions for chronic pain. Two major concerns are the lack of technological resources and the lack of appropriate materials for patients who may have low levels of reading, health and/or digital literacy. We will propose some recommendations to address common barriers faced by those providing care.

How do we improve patient compliance and adherence to long-term statin therapy?

PubMed

Maningat, Patricia; Gordon, Bruce R; Breslow, Jan L

2013-01-01

Statins are highly effective drugs prescribed to millions of people to lower LDL-cholesterol and decrease cardiovascular risk. The benefits of statin therapy seen in randomized clinical trials will only be replicated in real-life if patients adhere to the prescribed treatment regimen. But, about half of patients discontinue statin therapy within the first year, and adherence decreases with time. Patient, physician and healthcare system-related factors play a role in this problem. Recent studies have focused more on the patients' perspectives on non-adherence. Adverse events are cited as the most common cause of statin discontinuation; thus, the healthcare provider must be willing to ally and dialogue with patients to address concerns and assess the risks and benefits of continued statin therapy.

Engaging pregnant and parenting teens: early challenges and lessons learned from the Evaluation of Adolescent Pregnancy Prevention Approaches.

PubMed

Asheer, Subuhi; Berger, Amanda; Meckstroth, Alicia; Kisker, Ellen; Keating, Betsy

2014-03-01

This article draws on data from the ongoing federal Evaluation of Adolescent Pregnancy Prevention Approaches to discuss the early implementation experiences of two new and innovative programs intended to delay rapid repeat pregnancy among teen mothers: (1) AIM 4 Teen Moms, in Los Angeles County, California; and (2) Teen Options to Prevent Pregnancy (T.O.P.P.), in Columbus, Ohio. Program staff report common challenges in working with teen mothers, particularly concerning recruitment and retention, staff capacity and training, barriers to participation, and participants' overarching service needs. Lessons learned in addressing these challenges provide useful guidance to program developers, providers, policy makers, and stakeholders working with similar populations. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Dignity-conserving care actions in palliative care: an integrative review of Swedish research.

PubMed

Harstäde, Carina Werkander; Blomberg, Karin; Benzein, Eva; Östlund, Ulrika

2018-03-01

Previous research has proposed that persons in need of palliative care often have a loss of functions and roles that affects social and existential self-image. Moreover, these individuals also commonly suffer from complex multisymptoms. This, together with the situation of facing an impending death, can lead to a loss of dignity. Therefore, supporting these persons' dignity is a crucial challenge for professional nurses. The 'Dignity Care Intervention' addresses the multidimensionality of dignity by identifying patients' dignity-related concerns and suggests care actions to address them. At the present, the Dignity Care Intervention is adapted for implementation in Swedish care settings. Because expressions of dignity are influenced by culture, and an overview of care actions in a Swedish context is lacking, this integrative review aimed to find suggestions from Swedish research literature on what kind of care actions can preserve dignity. An integrative literature review was conducted using the databases SwePub and SweMed+. Articles published from 2006 to 2015 and theses published from 2000 to 2015 were searched for using the terms 'dignity' and 'palliative care'. Result sections of articles and theses were reviewed for dignity-conserving care actions synthesised by thematic analysis and categorised under themes and subthemes in Chochinov's model of dignity. Fifteen articles and 18 theses were included together providing suggestions of care actions in all themes and subthemes in the dignity model. Suggested care actions included listening, communication, information, symptom control, facilitating daily living and including patients in decision-making. Additionally, nurses' perceptiveness towards the patients was a core approach. The review offers culturally relevant suggestions on how to address specific dignity-related concerns. The adapted Dignity Care Intervention will be a way for Swedish nurses to provide person-centred palliative care that will conserve patients' dignity. © 2017 Nordic College of Caring Science.

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.

“It’s like heart failure. It’s chronic…and it will kill you”: A qualitative analysis of burnout among hospice and palliative care clinicians

PubMed Central

Kavalieratos, Dio; Siconolfi, Daniel E.; Steinhauser, Karen E.; Bull, Janet; Arnold, Robert M.; Swetz, Keith M.; Kamal, Arif H.

2017-01-01

Context Although prior surveys have identified rates of self-reported burnout among palliative care clinicians as high as 62%, limited data exist to elucidate the causes, ameliorators, and effects of this phenomenon. Objectives We explored burnout among palliative care clinicians, specifically their experiences with burnout, their perceived sources of burnout, and potential individual, interpersonal, organizational, and policy-level solutions to address burnout. Methods During the 2014 AAHPM/HPNA Annual Assembly, we conducted 3 focus groups to examine: personal narratives of burnout; how burnout differs within hospice and palliative care; and, strategies to mitigate burnout. Two investigators independently analyzed data using template analysis, an inductive/deductive qualitative analytic technique. Results We interviewed 20 palliative care clinicians (14 physicians, 4 advanced practice providers, 2 social workers). Common sources of burnout included: increasing workload, tensions between non-specialists and palliative care specialists, and regulatory issues. We heard grave concerns about the stability of the palliative care workforce, and concerns of providing, high-quality palliative care in light of a distressed, overburdened discipline. Participants proposed anti-burnout solutions including: promoting the provision of generalist palliative care, frequent rotations on-and-off service, and organizational support for self-care. We observed variability in sources of burnout between clinician type and by practice setting, such as role monotony among full-time clinicians. Conclusion Our results reinforce and expand upon the severity and potential ramifications of burnout on the palliative care workforce. Future research is needed to confirm our findings and to investigate interventions to address or prevent burnout. PMID:28063867

"Will my work affect my pregnancy?" Resources for anticipating and answering patients' questions.

PubMed

Grajewski, Barbara; Rocheleau, Carissa M; Lawson, Christina C; Johnson, Candice Y

2016-05-01

Authoritative information on occupational reproductive hazards is scarce and complex because exposure levels vary, multiple exposures may be present, and the reproductive toxicity of many agents remains unknown. For these reasons, women's health providers may find it challenging to effectively address workplace reproductive health issues with their patients who are pregnant, breast-feeding, or considering pregnancy. Reproductive epidemiologists at the Centers for Disease Control and Prevention National Institute for Occupational Safety and Health answered >200 public requests for occupational reproductive health information during 2009 through 2013. The most frequent occupations represented were health care (41%) and laboratory work (18%). The most common requests for exposure information concerned solvents (14%), anesthetic gases (10%), formaldehyde (7%), infectious agents in laboratories (7%) or health care settings (7%), and physical agents (14%), including ionizing radiation (6%). Information for developing workplace policies or guidelines was sought by 12% of the requestors. Occupational exposure effects on breast-feeding were an increasing concern among working women. Based on information developed in response to these requestors, information is provided for discussing workplace exposures with patients, assessing potential workplace reproductive hazards, and helping patients determine the best options for safe work in pregnancy. Appendices provide resources to address specific occupational exposures, employee groups, personal protective equipment, breast-feeding, and workplace regulations regarding work and pregnancy. These tools can help identify those most at risk of occupational reproductive hazards and improve workers' reproductive health. The information can also be used to inform research priorities and assist the development of workplace reproductive health policies. Published by Elsevier Inc.

Qualitative Exploration of Sexual Experiences Among Adults on the Autism Spectrum: Implications for Sex Education.

PubMed

Barnett, Jessica Penwell; Maticka-Tyndale, Eleanor

2015-12-01

The increasing prevalence of autism since the 1990s has led to growing demand for sex education that meets the needs of persons on the autism spectrum. Yet there is a dearth of research documenting the firsthand experiences and perspectives of autistic individuals. A thematic analysis was conducted of in-depth, Internet-facilitated interviews with 24 adults on the autism spectrum who were recruited from Internet community spaces between November 2012 and May 2013. Inclusion criteria were self-identification as a person on the autism spectrum, being a U.S. resident, being aged 18 or older, and having the ability to communicate orally or through writing. Participants were aged 18-61 and were living in the community at the time of interview, most with limited extrafamilial support. They were less likely than the general population to be heterosexual or gender-conforming and were more likely to have experienced romantic or sexual debut after age 18. Participants' most common concerns were courtship difficulties and sensory dysregulation in the context of partnered sexuality. These concerns were exacerbated by inadequate and inappropriate sex education experiences. Participants addressed challenges by using sensory barriers (e.g., latex gloves); planning when and how to have sex; negotiating alternatives to sexual scripts predicated on nondisabled experience; and practicing explicit and intentional communication. Individuals on the autism spectrum would benefit from sex education that normalizes differences (e.g., in identities and experiences of sexuality), is offered throughout young adulthood, addresses disability-relevant sensory and communication needs, and includes practicing neurotypical sociosexual norms. Copyright © 2015 by the Guttmacher Institute.

The donor organ as an 'object a': a Lacanian perspective on organ donation and transplantation medicine.

PubMed

Zwart, Hub

2014-11-01

Bioethical discourse on organ donation covers a wide range of topics, from informed consent procedures and scarcity issues up to 'transplant tourism' and 'organ trade'. This paper presents a 'depth ethics' approach, notably focussing on the tensions, conflicts and ambiguities concerning the status of the human body (as something which constitutes a whole, while at the same time being a set of replaceable elements or parts). These will be addressed from a psychoanalytical (Lacanian) angle. First, I will outline Lacan's view on embodiment as such. Subsequently, I will argue that, for organ recipients, the donor organ becomes what Lacan refers to as an object a, the 'partial object' of desire, the elusive thing we are deprived of, apparently beyond our grasp. Within the recipient's body an empty space emerges, a kind of 'vacuole', once occupied by a faltering organ (now removed). This space can only be filled by a 'gift' from the other, by an object a. Once implanted, however, this implant becomes an 'extimate' object: something both 'external' and 'intimate', both 'embedded' and 'foreign', and which is bound to remain an object of concern for quite some time, if not for life. A Lacanian analysis allows us, first of all, to address the question what organ transplantation has in common with other bodily practices involving bodily parts procured from others, such as cannibalism. But it also reveals the basic difference between the two, as well as the distance between the 'fragmented body' of Frankenstein's 'monster'--as an aggregate of replaceable parts--and the multiple organ recipients (the 'puzzle people') of today.

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.

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.…

Factors related to parental age of first concern in toddlers with autism spectrum disorder.

PubMed

Matheis, Maya; Matson, Johnny L; Burns, Claire O; Jiang, Xinrui; Peters, W Jason; Moore, Michael; de Back, Kaitlin A; Estabillo, Jasper

2017-05-01

The age of first concern (AOC) of parents of children with autism spectrum disorders (ASD) has substantial implications for early diagnosis and intervention. The current study sought to determine the average AOC, what types of first concerns are most common, and what factors predict earlier AOC in toddlers with ASD. This study analyzed the predictive influence of the type of concern, symptom severity, medical diagnoses, and other independent variables on AOC among toddlers with ASD using multiple regressions. The mean AOC was found to be 13.97 months (SD = 7.86). The most commonly reported first concern was speech/language. First concerns related to communication, speech/language predicted later AOC, while motor concerns predicted earlier AOC. Concerns that are more closely related to social communication deficits characteristic of ASD predicted later AOC. The implications of these findings on screening/assessment and intervention are discussed.

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...

Anticipating and addressing workplace static magnetic field effects at levels <0.5 mT.

PubMed

Emery, R J; Hopkins, J R; Charlton, M A

2000-11-01

Magnetic resonance, once a research tool limited to the basic sciences, has experienced an increase in popularity due to its unique ability to analyze certain living systems in vivo. Expanding applications in the biomedical sciences have resulted in magnetic sources being located in research institutions nationally. Space and resource limitations sometimes necessitate siting magnetic resonance units in proximity to other institutional operations. For magnetic field shielding and personnel protection considerations, the generally accepted 0.5 mT (milliTesla) limit for implanted cardiac devices is commonly used as the conservative basis for decisions. But the effects of magnetic fields on equipment can be easily observed at levels far below 0.5 mT, often resulting in concern and apprehension on the part of personnel in the surrounding areas. Responding to recurrent worker concerns spawned by noticeable effects on equipment at exposure levels <0.5 mT can strain finite radiation safety program resources. To enhance the ability to anticipate possible facility incompatibility issues associated with the installation of magnetic sources, a literature review was conducted to summarize documented equipment effects. Various types of equipment were found to be impacted at levels ranging down to perhaps 0.001 mT. Armed with this information, practicing radiation safety professionals can better anticipate facility incompatibility issues and improve their responses to worker concerns initiated by observed effects on equipment.

