Investigating the Fundamental Scientific Issues Affecting the Long-term Geologic Storage of Carbon Dioxide

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

Spangler, Lee; Cunningham, Alfred; Barnhart, Elliot

2014-12-19

The Zero Emissions Research and Technology (ZERT) collaborative was formed to address basic science and engineering knowledge gaps relevant to geologic carbon sequestration. The original funding round of ZERT (ZERT I) identified and addressed many of these gaps. ZERT II has focused on specific science and technology areas identified in ZERT I that showed strong promise and needed greater effort to fully develop.

76 FR 12959 - Promoting Community Integrated Pest Management To Prevent Tick-Borne Diseases; Notice of Public...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-09

...EPA will host a National Community Integrated Pest Management (IPM) for Preventing Tick-Borne Diseases Conference on March 30 and 31, 2011, under the auspices of EPA's Pesticide Program Dialog Committee (Public Health Work Group). The objectives of the conference are to identify knowledge gaps and barriers to effective community-wide tick control; propose the next steps in addressing knowledge gaps and eliminating barriers; and develop a framework for addressing the highest priority needs. The agenda for this conference will be posted at http://www.epa.gov/pestwise/ and placed in the docket in advance of the meeting.

Towards a Consensus View on Understanding Nanomaterials Hazards and Managing Exposure: Knowledge Gaps and Recommendations

PubMed Central

Hunt, Geoffrey; Lynch, Iseult; Cassee, Flemming; Handy, Richard D.; Fernandes, Teresa F.; Berges, Markus; Kuhlbusch, Thomas A. J.; Dusinska, Maria; Riediker, Michael

2013-01-01

The aim of this article is to present an overview of salient issues of exposure, characterisation and hazard assessment of nanomaterials as they emerged from the consensus-building of experts undertaken within the four year European Commission coordination project NanoImpactNet. The approach adopted is to consolidate and condense the findings and problem-identification in such a way as to identify knowledge-gaps and generate a set of interim recommendations of use to industry, regulators, research bodies and funders. The categories of recommendation arising from the consensual view address: significant gaps in vital factual knowledge of exposure, characterisation and hazards; the development, dissemination and standardisation of appropriate laboratory protocols; address a wide range of technical issues in establishing an adequate risk assessment platform; the more efficient and coordinated gathering of basic data; greater inter-organisational cooperation; regulatory harmonization; the wider use of the life-cycle approaches; and the wider involvement of all stakeholders in the discussion and solution-finding efforts for nanosafety. PMID:28809359

New horizons in the implementation and research of comprehensive geriatric assessment: knowing, doing and the 'know-do' gap.

PubMed

Gladman, John R F; Conroy, Simon Paul; Ranhoff, Anette Hylen; Gordon, Adam Lee

2016-03-01

In this paper, we outline the relationship between the need to put existing applied health research knowledge into practice (the 'know-do gap') and the need to improve the evidence base (the 'know gap') with respect to the healthcare process used for older people with frailty known as comprehensive geriatric assessment (CGA). We explore the reasons for the know-do gap and the principles of how these barriers to implementation might be overcome. We explore how these principles should affect the conduct of applied health research to close the know gap. We propose that impaired flow of knowledge is an important contributory factor in the failure to implement evidence-based practice in CGA; this could be addressed through specific knowledge mobilisation techniques. We describe that implementation failures are also produced by an inadequate evidence base that requires the co-production of research, addressing not only effectiveness but also the feasibility and acceptability of new services, the educational needs of practitioners, the organisational requirements of services, and the contribution made by policy. Only by tackling these issues in concert and appropriate proportion, will the know and know-do gaps for CGA be closed. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

STEMMING the Gap

ERIC Educational Resources Information Center

Kahler, Jim; Valentine, Nancy

2011-01-01

America has a gap when it comes to youth pursuing science and technology careers. In an effort to improve the knowledge and application of science, technology, engineering, and math (STEM), after-school programs can work in conjunction with formal in-school curriculum to improve science education. One organization that actively addresses this…

Usefulness of a KT Event to Address Practice and Policy Gaps Related to Integrated Care.

PubMed

Jackson, Karen; Boakye, Omenaa; Wallace, Nicole

2016-02-01

There are limited evaluations of the impact of knowledge translation (KT) activities aimed at addressing practice and policy gaps. We report on the impact of an interactive, end-of-grant KT event. Although action items were developed and key stakeholder support attained, minimal follow-through had occurred three months after the KT event. Several organizational obstacles to transitioning knowledge into action were identified: leadership, program policies, infrastructure, changing priorities, workload and physician engagement. Key messages include: (1) ensure ongoing and facilitated networking opportunities, (2) invest in building implementation capacity, (3) target multi-level implementation activities and (4) focus further research on KT evaluation. Copyright © 2016 Longwoods Publishing.

The Role of the Petite Bourgeoisie within Capitalism: A Response to Pyong Gap Min.

ERIC Educational Resources Information Center

Bonacich, Edna

1989-01-01

Presents an argument against Pyong Gap Min's interpretations of the author's views on Korean immigrant entrepreneurship in Los Angeles (California). Addresses the issues of empirical accuracy and policy implications that Min criticized. Discusses differences between Min's approach to social knowledge and her own. (JS)

Easing the transition between hospital and home: translating knowledge into action.

PubMed

Baumbusch, Jennifer; Semeniuk, Pat; McDonald, Heather; Khan, Koushambhi Basu; Reimer Kirkham, Sheryl; Tan, Elsie; Anderson, Joan M

2007-10-01

Knowledge translation is an interactive, dynamic approach to the uptake of evidence-based knowledge. In this article, the authors present a collaborative model for knowledge translation that grew out of a program of research focusing on the experiences of patients from ethnoculturally diverse groups as they were discharged home from hospital. Research findings highlight issues around gaps in the continuity of services and language and communication. The authors discuss a number of knowledge translation initiatives that were developed to address these gaps. Key to the success of this process has been a collaborative relationship between researchers and practitioners that is grounded in the shared goal of knowledge translation to support ethically sound decision-making in the delivery of health-care services.

A controlled investigation of continuing pain education for long-term care staff.

PubMed

Ghandehari, Omeed O; Hadjistavropoulos, Thomas; Williams, Jaime; Thorpe, Lilian; Alfano, Dennis P; Dal Bello-Haas, Vanina; Malloy, David C; Martin, Ronald R; Rahaman, Omar; Zwakhalen, Sandra M G; Carleton, R N; Hunter, Paulette V; Lix, Lisa M

2013-01-01

The underassessment and undertreatment of pain in residents of long-term care (LTC) facilities has been well documented. Gaps in staff knowledge and inaccurate beliefs have been identified as contributors. To investigate the effectiveness of an expert-based continuing education program in pain assessment⁄management for LTC staff. Participants included 131 LTC staff members who were randomly assigned to either an interactive pain education (PE) program, which addressed gaps in knowledge such as medication management, or an interactive control program consisting of general dementia education without a specific clinical focus. Participants attended three sessions, each lasting 3 h, and completed measures of pain-related knowledge and attitudes⁄beliefs before, immediately after and two weeks following the program. Focus groups were conducted with a subset of participants to gauge perception of the training program and barriers to implementing pain-related strategies. Analysis using ANOVA revealed that PE participants demonstrated larger gains compared with control participants with regard to pain knowledge and pain beliefs. Barriers to implementing pain-related strategies certainly exist. Nonetheless, qualitative analyses demonstrated that PE participants reported that they overcame many of these barriers and used pain management strategies four times more frequently than control participants. Contrary to previous research, the present study found that the interactive PE program was effective in changing pain beliefs and improving knowledge. Continuing PE in LTC has the potential to address knowledge gaps among front-line LTC providers.

Addressing uncertainty: how to conserve and manage rare or little-known fungi

Treesearch

Randy Molina; Thomas R. Horton; James M. Trappe; Bruce G. Marcot

2011-01-01

One of the greater challenges in conserving fungi comes from our incomplete knowledge of degree of rarity, risk status, and habitat requirements of most fungal species. We discuss approaches to immediately begin closing knowledge gaps, including: (1) harnessing collective expert knowledge so that data from professional experiences (e.g., personal collection and...

State of the Art in HIV Drug Resistance: Science and Technology Knowledge Gap.

PubMed

Boucher, Charles A; Bobkova, Marina R; Geretti, Anna Maria; Hung, Chien-Ching; Kaiser, Rolf; Marcelin, Anne-Geneviève; Streinu-Cercel, Adrian; van Wyk, Jean; Dorr, Pat; Vandamme, Anne-Mieke

2018-01-01

Resistance to antiretroviral therapy (ART) threatens the efficacy of human immunodeficiency virus type 1 (HIV-1) treatment. We present a review of knowledge gaps in the science and technologies of acquired HIV-1 drug resistance (HIVDR) in an effort to facilitate research, scientific exchange, and progress in clinical management. The expert authorship of this review convened to identify data gaps that exist in the field of HIVDR and discuss their clinical implications. A subsequent literature review of trials and current practices was carried out to provide supporting evidence. Several gaps were identified across HIVDR science and technology. A summary of the major gaps is presented, with an expert discussion of their implications within the context of the wider field. Crucial to optimizing the use of ART will be improved understanding of protease inhibitors and, in particular, integrase strand transfer inhibitors (INSTI) in the context of HIVDR. Limited experience with INSTI represents an important knowledge gap in HIV resistance science. Utilizing such knowledge in a clinical setting relies on accurate testing and analysis of resistance-associated mutations. As next-generation sequencing becomes more widely available, a gap in the interpretation of data is the lack of a defined, clinically relevant threshold of minority variants. Further research will provide evidence on where such thresholds lie and how they can be most effectively applied. Expert discussion identified a series of gaps in our knowledge of HIVDR. Addressing prefsuch gaps through further research and characterization will facilitate the optimal use of ART therapies and technologies.

Research Priorities in Mental Health, Justice, and Safety: A Multidisciplinary Stakeholder Report

PubMed Central

Crocker, Anne G.; Nicholls, Tonia L.; Seto, Michael C.; Roy, Laurence; Leclair, Marichelle C.; Brink, Johann; Simpson, Alexander I. F.; Côté, Gilles

2015-01-01

This paper is based on the report following the National Research Agenda Meeting on Mental Health, Justice, and Safety held in Montreal on November 19, 2014, which convened academics; health, social, and legal professionals; and people with lived experience of mental illness from across Canada. The goal was to identify research priorities addressing relevant knowledge gaps and research strategies that can translate into public policy action and improvements in evidence-based services. Participants identified key challenges: (1) inadequate identification and response to needs by civil mental health services and frontline law enforcement, (2) limited specialized resources in forensic and correctional settings, (3) fragmented care and gaps between systems, (4) limited resources for adequate community reintegration, and (5) poor knowledge transfer strategies as obstacles to evidence-based policies. Knowledge gaps were identified in epidemiology and risk reduction, frontline training and programs, forensic and correctional practices, organizations and institutions, knowledge transfer, and rehabilitation. Finally, participants identified potential sources of support to conduct real time research with regard to data collection and sharing. The findings represent a roadmap for how forensic mental health systems can best proceed to address current challenges through research and practice initiatives, drawing from lived, clinical and research experiences of a multidisciplinary group of experts. PMID:26681928

Empirical Research on Spatial Diffusion Process of Knowledge Spillovers

NASA Astrophysics Data System (ADS)

Jin, Xuehui

2018-02-01

Firstly, this paper gave a brief review of the core issues of previous studies on spatial distribution of knowledge spillovers. That laid the theoretical foundation for further research. Secondly, this paper roughly described the diffusion process of solar patents in Bejing-Tianjin-Hebei and the Pearl River Delta regions by means of correlation analysis based on patent information of the application date and address of patentee. After that, this paper introduced the variables of spatial distance, knowledge absorptive capacity, knowledge gap and pollution control and built the empirical model of patent, and then collecting data to test them. The results showed that knowledge absorptive capacity was the most significant factor than the other three, followed by the knowledge gap. The influence of spatial distance on knowledge spillovers was limited and the most weak influence factor was pollution control.

A controlled investigation of continuing pain education for long-term care staff

PubMed Central

Ghandehari, Omeed O; Hadjistavropoulos, Thomas; Williams, Jaime; Thorpe, Lilian; Alfano, Dennis P; Bello-Haas, Vanina Dal; Malloy, David C; Martin, Ronald R; Rahaman, Omar; Zwakhalen, Sandra MG; Carleton, R Nicholas; Hunter, Paulette V; Lix, Lisa M

2013-01-01

BACKGROUND: The underassessment and undertreatment of pain in residents of long-term care (LTC) facilities has been well documented. Gaps in staff knowledge and inaccurate beliefs have been identified as contributors. OBJECTIVES: To investigate the effectiveness of an expert-based continuing education program in pain assessment/management for LTC staff. METHODS: Participants included 131 LTC staff members who were randomly assigned to either an interactive pain education (PE) program, which addressed gaps in knowledge such as medication management, or an interactive control program consisting of general dementia education without a specific clinical focus. Participants attended three sessions, each lasting 3 h, and completed measures of pain-related knowledge and attitudes/beliefs before, immediately after and two weeks following the program. Focus groups were conducted with a subset of participants to gauge perception of the training program and barriers to implementing pain-related strategies. RESULTS: Analysis using ANOVA revealed that PE participants demonstrated larger gains compared with control participants with regard to pain knowledge and pain beliefs. Barriers to implementing pain-related strategies certainly exist. Nonetheless, qualitative analyses demonstrated that PE participants reported that they overcame many of these barriers and used pain management strategies four times more frequently than control participants. CONCLUSIONS: Contrary to previous research, the present study found that the interactive PE program was effective in changing pain beliefs and improving knowledge. Continuing PE in LTC has the potential to address knowledge gaps among front-line LTC providers. PMID:23457681

The Financial Literacy of Social Work Students

ERIC Educational Resources Information Center

Kindle, Peter A.

2013-01-01

The financial literacy of social work students has become the focus of curriculum development and research, but no study to date has attempted to assess the financial knowledge possessed by social work students. This study addressed that gap by assessing the level of objective financial knowledge reported by social work student respondents…

Narrative Review of Pedagogical Interventions on Nutrition Knowledge and Weight Prejudice

ERIC Educational Resources Information Center

Werkhoven, Thea; Cotton, Wayne; Dudley, Dean

2016-01-01

Objectives: To synthesize and review pedagogically informed interventions that increase nutrition knowledge and decrease weight prejudice among practicing and pre-service health and education professionals. These factors have been addressed as separate entities in intervention-based research and this represents a gap in current literature. The…

Math Learning Begins at Home

ERIC Educational Resources Information Center

Eason, Sarah H.; Levine, Susan C.

2017-01-01

Children demonstrate gaps in the math knowledge that they possess by the time they begin school, and these gaps have been found to predict long-term outcomes not only in math but also in reading. Consequently, it is important to identify what accounts for these early differences and how they can be addressed to ensure that all children enter…

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

Design Constraints Regarding The Use Of Fluids In Emergency Medical Systems For Space Flight

NASA Technical Reports Server (NTRS)

McQuillen, John

2013-01-01

The Exploration Medical Capability Project of the Human Research Program is tasked with identifying, investigating and addressing gaps existing gaps in either knowledge or technology that need to be addressed in order to enable safer exploration missions. There are several gaps that involve treatment for emergency medical situations. Some of these treatments involve the handling of liquids in the spacecraft environment which involve gas-liquid mixtures handling, dissolution chemistry and thermal issues. Some of the recent technology efforts include the Intravenous fluid generation (IVGEN) experiment, the In-Suit Injection System (ISIS) experiment, and medical suction. Constraints include limited volume, shelf life, handling biohazards, availability of power, crew time and medical training.

The humanistic and economic burden of Dravet syndrome on caregivers and families: Implications for future research.

PubMed

Jensen, Mark P; Brunklaus, Andreas; Dorris, Liam; Zuberi, Sameer M; Knupp, Kelly G; Galer, Bradley S; Gammaitoni, Arnold R

2017-05-01

We reviewed the current literature with respect to the humanistic and financial burdens of Dravet Syndrome (DS) on the caregivers of children with DS, in order to (1) identify key unanswered questions or gaps in knowledge that need to be addressed and then, based on these knowledge gaps, (2) propose a research agenda for the scientific community to address in the coming decade. The findings support the conclusion that caring for a child with DS is associated with significant humanistic burden and direct costs. However, due in part to the paucity of studies, as well as the lack of measures of specific burden domains, there remains much that is not known regarding the burden of caregiving for children with DS. To address the significant knowledge gaps in this area, research is needed that will: (1) identify the specific domains of caregivers' lives that are impacted by caring for a child with DS; (2) identify or, if needed, develop measures of caregiving impact in this area; (3) identify the factors that influence DS caregiving burden; (4) develop and evaluate the efficacy of treatments for reducing the negative impact of DS and its comorbidities on DS caregivers; (5) quantify the direct medical costs associated with DS and DS comorbidities and identify the factors that influence these costs; and (6) quantify and fully explore the indirect costs of DS. Research that addresses these goals will provide the empirical foundation needed for improving the quality of life of children with DS and their families. Copyright © 2017 Elsevier Inc. All rights reserved.

After the Gap Analysis: Education and Practice Changes to Prepare Nurses of the Future.

PubMed

Beauvais, Audrey Marie; Kazer, Meredith Wallace; Aronson, Barbara; Conlon, Suzanne E; Forte, Pamela; Fries, Kathleen S; Hahn, Judith M; Hullstrung, Russell; Levvis, Meg; McCauley, Paula; Morgan, Patricia Padula; Perfetto, Linda; Rebeschi, Lisa M; Solernou, Sheila B; Span, Patricia; Sundean, Lisa J

The purpose of the study was to describe the Connecticut Nursing Collaborative-Action Coalition's work in identifying and addressing gaps between nursing education and practice based on the Institute of Medicine's Future of Nursing report. Massachusetts Nurse of the Future (NOF) Competencies highlight the knowledge, skills, and attitudes/behaviors required for professional nurses. Integrating these concepts into the educational system will prepare the nursing workforce to respond to current/future health care needs and population health issues. Education and practice partners in four regions conducted a gap analysis of the education to practice transition for new graduate nurses using NOF as a framework for assessment. Gaps in competencies were similar across regions. However, each organization uniquely addressed curricular gaps to best prepare nurses of the future. Curriculum improvements will provide students the advantage of being prepared for the rapid changes happening in health care.

Level and determinants of diabetes knowledge in patients with diabetes in Zimbabwe: a cross-sectional study

PubMed Central

Mufunda, Esther; Wikby, Kerstin; Björn, Albin; Hjelm, Katarina

2012-01-01

Introduction A previous study of beliefs about health and illness in Zimbabweans with diabetes mellitus indicated limited knowledge about diabetes and the body, affecting self-care and health-care seeking behaviour. The aim of this study was to assess the level of diabetes knowledge in Zimbabwean adults with diabetes mellitus, to determine the main gaps in knowledge and identify the socio-demographic and diabetes-related determinants that predict diabetes awareness and self-care practices. Methods A cross-sectional descriptive study was performed using a standardized self-report Diabetes Knowledge Test questionnaire (DKT) of 58 respondents, 32 women and 26 men. Results were analysed with descriptive and analytic statistical methods. Results The majority of the respondents scored average knowledge on all three sub-scales: general knowledge, insulin use and total knowledge, with an overall score of 63.1± 14, 2%. Major knowledge gaps were in areas related to diet, insulin use and glycaemic control. No significant differences in mean scores were detected in the diabetes knowledge sub-scales when comparisons were made of mean knowledge scores in relation to socio-demographic and diabetes-related characteristics. However, diabetes-related complications were significantly associated with lower total and general diabetes knowledge, and female gender was an independent determinant of low general knowledge. Conclusion Knowledge gaps were evident in areas regarding insulin use, diet and glycaemic control. Low diabetes knowledge was associated with female gender and could be a risk factor for development of diabetes-related complications. Knowledge gaps need to be addressed in diabetes education to prevent development of diabetes-related complications. PMID:23396799

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

Cort, K. A.; Hostick, D. J.; Belzer, D. B.

The purpose of the project was to identify and characterize the modeling of deployment programs within the EERE Technology Development (TD) programs, address possible improvements to the modeling process, and note gaps in knowledge for future research.

Human Research Program Space Radiation Standing Review Panel (SRP)

NASA Technical Reports Server (NTRS)

Woloschak, Gayle; Steinberg-Wright, S.; Coleman, Norman; Grdina, David; Hill, Colin; Iliakis, George; Metting, Noelle; Meyers, Christina

2010-01-01

The Space Radiation Standing Review Panel (SRP) met at the NASA Johnson Space Center (JSC) on December 9-11, 2009 to discuss the areas of current and future research targeted by the Space Radiation Program Element (SRPE) of the Human Research Program (HRP). Using evidence-based knowledge as a background for identified risks to astronaut health and performance, NASA had identified gaps in knowledge to address those risks. Ongoing and proposed tasks were presented to address the gaps. The charge to the Space Radiation SRP was to review the gaps, evaluate whether the tasks addressed these gaps and to make recommendations to NASA s HRP Science Management Office regarding the SRP's review. The SRP was requested to evaluate the practicality of the proposed efforts in light of the demands placed on the HRP. Several presentations were made to the SRP during the site visit and the SRP spent sufficient time to address the SRP charge. The SRP made a final debriefing to the HRP Program Scientist, Dr. John B. Charles, on December 11, 2009. The SRP noted that current SRPE strategy is properly science-based and views this as the best assurance of the likelihood that answers to the questions posed as gaps in knowledge can be found, that the uncertainty in risk estimates can be reduced, and that a solid, cost-effective approach to risk reduction solutions is being developed. The current approach of the SRPE, based on the use of carefully focused research solicitations, requiring thorough peer-review and approaches demonstrated to be on the path to answering the NASA strategic questions, addressed to a broad extramural community of qualified scientists, optimally positioned to take advantage of serendipitous discoveries and to leverage scientific advances made elsewhere, is sound and appropriate. The SRP viewed with concern statements by HRP implying that the only science legitimately deserving support should be "applied" or, in some instances that the very term "research" might be frowned upon. We understand the desire of management to ensure that research stay focused on mission objectives, but the terms used are code words fraught with different meaning for scientists. Such expressions, taken at face value, convey a profoundly flawed view of science, can easily lead down counterproductive paths, and have the potential to irretrievably corrupt NASA requirements. The SRP understands and endorses the mandate to keep research efforts focused on the mission needs. However, thoughtful application of knowledge gained by understanding the mechanisms and pathways of biological effects cannot be replaced.

Strategic Evaluation of University Knowledge and Technology Transfer Effectiveness

ERIC Educational Resources Information Center

Tran, Thien Anh

2013-01-01

Academic knowledge and technology transfer has been growing in importance both in academic research and practice. A critical question in managing this activity is how to evaluate its effectiveness. The literature shows an increasing number of studies done to address this question; however, it also reveals important gaps that need more research.…

Knowledge Mobilisation in Education across Canada: A Cross-Case Analysis of 44 Research Brokering Organisations

ERIC Educational Resources Information Center

Cooper, Amanda

2014-01-01

Knowledge mobilisation (KMb) attempts to address research-policy-practice gaps in education. Research brokering organisations (RBOs) are third party, intermediary organisations whose active role between research producers and users is a catalyst for research use in education. Sample: 44 Canadian RBOs in the education sector. Methodology: employed…

Theory and Practice in EFL Teacher Education: Bridging the Gap. New Perspectives on Language and Education

ERIC Educational Resources Information Center

Huttner, Julia; Mehlmauer-Larcher, Barbara; Reichl, Susanne; Schiftner, Barbara

2011-01-01

This volume addresses the complex issues surrounding language teacher education, especially in EFL, and the development of professionalism in this field. By applying such concepts as Shulman's "pedagogical content knowledge", the development of teachers' knowledge base is investigated in a variety of settings, thus underpinning the contextual…

Cybernetics: a possible solution for the "knowledge gap" between "external" and "internal" in evaluation processes.

PubMed

Levin-Rozalis, Miri

2010-11-01

This paper addresses the issue of the knowledge gap between evaluators and the entity being evaluated: the dilemma of the knowledge of professional evaluators vs. the in-depth knowledge of the evaluated subjects. In order to optimize evaluative outcomes, the author suggests an approach based on ideas borrowed from the science of cybernetics as a method of evaluation--one that enables in-depth perception of the evaluated field without jeopardizing a rigorous study or the evaluator's professionalism. The paper focuses on the main concepts that deal with this dilemma--showing how cybernetics combines the different bodies of knowledge of the different stakeholders, including the professional evaluator, resulting in a coherent body of knowledge created mainly by those internal to the process, owned by them, and relevant to all--those who are internal and those who are external and their different purposes. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Using Constitutional Law Classes to Address the "Civic Empowerment Gap" among Inner-City Public High School Students

ERIC Educational Resources Information Center

Addington, Lynn A.

2016-01-01

Civic knowledge and participation are low among all students, but this pattern is even more pronounced for those who are poor, belong to a racial or ethnic minority group, or reside in a disadvantaged community. One remedy for this resulting "civic empowerment gap" is a call for teaching more effective civics classes in urban public…

Classroom Teachers' Craft Knowledge of Their Inclusive Practice

ERIC Educational Resources Information Center

Black-Hawkins, Kristine; Florian, Lani

2012-01-01

Whilst recent decades have seen significant progress in research on inclusive education, many teachers still feel that the research literature does not fully address their professional concerns about how to enact a policy of inclusion in their classrooms. To help to bridge this gap, we drew on the concept of craft knowledge to undertake a detailed…

Experimental studies of dead-wood biodiversity - A review identifying global gaps in knowledge

Treesearch

Sebastian Seibold; Claus Bässler; Roland Brandl; Martin M. Gossner; Simon Thorn; Michael D. Ulyshen; Jörg Müller

2015-01-01

The importance of dead wood for biodiversity is widely recognized but strategies for conservation exist only in some regions worldwide. Most strategies combine knowledge from observational and experimental studies but remain preliminary as many facets of the complex relationships are unstudied. In this first global review of 79 experimental studies addressing...

Developing Deep Understanding and Literacy while Addressing a Gender-Based Literacy Gap

ERIC Educational Resources Information Center

Sun, Yanqing; Zhang, Jianwei; Scardamalia, Marlene

2010-01-01

Online discourse from a class of 22 students (11 boys and 11 girls) was analysed to assess advances in conceptual understanding and literacy. The students worked over a two-year period (Grades 3-4), during which they contributed notes to an online Knowledge Building environment--Knowledge Forum[R]. Contributions revealed that both boys and girls…

Optimizing administrative datasets to examine acute kidney injury in the era of big data: workgroup statement from the 15(th) ADQI Consensus Conference.

PubMed

Siew, Edward D; Basu, Rajit K; Wunsch, Hannah; Shaw, Andrew D; Goldstein, Stuart L; Ronco, Claudio; Kellum, John A; Bagshaw, Sean M

2016-01-01

The purpose of this review is to report how administrative data have been used to study AKI, identify current limitations, and suggest how these data sources might be enhanced to address knowledge gaps in the field. 1) To review the existing evidence-base on how AKI is coded across administrative datasets, 2) To identify limitations, gaps in knowledge, and major barriers to scientific progress in AKI related to coding in administrative data, 3) To discuss how administrative data for AKI might be enhanced to enable "communication" and "translation" within and across administrative jurisdictions, and 4) To suggest how administrative databases might be configured to inform 'registry-based' pragmatic studies. Literature review of English language articles through PubMed search for relevant AKI literature focusing on the validation of AKI in administrative data or used administrative data to describe the epidemiology of AKI. Acute Dialysis Quality Initiative (ADQI) Consensus Conference September 6-7(th), 2015, Banff, Canada. Hospitalized patients with AKI. The coding structure for AKI in many administrative datasets limits understanding of true disease burden (especially less severe AKI), its temporal trends, and clinical phenotyping. Important opportunities exist to improve the quality and coding of AKI data to better address critical knowledge gaps in AKI and improve care. A modified Delphi consensus building process consisting of review of the literature and summary statements were developed through a series of alternating breakout and plenary sessions. Administrative codes for AKI are limited by poor sensitivity, lack of standardization to classify severity, and poor contextual phenotyping. These limitations are further hampered by reduced awareness of AKI among providers and the subjective nature of reporting. While an idealized definition of AKI may be difficult to implement, improving standardization of reporting by using laboratory-based definitions and providing complementary information on the context in which AKI occurs are possible. Administrative databases may also help enhance the conduct of and inform clinical or registry-based pragmatic studies. Data sources largely restricted to North American and Europe. Administrative data are rapidly growing and evolving, and represent an unprecedented opportunity to address knowledge gaps in AKI. Progress will require continued efforts to improve awareness of the impact of AKI on public health, engage key stakeholders, and develop tangible strategies to reconfigure infrastructure to improve the reporting and phenotyping of AKI. WHY IS THIS REVIEW IMPORTANT?: Rapid growth in the size and availability of administrative data has enhanced the clinical study of acute kidney injury (AKI). However, significant limitations exist in coding that hinder our ability to better understand its epidemiology and address knowledge gaps. The following consensus-based review discusses how administrative data have been used to study AKI, identify current limitations, and suggest how these data sources might be enhanced to improve the future study of this disease. WHAT ARE THE KEY MESSAGES?: The current coding structure of administrative data is hindered by a lack of sensitivity, standardization to properly classify severity, and limited clinical phenotyping. These limitations combined with reduced awareness of AKI and the subjective nature of reporting limit understanding of disease burden across settings and time periods. As administrative data become more sophisticated and complex, important opportunities to employ more objective criteria to diagnose and stage AKI as well as improve contextual phenotyping exist that can help address knowledge gaps and improve care.

EPA Response to BOSC Report on ORD Research Programs

EPA Pesticide Factsheets

The Air, Climate, and Energy research program is structured to provide research results that address EPA priorities and mandates, meet partners’ needs, fill knowledge gaps, and complement broader efforts across the federal government.

Characterization of frictional interference in closely-spaced reinforcements in MSE walls.

DOT National Transportation Integrated Search

2014-09-01

This research addresses one of several knowledge gaps in the understanding of tall MSE wall behavior: prediction of reinforcement loads impacted by frictional interference of closely-spaced reinforcements associated with tall walls.

Improving the Pharmacologic Management of Pain in Older Adults: Identifying the Research Gaps and Methods to Address Them

PubMed Central

Reid, M. C.; Bennett, David A.; Chen, Wen G.; Eldadah, Basil A.; Farrar, John T.; Ferrell, Bruce; Gallagher, Rollin M.; Hanlon, Joseph T.; Herr, Keela; Horn, Susan D.; Inturrisi, Charles E.; Lemtouni, Salma; Lin, Yu Woody; Michaud, Kaleb; Morrison, R. Sean; Neogi, Tuhina; Porter, Linda L.; Solomon, Daniel H.; Von Korff, Michael; Weiss, Karen; Witter, James; Zacharoff, Kevin L.

