Feasibility of an International Multiple Sclerosis Rehabilitation Data Repository: Perceived Challenges and Motivators for Sharing Data.

PubMed

Bradford, Elissa Held; Baert, Ilse; Finlayson, Marcia; Feys, Peter; Wagner, Joanne

2018-01-01

Multiple sclerosis (MS) rehabilitation evidence is limited due to methodological factors, which may be addressed by a data repository. We describe the perceived challenges of, motivators for, interest in participating in, and key features of an international MS rehabilitation data repository. A multimethod sequential investigation was performed with the results of two focus groups, using nominal group technique, and study aims informing the development of an online questionnaire. Percentage agreement and key quotations illustrated questionnaire findings. Subgroup comparisons were made between clinicians and researchers and between participants in North America and Europe. Rehabilitation professionals from 25 countries participated (focus groups: n = 21; questionnaire: n = 166). The top ten challenges (C) and motivators (M) identified by the focus groups were database control/management (C); ethical/legal concerns (C); data quality (C); time, effort, and cost (C); best practice (M); uniformity (C); sustainability (C); deeper analysis (M); collaboration (M); and identifying research needs (M). Percentage agreement with questionnaire statements regarding challenges to, motivators for, interest in, and key features of a successful repository was at least 80%, 85%, 72%, and 83%, respectively, across each group of statements. Questionnaire subgroup analysis revealed a few differences (P < .05), including that clinicians more strongly identified with improving best practice as a motivator. Findings support clinician and researcher interest in and potential for success of an international MS rehabilitation data repository if prioritized challenges and motivators are addressed and key features are included.

Ares Knowledge Capture: Summary and Key Themes Presentation

NASA Technical Reports Server (NTRS)

Coates, Ralph H.

2011-01-01

This report has been developed by the National Aeronautics and Space Administration (NASA) Human Exploration and Operations Mission Directorate (HEOMD) Risk Management team in close coordination with the MSFC Chief Engineers Office. This document provides a point-in-time, cumulative, summary of actionable key lessons learned derived from the design project. Lessons learned invariably address challenges and risks and the way in which these areas have been addressed. Accordingly the risk management thread is woven throughout the document.

Navigating political minefields: partnerships in organizational case study research.

PubMed

Moll, Sandra

2012-01-01

The purpose of this paper is to examine key challenges associated with conducting politically sensitive research within a workplace setting, and to highlight strategic partnerships that can be developed to address these challenges. The author's research on employee mental health issues within a large healthcare facility serves as the foundation for identification and description of "political minefields" that investigators may encounter when conducting organizational case study research. Key methodological principles from the literature on qualitative case study research will frame discussion of how to understand and address political sensitivities in the research process. The benefits of conducting organizational case study research will be outlined, followed by discussion of methodological challenges that can emerge in negotiating entry, collecting data (gatekeepers, researcher reflexivity, participant authenticity and non-maleficence), and communicating research findings. Courage, collaboration and clear communication with stakeholders at all levels of the organization are critical to the success of workplace based case study research.

Family caregiving challenges in advanced colorectal cancer: patient and caregiver perspectives.

PubMed

Mosher, Catherine E; Adams, Rebecca N; Helft, Paul R; O'Neil, Bert H; Shahda, Safi; Rattray, Nicholas A; Champion, Victoria L

2016-05-01

Family caregivers of advanced colorectal cancer patients may be at increased risk for psychological distress. Yet their key challenges in coping with the patient's illness are not well understood. Soliciting both patient and caregiver perspectives on these challenges would broaden our understanding of the caregiving experience. Thus, the purpose of this research was to identify caregivers' key challenges in coping with their family member's advanced colorectal cancer from the perspective of patients and caregivers. Individual, semi-structured qualitative interviews were conducted with 23 advanced colorectal cancer patients and 23 primary family caregivers. Interview data were analyzed via thematic analysis. In nearly all cases, patient and caregiver reports of the caregiver's key challenge were discrepant. Across patient and caregiver reports, caregivers' key challenges included processing emotions surrounding the patient's initial diagnosis or recurrence and addressing the patient's practical and emotional needs. Other challenges included coping with continual uncertainty regarding the patient's potential functional decline and prognosis and observing the patient suffer from various physical symptoms. Findings suggest that eliciting the perspectives of both patients and caregivers regarding caregivers' challenges provides a more comprehensive understanding of their experience. Results also point to the need to assist caregivers with the emotional and practical aspects of caregiving.

Identifying and Addressing Themes of Job Dissatisfaction for Secondary Principals

ERIC Educational Resources Information Center

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

2017-01-01

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

Answering the Oregon challenge : climate change

DOT National Transportation Integrated Search

2009-01-13

This paper outlines Gov. Kulongoski's agenda concerning the issue of climate change. It addresses several key topics: greenhouse gas reduction, energy efficiency, renewable energy, and sustainable transportation.

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

PubMed

Said, Maya; Zerhouni, Elias

2014-11-01

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

Engage key social concepts for sustainability

Treesearch

C. C. Hicks; A. Levine; A. Agrawal; X. Basurto; S. J. Breslow; C. Carothers; Susan Charnley; S. Coulthard; N. Dolsak; J. Donatuto; C. Garcia-Quijano; M. B. Mascia; K. Norman; M. R. Poe; T. Satterfield; K. St. Martin; P. S. Levin

2016-01-01

With humans altering climate processes, biogeochemical cycles, and ecosystem functions (1), governments and societies confront the challenge of shaping a sustainable future for people and nature. Policies and practices to address these challenges must draw on social sciences, along with natural sciences and engineering (2). Although various social science approaches...

Lessons from first generation biofuels and implications for the sustainability appraisal of second generation biofuels☆

PubMed Central

Mohr, Alison; Raman, Sujatha

2013-01-01

Aims The emergence of second generation (2G) biofuels is widely seen as a sustainable response to the increasing controversy surrounding the first generation (1G). Yet, sustainability credentials of 2G biofuels are also being questioned. Drawing on work in Science and Technology Studies, we argue that controversies help focus attention on key, often value-related questions that need to be posed to address broader societal concerns. This paper examines lessons drawn from the 1G controversy to assess implications for the sustainability appraisal of 2G biofuels. Scope We present an overview of key 1G sustainability challenges, assess their relevance for 2G, and highlight the challenges for policy in managing the transition. We address limitations of existing sustainability assessments by exploring where challenges might emerge across the whole system of bioenergy and the wider context of the social system in which bioenergy research and policy are done. Conclusions Key lessons arising from 1G are potentially relevant to the sustainability appraisal of 2G biofuels depending on the particular circumstances or conditions under which 2G is introduced. We conclude that sustainability challenges commonly categorised as either economic, environmental or social are, in reality, more complexly interconnected (so that an artificial separation of these categories is problematic). PMID:24926117

Lessons from first generation biofuels and implications for the sustainability appraisal of second generation biofuels.

PubMed

Mohr, Alison; Raman, Sujatha

2013-12-01

The emergence of second generation (2G) biofuels is widely seen as a sustainable response to the increasing controversy surrounding the first generation (1G). Yet, sustainability credentials of 2G biofuels are also being questioned. Drawing on work in Science and Technology Studies, we argue that controversies help focus attention on key, often value-related questions that need to be posed to address broader societal concerns. This paper examines lessons drawn from the 1G controversy to assess implications for the sustainability appraisal of 2G biofuels. We present an overview of key 1G sustainability challenges, assess their relevance for 2G, and highlight the challenges for policy in managing the transition. We address limitations of existing sustainability assessments by exploring where challenges might emerge across the whole system of bioenergy and the wider context of the social system in which bioenergy research and policy are done. Key lessons arising from 1G are potentially relevant to the sustainability appraisal of 2G biofuels depending on the particular circumstances or conditions under which 2G is introduced. We conclude that sustainability challenges commonly categorised as either economic, environmental or social are, in reality, more complexly interconnected (so that an artificial separation of these categories is problematic).

Toward a Critical-Sentimental Orientation in Human Rights Education

ERIC Educational Resources Information Center

Zembylas, Michalinos

2016-01-01

This paper addresses one of the challenges in human rights education (HRE) concerning the conceptualization of a pedagogical orientation that avoids both the pitfalls of a purely juridical address and a "cheap sentimental" approach. The paper uses as its point of departure Richard Rorty's key intervention on human rights discourse and…

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

NASA Astrophysics Data System (ADS)

Gibbs, M.

2016-12-01

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

Key Competencies for Education in a European Context: Narratives of Accountability or Care

ERIC Educational Resources Information Center

Deakin, Ruth

2008-01-01

This article addresses the ideological challenges and opportunities presented by the European Commission's commitment to the identification of key competencies for education and training, and the development of indicators which can be used to monitor and evaluate progress towards these competences across the European Union. It explores the…

Electrokinetic Enrichment and Detection of Neuropeptide for Performance Monitor

DTIC Science & Technology

2016-06-14

conditions for key neurological biomarkers of interest, by using nanoparticles and aptamers to enhance specificity. Additionally, biomarker...conditions for key neurological biomarkers of interest, by using nanoparticles and aptamers to enhance specificity. Additionally, biomarker...nanoparticle immunoassays and aptamer -based approaches for enhancing detection specificity. Experiment: Towards addressing AFRL’s grand challenge of

Electrokinetic enrichment and detection of neuropeptide for performance monitoring

DTIC Science & Technology

2016-06-14

conditions for key neurological biomarkers of interest, by using nanoparticles and aptamers to enhance specificity. Additionally, biomarker...conditions for key neurological biomarkers of interest, by using nanoparticles and aptamers to enhance specificity. Additionally, biomarker...nanoparticle immunoassays and aptamer -based approaches for enhancing detection specificity. Experiment: Towards addressing AFRL’s grand challenge of

The Sanford Science Education Center: Addressing Key Design Challenges in Sharing Complex Science with Diverse Audiences

ERIC Educational Resources Information Center

Inverness Research, 2016

2016-01-01

In facilities throughout the United States and abroad, communities of scientists share infrastructure, instrumentation, and equipment to conduct scientific research. In these large facilities--laboratories, accelerators, telescope arrays, and research vessels--scientists are researching key questions that have the potential to make a significant…

Feasibility of an International Multiple Sclerosis Rehabilitation Data Repository

PubMed Central

Bradford, Elissa Held; Baert, Ilse; Finlayson, Marcia; Feys, Peter

2018-01-01

Abstract Background: Multiple sclerosis (MS) rehabilitation evidence is limited due to methodological factors, which may be addressed by a data repository. We describe the perceived challenges of, motivators for, interest in participating in, and key features of an international MS rehabilitation data repository. Methods: A multimethod sequential investigation was performed with the results of two focus groups, using nominal group technique, and study aims informing the development of an online questionnaire. Percentage agreement and key quotations illustrated questionnaire findings. Subgroup comparisons were made between clinicians and researchers and between participants in North America and Europe. Results: Rehabilitation professionals from 25 countries participated (focus groups: n = 21; questionnaire: n = 166). The top ten challenges (C) and motivators (M) identified by the focus groups were database control/management (C); ethical/legal concerns (C); data quality (C); time, effort, and cost (C); best practice (M); uniformity (C); sustainability (C); deeper analysis (M); collaboration (M); and identifying research needs (M). Percentage agreement with questionnaire statements regarding challenges to, motivators for, interest in, and key features of a successful repository was at least 80%, 85%, 72%, and 83%, respectively, across each group of statements. Questionnaire subgroup analysis revealed a few differences (P < .05), including that clinicians more strongly identified with improving best practice as a motivator. Conclusions: Findings support clinician and researcher interest in and potential for success of an international MS rehabilitation data repository if prioritized challenges and motivators are addressed and key features are included. PMID:29507539

The Challenge of Violence. [Student Text and] Teacher's Guide.

ERIC Educational Resources Information Center

Croddy, Marshall; Degelman, Charles; Hayes, Bill

This document addresses violence as one of the key challenges facing the democratic and pluralistic republic under the framework of the Constitution and its Bill of Rights. Primary focus is on criminal violence and the factors and behaviors that contribute to violent crime. The text is organized into three chapters: (1) "The Problem of…

Investigating the Relationship between Dialogue Structure and Tutoring Effectiveness: A Hidden Markov Modeling Approach

ERIC Educational Resources Information Center

Boyer, Kristy Elizabeth; Phillips, Robert; Ingram, Amy; Ha, Eun Young; Wallis, Michael; Vouk, Mladen; Lester, James

2011-01-01

Identifying effective tutorial dialogue strategies is a key issue for intelligent tutoring systems research. Human-human tutoring offers a valuable model for identifying effective tutorial strategies, but extracting them is a challenge because of the richness of human dialogue. This article addresses that challenge through a machine learning…

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.

Social media and pharmacovigilance: A review of the opportunities and challenges

PubMed Central

Sloane, Richard; Osanlou, Orod; Lewis, David; Bollegala, Danushka; Maskell, Simon; Pirmohamed, Munir

2015-01-01

Adverse drug reactions come at a considerable cost on society. Social media are a potentially invaluable reservoir of information for pharmacovigilance, yet their true value remains to be fully understood. In order to realize the benefits social media holds, a number of technical, regulatory and ethical challenges remain to be addressed. We outline these key challenges identifying relevant current research and present possible solutions. PMID:26147850

Strategic management and organizational behavior in dental education: reflections on key issues in an environment of change.

PubMed

Dunning, David G; Durham, Timothy M; Lange, Brian M; Aksu, Mert N

2009-06-01

With issues such as shrinking revenue, access to care, faculty workloads, and graying faculty, dental schools are faced with difficult challenges that fall to dental school deans to manage. Do dental school deans have the organizational skill sets and ethical frameworks necessary to address the challenges now facing dental schools? The purpose of this article is to pose questions and suggestions regarding some of the key issues in dental colleges today and to stimulate discussion in the dental community about needed changes in dental education.

Human Mars Surface Science Operations

NASA Technical Reports Server (NTRS)

Bobskill, Marianne R.; Lupisella, Mark L.

2014-01-01

Human missions to the surface of Mars will have challenging science operations. This paper will explore some of those challenges, based on science operations considerations as part of more general operational concepts being developed by NASA's Human Spaceflight Architecture (HAT) Mars Destination Operations Team (DOT). The HAT Mars DOT has been developing comprehensive surface operations concepts with an initial emphasis on a multi-phased mission that includes a 500-day surface stay. This paper will address crew science activities, operational details and potential architectural and system implications in the areas of (a) traverse planning and execution, (b) sample acquisition and sample handling, (c) in-situ science analysis, and (d) planetary protection. Three cross-cutting themes will also be explored in this paper: (a) contamination control, (b) low-latency telerobotic science, and (c) crew autonomy. The present traverses under consideration are based on the report, Planning for the Scientific Exploration of Mars by Humans1, by the Mars Exploration Planning and Analysis Group (MEPAG) Human Exploration of Mars-Science Analysis Group (HEM-SAG). The traverses are ambitious and the role of science in those traverses is a key component that will be discussed in this paper. The process of obtaining, handling, and analyzing samples will be an important part of ensuring acceptable science return. Meeting planetary protection protocols will be a key challenge and this paper will explore operational strategies and system designs to meet the challenges of planetary protection, particularly with respect to the exploration of "special regions." A significant challenge for Mars surface science operations with crew is preserving science sample integrity in what will likely be an uncertain environment. Crewed mission surface assets -- such as habitats, spacesuits, and pressurized rovers -- could be a significant source of contamination due to venting, out-gassing and cleanliness levels associated with crew presence. Low-latency telerobotic science operations has the potential to address a number of contamination control and planetary protection issues and will be explored in this paper. Crew autonomy is another key cross-cutting challenge regarding Mars surface science operations, because the communications delay between earth and Mars could as high as 20 minutes one way, likely requiring the crew to perform many science tasks without direct timely intervention from ground support on earth. Striking the operational balance between crew autonomy and earth support will be a key challenge that this paper will address.

The Extent to Which Collaborative Teams of Educators Link the Results of Functional Assessment to Function-Based Interventions

ERIC Educational Resources Information Center

de Courcy-Bower, Laurie

2010-01-01

A promising approach to addressing challenging behavior in schools is to develop and implement "function-based interventions" (Dunlap et al., 2006; Hanley, Iwata, & McCord, 2003). Function-based interventions are individualized interventions in which five key outcomes of functional assessment (i.e., identification of challenging behavior,…

Balancing the Tensions and Meeting the Conceptual Challenges of Education for Sustainable Development and Climate Change

ERIC Educational Resources Information Center

Blum, Nicole; Nazir, Joanne; Breiting, Soren; Goh, Kim Chuan; Pedretti, Erminia

2013-01-01

This paper addresses one of the key challenges for work on education, sustainable development and climate change: the overall conceptualisation of central ideas such as Environmental Education (EE), Education for Sustainable Development (ESD) and Climate Change Education (CCE). What do these concepts mean in diverse contexts and amongst diverse…

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

PubMed Central

2017-01-01

Background Shortages of Human Resources for Health (HRH) in rural areas are often driven by poor working and living conditions, inadequate salaries and benefits, lack of training and career development opportunities amongst others. The South African government has adopted a human resource strategy for the health sector in 2011 aimed at addressing these challenges. Aim This study reviews the challenges faced by health personnel against government strategies aimed at attracting and retaining health personnel in these underserved areas. Setting The study was conducted in six primary health care service sites in the Hlabisa sub-district of Umkhanyakude, located in northern KwaZulu-Natal, South Africa. Methods The study population comprised 25 health workers including 11 professional nurses, 4 staff nurses and 10 doctors (4 medical doctors, 3 foreign medical doctors and 3 doctors undertaking community service). Qualitative data were collected from semi-structured interviews and analysed using thematic analysis. Results Government initiatives including the rural allowance, deployment of foreign medical doctors and the presence of health personnel undertaking their community service in rural areas are positively viewed by health personnel working in rural health facilities. However, poor living and working conditions, together with inadequate personal development opportunities, remain unresolved challenges. It is these challenges that will continue to dissuade experienced health personnel from remaining in these underserved areas. Conclusion South Africa’s HRH strategy for the Health Sector 2012/13–2015/16 had highlighted the key challenges raised by respondents and identified strategies aimed at addressing these challenges. Implementation of these strategies is key to improving both living and working conditions, and providing health personnel with opportunities for further development will require inter-ministerial collaboration if the HRH 2030 objectives are to be realised. PMID:28828878

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

PubMed

Mburu, Grace; George, Gavin

2017-07-31

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

Engineering the LISA Project: Systems Engineering Challenges

NASA Technical Reports Server (NTRS)

Evans, Jordan P.

2006-01-01

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

Social media and pharmacovigilance: A review of the opportunities and challenges.

PubMed

Sloane, Richard; Osanlou, Orod; Lewis, David; Bollegala, Danushka; Maskell, Simon; Pirmohamed, Munir

2015-10-01

Adverse drug reactions come at a considerable cost on society. Social media are a potentially invaluable reservoir of information for pharmacovigilance, yet their true value remains to be fully understood. In order to realize the benefits social media holds, a number of technical, regulatory and ethical challenges remain to be addressed. We outline these key challenges identifying relevant current research and present possible solutions. © 2015 The British Pharmacological Society.

Ethical challenges within Veterans Administration healthcare facilities: perspectives of managers, clinicians, patients, and ethics committee chairpersons.

PubMed

Foglia, Mary Beth; Pearlman, Robert A; Bottrell, Melissa; Altemose, Jane K; Fox, Ellen

2009-04-01

To promote ethical practices, healthcare managers must understand the ethical challenges encountered by key stakeholders. To characterize ethical challenges in Veterans Administration (VA) facilities from the perspectives of managers, clinicians, patients, and ethics consultants. We conducted focus groups with patients (n = 32) and managers (n = 38); semi-structured interviews with managers (n = 31), clinicians (n = 55), and ethics committee chairpersons (n = 21). Data were analyzed using content analysis. Managers reported that the greatest ethical challenge was fairly distributing resources across programs and services, whereas clinicians identified the effect of resource constraints on patient care. Ethics committee chairpersons identified end-of-life care as the greatest ethical challenge, whereas patients identified obtaining fair, respectful, and caring treatment. Perspectives on ethical challenges varied depending on the respondent's role. Understanding these differences can help managers take practical steps to address these challenges. Further, ethics committees seemingly, are not addressing the range of ethical challenges within their institutions.

American Society of Clinical Oncology Summit on Addressing Obesity Through Multidisciplinary Provider Collaboration: Key Findings and Recommendations for Action.

PubMed

Ligibel, Jennifer A; Alfano, Catherine M; Hershman, Dawn L; Merrill, Janette K; Basen-Engquist, Karen; Bloomgarden, Zachary T; Demark-Wahnefried, Wendy; Dixon, Suzanne; Hassink, Sandra G; Jakicic, John M; Morton, John Magaña; Okwuosa, Tochi M; Powell-Wiley, Tiffany M; Rothberg, Amy E; Stephens, Mark; Streett, Sarah E; Wild, Robert A; Westman, Eric A; Williams, Ronald J; Wollins, Dana S; Hudis, Clifford A

2017-11-01

Given the increasing evidence that obesity increases the risk of developing and dying from malignancy, the American Society of Clinical Oncology (ASCO) launched an Obesity Initiative in 2013 that was designed to increase awareness among oncology providers and the general public of the relationship between obesity and cancer and to promote research in this area. Recognizing that the type of societal change required to impact the obesity epidemic will require a broad-based effort, ASCO hosted the "Summit on Addressing Obesity through Multidisciplinary Collaboration" in 2016. This meeting was held to review current challenges in addressing obesity within the respective health care provider communities and to identify priorities that would most benefit from a collective and cross-disciplinary approach. Efforts focused on four key areas: provider education and training; public education and activation; research; and policy and advocacy. Summit attendees discussed current challenges in addressing obesity within their provider communities and identified priorities that would most benefit from multidisciplinary collaboration. A synopsis of recommendations to facilitate future collaboration, as well as examples of ongoing cooperative efforts, provides a blueprint for multidisciplinary provider collaboration focused on obesity prevention and treatment. © 2017 The Obesity Society.

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

PubMed

Johnston, Lee M; Finegood, Diane T

2015-03-18

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

Multi-disciplinary interoperability challenges (Ian McHarg Medal Lecture)

NASA Astrophysics Data System (ADS)

Annoni, Alessandro

2013-04-01

Global sustainability research requires multi-disciplinary efforts to address the key research challenges to increase our understanding of the complex relationships between environment and society. For this reason dependence on ICT systems interoperability is rapidly growing but, despite some relevant technological improvement is observed, in practice operational interoperable solutions are still lacking. Among the causes is the absence of a generally accepted definition of "interoperability" in all its broader aspects. In fact the concept of interoperability is just a concept and the more popular definitions are not addressing all challenges to realize operational interoperable solutions. The problem become even more complex when multi-disciplinary interoperability is required because in that case solutions for interoperability of different interoperable solution should be envisaged. In this lecture the following definition will be used: "interoperability is the ability to exchange information and to use it". In the lecture the main challenges for addressing multi-disciplinary interoperability will be presented and a set of proposed approaches/solutions shortly introduced.

Adaptive Management: From More Talk to Real Action

NASA Astrophysics Data System (ADS)

Williams, Byron K.; Brown, Eleanor D.

2014-02-01

The challenges currently facing resource managers are large-scale and complex, and demand new approaches to balance development and conservation goals. One approach that shows considerable promise for addressing these challenges is adaptive management, which by now is broadly seen as a natural, intuitive, and potentially effective way to address decision-making in the face of uncertainties. Yet the concept of adaptive management continues to evolve, and its record of success remains limited. In this article, we present an operational framework for adaptive decision-making, and describe the challenges and opportunities in applying it to real-world problems. We discuss the key elements required for adaptive decision-making, and their integration into an iterative process that highlights and distinguishes technical and social learning. We illustrate the elements and processes of the framework with some successful on-the-ground examples of natural resource management. Finally, we address some of the difficulties in applying learning-based management, and finish with a discussion of future directions and strategic challenges.

Rocks: A Concrete Activity That Introduces Normal Distribution, Sampling Error, Central Limit Theorem and True Score Theory

ERIC Educational Resources Information Center

Van Duzer, Eric

2011-01-01

This report introduces a short, hands-on activity that addresses a key challenge in teaching quantitative methods to students who lack confidence or experience with statistical analysis. Used near the beginning of the course, this activity helps students develop an intuitive insight regarding a number of abstract concepts which are key to…

Key Issues in Hymenoptera Venom Allergy: An Update.

PubMed

Alfaya Arias, T; Soriano Gómis, V; Soto Mera, T; Vega Castro, A; Vega Gutiérrez, J M; Alonso Llamazares, A; Antolín Amérigo, D; Carballada Gonzalez, F J; Dominguez Noche, C; Gutierrez Fernandez, D; Marques Amat, L; Martinez Arcediano, A; Martinez San Ireneo, M; Moreno Ancillo, A; Puente Crespo, Y; Ruiz Leon, B; Sánchez Morillas, L

In this review, the Hymenoptera Allergy Committee of the SEAIC analyzes the most recent scientific literature addressing problems related to the diagnosis of hymenoptera allergy and to management of venom immunotherapy. Molecular diagnosis and molecular risk profiles are the key areas addressed. The appearance of new species of hymenoptera that are potentially allergenic in Spain and the associated diagnostic and therapeutic problems are also described. Finally, we analyze the issue of mast cell activation syndrome closely related to hymenoptera allergy, which has become a new diagnostic challenge for allergists given its high prevalence in patients with venom anaphylaxis.

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

PubMed

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

2015-12-01

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

Speed-Accuracy Tradeoffs in Speech Production

DTIC Science & Technology

2017-06-01

imaging data of speech production. A theoretical framework for considering Fitts’ law in the domain of speech production is elucidated. Methodological ...articulatory kinematics conform to Fitts’ law. A second, associated goal is to address the methodological challenges inherent in performing Fitts-style...analysis on rtMRI data of speech production. Methodological challenges include segmenting continuous speech into specific motor tasks, defining key

Another Challenge for Africa: Ethnic Stability

DTIC Science & Technology

2011-03-24

is a cultural , deep-seated personal matter to the African people. Still, ethnicity is a key foundational challenge for Africa to adequately address...Issues, Diplomacy as an Element of National Power CLASSIFICATION: Unclassified Ethnicity is a cultural , deep-seated personal matter to the...history, geography, political system, economics, demographics, culture , and languages. From a U.S. perspective, most know of Africa from news

Developing Inclusive Teaching and Learning Through the Principles of Universal Design.

PubMed

Knarlag, Kjetil; Olaussen, Elinor

2016-01-01

For decades, the term reasonable accommodations has been the lead strategy and praxis in addressing diversity and disabilities in Higher Education. Universal Design for Learning (UDL) is a well-known theory and a practical approach which challenges these traditions in order to improve inclusive teaching and learning in the American school system. A European funded project, UDLL, has transferred these theories to a European context, and developed best practice guidelines for key stakeholders in European Higher Education Institutions. This universal approach challenges established traditions, methods and mindsets in addressing the diverse student population.

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

PubMed

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

2013-03-01

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

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

PubMed Central

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

2011-01-01

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

ESA Sample Fetch Rover: Heritage and Way Forward

NASA Astrophysics Data System (ADS)

Duvet, L.; Beyer, F.; Delfa, J.; Zekri, E.

2018-04-01

The Sample Fetch Rover (SFR) is one of the key elements of the Mars Sample Return (MSR) campaign architecture. We will present the SFR heritage as well as a way forward identified to address this engineering challenge.

7 Key Challenges for Visualization in Cyber Network Defense

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

Best, Daniel M.; Endert, Alexander; Kidwell, Dan

In this paper we present seven challenges, informed by two user studies, to be considered when developing a visualization for cyber security purposes. Cyber security visualizations must go beyond isolated solutions and “pretty picture” visualizations in order to make impact to users. We provide an example prototype that addresses the challenges with a description of how they are met. Our aim is to assist in increasing utility and adoption rates for visualization capabilities in cyber security.

Listening for Prescriptions: A National Consultation on Pharmaceutical Policy Issues

PubMed Central

Morgan, Steve; Cunningham, Colleen M.

2010-01-01

Objectives and Methods: Pharmaceutical policy is an increasingly costly, essential and challenging component of health system management. We sought to identify priority pharmaceutical policy issues in Canada and to translate them into research priorities using key informant interviews, stakeholder surveys and a deliberative workshop. Results: We found consensus on overarching policy goals: to provide all Canadians with equitable and sustainable access to necessary medicines. We also found widespread frustration that many key pharmaceutical policy issues in Canada — including improving prescription drug financing and pricing — have been persistent challenges owing to a lack of policy coordination. The coverage of extraordinarily costly medicines for serious conditions was identified as a rapidly emerging policy issue. Conclusion: Targeted research and knowledge translation activities can help address key policy issues and, importantly, challenges of policy coordination in Canada and thereby reduce inequity and inefficiency in policy approaches and outcomes. PMID:22043223

Gathering Strength: Canada's Aboriginal Action Plan. A Progress Report = Rassembler nos forces: Le plan d'action du Canada pour les questions autochtones. Rapport d'etape.

ERIC Educational Resources Information Center

Department of Indian Affairs and Northern Development, Ottawa (Ontario).

Gathering Strength is an integrated government-wide plan to address the key challenges facing Canada's Aboriginal people. Following an initial section on reconciliation of historic grievances, this report describes initiatives in the four areas addressed by the action plan: (1) partnerships (all schools received public awareness materials;…

Legal Challenges and Pitfalls for Start-up Companies - 48 Common Questions and Answers.

PubMed

Staehelin, Matthias

2014-12-01

Transforming a business idea into reality requires a legal implementation plan. The following 48 questions and answers address key issues that typically arise in start-up situations. Early planning can help avoid costly mistakes.

Issues in Distance Education: A Primer for Higher Education Decision Makers

ERIC Educational Resources Information Center

Beaudoin, Michael

2016-01-01

This chapter presents an overview of current issues related to distance learning in higher education. It identifies central questions, issues, challenges, and opportunities that must be addressed by decision makers, as well as key attributes of effective leaders.

Managing the Risks of Climate Change and Terrorism

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

Rosa, Eugene; Dietz, Tom; Moss, Richard H.

2012-04-07

The article describes challenges to comparative risk assessment, a key approach for managing uncertainty in decision making, across diverse threats such as terrorism and climate change and argues new approaches will be particularly important in addressing decisions related to sustainability.

Simplified web-based decision support method for traffic management and work zone analysis.

DOT National Transportation Integrated Search

2017-01-01

Traffic congestion mitigation is one of the key challenges that transportation planners and operations engineers face when planning for construction and maintenance activities. There is a wide variety of approaches and methods that address work zone ...

Simplified web-based decision support method for traffic management and work zone analysis.

DOT National Transportation Integrated Search

2015-06-01

Traffic congestion mitigation is one of the key challenges that transportation planners and operations engineers face when : planning for construction and maintenance activities. There is a wide variety of approaches and methods that address work : z...

Performance Prediction and Validation: Data, Frameworks, and Considerations

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

Tinnesand, Heidi

2017-05-19

Improving the predictability and reliability of wind power generation and operations will reduce costs and potentially establish a framework to attract new capital into the distributed wind sector, a key cost reduction requirement highlighted in results from the distributed wind future market assessment conducted with dWind. Quantifying and refining the accuracy of project performance estimates will also directly address several of the key challenges identified by industry stakeholders in 2015 as part of the distributed wind resource assessment workshop and be cross-cutting for several other facets of the distributed wind portfolio. This presentation covers the efforts undertaken in 2016 tomore » address these topics.« less

Developing content for an interprofessional training on fear of cancer recurrence (FCR): Key informant interviews of healthcare professionals, researchers and cancer survivors.

PubMed

Berrett-Abebe, Julie; Cadet, Tamara; Vitello, Joan; Maramaldi, Peter

2018-04-10

Growing numbers of cancer survivors are receiving healthcare through primary care practitioners, who often lack cancer-specific expertise to effectively treat survivors' concerns. Addressing that gap, this study aimed to develop content for a training on fear of cancer recurrence (FCR), a common concern in survivorship. Grounded in naturalistic inquiry, 42 key-informant interviews were conducted, transcribed, and analyzed for themes. Participants were healthcare professionals, researchers, and cancer survivors Results: Results included themes ranging from: rich conceptualizations of FCR, opportunities and challenges for addressing FCR in healthcare settings, interventions to address FCR, and important information to include in a training on FCR. This paper provides content for an interprofessional training and highlights the importance of developing trainings for interprofessional teams, given identified barriers that physicians face in addressing FCR and other psychosocial concerns of survivors in primary care.

Community Response and Engagement During Extreme Water Events in Saskatchewan, Canada and Queensland, Australia

NASA Astrophysics Data System (ADS)

McMartin, Dena W.; Sammel, Alison J.; Arbuthnott, Katherine

2018-01-01

Technology alone cannot address the challenges of how societies, communities, and individuals understand water accessibility, water management, and water consumption, particularly under extreme conditions like floods and droughts. At the community level, people are increasingly aware challenges related to responses to and impacts of extreme water events. This research begins with an assessment of social and political capacities of communities in two Commonwealth jurisdictions, Queensland, Australia and Saskatchewan, Canada, in response to major flooding events. The research further reviews how such capacities impact community engagement to address and mitigate risks associated with extreme water events and provides evidence of key gaps in skills, understanding, and agency for addressing impacts at the community level. Secondary data were collected using template analysis to elucidate challenges associated with education (formal and informal), social and political capacity, community ability to respond appropriately, and formal government responses to extreme water events in these two jurisdictions. The results indicate that enhanced community engagement alongside elements of an empowerment model can provide avenues for identifying and addressing community vulnerability to negative impacts of flood and drought.

Dental Education Required for the Changing Health Care Environment.

PubMed

Fontana, Margherita; González-Cabezas, Carlos; de Peralta, Tracy; Johnsen, David C

2017-08-01

To be able to meet the demands for care in 2040, dental graduates will need to address challenges resulting from the rapidly changing health care environment with knowledge and sets of skills to build on current standards and adapt to the future. The purposes of this article are to 1) analyze key challenges likely to evolve considerably between now and 2040 that will impact dental education and practice and 2) propose several sets of skills and educational outcomes necessary to address these challenges. The challenges discussed include changes in prevalence of oral diseases, dental practice patterns, materials and technologies, integrated medical-dental care, role of electronic health records, cultural competence, integrated curricula, interprofessional education, specialty-general balance, and web/cloud-based collaborations. To meet these challenges, the dental graduate will need skills such as core knowledge in basic and clinical dentistry, technical proficiency, critical thinking skills for lifelong learning, ethical and professional values, ability to manage a practice, social responsibility, and ability to function in a collegial intra- and interprofessional setting. Beyond the skills of the individual dentist will be the need for leadership in academia and the practice community. Academic and professional leaders will need to engage key constituencies to develop strategic directions and agendas with all parties pointed toward high standards for individual patients and the public at large. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

World pharmaceuticals--Financial Times tenth annual conference. 22-23 April 1999, London, UK.

PubMed

Muhsin, M

1999-07-01

This two-day conference was organized by The Financial Times, in association with PriceWaterhouseCoopers LLP. The general theme of the event was the state of the healthcare industry, past, present and future. The main areas covered included addressing the challenges of the 1990s, anticipating the challenges of the next decade, the changing shape of global marketing, IT in healthcare, consolidation challenges, shareholder expectations, and new strategies and technologies for growth sustenance within the industry. Key speakers within the industry addressed these issues to an audience of approximately 200 healthcare business executives. The first day was chaired by Mr Robert Cawthorn (Chairman Emeritus, Rhone-Poulenc Rorer Inc) and the second by Professor Trevor Jones (Director General, Association of the British Pharmaceutical Industry).

Organoids as Models for Neoplastic Transformation | Office of Cancer Genomics

Cancer.gov

Cancer models strive to recapitulate the incredible diversity inherent in human tumors. A key challenge in accurate tumor modeling lies in capturing the panoply of homo- and heterotypic cellular interactions within the context of a three-dimensional tissue microenvironment. To address this challenge, researchers have developed organotypic cancer models (organoids) that combine the 3D architecture of in vivo tissues with the experimental facility of 2D cell lines.

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

PubMed

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

2018-03-16

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

Discovery of innovative therapeutics: today's realities and tomorrow's vision. 1. Criticisms faced by the pharmaceutical industry.

PubMed

Abou-Gharbia, Magid; Childers, Wayne E

2013-07-25

The pharmaceutical industry is facing enormous challenges, including reduced efficiency, declining innovation, key patent expirations, fierce price competition from generics, high regulatory hurdles, and a tarnished image. There is a clear need for change in the paradigms designed to address these challenges. Pharma has responded by embarking on a range of initiatives. However, along the way the industry has accrued critics whose accusations have tainted its reputation. The first part of this two-part series will discuss the criticisms that have been leveled at the pharmaceutical industry and summarize the supporting data for and against these criticisms. The second installment will focus on the current challenges facing the pharmaceutical industry and Pharma's responses to address these challenges. It will describe the industry's changing perspective and new business models for coping with the recent loss of talent and declining clinical pipelines as well as present some examples of recent drug discovery successes.

The Challenges of Modularization.

ERIC Educational Resources Information Center

Brown, Sally; Saunders, Danny

1995-01-01

Discusses the movement towards credit accumulation and transfer in higher education institutions based on experiences at two universities in the United Kingdom, the University of Northumbria and the University of Glamorgan. Modularization, or unitization, and semesterization are considered, and three key areas are addressed: management, student…

Unpacking the concept of land degradation neutrality and addressing its operation through the Rio Conventions.

PubMed

Akhtar-Schuster, Mariam; Stringer, Lindsay C; Erlewein, Alexander; Metternicht, Graciela; Minelli, Sara; Safriel, Uriel; Sommer, Stefan

2017-06-15

The world's commitment towards land degradation neutrality (LDN) became enshrined in various international agreements and decisions throughout the year 2015. The challenge now becomes one of addressing its operation, in order to achieve these new policy goals and targets by the year 2030. Advancing LDN demands attention to what the concept seeks to achieve, as well as unravelling the perspectives of the key multi-lateral environmental agreements through which progress can be made. The three Rio Conventions (the UN Convention to Combat Desertification (UNCCD), the UN Framework Convention on Climate Change (UNFCCC) and the Convention on Biological Diversity (CBD)) all play key roles in shaping the international LDN governance and implementation context. Their different but related foci create a number of challenges and opportunities for advancing LDN. In this paper we critically analyze the literature to elucidate potential challenges and opportunities in moving LDN towards implementation, considering the mandates and objectives of all three Rio Conventions. We first unpack the concept of LDN's aspirations. We highlight the importance of the definitions and terminology used, and the relationships between those definitions, terms and the actors using them, as well as their implications in framing the range of policy actions and synergies that could benefit progress towards multiple Sustainable Development Goals. We then examine the LDN pilot project spearheaded by the UNCCD to identify key lessons for LDN implementation. Synthesizing these lessons, we present a portfolio of blended interventions that seeks to address the aspirations of the UNCCD, UNFCCC and CBD in the LDN space, identifying synergistic options for national actions to move towards LDN. Overall, our analysis provides insights in advancing LDN from its current position as a policy target, towards synergetic action. Copyright © 2016 Elsevier Ltd. All rights reserved.

Challenges in image-guided therapy system design.

PubMed

Dimaio, Simon; Kapur, Tina; Cleary, Kevin; Aylward, Stephen; Kazanzides, Peter; Vosburgh, Kirby; Ellis, Randy; Duncan, James; Farahani, Keyvan; Lemke, Heinz; Peters, Terry; Lorensen, William Bill; Gobbi, David; Haller, John; Clarke, Laurence Larry; Pizer, Stephen; Taylor, Russell; Galloway, Robert; Fichtinger, Gabor; Hata, Nobuhiko; Lawson, Kimberly; Tempany, Clare; Kikinis, Ron; Jolesz, Ferenc

2007-01-01

System development for image-guided therapy (IGT), or image-guided interventions (IGI), continues to be an area of active interest across academic and industry groups. This is an emerging field that is growing rapidly: major academic institutions and medical device manufacturers have produced IGT technologies that are in routine clinical use, dozens of high-impact publications are published in well regarded journals each year, and several small companies have successfully commercialized sophisticated IGT systems. In meetings between IGT investigators over the last two years, a consensus has emerged that several key areas must be addressed collaboratively by the community to reach the next level of impact and efficiency in IGT research and development to improve patient care. These meetings culminated in a two-day workshop that brought together several academic and industrial leaders in the field today. The goals of the workshop were to identify gaps in the engineering infrastructure available to IGT researchers, develop the role of research funding agencies and the recently established US-based National Center for Image Guided Therapy (NCIGT), and ultimately to facilitate the transfer of technology among research centers that are sponsored by the National Institutes of Health (NIH). Workshop discussions spanned many of the current challenges in the development and deployment of new IGT systems. Key challenges were identified in a number of areas, including: validation standards; workflows, use-cases, and application requirements; component reusability; and device interface standards. This report elaborates on these key points and proposes research challenges that are to be addressed by a joint effort between academic, industry, and NIH participants.

Challenges in tackling tuberculosis on the Thai-Myanmar border: findings from a qualitative study with health professionals.

PubMed

Kaji, Aiko; Thi, Sein Sein; Smith, Terrence; Charunwatthana, Prakaykaew; Nosten, Francois H

2015-10-09

Myanmar and Thailand belong to the top 22 high burden countries for tuberculosis (TB). Health care organizations play an essential role in addressing TB control in the two bridging border jurisdictions, Tak province, Thailand and Myawaddy district, Kayin state, Myanmar. However, health professionals face difficulties in TB control effort due to the nature of fluid population movements, resource constraints and ambiguous mechanisms to implement collaboration along the border. The purpose of this study is to identify the challenges to TB control among Myanmar migrants faced by stakeholders, focusing on the area of collaboration and interaction along the border. The study conducted in-depth interviews with health policy makers and health care providers responsible for developing and implementing policies and TB programs in Tak province, Thailand and Myawaddy district, Kayin state, Myanmar. The participants included members of government organizations, United Nations agencies, community based organizations, and international NGO. One or two key stakeholders from each organization were approached to participate in the study. We gathered baseline information to identify TB policies and programs available on websites, brochures, and publications. Observations including field notes were made on site. The data transcriptions were coded for qualitative data analysis. Coding also developed categories that led to key themes. A total of 31 respondents (18 in Thailand and 13 in Myanmar) participated in the study. The main theme reported by participants was challenges in limited corroboration and coordination among stakeholders. Unstructured information sharing and lack of communication hindered the stakeholders from engaging in TB control. The respondents stressed that referral mechanisms across the border need to be strengthened. Other challenges were associated with increasing loss to follow up and subsequent MDR cases, constraints of service delivery, shortage of human resources, limited staff capacities within organizations and poor socioeconomic status of patients. Health professionals face many challenges in effectively addressing TB control. Addressing the insufficient coordination and collaboration by strengthening bi-national collaborative mechanisms among health care organizations is an essential step in reducing the burden of disease. Additional support and resources from governmental and non-governmental agencies will be required to address the challenges.

Water and fire safety issues addressed.

PubMed

Arrowsmith, Mike

2014-11-01

One of the four conference streams at last month's Healthcare Estates 2014 event focused on some of the key engineering challenges and opportunities facing healthcare estates managers and healthcare engineers. Mike Arrowsmith, HEJ's technical editor, provides an overview of the engineering sessions at this year's IHEEM conference.

Federal Aviation Administration : reauthorization provides opportunities to address key agency challenges

DOT National Transportation Integrated Search

2003-04-10

Much has changed since the Wendell H. Ford Aviation Investment and Reform Act for the 21st Century (AIR-21) reauthorized the Federal Aviation Administration's (FAA) programs 3 years ago. At that time, air traffic was increasing, and concerns about co...

Guidelines for successful self-scheduling on nursing units.

PubMed

Russell, Elizabeth; Hawkins, Jenna; Arnold, Kara A

2012-09-01

Self-scheduling programs are an increasingly popular strategy utilized by employers to address the individual and organizational challenges resulting from employee work-life imbalance among the nursing workforce. Certain key components will ensure buy-in and support from staff when self-scheduling programs are developed.

Leadership Skills for Department Chairs.

ERIC Educational Resources Information Center

Gmelch, Walter H.; Miskin, Val D.

This guide to leadership for college department chairs addresses three major challenges: (1) developing understanding and clarity about the motives and role of a department chair; (2) understanding the strategic planning process for creating a productive department; and (3) developing key leadership skills required for effectiveness. The first…

Use of Adverse Outcome Pathways to Inform Decisions on Chemical Innovation, Regulation & Stewardship

EPA Science Inventory

An invited group of scientists participated in a SETAC Pellston WorkshopTM, “Advancing the Adverse Outcome Pathway (AOP) Concept – An International Horizon Scanning Approach,” in April 2017. The workshop addressed key challenges or limitations of AOP constructs...

Monitoring biological diversity: strategies, tools, limitations, and challenges

USGS Publications Warehouse

Beever, E.A.

2006-01-01

Monitoring is an assessment of the spatial and temporal variability in one or more ecosystem properties, and is an essential component of adaptive management. Monitoring can help determine whether mandated environmental standards are being met and can provide an early-warning system of ecological change. Development of a strategy for monitoring biological diversity will likely be most successful when based upon clearly articulated goals and objectives and may be enhanced by including several key steps in the process. Ideally, monitoring of biological diversity will measure not only composition, but also structure and function at the spatial and temporal scales of interest. Although biodiversity monitoring has several key limitations as well as numerous theoretical and practical challenges, many tools and strategies are available to address or overcome such challenges; I summarize several of these. Due to the diversity of spatio-temporal scales and comprehensiveness encompassed by existing definitions of biological diversity, an effective monitoring design will reflect the desired sampling domain of interest and its key stressors, available funding, legal requirements, and organizational goals.

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

Morrison-Saunders, Angus, E-mail: a.morrison-saunders@murdoch.edu.au; North-West University; Pope, Jenny, E-mail: jenny@integral-sustainability.net

This paper conceptualises what sustainability assessment follow-up might entail for three models of sustainability assessment: EIA-driven integrated assessment, objectives-led integrated assessment and the contribution to sustainability model. The first two are characterised by proponent monitoring and evaluation of individual impacts and indicators while the latter takes a holistic view based around focused sustainability criteria relevant to the context. The implications of three sustainability challenges on follow-up are also examined: contested time horizons and value changes, trade-offs, and interdisciplinarity. We conclude that in order to meet these challenges some form of adaptive follow-up is necessary and that the contribution to sustainabilitymore » approach is the best approach. -- Highlights: • We explore sustainability follow-up for three different sustainability models. • Long-time frames require adaptive follow-up and are a key follow-up challenge. • Other key challenges include interdisciplinarity, and trade-offs. • Sustainability follow-up should be a direction of travel and not an outcome. • Only the follow-up for contribution to sustainability model addresses sustainability challenges sufficiently.« less

National health inequality monitoring: current challenges and opportunities.

PubMed

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

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

Centennial Challenges Program Overview: How NASA Successfully Involves the General Public in the Solving of Current Technology Gaps

NASA Technical Reports Server (NTRS)

Roman, Monsi C.; Kim, Tony; Sudnik, Janet; Sivak, Amy; Porter, Molly; Cylar, Rosaling; Cavanaugh, Dominique; Krome, Kim

2017-01-01

The National Aeronautics and Space Administration (NASA) Centennial Challenges Program, part of the Space Technology Mission Directorate (STMD), addresses key technology needs of NASA and the nation, while facilitating new sources of innovation outside the traditional community. This is done by the direct engagement of the public at large, through the offering of Congressional authorized prize purses and associated challenges developed by NASA and the aerospace community and set up as a competition awarding the prize money for achieving the specified technology goal.

Retail food environments research: Promising future with more work to be done.

PubMed

Fuller, Daniel; Engler-Stringer, Rachel; Muhajarine, Nazeem

2016-06-09

As members of the scientific committee for the Food Environments in Canada conference, we reflect on the current state of food environments research in Canada. We are very encouraged that the field is growing and there have been many collaborative efforts to link researchers in Canada, including the 2015 Food Environments in Canada Symposium and Workshop. We believe there are 5 key challenges the field will need to collectively address: theory and causality; replication and extension; consideration of rural, northern and vulnerable populations; policy analysis; and intervention research. In addressing the challenges, we look forward to working together to conduct more sophisticated, complex and community-driven food environments research in the future.

Ethical challenges facing veterinary professionals in Ireland: results from Policy Delphi with vignette methodology

PubMed Central

Magalhães-Sant'Ana, M.; More, S. J.; Morton, D. B.; Hanlon, A.

2016-01-01

Ethics is key to the integrity of the veterinary profession. Despite its importance, there is a lack of applied research on the range of ethical challenges faced by veterinarians. A three round Policy Delphi with vignette methodology was used to record the diversity of views on ethical challenges faced by veterinary professionals in Ireland. Forty experts, comprising veterinary practitioners, inspectors and nurses, accepted to participate. In round 1, twenty vignettes describing a variety of ethically challenging veterinary scenarios were ranked in terms of ethical acceptability, reputational risk and perceived standards of practice. Round 2 aimed at characterising challenges where future policy development or professional guidance was deemed to be needed. In round 3, possible solutions to key challenges were explored. Results suggest that current rules and regulations are insufficient to ensure best veterinary practices and that a collective approach is needed to harness workable solutions for the identified ethical challenges. Challenges pertaining mostly to the food chain seem to require enforcement measures whereas softer measures that promote professional discretion were preferred to address challenges dealing with veterinary clinical services. These findings can support veterinary representative bodies, advisory committees and regulatory authorities in their decision making, policy and regulation. PMID:27613779

Ethical challenges facing veterinary professionals in Ireland: results from Policy Delphi with vignette methodology.

PubMed

Magalhães-Sant'Ana, M; More, S J; Morton, D B; Hanlon, A

2016-10-29

Ethics is key to the integrity of the veterinary profession. Despite its importance, there is a lack of applied research on the range of ethical challenges faced by veterinarians. A three round Policy Delphi with vignette methodology was used to record the diversity of views on ethical challenges faced by veterinary professionals in Ireland. Forty experts, comprising veterinary practitioners, inspectors and nurses, accepted to participate. In round 1, twenty vignettes describing a variety of ethically challenging veterinary scenarios were ranked in terms of ethical acceptability, reputational risk and perceived standards of practice. Round 2 aimed at characterising challenges where future policy development or professional guidance was deemed to be needed. In round 3, possible solutions to key challenges were explored. Results suggest that current rules and regulations are insufficient to ensure best veterinary practices and that a collective approach is needed to harness workable solutions for the identified ethical challenges. Challenges pertaining mostly to the food chain seem to require enforcement measures whereas softer measures that promote professional discretion were preferred to address challenges dealing with veterinary clinical services. These findings can support veterinary representative bodies, advisory committees and regulatory authorities in their decision making, policy and regulation. British Veterinary Association.

Development, Testing, and Validation of a Model-Based Tool to Predict Operator Responses in Unexpected Workload Transitions

NASA Technical Reports Server (NTRS)

Sebok, Angelia; Wickens, Christopher; Sargent, Robert

2015-01-01

One human factors challenge is predicting operator performance in novel situations. Approaches such as drawing on relevant previous experience, and developing computational models to predict operator performance in complex situations, offer potential methods to address this challenge. A few concerns with modeling operator performance are that models need to realistic, and they need to be tested empirically and validated. In addition, many existing human performance modeling tools are complex and require that an analyst gain significant experience to be able to develop models for meaningful data collection. This paper describes an effort to address these challenges by developing an easy to use model-based tool, using models that were developed from a review of existing human performance literature and targeted experimental studies, and performing an empirical validation of key model predictions.

NCI and the Cancer Community: Focus on Patients Through Innovative Research

Cancer.gov

At the 2018 AACR Annual Meeting , NCI Director Norman Sharpless describes the key focus areas where NCI can be particularly important to the cancer research enterprise on advancing progress and explains how addressing the challenges of the cancer research landscape requires innovative thinking.

Identifying Key Events in AOPs for Embryonic Disruption using Computational Toxicology (European Teratology Society - AOP symp.)

EPA Science Inventory

Addressing safety aspects of drugs and environmental chemicals relies extensively on animal testing; however, the quantity of chemicals needing assessment and challenges of species extrapolation require alternative approaches to traditional animal studies. Newer in vitro and in s...

Preparing Mathematics Teachers for Technology-Rich Environments

ERIC Educational Resources Information Center

Sturdivant, Rodney X.; Dunham, Penelope; Jardine, Richard

2009-01-01

This article describes key elements for faculty development programs to prepare mathematics teachers for technology-rich environments. We offer practical examples from our experiences in teaching mathematics with technology and in teaching others to incorporate technology-based pedagogies. We address challenges faced by faculty using technology,…

Design Environment for Novel Vertical Lift Vehicles: DELIVER

NASA Technical Reports Server (NTRS)

Theodore, Colin

2016-01-01

This is a 20 minute presentation discussing the DELIVER vision. DELIVER is part of the ARMD Transformative Aeronautics Concepts Program, particularly the Convergent Aeronautics Solutions Project. The presentation covers the DELIVER vision, transforming markets, conceptual design process, challenges addressed, technical content, and FY2016 key activities.

Development Of A Solid Oxide Fuel Cell Stack By Delphi And Battelle

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

Mukerjee, Subhasish; Shaffer, Steven J.; Zizelman, James

2003-01-20

Delphi and Battelle are developing a Solid Oxide Fuel Cell (SOFC) stack for transportation and residential applications. This paper describes the status of development of the Generation 2 stack and key progress made in addressing some of the challenges in this technology.