Heavy Metals in Marine Pollution Perspective-A Mini Review

NASA Astrophysics Data System (ADS)

Ansari, T. M.; Marr, I. L.; Tariq, N.

Anthropogenic inputs of pollutants such as heavy metals into the marine environment have increased their levels to large extents within past a few decades. These pollutants tend to accumulate in the bottom sediments. As a result, ecosystems such as seaports or other industrialized coastal areas that have chronic inputs of metals have highly contaminated sediments. This characteristic has led to concerns over the ecological effects that may be associated with sediment quality. Of particular concern are toxic effects and the potential for bioaccumulation of metals in biota exposed to the sediments. The availability of heavy metals to the biomass of a polluted region is the prime concern both in terms of the prediction of the effects of metal pollution on an ecosystem and in terms of possible human health risks. With growing interest on environmental issues, several intriguing questions related to heavy metals are often raised. This review addresses the basic concepts, sources, speciation, mode of action, levels, analytical measurement, bioavailability, bioaccumulation, biological role and toxicity of heavy metals in the marine environment. Lead, Cadmium, Zinc, Copper, Manganese, Iron, Mercury, Arsenic and Barium are selected because these metals are common and are often at measurable levels in marine samples. An attempt has been made to answer the queries presented by the environmentalists working on various aspects of heavy metal pollution in the marine environment

[Modeling integrative oncology care program for Arab patients in north Israel: towards quality of life improvement during chemotherapy].

PubMed

Ben-Arye, Eran; Dagash, Jamal; Silbermann, Michael; Saad, Bashar; Steiner, Mariana; Popper-Giveon, Ariela; Lev, Efraim; Agbarya, Abed; Sela, Gil Bar; Karkabi, Khaled; Schiff, Elad

2015-01-01

In the last decade, a number of integrative oncology programs have been established within leading oncology departments in Israel aiming to provide consultations that address patients' concerns and improve their quality of life (QOL). To identify Arab cancer patients' attitudes, needs and expectations concerning integration of complementary and traditional medicine (CTM) in their supportive oncology care. This article presents studies based on both qualitative (including interviews with patients, oncologists and CTM practitioners) and quantitative studies which were designed to evaluate patients' attitudes, needs and expectations regarding CTM integration in supportive oncology care. Of the 313 Arab respondents, 109 reported on the use of herbal medicine for cancer-associated outcomes. Over 78% of respondents considered QOL improvement as their main expectation of integrated CM consultation. Similar expectations were expressed in studies exploring 155 cancer care practitioners in Israel and Arab countries, 27 CTM-trained Arab practitioners, and a sample of 15 Arab patients referred to integrative medicine consultation. Arab cancer patients support QOL-oriented integrated medicine programs provided in oncology settings. Integrative medicine consultation should provide patients with an evidence-based recommendation on efficacy and safety of herbs commonly used concomitant with chemotherapy. We recommend designing integrative oncology training courses for physicians who will provide evidence-based consultation attuned with Arab patients' needs, concerns and cultural-sensitive orientation.

Factors associated with adolescent and caregiver reported problems in using asthma medications.

PubMed

Sleath, Betsy; Carpenter, Delesha M; Walsh, Kathleen E; Davis, Scott A; Watson, Claire Hayes; Lee, Charles; Loughlin, Ceila E; Garcia, Nacire; Reuland, Daniel S; Tudor, Gail

2018-04-18

The purpose of this study was to: (a) describe the types of medication problems/concerns youth with asthma and their caregivers reported and (b) examine the association between socio-demographic characteristics and youth and caregiver reported medication problems/concerns. English-and Spanish-speaking youth ages 11-17 with persistent asthma were recruited at four pediatric clinics. Youth were interviewed and caregivers completed questionnaires about reported asthma medication concerns/problems. Multiple logistic regression was used to analyze the data. Three hundred and fifty-nine youth were recruited. Eighty percent of youth and 70% of caregivers reported one or more problems in using asthma medications. The most commonly reported problems by youth were: (a) hard to remember when to take the asthma medication (54%) and (b) hard to use asthma medication at school (34%). Younger children were significantly more likely to report difficulty in understanding their asthma medication's directions and difficulty reading the print on the medication's package. Caregivers' top-reported problem was that it is hard for their child to remember to take their asthma medications (49%). Caregivers without Medicaid were significantly more likely to express difficulty paying for their child's asthma medications. Difficulty remembering to take asthma medication was a significant problem for youth and their caregivers. Providers should work with youth and their caregivers to identify asthma medication problems and discuss strategies to address those problems.

Debunking some judicial myths about epidemiology and its relevance to UK tort law.

PubMed

Mcivor, Claire

2013-01-01

Due to the limitations of current medical knowledge, claimants in complicated disease litigation often experience difficulties in proving causation. This paper aims to demonstrate that in some instances these difficulties could be overcome through greater use of epidemiological evidence. To encourage greater use of such evidence, it is first of all necessary to address and correct a series of common judicial misconceptions of epidemiology as a scientific discipline. By distinguishing epidemiology from the application of bare statistics, and by explaining that the courts are not automatically bound by an epidemiological result of 51+% to hold that causation has been established, this paper seeks to allay common judicial concerns about epidemiological evidence. It further seeks to demonstrate that the current judicial approach to determining questions of probabilistic causation is fundamentally flawed and that it could be significantly improved through greater use of specialist epidemiological expert witnesses. On the issue of expertise, the paper goes on to highlight the problems associated with the tendency of UK lawyers to turn to clinicians as experts on all matters of biomedical science.

Power to the People: Data Citizens in the Age of Precision Medicine

PubMed Central

Evans, Barbara J.

2017-01-01

Twentieth-century bioethics celebrated individual autonomy but framed autonomy largely in terms of an individual’s power to make decisions and act alone. The most pressing challenges of big data science in the twenty-first century can only be resolved through collective action and common purpose. This Article surveys some of these challenges and asks how common purpose can ever emerge on the present bioethical and regulatory landscape. The solution may lie in embracing a broader concept of autonomy that empowers individuals to protect their interests by exercising meaningful rights of data citizenship. This Article argues that twentieth-century bioethics was a paternalistic, top-down affair in which self-proclaimed ethics experts set standards to protect research subjects portrayed as autonomous yet too vulnerable and disorganized to protect themselves. The time may be ripe for BioEXIT, a popular uprising of regular people seeking a meaningful voice in establishing citizen-led ethical and privacy standards to advance big-data science while addressing the concerns people feel about the privacy of their health data. PMID:29118898

Science, Politics, and Watershed Management: Another Task for Hydrologists

NASA Astrophysics Data System (ADS)

Wise, W. R.

2002-05-01

The lowest common denominator in hydrology should be "common" sense. The basic concepts that need to be addressed during watershed management are tractable by the general public when presented effectively. Of course the details should be left to the professionals. An uninformed public will feel disenfranchised when "experts" pummel it with technical content beyond its comfort level. To be effective, the hydrologic professional needs to be competent to perform the required analyses and prepared to win the trust of all concerned parties. In the adversarial roles played by developers and growth opponents, distrust reigns supreme. Usually this distrust is fed first and foremost by a lack of communication between the parties. In today's litigious environment, the results can be maddening. The author's experience in high profile hydrologic projects have infused him with the knowledge that effective communication is a critical lubricant to the watershed management process. It is the hydrologic community's duty to facilitate the policy makers' genuine education on watershed processes. The former must act now, if previous problems are not to be repeated.

Limited availability of psoriasis and phototherapy care: an analysis of advertisements.

PubMed

Hancox, John G; Balkrishnan, Rajesh; Battle, Jamila; Housman, Tam Salam; Fleischer, Alan B; Feldman, Steven R

2005-08-01

Because the number of dermatologists remains stable, patients with medical dermatologic conditions such as psoriasis may find it increasingly difficult to access dermatological treatment. Measuring the competition in the marketing of dermatologic care may provide insight into the availability of dermatology services. The purpose of this study was to determine to what extent dermatologists are using the Yellow Pages to advertise to patients with psoriasis. We performed a quantitative and qualitative assessment of dermatologists' Yellow Pages advertisements in small cities and the ten largest metropolitan regions in the country. Per capita, more advertisements were found in smaller markets than larger markets and a higher percentage was descriptive rather than just a name, address and phone number. Cosmetic and surgical advertisements were more common than psoriasis ads in both markets. Cosmetic ads were more prevalent in larger markets. In all regions, psoriasis and psoriasis treatment ads were least common. These findings raise the concern that incentive structures in the United States healthcare system do not adequately support delivery of dermatologic care for psoriasis. Efforts to promote psoriasis care should be encouraged.

Religion and Environmental Education: Building on Common Ground

ERIC Educational Resources Information Center

Hitzhusen, Gregory E.

2006-01-01

Environmental educators are beginning to consider how to incorporate religious resources into their curricula. Common concerns about religion pose a challenge for integration, but these concerns are manageable. Reflection on the precursors of environmental citizenship behaviour provides a framework for considering some of the ways that religious…

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.

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.

Sustainability Tools Inventory Initial Gap Analysis

EPA Science Inventory

This report identifies a suite of tools that address a comprehensive set of community sustainability concerns. The objective is to discover whether "gaps" exist in the tool suite’s analytic capabilities. These tools address activities that significantly influence resource consu...

77 FR 13147 - Boston Harbor Islands National Recreation Area Advisory Council; Notice of Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-05

... written statement concerning the matters to be discussed. Persons who wish to file a written statement at.... Before including your address, phone number, email address, or other personal identifying information in...

Measuring, evaluating and improving hospital quality parameters/dimensions--an integrated healthcare quality approach.

PubMed

Zineldin, Mosad; Camgöz-Akdağ, Hatice; Vasicheva, Valiantsina

2011-01-01

This paper aims to examine the major factors affecting cumulative summation, to empirically examine the major factors affecting satisfaction and to address the question whether patients in Kazakhstan evaluate healthcare similarly or differently from patients in Egypt and Jordan. A questionnaire, adapted from previous research, was distributed to Kazakhstan inpatients. The questionnaire contained 39 attributes about five newly-developed quality dimensions (5Qs), which were identified to be the most relevant attributes for hospitals. The questionnaire was translated into Russian to increase the response rate and improve data quality. Almost 200 usable questionnaires were returned. Frequency distribution, factor analysis and reliability checks were used to analyze the data. The three biggest concerns for Kazakhstan patients are: infrastructure; atmosphere; and interaction. Hospital staffs concern for patients' needs, parking facilities for visitors, waiting time and food temperature were all common specific attributes, which were perceived as concerns. These were shortcomings in all three countries. Improving health service quality by applying total relationship management and the 5Qs model together with a customer-orientation strategy is recommended. Results can be used by hospital staff to reengineer and redesign creatively their quality management processes and help move towards more effective healthcare quality strategies. Patients in three countries have similar concerns and quality perceptions. The paper describes a new instrument and method. The study assures relevance, validity and reliability, while being explicitly change-oriented. The authors argue that patient satisfaction is a cumulative construct, summing satisfaction as five different qualities (5Qs): object; processes; infrastructure; interaction and atmosphere.

What does it mean when people say that they have received expressions of concern about their drinking or advice to cut down on the AUDIT scale?

PubMed

Cunningham, John A; Godinho, Alexandra; Kushnir, Vladyslav; Bertholet, Nicolas

2017-12-02

The Alcohol Use Disorders Identification Test (AUDIT) is a commonly used scale to measure severity of alcohol consumption that contains an item asking if anyone has expressed concern about your drinking or suggested you cut down. What does it mean when a participant says yes to this question? Participants who were 18 or older and who drank at least weekly were recruited to complete a survey about their drinking from the Mechanical Turk platform. Comparisons were made between at risk (n = 2565) and high risk drinkers (n = 581) who said that someone had expressed concern about their drinking regarding who had expressed concern. If the person expressing concern was a health professional, the participant was also asked what type of support was provided. Expressions of concern about drinking were received more often by high risk than at risk drinkers. The most common type of person to have expressed concern was a relative, followed by a friend, or a marital partner. About one quarter of participants had received expressions of concern from a medical doctor or other health professional. All health professionals' expressions of concern were accompanied by a suggestion to cut down and about half provided some additional support (the most common type of support was brief advice). Expressions of concern come from a variety of sources and the likelihood of their occurrence is partially related to amount of alcohol intake.