2011-01-01

Objective There has been a growing recognition of the need for better pharmacologic management of chronic pain among older adults. To address this need, the National Institutes of Health Pain Consortium sponsored an “Expert Panel Discussion on the Pharmacological Management of Chronic Pain in Older Adults” conference in September, 2010, to identify research gaps and strategies to address them. Specific emphasis was placed on ascertaining gaps regarding use of opioid and non-steroidal anti-inflammatory medications because of continued uncertainties regarding their risks and benefits. Design Eighteen panel members provided oral presentations; each was followed by a multidisciplinary panel discussion. Meeting transcripts and panelists’ slide presentations were reviewed to identify the gaps, and the types of studies and research methods panelists suggested could best address them. Results Fifteen gaps were identified in the areas of treatment(e.g., uncertainty regarding the long-term safety and efficacy of commonly prescribed analgesics), epidemiology (e.g., lack of knowledge regarding the course of common pain syndromes), and implementation(e.g., limited understanding of optimal strategies to translate evidence-based pain treatments into practice). Analyses of data from electronic health care databases, observational cohort studies, and ongoing cohort studies (augmented with pain and other relevant outcomes measures) were felt to be practical methods for building an age-appropriate evidence base to improve the pharmacologic management of pain in later life. Conclusions Addressing the gaps presented in the current report was judged by the panel to have substantial potential to improve the health and well being of older adults with chronic pain. PMID:21834914

Canadian residents' perceived manager training needs.

PubMed

Stergiopoulos, Vicky; Lieff, Susan; Razack, Saleem; Lee, A Curtis; Maniate, Jerry M; Hyde, Stacey; Taber, Sarah; Frank, Jason R

2010-01-01

Despite widespread endorsement for administrative training during residency, teaching and learning in this area remains intermittent and limited in most programmes. To inform the development of a Manager Train-the-Trainer program for faculty, the Royal College of Physicians and Surgeons of Canada undertook a survey of perceived Manager training needs among postgraduate trainees. A representative sample of Canadian specialty residents received a web-based questionnaire in 2009 assessing their perceived deficiencies in 13 Manager knowledge and 11 Manager skill domains, as determined by gap scores (GSs). GSs were defined as the difference between residents' perceived current and desired level of knowledge or skill in selected Manager domains. Residents' educational preferences for furthering their Manager knowledge and skills were also elicited. Among the 549 residents who were emailed the survey, 199 (36.2%) responded. Residents reported significant gaps in most knowledge and skills domains examined. Residents' preferred educational methods for learning Manager knowledge and skills included workshops, web-based formats and interactive small groups. The results of this national survey, highlighting significant perceived gaps in multiple Manager knowledge and skills domains, may inform the development of Manager curricula and faculty development activities to address deficiencies in training in this important area.

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

Sofu, Tanju; LaChance, Jeffrey L.; Bari, R.

This report proposes potential research priorities for the Department of Energy (DOE) with the intent of improving the licensability of the Sodium Fast Reactor (SFR). In support of this project, five panels were tasked with identifying potential safety-related gaps in available information, data, and models needed to support the licensing of a SFR. The areas examined were sodium technology, accident sequences and initiators, source term characterization, codes and methods, and fuels and materials. It is the intent of this report to utilize a structured and transparent process that incorporates feedback from all interested stakeholders to suggest future funding priorities formore » the SFR research and development. While numerous gaps were identified, two cross-cutting gaps related to knowledge preservation were agreed upon by all panels and should be addressed in the near future. The first gap is a need to re-evaluate the current procedures for removing the Applied Technology designation from old documents. The second cross-cutting gap is the need for a robust Knowledge Management and Preservation system in all SFR research areas. Closure of these and the other identified gaps will require both a reprioritization of funding within DOE as well as a re-evaluation of existing bureaucratic procedures within the DOE associated with Applied Technology and Knowledge Management.« less

Electronic patient records in action: Transforming information into professionally relevant knowledge.

PubMed

Winman, Thomas; Rystedt, Hans

2011-03-01

The implementation of generic models for organizing information in complex institutions like those in healthcare creates a gap between standardization and the need for locally relevant knowledge. The present study addresses how this gap can be bridged by focusing on the practical work of healthcare staff in transforming information in EPRs into knowledge that is useful for everyday work. Video recording of shift handovers on a rehabilitation ward serves as the empirical case. The results show how extensive selections and reorganizations of information in EPRs are carried out in order to transform information into professionally relevant accounts. We argue that knowledge about the institutional obligations and professional ways of construing information are fundamental for these transitions. The findings point to the need to consider the role of professional knowledge inherent in unpacking information in efforts to develop information systems intended to bridge between institutional and professional boundaries in healthcare. © The Author(s) 2011.

AN EVALUATION OF HANFORD SITE TANK FARM SUBSURFACE CONTAMINATION FY2007

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

MANN, F.M.

2007-07-10

The Tank Farm Vadose Zone (TFVZ) Project conducts activities to characterize and analyze the long-term environmental and human health impacts from tank waste releases to the vadose zone. The project also implements interim measures to mitigate impacts, and plans the remediation of waste releases from tank farms and associated facilities. The scope of this document is to report data needs that are important to estimating long-term human health and environmental risks. The scope does not include technologies needed to remediate contaminated soils and facilities, technologies needed to close tank farms, or management and regulatory decisions that will impact remediation andmore » closure. This document is an update of ''A Summary and Evaluation of Hanford Site Tank Farm Subsurface Contamination''. That 1998 document summarized knowledge of subsurface contamination beneath the tank farms at the time. It included a preliminary conceptual model for migration of tank wastes through the vadose zone and an assessment of data and analysis gaps needed to update the conceptual model. This document provides a status of the data and analysis gaps previously defined and discussion of the gaps and needs that currently exist to support the stated mission of the TFVZ Project. The first data-gaps document provided the basis for TFVZ Project activities over the previous eight years. Fourteen of the nineteen knowledge gaps identified in the previous document have been investigated to the point that the project defines the current status as acceptable. In the process of filling these gaps, significant accomplishments were made in field work and characterization, laboratory investigations, modeling, and implementation of interim measures. The current data gaps are organized in groups that reflect Components of the tank farm vadose zone conceptual model: inventory, release, recharge, geohydrology, geochemistry, and modeling. The inventory and release components address residual wastes that will remain in the tanks and tank-farm infrastructure after closure and potential losses from leaks during waste retrieval. Recharge addresses the impacts of current conditions in the tank farms (i.e. gravel covers that affect infiltration and recharge) as well as the impacts of surface barriers. The geohydrology and geochemistry components address the extent of the existing subsurface contaminant inventory and drivers and pathways for contaminants to be transported through the vadose zone and groundwater. Geochemistry addresses the mobility of key reactive contaminants such as uranium. Modeling addresses conceptual models and how they are simulated in computers. The data gaps will be used to provide input to planning (including the upcoming C Farm Data Quality Objective meetings scheduled this year).« less

Exploration Medical Capability - Technology Watch

NASA Technical Reports Server (NTRS)

Krihak, Michael; Watkins, Sharmila; Barr, Yael; Barsten, Kristina; Fung, Paul; Baumann, David

2011-01-01

The objectives of the Technology Watch process are to identify emerging, high-impact technologies that augment current ExMC development efforts, and to work with academia, industry, and other government agencies to accelerate the development of medical care and research capabilities for the mitigation of potential health issues that could occur during space exploration missions. The establishment of collaborations with these entities is beneficial to technology development, assessment and/or insertion. Such collaborations also further NASA s goal to provide a safe and healthy environment for human exploration. The Tech Watch project addresses requirements and capabilities identified by knowledge and technology gaps that are derived from a discrete set of medical conditions that are most likely to occur on exploration missions. These gaps are addressed through technology readiness level assessments, market surveys, collaborations and distributed innovation opportunities. Ultimately, these gaps need to be closed with respect to exploration missions, and may be achieved through technology development projects. Information management is a key aspect to this process where Tech Watch related meetings, research articles, collaborations and partnerships are tracked by the HRP s Exploration Medical Capabilities (ExMC) Element. In 2011, ExMC will be introducing the Tech Watch external website and evidence wiki that will provide access to ExMC technology and knowledge gaps, technology needs and requirements documents.

Valuing mortality impacts of smoke exposure from major southern California wildfires

Treesearch

Ikuho Kochi; Patricia A. Champ; John B. Loomis; Geoffrey H. Donovan

2012-01-01

While the mortality impacts of urban air pollution have been well addressed in the literature, very little is known about the mortality impacts and associated social cost from wildfire-smoke exposure (Kochi et al., 2010; U.S. Environmental Protection Agency, 2004). In an attempt to address this knowledge gap, we estimate the social cost associated with excess mortality...

The Relationship between the Use of Spaced Repetition Software with a TOEIC Word List and TOEIC Score Gains

ERIC Educational Resources Information Center

Bower, Jack Victor; Rutson-Griffiths, Arthur

2016-01-01

A strong relationship between L2 vocabulary knowledge and L2 reading and listening comprehension is well established. However, less research has been conducted to explore correlations between pedagogic interventions to increase vocabulary knowledge and score gains on standardized L2 proficiency tests. This study addresses this gap in the research…

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

PubMed Central

Reinhardt, Kristina; Fanzo, Jessica

2014-01-01

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

Data Mining Activities for Bone Discipline - Current Status

NASA Technical Reports Server (NTRS)

Sibonga, J. D.; Pietrzyk, R. A.; Johnston, S. L.; Arnaud, S. B.

2008-01-01

The disciplinary goals of the Human Research Program are broadly discussed. There is a critical need to identify gaps in the evidence that would substantiate a skeletal health risk during and after spaceflight missions. As a result, data mining activities will be engaged to gather reviews of medical data and flight analog data and to propose additional measures and specific analyses. Several studies are briefly reviewed which have topics that partially address these gaps in knowledge, including bone strength recovery with recovery of bone mass density, current renal stone formation knowledge, herniated discs, and a review of bed rest studies conducted at Ames Human Research Facility.

ILCOR Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: A Consensus Statement.

PubMed

Kleinman, Monica E; Perkins, Gavin D; Bhanji, Farhan; Billi, John E; Bray, Janet E; Callaway, Clifton W; de Caen, Allan; Finn, Judith C; Hazinski, Mary Fran; Lim, Swee Han; Maconochie, Ian; Morley, Peter; Nadkarni, Vinay; Neumar, Robert W; Nikolaou, Nikolaos; Nolan, Jerry P; Reis, Amelia; Sierra, Alfredo F; Singletary, Eunice M; Soar, Jasmeet; Stanton, David; Travers, Andrew; Welsford, Michelle; Zideman, David

2018-04-26

Despite significant advances in the field of resuscitation science, important knowledge gaps persist. Current guidelines for resuscitation are based on the International Liaison Committee on Resuscitation 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, which includes treatment recommendations supported by the available evidence. The writing group developed this consensus statement with the goal of focusing future research by addressing the knowledge gaps identified during and after the 2015 International Liaison Committee on Resuscitation evidence evaluation process. Key publications since the 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations are referenced, along with known ongoing clinical trials that are likely to affect future guidelines. © 2018 European Resuscitation Council and American Heart Association, Inc. Published by Elsevier B.V. All rights reserved. Copyright © 2018 European Resuscitation Council and American Heart Association, Inc. Published by Elsevier B.V. All rights reserved.

Economic Incentives for Stormwater Control (ISBN9781439845608)

EPA Science Inventory

Addressing a huge knowledge gap from a policy perspective, this book focuses on the economic tools available for stormwater runoff control. It provides case studies demonstrating the application of various incentives, such as tradable credits, fees with rebates, and auction mecha...

Criteria for Initial Appointment in Rank and Subsequent Promotion for Faculty in Two-Year Public Colleges

ERIC Educational Resources Information Center

Orf, Michael A.

2013-01-01

The growth of community colleges over the last five decades has not been met with a commensurate expansion of knowledge about policy development. In order to address this gap in knowledge, this study aimed to determine the prevalence of rank among two-year colleges in the United States; to identify the criteria used to determine rank upon hire for…

Understanding the Impact of Guiding Inquiry: The Relationship between Directive Support, Student Attributes, and Transfer of Knowledge, Attitudes, and Behaviours in Inquiry Learning

ERIC Educational Resources Information Center

Roll, Ido; Butler, Deborah; Yee, Nikki; Welsh, Ashley; Perez, Sarah; Briseno, Adriana; Perkins, Katherine; Bonn, Doug

2018-01-01

Guiding inquiry learning has been shown to increase knowledge gains. Yet, little is known about the effect of guidance on attitudes and behaviours, its interaction with student attributes, and transfer of impact once guidance is removed. We address these gaps in the context of an interactive Physics simulation on electric circuits…

Health literacy and knowledge in a cohort of Australian patients taking warfarin.

PubMed

Yiu, Angela W; Bajorek, Beata V

2018-01-01

To 1) characterise older patients taking warfarin, 2) assess these patients' level of warfarin knowledge, and 3) describe their strengths and limitations in health literacy, and 4) explore relationships between participants' characteristics, warfarin knowledge and health literacy. A warfarin knowledge questionnaire and Health Literacy Questionnaire (HLQ) were administered to older patients (aged >65 years, N=34) taking warfarin in an Australian general practice setting. Key gaps in participant knowledge pertained to the consequences of an international normalized ratio (INR) being below the target INR range and safety issues such as when to seek medical attention. A limitation for participants with a lower level of health literacy was the ability to appraise health information. Patients who needed assistance in completing the HLQs had significantly lower warfarin knowledge scores (p=0.03). Overseas-born participants and those taking 5 or more long-term medications had lower HLQ scores for specific scales (p<0.05). In this study warfarin knowledge gaps and a limitation of health literacy amongst a small sample of older patients were identified. The findings suggest that education and resources may need to be tailored to the needs of older patients taking warfarin and their carers to address these knowledge gaps and limitations in health literacy. Patients who may need greater support include those that need assistance in completing the HLQ, are overseas-born, or are taking 5 or more long-term medications.

Background review for diagnostic test development for Zika virus infection.

PubMed

Charrel, Rémi N; Leparc-Goffart, Isabelle; Pas, Suzan; de Lamballerie, Xavier; Koopmans, Marion; Reusken, Chantal

2016-08-01

To review the state of knowledge about diagnostic testing for Zika virus infection and identify areas of research needed to address the current gaps in knowledge. We made a non-systematic review of the published literature about Zika virus and supplemented this with information from commercial diagnostic test kits and personal communications with researchers in European preparedness networks. The review covered current knowledge about the geographical spread, pathogen characteristics, life cycle and infection kinetics of the virus. The available molecular and serological tests and biosafety issues are described and discussed in the context of the current outbreak strain. We identified the following areas of research to address current knowledge gaps: (i) an urgent assessment of the laboratory capacity and capability of countries to detect Zika virus; (ii) rapid and extensive field validation of the available molecular and serological tests in areas with and without Zika virus transmission, with a focus on pregnant women; (iii) monitoring the genomic diversity of circulating Zika virus strains; (iv) prospective studies into the virus infection kinetics, focusing on diagnostic sampling (specimen types, combinations and timings); and (v) developing external quality assessments for molecular and serological testing, including differential diagnosis for similar viruses and symptom clusters. The availability of reagents for diagnostic development (virus strains and antigens, quantified viral ribonucleic acid) needs to be facilitated. An international laboratory response is needed, including preparation of protocols for prospective studies to address the most pressing information needs.

Background review for diagnostic test development for Zika virus infection

PubMed Central

Charrel, Rémi N; Leparc-Goffart, Isabelle; Pas, Suzan; de Lamballerie, Xavier; Koopmans, Marion; Reusken, Chantal

2016-01-01

Abstract Objective To review the state of knowledge about diagnostic testing for Zika virus infection and identify areas of research needed to address the current gaps in knowledge. Methods We made a non-systematic review of the published literature about Zika virus and supplemented this with information from commercial diagnostic test kits and personal communications with researchers in European preparedness networks. The review covered current knowledge about the geographical spread, pathogen characteristics, life cycle and infection kinetics of the virus. The available molecular and serological tests and biosafety issues are described and discussed in the context of the current outbreak strain. Findings We identified the following areas of research to address current knowledge gaps: (i) an urgent assessment of the laboratory capacity and capability of countries to detect Zika virus; (ii) rapid and extensive field validation of the available molecular and serological tests in areas with and without Zika virus transmission, with a focus on pregnant women; (iii) monitoring the genomic diversity of circulating Zika virus strains; (iv) prospective studies into the virus infection kinetics, focusing on diagnostic sampling (specimen types, combinations and timings); and (v) developing external quality assessments for molecular and serological testing, including differential diagnosis for similar viruses and symptom clusters. The availability of reagents for diagnostic development (virus strains and antigens, quantified viral ribonucleic acid) needs to be facilitated. Conclusion An international laboratory response is needed, including preparation of protocols for prospective studies to address the most pressing information needs. PMID:27516635

“My Older Clients Fall Through Every Crack in the System”: Geriatrics Knowledge Among Legal Professionals

PubMed Central

Soones, Tacara; Ahalt, Cyrus; Garrigues, Sarah; Faigman, David; Williams, Brie A.

2014-01-01

With the rapid aging of the criminal justice population, legal professionals increasingly provide front-line identification and response to age-related health conditions (including cognitive and physical impairments) that may affect legal outcomes, such as the ability to participate in one's defense or stay safe in jail. The goals of this study were to assess legal professionals’ ability to recognize and respond to age-related conditions that could affect legal outcomes and to identify recommendations to address important knowledge gaps. This was a mixed quantitative-qualitative study. Legal professionals (N=72) in the criminal justice system were surveyed to describe their demographics, expertise and prior aging-related training, and to inform the qualitative interview guide. Those surveyed included attorneys (district attorneys (25%), public defenders and legal advocates (58%)), judges (6%), and court-affiliated social workers (11%). In-depth qualitative interviews were then conducted with a subset of 10 legal professionals who worked with older adults at least weekly. Results from the surveys and interviews revealed knowledge deficits in four important areas: age-related health, identification of cognitive impairment, assessment of safety risk, and optimization of services upon release from jail. Four recommendations to close these gaps emerged: (1) educate legal professionals about age-related health; (2) train professionals to identify cognitive and sensory impairment; (3) develop checklists to identify those at risk of poor health or safety; and (4) improve knowledge of and access to transitional services for older adults. These findings suggest that geriatrics knowledge gaps among legal professionals exist that may lead to adverse medical or legal outcomes for criminal justice-involved older adults and that partnerships between healthcare and legal professionals are needed to address these challenges. PMID:24611718

EnviroAtlas in the Classroom: New K-16 Lesson Plans that Empower Tomorrow’s Decision-Makers

EPA Pesticide Factsheets

EPA’s new suite of educational materials aims to address that knowledge gap with classroom-ready lessons that teach students about the environment’s effects on their daily lives, including their health and well-being.

Advances in Planetary Protection at the Deep Space Gateway

NASA Astrophysics Data System (ADS)

Spry, J. A.; Siegel, B.; Race, M.; Rummel, J. D.; Pugel, D. E.; Groen, F. J.; Kminek, G.; Conley, C. A.; Carosso, N. J.

2018-02-01

Planetary protection knowledge gaps that can be addressed by science performed at the Deep Space Gateway in the areas of human health and performance, space biology, and planetary sciences that enable future exploration in deep space, at Mars, and other targets.

Nurse Faculty Knowledge of and Confidence in Teaching Genetics/Genomics: Implications for Faculty Development.

PubMed

Donnelly, Mary Katherine; Nersesian, Paula V; Foronda, Cynthia; Jones, Emily L; Belcher, Anne E

The aims of this project were to (1) assess nurse faculty members' knowledge of and confidence in teaching genetics/genomics to nursing students and (2) identify the needs of faculty members to inform a faculty development initiative. Significant knowledge gaps were noted, and more than 50% of respondents indicated that they lacked confidence in teaching genetics/genomics. Strategies to address this problem included identifying champions of genetics/genomics education, use of an educational template, and threading genetics/genomics throughout the curriculum.

School nurses can address existing gaps in school-age sleep research.

PubMed

Willgerodt, Mayumi A; Kieckhefer, Gail M

2013-06-01

Sleep has been linked to a host of physical, behavioral, and emotional outcomes, and research has documented that youth across the globe are experiencing inadequate sleep. Despite this knowledge, however, very little research has been conducted on school-age children; much of the extant research has focused on infants, toddlers, preschoolers, adolescents, and adults. School-age children exhibit increasing independence around health-related behaviors, which provide health professionals the opportunity to educate and promote healthy sleep behaviors. This commentary extends previous research reviews by identifying the current gaps in sleep research, highlighting future directions needed in sleep research, and explaining why school nurses are best suited to address this growing public health issue.

Past and Present: A Review of Antenatal Corticosteroids and Recommendations for Late Preterm Birth Steroids.

PubMed

Dixon, C Luke; Too, Gloria; Saade, George R; Gyamfi-Bannerman, Cynthia

2018-05-23

Since 1972, the beneficial neonatal effects of antenatal corticosteroids (ACSs) have been repeatedly demonstrated in pregnancies at risk of preterm birth before 34 weeks' gestation. While ACS utilization before 34 weeks has been high since the 1990s, knowledge gaps regarding the risks and benefits of ACS continue to exist. Recent evidence has been published regarding the benefit of ACS in the late preterm period. This review addresses the evidence and knowledge gaps for ACS use before and after 34 weeks' gestation. We also provide recommendations for ACS use in the late preterm period. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Lunar Ice Cube: Development of a Deep Space Cubesat Mission

NASA Astrophysics Data System (ADS)

Clark, P. E.; Malphrus, B.; McElroy, D.; Schabert, J.; Wilczewski, S.; Farrell, W.; Brambora, C.; Macdowall, R.; Folta, D.; Hurford, T.; Patel, D.; Banks, S.; Reuter, D.; Brown, K.; Angkasa, K.; Tsay, M.

2017-10-01

Lunar Ice Cube, a 6U deep space cubesat mission, will be deployed by EM1. It will demonstrate cubesat propulsion, the Busek BIT 3 RF Ion engine, and a compact instrument capable of addressing HEOMD Strategic Knowledge Gaps related to lunar volatiles.

Chinese University EFL Teachers' Perceptions of Plagiarism

ERIC Educational Resources Information Center

Lei, Jun; Hu, Guangwei

2015-01-01

Although Chinese university students' perceptions of plagiarism have been extensively investigated, those of their teachers have been surprisingly under-researched. This study sought to address this gap by investigating 112 Chinese university English teachers' knowledge of and attitudes towards plagiarism. While 57 participating teachers had…

Invited Commentary on "Centers for Disease Control and Prevention Report to Congress: Traumatic Brain Injury in the United States: Epidemiology and Rehabilitation".

PubMed

Flanagan, Steven R

2015-10-01

Traumatic brain injury (TBI) is a significant health problem, afflicting millions of people worldwide. Despite increasing awareness of its burden on patients, families, and society, much remains unknown regarding TBI incidence, how best to assess outcomes post-injury, and the most effective means of providing rehabilitation services. The Centers for Disease Control and Prevention recently published recommendations to Congress that address these critical knowledge gaps. The report is the end product of work completed by a notable panel of experts and stakeholders that makes overarching recommendations aimed at addressing knowledge gaps in TBI, with the ultimate goal of decreasing injury occurrence and improving outcomes. It is a succinct and powerful report that should serve as a call to action to fund innovative research and reverse a trend in health care that restricts access to rehabilitation services. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Total Pancreatectomy With Islet Autotransplantation

PubMed Central

Bellin, Melena D.; Gelrud, Andres; Arreaza-Rubin, Guillermo; Dunn, Ty B.; Humar, Abhinav; Morgan, Katherine A.; Naziruddin, Bashoo; Rastellini, Cristiana; Rickels, Michael R.; Schwarzenberg, Sarah J.; Andersen, Dana K.

2015-01-01

A workshop sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases focused on research gaps and opportunities in total pancreatectomy with islet autotransplantation (TPIAT) for the management of chronic pancreatitis. The session was held on July 23, 2014 and structured into 5 sessions: (1) patient selection, indications, and timing; (2) technical aspects of TPIAT; (3) improving success of islet autotransplantation; (4) improving outcomes after total pancreatectomy; and (5) registry considerations for TPIAT. The current state of knowledge was reviewed; knowledge gaps and research needs were specifically highlighted. Common themes included the need to identify which patients best benefit from and when to intervene with TPIAT, current limitations of the surgical procedure, diabetes remission and the potential for improvement, opportunities to better address pain remission, GI complications in this population, and unique features of children with chronic pancreatitis considered for TPIAT. The need for a multicenter patient registry that specifically addresses the complexities of chronic pancreatitis and total pancreatectomy outcomes and postsurgical diabetes outcomes was repeatedly emphasized. PMID:25599324

Addressing knowledge gaps in molecular, sero-surveillance and monitoring approaches on Zika epidemics and other arbovirus co-infections: A structured review.

PubMed

Tambo, Ernest; Khayeka-Wandabwa, Christopher; Olalubi, Oluwasogo A; Adedeji, Ahmed A; Ngogang, Jeanne Y; Khater, Emad Im

2017-05-01

Globalization, with consequent increased travel and trade, rapid urbanization and growing weather variation events due to climate change has contributed to the recent unprecedented Zika virus (ZIKV) pandemic. This has emphasized the pressing need for local, national, regional and global community collaborative proactiveness, leadership and financial investment resilience in research and development. This paper addresses the potential knowledge gaps and impact of early detection and monitoring approaches on ZIKV epidemics and related arboviral infections steered towards effective prevention and smart response strategies. We advocate for the development and validation of robust field and point of care diagnostic tools that are more sensitive, specific and cost effective for use in ZIKV epidemics and routine pathophysiology surveillance and monitoring systems as an imperative avenue in understanding Zika-related and other arbovirus trends and apply genomic and proteomic characterisation approaches in guiding annotation efforts in order to design and implement public health burden mitigation and adaptation strategies.

Stakeholder Meeting: Integrated Knowledge Translation Approach to Address the Caregiver Support Gap.

PubMed

Holroyd-Leduc, Jayna M; McMillan, Jacqueline; Jette, Nathalie; Brémault-Phillips, Suzette C; Duggleby, Wendy; Hanson, Heather M; Parmar, Jasneet

2017-03-01

Family caregivers are an integral and increasingly overburdened part of the health care system. There is a gap between what research evidence shows is beneficial to caregivers and what is actually provided. Using an integrated knowledge translation approach, a stakeholder meeting was held among researchers, family caregivers, caregiver associations, clinicians, health care administrators, and policy makers. The objectives of the meeting were to review current research evidence and conduct multi-stakeholder dialogue on the potential gaps, facilitators, and barriers to the provision of caregiver supports. A two-day meeting was attended by 123 individuals. Three target populations of family caregivers were identified for discussion: caregivers of seniors with dementia, caregivers in end-of-life care, and caregivers of frail seniors with complex health needs. The results of this meeting can and are being used to inform the development of implementation research endeavours and policies targeted at providing evidence-informed caregiver supports.

Suicide and Suicide Risk in Lesbian, Gay, Bisexual, and Transgender Populations: Review and Recommendations

PubMed Central

Haas, Ann P.; Eliason, Mickey; Mays, Vickie M.; Mathy, Robin M.; Cochran, Susan D.; D'Augelli, Anthony R.; Silverman, Morton M.; Fisher, Prudence W.; Hughes, Tonda; Rosario, Margaret; Russell, Stephen T.; Malley, Effie; Reed, Jerry; Litts, David A.; Haller, Ellen; Sell, Randall L.; Remafedi, Gary; Bradford, Judith; Beautrais, Annette L.; Brown, Gregory K.; Diamond, Gary M.; Friedman, Mark S.; Garofalo, Robert; Turner, Mason S.; Hollibaugh, Amber; Clayton, Paula J.

2011-01-01

Despite strong indications of elevated risk of suicidal behavior in lesbian, gay, bisexual, and transgender people, limited attention has been given to research, interventions or suicide prevention programs targeting these populations. This article is a culmination of a three-year effort by an expert panel to address the need for better understanding of suicidal behavior and suicide risk in sexual minority populations, and stimulate the development of needed prevention strategies, interventions and policy changes. This article summarizes existing research findings, and makes recommendations for addressing knowledge gaps and applying current knowledge to relevant areas of suicide prevention practice. PMID:21213174

Improving Clinical Practices for Children with Language and Learning Disorders

ERIC Educational Resources Information Center

Kamhi, Alan G.

2014-01-01

Purpose: This lead article of the Clinical Forum addresses some of the gaps that exist between clinical practice and current knowledge about instructional factors that influence learning and language development. Method: Topics reviewed and discussed include principles of learning, generalization, treatment intensity, processing interventions,…

Smokeless tobacco control policies in South Asia: a gap analysis and recommendations.

PubMed

Khan, Amina; Huque, Rumana; Shah, Sarwat K; Kaur, Jagdish; Baral, Sushil; Gupta, Prakash C; Cherukupalli, Rajeev; Sheikh, Aziz; Selvaraj, Sakthivel; Nargis, Nigar; Cameron, Ian; Siddiqi, Kamran

2014-06-01

Almost a fifth of the world's tobacco is consumed in smokeless form. Its consumption is particularly common in South Asia, where an increasing array of smokeless tobacco (SLT) products is widely available. Mindful of the growing public health threat from SLT, a group of international academics and policy makers recently gathered to identify policy and knowledge gaps and proposed strategies to address these. We reviewed key policy documents and interviewed policy makers and representatives of civil society organizations in 4 South Asian countries: Bangladesh, India, Nepal, and Pakistan. We explored if SLT features in existing tobacco control policies and, if so, the extent to which these are implemented and enforced. We also investigated barriers to effective policy formulation and implementation. The findings were presented at an international meeting of experts and were refined in the light of the ensuing discussion in order to inform policy and research recommendations. We found that the existing SLT control policies in these 4 South Asian countries were either inadequate or poorly implemented. Taxes were low and easily evaded; regulatory mechanisms, such as licensing and trading standards, either did not exist or were inadequately enforced to regulate the composition and sales of such products; and there was little or no cessation support for those who wanted to quit. Limited progress has been made so far to address the emerging public health threat posed by SLT consumption in South Asia. International and regional cooperation is required to advocate for effective policy and to address knowledge gaps.

Developing a Research Agenda for Integrating Palliative Care into Critical Care and Pulmonary Practice To Improve Patient and Family Outcomes

PubMed Central

Reinke, Lynn F.; Cox, Christopher; Kross, Erin K.; Benzo, Roberto P.; Curtis, J. Randall

2017-01-01

Abstract Background: Palliative care is a medical specialty and philosophy of care that focuses on reducing suffering among patients with serious illness and their family members, regardless of disease diagnosis or prognosis. As critical illness or moderate to severe pulmonary disease confers significant disease-related symptom burdens, palliative care and palliative care specialists can aid in reducing symptom burden and improving quality of life among these patients and their family members. Objective: The objective of this article is to review the existing gaps in evidence for palliative care in pulmonary disease and critical illness and to use an interdisciplinary working group convened by the National Institutes of Health and the National Palliative Care Research Center to develop a research agenda to address these gaps. Methods: We completed a narrative review of the literature concerning the integration of palliative care into pulmonary and/or critical care. The review was based on recent systematic reviews on these topics as well as a summary of relevant articles identified through hand search. We used this review to identify gaps in current knowledge and develop a research agenda for the future. Results: We identified key areas of need and knowledge gaps that should be addressed to improve palliative care for patients with pulmonary and critical illness. These areas include developing and validating patient- and family-centered outcomes, identifying the key components of palliative care that are effective and cost-effective, developing and evaluating different models of palliative care delivery, and determining the effectiveness and cost-effectiveness of palliative care interventions. Conclusions: The goal of this research agenda is to encourage researchers, clinicians, healthcare systems, and research funders to identify research that can address these gaps and improve the lives of patients with pulmonary and critical illness and their family members. PMID:28379812

Toward an Emerging Role for Motivational Interviewing in Primary Care.