Voluntary medical male circumcision: a qualitative study exploring the challenges of costing demand creation in eastern and southern Africa.

PubMed

Bertrand, Jane T; Njeuhmeli, Emmanuel; Forsythe, Steven; Mattison, Sarah K; Mahler, Hally; Hankins, Catherine A

2011-01-01

This paper proposes an approach to estimating the costs of demand creation for voluntary medical male circumcision (VMMC) scale-up in 13 countries of eastern and southern Africa. It addresses two key questions: (1) what are the elements of a standardized package for demand creation? And (2) what challenges exist and must be taken into account in estimating the costs of demand creation? We conducted a key informant study on VMMC demand creation using purposive sampling to recruit seven people who provide technical assistance to government programs and manage budgets for VMMC demand creation. Key informants provided their views on the important elements of VMMC demand creation and the most effective funding allocations across different types of communication approaches (e.g., mass media, small media, outreach/mobilization). The key finding was the wide range of views, suggesting that a standard package of core demand creation elements would not be universally applicable. This underscored the importance of tailoring demand creation strategies and estimates to specific country contexts before estimating costs. The key informant interviews, supplemented by the researchers' field experience, identified these issues to be addressed in future costing exercises: variations in the cost of VMMC demand creation activities by country and program, decisions about the quality and comprehensiveness of programming, and lack of data on critical elements needed to "trigger the decision" among eligible men. Based on this study's findings, we propose a seven-step methodological approach to estimate the cost of VMMC scale-up in a priority country, based on our key assumptions. However, further work is needed to better understand core components of a demand creation package and how to cost them. Notwithstanding the methodological challenges, estimating the cost of demand creation remains an essential element in deriving estimates of the total costs for VMMC scale-up in eastern and southern Africa.

Voluntary Medical Male Circumcision: A Qualitative Study Exploring the Challenges of Costing Demand Creation in Eastern and Southern Africa

PubMed Central

Bertrand, Jane T.; Njeuhmeli, Emmanuel; Forsythe, Steven; Mattison, Sarah K.; Mahler, Hally; Hankins, Catherine A.

2011-01-01

Background This paper proposes an approach to estimating the costs of demand creation for voluntary medical male circumcision (VMMC) scale-up in 13 countries of eastern and southern Africa. It addresses two key questions: (1) what are the elements of a standardized package for demand creation? And (2) what challenges exist and must be taken into account in estimating the costs of demand creation? Methods and Findings We conducted a key informant study on VMMC demand creation using purposive sampling to recruit seven people who provide technical assistance to government programs and manage budgets for VMMC demand creation. Key informants provided their views on the important elements of VMMC demand creation and the most effective funding allocations across different types of communication approaches (e.g., mass media, small media, outreach/mobilization). The key finding was the wide range of views, suggesting that a standard package of core demand creation elements would not be universally applicable. This underscored the importance of tailoring demand creation strategies and estimates to specific country contexts before estimating costs. The key informant interviews, supplemented by the researchers' field experience, identified these issues to be addressed in future costing exercises: variations in the cost of VMMC demand creation activities by country and program, decisions about the quality and comprehensiveness of programming, and lack of data on critical elements needed to “trigger the decision” among eligible men. Conclusions Based on this study's findings, we propose a seven-step methodological approach to estimate the cost of VMMC scale-up in a priority country, based on our key assumptions. However, further work is needed to better understand core components of a demand creation package and how to cost them. Notwithstanding the methodological challenges, estimating the cost of demand creation remains an essential element in deriving estimates of the total costs for VMMC scale-up in eastern and southern Africa. PMID:22140450

Global Antimicrobial Stewardship: A Closer Look at the Formidable Implementation Challenges

PubMed Central

Tiong, John J. L.; Loo, Jason S. E.; Mai, Chun-Wai

2016-01-01

Antimicrobial stewardship (AMS) has been touted as one of the key strategies required in tackling worldwide escalation of antibiotic resistance. Although AMS has optimized antibiotic usage and reduced the incidence of resistance development in some regions, its full global potential has been curtailed by various AMS-impeding factors. This article seeks to highlight in a detailed perspective, the key challenges that hamper global AMS endeavors, some of which include the paucity of effective implementation strategies that cater for the challenging settings of developing nations, the slow response of governments, uncoordinated AMS activities as well as implementation fragmentation across different sectors and countries. The authors of this article call upon all stakeholders to pay attention to these seemingly obvious but often under-addressed problems. If left unresolved, this may render all current and future AMS initiatives pointless. PMID:27899924

Commercial Orbital Transportation Services (COTS) Program Lessons Learned

NASA Technical Reports Server (NTRS)

Lindenmoyer, Alan; Horkachuck, Mike; Shotwell, Gwynne; Manners, Bruce; Culbertson, Frank

2015-01-01

This report has been developed by the National Aeronautics and Space Administration (NASA) Human Exploration and Operations Mission Directorate (HEOMD) Risk Management team in close coordination with the COTS Program. This document provides a point-in-time, cumulative, summary of actionable key lessons learned derived from the design project. Lessons learned invariably address challenges and risks and the way in which these areas have been addressed. Accordingly the risk management thread is woven throughout the document.

ESMD Risk Management Workshop: Systems Engineering and Integration Risks

NASA Technical Reports Server (NTRS)

Thomas, L. Dale

2005-01-01

This report has been developed by the National Aeronautics and Space Administration (NASA) Exploration Systems Mission Directorate (ESMD) Risk Management team in close coordination with the Systems Engineering Team. This document provides a point-in-time, cumulative, summary of key lessons learned derived from the SE RFP Development process. Lessons learned invariably address challenges and risks and the way in which these areas have been addressed. Accordingly the risk management thread is woven throughout the document.

Advances in space robotics

NASA Technical Reports Server (NTRS)

Varsi, Giulio

1989-01-01

The problem of the remote control of space operations is addressed by identifying the key technical challenge: the management of contact forces and the principal performance parameters. Three principal classes of devices for remote operation are identified: anthropomorphic exoskeletons, computer aided teleoperators, and supervised telerobots. Their fields of application are described, and areas in which progress has reached the level of system or subsystem laboratory demonstrations are indicated. Key test results, indicating performance at a level useful for design tradeoffs, are reported.

A Multiyear Investigation of Combating Bullying in Middle School: Stakeholder Perspectives

ERIC Educational Resources Information Center

Shriberg, David; Burns, Mallory; Desai, Poonam; Grunewald, Stephanie; Pitt, Rachel

2015-01-01

Working collaboratively to address bullying among middle school students is an ongoing challenge. This study used participatory action research to collaborate with key stakeholders within a middle school to identify needs and implement more effective practices. Extensive qualitative and quantitative data are presented, along with process…

Preparing STEM Teachers: The Key to Global Competitiveness

ERIC Educational Resources Information Center

American Association of Colleges for Teacher Education (NJ1), 2007

2007-01-01

Like many sectors in society, the teacher preparation community is working to address challenges the nation faces in relation to global competitiveness. This document highlights institutions around the country that are preparing tomorrow's teachers in the fields of science, technology, engineering, and mathematics (STEM). Well-known shortages of…

The Complexity of Transdisciplinary Literature Reviews

ERIC Educational Resources Information Center

Montuori, Alfonso

2013-01-01

The transdisciplinary literature review is an opportunity to situate the inquirer in an ecology of ideas. This article explores how we might approach this process from a perspective of complexity, and addresses some of the key challenges and opportunities. Four main dimensions are considered: (a) inquiry-based rather than discipline-based; (b)…

The New Literacies of Online Reading Comprehension: Future Directions

ERIC Educational Resources Information Center

Coiro, Julie

2012-01-01

Research in four areas has the potential to dramatically improve how practitioners address the challenges of integrating digital texts and tasks into their literacy curriculum. Advances in defining and measuring key components of online reading comprehension are rapidly emerging. In addition, instructional models, such as Internet reciprocal…

The American University: National Treasure or Endangered Species?

ERIC Educational Resources Information Center

Ehrenberg, Ronald G. Ed.

This book of nine essays was written to honor Frank H. T. Rhodes, President Emeritus of Cornell University (New York) and addresses ways in which research universities can respond to current challenges. An introductory chapter, "The American University: Dilemmas and Directions" (Ronald G. Ehrenberg), identifies key issues raised in the following…

Response: Critical Realism--Response to Longhofer and Floersch

ERIC Educational Resources Information Center

Briar-Lawson, Katharine

2012-01-01

This article addresses key challenges posed by critical realism, proposed by Longhofer and Floersch, as a philosophical underpinning for a science of social work. As a response to Longhofer and Floersch, it is argued that critical realism may be instructive in debates about structural conditions that dictate more inclusive interventions and…

Family-Centered Early Intervention with Infants & Toddlers: Innovative Cross-Disciplinary Approaches.

ERIC Educational Resources Information Center

Brown, Wesley, Ed.; And Others

This multi-contributor volume addresses the challenges of providing early intervention services to infants and toddlers with disabilities, within a family-centered framework. The book provides a legislative review of the key elements of eligibility, assessment, and evaluation and then examines service coordination, curricula, special intervention…

A call to action.

PubMed

Thompson, Tommy G

2006-01-01

To summarize the challenges facing the U.S. health care system between now and 2013. Between now and 2013, the American health care system will need to make major changes to successfully address Medicare's funding challenges. Making the patient a partner in care, developing systems that promote and reward prevention efforts, and ensuring that health care purchasers understand and pursue value will be key. The growing prevalence of diabetes and cardiometabolic conditions is one area in which concerted efforts are needed.

Patient-Reported Outcomes and Survivorship in Radiation Oncology: Overcoming the Cons

PubMed Central

Siddiqui, Farzan; Liu, Arthur K.; Watkins-Bruner, Deborah; Movsas, Benjamin

2014-01-01

Purpose Although patient-reported outcomes (PROs) have become a key component of clinical oncology trials, many challenges exist regarding their optimal application. The goal of this article is to methodically review these barriers and suggest strategies to overcome them. This review will primarily focus on radiation oncology examples, will address issues regarding the “why, how, and what” of PROs, and will provide strategies for difficult problems such as methods for reducing missing data. This review will also address cancer survivorship because it closely relates to PROs. Methods Key articles focusing on PROs, quality of life, and survivorship issues in oncology trials are highlighted, with an emphasis on radiation oncology clinical trials. Publications and Web sites of various governmental and regulatory agencies are also reviewed. Results The study of PROs in clinical oncology trials has become well established. There are guidelines provided by organizations such as the US Food and Drug Administration that clearly indicate the importance of and methodology for studying PROs. Clinical trials in oncology have repeatedly demonstrated the value of studying PROs and suggested ways to overcome some of the key challenges. The Radiation Therapy Oncology Group (RTOG) has led some of these efforts, and their contributions are highlighted. The current state of cancer survivorship guidelines is also discussed. Conclusion The study of PROs presents significant benefits in understanding and treating toxicities and enhancing quality of life; however, challenges remain. Strategies are presented to overcome these hurdles, which will ultimately improve cancer survivorship. PMID:25113760

Challenges of standardized continuous quality improvement programs in community pharmacies: the case of SafetyNET-Rx.

PubMed

Boyle, Todd A; MacKinnon, Neil J; Mahaffey, Thomas; Duggan, Kellie; Dow, Natalie

2012-01-01

Research on continuous quality improvement (CQI) in community pharmacies lags in comparison to service, manufacturing, and various health care sectors. As a result, very little is known about the challenges community pharmacies face when implementing CQI programs in general, let alone the challenges of implementing a standardized and technologically sophisticated one. This research identifies the initial challenges of implementing a standardized CQI program in community pharmacies and how such challenges were addressed by pharmacy staff. Through qualitative interviews, a multisite study of the SafetyNET-Rx CQI program involving community pharmacies in Nova Scotia, Canada, was performed to identify such challenges. Interviews were conducted with the CQI facilitator (ie, staff pharmacist or technician) in 55 community pharmacies that adopted the SafetyNET-Rx program. Of these 55 pharmacies, 25 were part of large national corporate chains, 22 were part of banner chains, and 8 were independent pharmacies. A total of 10 different corporate chains and banners were represented among the 55 pharmacies. Thematic content analysis using well-established coding procedures was used to explore the interview data and elicit the key challenges faced. Six major challenges were identified, specifically finding time to report, having all pharmacy staff involved in quality-related event (QRE) reporting, reporting apprehensiveness, changing staff relationships, meeting to discuss QREs, and accepting the online technology. Challenges were addressed in a number of ways including developing a manual-online hybrid reporting system, managers paying staff to meet after hours, and pharmacy managers showing visible commitment to QRE reporting and learning. This research identifies key challenges to implementing CQI programs in community pharmacies and also provides a starting point for future research relating to how the challenges of QRE reporting and learning in community pharmacies change over time. Copyright © 2012 Elsevier Inc. All rights reserved.

Behaviour change for better health: nutrition, hygiene and sustainability.

PubMed

Newson, Rachel S; Lion, Rene; Crawford, Robert J; Curtis, Valerie; Elmadfa, Ibrahim; Feunekes, Gerda I J; Hicks, Cheryl; van Liere, Marti; Lowe, C Fergus; Meijer, Gert W; Pradeep, B V; Reddy, K Srinath; Sidibe, Myriam; Uauy, Ricardo

2013-01-01

As the global population grows there is a clear challenge to address the needs of consumers, without depleting natural resources and whilst helping to improve nutrition and hygiene to reduce the growth of noncommunicable diseases. For fast-moving consumer goods companies, like Unilever, this challenge provides a clear opportunity to reshape its business to a model that decouples growth from a negative impact on natural resources and health. However, this change in the business model also requires a change in consumer behaviour. In acknowledgement of this challenge Unilever organised a symposium entitled 'Behaviour Change for Better Health: Nutrition, Hygiene and Sustainability'. The intention was to discuss how consumers can be motivated to live a more healthy and sustainable lifestlye in today's environment. This article summarises the main conclusions of the presentations given at the symposium. Three main topics were discussed. In the first session, key experts discussed how demographic changes - particularly in developing and emerging countries - imply the need for consumer behaviour change. The second session focused on the use of behaviour change theory to design, implement and evaluate interventions, and the potential role of (new or reformulated) products as agents of change. In the final session, key issues were discussed regarding the use of collaborations to increase the impact and reach, and to decrease the costs, of interventions. The symposium highlighted a number of key scientific challenges for Unilever and other parties that have set nutrition, hygiene and sustainability as key priorities. The key challenges include: adapting behaviour change approaches to cultures in developing and emerging economies; designing evidence-based behaviour change interventions, in which products can play a key role as agents of change; and scaling up behaviour change activities in cost-effective ways, which requires a new mindset involving public-private partnerships.

Behaviour change for better health: nutrition, hygiene and sustainability

PubMed Central

2013-01-01

As the global population grows there is a clear challenge to address the needs of consumers, without depleting natural resources and whilst helping to improve nutrition and hygiene to reduce the growth of noncommunicable diseases. For fast-moving consumer goods companies, like Unilever, this challenge provides a clear opportunity to reshape its business to a model that decouples growth from a negative impact on natural resources and health. However, this change in the business model also requires a change in consumer behaviour. In acknowledgement of this challenge Unilever organised a symposium entitled ‘Behaviour Change for Better Health: Nutrition, Hygiene and Sustainability’. The intention was to discuss how consumers can be motivated to live a more healthy and sustainable lifestlye in today’s environment. This article summarises the main conclusions of the presentations given at the symposium. Three main topics were discussed. In the first session, key experts discussed how demographic changes – particularly in developing and emerging countries – imply the need for consumer behaviour change. The second session focused on the use of behaviour change theory to design, implement and evaluate interventions, and the potential role of (new or reformulated) products as agents of change. In the final session, key issues were discussed regarding the use of collaborations to increase the impact and reach, and to decrease the costs, of interventions. The symposium highlighted a number of key scientific challenges for Unilever and other parties that have set nutrition, hygiene and sustainability as key priorities. The key challenges include: adapting behaviour change approaches to cultures in developing and emerging economies; designing evidence-based behaviour change interventions, in which products can play a key role as agents of change; and scaling up behaviour change activities in cost-effective ways, which requires a new mindset involving public–private partnerships. PMID:23530770

The organisational and human resource challenges facing primary care trusts: protocol of a multiple case study

PubMed Central

2001-01-01

Background The study is designed to assess the organisational and human resource challenges faced by Primary Care Trusts (PCTs). Its objectives are to: specify the organisational and human resources challenges faced by PCTs in fulfilling the roles envisaged in government and local policy; examine how PCTs are addressing these challenges, in particular, to describe the organisational forms they have adopted, and the OD/HR strategies and initiatives they have planned or in place; assess how effective these structures, strategies and initiatives have been in enabling the PCTs to meet the organisational and human resources challenges they face; identify the factors, both internal to the PCT and in the wider health community, which have contributed to the success or failure of different structures, strategies and initiatives. Methods The study will be undertaken in three stages. In Stage 1 the key literature on public sector and NHS organisational development and human resources management will be reviewed, and discussions will be held with key researchers and policy makers working in this area. Stage 2 will focus on detailed case studies in six PCTs designed to examine the organisational and human resources challenges they face. Data will be collected using semi-structured interviews, group discussion, site visits, observation of key meetings and examination of local documentation. The findings from the case study PCTs will be cross checked with a Reference Group of up to 20 other PCG/Ts, and key officers working in organisational development or primary care at local, regional and national level. In Stage 3 analysis of findings from the preparatory work, the case studies and the feedback from the Reference Group will be used to identify practical lessons for PCTs, key messages for policy makers, and contributions to further theoretical development. PMID:11737883

Reclaiming Gender and Power in Sexual Violence Prevention in Adolescence.

PubMed

Miller, Elizabeth

2018-03-01

The Mentors in Violence Prevention (MVP) model seeks to address the root causes of gender violence using a bystander approach and leadership training to challenge structures of patriarchy. Emerging research on adolescent relationship abuse and sexual violence points to key modifiable targets-transforming gender norms, addressing homophobia, integrating with comprehensive sexuality education, and acknowledging the needs of youth already exposed to violence. A social justice-based bystander approach such as the MVP model should be part of a multi-level approach to sexual violence prevention that addresses gender and power, encourages healthy sexuality conversations, and provides safety and support for survivors.

Ineffective Healthcare Technology Management in Benin’s Public Health Sector: The Perceptions of Key Actors and Their Ability to Address the Main Problems

PubMed Central

Houngbo, P. Thierry; De Cock Buning, Tjard; Bunders, Joske; Coleman, Harry L. S.; Medenou, Daton; Dakpanon, Laurent; Zweekhorst, Marjolein

2017-01-01

Background: Low-income countries face many contextual challenges to manage healthcare technologies effectively, as the majority are imported and resources are constrained to a greater extent. Previous healthcare technology management (HTM) policies in Benin have failed to produce better quality of care for the population and costeffectiveness for the government. This study aims to identify and assess the main problems facing HTM in Benin’s public health sector, as well as the ability of key actors within the sector to address these problems. Methods: We conducted 2 surveys in 117 selected health facilities. The first survey was based on 377 questionnaires and 259 interviews, and the second involved observation and group interviews at health facilities. The Temple-Bird Healthcare Technology Package System (TBHTPS), tailored to the context of Benin’s health system, was used as a conceptual framework. Results: The findings of the first survey show that 85% of key actors in Benin’s HTM sector characterized the system as failing in components of the TBHTPS framework. Biomedical, clinical, healthcare technology engineers and technicians perceived problems most severely, followed by users of equipment, managers and hospital directors, international organization officers, local and foreign suppliers, and finally policy-makers, planners and administrators at the Ministry of Health (MoH). The 5 most important challenges to be addressed are policy, strategic management and planning, and technology needs assessment and selection – categorized as major enabling inputs (MEI) in HTM by the TBHTPS framework – and installation and commissioning, training and skill development and procurement, which are import and use activities (IUA). The ability of each key actor to address these problems (the degree of political or administrative power they possess) was inversely proportional to their perception of the severity of the problems. Observational data gathered during site visits described a different set of challenges including maintenance and repair, distribution, installation and commissioning, use and training and personnel skill development. Conclusion: The lack of experiential and technical knowledge in policy development processes could underpin many of the continuing problems in Benin’s HTM system. Before solutions can be devised to these problems, it is necessary to investigate their root causes, and which problems are most amenable to policy development. PMID:28949474

Key enzymes and proteins of crop insects as candidate for RNAi based gene silencing

PubMed Central

Kola, Vijaya Sudhakara Rao; Renuka, P.; Madhav, Maganti Sheshu; Mangrauthia, Satendra K.

2015-01-01

RNA interference (RNAi) is a mechanism of homology dependent gene silencing present in plants and animals. It operates through 21–24 nucleotides small RNAs which are processed through a set of core enzymatic machinery that involves Dicer and Argonaute proteins. In recent past, the technology has been well appreciated toward the control of plant pathogens and insects through suppression of key genes/proteins of infecting organisms. The genes encoding key enzymes/proteins with the great potential for developing an effective insect control by RNAi approach are actylcholinesterase, cytochrome P450 enzymes, amino peptidase N, allatostatin, allatotropin, tryptophan oxygenase, arginine kinase, vacuolar ATPase, chitin synthase, glutathione-S-transferase, catalase, trehalose phosphate synthase, vitellogenin, hydroxy-3-methylglutaryl coenzyme A reductase, and hormone receptor genes. Through various studies, it is demonstrated that RNAi is a reliable molecular tool which offers great promises in meeting the challenges imposed by crop insects with careful selection of key enzymes/proteins. Utilization of RNAi tool to target some of these key proteins of crop insects through various approaches is described here. The major challenges of RNAi based insect control such as identifying potential targets, delivery methods of silencing trigger, off target effects, and complexity of insect biology are very well illustrated. Further, required efforts to address these challenges are also discussed. PMID:25954206

Tailored combination prevention packages and PrEP for young key populations

PubMed Central

Pettifor, Audrey; Nguyen, Nadia L; Celum, Connie; Cowan, Frances M; Go, Vivian; Hightow-Weidman, Lisa

2015-01-01

Introduction Young key populations, defined in this article as men who have sex with men, transgender persons, people who sell sex and people who inject drugs, are at particularly high risk for HIV. Due to the often marginalized and sometimes criminalized status of young people who identify as members of key populations, there is a need for HIV prevention packages that account for the unique and challenging circumstances they face. Pre-exposure prophylaxis (PrEP) is likely to become an important element of combination prevention for many young key populations. Objective In this paper, we discuss important challenges to HIV prevention among young key populations, identify key components of a tailored combination prevention package for this population and examine the role of PrEP in these prevention packages. Methods We conducted a comprehensive review of the evidence to date on prevention strategies, challenges to prevention and combination prevention packages for young key populations. We focused specifically on the role of PrEP in these prevention packages and on young people under the age of 24, and 18 in particular. Results and discussion Combination prevention packages that include effective, acceptable and scalable behavioural, structural and biologic interventions are needed for all key populations to prevent new HIV infections. Interventions in these packages should meaningfully involve beneficiaries in the design and implementation of the intervention, and take into account the context in which the intervention is being delivered to thoughtfully address issues of stigma and discrimination. These interventions will likely be most effective if implemented in conjunction with strategies to facilitate an enabling environment, including increasing access to HIV testing and health services for PrEP and other prevention strategies, decriminalizing key populations’ practices, increasing access to prevention and care, reducing stigma and discrimination, and fostering community empowerment. PrEP could offer a highly effective, time-limited primary prevention for young key populations if it is implemented in combination with other programs to increase access to health services and encourage the reliable use of PrEP while at risk of HIV exposure. Conclusions Reductions in HIV incidence will only be achieved through the implementation of combinations of interventions that include biomedical and behavioural interventions, as well as components that address social, economic and other structural factors that influence HIV prevention and transmission. PMID:25724507

Behavioral medicine: a voyage to the future.

PubMed

Keefe, Francis J

2011-04-01

This paper discusses trends and future directions in behavioral medicine. It is divided into three sections. The first briefly reviews key developments in the history of behavioral medicine. The second section highlights trends and future directions in pain research and practice as a way of illustrating future directions for behavioral medicine. Consistent with the biopsychosocial model of pain, this section focuses on trends and future directions in three key areas: biological, psychological, and social. The third section describes recent Society of Behavioral Medicine initiatives designed to address some of the key challenges facing our field as we prepare for the future.

Systems Engineering Lessons Learned from Solar Array Structures and Mechanisms Deployment

NASA Technical Reports Server (NTRS)

Vipavetz, Kevin; Kraft, Thomas

2013-01-01

This report has been developed by the National Aeronautics and Space Administration (NASA) Human Exploration and Operations Mission Directorate (HEOMD) Risk Management team in close coordination with the Engineering Directorate at LaRC. This document provides a point-in-time, cumulative, summary of actionable key lessons learned derived from the design project. Lessons learned invariably address challenges and risks and the way in which these areas have been addressed. Accordingly the risk management thread is woven throughout the document.

Methodological issues associated with preclinical drug development and increased placebo effects in schizophrenia clinical trials.

PubMed

Brown, Matt A; Bishnoi, Ram J; Dholakia, Sara; Velligan, Dawn I

2016-01-20

Recent failures to detect efficacy in clinical trials investigating pharmacological treatments for schizophrenia raise concerns regarding the potential contribution of methodological shortcomings to this research. This review provides an examination of two key methodological issues currently suspected of playing a role in hampering schizophrenia drug development; 1) limitations on the translational utility of preclinical development models, and 2) methodological challenges posed by increased placebo effects. Recommendations for strategies to address these methodological issues are addressed.

MDA Challenges for Operational Research and Analysis

DTIC Science & Technology

2009-10-01

Analysis Dr. Ross Graham Director General Centre for Operational Research and Analysis Report Documentation Page Form ApprovedOMB No. 0704-0188 Public...AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Defence R&D Canada, Centre for...Awareness for the Gov’t of Canada. RJOC(W) RJOC(E) Regional Joint Operations Centres are key enablers Defence R&D Canada • R & D pour la défense

Accident Case Study of Organizational Silence Communication Breakdown: Shuttle Columbia, Mission STS-107

NASA Technical Reports Server (NTRS)

Rocha, Rodney

2011-01-01

This report has been developed by the National Aeronautics and Space Administration (NASA) ESMD Risk and Knowledge Management team. This document provides a point-in-time, cumulative, summary of key lessons learned derived from the official Columbia Accident Investigation Board (CAIB). Lessons learned invariably address challenges and risks and the way in which these areas have been addressed. Accordingly the risk management thread is woven throughout the document. This report is accompanied by a video that will be sent at request

Assessing the American Association of Neuroscience Nurses' Progress on the Institute of Medicine Report.

PubMed

Madden, Lori Kennedy; Hundley, Lynn; Summers, Debbie; Villanueva, Nancy; Walter, Suzy Mascaro

2017-06-01

The American Association of Neuroscience Nurses (AANN) has worked toward meeting the challenges and addressing the key messages from the 2010 Institute of Medicine report on the future of nursing. In 2012, AANN developed an article summarizing how the association has addressed key issues. Since that time, new recommendations have been made to advance nursing, and AANN has updated its strategic plan. The AANN has assessed organizational progress in these initiatives in a 2017 white paper. This process included review of plans since the initial report and proposal of further efforts the organization can make in shaping the future of neuroscience nursing. The purpose of this manuscript is to provide an overview of the AANN white paper.

Nanotechnology: Development and challenges in Indonesia

NASA Astrophysics Data System (ADS)

Joni, I. Made; Muthukannan, Vanitha; Hermawan, Wawan; Panatarani, Camellia

2018-02-01

Nanotechnology today is regarded as a revolutionary technology that can help to address the key needs related to energy, environment, health and agriculture in developing countries. This paper is a short review on the development and challenges of nanotechnology in Indonesia. Nanotechnology offers great potential benefits, there is emerging concerns arising from its novel physicochemical properties. The main applications of nanotechnology in the different sectors which is vital and its economic impact in Indonesia is also discussed. The achievment and development of nanotechnology including synthesis and dispersion of nanoparticles (NPs) and its applications in various fields is briefly addressed in Nanotehcnology and Graphene Research Center, Universitas Padjadjaran (Unpad). Despite significant progress in developmental goals, many challenges in the development of nanotechnology proccesing need to be resolved such as support infrastructure and evolution of new form of collaborative arrangements between various sectors and policies which is emerged as an important factor enabling development.

Conservation biology in Asia: the major policy challenges.

PubMed

McNeely, Jeffrey A; Kapoor-Vijay, Promila; Zhi, Lu; Olsvig-Whittaker, Linda; Sheikh, Kashif M; Smith, Andrew T

2009-08-01

With about half the world's human population and booming economies, Asia faces numerous challenges to its biodiversity. The Asia Section of the Society for Conservation Biology has identified some key policy issues in which significant progress can be made. These include developing new sources of funding for forest conservation; identifying potential impacts of energy alternatives on the conservation of biodiversity; curbing the trade in endangered species of plants and animals; a special focus on the conservation of mountain biodiversity; enhancing relevant research; ensuring that conservation biology contributes to major international conventions and funding mechanisms; using conservation biology to build a better understanding of zoonotic diseases; more effectively addressing human-animal conflicts; enhancing community-based conservation; and using conservation biology to help address the pervasive water-deficit problems in much of Asia. These challenges can be met through improved regional cooperation among the relevant stakeholders.

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

NASA Technical Reports Server (NTRS)

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

2011-01-01

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

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

PubMed Central

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

2017-01-01

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

Rethinking Global Water Governance for the 21st Century

NASA Astrophysics Data System (ADS)

Ajami, N. K.; Cooley, H.

2012-12-01

Growing pressure on the world's water resources is having major impacts on our social and economic well-being. According to the United Nations, today, at least 1.1 billion people do not have access to clean drinking water. Pressures on water resources are likely to continue to worsen in response to decaying and crumbling infrastructure, continued population growth, climate change, degradation of water quality, and other challenges. If these challenges are not addressed, they pose future risks for many countries around the world, making it urgent that efforts are made to understand both the nature of the problems and the possible solutions that can effectively reduce the associated risks. There is growing understanding of the need to rethink governance to meet the 21st century water challenges. More and more water problems extend over traditional national boundaries and to the global community and the types and numbers of organizations addressing water issues are large and growing. Economic globalization and transnational organizations and activities point to the need for improving coordination and integration on addressing water issues, which are increasingly tied to food and energy security, trade, global climate change, and other international policies. We will present some of the key limitations of global water governance institutions and provide recommendations for improving these institutions to address 21st century global water challenges more effectively.

Identifying priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India: a qualitative inquiry

PubMed Central

Chamania, Shobha; Potokar, Tom; Ivers, Rebecca

2018-01-01

Objectives This study aimed to identify priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India. Design Qualitative inquiry; data were collected through semistructured in-depth interviews and focus group discussions. Setting Nine sites in urban and rural settings across India, through primary, secondary and tertiary health facilities. Participants Healthcare providers, key informants, burns survivors and/or their carers. Results Participants acknowledged the challenges of burns care and recovery, and identified the need for prolonged rehabilitation. Challenges identified included poor communication between healthcare providers and survivors, limited rehabilitation services, difficulties with transportation to health facility and high cost associated with burns care. Burns survivors and healthcare providers identified the stigma attached with burns as the biggest challenge within the healthcare system, as well as in the community. Systems barriers (eg, limited infrastructure and human resources), lack of economic and social support, and poor understanding of recovery and rehabilitation were identified as major barriers to recovery. Conclusions Though further research is needed for addressing gaps in data, strengthening of health systems can enable providers to address issues such as developing/providing, protocols, capacity building, effective coordination between key organisations and referral networks. PMID:29523568

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

PubMed Central

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

2016-01-01

Context: The recent explosion in available electronic health record (EHR) data is motivating a rapid expansion of electronic health care predictive analytic (e-HPA) applications, defined as the use of electronic algorithms that forecast clinical events in real time with the intent to improve patient outcomes and reduce costs. There is an urgent need for a systematic framework to guide the development and application of e-HPA to ensure that the field develops in a scientifically sound, ethical, and efficient manner. Objectives: Building upon earlier frameworks of model development and utilization, we identify the emerging opportunities and challenges of e-HPA, propose a framework that enables us to realize these opportunities, address these challenges, and motivate e-HPA stakeholders to both adopt and continuously refine the framework as the applications of e-HPA emerge. Methods: To achieve these objectives, 17 experts with diverse expertise including methodology, ethics, legal, regulation, and health care delivery systems were assembled to identify emerging opportunities and challenges of e-HPA and to propose a framework to guide the development and application of e-HPA. Findings: The framework proposed by the panel includes three key domains where e-HPA differs qualitatively from earlier generations of models and algorithms (Data Barriers, Transparency, and Ethics) and areas where current frameworks are insufficient to address the emerging opportunities and challenges of e-HPA (Regulation and Certification; and Education and Training). The following list of recommendations summarizes the key points of the framework: Data Barriers: Establish mechanisms within the scientific community to support data sharing for predictive model development and testing.Transparency: Set standards around e-HPA validation based on principles of scientific transparency and reproducibility.Ethics: Develop both individual-centered and society-centered risk-benefit approaches to evaluate e-HPA.Regulation and Certification: Construct a self-regulation and certification framework within e-HPA.Education and Training: Make significant changes to medical, nursing, and paraprofessional curricula by including training for understanding, evaluating, and utilizing predictive models. PMID:27141516

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

PubMed

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

2016-01-01

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

Higher Education in Ethiopia: Expansion, Quality Assurance and Institutional Autonomy

ERIC Educational Resources Information Center

Akalu, Girmaw Abebe

2014-01-01

This article chronicles the key challenges facing Ethiopia as it embarks on an ambitious, ideologically-driven and aggressive expansion of its higher education system in an effort to address its national goals of economic growth and poverty reduction. It is argued that the urge for higher education expansion has placed undue pressures particularly…

Electronic Ramp to Success: Designing Campus Web Pages for Users with Disabilities.

ERIC Educational Resources Information Center

Coombs, Norman

2002-01-01

Discusses key issues in addressing the challenge of Web accessibility for people with disabilities, including tools for Web authoring, repairing, and accessibility validation, and relevant legal issues. Presents standards for Web accessibility, including the Section 508 Standards from the Federal Access Board, and the World Wide Web Consortium's…

Mixing Methods in Randomized Controlled Trials (RCTs): Validation, Contextualization, Triangulation, and Control

ERIC Educational Resources Information Center

Spillane, James P.; Pareja, Amber Stitziel; Dorner, Lisa; Barnes, Carol; May, Henry; Huff, Jason; Camburn, Eric

2010-01-01

In this paper we described how we mixed research approaches in a Randomized Control Trial (RCT) of a school principal professional development program. Using examples from our study we illustrate how combining qualitative and quantitative data can address some key challenges from validating instruments and measures of mediator variables to…

Journeys into Inner/Outer Space: Reflections on the Methodological Challenges of Negotiating Insider/Outsider Status in International Educational Research

ERIC Educational Resources Information Center

Savvides, Nicola; Al-Youssef, Joanna; Colin, Mindy; Garrido, Cecilia

2014-01-01

This article highlights key theoretical and methodological issues and implications of being an insider/outsider when undertaking qualitative research in international educational settings. It first addresses discourses of "self" and "other," noting that identity and belonging emerge from fluid engagement between researchers and…

Conducting Program Evaluation with Hispanics in Rural Settings: Ethical Issues and Evaluation Challenges

ERIC Educational Resources Information Center

Loi, Claudia X. Aguado; McDermott, Robert J.

2010-01-01

Conducting evaluations that are both valid and ethical is imperative for the support and sustainability of programs that address underserved and vulnerable populations. A key component is to have evaluators who are knowledgeable about relevant cultural issues and sensitive to population needs. Hispanics in rural settings are vulnerable for many…

An Analysis of Communication as a Key Component in Leadership with Diverse School Populations

ERIC Educational Resources Information Center

Cagle, Jo E.; Wiley, Sandy T.

2012-01-01

"Effective Communication as an Essential Element of Leaders with Diverse School Populations" describes a problem based learning project focused on issues related to practices used by principals to address diverse school populations. The team found that communication between principals and diverse populations in schools was a challenge.…

Surveying Immigrant Communities: Policy Imperatives and Technical Challenges.

ERIC Educational Resources Information Center

DaVanzo, Julie; And Others

While national debates focus on rising immigration and its impact, current data on immigrants and how they affect the national life are limited. To determine the feasibility of conducting a national survey of immigrants, a pilot project surveyed Salvadorans and Filipinos in Los Angeles in 1991. This report addresses key methodological issues in…

A One-Year Introductory Robotics Curriculum for Computer Science Upperclassmen

ERIC Educational Resources Information Center

Correll, N.; Wing, R.; Coleman, D.

2013-01-01

This paper describes a one-year introductory robotics course sequence focusing on computational aspects of robotics for third- and fourth-year students. The key challenges this curriculum addresses are "scalability," i.e., how to teach a robotics class with a limited amount of hardware to a large audience, "student assessment,"…

An Evaluation of an Online Postgraduate Dementia Studies Program

ERIC Educational Resources Information Center

Innes, Anthea; Kelly, Fiona; McCabe, Louise

2012-01-01

Education is key to addressing the challenges of providing high-quality care to the ever growing number of people with dementia. Although dementia education is required for multiple professions and disciplines working with people with dementia and their families and friends, there is a gap in knowledge of students' views about university-level…

Acting Out! Combating Homophobia through Teacher Activism. Practitioner Inquiry Series

ERIC Educational Resources Information Center

Blackburn, Mollie V., Ed.; Clark, Caroline T., Ed.; Kenney, Lauren M., Ed.; Smith, Jill M., Ed.

2009-01-01

In this volume, teachers from urban, suburban, and rural districts join together in a teacher inquiry group to challenge homophobia and heterosexism in schools and classrooms. To create safe learning environments for all students they address key topics, including seizing teachable moments, organizing faculty, deciding whether to come out in the…

77 FR 30017 - International Capacity Building With Respect to Food Safety; Public Meeting; Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-21

... the global supply chain as a key Agency priority. Indeed, two recent reports have focused on the challenges of global supply chains: FDA's ``Pathway to Global Product Safety and Quality,'' and the Institute... more authorities to address the increasingly globalized food supply and prevent problems before they...

Can interpreting sediment toxicity tests a mega sites benefit from novel approaches to normalization to address batching of tests?

EPA Science Inventory

Sediment toxicity tests are a key tool used in Ecological Risk Assessments for contaminated sediment sites. Interpreting test results and defining toxicity is often a challenge. This is particularly true at mega sites where the testing regime is large, and by necessity performed ...

Synchronous Chat and Electronic Ink for Distance Support in Mathematics

ERIC Educational Resources Information Center

Loch, Birgit; McDonald, Christine

2007-01-01

For online mathematics instructors, synchronous communication can be a challenge due to the need for specialized symbols, graphics, or notations to explain key concepts. While software tools exist to support such communication, they can often be cumbersome and time-consuming for users to adopt in online exchanges. As one way of addressing this…

Towards the just and sustainable use of antibiotics.

PubMed

Merrett, Gemma L Buckland; Bloom, Gerald; Wilkinson, Annie; MacGregor, Hayley

2016-01-01

The emergence and spread of antibiotic resistant pathogens poses a big challenge to policy-makers, who need to oversee the transformation of health systems that evolved to provide easy access to these drugs into ones that encourage appropriate use of antimicrobials, whilst reducing the risk of resistance. This is a particular challenge for low and middle-income countries with pluralistic health systems where antibiotics are available in a number of different markets. This review paper considers access and use of antibiotics in these countries from a complex adaptive system perspective. It highlights the main areas of intervention that could provide the key to addressing the sustainable long term use and availability of antibiotics. A focus on the synergies between interventions addressing access strategies, antibiotic quality, diagnostics for low-resource settings, measures to encourage just and sustainable decision making and help seeking optimal therapeutic and dosing strategies are key levers for the sustainable future of antibiotic use. Successful integration of such strategies will be dependent on effective governance mechanisms, effective partnerships and coalition building and accurate evaluation systems at national, regional and global levels.

Programming time-multiplexed reconfigurable hardware using a scalable neuromorphic compiler.

PubMed

Minkovich, Kirill; Srinivasa, Narayan; Cruz-Albrecht, Jose M; Cho, Youngkwan; Nogin, Aleksey

2012-06-01

Scalability and connectivity are two key challenges in designing neuromorphic hardware that can match biological levels. In this paper, we describe a neuromorphic system architecture design that addresses an approach to meet these challenges using traditional complementary metal-oxide-semiconductor (CMOS) hardware. A key requirement in realizing such neural architectures in hardware is the ability to automatically configure the hardware to emulate any neural architecture or model. The focus for this paper is to describe the details of such a programmable front-end. This programmable front-end is composed of a neuromorphic compiler and a digital memory, and is designed based on the concept of synaptic time-multiplexing (STM). The neuromorphic compiler automatically translates any given neural architecture to hardware switch states and these states are stored in digital memory to enable desired neural architectures. STM enables our proposed architecture to address scalability and connectivity using traditional CMOS hardware. We describe the details of the proposed design and the programmable front-end, and provide examples to illustrate its capabilities. We also provide perspectives for future extensions and potential applications.

Scaling-up HIV responses with key populations in West Africa.

PubMed

Wheeler, Tisha; Wolf, R Cameron; Kapesa, Laurent; Cheng Surdo, Alison; Dallabetta, Gina

2015-03-01

Despite decades of HIV responses in pockets of West and Central Africa (WCA), the HIV response with key populations remains an understudied area. Recently, there has been a proliferation of studies highlighting epidemiologic and behavioral data that challenge attitudes of complacency among donors and country governments uncomfortable in addressing key populations. The articles in this series highlight new studies that provide a better understanding of the epidemiologic and structural burden facing key populations in the WCA region and how to improve responses through more effective targeting. Key populations face pervasive structural barriers including institutional and sexual violence and an intersection of stigma, criminalization, and marginalization as sexual minorities. Despite decades of smaller interventions that have shown the importance of integrated services for key populations, there remains incongruent provision of outreach or testing or family planning pointing to sustained risk. There remains an incongruent resource provision for key populations where they shoulder the burden of HIV and their access to services alone could turn around HIV epidemics within the region. These proximal and distal determinants must be addressed in regional efforts, led by the community, and resourced for scale, targeting those most at risk for the acquisition and transmission of HIV. This special issue builds the knowledge base for the region focusing on interventions that remove barriers to service access including treatment uptake for those living with HIV. Better analysis and use of data for strategic planning are shown to lead to more effective targeting of prevention, care, and HIV treatment programs with key populations. These articles further demonstrate the immediate need for comprehensive action to address HIV among key populations throughout the WCA region.

Risk selection and risk adjustment: improving insurance in the individual and small group markets.

PubMed

Baicker, Katherine; Dow, William H

2009-01-01

Insurance market reforms face the key challenge of addressing the threat that risk selection poses to the availability, of stable, high-value insurance policies that provide long-term risk protection. Many of the strategies in use today fail to address this breakdown in risk pooling, and some even exacerbate it. Flexible risk adjustment schemes are a promising avenue for promoting market stability and limiting insurer cream-skimming, potentially providing greater benefits at lower cost. Reforms intended to increase insurance coverage and the value of care delivered will be much more effective if implemented in conjunction with policies that address these fundamental selection issues.

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

PubMed

Lu, Zhengwu

2010-01-01

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

Information and communication technologies and gender in climate change and green economy: Situating women’s opportunities and challenges in Zambian policies and strategies

PubMed Central

2016-01-01

Zambia’s 2012 report on the United Nations Conference on Sustainable Development (RIO +20) identifies existing opportunities on the country’s transitioning to green economy. The RIO +20 conference of 2012 has resulted in new momentum in addressing problems of sustainable development. However, this article argues that there are practical challenges that require paying attention to, especially those involving women. The article addressed one key question: To what extent can women participate in the transitioning process to green economy in Zambia and what opportunities and challenges exists? The study used document analysis to answer the above question. National policy documents were reviewed to understand interventions on environmental management. Whilst going through the documents, the study used gender analysis frameworks (education, skills, roles in family and society, access to infrastructure) to bring out qualitative and quantitative information on women. Using suggested green economy interventions in the literature as benchmark, qualitative analysis was used to project possible participation of women in green economy activities and possible challenges to be faced. The study found that participation of women will be limited despite existing opportunities because of challenges of access to information and communication technology infrastructures, low educational levels and skills and financial constraints. As Zambia undergoes a transitioning process, these limitations should be addressed in planned green economy policies and interventions to maximise benefits.

Multidisciplinary design and analytic approaches to advance prospective research on the multilevel determinants of child health.

PubMed

Johnson, Sara B; Little, Todd D; Masyn, Katherine; Mehta, Paras D; Ghazarian, Sharon R

2017-06-01

Characterizing the determinants of child health and development over time, and identifying the mechanisms by which these determinants operate, is a research priority. The growth of precision medicine has increased awareness and refinement of conceptual frameworks, data management systems, and analytic methods for multilevel data. This article reviews key methodological challenges in cohort studies designed to investigate multilevel influences on child health and strategies to address them. We review and summarize methodological challenges that could undermine prospective studies of the multilevel determinants of child health and ways to address them, borrowing approaches from the social and behavioral sciences. Nested data, variation in intervals of data collection and assessment, missing data, construct measurement across development and reporters, and unobserved population heterogeneity pose challenges in prospective multilevel cohort studies with children. We discuss innovations in missing data, innovations in person-oriented analyses, and innovations in multilevel modeling to address these challenges. Study design and analytic approaches that facilitate the integration across multiple levels, and that account for changes in people and the multiple, dynamic, nested systems in which they participate over time, are crucial to fully realize the promise of precision medicine for children and adolescents. Copyright © 2017 Elsevier Inc. All rights reserved.

Emerging perspectives in social neuroscience and neuroeconomics of aging

PubMed Central

Mather, Mara

2011-01-01

This article introduces the special issue of ‘Social Cognitive and Affective Neuroscience’ on Aging Research, and offers a broad conceptual and methodological framework for considering advances in life course research in social neuroscience and neuroeconomics. The authors highlight key areas of inquiry where aging research is raising new insights about how to conceptualize and examine critical questions about the links between cognition, emotion and motivation in social and economic behavior, as well as challenges that need to be addressed when taking a life course perspective in these fields. They also point to several emerging approaches that hold the potential for addressing these challenges, through bridging approaches from laboratory and population-based science, bridging inquiry across life stages and expanding measurement of core psychological phenotypes. PMID:21482573

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

PubMed

de Groot, Lisette C P G M

2016-05-01

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

Schools of public health in low and middle-income countries: an imperative investment for improving the health of populations?

PubMed

Rabbani, Fauziah; Shipton, Leah; White, Franklin; Nuwayhid, Iman; London, Leslie; Ghaffar, Abdul; Ha, Bui Thi Thu; Tomson, Göran; Rimal, Rajiv; Islam, Anwar; Takian, Amirhossein; Wong, Samuel; Zaidi, Shehla; Khan, Kausar; Karmaliani, Rozina; Abbasi, Imran Naeem; Abbas, Farhat

2016-09-07

Public health has multicultural origins. By the close of the nineteenth century, Schools of Public Health (SPHs) began to emerge in western countries in response to major contemporary public health challenges. The Flexner Report (1910) emphasized the centrality of preventive medicine, sanitation, and public health measures in health professional education. The Alma Ata Declaration on Primary Health Care (PHC) in 1978 was a critical milestone, especially for low and middle-income countries (LMICs), conceptualizing a close working relationship between PHC and public health measures. The Commission on Social Determinants of Health (2005-2008) strengthened the case for SPHs in LMICs as key stakeholders in efforts to reduce global health inequities. This scoping review groups text into public health challenges faced by LMICs and the role of SPHs in addressing these challenges. The challenges faced by LMICs include rapid urbanization, environmental degradation, unfair terms of global trade, limited capacity for equitable growth, mass displacements associated with conflicts and natural disasters, and universal health coverage. Poor governance and externally imposed donor policies and agendas, further strain the fragile health systems of LMICs faced with epidemiological transition. Moreover barriers to education and research imposed by limited resources, political and economic instability, and unbalanced partnerships additionally aggravate the crisis. To address these contextual challenges effectively, SPHs are offering broad based health professional education, conducting multidisciplinary population based research and fostering collaborative partnerships. SPHs are also looked upon as the key drivers to achieve sustainable development goals (SDGs). SPHs in LMICs can contribute to overcoming several public health challenges being faced by LMICs, including achieving SDGs. Most importantly they can develop cadres of competent and well-motivated public health professionals: educators, practitioners and researchers who ask questions that address fundamental health determinants, seek solutions as agents of change within their mandates, provide specific services and serve as advocates for multilevel partnerships. Funding support, human resources, and agency are unfortunately often limited or curtailed in LMICs, and this requires constructive collaboration between LMICs and counterpart institutions from high income countries.

Challenges in the Accurate Surveillance of Booster Seat and Bicycle Helmet Usage by Children: Lessons from the Field

PubMed Central

Pankratz, Curt; Warda, Lynne; Piotrowski, Caroline

2016-01-01

Motor vehicle collisions and bicycle collisions and falls are a leading cause of death by preventable injury for children. In order to design, implement and evaluate campaigns and programs aimed at improving child safety, accurate surveillance is needed. This paper examined the challenges that confront efforts to collect surveillance data relevant to child traffic safety, including observation, interview, and focus group methods. Strategies to address key challenges in order to improve the efficiency and accuracy of surveillance methods were recommended. The potential for new technology to enhance existing surveillance methods was also explored. PMID:27399749

Teacher Professional Development Programmes in MST for Developing Contexts

ERIC Educational Resources Information Center

James, Angela; Bansilal, Sarah; Webb, Lyn; Goba, Busisiwe; Khuzwayo, Herbert

2015-01-01

Since 1994, the democratic South African government has introduced change in all spheres of South African life in a bid to address some challenges such as the redundant, racialised curriculum, the poor results achieved by learners in Grade 12, and the fact that few black matriculants were entering science based careers. A key feature of these poor…

"Philia" and Pedagogy "Side by Side": The Perils and Promise of Teacher-Student Friendships

ERIC Educational Resources Information Center

Shuffelton, Amy B.

2012-01-01

This paper asks whether teachers and students can be friends with one another and yet maintain their integrity as teachers and students. It provides an account of friendship, drawing on Aristotle, Montaigne, and contemporary work by Elizabeth Telfer and Lawrence Blum, and addresses two key challenges: first, that teachers must be impartial and…

I've Got You Covered: Adventures in Social Justice-Informed Co-Teaching

ERIC Educational Resources Information Center

Cobb, Cam; Sharma, Manu

2015-01-01

What is social justice-informed co-teaching? Why is it important? How can social justice pedagogy deepen co-teaching practices? What are the key challenges and possibilities open to teachers and learners involved in a social-justice informed co-teaching experience? These questions are useful to ask as they begin to address new pedagogical…

Effective Educational Practice: A Crucial First Step in Addressing the Needs of Traditionally Overlooked Students

ERIC Educational Resources Information Center

Dimeo, Jennifer Kumpost

2013-01-01

Students who are traditionally overlooked in academic settings (e.g. poor, Black, Hispanic American, Latino/Latina) are not likely to have educational experiences that reflect equity in access to excellence in education. These students regularly encounter challenges that reflect a poor educational fit and their key needs are often overlooked in…

Biodiversity informatics: challenges and opportunities for applying biodiversity information to management and conservation

Treesearch

James S. Kagan

2006-01-01

Researchers, land managers, and the public currently often are unable to obtain useful biodiversity information because the subject represents such a large component of biology and ecology, and systems to compile and organize this information do not exist. Information on vascular plant taxonomy, as addressed by the Global Biodiversity Information Facility and key...

A Logically Centralized Approach for Control and Management of Large Computer Networks

ERIC Educational Resources Information Center

Iqbal, Hammad A.

2012-01-01

Management of large enterprise and Internet service provider networks is a complex, error-prone, and costly challenge. It is widely accepted that the key contributors to this complexity are the bundling of control and data forwarding in traditional routers and the use of fully distributed protocols for network control. To address these…

A Human-Centered Approach to Medical Informatics for Medical Students, Residents, and Practicing Clinicians.

ERIC Educational Resources Information Center

Stahlhut, Richard W.; Gosbee, John W.; Gardner-Bonneau, Daryle J.

1997-01-01

Describes development of a curriculum in medical information science that focuses on practical problems in clinical medicine rather than details of information technology. Design was guided by identification of six key clinical challenges that must be addressed by practitioners in the near future and by examination of past failures of informatics…

Examining Variation in Achievement Impacts across the KIPP Network of Charter Schools

ERIC Educational Resources Information Center

Tuttle, Christina Clark; Gleason, Philip; Furgeson, Joshua

2012-01-01

As a condition of its i3 grant, KIPP contracted with an independent evaluator (Mathematica) to address a key research question: does KIPP maintain its demonstrated effectiveness as it scales? While this question sounds simple enough in theory, it poses several methodological and practical challenges. This paper outlines some of those key…

Integrating Health and Sustainability: The Higher Education Sector as a Timely Catalyst

ERIC Educational Resources Information Center

Orme, J.; Dooris, M.

2010-01-01

Higher education is an influential sector with enormous potential to impact positively on health and sustainability. The purpose of this paper was to explore its emergent role as a key setting for promoting health and sustainability and for addressing their challenges in an integrated and coherent way. Acknowledging both the relative narrowness of…

Lidar remote sensing of above-ground biomass in three biomes.