Development and implementation of the Good Neighbor Agreement (GNA) practice in the USA sustainable mining development.

NASA Astrophysics Data System (ADS)

Masaitis, Alexandra

2014-05-01

New economic, environmental and social challenges for the mining industry in the USA show the need to implement "responsible" mining practices that include improved community involvement. Conflicts which occur in the US territory and with US mining companies around the world are now common between the mining proponents, NGO's and communities. These conflicts can sometimes be alleviated by early development of modes of communication, and a formal discussion format that allows airing of concerns and potential resolution of problems. One of the methods that can formalize this process is to establish a Good Neighbor Agreement (GNA), which deals specifically with challenges in relationships between mining operations and the local communities. It is a new practice related to mining operations that are oriented toward social needs and concerns of local communities that arise during the normal life of a mine, which can achieve sustainable mining practices. The GNA project being currently developed at the University of Nevada, USA in cooperation with the Newmont Mining Corporation has a goal of creating an open company/community dialog that will help identify and address sociological and environmental concerns associated with mining. Discussion: The Good Neighbor Agreement currently evolving will address the following: 1. Identify spheres of possible cooperation between mining companies, government organizations, and NGO's. 2. Provide an economically viable mechanism for developing a partnership between mining operations and the local communities that will increase mining industry's accountability and provide higher levels of confidence for the community that a mine is operated in a safe and sustainable manner. Implementation of the GNA can help identify and evaluate conflict criteria in mining/community relationships; determine the status of concerns; determine the role and responsibilities of stakeholders; analyze problem resolution feasibility; maintain the community involvement and support through economic benefits and environmental safeguards; develop options for the concerns resolution. Difficulties in establishing the GNA standards include lack of insurance/bonding policies, and by the lack of audit and monitoring that could determine the level of exposure of the local community and the environment to the contaminants released at the mine sites. Since many problems of mines can occur during closure and post-closure, GNA's should address those issues also. The goal of the GNA is to have open access for the public to the safety, health, and environmental information pertaining to the mining operation, as well as to educate the local communities about mining practices that promote mutual acknowledgment of the need to build a relationship amenable to each other's needs. Frequent conflicts between mining companies and surrounding communities lead to work disruptions or even mine closures and show the necessity of a less confrontational approach to environmental and social justice. The Good Neighbor Agreement is a unique way to provide the benefits for the both mining operations and local community to provide a mechanism for risk redaction and communication that offer the potential to protect both mining and community interests.

Can small institutes address some problems facing biomedical researchers?

PubMed

Sheetz, Michael P

2014-11-01

At a time of historically low National Institutes of Health funding rates and many problems with the conduct of research (unfunded mandates, disgruntled reviewers, and rampant paranoia), there is a concern that biomedical research as a profession is waning in the United States (see "Rescuing US biomedical research from its systemic flaws" by Alberts and colleagues in the Proceedings of the National Academy of Sciences). However, it is wonderful to discover something new and to tackle tough puzzles. If we could focus more of our effort on discussing scientific problems and doing research, then we could be more productive and perhaps happier. One potential solution is to focus efforts on small thematic institutes in the university structure that can provide a stimulating and supportive environment for innovation and exploration. With an open-lab concept, there are economies of scale that can diminish paperwork and costs, while providing greater access to state-of-the-art equipment. Merging multiple disciplines around a common theme can catalyze innovation, and this enables individuals to develop new concepts without giving up the credit they deserve, because it is usually clear who did the work. Small institutes do not solve larger systemic problems but rather enable collective efforts to address the noisome aspects of the system and foster an innovative community effort to address scientific problems. © 2014 Sheetz.

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

ERIC Educational Resources Information Center

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

2006-01-01

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

The Perceptions of Superintendents and Emergency Responders Concerning the Usefulness of Geographical Information Systems in Illinois School District's Crisis Response Procedures

ERIC Educational Resources Information Center

Roundcount, Travis R.

2010-01-01

Across the United States, many communities are concerned with the prevention and response to school violence. To address their concerns, school districts and emergency responders (law enforcement) have increased their use of technological information when planning for and responding to a crisis event. There are many different types of security…

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

ERIC Educational Resources Information Center

Arce, Lauren Y.

2017-01-01

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

MACCIS 2.0 - An Architecture Description Framework for Technical Infostructures and Their Enterprise Environment

DTIC Science & Technology

2004-06-01

Viewpoint Component Viewpoint View Architecture Description of Enterprise or Infostructure View Security Concern Business Security Model Business...security concern, when applied to the different viewpoints, addresses both stakeholders, and is described as a business security model or component...Viewpoint View Architecture Description of Enterprise or Infostructure View Security Concern Business Security Model Business Stakeholder IT Architect

Accountability

ERIC Educational Resources Information Center

Fielding, Michael; Inglis, Fred

2017-01-01

This contribution republishes extracts from two important articles published around 2000 concerning the punitive accountability system suffered by English primary and secondary schools. The first concerns the inspection agency Ofsted, and the second managerialism. Though they do not directly address assessment, they are highly relevant to this…

7 CFR 1468.1 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-01-01

... financial assistance to eligible farmers and ranchers to address soil, water, and related natural resource concerns, water quality protection or improvement; wetland restoration and protection; wildlife habitat... concerns for producers of wheat, feed grains, cotton, and rice, resulting in consolidation of payments that...

7 CFR 1468.1 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-01-01

... financial assistance to eligible farmers and ranchers to address soil, water, and related natural resource concerns, water quality protection or improvement; wetland restoration and protection; wildlife habitat... concerns for producers of wheat, feed grains, cotton, and rice, resulting in consolidation of payments that...

7 CFR 1468.1 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-01-01

... financial assistance to eligible farmers and ranchers to address soil, water, and related natural resource concerns, water quality protection or improvement; wetland restoration and protection; wildlife habitat... concerns for producers of wheat, feed grains, cotton, and rice, resulting in consolidation of payments that...

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

PubMed

McGraw, Deven

2013-01-01

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

Inhibition of microbial metabolism in anaerobic lagoons by selected sulfonamides, tetracyclines, lincomycin, and tylosin tartrate

USGS Publications Warehouse

Loftin, Keith A.; Henny, Cynthia; Adams, Craig D.; Surampali, Rao; Mormile, Melanie R.

2005-01-01

Antibiotics are used to maintain healthy livestock and to promote weight gain in concentrated animal feed operations. Antibiotics rarely are metabolized completely by livestock and, thus, are often present in livestock waste and in waste-treatment lagoons. The introduction of antibiotics into anaerobic lagoons commonly used for swine waste treatment has the potential for negative impacts on lagoon performance, which relies on a consortium of microbes ranging from fermentative microorganisms to methanogens. To address this concern, the effects of eight common veterinary antibiotics on anaerobic activity were studied. Anaerobic microcosms, prepared from freshly collected lagoon slurries, were amended with individual antibiotics at 10 mg/L for the initial screening study and at 1, 5, and 25 mg/L for the dose-response study. Monitored metabolic indicators included hydrogen, methane, and volatile fatty acid concentrations as well as chemical oxygen demand. The selected antibiotics significantly inhibited methane production relative to unamended controls, thus indicating that antibiotics at concentrations commonly found in swine lagoons can negatively impact anaerobic metabolism. Additionally, historical antibiotic usage seems to be a potential factor in affecting methane production. Specifically, less inhibition of methane production was noted in samples taken from the lagoon with a history of multiple-antibiotic use.

Inhibition of microbial metabolism in anaerobic lagoons by selected sulfonamides, tetracyclines, lincomycin, and tylosin tartrate.

PubMed

Loftin, Keith A; Henny, Cynthia; Adams, Craig D; Surampali, Rao; Mormile, Melanie R

2005-04-01

Antibiotics are used to maintain healthy livestock and to promote weight gain in concentrated animal feed operations. Antibiotics rarely are metabolized completely by livestock and, thus, are often present in livestock waste and in waste-treatment lagoons. The introduction of antibiotics into anaerobic lagoons commonly used for swine waste treatment has the potential for negative impacts on lagoon performance, which relies on a consortium of microbes ranging from fermentative microorganisms to methanogens. To address this concern, the effects of eight common veterinary antibiotics on anaerobic activity were studied. Anaerobic microcosms, prepared from freshly collected lagoon slurries, were amended with individual antibiotics at 10 mg/L for the initial screening study and at 1, 5, and 25 mg/L for the dose-response study. Monitored metabolic indicators included hydrogen, methane, and volatile fatty acid concentrations as well as chemical oxygen demand. The selected antibiotics significantly inhibited methane production relative to unamended controls, thus indicating that antibiotics at concentrations commonly found in swine lagoons can negatively impact anaerobic metabolism. Additionally, historical antibiotic usage seems to be a potential factor in affecting methane production. Specifically, less inhibition of methane production was noted in samples taken from the lagoon with a history of multiple-antibiotic use.

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

PubMed

Taylor, Rosemary A; Taylor, Steven S

2018-06-27

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

32 CFR 281.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... matters concerning the Air Force. The Secretary of Homeland Security, addressing matters concerning the... 32 National Defense 2 2010-07-01 2010-07-01 false Definitions. 281.3 Section 281.3 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS...

32 CFR 281.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... matters concerning the Air Force. The Secretary of Homeland Security, addressing matters concerning the... 32 National Defense 2 2014-07-01 2014-07-01 false Definitions. 281.3 Section 281.3 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS...

Women and Disabilities: A National Forum.

ERIC Educational Resources Information Center

Boyle, Gail; And Others

1988-01-01

The paper reports on a June, 1988, Canadian forum concerned with oppression of disabled women, especially women with mental handicaps. Specifically addressed were issues concerning employment, education, reproductive rights, violence against women, sexuality, motherhood, participation in the women's movement, and inclusion in research and policy…

An approach to mental health in low and middle income countries: a case example from urban India

PubMed Central

Maitra, Shubhada; Brault, Marie A.; Schensul, Stephen L.; Schensul, Jean J.; Nastasi, Bonnie K.; Verma, Ravi K.; Burleson, Joseph A.

2015-01-01

Women in low and middle income countries (LMICs) facing poverty, challenging living conditions and gender inequality often express their emotional difficulties through physical health concerns and seek care at primary health facilities. However, primary care providers in LMICs only treat the physical health symptoms and lack appropriate services to address women's mental health problems. This paper, presents data from the counseling component of a multilevel, research and intervention project in a low income community in Mumbai, India whose objective was to improve sexual health and reduce HIV/STI risk among married women. Qualitative data from counselor notes shows that poor mental health, associated with negative and challenging life situations, is most often expressed by women as gynecological concerns through the culturally-based syndrome of tenshun. A path analysis was conducted on baseline quantitative data that confirmed the relationships between sources of tenshum, emotional status and symptoms of common mental disorders (CMDs). Based on these findings, the authors propose a need for culturally appropriate primary care services for LMICs that would integrate mental and physical health. This approach would reduce mental health morbidity among women through early intervention and prevention of the development of CMDs. PMID:26834278

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.

Religion in Organized Medicine: The AMA's Committee and Department of Medicine and Religion, 1961-1974.

PubMed

Kim, Daniel; Curlin, Farr; Wolenberg, Kelly; Sulmasy, Daniel

2014-01-01

The history commonly told of the relationship between modern medicine and religion is one of steady, even inevitable, separation rooted in the Enlightenment. The divorce between medicine and religion, it is thought, had become nearly total before a recent surge of interest in the spiritual and religious dimensions of health care. This narrative, however, misjudges a persistent sense of spiritual need in illness that medical practice, even today, is unable to entirely ignore. Relying on primary sources, we recount here the little known story of the rise and fall of the Committee on Medicine and Religion and the Department of Medicine and Religion at the American Medical Association between 1961 and 1974. Arising in a context of a widely perceived dehumanization of care and the emergence of new ethical dilemmas at the bedside--concerns with significant parallels today--the initiative garnered striking physician enthusiasm and achieved dramatic successes nationally before coming to a puzzling end in 1972. We argue that its demise was linked to the AMA's contentious internal debate on abortion, and conclude with a note of caution regarding the status of normative concerns in medicine's ongoing efforts to address the spiritual and religious dimensions of its practices.