PubMed

Keeley, Robert; Engel, Matthew; Reed, Alex; Brody, David; Burke, Brian L

2018-05-18

Implementing Motivational Interviewing (MI) in primary care settings has been problematic due in part to persistent gaps in knowledge. Examples include poor understanding of how to effectively train persons to conduct MI, or of which aspects of MI-related communication are associated with better outcomes for patients. This review describes how recent research findings addressing the knowledge gaps support a growing role for MI in primary care. Two trials of MI training combined classroom time with ongoing coaching and feedback, resulting in enhanced MI ability relative to a control arm where PCPs received minimal or no MI training. A third MI training trial excluded coaching and feedback, failing to increase use of MI. Adding to a growing list of behavioral health-related problems for which MI training has shown some effectiveness, a trial of training PCPs to use MI with depressed patients was associated with significantly improved depressive symptoms. Moreover, aspects of the PCPs' MI-related language and patients' arguments for positive behavior changes, "change talk," appeared to explain the positive effects of MI training on depression outcome. MI-training approaches have improved such that PCPs and possibly other clinic staff may want to consider MI training as a way to more effectively support their patients as they address behavioral health-related problems (e.g., tobacco use). MI training should focus on eliciting "change talk" from patients. Researchers and funding agencies might collaborate to continue closing knowledge gaps in the MI literature.

Nursing as concrete philosophy, Part I: Risjord on nursing knowledge.

PubMed

Theodoridis, Kyriakos

2018-04-01

This essay addresses the problem of the essentiality of nursing knowledge and what kind of theory, if any, is essential to nursing practice. The overarching aim of the essay was to argue for the thesis that nursing may be described as a kind of philosophical activity, and, consequently, that philosophy is the kind of "theory" that is essential to nursing practice and to the nursing discipline at large. The essay consists of two papers. The present paper, Part I, is a critical examination of Mark Risjord's discussion of the problem of the theory-practice gap in his Nursing Knowledge: Practice, Science, Philosophy, from 2010. According to Risjord, the cause of the theory-practice gap originates in an erroneous conception of science (logical positivism) which had a decisive influence upon the way nursing scholars appropriated theoretical frameworks for the nursing discipline. This philosophical influence is considered in effect to have generated the theory-practice gap. In order to bridge the gap, Risjord suggests, the nursing discipline needs to adopt a standpoint epistemology conjoined with a postpositivist conception of scientific theory. In this way, a legitimate brand of nursing science may be developed and the theory-practice gap overcome. I will argue that neither Risjord's diagnosis of the problem, nor his recommended cure, may succeed in rescuing the nursing discipline from the theory-practice gap. Rather, the real cause of the theory-practice gap, I will claim, derives from an erroneous conception of nursing (not of science), namely the conception of nursing as a kind of science (roughly speaking). On my view, to overcome the gap, the nursing discipline needs to make salient the inherently philosophical character of nursing. In the second paper (Part II), I will continue the discussion of nursing knowledge and delineate the thesis of nursing as a kind of concrete philosophy. © 2017 John Wiley & Sons Ltd.

Closing the mycetoma knowledge gap.

PubMed

van de Sande, Wendy; Fahal, Ahmed; Ahmed, Sarah Abdalla; Serrano, Julian Alberto; Bonifaz, Alexandro; Zijlstra, Ed

2018-04-01

On 28th May 2016, mycetoma was recognized as a neglected tropical disease by the World Health Organization. This was the result of a 4-year journey starting in February 2013 with a meeting of global mycetoma experts. Knowledge gaps were identified and included the incidence, prevalence, and mapping of mycetoma; the mode of transmission; the development of methods for early diagnosis; and better treatment. In this review, we review the road to recognition, the ISHAM working group meeting in Argentina, and we address the progress made in closing the knowledge gaps since 2013. Progress included adding another 9000 patients to the literature, which allowed us to update the prevalence map on mycetoma. Furthermore, based on molecular phylogeny, species names were corrected and four novel mycetoma causative agents were identified. By mapping mycetoma causative agents an association with Acacia trees was found. For early diagnosis, three different isothermal amplification techniques were developed, and novel antigens were discovered. To develop better treatment strategies for mycetoma patients, in vitro susceptibility tests for the coelomycete agents of black grain mycetoma were developed, and the first randomized clinical trial for eumycetoma started early 2017.

Clinical utility of EEG in diagnosing and monitoring epilepsy in adults.

PubMed

Tatum, W O; Rubboli, G; Kaplan, P W; Mirsatari, S M; Radhakrishnan, K; Gloss, D; Caboclo, L O; Drislane, F W; Koutroumanidis, M; Schomer, D L; Kasteleijn-Nolst Trenite, D; Cook, Mark; Beniczky, S

2018-05-01

Electroencephalography (EEG) remains an essential diagnostic tool for people with epilepsy (PWE). The International Federation of Clinical Neurophysiology produces new guidelines as an educational service for clinicians to address gaps in knowledge in clinical neurophysiology. The current guideline was prepared in response to gaps present in epilepsy-related neurophysiological assessment and is not intended to replace sound clinical judgement in the care of PWE. Furthermore, addressing specific pathophysiological conditions of the brain that produce epilepsy is of primary importance though is beyond the scope of this guideline. Instead, our goal is to summarize the scientific evidence for the utility of EEG when diagnosing and monitoring PWE. Copyright © 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Reciprocal Elucidation: A Student-Led Pedagogy in Multidisciplinary Undergraduate Research Conferences

ERIC Educational Resources Information Center

Walkington, Helen; Hill, Jennifer; Kneale, Pauline E.

2017-01-01

There is no previous study of the benefits of attending a national multidisciplinary conference dedicated to undergraduate researchers, despite the growing number of such conferences internationally. This paper addresses the gap in knowledge of the learning gains from these conferences, and reveals a student driven learning process, a…

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

Cort, K. A.; Hostick, D. J.; Belzer, D. B.

This report compiles information and conclusions gathered as part of the “Modeling EERE Deployment Programs” project. The purpose of the project was to identify and characterize the modeling of deployment programs within the EERE Technology Development (TD) programs, address possible improvements to the modeling process, and note gaps in knowledge in which future research is needed.

Tenant Recruitment and Support Processes in Sustainability-Profiled Business Incubators

ERIC Educational Resources Information Center

Bank, Natasha; Kanda, Wisdom

2016-01-01

Recruitment and support processes in sustainability-profiled incubators have received little research attention. The article addresses this knowledge gap in an empirical investigation of three sustainability-oriented incubators in Sweden, Finland and Germany. The data are based on interviews with managers, stakeholders and tenants in Green Tech…

Reconciliation in Practice. Peaceworks No. 111

ERIC Educational Resources Information Center

McKone, Kelly

2015-01-01

This report addresses a critical knowledge gap between reconciliation theory and practice in post-conflict settings. Spearheaded by the Center for Applied Research on Conflict at the United States Institute of Peace (USIP), the larger project goal is to map reconciliation practices to better understand how reconciliation is conceived, what…

Predicting Nursing Facility Transition Candidates Using AID: A Case Study

ERIC Educational Resources Information Center

James, Mary L.; Wiley, Elizabeth; Fries, Brant E.

2007-01-01

Purpose: Although the nursing facility transition literature is growing, little research has analyzed the characteristics of individuals so assisted or compared participants to those who remain institutionalized. This article describes an analytic method that researchers can apply to address these knowledge gaps, using the Arkansas Passages…

Flipped ESL Teacher Professional Development: Embracing Change to Remain Relevant

ERIC Educational Resources Information Center

Razak, Rafiza Abdul; Kaur, Dalwinder; Halili, Siti Hajar; Ramlan, Zahri

2016-01-01

Many traditional professional development programs that are initiated to equip ESL teachers with knowledge and skills have been futile for numerous reasons. This paper addresses a gap in the recent research of ESL teachers' professional development. Literature has revealed many shortcomings of the traditional and online professional development…

Filling the knowledge gap: Integrating quantitative genetics and genomics in graduate education and outreach

USDA-ARS?s Scientific Manuscript database

The genomics revolution provides vital tools to address global food security. Yet to be incorporated into livestock breeding, molecular techniques need to be integrated into a quantitative genetics framework. Within the U.S., with shrinking faculty numbers with the requisite skills, the capacity to ...

Novel approaches to effects-based monitoring: 21st century tools for bio-effects prediction and surveillance

EPA Science Inventory

Effects-based monitoring (EBM) has been employed as a complement to chemical monitoring to help address knowledge gaps between chemical occurrence and biological effects. We have piloted several pathway-based approaches to EBM, that utilize modern bioinformatic and high throughpu...

Integrating themes, evidence gaps, and research needs identified by workshop on iron screening and supplementation in iron-replete pregnant women and young children.

PubMed

Brannon, Patsy M; Stover, Patrick J; Taylor, Christine L

2017-12-01

This report addresses the evidence and the uncertainties, knowledge gaps, and research needs identified by participants at the NIH workshop related to iron screening and routine iron supplementation of largely iron-replete pregnant women and young children (6-24 mo) in developed countries. The workshop presentations and panel discussions focused on current understanding and knowledge gaps related to iron homeostasis, measurement of and evidence for iron status, and emerging concerns about supplementing iron-replete members of these vulnerable populations. Four integrating themes emerged across workshop presentations and discussion and centered on 1 ) physiologic or developmental adaptations of iron homeostasis to pregnancy and early infancy, respectively, and their implications, 2 ) improvement of the assessment of iron status across the full continuum from iron deficiency anemia to iron deficiency to iron replete to iron excess, 3 ) the linkage of iron status with health outcomes beyond hematologic outcomes, and 4 ) the balance of benefit and harm of iron supplementation of iron-replete pregnant women and young children. Research that addresses these themes in the context of the full continuum of iron status is needed to inform approaches to the balancing of benefits and harms of screening and routine supplementation. © 2017 American Society for Nutrition.

Learning from research on the information behaviour of healthcare professionals: a review of the literature 2004-2008 with a focus on emotion.

PubMed

Fourie, Ina

2009-09-01

A review, focusing on emotion, was conducted of reported studies on the information behaviour of healthcare professionals (2004-2008). Findings were intended to offer guidelines on information services and information literacy training, to note gaps in research and to raise research interest. Databases were searched for literature published from January 2004 to December 2008 and indexed on eric, Library and Information Science Abstracts, medline, PsycINFO, Social Services Abstracts, Sociological Abstracts, Health Source: Nursing/Academic Edition; Library, Information Science & Technology Abstracts; Psychology and Behavioral Sciences Collection; Social Work Abstracts; SocINDEX with Full Text; SPORTDiscus; cinhal; and the ISI Web of Knowledge databases. Key journals were manually scanned and citations followed. Literature was included if reporting on issues concerning emotion. Emotion in information behaviour in healthcare contexts is scantily addressed. This review, however, offers some insight into the difficulty in identifying and expressing information needs; sense making and the need to fill knowledge gaps; uncertainty; personality and coping skills; motivation to seeking information; emotional experiences during information seeking; self-confidence and attitude; emotional factors in the selection of information channels; and seeking information for psychological or emotional reasons. Suggestions following findings, address information literacy programs, information services and research gaps.

Spinal Cord Injury Clinical Registries: Improving Care across the SCI Care Continuum by Identifying Knowledge Gaps.

PubMed

Dvorak, Marcel F; Cheng, Christiana L; Fallah, Nader; Santos, Argelio; Atkins, Derek; Humphreys, Suzanne; Rivers, Carly S; White, Barry A B; Ho, Chester; Ahn, Henry; Kwon, Brian K; Christie, Sean; Noonan, Vanessa K

2017-10-15

Timely access and ongoing delivery of care and therapeutic interventions is needed to maximize recovery and function after traumatic spinal cord injury (tSCI). To ensure these decisions are evidence-based, access to consistent, reliable, and valid sources of clinical data is required. The Access to Care and Timing Model used data from the Rick Hansen SCI Registry (RHSCIR) to generate a simulation of healthcare delivery for persons after tSCI and to test scenarios aimed at improving outcomes and reducing the economic burden of SCI. Through model development, we identified knowledge gaps and challenges in the literature and current health outcomes data collection throughout the continuum of SCI care. The objectives of this article were to describe these gaps and to provide recommendations for bridging them. Accurate information on injury severity after tSCI was hindered by difficulties in conducting neurological assessments and classifications of SCI (e.g., timing), variations in reporting, and the lack of a validated SCI-specific measure of associated injuries. There was also limited availability of reliable data on patient factors such as multi-morbidity and patient-reported measures. Knowledge gaps related to structures (e.g., protocols) and processes (e.g., costs) at each phase of care have prevented comprehensive evaluation of system performance. Addressing these knowledge gaps will enhance comparative and cost-effectiveness evaluations to inform decision-making and standards of care. Recommendations to do so were: standardize data element collection and facilitate database linkages, validate and adopt more outcome measures for SCI, and increase opportunities for collaborations with stakeholders from diverse backgrounds.

Spinal Cord Injury Clinical Registries: Improving Care across the SCI Care Continuum by Identifying Knowledge Gaps

PubMed Central

Cheng, Christiana L.; Fallah, Nader; Santos, Argelio; Atkins, Derek; Humphreys, Suzanne; Rivers, Carly S.; White, Barry A.B.; Ho, Chester; Ahn, Henry; Kwon, Brian K.; Christie, Sean; Noonan, Vanessa K.

2017-01-01

Abstract Timely access and ongoing delivery of care and therapeutic interventions is needed to maximize recovery and function after traumatic spinal cord injury (tSCI). To ensure these decisions are evidence-based, access to consistent, reliable, and valid sources of clinical data is required. The Access to Care and Timing Model used data from the Rick Hansen SCI Registry (RHSCIR) to generate a simulation of healthcare delivery for persons after tSCI and to test scenarios aimed at improving outcomes and reducing the economic burden of SCI. Through model development, we identified knowledge gaps and challenges in the literature and current health outcomes data collection throughout the continuum of SCI care. The objectives of this article were to describe these gaps and to provide recommendations for bridging them. Accurate information on injury severity after tSCI was hindered by difficulties in conducting neurological assessments and classifications of SCI (e.g., timing), variations in reporting, and the lack of a validated SCI-specific measure of associated injuries. There was also limited availability of reliable data on patient factors such as multi-morbidity and patient-reported measures. Knowledge gaps related to structures (e.g., protocols) and processes (e.g., costs) at each phase of care have prevented comprehensive evaluation of system performance. Addressing these knowledge gaps will enhance comparative and cost-effectiveness evaluations to inform decision-making and standards of care. Recommendations to do so were: standardize data element collection and facilitate database linkages, validate and adopt more outcome measures for SCI, and increase opportunities for collaborations with stakeholders from diverse backgrounds. PMID:28745934

Working group report on advanced high-voltage high-power and energy-storage space systems

NASA Technical Reports Server (NTRS)

Cohen, H. A.; Cooke, D. L.; Evans, R. W.; Hastings, D.; Jongeward, G.; Laframboise, J. G.; Mahaffey, D.; Mcintyre, B.; Pfizer, K. A.; Purvis, C.

1986-01-01

Space systems in the future will probably include high-voltage, high-power energy-storage and -production systems. Two such technologies are high-voltage ac and dc systems and high-power electrodynamic tethers. The working group identified several plasma interaction phenomena that will occur in the operation of these power systems. The working group felt that building an understanding of these critical interaction issues meant that several gaps in our knowledge had to be filled, and that certain aspects of dc power systems have become fairly well understood. Examples of these current collection are in quiescent plasmas and snap over effects. However, high-voltage dc and almost all ac phenomena are, at best, inadequately understood. In addition, there is major uncertainty in the knowledge of coupling between plasmas and large scale current flows in space plasmas. These gaps in the knowledge are addressed.

The Trajectory of Dispersal Research in Conservation Biology. Systematic Review

PubMed Central

Driscoll, Don A.; Banks, Sam C.; Barton, Philip S.; Ikin, Karen; Lentini, Pia; Lindenmayer, David B.; Smith, Annabel L.; Berry, Laurence E.; Burns, Emma L.; Edworthy, Amanda; Evans, Maldwyn J.; Gibson, Rebecca; Heinsohn, Rob; Howland, Brett; Kay, Geoff; Munro, Nicola; Scheele, Ben C.; Stirnemann, Ingrid; Stojanovic, Dejan; Sweaney, Nici; Villaseñor, Nélida R.; Westgate, Martin J.

2014-01-01

Dispersal knowledge is essential for conservation management, and demand is growing. But are we accumulating dispersal knowledge at a pace that can meet the demand? To answer this question we tested for changes in dispersal data collection and use over time. Our systematic review of 655 conservation-related publications compared five topics: climate change, habitat restoration, population viability analysis, land planning (systematic conservation planning) and invasive species. We analysed temporal changes in the: (i) questions asked by dispersal-related research; (ii) methods used to study dispersal; (iii) the quality of dispersal data; (iv) extent that dispersal knowledge is lacking, and; (v) likely consequences of limited dispersal knowledge. Research questions have changed little over time; the same problems examined in the 1990s are still being addressed. The most common methods used to study dispersal were occupancy data, expert opinion and modelling, which often provided indirect, low quality information about dispersal. Although use of genetics for estimating dispersal has increased, new ecological and genetic methods for measuring dispersal are not yet widely adopted. Almost half of the papers identified knowledge gaps related to dispersal. Limited dispersal knowledge often made it impossible to discover ecological processes or compromised conservation outcomes. The quality of dispersal data used in climate change research has increased since the 1990s. In comparison, restoration ecology inadequately addresses large-scale process, whilst the gap between knowledge accumulation and growth in applications may be increasing in land planning. To overcome apparent stagnation in collection and use of dispersal knowledge, researchers need to: (i) improve the quality of available data using new approaches; (ii) understand the complementarities of different methods and; (iii) define the value of different kinds of dispersal information for supporting management decisions. Ambitious, multi-disciplinary research programs studying many species are critical for advancing dispersal research. PMID:24743447

The trajectory of dispersal research in conservation biology. Systematic review.

PubMed

Driscoll, Don A; Banks, Sam C; Barton, Philip S; Ikin, Karen; Lentini, Pia; Lindenmayer, David B; Smith, Annabel L; Berry, Laurence E; Burns, Emma L; Edworthy, Amanda; Evans, Maldwyn J; Gibson, Rebecca; Heinsohn, Rob; Howland, Brett; Kay, Geoff; Munro, Nicola; Scheele, Ben C; Stirnemann, Ingrid; Stojanovic, Dejan; Sweaney, Nici; Villaseñor, Nélida R; Westgate, Martin J

2014-01-01

Dispersal knowledge is essential for conservation management, and demand is growing. But are we accumulating dispersal knowledge at a pace that can meet the demand? To answer this question we tested for changes in dispersal data collection and use over time. Our systematic review of 655 conservation-related publications compared five topics: climate change, habitat restoration, population viability analysis, land planning (systematic conservation planning) and invasive species. We analysed temporal changes in the: (i) questions asked by dispersal-related research; (ii) methods used to study dispersal; (iii) the quality of dispersal data; (iv) extent that dispersal knowledge is lacking, and; (v) likely consequences of limited dispersal knowledge. Research questions have changed little over time; the same problems examined in the 1990s are still being addressed. The most common methods used to study dispersal were occupancy data, expert opinion and modelling, which often provided indirect, low quality information about dispersal. Although use of genetics for estimating dispersal has increased, new ecological and genetic methods for measuring dispersal are not yet widely adopted. Almost half of the papers identified knowledge gaps related to dispersal. Limited dispersal knowledge often made it impossible to discover ecological processes or compromised conservation outcomes. The quality of dispersal data used in climate change research has increased since the 1990s. In comparison, restoration ecology inadequately addresses large-scale process, whilst the gap between knowledge accumulation and growth in applications may be increasing in land planning. To overcome apparent stagnation in collection and use of dispersal knowledge, researchers need to: (i) improve the quality of available data using new approaches; (ii) understand the complementarities of different methods and; (iii) define the value of different kinds of dispersal information for supporting management decisions. Ambitious, multi-disciplinary research programs studying many species are critical for advancing dispersal research.

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

PubMed

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

2012-01-01

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

Proceedings from Bridging Health Disparities to Address the Opioid Epidemic: A Symposium at the Warren Alpert Medical School of Brown University.

PubMed

Dumenco, Luba; Monteiro, Kristina; Mello, Michael; Collins, Sally; Operario, Don; Scanlan, Karen; Dollase, Richard; George, Paul

2017-04-03

In response to the unprecedented rates of illicit drug use, including opioid addiction and overdose in Rhode Island, local healthcare institutions, led by the Warren Alpert Medical School (AMS) of Brown University, collaborated to present "Bridging Health Disparities to Address the Opioid Epidemic." This symposium sought to educate a wide array of healthcare providers and professionals around opioid use disorder, including the state of the opioid crisis in Rhode Island, national efforts around opioid misuse and how providers can work together to stem the opioid crisis in the state. The symposium included a keynote session which aimed to increase knowledge and decrease stigma. This was followed by two rounds of breakout sessions which focused on various components of opioid disorder treatment. We elicited feedback from participants in order to plan further interventions to educate providers in Rhode Island around the opioid epidemic. Primary Results: Initial feedback was positive. More importantly, this workshop allowed us to identify gaps in knowledge amongst healthcare providers in Rhode Island in order to plan further interventions for healthcare providers, including physicians, around opioid misuse, in Rhode Island. This symposium is one of the first steps that a consortium of healthcare institutions, including AMS, will take to address the opioid crisis in Rhode Island. Feedback from the event was elicited to identify gaps in healthcare provider knowledge and will be used to design and implement further interventions. [Full article available at http://rimed.org/rimedicaljournal-2017-04.asp].

Exploring an educational assessment tool to measure registered nurses' knowledge of hearing impairment and effective communication strategies: A USA study.

PubMed

Ruesch, Amy L

2018-01-01

Poor communication between the Registered Nurse and a hearing impaired patient can affect quality of care and health outcomes. Communication skills training programs for healthcare providers are needed to improve patient centered care. A descriptive research study, using a knowledge assessment tool developed and validated by the researcher, was conducted on 339 Registered Nurses to identify knowledge deficits to be addressed in a communication skills training program being designed. The educational tool measured the Registered Nurses' knowledge across four areas - hearing impairment, hearing aids, communication strategies, and regulations regarding access to care for a person with a hearing disability. Knowledge deficits were detected in all four areas. Using this educational assessment tool may enable nurse educators to tailor communication skills training programs to specifically address the gaps identified regarding hearing impairment and how to effectively communicate with the hearing impaired patient. Post training program, nurse educators can use the tool to evaluate effectiveness. Copyright © 2017 Elsevier Ltd. All rights reserved.

"My older clients fall through every crack in the system": geriatrics knowledge of legal professionals.

PubMed

Soones, Tacara; Ahalt, Cyrus; Garrigues, Sarah; Faigman, David; Williams, Brie A

2014-04-01

With the number of older adult arrestees and prisoners increasing rapidly, legal professionals increasingly provide front-line identification and response to age-related health conditions (including cognitive and physical impairments) that may affect legal outcomes, such as the ability to participate in one's defense or stay safe in jail. The goals of this study were to assess the ability of legal professionals to recognize and respond to age-related conditions that could affect legal outcomes and to identify recommendations to address important knowledge gaps. This was a mixed quantitative-qualitative study. Legal professionals (N = 72) in the criminal justice system were surveyed to describe their demographic characteristics, expertise, and prior aging-related training and to inform the qualitative interview guide. Those surveyed included attorneys (district attorneys (25%), public defenders and legal advocates (58%)), judges (6%), and court-affiliated social workers (11%). In-depth qualitative interviews were then conducted with a subset of 10 legal professionals who worked with older adults at least weekly. Results from the surveys and interviews revealed knowledge deficits in four important areas: age-related health, identification of cognitive impairment, assessment of safety risk, and optimization of services upon release from jail. Four recommendations to close these gaps emerged: educate legal professionals about age-related health, train professionals to identify cognitive and sensory impairment, develop checklists to identify those at risk of poor health or safety, and improve knowledge of and access to transitional services for older adults. These findings suggest that geriatrics knowledge gaps of legal professionals exist that may contribute to adverse medical or legal outcomes for older adults involved in the criminal justice system and that partnerships between healthcare and legal professionals are needed to address these challenges. © Published 2014. This article is a U.S. Government work and is in the public domain in the U.S.A.

Research to practice in The Journal of Continuing Education in the Health Professions: a thematic analysis of volumes 1 through 24.

PubMed

MacIntosh-Murray, Anu; Perrier, Laure; Davis, David

2006-01-01

Authors have stressed the importance of the broader contextual influences on practice improvement and learning and have expressed concern about gaps between research and practice. This implies a potential expansion of the knowledge base for continuing education in the health professions (CEHP) and an increased emphasis on research evidence for that knowledge. How has the content of The Journal of Continuing Education in the Health Professions (JCEHP) reflected those changes? What are the implications for CEHP practitioners? Based on all abstracts, tables of contents, and editorials, a thematic analysis was completed for volumes 1 through 24 of JCEHP. All texts were downloaded into qualitative analysis software and coded. Main code categories included demographics of articles, concepts relating to CEHP as a discipline, knowledge translation and outcomes-oriented continuing education, and theories and frameworks. Key themes were identified. Key themes include categories of topics included in JCEHP over the years, the increased prominence of research in JCEHP, a dual research evidence-to-practice gap, the professionalization of continuing education providers, and interdisciplinarity and the links with broader frameworks that have been proposed for CEHP. Two sets of research-to-practice gaps are portrayed in the journal: the gap between clinical research and practice and the gap between research and practice in CEHP. To close the first gap, authors have asserted that the second gap must be addressed, ensuring that CEHP practices themselves are evidence based, driven by theory-based research. This is a variation on prior debates regarding the need to define CEHP as a discipline, which uses the language of professionalization. The increased focus of continuing education on the contexts of health care providers' practices has multiplied the topics that are potentially relevant to CEHP practice.

Interactive Virtual Suturing Simulations: Enhancement of Student Learning in Veterinary Medicine

ERIC Educational Resources Information Center

Staton, Amy J.; Boyd, Christine B.

2013-01-01

This capstone addresses an instructional gap in the Morehead State University Veterinary Technology Program and in other similar programs around the globe. Students do not retain the knowledge needed to proficiently complete suture patterns nor do students receive sufficient instructional time during the year to master each suture pattern that is…

Equitable Education for All: Using a Comprehensive Instructional Model to Improve Preschool Teacher Practices

ERIC Educational Resources Information Center

Carlson, Abby G.; Curby, Timothy W.; Brown, Chavaughn A.; Trygstad, Kelly M.; Truong, Felicia R.

2017-01-01

The current study evaluates the effectiveness of a comprehensive instructional model, ("Every Child Ready"), as a vehicle to provide equitable education experiences for all children by compensating for gaps in teacher knowledge. The ECR instructional model addresses several challenges facing the early childhood landscape. Specifically,…

Nitrogen availability is a primary determinant of conifer mycorrhizas across complex environmental gradients

Treesearch

Filipa Cox; Nadia Barsoum; Erik A. Lilleskov; Martin I. Bidartondo

2010-01-01

Global environmental change has serious implications for functional biodiversity in temperate and boreal forests. Trees depend on mycorrhizal fungi for nutrient uptake, but predicted increases in nitrogen availability may alter fungal communities. To address a knowledge gap regarding the effects of nitrogen availability on mycorrhizal communities at large scales, we...

Restoration and economics: A union waiting to happen?

Treesearch

Alicia S.T. Robbins; Jean M. Daniels

2012-01-01

In this article, our objective is to introduce economics as a tool for the planning, prioritization, and evaluation of restoration projects. Studies that develop economic estimates of public values for ecological restoration employ methods that may be unfamiliar to practitioners. We hope to address this knowledge gap by describing economic concepts in the context of...

Motivating and Assisting Adult, Online Chemistry Students: A Review of the Literature

ERIC Educational Resources Information Center

Bannier, Betsy J.

2010-01-01

While comprehensive texts, articles, and literature reviews presenting research in the singular arenas of motivation, help-seeking, and online science learning are relatively easy to find, syntheses and interactions between these constructs are lacking. Part I of this review addresses this knowledge gap by drawing together key research from the…

Educators' Perceptions of Teaching Grade-Level Content to Students with Intellectual Disabilities

ERIC Educational Resources Information Center

Carlson, Christina V.

2016-01-01

The purpose of this study was to address a gap in the research literature by describing the perceptions of Special Education teachers of students with intellectual disabilities (ID), regarding the paradigm shift required in their teaching practices as they strove to implement current educational reform legislation. Knowledge of the lived…

Taking Culture into Account: A Maori Perspective on Visual Impairment

ERIC Educational Resources Information Center

Bevan-Brown, Jill; Walker, Taingunguru

2013-01-01

The authors open this article by noting that there is substantial research evidence showing that ethnic culture affects how disability is perceived and managed, and that taking a person's culture into account maximizes the effectiveness of the person's education. Jill Bevan-Brown and Taingunguru Walker, address this gap in knowledge by describing…

Sexual Assault Prevention for Women with Intellectual Disabilities: A Critical Review of the Evidence

ERIC Educational Resources Information Center

Barger, Erin; Wacker, Julia; Macy, Rebecca; Parish, Susan

2009-01-01

Although research has indicated that women with intellectual disabilities are significantly burdened with sexual violence, there is a dearth of sexual assault prevention research for them. To help address this serious knowledge gap, the authors summarize the findings of general sexual assault prevention research and discuss its implications for…

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…

Student-Produced Podcasts in Language Learning--Exploring Student Perceptions of Podcast Activities

ERIC Educational Resources Information Center

Phillips, Birgit

2017-01-01

Podcasts are a useful tool for developing speaking skills in language acquisition settings, particularly within the context of the emerging Mobile Assisted Language Learning (MALL). While much research has emphasized the effectiveness of teacher-produced podcasts, this study seeks to address the gap in knowledge on student-generated podcasts in…

Critical Race Theory-Social Constructivist Bricolage: A Health-Promoting Schools Research Methodology

ERIC Educational Resources Information Center

Nyika, Lawrence; Murray-Orr, Anne

2017-01-01

While the current literature recognises the capacity of diverse methodologies to provide informative understandings of health-promoting schools (HPS), there is a paucity of examples to show how different research strategies can be used. We address this knowledge gap by examining the significance of a critical race theory-social constructivist…

Tackling the Knowledge: Action Gap in Sustainable Consumption--Insights from a Participatory School Programme

ERIC Educational Resources Information Center

Barth, Matthias; Fischer, Daniel; Michelsen, Gerd; Nemnich, Claudia; Rode, Horst

2012-01-01

In the international policy discourse on sustainable consumption and production, education is acknowledged to be a powerful tool in changing unsustainable patterns of consumption. Current educational policies and programmes have responded to the consumption challenge mainly by including and addressing consumption issues in formal tuition in…

School Nurses Can Address Existing Gaps in School-Age Sleep Research

ERIC Educational Resources Information Center

Willgerodt, Mayumi A.; Kieckhefer, Gail M.