Treesearch

Michael A. Lefsky; Warren B. Cohen; David J. Harding; Geoffrey G. Parkers; Steven A. Acker; S. Thomas Gower

2002-01-01

Estimation of the amount of carbon stored in forests is a key challenge for understanding the global carbon cycle, one which remote sensing is expected to help address. However, estimation of carbon storage in moderate to high biomass forests is difficult for conventional optical and radar sensors. Lidar (light detection and ranging) instruments measure the vertical...

Federal Student Aid (FSA) Five-Year Strategic Plan. FY 2004-2008

ERIC Educational Resources Information Center

US Department of Education, 2004

2004-01-01

The FSA Five-Year Strategic Plan is a roadmap for FY 2004-2008 that identifies five long-range strategic objectives, tactical short-term goals, and performance management initiatives. In working toward the goals outlined in the plan, FSA will address a number of key challenges, including legacy system migration, business process re-engineering,…

Advancing Public Health through Continuing Education of Health Care Professionals

ERIC Educational Resources Information Center

Hudmon, Karen Suchanek; Addleton, Robert L.; Vitale, Frank M.; Christiansen, Bruce A.; Mejicano, George C.

2011-01-01

This article describes how the CS2day (Cease Smoking Today) initiative positioned continuing education (CE) in the intersection between medicine and public health. The authors suggest that most CE activities address the medical challenges that clinicians confront, often to the neglect of the public health issues that are key risk factors for the…

An integrated science plan for the Lake Tahoe basin: conceptual framework and research strategies

Treesearch

Zachary P. Hymanson; Michael W. Collopy

2010-01-01

An integrated science plan was developed to identify and refine contemporary science information needs for the Lake Tahoe basin ecosystem. The main objectives were to describe a conceptual framework for an integrated science program, and to develop research strategies addressing key uncertainties and information gaps that challenge government agencies in the theme...

Technology-Mediated Open and Distance Education for Agricultural Education and Improved Livelihoods in Sub-Saharan Africa. Country Case Studies

ERIC Educational Resources Information Center

Alluri, Krishna, Ed.; Zachmann, Rainer, Ed.

2008-01-01

The Learning for Livelihoods Sector of the Commonwealth of Learning (COL) addresses the major challenges related to learning and skills development that are key for living and for improvement of livelihoods. Developing conceptual frameworks, influencing policy, enabling technology-mediated learning, and strengthening networks and partnerships are…

Seafood traceability: current needs, available tools, and biotechnological challenges for origin certification.

PubMed

Leal, Miguel Costa; Pimentel, Tânia; Ricardo, Fernando; Rosa, Rui; Calado, Ricardo

2015-06-01

Market globalization and recurring food safety alerts have resulted in a growing consumer awareness of the need for food traceability. This is particularly relevant for seafood due to its perishable nature and importance as a key protein source for the population of the world. Here, we provide an overview of the current needs for seafood origin traceability, along with the limitations and challenges for its implementation. We focus on geochemical, biochemical, and molecular tools and how they should be optimized to be implemented globally and to address our societal needs. We suggest that seafood traceability is key to enforcing food safety regulations and fisheries control, combat fraud, and fulfill present and future expectations of conscientious producers, consumers, and authorities. Copyright © 2015 Elsevier Ltd. All rights reserved.

Design and implementation of a secure wireless mote-based medical sensor network.

PubMed

Malasri, Kriangsiri; Wang, Lan

2009-01-01

A medical sensor network can wirelessly monitor vital signs of humans, making it useful for long-term health care without sacrificing patient comfort and mobility. For such a network to be viable, its design must protect data privacy and authenticity given that medical data are highly sensitive. We identify the unique security challenges of such a sensor network and propose a set of resource-efficient mechanisms to address these challenges. Our solution includes (1) a novel two-tier scheme for verifying the authenticity of patient data, (2) a secure key agreement protocol to set up shared keys between sensor nodes and base stations, and (3) symmetric encryption/decryption for protecting data confidentiality and integrity. We have implemented the proposed mechanisms on a wireless mote platform, and our results confirm their feasibility.

Biocatalysis and biomimetics

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

Burrington, J.D.; Clark, D.S.

1989-01-01

This book presents recent advances in catalytic science and biotechnology. The chapters illustrate how many of the key challenges in biotechnology can be addressed by bringing together traditionally separate disciplines within chemistry and biology. The authors focus on emerging enabling technologies at the interfaces of catalysis and biology that will provide new opportunities for the chemicals industries. Key aspects to be presented within this major theme of catalysis and biotechnology are biomimetics and hybrid catalysts, biocatalytic applications of computers and expert systems, enzyme solid-state structure and immobilization, enzyme structure-activity relationships, and the use of enzymes under novel conditions.

MO-DE-207-04: Imaging educational program on solutions to common pediatric imaging challenges

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

Krishnamurthy, R.

This imaging educational program will focus on solutions to common pediatric imaging challenges. The speakers will present collective knowledge on best practices in pediatric imaging from their experience at dedicated children’s hospitals. The educational program will begin with a detailed discussion of the optimal configuration of fluoroscopes for general pediatric procedures. Following this introduction will be a focused discussion on the utility of Dual Energy CT for imaging children. The third lecture will address the substantial challenge of obtaining consistent image post -processing in pediatric digital radiography. The fourth and final lecture will address best practices in pediatric MRI includingmore » a discussion of ancillary methods to reduce sedation and anesthesia rates. Learning Objectives: To learn techniques for optimizing radiation dose and image quality in pediatric fluoroscopy To become familiar with the unique challenges and applications of Dual Energy CT in pediatric imaging To learn solutions for consistent post-processing quality in pediatric digital radiography To understand the key components of an effective MRI safety and quality program for the pediatric practice.« less

New challenges for grizzly bear management in Yellowstone National Park

USGS Publications Warehouse

van Manen, Frank T.; Gunther, Kerry A.

2016-01-01

A key factor contributing to the success of grizzly bear Ursus arctos conservation in the Greater Yellowstone Ecosystem has been the existence of a large protected area, Yellowstone National Park. We provide an overview of recovery efforts, how demographic parameters changed as the population increased, and how the bear management program in Yellowstone National Park has evolved to address new management challenges over time. Finally, using the management experiences in Yellowstone National Park, we present comparisons and perspectives regarding brown bear management in Shiretoko National Park.

Climate change challenges for central banks and financial regulators

NASA Astrophysics Data System (ADS)

Campiglio, Emanuele; Dafermos, Yannis; Monnin, Pierre; Ryan-Collins, Josh; Schotten, Guido; Tanaka, Misa

2018-06-01

The academic and policy debate regarding the role of central banks and financial regulators in addressing climate-related financial risks has rapidly expanded in recent years. This Perspective presents the key controversies and discusses potential research and policy avenues for the future. Developing a comprehensive analytical framework to assess the potential impact of climate change and the low-carbon transition on financial stability seems to be the first crucial challenge. These enhanced risk measures could then be incorporated in setting financial regulations and implementing the policies of central banks.

Communicating climate change and health in the media.

PubMed

Depoux, Anneliese; Hémono, Mathieu; Puig-Malet, Sophie; Pédron, Romain; Flahault, Antoine

2017-01-01

The translation of science from research to real-world change is a central goal of public health. Communication has an essential role to play in provoking a response to climate change. It must first raise awareness, make people feel involved and ultimately motivate them to take action. The goal of this research is to understand how the information related to this issue is being addressed and disseminated to different audiences-public citizens, politicians and key climate change stakeholders. Initial results show that the scientific voice struggles to globally highlight this issue to a general audience and that messages that address the topic do not meet the challenges, going from a dramatic framing to a basic adaptation framing. Communication experts can help inform scientists and policy makers on how to best share information about climate change in an engaging and motivating way. This study gives an insight about the key role of the media and communications in addressing themes relating to climate change and transmitting information to the public in order to take action.

Key considerations in designing a speech brain-computer interface.

PubMed

Bocquelet, Florent; Hueber, Thomas; Girin, Laurent; Chabardès, Stéphan; Yvert, Blaise

2016-11-01

Restoring communication in case of aphasia is a key challenge for neurotechnologies. To this end, brain-computer strategies can be envisioned to allow artificial speech synthesis from the continuous decoding of neural signals underlying speech imagination. Such speech brain-computer interfaces do not exist yet and their design should consider three key choices that need to be made: the choice of appropriate brain regions to record neural activity from, the choice of an appropriate recording technique, and the choice of a neural decoding scheme in association with an appropriate speech synthesis method. These key considerations are discussed here in light of (1) the current understanding of the functional neuroanatomy of cortical areas underlying overt and covert speech production, (2) the available literature making use of a variety of brain recording techniques to better characterize and address the challenge of decoding cortical speech signals, and (3) the different speech synthesis approaches that can be considered depending on the level of speech representation (phonetic, acoustic or articulatory) envisioned to be decoded at the core of a speech BCI paradigm. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Optically addressed ultra-wideband phased antenna array

NASA Astrophysics Data System (ADS)

Bai, Jian

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

Sub-federal ecological modernization: A case study of Colorado's new energy economy

NASA Astrophysics Data System (ADS)

Giannakouros, Stratis

European nations have often employed policies of explicit government intervention as a preferred means of addressing environmental and economic challenges. These policies have ranged from grey industrial policies focused solely on industrial growth, competitiveness and innovation to policies of stronger ecological modernization, which seek to align industrial interests with environmental protection. In recent years these policies have been mobilized to address the threat of climate change and promote environmental innovation. While some US Administrations have similarly recognized the need to address these challenges, the particular historical and political institutional dynamics of the US have meant that explicit government intervention has been eschewed in favor of more indirect strategies when dealing with economic and environmental challenges. This is evident in the rise of sub-federal policies at the level of US states. Supported by federal laboratories and public research, US states have adopted policies that look very much like sub-federal versions of industrial or ecological modernization policy. This thesis uses the Colorado case to highlight the importance of sub-federal institutions in addressing environmental and economic challenges in the US and explore its similarities to, and differences from, European approaches. To achieve this goal it first develops an analytical scheme within which to place policy initiatives on a continuum from grey industrial policy to strong ecological modernization policy by identifying key institutions that are influential in each policy type. This analytical scheme is then applied to the transitional renewable energy policy period from 2004-2012 in the state of Colorado. This period starts with the adoption of a renewable energy portfolio in 2004 and includes the `new energy economy' period from 2007-2010 as well as the years since. Looking at three key turning points this paper interprets the `new energy economy' strategy using the analytical scheme developed and identifies the political and social institutions that frame this transition. Drawing upon these findings, the paper analyses the implications of the Colorado case for understanding sub-federal initiatives in the US and concludes with a summary of the broader comparative institutional lessons.

Exploiting Advanced Hydrogel Technologies to Address Key Challenges in Regenerative Medicine

PubMed Central

Gentleman, Eileen

2018-01-01

Regenerative medicine aims to tackle a panoply of challenges, from repairing focal damage to articular cartilage to preventing pathological tissue remodelling after myocardial infarction. Hydrogels are water-swollen networks formed from synthetic or naturally derived polymers, and are emerging as important tools to address these challenges. Recent advances in hydrogel chemistries are enabling researchers to create hydrogels that can act as 3D ex vivo tissue models, allowing them to explore fundamental questions in cell biology by replicating tissues’ dynamic and non-linear physical properties. Enabled by emerging techniques such as 3D bioprinting, cell-laden hydrogels are also being developed with highly controlled tissue-specific architectures, vasculature, and biological functions that together can direct tissue repair. Moreover, advanced in situ forming and acellular hydrogels are increasingly finding use as delivery vehicles for bioactive compounds and in mediating host cell response. Here, we review advances in the design and fabrication of hydrogels for regenerative medicine. We also address how controlled chemistries are allowing for precise engineering of spatial and time-dependent properties in hydrogels with a look to how these materials will eventually translate to clinical applications. PMID:29316363

Current Challenges for HTCMC Aero-Propulsion Components

NASA Technical Reports Server (NTRS)

DiCarlo, James A.; Bansal, Narottam P.

2007-01-01

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

Challenges and opportunities for translating medical microdevices: insights from the programmable bio-nano-chip

PubMed Central

McRae, Michael P; Simmons, Glennon; McDevitt, John T

2016-01-01

This perspective highlights the major challenges for the bioanalytical community, in particular the area of lab-on-a-chip sensors, as they relate to point-of-care diagnostics. There is a strong need for general-purpose and universal biosensing platforms that can perform multiplexed and multiclass assays on real-world clinical samples. However, the adoption of novel lab-on-a-chip/microfluidic devices has been slow as several key challenges remain for the translation of these new devices to clinical practice. A pipeline of promising medical microdevice technologies will be made possible by addressing the challenges of integration, failure to compete with cost and performance of existing technologies, requisite for new content, and regulatory approval and clinical adoption. PMID:27071710

Understanding partnership practice in primary health as pedagogic work: what can Vygotsky's theory of learning offer?

PubMed

Hopwood, Nick

2015-01-01

Primary health policy in Australia has followed international trends in promoting models of care based on partnership between professionals and health service users. This reform agenda has significant practice implications, and has been widely adopted in areas of primary health that involve supporting families with children. Existing research shows that achieving partnership in practice is associated with three specific challenges: uncertainty regarding the role of professional expertise, tension between immediate needs and longer-term capacity development in families, and the need for challenge while maintaining relationships based on trust. Recently, pedagogic or learning-focussed elements of partnership practice have been identified, but there have been no systematic attempts to link theories of learning with the practices and challenges of primary health-care professionals working with families in a pedagogic role. This paper explores key concepts of Vygotsky's theory of learning (including mediation, the zone of proximal development, internalisation, and double stimulation), showing how pedagogic concepts can provide a bridge between the policy rhetoric of partnership and primary health practice. The use of this theory to address the three key challenges is explicitly discussed.

Establishing a Methodology to Examine the Effects of War-Zone PTSD on the Family: The Family Foundations Study

PubMed Central

Vasterling, Jennifer J.; Taft, Casey T.; Proctor, Susan P.; MacDonald, Helen Z.; Lawrence, Amy; Kalill, Kathleen; Kaiser, Anica P.; Lee, Lewina O.; King, Daniel W.; King, Lynda A.; Fairbank, John A.

2015-01-01

Military deployment may adversely affect not only returning veterans, but their families, as well. As a result, researchers have increasingly focused on identifying risk and protective factors for successful family adaptation to war-zone deployment, re-integration of the returning veteran, and the longer-term psychosocial consequences of deployment experienced by some veterans and families. Posttraumatic stress disorder (PTSD) among returning veterans may pose particular challenges to military and military veteran families; however, questions remain regarding the impact of the course of veteran PTSD and other potential moderating factors on family adaptation to military deployment. The Family Foundations Study builds upon an established longitudinal cohort of Army soldiers (i.e., the Neurocognition Deployment Health Study) to help address remaining knowledge gaps. This report describes the conceptual framework and key gaps in knowledge that guided the study design, methodological challenges and special considerations in conducting military family research, and how these gaps, challenges, and special considerations are addressed by the study. PMID:26077194

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

PubMed

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

2016-04-01

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

Social Work Grand Challenges: Leaders' Perceptions of the Potential for Partnering with Business.

PubMed

Long, Ashley

2018-04-23

Social work's ability to address complex societal problems such as those identified in the American Academy of Social Work and Social Welfare's Grand Challenges for Social Work is reliant on being innovative in how we prepare social workers and how we collaborate with others, including business. This research seeks to understand how leaders of major social work organizations perceive potential partnership with the business sector-including both possible threats and opportunities. Interviews were conducted with those serving on the Council on Social Work Education's Leadership Roundtable. The research explores how emerging partnership models can be helpful and ways in which the profession can prepare practitioners for better partnering with the business sector. Qualitative findings identify four key strategies to address the grand challenges and enhance partnerships: (1) more interdisciplinary work is needed, (2) social work students need to be adequately equipped for collaborative work, (3) a cohesive message is needed from the field, and (4) the potential benefits for partnering with business outweigh the risks.

Antiretroviral Therapy for the Prevention of HIV Transmission: What Will It Take?

PubMed Central

McNairy, Margaret L.; El-Sadr, Wafaa M.

2014-01-01

The evidence in support of use of antiretroviral therapy (ART) for prevention of human immunodeficiency virus (HIV) transmission is encouraging and has stimulated optimism for achieving a dramatic change in the trajectory of the HIV epidemic. Yet, there are substantial challenges that, if not addressed, could be the Achilles’ heel for this concept. These challenges require strengthening every step of the HIV care continuum, including expansion of HIV testing to reach all those with HIV infection, effective linkage to and retention in care, timely initiation of ART, and high levels of treatment adherence with viral load suppression. Also important is the identification of individuals with acute HIV infection whose contribution to HIV transmission may be substantial. Implementation research is needed to identify strategies that address these challenges and to determine the efficacy of ART for prevention in key populations as well as to evaluate the effectiveness of combination strategies for HIV prevention at the population level. PMID:24429438

The study of direct-to-consumer advertising for prescription drugs.

PubMed

Schommer, Jon C; Hansen, Richard A

2005-06-01

The objectives of this article are to (1) identify key methodological issues related to investigating the effects of direct-to-consumer advertising (DTCA) for prescription drugs, (2) highlight opportunities and challenges that these issues pose, and (3) provide suggestions to address these challenges and opportunities from a social and administrative pharmacy perspective. Through a review of existing literature and consultation with research colleagues, we identified 3 broad issues regarding the study of DTCA for prescription drugs: (1) the importance of problem formulation, (2) the role of health behavior and decision-making perspectives, and (3) data collection and data analysis challenges and opportunities. Based upon our findings, we developed recommendations for future research in this area. Clear problem formulation will be instructive for prioritizing research needs and for determining the role that health behavior and decision-making perspectives can serve in DTCA research. In addition, it appears that cluster bias, nonlinear relationships, mediating/moderating effects, time effects, acquiescent response, and case mix are particularly salient challenges for the DTCA research domain. We suggest that problem formulation, selection of sound theories upon which to base research, and data collection and data analysis challenges are key methodological issues related to investigating the effects of DTCA for prescription drugs.

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

PubMed

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

2011-02-01

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

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

PubMed Central

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

2016-01-01

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

How should the completeness and quality of curated nanomaterial data be evaluated?

NASA Astrophysics Data System (ADS)

Marchese Robinson, Richard L.; Lynch, Iseult; Peijnenburg, Willie; Rumble, John; Klaessig, Fred; Marquardt, Clarissa; Rauscher, Hubert; Puzyn, Tomasz; Purian, Ronit; Åberg, Christoffer; Karcher, Sandra; Vriens, Hanne; Hoet, Peter; Hoover, Mark D.; Hendren, Christine Ogilvie; Harper, Stacey L.

2016-05-01

Nanotechnology is of increasing significance. Curation of nanomaterial data into electronic databases offers opportunities to better understand and predict nanomaterials' behaviour. This supports innovation in, and regulation of, nanotechnology. It is commonly understood that curated data need to be sufficiently complete and of sufficient quality to serve their intended purpose. However, assessing data completeness and quality is non-trivial in general and is arguably especially difficult in the nanoscience area, given its highly multidisciplinary nature. The current article, part of the Nanomaterial Data Curation Initiative series, addresses how to assess the completeness and quality of (curated) nanomaterial data. In order to address this key challenge, a variety of related issues are discussed: the meaning and importance of data completeness and quality, existing approaches to their assessment and the key challenges associated with evaluating the completeness and quality of curated nanomaterial data. Considerations which are specific to the nanoscience area and lessons which can be learned from other relevant scientific disciplines are considered. Hence, the scope of this discussion ranges from physicochemical characterisation requirements for nanomaterials and interference of nanomaterials with nanotoxicology assays to broader issues such as minimum information checklists, toxicology data quality schemes and computational approaches that facilitate evaluation of the completeness and quality of (curated) data. This discussion is informed by a literature review and a survey of key nanomaterial data curation stakeholders. Finally, drawing upon this discussion, recommendations are presented concerning the central question: how should the completeness and quality of curated nanomaterial data be evaluated?Nanotechnology is of increasing significance. Curation of nanomaterial data into electronic databases offers opportunities to better understand and predict nanomaterials' behaviour. This supports innovation in, and regulation of, nanotechnology. It is commonly understood that curated data need to be sufficiently complete and of sufficient quality to serve their intended purpose. However, assessing data completeness and quality is non-trivial in general and is arguably especially difficult in the nanoscience area, given its highly multidisciplinary nature. The current article, part of the Nanomaterial Data Curation Initiative series, addresses how to assess the completeness and quality of (curated) nanomaterial data. In order to address this key challenge, a variety of related issues are discussed: the meaning and importance of data completeness and quality, existing approaches to their assessment and the key challenges associated with evaluating the completeness and quality of curated nanomaterial data. Considerations which are specific to the nanoscience area and lessons which can be learned from other relevant scientific disciplines are considered. Hence, the scope of this discussion ranges from physicochemical characterisation requirements for nanomaterials and interference of nanomaterials with nanotoxicology assays to broader issues such as minimum information checklists, toxicology data quality schemes and computational approaches that facilitate evaluation of the completeness and quality of (curated) data. This discussion is informed by a literature review and a survey of key nanomaterial data curation stakeholders. Finally, drawing upon this discussion, recommendations are presented concerning the central question: how should the completeness and quality of curated nanomaterial data be evaluated? Electronic supplementary information (ESI) available: (1) Detailed information regarding issues raised in the main text; (2) original survey responses. See DOI: 10.1039/c5nr08944a

Preprocessing Structured Clinical Data for Predictive Modeling and Decision Support

PubMed Central

Oliveira, Mónica Duarte; Janela, Filipe; Martins, Henrique M. G.

2016-01-01

Summary Background EHR systems have high potential to improve healthcare delivery and management. Although structured EHR data generates information in machine-readable formats, their use for decision support still poses technical challenges for researchers due to the need to preprocess and convert data into a matrix format. During our research, we observed that clinical informatics literature does not provide guidance for researchers on how to build this matrix while avoiding potential pitfalls. Objectives This article aims to provide researchers a roadmap of the main technical challenges of preprocessing structured EHR data and possible strategies to overcome them. Methods Along standard data processing stages – extracting database entries, defining features, processing data, assessing feature values and integrating data elements, within an EDPAI framework –, we identified the main challenges faced by researchers and reflect on how to address those challenges based on lessons learned from our research experience and on best practices from related literature. We highlight the main potential sources of error, present strategies to approach those challenges and discuss implications of these strategies. Results Following the EDPAI framework, researchers face five key challenges: (1) gathering and integrating data, (2) identifying and handling different feature types, (3) combining features to handle redundancy and granularity, (4) addressing data missingness, and (5) handling multiple feature values. Strategies to address these challenges include: cross-checking identifiers for robust data retrieval and integration; applying clinical knowledge in identifying feature types, in addressing redundancy and granularity, and in accommodating multiple feature values; and investigating missing patterns adequately. Conclusions This article contributes to literature by providing a roadmap to inform structured EHR data preprocessing. It may advise researchers on potential pitfalls and implications of methodological decisions in handling structured data, so as to avoid biases and help realize the benefits of the secondary use of EHR data. PMID:27924347

Representations of Linguistic and Ethnocultural Diversity in Poland's Education Policy, National School Curricula and Textbooks

ERIC Educational Resources Information Center

Kowalski, Ewa

2008-01-01

With its recent entry into the European Union (EU) and the adoption of multiethnic democracy as a national policy, a key challenge for Poland is to transform its education policy and practice in ways that are consistent with multicultural and pluralist values. This paper examines Poland's efforts to address these issues by exploring changes in the…

Addressing the STEM Challenge by Expanding Specialty Math and Science High Schools

ERIC Educational Resources Information Center

Atkinson, Robert D.; Hugo, Janet; Lundgren, Dennis; Shapiro, Martin J.; Thomas, Jerald

2007-01-01

If America is to succeed in the innovation-powered global economy, boosting math and science skills will be critical. This is why a wide array of task forces and organizations has recently raised the clarion call for more and better scientists and engineers. While the policy proposals offered are wide ranging, one key policy innovation has…

Predicting Social and Communicative Ability in School-Age Children with Autism Spectrum Disorder: A Pilot Study of the Social Attribution Task, Multiple Choice

ERIC Educational Resources Information Center

Burger-Caplan, Rebecca; Saulnier, Celine; Jones, Warren; Klin, Ami

2016-01-01

The Social Attribution Task, Multiple Choice is introduced as a measure of implicit social cognitive ability in children, addressing a key challenge in quantification of social cognitive function in autism spectrum disorder, whereby individuals can often be successful in explicit social scenarios, despite marked social adaptive deficits. The…

A Framework for K-12 Science Education: Practices, Crosscutting Concepts, and Core Ideas

ERIC Educational Resources Information Center

National Academies Press, 2012

2012-01-01

Science, engineering, and technology permeate nearly every facet of modern life and hold the key to solving many of humanity's most pressing current and future challenges. The United States' position in the global economy is declining, in part because U.S. workers lack fundamental knowledge in these fields. To address the critical issues of U.S.…

Scalable and Manageable Storage Systems

DTIC Science & Technology

2000-12-01

Despite our long- distance relationship, my brothers and sisters, Charfeddine, Amel, Ghazi, Hajer, Nabeel , and Ines overwhelmed me with more love and...that enable storage sys - tems to be more cost-effectively scalable. Furthermore, the dissertation proposes an approach to ensure automatic load...and addresses three key technical challenges to making storage sys - tems more cost-effectively scalable and manageable. 1.2 Dissertation research The

Recovering from 30 Years of War: Refugee Women and Children in Angola.

ERIC Educational Resources Information Center

Women's Commission for Refugee Women and Children, New York, NY.

After 30 years of war, Angola faces the challenge of creating a civil society. This report presents key findings of a visit to Angola, December 1-13, 1996, by the Women's Commission for Refugee Women and Children. The report describes conditions facing women and children affected by war in Angola, addresses the return process of refugees from…

The Problem of Gender Categorisation: Addressing Dilemmas Past and Present in Gender and Education Research

ERIC Educational Resources Information Center

Francis, Becky; Paechter, Carrie

2015-01-01

Developments in the field of gender theory as applied to education since the 1970s are briefly reviewed in order to highlight key challenges and debates around gender categorisation and identification in gender and education. We argue that conundrums of categorisation have haunted, and continue to haunt, the field of gender theory, and empirical…

Different Things Make Different People Happy: Examining Social Capital and Subjective Well-Being by Gender and Parental Status

ERIC Educational Resources Information Center

Kroll, Christian

2011-01-01

This paper addresses a number of key challenges in current subjective well-being (SWB) research: A new wave of studies should take into account that different things may make different people happy, thus going beyond a unitary "happiness formula". Furthermore, empirical results need to be connected to broader theoretical narratives.…

Managing the Scope of Study: Is It as Easy as Key Stage 3?

ERIC Educational Resources Information Center

Dickson, Anna

2017-01-01

Anna Dickson and her department sought a solution to the challenges posed to their pupils by the expanded curricular scope of the new GCSE. In particular, they wanted to address the difficulties their pupils experienced in understanding the Cold War. Dickson outlines here how she drew on the work of other history teachers theorising about the…

Geographic variability in lidar predictions of forest stand structure in the Pacific Northwest

Treesearch

Michael A. Lefsky; Andrew T. Hudak; Warren B. Cohen; S. A. Acker

2005-01-01

Estimation of the amount of carbon stored in forests is a key challenge for understanding the global carbon cycle, one which remote sensing is expected to help address. However, carbon storage in moderate to high biomass forests is difficult to estimate with conventional optical or radar sensors. Lidar (light detection and ranging) instruments measure the vertical...

UAS Integration into the NAS Project

NASA Technical Reports Server (NTRS)

Bauer, Jeff

2010-01-01

The goal of the UAS Integration in the NAS Project is to contribute capabilities that reduce technical barriers related to the safety and operational challenges associated with enabling routine UAS access to the NAS This goal will be accomplished through a two-phased approach of system-level integration of key concepts, technologies and/or procedures, and demonstrations of integrated capabilities in an operationally relevant environment. Technical objectives include: PHASE 1: a) Validating the key technical areas identified by this project. System-level analyses, a State of the Art Analysis (SOAA), and a ConOps will identify the challenges and barriers preventing routine UAS access to the NAS. b) Developing a national roadmap and gap analysis identifying specific deliverables in the area of operations, procedures, and technologies that will impact future policy decisions. PHASE 2: a) Provide regulators with a methodology for developing airworthiness requirements for UAS and data to support development of certifications standards and regulatory guidance. b) Provide systems-level integrated testing of concepts and/or capabilities that address barriers to routine access to the NAS. Through simulation and flight testing, address issues including separation assurance, communications requirements, and Pilot Aircraft Interfaces (PAIs) in operationally relevant environments

Micronutrient Fortification of Food in Southeast Asia: Recommendations from an Expert Workshop

PubMed Central

Gayer, Justine; Smith, Geoffry

2015-01-01

Micronutrient deficiencies remain a significant public health issue in Southeast Asia, particularly in vulnerable populations, such as women of reproductive age and young children. An important nutrition-specific intervention to address micronutrient malnutrition is fortification of staple foods and condiments. In October 2013, the International Life Sciences Institute (ILSI) Southeast Asia Region held a workshop on micronutrient fortification of food in Bangkok, Thailand. The objective was to engage multiple stakeholders in a discussion on food fortification and its importance as a public health intervention in Southeast Asia, and to identify and address key challenges/gaps in and potential opportunities for fortification of foods in ASEAN countries. Key challenges that were identified include: “scaling up” and mobilizing sustainable support for fortification programs in the form of multi-stakeholder partnerships, effecting policy change to support mandatory fortification, long-term monitoring of the programs’ compliance and efficacy in light of limited resources, and increasing awareness and uptake of fortified products through social marketing campaigns. Future actions recommended include the development of terms of engagement and governance for multi-stakeholder partnerships, moving towards a sustainable business model and more extensive monitoring, both for effectiveness and efficacy and for enforcement of fortification legislation. PMID:25608937

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

PubMed

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

2014-08-13

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

E-DECIDER Disaster Response and Decision Support Cyberinfrastructure: Technology and Challenges

NASA Astrophysics Data System (ADS)

Glasscoe, M. T.; Parker, J. W.; Pierce, M. E.; Wang, J.; Eguchi, R. T.; Huyck, C. K.; Hu, Z.; Chen, Z.; Yoder, M. R.; Rundle, J. B.; Rosinski, A.

2014-12-01

Timely delivery of critical information to decision makers during a disaster is essential to response and damage assessment. Key issues to an efficient emergency response after a natural disaster include rapidly processing and delivering this critical information to emergency responders and reducing human intervention as much as possible. Essential elements of information necessary to achieve situational awareness are often generated by a wide array of organizations and disciplines, using any number of geospatial and non-geospatial technologies. A key challenge is the current state of practice does not easily support information sharing and technology interoperability. NASA E-DECIDER (Emergency Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response) has worked with the California Earthquake Clearinghouse and its partners to address these issues and challenges by adopting the XChangeCore Web Service Data Orchestration technology and participating in several earthquake response exercises. The E-DECIDER decision support system provides rapid delivery of advanced situational awareness data products to operations centers and emergency responders in the field. Remote sensing and hazard data, model-based map products, information from simulations, damage detection, and crowdsourcing is integrated into a single geospatial view and delivered through a service oriented architecture for improved decision-making and then directly to mobile devices of responders. By adopting a Service Oriented Architecture based on Open Geospatial Consortium standards, the system provides an extensible, comprehensive framework for geospatial data processing and distribution on Cloud platforms and other distributed environments. While the Clearinghouse and its partners are not first responders, they do support the emergency response community by providing information about the damaging effects earthquakes. It is critical for decision makers to maintain a situational awareness that is knowledgeable of potential and current conditions, possible impacts on populations and infrastructure, and other key information. E-DECIDER and the Clearinghouse have worked together to address many of these issues and challenges to deliver interoperable, authoritative decision support products.

Endangered species and nature conservation: science issues and challenges.

PubMed

Szaro, Robert C

2008-06-01

The issues and challenges facing us in ensuring the survival of as many species and ecosystems as possible call for a renewed research focus to address how to improve management strategies and policy making now and into the future. The key issues to be addressed by activities of the International Union of Forest Research Organization's (IUFRO) Task Force on Endangered Species and Nature Conservation include such issues as: (i) preventing species from being listed by maintaining species populations at sufficient levels that they do not require listing; (ii) recovering threatened and endangered species; (iii) developing management practices and strategies; (iv) balancing actions affecting suites of threatened or endangered species; (v) developing conservation strategies for species without definitive taxonomic treatments; (vi) dealing with global change; (vii) dealing with invasive species; and (viii) restoring critical habitats. © 2008 ISZS, Blackwell Publishing and IOZ/CAS.

A Nominal Balloon Instrument Payload to Address Questions from the Planetary Decadal Survey

NASA Astrophysics Data System (ADS)

Young, Eliot; Kremic, Tibor; Dankanich, John

The Planetary Science Decadal Survey (entitled "Visions and Voyages for Planetary Science in the Decade 2013 - 2022", available online at https://solarsystem.nasa.gov/2013decadal/) serves as a roadmap for activities to be pursued by the Planetary Science Division of NASA's Science Mission Directorate. This document outlines roughly 200 key research areas and questions in chapters covering different parts of the solar system (e.g., Mars, Small Bodies, etc.). We have reviewed the Decadal Survey to assess whether any of the key questions can be addressed by high altitude balloon-borne payloads. Although some questions can only be answered by in situ experiments, we found that approximately one quarter of the key questions were well suited to balloon payloads. In many of those cases, balloons were competitive or superior to other existing facilities, including HST, SOFIA or Keck telescopes. We will present specific telescope and instrument bench designs that are capable of addressing key questions in the Decadal Survey. The instrument bench takes advantage of two of the main benefits of high-altitude observations: diffraction-limited imaging in visible and UV wavelengths and unobstructed spectroscopy in near-IR (1 - 5 microns) wavelengths. Our optical prescription produces diffraction-limited PSFs in both visible and IR beams. We will discuss pointing and thermal stability, two of the main challenges facing a balloon-borne telescope.

Implementing Culture Change in Nursing Homes: An Adaptive Leadership Framework

PubMed Central

Corazzini, Kirsten; Twersky, Jack; White, Heidi K.; Buhr, Gwendolen T.; McConnell, Eleanor S.; Weiner, Madeline; Colón-Emeric, Cathleen S.

2015-01-01

Purpose of the Study: To describe key adaptive challenges and leadership behaviors to implement culture change for person-directed care. Design and Methods: The study design was a qualitative, observational study of nursing home staff perceptions of the implementation of culture change in each of 3 nursing homes. We conducted 7 focus groups of licensed and unlicensed nursing staff, medical care providers, and administrators. Questions explored perceptions of facilitators and barriers to culture change. Using a template organizing style of analysis with immersion/crystallization, themes of barriers and facilitators were coded for adaptive challenges and leadership. Results: Six key themes emerged, including relationships, standards and expectations, motivation and vision, workload, respect of personhood, and physical environment. Within each theme, participants identified barriers that were adaptive challenges and facilitators that were examples of adaptive leadership. Commonly identified challenges were how to provide person-directed care in the context of extant rules or policies or how to develop staff motivated to provide person-directed care. Implications: Implementing culture change requires the recognition of adaptive challenges for which there are no technical solutions, but which require reframing of norms and expectations, and the development of novel and flexible solutions. Managers and administrators seeking to implement person-directed care will need to consider the role of adaptive leadership to address these adaptive challenges. PMID:24451896

Design and Implementation of a Secure Wireless Mote-Based Medical Sensor Network

PubMed Central

Malasri, Kriangsiri; Wang, Lan

2009-01-01

A medical sensor network can wirelessly monitor vital signs of humans, making it useful for long-term health care without sacrificing patient comfort and mobility. For such a network to be viable, its design must protect data privacy and authenticity given that medical data are highly sensitive. We identify the unique security challenges of such a sensor network and propose a set of resource-efficient mechanisms to address these challenges. Our solution includes (1) a novel two-tier scheme for verifying the authenticity of patient data, (2) a secure key agreement protocol to set up shared keys between sensor nodes and base stations, and (3) symmetric encryption/decryption for protecting data confidentiality and integrity. We have implemented the proposed mechanisms on a wireless mote platform, and our results confirm their feasibility. PMID:22454585

Challenges for health care providers, parents and patients who face a child hood cancer diagnosis in Zambia.

PubMed

Walubita, Mulima; Sikateyo, Bornwell; Zulu, Joseph M

2018-05-02

Zambia is experiencing high prevalence of childhood cancer. However, very few children access and complete treatment for cancer. This study aimed to document the challenges for health care providers, parents and patients who face a child hood cancer diagnosis in Zambia, and their coping strategies. This was an exploratory health facility-based qualitative study that was conducted at a Paediatric oncology ward at referral hospital in Zambia. In-depth individual interviews conducted with fifteen (15) caregivers and seven (7) key informants were analysed using thematic analysis. Several challenges related to managing the childhood cancer diagnosis were recorded. Individual and family challenges were inadequate knowledge on childhood cancer, lack of finances to meet treatment and transport costs as well as long period of hospitalisation that affected women's ability to perform multiple responsibilities. Whereas challenges at community level were inadequate support to address emotional and physical distress and social stigmatisation experienced by caregivers. Health systems issues included inadequate specialised health workers, poor communication among health workers, limited space and beds as well as insufficient supplies such as blood. Cultural related factors were the belief that cancer is a product of witchcraft as well as religious beliefs regarding the role of faith healing in childhood cancer treatment. Coping strategies used by parents/ caregivers included praying to God, material support from organisations and church as well as delaying having another child. Addressing the challenges for health care providers, parents and patients who face a childhood cancer diagnosis may require adopting a systems or an ecological approach that allows developing strategies that simultaneously address challenges related to the individual, family, community, health system and cultural aspects.

The challenges in defining and measuring diagnostic error.

PubMed

Zwaan, Laura; Singh, Hardeep

2015-06-01

Diagnostic errors have emerged as a serious patient safety problem but they are hard to detect and complex to define. At the research summit of the 2013 Diagnostic Error in Medicine 6th International Conference, we convened a multidisciplinary expert panel to discuss challenges in defining and measuring diagnostic errors in real-world settings. In this paper, we synthesize these discussions and outline key research challenges in operationalizing the definition and measurement of diagnostic error. Some of these challenges include 1) difficulties in determining error when the disease or diagnosis is evolving over time and in different care settings, 2) accounting for a balance between underdiagnosis and overaggressive diagnostic pursuits, and 3) determining disease diagnosis likelihood and severity in hindsight. We also build on these discussions to describe how some of these challenges can be addressed while conducting research on measuring diagnostic error.

Practical Challenges of Systems Thinking and Modeling in Public Health

PubMed Central

Trochim, William M.; Cabrera, Derek A.; Milstein, Bobby; Gallagher, Richard S.; Leischow, Scott J.

2006-01-01

Objectives. Awareness of and support for systems thinking and modeling in the public health field are growing, yet there are many practical challenges to implementation. We sought to identify and describe these challenges from the perspectives of practicing public health professionals. Methods. A systems-based methodology, concept mapping, was used in a study of 133 participants from 2 systems-based public health initiatives (the Initiative for the Study and Implementation of Systems and the Syndemics Prevention Network). This method identified 100 key challenges to implementation of systems thinking and modeling in public health work. Results. The project resulted in a map identifying 8 categories of challenges and the dynamic interactions among them. Conclusions. Implementation by public health professionals of the 8 simple rules we derived from the clusters in the map identified here will help to address challenges and improve the organization of systems that protect the public’s health. PMID:16449581

Doing qualitative research on suicide in a developing country: practical and ethical challenges.

PubMed

Mugisha, James; Knizek, Birthe Loa; Kinyanda, Eugene; Hjelmeland, Heidi

2011-01-01

This article describes and discusses the challenges faced by researchers who conducted a qualitative interview study on attitudes toward suicide among the Baganda, Uganda. Many of the challenges addressed in this article have not been described earlier in suicide research conducted in the developing world. The aim of this study was to explore attitudes and cultural responses toward suicide among the Baganda, Uganda. Data were collected and analyzed using grounded theory. A total of 28 focus group discussions and 30 key informant interviews were conducted. The findings of this study are organized under two broad categories: community access challenges and expectation challenges. Community access challenges entailed cultural, legal, rapport, informed consent, language, and other research process related issues that could hinder effective access to the study respondents. Expectation challenges concerned how to deal with the immediate and strategic needs of the study communities. This study demonstrates that culturally sensitive approaches to data collection can reduce ethical challenges and, through innovative approaches, practical challenges faced during data collection can be minimized.

A multi-level systems perspective for the science of team science.

PubMed

Börner, Katy; Contractor, Noshir; Falk-Krzesinski, Holly J; Fiore, Stephen M; Hall, Kara L; Keyton, Joann; Spring, Bonnie; Stokols, Daniel; Trochim, William; Uzzi, Brian

2010-09-15

This Commentary describes recent research progress and professional developments in the study of scientific teamwork, an area of inquiry termed the "science of team science" (SciTS, pronounced "sahyts"). It proposes a systems perspective that incorporates a mixed-methods approach to SciTS that is commensurate with the conceptual, methodological, and translational complexities addressed within the SciTS field. The theoretically grounded and practically useful framework is intended to integrate existing and future lines of SciTS research to facilitate the field's evolution as it addresses key challenges spanning macro, meso, and micro levels of analysis.

Effectively executing a comprehensive marketing communication strategy.

PubMed

Gombeski, William R; Taylor, Jan; Piccirilli, Ami; Cundiff, Lee; Britt, Jason

2007-01-01

Marketers are under increasing scrutiny from their management to demonstrate accountability for the resources they receive. Three models are presented to help marketers execute their customer communication activities more effectively. Benefits of using the "Identification of Strategic Communication Elements," "Business Communication" and "Communications Management Process" models include (1) more effective upfront strategic and tactical planning, (2) ensuring key communication principles are addressed, (3) easier communication program communication, (4) provides a framework for program evaluation and market research and (5) increases the creative thinking marketers need when addressing the major marketing challenges. The ultimate benefit is the greater likelihood of more positive marketing results.

Exploring the Human Fabric through an Analyst's Eyes

NASA Astrophysics Data System (ADS)

Belov, Nadya; Patti, Jeff; Wilcox, Saki; Almanzar, Rafael; Kim, Janet; Kellogg, Jennifer; Dang, Steven

The nature and type of conflicts drastically changed in the last half of the twentieth century. Wars are no longer limited to the field; they are supplemented with guerrilla warfare and other asymmetric warfare tactics including domestic terrorism. Domestic terrorism has demonstrated a need for improved homeland security capabilities. Establishing and maintaining the understanding of the key players and the underlying social networks is essential to combating asynchronous warfare tactics. Herein, we identify the key challenges addressed by our Collection/Exploitation Decision System (CEDS) that assist analysts in maintaining an up-to-date understanding of dynamic human networks.

Parameter as a Switch Between Dynamical States of a Network in Population Decoding.

PubMed

Yu, Jiali; Mao, Hua; Yi, Zhang

2017-04-01

Population coding is a method to represent stimuli using the collective activities of a number of neurons. Nevertheless, it is difficult to extract information from these population codes with the noise inherent in neuronal responses. Moreover, it is a challenge to identify the right parameter of the decoding model, which plays a key role for convergence. To address the problem, a population decoding model is proposed for parameter selection. Our method successfully identified the key conditions for a nonzero continuous attractor. Both the theoretical analysis and the application studies demonstrate the correctness and effectiveness of this strategy.

Addressing informatics challenges in Translational Research with workflow technology.

PubMed

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

2008-09-01

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

Land use politics and law in the 1970's

NASA Technical Reports Server (NTRS)

Lamb, C. M.

1975-01-01

Political facets of the general land use challenge faced in the United States, and the legal authority for governmental action by state and federal officials under given conditions are discussed. Some current and future implications of these political and legal developments are presented. An overview of local versus state versus federal powers is presented along with practices for solving the nation's land use challenge. An analysis is provided of land use law and politics in five states playing active roles in land control. Land use politics and law at the federal level is addressed, with emphasis on three key legislative measures.

Can nurses rise to the public health challenge? How a novel solution in nurse education can address this contemporary question.

PubMed

Turner-Wilson, Angela L; Mills, Anne M; Rees, Karen

2017-10-01

This paper raises the problem of how improvements in health outcomes, a key component in many governments' strategies, can be achieved. The work highlights a novel undergraduate educational approach which offers solutions to public health challenges within nursing. Against the backdrop of one UK university institution it discusses approaches that can guide nursing students towards a deeper understanding and engagement within the principles of public health. It then proposes how nurses can use their learning to become leaders of health improvement. Copyright © 2017 Elsevier Ltd. All rights reserved.

Multilayered Functional Insulation System (MFIS) for AC Power Transmission in High Voltage Hybrid Electrical Propulsion

NASA Technical Reports Server (NTRS)

Lizcano, Maricela

2017-01-01

High voltage hybrid electric propulsion systems are now pushing new technology development efforts for air transportation. A key challenge in hybrid electric aircraft is safe high voltage distribution and transmission of megawatts of power (>20 MW). For the past two years, a multidisciplinary materials research team at NASA Glenn Research Center has investigated the feasibility of distributing high voltage power on future hybrid electric aircraft. This presentation describes the team's approach to addressing this challenge, significant technical findings, and next steps in GRC's materials research effort for MW power distribution on aircraft.

Social enterprise: new pathways to health and well-being?

PubMed

Roy, Michael J; Donaldson, Cam; Baker, Rachel; Kay, Alan

2013-01-01

In this article we attempt to make sense of recent policy directions and controversies relating to the 'social enterprise' and 'health' interface. In doing so, we outline the unrecognised potential of social enterprise for generating health and well-being improvement, and the subsequent challenges for government, the sector itself, and for the research community. Although we focus primarily upon the U.K. policy landscape, the key message--that social enterprise could represent an innovative and sustainable public health intervention--is a useful contribution to the ongoing international debate on how best to address the challenge of persistent and widening health inequalities.

Design considerations and strategies for lunar-based observations

NASA Technical Reports Server (NTRS)

Snoddy, William C.; Nein, Max E.; Hilchey, John D.

1994-01-01

This paper addresses the design considerations and strategies for astrophysical observations as key elements of an international solar system exploration program. Emphasis is placed on the technical and programmatic challenges and opportunities associated with an evolving program of lunar-based astronomy. Both robotic and human tended facilities are discussed ranging from relatively small meter-class transit telescopes to large interferometer and filled-aperture systems.

Challenging Representations: Constructing the Adult Literacy Learner over 30 Years of Policy and Practice in the United Kingdom

ERIC Educational Resources Information Center

Hamilton, Mary; Pitt, Kathy

2011-01-01

This article addresses the question, How do changes in policy discourses shape public representations of literacy learners and the goals of adult literacy education? It examines specifically how the agency of adult literacy learners is constructed. We carry out a critical discourse analysis of two key adult literacy policy documents from the U.K.:…

Re-Assessing Poverty Dynamics and State Protections in Britain and the US: The Role of Measurement Error

ERIC Educational Resources Information Center

Worts, Diana; Sacker, Amanda; McDonough, Peggy

2010-01-01

This paper addresses a key methodological challenge in the modeling of individual poverty dynamics--the influence of measurement error. Taking the US and Britain as case studies and building on recent research that uses latent Markov models to reduce bias, we examine how measurement error can affect a range of important poverty estimates. Our data…

Enhancing Young Hispanic Dual Language Learners' Achievement: Exploring Strategies and Addressing Challenges. Policy Information Report. ETS RR-15-01

ERIC Educational Resources Information Center

Ackerman, Debra J.; Tazi, Zoila

2015-01-01

Dual language learners, or DLLs, may have greater school readiness needs due to the key role English oral language skills play in the development of emerging literacy skills in English and their overall academic achievement. This especially can be the case if children's capacity to benefit from classroom instruction and interact with teachers and…

Higher Education Research Agendas for the Coming Decade: A UK Perspective on the Policy-Research Nexus

ERIC Educational Resources Information Center

Middlehurst, Robin

2014-01-01

From the perspective of the UK, this paper addresses two main themes. It presents a higher education (HE) research agenda for the next decade linked to key policy challenges and reflects on the dynamics of the research-policy landscape. The paper begins by identifying four dimensions of the UK that will continue to be important as a focus for…

A Bayesian Framework for Human Body Pose Tracking from Depth Image Sequences

PubMed Central

Zhu, Youding; Fujimura, Kikuo

2010-01-01

This paper addresses the problem of accurate and robust tracking of 3D human body pose from depth image sequences. Recovering the large number of degrees of freedom in human body movements from a depth image sequence is challenging due to the need to resolve the depth ambiguity caused by self-occlusions and the difficulty to recover from tracking failure. Human body poses could be estimated through model fitting using dense correspondences between depth data and an articulated human model (local optimization method). Although it usually achieves a high accuracy due to dense correspondences, it may fail to recover from tracking failure. Alternately, human pose may be reconstructed by detecting and tracking human body anatomical landmarks (key-points) based on low-level depth image analysis. While this method (key-point based method) is robust and recovers from tracking failure, its pose estimation accuracy depends solely on image-based localization accuracy of key-points. To address these limitations, we present a flexible Bayesian framework for integrating pose estimation results obtained by methods based on key-points and local optimization. Experimental results are shown and performance comparison is presented to demonstrate the effectiveness of the proposed approach. PMID:22399933

Extending health insurance coverage to the informal sector: Lessons from a private micro health insurance scheme in Lagos, Nigeria.

PubMed

Peterson, Lauren; Comfort, Alison; Hatt, Laurel; van Bastelaer, Thierry

2018-04-15

As a growing number of low- and middle-income countries commit to achieving universal health coverage, one key challenge is how to extend coverage to informal sector workers. Micro health insurance (MHI) provides a potential model to finance health services for this population. This study presents lessons from a pilot study of a mandatory MHI plan offered by a private insurance company and distributed through a microfinance bank to urban, informal sector workers in Lagos, Nigeria. Study methods included a survey of microfinance clients, key informant interviews, and a review of administrative records. Demographic, health care seeking, and willingness-to-pay data suggested that microfinance clients, particularly women, could benefit from a comprehensive MHI plan that improved access to health care and reduced out-of-pocket spending on health services. However, administrative data revealed declining enrollment, and key informant interviews further suggested low use of the health insurance plan. Key implementation challenges, including changes to mandatory enrollment requirements, insufficient client education and marketing, misaligned incentives, and weak back-office systems, undermined enrollment and use of the plan. Mandatory MHI plans, intended to mitigate adverse selection and facilitate private insurers' entry into new markets, present challenges for covering informal sector workers, including when distributed through agents such as a microfinance bank. Properly aligning the incentives of the insurer and the agent are critical to effectively distribute and service insurance. Further, an urban environment presents unique challenges for distributing MHI, addressing client perceptions of health insurance, and meeting their health care needs. Copyright © 2018 John Wiley & Sons, Ltd.

NASA's Solar Dynamics Observatory (SDO): A Systems Approach to a Complex Mission

NASA Technical Reports Server (NTRS)

Ruffa, John A.; Ward, David K.; Bartusek, LIsa M.; Bay, Michael; Gonzales, Peter J.; Pesnell, William D.

2012-01-01

The Solar Dynamics Observatory (SDO) includes three advanced instruments, massive science data volume, stringent science data completeness requirements, and a custom ground station to meet mission demands. The strict instrument science requirements imposed a number of challenging drivers on the overall mission system design, leading the SDO team to adopt an integrated systems engineering presence across all aspects of the mission to ensure that mission science requirements would be met. Key strategies were devised to address these system level drivers and mitigate identified threats to mission success. The global systems engineering team approach ensured that key drivers and risk areas were rigorously addressed through all phases of the mission, leading to the successful SDO launch and on-orbit operation. Since launch, SDO's on-orbit performance has met all mission science requirements and enabled groundbreaking science observations, expanding our understanding of the Sun and its dynamic processes.

NASA's Solar Dynamics Observatory (SDO): A Systems Approach to a Complex Mission

NASA Technical Reports Server (NTRS)

Ruffa, John A.; Ward, David K.; Bartusek, Lisa M.; Bay, Michael; Gonzales, Peter J.; Pesnell, William D.

2012-01-01

The Solar Dynamics Observatory (SDO) includes three advanced instruments, massive science data volume, stringent science data completeness requirements, and a custom ground station to meet mission demands. The strict instrument science requirements imposed a number of challenging drivers on the overall mission system design, leading the SDO team to adopt an integrated systems engineering presence across all aspects of the mission to ensure that mission science requirements would be met. Key strategies were devised to address these system level drivers and mitigate identified threats to mission success. The global systems engineering team approach ensured that key drivers and risk areas were rigorously addressed through all phases of the mission, leading to the successful SDO launch and on-orbit operation. Since launch, SDO s on-orbit performance has met all mission science requirements and enabled groundbreaking science observations, expanding our understanding of the Sun and its dynamic processes.

Focusing ecological research for conservation.

PubMed

Cristescu, Bogdan; Boyce, Mark S

2013-11-01

Ecologists are increasingly actively involved in conservation. We identify five key topics from a broad sweep of ecology that merit research attention to meet conservation needs. We examine questions from landscape ecology, behavioral ecology, ecosystem dynamics, community ecology, and nutrient cycling related to key topics. Based on literature review and publication trend assessment, consultation with colleagues, and roundtable discussions at the 24th International Congress for Conservation Biology, focused research on the following topics could benefit conservation while advancing ecological understanding: 1. Carbon sequestration, requiring increased linkages to biodiversity conservation; 2. Ecological invasiveness, challenging our ability to find solutions to ecological aliens; 3. Individual variation, having applications in the conservation of rare species; 4. Movement of organisms, integrating ecological processes across landscapes and scales and addressing habitat fragmentation; and 5. Trophic-level interactions, driving ecological dynamics at the ecosystem-level. Addressing these will require cross-disciplinary research under the overarching framework of conservation ecology.