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

Peters, J.; Glucksberg, N.; Fogg, A.

During the site closure of nuclear facilities where both radionuclides and chemicals are present in environmental media, state and federal regulatory agencies other than the Nuclear Regulatory Commission often have a stake in the regulation of the site closure process. At the Connecticut Yankee Atomic Power Company (CYAPCO) Haddam Neck Plant in Haddam, Connecticut, the site closure process includes both radiological and chemical cleanup which is regulated by two separate divisions within the state and two federal agencies. Each of the regulatory agencies has unique closure criteria which pertain to radionuclides and, consequently, there is overlapping and in some casesmore » disparate regulation of radionuclides. Considerable effort has been expended by CYAPCO to find common ground in meeting the site closure requirements for radionuclides required by each of the agencies. This paper discusses the approaches that have been used by CYAPCO to address radionuclide site closure requirements. Significant lessons learned from these approaches include the demonstration that public health cleanup criteria for most radionuclides of concern at nuclear power generation facilities are protective for chemical toxicity concerns and are protective for ecological receptors and, consequently, performing a baseline ecological risk assessment for radionuclides at power generation facilities is not generally necessary. (authors)« less

[Assessment of 10 years of memory consultations in the Franche-Comté: Description and analysis of the RAPID regional database].

PubMed

Bereau, M; Sylvestre, G; Mauny, F; Puyraveau, M; Baudier, F; Magnin, E; Berger, E; Vandel, P; Galmiche, J; Chopard, G

2015-09-01

The aim of this study was to evaluate the impact, on a regional scale (Franche-Comté), of 3 National Alzheimer care plans, particularly concerning the development of the offer of care management by clinicians as well as the panel of diagnoses concerned. Data on sociodemographic, neuropsychological and diagnostic characteristics were retrieved from the RAPID regional database between 1st January 2003 and 31st December 2012. These analyses focused exclusively on patients who had an initial consultation (n=12,017) during the same period. The existence of a previously established health network capable of carrying out governmental health plans has produced an effective interface between regional administrative structures responsible for the implementation of these plans and health professionals responsible for carrying out them out. This network study, the use of a battery of tests and a common software database have enabled the development of patient care management throughout the Franche-Comté region. It also showed the diversification of diagnoses mentioned over the past years as well as changes in clinical practices on how to address the issue of cognitive impairment. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

A study of dielectric breakdown along insulators surrounding conductors in liquid argon

DOE PAGES

Lockwitz, Sarah; Jostlein, Hans

2016-03-22

High voltage breakdown in liquid argon is an important concern in the design of liquid argon time projection chambers, which are often used as neutrino and dark matter detectors. We have made systematic measurements of breakdown voltages in liquid argon along insulators surrounding negative rod electrodes where the breakdown is initiated at the anode. The measurements were performed in an open cryostat filled with commercial grade liquid argon exposed to air, and not the ultra-pure argon required for electron drift. While not addressing all high voltage concerns in liquid argon, these measurements have direct relevance to the design of highmore » voltage feedthroughs especially for averting the common problem of flash-over breakdown. The purpose of these tests is to understand the effects of materials, of breakdown path length, and of surface topology for this geometry and setup. We have found that the only material-specific effects are those due to their permittivity. We have found that the breakdown voltage has no dependence on the length of the exposed insulator. Lastly, a model for the breakdown mechanism is presented that can help inform future designs.« less

Parents' information needs, self-efficacy and influences on consulting for childhood respiratory tract infections: a qualitative study.

PubMed

Ingram, Jenny; Cabral, Christie; Hay, Alastair D; Lucas, Patricia J; Horwood, Jeremy

2013-07-28

Acute respiratory tract infection (RTI) is the most common reason why parents consult primary care in the UK. Little is known about parents' perceptions of what may help them to make an appropriate decision to consult when their child is ill and how to improve self-care.Using qualitative methods, this study aimed to explore parents' views on support and information needs prior to consulting when children have RTIs with cough, and identify the triggers and barriers to consulting primary care. 7 focus groups and 30 semi-structured interviews were held with 60 parents (with children aged 5 months - 17 years) from a range of socio-economic backgrounds. Topics discussed were informed by the Health Belief Model, and explored parents' concerns and beliefs about susceptibility and severity of RTIs, beliefs about the triggers and barriers to consulting, and information and support seeking behaviour undertaken before consulting primary care. Discussions were audio-recorded, transcribed and analysed using thematic methods. Parents from all socio-economic backgrounds sought information from a wide range of sources about RTIs in children in order to identify which of their child's symptoms should be of concern and trigger a visit to the doctor. The perception of threat to a child of RTI (with cough) was increased with more severe illness and by perceived susceptibility to illness of a particular child; whilst experience with other children increased parental efficacy to cope with childhood cough at home. Psychological models of health behaviour informed the understanding of cultural beliefs and attitudes that underpin health related behaviours. A wide range of perceptions influence the likelihood that parents will seek help from primary care for a child with cough; these perceptions are similar across socio-economic groups. Parents' experience, confidence and efficacy influence the likelihood of consulting primary care for their child's RTI. Parents would value consistent advice from a trusted source that addresses common concerns and supports home care and decision making about help seeking.

Measuring transplant center performance: The goals are not controversial but the methods and consequences can be.

PubMed

Jay, Colleen; Schold, Jesse D

2017-03-01

Risks of regulatory scrutiny has generated widespread concern about increasingly risk averse transplant center behaviors regarding both donor and candidate acceptance patterns. To address potential unintended consequences threatening access to care, we discuss recent changes in regulatory metrics and potential improvements in quality oversight of transplant centers. Despite many recent changes to one-year patient and graft survival regulatory criteria, the capacity to accurately identify true underperforming centers and avoiding false positive flagging remains an area of great concern. Numerous studies have demonstrated restrictions in transplant volume and access following transplant center flagging. Current regulatory criteria are limited in their capacity to accurately identify poorly performing centers and potentially encourage risk-averse behavior by transplant centers. Efforts to address these concerns should focus on (1) improving risk-adjustment models with better data which captures the acuity of candidate and donor risk, (2) reconsidering primary outcomes measured to assess comprehensive transplant center performance, (3) improving education to address rational or perceived disincentives, and (4) using data more effectively to share best practices.

Home delivery of medication - the role of a patient information leaflet on maximising service uptake.

PubMed

Watson, L; Ahmed, N; Mccall, H; Minton, J; Benn, P; Edwards, S; Waters, L

2014-12-01

There are currently over 30,000 HIV-positive individuals in London and over 25,000 on anti-retroviral therapy. In 2009/2010, this equated to £170m spent by London's NHS on anti-retroviral drugs. Ways employed to reduce this cost include standardising the drugs patients are on and delivering medication to patients at home. Home delivery (HD) medication is exempt from value-added tax. The savings made from 10 patients using the home delivery service would free up resources to provide anti-retroviral therapy to one further patient. Studies have shown that concerns surrounding potential breaches of confidentiality are a potential barrier to some people using the home delivery service. In order to challenge these concerns, a leaflet was devised highlighting the major benefits to both the patient and the NHS of home delivery and addressing concerns over confidentiality. The leaflet was handed out to patients at the Mortimer Market Centre who were currently on anti-retroviral medication but not on home delivery. They were asked to complete a survey on their views of the service before and after reading the leaflet, whether they had been previously aware of the service and whether their concerns had been addressed. Some 79% felt that the patient information leaflet addressed all of their concerns, and it helped 11% decide whether to consider using home delivery. However, as more patients were opposed to the service after reading the patient information leaflet than those considering it, more work needs to be done to explore patients' concerns and other factors influencing home delivery service uptake. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Young Children's Response Tendencies toward Yes-No Questions Concerning Actions

ERIC Educational Resources Information Center

Fritzley, V. Heather; Lindsay, Rod C. L.; Lee, Kang

2013-01-01

Two experiments investigated response tendencies of preschoolers toward yes-no questions about actions. Two hundred 2- to 5-year-old children were asked questions concerning actions commonly associated with particular objects (e.g., drinking from a cup) and actions not commonly associated with particular objects (e.g., kicking a toothbrush). The…

Educational Choice. A Background Paper.

ERIC Educational Resources Information Center

Quality Education for Minorities Network, Washington, DC.

This paper addresses school choice, one proposal to address parental involvement concerns, focusing on historical background, definitions, rationale for advocating choice, implementation strategies, and implications for minorities and low-income families. In the past, transfer payment programs such as tuition tax credits and vouchers were…

Parenting--Challenge and Commitment

ERIC Educational Resources Information Center

Luckey, Eleanore Braun

1973-01-01

This is a revised version of the National Council on Family Relations Presidential address delivered November 3, 1972, Portland Oregon. This address concerned the new constitution and reorganization of N.C.F.R. and a plea for reexamination of the membership's commitment to family issues. (JC)

Service learning, social justice, and campus health.

PubMed

Ottenritter, Nan W

2004-01-01

Healthy campuses are critical so that students can learn and actively participate in shaping and maintaining a strong educational environment. This Viewpoint describes the commonalities between service learning, social justice, campus health, and the goals of Healthy Campus 2010, which was developed from the larger Healthy People 2010 objectives proposed by the US Department of Health and Human Services. The values, methods, and intended results of service learning are closely related to effective health promotion and disease prevention. Service learning focuses on personal and civic responsibility, thus providing students with opportunities for enhancing individual and community health. Service learning also espouses social justice and provides a vehicle for students to learn about, reflect on, and address health disparities. The author cites research concerning the effect of service learning on students in institutions of higher education and their social justice-related behaviors.

Supporting safe driving with arthritis: developing a driving toolkit for clinical practice and consumer use.

PubMed

Vrkljan, Brenda H; Cranney, Ann; Worswick, Julia; O'Donnell, Siobhan; Li, Linda C; Gélinas, Isabelle; Byszewski, Anna; Man-Son-Hing, Malcolm; Marshall, Shawn

2010-01-01

We conducted a series of focus groups to explore the information needs of clinicians and consumers related to arthritis and driving. An open coding analysis identified common themes across both consumer and clinician-based focus groups that underscored the importance of addressing driving-related concerns and the challenges associated with assessing safety. The results revealed that although driving is critical for maintaining independence and community mobility, drivers with arthritis experience several problems that can affect safe operation of a motor vehicle. Findings from this study are part of a broader research initiative that will inform the development of the Arthritis and Driving toolkit. This toolkit outlines strategies to support safe mobility for people with arthritis and will be an important resource in the coming years given the aging population.

Making meaning of Alcoholics Anonymous for social workers: myths, metaphors, and realities.

PubMed

Davis, D R; Jansen, G G

1998-03-01

Alcoholics Anonymous (AA), the increasingly popular mutual-help program for alcoholics, is often criticized for being just another substitute addiction, emphasizing "powerlessness" to already disenfranchised groups, being a religion or cult, adhering to a medical model of disease instead of a strengths perspective, and other such areas of concern to social workers. Many of these interpretations are based on viewing AA as an alternative treatment model or a rational service delivery model. This article addresses common critiques of AA by offering a way of understanding it as a "normative narrative community," where identity transformation takes place through the use of metaphor and storytelling. The article suggests alternative meanings of key metaphors, such as "powerlessness," describes areas of program strength and potential barriers for social workers, and reviews current research on AA effectiveness.

Evolutionary rescue: linking theory for conservation and medicine.

PubMed

Alexander, Helen K; Martin, Guillaume; Martin, Oliver Y; Bonhoeffer, Sebastian

2014-12-01

Evolutionary responses that rescue populations from extinction when drastic environmental changes occur can be friend or foe. The field of conservation biology is concerned with the survival of species in deteriorating global habitats. In medicine, in contrast, infected patients are treated with chemotherapeutic interventions, but drug resistance can compromise eradication of pathogens. These contrasting biological systems and goals have created two quite separate research communities, despite addressing the same central question of whether populations will decline to extinction or be rescued through evolution. We argue that closer integration of the two fields, especially of theoretical understanding, would yield new insights and accelerate progress on these applied problems. Here, we overview and link mathematical modelling approaches in these fields, suggest specific areas with potential for fruitful exchange, and discuss common ideas and issues for empirical testing and prediction.