2013-01-01

Sleep has been linked to a host of physical, behavioral, and emotional outcomes, and research has documented that youth across the globe are experiencing inadequate sleep. Despite this knowledge, however, very little research has been conducted on school-age children; much of the extant research has focused on infants, toddlers, preschoolers,…

Informal Numeracy Skills: The Structure and Relations among Numbering, Relations, and Arithmetic Operations in Preschool

ERIC Educational Resources Information Center

Purpura, David J.; Lonigan, Christopher J.

2013-01-01

Validating the structure of informal numeracy skills is critical to understanding the developmental trajectories of mathematics skills at early ages; however, little research has been devoted to construct evaluation of the Numbering, Relations, and Arithmetic Operations domains. This study was designed to address this knowledge gap by examining…

Total Pancreatectomy With Islet Auto-Transplantation (TPIAT): Summary of an NIDDK Workshop

PubMed Central

Bellin, Melena D.; Gelrud, Andres; Arreaza-Rubin, Guillermo; Dunn, Ty B.; Humar, Abhinav; Morgan, Katherine A.; Naziruddin, Bashoo; Rastellini, Cristiana; Rickels, Michael R.; Schwarzenberg, Sarah J.; Andersen, Dana K.

2014-01-01

A workshop sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) focused on research gaps and opportunities in total pancreatectomy with islet autotransplantation (TPIAT) for the management of chronic pancreatitis (CP). The session was held on July 23, 2014 and structured into five sessions: (1) patient selection, indications, and timing; (2) technical aspects of TPIAT; (3) improving success of islet autotransplantation; (4) improving outcomes after total pancreatectomy; and (5) registry considerations for TPIAT. The current state of knowledge was reviewed; knowledge gaps and research needs were specifically highlighted. Common themes included the need to identify which patients best benefit from and when to intervene with TPIAT, current limitations of the surgical procedure, diabetes remission and the potential for improvement, opportunities to better address pain remission, GI complications in this population, and unique features of children with CP considered for TPIAT. The need for a multicenter patient registry that specifically addresses the complexities of CP and total pancreatectomy outcomes as well as post-surgical diabetes outcomes was repeatedly emphasized. PMID:25333399

Achieving best outcomes of patients with cardiovascular diseases in China by enhancing the quality of medical care and establishing a learning health care system

PubMed Central

Jiang, Lixin; Krumholz, Harlan M; Li, Xi; Li, Jing; Hu, Shengshou

2016-01-01

Summary China faces the immediate need of addressing the rapidly growing population with cardiovascular disease (CVD) events and the increasing numbers who are living with CVD. Despite progress in increasing access to services, China faces the dual challenge of addressing gaps in quality of care and producing more evidence to support clinical practice. In this article, we address opportunities to strengthen performance measurement, programs to improve quality of care and national capacity to produce high impact knowledge for clinical practice. Moreover, we propose recommendations, with implications for other conditions, for how China can immediately leverage its Hospital Quality Monitoring System and other existing national platforms to evaluate and improve performance, as well as generate new knowledge to inform clinical decisions and national policies. PMID:26466053

The Role of Veterinary Education in Safety Policies for Animal-Assisted Therapy and Activities in Hospitals and Nursing Homes.

PubMed

Linder, Deborah E; Mueller, Megan K; Gibbs, Debra M; Siebens, Hannah C; Freeman, Lisa M

Animal-assisted activities (AAA) and animal-assisted therapy (AAT) programs are increasing in popularity, but current programs vary in their safety and health policies. Veterinarians can have an important role in ensuring the safety of both the animals and humans involved, but it is unclear how best to educate veterinary students to serve effectively in this role. Therefore, the goal of this study was to assess the knowledge gaps and perceptions of first-year veterinary students on health and safety aspects of AAA/AAT programs by administering a survey. This information could then guide future educational training in veterinary schools to address the knowledge gaps in this area. Formal education during the veterinary curriculum had not yet been provided to these students on AAA/AAT before the survey. Of 98 first-year veterinary students, 91 completed the survey. When asked about policies on visiting animals, 58% of students responded that nursing homes are required to have a policy and 67% responded that hospitals are required to have one. Three quarters of students reported that veterinarians, animal handlers, and facilities should share the responsibility for ensuring safe human-animal interaction in AAA/AAT programs. Most (82%) of the students responded that all or most national and local therapy animal groups prohibit animals that consume raw meat diets from participating in AAA/AAT programs. The results of this survey will help veterinary schools better identify knowledge gaps that can be addressed in veterinary curricula so future veterinarians will be equipped to provide appropriate public health information regarding AAA/AAT programs.

Knowledge translation in Africa for 21st century integrative biology: the "know-do gap" in family planning with contraceptive use among Somali women.

PubMed

Ahmed, Ahmed A; Mohamed, Abdullahi A; Guled, Ibrahim A; Elamin, Hayfa M; Abou-Zeid, Alaa H

2014-11-01

An emerging dimension of 21(st) century integrative biology is knowledge translation in global health. The maternal mortality rate in Somalia is amongst the highest in the world. We set out to study the "know-do" gap in family planning measures in Somalia, with a view to inform future interventions for knowledge integration between theory and practice. We interviewed 360 Somali females of reproductive age and compared university-educated females to women with less or no education, using structured interviews, with a validated questionnaire. The mean age of marriage was 18 years, with 4.5 pregnancies per marriage. The mean for the desired family size was 9.3 and 10.5 children for the university-educated group and the less-educated group, respectively. Importantly, nearly 90% of the university-educated group knew about family planning, compared to 45.6% of the less-educated group. All of the less-educated group indicated that they would never use contraceptives, as compared to 43.5% of the university-educated group. Prevalence of contraceptive use among ever-married women was 4.3%. In the less-educated group, 80.6% indicated that they would not recommend contraceptives to other women as compared to 66.0% of the university-educated group. There is a huge gap between knowledge and practice regarding family planning in Somalia. The attendant reasons for this gap, such as level of education, expressed personal religious beliefs and others, are examined here. For primary health care to gain traction in Africa, we need to address the existing "know-do" gaps that are endemic and adversely impacting on global health. This is the first independent research study examining the knowledge gaps for family planning in Somalia in the last 20 years, with a view to understanding knowledge integration in a global world. The results shall guide policy makers, donors, and implementers to develop a sound family planning policy and program to improve maternal and child health in 21(st) century primary healthcare.

Canopy and knowledge gaps when invasive alien insects remove foundation species.

PubMed

Marler, Thomas E; Lawrence, John H

2013-01-01

The armored scale Aulacaspis yasumatsui invaded the northern range of the cycad Cycas micronesica in 2003, and epidemic tree mortality ensued due to a lack of natural enemies of the insect. We quantified cycad demographic responses to the invasion, but the ecological responses to the selective removal of this foundation species have not been addressed. We use this case to highlight information gaps in our understanding of how alien invasive phytophagous insects force cascading adverse ecosystem changes. The mechanistic role of unique canopy gaps, oceanic island examples and threatened foundation species with distinctive traits are three issues that deserve research efforts in a quest to understand this facet of ecosystem change occurring across multiple settings globally.

Gaps and opportunities in refractory status epilepticus research in children: a multi-center approach by the Pediatric Status Epilepticus Research Group (pSERG).

PubMed

Sánchez Fernández, Iván; Abend, Nicholas S; Agadi, Satish; An, Sookee; Arya, Ravindra; Carpenter, Jessica L; Chapman, Kevin E; Gaillard, William D; Glauser, Tracy A; Goldstein, David B; Goldstein, Joshua L; Goodkin, Howard P; Hahn, Cecil D; Heinzen, Erin L; Mikati, Mohamad A; Peariso, Katrina; Pestian, John P; Ream, Margie; Riviello, James J; Tasker, Robert C; Williams, Korwyn; Loddenkemper, Tobias

2014-02-01

Status epilepticus (SE) is a life-threatening condition that can be refractory to initial treatment. Randomized controlled studies to guide treatment choices, especially beyond first-line drugs, are not available. This report summarizes the evidence that guides the management of refractory convulsive SE (RCSE) in children, defines gaps in our clinical knowledge and describes the development and works of the 'pediatric Status Epilepticus Research Group' (pSERG). A literature review was performed to evaluate current gaps in the pediatric SE and RCSE literature. In person and online meetings helped to develop and expand the pSERG network. The care of pediatric RCSE is largely based on extrapolations of limited evidence derived from adult literature and supplemented with case reports and case series in children. No comparative effectiveness trials have been performed in the pediatric population. Gaps in knowledge include risk factors for SE, biomarkers of SE and RCSE, second- and third-line treatment options, and long-term outcome. The care of children with RCSE is based on limited evidence. In order to address these knowledge gaps, the multicenter pSERG was established to facilitate prospective collection, analysis, and sharing of de-identified data and biological specimens from children with RCSE. These data will allow identification of treatment strategies associated with better outcomes and delineate evidence-based interventions to improve the care of children with SE. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Implementation science in healthcare: Introduction and perspective.

PubMed

Wensing, Michel

2015-01-01

Implementation science is the scientific study of the methods to promote the uptake of research findings into routine healthcare in clinical, organisational, or policy contexts. The presence of gaps between knowledge and practice is well documented and a range of strategies is available to overcome these gaps. To optimize their impact, it is recommended that implementation strategies are tailored to the target population, setting and goals for improvement. Themes for future research in the field are: implementation of personalized medicine, the economics of implementation, knowledge implementation in various health professions, patient involvement in implementation, and a better understanding of the determinants of implementation. Addressing these challenges requires dedicated training programs, research funding, and networks for effective collaboration with stakeholders in healthcare. Copyright © 2015. Published by Elsevier GmbH.

Forests under climate change and air pollution: gaps in understanding and future directions for research.

PubMed

Matyssek, R; Wieser, G; Calfapietra, C; de Vries, W; Dizengremel, P; Ernst, D; Jolivet, Y; Mikkelsen, T N; Mohren, G M J; Le Thiec, D; Tuovinen, J-P; Weatherall, A; Paoletti, E

2012-01-01

Forests in Europe face significant changes in climate, which in interaction with air quality changes, may significantly affect forest productivity, stand composition and carbon sequestration in both vegetation and soils. Identified knowledge gaps and research needs include: (i) interaction between changes in air quality (trace gas concentrations), climate and other site factors on forest ecosystem response, (ii) significance of biotic processes in system response, (iii) tools for mechanistic and diagnostic understanding and upscaling, and (iv) the need for unifying modelling and empirical research for synthesis. This position paper highlights the above focuses, including the global dimension of air pollution as part of climate change and the need for knowledge transfer to enable reliable risk assessment. A new type of research site in forest ecosystems ("supersites") will be conducive to addressing these gaps by enabling integration of experimentation and modelling within the soil-plant-atmosphere interface, as well as further model development. Copyright © 2011 Elsevier Ltd. All rights reserved.

A sociocultural analysis of Latino high school students' funds of knowledge and implications for culturally responsive engineering education

NASA Astrophysics Data System (ADS)

Mejia, Joel Alejandro

Previous studies have suggested that, when funds of knowledge are incorporated into science and mathematics curricula, students are more engaged and often develop richer understandings of scientific concepts. While there has been a growing body of research addressing how teachers may integrate students' linguistic, social, and cultural practices with science and mathematics instruction, very little research has been conducted on how the same can be accomplished with Latino and Latina students in engineering. The purpose of this study was to address this gap in the literature by investigating how fourteen Latino and Latina high school adolescents used their funds of knowledge to address engineering design challenges. This project was intended to enhance the educational experience of underrepresented minorities whose social and cultural practices have been traditionally undervalued in schools. This ethnographic study investigated the funds of knowledge of fourteen Latino and Latina high school adolescents and how they used these funds of knowledge in engineering design. Participant observation, bi-monthly group discussion, retrospective and concurrent protocols, and monthly one-on-one interviews were conducted during the study. A constant comparative analysis suggested that Latino and Latina adolescents, although profoundly underrepresented in engineering, bring a wealth of knowledge and experiences that are relevant to engineering design thinking and practice.

Poverty and Health Disparities for American Indian and Alaska Native Children: Current Knowledge and Future Prospects

PubMed Central

Sarche, Michelle; Spicer, Paul

2008-01-01

This report explores the current state of knowledge regarding inequalities and their effect on American Indian and Alaska Native children, underscoring gaps in our current knowledge and the opportunities for early intervention to begin to address persistent challenges in young American Indian and Alaska Native children’s development. This overview documents demographic, social, health, and health care disparities as they affect American Indian and Alaska Native children, the persistent cultural strengths that must form the basis for any conscientious intervention effort, and the exciting possibilities for early childhood interventions. PMID:18579879

Education-based disparities in knowledge of novel health risks: The case of knowledge gaps in HIV risk perceptions.

PubMed

Kiviniemi, Marc T; Orom, Heather; Waters, Erika A; McKillip, Megan; Hay, Jennifer L

2018-05-01

Risk perception is a key determinant of preventive health behaviour, but when asked, some individuals indicate they do not know their health risk. Low education is associated with both lack of knowledge about health risk and with the persistence and exacerbation of gaps in knowledge about health issues. This study uses the context of an emerging infectious disease threat to explore the hypothesis that the education-don't know risk relation results from differences in knowledge about the health issue of interest. Specifically, we examine whether patterns of change over time follow theoretical predictions that disparities in risk knowledge would increase over time in less educated sectors of the population (knowledge gap hypothesis). Secondary analysis of population-representative behavioural surveillance survey. We analysed data from the 1993 to 2000 Behavior Risk Factor Surveillance System surveys, which measured education and perceived HIV/AIDS risk in a population sample collected separately in each survey year; don't know responses were coded. In each year, individuals with higher education were less likely to respond don't know. The absolute prevalence of don't know responding dropped over time; nonetheless, there was an increase over time in the magnitude of the pattern of lower education being associated with greater don't know responding. We found support for the knowledge gap hypothesis. Over time, populations with greater education gained more knowledge about their HIV risk than populations with lower education. Results highlight the need to carefully consider health communication strategies to reach and address those individuals with low education and health knowledge. Statement of contribution What is already known on this subject? A meaningful potion of the population answers 'don't know' when asked to report their risk for health problems, indicating a lack of risk perception in the domain. Previous studies have shown that level of education is associated with don't know responding - those with lower educational attainment are more likely to respond don't know. The education-don't know responding relation suggests that lack of health information and health domain knowledge might be a factor in lacking risk perception, but this mechanism has not been previously tested. What does this study add? Patterns of changes in don't know responding over time as population-level knowledge of a health risk increase are consistent with the health information/health knowledge hypothesis outlined above. As population knowledge of HIV/AIDS risk in the United States increased over time (indicated by declining overall rates of don't know responses), the relation of education level to don't know responding actually became stronger. The pattern of change over time is the classic 'knowledge gap hypothesis' pattern, which has not been previously demonstrated for knowledge of personal health risk. The knowledge gap response pattern supports the health information/health knowledge hypothesis. © 2018 The British Psychological Society.

Current status of pharmacokinetic and safety studies of multidrug-resistant tuberculosis treatment in children.

PubMed

Garcia-Prats, A J; Svensson, E M; Weld, E D; Schaaf, H S; Hesseling, A C

2018-05-01

After decades of neglect, data are finally becoming available on the appropriate, safe dosing of key second-line anti-tuberculosis drugs used for treating multidrug-resistant tuberculosis (MDR-TB) in children, including levofloxacin (LVX), moxifloxacin (MFX), linezolid (LZD) and delamanid (DLM). Much needed data on some novel and repurposed drugs are still lacking, including for bedaquiline (BDQ), pretomanid (PTM) and clofazimine (CFZ). We review the status of pharmacokinetic (PK) and safety studies of key anti-tuberculosis medications in children with MDR-TB, identify priority knowledge gaps and note ongoing work to address those gaps, in the context of planning for an efficacy trial in children with MDR-TB. There is international consensus that an efficacy trial of a novel, all-oral, shortened MDR-TB treatment trial in children is both needed and feasible. Key novel and repurposed second-line anti-tuberculosis drugs include BDQ, DLM, PTM, MFX, LVX, CFZ and LZD. The rapidly emerging PK and safety data on these medications in children with MDR-TB from studies that are underway, completed or planned, will be critical in supporting such an efficacy trial. Commitment to addressing the remaining knowledge gaps, developing child-friendly formulations of key medications, improving the design of paediatric PK and safety studies, and development of international trial capacity in children with MDR-TB are important priorities.

Is It Bullying or Sexual Harassment? Knowledge, Attitudes, and Professional Development Experiences of Middle School Staff

ERIC Educational Resources Information Center

Charmaraman, Linda; Jones, Ashleigh E.; Stein, Nan; Espelage, Dorothy L.

2013-01-01

Background: This study fills a gap in the literature by examining how school staff members view bullying and sexual harassment and their role in preventing both. Given recent legislation, increasingly more attention is paid to bully prevention; however, student-on-student sexual harassment is less addressed. Methods: Four focus groups were…

Development of an Educational Packet for Persons with Life-Threatening Food Allergies

ERIC Educational Resources Information Center

Olson, Bradley F.; Teuber, Suzanne; Bruhn, Christine M.

2009-01-01

Previous studies have shown that those with severe food allergies have significant gaps in knowledge about their disease and how to prevent recurrences. The purpose of this study was to address these deficiencies by creating and testing an educational packet, "Coping with Food Allergies." Participants included 46 of 58 adults with documented…

Students' Attitudes toward a Group Coursework Protocol and Peer Assessment System

ERIC Educational Resources Information Center

Moraes, Caroline; Michaelidou, Nina; Canning, Louise

2016-01-01

This paper addresses a knowledge gap by presenting an empirical investigation of a group coursework protocol and peer assessment system (GCP&PAS) used in a UK university to support postgraduate marketing students in their assessed group activities. The aim of the research was to examine students' understanding of the GCP&PAS and their…

School Staff Responses to Gender-Based Bullying as Moral Interpretation: An Exploratory Study

ERIC Educational Resources Information Center

Anagnostopoulos, Dorothea; Buchanan, Nicole T.; Pereira, Christine; Lichty, Lauren F.

2009-01-01

Gender-based bullying is the most common form of violence that students encounter in U.S. public schools. Several large-scale surveys reveal its consequences for students. Fewer studies examine how school staff members make sense of and respond to such violence. The authors address this knowledge gap by presenting analyses of interviews conducted…

Inspiring Reading Success: Interest and Motivation in an Age of High-Stakes Testing

ERIC Educational Resources Information Center

Fink, Rosalee, Ed.; Samuels, S. Jay, Ed.

2007-01-01

Although recent U.S. legislation has had a profound impact on reading instruction and student achievement, some students continue to fall behind. This provocative text addresses this gap with a new perspective on reading instruction that goes beyond the realms of teacher content knowledge and methodology. The book shows how motivation and interest…

Innovation Practices in Schools: The Impact of Different Models of Organization on the Practice of Norwegian Municipalities

ERIC Educational Resources Information Center

Jentoft, Nina

2017-01-01

Services provided by primary schools have a significant impact on citizens' living conditions. We need more knowledge of how innovation activities in primary schools should be organized and managed. This article addresses this gap by raising the following question: "Why do municipalities have different ways of organizing preventive work in…

Practice to Evidence: Using Evaluability Assessment to Generate Practice-Based Evidence in Rural South Georgia

ERIC Educational Resources Information Center

Honeycutt, Sally; Hermstad, April; Carvalho, Michelle L.; Arriola, Kimberly R. Jacob; Ballard, Denise; Escoffery, Cam; Kegler, Michelle C.

2017-01-01

Evidence from formal evaluation of real-world practice can address gaps in the public health knowledge base and provide information about feasible, relevant strategies for varied settings. Interest in evaluability assessment (EA) as an approach for generating practice-based evidence has grown. EA has been central to several structured assessment…

Admissions Technology: A Case Study of a Public Institution of Higher Education

ERIC Educational Resources Information Center

Galvin, Lisa A.

2017-01-01

There is no research that directly illustrates how technology, or a lack thereof, in a higher education environment might influence the customer service and satisfaction of applicants and enrolled students. The problem addressed in this study is the gap of knowledge and scholarly research on antiquated technology and its effect on applicant…

Understanding Gaps between Student and Staff Perceptions of University Study in South Africa: A Case Study

ERIC Educational Resources Information Center

Jaffer, Faeeqa; Garraway, James

2016-01-01

"Under-preparedness" of students entering higher education is an issue that many academic institutions in South Africa are currently trying to address. Such students are seen as disadvantaged, lacking the skills, knowledge and/or language proficiency to navigate their way to success in higher education. This paper seeks to identify…

Adapting a Multifaceted U.S. HIV Prevention Education Program for Girls in Ghana

ERIC Educational Resources Information Center

Fiscian, Vivian Sarpomaa; Obeng, E. Kwame; Goldstein, Karen; Shea, Judy A.; Turner, Barbara J.

2009-01-01

We adapted a U.S. HIV prevention program to address knowledge gaps and cultural pressures that increase the risk of infection in adolescent Ghanaian girls. The theory-based nine-module HIV prevention program combines didactics and games, an interactive computer program about sugar daddies, and tie-and-dye training to demonstrate an economic…

Scientific Opinion on Risk Assessment of Synthetic Biology.

PubMed

Epstein, Michelle M; Vermeire, Theo

2016-08-01

In 2013, three Scientific Committees of the European Commission (EC) drafted Scientific Opinions on synthetic biology that provide an operational definition and address risk assessment methodology, safety aspects, environmental risks, knowledge gaps, and research priorities. These Opinions contribute to the international discussions on the risk governance for synthetic biology developments. Copyright © 2016 Elsevier Ltd. All rights reserved.

Building Capacity for Research and Audit: Outcomes of a Training Workshop for Pacific Physicians and Nurses

ERIC Educational Resources Information Center

Ekeroma, Alec J.; Kenealy, Tim; Shulruf, Boaz; Nosa, Vili; Hill, Andrew

2015-01-01

Building the research capacity of clinicians in the Pacific Island countries is important in addressing evidence gaps relevant to local policy and clinical practice. This paper aimed to assess the effectiveness of a reproductive health research workshop in increasing research knowledge and intention to perform research amongst a diverse group of…

Examinations and Educational Opportunity in China: Mobility and Bottlenecks for the Rural Poor

ERIC Educational Resources Information Center

Hannum, Emily; An, Xuehui; Cherng, Hua-Yu Sebastian

2011-01-01

Despite the important role played by examinations in educational stratification and mobility in China, to our knowledge there is no literature in English that investigates the impact of exams on educational attainment with empirical data. We address this gap with an investigation of how examinations shape opportunities for children of the rural…

What Is Technology? Investigating Student Conceptions about the Nature of Technology

ERIC Educational Resources Information Center

DiGironimo, Nicole

2011-01-01

The science education literature clearly shows that knowledge of the nature of technology is an educational goal; however there is a lack of research on student conceptions about the nature of technology. To address this gap in the literature, this research began with a thorough review of the literature on scientific and technological literacy,…

Molecular mechanisms regulating formation, trafficking and processing of annular gap junctions.

PubMed

Falk, Matthias M; Bell, Cheryl L; Kells Andrews, Rachael M; Murray, Sandra A

2016-05-24

Internalization of gap junction plaques results in the formation of annular gap junction vesicles. The factors that regulate the coordinated internalization of the gap junction plaques to form annular gap junction vesicles, and the subsequent events involved in annular gap junction processing have only relatively recently been investigated in detail. However it is becoming clear that while annular gap junction vesicles have been demonstrated to be degraded by autophagosomal and endo-lysosomal pathways, they undergo a number of additional processing events. Here, we characterize the morphology of the annular gap junction vesicle and review the current knowledge of the processes involved in their formation, fission, fusion, and degradation. In addition, we address the possibility for connexin protein recycling back to the plasma membrane to contribute to gap junction formation and intercellular communication. Information on gap junction plaque removal from the plasma membrane and the subsequent processing of annular gap junction vesicles is critical to our understanding of cell-cell communication as it relates to events regulating development, cell homeostasis, unstable proliferation of cancer cells, wound healing, changes in the ischemic heart, and many other physiological and pathological cellular phenomena.

The Knowledge Gap Versus the Belief Gap and Abstinence-Only Sex Education.

PubMed

Hindman, Douglas Blanks; Yan, Changmin

2015-08-01

The knowledge gap hypothesis predicts widening disparities in knowledge of heavily publicized public affairs issues among socioeconomic status groups. The belief gap hypothesis extends the knowledge gap hypothesis to account for knowledge and beliefs about politically contested issues based on empirically verifiable information. This analysis of 3 national surveys shows belief gaps developed between liberals and conservatives regarding abstinence-only sex education; socioeconomic status-based knowledge gaps did not widen. The findings partially support both belief gap and knowledge gap hypotheses. In addition, the unique contributions of exposure to Fox News, CNN, and MSNBC in this process were investigated. Only exposure to Fox News was linked to beliefs about abstinence-only sex education directly and indirectly through the cultivation of conservative ideology.

Achieving best outcomes for patients with cardiovascular disease in China by enhancing the quality of medical care and establishing a learning health-care system.

PubMed

Jiang, Lixin; Krumholz, Harlan M; Li, Xi; Li, Jing; Hu, Shengshou

2015-10-10

China has an immediate need to address the rapidly growing population with cardiovascular disease events and the increasing number of people living with this illness. Despite progress in increasing access to services, China faces the dual challenge of addressing gaps in quality of care and producing more evidence to support clinical practice. In this Review, we address opportunities to strengthen performance measurement, programmes to improve quality of care, and national capacity to produce high-impact knowledge for clinical practice. Moreover, we propose recommendations, with implications for other diseases, for how China can immediately make use of its Hospital Quality-Monitoring System and other existing national platforms to assess and improve performance of medical care, and to generate new knowledge to inform clinical decisions and national policies. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sustainable urban systems: Co-design and framing for transformation.

PubMed

Webb, Robert; Bai, Xuemei; Smith, Mark Stafford; Costanza, Robert; Griggs, David; Moglia, Magnus; Neuman, Michael; Newman, Peter; Newton, Peter; Norman, Barbara; Ryan, Chris; Schandl, Heinz; Steffen, Will; Tapper, Nigel; Thomson, Giles

2018-02-01

Rapid urbanisation generates risks and opportunities for sustainable development. Urban policy and decision makers are challenged by the complexity of cities as social-ecological-technical systems. Consequently there is an increasing need for collaborative knowledge development that supports a whole-of-system view, and transformational change at multiple scales. Such holistic urban approaches are rare in practice. A co-design process involving researchers, practitioners and other stakeholders, has progressed such an approach in the Australian context, aiming to also contribute to international knowledge development and sharing. This process has generated three outputs: (1) a shared framework to support more systematic knowledge development and use, (2) identification of barriers that create a gap between stated urban goals and actual practice, and (3) identification of strategic focal areas to address this gap. Developing integrated strategies at broader urban scales is seen as the most pressing need. The knowledge framework adopts a systems perspective that incorporates the many urban trade-offs and synergies revealed by a systems view. Broader implications are drawn for policy and decision makers, for researchers and for a shared forward agenda.

Closing the gap between knowledge and clinical application: challenges for genomic translation.

PubMed

Burke, Wylie; Korngiebel, Diane M

2015-01-01

Despite early predictions and rapid progress in research, the introduction of personal genomics into clinical practice has been slow. Several factors contribute to this translational gap between knowledge and clinical application. The evidence available to support genetic test use is often limited, and implementation of new testing programs can be challenging. In addition, the heterogeneity of genomic risk information points to the need for strategies to select and deliver the information most appropriate for particular clinical needs. Accomplishing these tasks also requires recognition that some expectations for personal genomics are unrealistic, notably expectations concerning the clinical utility of genomic risk assessment for common complex diseases. Efforts are needed to improve the body of evidence addressing clinical outcomes for genomics, apply implementation science to personal genomics, and develop realistic goals for genomic risk assessment. In addition, translational research should emphasize the broader benefits of genomic knowledge, including applications of genomic research that provide clinical benefit outside the context of personal genomic risk.

Achieving Health Equity: Closing The Gaps In Health Care Disparities, Interventions, And Research.

PubMed

Purnell, Tanjala S; Calhoun, Elizabeth A; Golden, Sherita H; Halladay, Jacqueline R; Krok-Schoen, Jessica L; Appelhans, Bradley M; Cooper, Lisa A

2016-08-01

In the United States, racial/ethnic minority, rural, and low-income populations continue to experience suboptimal access to and quality of health care despite decades of recognition of health disparities and policy mandates to eliminate them. Many health care interventions that were designed to achieve health equity fall short because of gaps in knowledge and translation. We discuss these gaps and highlight innovative interventions that help address them, focusing on cardiovascular disease and cancer. We also provide recommendations for advancing the field of health equity and informing the implementation and evaluation of policies that target health disparities through improved access to care and quality of care. Project HOPE—The People-to-People Health Foundation, Inc.

Addressing the knowledge gap: sexual violence and harassment in the UK Armed Forces.

PubMed

Godier, Lauren R; Fossey, M

2017-09-06

Despite media interest in alleged sexual violence and harassment in the UK military, there remains a paucity of UK-based peer-reviewed research in this area. Ministry of Defence and service-specific reports support the suggestion that UK service personnel may be at risk of experiencing sexual harassment. These reports however highlight a reluctance by service personnel to report sexual harassment through official channels. In this article, we discuss the paucity of UK-based research pertaining to the prevalence and impact of sexual harassment in the military, explore potential reasons for this gap in knowledge and outline future directions and priorities for academic research. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Soil erosion assessment - Mind the gap

NASA Astrophysics Data System (ADS)

Kim, Jongho; Ivanov, Valeriy Y.; Fatichi, Simone

2016-12-01

Accurate assessment of erosion rates remains an elusive problem because soil loss is strongly nonunique with respect to the main drivers. In addressing the mechanistic causes of erosion responses, we discriminate between macroscale effects of external factors - long studied and referred to as "geomorphic external variability", and microscale effects, introduced as "geomorphic internal variability." The latter source of erosion variations represents the knowledge gap, an overlooked but vital element of geomorphic response, significantly impacting the low predictability skill of deterministic models at field-catchment scales. This is corroborated with experiments using a comprehensive physical model that dynamically updates the soil mass and particle composition. As complete knowledge of microscale conditions for arbitrary location and time is infeasible, we propose that new predictive frameworks of soil erosion should embed stochastic components in deterministic assessments of external and internal types of geomorphic variability.

Observational Study Designs for Comparative Effectiveness Research: An Alternative Approach to Close Evidence Gaps in Head-and-Neck Cancer

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

Goulart, Bernardo H.L., E-mail: bhg@uw.edu; University of Washington, Seattle, Washington; Ramsey, Scott D.