Treating Substance Use Disorders in the Criminal Justice System

PubMed Central

Hiller, Matthew; Hamilton, Leah

2013-01-01

The large number of individuals with substance use disorders involved in the nation’s criminal justice system (CJS) represents a unique opportunity, as well as challenges, in addressing the dual concerns of public safety and public health. Unfortunately, a low proportion of those who could benefit from treatment actually receive it while involved in the CJS. This article presents a review of recent research on the effectiveness of major substance abuse treatment interventions used at different possible linkage points during criminal justice case processing, including diversion, jail, prison, and community supervision. This is followed by a discussion of key research and practice issues, including low rates of treatment access and under-utilization of medication-assisted treatment. Concluding comments discuss principles of effective treatment for offenders and identify key gaps in research and practice that need to be addressed to improve and expand provision of effective treatment for offenders. PMID:24132733

Microfluidic Model Porous Media: Fabrication and Applications.

PubMed

Anbari, Alimohammad; Chien, Hung-Ta; Datta, Sujit S; Deng, Wen; Weitz, David A; Fan, Jing

2018-05-01

Complex fluid flow in porous media is ubiquitous in many natural and industrial processes. Direct visualization of the fluid structure and flow dynamics is critical for understanding and eventually manipulating these processes. However, the opacity of realistic porous media makes such visualization very challenging. Micromodels, microfluidic model porous media systems, have been developed to address this challenge. They provide a transparent interconnected porous network that enables the optical visualization of the complex fluid flow occurring inside at the pore scale. In this Review, the materials and fabrication methods to make micromodels, the main research activities that are conducted with micromodels and their applications in petroleum, geologic, and environmental engineering, as well as in the food and wood industries, are discussed. The potential applications of micromodels in other areas are also discussed and the key issues that should be addressed in the near future are proposed. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Interactive planning of cryotherapy using physics-based simulation.

PubMed

Talbot, Hugo; Lekkal, Myriam; Bessard-Duparc, Remi; Cotin, Stephane

2014-01-01

Cryotherapy is a rapidly growing minimally invasive technique for the treatment of certain tumors. It consists in destroying cancer cells by extreme cold delivered at the tip of a needle-like probe. As the resulting iceball is often smaller than the targeted tumor, a key to the success of cryotherapy is the planning of the position and orientation of the multiple probes required to treat a tumor, while avoiding any damage to the surrounding tissues. In order to provide such a planning tool, a number of challenges need to be addressed such as fast and accurate computation of the freezing process or interactive positioning of the virtual cryoprobes in the pre-operative image volume. To address these challenges, we present an approach which relies on an advanced computational framework, and a gesture-based planning system using contact-less technology to remain compatible with a use in a sterile environment.

Systems thinking and ethics in public health: a necessary and mutually beneficial partnership.

PubMed

Silva, Diego S; Smith, Maxwell J; Norman, Cameron D

2018-06-13

Systems thinking has emerged as a means of conceptualizing and addressing complex public health problems, thereby challenging more commonplace understanding of problems and corresponding solutions as straightforward explanations of cause and effect. Systems thinking tries to address the complexity of problems through qualitative and quantitative modeling based on a variety of systems theories, each with their own assumptions and, more importantly, implicit and unexamined values. To date, however, there has been little engagement between systems scientists and those working in bioethics and public health ethics. The goal of this paper is to begin to consider what it might mean to combine systems thinking with public health ethics to solve public health challenges. We argue that there is a role for ethics in systems thinking in public health as a means of elucidating implicit assumptions and facilitating ethics debate and dialogue with key stakeholders.

From anatomical 'competence' to complex capability. The views and experiences of UK tutors on how we should teach anatomy to medical students.

PubMed

Regan de Bere, Sam; Mattick, Karen

2010-10-01

Developments in clinical education have recently challenged the identity of anatomy teaching and learning, leading to high profile debate over the potential implications for the competence levels of new doctors. However, the emphasis remains on methods of teaching, rather than a review of what well-rounded anatomical learning actually entails, and how teaching can address contemporary learning needs. This paper identifies and addresses some of these issues, drawing on expert views captured in qualitative research with anatomy tutors at twenty different medical schools in the UK. Three main themes emerging from our analysis are described: anatomy as a subject matter, the challenges of teaching or learning anatomy, and the use of teaching methods. We also detail how inductive analysis generated new hypotheses worthy of further consideration. These fall into two key categories: (1) improving anatomy curriculum design and (2) advancing anatomy education research.

Public perceptions and information gaps in solar energy in Texas

NASA Astrophysics Data System (ADS)

Rai, Varun; Beck, Ariane L.

2015-07-01

Studying the behavioral aspects of the individual decision-making process is important in identifying and addressing barriers in the adoption of residential solar photovoltaic (PV). However, there is little systematic research focusing on these aspects of residential PV in Texas, an important, large, populous state, with a range of challenges in the electricity sector including increasing demand, shrinking reserve margins, constrained water supply, and challenging emissions reduction targets under proposed federal regulations. This paper aims to address this gap through an empirical investigation of a new survey-based dataset collected in Texas on solar energy perceptions and behavior. The results of this analysis offer insights into the perceptions and motivations influencing intentions and behavior toward solar energy in a relatively untapped market and help identify information gaps that could be targeted to alleviate key barriers to adopting solar, thereby enabling significant emissions reductions in the residential sector in Texas.

Developing an interministerial substance use response strategy for Lebanon: process, content and lessons learned.

PubMed

Hajal, Sandra; Kik, Nour; El Chammay, Rabih; Ammar, Walid

2017-05-01

Evidence on substance use in Lebanon shows an increase in usage, limited availability and accessibility to evidence-based services, and high level of stigma and discrimination. In line with the "Mental Health and Substance Use Strategy for Lebanon 2015-2020", the Ministry of Public Health initiated the process of developing a strategy focused on substance use response to address these challenges in collaboration with the Ministries of Education and Higher Education, Interior and Municipalities, Justice and Social Affairs. The result of this process was a strategy launched jointly by the ministries including six domains of action covering the whole spectrum of substance use response with strategic objectives addressing the challenges identified through stakeholders' consultations. The following key principles adopted throughout the process contributed to the successful development of the strategy: building on evidence and international frameworks, maximizing the participation of all stakeholders, prioritising national consensus, maintaining flexibility and maximizing transparency.

Zoos and public health: A partnership on the One Health frontier.

PubMed

Robinette, C; Saffran, L; Ruple, A; Deem, S L

2017-06-01

Today, accredited zoos are not just places for entertainment, they are actively involved in research for conservation and health. During recent decades in which the challenges for biodiversity conservation and public health have escalated, zoos have made significant changes to address these difficulties. Zoos increasingly have four key areas of focus: education, recreation, conservation, and research. These key areas are important in addressing an interrelated global conservation ( i.e. habitat and wildlife loss) and public health crisis. Zoo and public health professionals working together within a One Health framework represent a powerful alliance to address current and future conservation and public health problems around the world. For researchers, practitioners, and students, the collaboration between zoos and public health institutions offers the opportunity to both teach and operationalize this transdisciplinary approach. Using examples from our programs, we give a template for moving forward with collaborative initiatives and sustainable solutions involving partners in both zoos and public health institutions. We provide examples of cooperative programs and suggest a model for consideration in the development of further activities in this area.

Optimizing health information technology's role in enabling comparative effectiveness research.

PubMed

Navathe, Amol S; Conway, Patrick H

2010-12-01

Health information technology (IT) is a key enabler of comparative effectiveness research (CER). Health IT standards for data sharing are essential to advancing the research data infrastructure, and health IT is critical to the next step of incorporating clinical data into data sources. Four key principles for advancement of CER are (1) utilization of data as a strategic asset, (2) leveraging public-private partnerships, (3) building robust, scalable technology platforms, and (4) coordination of activities across government agencies. To maximize the value of the resources, payers and providers must contribute data to initiatives, engage with government agencies on lessons learned, continue to develop new technologies that address key challenges, and utilize the data to improve patient outcomes and conduct research.

Implementation of an inter-agency transition model for youth with spina bifida.

PubMed

Lindsay, S; Cruickshank, H; McPherson, A C; Maxwell, J

2016-03-01

To address gaps in transfer of care and transition support, a paediatric hospital and adult community health care centre partnered to implement an inter-agency transition model for youth with spina bifida. Our objective was to understand the enablers and challenges experienced in the implementation of the model. Using a descriptive, qualitative design, we conducted semi-structured interviews, in-person or over the phone, with 12 clinicians and nine key informants involved in implementing the spina bifida transition model. We recruited all 21 participants from an urban area of Ontario, Canada. Clinicians and key informants experienced several enablers and challenges in implementing the spina bifida transition model. Enablers included dedicated leadership, advocacy, funding, inter-agency partnerships, cross-appointed staff and gaps in co-ordinated care to connect youth to adult services. Challenges included gaps in the availability of adult specialty services, limited geographical catchment of adult services, limited engagement of front-line staff, gaps in communication and role clarity. Although the transition model has realized some initial successes, there are still many challenges to overcome in transferring youth with spina bifida to adult health care and transitioning to adulthood. © 2015 John Wiley & Sons Ltd.

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

Wei, Xiaoliang; Duan, Wentao; Huang, Jinhua

Nonaqueous redox flow batteries are promising in pursuit of high-energy storage systems owing to the broad voltage window, but currently are facing key challenges such as poor cycling stability and lack of suitable membranes. Here we report a new nonaqueous all-organic flow chemistry that demonstrates an outstanding cell cycling stability primarily because of high chemical persistency of the organic radical redox species and their good compatibility with the supporting electrolyte. A feasibility study shows that Daramic® and Celgard® porous separators can lead to high cell conductivity in flow cells thus producing remarkable cell efficiency and material utilization even at highmore » current operations. This result suggests that the thickness and pore size are the key performance-determining factors for porous separators. With the greatly improved flow cell performance, this new flow system largely addresses the above mentioned challenges and the findings may greatly expedite the development of durable nonaqueous flow batteries.« less

Advanced visualization platform for surgical operating room coordination: distributed video board system.

PubMed

Hu, Peter F; Xiao, Yan; Ho, Danny; Mackenzie, Colin F; Hu, Hao; Voigt, Roger; Martz, Douglas

2006-06-01

One of the major challenges for day-of-surgery operating room coordination is accurate and timely situation awareness. Distributed and secure real-time status information is key to addressing these challenges. This article reports on the design and implementation of a passive status monitoring system in a 19-room surgical suite of a major academic medical center. Key design requirements considered included integrated real-time operating room status display, access control, security, and network impact. The system used live operating room video images and patient vital signs obtained through monitors to automatically update events and operating room status. Images were presented on a "need-to-know" basis, and access was controlled by identification badge authorization. The system delivered reliable real-time operating room images and status with acceptable network impact. Operating room status was visualized at 4 separate locations and was used continuously by clinicians and operating room service providers to coordinate operating room activities.

Devolution and human resources in primary healthcare in rural Mali

PubMed Central

2011-01-01

Devolution, as other types of decentralization (e.g. deconcentration, delegation, privatization), profoundly changes governance relations in the health system. Devolution is meant to affect performance of the health system by transferring responsibilities and authority to locally elected governments. The key question of this article is: what does devolution mean for human resources for health in Mali? This article assesses the key advantages and dilemmas associated with devolution such as responsiveness to local needs, downward accountability and health worker retention. Challenges of politics and capacities are also addressed in relation to human resources for health at the local level. Examples are derived from experiences in Mali with a capacity development programme and from case studies of other countries. It is not research findings that are presented, but highlights of key issues at stake aimed at inspiring the debate in Mali and elsewhere. A first lesson from the discussion suggests that in the context of human resources for health, decentralization of authority and resources is not the main issue. The challenge is to develop or strengthen accountability of those who decide and act, whether they are local politicians, bureaucrats or community representatives. If decentralization policies do not address public accountability, they will not fundamentally change human resource management, quality and equity of staffing. A second lesson is that successful devolution requires innovations in capacity development of all actors involved and in designing effective incentive measures. A final key conclusion is that the topic of devolution policy and its effects on human resources for health, and vice versa, merit more attention. A better understanding may lead to more appropriate policy designs and better preparation for the actors involved in countries that are embarking on decentralization, as is the case in Mali. PMID:21651817

Ethical challenges in resuscitation.

PubMed

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

2018-06-01

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

Early integration of the individual student in academic activities: a novel classroom concept for graduate education in molecular biophysics and structural biology

PubMed Central

2014-01-01

Background A key challenge in interdisciplinary research is choosing the best approach from a large number of techniques derived from different disciplines and their interfaces. Results To address this challenge in the area of Biophysics and Structural Biology, we have designed a graduate level course to teach students insightful use of experimental biophysical approaches in relationship to addressing biological questions related to biomolecular interactions and dynamics. A weekly seminar and data and literature club are used to compliment the training in class. The course contains wet-laboratory experimental demonstration and real-data analysis as well as lectures, grant proposal preparation and assessment, and student presentation components. Active student participation is mandatory in all aspects of the class. Students prepare materials for the class receiving individual and iterative feedback from course directors and local experts generating high quality classroom presentations. Conclusions The ultimate goal of the course is to teach students the skills needed to weigh different experimental approaches against each other in addressing a specific biological question by thinking and executing academic tasks like faculty. PMID:25132964

Early integration of the individual student in academic activities: a novel classroom concept for graduate education in molecular biophysics and structural biology.

PubMed

Leuba, Sanford H; Carney, Sean M; Dahlburg, Elizabeth M; Eells, Rebecca J; Ghodke, Harshad; Yanamala, Naveena; Schauer, Grant; Klein-Seetharaman, Judith

2014-01-01

A key challenge in interdisciplinary research is choosing the best approach from a large number of techniques derived from different disciplines and their interfaces. To address this challenge in the area of Biophysics and Structural Biology, we have designed a graduate level course to teach students insightful use of experimental biophysical approaches in relationship to addressing biological questions related to biomolecular interactions and dynamics. A weekly seminar and data and literature club are used to compliment the training in class. The course contains wet-laboratory experimental demonstration and real-data analysis as well as lectures, grant proposal preparation and assessment, and student presentation components. Active student participation is mandatory in all aspects of the class. Students prepare materials for the class receiving individual and iterative feedback from course directors and local experts generating high quality classroom presentations. The ultimate goal of the course is to teach students the skills needed to weigh different experimental approaches against each other in addressing a specific biological question by thinking and executing academic tasks like faculty.

Communicative challenges in the home care of older persons - a qualitative exploration.

PubMed

Sundler, Annelie J; Eide, Hilde; van Dulmen, Sandra; Holmström, Inger K

2016-10-01

To explore communicative challenges in encounters between nurse assistants and older persons during home care visits. The older population is increasing worldwide. Currently, there is a shift in care for older people from institutional care to home care. Providing home care in a person's home involves several challenges, including the complexity of communication. A descriptive observational design with a qualitative approach was used. The data consisted of audio recordings of real-life encounters during home care visits between nurse assistants and older persons, collected in 2014. A hermeneutic phenomenological analysis was conducted. Communicative challenges were identified: (a) in situations where the older persons had a different view than the nurse assistants on the care task and its content; and (b) when unexpected actions or turns occurred in the communication. Challenges included older person's existential issues, fragility and worries and concerns, which often appeared to be only vaguely expressed and difficult to verbally detect and tackle. This engendered a risk of misinterpretation or ignorance of these challenges. The findings point to the importance of communication as the key to facilitate person-centred home care. Communication training should focus more on addressing needs and existential issues in older persons. Person-centred home care for older persons needs to be addressed at both an individual and an organizational level. © 2016 John Wiley & Sons Ltd.

Experiences of a Rail Yard Community: Life Is Hard

PubMed Central

Spencer-Hwang, Rhonda; Montgomery, Susanne; Dougherty, Molly; Valladares, Johanny; Rangel, Sany; Gleason, Peter; Soret, Sam

2015-01-01

Community groups and local air pollution control agencies have identified the San Bernardino Railyard (SBR) as a significant public health and environmental justice issue. In response, the authors conducted a comprehensive study with community members living in close proximity to the rail yard. The purpose of this article is to share the community's perceptions about the rail yard and ideas on sustainable change. A qualitative study using key informant interviews and focus group discussions was conducted and resulted in four emerging themes. Themes emerged as follows: “health as an unattainable value,” “air quality challenges,” “rail yard pros and cons,” and “violence and unemployment ripple effect.” Community participants expressed concern for poor air quality, but other challenges took priority. The authors' findings suggest that future mitigation work to reduce air pollution exposure should not only focus on reducing risk from air pollution but address significant cooccurring community challenges. A “Health in All Policies” approach is warranted in addressing impacted communities in close proximity to the goods movement industry. PMID:25226779

Next Generation Distributed Computing for Cancer Research

PubMed Central

Agarwal, Pankaj; Owzar, Kouros

2014-01-01

Advances in next generation sequencing (NGS) and mass spectrometry (MS) technologies have provided many new opportunities and angles for extending the scope of translational cancer research while creating tremendous challenges in data management and analysis. The resulting informatics challenge is invariably not amenable to the use of traditional computing models. Recent advances in scalable computing and associated infrastructure, particularly distributed computing for Big Data, can provide solutions for addressing these challenges. In this review, the next generation of distributed computing technologies that can address these informatics problems is described from the perspective of three key components of a computational platform, namely computing, data storage and management, and networking. A broad overview of scalable computing is provided to set the context for a detailed description of Hadoop, a technology that is being rapidly adopted for large-scale distributed computing. A proof-of-concept Hadoop cluster, set up for performance benchmarking of NGS read alignment, is described as an example of how to work with Hadoop. Finally, Hadoop is compared with a number of other current technologies for distributed computing. PMID:25983539

Teaching adaptive leadership to family medicine residents: what? why? how?

PubMed

Eubank, Daniel; Geffken, Dominic; Orzano, John; Ricci, Rocco

2012-09-01

Health care reform calls for patient-centered medical homes built around whole person care and healing relationships. Efforts to transform primary care practices and deliver these qualities have been challenging. This study describes one Family Medicine residency's efforts to develop an adaptive leadership curriculum and use coaching as a teaching method to address this challenge. We review literature that describes a parallel between the skills underlying such care and those required for adaptive leadership. We address two questions: What is leadership? Why focus on adaptive leadership? We then present a synthesis of leadership theories as a set of process skills that lead to organization learning through effective work relationships and adaptive leadership. Four models of the learning process needed to acquire such skills are explored. Coaching is proposed as a teaching method useful for going beyond information transfer to create the experiential learning necessary to acquire the process skills. Evaluations of our efforts to date are summarized. We discuss key challenges to implementing such a curriculum and propose that teaching adaptive leadership is feasible but difficult in the current medical education and practice contexts.

Integrated mixed methods policy analysis for sustainable food systems: trends, challenges and future research.

PubMed

Cuevas, Soledad

Agriculture is a major contributor to greenhouse gas emissions, an important part of which is associated to deforestation and indirect land use change. Appropriate and coherent food policies can play an important role in aligning health, economic and environmental goals. From the point of view of policy analysis, however, this requires multi-sectoral, interdisciplinary approaches which can be highly complex. Important methodological advances in the area are not exempted from limitations and criticism. We argue that there is scope for further developments in integrated quantitative and qualitative policy analysis combining existing methods, including mathematical modelling and stakeholder analysis. We outline methodological trends in the field, briefly characterise integrated mixed methods policy analysis and identify contributions, challenges and opportunities for future research. In particular, this type of approach can help address issues of uncertainty and context-specific validity, incorporate multiple perspectives and help advance meaningful interdisciplinary collaboration in the field. Substantial challenges remain, however, such as the integration of key issues related to non-communicable disease, or the incorporation of a broader range of qualitative approaches that can address important cultural and ethical dimensions of food.

Next generation distributed computing for cancer research.

PubMed

Agarwal, Pankaj; Owzar, Kouros

2014-01-01

Advances in next generation sequencing (NGS) and mass spectrometry (MS) technologies have provided many new opportunities and angles for extending the scope of translational cancer research while creating tremendous challenges in data management and analysis. The resulting informatics challenge is invariably not amenable to the use of traditional computing models. Recent advances in scalable computing and associated infrastructure, particularly distributed computing for Big Data, can provide solutions for addressing these challenges. In this review, the next generation of distributed computing technologies that can address these informatics problems is described from the perspective of three key components of a computational platform, namely computing, data storage and management, and networking. A broad overview of scalable computing is provided to set the context for a detailed description of Hadoop, a technology that is being rapidly adopted for large-scale distributed computing. A proof-of-concept Hadoop cluster, set up for performance benchmarking of NGS read alignment, is described as an example of how to work with Hadoop. Finally, Hadoop is compared with a number of other current technologies for distributed computing.

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

PubMed

Bosomworth, Karyn; Owen, Christine; Curnin, Steven

2017-04-01

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

Electric power restructuring in iran: achievements and challenges

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

Khosroshahi, Kaveh Aflaki; Jadid, Shahram; Shahidehpour, Mohammad

2009-03-15

Although the power market in Iran is not fully constructed, several key steps have been taken to meet privatization and restructuring objectives. The addition of a power exchange sector has placed the power market on par with that in other countries. Operational concerns that still need to be addressed include technical and non-technical losses, enhancing new investment, and providing incentives for introducing energy efficiency and promoting green power generation. (author)

Innovation in nanomedicine through materials nanoarchitectonics.

PubMed

Kujawa, Piotr; Winnik, Françoise M

2013-06-18

Materials nanoarchitectonics has led to important innovations in the design and construction of systems in nanoelectronics, nanomachinery, and energy conversion. Recent publications point to the fact that the same approach may be applied successfully to other fields. In this Perspective, we define the key features of materials nanoarchitectonics and examine how they can be used to address current challenges in nanomedicine, placing emphasis on colloidal agents for therapeutic and diagnostic applications.

Effectiveness and Usability of the Sensory Processing Measure-Preschool Quick Tips: Data-Driven Intervention Following the Use of the SPM-Preschool in an Early Childhood, Multiple-Case Study

ERIC Educational Resources Information Center

Olson, Carol H.; Henry, Diana A.; Kliner, Ashley Peck; Kyllo, Alissa; Richter, Chelsea Munson; Charley, Jane; Whitcher, Meagan Chapman; Reinke, Katherine Roth; Tysver, Chelsay Horner; Wagner, Lacey; Walworth, Jessica

2016-01-01

This pre- and posttest multiple-case study examined the effectiveness and usability of the Sensory Processing Measure-Preschool Quick Tips (SPM-P QT) by key stakeholders (parents and teachers) for implementing data-driven intervention to address sensory processing challenges. The Sensory Processing Measure-Preschool (SPM-P) was administered as an…

The Collins Center Update. Volume 7, Issue 3, April-June 2005

DTIC Science & Technology

2005-06-01

paced dynamic, free play environment. The exercise, guided by the participants’ own goals and objectives challenged the students to increase...of theater-level campaign planning. In JLASS, USAWC students developed and fought campaign plans with students from the other SLCs in a free ... play computer-assisted wargame. The objective of JLASS is to promote joint professional military education of all participants by addressing key issues

Outcomes-Based Authentic Learning, Portfolio Assessment, and a Systems Approach to "Complex Problem-Solving": Related Pillars for Enhancing the Innovative Role of PBL in Future Higher Education

ERIC Educational Resources Information Center

Richards, Cameron

2015-01-01

The challenge of better reconciling individual and collective aspects of innovative problem-solving can be productively addressed to enhance the role of PBL as a key focus of the creative process in future higher education. This should involve "active learning" approaches supported by related processes of teaching, assessment and…

Manipulating Memories: The Ethics of Yesterday's Science Fiction and Today's Reality.

PubMed

Robillard, Julie M; Illes, Judy

2016-12-01

The paper addresses recent advances in memory manipulation from the perspective of the four key pillars of neuroethics: the self, social policy, neurotechnology, and education and outreach. We provide examples for each pillar, assess their neuroethical implications, and conclude with a call for an ethics framework that is specifically tailored for the ethical challenges of memory manipulation. © 2016 American Medical Association. All Rights Reserved.

The evolution of process-based hydrologic models: historical challenges and the collective quest for physical realism

NASA Astrophysics Data System (ADS)

Clark, Martyn P.; Bierkens, Marc F. P.; Samaniego, Luis; Woods, Ross A.; Uijlenhoet, Remko; Bennett, Katrina E.; Pauwels, Valentijn R. N.; Cai, Xitian; Wood, Andrew W.; Peters-Lidard, Christa D.

2017-07-01

The diversity in hydrologic models has historically led to great controversy on the correct approach to process-based hydrologic modeling, with debates centered on the adequacy of process parameterizations, data limitations and uncertainty, and computational constraints on model analysis. In this paper, we revisit key modeling challenges on requirements to (1) define suitable model equations, (2) define adequate model parameters, and (3) cope with limitations in computing power. We outline the historical modeling challenges, provide examples of modeling advances that address these challenges, and define outstanding research needs. We illustrate how modeling advances have been made by groups using models of different type and complexity, and we argue for the need to more effectively use our diversity of modeling approaches in order to advance our collective quest for physically realistic hydrologic models.

The evolution of process-based hydrologic models: historical challenges and the collective quest for physical realism

NASA Astrophysics Data System (ADS)

Clark, M. P.; Nijssen, B.; Wood, A.; Mizukami, N.; Newman, A. J.

2017-12-01

The diversity in hydrologic models has historically led to great controversy on the "correct" approach to process-based hydrologic modeling, with debates centered on the adequacy of process parameterizations, data limitations and uncertainty, and computational constraints on model analysis. In this paper, we revisit key modeling challenges on requirements to (1) define suitable model equations, (2) define adequate model parameters, and (3) cope with limitations in computing power. We outline the historical modeling challenges, provide examples of modeling advances that address these challenges, and define outstanding research needs. We illustrate how modeling advances have been made by groups using models of different type and complexity, and we argue for the need to more effectively use our diversity of modeling approaches in order to advance our collective quest for physically realistic hydrologic models.

Message Variability and Heterogeneity: A Core Challenge for Communication Research

PubMed Central

Slater, Michael D.; Peter, Jochen; Valkenberg, Patti

2015-01-01

Messages are central to human social experience, and pose key conceptual and methodological challenges in the study of communication. In response to these challenges, we outline a systematic approach to conceptualizing, operationalizing, and analyzing messages. At the conceptual level, we distinguish between two core aspects of messages: message variability (the defined and operationalized features of messages) and message heterogeneity (the undefined and unmeasured features of messages), and suggest preferred approaches to defining message variables. At the operational level, we identify message sampling, selection, and research design strategies responsive to issues of message variability and heterogeneity in experimental and survey research. At the analytical level, we highlight effective techniques to deal with message variability and heterogeneity. We conclude with seven recommendations to increase rigor in the study of communication through appropriately addressing the challenges presented by messages. PMID:26681816

Unmet needs in the transition to adulthood: 18- to 30-year-old people with hemophilia.

PubMed

Quon, Doris; Reding, Mark; Guelcher, Chris; Peltier, Skye; Witkop, Michelle; Cutter, Susan; Buranahirun, Cathy; Molter, Don; Frey, Mary Jane; Forsyth, Angela; Tran, Duc Bobby; Curtis, Randall; Hiura, Grant; Levesque, Justin; de la Riva, Debbie; Compton, Matthew; Iyer, Neeraj N; Holot, Natalia; Cooper, David L

2015-12-01

Young adults with hemophilia face unique challenges during the transition to adulthood, including issues associated with switching from pediatric to adult hematology care, building mature interpersonal relationships, and establishing an independent career with an assurance of medical insurance coverage. A greater understanding of these challenges is essential for developing effective strategies to address the specific needs of this population. These challenges may be differentiated from those of older adults with hemophilia in large part because of more extensive childhood prophylaxis and safer factor products, resulting in fewer joint problems and lower rates of HIV and HCV infections. This analysis of the changing nature and unmet needs of today's young adults entering into adult hemophilia treatment centers, as well as potential strategies for optimally addressing these needs, was developed following roundtable discussions between patients, caregivers, hematologists, and other health care professionals participating in comprehensive care. Challenges identified among young adults with hemophilia include psychosocial issues related to maturity, personal responsibility, and increased independence, as well as concerns regarding when and with whom to share information about one's hemophilia, limited awareness of educational and financial resources, and a low perceived value of regular hematology care. The initiatives proposed herein highlight important opportunities for health care professionals at pediatric and adult hemophilia treatment centers, as well as national organizations, community groups, and career counselors, to address key unmet needs of this patient population. © 2015 Wiley Periodicals, Inc.

Addressing the psychosocial and communication challenges posed by radiological/nuclear terrorism: key developments since NCRP Report No. 138.

PubMed

Becker, Steven M

2005-11-01

One of the most innovative aspects of NCRP Report No. 138 (Management of Terrorist Incidents Involving Radioactive Material) was the high priority it accorded to psychosocial and communication issues. While previous discussions of radiological and nuclear terrorism had occasionally referred to these topics, NCRP Report No. 138 was the first report of its kind to recognize the profound challenges posed by these issues and to place them at the heart of preparedness and response efforts. In the years since the report's release, a host of important developments have taken place in relation to psychosocial and communication issues. This paper reviews key changes and advances in five broad areas: (1) training exercises, (2) policy and guidance development, (3) findings on hospital and clinician needs, (4) survey research on public perceptions of radiological terrorism, and (5) risk communication for radiological and nuclear terrorism situations. The article concludes with a discussion of continuing psychosocial and communication challenges, including critical areas needing further attention as the nation moves to meet the threat of terrorism involving radioactive materials.

Statistical Teleodynamics: Toward a Theory of Emergence.

PubMed

Venkatasubramanian, Venkat

2017-10-24

The central scientific challenge of the 21st century is developing a mathematical theory of emergence that can explain and predict phenomena such as consciousness and self-awareness. The most successful research program of the 20th century, reductionism, which goes from the whole to parts, seems unable to address this challenge. This is because addressing this challenge inherently requires an opposite approach, going from parts to the whole. In addition, reductionism, by the very nature of its inquiry, typically does not concern itself with teleology or purposeful behavior. Modeling emergence, in contrast, requires the addressing of teleology. Together, these two requirements present a formidable challenge in developing a successful mathematical theory of emergence. In this article, I describe a new theory of emergence, called statistical teleodynamics, that addresses certain aspects of the general problem. Statistical teleodynamics is a mathematical framework that unifies three seemingly disparate domains-purpose-free entities in statistical mechanics, human engineered teleological systems in systems engineering, and nature-evolved teleological systems in biology and sociology-within the same conceptual formalism. This theory rests on several key conceptual insights, the most important one being the recognition that entropy mathematically models the concept of fairness in economics and philosophy and, equivalently, the concept of robustness in systems engineering. These insights help prove that the fairest inequality of income is a log-normal distribution, which will emerge naturally at equilibrium in an ideal free market society. Similarly, the theory predicts the emergence of the three classes of network organization-exponential, scale-free, and Poisson-seen widely in a variety of domains. Statistical teleodynamics is the natural generalization of statistical thermodynamics, the most successful parts-to-whole systems theory to date, but this generalization is only a modest step toward a more comprehensive mathematical theory of emergence.

A Multi-Level Systems Perspective for the Science of Team Science

PubMed Central

Börner, Katy; Contractor, Noshir; Falk-Krzesinski, Holly J.; Fiore, Stephen M.; Hall, Kara L.; Keyton, Joann; Spring, Bonnie; Stokols, Daniel; Trochim, William; Uzzi, Brian

2012-01-01

This Commentary describes recent research progress and professional developments in the study of scientific teamwork, an area of inquiry termed the “science of team science” (SciTS, pronounced “sahyts”). It proposes a systems perspective that incorporates a mixed-methods approach to SciTS that is commensurate with the conceptual, methodological, and translational complexities addressed within the SciTS field. The theoretically grounded and practically useful framework is intended to integrate existing and future lines of SciTS research to facilitate the field’s evolution as it addresses key challenges spanning macro, meso, and micro levels of analysis. PMID:20844283

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

PubMed

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

2018-03-22

Multinational clinical trials are logistically complex and require close coordination between various stakeholders. They must comply with global clinical standards and are accountable to multiple regulatory and ethical bodies. In resource-limited settings, it is challenging to understand how to apply global clinical standards to international, national, and local factors in clinical trials, making multiple-level stakeholder engagement an important element in the successful conduct of these clinical trials. During the planning and implementation of a large multinational clinical trial for intermittent preventive treatment of malaria in pregnancy in resource-limited areas of sub-Saharan Africa, we encountered numerous challenges, which required implementation of a range of engagement measures to ensure compliance with global clinical and regulatory standards. These challenges included coordination with ongoing global malaria efforts, heterogeneity in national regulatory structures, sub-optimal healthcare infrastructure, local practices and beliefs, and perspectives that view healthcare providers with undue trust or suspicion. In addition to engagement with international bodies, such as the World Health Organization, the Malaria in Pregnancy Consortium, the Steve Biko Centre for Bioethics, and the London School of Hygiene and Tropical Medicine, in order to address the challenges just described, Pfizer Inc. and Medicines for Malaria Venture (the "Sponsoring Entities" for these studies) and investigators liaised with national- and district-level stakeholders such as health ministers and regional/local community health workers. Community engagement measures undertaken by investigators included local meetings with community leaders to explain the research aims and answer questions and concerns voiced by the community. The investigators also engaged with family members of prospective trial participants in order to be sensitive to local practices and beliefs. Engagement with key stakeholders at international and national levels enabled the Sponsoring Entities to address challenges by aligning the study design with the requirements of health and regulatory agencies and to understand and address healthcare infrastructure needs prior to trial initiation. Local stakeholder engagement, including community members, study participants, and family enabled the investigators to address challenges by ensuring that study design and conduct were adapted to local considerations and ensuring accurate information about the study aims was shared with the public. ClinicalTrials.gov, ID: NCT01103063 . Registered on 7 April 2010.

25th anniversary article: key points for high-mobility organic field-effect transistors.

PubMed

Dong, Huanli; Fu, Xiaolong; Liu, Jie; Wang, Zongrui; Hu, Wenping

2013-11-20

Remarkable progress has been made in developing high performance organic field-effect transistors (OFETs) and the mobility of OFETs has been approaching the values of polycrystalline silicon, meeting the requirements of various electronic applications from electronic papers to integrated circuits. In this review, the key points for development of high mobility OFETs are highlighted from aspects of molecular engineering, process engineering and interface engineering. The importance of other factors, such as impurities and testing conditions is also addressed. Finally, the current challenges in this field for practical applications of OFETs are further discussed. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Embedding gender equality into institutional strategy.

PubMed

Ahmed, S

2017-01-01

The SiS (Sex in Science) Programme on the WGC (Wellcome Genome Campus) was established in 2011. Key participants include the Wellcome Trust Sanger Institute, EMB-EBI (EMBL-European Bioinformatics Institute), Open Targets and Elixir. The key objectives are to catalyse cultural change, develop partnerships, communicate activities and champion our women in science work at a national and international level (http://www.sanger.ac.uk/about/sex-science). In this paper, we highlight some of the many initiatives that have taken place since 2013, to address gender inequality at the highest levels; the challenges we have faced and how we have overcome these, and the future direction of travel.

High Temperature Materials Needs in NASA's Advanced Space Propulsion Programs

NASA Technical Reports Server (NTRS)

Eckel, Andrew J.; Glass, David E.

2005-01-01

In recent years, NASA has embarked on several new and exciting efforts in the exploration and use of space. The successful accomplishment of many planned missions and projects is dependent upon the development and deployment of previously unproven propulsion systems. Key to many of the propulsion systems is the use of emergent materials systems, particularly high temperature structural composites. A review of the general missions and benefits of utilizing high temperature materials will be presented. The design parameters and operating conditions will be presented for both specific missions/vehicles and classes of components. Key technical challenges and opportunities are identified along with suggested paths for addressing them.

Nanotechnology: Opportunities and Challenges

NASA Technical Reports Server (NTRS)

Meyyappan, Meyya

2003-01-01

Nanotechnology seeks to exploit novel physical, chemical, biological, mechanical, electrical, and other properties, which arise primarily due to the nanoscale nature of certain materials. A key example is carbon nanotubes (CNTs) which exhibit unique electrical and extraordinary mechanical properties and offer remarkable potential for revolutionary applications in electronics devices, computing, and data storage technology, sensors, composites, nanoelectromechanical systems (NEMS), and as tip in scanning probe microscopy (SPM) for imaging and nanolithography. Thus the CNT synthesis, characterization, and applications touch upon all disciplines of science and engineering. This presentation will provide an overview and progress report on this and other major research candidates in Nanotechnology and address opportunities and challenges ahead.

Community strategies to address cancer disparities in Appalachian Kentucky

PubMed Central

Schoenberg, Nancy E.; Howell, Britteny M.; Fields, Nell

2012-01-01

Central Appalachian residents suffer disproportionate health disparities, including an all-cancer mortality rate 17% higher than the general population. During 10 focus groups and 19 key informant interviews, 91 Appalachian residents identified cancer screening challenges and strategies. Challenges included: (1) inadequate awareness of screening need; (2) insufficient access to screening; and (3) lack of privacy. Strategies included (1) witnessing/storytelling; (2) capitalizing on family history; (3) improving publicity about screening resources; (4) relying on lay health advisors; and (5) bundling preventive services. These insights shaped our CBPR intervention and offer strategies to others working in Appalachia, rural locales, and other traditionally underserved communities. PMID:22143486

Community strategies to address cancer disparities in Appalachian Kentucky.

PubMed

Schoenberg, Nancy E; Howell, Britteny M; Fields, Nell

2012-01-01

Central Appalachian residents suffer disproportionate health disparities, including an all-cancer mortality rate 17% higher than the general population. During 10 focus groups and 19 key informant interviews, 91 Appalachian residents identified cancer screening challenges and strategies. Challenges included (1) inadequate awareness of screening need, (2) insufficient access to screening, and (3) lack of privacy. Strategies included (1) witnessing/storytelling, (2) capitalizing on family history, (3) improving publicity about screening resources, (4) relying on lay health advisors, and (5) bundling preventive services. These insights shaped our community-based participatory research intervention and offered strategies to others working in Appalachia, rural locales, and other traditionally underserved communities.

Games for learning: vast wasteland or a digital promise?

PubMed

Levine, Michael H; Vaala, Sarah E

2013-01-01

Research about emerging best practices in the learning sciences points to the potential of deploying digital games as one possible solution to the twin challenges of weak student engagement and the need for more robust achievement in literacy, science, technology, and math. This chapter reviews key cross-cutting themes in this special volume, drawing perspective from the context of the current United States program and policy reform. The authors conclude that digital games have some unique potential to address pressing educational challenges, but that new mechanisms for advancing purposeful research and development must be adopted by both policymakers and industry leaders. Copyright © 2013 Wiley Periodicals, Inc., A Wiley Company.

Advances in Antibody Design

PubMed Central

Tiller, Kathryn E.; Tessier, Peter M.

2017-01-01

The use of monoclonal antibodies as therapeutics requires optimizing several of their key attributes. These include binding affinity and specificity, folding stability, solubility, pharmacokinetics, effector functions, and compatibility with the attachment of additional antibody domains (bispecific antibodies) and cytotoxic drugs (antibody–drug conjugates). Addressing these and other challenges requires the use of systematic design methods that complement powerful immunization and in vitro screening methods. We review advances in designing the binding loops, scaffolds, domain interfaces, constant regions, post-translational and chemical modifications, and bispecific architectures of antibodies and fragments thereof to improve their bioactivity. We also highlight unmet challenges in antibody design that must be overcome to generate potent antibody therapeutics. PMID:26274600

The role of manufacturing in affecting the social dimension of sustainability

DOE PAGES

Sutherland, John W.; Richter, Justin S.; Hutchins, Margot J.; ...

2016-08-03

Manufacturing affects all three dimensions of sustainability: economy, environment, and society. This paper addresses the last of these dimensions. It explores social impacts identified by national level social indicators, frameworks, and principles. The effects of manufacturing on social performance are framed for different stakeholder groups with associated social needs. Methodology development as well as various challenges for social life cycle assessment (S-LCA) are further examined. Efforts to integrate social and another dimension of sustainability are considered, with attention to globalization challenges, including offshoring and reshoring. The study concludes with a summary of key takeaways and promising directions for future work.

View from the Top: Perspectives on Women in Gastroenterology from Society Leaders.

PubMed

Schmitt, Colleen M; Allen, John I

2016-06-01

Women are making great strides at all levels of medicine, including gastroenterology. The proportion of women members in gastroenterology societies has increased nearly 2-fold and the percent of women trainees is 36%. Although there continue to be challenges for women in academic and community practice, the American Gastroenterological Association, American Society of Gastrointestinal Endoscopy, and other gastroenterology societies have dedicated substantial resources to foster careers of women in gastroenterology and develop women as leaders in our societies. This article outlines ongoing challenges for women in gastroenterology and some key initiatives addressing barriers to success. Copyright © 2016 Elsevier Inc. All rights reserved.

Reconstruction software of the silicon tracker of DAMPE mission

NASA Astrophysics Data System (ADS)

Tykhonov, A.; Gallo, V.; Wu, X.; Zimmer, S.

2017-10-01

DAMPE is a satellite-borne experiment aimed to probe astroparticle physics in the GeV-TeV energy range. The Silicon tracker (STK) is one of the key components of DAMPE, which allows the reconstruction of trajectories (tracks) of detected particles. The non-negligible amount of material in the tracker poses a challenge to its reconstruction and alignment. In this paper we describe methods to address this challenge. We present the track reconstruction algorithm and give insight into the alignment algorithm. We also present our CAD-to-GDML converter, an in-house tool for implementing detector geometry in the software from the CAD drawings of the detector.

The role of manufacturing in affecting the social dimension of sustainability

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

Sutherland, John W.; Richter, Justin S.; Hutchins, Margot J.

Manufacturing affects all three dimensions of sustainability: economy, environment, and society. This paper addresses the last of these dimensions. It explores social impacts identified by national level social indicators, frameworks, and principles. The effects of manufacturing on social performance are framed for different stakeholder groups with associated social needs. Methodology development as well as various challenges for social life cycle assessment (S-LCA) are further examined. Efforts to integrate social and another dimension of sustainability are considered, with attention to globalization challenges, including offshoring and reshoring. The study concludes with a summary of key takeaways and promising directions for future work.

Site-Selective Orientated Immobilization of Antibodies and Conjugates for Immunodiagnostics Development

PubMed Central

Rusling, James

2016-01-01

Immobilized antibody systems are the key to develop efficient diagnostics and separations tools. In the last decade, developments in the field of biomolecular engineering and crosslinker chemistry have greatly influenced the development of this field. With all these new approaches at our disposal, several new immobilization methods have been created to address the main challenges associated with immobilized antibodies. Few of these challenges that we have discussed in this review are mainly associated to the site-specific immobilization, appropriate orientation, and activity retention. We have discussed the effect of antibody immobilization approaches on the parameters on the performance of an immunoassay. PMID:27876681

Review of 11 national policies for rare diseases in the context of key patient needs.

PubMed

Dharssi, Safiyya; Wong-Rieger, Durhane; Harold, Matthew; Terry, Sharon

2017-03-31

Rare diseases collectively exert a global public health burden in the severity of their manifestations and the total number of people they afflict. For many patients, considerable barriers exist in terms of access to appropriate care, delayed diagnosis and limited or non-existing treatment options. Motivated by these challenges, the rare disease patient community has played a critical role, elevating the patient voice and mobilizing legislation to support the development of programs that address the needs of patients with rare diseases.The US Orphan Drug Act of 1983 served as a key milestone in this journey, providing a roadmap for other countries to introduce and implement similar orphan drug legislation; more recently, the European Union (EU) has gone further to encourage the widespread adoption and implementation of rare disease plans or strategies designed to more adequately address the comprehensive needs of patients with rare diseases. Despite these legislative efforts and the growing contributions of patient advocacy groups in moving forward implementation and adoption of rare disease programs, gaps still exist across the policy landscape for several countries. To gain deeper insights into the challenges and opportunities to address key needs of rare disease patients, it is critical to define the current status of rare disease legislation and policy across a geographically and economically diverse selection of countries. We analyzed the rare disease policy landscape across 11 countries: Germany, France, the United Kingdom, Canada, Bulgaria, Turkey, Argentina, Mexico, Brazil, China, and Taiwan. The status and implementation of policy was evaluated for each country in the context of key patient needs across 5 dimensions: improving coordination of care, diagnostic resources, access to treatments, patient awareness and support, and promoting innovative research. Our findings highlight the continuing role of the patient community in driving the establishment and adoption of legislation and programs to improve rare disease care. Further, we found that while national rare disease plans provide important guidance for improving care, implementation of plans is uneven across countries. More research is needed to demonstrate the effect of specific elements of rare disease plans on patient outcomes.

Observing copepods through a genomic lens

PubMed Central

2011-01-01

Background Copepods outnumber every other multicellular animal group. They are critical components of the world's freshwater and marine ecosystems, sensitive indicators of local and global climate change, key ecosystem service providers, parasites and predators of economically important aquatic animals and potential vectors of waterborne disease. Copepods sustain the world fisheries that nourish and support human populations. Although genomic tools have transformed many areas of biological and biomedical research, their power to elucidate aspects of the biology, behavior and ecology of copepods has only recently begun to be exploited. Discussion The extraordinary biological and ecological diversity of the subclass Copepoda provides both unique advantages for addressing key problems in aquatic systems and formidable challenges for developing a focused genomics strategy. This article provides an overview of genomic studies of copepods and discusses strategies for using genomics tools to address key questions at levels extending from individuals to ecosystems. Genomics can, for instance, help to decipher patterns of genome evolution such as those that occur during transitions from free living to symbiotic and parasitic lifestyles and can assist in the identification of genetic mechanisms and accompanying physiological changes associated with adaptation to new or physiologically challenging environments. The adaptive significance of the diversity in genome size and unique mechanisms of genome reorganization during development could similarly be explored. Genome-wide and EST studies of parasitic copepods of salmon and large EST studies of selected free-living copepods have demonstrated the potential utility of modern genomics approaches for the study of copepods and have generated resources such as EST libraries, shotgun genome sequences, BAC libraries, genome maps and inbred lines that will be invaluable in assisting further efforts to provide genomics tools for copepods. Summary Genomics research on copepods is needed to extend our exploration and characterization of their fundamental biological traits, so that we can better understand how copepods function and interact in diverse environments. Availability of large scale genomics resources will also open doors to a wide range of systems biology type studies that view the organism as the fundamental system in which to address key questions in ecology and evolution. PMID:21933388

Strengthening mental health system governance in six low- and middle-income countries in Africa and South Asia: challenges, needs and potential strategies

PubMed Central

Marais, Debbie; Abdulmalik, Jibril; Ahuja, Shalini; Alem, Atalay; Chisholm, Dan; Egbe, Catherine; Gureje, Oye; Hanlon, Charlotte; Lund, Crick; Shidhaye, Rahul; Jordans, Mark; Kigozi, Fred; Mugisha, James; Upadhaya, Nawaraj; Thornicroft, Graham

2017-01-01

Abstract Poor governance has been identified as a barrier to effective integration of mental health care in low- and middle-income countries. Governance includes providing the necessary policy and legislative framework to promote and protect the mental health of a population, as well as health system design and quality assurance to ensure optimal policy implementation. The aim of this study was to identify key governance challenges, needs and potential strategies that could facilitate adequate integration of mental health into primary health care settings in low- and middle-income countries. Key informant qualitative interviews were held with 141 participants across six countries participating in the Emerging mental health systems in low- and middle-income countries (Emerald) research program: Ethiopia, India, Nepal, Nigeria, South Africa, and Uganda. Data were transcribed (and where necessary, translated into English) and analysed thematically using framework analysis, first at the country level, then synthesized at a cross-country level. While all the countries fared well with respect to strategic vision in the form of the development of national mental health policies, key governance strategies identified to address challenges included: strengthening capacity of managers at sub-national levels to develop and implement integrated plans; strengthening key aspects of the essential health system building blocks to promote responsiveness, efficiency and effectiveness; developing workable mechanisms for inter-sectoral collaboration, as well as community and service user engagement; and developing innovative approaches to improving mental health literacy and stigma reduction. Inadequate financing emerged as the biggest challenge for good governance. In addition to the need for overall good governance of a health care system, this study identifies a number of specific strategies to improve governance for integrated mental health care in low- and middle-income countries. PMID:28369396

Integrating the 3Ds: a nursing perspective.

PubMed

Villarruel, Antonia M; Bigelow, April; Alvarez, Carmen

2014-01-01

The 3Ds (diversity, disparities, and determinants) that serve as a framework for this supplement are concepts that are key foundations of nursing education, practice, and research. Despite this fact, however, the nursing profession has faced challenges recognizing the full potential of these concepts. While their importance is documented and acknowledged, they are not clearly evident or easily recognized within the nursing profession. In fact, there are many barriers to the integration of these concepts. We identify and address two barriers to addressing health disparities and increasing diversity: disconnects and discrimination. Furthermore, we discuss three factors-dissemination, durability, and data-that may facilitate nursing's efforts to integrate the 3Ds into the profession. Five pivotal models that address these barriers and facilitators are presented as exemplars that have the potential to guide efforts to address diversity, disparities, and social determinants of health and act as catalysts for change within the nursing profession.

Integrating the 3Ds: A Nursing Perspective

PubMed Central

Bigelow, April; Alvarez, Carmen

2014-01-01

The 3Ds (diversity, disparities, and determinants) that serve as a framework for this supplement are concepts that are key foundations of nursing education, practice, and research. Despite this fact, however, the nursing profession has faced challenges recognizing the full potential of these concepts. While their importance is documented and acknowledged, they are not clearly evident or easily recognized within the nursing profession. In fact, there are many barriers to the integration of these concepts. We identify and address two barriers to addressing health disparities and increasing diversity: disconnects and discrimination. Furthermore, we discuss three factors—dissemination, durability, and data—that may facilitate nursing's efforts to integrate the 3Ds into the profession. Five pivotal models that address these barriers and facilitators are presented as exemplars that have the potential to guide efforts to address diversity, disparities, and social determinants of health and act as catalysts for change within the nursing profession. PMID:24385663

Developing a comprehensive training curriculum for integrated predictive maintenance

NASA Astrophysics Data System (ADS)

Wurzbach, Richard N.

2002-03-01

On-line equipment condition monitoring is a critical component of the world-class production and safety histories of many successful nuclear plant operators. From addressing availability and operability concerns of nuclear safety-related equipment to increasing profitability through support system reliability and reduced maintenance costs, Predictive Maintenance programs have increasingly become a vital contribution to the maintenance and operation decisions of nuclear facilities. In recent years, significant advancements have been made in the quality and portability of many of the instruments being used, and software improvements have been made as well. However, the single most influential component of the success of these programs is the impact of a trained and experienced team of personnel putting this technology to work. Changes in the nature of the power generation industry brought on by competition, mergers, and acquisitions, has taken the historically stable personnel environment of power generation and created a very dynamic situation. As a result, many facilities have seen a significant turnover in personnel in key positions, including predictive maintenance personnel. It has become the challenge for many nuclear operators to maintain the consistent contribution of quality data and information from predictive maintenance that has become important in the overall equipment decision process. These challenges can be met through the implementation of quality training to predictive maintenance personnel and regular updating and re-certification of key technology holders. The use of data management tools and services aid in the sharing of information across sites within an operating company, and with experts who can contribute value-added data management and analysis. The overall effectiveness of predictive maintenance programs can be improved through the incorporation of newly developed comprehensive technology training courses. These courses address the use of key technologies such as vibration analysis, infrared thermography, and oil analysis not as singular entities, but as a toolbox resource from which to address overall equipment and plant reliability in a structured program and decision environment.

Biometric Methods for Secure Communications in Body Sensor Networks: Resource-Efficient Key Management and Signal-Level Data Scrambling

NASA Astrophysics Data System (ADS)

Bui, Francis Minhthang; Hatzinakos, Dimitrios

2007-12-01

As electronic communications become more prevalent, mobile and universal, the threats of data compromises also accordingly loom larger. In the context of a body sensor network (BSN), which permits pervasive monitoring of potentially sensitive medical data, security and privacy concerns are particularly important. It is a challenge to implement traditional security infrastructures in these types of lightweight networks since they are by design limited in both computational and communication resources. A key enabling technology for secure communications in BSN's has emerged to be biometrics. In this work, we present two complementary approaches which exploit physiological signals to address security issues: (1) a resource-efficient key management system for generating and distributing cryptographic keys to constituent sensors in a BSN; (2) a novel data scrambling method, based on interpolation and random sampling, that is envisioned as a potential alternative to conventional symmetric encryption algorithms for certain types of data. The former targets the resource constraints in BSN's, while the latter addresses the fuzzy variability of biometric signals, which has largely precluded the direct application of conventional encryption. Using electrocardiogram (ECG) signals as biometrics, the resulting computer simulations demonstrate the feasibility and efficacy of these methods for delivering secure communications in BSN's.

The role of non-governmental organizations in global health diplomacy: negotiating the Framework Convention on Tobacco Control.