Reflections concerning triply-periodic minimal surfaces.

PubMed

Schoen, Alan H

2012-10-06

In recent decades, there has been an explosion in the number and variety of embedded triply-periodic minimal surfaces (TPMS) identified by mathematicians and materials scientists. Only the rare examples of low genus, however, are commonly invoked as shape templates in scientific applications. Exact analytic solutions are now known for many of the low genus examples. The more complex surfaces are readily defined with numerical tools such as Surface Evolver software or the Landau-Ginzburg model. Even though table-top versions of several TPMS have been placed within easy reach by rapid prototyping methods, the inherent complexity of many of these surfaces makes it challenging to grasp their structure. The problem of distinguishing TPMS, which is now acute because of the proliferation of examples, has been addressed by Lord & Mackay (Lord & Mackay 2003 Curr. Sci. 85, 346-362).

Feminist and community psychology ethics in research with homeless women.

PubMed

Paradis, E K

2000-12-01

This paper presents a feminist and community psychology analysis of ethical concerns that can arise throughout the process of doing research with women who are homeless. The unique contexts of the lives of women who are homeless demand that researchers redefine traditional ethical constructs such as consent, privacy, harm, and bias. Research that fails to do this may perpetuate the stereotyping, marginalization, stigmatization, and victimization homeless women face. Feminist and community research ethics must go beyond the avoidance of harm to an active investment in the well-being of marginalized individuals and communities. Using feminist and community psychology ethics, this paper addresses some common problems in research with women who are homeless, and argues for the transformation of research from a tool for the advancement of science into a strategy for the empowerment of homeless women and their communities.

Bio-geomorphology and resilience thinking: Common ground and challenges

NASA Astrophysics Data System (ADS)

Thoms, Martin C.; Meitzen, Kimberly M.; Julian, Jason P.; Butler, David R.

2018-03-01

Geomorphology plays a fundamental role in shaping and maintaining landscapes, as well as influencing the social and ecological systems that occupy and utilize these landscapes. In turn, social-ecological systems can have a profound influence on geomorphic forms and processes. These interactions highlight the tightly coupled nature of geomorphic systems. Over the past decade, there has been a proliferation of research at the interface of geomorphology and resilience thinking, and the 2017 Binghamton Symposium brought together leading researchers from both communities to address mutual concerns and challenges of these two disciplines. This paper reviews some of the key intersections between the disciplines of bio-geomorphology and resilience thinking, and the papers presented at the symposium. The papers in this volume illustrate the current status of the disciplines, the difficulties in bridging the disciplines, and the issues that are emerging as research priorities.

Diversity and the Civic Spirit in British Neighbourhoods: An Investigation with MCDS and EMBES 2010 Data

PubMed Central

Heath, Anthony

2014-01-01

Recently, there has been a proliferation of studies investigating the relationship between diversity and outcomes such as social cohesion and civic mindedness. This article addresses several common problems in this field and, using data for British neighbourhoods, elaborates on the experiences of both white British and ethnic minority respondents. We conclude that, if anything, diversity should be encouraged to cement the integration progress of migrants and foster stronger identification with Britain in the second generation. Deprivation at the neighbourhood level along with individual factors such as fear of crime is a much stronger predictor of deterioration of the civic spirit than diversity. Bridging contacts have the expected strong positive association with cohesion outcomes; and contrary to policy concerns no strong negative impact is observed for associational bonding among minority ingroupers. PMID:25544783

Methods for exploring uncertainty in groundwater management predictions

USGS Publications Warehouse

Guillaume, Joseph H. A.; Hunt, Randall J.; Comunian, Alessandro; Fu, Baihua; Blakers, Rachel S; Jakeman, Anthony J.; Barreteau, Olivier; Hunt, Randall J.; Rinaudo, Jean-Daniel; Ross, Andrew

2016-01-01

Models of groundwater systems help to integrate knowledge about the natural and human system covering different spatial and temporal scales, often from multiple disciplines, in order to address a range of issues of concern to various stakeholders. A model is simply a tool to express what we think we know. Uncertainty, due to lack of knowledge or natural variability, means that there are always alternative models that may need to be considered. This chapter provides an overview of uncertainty in models and in the definition of a problem to model, highlights approaches to communicating and using predictions of uncertain outcomes and summarises commonly used methods to explore uncertainty in groundwater management predictions. It is intended to raise awareness of how alternative models and hence uncertainty can be explored in order to facilitate the integration of these techniques with groundwater management.

Addressing the psychosocial wellbeing of teenage children of cancer patients and survivors.

PubMed

Annunziata, Maria Antonietta; Muzzatti, Barbara; Surbone, Antonella

2016-02-01

Thomas is 13 years old. His parents report a sharp decline in his school grades caused, according to his teachers' opinions, by listlessness and lack of concentration. The parents of Julia, 16 years old, describe her as restless, evasive, isolated, and withdrawn from others and from her usual activities. Linda, 18 years old, is described by her parents as indecisive, uncertain, and almost lethargic. Normally resolute and a high academic achiever, she appears locked in herself, unable to make choices. We first learned about them through the accounts of their concerned parents. Claire, 19 years old, lost weight and exercised hard enough to induce amenorrhea after her young mother underwent treatment for breast cancer, including antihormonal treatment. These four teenagers have in common a parent diagnosed with cancer, undergoing or having just completed treatment.

Environmental regulation of plant gene expression: an RT-qPCR laboratory project for an upper-level undergraduate biochemistry or molecular biology course.

PubMed

Eickelberg, Garrett J; Fisher, Alison J

2013-01-01

We present a novel laboratory project employing "real-time" RT-qPCR to measure the effect of environment on the expression of the FLOWERING LOCUS C gene, a key regulator of floral timing in Arabidopsis thaliana plants. The project requires four 3-hr laboratory sessions and is aimed at upper-level undergraduate students in biochemistry or molecular biology courses. The project provides students with hands-on experience with RT-qPCR, the current "gold standard" for gene expression analysis, including detailed data analysis using the common 2-ΔΔCT method. Moreover, it provides a convenient starting point for many inquiry-driven projects addressing diverse questions concerning ecological biochemistry, naturally occurring genetic variation, developmental biology, and the regulation of gene expression in nature. Copyright © 2013 Wiley Periodicals, Inc.

Management of Vaginal Atrophy: Implications from the REVIVE Survey

PubMed Central

Wysocki, Susan; Kingsberg, Sheryl; Krychman, Michael

2014-01-01

Vulvar and vaginal atrophy (VVA) is a chronic and progressive medical condition common in postmenopausal women. Symptoms of VVA such as dyspareunia, vaginal dryness, irritation, and itching can negatively impact sexual function and quality of life. The REVIVE (REal Women’s VIews of Treatment Options for Menopausal Vaginal ChangEs) survey assessed knowledge about VVA and recorded attitudes about interactions with healthcare providers (HCPs) and available treatment options for VVA. The REVIVE survey identified unmet needs of women with VVA symptoms such as poor understanding of the condition, poor communication with HCPs despite the presence of vaginal symptoms, and concerns about the safety, convenience, and efficacy of available VVA treatments. HCPs can address these unmet needs by proactively identifying patients with VVA and educating them about the condition as well as discussing treatment preferences and available therapies for VVA. PMID:24987271

Management of Vaginal Atrophy: Implications from the REVIVE Survey.

PubMed

Wysocki, Susan; Kingsberg, Sheryl; Krychman, Michael

2014-01-01

Vulvar and vaginal atrophy (VVA) is a chronic and progressive medical condition common in postmenopausal women. Symptoms of VVA such as dyspareunia, vaginal dryness, irritation, and itching can negatively impact sexual function and quality of life. The REVIVE (REal Women's VIews of Treatment Options for Menopausal Vaginal ChangEs) survey assessed knowledge about VVA and recorded attitudes about interactions with healthcare providers (HCPs) and available treatment options for VVA. The REVIVE survey identified unmet needs of women with VVA symptoms such as poor understanding of the condition, poor communication with HCPs despite the presence of vaginal symptoms, and concerns about the safety, convenience, and efficacy of available VVA treatments. HCPs can address these unmet needs by proactively identifying patients with VVA and educating them about the condition as well as discussing treatment preferences and available therapies for VVA.

"Before the war we had it all": Family planning among couples in a post-conflict setting.

PubMed

Warren, Nicole; Alvarez, Carmen; Makambo, Maphie Tosha; Johnson-Agbakwu, Crista; Glass, Nancy

2017-08-01

There is little evidence about family planning knowledge, attitudes, and use among couples in post-conflict Democratic Republic of the Congo. We used qualitative descriptions to analyze data from 75 participants. Intimate partner violence (IPV) was common among participants. They were aware of family planning methods; however, IPV and fears of side effects were barriers to use. Although participants were concerned about the cost of large families, had positive attitudes toward family planning, and intended to use it, actual use was uncommon. The need for family planning was acute because of war-related poverty. Couples negotiated, but men had strong influence over family planning decisions. Couples saw health workers as a valuable resource. Interventions in this setting should include a couple-based approach that addresses IPV as well as family planning content.

Reflections concerning triply-periodic minimal surfaces

PubMed Central

Schoen, Alan H.

2012-01-01

In recent decades, there has been an explosion in the number and variety of embedded triply-periodic minimal surfaces (TPMS) identified by mathematicians and materials scientists. Only the rare examples of low genus, however, are commonly invoked as shape templates in scientific applications. Exact analytic solutions are now known for many of the low genus examples. The more complex surfaces are readily defined with numerical tools such as Surface Evolver software or the Landau–Ginzburg model. Even though table-top versions of several TPMS have been placed within easy reach by rapid prototyping methods, the inherent complexity of many of these surfaces makes it challenging to grasp their structure. The problem of distinguishing TPMS, which is now acute because of the proliferation of examples, has been addressed by Lord & Mackay (Lord & Mackay 2003 Curr. Sci. 85, 346–362). PMID:24098851

Improving Photometric Calibration of Meteor Video Camera Systems

NASA Technical Reports Server (NTRS)

Ehlert, Steven; Kingery, Aaron; Cooke, William

2016-01-01

Current optical observations of meteors are commonly limited by systematic uncertainties in photometric calibration at the level of approximately 0.5 mag or higher. Future improvements to meteor ablation models, luminous efficiency models, or emission spectra will hinge on new camera systems and techniques that significantly reduce calibration uncertainties and can reliably perform absolute photometric measurements of meteors. In this talk we discuss the algorithms and tests that NASA's Meteoroid Environment Office (MEO) has developed to better calibrate photometric measurements for the existing All-Sky and Wide-Field video camera networks as well as for a newly deployed four-camera system for measuring meteor colors in Johnson-Cousins BV RI filters. In particular we will emphasize how the MEO has been able to address two long-standing concerns with the traditional procedure, discussed in more detail below.

Shared decision-making in epilepsy management.

PubMed

Pickrell, W O; Elwyn, G; Smith, P E M

2015-06-01

Policy makers, clinicians, and patients increasingly recognize the need for greater patient involvement in clinical decision-making. Shared decision-making helps address these concerns by providing a framework for clinicians and patients to make decisions together using the best evidence. Shared decision-making is applicable to situations where several acceptable options exist (clinical equipoise). Such situations occur commonly in epilepsy, for example, in decisions regarding the choice of medication, treatment in pregnancy, and medication withdrawal. A talk model is a way of implementing shared decision-making during consultations, and decision aids are useful tools to assist in the process. Although there is limited evidence available for shared decision-making in epilepsy, there are several benefits of shared decision-making in general including improved decision quality, more informed choices, and better treatment concordance. Copyright © 2015 Elsevier Inc. All rights reserved.

Medico-legal perspectives on sudden cardiac death in young athletes.