Comparative effectiveness research (CER) has emerged as an approach to improve quality of care and patient outcomes while reducing healthcare costs by providing evidence to guide healthcare decisions. Randomized controlled trials (RCTs) have represented the ideal study design to support treatment decisions in head-and-neck (H and N) cancers. In RCTs, formal chance (randomization) determines treatment allocation, which prevents selection bias from distorting the measure of treatment effects. Despite this advantage, only a minority of patients qualify for inclusion in H and N RCTs, which limits the validity of their results to the broader H and N cancer patient population seenmore » in clinical practice. Randomized controlled trials often do not address other knowledge gaps in the management of H and N cancer, including treatment comparisons for rare types of H and N cancers, monitoring of rare or late toxicity events (eg, osteoradionecrosis), or in some instances an RCT is simply not feasible. Observational studies, or studies in which treatment allocation occurs independently of investigators' choice or randomization, may address several of these gaps in knowledge, thereby complementing the role of RCTs. This critical review discusses how observational CER studies complement RCTs in generating the evidence to inform healthcare decisions and improve the quality of care and outcomes of H and N cancer patients. Review topics include a balanced discussion about the strengths and limitations of both RCT and observational CER study designs; a brief description of design and analytic techniques to handle selection bias in observational studies; examples of observational studies that inform current clinical practices and management of H and N cancers; and suggestions for relevant CER questions that could be addressed by an observational study design.« less

Observational study designs for comparative effectiveness research: an alternative approach to close evidence gaps in head-and-neck cancer.

PubMed

Goulart, Bernardo H L; Ramsey, Scott D; Parvathaneni, Upendra

2014-01-01

Comparative effectiveness research (CER) has emerged as an approach to improve quality of care and patient outcomes while reducing healthcare costs by providing evidence to guide healthcare decisions. Randomized controlled trials (RCTs) have represented the ideal study design to support treatment decisions in head-and-neck (H&N) cancers. In RCTs, formal chance (randomization) determines treatment allocation, which prevents selection bias from distorting the measure of treatment effects. Despite this advantage, only a minority of patients qualify for inclusion in H&N RCTs, which limits the validity of their results to the broader H&N cancer patient population seen in clinical practice. Randomized controlled trials often do not address other knowledge gaps in the management of H&N cancer, including treatment comparisons for rare types of H&N cancers, monitoring of rare or late toxicity events (eg, osteoradionecrosis), or in some instances an RCT is simply not feasible. Observational studies, or studies in which treatment allocation occurs independently of investigators' choice or randomization, may address several of these gaps in knowledge, thereby complementing the role of RCTs. This critical review discusses how observational CER studies complement RCTs in generating the evidence to inform healthcare decisions and improve the quality of care and outcomes of H&N cancer patients. Review topics include a balanced discussion about the strengths and limitations of both RCT and observational CER study designs; a brief description of design and analytic techniques to handle selection bias in observational studies; examples of observational studies that inform current clinical practices and management of H&N cancers; and suggestions for relevant CER questions that could be addressed by an observational study design. Copyright © 2014 Elsevier Inc. All rights reserved.

Factors affecting self-reported medication adherence and hypertension knowledge: A cross-sectional study in rural villages, Yogyakarta Province, Indonesia.

PubMed

Rahmawati, Riana; Bajorek, Beata

2017-01-01

Objectives This study assessed medication adherence and hypertension knowledge, and their predictive factors, in people with hypertension, living in rural communities in Indonesia. Methods Data were acquired from 384 people living in eight rural villages via a researcher-administered questionnaire, a validated adherence scale, and a standardized hypertension knowledge survey. Multivariate analysis was used to identify the predictors of adherence and knowledge. Results Fifty-nine (15%) participants had good hypertension knowledge (score ≥ 8 out of 10). Compared to participants with poor knowledge, these participants had higher formal education (odds ratio = 2.7, 95% confidence interval = 1.5-4.7), and lived closer to a community health center (odds ratio = 1.8, 95% confidence interval = 1.0-3.3). Knowledge gaps about the need for long-term medication, hypertension complications, and the target blood pressure were identified. Good hypertension knowledge predicted good adherence to medication (odds ratio = 7.1, 95% confidence interval = 3.3-15.2). Only 42 (11%) participants were considered to have good adherence. Reasons for intentional nonadherence were beliefs that medicines should be taken only when symptoms are evident, limited access to healthcare services, and a preference using traditional medicines. Conclusion Strategies for addressing knowledge gaps and misconceptions about hypertension medication are needed, particularly for people with a low educational level and those living some distances from healthcare facilities.

Assessing the educational needs of Canadian gastroenterologists and gastroenterology nurses: challenges to optimal care in Crohn's Disease.

PubMed

Dupuis, Martin; Marshall, John K; Hayes, Sean M; Cytryn, Kayla; Murray, Suzanne

2009-12-01

A national needs assessment of Canadian gastroenterologists and gastroenterology nurses was undertaken to determine the perceived and unperceived educational and performance barriers to caring for patients with Crohn's disease (CD). A triangulated, mixed-method approach (qualitative and quantitative) was used to determine the nature and extent of knowledge gaps and barriers in the care of patients with CD. Qualitative interviews were conducted with nine gastroenterologists, four gastroenterology nurses and nine patients with CD. Based on this exploratory research, a survey was designed and launched nationally (37 gastroenterologists, 36 gastroenterology nurses). Findings indicated that Canadian gastroenterologists and gastroenterology nurses lacked clarity regarding their roles and responsibilities across the continuum of CD care, and face communication gaps within the health care team, undermining their effectiveness. Gastroenterologists identified challenges in optimal diagnosis due to unclear testing and diagnostic criteria. They recognized knowledge gaps when treating patient subgroups and in prescribing biological therapies. Furthermore, gastroenterologists self-identified gaps in skill, knowledge, and confidence in monitoring disease progression and effectively assessing response to therapy. When managing patients with CD, gastroenterologists expressed challenges with patient issues outside their domain of medical expertise, particularly with the skills needed to facilitate effective patient communication and education that would enhance adherence to recommended treatments. Educational initiatives should address diagnostic and treatment guidelines, as well as enhancement of clinical performance gaps in health care team processes and the patient-professional therapeutic relationship. To impact care and patient outcomes, these initiatives must be relevant to clinical practice settings and applicable to the practice context.

Assessing the educational needs of Canadian gastroenterologists and gastroenterology nurses: Challenges to optimal care in Crohn’s disease

PubMed Central

Dupuis, Martin; Marshall, John K; Hayes, Sean M; Cytryn, Kayla; Murray, Suzanne

2009-01-01

OBJECTIVE: A national needs assessment of Canadian gastroenterologists and gastroenterology nurses was undertaken to determine the perceived and unperceived educational and performance barriers to caring for patients with Crohn’s disease (CD). METHODS: A triangulated, mixed-method approach (qualitative and quantitative) was used to determine the nature and extent of knowledge gaps and barriers in the care of patients with CD. RESULTS: Qualitative interviews were conducted with nine gastroenterologists, four gastroenterology nurses and nine patients with CD. Based on this exploratory research, a survey was designed and launched nationally (37 gastroenterologists, 36 gastroenterology nurses). Findings indicated that Canadian gastroenterologists and gastroenterology nurses lacked clarity regarding their roles and responsibilities across the continuum of CD care, and face communication gaps within the health care team, undermining their effectiveness. Gastroenterologists identified challenges in optimal diagnosis due to unclear testing and diagnostic criteria. They recognized knowledge gaps when treating patient subgroups and in prescribing biological therapies. Furthermore, gastroenterologists self-identified gaps in skill, knowledge, and confidence in monitoring disease progression and effectively assessing response to therapy. When managing patients with CD, gastroenterologists expressed challenges with patient issues outside their domain of medical expertise, particularly with the skills needed to facilitate effective patient communication and education that would enhance adherence to recommended treatments. CONCLUSIONS: Educational initiatives should address diagnostic and treatment guidelines, as well as enhancement of clinical performance gaps in health care team processes and the patient-professional therapeutic relationship. To impact care and patient outcomes, these initiatives must be relevant to clinical practice settings and applicable to the practice context. PMID:20011732

Development of an Online Learning Module to Improve Pediatric Residents' Confidence and Knowledge of the Pubertal Examination.

PubMed

Ens, Andrea; Janzen, Katharine; Palmert, Mark R

2017-03-01

Pediatric residents must know how to perform pubertal examinations. The initial objective of this study was to evaluate pediatric resident knowledge and comfort related to the pubertal examination and to determine whether and why these examinations are avoided. The subsequent objective was to develop and assess a learning module (LM) addressing identified education gaps. A learning needs assessment (LNA) was administered to residents in four Canadian pediatric training programs. Identified themes and knowledge gaps were used to develop an online, case-based LM. A randomized assessment of the LM was conducted among residents from nine training programs across Canada. Sixty-four residents completed the LNA. About 52% reported discomfort introducing the pubertal examination, 50% reported a lack of confidence related to the examination, and 56% reported having avoided a warranted examination. Ninety-seven residents participated in the LM assessment. The baseline results were similar to those from the LNA in terms of discomfort, lack of confidence, and avoidance related to pubertal examinations. However, the intervention group showed improvement on a knowledge assessment compared with control group (p < .001). Confidence levels also improved in the intervention group LM (p < .01). Most residents (95%) stated they found the LM to be useful. Residents report being uncomfortable with and avoiding the pubertal examination and have significant knowledge gaps. The online, case-based LM used in this study improved the knowledge and confidence related to this aspect of pediatric care and may be an effective adjunct to pediatric training. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Transformation of Follicular Lymphoma

PubMed Central

Lossos, Izidore S.; Gascoyne, Randy D.

2011-01-01

Histological transformation of follicular lymphoma (FL) to a more aggressive non-Hodgkin's lymphomas is a pivotal event in the natural history of FL and is associated with poor outcome. While commonly observed in clinical practice and despite multiple studies designed to address its pathogenesis, the biology of this process represents an enigma. In this chapter we present a state of the art review summarizing the definition of histologic transformation, its incidence, pathogenesis, clinical manifestations, treatment and outcome. Furthermore, we specifically emphasize gaps in our knowledge that should be addressed in future studies. PMID:21658615

Practice gaps in the care of mitral valve regurgitation: Insights from the American College of Cardiology mitral regurgitation gap analysis and advisory panel.

PubMed

Wang, Andrew; Grayburn, Paul; Foster, Jill A; McCulloch, Marti L; Badhwar, Vinay; Gammie, James S; Costa, Salvatore P; Benitez, Robert Michael; Rinaldi, Michael J; Thourani, Vinod H; Martin, Randolph P

2016-02-01

The revised 2014 American College of Cardiology (ACC)/American Heart Association valvular heart disease guidelines provide evidenced-based recommendations for the management of mitral regurgitation (MR). However, knowledge gaps related to our evolving understanding of critical MR concepts may impede their implementation. The ACC conducted a multifaceted needs assessment to characterize gaps, practice patterns, and perceptions related to the diagnosis and treatment of MR. A key project element was a set of surveys distributed to primary care and cardiovascular physicians (cardiologists and cardiothoracic surgeons). Survey and other gap analysis findings were presented to a panel of 10 expert advisors from specialties of general cardiology, cardiac imaging, interventional cardiology, and cardiac surgeons with expertise in valvular heart disease, especially MR, and cardiovascular education. The panel was charged with assessing the relative importance and potential means of remedying identified gaps to improve care for patients with MR. The survey results identified several knowledge and practice gaps that may limit implementation of evidence-based recommendations for MR care. Specifically, half of primary care physicians reported uncertainty regarding timing of intervention for patients with severe primary or functional MR. Physicians in all groups reported that quantitative indices of MR severity were frequently not reported in clinical echocardiographic interpretations, and that these measurements were not consistently reviewed when provided in reports. In the treatment of MR, nearly 30% of primary care physician and general cardiologists did not know the volume of mitral valve repair surgeries by their reference cardiac surgeons and did not have a standard source to obtain this information. After review of the survey results, the expert panel summarized practice gaps into 4 thematic areas and offered proposals to address deficiencies and promote better alignment with the 2014 ACC/American Heart Association valvular disease guidelines. Important knowledge and skill gaps exist that may impede optimal care of the patient with MR. Focused educational and practice interventions should be developed to reduce these gaps. Copyright © 2015 Elsevier Inc. All rights reserved.

Endocrine Disruptors and Health Effects in Africa: A Call for Action.

PubMed

Bornman, Maria S; Aneck-Hahn, Natalie H; de Jager, Christiaan; Wagenaar, Gesina M; Bouwman, Hindrik; Barnhoorn, Irene E J; Patrick, Sean M; Vandenberg, Laura N; Kortenkamp, Andreas; Blumberg, Bruce; Kimmins, Sarah; Jegou, Bernard; Auger, Jacques; DiGangi, Joseph; Heindel, Jerrold J

2017-08-22

Africa faces a number of unique environmental challenges. Unfortunately, it lacks the infrastructure needed to support the comprehensive environmental studies that could provide the scientific basis to inform environmental policies. There are a number of known sources of endocrine-disrupting chemicals (EDCs) and other hazardous chemicals in Africa. However, a coordinated approach to identify and monitor these contaminants and to develop strategies for public health interventions has not yet been made. This commentary summarizes the scientific evidence presented by experts at the First African Endocrine Disruptors meeting. We describe a "call to action" to utilize the available scientific knowledge to address the impact of EDCs on human and wildlife health in Africa. We identify existing knowledge gaps about exposures to EDCs in Africa and describe how well-designed research strategies are needed to address these gaps. A lack of resources for research and a lag in policy implementation slows down intervention strategies and poses a challenge to advancing future health in Africa. To address the many challenges posed by EDCs, we argue that Africans should take the lead in prioritization and evaluation of environmental hazards, including EDCs. We recommend the institution of education and training programs for chemical users, adoption of the precautionary principle, establishment of biomonitoring programs, and funding of community-based epidemiology and wildlife research programs led and funded by African institutes and private companies. https://doi.org/10.1289/EHP1774.

Increased Science Instrumentation Funding Strengthens Mars Program

NASA Technical Reports Server (NTRS)

Graham, Lee D.; Graff, T. G.

2012-01-01

As the strategic knowledge gaps mature for the exploration of Mars, Mars sample return (MSR), and Phobos/Deimos missions, one approach that becomes more probable involves smaller science instrumentation and integrated science suites. Recent technological advances provide the foundation for a significant evolution of instrumentation; however, the funding support is currently too small to fully utilize these advances. We propose that an increase in funding for instrumentation development occur in the near-term so that these foundational technologies can be applied. These instruments would directly address the significant knowledge gaps for humans to Mars orbit, humans to the Martian surface, and humans to Phobos/ Deimos. They would also address the topics covered by the Decadal Survey and the Mars scientific goals, objectives, investigations and priorities as stated by the MEPAG. We argue that an increase of science instrumentation funding would be of great benefit to the Mars program as well as the potential for human exploration of the Mars system. If the total non-Earth-related planetary science instrumentation budget were increased 100% it would not add an appreciable amount to the overall NASA budget and would provide the real potential for future breakthroughs. If such an approach were implemented in the near-term, NASA would benefit greatly in terms of science knowledge of the Mars, Phobos/Deimos system, exploration risk mitigation, technology development, and public interest.

What do women know about government services and benefits?

PubMed

Gidengil, Elisabeth; Stolle, Dietlind

2012-01-01

This article examines how much women know about government services and benefits and discusses why this type of knowledge matters. Using data from a survey as well as focus groups conducted in Montreal and Toronto, we show that the women who are most likely to need information about these programs are often the least likely to be aware of them. This is especially true of low-income women, older women, and women who came to Canada as immigrants. We end by suggesting some steps that could be taken to address these knowledge gaps.

Death and Dying Course Offerings in Psychology: A Survey of Nine Midwestern States

ERIC Educational Resources Information Center

Eckerd, Lizabeth M.

2009-01-01

The certainty of facing death and bereavement and the complex personal and societal issues involved argue for the importance of death education. The current study addresses a gap in knowledge by beginning to assess the extent of dying, death, and bereavement (DD&B) course offerings by U.S. psychology departments. This article reports on data…

Using Different Conceptual Change Methods Embedded within 5E Model: A Sample Teaching of Endothermic-Exothermic Reactions

ERIC Educational Resources Information Center

Turk, Fatma; Calik, Muammer

2008-01-01

Since Widodo, Duit and Muller (2002) addressed that there is a gap between teacher's theoretical knowledge and their practical classroom constructivist behavior, we presented a sample teaching activity about Endothermic-Exothermic Reactions for teacher usage. Therein, the aim of this study is to design a 5E model to include students' alternative…

(Re)Writing Civics in the Digital Age: The Role of Social Media in Student (Dis)Engagement

ERIC Educational Resources Information Center

Portman Daley, Joannah

2012-01-01

(Re)Writing Civics in the Digital Age: The Role of Social Media in Student (Dis)Engagement addresses an important gap in the knowledge of civic rhetoric available in Rhetoric and Composition by using qualitative methods to explore the parameters of civic engagement through social media-based digital writing. With funding from URI's Office of…

Aptitude and Trait Predictors of Manned and Unmanned Aircraft Pilot Job Performance

DTIC Science & Technology

2016-04-22

actually fly RPAs. To address this gap, the present study evaluated pre-accession trait (Big Five personality domains) and aptitude (spatial...knowledge, and personality traits that predict successful job performance for manned aircraft pilots also predict successful job performance for RPA...aptitude and personality traits , job performance, remotely-piloted aircraft, unmanned aircraft systems 16. SECURITY CLASSIFICATION OF: 17

Career Issues and Workplace Considerations for the Transsexual Community: Bridging a Gap of Knowledge for Career Counselors and Mental Heath Care Providers

ERIC Educational Resources Information Center

Pepper, Shanti M.; Lorah, Peggy

2008-01-01

The field of career counseling has addressed the needs of several minority groups; however, the transsexual community has consistently been overlooked. Transsexual individuals may face many personal and professional obstacles due to the complex psychological aspects and expensive medical procedures inherent in "transitioning" (the complex and…

Advice and Identity in Institutional Talk: A Conversation Analytic Study of Academic Advising at the Undergraduate Level

ERIC Educational Resources Information Center

Norris, Alda M.

2011-01-01

Despite the importance of advising experiences, very little is known about the interpersonal communication dynamics of these interactions. This study addresses that knowledge gap by providing an analysis of audio recordings of advising sessions as they occurred in the offices of five academic advisors who met with undergraduate advisees (n= 28).…

Classroom versus Societal Willingness to Communicate: Investigating French as a Second Language in Flanders

ERIC Educational Resources Information Center

Denies, Katrijn; Yashima, Tomoko; Janssen, Rianne

2015-01-01

This study investigates willingness to communicate (WTC) and its determinants through structural equation modelling (SEM). Building on models by MacIntyre and Charos (1996) and Yashima (2002), it addresses 3 apparent gaps in the current knowledge base: It is the first SEM-based WTC study in a Western European context, investigating French as a…

Reaching Information Society Targets: Do National Culture Attitudes about ICT Acceptance and Use Matter?

ERIC Educational Resources Information Center

Hannan, Daniel D.

2013-01-01

The purpose of the study was to address a gap in the scholarly literature about one of the factors related to the Global Digital Divide by expanding the body of generalizable knowledge about the relationship between national culture attitudes about information and communications technology (ICT) acceptance and use (A&U) and national ICT use…

Hydrologic calibration and validation of SWAT in a snow-dominated Rocky Mountain watershed, Montana, USA

Treesearch

Robert S. Ahl; Scott W. Woods; Hans R. Zuuring

2008-01-01

The Soil and Water Assessment Tool (SWAT) has been applied successfully in temperate environments but little is known about its performance in the snow-dominated, forested, mountainous watersheds that provide much of the water supply in western North America. To address this knowledge gap, we configured SWAT to simulate the streamflow of Tenderfoot Creek (TCSWAT)....

Phylogeny, extinction and conservation: embracing uncertainties in a time of urgency

PubMed Central

Forest, Félix; Crandall, Keith A.; Chase, Mark W.; Faith, Daniel P.

2015-01-01

Evolutionary studies have played a fundamental role in our understanding of life, but until recently, they had only a relatively modest involvement in addressing conservation issues. The main goal of the present discussion meeting issue is to offer a platform to present the available methods allowing the integration of phylogenetic and extinction risk data in conservation planning. Here, we identify the main knowledge gaps in biodiversity science, which include incomplete sampling, reconstruction biases in phylogenetic analyses, partly known species distribution ranges, and the difficulty in producing conservation assessments for all known species, not to mention that much of the effective biological diversity remains to be discovered. Given the impact that human activities have on biodiversity and the urgency with which we need to address these issues, imperfect assumptions need to be sanctioned and surrogates used in the race to salvage as much as possible of our natural and evolutionary heritage. We discuss some aspects of the uncertainties found in biodiversity science, such as the ideal surrogates for biodiversity, the gaps in our knowledge and the numerous available phylogenetic diversity-based methods. We also introduce a series of cases studies that demonstrate how evolutionary biology can effectively contribute to biodiversity conservation science. PMID:25561663

Evaluation of Iranian college athletes' sport nutrition knowledge.

PubMed

Jessri, Mahsa; Jessri, Maryam; RashidKhani, Bahram; Zinn, Caryn

2010-06-01

The purpose of this study was to assess the nutrition knowledge and the factors determining this knowledge in Iranian college basketball and football athletes. By highlighting gaps in nutrition knowledge of these athletes, sport nutrition professionals may begin to address these gaps by educating athletes with a view toward minimizing injury and enhancing sport performance. Sixty-six basketball and 141 football players (response rate 78.4%) from 4 medical and 8 nonmedical universities in Tehran agreed to participate in this cross-sectional study. A 2-part questionnaire was used; the first part comprised questions identifying demographic information, and the second part comprised a previously well-validated questionnaire on sport nutrition knowledge. The overall knowledge score was 33.2% (+/- 12.3%). Men scored 28.2% (+/- 12.7%), and women, 38.7% (+/- 14.2%). In both genders, the highest score was obtained for the nutrients subcategory, and the supplements subcategory was the most poorly answered. When compared with their peers, a significantly higher score was obtained by women (p < .001), athletes at medical universities (p < .001), and those obtaining nutrition information from reputable sources (p = .03). The coach was cited by 89.4% of athletes as their main source of nutrition information. This study showed that the sport nutrition knowledge of these athletes is inadequate. Considering that this substandard level of knowledge may contribute to poor dietary behaviors, these athletes would benefit from nutrition-related training and education.

Fertility-related knowledge and information-seeking behaviour among people of reproductive age: a qualitative study.

PubMed

Hammarberg, Karin; Zosel, Rebecca; Comoy, Caroline; Robertson, Sarah; Holden, Carol; Deeks, Mandy; Johnson, Louise

2017-06-01

Some potentially modifiable factors adversely affect fertility and pregnancy health. To inform a fertility health promotion programme, this study investigated fertility knowledge and information-seeking behaviour among people of reproductive age. This was a qualitative study involving six focus group discussions with women and men who intended to have children in the future and eight paired interviews with couples who were actively trying to conceive. Participants (n = 74) themselves generally claimed 'low' to 'average' levels of knowledge about fertility. Most of them overestimated women's reproductive lifespan and had limited knowledge about the 'fertile window' of the menstrual cycle. The Internet was a common source of fertility-related information and social media was viewed as a potential effective avenue for dissemination of messages about fertility and how to protect it. Most participants agreed that primary health care providers, such as general practitioners (GPs), are well placed to provide information regarding fertility and pregnancy health. This study identified several gaps in knowledge among people of reproductive age about factors that influence fertility and pregnancy health negatively. Addressing these knowledge gaps in school curricula, primary care and health promotion would assist people to realize their reproductive goals and reduce the risk of infertility and adverse obstetric outcomes.

A cross-sectional study of pandemic influenza health literacy and the effect of a public health campaign

PubMed Central

2012-01-01

Background To ascertain the understanding of 2009 pandemic (H1N1) influenza and relevant infection control measures in an emergency department population and to assess the effectiveness of education campaigns in informing the public about the pandemic. Methods Questionnaires were administered to patients, visitors, non-clinical staff and volunteers. Data were collected on knowledge, preventative measures, information sources, attitudes to government and media reporting, perceived seriousness, behaviour change and intended compliance with future measures. Results were used to construct an overall knowledge score. Results There were 252 participants. Traditional forms of mass media (138 [55%]) remained the principal information source. Approximately 70% (176) accurately described mode of transmission and recommended precautions and 68% (175) reported behaviour change because of the pandemic. Gaps in knowledge included failure to identify certain high risk groups. Recall of government campaigns was significantly associated with a higher knowledge score. 60% (151) thought that authorities and media had exaggerated the threat; only 40% (101) would comply with recommended measures in a future pandemic. Conclusions The knowledge regarding pandemic influenza was high in this population and positively affected by official campaigns. Pandemic planning should address knowledge gaps and the impression that authorities had exaggerated the public-health threat. PMID:22830499

Knowledge, Attitudes, and Practices for Respiratory and Hearing Health among Midwestern Farmers.

PubMed

Cramer, Mary E; Wendl, Mary J; Sayles, Harlan; Duysen, Ellen; Achutan, Chandran

2017-07-01

The purpose of this study was to assess knowledge, attitudes, and practices for hearing and respiratory health/safety among farmers in seven Midwestern states served by a federally funded Agricultural Center. Findings provided a baseline to longitudinally track the Agricultural Center's program outcomes and to design community education to improve safety and health among farmers. This was a cross-sectional study using a 30 item mailed survey to describe farmers' operations, demographics, health conditions, related information sources, and knowledge/attitude/practices for personal protective equipment (PPE) (i.e., ear plugs/muffs and dust masks/respirators). Frequencies and percentages were calculated for each item and according to responses from younger versus older farmers. The unit of study was farm operators (N = 280) randomly selected from a publicly available database of corn/soybean and hog farmers in seven Midwestern states. Findings revealed important knowledge gaps among respondents regarding (1) hazardous exposure sources; (2) long-term health consequences of noise/dust exposure; (3) proper selection/fitting of PPE. Public health nurses and primary care providers in rural communities should address specific knowledge gaps in order to enhance farmers' perceived understanding of their susceptibility to hazardous exposures. Increasing farmers' knowledge through preferred venues may help to improve PPE effectiveness. © 2016 Wiley Periodicals, Inc.

Motivating and Assisting Adult, Online Chemistry Students: A Review of the Literature

NASA Astrophysics Data System (ADS)

Bannier, Betsy J.

2010-06-01

While comprehensive texts, articles, and literature reviews presenting research in the singular arenas of motivation, help-seeking, and online science learning are relatively easy to find, syntheses and interactions between these constructs are lacking. Part I of this review addresses this knowledge gap by drawing together key research from the domains of educational psychology and adult education, addressing the constructs of motivation, self-efficacy, adult learning, and help-seeking. Part II of this review extends and applies the motivation and help-seeking discussion to the emerging and exciting field of online chemistry education. The result is a comprehensive synthesis of the strengths and limitations of the currently existing body of knowledge related to the motivation and help-seeking behaviors of adult, online chemistry students.

HIV Prevention Among Transgender Populations: Knowledge Gaps and Evidence for Action.

PubMed

Poteat, Tonia; Malik, Mannat; Scheim, Ayden; Elliott, Ayana

2017-08-01

The purpose of this review is to summarize the available evidence-based HIV prevention interventions tailored for transgender people. A limited number of evidence-based HIV prevention interventions have been tested with transgender populations. Most existing interventions target behavior change among transgender women, with only one HIV prevention program evaluated for transgender men. Studies addressing biomedical interventions for transgender women are ongoing. Few interventions address social and structural barriers to HIV prevention, such as stigma, discrimination, and poverty. Evidence-based multi-level interventions that address the structural, biomedical, and behavioral risks for HIV among transgender populations, including transgender men, are needed to address disparities in HIV prevalence. Future research should address not only pre-exposure prophylaxis uptake and condom use but also structural barriers that limit access to these prevention strategies.

Knowledge gaps that hamper prevention and control of Mycobacterium avium subspecies paratuberculosis infection.

PubMed

Barkema, H W; Orsel, K; Nielsen, S S; Koets, A P; Rutten, V P M G; Bannantine, J P; Keefe, G P; Kelton, D F; Wells, S J; Whittington, R J; Mackintosh, C G; Manning, E J; Weber, M F; Heuer, C; Forde, T L; Ritter, C; Roche, S; Corbett, C S; Wolf, R; Griebel, P J; Kastelic, J P; De Buck, J

2018-05-01

In the last decades, many regional and country-wide control programmes for Johne's disease (JD) were developed due to associated economic losses, or because of a possible association with Crohn's disease. These control programmes were often not successful, partly because management protocols were not followed, including the introduction of infected replacement cattle, because tests to identify infected animals were unreliable, and uptake by farmers was not high enough because of a perceived low return on investment. In the absence of a cure or effective commercial vaccines, control of JD is currently primarily based on herd management strategies to avoid infection of cattle and restrict within-farm and farm-to-farm transmission. Although JD control programmes have been implemented in most developed countries, lessons learned from JD prevention and control programmes are underreported. Also, JD control programmes are typically evaluated in a limited number of herds and the duration of the study is less than 5 year, making it difficult to adequately assess the efficacy of control programmes. In this manuscript, we identify the most important gaps in knowledge hampering JD prevention and control programmes, including vaccination and diagnostics. Secondly, we discuss directions that research should take to address those knowledge gaps. © 2017 Blackwell Verlag GmbH.

Preparing for motherhood: authoritative knowledge and the undercurrents of shared experience in two childbirth education courses in Cagliari, Italy.

PubMed

Ketler, S K

2000-06-01

This article compares the social settings and teaching organization of two differently structured childbirth education courses in Cagliari, Italy, in order to understand how social processes and contexts work to negotiate authoritative knowledge. Although the explicit goal of both courses was to transmit biomedical knowledge, knowledge based in women's experience nonetheless dominated some course sessions. Thus, I examine the social processes and interactions that enabled women's experiential knowledge to dominate discussions and subsequently share in the authority of biomedical knowledge in some situations. Because few existing studies do so, this article also addresses a gap in our current understanding by exploring not only how experiential knowledge comes to share authority with biomedical knowledge, but also, why it is important that it does. Focusing on the efficacy of differently structured courses, this article informs the planning of future childbirth education courses in similar settings.

Discontinuities, cross-scale patterns, and the organization of ecosystems

USGS Publications Warehouse

Nash, Kirsty L.; Allen, Craig R.; Angeler, David G.; Barichievy, Chris; Eason, Tarsha; Garmestani, Ahjond S.; Graham, Nicholas A.J.; Granholm, Dean; Knutson, Melinda; Nelson, R. John; Nystrom, Magnus; Stow, Craig A.; Sandstrom, Shana M.

2014-01-01

Ecological structures and processes occur at specific spatiotemporal scales, and interactions that occur across multiple scales mediate scale-specific (e.g., individual, community, local, or regional) responses to disturbance. Despite the importance of scale, explicitly incorporating a multi-scale perspective into research and management actions remains a challenge. The discontinuity hypothesis provides a fertile avenue for addressing this problem by linking measureable proxies to inherent scales of structure within ecosystems. Here we outline the conceptual framework underlying discontinuities and review the evidence supporting the discontinuity hypothesis in ecological systems. Next we explore the utility of this approach for understanding cross-scale patterns and the organization of ecosystems by describing recent advances for examining nonlinear responses to disturbance and phenomena such as extinctions, invasions, and resilience. To stimulate new research, we present methods for performing discontinuity analysis, detail outstanding knowledge gaps, and discuss potential approaches for addressing these gaps.

Plug and Process Loads Capacity and Power Requirements Analysis

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

Sheppy, M.; Gentile-Polese, L.