PubMed

Lencucha, Raphael; Kothari, Anita; Labonté, Ronald

2011-09-01

The Framework Convention on Tobacco Control (FCTC) is an exemplar result of global health diplomacy, based on its global reach (binding on all World Health Organization member nations) and its negotiation process. The FCTC negotiations are one of the first examples of various states and non-state entities coming together to create a legally binding tool to govern global health. They have demonstrated that diplomacy, once consigned to interactions among state officials, has witnessed the dilution of its state-centric origins with the inclusion of non-governmental organizations (NGOs) in the diplomacy process. To engage in the discourse of global health diplomacy, NGO diplomats are immediately presented with two challenges: to convey the interests of larger publics and to contribute to inter-state negotiations in a predominantly state-centric system of governance that are often diluted by pressures from private interests or mercantilist self-interest on the part of the state itself. How do NGOs manage these challenges within the process of global health diplomacy itself? What roles do, and can, they play in achieving new forms of global health diplomacy? This paper addresses these questions through presentation of findings from a study of the roles assumed by one group of non-governmental actors (the Canadian NGOs) in the FCTC negotiations. The findings presented are drawn from a larger grounded theory study. Qualitative data were collected from 34 public documents and 18 in-depth interviews with participants from the Canadian government and Canadian NGOs. This analysis yielded five key activities or roles of the Canadian NGOs during the negotiation of the FCTC: monitoring, lobbying, brokering knowledge, offering technical expertise and fostering inclusion. This discussion begins to address one of the key goals of global health diplomacy, namely 'the challenges facing health diplomacy and how they have been addressed by different groups and at different levels of governance' (Kickbusch et al. 2007a: 972).

How should the completeness and quality of curated nanomaterial data be evaluated?†

PubMed Central

Marchese Robinson, Richard L.; Lynch, Iseult; Peijnenburg, Willie; Rumble, John; Klaessig, Fred; Marquardt, Clarissa; Rauscher, Hubert; Puzyn, Tomasz; Purian, Ronit; Åberg, Christoffer; Karcher, Sandra; Vriens, Hanne; Hoet, Peter; Hoover, Mark D.; Hendren, Christine Ogilvie; Harper, Stacey L.

2016-01-01

Nanotechnology is of increasing significance. Curation of nanomaterial data into electronic databases offers opportunities to better understand and predict nanomaterials’ behaviour. This supports innovation in, and regulation of, nanotechnology. It is commonly understood that curated data need to be sufficiently complete and of sufficient quality to serve their intended purpose. However, assessing data completeness and quality is non-trivial in general and is arguably especially difficult in the nanoscience area, given its highly multidisciplinary nature. The current article, part of the Nanomaterial Data Curation Initiative series, addresses how to assess the completeness and quality of (curated) nanomaterial data. In order to address this key challenge, a variety of related issues are discussed: the meaning and importance of data completeness and quality, existing approaches to their assessment and the key challenges associated with evaluating the completeness and quality of curated nanomaterial data. Considerations which are specific to the nanoscience area and lessons which can be learned from other relevant scientific disciplines are considered. Hence, the scope of this discussion ranges from physicochemical characterisation requirements for nanomaterials and interference of nanomaterials with nanotoxicology assays to broader issues such as minimum information checklists, toxicology data quality schemes and computational approaches that facilitate evaluation of the completeness and quality of (curated) data. This discussion is informed by a literature review and a survey of key nanomaterial data curation stakeholders. Finally, drawing upon this discussion, recommendations are presented concerning the central question: how should the completeness and quality of curated nanomaterial data be evaluated? PMID:27143028

Identifying Barriers to Collaboration Between Primary Care and Public Health: Experiences at the Local Level.

PubMed

Pratt, Rebekah; Gyllstrom, Beth; Gearin, Kim; Lange, Carol; Hahn, David; Baldwin, Laura-Mae; VanRaemdonck, Lisa; Nease, Don; Zahner, Susan

Interest is increasing in collaborations between public health and primary care to address the health of a community. Although the understanding of how these collaborations work is growing, little is known about the barriers facing these partners at the local level. The objective of this study was to identify barriers to collaboration between primary care and public health at the local level in 4 states. The study team, which comprised 12 representatives of Practice-Based Research Networks (networks of practitioners interested in conducting research in practice-based settings), identified 40 key informants from the public health and primary care fields in Colorado, Minnesota, Washington State, and Wisconsin. The key informants participated in standardized, semistructured telephone interviews with 8 study team members in 2014 and 2015. Interviews were audio recorded and transcribed verbatim. We analyzed key themes and subthemes by drawing on grounded theory. Primary care and public health participants identified similar barriers to collaboration. Barriers at the institutional level included the challenges of the primary care environment, in which providers feel overwhelmed and resources are tight; the need for systems change; a lack of partnership; and geographic challenges. Barriers to collaboration included mutual awareness, communication, data sharing, capacity, lack of resources, and prioritization of resources. Some barriers to collaboration (eg, changes to health care billing, demands on provider time) require systems change to overcome, whereas others (eg, a lack of shared priorities and mutual awareness) could be addressed through educational approaches, without adding resources or making a systemic change. Overcoming these common barriers may lead to more effective collaboration.

Dynamic Metabolic Model Building Based on the Ensemble Modeling Approach

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

Liao, James C.

2016-10-01

Ensemble modeling of kinetic systems addresses the challenges of kinetic model construction, with respect to parameter value selection, and still allows for the rich insights possible from kinetic models. This project aimed to show that constructing, implementing, and analyzing such models is a useful tool for the metabolic engineering toolkit, and that they can result in actionable insights from models. Key concepts are developed and deliverable publications and results are presented.

Campaign 2008: Innovative Ideas for Securing America. A Guide for Candidates

DTIC Science & Technology

2008-09-03

leadership to the Intelligence Community on “ cloak and dagger ” intelligence operations issues but is less involved in addressing key challenges in the day...that allow people in our intelligence agencies to do their jobs. “ Cloak and dagger ” issues typically garner public and media attention, but without...can we prevent future attacks by strengthening U.S. intelligence op- erations, tracking terrorist financing and preventing weapons of mass destruction

TCIA Secure Cyber Critical Infrastructure Modernization.

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

Keliiaa, Curtis M.

The Sandia National Laboratories (Sandia Labs) tribal cyber infrastructure assurance initiative was developed in response to growing national cybersecurity concerns in the the sixteen Department of Homeland Security (DHS) defined critical infrastructure sectors1. Technical assistance is provided for the secure modernization of critical infrastructure and key resources from a cyber-ecosystem perspective with an emphasis on enhanced security, resilience, and protection. Our purpose is to address national critical infrastructure challenges as a shared responsibility.

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

PubMed Central

2011-01-01

Background Mulago National Referral Hospital (MNRH), Uganda’s primary tertiary and teaching hospital, and Makerere University College of Health Sciences (MakCHS) have a close collaborative relationship. MakCHS students complete clinical rotations at MNRH, and MakCHS faculty partner with Mulago staff in clinical care and research. In 2009, as part of a strategic planning process, MakCHS undertook a qualitative study to examine care and service provision at MNRH, identify challenges, gaps, and solutions, and explore how MakCHS could contribute to improving care and service delivery at MNRH. Methods Key informant interviews (n=23) and focus group discussions (n=7) were conducted with nurses, doctors, administrators, clinical officers and other key stakeholders. Interviews and focus groups were tape recorded and transcribed verbatim, and findings were analyzed through collaborative thematic analysis. Results Challenges to care and service delivery at MNRH included resource constraints (staff, space, equipment, and supplies), staff inadequacies (knowledge, motivation, and professionalism), overcrowding, a poorly functioning referral system, limited quality assurance, and a cumbersome procurement system. There were also insufficiencies in the teaching of professionalism and communication skills to students, and patient care challenges that included lack of access to specialized services, risk of infections, and inappropriate medications. Suggestions for how MakCHS could contribute to addressing these challenges included strengthening referral systems and peripheral health center capacity, and establishing quality assurance mechanisms. The College could also strengthen the teaching of professionalism, communication and leadership skills to students, and monitor student training and develop courses that contribute to continuous professional development. Additionally, the College could provide in-service education for providers on professionalism, communication skills, strategies that promote evidence-based practice and managerial leadership skills. Conclusions Although there are numerous barriers to delivery of quality health services at MNRH, many barriers could be addressed by strengthening the relationship between the Hospital and MakCHS. Strategic partnerships and creative use of existing resources, both human and financial, could improve the quality of care and service delivery at MNRH. Improving services and providing more skills training could better prepare MakCHS graduates for leadership roles in other health care facilities, ultimately improving health outcomes throughout Uganda. PMID:21411007

Bridging the Divide: Challenges and Opportunities for Public Sector Agricultural Professionals Working with Amish and Mennonite Producers on Conservation.

PubMed

Brock, Caroline; Ulrich-Schad, Jessica D; Prokopy, Linda

2018-05-01

As Amish and Old Order and Conservative Mennonite (i.e., Plain) farmers increase their presence in the agricultural sector, it is crucial for public sector agricultural professionals to effectively work with them to mediate nonpoint source pollution and address issues like the hypoxic zone in the Gulf of Mexico. However, there is a dearth of research on how public sector agricultural professionals can better work with Plain producers on environmental management. There are also few training resources for those working with this key, yet hard to reach, population. Additionally, due to their religious doctrines, Plain communities strive to live apart from the "world" and may be discouraged from working with government entities and attending non-Plain people events. This study analyzes interview data from 23 Amish farmers in one region of Indiana and 18 public sector agricultural professionals from a variety of backgrounds and geographies in areas of the U.S. with heavy Plain populations. Public sector agricultural professionals identified some key agronomic challenges on Plain farms related to issues like poor pasture and manure management as well as socio-cultural challenges such as restrictions on electronic and phone communication. Educators should design outreach strategies that take into consideration that faith convictions and conservation concerns may vary greatly based on the specificities of the particular Plain church group. By better understanding this population and how to work with them, public sector agricultural professionals can more effectively work towards addressing environmental problems with this under-served group.

Translating upwards: linking the neural and social sciences via neuroeconomics.

PubMed

Levallois, Clement; Clithero, John A; Wouters, Paul; Smidts, Ale; Huettel, Scott A

2012-11-01

The social and neural sciences share a common interest in understanding the mechanisms that underlie human behaviour. However, interactions between neuroscience and social science disciplines remain strikingly narrow and tenuous. We illustrate the scope and challenges for such interactions using the paradigmatic example of neuroeconomics. Using quantitative analyses of both its scientific literature and the social networks in its intellectual community, we show that neuroeconomics now reflects a true disciplinary integration, such that research topics and scientific communities with interdisciplinary span exert greater influence on the field. However, our analyses also reveal key structural and intellectual challenges in balancing the goals of neuroscience with those of the social sciences. To address these challenges, we offer a set of prescriptive recommendations for directing future research in neuroeconomics.

Twenty years of research on water management issues in the Danube Macro-region - past developments and future directions.

PubMed

Feldbacher, Eva; Paun, Mihaela; Reckendorfer, Walter; Sidoroff, Manuela; Stanica, Adrian; Strimbu, Bogdan; Tusa, Iris; Vulturescu, Viorel; Hein, Thomas

2016-12-01

The Danube River-Danube Delta-Black Sea (DBS) region has witnessed major political, social and economic changes during the past three decades, which have profoundly affected the riverine, coastal and marine systems, their water management situation and the development of related research programmes. We reviewed the research activities in the DBS system of the past twenty years to determine the main funding bodies and to assess key research areas and how they varied over time and geographic region. As data basis we used a metadatabase filled with 478 projects addressing environmental and water management issues in the Danube River Basin, covering also the Danube Delta and the north-western Black Sea. As overall outcome extensive research efforts in the field of water management could be proven for the past two decades, despite the tumultuous times of political and economic transformations. One of the main findings was that EU funded projects played a key role for the development of transboundary research collaboration and were also the scientifically most productive one's. Historically, nutrient pollution was the main problem addressed, shifting to pollution in a broader sense and hydromorphological alterations in recent years. The newly arising challenges of climate change impacts and sediment management became important research questions in the last years, too. Most research was performed in the thematic field of navigation, followed by restoration and biodiversity issues. To meet all of the already identified and newly emerging challenges in the DBS System, cross-border and integrated (river-delta-sea) research activities are of major importance and have to be further promoted. We thus suggest drawing up a regional DBS Research Agenda linked to key challenges in water management to strengthen research collaboration and advance targeted scientific projects, an approach fostering also the scientific capacity in the region. Copyright © 2015 Elsevier B.V. All rights reserved.

Impact Challenges in Community Science-with-Practice: Lessons from PROSPER on Transformative Practitioner-Scientist Partnerships and Prevention Infrastructure Development

PubMed Central

Greenberg, Mark

2011-01-01

At present, evidence-based programs (EBPs) to reduce youth violence are failing to translate into widespread community practice, despite their potential for impact on this pervasive public health problem. In this paper we address two types of challenges in the achievement of such impact, drawing upon lessons from the implementation of a partnership model called PROSPER. First, we address five key challenges in the achievement of community-level impact through effective community planning and action: readiness and mobilization of community teams; maintaining EBP implementation quality; sustaining community teams and EBPs; demonstrating community-level impact; and continuous, proactive technical assistance. Second, we consider grand challenges in the large-scale translation of EBPs: (1) building, linking and expanding existing infrastructures to support effective EBP delivery systems, and (2) organizing networks of practitioner-scientist partnerships—networks designed to integrate diffusion of EBPs with research that examines effective strategies to do so. The PROSPER partnership model is an evidence-based delivery system for community-based prevention and has evolved through two decades of NIH-funded research, assisted by land grant universities' Cooperative Extension Systems. Findings and lessons of relevance to each of the challenges are summarized. In this context, we outline how practitioner-scientist partnerships can serve to transform EBP delivery systems, particularly in conjunction with supportive federal policy. PMID:21222151

Impact challenges in community science-with-practice: lessons from PROSPER on transformative practitioner-scientist partnerships and prevention infrastructure development.

PubMed

Spoth, Richard; Greenberg, Mark

2011-09-01

At present, evidence-based programs (EBPs) to reduce youth violence are failing to translate into widespread community practice, despite their potential for impact on this pervasive public health problem. In this paper we address two types of challenges in the achievement of such impact, drawing upon lessons from the implementation of a partnership model called PROSPER. First, we address five key challenges in the achievement of community-level impact through effective community planning and action: readiness and mobilization of community teams; maintaining EBP implementation quality; sustaining community teams and EBPs; demonstrating community-level impact; and continuous, proactive technical assistance. Second, we consider grand challenges in the large-scale translation of EBPs: (1) building, linking and expanding existing infrastructures to support effective EBP delivery systems, and (2) organizing networks of practitioner-scientist partnerships-networks designed to integrate diffusion of EBPs with research that examines effective strategies to do so. The PROSPER partnership model is an evidence-based delivery system for community-based prevention and has evolved through two decades of NIH-funded research, assisted by land grant universities' Cooperative Extension Systems. Findings and lessons of relevance to each of the challenges are summarized. In this context, we outline how practitioner-scientist partnerships can serve to transform EBP delivery systems, particularly in conjunction with supportive federal policy.

Strategies and Tools for Public Health Workforce Training Needs Assessments in Diverse and Changing Population Health Contexts.

PubMed

Aidala, Angela A; Cavaliere, Brittney; Cinnick, Samantha

2018-06-07

A key component of the improvement of public health infrastructure in the United States revolves around public health workforce development and training. Workforce challenges faced by the public health system have long been recognized, but there are additional challenges facing any region-wide or cross-jurisdictional effort to accurately assess priority workforce training needs and develop training resources to address those needs. These challenges include structural variability of public health organizations; diverse population health contexts; capturing both topic-specific skill sets and foundational competencies among public health workers; and reaching/representing the target population despite suspicion, disinterest, and/or assessment "fatigue" among employees asked to participate in workforce development surveys. The purpose of this article is to describe the challenges, strategies to meet those challenges, and lessons learned conducting public health workforce training needs assessments by academic and practice partners of the Region 2 Public Health Training Center (R2/PHTC). The R2/PHTC is hosted by the Mailman School of Public Health at Columbia University and serves New York, New Jersey, Puerto Rico, and the US Virgin Islands within its jurisdiction. Strategies for responding to diverse organizational structures and population health contexts across the region; defining training priorities that address both foundational competencies for public health professionals and content-specific training to address local public health needs; reaching/representing target populations of public health workers; and analysis and report writing to encourage rapid response to identified needs and comprehensive workforce development planning are discussed. Lessons learned are likely instructive to other workforce training needs assessments in complex and ever-changing public health environments.

Teaching bovine abdominal anatomy: use of a haptic simulator.

PubMed

Kinnison, Tierney; Forrest, Neil David; Frean, Stephen Philip; Baillie, Sarah

2009-01-01

Traditional methods of teaching anatomy to undergraduate medical and veterinary students are being challenged and need to adapt to modern concerns and requirements. There is a move away from the use of cadavers to new technologies as a way of complementing the traditional approaches and addressing resource and ethical problems. Haptic (touch) technology, which allows the student to feel a 3D computer-generated virtual environment, provides a novel way to address some of these challenges. To evaluate the practicalities and usefulness of a haptic simulator, first year veterinary students at the Royal Veterinary College, University of London, were taught basic bovine abdominal anatomy using a rectal palpation simulator: "The Haptic Cow." Over two days, 186 students were taught in small groups and 184 provided feedback via a questionnaire. The results were positive; the majority of students considered that the simulator had been useful for appreciating both the feel and location of key internal anatomical structures, had helped with their understanding of bovine abdominal anatomy and 3D visualization, and the tutorial had been enjoyable. The students were mostly in favor of the small group tutorial format, but some requested more time on the simulator. The findings indicate that the haptic simulator is an engaging way of teaching bovine abdominal anatomy to a large number of students in an efficient manner without using cadavers, thereby addressing some of the current challenges in anatomy teaching.

Climate Change Science, Impacts, Solutions - A Senior Science Course for Post-Secondary Students

NASA Astrophysics Data System (ADS)

Byrne, J. M.; Little, L. J.; Barnes, C. C.; Mirmasoudi, S.; Mansouri Kouhestani, F.; Reiger, C.; Rodriguez Bueno, R. A.

2015-12-01

The role of humanity in warming the global climate is well defined. The research community has predicted and documented many of the early impacts of climate change. The research literature has extensive assessments of future impacts on environment, cities, agriculture, human health, infrastructure, social and political changes, and the risks of military conflict. Society is facing massive infrastructure redevelopment, protection and possible abandonment due to increasing weather extremes. We have reached the point where science consensus is obvious and the population over much of the developed and developing world understands the urgency - humanity is changing the climate. The challenge is helping people help themselves. People understand there are consequences - they want to know how to minimize those consequences, and how to adapt to minimize the impacts. There is a dire need for a senior level course that addresses the key issues across disciplines. This course should cover a range of topics across many disciplinary boundaries, including: an introduction to the science, politics, health and well-being challenges of climate change; likely changes to personal and community lifestyles; consumption of energy and other resources. Population migration due to climate change impacts is a critical topic. Most important, the course must address the solutions to climate change. The population is demanding the power to address this massive challenge. This course will provide a multimedia curriculum on the impacts and solutions to our climate change dilemma.

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

NASA Astrophysics Data System (ADS)

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

2016-04-01

During the Anthropocene, mankind will face several global environmental challenges. One of the first and more successful responses provided by Science to these challenges is the collecting of long-term series of biophysical variables in order to improve our knowledge of natural systems. The huge amount of information gathered during the last decades by Research Infrastructures (RIs) has helped to understand the structure and functioning of natural systems at local and regional scales. But how can we address the global cross-scale and cross-disciplinary challenges posed by the global environment change? We believe that it will be necessary to observe, model better and understand the whole biosphere using long term data generated by international RIs. RIs play a key role on many of the last advances and discoveries in science, from the observation of the Higgs Boson at CERN to the exploration of the Universe by the telescopes of the European Southern Observatory in Chile. The scale of complexity, instrumentation, computing resources, technological advances, and also of the investments, and the size of research collaborations, do not have precedents in Science. RIs in environmental field are developing fast, but the corresponding communities need yet to further reflect the need for a wider global collaboration because the challenges to tackle are in essence of global nature. This contribution describes how COOP+ project (EU Horizon 2020 Coordination and Support Action) will promote the cooperation among RIs at a global scale to address global environmental challenges. Our project evolves from the experience of the sucessful FP7 COOPEUS project (see http://www.coopeus.eu), which explored the use and access to data from RIs in environmental research in Europe and USA. The general goal of COOP+ is to strengthen the links and coordination of the ESFRI RIs related to Marine Science (EMSO), Arctic and Atmospheric Research (EISCAT), Carbon Observation (ICOS) and Biodiversity (LifeWatch) with international counterparts (NEON, TERN, AMISR/SRI, CGSM, OOI, INPA/LBA, IMOS, OCN, AMERIFLUX, etc.) and to leverage international scientific cooperation and data exchange with non-EU countries. During the time span of COOP+ (March 2016 to July 2018), we will address several important questions regarding RIs: What could be the contribution of international RIs to address cross-disciplinary global challenges like modelling and understanding the carbon cycle? Is it feasible to join the knowledge gathered in Arctic research with marine science outputs into comprehensive global models? What collaboration approaches could be implemented to foster the cooperation among RIs? What is the role of local observatories (bottom-up) in this cooperation framework? This contribution will describe COOP+ project using the concept of global challenge. We will describe several possible case study that could be addressed by a network of international RIs.

Best practices for using natural experiments to evaluate retail food and beverage policies and interventions.

PubMed

Taillie, Lindsey Smith; Grummon, Anna H; Fleischhacker, Sheila; Grigsby-Toussaint, Diana S; Leone, Lucia; Caspi, Caitlin Eicher

2017-12-01

Policy and programmatic change in the food retail setting, including excise taxes on beverages with added-caloric sweeteners, new supermarkets in food deserts, and voluntary corporate pledges, often require the use of natural experimental evaluation for impact evaluation when randomized controlled trials are not possible. Although natural experimental studies in the food retail setting provide important opportunities to test how nonrandomized interventions affect behavioral and health outcomes, researchers face several key challenges to maintaining strong internal and external validity when conducting these studies. Broadly, these challenges include 1) study design and analysis; 2) selection of participants, selection of measures, and obtainment of data; and 3) real-world considerations. This article addresses these challenges and different approaches to meeting them. Case studies are used to illustrate these approaches and to highlight advantages and disadvantages of each approach. If the trade-offs required to address these challenges are carefully considered, thoughtful natural experimental evaluations can minimize bias and provide critical information about the impacts of food retail interventions to a variety of stakeholders, including the affected population, policymakers, and food retailers. © The Author(s) 2017. 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.

Social-ecological innovation in remote mountain areas: Adaptive responses of forest-dependent communities to the challenges of a changing world.

PubMed

Melnykovych, Mariana; Nijnik, Maria; Soloviy, Ihor; Nijnik, Albert; Sarkki, Simo; Bihun, Yurij

2018-02-01

To better understand how constantly changing human-environment interactions could be better organized to respond to current challenges, we examined the Ukrainian Carpathians as an example case of complex forest social-ecological systems (FSES). We did it by interviewing diverse and relevant local stakeholder (N=450). In particular, we strived to: i) outline how people and nature are linked and interact in coupled FSES; ii) examine the preferences of stakeholders on the forests and associated ecosystem services (ES); iii) map key drivers threatening well-being of FSES and iv) identify potential responses to address the challenges at a local scale. To answer these questions we followed a mixed method route by integrating qualitative (participatory) and quantitative data collection and analyses, with further application of a Driving Force-Pressure-State-Impact-Response (DPSIR) framework in combination with the ES approach in order to assess benefits, threats to these benefits, and responses regarding the studied FSES. We found that the key benefit from FSES is timber and non-wood forest products (like berries and mushrooms), but also various regulating services were ranked highly by respondents. To explore social-ecological innovation, with potential responses of forest-dependent communities to challenges they face, we employed a commonly used assumption that governance must fit to the particular characteristics of FSES in order to enable sustainability. For the particular case of the Ukrainian Carpathians, we identified and discussed the following five nonconformities or "misfits" threatening sustainability: 1) Spatial misfit in legislation; 2) Poor contextualization; 3) Trap of the single ES; 4) Participatory misfit; and 5) Robbing the commons. By conceptualizing those key threats, we proposed responses for sustainability. The findings contributed to an advanced understanding of complex FSES, their key challenges and potential solutions in order to secure well-being of people and nature in coupled social-ecological systems, in the conditions of a changing world. Copyright © 2017 Elsevier B.V. All rights reserved.

The evolution of process-based hydrologic models: historical challenges and the collective quest for physical realism

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

Clark, Martyn P.; Bierkens, Marc F. P.; Samaniego, Luis

The diversity in hydrologic models has historically led to great controversy on the correct approach to process-based hydrologic modeling, with debates centered on the adequacy of process parameterizations, data limitations and uncertainty, and computational constraints on model analysis. Here, we revisit key modeling challenges on requirements to (1) define suitable model equations, (2) define adequate model parameters, and (3) cope with limitations in computing power. We outline the historical modeling challenges, provide examples of modeling advances that address these challenges, and define outstanding research needs. We also illustrate how modeling advances have been made by groups using models of different type and complexity,more » and we argue for the need to more effectively use our diversity of modeling approaches in order to advance our collective quest for physically realistic hydrologic models.« less

The evolution of process-based hydrologic models: historical challenges and the collective quest for physical realism

DOE PAGES

Clark, Martyn P.; Bierkens, Marc F. P.; Samaniego, Luis; ...

2017-07-11

The diversity in hydrologic models has historically led to great controversy on the correct approach to process-based hydrologic modeling, with debates centered on the adequacy of process parameterizations, data limitations and uncertainty, and computational constraints on model analysis. Here, we revisit key modeling challenges on requirements to (1) define suitable model equations, (2) define adequate model parameters, and (3) cope with limitations in computing power. We outline the historical modeling challenges, provide examples of modeling advances that address these challenges, and define outstanding research needs. We also illustrate how modeling advances have been made by groups using models of different type and complexity,more » and we argue for the need to more effectively use our diversity of modeling approaches in order to advance our collective quest for physically realistic hydrologic models.« less

Challenges of Applying a Comprehensive Model of Intervention Fidelity

PubMed Central

Bosak, Kelly; Pozehl, Bunny; Yates, Bernice

2014-01-01

Applying a comprehensive model of fidelity to interventions delivered by Information and Communication Technology (ICT) has multiple challenges. Fidelity must be considered in the design, implementation, evaluation, and reporting of the intervention. The fidelity strategies must address the unique aspects of the technology, including training providers to instruct participants to use the technology and to provide standardized feedback, rather than deliver the intervention in-person. Other challenges include the nonspecific effects resulting from participants accessing unintended content in interventions delivered by the Internet. ICT allows participant receipt and enactment of intervention skills to be assessed by electronic evidence, rather than in-person observation. Interventions using ICT, such as the Internet are unique, and there is less control of participant interaction with various electronic components. Monitoring participant use and providing standardized feedback for receipt and enactment of intervention skills is key to ensuring intervention fidelity. The final challenges involve evaluating and reporting fidelity. PMID:21474676

Community-based participatory research in Little Haiti: challenges and lessons learned.

PubMed

Kobetz, Erin; Menard, Janelle; Diem, Joshua; Barton, Betsy; Blanco, Jenny; Pierre, Larry; Auguste, Pascale D; Etienne, Marie; Brewster, Cheryl

2009-01-01

Community-based participatory research (CBPR) is an effective methodology for developing relevant interventions with socially marginalized communities. However, implementing CBPR methods is challenging for several reasons. This paper presents challenges encountered in the context of an ongoing CBPR initiative in Little Haiti in Miami, Florida, and describes the solutions used to address them. We sought to describe the challenges faced and lessons learned while conducting CBPR in Little Haiti. Community-academic partnerships were created to guide the creation of culturally relevant cancer interventions and research. Historical distrust of research, cultural constructions of health and illness, and literacy issues are key considerations when developing partnerships with Haitian and other marginalized, immigrant communities. Partnerships are fostered over time through demonstrated mutual commitment to improving health and building community capacity. Communities must play an active role throughout the research process to ensure that studies are culturally relevant, and ensuing intervention, sustainable.

Lessons learned from national food fortification projects: experiences from Morocco, Uzbekistan, and Vietnam.

PubMed

Wirth, James P; Laillou, Arnaud; Rohner, Fabian; Northrop-Clewes, Christine A; Macdonald, Barbara; Moench-Pfanner, Regina

2012-12-01

Fortification of staple foods has been repeatedly recommended as an effective approach to reduce micronutrient deficiencies. With the increased number of fortification projects globally, there is a need to share practical lessons learned relating to their implementation and responses to project-related and external challenges. To document the achievements, challenges, lessons learned, and management responses associated with national fortification projects in Morocco, Uzbekistan, and Vietnam. Independent end-of-project evaluations conducted for each project served as the primary data source and contain the history of and project activities undertaken for, each fortification project. Other sources, including national policy documents, project reports from the Global Alliance for Improved Nutrition (GAIN) and other stakeholders, industry assessments, and peer-reviewed articles, were used to document the current responses to challenges and future project plans. All projects had key achievements related to the development of fortification standards and the procurement of equipment for participating industry partners. Mandatory fortification of wheat flour was a key success in Morocco and Uzbekistan. Ensuring the quality of fortified foods was a common challenge experienced across the projects, as were shifts in consumption patterns and market structures. Adjustments were made to the projects' design to address the challenges faced. National fortification projects are dynamic and must be continually modified in response to specific performance issues and broader shifts in market structure and consumption patterns.

Neglected tropical diseases: exploring long term practical approaches to achieve sustainable disease elimination and beyond.

PubMed

Ortu, Giuseppina; Williams, Oliver

2017-09-27

Remarkable progress has been made in the fight against neglected tropical diseases, but new challenges have emerged. Innovative diagnostics, better drugs and new insecticides are often identified as the priority; however, access to these new tools may not be sufficient to achieve and sustain disease elimination, if certain challenges and priorities are not considered. The authors summarise key operational challenges, and based on these, identify two major priorities: strengthening the capacity of the primary health care health system in correctly diagnosing and managing neglected tropical diseases; and establishing an effective disease surveillance process. Five steps are proposed as concrete actions to build an effective primary health care service for neglected tropical diseases, and a health management information system capable of accurately reporting these diseases. Community engagement and formalization of community health workers role are proposed as essential components of these steps. Shift of financial support from disease oriented programmes to disease integrated interventions, improved access to international guidelines for primary health care staff, and availability of donated drugs in health care structures are also suggested as key elements of the proposed process. The authors conclude that failure to address these priorities now may lead to further challenges on the long path towards neglected tropical disease elimination and beyond.

Rewards and challenges of family practice

PubMed Central

Manca, Donna P.; Varnhagen, Stanley; Brett-MacLean, Pamela; Allan, G. Michael; Szafran, Olga; Ausford, Allen; Rowntree, Carol; Rumzan, Ismael; Turner, Diana

2007-01-01

OBJECTIVE To identify and describe the important rewards and challenges that affect family physicians in Alberta. DESIGN Web-based qualitative study using the Delphi method. SETTING Province of Alberta. PARTICIPANTS Twenty-eight family physicians practising in Alberta. METHODS The study website presented a description of the project, ethical information, a calendar of events, and contact information. Delphi surveys and demographic questionnaires were password protected. Five rounds of surveys were conducted between May 2004 and January 2005. Participants were notified of each round of surveys and prompted by e–mail ifthey did not respond. FINDINGS Participants identified 8 key rewards and 9 key challenges. The research team identified 2 additional challenges that were validated by participants. In order of perceived importance, key rewards were providing diverse and comprehensive care; providing preventive care; having relationships with patients and their families; being an immersed witness to the human condition; providing continuity of care and receiving ongoing feedback; having flexibility and control of practice and job security; maintaining and acquiring skills and knowledge; teaching and sharing knowledge and gaining experience and mentoring. The challenges, in order of perceived need to be addressed, were workload and time pressures and meeting demands; the need to promote the rewards of family practice to those considering joining the profession; overhead and income inequities; getting respect from specialists; the need to ensure that the rewards identified are not adversely affected by primary care reform; lack of availability of specialists, procedures, tests, and other resources; running a practice as a small business; paperwork, telephone calls, and forms; maintaining and acquiring skills and knowledge; patients’ expectations; and medicolegal issues, insurance paperwork, and dealing with medical claims related to motor vehicle accidents. CONCLUSION The rewards and challenges reported by participants outline the positive and negative factors in family practice. The challenges provide a focus for further work. PMID:17872645

TaxaGloss - A Glossary and Translation Tool for Biodiversity Studies.

PubMed

Collin, Rachel; Fredericq, Suzanne; Freshwater, D Wilson; Gilbert, Edward; Madrid, Maycol; Maslakova, Svetlana; Miglietta, Maria Pia; Rocha, Rosana M; Rodríguez, Estefanía; Thacker, Robert W

2016-01-01

Correctly identifying organisms is key to most biological research, and is especially critical in areas of biodiversity and conservation. Yet it remains one of the greatest challenges when studying all but the few well-established model systems. The challenge is in part due to the fact that most species have yet to be described, vanishing taxonomic expertise and the relative inaccessibility of taxonomic information. Furthermore, identification keys and other taxonomic resources are based on complex, taxon-specific vocabularies used to describe important morphological characters. Using these resources is made difficult by the fact that taxonomic documentation of the world's biodiversity is an international endeavour, and keys and field guides are not always available in the practitioner's native language. To address this challenge, we have developed a publicly available on-line illustrated multilingual glossary and translation tool for technical taxonomic terms using the Symbiota Software Project biodiversity platform. Illustrations, photographs and translations have been sourced from the global community of taxonomists working with marine invertebrates and seaweeds. These can be used as single-language illustrated glossaries or to make customized translation tables. The glossary has been launched with terms and illustrations of seaweeds, tunicates, sponges, hydrozoans, sea anemones, and nemerteans, and already includes translations into seven languages for some groups. Additional translations and development of terms for more taxa are underway, but the ultimate utility of this tool depends on active participation of the international taxonomic community.

Challenges in the development and reimbursement of personalized medicine-payer and manufacturer perspectives and implications for health economics and outcomes research: a report of the ISPOR personalized medicine special interest group.

PubMed

Faulkner, Eric; Annemans, Lieven; Garrison, Lou; Helfand, Mark; Holtorf, Anke-Peggy; Hornberger, John; Hughes, Dyfrig; Li, Tracy; Malone, Daniel; Payne, Katherine; Siebert, Uwe; Towse, Adrian; Veenstra, David; Watkins, John

2012-12-01

Personalized medicine technologies can improve individual health by delivering the right dose of the right drug to the right patient at the right time but create challenges in deciding which technologies offer sufficient value to justify widespread diffusion. Personalized medicine technologies, however, do not neatly fit into existing health technology assessment and reimbursement processes. In this article, the Personalized Medicine Special Interest Group of the International Society for Pharmacoeconomics and Outcomes Research evaluated key development and reimbursement considerations from the payer and manufacturer perspectives. Five key areas in which health economics and outcomes research best practices could be developed to improve value assessment, reimbursement, and patient access decisions for personalized medicine have been identified. These areas are as follows: 1 research prioritization and early value assessment, 2 best practices for clinical evidence development, 3 best practices for health economic assessment, 4 addressing health technology assessment challenges, and 5 new incentive and reimbursement approaches for personalized medicine. Key gaps in health economics and outcomes research best practices, decision standards, and value assessment processes are also discussed, along with next steps for evolving health economics and outcomes research practices in personalized medicine. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Implementing Culture Change in Nursing Homes: An Adaptive Leadership Framework.

PubMed

Corazzini, Kirsten; Twersky, Jack; White, Heidi K; Buhr, Gwendolen T; McConnell, Eleanor S; Weiner, Madeline; Colón-Emeric, Cathleen S

2015-08-01

To describe key adaptive challenges and leadership behaviors to implement culture change for person-directed care. The study design was a qualitative, observational study of nursing home staff perceptions of the implementation of culture change in each of 3 nursing homes. We conducted 7 focus groups of licensed and unlicensed nursing staff, medical care providers, and administrators. Questions explored perceptions of facilitators and barriers to culture change. Using a template organizing style of analysis with immersion/crystallization, themes of barriers and facilitators were coded for adaptive challenges and leadership. Six key themes emerged, including relationships, standards and expectations, motivation and vision, workload, respect of personhood, and physical environment. Within each theme, participants identified barriers that were adaptive challenges and facilitators that were examples of adaptive leadership. Commonly identified challenges were how to provide person-directed care in the context of extant rules or policies or how to develop staff motivated to provide person-directed care. Implementing culture change requires the recognition of adaptive challenges for which there are no technical solutions, but which require reframing of norms and expectations, and the development of novel and flexible solutions. Managers and administrators seeking to implement person-directed care will need to consider the role of adaptive leadership to address these adaptive challenges. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

An SSH key management system: easing the pain of managing key/user/account associations

NASA Astrophysics Data System (ADS)

Arkhipkin, D.; Betts, W.; Lauret, J.; Shiryaev, A.

2008-07-01

Cyber security requirements for secure access to computing facilities often call for access controls via gatekeepers and the use of two-factor authentication. Using SSH keys to satisfy the two factor authentication requirement has introduced a potentially challenging task of managing the keys and their associations with individual users and user accounts. Approaches for a facility with the simple model of one remote user corresponding to one local user would not work at facilities that require a many-to-many mapping between users and accounts on multiple systems. We will present an SSH key management system we developed, tested and deployed to address the many-to-many dilemma in the environment of the STAR experiment. We will explain its use in an online computing context and explain how it makes possible the management and tracing of group account access spread over many sub-system components (data acquisition, slow controls, trigger, detector instrumentation, etc.) without the use of shared passwords for remote logins.

Dissemination and implementation of evidence based, mental health interventions in post conflict, low resource settings

PubMed Central

Tol, Wietse; Jordans, Mark; Zangana, Goran Sabir; Amin, Ahmed Mohammed; Bolton, Paul; Bass, Judith; Bonilla-Escobar, Fransisco Javier; Thornicroft, Graham

2014-01-01

The burden of mental health problems in (post)conflict low- and middle-income countries (LMIC) is substantial. Despite growing evidence for the effectiveness of selected mental health programs in conflict-affected LMIC and growing policy support, actual uptake and implementation have been slow. A key direction for future research, and a new frontier within science and practice, is Dissemination and Implementation (DI) which directly addresses the movement of evidence-based, effective health care approaches from experimental settings into routine use. This paper outlines some key implementation challenges, and strategies to address these, while implementing evidence-based treatments in conflict-affected LMIC based on the authors’ collective experiences. Dissemination and implementation evaluation and research in conflict settings is an essential new research direction. Future DI work in LMIC should include: 1) defining concepts and developing measurement tools, 2) the measurement of DI outcomes for all programming, and 3) the systematic evaluation of specific implementation strategies. PMID:28316559

Transcriptomic resources for environmental risk assessment: a case study in the Venice lagoon.

PubMed

Milan, M; Pauletto, M; Boffo, L; Carrer, C; Sorrentino, F; Ferrari, G; Pavan, L; Patarnello, T; Bargelloni, L

2015-02-01

The development of new resources to evaluate the environmental status is becoming increasingly important representing a key challenge for ocean and coastal management. Recently, the employment of transcriptomics in aquatic toxicology has led to increasing initiatives proposing to integrate eco-toxicogenomics in the evaluation of marine ecosystem health. However, several technical issues need to be addressed before introducing genomics as a reliable tool in regulatory ecotoxicology. The Venice lagoon constitutes an excellent case, in which the assessment of environmental risks derived from the nearby industrial activities represents a crucial task. In this context, the potential role of genomics to assist environmental monitoring was investigated through the definition of reliable gene expression markers associated to chemical contamination in Manila clams, and their subsequent employment for the classification of Venice lagoon areas. Overall, the present study addresses key issues to evaluate the future outlooks of genomics in the environmental monitoring and risk assessment. Copyright © 2014 Elsevier Ltd. All rights reserved.

Gene Therapy in Heart Failure.

PubMed

Fargnoli, Anthony S; Katz, Michael G; Bridges, Charles R; Hajjar, Roger J

2017-01-01

Heart failure is a significant burden to the global healthcare system and represents an underserved market for new pharmacologic strategies, especially therapies which can address root cause myocyte dysfunction. Modern drugs, surgeries, and state-of-the-art interventions are costly and do not improve survival outcome measures. Gene therapy is an attractive strategy, whereby selected gene targets and their associated regulatory mechanisms can be permanently managed therapeutically in a single treatment. This in theory could be sustainable for the patient's life. Despite the promise, however, gene therapy has numerous challenges that must be addressed together as a treatment plan comprising these key elements: myocyte physiologic target validation, gene target manipulation strategy, vector selection for the correct level of manipulation, and carefully utilizing an efficient delivery route that can be implemented in the clinic to efficiently transfer the therapy within safety limits. This chapter summarizes the key developments in cardiac gene therapy from the perspective of understanding each of these components of the treatment plan. The latest pharmacologic gene targets, gene therapy vectors, delivery routes, and strategies are reviewed.

Linking an agency strategic review to increase knowledge management: San Francisco County Human Service Agency.

PubMed

Harrison, Lindsay

2012-01-01

Led by the agency director, the agency engaged in a Strategic Review, based on a comprehensive assessment of agency performance that identified strategies to improve organizational effectiveness through increased data-informed practice and knowledge management. The Strategic Review gathered information on staff perceptions, perceptions of external stakeholders, changing citywide and neighborhood demographics, policy mandates, and budget and workload issues. The need for the review was based upon multiple, substantial changes not addressed in the 2000 Strategic Plan, including the 2004 merger of the Department of Human Services and the Department of Aging and Adult Services, changes among the executive management team, transitions among key political entities, new policy mandates and changing budget allocations. This case study describes the Strategic Review process and content, summarizing key challenges and lessons related to addressing workload demands, fostering positive staff attitudes, balancing internal and external information needs, and integrating data use and planning processes across the agency. Copyright © Taylor & Francis Group, LLC

Neoepitopes as cancer immunotherapy targets: key challenges and opportunities.

PubMed

Brennick, Cory A; George, Mariam M; Corwin, William L; Srivastava, Pramod K; Ebrahimi-Nik, Hakimeh

2017-03-01

Over the last half century, it has become well established that cancers can elicit a host immune response that can target them with high specificity. Only within the last decade, with the advances in high-throughput gene sequencing and bioinformatics approaches, are we now on the forefront of harnessing the host's immune system to treat cancer. Recently, some strides have been taken toward understanding effective tumor-specific MHC I restricted epitopes or neoepitopes. However, many fundamental questions still remain to be addressed before this therapy can live up to its full clinical potential. In this review, we discuss the major hurdles that lie ahead and the work being done to address them.

The Untold Story: Examining Ontario's Community Health Centres' Initiatives to Address Upstream Determinants of Health

PubMed Central

Collins, Patricia A.; Resendes, Sarah J.; Dunn, James R.

2014-01-01

Background: Unlike traditional primary care centres, part of the Community Health Centre (CHC) mandate is to address upstream health determinants. In Ontario, CHCs refer to these activities as Community Initiatives (CIs); yet, little is known about how CIs operate. The objective of this study was to examine the scope, resource requirements, partnerships, successes and challenges among selected Ontario CIs. Methods: We conducted qualitative interviews with 10 CHC staff members representing 11 CIs across Ontario. CIs were identified through an online inventory, recruited by e-mail and interviewed between March and June 2011. Results: Most CIs aim to increase community participation, while addressing social isolation and poverty. They draw minimal financial resources from their CHC, and employ highly skilled staff to support implementation. Most enlist support from various partners, and use numerous methods for community engagement. Successes include improved community relations, increased opportunities for education and employment and rewarding partnerships, while insufficient funding was a commonly identified challenge. Conclusions: Despite minimal attention from researchers and funders, our findings suggest that CIs play key capacity-building roles in vulnerable communities across Ontario, and warrant further investigation. PMID:25410693

Physician-entrepreneurship: a user's manual, part 1: critical questions for early-stage medical ventures.

PubMed

Lexa, Frank James; Lexa, Frank J

2005-07-01

The medical field is one of the most exciting in America for entrepreneurs. Radiologists and other medical practitioners are in a unique position to take advantage of opportunities to invent and create innovative products and services. Physicians have led many of the most important revolutionary and evolutionary changes that have occurred in the field in the past 100 years. However, many radiologists find the process of entrepreneurship a daunting one and are often deterred from acting on their ideas. This article addresses the key issues and challenges that entrepreneurs face when embarking on new enterprises. Although most of these issues face all entrepreneurs at this stage, this article focuses on medical innovation and its particular challenges. This article concentrates on the kinds of questions that physician-entrepreneurs need to ask before jumping in, the types of common pitfalls that await those who don't address these issues, and some answers to seek if you are to beat the odds and succeed.

Genetic Testing Integration Panels (GTIPs): A novel approach for considering integration of direct-to-consumer and other new genetic tests into patient care

PubMed Central

Uhlmann, Wendy R.; Sharp, Richard R.

2014-01-01

There has been a dramatic increase in the number of genetic tests available but few tests have practice guidelines. In addition, many tests have become available outside of genetics clinics through direct-to-consumer (DTC) companies and several offer tests not considered standard of care. To address several practical challenges associated with the rapid introduction of clinical and DTC genetic tests, we propose that genetic counselors and geneticists organize expert panels in their institutions to discuss the integration of new tests into patient care. We propose the establishment of Genetic Testing Integration Panels (GTIPs) to bring together local experts in medical genetics, genetic counseling, bioethics and law, health communication and clinical laboratory genetics. We describe key features of this approach and consider some of the potential advantages and limitations of using a GTIP to address the many clinical challenges raised by rapidly emerging clinical and DTC genetic tests. PMID:22246561

Examples L-Band Interference will be Presented and Discussed, as well as the Importance of L-Band Soil Moisture Observations

NASA Technical Reports Server (NTRS)

Kim, Edward

2010-01-01

Examples of L-band interference will be presented and discussed, as well as the importance of L-band soil moisture observations, as part of this one-day GEOSS workshop XXXVII on "Data Quality and Radio Spectrum Allocation Impact on Earth Observations" will address the broad challenges of data quality and the impact of generating reliable information for decision makers who are Earth data users but not necessarily experts in the Earth observation field. GEO has initiated a data quality assessment task (DA-09-01a) and workshop users will review and debate the directions and challenges of this effort. Radio spectrum allocation is an element of data availability and data quality, and is also associated with a GEO task (AR-06-11). A recent U.S. National Research Council report on spectrum management will be addressed as part of the workshop. Key representatives from industry, academia, and government will provide invited talks on these and related issues that impact GEOSS implementation.

Using Decision Analysis to Improve Malaria Control Policy Making

PubMed Central

Kramer, Randall; Dickinson, Katherine L.; Anderson, Richard M.; Fowler, Vance G.; Miranda, Marie Lynn; Mutero, Clifford M.; Saterson, Kathryn A.; Wiener, Jonathan B.

2013-01-01

Malaria and other vector-borne diseases represent a significant and growing burden in many tropical countries. Successfully addressing these threats will require policies that expand access to and use of existing control methods, such as insecticide-treated bed nets and artemesinin combination therapies for malaria, while weighing the costs and benefits of alternative approaches over time. This paper argues that decision analysis provides a valuable framework for formulating such policies and combating the emergence and re-emergence of malaria and other diseases. We outline five challenges that policy makers and practitioners face in the struggle against malaria, and demonstrate how decision analysis can help to address and overcome these challenges. A prototype decision analysis framework for malaria control in Tanzania is presented, highlighting the key components that a decision support tool should include. Developing and applying such a framework can promote stronger and more effective linkages between research and policy, ultimately helping to reduce the burden of malaria and other vector-borne diseases. PMID:19356821

Personal Health, Person-centred Health and Personalised Medicine - Concepts, Consumers, Confusion and Challenges in the Informatics World.

PubMed

Rigby, M

2012-01-01

To define and assess 'Consumer Health Informatics' and related emergent issues in an era of new media and of personalisation of care, and from this to define what actions need to be taken to optimise benefits and address risks. Definition of key concepts; review of health personalisation, emergent health information and communication technologies and knowledge sources available to citizens and social media; and identification of unresolved issues threatening optimal use of each. A structured review supported by citations and examples. Several new aspects of consumer health informatics are emerging, including new knowledge sources, feedback on treatments and care providers, on-line videos, and a new generation of patient experience sites including those which are for profit and seek to influence treatment paradigms. Not just the information usage, but also the potential social challenges and malicious abuses, are global issues, and also transcend the traditional health community and thus should be addressed in partnership with other global agencies.

Anthropology, brokerage, and collaboration in the development of a Tongan public psychiatry: Local lessons for global mental health.

PubMed

Poltorak, Mike

2016-12-01

The Global Mental Health (GMH) movement has raised questions of the translatability of psychiatric concepts and the challenges of community engagement. In Tonga, the local psychiatrist Dr Puloka successfully established a publicly accessible psychiatry that has improved admission rates for serious mental illnesses and addressed some of the stigma attached to diagnosis. On the basis of historical analysis and ethnographic fieldwork with healers, doctors, and patients since 1998, this article offers an ethnographic contextualization of the development and reception of Puloka's three key interventions during the 1990s: (a) collaboration with traditional healers; (b) translation of psychiatric diagnoses into local cultural concepts; and (c) encouraging freedom of movement and legal appeal to involuntary admission. Dr Puloka's use of medical anthropological and transcultural psychiatry research informed a community-engaged brokerage between the implications of psychiatric nosologies and local needs that can address some of the challenges of the Global Mental Health movement.

Injury prevention in Australian Indigenous communities.

PubMed

Ivers, Rebecca; Clapham, Kathleen; Senserrick, Teresa; Lyford, Marilyn; Stevenson, Mark

2008-12-01

Injury prevention in Indigenous communities in Australia is a continuing national challenge, with Indigenous fatality rates due to injury three times higher than the general population. Suicide and transport are the leading causes of injury mortality, and assault, transport and falls the primary causes of injury morbidity. Addressing the complex range of injury problems in disadvantaged Indigenous communities requires considerable work in building or enhancing existing capacity of communities to address local safety issues. Poor data, lack of funding and absence of targeted programs are some of the issues that impede injury prevention activities. Traditional approaches to injury prevention can be used to highlight key areas of need, however adaptations are needed in keeping with Indigenous peoples' holistic approach to health, linked to land and linked to community in order to address the complex spiritual, emotional and social determinants of Indigenous injury.

Advancing drug availability-experiences from Africa.

PubMed

Powell, Richard A; Kaye, Richard Mugula; Ddungu, Henry; Mwangi-Powell, Faith

2010-07-01

International health and drug regulatory authorities acknowledge that analgesics (especially opioids) are insufficiently available for pain management in many countries. In Africa, reported morphine consumption is far below the global mean, with multiple factors hampering opioid supply. Since 2006, the African Palliative Care Association has hosted three regional drug availability workshops across the continent to address this issue. Using an interactive format, the workshops have identified country-specific barriers to opioid and other essential medication accessibility before supporting participants to develop action plans to address recognized impediments. Despite multiple challenges, a number of successes have arisen from the implementation of the plans. However, key issues remain, including the introduction of supportive policy environments, effective educational initiatives, and measures to address supply-chain obstacles impeding drug availability. Copyright 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Review of Research Status and Development Trends of Wireless Passive LC Resonant Sensors for Harsh Environments.

PubMed

Li, Chen; Tan, Qiulin; Jia, Pinggang; Zhang, Wendong; Liu, Jun; Xue, Chenyang; Xiong, Jijun

2015-06-04

Measurement technology for various key parameters in harsh environments (e.g., high-temperature and biomedical applications) continues to be limited. Wireless passive LC resonant sensors offer long service life and can be suitable for harsh environments because they can transmit signals without battery power or wired connections. Consequently, these devices have become the focus of many current research studies. This paper addresses recent research, key technologies, and practical applications relative to passive LC sensors used to monitor temperature, pressure, humidity, and harmful gases in harsh environments. The advantages and disadvantages of various sensor types are discussed, and prospects and challenges for future development of these sensors are presented.

Review of Research Status and Development Trends of Wireless Passive LC Resonant Sensors for Harsh Environments

PubMed Central

Li, Chen; Tan, Qiulin; Jia, Pinggang; Zhang, Wendong; Liu, Jun; Xue, Chenyang; Xiong, Jijun

2015-01-01

Measurement technology for various key parameters in harsh environments (e.g., high-temperature and biomedical applications) continues to be limited. Wireless passive LC resonant sensors offer long service life and can be suitable for harsh environments because they can transmit signals without battery power or wired connections. Consequently, these devices have become the focus of many current research studies. This paper addresses recent research, key technologies, and practical applications relative to passive LC sensors used to monitor temperature, pressure, humidity, and harmful gases in harsh environments. The advantages and disadvantages of various sensor types are discussed, and prospects and challenges for future development of these sensors are presented. PMID:26053753

Electricity Market Games: How Agent-Based Modeling Can Help under High Penetrations of Variable Generation

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

Gallo, Giulia

Integrating increasingly high levels of variable generation in U.S. electricity markets requires addressing not only power system and grid modeling challenges but also an understanding of how market participants react and adapt to them. Key elements of current and future wholesale power markets can be modeled using an agent-based approach, which may prove to be a useful paradigm for researchers studying and planning for power systems of the future.

Homeland security challenges in nursing practice.

PubMed

Boatright, Connie; McGlown, K Joanne

2005-09-01

Nurses need a comprehensive knowledge of doctrine, laws, regulations,programs, and processes that build the operational framework for health care preparedness. Key components of this knowledge base reside in the areas of: evolution of homeland security: laws and mandates affecting health care and compliance and regulatory issues for health care organizations. This article addresses primary components in both of these areas, after first assessing the status of nursing's involvement (in homeland security), as portrayed in the professional literature.