PubMed

Oliva, Antonio; Grassi, Vincenzo M; Campuzano, Oscar; Brion, Maria; Arena, Vincenzo; Partemi, Sara; Coll, Monica; Pascali, Vincenzo L; Brugada, Josep; Carracedo, Angel; Brugada, Ramon

2017-03-01

Sudden cardiac death (SCD) in a young athlete represents a dramatic event, and an increasing number of medico-legal cases have addressed this topic. In addition to representing an ethical and medico-legal responsibility, prevention of SCD is directly correlated with accurate eligibility/disqualification decisions, with an inappropriate pronouncement in either direction potentially leading to legal controversy. This review summarizes the common causes of SCD in young athletes, divided into structural (hypertrophic cardiomyopathy, arrhythmogenic cardiomyopathy, congenital coronary artery anomalies, etc.), electrical (Brugada, congenital LQT, Wolf-Parkinson-White syndrome, etc.), and acquired cardiac abnormalities (myocarditis, etc.). In addition, the roles of hereditary cardiac anomalies in SCD in athletes and the effects of a positive result on them and their families are discussed. The medico-legal relevance of pre-participation screening is analyzed, and recommendations from the American Heart Association and European Society of Cardiology are compared. Finally, the main issues concerning the differentiation between physiologic cardiac adaptation in athletes and pathologic findings and, thereby, definition of the so-called gray zone, which is based on exact knowledge of the mechanism of cardiac remodeling including structural or functional adaptions, will be addressed.

Conservation of native Pacific trout diversity in western North America

USGS Publications Warehouse

Penaluna, Brooke E.; Abadía-Cardoso, Alicia; Dunham, Jason B.; García de León, Francisco J; Gresswell, Robert E.; Luna, Arturo Ruiz; Taylor, Eric B.; Shepard, Bradley B.; Al-Chokhachy, Robert K.; Muhlfeld, Clint C.; Bestgen, Kevin R.; Rogers, Kevin H.; Escalante, Marco A; Keeley, Ernest R; Temple, Gabriel; Williams, Jack E.; Matthews, Kathleen; Pierce, Ron; Mayden, Richard L.; Kovach, Ryan; Garza, John Carlos; Fausch, Kurt D.

2016-01-01

Pacific trout Oncorhynchus spp. in western North America are strongly valued in ecological, socioeconomic, and cultural views, and have been the subject of substantial research and conservation efforts. Despite this, the understanding of their evolutionary histories, overall diversity, and challenges to their conservation is incomplete. We review the state of knowledge on these important issues, focusing on Pacific trout in the genus Oncorhynchus. Although most research on salmonid fishes emphasizes Pacific salmon, we focus on Pacific trout because they share a common evolutionary history, and many taxa in western North America have not been formally described, particularly in the southern extent of their ranges. Research in recent decades has led to the revision of many hypotheses concerning the origin and diversification of Pacific trout throughout their range. Although there has been significant success at addressing past threats to Pacific trout, contemporary and future threats represented by nonnative species, land and water use activities, and climate change pose challenges and uncertainties. Ultimately, conservation of Pacific trout depends on how well these issues are understood and addressed, and on solutions that allow these species to coexist with a growing scope of human influences.

Ethical conflict resolution based on an ethics of relationships for brain injury rehabilitation.

PubMed

Malec, J F

1996-11-01

An ethics of relationships for brain injury (BI) rehabilitation is described based on three principles; (1) human relationships are important; (2) human relationships are as important as individual survival; (3) human relationships are important enough to extend throughout the family of humankind. Within the context of this ethics of relationships, ethical conflict resolution (ECR) is offered as a process to address disagreements among those involved in BI rehabilitation. ECR provides a means to arrive at moral decisions in situations in which people disagree about the appropriate course of action because of differing values. ECR recognizes that, although disagreements in BI rehabilitation settings can be associated with multiple other factors, including disturbed self-awareness, emotions, communication, and interpersonal dynamics, such disagreements may also be value-based, either in whole or part. ECR invites the professional team to identify the value-based portion of these disagreements and provides a rational and supportive process to address disagreements. In this discussion of ECR, common and potentially universal areas of ethical concern in BI rehabilitation are identified, as well as potential risks. Specific examples of the application of ECR in cases of vegetative state, coma stimulation, and cognitive rehabilitation are described.

On power and empowerment.

PubMed

Pratto, Felicia

2016-03-01

This study presents a conceptual analysis of social power. The most common theories of power are social-relational, an approach instantiated in a range of contemporary experiments that give participants the chance to control other people's outcomes. The relational approach is also reflected in various analyses of international relations. In comparing and contrasting relational theories of power, I identify logical inconsistencies and shortcomings in their ability to address empowerment and reductions in inequality. In turn, I propose a new ecological conceptualization of empowerment as the state of being able to achieve one's goals and of power as stemming from a combination of the capacity of the party and the affordances of the environment. I explain how this new conceptualization can describe the main kinds of power social relations, avoid logical contradictions, and moreover, distinguish power from agency and from control. This new conceptualization of power as the possibility of meeting goals, coupled with recognizing survival as the fundamental goal of all living things, implies an absolute and not relative or relational standard for power, namely well-being. It also allows us to conceive of power in ways that help address the many social concerns that have motivated research on power. © 2015 The British Psychological Society.

Perspectives on Breast Health Education and Services Among Recent Hispanic Immigrant Women in the Midwest: a Qualitative Study in Lancaster County, Nebraska.

PubMed

Ramos, Athena K; Correa, Antonia; Trinidad, Natalia

2016-12-01

Breast cancer is the most common cause of cancer death among Hispanic women in the USA. Throughout the country, Hispanic immigrants face many barriers to achieving optimal breast health. Three focus groups were conducted to explore challenges and opportunities in access to breast health services and information among recent Hispanic immigrant women in Lancaster Country, Nebraska. Respondents perceived breast cancer as a serious issue and were concerned about it, but there were few cues to action to improve health given the limited information and access to services available to low-income Spanish-speaking individuals in the community. Results highlighted the need for culturally and linguistically appropriate health education and services, accessibility and promotion of low-cost screening and treatment services, and inclusive policies to promote preventative healthcare services for all women regardless of immigration status. Health is more than just clinical care, and therefore, it is important to understand the contextual and cultural factors that have resulted in low screening rates and develop methods to address these them. Failure to address these aspects of social determinants of health could hamper efforts to improve breast health and reduce disparities.

Demystifying the Millennial student: a reassessment in measures of character and engagement in professional education.

PubMed

DiLullo, Camille; McGee, Patricia; Kriebel, Richard M

2011-01-01

The characteristic profile of Millennial Generation students, driving many educational reforms, can be challenged by research in a number of fields including cognition, learning style, neurology, and psychology. This evidence suggests that the current aggregate view of the Millennial student may be less than accurate. Statistics show that Millennial students are considerably diverse in backgrounds, personalities, and learning styles. Data are presented regarding technological predilection, multitasking, reading, critical thinking, professional behaviors, and learning styles, which indicate that students in the Millennial Generation may not be as homogenous in fundamental learning strategies and attitudes as is regularly proposed. Although their common character traits have implications for instruction, no available evidence demonstrates that these traits impact their fundamental process of learning. Many curricular strategies have been implemented to address alleged changes in the manner by which Millennial students learn. None has clearly shown superior outcomes in academic accomplishments or developing expertise for graduating students and concerns persist related to the successful engagement of Millennial students in the process of learning. Four factors for consideration in general curricular design are proposed to address student engagement and optimal knowledge acquisition for 21st century learners. Copyright © 2011 American Association of Anatomists.

A Multi-Technology Communication Platform for Urban Mobile Sensing.

PubMed

Almeida, Rodrigo; Oliveira, Rui; Luís, Miguel; Senna, Carlos; Sargento, Susana

2018-04-12

A common concern in smart cities is the focus on sensing procedures to provide city-wide information to city managers and citizens. To meet the growing demands of smart cities, the network must provide the ability to handle a large number of mobile sensors/devices, with high heterogeneity and unpredictable mobility, by collecting and delivering the sensed information for future treatment. This work proposes a multi-wireless technology communication platform for opportunistic data gathering and data exchange with respect to smart cities. Through the implementation of a proprietary long-range (LoRa) network and an urban sensor network, our platform addresses the heterogeneity of Internet of Things (IoT) devices while conferring communications in an opportunistic manner, increasing the interoperability of our platform. It implements and evaluates a medium access communication (MAC) protocol for LoRa networks with multiple gateways. It also implements mobile Opportunistic VEhicular (mOVE), a delay-tolerant network (DTN)-based architecture to address the mobility dimension. The platform provides vehicle-to-everything (V2X) communication with support for highly reliable and actionable information flows. Moreover, taking into account the high mobility pattern that a smart city scenario presents, we propose and evaluate two forwarding strategies for the opportunistic sensor network.

Ethical concerns in nurse migration.

PubMed

McElmurry, Beverly J; Solheim, Karen; Kishi, Rieko; Coffia, Marcia A; Woith, Wendy; Janepanish, Poolsuk

2006-01-01

International nurse migration is natural and to be expected. Recently, however, those who have fostered nurse migration believe that it will solve nursing shortages in developed countries and offer nurse migrants better working conditions and an improved quality of life. Whether natural or manipulated, migration flow patterns largely occur from developing to developed countries. In this article, nurse migration is examined using primary health care (PHC) as an ethical framework. The unmanaged flow of nurse migrants from developing to developed countries is inconsistent with "health for all" principles. Removing key health personnel from countries experiencing resource shortages is contrary to PHC equity. Often, nurse migrants are placed in vulnerable, inequitable work roles, and employing nurse migrants fails to address basic causes of nurse shortages in developed countries, such as dissatisfaction with work conditions and decreased funding for academic settings. Nurse migration policies and procedures can be developed to satisfy PHC ethics criteria if they (1) leave developing countries enhanced rather than depleted, (2) contribute to country health outcomes consistent with essential care for all people, (3) are based on community participation, (4) address common nursing labor issues, and (5) involve equitable and clear financial arrangements.

Properties of acetylene

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

Pavlovcak, J.T.

1994-12-31

Acetylene continues to be the most widely used fuel in the oxyfuel cutting and welding industry. It displays properties that enhance its benefits to the industry, but at the same time, present potential hazards that have to be addressed. The presentation explores the main properties or characteristics of acetylene -- odor, toxicity, flammability, composition, and manufacture. it expands on those properties that are unique to acetylene and which account for its main value to the user or which constitute the chief concern for safe use of acetylene. The presentation explains characteristics such as anosmia, flammable or explosive range, ignition energy,more » autoignition temperature, and flame temperature, comparing these values for acetylene to other common gaseous fuels. it explains the unique property of acetylene to decompose explosively in the absence of air or oxygen. The toxicological aspects of acetylene is discussed, including anesthetic effect and simple asphyxiant, showing the increasing severity of symptoms to increasing levels of oxygen deficiency. The main value of this basic review of the properties of acetylene is to remind people of the benefits of acetylene due to its unique properties, and to realert them to the potential hazards that also have to be addressed to control the properties of acetylene.« less

Improving Mental Health Access for Low-Income Children and Families in the Primary Care Setting

PubMed Central

Godoy, Leandra; Beers, Lee Savio; Lewin, Amy

2017-01-01

Poverty is a common experience for many children and families in the United States. Children <18 years old are disproportionately affected by poverty, making up 33% of all people in poverty. Living in a poor or low-income household has been linked to poor health and increased risk for mental health problems in both children and adults that can persist across the life span. Despite their high need for mental health services, children and families living in poverty are least likely to be connected with high-quality mental health care. Pediatric primary care providers are in a unique position to take a leading role in addressing disparities in access to mental health care, because many low-income families come to them first to address mental health concerns. In this report, we discuss the impact of poverty on mental health, barriers to care, and integrated behavioral health care models that show promise in improving access and outcomes for children and families residing in the contexts of poverty. We also offer practice recommendations, relevant to providers in the primary care setting, that can help improve access to mental health care in this population. PMID:27965378

Breathing SPACE-a practical approach to the breathless patient.

PubMed

Hopkinson, Nicholas S; Baxter, Noel

2017-01-30

Breathlessness is a common symptom that may have multiple causes in any one individual and causes that may change over time. Breathlessness campaigns encourage people to see their General Practitioner if they are unduly breathless. Members of the London Respiratory Network collaborated to develop a tool that would encourage a holistic approach to breathlessness, which was applicable both at the time of diagnosis and during ongoing management. This has led to the development of the aide memoire "Breathing SPACE", which encompasses five key themes-smoking, pulmonary disease, anxiety/psychosocial factors, cardiac disease, and exercise/fitness. A particular concern was to ensure that high-value interventions (smoking cessation and exercise interventions) are prioritised across the life-course and throughout the course of disease management. The approach is relevant both to well people and in those with an underling diagnosis or diagnoses. The inclusion of anxiety draws attention to the importance of mental health issues. Parity of esteem requires the physical health problems of people with mental illness to be addressed. The SPACE mnemonic also addresses the problem of underdiagnosis of heart disease in people with lung disease and vice versa, as well as the systematic undertreatment of these conditions where they do co-occur.