2014-09-01

This report addresses gaps in actionable knowledge that would help reduce the plug load capacities designed into buildings. Prospective building occupants and real estate brokers lack accurate references for plug and process load (PPL) capacity requirements, so they often request 5-10 W/ft2 in their lease agreements. Limited initial data, however, suggest that actual PPL densities in leased buildings are substantially lower. Overestimating PPL capacity leads designers to oversize electrical infrastructure and cooling systems. Better guidance will enable improved sizing and design of these systems, decrease upfront capital costs, and allow systems to operate more energy efficiently. The main focus ofmore » this report is to provide industry with reliable, objective third-party guidance to address the information gap in typical PPL densities for commercial building tenants. This could drive changes in negotiations about PPL energy demands.« less

Optical inspection methods and their applications in the manufactured industrial sector: knowledge transfer to Panamanian industry

NASA Astrophysics Data System (ADS)

Pino, Abdiel O.; Pladellorens, Josep

2014-07-01

A means of facilitating the transfer of Optical inspection methods knowledge and skills from academic institutions and their research partners into Panama optics and optical research groups is described. The process involves the creation of an Integrated Knowledge Group Research (IKGR), a partnership led by Polytechnic University of Panama with the support of the SENACYT and Optics and Optometry Department, Polytechnic University of Catalonia. This paper describes the development of the Project for knowledge transfer "Implementation of a method of optical inspection of low cost for improving the surface quality of rolled material of metallic and nonmetallic industrial use", this project will develop a method for measuring the surface quality using texture analysis speckle pattern formed on the surface to be characterized. The project is designed to address the shortage of key skills in the field of precision engineering for optical applications. The main issues encountered during the development of the knowledge transfer teaching and learning are discussed, and the outcomes from the first four months of knowledge transfer activities are described. In overall summary, the results demonstrate how the Integrated Knowledge Group Research and new approach to knowledge transfer has been effective in addressing the engineering skills gap in precision optics for manufactured industrial sector.

OWL2 benchmarking for the evaluation of knowledge based systems.

PubMed

Khan, Sher Afgun; Qadir, Muhammad Abdul; Abbas, Muhammad Azeem; Afzal, Muhammad Tanvir

2017-01-01

OWL2 semantics are becoming increasingly popular for the real domain applications like Gene engineering and health MIS. The present work identifies the research gap that negligible attention has been paid to the performance evaluation of Knowledge Base Systems (KBS) using OWL2 semantics. To fulfil this identified research gap, an OWL2 benchmark for the evaluation of KBS is proposed. The proposed benchmark addresses the foundational blocks of an ontology benchmark i.e. data schema, workload and performance metrics. The proposed benchmark is tested on memory based, file based, relational database and graph based KBS for performance and scalability measures. The results show that the proposed benchmark is able to evaluate the behaviour of different state of the art KBS on OWL2 semantics. On the basis of the results, the end users (i.e. domain expert) would be able to select a suitable KBS appropriate for his domain.

Anticipating the Ethical Challenges of Psychiatric Genetic Testing.

PubMed

Appelbaum, Paul S; Benston, Shawna

2017-07-01

Genetic testing for mental illness is likely to become increasingly prevalent as the science behind it is refined. This article identifies anticipated ethical challenges for patients, psychiatrists, and genetic counselors and makes recommendations for addressing them. Many of the ethical challenges of psychiatric genetic testing are likely to stem from failures to comprehend the nature and implications of test results. Recent studies have identified gaps in the knowledge base of psychiatrists and genetic counselors, which limit their abilities to provide patients with appropriate education. A small number of studies have demonstrated the value of counseling in empowering patients to deal with relevant genetic information. Psychiatrists and other health professionals must be able to assist patients and families in making informed decisions about genetic testing and interpreting test results. Filling their knowledge gaps on these issues will be a critical step towards meeting these responsibilities.

EcAMSat and BioSentinel: Autonomous Bio Nanosatellites Addressing Strategic Knowledge Gaps for Manned Spaceflight Beyond LEO

NASA Technical Reports Server (NTRS)

Padgen, Michael R.

2017-01-01

Manned missions beyond low Earth orbit (LEO) require that several strategic knowledge gaps about the effects of space travel on the human body be addressed. NASA Ames Research Center has been the leader in developing autonomous bio nanosatellites, including past successful missions for GeneSat, PharmaSat, and O/OREOS, that tackled some of these issues. These nanosatellites provide in situ measurements, which deliver insight into the dynamic changes in cell behavior in microgravity. In this talk, two upcoming bio nanosatellites developed at Ames, the E. coli Antimicrobial Satellite (EcAMSat) and BioSentinel, will be discussed. Both satellites contain microfluidic systems that precisely deliver nutrients to the microorganisms stored within wells of fluidic cards. Each well, in turn, has its own 3-color LED and detector system which is used to monitor changes in metabolic activity with alamarBlue, a redox indicator, and the optical density of the cells. EcAMSat investigates the effects of microgravity on bacterial resistance to antimicrobial drugs, vital knowledge for understanding how to maintain the health of astronauts in long-term and beyond LEO spaceflight. The behavior of wild type and mutant uropathic E. coli will be compared in microgravity and with ground data to help understand the molecular mechanisms behind antibiotic resistance and how these phenotypes might change in space. BioSentinel seeks to directly measure the effects of space radiation on budding yeast S. cerevisiae, particularly double strand breaks (DSB). While hitching a ride on the SLS EM-1 mission (Orion's first unmanned mission to the moon) in 2018, BioSentinel will be kicked off and enter into a heliocentric orbit, becoming the first study of the effects of radiation on living organisms outside LEO since the Apollo program. The yeast are stored in eighteen independent 16-well microfluidic cards, which will be individually activated over the 12 month mission duration. In addition to the wild type and radiation-sensitive mutant strains, a BioSentinel strain of yeast has been developed, which requires a DSB to reactivate growth, thereby allowing for a direct measurement of DSBs caused by radiation. These two missions demonstrate the utility of using autonomous nanosatellites to address strategic knowledge gaps in the push to once again extend manned spaceflight beyond LEO.

EcAMSat and BioSentinel: Autonomous Bio Nanosatellites Addressing Strategic Knowledge Gaps for Manned Spaceflight Beyond LEO

NASA Technical Reports Server (NTRS)

Padgen, Mike

2017-01-01

Manned missions beyond low Earth orbit (LEO) require that several strategic knowledge gaps about the effects of space travel on the human body be addressed. NASA Ames Research Center has been the leader in developing autonomous bio nanosatellites, including past successful missions for GeneSat, PharmaSat, and OOREOS, that tackled some of these issues. These nanosatellites provide in situ measurements, which deliver insight into the dynamic changes in cell behavior in microgravity. In this talk, two upcoming bio nanosatellites developed at Ames, the E. coli Antimicrobial Satellite (EcAMSat) and BioSentinel, will be discussed. Both satellites contain microfluidic systems that precisely deliver nutrients to the microorganisms stored within wells of fluidic cards. Each well, in turn, has its own 3-color LED and detector system which is used to monitor changes in metabolic activity with alamarBlue, a redox indicator, and the optical density of the cells. EcAMSat investigates the effects of microgravity on bacterial resistance to antimicrobial drugs, vital knowledge for understanding how to maintain the health of astronauts in long-term and beyond LEO spaceflight. The behavior of wild type and mutant uropathic E. coli will be compared in microgravity and with ground data to help understand the molecular mechanisms behind antibiotic resistance and how these phenotypes might change in space. BioSentinel seeks to directly measure the effects of space radiation on budding yeast S. cerevisiae, particularly double strand breaks (DSB). While hitching a ride on the SLS EM-1 mission (Orions first unmanned mission to the moon) in 2018, BioSentinel will be kicked off and enter into a heliocentric orbit, becoming the first study of the effects of radiation on living organisms outside LEO since the Apollo program. The yeast are stored in eighteen independent 16-well microfluidic cards, which will be individually activated over the 12 month mission duration. In addition to the wild type and radiation-sensitive mutant strains, a BioSentinel strain of yeast has been developed, which requires a DSB to reactivate growth, thereby allowing for a direct measurement of DSBs caused by radiation. These two missions demonstrate the utility of using autonomous nanosatellites to address strategic knowledge gaps in the push to once again extend manned spaceflight beyond LEO.

Recent developments in pediatric headache.

PubMed

Hershey, Andrew D

2010-06-01

This review will focus on some of the recent findings in pediatric headache including headache characteristics, epidemiology, comorbid associations and treatment updates. Pediatric headache remains a frequent health problem for children and their families, yet there remain many gaps in our knowledge. This review will broadly address some of the recent findings and highlight the gaps in our understanding and treatment of pediatric headache. There will be a focus on pediatric migraine as this has been the best characterized and studied. Our understanding of pediatric headache is improving with increased recognition of the characteristics and associated symptomology. This should further guide the individualized treatment approaches for improved outcome and reduction of progression into adulthood.

Understanding the Financial Knowledge Gap: A New Dimension of Inequality in Later Life.

PubMed

Khan, Mohammad Nuruzzaman; Rothwell, David W; Cherney, Katrina; Sussman, Tamara

2017-01-01

To understand individuals' financial behaviors, it is important to understand the financial knowledge gap - the distance between one's objective and subjective financial knowledge. Overestimating one's financial knowledge can lead to risky financial behaviors. To date, limited empirical work has examined how financial knowledge gap varies across age groups. We analyze the size and nature of the financial knowledge gap and its variation across age groups. Using nationally representative data, we find robust evidence that older adults overestimate their financial knowledge. Social workers can assess the financial knowledge gap and educate their clients to protect from financial fraud, exploitation, and abuse.

Making Social Work Count: A Curriculum Innovation to Teach Quantitative Research Methods and Statistical Analysis to Undergraduate Social Work Students in the United Kingdom

ERIC Educational Resources Information Center

Teater, Barbra; Roy, Jessica; Carpenter, John; Forrester, Donald; Devaney, John; Scourfield, Jonathan

2017-01-01

Students in the United Kingdom (UK) are found to lack knowledge and skills in quantitative research methods. To address this gap, a quantitative research method and statistical analysis curriculum comprising 10 individual lessons was developed, piloted, and evaluated at two universities The evaluation found that BSW students' (N = 81)…

Soil heating during burning of forest slash piles and wood piles

Treesearch

Matt D. Busse; Carol J. Shestak; Ken R. Hubbert

2013-01-01

Pile burning of conifer slash is a common fuel reduction practice in forests of the western United States that has a direct, yet poorly quantified effect on soil heating. To address this knowledge gap, we measured the heat pulse beneath hand-built piles ranging widely in fuel composition and pile size in sandy-textured soils of the Lake Tahoe Basin. The soil heat pulse...

Quality versus Quantity: The Role of Socioeconomic Status on Parent-Reported Service Knowledge, Service Use, Unmet Service Needs, and Barriers to Service Use

ERIC Educational Resources Information Center

Pickard, Katherine E.; Ingersoll, Brooke R.

2016-01-01

Research within the autism spectrum disorder field has emphasized the role of socioeconomic status in shaping parents' ability to access services for their child with autism spectrum disorder. However, research has yet to explore the possible mechanisms underlying this relationship. This study sought to address this research gap by examining the…

Extension in Tough Times--Addressing Failures in Public and Private Extension, Lessons from the Tasmanian Wool Industry, Australia

ERIC Educational Resources Information Center

Hunt, Warren; Coutts, Jeff

2009-01-01

This paper reports research on the impact of introducing a range of extension approaches into the wool-growing regions of Tasmania Australia to meet an emerging knowledge and skills gap in the sector. The wool-growing industry of the state has experienced minimal government extension support for over 15 years. There is a failure in both private…

Linguistic Outcomes of English Medium Instruction Programmes in Higher Education: A Study on Economics Undergraduates at a Catalan University

ERIC Educational Resources Information Center

Ament, Jennifer R.; Pérez-Vidal, Carmen

2015-01-01

Globalisation and international mobility in the 21st century has led to the internationalisation of the English language (Crystal, 2003). Research regarding linguistic gains at university levels is however extremely scarce. This study aims to address this gap of knowledge and provide some answers as to how much linguistic gain can be expected…

Widening the Aim of Health Promotion to Include the Most Disadvantaged: Vulnerable Adolescents and the Social Determinants of Health

ERIC Educational Resources Information Center

Mohajer, Nicole; Earnest, Jaya

2010-01-01

Growing numbers of adolescents are marginalized by social factors beyond their control, leading to poor health outcomes for their families and future generations. Although the role of the social determinants of health has been recognized for many years, there is a gap in our knowledge about the strategies needed to address these factors in health…

Comparison of the volatile emission profiles of ground almond and pistachio mummies: part 1 – addressing a gap in knowledge of current attractants of navel orangeworm

USDA-ARS?s Scientific Manuscript database

Over the years various tissues of almond and pistachios have been evaluated for their ability to attract the navel orangeworm moth, a major insect pest to almond and pistachio orchards in California. Almond meal, which typically consists of ground almond kernels, is the current monitoring tool for n...

The Study to Explore Early Development (SEED): A Multisite Epidemiologic Study of Autism by the Centers for Autism and Developmental Disabilities Research and Epidemiology (CADDRE) Network

ERIC Educational Resources Information Center

Schendel, Diana E.; DiGuiseppi, Carolyn; Croen, Lisa A.; Fallin, M. Daniele; Reed, Philip L.; Schieve, Laura A.; Wiggins, Lisa D.; Daniels, Julie; Grether, Judith; Levy, Susan E.; Miller, Lisa; Newschaffer, Craig; Pinto-Martin, Jennifer; Robinson, Cordelia; Windham, Gayle C.; Alexander, Aimee; Aylsworth, Arthur S.; Bernal, Pilar; Bonner, Joseph D.; Blaskey, Lisa; Bradley, Chyrise; Collins, Jack; Ferretti, Casara J.; Farzadegan, Homayoon; Giarelli, Ellen; Harvey, Marques; Hepburn, Susan; Herr, Matthew; Kaparich, Kristina; Landa, Rebecca; Lee, Li-Ching; Levenseller, Brooke; Meyerer, Stacey; Rahbar, Mohammad H.; Ratchford, Andria; Reynolds, Ann; Rosenberg, Steven; Rusyniak, Julie; Shapira, Stuart K.; Smith, Karen; Souders, Margaret; Thompson, Patrick Aaron; Young, Lisa; Yeargin-Allsopp, Marshalyn

2012-01-01

The Study to Explore Early Development (SEED), a multisite investigation addressing knowledge gaps in autism phenotype and etiology, aims to: (1) characterize the autism behavioral phenotype and associated developmental, medical, and behavioral conditions and (2) investigate genetic and environmental risks with emphasis on immunologic, hormonal,…

Sabotaging Our Sisters: Perceptions of Female Relational Aggression in Higher Education among Female Faculty and Administrators at Three Western U.S. Universities

ERIC Educational Resources Information Center

Nyborg, Deborah G.

2012-01-01

The purpose of this study was to explore and understand relational workplace aggression among female faculty and administrators at three western U.S. universities. This study was designed to address the gap in empirical knowledge of the phenomenon by elucidating how workplace relational aggression affects the lives of female university faculty and…

Meanings and implications of acceptability judgements for wilderness use impacts

Treesearch

Amy F. Hoss; Mark W. Brunson

2000-01-01

While the concept of “acceptability” is central to the Limits of Acceptable Change (LAC) framework, there is inadequate understanding of how “acceptability” is judged and how unacceptable conditions affect visitor experiences. To address this knowledge gap, visitors to nine wilderness areas were interviewed. Judgments of social and environmental conditions fell into...

An educational programme for nursing college staff and students during a MERS- coronavirus outbreak in Saudi Arabia.

PubMed

Stirling, Bridget V; Harmston, Jennie; Alsobayel, Hana

2015-01-01

The Middle Eastern Respiratory Syndrome Coronavirus is a serious and emerging issue in Saudi Arabia and the world. A response was required to reduce possible disease transmission between the hospital and university. College of Nursing academic staff developed a programme in response to the educational and emotional needs of participants. A MERS-CoV Task Force responded to the rapidly unfolding epidemic. The aim was to find out what nursing staff and nursing students in the college knew about MERS- CoV. While most gaps in knowledge were addressed after an intense information seminar, other learning needs were identified and responded to. The Task Force developed mandatory information sessions for all nursing faculty, students and staff. All staff were informed by email, letters and posters. There are 28 faculty staff, 84 support staff and 480 students in the College of Nursing. The information settings all took place within the College of Nursing, Princess Nourah University, Kingdom of Saudi Arabia. Questionnaires were given to faculty, students and staff to understand their baseline knowledge. After the sessions, faculty, students and staff were asked about what was learned through the sessions, and what educational needs still needed to be addressed. Approval was sought and received by the Ethics Committee for the College of Nursing. Participants completed informed consent forms and the voluntary nature of the study was explained. The total number of people attending the education sessions was133, including 65 students. 18 faculty members attended and 57 support staff. Data was gathered on gaps in participant knowledge and a plan was developed to address the gaps. Policies were established around student participation in clinical and return to work practices for staff with any symptoms. In hospitals there is above average risk for exposure to infectious diseases. Student nurses travel between hospital and university, with the capacity to act as a conduit of pathogens to large, susceptible populations. Nursing colleges must respond thoroughly to protect students and staff and prevent spread of disease into the university community in the midst of an epidemic.

Toxoplasmosis – Awareness and knowledge among medical doctors in Nigeria

PubMed Central

Efunshile, Akinwale Michael; Elikwu, Charles John

2017-01-01

Toxoplasma gondii is a zoonotic parasite causing high disease burden worldwide. A One Health approach is needed to understand, prevent, and control toxoplasmosis, while knowledge gaps in the One Health aspects have been identified among medical professionals in earlier studies. As a One Health collaboration between veterinary and medical fields, we surveyed the knowledge on toxoplasmosis among medical doctors in Nigeria. The knowledge questions, which the participants answered without consulting literature and colleagues, covered epidemiological One Health aspects as well as clinical interspecialty aspects of T. gondii infections. Altogether 522 medical doctors from four tertiary hospitals completed the questionnaire. The mean number of correct answers in the knowledge questions was 7.5, and 8.4% of the participants selected at least 12 of the 17 correct answers. The proportion of medical doctors scoring such a high score was significantly higher among those who reported having seen a case of clinical toxoplasmosis than in those who did not. While 62% of the medical doctors participating in our study knew that cats can shed T. gondii in their feces, 36% incorrectly suggested that humans could do that too. That T. gondii infection can be meatborne was known by 69%, but that it can be also waterborne only by 28% of the medical doctors participating in our study. Most of the medical doctors, 78%, knew that clinical toxoplasmosis may involve the central nervous system, while only 37% answered that it can involve the eyes. Our results suggested knowledge gaps, which need to be addressed in Continuous Medical Education. The identified gaps included both intersectoral One Health aspects and interspecialty aspects: For prevention and management of toxoplasmosis, knowing the main transmission routes and that the parasite can affect several organs is relevant. PMID:29261738

Toxoplasmosis - Awareness and knowledge among medical doctors in Nigeria.

PubMed

Efunshile, Akinwale Michael; Elikwu, Charles John; Jokelainen, Pikka

2017-01-01

Toxoplasma gondii is a zoonotic parasite causing high disease burden worldwide. A One Health approach is needed to understand, prevent, and control toxoplasmosis, while knowledge gaps in the One Health aspects have been identified among medical professionals in earlier studies. As a One Health collaboration between veterinary and medical fields, we surveyed the knowledge on toxoplasmosis among medical doctors in Nigeria. The knowledge questions, which the participants answered without consulting literature and colleagues, covered epidemiological One Health aspects as well as clinical interspecialty aspects of T. gondii infections. Altogether 522 medical doctors from four tertiary hospitals completed the questionnaire. The mean number of correct answers in the knowledge questions was 7.5, and 8.4% of the participants selected at least 12 of the 17 correct answers. The proportion of medical doctors scoring such a high score was significantly higher among those who reported having seen a case of clinical toxoplasmosis than in those who did not. While 62% of the medical doctors participating in our study knew that cats can shed T. gondii in their feces, 36% incorrectly suggested that humans could do that too. That T. gondii infection can be meatborne was known by 69%, but that it can be also waterborne only by 28% of the medical doctors participating in our study. Most of the medical doctors, 78%, knew that clinical toxoplasmosis may involve the central nervous system, while only 37% answered that it can involve the eyes. Our results suggested knowledge gaps, which need to be addressed in Continuous Medical Education. The identified gaps included both intersectoral One Health aspects and interspecialty aspects: For prevention and management of toxoplasmosis, knowing the main transmission routes and that the parasite can affect several organs is relevant.

Knowledge, attitudes, and practices regarding travel health among Muscat International Airport travelers in Oman: Identifying the gaps and addressing the challenges.

PubMed

Al-Abri, Seif S; Abdel-Hady, Doaa M; Al-Abaidani, Idris S

2016-06-01

Although the majority of travel-associated communicable diseases can be prevented, the public health burden of these diseases remains significant. Relatively little is known about how travelers know and perceive the health risks associated with travel and how they utilize preventive measures before and while traveling abroad. This study was conducted to determine the level of the knowledge, attitudes, and practices (KAP) of Muscat International Airport travelers about travel health in order to assess the knowledge gap and the need for travel health services in Oman. A cross-sectional study was conducted over a period of 1week using a self-administered questionnaire. The overall level of knowledge about vaccine-preventable diseases, food safety, and preventive measures against insect bites of the participants was inadequate. The practice concerning preventive travel health measures, such as the use of specific immunizations and antimalarial prophylaxis, was very limited, and influenced by some personal and travel-related factors. The inadequate level of travelers' knowledge and poor utilization of travel medicine services highlights the need for the provisions of specialized travel medicine services at the national level and to develop educational materials promoting the importance of pre-travel health advice. Copyright © 2016 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

An integrated science-based methodology to assess potential risks and implications of engineered nanomaterials.

PubMed

Tolaymat, Thabet; El Badawy, Amro; Sequeira, Reynold; Genaidy, Ash

2015-11-15

There is an urgent need for broad and integrated studies that address the risks of engineered nanomaterials (ENMs) along the different endpoints of the society, environment, and economy (SEE) complex adaptive system. This article presents an integrated science-based methodology to assess the potential risks of engineered nanomaterials. To achieve the study objective, two major tasks are accomplished, knowledge synthesis and algorithmic computational methodology. The knowledge synthesis task is designed to capture "what is known" and to outline the gaps in knowledge from ENMs risk perspective. The algorithmic computational methodology is geared toward the provision of decisions and an understanding of the risks of ENMs along different endpoints for the constituents of the SEE complex adaptive system. The approach presented herein allows for addressing the formidable task of assessing the implications and risks of exposure to ENMs, with the long term goal to build a decision-support system to guide key stakeholders in the SEE system towards building sustainable ENMs and nano-enabled products. Published by Elsevier B.V.

Endocrine Disruptors and Health Effects in Africa: A Call for Action

PubMed Central

Aneck-Hahn, Natalie H.; de Jager, Christiaan; Wagenaar, Gesina M.; Bouwman, Hindrik; Barnhoorn, Irene E.J.; Patrick, Sean M.; Vandenberg, Laura N.; Kortenkamp, Andreas; Blumberg, Bruce; Kimmins, Sarah; Jegou, Bernard; Auger, Jacques; DiGangi, Joseph; Heindel, Jerrold J.

2017-01-01

Background: Africa faces a number of unique environmental challenges. Unfortunately, it lacks the infrastructure needed to support the comprehensive environmental studies that could provide the scientific basis to inform environmental policies. There are a number of known sources of endocrine-disrupting chemicals (EDCs) and other hazardous chemicals in Africa. However, a coordinated approach to identify and monitor these contaminants and to develop strategies for public health interventions has not yet been made. Objectives: This commentary summarizes the scientific evidence presented by experts at the First African Endocrine Disruptors meeting. We describe a “call to action” to utilize the available scientific knowledge to address the impact of EDCs on human and wildlife health in Africa. Discussion: We identify existing knowledge gaps about exposures to EDCs in Africa and describe how well-designed research strategies are needed to address these gaps. A lack of resources for research and a lag in policy implementation slows down intervention strategies and poses a challenge to advancing future health in Africa. Conclusion: To address the many challenges posed by EDCs, we argue that Africans should take the lead in prioritization and evaluation of environmental hazards, including EDCs. We recommend the institution of education and training programs for chemical users, adoption of the precautionary principle, establishment of biomonitoring programs, and funding of community-based epidemiology and wildlife research programs led and funded by African institutes and private companies. https://doi.org/10.1289/EHP1774 PMID:28935616

Co-occurring medical conditions in adults with Down syndrome: A systematic review toward the development of health care guidelines.

PubMed

Capone, George T; Chicoine, Brian; Bulova, Peter; Stephens, Mary; Hart, Sarah; Crissman, Blythe; Videlefsky, Andrea; Myers, Katherine; Roizen, Nancy; Esbensen, Anna; Peterson, Moya; Santoro, Stephanie; Woodward, Jason; Martin, Barry; Smith, David

2018-01-01

Adults with Down syndrome (DS) represent a unique population who are in need of clinical guidelines to address their medical care. The United States Preventive Service Task Force (USPSTF) has developed criteria for prioritizing conditions of public health importance with the potential for providing screening recommendations to improve clinical care. The quality of existing evidence needed to inform clinical guidelines has not been previously reviewed. Using the National Library of Medicine (NLM) database PubMed, we first identified 18 peer reviewed articles that addressed co-occurring medical conditions in adults with DS. Those conditions discussed in over half of the articles were prioritized for further review. Second, we performed detailed literature searches on these specific conditions. To inform the search strategy and review process a series of key questions were formulated a priori. The quality of available evidence was then graded and knowledge gaps were identified. The number of participating adults and the design of clinical studies varied by condition and were often inadequate for answering all of our key questions. We provide data on thyroid disease, cervical spine disease, hearing impairment, overweight-obesity, sleep apnea, congenital heart disease, and osteopenia-osteoporosis. Minimal evidence demonstrates massive gaps in our clinical knowledge that compromises clinical decision-making and management of these medically complex individuals. The development of evidence-based clinical guidance will require an expanded clinical knowledge-base in order to move forward. © 2017 Wiley Periodicals, Inc.

Aerosol-Radiation-Cloud Interactions in the South-East Atlantic: Future Suborbital Activities to Address Knowledge Gaps in Satellite and Model Assessments

NASA Technical Reports Server (NTRS)

Redemann, Jens; Wood, R.; Zuidema, P.; Haywood, J.; Piketh, S.; Formenti, P.; L'Ecuyer, T.; Kacenelenbogen, M.; Segal-Rosenheimer, M.; Shinozuka, Y.;

Primary care providers' cancer genetic testing-related knowledge, attitudes, and communication behaviors: A systematic review and research agenda.

PubMed

Hamilton, Jada G; Abdiwahab, Ekland; Edwards, Heather M; Fang, Min-Lin; Jdayani, Andrew; Breslau, Erica S

2017-03-01

Primary care providers (PCPs) can play a critical role in helping patients receive the preventive health benefits of cancer genetic risk information. Thus, the objective of this systematic review was to identify studies of US PCPs' knowledge, attitudes, and communication-related behaviors regarding genetic tests that could inform risk-stratification approaches for breast, colorectal, and prostate cancer screening in order to describe current findings and research gaps. We conducted a systematic search of six electronic databases to identify peer-reviewed empirical articles relating to US PCPs and genetic testing for breast, colorectal, or prostate cancer published in English from 2008 to 2016. We reviewed these data and used narrative synthesis methods to integrate findings into a descriptive summary and identify research needs. We identified 27 relevant articles. Most focused on genetic testing for breast cancer (23/27) and colorectal cancer risk (12/27); only one study examined testing for prostate cancer risk. Most articles addressed descriptive research questions (24/27). Many studies (24/27) documented PCPs' knowledge, often concluding that providers' knowledge was incomplete. Studies commonly (11/27) examined PCPs' attitudes. Across studies, PCPs expressed some concerns about ethical, legal, and social implications of testing. Attitudes about the utility of clinical genetic testing, including for targeted cancer screening, were generally favorable; PCPs were more skeptical of direct-to-consumer testing. Relatively fewer studies (9/27) examined PCPs' communication practices regarding cancer genetic testing. This review indicates a need for investigators to move beyond descriptive research questions related to PCPs' knowledge and attitudes about cancer genetic testing. Research is needed to address important gaps regarding the development, testing, and implementation of innovative interventions and educational programs that can improve PCPs' genetic testing knowledge, assuage concerns about the appropriateness of cancer genetic testing, and promote open and effective patient-provider communication about genetic risk and genetic testing.

Aerosol-Radiation-Cloud Interactions in the South-East Atlantic: Future Suborbital Activities to Address Knowledge Gaps in Satellite and Model Assessments

NASA Astrophysics Data System (ADS)

Redemann, J.; Wood, R.; Zuidema, P.; Haywood, J. M.; Piketh, S.; Formenti, P.; L'Ecuyer, T. S.; Kacenelenbogen, M. S.; Segal-Rosenhaimer, M.; Shinozuka, Y.; LeBlanc, S. E.; Vaughan, M. A.; Schmidt, S.; Flynn, C. J.; Song, S.; Schmid, B.; Luna, B.; Abel, S.

2015-12-01

Southern Africa produces almost a third of the Earth's biomass burning (BB) aerosol particles. Particles lofted into the mid-troposphere are transported westward over the South-East (SE) Atlantic, home to one of the three permanent subtropical stratocumulus (Sc) cloud decks in the world. The SE Atlantic stratocumulus deck interacts with the dense layers of BB aerosols that initially overlay the cloud deck, but later subside and may mix into the clouds. These interactions include adjustments to aerosol-induced solar heating and microphysical effects, and their global representation in climate models remains one of the largest uncertainties in estimates of future climate. Hence, new observations over the SE Atlantic have significant implications for global climate change scenarios. Our understanding of aerosol-cloud interactions in the SE Atlantic is hindered both by the lack of knowledge on aerosol and cloud properties, as well as the lack of knowledge about detailed physical processes involved. Most notably, we are missing knowledge on the absorptive and cloud nucleating properties of aerosols, including their vertical distribution relative to clouds, on the locations and degree of aerosol mixing into clouds, on the processes that govern cloud property adjustments, and on the importance of aerosol effects on clouds relative to co-varying synoptic scale meteorology. We discuss the current knowledge of aerosol and cloud property distributions based on satellite observations and sparse suborbital sampling. Recent efforts to make full use of A-Train aerosol sensor synergies will be highlighted. We describe planned field campaigns in the region to address the existing knowledge gaps. Specifically, we describe the scientific objectives and implementation of the five synergistic, international research activities aimed at providing some of the key aerosol and cloud properties and a process-level understanding of aerosol-cloud interactions over the SE Atlantic: NASA's ORACLES, the UK Met Office's CLARIFY-2016, the DoE's LASIC, NSF's ONFIRE, and CNRS' AEROCLO-SA.

Results of a Veterans Affairs employee education program on antimicrobial stewardship for older adults.

PubMed

Heath, Barbara; Bernhardt, Jaime; Michalski, Thomas J; Crnich, Christopher J; Moehring, Rebekah; Schmader, Kenneth E; Olds, Danielle; Higgins, Patricia A; Jump, Robin L P

2016-03-01

We describe a course in the Veterans Affairs (VA) Employee Education System designed to engage nursing staff working in VA long-term care facilities as partners in antimicrobial stewardship. We found that the course addressed an important knowledge gap. Our outcomes suggest opportunities to engage nursing staff in advancing antimicrobial stewardship, particularly in the long-term care setting. Published by Elsevier Inc.