DOD Financial Management: Challenges in Attaining Audit Readiness and Improving Business Processes and Systems

DTIC Science & Technology

2012-04-18

enterprise architecture and transition plan, and improved investment control processes. This statement is primarily based on GAO’s prior work...business system investments , they had not yet performed the key step of validating assessment results. GAO has made prior recommendations to address...be prepared no later than March 1, 1997. See 31 U.S.C. § 3515. 2An agency’s general fund accounts are those accounts in the U.S. Treasury holding

Overcoming the Coupling Dilemma in DNA-Programmable Nanoparticle Assemblies by "Ag+ Soldering".

PubMed

Wang, Huiqiao; Li, Yulin; Liu, Miao; Gong, Ming; Deng, Zhaoxiang

2015-05-20

Strong coupling between nanoparticles is critical for facilitating charge and energy transfers. Despite the great success of DNA-programmable nanoparticle assemblies, the very weak interparticle coupling represents a key barrier to various applications. Here, an extremely simple, fast, and highly efficient process combining DNA-programming and molecular/ionic bonding is developed to address this challenge, which exhibits a seamless fusion with DNA nanotechnology. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Coalition, partnership, and constituency building by a state public health agency: a retrospective.

PubMed

Kimbrell, J D

2000-03-01

This article is a retrospective that traces the development of an evolutionary process for a state health agency in addressing the challenge of implementing core public health functions and the provision of essential services. Coalition, partnership, and constituency building were critical elements in the process. Various initiatives are described and their importance as building blocks to a larger process of organizational change is explained. Key lessons from the process are outlined.

Where are they now? Cash and Counseling successes and challenges over time

PubMed Central

Simon-Rusinowitz, Lori; Schwartz, Abby J.; Loughlin, Dawn; Sciegaj, Mark; Mahoney, Kevin J.; Donkoh, Yaw

2014-01-01

The positive results of the Cash & Counseling Demonstration and Evaluation (CCDE) led to the funding of a replication project that included 12 more states in 2008. Since then, the political and economic environments have changed. The authors sought to investigate how well the three original and 12 replication CCDE programs are coping with current challenges, and how their experiences may inform the growth and sustainability of emerging participant-directed programs. Semistructured telephone interviews were conducted with the 15 Cash & Counseling state program administrators. Key topics addressed included: successful aspects of state programs, biggest challenges for each program, and information program administrators would like to learn from state colleagues. Themes related to budget issues (e.g., staff shortages and program funding cuts) and non-budget related issues (e.g., understanding of program operations) emerged from the interviews. State program administrators also discussed program successes. To promote the sustainability and growth of participant-directed programs, existing participant-directed programs should be tied to national policy trends as well as review whether or not the programs address participant-directed principles. The development of new participant-directed programs should be based on other states’ experiences as discussed in this paper. PMID:25750590

Inernational research in health care management: its need in the 21st century, methodological challenges, ethical issues, pitfalls, and practicalities.

PubMed

Buttigieg, Sandra C; Rathert, Cheryl; D'Aunno, Thomas A; Savage, Grant T

2015-01-01

This commentary argues in favor of international research in the 21st century. Advances in technology, science, communication, transport, and infrastructure have transformed the world into a global village. Industries have increasingly adopted globalization strategies. Likewise, the health sector is more internationalized whereby comparisons between diverse health systems, international best practices, international benchmarking, cross-border health care, and cross-cultural issues have become important subjects in the health care literature. The focus has now turned to international, collaborative, cross-national, and cross-cultural research, which is by far more demanding than domestic studies. In this commentary, we explore the methodological challenges, ethical issues, pitfalls, and practicalities within international research and offer possible solutions to address them. The commentary synthesizes contributions from four scholars in the field of health care management, who came together during the annual meeting of the Academy of Management to discuss with members of the Health Care Management Division the challenges of international research. International research is worth pursuing; however, it calls for scholarly attention to key methodological and ethical issues for its success. This commentary addresses salient issues pertaining to international research in one comprehensive account.

MEASUREMENT ISSUES IN HOME-VISITING RESEARCH WITHIN TRIBAL COMMUNITIES: CHALLENGES AND STRATEGIES.

PubMed

Whitesell, Nancy Rumbaugh; Bolan, Marc; Chomos, Julianna C; Heath, Debra; Miles, Jon; Salvador, Melina; Whitmore, Corrie; Barlow, Allison

2018-05-04

In this article, Tribal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) grantees share strategies they have developed and adopted to address the most common barriers to effective measurement (and thus to effective evaluation) encountered in the course of implementation and evaluation of their home-visiting programs. We identify key challenges in measuring outcomes in Tribal MIECHV Programs and provide practical examples of various strategies used to address these challenges within diverse American Indian and Alaska Native cultural and contextual settings. Notably, high-quality community engagement is a consistent thread throughout these strategies and fundamental to successful measurement in these communities. These strategies and practices reflect the experiences and innovative solutions of practitioners working on the ground to deliver and evaluate intervention programs to tribal communities. They may serve as models for getting high-quality data to inform intervention while working within the constraints and requirements of program funding. The utility of these practical solutions extends beyond the Tribal MIECHV grantees and offers the potential to inform a broad array of intervention evaluation efforts in tribal and other community contexts. © 2018 Michigan Association for Infant Mental Health.

Writing implementation research grant proposals: ten key ingredients

PubMed Central

2012-01-01

Background All investigators seeking funding to conduct implementation research face the challenges of preparing a high-quality proposal and demonstrating their capacity to conduct the proposed study. Applicants need to demonstrate the progressive nature of their research agenda and their ability to build cumulatively upon the literature and their own preliminary studies. Because implementation science is an emerging field involving complex and multilevel processes, many investigators may not feel equipped to write competitive proposals, and this concern is pronounced among early stage implementation researchers. Discussion This article addresses the challenges of preparing grant applications that succeed in the emerging field of dissemination and implementation. We summarize ten ingredients that are important in implementation research grants. For each, we provide examples of how preliminary data, background literature, and narrative detail in the application can strengthen the application. Summary Every investigator struggles with the challenge of fitting into a page-limited application the research background, methodological detail, and information that can convey the project’s feasibility and likelihood of success. While no application can include a high level of detail about every ingredient, addressing the ten ingredients summarized in this article can help assure reviewers of the significance, feasibility, and impact of the proposed research. PMID:23062065

Pandemic policy and planning considerations for universities: findings from a tabletop exercise.

PubMed

Beaton, Randal; Stergachis, Andy; Thompson, Jack; Osaki, Carl; Johnson, Clark; Charvat, Steven J; Marsden-Haug, Nicola

2007-12-01

The potential for a novel influenza virus to cause a pandemic represents a significant threat to global health. Planning for pandemic flu, as compared to planning for other types of hazards, presents some unique challenges to businesses, communities, and education institutions. To identify and address the challenges that may be faced by major metropolitan universities during a flu pandemic, a tabletop exercise was developed, offered, and evaluated. Its purpose was to assess existing University of Washington (UW) plans and policies for responding to an influenza pandemic. On May 31, 2006, more than 50 participants, including UW administrators and unit leaders and a number of key external partners, participated in a tabletop exercise designed to simulate all phases of an influenza pandemic. This exercise revealed existing gaps in university pandemic influenza plans and policies, including issues related to isolation and quarantine, continuity of operations, disaster mental health services, integration of volunteers into a disaster response, tracking travel of university students and personnel, communication problems, and ways to meet the needs of resident and foreign students and faculty during an outbreak. Policy and planning recommendations are offered that address each of these challenges faced by UW as well as other major research universities and colleges.

The 'global health' education framework: a conceptual guide for monitoring, evaluation and practice

PubMed Central

2011-01-01

Background In the past decades, the increasing importance of and rapid changes in the global health arena have provoked discussions on the implications for the education of health professionals. In the case of Germany, it remains yet unclear whether international or global aspects are sufficiently addressed within medical education. Evaluation challenges exist in Germany and elsewhere due to a lack of conceptual guides to develop, evaluate or assess education in this field. Objective To propose a framework conceptualising 'global health' education (GHE) in practice, to guide the evaluation and monitoring of educational interventions and reforms through a set of key indicators that characterise GHE. Methods Literature review; deduction. Results and Conclusion Currently, 'new' health challenges and educational needs as a result of the globalisation process are discussed and linked to the evolving term 'global health'. The lack of a common definition of this term complicates attempts to analyse global health in the field of education. The proposed GHE framework addresses these problems and presents a set of key characteristics of education in this field. The framework builds on the models of 'social determinants of health' and 'globalisation and health' and is oriented towards 'health for all' and 'health equity'. It provides an action-oriented construct for a bottom-up engagement with global health by the health workforce. Ten indicators are deduced for use in monitoring and evaluation. PMID:21501519

The personal health record: consumers banking on their health.

PubMed

Ball, Marion J; Costin, Melinda Y; Lehmann, Christoph

2008-01-01

With personal health records (PHRs) acting much like ATM cards, increasingly wired consumers can "bank on health", accessing their own personal health information and a wide array of services. Consumer-owned, the PHR is dependent upon the existence of the legal electronic medical record (EMR) and interoperability. Working PHRs are in place in Veterans Health Administration, private health care institutions, and in the commercial sector. By allowing consumers to become involved in their own care, the PHR creates new roles and relationships. New tools change the clinician's workflow and thought flow, and pose new challenges for consumers. Key components of the PHR include the EMR and regional health information organizations (RHIOs); key strategies focus on human factors in successful project management. Online resources provided by the National Library of Medicine and Health On the Net help address consumer needs for information that is reliable and understandable. The growth of self-management tools adds to the challenge and the promise of PHRs for clinicians and consumers alike.

Metabolic Phenotyping of Diet and Dietary Intake.

PubMed

Brignardello, J; Holmes, E; Garcia-Perez, I

Nutrition provides the building blocks for growth, repair, and maintenance of the body and is key to maintaining health. Exposure to fast foods, mass production of dietary components, and wider importation of goods have challenged the balance between diet and health in recent decades, and both scientists and clinicians struggle to characterize the relationship between this changing dietary landscape and human metabolism with its consequent impact on health. Metabolic phenotyping of foods, using high-density data-generating technologies to profile the biochemical composition of foods, meals, and human samples (pre- and postfood intake), can be used to map the complex interaction between the diet and human metabolism and also to assess food quality and safety. Here, we outline some of the techniques currently used for metabolic phenotyping and describe key applications in the food sciences, ending with a broad outlook at some of the newer technologies in the field with a view to exploring their potential to address some of the critical challenges in nutritional science. © 2017 Elsevier Inc. All rights reserved.

Pediatric Care Coordination: Lessons Learned and Future Priorities.

PubMed

Cady, Rhonda G; Looman, Wendy S; Lindeke, Linda L; LaPlante, Bonnie; Lundeen, Barbara; Seeley, Amanda; Kautto, Mary E

2015-09-30

A fundamental component of the medical home model is care coordination. In Minnesota, this model informed design and implementation of the state's health care home (HCH) model, a key element of statewide healthcare reform legislation. Children with medical complexity (CMC) often require care from multiple specialists and community resources. Coordinating this multi-faceted care within the HCH is challenging. This article describes the need for specialized models of care coordination for CMC. Two models of care coordination for CMC were developed to address this challenge. The TeleFamilies Model of Pediatric Care Coordination uses an advanced practice registered nurse care (APRN) coordinator embedded within an established HCH. The PRoSPer Model of Pediatric Care Coordination uses a registered nurse/social worker care coordinator team embedded within a specialty care system. We describe key findings from implementation of these models, and conclude with lessons learned. Replication of the models is encouraged to increase the evidence base for care coordination for the growing population of children with medical complexities.

“I Need my Own Place to get Better”: Patient Perspectives on the Role of Housing in Potentially Preventable Hospitalizations

PubMed Central

Quensell, Michelle L.; Taira, Deborah A.; Seto, Todd B.; Braun, Kathryn L.; Sentell, Tetine L.

2017-01-01

Objective To analyze patient perspectives on the role of housing in their potentially preventable hospitalization. Methods Individuals admitted with cardiovascular-or diabetes-related diagnoses (n = 90) in a major medical center in Hawai‘i completed an in-person interview eliciting patient perspectives on key factors leading to hospitalization. Using the framework approach, two independent coders identified themes. This study focused on housing-related findings. Results Overall, 23% of participants reported housing as a precipitating factor to their hospitalization, including 12 with no regular place to stay. Four housing-related themes emerged: challenges meeting basic needs, complex chronic care management difficulties, stigma and relationship with provider, and stress and other mental health issues. Discussion Almost 25% of patients identified housing as a key factor to their hospital stay. Patient-reported themes highlight specific mechanisms by which housing challenges may lead to hospitalization. Addressing housing issues could help reduce the number and associated cost burden of preventable hospitalizations. PMID:28529224

Long-Term Preservation of NASA Heliophysics Data and Access: Where We Were and Where We're Going

NASA Technical Reports Server (NTRS)

McGuire, Robert E.

2011-01-01

The importance of ensuring preservation and useful access to the unique science potential of past, present and future NASA solar and space physics (i.e. heliophysics) data has been recognized since the inception of NASA but remains challenging. In this talk, I will briefly review the history of this topic and and then discuss the present NASA model for heliophysics science data management, including key current resources for finding and using data projects like the Space Physics Data Facility. I will highlight expected future directions, building on working elements of the present program and exploiting new technology, to further improve the data environment, address existing issues and anticipate emerging challenges.

Toward Impactful Collaborations on Computing and Mental Health

PubMed Central

Dinakar, Karthik; Picard, Rosalind; Christensen, Helen; Torous, John

2018-01-01

We describe an initiative to bring mental health researchers, computer scientists, human-computer interaction researchers, and other communities together to address the challenges of the global mental ill health epidemic. Two face-to-face events and one special issue of the Journal of Medical Internet Research were organized. The works presented in these events and publication reflect key state-of-the-art research in this interdisciplinary collaboration. We summarize the special issue articles and contextualize them to present a picture of the most recent research. In addition, we describe a series of collaborative activities held during the second symposium and where the community identified 5 challenges and their possible solutions. PMID:29426812

Using Patient Avatars to Promote Health Data Sharing Applications: Perspectives and Regulatory Challenges.

PubMed

Dahi, Alan; Forgó, Nikolaus; Jensen, Sarah; Stauch, Marc

2016-04-01

The potential of ICT to address problems in modern healthcare is considerable, and an ICT-driven revolution in healthcare appears imminent. Such developments maybe viewed largely in positive terms. Thus they should result in enhanced treatment and care options, empowering patients--including by permitting greater self-management of illness outside hospital, while offering economic benefits and costs savings over traditional healthcare provision. However, the new possibilities also present manifold risks, such as of data breaches, encroachments on subject autonomy, as well as of other harms. This article considers some of the key regulatory challenges against the background of the progress of the current EU Commission-sponsored 'MyHealthAvatar' project.

First Passage under Restart

NASA Astrophysics Data System (ADS)

Pal, Arnab; Reuveni, Shlomi

2017-01-01

First passage under restart has recently emerged as a conceptual framework suitable for the description of a wide range of phenomena, but the endless variety of ways in which restart mechanisms and first passage processes mix and match hindered the identification of unifying principles and general truths. Hope that these exist came from a recently discovered universality displayed by processes under optimal, constant rate, restart—but extensions and generalizations proved challenging as they marry arbitrarily complex processes and restart mechanisms. To address this challenge, we develop a generic approach to first passage under restart. Key features of diffusion under restart—the ultimate poster boy for this wide and diverse class of problems—are then shown to be completely universal.

Web Services Security - Implementation and Evaluation Issues

NASA Astrophysics Data System (ADS)

Pimenidis, Elias; Georgiadis, Christos K.; Bako, Peter; Zorkadis, Vassilis

Web services development is a key theme in the utilization the commercial exploitation of the semantic web. Paramount to the development and offering of such services is the issue of security features and they way these are applied in instituting trust amongst participants and recipients of the service. Implementing such security features is a major challenge to developers as they need to balance these with performance and interoperability requirements. Being able to evaluate the level of security offered is a desirable feature for any prospective participant. The authors attempt to address the issues of security requirements and evaluation criteria, while they discuss the challenges of security implementation through a simple web service application case.

Implementing an organization-wide quality improvement initiative: insights from project leads, managers, and frontline nurses.

PubMed

Jeffs, Lianne P; Lo, Joyce; Beswick, Susan; Campbell, Heather

2013-01-01

With the movement to advance quality care and improve health care outcomes, organizations have increasingly implemented quality improvement (QI) initiatives to meet these requirements. Key to implementation success is the multilevel involvement of frontline clinicians and leadership. To explore the perceptions and experiences of frontline nurses, project leads, and managers associated with an organization-wide initiative aimed at engaging nurses in quality improvement work. To address the aims of this study, a qualitative research approach was used. Two focus groups were conducted with a total of 13 nurse participants, and individual interviews were done with 10 managers and 6 project leads. Emergent themes from the interview data included the following: improving care in a networked approach; driving QI and having a sense of pride; and overcoming challenges. Specifically, our findings elucidate the value of communities of practice and ongoing mentorship for nurses as key strategies to acquire and apply QI knowledge to a QI project on their respective units. Key challenges emerged including workload and time constraints, as well as resistance to change from staff. Our study findings suggest that leaders need to provide learning opportunities and protected time for frontline nurses to participate in QI projects.

Global megatrends and their implications for environmental assessment practice

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

Retief, Francois, E-mail: francois.retief@nwu.ac.za; Bond, Alan; Research Unit for Environmental Sciences and Management, North-West University

This paper addresses the future of environmental assessment (EA) practice in light of a rapidly changing world. We apply a literature review-based methodology to firstly identify key global megatrends and then reflect upon the implications for EA practice based on some known challenges. The key megatrends identified are synthesised into six categories: i) demographics, ii) urbanization, iii) technological innovation, iv) power shifts, v) resource scarcity and vi) climate change. We then discuss the implications of these megatrends for EA practice against four known EA challenges namely: dealing with i) complexity and uncertainty, ii) efficiency, iii) significance and iv) communication andmore » participation. Our analysis suggests important implications for EA practice such as: increased difficulties with accuracy of prediction; the need for facilitative adaptation; an increase in the occurrence of unexpected events; higher expectations for procedural efficiency; challenges with information and communication management; dealing with significance judgements; and mitigation amidst resource scarcity and increasing pressures on earth systems. The megatrends underscore the need for continued evolution of EA thinking and practice, especially moving away from seeking a predictable single future or outcome towards the possibility of multiple scenarios with associated adaptability and enhanced system resilience capable of responding to rapid change.« less

Patient and healthcare perspectives on the importance and efficacy of addressing spiritual issues within an interdisciplinary bone marrow transplant clinic: a qualitative study

PubMed Central

Sinclair, Shane; McConnell, Shelagh; Raffin Bouchal, Shelley; Ager, Naree; Booker, Reanne; Enns, Bert; Fung, Tak

2015-01-01

Objectives The purpose of this study was to use a qualitative approach to better understand the importance and efficacy of addressing spiritual issues within an interdisciplinary bone marrow transplant clinic from the perspectives of patients and healthcare providers. Setting Participants were recruited from the bone marrow transplant clinic of a large urban outpatient cancer care centre in western Canada. Participants: Focus groups were conducted with patients (n=7) and healthcare providers (n=9) to explore the importance of addressing spiritual issues across the treatment trajectory and to identify factors associated with effectively addressing these needs. Results Data were analysed using the qualitative approach of latent content analysis. Addressing spiritual issues was understood by patients and healthcare providers, as a core, yet under addressed, component of comprehensive care. Both sets of participants felt that addressing basic spiritual issues was the responsibility of all members of the interdisciplinary team, while recognising the need for specialised and embedded support from a spiritual care professional. While healthcare providers felt that the impact of the illness and treatment had a negative effect on patients’ spiritual well-being, patients felt the opposite. Skills, challenges, key time points and clinical indicators associated with addressing spiritual issues were identified. Conclusions Despite a number of conceptual and clinical challenges associated with addressing spiritual issues patients and their healthcare providers emphasised the importance of an integrated approach whereby basic spiritual issues are addressed by members of the interdisciplinary team and by an embedded spiritual care professional, who in addition also provides specialised support. The identification of clinical issues associated with addressing spiritual needs provides healthcare providers with clinical guidance on how to better integrate this aspect of care into their clinical practice, while also identifying acute incidences when a more targeted and specialised approach may be of benefit. PMID:26614623

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.

Numerical simulation of turbulent combustion: Scientific challenges

NASA Astrophysics Data System (ADS)

Ren, ZhuYin; Lu, Zhen; Hou, LingYun; Lu, LiuYan

2014-08-01

Predictive simulation of engine combustion is key to understanding the underlying complicated physicochemical processes, improving engine performance, and reducing pollutant emissions. Critical issues as turbulence modeling, turbulence-chemistry interaction, and accommodation of detailed chemical kinetics in complex flows remain challenging and essential for high-fidelity combustion simulation. This paper reviews the current status of the state-of-the-art large eddy simulation (LES)/prob-ability density function (PDF)/detailed chemistry approach that can address the three challenging modelling issues. PDF as a subgrid model for LES is formulated and the hybrid mesh-particle method for LES/PDF simulations is described. Then the development need in micro-mixing models for the PDF simulations of turbulent premixed combustion is identified. Finally the different acceleration methods for detailed chemistry are reviewed and a combined strategy is proposed for further development.

Predictive Systems for Customer Interactions

NASA Astrophysics Data System (ADS)

Vijayaraghavan, Ravi; Albert, Sam; Singh, Vinod Kumar; Kannan, Pallipuram V.

With the coming of age of web as a mainstream customer service channel, B2C companies have invested substantial resources in enhancing their web presence. Today customers can interact with a company, not only through the traditional phone channel but also through chat, email, SMS or web self-service. Each of these channels is best suited for some services and ill-matched for others. Customer service organizations today struggle with the challenge of delivering seamlessly integrated services through these different channels. This paper will evaluate some of the key challenges in multi-channel customer service. It will address the challenge of creating the right channel mix i.e. providing the right choice of channels for a given customer/behavior/issue profile. It will also provide strategies for optimizing the performance of a given channel in creating the right customer experience.

An Information Architect's View of Earth Observations for Disaster Risk Management

NASA Astrophysics Data System (ADS)

Moe, K.; Evans, J. D.; Cappelaere, P. G.; Frye, S. W.; Mandl, D.; Dobbs, K. E.

2014-12-01

Satellite observations play a significant role in supporting disaster response and risk management, however data complexity is a barrier to broader use especially by the public. In December 2013 the Committee on Earth Observation Satellites Working Group on Information Systems and Services documented a high-level reference model for the use of Earth observation satellites and associated products to support disaster risk management within the Global Earth Observation System of Systems context. The enterprise architecture identified the important role of user access to all key functions supporting situational awareness and decision-making. This paper focuses on the need to develop actionable information products from these Earth observations to simplify the discovery, access and use of tailored products. To this end, our team has developed an Open GeoSocial API proof-of-concept for GEOSS. We envision public access to mobile apps available on smart phones using common browsers where users can set up a profile and specify a region of interest for monitoring events such as floods and landslides. Information about susceptibility and weather forecasts about flood risks can be accessed. Users can generate geo-located information and photos of local events, and these can be shared on social media. The information architecture can address usability challenges to transform sensor data into actionable information, based on the terminology of the emergency management community responsible for informing the public. This paper describes the approach to collecting relevant material from the disasters and risk management community to address the end user needs for information. The resulting information architecture addresses the structural design of the shared information in the disasters and risk management enterprise. Key challenges are organizing and labeling information to support both online user communities and machine-to-machine processing for automated product generation.

Partnerships for Policy Development: A Case Study From Uganda’s Costed Implementation Plan for Family Planning

PubMed Central

Lipsky, Alyson B; Gribble, James N; Cahaelen, Linda; Sharma, Suneeta

2016-01-01

ABSTRACT In global health, partnerships between practitioners and policy makers facilitate stakeholders in jointly addressing those issues that require multiple perspectives for developing, implementing, and evaluating plans, strategies, and programs. For family planning, costed implementation plans (CIPs) are developed through a strategic government-led consultative process that results in a detailed plan for program activities and an estimate of the funding required to achieve an established set of goals. Since 2009, many countries have developed CIPs. Conventionally, the CIP approach has not been defined with partnerships as a focal point; nevertheless, cooperation between key stakeholders is vital to CIP development and execution. Uganda launched a CIP in November 2014, thus providing an opportunity to examine the process through a partnership lens. This article describes Uganda’s CIP development process in detail, grounded in a framework for assessing partnerships, and provides the findings from 22 key informant interviews. Findings reveal strengths in Uganda’s CIP development process, such as willingness to adapt and strong senior management support. However, the evaluation also highlighted challenges, including district health officers (DHOs), who are a key group of implementers, feeling excluded from the development process. There was also a lack of planning around long-term partnership practices that could help address anticipated execution challenges. The authors recommend that future CIP development efforts use a long-term partnership strategy that fosters accountability by encompassing both the short-term goal of developing the CIP and the longer-term goal of achieving the CIP objectives. Although this study focused on Uganda’s CIP for family planning, its lessons have implications for any policy or strategy development efforts that require multiple stakeholders to ensure successful execution. PMID:27353621

Key on demand (KoD) for software-defined optical networks secured by quantum key distribution (QKD).

PubMed

Cao, Yuan; Zhao, Yongli; Colman-Meixner, Carlos; Yu, Xiaosong; Zhang, Jie

2017-10-30

Software-defined optical networking (SDON) will become the next generation optical network architecture. However, the optical layer and control layer of SDON are vulnerable to cyberattacks. While, data encryption is an effective method to minimize the negative effects of cyberattacks, secure key interchange is its major challenge which can be addressed by the quantum key distribution (QKD) technique. Hence, in this paper we discuss the integration of QKD with WDM optical networks to secure the SDON architecture by introducing a novel key on demand (KoD) scheme which is enabled by a novel routing, wavelength and key assignment (RWKA) algorithm. The QKD over SDON with KoD model follows two steps to provide security: i) quantum key pools (QKPs) construction for securing the control channels (CChs) and data channels (DChs); ii) the KoD scheme uses RWKA algorithm to allocate and update secret keys for different security requirements. To test our model, we define a security probability index which measures the security gain in CChs and DChs. Simulation results indicate that the security performance of CChs and DChs can be enhanced by provisioning sufficient secret keys in QKPs and performing key-updating considering potential cyberattacks. Also, KoD is beneficial to achieve a positive balance between security requirements and key resource usage.

Improving access to important recovery information for heart patients with low health literacy: reflections on practice-based initiatives.

PubMed

Naccarella, Lucio; Biuso, Catuscia; Jennings, Amanda; Patsamanis, Harry

2018-05-29

Evidence exists for the association between health literacy and heart health outcomes. Cardiac rehabilitation is critical for recovery from heart attack and reducing hospital readmissions. Despite this, <30% of people participate in a program. Significant patient, hospital and health system challenges exist to improve recovery through increased heart health literacy. This brief case study reflects and documents practice-based initiatives by Heart Foundation Victoria to improve access to recovery information for patients with low literacy levels. Three key initiatives, namely the Six Steps To Cardiac Recovery resource, the Love Your Heart book and the nurse ambassador program, were implemented informed by mixed methods that assessed need and capacity at the individual, organisational and systems levels. Key outcomes included increased access to recovery information for patients with low health literacy, nurse knowledge and confidence to engage with patients on recovery information, improved education of patients and improved availability and accessibility of information for patients in diverse formats. Given the challenges involved in addressing heart health literacy, multifaceted practice-based approaches are essential to improve access to recovery information for patients with low literacy levels. What is known about the topic? Significant challenges exist for patients with lower health literacy receiving recovery information after a heart attack in hospitals. What does this paper add? This case study provides insights into a practice-based initiative by Heart Foundation Victoria to improve access to recovery information for patients with low literacy levels. What are the implications for practitioners? Strategies to improve recovery through increased heart health literacy must address the needs of patients, nursing staff and the health system within hospitals. Such strategies need to be multifaceted and designed to build the capacity of nurses, heart patients and their carers, as well as support from hospital management.

Challenges to collaboration in school mental health and strategies for overcoming them.

PubMed

Weist, Mark D; Mellin, Elizabeth A; Chambers, Kerri L; Lever, Nancy A; Haber, Deborah; Blaber, Christine

2012-02-01

This article reviews challenges to collaboration in school mental health (SMH) and presents practical strategies for overcoming them. The importance of collaboration to the success of SMH programs is reviewed, with a particular focus on collaboration between school- and community-employed professionals. Challenges to effective collaboration between school- and community-employed professionals in SMH are considered. Strategies for overcoming challenges to effective collaboration are presented. Marginalization of the SMH agenda, limited interdisciplinary teamwork, restricted coordination mechanisms, confidentiality concerns, and resource and funding issues are key challenges to collaboration. Strategies targeted toward each of these challenges may help improve the effectiveness of SMH programs and ultimately student outcomes. Collaboration between school- and community-employed professionals is critical to the success of SMH programs. Despite its promise, the success of SMH programs can be jeopardized by ineffective collaboration between school- and community-employed professionals. Strategies to overcome marginalization, promote authentic interdisciplinary teamwork, build effective coordination mechanisms, protect student and family confidentiality, and promote policy change and resource enhancements should be addressed in SMH improvement planning. © 2012, American School Health Association.

Interdisciplinary interpretations and applications of the concept of scale in landscape research.

PubMed

Higgins, Sarah; Mahon, Marie; McDonagh, John

2012-12-30

The spatial dimensions of many social, economic and environmental challenges facing 21st century societies can be addressed through the idea of landscape. The European Landscape Convention--ELC (Council of Europe, 2000--Article 1a) views landscape as representing not simply the environment, but the world "as perceived by people". As a concept, landscape is increasingly understood as uniting the physical, mental, natural and cultural dimensions of human existence; good quality landscapes are thus integral to our well-being. The problems and challenges facing our landscapes require greater understanding of how they function and change, as well as their meanings and values. Scholars working in the area of landscape research have increasingly advocated the need to enhance integrative approaches between the natural, human and applied sciences. However, drawing together the collective insights from across the sciences presents a range of conceptual and methodological issues. The question of scale as it pertains to different scientific realms is a key example of this kind of challenge to integrative approaches. The multi-scale nature of the social, environmental and economic challenges embedded in the landscape demands that scholars address these key issues of scale in their research. The aim of this paper is to review how the concept of scale has been interpreted and applied within the arena of landscape research, focussing specifically on three of the principal disciplinary contributors--ecology/landscape ecology, geography and spatial planning. The objective of this discussion is to synthesise scalar issues that feature within and across these perspectives, to better understand how they impact on the way landscape is conceptualised and thus produced through academic and related policy discourses. It seeks out points of tension as well as convergence when dealing with scale. It reflects on academic, policy and practice-related concerns that would form part of longer-term holistic strategies for landscape protection, planning and management in line with those being advocated by the ELC. Copyright © 2012 Elsevier Ltd. All rights reserved.

Towards sustainable and multifunctional agriculture in farmland landscapes: Lessons from the integrative approach of a French LTSER platform.

PubMed

Bretagnolle, Vincent; Berthet, Elsa; Gross, Nicolas; Gauffre, Bertrand; Plumejeaud, Christine; Houte, Sylvie; Badenhausser, Isabelle; Monceau, Karine; Allier, Fabrice; Monestiez, Pascal; Gaba, Sabrina

2018-06-15

Agriculture is currently facing unprecedented challenges: ensuring food, fiber and energy production in the face of global change, maintaining the economic performance of farmers and preserving natural resources such as biodiversity and associated key ecosystem services for sustainable agriculture. Addressing these challenges requires innovative landscape scale farming systems that account for changing economic and environmental targets. These novel agricultural systems need to be recognized, accepted and promoted by all stakeholders, including local residents, and supported by public policies. Agroecosystems should be considered as socio-ecological systems and alternative farming systems should be based on ecological principles while taking societal needs into account. This requires an in-depth knowledge of the multiple interactions between sociological and ecological dynamics. Long Term Socio-Ecological Research platforms (LTSER) are ideal for acquiring this knowledge as they (i) are not constrained by traditional disciplinary boundaries, (ii) operate at a large spatial scale involving all stakeholders, and (iii) use systemic approaches to investigate biodiversity and ecosystem services. This study presents the socio-ecological research strategy from the LTSER "Zone Atelier Plaine & Val de Sèvre" (ZA PVS), a large study area where data has been sampled since 1994. Its global aim is to identify effective solutions for agricultural development and the conservation of biodiversity in farmlands. Three main objectives are targeted by the ZAPVS. The first objective is intensive monitoring of landscape features, the main taxa present and agricultural practices. The second objective is the experimental investigation, in real fields with local farmers, of important ecosystem functions and services, in relation to pesticide use, crop production and farming socio-economic value. The third aim is to involve stakeholders through participatory research, citizen science and the dissemination of scientific results. This paper underlines the relevance of LTSERs for addressing agricultural challenges, while acknowledging that there are some yet unsolved key challenges. Copyright © 2018 Elsevier B.V. All rights reserved.

Paying for obesity: a changing landscape.

PubMed

Simpson, Lisa A; Cooper, Julie

2009-06-01

Coverage for obesity related services is highly variable. Despite this, health plans, purchasers, and states have mounted numerous recent initiatives. To identify the range of approaches being used to address coverage and reimbursement for childhood obesity services. Key informant interviews were conducted using a semi-structured protocol to identify the types of activities they or their organization were engaged in to address childhood obesity, to learn about private payer policies and procedures, to identify best practices, potential resources and/or other key informants. Domains addressed in the protocol included scope of the respondent's organization's activities, the rationale for supporting obesity activities, the degree to which obesity services were a covered benefit and what if any barriers or challenges were encountered in implementation, the policy climate within which the organization operates (e.g. state legislation, initiatives or task forces), and any assessment of the impact and/or cost of implementing their initiatives. The individuals interviewed represented respondents from each of the following categories: employer, health plan, and state insurance programs and conducted by phone between November 2007 and March 2008. In addition to the information gathered by the key informant interviews we conducted a search of the relevant peer review and grey literature between 2005 and 2008 and input from a national expert advisory group. Significant variation, as well as recent changes, were identified in both the private and public sector. Approaches included new benefits and incentives for parents and providers. Only anecdotal evidence of impact of the recent changes was available. There is important forward movement in how public and private players are addressing paying for obesity related services. Medicaid and SCHIP programs have an opportunity to provide additional leadership. Substantial investments in evaluation and research are needed to learn which approaches are most effective.

Re-Form: FPGA-Powered True Codesign Flow for High-Performance Computing In The Post-Moore Era

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

Cappello, Franck; Yoshii, Kazutomo; Finkel, Hal

Multicore scaling will end soon because of practical power limits. Dark silicon is becoming a major issue even more than the end of Moore’s law. In the post-Moore era, the energy efficiency of computing will be a major concern. FPGAs could be a key to maximizing the energy efficiency. In this paper we address severe challenges in the adoption of FPGA in HPC and describe “Re-form,” an FPGA-powered codesign flow.

State politics and the creation of health insurance exchanges.

PubMed

Jones, David K; Greer, Scott L

2013-08-01

Health insurance exchanges are a key component of the Affordable Care Act. Each exchange faces the challenge of minimizing friction with existing policies, coordinating churn between programs, and maximizing take-up. State-run exchanges would likely be better positioned to address these issues than a federally run exchange, yet only one third of states chose this path. Policymakers must ensure that their exchange-whether state or federally run-succeeds. Whether this happens will greatly depend on the political dynamics in each state.

Airway management in neuroanesthesiology.

PubMed

Aziz, Michael

2012-06-01

Airway management for neuroanesthesiology brings together some key principles that are shared throughout neuroanesthesiology. This article appropriately targets the cervical spine with associated injury and the challenges surrounding airway management. The primary focus of this article is on the unique airway management obstacles encountered with cervical spine injury or cervical spine surgery, and unique considerations regarding functional neurosurgery are addressed. Furthermore, topics related to difficult airway management for those with rheumatoid arthritis or pituitary surgery are reviewed. Copyright © 2012 Elsevier Inc. All rights reserved.

Meeting the Energy Challenges of the 1990s. Experts Define the Key Policy Issues.

DTIC Science & Technology

1992-03-01

Forecast of Low Emission Fuel Usage-Liquid 79 Fuels Figure 2.10: Forecast of Low Emission Fuel Usage- 81 Gaseous Fuels Figure 2.11: Global Warming From...environmental problems caused by acid rain, smog, and global warming , he said. According to Mr. Lovins, utilities as well as their customers benefit from...made in relation to these effects. The panel- ists addressed the links between global warming and the fossil fuels that now produce nearly 90 percent

Clues to the Foundations of Numerical Cognitive Impairments: Evidence From Genetic Disorders

PubMed Central

Simon, Tony J.

2011-01-01

Several neurodevelopmental disorders of known genetic etiology generate phenotypes that share the characteristic of numerical and mathematical cognitive impairments. This article reviews some of the main findings that suggest a possible key role that spatial and temporal information processing impairments may play in the atypical development of numerical cognitive competence. The question of what neural substrate might underlie these impairments is also addressed, as are the challenges for interpreting neural structure/cognitive function mapping in atypically developing populations. PMID:21761998

National Aeronautics and Space Administration Science and Engineering Apprentice Program

NASA Technical Reports Server (NTRS)

1997-01-01

The National Aeronautics and Space Administration's Science and Engineering Apprentice Program for high school students is one of NASA's many efforts toward a goal of scientific literacy. It embraces science, mathematics, and technology as keys to purposeful and sustained progress and security for our nation and its people. It serves as a model for helping reform education by striving to address mechanisms to influence the knowledge, skills, and attitudes of our students. It focuses on what to do today to meet the challenges of tomorrow.

Inorganic Nanoparticles in Cancer Therapy

PubMed Central

Bhattacharyya, Sanjib; Kudgus, Rachel A.; Bhattacharya, Resham; Mukherjee, Priyabrata

2011-01-01

Nanotechnology is an evolving field with enormous potential for biomedical applications. The growing interest to use inorganic nanoparticles in medicine is due to the unique size and shape-dependent optoelectronic properties. Herein, we will focus on gold, silver and platinum nanoparticles, discussing recent developments for therapeutic applications with regard to cancer in terms of nanoparticles being used as a delivery vehicle as well as therapeutic agents. We will also discuss some of the key challenges to be addressed in future studies. PMID:21104301

State Politics and the Creation of Health Insurance Exchanges

PubMed Central

Greer, Scott L.

2013-01-01

Health insurance exchanges are a key component of the Affordable Care Act. Each exchange faces the challenge of minimizing friction with existing policies, coordinating churn between programs, and maximizing take-up. State-run exchanges would likely be better positioned to address these issues than a federally run exchange, yet only one third of states chose this path. Policymakers must ensure that their exchange—whether state or federally run—succeeds. Whether this happens will greatly depend on the political dynamics in each state. PMID:23763405

Integration of analytical measurements and wireless communications--current issues and future strategies.

PubMed

Diamond, Dermot; Lau, King Tong; Brady, Sarah; Cleary, John

2008-05-15

Rapid developments in wireless communications are opening up opportunities for new ways to perform many types of analytical measurements that up to now have been restricted in scope due to the need to have access to centralised facilities. This paper will address both the potential for new applications and the challenges that currently inhibit more widespread integration of wireless communications with autonomous sensors and analytical devices. Key issues are identified and strategies for closer integration of analytical information and wireless communications systems discussed.

Community health clinical education in Canada: part 2--developing competencies to address social justice, equity, and the social determinants of health.

PubMed

Cohen, Benita E; Gregory, David

2009-01-01

Recently, several Canadian professional nursing associations have highlighted the expectations that community health nurses (CHNs) should address the social determinants of health and promote social justice and equity. These developments have important implications for (pre-licensure) CHN clinical education. This article reports the findings of a qualitative descriptive study that explored how baccalaureate nursing programs in Canada address the development of competencies related to social justice, equity, and the social determinants of health in their community health clinical courses. Focus group interviews were held with community health clinical course leaders in selected Canadian baccalaureate nursing programs. The findings foster understanding of key enablers and challenges when providing students with clinical opportunities to develop the CHN role related to social injustice, inequity, and the social determinants of health. The findings may also have implications for nursing programs internationally that are addressing these concepts in their community health clinical courses.

The challenges of implementing advanced access for residents in family medicine in Quebec. Do promising strategies exist?

PubMed

Abou Malham, Sabina; Touati, Nassera; Maillet, Lara; Breton, Mylaine

2018-12-01

The advanced access (AA) model is a highly recommended innovation to improve timely access to primary healthcare. Despite that many studies have shown positive impacts for healthcare professionals, and for patients, implementing this model in clinics with a teaching mission for family medicine residents poses specific challenges. To identify these challenges within these clinics, as well as potential strategies to address them. The authors adopted a qualitative multiple case study design, collected data in 2016 using semi-structured interviews (N = 40) with healthcare professionals and clerical staff in four family medicine units in Quebec, and performed a thematic analysis. They validated results through a discussion workshop, involving many family physicians and residents practicing in different regions Results: Five challenges emerged from the data: 1) choosing, organizing residents' patient; 2) managing and balancing residents' appointment schedules; 3) balancing timely access with relational continuity; 4) understanding the AA model; 5) establishing collaborative practices with other health professionals. Several promising strategies were suggested to address these challenges, including clearly defining residents' patient panels; adopting a team-based care approach; incorporating the model into academic curriculum and clinical training; proactive and ongoing education of health professionals, residents, and patients; involving residents in the change process and in adjustment strategies. To meet the challenges of implementing AA, decision-makers should consider exposing residents to AA during academic training and clinical internships, involving them in team work on arrival, engaging them as key actors in the implementation and in intra- and inter-professional collaborative models.

The challenges of implementing advanced access for residents in family medicine in Quebec. Do promising strategies exist?

PubMed Central

Abou Malham, Sabina; Touati, Nassera; Maillet, Lara; Breton, Mylaine

2018-01-01

ABSTRACT Background: The advanced access (AA) model is a highly recommended innovation to improve timely access to primary healthcare. Despite that many studies have shown positive impacts for healthcare professionals, and for patients, implementing this model in clinics with a teaching mission for family medicine residents poses specific challenges. Objective: To identify these challenges within these clinics, as well as potential strategies to address them. Design: The authors adopted a qualitative multiple case study design, collected data in 2016 using semi-structured interviews (N = 40) with healthcare professionals and clerical staff in four family medicine units in Quebec, and performed a thematic analysis. They validated results through a discussion workshop, involving many family physicians and residents practicing in different regions Results: Five challenges emerged from the data: 1) choosing, organizing residents’ patient; 2) managing and balancing residents’ appointment schedules; 3) balancing timely access with relational continuity; 4) understanding the AA model; 5) establishing collaborative practices with other health professionals. Several promising strategies were suggested to address these challenges, including clearly defining residents’ patient panels; adopting a team-based care approach; incorporating the model into academic curriculum and clinical training; proactive and ongoing education of health professionals, residents, and patients; involving residents in the change process and in adjustment strategies. Conclusions: To meet the challenges of implementing AA, decision-makers should consider exposing residents to AA during academic training and clinical internships, involving them in team work on arrival, engaging them as key actors in the implementation and in intra- and inter-professional collaborative models. PMID:29464984

When doctor becomes patient: challenges and strategies in caring for physician-patients.

PubMed

Domeyer-Klenske, Amy; Rosenbaum, Marcy

2012-01-01

The current study was aimed at exploring the challenges that arise in the doctor-patient relationship when the patient is also a physician and identifying strategies physicians use to meet these challenges. No previous research has systematically investigated primary care physicians' perspectives on caring for physician-patients. Family medicine (n=15) and general internal medicine (n=14) physicians at a large Midwestern university participated in semi-structured interviews where they were asked questions about their experiences with physician-patients and the strategies they used to meet the unique needs of this patient population. Thematic analysis was used to identify common responses. Three of the challenges most commonly discussed by physician participants were: (1) maintaining boundaries between relationships with colleagues or between roles as physician/colleague/friend, (2) avoiding assumptions about patient knowledge and health behaviors, and (3) managing physician-patients' access to informal consultations, personal test results, and opinions from other colleagues. We were able to identify three main strategies clinicians use in addressing these perceived challenges: (1) Ignore the physician-patient's background, (2) Acknowledge the physician-patient's background and negotiate care, and (3) Allow care to be driven primarily by the physician-patient. It is important that primary care physicians understand the challenges inherent in treating physicians and develop a strategy with which they are comfortable addressing them. Explicitly communicating with the physician-patient to ensure boundaries are maintained, assumptions about the physician-patient are avoided, and physician-patient access is properly managed are key to providing quality care to physician-patients.

What are the barriers of quality survivorship care for haematology cancer patients? Qualitative insights from cancer nurses.

PubMed

Langbecker, Danette; Ekberg, Stuart; Yates, Patsy; Chan, Alexandre; Chan, Raymond Javan

2016-02-01

Many haematological cancer survivors report long-term physiological and psychosocial effects beyond treatment completion. These survivors continue to experience impaired quality of life (QoL) as a result of their disease and aggressive treatment. As key members of the multidisciplinary team, the purpose of this study is to examine the insights of cancer nurses to inform future developments in survivorship care provision. Open text qualitative responses from two prospective Australian cross-sectional surveys of nurses (n = 136) caring for patients with haematological cancer. Data were analysed thematically, using an inductive approach to identify themes. This study has identified a number of issues that nurses perceive as barriers to quality survivorship care provision. Two main themes were identified: the first relating to the challenges nurses face in providing care ('care challenges') and the second relating to the challenges of providing survivorship care within contemporary health care systems ('system challenges'). Cancer nurses perceive the nature of haematological cancer and its treatment and of the health care system itself, as barriers to the provision of quality survivorship care. Care challenges such as the lack of a standard treatment path and the relapsing or remitting nature of haematological cancers may be somewhat intractable, but system challenges relating to clearly defining and delineating professional responsibilities and exchanging information with other clinicians are not. Addressing the issues identified will facilitate cancer nurses' provision of survivorship care and help address haematological survivors' needs with regard to the physical and psychosocial consequences of their cancer and treatment.

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

PubMed Central

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

2015-01-01

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

NASA's UAS NAS Access Project

NASA Technical Reports Server (NTRS)

Johnson, Charles W.

2011-01-01

The vision of the Unmanned Aircraft System (UAS) Integration in the National Airspace System (NAS) Project is "A global transportation system which allows routine access for all classes of UAS." The goal of the UAS Integration in the NAS Project is to "contribute capabilities that reduce technical barriers related to the safety and operational challenges associated with enabling routine UAS access to the NAS." This goal will be accomplished through a two-phased approach based on development of system-level integration of key concepts, technologies and/or procedures, and demonstrations of integrated capabilities in an operationally relevant environment. Phase 1 will take place the first two years of the Project and Phase 2 will take place the following three years. The Phase 1 and 2 technical objectives are: Phase 1: Developing a gap analysis between current state of the art and the Next Generation Air Transportation System (NextGen) UAS Concept of Operations . Validating the key technical areas identified by this Project . Conducting initial modeling, simulation, and flight testing activities . Completing Sub-project Phase 1 deliverables (spectrum requirements, comparative analysis of certification methodologies, etc.) and continue Phase 2 preparation (infrastructure, tools, etc.) Phase 2: Providing regulators with a methodology for developing airworthiness requirements for UAS, and data to support development of certifications standards and regulatory guidance . Providing systems-level, integrated testing of concepts and/or capabilities that address barriers to routine access to the NAS. Through simulation and flight testing, address issues including separation assurance, communications requirements, and human systems integration in operationally relevant environments. The UAS in the NAS Project will demonstrate solutions in specific technology areas, which will address operational/safety issues related to UAS access to the NAS. Since the resource allocation for this Project is limited ($150M over the five years), the focus is on reducing the technical barriers where NASA has unique capabilities. As a result, technical areas, such as Sense and Avoid (SAA) and beyond line of sight command and control will not be addressed. While these are critical barriers to UAS access, currently, there is a great deal of global effort being exercised to address these challenge areas. Instead, specific technology development in areas where there is certainty that NASA can advance the research to high technology readiness levels will be the Project's focus. Specific sub-projects include Separation Assurance, Human Systems Integration, Communications, Certification, and Integrated Test and Evaluation. Each sub-project will transfer technologies to relevant key stakeholders and decision makers through research transition teams, technology forums, or through other analogous means.

SHM reliability and implementation - A personal military aviation perspective

NASA Astrophysics Data System (ADS)

Lindgren, Eric A.

2016-02-01

Structural Health Monitoring has been proposed as a solution to address the needs of military aviation to reduce the time and cost to perform nondestructive inspections. While the potential to realize significant benefits exist, there are considerations that have to be addressed before such systems can be integrated into military platforms. Some considerations are pervasive to all aviation, such as how to assess the reliability and reproducible capability of these systems. However, there are other challenges unique to military aviation that must be overcome before these types of systems can be used. This presentation and paper are intended as a complement to the review of the outcome of the SAE G-11 SHM committee special workshop on SHM reliability in April of 2015. It will address challenges unique to military aviation that stem from different approaches to managing structural integrity (i.e. safety), frequency of use, design differences, various maintenance practices, and additional descriptions addressing differences in the execution of inspections. The objective of this presentation is to improve the awareness of the research and development community to the different and unique requirements found in military aviation, including the differences between countries, services, and aircraft type. This information should assist the research and development community in identifying and attacking key challenges. It is not intended to be comprehensive overview of all stakeholders' perspectives, but to serve as a launch point for additional discussion and exploration of opportunities to realize the potential of Structural Health Monitoring to assist in the management of military aviation assets. The views expressed in this publication are those of the author and do not reflect the official policy or position of the United States Air Force, Department of Defense, or the United States Government.

Imaging the cell surface and its organization down to the level of single molecules.

PubMed

Klenerman, David; Shevchuk, Andrew; Novak, Pavel; Korchev, Yuri E; Davis, Simon J

2013-02-05

Determining the organization of key molecules on the surface of live cells in two dimensions and how this changes during biological processes, such as signalling, is a major challenge in cell biology and requires methods with nanoscale spatial resolution and high temporal resolution. Here, we review biophysical tools, based on scanning ion conductance microscopy and single-molecule fluorescence and the combination of both of these methods, which have recently been developed to address these issues. We then give examples of how these methods have been be applied to provide new insights into cell membrane organization and function, and discuss some of the issues that will need to be addressed to further exploit these methods in the future.

Nuclear Explosion Monitoring Advances and Challenges

NASA Astrophysics Data System (ADS)

Baker, G. E.

2015-12-01

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

Assessing the feasibility of introducing health insurance in Afghanistan: a qualitative stakeholder analysis.

PubMed

Zeng, Wu; Kim, Christine; Archer, Lauren; Sayedi, Omarzaman; Jabarkhil, Mohammad Yousuf; Sears, Kathleen

2017-02-22

In the last decade, the health status of Afghans has improved drastically. However, the health financing system in Afghanistan remains fragile due to high out-of-pocket spending and reliance on donor funding. To address the country's health financing challenges, the Ministry of Public Health investigated health insurance as a mechanism to mobilize resources for health. This paper presents stakeholders' opinions on seven preconditions of implementing this approach, as their understanding and buy-in to such an approach will determine its success. Key informant interviews and focus group discussions were conducted with stakeholders. The interviews focused on perceptions of the seven preconditions of introducing health insurance, and adapting a framework developed by the International Labor Organization. Content analysis was conducted after interviews and discussions were transcribed and coded. Almost all of the stakeholders from government agencies, the private sector, and development partners are interested in introducing health insurance in Afghanistan, and they were aware of the challenges of the country's health financing system. Stakeholders acknowledged that health insurance could be an instrument to address these challenges. However, stakeholders differed in their beliefs about how and when to initiate a health insurance scheme. In addition to increasing insecurity in the country, they saw a lack of clear legal guidance, low quality of healthcare services, poor awareness among the population, limited technical capacity, and challenges to willingness to pay as the major barriers to establishing a successful nationwide health insurance scheme. The identified barriers prevent Afghanistan from establishing health insurance in the short term. Afghanistan must progressively address these major impediments in order to build a health insurance system.

Human body motion tracking based on quantum-inspired immune cloning algorithm

NASA Astrophysics Data System (ADS)

Han, Hong; Yue, Lichuan; Jiao, Licheng; Wu, Xing

2009-10-01

In a static monocular camera system, to gain a perfect 3D human body posture is a great challenge for Computer Vision technology now. This paper presented human postures recognition from video sequences using the Quantum-Inspired Immune Cloning Algorithm (QICA). The algorithm included three parts. Firstly, prior knowledge of human beings was used, the key joint points of human could be detected automatically from the human contours and skeletons which could be thinning from the contours; And due to the complexity of human movement, a forecasting mechanism of occlusion joint points was addressed to get optimum 2D key joint points of human body; And then pose estimation recovered by optimizing between the 2D projection of 3D human key joint points and 2D detection key joint points using QICA, which recovered the movement of human body perfectly, because this algorithm could acquire not only the global optimal solution, but the local optimal solution.

Advancing antimicrobial stewardship: Summary of the 2015 CIDSC Report.