Modeling the Impact of School-based Universal Depression Screening on Additional Service Capacity Needs: A System Dynamics Approach

PubMed Central

Lyon, Aaron R.; Maras, Melissa A.; Pate, Christina M.; Igusa, Takeru; Stoep, Ann Vander

2016-01-01

Although it is widely known that the occurrence of depression increases over the course of adolescence, symptoms of mood disorders frequently go undetected. While schools are viable settings for conducting universal screening to systematically identify students in need of services for common health conditions, particularly those that adversely affect school performance, few school districts routinely screen their students for depression. Among the most commonly referenced barriers are concerns that the number of students identified may exceed schools’ service delivery capacities, but few studies have evaluated this concern systematically. System dynamics (SD) modeling may prove a useful approach for answering questions of this sort. The goal of the current paper is therefore to demonstrate how SD modeling can be applied to inform implementation decisions in communities. In our demonstration, we used SD modeling to estimate the additional service demand generated by universal depression screening in a typical high school. We then simulated the effects of implementing “compensatory approaches” designed to address anticipated increases in service need through (1) the allocation of additional staff time and (2) improvements in the effectiveness of mental health interventions. Results support the ability of screening to facilitate more rapid entry into services and suggest that improving the effectiveness of mental health services for students with depression via the implementation of an evidence-based treatment protocol may have a limited impact on overall recovery rates and service availability. In our example, the SD approach proved useful in informing systems’ decision-making about the adoption of a new school mental health service. PMID:25601192

Greater sage-grouse as an umbrella species for sagebrush-associated vertebrates

USGS Publications Warehouse

Rowland, M.M.; Wisdom, M.J.; Suring, L.H.; Meinke, C.W.

2006-01-01

Widespread degradation of the sagebrush ecosystem in the western United States, including the invasion of cheatgrass, has prompted resource managers to consider a variety of approaches to restore and conserve habitats for sagebrush-associated species. One such approach involves the use of greater sage-grouse, a species of prominent conservation interest, as an umbrella species. This shortcut approach assumes that managing habitats to conserve sage-grouse will simultaneously benefit other species of conservation concern. The efficacy of using sage-grouse as an umbrella species for conservation management, however, has not been fully evaluated. We tested that concept by comparing: (1) commonality in land-cover associations, and (2) spatial overlap in habitats between sage-grouse and 39 other sagebrush-associated vertebrate species of conservation concern in the Great Basin ecoregion. Overlap in species' land-cover associations with those of sage-grouse, based on the ?? (phi) correlation coefficient, was substantially greater for sagebrush obligates (x??=0.40) than non-obligates (x??=0.21). Spatial overlap between habitats of target species and those associated with sage-grouse was low (mean ?? = 0.23), but somewhat greater for habitats at high risk of displacement by cheatgrass (mean ?? = 0.33). Based on our criteria, management of sage-grouse habitats likely would offer relatively high conservation coverage for sagebrush obligates such as pygmy rabbit (mean ?? = 0.84), but far less for other species we addressed, such as lark sparrow (mean ?? = 0.09), largely due to lack of commonality in land-cover affinity and geographic ranges of these species and sage-grouse.

Cultural beliefs that may discourage breastfeeding among Lebanese women: a qualitative analysis

PubMed Central

Osman, Hibah; El Zein, Lama; Wick, Livia

2009-01-01

Background Although the health benefits of breastfeeding are well established, early introduction of formula remains a common practice. Cultural beliefs and practices can have an important impact on breastfeeding. This paper describes some common beliefs that may discourage breastfeeding in Lebanon. Methods Participants were healthy first-time mothers recruited from hospitals throughout Lebanon to participate in a study on usage patterns of a telephone hotline for postpartum support. The hotline was available to mothers for the first four months postpartum and patterns of usage, as well as questions asked were recorded. Thematic analysis of the content of questions which referred to cultural beliefs and practices related to breastfeeding was conducted. Results Twenty four percent of the 353 women enrolled in the study called the hotline, and 50% of the calls included questions about breastfeeding. Mothers expressed concern about having adequate amounts of breast milk or the quality of their breast milk. Concerns that the mother could potentially harm her infant though breastfeeding were rooted in a number of cultural beliefs. Having an inherited inability to produce milk, having "bad milk", and transmission of abdominal cramps to infants through breast milk were among the beliefs that were expressed. Although the researchers live and work in Lebanon, they were not aware of many of the beliefs that are reported in this study. Conclusion There are a number of cultural beliefs that could potentially discourage breastfeeding among Lebanese women. Understanding and addressing local beliefs and customs can help clinicians to provide more culturally appropriate counselling about breastfeeding. PMID:19883506

[Intravenous rehydration for diarrheal dehydration of eutrophic children: survey of protocols provided at Colombian medical schools].

PubMed

Flórez, Iván Darío; Ramos, Esteban; Bernal, Carlos; Cuéllar, Olga Juliana; Cornejo, José William

2011-01-01

In all cases of severe dehydration from diarrhea, WHO recommends rapid rehydration. If oral rehydration in children is contraindicated, intravenous rehydration is recommended for immediate administration. However, methods of intravenous rehydration appear to be inadequately addressed in the medical schools of Colombia. Current approaches to oral rehydration were summarized, and instructors were informed concerning current WHO recommendations. A survey was designed for pediatric instructors in Colombian medical schools. Direct questions about rehydration methods were included as well as presentation of theoretical clinical situations with dehydrated children. The survey also asked for the conditions necessary for intravenous rehydration and method of administration (volume, solution, concentration and speed of infusion). Forty-one surveys were included (82% of medical schools in Colombia). Inadequate contraindications for oral rehydration therapy were made in 41%. Rapid and slow intravenous rehydration was recommended in 71% and 29%, respectively; 57% recommended fluid bolus to rehydrate. Adequate volumes were recommended by less than half of the respondents and adequate sodium concentration was recommended by 85%. In 56% of medical schools, glucose was not included in solutions and 66% use Ringer lactate. Normal saline solution, dextrose solution with electrolytes and polyelectrolytes solutions are also used. Misconceptions are common concerning the contraindications to oral rehydration therapy. One-third of medical schools promote a slow therapy despite the superiority of the rapid therapy. Uniformity for rapid therapy schemes is lacking. Bolus rehydration is commonly advocated despite the fact that this method is unsupported by the literature. Concepts about rehydration must be updated in medical schools and a national guide for intravenous rehydration is recommended.

Behavior Analytic Consultation for Academic Referral Concerns

ERIC Educational Resources Information Center

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

2016-01-01

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

Tailoring Software Inspections for Aspect-Oriented Programming

ERIC Educational Resources Information Center

Watkins, Charlette Ward

2009-01-01

Aspect-Oriented Software Development (AOSD) is a new approach that addresses limitations inherent in conventional programming, especially the principle of separation of concerns by emphasizing the encapsulation and modularization of crosscutting concerns through a new abstraction, the "aspect." Aspect-oriented programming is an emerging AOSD…

Adolescent Social Issues: Using Media to Address Crucial Concerns.

ERIC Educational Resources Information Center

Sokoloff, Michele

1987-01-01

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

Psychological Approaches to Problems of Children and Adolescents.

ERIC Educational Resources Information Center

Grimes, Jeff, Ed.

This document, intended as a resource for school psychologists, contains articles addressing a variety of psychological and behavioral problems of children and adolescents. Each chapter includes the following content: background information concerning the specific topic, approaches for assessing the behavior of concern, intervention possibilities,…

[DSM-5: important changes in the field of addictive diseases].

PubMed

Heinz, A; Friedel, E

2014-05-01

There are two major changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) concerning the field of addiction. Firstly, the previous distinction between abuse and dependence has been abolished and both disorders are now subsumed under the category addiction and related disorders. Secondly, pathological gambling has now been included in the section of addiction with slight changes in diagnostic criteria. Both changes have major implications for the definition and conceptualization of what we call a psychiatric "disease" or "disorder", which have also been addressed in the introductory statement of DSM-5. Concerning the category of abuse that is now part of substance use disorders, there is a concern that a well-defined disorder ("dependence") is now mixed with a less well-defined syndrome ("abuse"). The inclusion of non-substance, behavioral addictions poses the danger of pathologizing a wide range of human behavior in future revisions of the classification. Both concerns are further addressed in this article.

Fitness for duty in the nuclear power industry: A review of technical issues

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

Moore, C.; Barnes, V.; Hauth, J.

This report presents information gathered and analyzed in support of the US Nuclear Regulatory Commission's (NRC's) efforts to develop a rule that will ensure that workers with unescorted access to protected areas of nuclear power plants are fit for duty. This report supplements information previously published in NUREG/CR-5227, Fitness for Duty in the Nuclear Power Industry: A Review of Technical Issues (Barnes et al., 1988). The primary potential fitness-for-duty concern addressed in both of these reports is impairment caused by substance abuse, although other fitness concerns are discussed. This report addresses issues pertaining to workers' use and misuse of alcohol,more » prescription drugs, and over-the-counter drugs as fitness-for-duty concerns; responds to several questions raised by NRC Commissioners; discusses subversion of the chemical testing process and methods of preventing such subversion; and examines concerns about the urinalysis cutoff levels used when testing for marijuana metabolites, amphetamines, and phencyclidine (PCP).« less

OP-8 SOCIAL CONCERNS IN CHILDREN BEING INVESTIGATED FOR CHRONIC INTESTINAL PSEUDO-OBSTRUCTION.

PubMed

J, Brind; E, Bowring; K, Larmour; H, Cronin; L, Barkley; A, Rybak; E, Saliakellis; Kj, Lindley; O, Borrelli; N, Thapar

2015-10-01

Fabricated induced illness (FII) is recognised amongst children presenting with suspected Chronic Intestinal Pseudo-Obstruction (CIPO) (Hyman 2012). We aimed to investigate the presence, nature and potential causes of social concerns in children being referred to our national centre with possible CIPO. All patients accepted into the CIPO diagnostic pathway over 3 years (April 2012-April 2015) were reviewed. Acceptance criteria included all of the following (1) referral from a paediatric gastroenterologist or surgeon suspecting a diagnosis of CIPO, (2) mechanical obstruction of the intestine excluded and 3) reliance on specialised enteral or parenteral feeding. The presence and nature of social concerns were recorded pre- & post-assessment along with associated characteristics pertaining to the referral, family situation as well as child protection. Comparison was made to referrals to the IBD service within the department. Of 78 accepted children (mean 5.2 years, 42F) 57 were diagnosed with CIPO, 53 (4.2yrs 31F) by abnormal antroduodenal manometry (ADM) and 4, unsuitable for ADM, by clinical picture. Of the remaining 21 patients (5.8yrs 12F) with normal ADM, 8 were found to have FII; 4 driven by a parent and 4 by the patient (teenage girls). The remaining 13 patients had non-CIPO diagnoses. Of those with normal ADM 17/21 had social concerns; 10 with formal child protection or FII and 7 with concerns over treatment compliance and ambiguity of symptoms. Of those with CIPO 18/57 had social concerns including 2 formally listed as child protection for neglect/parenting concerns and 1 with possible FII. The remaining CIPO cases had a variety of concerns mainly around ambiguity and reliability of reporting. Comparison with a newly diagnosed IBD cohort (161 patients) during the same period revealed only 7 with social concerns. Recurrent themes in those with social concerns, particularly CIPO, included consumerism, internet and media involvement (Facebook, fundraising and celebrity events), resistance to positive news and pain predominant clinical picture. Social concerns (including safeguarding and child protection) in children thought to have CIPO are prevalent (45%) and approximately 10-fold higher than seen in IBD (4.3%). Although commoner in non-CIPO patients, social concerns are also prevalent in those proven to have CIPO (32%). These concerns should be explored and addressed along with an emerging 'profile' of associated risk factors such as use of multi-media, medical consumerism and a pain predominant clinical picture.