The Views, Verdict and Recommendations for School and Home Sex and Relationships Education by Young Deaf and Hearing People

ERIC Educational Resources Information Center

Suter, Sarah; McCracken, Wendy; Calam, Rachel

2012-01-01

The purpose of this survey study was to explore the views of young deaf and hearing people (16-25 years old) on school and home sex and relationships education (SRE). The study addressed a critical knowledge gap in the research literature on deaf youth's perception of SRE. The small-scale study explored young deaf people's experiences of SRE and…

Explaining the black-white gap in cognitive test scores: Toward a theory of adverse impact.

PubMed

Cottrell, Jonathan M; Newman, Daniel A; Roisman, Glenn I

2015-11-01

In understanding the causes of adverse impact, a key parameter is the Black-White difference in cognitive test scores. To advance theory on why Black-White cognitive ability/knowledge test score gaps exist, and on how these gaps develop over time, the current article proposes an inductive explanatory model derived from past empirical findings. According to this theoretical model, Black-White group mean differences in cognitive test scores arise from the following racially disparate conditions: family income, maternal education, maternal verbal ability/knowledge, learning materials in the home, parenting factors (maternal sensitivity, maternal warmth and acceptance, and safe physical environment), child birth order, and child birth weight. Results from a 5-wave longitudinal growth model estimated on children in the NICHD Study of Early Child Care and Youth Development from ages 4 through 15 years show significant Black-White cognitive test score gaps throughout early development that did not grow significantly over time (i.e., significant intercept differences, but not slope differences). Importantly, the racially disparate conditions listed above can account for the relation between race and cognitive test scores. We propose a parsimonious 3-Step Model that explains how cognitive test score gaps arise, in which race relates to maternal disadvantage, which in turn relates to parenting factors, which in turn relate to cognitive test scores. This model and results offer to fill a need for theory on the etiology of the Black-White ethnic group gap in cognitive test scores, and attempt to address a missing link in the theory of adverse impact. (c) 2015 APA, all rights reserved).

An Assessment of Environmental Health Needs for Manned Spacecraft

NASA Technical Reports Server (NTRS)

Macatangay, Ariel V.

2013-01-01

Environmental health fundamentally addresses the physical, chemical, and biological risks external to the human body that can impact the health of a person by assessing and controlling these risks in order to generate and maintain a health-supportive environment. Environmental monitoring coupled with other measures including active and passive controls and the implementation of environmental standards (SMACs, SWEGs, microbial and acoustics limits) are used to ensure environmental health in manned spacecraft. NASA scientists and engineers consider environmental monitoring a vital component to an environmental health management strategy for maintaining a healthy crew and achieving mission success. Environmental monitoring data confirms the health of ECLS systems, in addition to contributing to the management of the health of human systems. Crew health risks associated with the environment were reviewed by agency experts with the goal of determining risk-based environmental monitoring needs for future NASA manned missions. Once determined, gaps in knowledge and technology, required to address those risks, were identified for various types of Exploration missions. This agency-wide assessment of environmental health needs will help guide the activities/hardware development efforts to close those gaps and advance the knowledge required to meet NASA manned space exploration objectives. Details of this assessment and findings are presented in this paper.

Robustness of risk maps and survey networks to knowledge gaps about a new invasive pest.

PubMed

Yemshanov, Denys; Koch, Frank H; Ben-Haim, Yakov; Smith, William D

2010-02-01

In pest risk assessment it is frequently necessary to make management decisions regarding emerging threats under severe uncertainty. Although risk maps provide useful decision support for invasive alien species, they rarely address knowledge gaps associated with the underlying risk model or how they may change the risk estimates. Failure to recognize uncertainty leads to risk-ignorant decisions and miscalculation of expected impacts as well as the costs required to minimize these impacts. Here we use the information gap concept to evaluate the robustness of risk maps to uncertainties in key assumptions about an invading organism. We generate risk maps with a spatial model of invasion that simulates potential entries of an invasive pest via international marine shipments, their spread through a landscape, and establishment on a susceptible host. In particular, we focus on the question of how much uncertainty in risk model assumptions can be tolerated before the risk map loses its value. We outline this approach with an example of a forest pest recently detected in North America, Sirex noctilio Fabricius. The results provide a spatial representation of the robustness of predictions of S. noctilio invasion risk to uncertainty and show major geographic hotspots where the consideration of uncertainty in model parameters may change management decisions about a new invasive pest. We then illustrate how the dependency between the extent of uncertainties and the degree of robustness of a risk map can be used to select a surveillance network design that is most robust to knowledge gaps about the pest.

Exploring sex and gender differences in sleep health: a Society for Women's Health Research Report.

PubMed

Mallampalli, Monica P; Carter, Christine L

2014-07-01

Previous attempts have been made to address sleep disorders in women; however, significant knowledge gaps in research and a lack of awareness among the research community continue to exist. There is a great need for scientists and clinicians to consider sex and gender differences in their sleep research to account for the unique biology of women. To understand the role of sex differences in sleep and the state of women's sleep health research, the Society for Women's Health Research convened an interdisciplinary expert panel of well-established sleep researchers and clinicians for a roundtable meeting. Focused discussions on basic and clinical research along with a focus on specific challenges facing women with sleep-related problems and effective therapies led to the identification of knowledge gaps and the development of research-related recommendations. Additionally, sex differences in sleep disorders were noted and discussed in the context of underlying hormonal differences. Differences in sleep behavior and sleep disorders may not only be driven by biological factors but also by gender differences in the way women and men report symptoms. Progress has been made in identifying sex and gender differences in many areas of sleep, but major research gaps in the areas of epidemiology, sleep regulation, sleep quality, diagnosis, and treatment need to be addressed. Identifying the underlying nature of sex and gender differences in sleep research has potential to accelerate improved care for both men and women facilitating better diagnosis, treatment, and ultimately prevention of sleep disorders and related comorbid conditions.

Exploring Sex and Gender Differences in Sleep Health: A Society for Women's Health Research Report

PubMed Central

Mallampalli, Monica P.

2014-01-01

Abstract Previous attempts have been made to address sleep disorders in women; however, significant knowledge gaps in research and a lack of awareness among the research community continue to exist. There is a great need for scientists and clinicians to consider sex and gender differences in their sleep research to account for the unique biology of women. To understand the role of sex differences in sleep and the state of women's sleep health research, the Society for Women's Health Research convened an interdisciplinary expert panel of well-established sleep researchers and clinicians for a roundtable meeting. Focused discussions on basic and clinical research along with a focus on specific challenges facing women with sleep-related problems and effective therapies led to the identification of knowledge gaps and the development of research-related recommendations. Additionally, sex differences in sleep disorders were noted and discussed in the context of underlying hormonal differences. Differences in sleep behavior and sleep disorders may not only be driven by biological factors but also by gender differences in the way women and men report symptoms. Progress has been made in identifying sex and gender differences in many areas of sleep, but major research gaps in the areas of epidemiology, sleep regulation, sleep quality, diagnosis, and treatment need to be addressed. Identifying the underlying nature of sex and gender differences in sleep research has potential to accelerate improved care for both men and women facilitating better diagnosis, treatment, and ultimately prevention of sleep disorders and related comorbid conditions. PMID:24956068

Regulatory Technology Development Plan - Sodium Fast Reactor. Mechanistic Source Term - Trial Calculation. Work Plan

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

Grabaskas, David; Bucknor, Matthew; Jerden, James

2016-02-01

The overall objective of the SFR Regulatory Technology Development Plan (RTDP) effort is to identify and address potential impediments to the SFR regulatory licensing process. In FY14, an analysis by Argonne identified the development of an SFR-specific MST methodology as an existing licensing gap with high regulatory importance and a potentially long lead-time to closure. This work was followed by an initial examination of the current state-of-knowledge regarding SFR source term development (ANLART-3), which reported several potential gaps. Among these were the potential inadequacies of current computational tools to properly model and assess the transport and retention of radionuclides duringmore » a metal fuel pool-type SFR core damage incident. The objective of the current work is to determine the adequacy of existing computational tools, and the associated knowledge database, for the calculation of an SFR MST. To accomplish this task, a trial MST calculation will be performed using available computational tools to establish their limitations with regard to relevant radionuclide release/retention/transport phenomena. The application of existing modeling tools will provide a definitive test to assess their suitability for an SFR MST calculation, while also identifying potential gaps in the current knowledge base and providing insight into open issues regarding regulatory criteria/requirements. The findings of this analysis will assist in determining future research and development needs.« less

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

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

Rapp, Juergen

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

An official American Thoracic Society/European Respiratory Society statement: research questions in COPD.

PubMed

Celli, Bartolome R; Decramer, Marc; Wedzicha, Jadwiga A; Wilson, Kevin C; Agustí, Alvar A; Criner, Gerard J; MacNee, William; Make, Barry J; Rennard, Stephen I; Stockley, Robert A; Vogelmeier, Claus; Anzueto, Antonio; Au, David H; Barnes, Peter J; Burgel, Pierre-Regis; Calverley, Peter M; Casanova, Ciro; Clini, Enrico M; Cooper, Christopher B; Coxson, Harvey O; Dusser, Daniel J; Fabbri, Leonardo M; Fahy, Bonnie; Ferguson, Gary T; Fisher, Andrew; Fletcher, Monica J; Hayot, Maurice; Hurst, John R; Jones, Paul W; Mahler, Donald A; Maltais, François; Mannino, David M; Martinez, Fernando J; Miravitlles, Marc; Meek, Paula M; Papi, Alberto; Rabe, Klaus F; Roche, Nicolas; Sciurba, Frank C; Sethi, Sanjay; Siafakas, Nikos; Sin, Don D; Soriano, Joan B; Stoller, James K; Tashkin, Donald P; Troosters, Thierry; Verleden, Geert M; Verschakelen, Johny; Vestbo, Jorgen; Walsh, John W; Washko, George R; Wise, Robert A; Wouters, Emiel F M; ZuWallack, Richard L

2015-06-01

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality and resource use worldwide. The goal of this official American Thoracic Society (ATS)/European Respiratory Society (ERS) Research Statement is to describe evidence related to diagnosis, assessment, and management; identify gaps in knowledge; and make recommendations for future research. It is not intended to provide clinical practice recommendations on COPD diagnosis and management. Clinicians, researchers and patient advocates with expertise in COPD were invited to participate. A literature search of Medline was performed, and studies deemed relevant were selected. The search was not a systematic review of the evidence. Existing evidence was appraised and summarised, and then salient knowledge gaps were identified. Recommendations for research that addresses important gaps in the evidence in all areas of COPD were formulated via discussion and consensus. Great strides have been made in the diagnosis, assessment and management of COPD, as well as understanding its pathogenesis. Despite this, many important questions remain unanswered. This ATS/ERS research statement highlights the types of research that leading clinicians, researchers and patient advocates believe will have the greatest impact on patient-centred outcomes. Copyright ©ATS/ERS 2015.

Carbon and nitrogen dynamics and greenhouse gas emissions in constructed wetlands treating wastewater: a review

NASA Astrophysics Data System (ADS)

Jahangir, M. M. R.; Richards, K. G.; Healy, M. G.; Gill, L.; Müller, C.; Johnston, P.; Fenton, O.

2016-01-01

The removal efficiency of carbon (C) and nitrogen (N) in constructed wetlands (CWs) is very inconsistent and frequently does not reveal whether the removal processes are due to physical attenuation or whether the different species have been transformed to other reactive forms. Previous research on nutrient removal in CWs did not consider the dynamics of pollution swapping (the increase of one pollutant as a result of a measure introduced to reduce a different pollutant) driven by transformational processes within and around the system. This paper aims to address this knowledge gap by reviewing the biogeochemical dynamics and fate of C and N in CWs and their potential impact on the environment, and by presenting novel ways in which these knowledge gaps may be eliminated. Nutrient removal in CWs varies with the type of CW, vegetation, climate, season, geographical region, and management practices. Horizontal flow CWs tend to have good nitrate (NO3-) removal, as they provide good conditions for denitrification, but cannot remove ammonium (NH4+) due to limited ability to nitrify NH4+. Vertical flow CWs have good NH4+ removal, but their denitrification ability is low. Surface flow CWs decrease nitrous oxide (N2O) emissions but increase methane (CH4) emissions; subsurface flow CWs increase N2O and carbon dioxide (CO2) emissions, but decrease CH4 emissions. Mixed species of vegetation perform better than monocultures in increasing C and N removal and decreasing greenhouse gas (GHG) emissions, but empirical evidence is still scarce. Lower hydraulic loadings with higher hydraulic retention times enhance nutrient removal, but more empirical evidence is required to determine an optimum design. A conceptual model highlighting the current state of knowledge is presented and experimental work that should be undertaken to address knowledge gaps across CWs, vegetation and wastewater types, hydraulic loading rates and regimes, and retention times, is suggested. We recommend that further research on process-based C and N removal and on the balancing of end products into reactive and benign forms is critical to the assessment of the environmental performance of CWs.

Knowledge and confidence of Australian emergency department clinicians in managing patients with mental health-related presentations: findings from a national qualitative study

PubMed Central

2013-01-01

Background Mental health related presentations are common in Australian Emergency Departments (EDs). We sought to better understand ED staff knowledge and levels of confidence in treating people with mental health related problems using qualitative methods. Methods This was a qualitative learning needs analysis of Australian emergency doctors and nurses regarding the assessment and management of mental health presentations. Participants were selected for semi-structured telephone interview using criterion-based sampling. Recruitment was via the Australasian College for Emergency Medicine and College of Emergency Nursing Australasia membership databases. Interviews were audio-recorded and transcribed verbatim. Thematic framework analysis was used to identify perceived knowledge gaps and levels of confidence among participants in assessing and managing patients attending EDs with mental health presentations. Results Thirty-six staff comprising 20 doctors and 16 nurses consented to participate. Data saturation was achieved for four major areas where knowledge gaps were reported. These were: assessment (risk assessment and assessment of mental status), management (psychotherapeutic skills, ongoing management, medication management and behaviour management), training (curriculum and rotations), and application of mental health legislation. Participants’ confidence in assessing mental health patients was affected by environmental, staff, and patient related factors. Clinicians were keen to learn more about evidence based practice to provide better care for this patient group. Areas where clinicians felt the least confident were in the effective assessment and management of high risk behaviours, providing continuity of care, managing people with dual diagnosis, prescribing and effectively managing medications, assessing and managing child and adolescent mental health, and balancing the caseload in ED. Conclusion Participants were most concerned about knowledge gaps in risk assessment, particularly for self-harming patients, violent and aggressive patients and their management, and distinguishing psychiatric from physical illness. Staff confidence was enhanced by better availability of skilled psychiatric support staff to assist in clinical decision-making for complex cases and via the provision of a safe ED environment. Strategies to enhance the care of patients with mental health presentations in Australian emergency departments should address these gaps in knowledge and confidence. PMID:23317351

Bridging the gaps: An overview of wood across time and space in diverse rivers

NASA Astrophysics Data System (ADS)

Wohl, Ellen

2017-02-01

Nearly 50 years of research focused on large wood (LW) in rivers provide a basis for understanding how wood enters rivers; how wood decays, breaks, and is transported downstream; and how at least temporarily stable wood influences channel geometry, fluxes of water, sediment, and organic matter, and the abundance and diversity of aquatic and riparian organisms. Field-based studies have led to qualitative conceptual models and to numerical stimulations of river processes involving wood. Numerous important gaps remain, however, in our understanding of wood dynamics. The majority of research on wood in rivers focuses on small- to medium-sized rivers, defined using the ratio of wood piece size to channel width as channels narrower than the locally typical wood-piece length (small) and slightly narrower than the longer wood pieces present (medium). Although diverse geographic regions and biomes are represented by one or a few studies in each region, the majority of research comes from perennial rivers draining temperate conifer forests. Regional syntheses most commonly focus on the Pacific Northwest region of North America where most of these studies originate. Consequently, significant gaps in our understanding include lack of knowledge of wood-related processes in large rivers, dryland rivers, and rivers of the high and low latitudes. Using a wood budget as an organizing framework, this paper identifies other gaps related to wood recruitment, transport, storage, and how beavers influence LW dynamics. With respect to wood recruitment, we lack information on the relative importance of mass tree mortality and transport of buried or surficial downed wood from the floodplain into the channel in diverse settings. Knowledge gaps related to wood transport include transport distances of LW and thresholds for LW mobility in small to medium rivers. With respect to wood storage, we have limited data on longitudinal trends in LW loads within unaltered large and great rivers and on fluctuations in LW load over time intervals greater than a few years. Other knowledge gaps relate to physical and ecological effects of wood, including the magnitude of flow resistance caused by LW; patterns of wood-related sediment storage for diverse river sizes and channel geometry; quantification of channel-floodplain-LW interactions; and potential threshold effects of LW in relation to physical processes and biotic communities. Finally, knowledge gaps are related to management of large wood and river corridors, including understanding the consequences of enormous historical reductions in LW load in rivers through the forested portions of the temperate zone; and how to effectively reintroduce and manage existing LW in river corridors, which includes enhancing public understanding of the importance of LW. Addressing these knowledge gaps requires more case studies from diverse rivers, as well as more syntheses and metadata analyses.

Epidemiology of Environmental Exposures and Human Autoimmune Diseases: Findings from a National Institute of Environmental Health Sciences Expert Panel Workshop

PubMed Central

Alfredsson, Lars; Costenbader, Karen H.; Kamen, Diane L.; Nelson, Lorene; Norris, Jill M.; De Roos, Anneclaire J.

2012-01-01

Autoimmune diseases (AID) are a collection of many complex disorders of unknown etiology resulting in immune responses to self-antigens and are thought to result from interactions between genetic and environmental factors. Here we review the epidemiologic evidence for the role of environmental factors in the development of human AID, the conclusions that can be drawn from the existing data, critical knowledge gaps, and research needed to fill these gaps and to resolve uncertainties. We specifically summarize the state of knowledge and our levels of confidence in the role of specific agents in the development of autoimmune diseases, and we define the areas of greatest impact for future investigations. Among our consensus findings we are confident that: 1) crystalline silica exposure can contribute to the development of several AID; 2) solvent exposure can contribute to the development of systemic sclerosis; 3) smoking can contribute to the development of seropositive rheumatoid arthritis; and 4) an inverse association exists between ultraviolet radiation exposure and the risk of development of multiple sclerosis. We suggest that more studies of phenotypes, genotypes, and multiple exposures are needed. Additional knowledge gaps needing investigation include: defining important windows in the timing of exposures and latencies relating to age, developmental state, and hormonal changes; understanding dose-response relationships; and elucidating mechanisms for disease development. Addressing these essential issues will require more resources to support research, particularly of rare AID, but knowledge of the risks conferred by environmental factors in specific genetic contexts could pave the way for prevention of AID in the future. PMID:22739348

Professional Development Perceptions and Practices Among U.S. Physicians: A Cross-Specialty National Survey.

PubMed

Cook, David A; Blachman, Morris J; Price, David W; West, Colin P; Berger, Richard A; Wittich, Christopher M

2017-09-01

Professional development (PD)-both for-credit continuing medical education (CME) and informal self-directed or point-of-care learning-is vital to all physicians. The authors sought to understand physicians' PD perceptions and practices and how these vary by specialty and practice type. The authors administered an Internet and paper survey, from September 2015 to April 2016, to randomly sampled U.S. physicians. Survey items addressed perceived PD needs and barriers and how physicians identify knowledge/skills gaps. Of 4,648 invitees, 988 (21.6%) responded. Respondents believed that they already know what they need to learn (mean 5.8 [1 = strongly disagree; 7 = strongly agree]), can answer clinical questions using available resources (5.9), and want credit for learning during patient care (5.1). They did not strongly desire help identifying learning gaps (4.0) or indicate difficulty accumulating CME credits (3.1). Most PD was done during personal time (5.5). Competencies regarding medical knowledge/skills, wellness, informatics, and practice/systems improvement were rated the highest priority, while research, teaching, and professionalism were rated the lowest. The most important sources used to identify knowledge/skills gaps were immediate patient care needs (4.1 [1 = not important; 5 = extremely important]), personal awareness (3.8), and practice updates (3.7). The most important barriers were time (3.5) and cost (2.9). Differences by specialty and practice type were generally small and not statistically significant. Physicians feel confident in identifying their own learning needs, perceive medical knowledge/skills as their highest-priority need, and desire more credit for learning during patient care.

Cassava whitefly, Bemisia tabaci (Gennadius) (Hemiptera: Aleyrodidae) in East African farming landscapes: a review of the factors determining abundance.

PubMed

Macfadyen, S; Paull, C; Boykin, L M; De Barro, P; Maruthi, M N; Otim, M; Kalyebi, A; Vassão, D G; Sseruwagi, P; Tay, W T; Delatte, H; Seguni, Z; Colvin, J; Omongo, C A

2018-02-13

Bemisia tabaci (Gennadius) (Hemiptera: Aleyrodidae) is a pest species complex that causes widespread damage to cassava, a staple food crop for millions of households in East Africa. Species in the complex cause direct feeding damage to cassava and are the vectors of multiple plant viruses. Whilst significant work has gone into developing virus-resistant cassava cultivars, there has been little research effort aimed at understanding the ecology of these insect vectors. Here we assess critically the knowledge base relating to factors that may lead to high population densities of sub-Saharan African (SSA) B. tabaci species in cassava production landscapes of East Africa. We focus first on empirical studies that have examined biotic or abiotic factors that may lead to high populations. We then identify knowledge gaps that need to be filled to deliver sustainable management solutions. We found that whilst many hypotheses have been put forward to explain the increases in abundance witnessed since the early 1990s, there are little published data and these tend to have been collected in a piecemeal manner. The most critical knowledge gaps identified were: (i) understanding how cassava cultivars and alternative host plants impact population dynamics and natural enemies; (ii) the impact of natural enemies in terms of reducing the frequency of outbreaks and (iii) the use and management of insecticides to delay the development of resistance. In addition, there are several fundamental methodologies that need to be developed and deployed in East Africa to address some of the more challenging knowledge gaps.

Soil heating during the complete combustion of mega-logs and broadcast burning in central Oregon USA pumice soils

Treesearch

Jane E. Smith; Ariel D. Cowan; Stephen A. Fitzgerald

2016-01-01

The environmental effect of extreme soil heating, such as occurs with the complete combustion of large downed wood during wildfires, is a post-fire management concern to forest managers. To address this knowledge gap, we stacked logs to create ‘mega-log’ burning conditions and compared the temperature, duration and penetration of the soil heat pulse in nine high...

High Frontier, The Journal for Space & Missile Professionals. Volume 5, Number 1

DTIC Science & Technology

2008-11-01

competency of CAS integration and control. There are also air mobility liaison officers ( AMLOs ) corps and divisions levels. These officers are...deliberately assigned to a TACP similar to AMLOs and ISR LNOs. The Army identified this knowledge gap as an issue and developed Functional Area 40...An obvious way to address this need is by adding space professionals, similar to AMLOs and ISR LNOs, to TACPs. Because this follows an established

Chronic Pancreatitis: Current Status and Challenges for Prevention and Treatment.

PubMed

Lew, Daniel; Afghani, Elham; Pandol, Stephen

2017-07-01

This paper reviews the current status of our understanding of the epidemiology, diagnosis, and management of the continuum of pancreatic diseases from acute and recurrent acute pancreatitis to chronic pancreatitis and the diseases that are often linked with pancreatitis including diabetes mellitus and pancreatic cancer. In addition to reviewing the current state of the field, we identify gaps in knowledge that are necessary to address to improve patient outcomes in these conditions.

Capturing the Stratosphere’s Influence on Seasonal and Intraseasonal Predictability in a State-of-the-Art Navy Global Environmental Model (NAVGEM)

DTIC Science & Technology

2012-09-30

Atlantic Oscillation (NAO) – one of the most prominent modes of intraseasonal tropospheric variability extending from the subtropical Atlantic to the...and dominant physical coupling pathways governing the stratosphere- troposphere interaction that are most relevant for atmospheric prediction on time...following recommendations of WCRP (2008) and NAS (2010) to address knowledge gaps in our current understanding of coupled troposphere -stratosphere

Nursing Student Work-Study Internship Program: An Academic Partnership.

PubMed

Wallace, Jonalyn

2016-06-01

A large northern California-based integrated health system and five universities partnered to conduct an innovative work-study internship program designed to address the education-to-practice gap for nursing students. The nursing student work-study intern-ship program provides prelicensure nursing students with a paid internship in the health system. Interns are exposed to the realities of clinical practice and master learned skills working under the supervision of an RN preceptor. Work-study interns reported that participation in the program exposed them to new clinical situations, helped them integrate clinical knowledge and critical thinking skills, improved prioritization and time management skills, and expanded their communication skills within the interprofessional team. Interns cited feeling better equipped to safely and effectively transition into the new graduate role. The nursing student work-study program shows how an academic practice partnership can address the education-to-practice gap in an innovative manner. [J Nurs Educ. 2016;55(6):357-359.]. Copyright 2016, SLACK Incorporated.

Let's talk about sex: gender norms and sexual health in English schools.

PubMed

Jamal, Farah; Bonell, Chris; Wooder, Kai; Blake, Simon

2015-03-01

The sexual health of young people in England is an urgent public health concern. While interventions to address young people's sexual health have focussed on knowledge, skills and contraception access, amazingly none in the UK has explicitly addressed the effects of the social hierarchies of gender and gendered behavioural ideals that shape young people's sexual expectations, attitudes and behaviour. The lack of attention to gender is a persistent gap in health research, practice and policy. A rigorous evaluation of such an intervention package would go some way to building an evidence base for challenging gender norms, which appear to be strongly associated with adverse sexual health outcomes.

Comparing Self-Regulatory and Early Academic Skills as Predictors of Later Math, Reading, and Science Elementary School Achievement

NASA Astrophysics Data System (ADS)

Murrah, William M., III

The achievement score gaps between advantaged and disadvantaged children at school entry is a major problem in education today. Identifying the skills critical for school readiness is an important step in developing interventions aimed at addressing these score gaps. The purpose of this study is to compare a number of school readiness skills with an eye toward finding out which are the best predictors of later academic achievement in math, reading, and science. The predictors were early reading, math, general knowledge, socioemotional skills, and motor skills. Data were obtained from the Early Childhood Longitudinal Study of 1998 (NCES, 1998) database. While controlling for an extensive set of family characteristics, predictions were made across five years - from the end of kindergarten to the end of fifth grade. Consistent with current findings, reading and math skills predicted later achievement. Interestingly, general knowledge, attention, and fine motor skills also proved to be important predictors of later academic achievement, but socioemotional skills were not. The findings were interpreted from a neurobiological perspective involving the development of self-regulation. These school entry skills are used to predict later achievement in reading, math, and science. I argued that in addition to acquiring early academic knowledge, children need to regulate the use of this knowledge to meet academic goals.

Ontology-Based Gap Analysis for Technology Selection: A Knowledge Management Framework for the Support of Equipment Purchasing Processes

NASA Astrophysics Data System (ADS)

Macris, Aristomenis M.; Georgakellos, Dimitrios A.

Technology selection decisions such as equipment purchasing and supplier selection are decisions of strategic importance to companies. The nature of these decisions usually is complex, unstructured and thus, difficult to be captured in a way that will be efficiently reusable. Knowledge reusability is of paramount importance since it enables users participate actively in process design/redesign activities stimulated by the changing technology selection environment. This paper addresses the technology selection problem through an ontology-based approach that captures and makes reusable the equipment purchasing process and assists in identifying (a) the specifications requested by the users' organization, (b) those offered by various candidate vendors' organizations and (c) in performing specifications gap analysis as a prerequisite for effective and efficient technology selection. This approach has practical appeal, operational simplicity, and the potential for both immediate and long-term strategic impact. An example from the iron and steel industry is also presented to illustrate the approach.

The unrecognized burden of typhoid fever.

PubMed

Obaro, Stephen K; Iroh Tam, Pui-Ying; Mintz, Eric Daniel

2017-03-01

Typhoid fever (TF), caused by Salmonella enterica serovar Typhi, is the most common cause of enteric fever, responsible for an estimated 129,000 deaths and more than 11 million cases annually. Although several reviews have provided global and regional TF disease burden estimates, major gaps in our understanding of TF epidemiology remain. Areas covered: We provide an overview of the gaps in current estimates of TF disease burden and offer suggestions for addressing them, so that affected communities can receive the full potential of disease prevention offered by vaccination and water, sanitation, and hygiene interventions. Expert commentary: Current disease burden estimates for TF do not capture cases from certain host populations, nor those with atypical presentations of TF, which may lead to substantial underestimation of TF cases and deaths. These knowledge gaps pose major obstacles to the informed use of current and new generation typhoid vaccines.

Is operational research delivering the goods? The journey to success in low-income countries.

PubMed

Zachariah, Rony; Ford, Nathan; Maher, Dermot; Bissell, Karen; Van den Bergh, Rafael; van den Boogaard, Wilma; Reid, Tony; Castro, Kenneth G; Draguez, Bertrand; von Schreeb, Johan; Chakaya, Jeremiah; Atun, Rifat; Lienhardt, Christian; Enarson, Don A; Harries, Anthony D

2012-05-01

Operational research in low-income countries has a key role in filling the gap between what we know from research and what we do with that knowledge-the so-called know-do gap, or implementation gap. Planned research that does not tangibly affect policies and practices is ineffective and wasteful, especially in settings where resources are scarce and disease burden is high. Clear parameters are urgently needed to measure and judge the success of operational research. We define operational research and its relation with policy and practice, identify why operational research might fail to affect policy and practice, and offer possible solutions to address these shortcomings. We also propose measures of success for operational research. Adoption and use of these measures could help to ensure that operational research better changes policy and practice and improves health-care delivery and disease programmes. Copyright © 2012 Elsevier Ltd. All rights reserved.

Role of art centres for Aboriginal Australians living with dementia in remote communities.

PubMed

Lindeman, Melissa; Mackell, Paulene; Lin, Xiaoping; Farthing, Annie; Jensen, Heather; Meredith, Maree; Haralambous, Betty

2017-06-01

To explore the role art centres in remote communities play for Aboriginal and Torres Strait Islander Australians living with dementia. A comprehensive literature search was undertaken, with no restrictions on articles regarding year of publication. Art programmes have been found to be of benefit to both people living with dementia and their carers, particularly when programmes are administered in environments that are culturally revered. Findings indicate remote art centres play a key role in maintaining traditions, culture and practices unique to Aboriginal and Torres Strait Islanders, but there is a gap in knowledge regarding how they cater for the needs of people with dementia. Addressing this gap will be helpful in remote areas where prevalence of dementia is up to five times that of non-Aboriginal people, and there are limited health and support services. Further research is required to explore strengths and gaps of current practices. © 2017 AJA Inc.

Bedside, classroom and bench: collaborative strategies to generate evidence-based knowledge for nursing practice.