PubMed

Khan, F; Arthur, J; Maidment, L; Blue, D

2016-11-03

Antimicrobial resistance (AMR) is recognized as an important global public health concern that has a cross-cutting impact on human health, animal health, food and agriculture and the environment. The Communicable and Infectious Disease Steering Committee (CIDSC) of the Pan-Canadian Public Health Network (PHN) created a Task Group on Antimicrobial Stewardship to look at this issue from a Canadian perspective. To summarize the key findings of the Task Group Report that identified core components of antimicrobial stewardship programs, best practices, key challenges, gaps and recommendations to advance stewardship across jurisdictions. Search strategies were developed to identify scientific literature, grey literature and relevant websites on antimicrobial stewardship. The information was reviewed and based on this evidence, expert opinion and consensus-building, the Task Group identified core components, best practices, key challenges and gaps and developed recommendations to advance stewardship in Canada. The four components of a promising antimicrobial stewardship initiative were: leadership, interventions, monitoring/evaluation and future research. Best practices include a multi-sectoral/multipronged approach involving a wide range of stakeholders at the national, provincial/territorial, local and health care organizational levels. Key challenges and gaps identified were: the success and sustainability of stewardship undertakings require appropriate and sustained resourcing and expertise; there is limited evidence about how to effectively implement treatment guidance; and there is a challenge in ensuring accessibility, standardization and consistency of use among professionals. ​: Recommendations to the CIDSC about how to advance stewardship across jurisdictions included the following: institute a national infrastructure; develop best practices to implement stewardship programs; develop education and promote awareness; establish consistent evidence-based guidance, resources, tools and training; mandate the incorporation of stewardship education; develop audit and feedback tools; establish benchmarks and performance targets for stewardship; and conduct timely evaluation of stewardship programs. Findings of this report will inform a more systematic approach to addressing antimicrobial stewardship Canada-wide.

Strengthening mental health system governance in six low- and middle-income countries in Africa and South Asia: challenges, needs and potential strategies.

PubMed

Petersen, Inge; Marais, Debbie; Abdulmalik, Jibril; Ahuja, Shalini; Alem, Atalay; Chisholm, Dan; Egbe, Catherine; Gureje, Oye; Hanlon, Charlotte; Lund, Crick; Shidhaye, Rahul; Jordans, Mark; Kigozi, Fred; Mugisha, James; Upadhaya, Nawaraj; Thornicroft, Graham

2017-06-01

Poor governance has been identified as a barrier to effective integration of mental health care in low- and middle-income countries. Governance includes providing the necessary policy and legislative framework to promote and protect the mental health of a population, as well as health system design and quality assurance to ensure optimal policy implementation. The aim of this study was to identify key governance challenges, needs and potential strategies that could facilitate adequate integration of mental health into primary health care settings in low- and middle-income countries. Key informant qualitative interviews were held with 141 participants across six countries participating in the Emerging mental health systems in low- and middle-income countries (Emerald) research program: Ethiopia, India, Nepal, Nigeria, South Africa, and Uganda. Data were transcribed (and where necessary, translated into English) and analysed thematically using framework analysis, first at the country level, then synthesized at a cross-country level. While all the countries fared well with respect to strategic vision in the form of the development of national mental health policies, key governance strategies identified to address challenges included: strengthening capacity of managers at sub-national levels to develop and implement integrated plans; strengthening key aspects of the essential health system building blocks to promote responsiveness, efficiency and effectiveness; developing workable mechanisms for inter-sectoral collaboration, as well as community and service user engagement; and developing innovative approaches to improving mental health literacy and stigma reduction. Inadequate financing emerged as the biggest challenge for good governance. In addition to the need for overall good governance of a health care system, this study identifies a number of specific strategies to improve governance for integrated mental health care in low- and middle-income countries. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Quantum key distribution with untrusted detectors

NASA Astrophysics Data System (ADS)

González, P.; Rebón, L.; Ferreira da Silva, T.; Figueroa, M.; Saavedra, C.; Curty, M.; Lima, G.; Xavier, G. B.; Nogueira, W. A. T.

2015-08-01

Side-channel attacks currently constitute the main challenge for quantum key distribution (QKD) to bridge theory with practice. So far two main approaches have been introduced to address this problem, (full) device-independent QKD and measurement-device-independent QKD. Here we present a third solution that might exceed the performance and practicality of the previous two in circumventing detector side-channel attacks, which arguably is the most hazardous part of QKD implementations. Our proposal has, however, one main requirement: the legitimate users of the system need to ensure that their labs do not leak any unwanted information to the outside. The security in the low-loss regime is guaranteed, while in the high-loss regime we already prove its robustness against some eavesdropping strategies.

Local Implementation of Alcohol Screening and Brief Intervention at Five Veterans Health Administration Primary Care Clinics: Perspectives of Clinical and Administrative Staff.

PubMed

Williams, Emily C; Achtmeyer, Carol E; Young, Jessica P; Rittmueller, Stacey E; Ludman, Evette J; Lapham, Gwen T; Lee, Amy K; Chavez, Laura J; Berger, Douglas; Bradley, Katharine A

2016-01-01

Population-based alcohol screening, followed by brief intervention for patients who screen positive for unhealthy alcohol use, is widely recommended for primary care settings and considered a top prevention priority, but is challenging to implement. However, new policy initiatives in the U.S., including the Affordable Care Act, may help launch widespread implementation. While the nationwide Veterans Health Administration (VA) has achieved high rates of documented alcohol screening and brief intervention, research has identified quality problems with both. We conducted a qualitative key informant study to describe local implementation of alcohol screening and brief intervention from the perspectives of frontline adopters in VA primary care in order to understand the process of implementation and factors underlying quality problems. A purposive snowball sampling method was used to identify and recruit key informants from 5 VA primary care clinics in the northwestern U.S. Key informants completed 20-30 minute semi-structured interviews, which were recorded, transcribed, and qualitatively analyzed using template analysis. Key informants (N=32) included: clinical staff (n=14), providers (n=14), and administrative informants (n=4) with varying participation in implementation of and responsibility for alcohol screening and brief intervention at the medical center. Ten inter-related themes (5 a priori and 5 emergent) were identified and grouped into 3 applicable domains of Greenhalgh's conceptual framework for dissemination of innovations, including values of adopters (theme 1), processes of implementation (themes 2 and 3), and post-implementation consequences in care processes (themes 4-10). While key informants believed alcohol use was relevant to health and important to address, the process of implementation (in which no training was provided and electronic clinical reminders "just showed up") did not address critical training and infrastructure needs. Key informants lacked understanding of the goals of screening and brief intervention, believed referral to specialty addictions treatment (as opposed to offering brief intervention) was the only option for following up on a positive screen, reported concern regarding limited availability of treatment resources, and lacked optimism regarding patients' interest in seeking help. Findings suggest that the local process of implementing alcohol screening and brief intervention may have inadequately addressed important adopter needs and thus may have ultimately undermined, instead of capitalized on, staff and providers' belief in the importance of addressing alcohol use as part of primary care. Additional implementation strategies, such as training or academic detailing, may address some unmet needs and help improve the quality of both screening and brief intervention. However, these strategies may be resource-intensive and insufficient for comprehensively addressing implementation barriers. Published by Elsevier Inc.

Requirements, techniques, and costs for contaminant removal from landfill gas.

PubMed

Kuhn, John N; Elwell, Anthony C; Elsayed, Nada H; Joseph, Babu

2017-05-01

Waste-to-energy projects are an increasingly prominent component of future energy portfolios. Landfill gas (LFG)-to-energy (LFGTE) projects are particularly important as they address greenhouse gas emissions. Contaminants in LFG may hamper these projects both from environmental and economic standpoints. The purpose of this review is to highlight key aspects (LFG composition ranges, LFG flowrates, and allowable tolerances for LFGTE technologies, performance and costs for contaminant removal by adsorption). Removal of key contaminants, H 2 S and siloxanes, by adsorption are surveyed in terms of adsorption capacities and regeneration abilities. Based on the open literature, costing analyses are tabulated and discussed. The findings indicate economics of contaminant removal depend heavily on the feed concentrations of contaminants, allowable tolerances for the LFGTE technology, and the current market for the product. Key trends, identification of challenges, and general purification guidelines for purifying LFG for energy projects are also discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Challenges for Policy Makers and Organizational Leaders: Addressing Trends in Mental Health Inequalities

PubMed Central

Rentmeester, Christy A.

2013-01-01

We typically think of acutely and chronically mentally ill patients as those who belong in psychiatric hospitals and the latter category of patients belonging in “regular” hospitals, but the intersection of physical and mental illness draws attention to important challenges for policy makers and organizational leaders. This article illuminates some broad trends in the health status of people with mental illnesses, canvasses important features of inequalities suffered by people with mental illnesses, and suggests strategies for systemic reform. Most reform recommendations I offer are in the area of healthcare organization leadership and management. Other key reforms will likely be legislative, regulatory, and insurance-related. Social and cultural reforms in organizational practices and structures will also be critical. PMID:24596844

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

Gu, Meng; He, Yang; Zheng, Jianming

Silicon (Si), associated with its natural abundance, low discharge voltage vs. Li/Li+, and extremely high theoretical discharge capacity (~ 4200 mAh g-1,), has been extensively explored as anode for lithium ion battery. One of the key challenges for using Si as anode is the large volume change upon lithiation and delithiation, which causes a fast capacity fading. Over the last few years, dramatic progress has been made for addressing this issue. In this paper, we summarize the progress towards tailoring of Si as anode for lithium ion battery. The paper is organized such that it covers the fundamentals, the promisemore » offered based on nanoscale designing, and the remaining challenges that need to be attacked to allow using of Si based materials as anode for battery.« less

Improving data collection processes for routine evaluation of treatment cost-effectiveness.

PubMed

Monto, Sari; Penttilä, Riku; Kärri, Timo; Puolakka, Kari; Valpas, Antti; Talonpoika, Anna-Maria

2016-04-01

The healthcare system in Finland has begun routine collection of health-related quality of life (HRQoL) information for patients in hospitals to support more systematic cost-effectiveness analysis (CEA). This article describes the systematic collection of HRQoL survey data, and addresses challenges in the implementation of patient surveys and acquisition of cost data in the case hospital. Challenges include problems with incomplete data and undefined management processes. In order to support CEA of hospital treatments, improvements are sought from the process management literature and in the observation of healthcare professionals. The article has been written from an information system and process management perspective, concluding that process ownership, automation of data collection and better staff training are keys to generating more reliable data.

Moving from full-time healing work to paid employment: challenges and celebrations.

PubMed

Bergmans, Yvonne; Carruthers, Anne; Ewanchuk, Elizabeth; James, Judy; Wren, Kate; Yager, Christina

2009-01-01

The experiences and barriers associated with the return to paid employment following healing from recurrent suicide attempts related to mental illness have not been addressed in the literature to date. This paper is a collaborative case study between graduates (experts by experience) and facilitators of a psychosocial/psychoeducational group for people with recurrent suicide attempts. The journeys taken by the experts by experience are explored through thematic narrative analysis. Issues of stigma, disclosure, accommodations, maintaining wellness and coming to re-define a sense of self were consistent themes found throughout all narratives. The paper identified key areas of challenge and celebration, suggesting the need for enhanced support from health care providers, workplace managers, supervisors and colleagues for successful transitions into the workplace.

Genome-wide analysis of alternative splicing during dendritic cell response to a bacterial challenge.

PubMed

Rodrigues, Raquel; Grosso, Ana Rita; Moita, Luís

2013-01-01

The immune system relies on the plasticity of its components to produce appropriate responses to frequent environmental challenges. Dendritic cells (DCs) are critical initiators of innate immunity and orchestrate the later and more specific adaptive immunity. The generation of diversity in transcriptional programs is central for effective immune responses. Alternative splicing is widely considered a key generator of transcriptional and proteomic complexity, but its role has been rarely addressed systematically in immune cells. Here we used splicing-sensitive arrays to assess genome-wide gene- and exon-level expression profiles in human DCs in response to a bacterial challenge. We find widespread alternative splicing events and splicing factor transcriptional signatures induced by an E. coli challenge to human DCs. Alternative splicing acts in concert with transcriptional modulation, but these two mechanisms of gene regulation affect primarily distinct functional gene groups. Alternative splicing is likely to have an important role in DC immunobiology because it affects genes known to be involved in DC development, endocytosis, antigen presentation and cell cycle arrest.

Issues and Challenges Facing Flexible Lithium-Ion Batteries for Practical Application.

PubMed

Cha, Hyungyeon; Kim, Junhyeok; Lee, Yoonji; Cho, Jaephil; Park, Minjoon

2017-12-27

With the advent of flexible electronics, lithium-ion batteries have become a key component of high performance energy storage systems. Thus, considerable effort is made to keep up with the development of flexible lithium-ion batteries. To date, many researchers have studied newly designed batteries with flexibility, however, there are several significant challenges that need to be overcome, such as degradation of electrodes under external load, poor battery performance, and complicated cell preparation procedures. In addition, an in-depth understanding of the current challenges for flexible batteries is rarely addressed in a systematical and practical way. Herein, recent progress and current issues of flexible lithium-ion batteries in terms of battery materials and cell designs are reviewed. A critical overview of important issues and challenges for the practical application of flexible lithium-ion batteries is also provided. Finally, the strategies are discussed to overcome current limitations of the practical use of flexible lithium-based batteries, providing a direction for future research. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Mental health and support among young key populations: an ecological approach to understanding and intervention

PubMed Central

Mutumba, Massy; Harper, Gary W

2015-01-01

Introduction The patterning of the HIV epidemic within young key populations (YKPs) highlights disproportionate burden by mental disorders in these populations. The mental wellbeing of YKPs is closely associated with biological predispositions and psychosocial factors related to YKPs’ sexual and gender identities and socio-economic status. The purpose of this paper is to highlight sources of risk and resilience, as well as identify treatment and supports for mental health disorders (MHDs) among YKPs. Discussion This paper utilizes Bronfenbrenner's Bioecological Systems Theory and the Social Stress Model to explore the risk and protective factors for MHDs across YKPs’ ecological systems, and identify current gaps in treatment and support for MHDs among these youth. We emphasize the fluidity and intersections across these categorizations which reinforce the vulnerability of these populations, the lack of concrete data to inform mental health interventions among YKPs, and the need to ground YKP interventions and programmes with human rights principles stipulated in the convention on the rights of a child. Conclusions We put forth recommendations for future research and strategies to address the mental wellbeing of YKPs, including the need for integrated interventions that address the multiplicity of risk factors inherent in the multiple group membership, rather than single-focus interventions whilst addressing the unique needs or challenges of YKPs. PMID:25724505

From Rosalind Franklin to Barack Obama: Data Sharing Challenges and Solutions in Genomics and Personalised Medicine

PubMed Central

Lawler, Mark; Maughan, Tim

2017-01-01

The collection, storage and use of genomic and clinical data from patients and healthy individuals is a key component of personalised medicine enterprises such as the Precision Medicine Initiative, the Cancer Moonshot and the 100,000 Genomes Project. In order to maximise the value of this data, it is important to embed a culture within the scientific, medical and patient communities that supports the appropriate sharing of genomic and clinical information. However, this aspiration raises a number of ethical, legal and regulatory challenges that need to be addressed. The Global Alliance for Genomics and Health, a worldwide coalition of researchers, healthcare professionals, patients and industry partners, is developing innovative solutions to support the responsible and effective sharing of genomic and clinical data. This article identifies the challenges that a data sharing culture poses and highlights a series of practical solutions that will benefit patients, researchers and society. PMID:28517986

From Rosalind Franklin to Barack Obama: Data Sharing Challenges and Solutions in Genomics and Personalised Medicine.

PubMed

Lawler, Mark; Maughan, Tim

2017-04-01

The collection, storage and use of genomic and clinical data from patients and healthy individuals is a key component of personalised medicine enterprises such as the Precision Medicine Initiative, the Cancer Moonshot and the 100,000 Genomes Project. In order to maximise the value of this data, it is important to embed a culture within the scientific, medical and patient communities that supports the appropriate sharing of genomic and clinical information. However, this aspiration raises a number of ethical, legal and regulatory challenges that need to be addressed. The Global Alliance for Genomics and Health, a worldwide coalition of researchers, healthcare professionals, patients and industry partners, is developing innovative solutions to support the responsible and effective sharing of genomic and clinical data. This article identifies the challenges that a data sharing culture poses and highlights a series of practical solutions that will benefit patients, researchers and society.

Optimizing learning in healthcare: how Island Health is evolving to learn at the speed of change.

PubMed

Gottfredson, Conrad; Stroud, Carol; Jackson, Mary; Stevenson, R Lynn; Archer, Jana

2014-01-01

Healthcare organizations are challenged with constrained resources and increasing service demands by an aging population with complex care needs. Exponential growth in competency requirements also challenges staff's ability to provide quality patient care. How can a healthcare organization support its staff to learn "at or above the speed of change" while continuing to provide the quality patient care? Island Health is addressing this challenge by transforming its traditional education model into an innovative, evidence-based learning and performance support approach. Implementation of the methodology is yielding several lessons learned, both for the internal Learning and Performance Support team, and for what it takes to bring a new way of doing business into an organization. A key result is that this approach is enabling the organization to be more responsive in helping staff gain and maintain competencies.

The psychosocial challenges of solid organ transplant recipients during childhood.

PubMed

Annunziato, Rachel A; Jerson, Bradley; Seidel, Jordan; Glenwick, David S

2012-11-01

A large proportion of pediatric solid organ transplant recipients are young children, yet dedicated studies on the challenges faced by these patients are sparse. The present article aims to provide a summary of key considerations for pediatric solid organ transplant teams, describing what challenges are more likely for younger patients and how they might identify and address these circumstances. Our findings suggest that the mental health of patients and caregivers, issues at school, neurocognitive difficulties, and self-management are areas of particular relevance for children. We offer several recommendations that stem from these identified areas of concern. Dedicated focus on the well-being of younger patients could in the long-term stave off adverse events that are often associated with adolescence. In the short-term, certainly intervening in any of these domains could lead to improved quality of life during childhood. © 2012 John Wiley & Sons A/S.

Achieving Transformational Materials Performance in a New Era of Science

ScienceCinema

Sarrao, John

2017-12-22

The inability of current materials to meet performance requirements is a key stumbling block for addressing grand challenges in energy and national security. Fortunately, materials research is on the brink of a new era - a transition from observation and validation of materials properties to prediction and control of materials performance. In this talk, I describe the nature of the current challenge, the prospects for success, and a specific facility concept, MaRIE, that will provide the needed capabilities to meet these challenges, especially for materials in extreme environments. MaRIE, for Matter-Radiation Interactions in Extremes, is Los Alamos' concept to realize this vision of 21st century materials research. This vision will be realized through enhancements to the current LANSCE accelerator, development of a fourth-generation x-ray light source co-located with the proton accelerator, and a comprehensive synthesis and characterization facility focused on controlling complex materials and the defect/structure link to materials performance.

Herbal medicine research and global health: an ethical analysis.

PubMed

Tilburt, Jon C; Kaptchuk, Ted J

2008-08-01

Governments, international agencies and corporations are increasingly investing in traditional herbal medicine research. Yet little literature addresses ethical challenges in this research. In this paper, we apply concepts in a comprehensive ethical framework for clinical research to international traditional herbal medicine research. We examine in detail three key, underappreciated dimensions of the ethical framework in which particularly difficult questions arise for international herbal medicine research: social value, scientific validity and favourable risk-benefit ratio. Significant challenges exist in determining shared concepts of social value, scientific validity and favourable risk-benefit ratio across international research collaborations. However, we argue that collaborative partnership, including democratic deliberation, offers the context and process by which many of the ethical challenges in international herbal medicine research can, and should be, resolved. By "cross-training" investigators, and investing in safety-monitoring infrastructure, the issues identified by this comprehensive framework can promote ethically sound international herbal medicine research that contributes to global health.

Lessons Learned from the Evolution of an Academic Community Partnership: Creating "Patient Voices".

PubMed

Chambers, Meghan K; Ireland, Anna; D'Aniello, Rona; Lipnicki, Stephanie; Glick, Myron; Tumiel-Berhalter, Laurene

2015-01-01

Long-term partners received federal funding to develop the Patient Voices Network, a partnership of safety-net family practices and their patients to develop health improvement strategies. The scope and structure of the newly funded grant presented unexpected challenges that threatened the future of the partnership.Purpose of Article: To present a case study of the evolution of an existing partnership and offer lessons learned along with recommendations for future partnerships. Federal funding formalized the partnership in a way that required looking at it through a new lens. Leadership, programmatic, personnel, and financial challenges emerged. Short-term and long-term strategies were applied to address evolving needs. This case study demonstrates how federal funding raises the bar for academic-community partnerships and how challenges can be worked through, particularly if the partnership embraces the key principles of community-based participatory research (CBPR). Recommendations have been applied successfully to future initiatives.

Technology Challenges for Deep-Throttle Cryogenic Engines for Space Exploration

NASA Technical Reports Server (NTRS)

Brown, Kendall K.; Nelson, Karl W.

2005-01-01

Historically, cryogenic rocket engines have not been used for in-space applications due to their additional complexity, the mission need for high reliability, and the challenges of propellant boil-off. While the mission and vehicle architectures are not yet defined for the lunar and Martian robotic and human exploration objectives, cryogenic rocket engines offer the potential for higher performance and greater architecture/mission flexibility. In-situ cryogenic propellant production could enable a more robust exploration program by significantly reducing the propellant mass delivered to low earth orbit, thus warranting the evaluation of cryogenic rocket engines versus the hypergolic bi-propellant engines used in the Apollo program. A multi-use engine. one which can provide the functionality that separate engines provided in the Apollo mission architecture, is desirable for lunar and Mars exploration missions because it increases overall architecture effectiveness through commonality and modularity. The engine requirement derivation process must address each unique mission application and each unique phase within each mission. The resulting requirements, such as thrust level, performance, packaging, bum duration, number of operations; required impulses for each trajectory phase; operation after extended space or surface exposure; availability for inspection and maintenance; throttle range for planetary descent, ascent, acceleration limits and many more must be addressed. Within engine system studies, the system and component technology, capability, and risks must be evaluated and a balance between the appropriate amount of technology-push and technology-pull must be addressed. This paper will summarize many of the key technology challenges associated with using high-performance cryogenic liquid propellant rocket engine systems and components in the exploration program architectures. The paper is divided into two areas. The first area describes how the mission requirements affect the engine system requirements and create system level technology challenges. An engine system architecture for multiple applications or a family of engines based upon a set of core technologies, design, and fabrication approaches may reduce overall programmatic cost and risk. The engine system discussion will also address the characterization of engine cycle figures of merit, configurations, and design approaches for some in-space vehicle alternatives under consideration. The second area evaluates the component-level technology challenges induced from the system requirements. Component technology issues are discussed addressing injector, thrust chamber, ignition system, turbopump assembly, and valve design for the challenging requirements of high reliability, robustness, fault tolerance, deep throttling, reasonable performance (with respect to weight and specific impulse).

Technology Challenges for Deep-Throttle Cryogenic Engines for Space Exploration

NASA Astrophysics Data System (ADS)

Brown, Kendall K.; Nelson, Karl W.

2005-02-01

Historically, cryogenic rocket engines have not been used for in-space applications due to their additional complexity, the mission need for high reliability, and the challenges of propellant boil-off. While the mission and vehicle architectures are not yet defined for the lunar and Martian robotic and human exploration objectives, cryogenic rocket engines offer the potential for higher performance and greater architecture/mission flexibility. In-situ cryogenic propellant production could enable a more robust exploration program by significantly reducing the propellant mass delivered to low earth orbit, thus warranting the evaluation of cryogenic rocket engines versus the hypergolic bipropellant engines used in the Apollo program. A multi-use engine, one which can provide the functionality that separate engines provided in the Apollo mission architecture, is desirable for lunar and Mars exploration missions because it increases overall architecture effectiveness through commonality and modularity. The engine requirement derivation process must address each unique mission application and each unique phase within each mission. The resulting requirements, such as thrust level, performance, packaging, burn duration, number of operations; required impulses for each trajectory phase; operation after extended space or surface exposure; availability for inspection and maintenance; throttle range for planetary descent, ascent, acceleration limits and many more must be addressed. Within engine system studies, the system and component technology, capability, and risks must be evaluated and a balance between the appropriate amount of technology-push and technology-pull must be addressed. This paper will summarize many of the key technology challenges associated with using high-performance cryogenic liquid propellant rocket engine systems and components in the exploration program architectures. The paper is divided into two areas. The first area describes how the mission requirements affect the engine system requirements and create system level technology challenges. An engine system architecture for multiple applications or a family of engines based upon a set of core technologies, design, and fabrication approaches may reduce overall programmatic cost and risk. The engine system discussion will also address the characterization of engine cycle figures of merit, configurations, and design approaches for some in-space vehicle alternatives under consideration. The second area evaluates the component-level technology challenges induced from the system requirements. Component technology issues are discussed addressing injector, thrust chamber, ignition system, turbopump assembly, and valve design for the challenging requirements of high reliability, robustness, fault tolerance, deep throttling, reasonable performance (with respect to weight and specific impulse).

Dis-integration of communication in healthcare education: Workplace learning challenges and opportunities.

PubMed

Rosenbaum, Marcy E

2017-11-01

The purpose of this paper, based on a 2016 Heidelberg International Conference on Communication in Healthcare (ICCH) plenary presentation, is to examine a key problem in communication skills training for health professional learners. Studies have pointed to a decline in medical students' communication skills and attitudes as they proceed through their education, particularly during their clinical workplace training experiences. This paper explores some of the key factors in this disintegration, drawing on selected literature and highlighting some curriculum efforts and research conducted at the University of Iowa Carver College of Medicine as a case study of these issues. Five key factors contributing to the disintegration of communication skills and attitudes are presented including: 1) lack of formal communication skills training during clinical clerkships; 2) informal workplace teaching failing to explicitly address learner clinical communication skills; 3) emphasizing content over process in relation to clinician-patient interactions; 4) the relationship between ideal communication models and the realities of clinical practice; and 5) clinical teachers' lack of knowledge and skills to effectively teach about communication in the clinical workplace. Within this discussion, potential practical responses by individual clinical teachers and broader curricular and faculty development efforts to address each of these factors are presented. Copyright © 2017 Elsevier B.V. All rights reserved.

SERVIR HIMALYA: Enabling Improved Environmental Management and Livelihoods in the HKH

NASA Astrophysics Data System (ADS)

Bajracharya, B.; Murthy, M. S. R.; Shrestha, B.

2014-11-01

With an overarching goal to improve environmental management and resilience to climate change, SERVIR-Himalaya is established as a collaborative initiative of USAID, NASA and ICIMOD. The SERVIR-Himalaya has been the key instrument to provide integrated and innovative geospatial solutions for generation and dissemination of information and knowledge resources on mountain environments. The SERVIR applications, products and services are viewed as essential cross-cutting elements to achieve the greater impacts on addressing Himalayan livelihood challenges. The broad thematic areas which are also subset of the societal benefit areas of Global Earth Observation (GEO), namely - agriculture and food security, ecosystems and sustainable landscapes, and disaster risk management are addressed. On the cross-cutting theme, SERVIR Himalaya is also focusing on developing regional level applications providing key information systems and services on multiple themes of regional significance. The regional level science applications include use of MODIS satellite information products and services for environmental and natural resources monitoring in the Himalayan region. Regional and national training and workshops, on-the-job training, internships and exchange programs and technical backstopping are key capacity building components to enhance the capacity of partners from national institutions in the regional member countries. These efforts are also seen as receiving feedback on the science applications, identify additional needs, and increase synergy by exploring opportunities for collaboration.

Considerations on Caring for Caregivers in an Aging Society.

PubMed

Sinha, Dr Samir K

2015-01-01

While it is anticipated that healthcare systems around the world will continue to rely heavily on family members and friends to provide unpaid care especially to meet the needs of our aging population, current assumptions and issues around caregivers need to be challenged and addressed if we are to expect their future support. This paper builds on Williams et al's assertion that many current assumptions and issues around caregivers need to be challenged and addressed if we are to expect their future support. Indeed, with the pool of available caregivers expected to actually shrink in the future, this paper therefore examines four key policy issues in greater depth that we can address to enable individuals to age in place and others to maintain and take on caregiving roles. Through the establishment of policies that support robust and longterm capacity planning; make clear what care recipients and caregivers can expect to receive in the form of government supports; appreciate the increasing diversity that is occurring among those taking on caregiving roles and those requiring care; and recognize the need to invest in strategies that combat social isolation, we may not only improve our future health and well-being but ensure we are also enabled to care for ourselves as we age.

Opportunities and Challenges in Establishing a Cohort Study: An Example From Cleft Lip/Palate Research in the United Kingdom.

PubMed

Stock, Nicola Marie; Humphries, Kerry; Pourcain, Beate St; Bailey, Maggie; Persson, Martin; Ho, Karen M; Ring, Susan; Marsh, Cathy; Albery, Liz; Rumsey, Nichola; Sandy, Jonathan

2016-05-01

Cleft lip and/or palate (CL/P) is one of the most common birth conditions in the world, but little is known about its causes. Professional opinion remains divided as to which treatments may be the most beneficial for patients with CL/P, and the factors that contribute to psychological adjustment are poorly understood. The use of different methodological approaches and tools plays a key role in hampering efforts to address discrepancies within the evidence base. A new UK-wide program of research, The Cleft Collective, was established to combat many of these methodological challenges and to address some of the key research questions important to all CL/P stakeholders. To describe the establishment of CL/P cohort studies in the United Kingdom and to consider the many opportunities this resource will generate. To date, protocols have been developed and implemented within most UK cleft teams. Biological samples, environmental information, and data pertaining to parental psychological well-being and child development are being collected successfully. Recruitment is currently on track to meet the ambitious target of approximately 9800 individuals from just more than 3000 families. The Cleft Collective cohort studies represent a significant step forward for research in the field of CL/P. The data collected will form a comprehensive resource of information about individuals with CL/P and their families. This resource will provide the basis for many future projects and collaborations, both in the United Kingdom and around the world.

RF Technologies for Advancing Space Communication Infrastructure

NASA Technical Reports Server (NTRS)

Romanofsky, Robert R.; Bibyk, Irene K.; Wintucky, Edwin G.

2006-01-01

This paper will address key technologies under development at the NASA Glenn Research Center designed to provide architecture-level impacts. Specifically, we will describe deployable antennas, a new type of phased array antenna and novel power amplifiers. The evaluation of architectural influence can be conducted from two perspectives where said architecture can be analyzed from either the top-down to determine the areas where technology improvements will be most beneficial or from the bottom-up where each technology s performance advancement can affect the overall architecture s performance. This paper will take the latter approach with focus on some technology improvement challenges and address architecture impacts. For example, using data rate as a performance metric, future exploration scenarios are expected to demand data rates possibly exceeding 1 Gbps. To support these advancements in a Mars scenario, as an example, Ka-band and antenna aperture sizes on the order of 10 meters will be required from Mars areostationary platforms. Key technical challenges for a large deployable antenna include maximizing the ratio of deployed-to-packaged volume, minimizing aerial density, maintaining RMS surface accuracy to within 1/20 of a wavelength or better, and developing reflector rigidization techniques. Moreover, the high frequencies and large apertures manifest a new problem for microwave engineers that are familiar to optical communications specialists: pointing. The fine beam widths and long ranges dictate the need for electronic or mechanical feed articulation to compensate for spacecraft attitude control limitations.

The sustainability of community-based therapeutic care (CTC) in nonemergency contexts.

PubMed

Gatchell, Valerie; Forsythe, Vivienne; Thomas, Paul-Rees

2006-09-01

Concern Worldwide is an international humanitarian nongovernmental organization that piloted and is now implementing and researching community-based therapeutic care (CTC) approaches to managing acute malnutrition. Experience in several countries suggests that there are key issues to be addressed at the international, national, regional, and community levels for community-based treatment of acute malnutrition to be sustainable. At the national level there must be demonstrated commitment to a clear health policy and strategy to address outpatient treatment of acute malnutrition. In addition, locally available, affordable ready-to-use therapeutic food (RUTF) must be accessible. At the regional level a functional health system and appropriate capacity for service provision are required. Integration of outpatient services should be viewed as a process with different levels of inputs at different phases depending on the capacity of the Ministry of Health (MOH). There is a need for indicators to facilitate scale-up and scale-back for future emergency response. Strong community participation and active screening linked to health service provision at the local level is paramount for sustainable assessment and referral of severe acute malnutrition. FUTURE CHALLENGES TO SUSTAIN COMMUNITY-BASED THERAPEUTIC CARE. Key challenges to the sustainable treatment of severe acute malnutrition include the development of locally produced RUTF, development of international standards on local RUTF production, the integration of outpatient treatment protocols into international health and nutrition guidelines, and further operational research into integration of community-based treatment of severe acute malnutrition into health systems in nonemergency contexts.

Leveraging human decision making through the optimal management of centralized resources

NASA Astrophysics Data System (ADS)

Hyden, Paul; McGrath, Richard G.

2016-05-01

Combining results from mixed integer optimization, stochastic modeling and queuing theory, we will advance the interdisciplinary problem of efficiently and effectively allocating centrally managed resources. Academia currently fails to address this, as the esoteric demands of each of these large research areas limits work across traditional boundaries. The commercial space does not currently address these challenges due to the absence of a profit metric. By constructing algorithms that explicitly use inputs across boundaries, we are able to incorporate the advantages of using human decision makers. Key improvements in the underlying algorithms are made possible by aligning decision maker goals with the feedback loops introduced between the core optimization step and the modeling of the overall stochastic process of supply and demand. A key observation is that human decision-makers must be explicitly included in the analysis for these approaches to be ultimately successful. Transformative access gives warfighters and mission owners greater understanding of global needs and allows for relationships to guide optimal resource allocation decisions. Mastery of demand processes and optimization bottlenecks reveals long term maximum marginal utility gaps in capabilities.

Improving Control of Tuberculosis in Low-Burden Countries: Insights from Mathematical Modeling

PubMed Central

White, Peter J.; Abubakar, Ibrahim

2016-01-01

Tuberculosis control and elimination remains a challenge for public health even in low-burden countries. New technology and novel approaches to case-finding, diagnosis, and treatment are causes for optimism but they need to be used cost-effectively. This in turn requires improved understanding of the epidemiology of TB and analysis of the effectiveness and cost-effectiveness of different interventions. We describe the contribution that mathematical modeling can make to understanding epidemiology and control of TB in different groups, guiding improved approaches to public health interventions. We emphasize that modeling is not a substitute for collecting data but rather is complementary to empirical research, helping determine what are the key questions to address to maximize the public-health impact of research, helping to plan studies, and making maximal use of available data, particularly from surveillance, and observational studies. We provide examples of how modeling and related empirical research inform policy and discuss how a combination of these approaches can be used to address current questions of key importance, including use of whole-genome sequencing, screening and treatment for latent infection, and combating drug resistance. PMID:27199896

Statistical mentoring at early training and career stages

DOE PAGES

Anderson-Cook, Christine M.; Hamada, Michael S.; Moore, Leslie M.; ...

2016-06-27

At Los Alamos National Laboratory (LANL), statistical scientists develop solutions for a variety of national security challenges through scientific excellence, typically as members of interdisciplinary teams. At LANL, mentoring is actively encouraged and practiced to develop statistical skills and positive career-building behaviors. Mentoring activities targeted at different career phases from student to junior staff are an important catalyst for both short and long term career development. This article discusses mentoring strategies for undergraduate and graduate students through internships as well as for postdoctoral research associates and junior staff. Topics addressed include project selection, progress, and outcome; intellectual and social activitiesmore » that complement the student internship experience; key skills/knowledge not typically obtained in academic training; and the impact of such internships on students’ careers. Experiences and strategies from a number of successful mentorships are presented. Feedback from former mentees obtained via a questionnaire is incorporated. As a result, these responses address some of the benefits the respondents received from mentoring, helpful contributions and advice from their mentors, key skills learned, and how mentoring impacted their later careers.« less

Statistical mentoring at early training and career stages

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

Anderson-Cook, Christine M.; Hamada, Michael S.; Moore, Leslie M.

At Los Alamos National Laboratory (LANL), statistical scientists develop solutions for a variety of national security challenges through scientific excellence, typically as members of interdisciplinary teams. At LANL, mentoring is actively encouraged and practiced to develop statistical skills and positive career-building behaviors. Mentoring activities targeted at different career phases from student to junior staff are an important catalyst for both short and long term career development. This article discusses mentoring strategies for undergraduate and graduate students through internships as well as for postdoctoral research associates and junior staff. Topics addressed include project selection, progress, and outcome; intellectual and social activitiesmore » that complement the student internship experience; key skills/knowledge not typically obtained in academic training; and the impact of such internships on students’ careers. Experiences and strategies from a number of successful mentorships are presented. Feedback from former mentees obtained via a questionnaire is incorporated. As a result, these responses address some of the benefits the respondents received from mentoring, helpful contributions and advice from their mentors, key skills learned, and how mentoring impacted their later careers.« less

The Potential of Knowing More: A Review of Data-Driven Urban Water Management.

PubMed

Eggimann, Sven; Mutzner, Lena; Wani, Omar; Schneider, Mariane Yvonne; Spuhler, Dorothee; Moy de Vitry, Matthew; Beutler, Philipp; Maurer, Max

2017-03-07

The promise of collecting and utilizing large amounts of data has never been greater in the history of urban water management (UWM). This paper reviews several data-driven approaches which play a key role in bringing forward a sea change. It critically investigates whether data-driven UWM offers a promising foundation for addressing current challenges and supporting fundamental changes in UWM. We discuss the examples of better rain-data management, urban pluvial flood-risk management and forecasting, drinking water and sewer network operation and management, integrated design and management, increasing water productivity, wastewater-based epidemiology and on-site water and wastewater treatment. The accumulated evidence from literature points toward a future UWM that offers significant potential benefits thanks to increased collection and utilization of data. The findings show that data-driven UWM allows us to develop and apply novel methods, to optimize the efficiency of the current network-based approach, and to extend functionality of today's systems. However, generic challenges related to data-driven approaches (e.g., data processing, data availability, data quality, data costs) and the specific challenges of data-driven UWM need to be addressed, namely data access and ownership, current engineering practices and the difficulty of assessing the cost benefits of data-driven UWM.

Global Software Development with Cloud Platforms

NASA Astrophysics Data System (ADS)

Yara, Pavan; Ramachandran, Ramaseshan; Balasubramanian, Gayathri; Muthuswamy, Karthik; Chandrasekar, Divya

Offshore and outsourced distributed software development models and processes are facing challenges, previously unknown, with respect to computing capacity, bandwidth, storage, security, complexity, reliability, and business uncertainty. Clouds promise to address these challenges by adopting recent advances in virtualization, parallel and distributed systems, utility computing, and software services. In this paper, we envision a cloud-based platform that addresses some of these core problems. We outline a generic cloud architecture, its design and our first implementation results for three cloud forms - a compute cloud, a storage cloud and a cloud-based software service- in the context of global distributed software development (GSD). Our ”compute cloud” provides computational services such as continuous code integration and a compile server farm, ”storage cloud” offers storage (block or file-based) services with an on-line virtual storage service, whereas the on-line virtual labs represent a useful cloud service. We note some of the use cases for clouds in GSD, the lessons learned with our prototypes and identify challenges that must be conquered before realizing the full business benefits. We believe that in the future, software practitioners will focus more on these cloud computing platforms and see clouds as a means to supporting a ecosystem of clients, developers and other key stakeholders.

Challenges in adapting existing clinical natural language processing systems to multiple, diverse health care settings.

PubMed

Carrell, David S; Schoen, Robert E; Leffler, Daniel A; Morris, Michele; Rose, Sherri; Baer, Andrew; Crockett, Seth D; Gourevitch, Rebecca A; Dean, Katie M; Mehrotra, Ateev

2017-09-01

Widespread application of clinical natural language processing (NLP) systems requires taking existing NLP systems and adapting them to diverse and heterogeneous settings. We describe the challenges faced and lessons learned in adapting an existing NLP system for measuring colonoscopy quality. Colonoscopy and pathology reports from 4 settings during 2013-2015, varying by geographic location, practice type, compensation structure, and electronic health record. Though successful, adaptation required considerably more time and effort than anticipated. Typical NLP challenges in assembling corpora, diverse report structures, and idiosyncratic linguistic content were greatly magnified. Strategies for addressing adaptation challenges include assessing site-specific diversity, setting realistic timelines, leveraging local electronic health record expertise, and undertaking extensive iterative development. More research is needed on how to make it easier to adapt NLP systems to new clinical settings. A key challenge in widespread application of NLP is adapting existing systems to new clinical settings. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Paleoclimate networks: a concept meeting central challenges in the reconstruction of paleoclimate dynamics

NASA Astrophysics Data System (ADS)

Rehfeld, Kira; Goswami, Bedartha; Marwan, Norbert; Breitenbach, Sebastian; Kurths, Jürgen

2013-04-01

Statistical analysis of dependencies amongst paleoclimate data helps to infer on the climatic processes they reflect. Three key challenges have to be addressed, however: the datasets are heterogeneous in time (i) and space (ii), and furthermore time itself is a variable that needs to be reconstructed, which (iii) introduces additional uncertainties. To address these issues in a flexible way we developed the paleoclimate network framework, inspired by the increasing application of complex networks in climate research. Nodes in the paleoclimate network represent a paleoclimate archive, and an associated time series. Links between these nodes are assigned, if these time series are significantly similar. Therefore, the base of the paleoclimate network is formed by linear and nonlinear estimators for Pearson correlation, mutual information and event synchronization, which quantify similarity from irregularly sampled time series. Age uncertainties are propagated into the final network analysis using time series ensembles which reflect the uncertainty. We discuss how spatial heterogeneity influences the results obtained from network measures, and demonstrate the power of the approach by inferring teleconnection variability of the Asian summer monsoon for the past 1000 years.

Challenges in acute heart failure clinical management: optimizing care despite incomplete evidence and imperfect drugs.

PubMed

Teichman, Sam L; Maisel, Alan S; Storrow, Alan B

2015-03-01

Acute heart failure is a common condition associated with considerable morbidity, mortality, and cost. However, evidence-based data on treating heart failure in the acute setting are limited, and current individual treatment options have variable efficacy. The healthcare team must often individualize patient care in ways that may extend beyond available clinical guidelines. In this review, we address the question, "How do you do the best you can clinically with incomplete evidence and imperfect drugs?" Expert opinion is provided to supplement guideline-based recommendations and help address the typical challenges that are involved in the management of patients with acute heart failure. Specifically, we discuss 4 key areas that are important in the continuum of patient care: differential diagnosis and risk stratification; choice and implementation of initial therapy; assessment of the adequacy of therapy during hospitalization or observation; and considerations for discharge/transition of care. A case study is presented to highlight the decision-making process throughout each of these areas. Evidence is accumulating that should help guide patients and healthcare providers on a path to better quality of care.

Reshaping the Food System for Ecological Public Health

PubMed Central

Lang, Tim

2009-01-01

Twenty-first-century food policy will have to address a new set of fundamentals. Some are relatively new such as climate change and peak oil, and some merely new versions of very old ones such as water, population, land pressures, labor, and urbanisation. Policy-makers now need radically to alter the policy mix inherited from the last major policy reconfiguration in the mid-20th century. Then the demon was supply, and poor health was mainly due to underconsumption and poverty. The policy solution was to raise output and reduce prices. Today the challenge is more complex, a coexistence of over-, under-, and malconsumption alongside continuing gross inequalities within and between nations. The article proposes that a new paradigm is emerging, termed here ecological public health, which sees human and planetary health as linked and food as a key connection point. The article outlines aspects of what this entails, stressing the need for food policy to address not just supply but governance and consumer cultural challenges too. Seven priorities are proposed for policy-makers. PMID:23144673

Control group design: enhancing rigor in research of mind-body therapies for depression.

PubMed

Kinser, Patricia Anne; Robins, Jo Lynne

2013-01-01

Although a growing body of research suggests that mind-body therapies may be appropriate to integrate into the treatment of depression, studies consistently lack methodological sophistication particularly in the area of control groups. In order to better understand the relationship between control group selection and methodological rigor, we provide a brief review of the literature on control group design in yoga and tai chi studies for depression, and we discuss challenges we have faced in the design of control groups for our recent clinical trials of these mind-body complementary therapies for women with depression. To address the multiple challenges of research about mind-body therapies, we suggest that researchers should consider 4 key questions: whether the study design matches the research question; whether the control group addresses performance, expectation, and detection bias; whether the control group is ethical, feasible, and attractive; and whether the control group is designed to adequately control for nonspecific intervention effects. Based on these questions, we provide specific recommendations about control group design with the goal of minimizing bias and maximizing validity in future research.

Control Group Design: Enhancing Rigor in Research of Mind-Body Therapies for Depression

PubMed Central

Kinser, Patricia Anne; Robins, Jo Lynne

2013-01-01

Although a growing body of research suggests that mind-body therapies may be appropriate to integrate into the treatment of depression, studies consistently lack methodological sophistication particularly in the area of control groups. In order to better understand the relationship between control group selection and methodological rigor, we provide a brief review of the literature on control group design in yoga and tai chi studies for depression, and we discuss challenges we have faced in the design of control groups for our recent clinical trials of these mind-body complementary therapies for women with depression. To address the multiple challenges of research about mind-body therapies, we suggest that researchers should consider 4 key questions: whether the study design matches the research question; whether the control group addresses performance, expectation, and detection bias; whether the control group is ethical, feasible, and attractive; and whether the control group is designed to adequately control for nonspecific intervention effects. Based on these questions, we provide specific recommendations about control group design with the goal of minimizing bias and maximizing validity in future research. PMID:23662111

Statistical tools for analysis and modeling of cosmic populations and astronomical time series: CUDAHM and TSE

NASA Astrophysics Data System (ADS)

Loredo, Thomas; Budavari, Tamas; Scargle, Jeffrey D.

2018-01-01

This presentation provides an overview of open-source software packages addressing two challenging classes of astrostatistics problems. (1) CUDAHM is a C++ framework for hierarchical Bayesian modeling of cosmic populations, leveraging graphics processing units (GPUs) to enable applying this computationally challenging paradigm to large datasets. CUDAHM is motivated by measurement error problems in astronomy, where density estimation and linear and nonlinear regression must be addressed for populations of thousands to millions of objects whose features are measured with possibly complex uncertainties, potentially including selection effects. An example calculation demonstrates accurate GPU-accelerated luminosity function estimation for simulated populations of $10^6$ objects in about two hours using a single NVIDIA Tesla K40c GPU. (2) Time Series Explorer (TSE) is a collection of software in Python and MATLAB for exploratory analysis and statistical modeling of astronomical time series. It comprises a library of stand-alone functions and classes, as well as an application environment for interactive exploration of times series data. The presentation will summarize key capabilities of this emerging project, including new algorithms for analysis of irregularly-sampled time series.

The World Report on Disability and its implications for rehabilitation psychology.

PubMed

MacLachlan, Malcolm; Mannan, Hasheem

2014-05-01

This study reviewed the World Report on Disability (World Health Organization & World Bank, 2011) and explored its implications for rehabilitation psychology. Key findings and recommendations were identified within the World Report and issues that are salient to the profession, practice and research within rehabilitation psychology were highlighted. The World Report has a particular emphasis on disability in low-income countries, where the majority of people with disabilities live. Despite the origins and development of rehabilitation psychology within high-income countries, the profession has much to contribute to addressing many of the challenges identified in the World Report. Specific targeted contributions might include addressing the human resources for health crisis in rehabilitation; developing prosocial and community-based interventions and programs; helping to identify and overcome difficulties to accessing health care; refining the measurement and classification of disability; and strengthening research, policy and advocacy for and with people with disabilities. The World Report on Disability presents exciting and challenging opportunities that exist for rehabilitation psychology practitioners and researchers, and for the profession itself. (c) 2014 APA, all rights reserved.

Health worker perceptions of integrating mobile phones into community case management of malaria in Saraya, Senegal.

PubMed

Blanas, Demetri A; Ndiaye, Youssoupha; MacFarlane, Matthew; Manga, Isaac; Siddiqui, Ammar; Velez, Olivia; Kanter, Andrew S; Nichols, Kim; Hennig, Nils

2015-05-01

Although community case management of malaria increases access to life-saving care in isolated settings, it contends with many logistical challenges. Mobile phone health information technology may present an opportunity to address a number of these barriers. Using the wireless adaptation of the technology acceptance model, this study assessed availability, ease of use, usefulness, and job relevance of mobile phones by health workers in Saraya, Senegal. This study conducted seven key informant interviews with government health workers, and three focus groups and 76 surveys with lay health workers. Principal findings included that mobile phones are already widely available and used, and that participants valued using phones to address training, stock management, programme reporting, and transportation challenges. By documenting widespread use of mobile phones and health worker perceptions of their most useful applications, this paper provides a framework for their integration into the community case management of malaria programme in Saraya, Senegal. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Nano/microvehicles for efficient delivery and (bio)sensing at the cellular level

PubMed Central

Esteban-Fernández de Ávila, B.; Yáñez-Sedeño, P.

2017-01-01

A perspective review of recent strategies involving the use of nano/microvehicles to address the key challenges associated with delivery and (bio)sensing at the cellular level is presented. The main types and characteristics of the different nano/microvehicles used for these cellular applications are discussed, including fabrication pathways, propulsion (catalytic, magnetic, acoustic or biological) and navigation strategies, and relevant parameters affecting their propulsion performance and sensing and delivery capabilities. Thereafter, selected applications are critically discussed. An emphasis is made on enhancing the extra- and intra-cellular biosensing capabilities, fast cell internalization, rapid inter- or intra-cellular movement, efficient payload delivery and targeted on-demand controlled release in order to greatly improve the monitoring and modulation of cellular processes. A critical discussion of selected breakthrough applications illustrates how these smart multifunctional nano/microdevices operate as nano/microcarriers and sensors at the intra- and extra-cellular levels. These advances allow both the real-time biosensing of relevant targets and processes even at a single cell level, and the delivery of different cargoes (drugs, functional proteins, oligonucleotides and cells) for therapeutics, gene silencing/transfection and assisted fertilization, while overcoming challenges faced by current affinity biosensors and delivery vehicles. Key challenges for the future and the envisioned opportunities and future perspectives of this remarkably exciting field are discussed. PMID:29147499

Standoff Human Identification Using Body Shape

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

Matzner, Shari; Heredia-Langner, Alejandro; Amidan, Brett G.

2015-09-01

The ability to identify individuals is a key component of maintaining safety and security in public spaces and around critical infrastructure. Monitoring an open space is challenging because individuals must be identified and re-identified from a standoff distance nonintrusively, making methods like fingerprinting and even facial recognition impractical. We propose using body shape features as a means for identification from standoff sensing, either complementing other identifiers or as an alternative. An important challenge in monitoring open spaces is reconstructing identifying features when only a partial observation is available, because of the view-angle limitations and occlusion or subject pose changes. Tomore » address this challenge, we investigated the minimum number of features required for a high probability of correct identification, and we developed models for predicting a key body feature—height—from a limited set of observed features. We found that any set of nine randomly selected body measurements was sufficient to correctly identify an individual in a dataset of 4426 subjects. For predicting height, anthropometric measures were investigated for correlation with height. Their correlation coefficients and associated linear models were reported. These results—a sufficient number of features for identification and height prediction from a single feature—contribute to developing systems for standoff identification when views of a subject are limited.« less

Global-to-local policy transfer in the introduction of new molecular tuberculosis diagnostics in South Africa.

PubMed

Colvin, C J; Leon, N; Wills, C; van Niekerk, M; Bissell, K; Naidoo, P

2015-11-01

Lack of innovation in diagnostics has contributed to tuberculosis (TB) remaining a global health challenge. It is critical to understand how new diagnostic technologies are translated into policies and how these are implemented. To examine policy transfer for two rapid molecular diagnostic tests, GenoType(®) MDRTBplus and Xpert(®) MTB/RIF, to understand policy development, uptake and implementation in South Africa. A policy transfer analysis framework integrating the key dimensions of policy transfer into one coherent model was used. Two phases of key informant interviews were undertaken with a wide range of stakeholders. Both tests were developed through innovative partnerships and responded to urgent public health needs. GenoType was introduced through a process that was more inclusive than that for Xpert. National policy and planning processes were opaque for both tests. Their implementation, maintenance and expansion suffered from poor communication and coordination, insufficient attention to resource implications, technical challenges and a lack of broader health systems thinking. Our analysis identified the risks and benefits of partnerships for technological innovation, the complex intersections between global and national actors and the impact of health systems on policy transfer, and the risks of rescue- and technology-focused thinking in addressing public health challenges.

Automated Rock Identification for Future Mars Exploration Missions

NASA Technical Reports Server (NTRS)

Gulick, V. C.; Morris, R. L.; Gazis, P.; Bishop, J. L.; Alena, R.; Hart, S. D.; Horton, A.

2003-01-01

A key task for human or robotic explorers on the surface of Mars is choosing which particular rock or mineral samples should be selected for more intensive study. The usual challenges of such a task are compounded by the lack of sensory input available to a suited astronaut or the limited downlink bandwidth available to a rover. Additional challenges facing a human mission include limited surface time and the similarities in appearance of important minerals (e.g. carbonates, silicates, salts). Yet the choice of which sample to collect is critical. To address this challenge we are developing science analysis algorithms to interface with a Geologist's Field Assistant (GFA) device that will allow robotic or human remote explorers to better sense and explore their surroundings during limited surface excursions. We aim for our algorithms to interpret spectral and imaging data obtained by various sensors. The algorithms, for example, will identify key minerals, rocks, and sediments from mid-IR, Raman, and visible/near-IR spectra as well as from high resolution and microscopic images to help interpret data and to provide high-level advice to the remote explorer. A top-level system will consider multiple inputs from raw sensor data output by imagers and spectrometers (visible/near-IR, mid-IR, and Raman) as well as human opinion to identify rock and mineral samples.