Managing Tomorrow's University.

ERIC Educational Resources Information Center

Michalak, Craig L., Ed.

The issues addressed in this conference report concern budgeting, the resourceful manager, extramural funding, employer-employee interaction, management information systems, and management of the university in the future. Contents include: the keynote address by F. E. Balderston; "University Budgeting in an Era of Scarce Resources," by F. M. Bowen…

Privacy Questions from Practicing School Nurses

ERIC Educational Resources Information Center

Bergren, Martha Dewey

2004-01-01

This Question and Answer (Q&A) article addresses practice issues related to school health records and school nursing documentation that were posed by school nurses in the field. Specifically, the questions addressed concern the following: education records, medication privacy issues, sharing of sensitive health information, privacy of…

New Haven Conn. Group Awarded EPA Grant to Help Air and Water Issues

EPA Pesticide Factsheets

A Connecticut organization working to address water and air pollution issues in New Haven was one of three groups in New England to receive an EPA grant award of $30,000 each, to help communities directly address local environmental concerns.

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

PubMed

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

2015-12-23

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

32 CFR 281.3 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 2 2011-07-01 2011-07-01 false Definitions. 281.3 Section 281.3 National... SETTLING PERSONNEL AND GENERAL CLAIMS AND PROCESSING ADVANCE DECISION REQUESTS § 281.3 Definitions. Armed.... 554, and 32 U.S.C. 714. Secretary concerned. The Secretary of the Army, addressing matters concerning...

32 CFR 281.3 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 2 2012-07-01 2012-07-01 false Definitions. 281.3 Section 281.3 National... SETTLING PERSONNEL AND GENERAL CLAIMS AND PROCESSING ADVANCE DECISION REQUESTS § 281.3 Definitions. Armed.... 554, and 32 U.S.C. 714. Secretary concerned. The Secretary of the Army, addressing matters concerning...

32 CFR 281.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 2 2013-07-01 2013-07-01 false Definitions. 281.3 Section 281.3 National... SETTLING PERSONNEL AND GENERAL CLAIMS AND PROCESSING ADVANCE DECISION REQUESTS § 281.3 Definitions. Armed.... 554, and 32 U.S.C. 714. Secretary concerned. The Secretary of the Army, addressing matters concerning...

Linking Assessment to Undergraduate Student Capabilities through Portfolio Examination

ERIC Educational Resources Information Center

O'Sullivan, Anthony J.; Harris, Peter; Hughes, Chris S.; Toohey, Susan M.; Balasooriya, Chinthaka; Velan, Gary; Kumar, Rakesh K.; McNeil, H. Patrick

2012-01-01

Portfolios are an established method of assessment, although concerns do exist around their validity for capabilities such as reflection and self-direction. This article describes an e-portfolio which closely aligns learning and reflection to graduate capabilities, incorporating features that address concerns about portfolios. Students are…

HIV Prevention Readiness in Undergraduates and Inmates.

ERIC Educational Resources Information Center

Antonio, Michael E.; And Others

Prevention of Human Immunodeficiency Virus (HIV) transmission is increasingly an international priority. Education of high-risk populations, such as incarcerated individuals, is particularly important in thwarting the spread of HIV. To address this concern, the attitudes, beliefs, and knowledge of inmates concerning HIV and AIDS related issues are…

Thinking like animals or thinking like colleagues?

PubMed

Dennett, Daniel C; Lambert, Enoch

2017-01-01

We comment on ways in which Lake et al. advance our understanding of the machinery of intelligence and offer suggestions. The first set concerns animal-level versus human-level intelligence. The second concerns the urgent need to address ethical issues when evaluating the state of artificial intelligence.

Overstimulated Consumers or Next-Generation Learners? Parent Tensions About Child Mobile Technology Use.

PubMed

Radesky, Jenny S; Eisenberg, Staci; Kistin, Caroline J; Gross, Jamie; Block, Gabrielle; Zuckerman, Barry; Silverstein, Michael

2016-11-01

Mobile technology is ubiquitous, but its impact on family life has not been thoroughly addressed in the scientific literature or in clinical practice guidelines. We aimed to understand parents' views regarding mobile technology use by young children, aged 0 to 8 years, including perceived benefits, concerns, and effects on family interactions, with the goal of informing pediatric guidelines. We conducted 35 in-depth, semistructured group and individual interviews with English-speaking caregivers of diverse ethnic backgrounds, educational levels, and employment statuses. After thematic saturation, results were validated through expert triangulation and member checking. Participants included 22 mothers, 9 fathers, and 4 grandmothers; 31.4% were single parents, 42.9% were of nonwhite race or ethnicity, and 40.0% completed high school or less. Participants consistently expressed a high degree of tension regarding their child's mobile technology use, from which several themes emerged: (1) effects on the child-fear of missing out on educational benefits vs concerns about negative effects on thinking and imagination; (2) locus of control-wanting to use digital devices in beneficial ways vs feeling that rapidly evolving technologies are beyond their control (a tension more common in low-income caregivers); and (3) family stress-the necessity of device use in stressed families (eg, to control a child's behavior or as an inexpensive learning/entertainment tool) vs its displacement of family time. Caregivers of young children describe many novel concepts regarding use of mobile technology, raising issues not addressed by current anticipatory guidance. Guidance may be more effectively implemented if it takes into account parents' uncertainties, locus of control, and functional uses of mobile devices in families. © 2016 Annals of Family Medicine, Inc.

"It Is Like Heart Failure. It Is Chronic … and It Will Kill You": A Qualitative Analysis of Burnout Among Hospice and Palliative Care Clinicians.

PubMed

Kavalieratos, Dio; Siconolfi, Daniel E; Steinhauser, Karen E; Bull, Janet; Arnold, Robert M; Swetz, Keith M; Kamal, Arif H

2017-05-01

Although prior surveys have identified rates of self-reported burnout among palliative care clinicians as high as 62%, limited data exist to elucidate the causes, ameliorators, and effects of this phenomenon. We explored burnout among palliative care clinicians, specifically their experiences with burnout, their perceived sources of burnout, and potential individual, interpersonal, organizational, and policy-level solutions to address burnout. During the 2014 American Academy of Hospice and Palliative Medicine/Hospice and Palliative Nurses Association Annual Assembly, we conducted three focus groups to examine personal narratives of burnout, how burnout differs within hospice and palliative care, and strategies to mitigate burnout. Two investigators independently analyzed data using template analysis, an inductive/deductive qualitative analytic technique. We interviewed 20 palliative care clinicians (14 physicians, four advanced practice providers, and two social workers). Common sources of burnout included increasing workload, tensions between nonspecialists and palliative care specialists, and regulatory issues. We heard grave concerns about the stability of the palliative care workforce and concerns about providing high-quality palliative care in light of a distressed and overburdened discipline. Participants proposed antiburnout solutions, including promoting the provision of generalist palliative care, frequent rotations on-and-off service, and organizational support for self-care. We observed variability in sources of burnout between clinician type and by practice setting, such as role monotony among full-time clinicians. Our results reinforce and expand on the severity and potential ramifications of burnout on the palliative care workforce. Future research is needed to confirm our findings and investigate interventions to address or prevent burnout. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Overstimulated Consumers or Next-Generation Learners? Parent Tensions About Child Mobile Technology Use

PubMed Central

Radesky, Jenny S.; Eisenberg, Staci; Kistin, Caroline J.; Gross, Jamie; Block, Gabrielle; Zuckerman, Barry; Silverstein, Michael

2016-01-01

PURPOSE Mobile technology is ubiquitous, but its impact on family life has not been thoroughly addressed in the scientific literature or in clinical practice guidelines. We aimed to understand parents’ views regarding mobile technology use by young children, aged 0 to 8 years, including perceived benefits, concerns, and effects on family interactions, with the goal of informing pediatric guidelines. METHODS We conducted 35 in-depth, semistructured group and individual interviews with English-speaking caregivers of diverse ethnic backgrounds, educational levels, and employment statuses. After thematic saturation, results were validated through expert triangulation and member checking. RESULTS Participants included 22 mothers, 9 fathers, and 4 grandmothers; 31.4% were single parents, 42.9% were of nonwhite race or ethnicity, and 40.0% completed high school or less. Participants consistently expressed a high degree of tension regarding their child’s mobile technology use, from which several themes emerged: (1) effects on the child—fear of missing out on educational benefits vs concerns about negative effects on thinking and imagination; (2) locus of control—wanting to use digital devices in beneficial ways vs feeling that rapidly evolving technologies are beyond their control (a tension more common in low-income caregivers); and (3) family stress—the necessity of device use in stressed families (eg, to control a child’s behavior or as an inexpensive learning/entertainment tool) vs its displacement of family time. CONCLUSIONS Caregivers of young children describe many novel concepts regarding use of mobile technology, raising issues not addressed by current anticipatory guidance. Guidance may be more effectively implemented if it takes into account parents’ uncertainties, locus of control, and functional uses of mobile devices in families. PMID:28376436

Participatory Workplace Wellness Programs: Reward, Penalty, and Regulatory Conflict

PubMed Central

Pomeranz, Jennifer L

2015-01-01

Context In keeping with the Patient Protection and Affordable Care Act, Congress revised the law related to workplace wellness programs. In June 2013, the Departments of Treasury, Labor, and Health and Human Services passed the final regulations, updating their 2006 regulatory framework. Participatory programs that reward the completion of a health risk assessment are now the most common type of wellness program in the United States. However, legal and ethical concerns emerge when employers utilize incentives that raise questions about the voluntariness of such programs. At issue is that under the Americans with Disabilities Act (ADA) of 1990, employers cannot require health-related inquiries and exams. Methods To analyze the current interpretation of the ADA, I conducted research on both LexisNexis and federal agency websites. The resulting article evaluates the differences in the language of Congress's enabling legislation and the federal departments’ regulations and how they may conflict with the ADA. It also reviews the federal government's authority to address both the legal conflict and ethical concerns related to nonvoluntary participatory programs. Findings Employers’ practices and the federal departments’ regulations conflict with the current interpretation of the ADA by permitting employers to penalize employees who do not complete a health risk assessment. The departments’ regulations may be interpreted as conflicting with Congress's legislation, which mentions penalties only for health-contingent wellness programs. Furthermore, the regulatory protections for employees applicable to health-contingent wellness programs do not apply to participatory programs. Conclusions Either Congress or the federal agencies should address the conflict among employers’ practices, the wellness regulations, and the ADA and also consider additional protections for employees. Employers can avoid ethical and legal complications by offering voluntary programs with positive incentives. PMID:26044631

Speaking Up: Veterinary Ethical Responsibilities and Animal Welfare Issues in Everyday Practice

PubMed Central

Hernandez, Elein; Fawcett, Anne; Brouwer, Emily; Rau, Jeff

2018-01-01

Simple Summary Veterinarians have an ethical obligation to provide good care for the animals that they see in practice. However, at times, there may be conflicts between the interests of animal caregivers or owners, the interests of veterinarians and the interests of animals. We provide an overview of why and how veterinary ethics is taught to veterinary students, as well as providing a context for thinking about veterinary ethical challenges and animal welfare issues. We argue that veterinarians are ethically obliged to speak up and ask questions when problems arise or are seen and provide a series of clinical case examples in which there is scope for veterinarians to improve animal welfare by ‘speaking up’. Abstract Although expectations for appropriate animal care are present in most developed countries, significant animal welfare challenges continue to be seen on a regular basis in all areas of veterinary practice. Veterinary ethics is a relatively new area of educational focus but is thought to be critically important in helping veterinarians formulate their approach to clinical case management and in determining the overall acceptability of practices towards animals. An overview is provided of how veterinary ethics are taught and how common ethical frameworks and approaches are employed—along with legislation, guidelines and codes of professional conduct—to address animal welfare issues. Insufficiently mature ethical reasoning or a lack of veterinary ethical sensitivity can lead to an inability or difficulty in speaking up about concerns with clients and ultimately, failure in their duty of care to animals, leading to poor animal welfare outcomes. A number of examples are provided to illustrate this point. Ensuring that robust ethical frameworks are employed will ultimately help veterinarians to “speak up” to address animal welfare concerns and prevent future harms. PMID:29361786

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