Identifying and overcoming implementation challenges: Experience of 59 noninstitutional long-term services and support pilot programs in the Veterans Health Administration

PubMed Central

Sullivan, Jennifer L.; Adjognon, Omonyêlé L.; Engle, Ryann L.; Shin, Marlena H.; Afable, Melissa K.; Rudin, Whitney; White, Bert; Shay, Kenneth; Lukas, Carol VanDeusen

2018-01-01

Background: From 2010 to 2013, the Department of Veterans Affairs (VA) funded a large pilot initiative to implement noninstitutional long-term services and supports (LTSS) programs to support aging Veterans. Our team evaluated implementation of 59 VA noninstitutional LTSS programs. Purpose: The specific objectives of this study are to (a) examine the challenges influencing program implementation comparing active sites that remained open and inactive sites that closed during the funding period and (b) identify ways that active sites overcame the challenges they experienced. Methodology: Key informant semistructured interviews occurred between 2011 and 2013. We conducted 217 telephone interviews over four time points. Content analysis was used to identify emergent themes. The study team met regularly to define each challenge, review all codes, and discuss discrepancies. For each follow-up interview with the sites, the list of established challenges was used as a priori themes. Emergent data were also coded. Results: The challenges affecting implementation included human resources and staffing issues, infrastructure, resources allocation and geography, referrals and marketing, leadership support, and team dynamics and processes. Programs were able to overcome challenges by communicating with team members and other areas in the organization, utilizing information technology solutions, creative use of staff and flexible schedules, and obtaining additional resources. Discussion: This study highlights several common challenges programs can address during the program implementation. The most often mentioned strategy was effective communication. Strategies also targeted several components of the organization including organizational functions and processes (e.g., importance of coordination within a team and across disciplines to provide good care), infrastructure (e.g., information technology and human resources), and program fit with priorities in the organization (e.g., leadership support). Implications: Anticipating potential pitfalls of program implementation for future noninstitutional LTSS programs can improve implementation efficiency and program sustainability. Staff at multiple levels in the organization must fully support noninstitutional LTSS programs to address these challenges. PMID:28125459

Identifying and overcoming implementation challenges: Experience of 59 noninstitutional long-term services and support pilot programs in the Veterans Health Administration.

PubMed

Sullivan, Jennifer L; Adjognon, Omonyêlé L; Engle, Ryann L; Shin, Marlena H; Afable, Melissa K; Rudin, Whitney; White, Bert; Shay, Kenneth; Lukas, Carol VanDeusen

From 2010 to 2013, the Department of Veterans Affairs (VA) funded a large pilot initiative to implement noninstitutional long-term services and supports (LTSS) programs to support aging Veterans. Our team evaluated implementation of 59 VA noninstitutional LTSS programs. The specific objectives of this study are to (a) examine the challenges influencing program implementation comparing active sites that remained open and inactive sites that closed during the funding period and (b) identify ways that active sites overcame the challenges they experienced. Key informant semistructured interviews occurred between 2011 and 2013. We conducted 217 telephone interviews over four time points. Content analysis was used to identify emergent themes. The study team met regularly to define each challenge, review all codes, and discuss discrepancies. For each follow-up interview with the sites, the list of established challenges was used as a priori themes. Emergent data were also coded. The challenges affecting implementation included human resources and staffing issues, infrastructure, resources allocation and geography, referrals and marketing, leadership support, and team dynamics and processes. Programs were able to overcome challenges by communicating with team members and other areas in the organization, utilizing information technology solutions, creative use of staff and flexible schedules, and obtaining additional resources. This study highlights several common challenges programs can address during the program implementation. The most often mentioned strategy was effective communication. Strategies also targeted several components of the organization including organizational functions and processes (e.g., importance of coordination within a team and across disciplines to provide good care), infrastructure (e.g., information technology and human resources), and program fit with priorities in the organization (e.g., leadership support). Anticipating potential pitfalls of program implementation for future noninstitutional LTSS programs can improve implementation efficiency and program sustainability. Staff at multiple levels in the organization must fully support noninstitutional LTSS programs to address these challenges.

dataMares - An online platform for the fast, effective dissemination of science

NASA Astrophysics Data System (ADS)

Johnson, A. F.; Aburto-Oropeza, O.; Moreno-Báez, M.; Giron-Nava, A.; Lopez-Sagástegui, R.; Lopez-Sagástegui, C.

2016-02-01

One of the current challenges in public policy development, especially related to natural resource management and conservation, is that there are very few tools that help easily identify and incorporate relevant scientific findings and data into public policy. This can also lead to a repetition of research efforts and the collect of information that in some cases might already exist. The key to addressing this challenge is to develop collaborative research tools, which can be used by different sectors of society including key stakeholder groups, managers, policy makers and the public. Here we present an "open science" platform capable of handling large data and disseminating results to a wide audience quickly. dataMares uses business intelligence software to allow the dynamic presentation of data quickly to a range of users online. dataMares provides Robust and up-to-date scientific information for decision-makers, resource managers, conservation practitioners, fishers, community members, and regional and national level decision-makers in a nutshell. It can also be used in the training of young scientists and allows quick and open connections with the journalism industry.

Seven Foundational Principles of Population Health Policy.

PubMed

Bhattacharya, Dru; Bhatt, Jay

2017-10-01

In 2016, Keyes and Galea issued 9 foundational principles of population health science and invited further deliberations by specialists to advance the field. This article presents 7 foundational principles of population health policy whose intersection with health care, public health, preventive medicine, and now population health, presents unique challenges. These principles are in response to a number of overarching questions that have arisen in over a decade of the authors' collective practice in the public and private sectors, and having taught policy within programs of medicine, law, nursing, and public health at the graduate and executive levels. The principles address an audience of practitioners and policy makers, mindful of the pressing health care challenges of our time, including: rising health-related expenditures, an aging population, workforce shortages, health disparities, and a backdrop of inequities rooted in social determinants that have not been adequately translated into formal policies or practices among the key stakeholders in population health. These principles are meant to empower stakeholders-whether it is the planner or the practitioner, the decision maker or the dedicated caregiver-and inform the development of practical tools, research, and education.

Models of Integrating Physical Therapists into Family Health Teams in Ontario, Canada: Challenges and Opportunities

PubMed Central

Mandoda, Shilpa; Landry, Michel D.

2011-01-01

ABSTRACT Purpose: To explore the potential for different models of incorporating physical therapy (PT) services within the emerging network of family health teams (FHTs) in Ontario and to identify challenges and opportunities of each model. Methods: A two-phase mixed-methods qualitative descriptive approach was used. First, FHTs were mapped in relation to existing community-based PT practices. Second, semi-structured key-informant interviews were conducted with representatives from urban and rural FHTs and from a variety of community-based PT practices. Interviews were digitally recorded, transcribed verbatim, and analyzed using a categorizing/editing approach. Results: Most participants agreed that the ideal model involves embedding physical therapists directly into FHTs; in some situations, however, partnering with an existing external PT provider may be more feasible and sustainable. Access and funding remain the key issues, regardless of the model adopted. Conclusion: Although there are differences across the urban/rural divide, there exist opportunities to enhance and optimize existing delivery models so as to improve client access and address emerging demand for community-based PT services. PMID:22654231

Blackbrush (Coleogyne ramosissima Torr.): State of our knowledge and future challenges

USGS Publications Warehouse

Pendleton, Rosemary L.; Pendleton, Burton K.; Meyer, Susan E.; Richardson, Bryce A.; Esque, Todd C.; Kitchen, Stanley G.

2015-01-01

Covering 130,000 square miles and a wide range of elevations from desert to alpine in Arizona, Utah, Colorado, and New Mexico, the Colorado Plateau has long fascinated researchers. The Colorado Plateau VI provides readers with a plethora of updates and insights into land conservation and management questions currently surrounding the region. The Colorado Plateau VI’s contributors show how new technologies for monitoring, spatial analysis, restoration, and collaboration improve our understanding, management, and conservation of outcomes at the appropriate landscape scale for the Colorado Plateau. The volume’s chapters fall into five major themes: monitoring as a key tool for addressing management challenges, restoration approaches to improving ecosystem condition and function, collaboration and organizational innovations to achieve conservation and management objectives, landscape-scale approaches to understanding, and managing key species and ecological communities. Focusing on the integration of science into resource management issues over the Colorado Plateau, this volume includes contributions from dozens of leading scholars of the region. The Colorado Plateau VI proves a valuable resource to all interested in the conservation management, natural history, and cultural biological resources of the Colorado Plateau.

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

PubMed

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

2014-03-01

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

Assessing the Fragile X Syndrome Newborn Screening Landscape.

PubMed

Riley, Catharine; Wheeler, Anne

2017-06-01

Fragile X syndrome (FXS) is the most common known inherited form of intellectual disability. Early identification is an important step in linking FXS individuals with appropriate and timely medical and social services. Newborn screening (NBS) is 1 approach that has been used for other conditions to facilitate early identification. A literature review was conducted to identify issues, barriers, challenges, and approaches to addressing challenges related to NBS for FXS. Search terms included: fragile X syndrome, FMR1, newborn screening, screening, and genetic testing. To supplement the literature review, 9 key informant interviews were conducted. Information gathered through these interviews supplemented what was identified in the literature. Information from both the literature review and supplemental interviews was reviewed by 3 researchers who discussed and came to consensus on thematic areas and categorization of issues. The barriers and challenges related to NBS for FXS identified in the literature and by experts and stakeholders are categorized into 5 thematic areas: public health burden, treatment, timing, screening/testing methodologies, and translating results. Summaries of these issues and barriers are provided, along with potential approaches to addressing them. The issues and barriers described in this article highlight limited areas of knowledge that need be addressed to improve our understanding of FXS and the potential benefit of NBS. The landscape of NBS for FXS could be influenced by a series of research findings over time or a larger breakthrough that demonstrates an effective targeted treatment that has to be implemented early in life. Copyright © 2017 by the American Academy of Pediatrics.

Automated Vehicle Policy and Regulation: A State Perspective Workshop: Summary

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

Young, Stanley E.; Levine, Aaron

2016-06-01

A workshop held on May 18, 2016, at the University of Maryland focused on key principles that should govern state policy decisions intended to ensure the safe operation of autonomous vehicles (AVs). The patchwork approach taken by early state adopters had primarily addressed only testing of these vehicles. As uncertainties in technology and business models play out, and in the absence of more suitable policies and regulations, states are relying on laws created for conventional vehicles to govern AV operations. The workshop addressed these challenges with three panel discussions that examined the underpinnings of policy development, factors affecting policy decisions,more » and the ultimate impact of AVs in a number of areas, including economic competitiveness; quality of mobility, particularly for disabled community; and energy use and emissions.« less

Opto-mechanical design of ShaneAO: the adaptive optics system for the 3-meter Shane Telescope

NASA Astrophysics Data System (ADS)

Ratliff, C.; Cabak, J.; Gavel, D.; Kupke, R.; Dillon, D.; Gates, E.; Deich, W.; Ward, J.; Cowley, D.; Pfister, T.; Saylor, M.

2014-07-01

A Cassegrain mounted adaptive optics instrument presents unique challenges for opto-mechanical design. The flexure and temperature tolerances for stability are tighter than those of seeing limited instruments. This criteria requires particular attention to material properties and mounting techniques. This paper addresses the mechanical designs developed to meet the optical functional requirements. One of the key considerations was to have gravitational deformations, which vary with telescope orientation, stay within the optical error budget, or ensure that we can compensate with a steering mirror by maintaining predictable elastic behavior. Here we look at several cases where deformation is predicted with finite element analysis and Hertzian deformation analysis and also tested. Techniques used to address thermal deformation compensation without the use of low CTE materials will also be discussed.

Current Status of a NASA High-Altitude Balloon-Based Observatory for Planetary Science

NASA Technical Reports Server (NTRS)

Varga, Denise M.; Dischner, Zach

2015-01-01

Recent studies have shown that progress can be made on over 20% of the key questions called out in the current Planetary Science Decadal Survey by a high-altitude balloon-borne observatory. Therefore, NASA has been assessing concepts for a gondola-based observatory that would achieve the greatest possible science return in a low-risk and cost-effective manner. This paper addresses results from the 2014 Balloon Observation Platform for Planetary Science (BOPPS) mission, namely successes in the design and performance of the Fine Pointing System. The paper also addresses technical challenges facing the new Gondola for High Altitude Planetary Science (GHAPS) reusable platform, including thermal control for the Optical Telescope Assembly, power generation and management, and weight-saving considerations that the team will be assessing in 2015 and beyond.

Community resiliency as a measure of collective health status: perspectives from rural communities.

PubMed

Kulig, Judith C; Edge, Dana; Joyce, Brenda

2008-12-01

Community resiliency is a theoretical framework useful for describing the process used by communities to address adversity. A mixed-method 2-year case study was conducted to gather information about community resiliency in 2 rural communities. This article focuses on the themes generated from qualitative interviews with 55 members of these communities. The participants viewed community as a place of interdependence and interaction. The majority saw community resiliency as the ability to address challenges. Characteristics included physical and social infrastructure, population characteristics, conceptual characteristics, and problem-solving processes. Barriers included negative individual attitudes and lack of infrastructure in rural communities. Nurses could play a key role in enhancing the resiliency of rural communities by developing and implementing programs based on the Community Resiliency Model, which was supported in this study.

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

PubMed

Budge, Stephanie L; Dickey, Lore M

2017-03-01

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

Virtualization of the Y.E.S. Congress 2009 Roundtable Symposia (Invited)

NASA Astrophysics Data System (ADS)

Gonzales, L. M.; Gaines, S. M.

2009-12-01

The Y.E.S. Congress 2009 was the first international conference organized by the Y.E.S. Network, an association of early-career geoscientists who represent professional societies, geoscience companies, geoscience departments, and interested policy makers from across the world, in collaboration with the International Year of Planet Earth (IYPE). The conference, hosted by the China University of Geosciences in Beijing, focused on scientific and career challenges faced by early-career geoscientists, with a particular emphasis on how the Y.E.S. Network can work collaboratively and internationally towards solving these challenges and furthering the IYPE motto of “Earth Sciences for Society”. A key features of the Y.E.S. Congress was the implementation of “virtualized” roundtable symposia which engaged senior and early-career geoscientists via presentations, panel discussions, and working group sessions in which strategies related to scientific challenges (i.e. climate change in the polar regions, natural hazards, natural resource sustainability) and academic and career pathway challenges (i.e. academic-industry linkages, gender parity in the geosciences, geoscience education sustainability, and international licensure issues) were developed. These strategies were then tasked to the Y.E.S. Network for further development and implementation. The virtualization of the roundtable symposia facilitated active discussion between those participants and speakers who were physically located at the conference facilities in Beijing with a wider international audience of virtual participants and speakers. This talk will address the key features of the roundtable virtualization, the successes and challenges faced during the pre-conference set-up as well as during the roundtable sessions, and potential future applications.

Enablers and challenges to occupational therapists’ research engagement: A qualitative study

PubMed Central

Di Bona, Laura; Wenborn, Jennifer; Field, Becky; Hynes, Sinéad M; Ledgerd, Ritchard; Mountain, Gail; Swinson, Tom

2017-01-01

Introduction To develop occupational therapy’s evidence base and improve its clinical outcomes, occupational therapists must increase their research involvement. Barriers to research consumption and leadership are well documented, but those relating to delivering research interventions, less so. Yet, interventions need to be researched within practice to demonstrate their clinical effectiveness. This study aims to improve understanding of challenges and enablers experienced by occupational therapists who deliver interventions within research programmes. Method Twenty-eight occupational therapists who participated in the Valuing Active Life in Dementia (VALID) research programme reported their experiences in five focus groups. Data were analysed thematically to identify key and subthemes. Results Occupational therapists reported that overwhelming paperwork, use of videos, recruitment and introducing a new intervention challenged their research involvement, whereas support, protected time and a positive attitude enabled it. The impact of these challenges and enablers varied between therapists and organisations. Conclusion Challenges and enablers to research involvement can be identified but must be addressed within individual and organisational contexts. Multifaceted collective action to minimise challenges and maximise enablers can facilitate clinicians’ involvement in research. Using this approach should enable occupational therapists to increase their research involvement, thus demonstrating the clinical effectiveness of their interventions. PMID:29170592

Strategies for the nurse executive to keep the rural hospitals open.

PubMed

Shride, S E

1997-01-01

Rural hospitals are confronted with multiple challenges to survive in the competitive health care environment of today's world. Declining population, corporate mergers and downsizing, transportation, cost of technology, and health manpower shortages are only a few of the issues rural hospitals must be prepared to address in order to survive. Federal- and state-administered programs are available that can contribute to the survival of the rural hospital. The nurse executive has a key role in contributing to the planning, development, and implementation of survival strategies.

The impact of aging physiology in critical care.

PubMed

Walker, Mandi; Spivak, Mark; Sebastian, Mary

2014-03-01

Aging physiology greatly impacts care delivery in the geriatric patient population. Consideration should be given to addressing the patient-specific needs regarding the systemic changes seen in the aging patient. Each major body system presents its own unique challenges to the critical care practitioner, and a comprehensive understanding of these changes is necessary to effectively care for this patient population. This article summarizes these changes and provides key points for the practitioner to consider when caring for the aging patient in the critical care arena. Copyright © 2014 Elsevier Inc. All rights reserved.

Pathogenesis of Crohn's disease

PubMed Central

Boyapati, Ray; Satsangi, Jack

2015-01-01

Significant progress in our understanding of Crohn's disease (CD), an archetypal common, complex disease, has now been achieved. Our ability to interrogate the deep complexities of the biological processes involved in maintaining gut mucosal homeostasis is a major over-riding factor underpinning this rapid progress. Key studies now offer many novel and expansive insights into the interacting roles of genetic susceptibility, immune function, and the gut microbiota in CD. Here, we provide overviews of these recent advances and new mechanistic themes, and address the challenges and prospects for translation from concept to clinic. PMID:26097717

Teaching prevention on sensitive topics: key elements and pedagogical techniques.

PubMed

Russell, Beth S; Soysa, Champika K; Wagoner, Marc J; Dawson, Lori

2008-09-01

This paper presents a set of topical and pedagogical considerations for instructors teaching material on sensitive topics with either the primary or secondary aim of addressing prevention. Prevention can be approached as an effort to create changes in an individual's attitudes/beliefs, knowledge, and behavior. Following this framework, classroom content that challenges students' perceptions, preconceived notions, and attitudes can be seen as preventive in nature. Preparing students to work through the same layers of complexity that thoroughly trained and experienced researchers and practitioners struggle with requires particular attention to the classroom environment.

Considerations for the design, analysis and presentation of in vivo studies.

PubMed

Ranstam, J; Cook, J A

2017-03-01

To describe, explain and give practical suggestions regarding important principles and key methodological challenges in the study design, statistical analysis, and reporting of results from in vivo studies. Pre-specifying endpoints and analysis, recognizing the common underlying assumption of statistically independent observations, performing sample size calculations, and addressing multiplicity issues are important parts of an in vivo study. A clear reporting of results and informative graphical presentations of data are other important parts. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Web Service Execution and Monitoring in Integrated Applications in Support of Business Communities

NASA Astrophysics Data System (ADS)

Chiriacescu, Rares M.; SzóKe, Alexandru; Portase, Sorin; Florea, Monica

Emerging technology is one of the key factors that drive the business world to faster adaptation, reaction and shorter communication path. Building upon such technologies, business communities emerge, geared toward high flexibility in their offerings and collaboration: business-to-customer and business-to-business collaborations. Adapting to the market requirements, companies must address several technical challenges that arise from the main requirements of the system they have to introduce: a high degree of flexibility, heterogeneous system collaboration and security of the transferred data.

Infusing Reliability Techniques into Software Safety Analysis

NASA Technical Reports Server (NTRS)

Shi, Ying

2015-01-01

Software safety analysis for a large software intensive system is always a challenge. Software safety practitioners need to ensure that software related hazards are completely identified, controlled, and tracked. This paper discusses in detail how to incorporate the traditional reliability techniques into the entire software safety analysis process. In addition, this paper addresses how information can be effectively shared between the various practitioners involved in the software safety analyses. The author has successfully applied the approach to several aerospace applications. Examples are provided to illustrate the key steps of the proposed approach.

Three-phase flow measurement in the petroleum industry

NASA Astrophysics Data System (ADS)

Thorn, R.; Johansen, G. A.; Hjertaker, B. T.

2013-01-01

The problem of how to accurately measure the flowrate of oil-gas-water mixtures in a pipeline remains one of the key challenges in the petroleum industry. This paper discusses why three-phase flow measurement is still important and why it remains a difficult problem to solve. The measurement strategies and principal base technologies currently used by commercial manufacturers are described, and research developments that could influence future flowmeter design are considered. Finally, future issues, which will need to be addressed by manufacturers and users of three-phase flowmeters, are discussed.

SKA Telescope Manager (TM): status and architecture overview

NASA Astrophysics Data System (ADS)

Natarajan, Swaminathan; Barbosa, Domingos; Barraca, Joao P.; Bridger, Alan; Choudhury, Subhrojyoti R.; Di Carlo, Matteo; Dolci, Mauro; Gupta, Yashwant; Guzman, Juan; Van den Heever, Lize; Le Roux, Gerhard; Nicol, Mark; Patil, Mangesh; Smareglia, Riccardo; Swart, Paul; Thompson, Roger; Vrcic, Sonja; Williams, Stewart

2016-07-01

The SKA radio telescope project is building two telescopes, SKA-Low in Australia and SKA-Mid in South Africa respectively. The Telescope Manager is responsible for the observations lifecycle and for monitoring and control of each instrument, and is being developed by an international consortium. The project is currently in the design phase, with the Preliminary Design Review having been successfully completed, along with re-baselining to match project scope to available budget. This report presents the status of the Telescope Manager work, key architectural challenges and our approach to addressing them.

Techno-economic, location, and carbon emission analysis of thermochemical biomass to transportation fuels

NASA Astrophysics Data System (ADS)

Wright, Mark Mba

There are significant technological and systemic challenges faced by today's advanced biofuel industry. These challenges stem from the current state-of-technology and from the system (consumer market, infrastructure, environment...) in which this emerging industry is being developed. The state-of-technology will improve with continued efforts in technology development, but novel approaches are required to investigate the systemic challenges that limit the adoption of advanced biofuels. The motivation of this dissertation is to address the question of how to find cost-effective, sustainable, and environmentally responsible pathways for the production of biofuels. Economic competitiveness, long-term viability, and benign environmental impact are key for biofuels to be embraced by industry, government, and consumers. Techno-economic, location, and carbon emission analysis are research methodologies that help address each of these issues. The research approach presented in this dissertation is to combine these three methodologies into a holistic study of advanced biofuel technologies. The value of techno-economic, location, and carbon emission analysis is limited when conducted in isolation because of current public perception towards energy technologies. Energy technologies are evaluated based on multiple criteria with a significant emphasis on the three areas investigated in this study. There are important aspects within each of these fields that could significantly limit the value of advances in other fields of study. Therefore, it is necessary that future research in advanced biofuels always consider the systemic challenges faced by novel developments.

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

PubMed

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

2015-06-05

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

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

PubMed

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

2016-01-01

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

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

PubMed Central

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

2016-01-01

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

Community-level climate change vulnerability research: trends, progress, and future directions

NASA Astrophysics Data System (ADS)

McDowell, Graham; Ford, James; Jones, Julie

2016-03-01

This study systematically identifies, characterizes, and critically evaluates community-level climate change vulnerability assessments published over the last 25 years (n = 274). We find that while the field has advanced considerably in terms of conceptual framing and methodological approaches, key shortcomings remain in how vulnerability is being studied at the community-level. We argue that vulnerability research needs to more critically engage with the following: methods for evaluating future vulnerability, the relevance of vulnerability research for decision-making, interdependencies between social and ecological systems, attention to researcher / subject power dynamics, critical interpretation of key terms, and consideration of the potentially positive opportunities presented by a changing climate. Addressing these research needs is necessary for generating knowledge that supports climate-affected communities in navigating the challenges and opportunities ahead.

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

PubMed

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

2017-09-08

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

Nanocuration workflows: Establishing best practices for identifying, inputting, and sharing data to inform decisions on nanomaterials

PubMed Central

Powers, Christina M; Mills, Karmann A; Morris, Stephanie A; Klaessig, Fred; Gaheen, Sharon; Lewinski, Nastassja

2015-01-01

Summary There is a critical opportunity in the field of nanoscience to compare and integrate information across diverse fields of study through informatics (i.e., nanoinformatics). This paper is one in a series of articles on the data curation process in nanoinformatics (nanocuration). Other articles in this series discuss key aspects of nanocuration (temporal metadata, data completeness, database integration), while the focus of this article is on the nanocuration workflow, or the process of identifying, inputting, and reviewing nanomaterial data in a data repository. In particular, the article discusses: 1) the rationale and importance of a defined workflow in nanocuration, 2) the influence of organizational goals or purpose on the workflow, 3) established workflow practices in other fields, 4) current workflow practices in nanocuration, 5) key challenges for workflows in emerging fields like nanomaterials, 6) examples to make these challenges more tangible, and 7) recommendations to address the identified challenges. Throughout the article, there is an emphasis on illustrating key concepts and current practices in the field. Data on current practices in the field are from a group of stakeholders active in nanocuration. In general, the development of workflows for nanocuration is nascent, with few individuals formally trained in data curation or utilizing available nanocuration resources (e.g., ISA-TAB-Nano). Additional emphasis on the potential benefits of cultivating nanomaterial data via nanocuration processes (e.g., capability to analyze data from across research groups) and providing nanocuration resources (e.g., training) will likely prove crucial for the wider application of nanocuration workflows in the scientific community. PMID:26425437

From clinical integration to accountable care.

PubMed

Shields, Mark

2011-01-01

Four key challenges to reforming health care organizations can be addressed by a clinical integration model patterned after Advocate Physician Partners (APP). These challenges are: predominance of small group practices, dominant fee-for-service reimbursement methods, weaknesses of the traditional hospital medical staff structure and a need to partner with commercial insurance companies. APP has demonstrated teamwork between 3800 physicians and hospitals to improve quality, patient safety and cost-effectiveness. Building on this model, an innovative contract with Blue Cross Blue Shield of Illinois serves as a prototype for a commercial Accountable Care Organization. For this contract to succeed, APP must outperform the market competition. To accomplish this, APP has implemented strategies to reduce readmissions, avoid unnecessary admissions and emergency room visits, expand primary care access, and enhance quality and patient safety.

Literature review: issues surrounding education of English-as-a-Second Language (ESL) nursing students.

PubMed

Choi, Liza Lai Shan

2005-07-01

Examined in this article are the challenges faced by English-as-a-Second Language (ESL) nursing students. Nursing faculties need to address these challenges to meet the increasing diversity of the health care system. A key concern is the ability of ESL nursing students to communicate effectively in English. The Cummins model for English language acquisition provides a template for ESL nursing students to bridge this communication barrier. The literature suggests some particular needs of ESL nursing students can be met through modification of nursing programs. Further research into factors affecting the quality of nursing education for ESL students is warranted. A quantitative analysis is required to see if there exists a positive correlation between improved English language acquisition and academic success by ESL nursing students.

New Frontiers in Analyzing Dynamic Group Interactions: Bridging Social and Computer Science

PubMed Central

Lehmann-Willenbrock, Nale; Hung, Hayley; Keyton, Joann

2017-01-01

This special issue on advancing interdisciplinary collaboration between computer scientists and social scientists documents the joint results of the international Lorentz workshop, “Interdisciplinary Insights into Group and Team Dynamics,” which took place in Leiden, The Netherlands, July 2016. An equal number of scholars from social and computer science participated in the workshop and contributed to the papers included in this special issue. In this introduction, we first identify interaction dynamics as the core of group and team models and review how scholars in social and computer science have typically approached behavioral interactions in groups and teams. Next, we identify key challenges for interdisciplinary collaboration between social and computer scientists, and we provide an overview of the different articles in this special issue aimed at addressing these challenges. PMID:29249891

Micropatterning strategies to engineer controlled cell and tissue architecture in vitro.

PubMed

D'Arcangelo, Elisa; McGuigan, Alison P

2015-01-01

Micropatterning strategies, which enable control over cell and tissue architecture in vitro, have emerged as powerful platforms for modelling tissue microenvironments at different scales and complexities. Here, we provide an overview of popular micropatterning techniques, along with detailed descriptions, to guide new users through the decision making process of which micropatterning procedure to use, and how to best obtain desired tissue patterns. Example techniques and the types of biological observations that can be made are provided from the literature. A focus is placed on microcontact printing to obtain co-cultures of patterned, confluent sheets, and the challenges associated with optimizing this protocol. Many issues associated with microcontact printing, however, are relevant to all micropatterning methodologies. Finally, we briefly discuss challenges in addressing key limitations associated with current micropatterning technologies.

Big Data: Next-Generation Machines for Big Science

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

Hack, James J.; Papka, Michael E.

Addressing the scientific grand challenges identified by the US Department of Energy’s (DOE’s) Office of Science’s programs alone demands a total leadership-class computing capability of 150 to 400 Pflops by the end of this decade. The successors to three of the DOE’s most powerful leadership-class machines are set to arrive in 2017 and 2018—the products of the Collaboration Oak Ridge Argonne Livermore (CORAL) initiative, a national laboratory–industry design/build approach to engineering nextgeneration petascale computers for grand challenge science. These mission-critical machines will enable discoveries in key scientific fields such as energy, biotechnology, nanotechnology, materials science, and high-performance computing, and servemore » as a milestone on the path to deploying exascale computing capabilities.« less

Microtools for single-cell analysis in biopharmaceutical development and manufacturing.

PubMed

Love, Kerry Routenberg; Bagh, Sangram; Choi, Jonghoon; Love, J Christopher

2013-05-01

Biologic drugs are promoting growth in the biopharmaceutical industry. Despite the clinical benefits of these drugs, the time and costs required to bring new biologics to market still are substantial. Three key challenges, among others, persist in the development of biologic drugs: namely, establishing product similarity, product toxicity, and global accessibility. New classes of microtools that facilitate the isolation and interrogation of single cells have the potential to impact each of these challenges. This opinion considers recent examples of microtools with demonstrated or potential utility to address problems in these areas. Integrating these advanced technologies into the development of new biologics could greatly reduce time and costs required to bring alternative products to market, and thus expand their global availability. Copyright © 2013 Elsevier Ltd. All rights reserved.

Progress in the development of paper-based diagnostics for low-resource point-of-care settings

PubMed Central

Byrnes, Samantha; Thiessen, Gregory; Fu, Elain

2014-01-01

This Review focuses on recent work in the field of paper microfluidics that specifically addresses the goal of translating the multistep processes that are characteristic of gold-standard laboratory tests to low-resource point-of-care settings. A major challenge is to implement multistep processes with the robust fluid control required to achieve the necessary sensitivity and specificity of a given application in a user-friendly package that minimizes equipment. We review key work in the areas of fluidic controls for automation in paper-based devices, readout methods that minimize dedicated equipment, and power and heating methods that are compatible with low-resource point-of-care settings. We also highlight a focused set of recent applications and discuss future challenges. PMID:24256361

Nanoplasmonics: a frontier of photovoltaic solar cells

NASA Astrophysics Data System (ADS)

Gu, Min; Ouyang, Zi; Jia, Baohua; Stokes, Nicholas; Chen, Xi; Fahim, Narges; Li, Xiangping; Ventura, Michael James; Shi, Zhengrong

2012-12-01

Nanoplasmonics recently has emerged as a new frontier of photovoltaic research. Noble metal nanostructures that can concentrate and guide light have demonstrated great capability for dramatically improving the energy conversion efficiency of both laboratory and industrial solar cells, providing an innovative pathway potentially transforming the solar industry. However, to make the nanoplasmonic technology fully appreciated by the solar industry, key challenges need to be addressed; including the detrimental absorption of metals, broadband light trapping mechanisms, cost of plasmonic nanomaterials, simple and inexpensive fabrication and integration methods of the plasmonic nanostructures, which are scalable for full size manufacture. This article reviews the recent progress of plasmonic solar cells including the fundamental mechanisms, material fabrication, theoretical modelling and emerging directions with a distinct emphasis on solutions tackling the above-mentioned challenges for industrial relevant applications.

Atmosphere Revitalization Technology Development for Crewed Space Exploration

NASA Technical Reports Server (NTRS)

Perry, Jay L.; Carrasquillo, Robyn L.; Harris, Danny W.

2006-01-01

As space exploration objectives extend human presence beyond low Earth orbit, the solutions to technological challenges presented by supporting human life in the hostile space environment must build upon experience gained during past and present crewed space exploration programs. These programs and the cabin atmosphere revitalization process technologies and systems developed for them represent the National Aeronautics and Space Administration s (NASA) past and present operational knowledge base for maintaining a safe, comfortable environment for the crew. The contributions of these programs to the NASA s technological and operational working knowledge base as well as key strengths and weaknesses to be overcome are discussed. Areas for technological development to address challenges inherent with the Vision for Space Exploration (VSE) are presented and a plan for their development employing unit operations principles is summarized

ECLSS and Thermal Systems Integration Challenges Across the Constellation Architecture

NASA Technical Reports Server (NTRS)

Carrasquillo, Robyn

2010-01-01

As the Constellation Program completes its initial capability Preliminary Design Review milestone for the Initial Capability phase, systems engineering of the Environmental Control and Life Support (ECLS) and Thermal Systems for the various architecture elements has progressed from the requirements to design phase. As designs have matured for the Ares, Orion, Ground Systems, and Extravehicular (EVA) System, a number of integration challenges have arisen requiring analyses and trades, resulting in changes to the design and/or requirements. This paper will address some of the key integration issues and results, including the Orion-to-Ares shared compartment venting and purging, Orion-to-EVA suit loop integration issues with the suit system, Orion-to-ISS and Orion-to-Altair intermodule ventilation, and Orion and Ground Systems impacts from post-landing environments.

New Frontiers in Analyzing Dynamic Group Interactions: Bridging Social and Computer Science.

PubMed

Lehmann-Willenbrock, Nale; Hung, Hayley; Keyton, Joann

2017-10-01

This special issue on advancing interdisciplinary collaboration between computer scientists and social scientists documents the joint results of the international Lorentz workshop, "Interdisciplinary Insights into Group and Team Dynamics," which took place in Leiden, The Netherlands, July 2016. An equal number of scholars from social and computer science participated in the workshop and contributed to the papers included in this special issue. In this introduction, we first identify interaction dynamics as the core of group and team models and review how scholars in social and computer science have typically approached behavioral interactions in groups and teams. Next, we identify key challenges for interdisciplinary collaboration between social and computer scientists, and we provide an overview of the different articles in this special issue aimed at addressing these challenges.

Legal Support for Palliative Care Patients.

PubMed

Ezer, Tamar; Burke-Shyne, Naomi; Hepford, Kiera

2018-02-01

Palliative care patients face legal issues that impact their quality of life. Legal support, embedded in holistic palliative care services, has developed globally over the last decade to address this. This article aims to trace the origins of legal support for palliative care patients, detail models of legal support, and describe achievements and challenges. The article draws on years of work in this area and the available literature. Common legal issues include disposing of property and drafting wills, planning for children, dealing with debt and securing social benefits, and addressing discrimination. Diverse approaches to integrating legal support include developing paralegal skills, accessing skilled legal advice, empowering patients and families, and building awareness of rights among health care workers. There is robust and growing acceptance of legal support as a key component of holistic palliative care, and many palliative care professionals are identifying and addressing the legal needs they encounter through mediation, guidance on basic rights, or referrals to a lawyer. Addressing legal problems can contribute to peace of mind, well-being, and the health of patients. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Forms of benefit sharing in global health research undertaken in resource poor settings: a qualitative study of stakeholders' views in Kenya.

PubMed

Lairumbi, Geoffrey M; Parker, Michael; Fitzpatrick, Raymond; English, Michael C

2012-01-17

Increase in global health research undertaken in resource poor settings in the last decade though a positive development has raised ethical concerns relating to potential for exploitation. Some of the suggested strategies to address these concerns include calls for providing universal standards of care, reasonable availability of proven interventions and more recently, promoting the overall social value of research especially in clinical research. Promoting the social value of research has been closely associated with providing fair benefits to various stakeholders involved in research. The debate over what constitutes fair benefits; whether those that addresses micro level issues of justice or those focusing on the key determinants of health at the macro level has continued. This debate has however not benefited from empirical work on what stakeholders consider fair benefits. This study explores practical experiences of stakeholders involved in global health research in Kenya, over what benefits are fair within a developing world context. We conducted in-depth interviews with key informants drawn from within the broader health research system in Kenya including researchers from the mainstream health research institutions, networks and universities, teaching hospitals, policy makers, institutional review boards, civil society organisations and community representative groups.The range of benefits articulated by stakeholders addresses both micro and macro level concerns for justice by for instance, seeking to engage with interests of those facilitating research, and the broader systemic issues that make resource poor settings vulnerable to exploitation. We interpret these views to suggest a need for global health research to engage with current crises that face people in these settings as well as the broader systemic issues that produce them. Global health research should provide benefits that address both the micro and macro level issues of justice in order to forestall exploitation. Embracing the two is however challenging in terms of how the various competing interests/needs should be balanced ethically, especially in the absence of structures to guide the process. This challenge should point to the need for greater dialogue to facilitate value clarification among stakeholders.

Viewing the Kenyan health system through an equity lens: implications for universal coverage

PubMed Central

2011-01-01

Introduction Equity and universal coverage currently dominate policy debates worldwide. Health financing approaches are central to universal coverage. The way funds are collected, pooled, and used to purchase or provide services should be carefully considered to ensure that population needs are addressed under a universal health system. The aim of this paper is to assess the extent to which the Kenyan health financing system meets the key requirements for universal coverage, including income and risk cross-subsidisation. Recommendations on how to address existing equity challenges and progress towards universal coverage are made. Methods An extensive review of published and gray literature was conducted to identify the sources of health care funds in Kenya. Documents were mainly sourced from the Ministry of Medical Services and the Ministry of Public Health and Sanitation. Country level documents were the main sources of data. In cases where data were not available at the country level, they were sought from the World Health Organisation website. Each financing mechanism was analysed in respect to key functions namely, revenue generation, pooling and purchasing. Results The Kenyan health sector relies heavily on out-of-pocket payments. Government funds are mainly allocated through historical incremental approach. The sector is largely underfunded and health care contributions are regressive (i.e. the poor contribute a larger proportion of their income to health care than the rich). Health financing in Kenya is fragmented and there is very limited risk and income cross-subsidisation. The country has made little progress towards achieving international benchmarks including the Abuja target of allocating 15% of government's budget to the health sector. Conclusions The Kenyan health system is highly inequitable and policies aimed at promoting equity and addressing the needs of the poor and vulnerable have not been successful. Some progress has been made towards addressing equity challenges, but universal coverage will not be achieved unless the country adopts a systemic approach to health financing reforms. Such an approach should be informed by the wider health system goals of equity and efficiency. PMID:21612669

Prioritizing vulnerable children: why should we address inequity?

PubMed

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

2015-11-01

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

Enhancing capacity among faith-based organizations to implement evidence-based cancer control programs: a community-engaged approach.

PubMed

Leyva, Bryan; Allen, Jennifer D; Ospino, Hosffman; Tom, Laura S; Negrón, Rosalyn; Buesa, Richard; Torres, Maria Idalí

2017-09-01

Evidence-based interventions (EBIs) to promote cancer control among Latinos have proliferated in recent years, though adoption and implementation of these interventions by faith-based organizations (FBOs) is limited. Capacity building may be one strategy to promote implementation. In this qualitative study, 18 community key informants were interviewed to (a) understand existing capacity for health programming among Catholic parishes, (b) characterize parishes' resource gaps and capacity-building needs implementing cancer control EBIs, and (c) elucidate strategies for delivering capacity-building assistance to parishes to facilitate implementation of EBIs. Semi-structured qualitative interviews were conducted. Key informants concurred about the capacity of Catholic parishes to deliver health programs, and described attributes of parishes that make them strong partners in health promotion initiatives, including a mission to address physical and mental health, outreach to marginalized groups, altruism among members, and existing engagement in health programming. However, resource gaps and capacity building needs were also identified. Specific recommendations participants made about how existing resources might be leveraged to address challenges include to: establish parish wellness committees; provide "hands-on" learning opportunities for parishioners to gain program planning skills; offer continuous, tailored, on-site technical assistance; facilitate relationships between parishes and community resources; and provide financial support for parishes. Leveraging parishes' existing resources and addressing their implementation needs may improve adoption of cancer control EBIs.

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

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

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

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

Limiting the consumption of sugar sweetened beverages in Mexico's obesogenic environment: a qualitative policy review and stakeholder analysis.

PubMed

Moise, Nathalie; Cifuentes, Enrique; Orozco, Emanuel; Willett, Walter

2011-11-01

Mexico is building a legal framework to address its childhood obesity epidemic. Sugar sweetened beverages (SSB) in the school environment represent a major policy challenge. We addressed the following questions: What barriers inhibit political attention to SSB and childhood obesity? What political instruments, international and national, exist to guide agenda setting in Mexico? What opportunities exist for policy adoption? We conducted a systematic review of international and national legal instruments concerned with SSB consumption. We traced process, conducting interviews with key informants. Thematic analysis helped us identify barriers and opportunities for public health interventions. We found 11 national policy instruments, but detected implementation gaps and weak fiscal policies on SSB consumption in schools: limited drinking water infrastructure, SSB industry interests, and regulatory ambiguities addressing reduction of sugar in beverages. Public policy should target marketing practices and taxation. The school environment remains a promising target for policy. Access to safe drinking water must complement comprehensive and multi-sector policy approaches to reduce access to SSB.

Virtual coach technology for supporting self-care.

PubMed

Ding, Dan; Liu, Hsin-Yi; Cooper, Rosemarie; Cooper, Rory A; Smailagic, Asim; Siewiorek, Dan

2010-02-01

"Virtual Coach" refers to a coaching program or device aiming to guide users through tasks for the purpose of prompting positive behavior or assisting with learning new skills. This article reviews virtual coach interventions with the purpose of guiding rehabilitation professionals to comprehend more effectively the essential components of such interventions, the underlying technologies and their integration, and example applications. A design space of virtual coach interventions including self-monitoring, context awareness, interface modality, and coaching strategies were identified and discussed to address when, how, and what coaching messages to deliver in an automated and intelligent way. Example applications that address various health-related issues also are provided to illustrate how a virtual coach intervention is developed and evaluated. Finally, the article provides some insight into addressing key challenges and opportunities in designing and implementing virtual coach interventions. It is expected that more virtual coach interventions will be developed in the field of rehabilitation to support self-care and prevent secondary conditions in individuals with disabilities.

Exploring the adequacy of smoking cessation support for pregnant and postpartum women

PubMed Central

2013-01-01

Background Smoking in pregnancy exemplifies the relationship between tobacco use and health inequalities. While difficulty reaching and engaging this population in cessation support is often highlighted in the literature, there is limited research that explores the factors that shape the provision and use of support by this subpopulation. Using Ontario, Canada, as a case study, this study examines how the use of cessation support by women is encouraged or discouraged by cessation policy, programming and practice; how geographical and sociocultural factors influence provision and uptake of support; and how barriers and challenges can be addressed through a comprehensive approach. Methods Semi-structured, in-depth interviews with key informants (31) and pregnant or postpartum women (29) were conducted to examine the cessation needs of this subpopulation, barriers to the provision and uptake of cessation support and directions for policy, service provision and programming. Results Key barriers included: the absence of a provincial cessation strategy and funding, capacity and engagement/accessibility issues. Geographical features presented additional challenges to provision/uptake, as did the absence of resources tailored to Aboriginal women and adolescents. Key informants recommended a comprehensive cessation strategy to facilitate coordination of cessation resources provincially and locally and elucidated the need for capacity building within tobacco control and within reproductive, child and maternal health. Participants also highlighted the need to further develop tobacco control policies and target the social determinants of health through poverty reduction, housing and education support. The provision of incentives, transportation, childcare and meals/snacks; adoption of woman-centred, harm-reduction and stigma reduction approaches; and promotion of programs through a variety of local venues were recommended by participants to address engagement and accessibility issues. Conclusions The current cessation system in Ontario is not equipped to adequately reduce smoking among pregnant and postpartum women. A comprehensive, multi-sector strategy designed to provide tailored and sustainable support through different system entry points is needed. A cultural shift in practice is also necessary to eliminate mixed messaging, strengthen practice and encourage open channels of communication about smoking between women and their providers. The study highlights the need to address smoking among women in a more holistic manner and for capacity building strategies that focus on strengthening providers’ competency and confidence in practice. Future research should explore: capacity building strategies, especially among rural and remote communities; the smoking and cessation experiences of different subpopulations of pregnant and postpartum women; the effectiveness of tailored strategies; and interventions that address smoking among partners and other family members. PMID:23672201

Scientific governance and the process for exposure scenario development in REACH.

PubMed

Money, Chris D; Van Hemmen, Joop J; Vermeire, Theo G

2007-12-01

The primary process established by the European Commission to address the science needed to define key REACH concepts and to help rationally implement REACH's ambitions is enshrined in a series of activities known as the REACH Implementation Projects (RIPs). These are projects that aim to define the methodology that could be used, and present the basis for guidance on the actual principles and procedures that may be (are proposed to be) followed in the development of the required documentation that ensures the safe use of chemicals. In order to develop soundly based and equitable regulation, it is necessary that science governance using established and accepted scientific principles must take a leading role. The extent to which such governance is embraced will be determined by many factors, but notably the process adopted to enable scientific discussion to take place. This article addresses the issues of science as they have impacted on the exemplification of the Exposure Scenario concept under REACH. The current RIP activities have created a non-adversarial process in which the key stakeholders are able to discuss the key REACH challenges. But the RIP activities will be finalised before REACH comes into force. A suitable mechanism should perhaps now be identified to ensure that this positive spirit of scientific discussion and collaboration can continue to benefit REACH and those that it serves well into the future.

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

PubMed

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

2011-08-08

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

Nanomaterials in the aquatic environment: An EU-USA perspective on the status of ecotoxicity testing, research priorities and challenges ahead

PubMed Central

Selck, Henriette; Handy, Richard D.; Fernandes, Teresa F.; Klaine, Stephen J.; Petersen, Elijah J.

2016-01-01

The US-EU Community of Research (CoR) was established in 2012 to provide a platform for scientists to develop a ‘shared repertoire of protocols and methods to overcome nanotechnology environmental health and safety (nanoEHS) research gaps and barriers’ (www.us-eu.org/). Based on work within the Ecotoxicology CoR (2012–2015) we provide here an overview of the state-of-the-art of nanomaterials (NMs) in the aquatic environment by addressing different research questions with a focus on ecotoxicological test systems and the challenges faced when assessing nanomaterial (NM) hazards (e.g., uptake routes, bioaccumulation, toxicity, test protocols and model organisms). Our recommendation is to place particular importance on studying the ecological effects of aged/weathered NMs, as-manufactured NMs, as well as NMs released from consumer products in addressing the following overarching research topics: i) NM characterization and quantification in environmental and biological matrices, ii) NM transformation in the environment and consequences for bioavailability and toxicity, iii) alternative methods to assess exposure, iv) influence of exposure scenarios on bioavailability and toxicity, v) development of more environmentally realistic bioassays and vi) uptake, internal distribution, and depuration of NMs. Research addressing these key topics will reduce uncertainty in ecological risk assessment and support the sustainable development of nanotechnology. PMID:27089437

Toward sustainable environmental quality: Identifying priority research questions for Latin America.

PubMed

Furley, Tatiana Heid; Brodeur, Julie; Silva de Assis, Helena C; Carriquiriborde, Pedro; Chagas, Katia R; Corrales, Jone; Denadai, Marina; Fuchs, Julio; Mascarenhas, Renata; Miglioranza, Karina Sb; Miguez Caramés, Diana Margarita; Navas, José Maria; Nugegoda, Dayanthi; Planes, Estela; Rodriguez-Jorquera, Ignacio Alejandro; Orozco-Medina, Martha; Boxall, Alistair Ba; Rudd, Murray A; Brooks, Bryan W

2018-05-01

The Global Horizon Scanning Project (GHSP) is an innovative initiative that aims to identify important global environmental quality research needs. Here we report 20 key research questions from Latin America (LA). Members of the Society of Environmental Toxicology and Chemistry (SETAC) LA and other scientists from LA were asked to submit research questions that would represent priority needs to address in the region. One hundred questions were received, then partitioned among categories, examined, and some rearranged during a workshop in Buenos Aires, Argentina. Twenty priority research questions were subsequently identified. These research questions included developing, improving, and harmonizing across LA countries methods for 1) identifying contaminants and degradation products in complex matrices (including biota); 2) advancing prediction of contaminant risks and effects in ecosystems, addressing lab-to-field extrapolation challenges, and understanding complexities of multiple stressors (including chemicals and climate change); and 3) improving management and regulatory tools toward achieving sustainable development. Whereas environmental contaminants frequently identified in these key questions were pesticides, pharmaceuticals, endocrine disruptors or modulators, plastics, and nanomaterials, commonly identified environmental challenges were related to agriculture, urban effluents, solid wastes, pulp and paper mills, and natural extraction activities. Several interesting research topics included assessing and preventing pollution impacts on conservation protected areas, integrating environment and health assessments, and developing strategies for identification, substitution, and design of less hazardous chemicals (e.g., green chemistry). Finally, a recurrent research need included developing an understanding of differential sensitivity of regional species and ecosystems to environmental contaminants and other stressors. Addressing these critical questions will support development of long-term strategic research efforts to advance more sustainable environmental quality and protect public health and the environment in LA. Integr Environ Assess Manag 2018;14:344-357. © 2018 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC). © 2018 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Toward sustainable environmental quality: Identifying priority research questions for Latin America

PubMed Central

Furley, Tatiana Heid; Brodeur, Julie; Silva de Assis, Helena C; Carriquiriborde, Pedro; Chagas, Katia R; Corrales, Jone; Denadai, Marina; Fuchs, Julio; Mascarenhas, Renata; Miglioranza, Karina SB; Miguez Caramés, Diana Margarita; Navas, José Maria; Nugegoda, Dayanthi; Planes, Estela; Rodriguez‐Jorquera, Ignacio Alejandro; Orozco‐Medina, Martha; Boxall, Alistair BA; Rudd, Murray A

2018-01-01

ABSTRACT The Global Horizon Scanning Project (GHSP) is an innovative initiative that aims to identify important global environmental quality research needs. Here we report 20 key research questions from Latin America (LA). Members of the Society of Environmental Toxicology and Chemistry (SETAC) LA and other scientists from LA were asked to submit research questions that would represent priority needs to address in the region. One hundred questions were received, then partitioned among categories, examined, and some rearranged during a workshop in Buenos Aires, Argentina. Twenty priority research questions were subsequently identified. These research questions included developing, improving, and harmonizing across LA countries methods for 1) identifying contaminants and degradation products in complex matrices (including biota); 2) advancing prediction of contaminant risks and effects in ecosystems, addressing lab‐to‐field extrapolation challenges, and understanding complexities of multiple stressors (including chemicals and climate change); and 3) improving management and regulatory tools toward achieving sustainable development. Whereas environmental contaminants frequently identified in these key questions were pesticides, pharmaceuticals, endocrine disruptors or modulators, plastics, and nanomaterials, commonly identified environmental challenges were related to agriculture, urban effluents, solid wastes, pulp and paper mills, and natural extraction activities. Several interesting research topics included assessing and preventing pollution impacts on conservation protected areas, integrating environment and health assessments, and developing strategies for identification, substitution, and design of less hazardous chemicals (e.g., green chemistry). Finally, a recurrent research need included developing an understanding of differential sensitivity of regional species and ecosystems to environmental contaminants and other stressors. Addressing these critical questions will support development of long‐term strategic research efforts to advance more sustainable environmental quality and protect public health and the environment in LA. Integr Environ Assess Manag 2018;14:344–357. © 2018 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC) PMID:29469193

MO-E-18A-01: Imaging: Best Practices In Pediatric Imaging

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

Willis, C; Strauss, K; MacDougall, R

This imaging educational program will focus on solutions to common pediatric imaging challenges. The speakers will present collective knowledge on best practices in pediatric imaging from their experience at dedicated children's hospitals. Areas of focus will include general radiography, the use of manual and automatic dose management in computed tomography, and enterprise-wide radiation dose management in the pediatric practice. The educational program will begin with a discussion of the complexities of exposure factor control in pediatric projection radiography. Following this introduction will be two lectures addressing the challenges of computed tomography (CT) protocol optimization in the pediatric population. The firstmore » will address manual CT protocol design in order to establish a managed radiation dose for any pediatric exam on any CT scanner. The second CT lecture will focus on the intricacies of automatic dose modulation in pediatric imaging with an emphasis on getting reliable results in algorithmbased technique selection. The fourth and final lecture will address the key elements needed to developing a comprehensive radiation dose management program for the pediatric environment with particular attention paid to new regulations and obligations of practicing medical physicists. Learning Objectives: To understand how general radiographic techniques can be optimized using exposure indices in order to improve pediatric radiography. To learn how to establish diagnostic dose reference levels for pediatric patients as a function of the type of examination, patient size, and individual design characteristics of the CT scanner. To learn how to predict the patient's radiation dose prior to the exam and manually adjust technique factors if necessary to match the patient's dose to the department's established dose reference levels. To learn how to utilize manufacturer-provided automatic dose modulation technology to consistently achieve patient doses within the department's established size-based diagnostic reference range. To understand the key components of an enterprise-wide pediatric dose management program that integrates the expanding responsibilities of medial physicists in the new era of dose monitoring.« less