PubMed

Weaver, Charlotte A; Warren, Judith J; Delaney, Connie

2005-12-01

The rise of evidence-base practice (EBP) as a standard for care delivery is rapidly emerging as a global phenomenon that is transcending political, economic and geographic boundaries. Evidence-based nursing (EBN) addresses the growing body of nursing knowledge supported by different levels of evidence for best practices in nursing care. Across all health care, including nursing, we face the challenge of how to most effectively close the gap between what is known and what is practiced. There is extensive literature on the barriers and difficulties of translating research findings into practical application. While the literature refers to this challenge as the "Bench to Bedside" lag, this paper presents three collaborative strategies that aim to minimize this gap. The Bedside strategy proposes to use the data generated from care delivery and captured in the massive data repositories of electronic health record (EHR) systems as empirical evidence that can be analysed to discover and then inform best practice. In the Classroom strategy, we present a description for how evidence-based nursing knowledge is taught in a baccalaureate nursing program. And finally, the Bench strategy describes applied informatics in converting paper-based EBN protocols into the workflow of clinical information systems. Protocols are translated into reference and executable knowledge with the goal of placing the latest scientific knowledge at the fingertips of front line clinicians. In all three strategies, information technology (IT) is presented as the underlying tool that makes this rapid translation of nursing knowledge into practice and education feasible.

Contemporary disease management in Quebec.

PubMed

Gogovor, Amédé; Savoie, Michelle; Moride, Yola; Krelenbaum, Marilyn; Montague, Terrence

2008-01-01

Health or disease management (DM) has emerged as a promising solution to improve the quality of healthcare and patient outcomes in a cost-efficient way. This solution is particularly relevant in the care of our increasing, and aging, patient populations with multiple chronic diseases. This article reviews the recent history and current status of DM in the province of Quebec and summarizes its evolving perspectives and future prospects. Most DM projects in Quebec have developed from a public-private partnership, and they have addressed several disease states. The results of completed programs confirmed the presence of care gaps--the differences between best and usual care in several disease states. They also identified process changes leading to improved practices and enhanced professional satisfaction among stakeholders. Priorities identified for further research include increased knowledge of the underlying causes of care gaps and greater concentration on the measurement of clinical, humanistic and fiscal outcomes and their causal links to DM structures and processes. Although still embryonic in Quebec and Canada, the available evidence suggests that DM partnerships are practical and functional vehicles to expedite knowledge creation and transfer in the care of whole populations of patients. Future projects offer the promise of updated knowledge and continuously improved care and outcomes.

Getting to the guts of the matter: the status and potential of 'omics' research of parasitic protists of the human gastrointestinal system.

PubMed

Jex, Aaron R; Koehler, Anson V; Ansell, Brendan R; Baker, Louise; Karunajeewa, Harin; Gasser, Robin B

2013-11-01

Parasitic protists are a major cause of diarrhoeal illnesses in humans globally. Collectively, enteric pathogens exceed all other forms of infectious disease, in terms of their estimated global prevalence and socioeconomic impact. They have a disproportionately high impact on children in impoverished communities, leading to acute (diarrhoea, vomiting, dehydration and death) and chronic disease (malabsorption, malnutrition, physical and cognitive stunting and predisposition to chronic, non-communicable disease) consequences. However, historically, investment in research and disease control measures has been disproportionately poor, leading to their current classification as neglected pathogens. A sound understanding of their biology is essential in underpinning detection, treatment and control efforts. One major tool in rapidly improving our knowledge of these parasites is the use of biological systems, including 'omic' technologies. In recent years, these tools have shown significant success when applied to enteric protists. This review summarises much of this knowledge and highlights the significant remaining knowledge gaps. A major focus of the present review was to provide a perspective on a way forward to address these gaps using advanced biotechnologies. Copyright © 2013 Australian Society for Parasitology Inc. Published by Elsevier Ltd. All rights reserved.

Investigation of Stroke Needs (INVISION) Study: Stroke Awareness and Education

PubMed Central

Ing, Marissa M; Linton, Kristen F; Vento, Megan A

2015-01-01

The objective of this study was to assess the overall understanding and effectiveness of current inpatient stroke education practice by using the data from the Investigation of Stroke Needs (INVISION) Study, a qualitative study assessing various challenges and barriers of the hemorrhagic stroke survivors and their caregivers. Semi-structured interviews were conducted on patients who were recently hospitalized with intracerebral hemorrhage (ICH) and their caregivers during the follow-up visits. The electronic medical record for each patient was reviewed to assess whether they received standard stroke education material during their hospitalization. A phenomenological approach was utilized to identify gaps of education and knowledge in the targeted sample. A total of 21 participants were interviewed. Despite receiving formal stroke education material during their hospitalization, there were three major gaps in stroke knowledge that participants noted, including (1) lack of stroke knowledge/awareness, (2) need for stroke education, and (3) fear of recurrent stroke and comorbid diseases. The majority of ICH survivors had no memory of their hospitalization. This study suggests a need for increased continuity and communication with health-care providers to address the evolving educational and practical needs of stroke patients and their caregivers after hospital discharge. PMID:25954601

Bridging the Gap in Knowledge Transfer between Academia and Practitioners

ERIC Educational Resources Information Center

Gera, Rajat

2012-01-01

Purpose: The paper intends to identify the causes or gaps in transfer of managerial knowledge between academia and practitioners and to develop a framework that overcomes the gaps through knowledge management, information technology and human resource practices. The paper aims to suggest a strategic approach based on the knowledge transfer cycle.…

Experimental Evidence of the Knowledge Gap: Message Arousal, Motivation, and Time Delay

ERIC Educational Resources Information Center

Grabe, Maria Elizabeth; Yegiyan, Narine; Kamhawi, Rasha

2008-01-01

This study experimentally tested the knowledge gap from an information processing perspective. Specifically, knowledge acquisition was investigated under conditions of medium and low news message arousal, with time delay. Results show the persistence of a knowledge gap, particularly for low arousing messages. In fact, at low levels of message…

A parallel curriculum in lifestyle medicine.

PubMed

Pojednic, Rachele; Frates, Elizabeth

2017-02-01

Less than 50 per cent of US primary care doctors routinely provide guidance to their patients on lifestyle behaviours such as diet, physical activity or weight control, despite the prediction by the World Health Organization that by 2020, two-thirds of disease worldwide will be the result of poor lifestyle choices. This gap in patient-clinician dialogue is perhaps the result of a lack of structured training in medical school surrounding the components of lifestyle medicine. Although Harvard Medical School does have a required course in nutrition, there are no requirements for the other components of lifestyle medicine, including physical activity, behaviour change and self-care. Since 2009 Harvard Medical School has addressed this absence in the curriculum by developing a student-led, faculty member-advised, parallel curriculum in lifestyle medicine. Medical student participants were invited to take part in anonymous questionnaires between 2009 and 2013, which gathered data about personal ability and attitude in counselling patients on lifestyle behaviours, as well as subjective data on the curriculum content and applications to effective medical practice. Less than 50 per cent of US primary care doctors routinely provide guidance to their patients on lifestyle behaviours IMPLICATION: Each year, students have pointed to a lack of lifestyle medicine knowledge because of a gap in the traditional curriculum surrounding topics such as physical activity, nutrition and behaviour-change strategies, and indicated that the inclusion of this knowledge and these skills was an important component of medical education. Although participation is currently voluntary, this is the first such curriculum of this type and addresses a critical gap in undergraduate medical education. © 2015 John Wiley & Sons Ltd.

Public Resistance is Waste-Based and What to Do About That - 13412

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

Ford, Laurie

2013-07-01

'Nuclear Communicators' connect a highly advanced sci-tech world with the world of everyday living. One challenge is helping stakeholders fit together three Big Ideas: (1) the valuable nuclear energy resource, (2) nuclear energy's invisible mortal dangers and potential bad-guy threats, and (3) critical scientific and engineering knowledge that is far over the heads of average (grade 8) USA reading levels. This article provides an overview of what does - and does not - work in our public communications. What does not work: 1. Going off topic. Address what concerns people most: how to manage nuclear wastes. 2. Underestimating public intelligence.more » What works: 1. Doing your homework on community history regarding nuclear materials. 2. Having discussion forums and public meetings with special guests from industry, government, and local leaders. 3. Regular cycles of communication with community groups to build a long-term dialogue. Solutions to some communication challenges require handling four gaps and one jungle: 1. Facts gap - Honest information about waste disposition. 2. Time gap - The timelines associated with waste management include 300 years, 10,000 years, and 703.8 million years. How do we talk about this? 3. Money gap - Who pays for new waste management challenges and technologies? 4. Confidence gap - Link local options to regional, national, and global knowledge. 5. Decision jungle - How can we make waste management rules and infrastructure more logical and transparent? Public communication needs to be grounded in facts for people who want to be credible actors in the new nuclear world. (authors)« less

Does child and adolescent mental health in-service training result in equivalent knowledge gain among cadres of non-specialist health workers in Uganda? A pre-test post-test study.

PubMed

Akol, Angela; Nalugya, Joyce; Nshemereirwe, Sylvia; Babirye, Juliet N; Engebretsen, Ingunn Marie Stadskleiv

2017-01-01

Early identification and management of child and adolescent mental health (CAMH) disorders helps to avert mental illness in adulthood but a CAMH treatment gap exists in Uganda. CAMH integration into primary health care (PHC) through in-service training of non-specialist health workers (NSHW) using the World Health Organisation (WHO) Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) is a strategy to address this gap. However, results of such training are not supported by information on training development or delivery; and are undifferentiated by NSHW cadre. We aim to describe an in-service CAMH training for NSHW in Uganda and assess cadre-differentiated learning outcomes. Thirty-six clinical officers, nurses and midwives from 18 randomly selected PHC clinics in eastern Uganda were trained for 5 days on CAMH screening and referral using a curriculum based on the mhGAP-IG version 1.0 and PowerPoint slides from the International Association of Child and Adolescent Psychiatry and Allied Professions (IACAPAP). The residential training was evaluated through pre- and post- training tests of CAMH knowledge and attitudes using the participants' post-test scores; and the difference between pre-test and post-test scores. Two-tailed t-tests assessed differences in mean pre-test and post-test scores between the cadres; hierarchical linear regression tested the association between cadre and post test scores; and logistic regression evaluated the relationship between cadre and knowledge gain at three pre-determined cut off points. Thirty-three participants completed both pre-and post-tests. Improved mean scores from pre- to post-test were observed for both clinical officers (20% change) and nurse/midwives (18% change). Clinical officers had significantly higher mean test scores than nurses and midwives (p < 0.05) but cadre was not significantly associated with improvement in CAMH knowledge at the 10% (AOR 0.08; 95 CI [0.01, 1.19]; p = 0.066), 15% (AOR 0.16; 95% CI [0.01, 2.21]; p = 0.170), or 25% (AOR 0.13; 95% CI [0.01, 1.74]; p = 0.122) levels. We aimed to examine CAMH learning outcomes by NSHW cadre. NSHW cadre does not influence knowledge gain from in-service CAMH training. Thus, an option for integrating CAMH into PHC in Uganda using the mhGAP-IG and IACAPAP PowerPoint slides is to proceed without cadre differentiation.

Heavy agricultural workloads and low crop diversity are strong barriers to improving child feeding practices in the Bolivian Andes.

PubMed

Jones, Andrew D; Cruz Agudo, Yesmina; Galway, Lindsay; Bentley, Jeffery; Pinstrup-Andersen, Per

2012-11-01

Most nutrition initiatives to date aimed at improving infant and young child feeding (IYCF) have emphasized addressing knowledge gaps through behavior change messaging with less focus on addressing the underlying environmental barriers that may shape these behaviors. This research integrates an analysis of longitudinal dietary data with qualitative data on barriers to improved child feeding to identify the nature and extent of the barriers caregivers face to improving IYCF practices in a farming region of the Bolivian Andes, and to determine the relative influence of these barriers on caregivers' abilities to improve IYCF practices. Sixty-nine caregivers were selected from a sample of 331 households that participated in a longitudinal survey assessing changes in IYCF practices among caregivers with children aged 0-36 months from March 2009 to March 2010. Forty-nine barriers within 12 categories of barriers were identified through semi-structured interviews with the 69 caregivers. The most frequently reported barriers were those related to women's time dedicated to agricultural labor, the limited diversity of household agricultural production, and lack of support for child feeding from spouses and mothers-in-law. In multivariate analyses controlling for several variables that could potentially influence IYCF practices, these barriers were negatively associated with changes to the diversity of child diets, child dietary energy intake, and child meal frequency. While knowledge gaps and individual-level influences affected IYCF practices, physical and social caregiving environments in this region of Bolivia were even more important. Behavior change communication alone will likely not address the social and environmental barriers to improved child feeding that often prevent translation of improved knowledge into action. Particularly in rural regions, agriculture may strongly influence child feeding, not only indirectly through household food security, but also directly by affecting women's caregiving capacity. Copyright © 2012 Elsevier Ltd. All rights reserved.

Heavy agricultural workloads and low crop diversity are strong barriers to improving child feeding practices in the Bolivian Andes

PubMed Central

Jones, Andrew D; Agudo, Yesmina Cruz; Galway, Lindsay; Bentley, Jeffery; Pinstrup-Andersen, Per

2012-01-01

Most nutrition initiatives to date aimed at improving infant and young child feeding (IYCF) have emphasized addressing knowledge gaps through behavior change messaging with less focus on addressing the underlying environmental barriers that may shape these behaviors. This research integrates an analysis of longitudinal dietary data with qualitative data on barriers to improved child feeding to identify the nature and extent of the barriers caregivers face to improving IYCF practices in a farming region of the Bolivian Andes, and to determine the relative influence of these barriers on caregivers’ abilities to improve IYCF practices. Sixty-nine caregivers were selected from a sample of 331 households that participated in a longitudinal survey assessing changes in IYCF practices among caregivers with children aged 0–36 months from March 2009 to March 2010. Forty-nine barriers within 12 categories of barriers were identified through semi-structured interviews with the 69 caregivers. The most frequently reported barriers were those related to women’s time dedicated to agricultural labor, the limited diversity of household agricultural production, and lack of support for child feeding from spouses and mothers-in-law. In multivariate analyses controlling for several variables that could potentially influence IYCF practices, these barriers were negatively associated with changes to the diversity of child diets, child dietary energy intake, and child meal frequency. While knowledge gaps and individual-level influences affected IYCF practices, physical and social caregiving environments in this region of Bolivia were even more important. Behavior change communication alone will likely not address the social and environmental barriers to improved child feeding that often prevent translation of improved knowledge into action. Particularly in rural regions, agriculture may strongly influence child feeding, not only indirectly through household food security, but also directly by affecting women’s caregiving capacity. PMID:22867863

On the Need to Establish an International Soil Modeling Consortium

NASA Astrophysics Data System (ADS)

Vereecken, H.; Vanderborght, J.; Schnepf, A.

2014-12-01

Soil is one of the most critical life-supporting compartments of the Biosphere. Soil provides numerous ecosystem services such as a habitat for biodiversity, water and nutrients, as well as producing food, feed, fiber and energy. To feed the rapidly growing world population in 2050, agricultural food production must be doubled using the same land resources footprint. At the same time, soil resources are threatened due to improper management and climate change. Despite the many important functions of soil, many fundamental knowledge gaps remain, regarding the role of soil biota and biodiversity on ecosystem services, the structure and dynamics of soil communities, the interplay between hydrologic and biotic processes, the quantification of soil biogeochemical processes and soil structural processes, the resilience and recovery of soils from stress, as well as the prediction of soil development and the evolution of soils in the landscape, to name a few. Soil models have long played an important role in quantifying and predicting soil processes and related ecosystem services. However, a new generation of soil models based on a whole systems approach comprising all physical, mechanical, chemical and biological processes is now required to address these critical knowledge gaps and thus contribute to the preservation of ecosystem services, improve our understanding of climate-change-feedback processes, bridge basic soil science research and management, and facilitate the communication between science and society. To meet these challenges an international community effort is required, similar to initiatives in systems biology, hydrology, and climate and crop research. Our consortium will bring together modelers and experimental soil scientists at the forefront of new technologies and approaches to characterize soils. By addressing these aims, the consortium will contribute to improve the role of soil modeling as a knowledge dissemination instrument in addressing key global issues and stimulate the development of translational research activities. This presentation will provide a compelling case for this much-needed effort, with a focus on tangible benefits to the scientific and food security communities.

Threats and knowledge gaps for ecosystem services provided by kelp forests: a northeast Atlantic perspective

PubMed Central

Smale, Dan A; Burrows, Michael T; Moore, Pippa; O'Connor, Nessa; Hawkins, Stephen J

2013-01-01

Kelp forests along temperate and polar coastlines represent some of most diverse and productive habitats on the Earth. Here, we synthesize information from >60 years of research on the structure and functioning of kelp forest habitats in European waters, with particular emphasis on the coasts of UK and Ireland, which represents an important biogeographic transition zone that is subjected to multiple threats and stressors. We collated existing data on kelp distribution and abundance and reanalyzed these data to describe the structure of kelp forests along a spatial gradient spanning more than 10° of latitude. We then examined ecological goods and services provided by kelp forests, including elevated secondary production, nutrient cycling, energy capture and flow, coastal defense, direct applications, and biodiversity repositories, before discussing current and future threats posed to kelp forests and identifying key knowledge gaps. Recent evidence unequivocally demonstrates that the structure of kelp forests in the NE Atlantic is changing in response to climate- and non-climate-related stressors, which will have major implications for the structure and functioning of coastal ecosystems. However, kelp-dominated habitats along much of the NE Atlantic coastline have been chronically understudied over recent decades in comparison with other regions such as Australasia and North America. The paucity of field-based research currently impedes our ability to conserve and manage these important ecosystems. Targeted observational and experimental research conducted over large spatial and temporal scales is urgently needed to address these knowledge gaps. PMID:24198956

Threats and knowledge gaps for ecosystem services provided by kelp forests: a northeast Atlantic perspective.

PubMed

Smale, Dan A; Burrows, Michael T; Moore, Pippa; O'Connor, Nessa; Hawkins, Stephen J

2013-10-01

Kelp forests along temperate and polar coastlines represent some of most diverse and productive habitats on the Earth. Here, we synthesize information from >60 years of research on the structure and functioning of kelp forest habitats in European waters, with particular emphasis on the coasts of UK and Ireland, which represents an important biogeographic transition zone that is subjected to multiple threats and stressors. We collated existing data on kelp distribution and abundance and reanalyzed these data to describe the structure of kelp forests along a spatial gradient spanning more than 10° of latitude. We then examined ecological goods and services provided by kelp forests, including elevated secondary production, nutrient cycling, energy capture and flow, coastal defense, direct applications, and biodiversity repositories, before discussing current and future threats posed to kelp forests and identifying key knowledge gaps. Recent evidence unequivocally demonstrates that the structure of kelp forests in the NE Atlantic is changing in response to climate- and non-climate-related stressors, which will have major implications for the structure and functioning of coastal ecosystems. However, kelp-dominated habitats along much of the NE Atlantic coastline have been chronically understudied over recent decades in comparison with other regions such as Australasia and North America. The paucity of field-based research currently impedes our ability to conserve and manage these important ecosystems. Targeted observational and experimental research conducted over large spatial and temporal scales is urgently needed to address these knowledge gaps.

The unrealized promise of infant statistical word-referent learning

PubMed Central

Smith, Linda B.; Suanda, Sumarga H.; Yu, Chen

2014-01-01

Recent theory and experiments offer a new solution as to how infant learners may break into word learning, by using cross-situational statistics to find the underlying word-referent mappings. Computational models demonstrate the in-principle plausibility of this statistical learning solution and experimental evidence shows that infants can aggregate and make statistically appropriate decisions from word-referent co-occurrence data. We review these contributions and then identify the gaps in current knowledge that prevent a confident conclusion about whether cross-situational learning is the mechanism through which infants break into word learning. We propose an agenda to address that gap that focuses on detailing the statistics in the learning environment and the cognitive processes that make use of those statistics. PMID:24637154

Doing the Scut Work of Infant Care: Does Religiousness Encourage Father Involvement?

PubMed

Demaris, Alfred; Mahoney, Annette; Pargament, Kenneth I

2011-04-01

Considerable debate exists regarding whether religiousness promotes or impedes greater father involvement in parenting. Our study addresses this issue using a Midwestern longitudinal dataset that tracks the transition to first parenthood for 169 married couples. We focus on performance of the "messier" tasks of infant care. We find little evidence that religiousness enhances father involvement in this domain. Biblically conservative couples exhibit a greater gender gap in childcare than others, with mothers more involved than fathers. The gender gap is also greater the more fathers work outside the home, the greater mothers' knowledge of infant development, and the more unadaptable the infant. Average daily childcare is lower the greater spouses' work hours, but higher with difficult pregnancies or fussy babies.

Doing the Scut Work of Infant Care: Does Religiousness Encourage Father Involvement?

PubMed Central

DeMaris, Alfred; Mahoney, Annette; Pargament, Kenneth I.

2011-01-01

Considerable debate exists regarding whether religiousness promotes or impedes greater father involvement in parenting. Our study addresses this issue using a Midwestern longitudinal dataset that tracks the transition to first parenthood for 169 married couples. We focus on performance of the “messier” tasks of infant care. We find little evidence that religiousness enhances father involvement in this domain. Biblically conservative couples exhibit a greater gender gap in childcare than others, with mothers more involved than fathers. The gender gap is also greater the more fathers work outside the home, the greater mothers’ knowledge of infant development, and the more unadaptable the infant. Average daily childcare is lower the greater spouses’ work hours, but higher with difficult pregnancies or fussy babies. PMID:21966024

"They Didn't Even Let Me Say Goodbye": A Study of Imprisoned Primary Carer Fathers' Care Planning for Children at the Point of Arrest in Victoria, Australia

ERIC Educational Resources Information Center

Bartlett, Tess S.; Flynn, Catherine A.; Trotter, Christopher J.

2018-01-01

In Victoria, data indicates that in 2013-2014 there were 74,992 adult male arrests, yet little formal attention has been paid to the parenting status of these men, despite knowledge of the impact of parental arrest and incarceration on children being well established. This article addresses a gap in the literature by providing new insights into…

Chronic Pancreatitis: Current Status and Challenges for Prevention and Treatment

PubMed Central

Lew, Daniel; Afghani, Elham

2017-01-01

This paper reviews the current status of our understanding of the epidemiology, diagnosis, and management of the continuum of pancreatic diseases from acute and recurrent acute pancreatitis to chronic pancreatitis and the diseases that are often linked with pancreatitis including diabetes mellitus and pancreatic cancer. In addition to reviewing the current state of the field, we identify gaps in knowledge that are necessary to address to improve patient outcomes in these conditions. PMID:28501969

Bridging the Semantic Gap Between Heterogeneous Modeling Formalisms and FMI

DTIC Science & Technology

2014-04-25

Naval Research Laboratory (NRL #N0013-12-1-G015), and the following companies: Bosch, National Instruments, and Toyota ). 1 of contract, these two...but only on the interconnections of the FMUs in the network). To our knowledge , the question how to create FMUs has not been formally addressed. This...unbounded length. The main characteristic of SDF is that the number of tokens that each actor consumes from its input queues and produces to its output

Bridging the Higher Education Divide: Strengthening Community Colleges and Restoring the American Dream. The Report of The Century Foundation Task Force on Preventing Community Colleges from Becoming Separate and Unequal

ERIC Educational Resources Information Center

Century Foundation, 2013

2013-01-01

American community colleges stand at the confluence of four mighty rivers that are profoundly influencing all of American life. At a time of growing economic globalization, community colleges are a critical element in the strategy to address the skills and education gap to meet the emerging needs of industries in the new knowledge economy. In…

Police training to align law enforcement and HIV prevention: preliminary evidence from the field.

PubMed

Beletsky, Leo; Agrawal, Alpna; Moreau, Bruce; Kumar, Pratima; Weiss-Laxer, Nomi; Heimer, Robert

2011-11-01

Having identified gaps in implementation of Rhode Island's syringe access law and police occupational safety education, public health and police professionals developed police training to boost legal knowledge, improve syringe access attitudes, and address needlestick injuries. Baseline data (94 officers) confirmed anxiety about needlestick injuries, poor legal knowledge, and occupational risk overestimation. Before training, respondents believed that syringe access promotes drug use (51%), increases likelihood of police needlestick injuries (58%), and fails to reduce epidemics (38%). Pretraining to posttraining evaluation suggested significant shifts in legal and occupational safety knowledge; changes in attitudes toward syringe access were promising. Training that combines occupational safety with syringe access content can help align law enforcement with public health goals. Additional research is needed to assess street-level effect and to inform intervention tailoring.

On-site comprehensive curriculum to teach reproductive health to female adolescents in Kenya.

PubMed

Gaughran, Margaret; Asgary, Ramin

2014-04-01

Rates of sexually transmitted infections (STIs) and unplanned pregnancy are high in Kenya, and limited reproductive health education exists in schools. We designed and implemented a 6-week reproductive health curriculum in Laikipia District, Kenya, in 2011, which included didactic sessions, educational games, and open discussions. We applied a mixed quantitative and qualitative methods to evaluate this curriculum including a comprehensive 35-item survey to assess pre- and post-training knowledge, attitudes, and practices of female teenagers regarding STIs/HIV and family planning using paired t-test as well as complementary focus groups (n=42) and individual interviews (n=20). Average age for 42 female teenagers was 16.5 (± 1.31) years. Pre-test questionnaires revealed lack of knowledge about different types of STIs, specifically chlamydia, but adequate knowledge of basic contraception including abstinence and condom use. By the conclusion of the study, we observed improvement in following educational domains: general knowledge of HIV/AIDS (85% ± 7.5% to 94% ± 5.6%) (p<0.001); general knowledge of teen pregnancy and STIs (57% ± 19% to 82% ± 13%) (p<0.001); and overall scores of knowledge, attitude, and self-efficacy (81% ± 6.6% to 90% ± 5%) (p<0.001). Focus group discussions, however, revealed persistent misconceptions and knowledge gaps with themes regarding HIV transmission risk factors, perceived difficulty negotiating condom use, masturbation and its perceived consequences, and issues surrounding female circumcision. Important misconceptions and gaps in reproductive practices were identified and addressed using a mixed methods approach. Despite prior basic knowledge and positive attitudes on STI prevention and family planning, complementary teaching approaches were instrumental in improving overall knowledge of STIs other than HIV as well as family planning. The curriculum was feasible, well received, and achieved its educational goals.

Healthcare Professionals' Knowledge of Influenza and Influenza Vaccination: Results of a National Survey in Poland.

PubMed

Kuchar, Ernest; Ludwikowska, Kamila; Antczak, Adam; Nitsch-Osuch, Aneta

2018-01-01

In Poland, the seasonal influenza vaccination rate is just barely 3% which may be related to the unsatisfactory knowledge of influenza among healthcare professionals, poor recognition of the benefits of influenza immunization and the fear of side effects. To address these issues, we surveyed healthcare professionals through an online questionnaire consisting of 18 closed-ended items. The questionnaire was completed by 495 healthcare professionals, mostly physicians (83%). The results revealed gaps in the knowledge concerning influenza diagnosis, complications, risk groups, and prognostic factors. On average, respondents only answered 4.8 of the 18 questions correctly (27%). Only 10% of respondents passed the threshold of 50% correct answers. The knowledge of contraindications to vaccination far outweighed the knowledge of indications for vaccination. Poor knowledge with a focus on the adverse effects of immunization may be a significant factor responsible for the low vaccination rate in Poland. To increase vaccination rate, healthcare professionals need to be educated about influenza-related risks and benefits of vaccination.

Gap analysis: synergies and opportunities for effective nursing leadership.

PubMed

Davis-Ajami, Mary Lynn; Costa, Linda; Kulik, Susan

2014-01-01

Gap analysis encompasses a comprehensive process to identify, understand, address, and bridge gaps in service delivery and nursing practice. onducting gap analysis provides structure to information gathering and the process of finding sustainable solutions to important deficiencies. Nursing leaders need to recognize, measure, monitor, and execute on feasible actionable solutions to help organizations make adjustments to address gaps between what is desired and the actual real-world conditions contributing to the quality chasm in health care. Gap analysis represents a functional and comprehensive tool to address organizational deficiencies. Using gap analysis proactively helps organizations map out and sustain corrective efforts to close the quality chasm. Gaining facility in gap analysis should help the nursing profession's contribution to narrowing the quality chasm.

Succession Planning in State Health Agencies in the United States: A Brief Report.

PubMed

Harper, Elizabeth; Leider, Jonathon P; Coronado, Fatima; Beck, Angela J

2017-11-02

Approximately 25% of the public health workforce plans to retire by 2020. Succession planning is a core capability of the governmental public health enterprise; however, limited data are available regarding these efforts in state health agencies (SHAs). We analyzed 2016 Workforce Gaps Survey data regarding succession planning in SHAs using the US Office of Personnel Management's (OPM's) succession planning model, including 6 domains and 27 activities. Descriptive statistics were calculated for all 41 responding SHAs. On average, SHAs self-reported adequately addressing 11 of 27 succession planning activities, with 93% of SHAs adequately addressing 1 or more activities and 61% adequately addressing 1 or more activities in each domain. The majority of OPM-recommended succession planning activities are not being addressed, and limited succession planning occurs across SHAs. Greater activity in the OPM-identified succession planning domains may help SHAs contend with significant turnover and better preserve institutional knowledge.

Children's safety initiative: a national assessment of pediatric educational needs among emergency medical services providers.

PubMed

Hansen, Matthew; Meckler, Garth; Dickinson, Caitlyn; Dickenson, Kathryn; Jui, Jonathan; Lambert, William; Guise, Jeanne-Marie

2015-01-01

Emergency medical services (EMS) providers may have critical knowledge gaps in pediatric care due to lack of exposure and training. There is currently little evidence to guide educators to the knowledge gaps that most need to be addressed to improve patient safety. The objective of this study was to identify educational needs of EMS providers related to pediatric care in various domains in order to inform development of curricula. The Children's Safety Initiative-EMS performed a three-phase Delphi survey on patient safety in pediatric emergencies among providers and content experts in pediatric emergency care, including physicians, nurses, and prehospital providers of all levels. Each round included questions related to educational needs of providers or the effect of training on patient safety events. We identified knowledge gaps in the following domains: case exposure, competency and knowledge, assessment and decision making, and critical thinking and proficiency. Individual knowledge gaps were ranked by portion of respondents who ranked them "highly likely" (Likert-type score 7-10 out of 10) to contribute to safety events. There were 737 respondents who were included in analysis of the first phase of the survey. Paramedics were 50.8% of respondents, EMT-basics/first responders were 22%, and physicians 11.4%. The top educational priorities identified in the final round of the survey include pediatric airway management, responder anxiety when working with children, and general pediatric skills among providers. The top three needs in decision-making include knowing when to alter plans mid-course, knowing when to perform an advanced airway, and assessing pain in children. The top 3 technical or procedural skills needs were pediatric advanced airway, neonatal resuscitation, and intravenous/intraosseous access. For neonates, specific educational needs identified included knowing appropriate vital signs and preventing hypothermia. This is the first large-scale Delphi survey related to pediatric prehospital education. Our results provide foundational information related to the educational needs of prehospital providers. Medical directors and educators can use the results to shape future curricular development.

The gap in scientific knowledge and role of science communication in South Korea.

PubMed

Chang, Jeong-Heon; Kim, Sei-Hill; Kang, Myung-Hyun; Shim, Jae Chul; Ma, Dong Hoon

2017-01-01

Using data from a national survey of South Koreans, this study explores the role of science communication in enhancing three different forms of scientific knowledge ( factual, procedural, and subjective). We first assess learning effects, looking at the extent to which citizens learn science from different channels of communication (interpersonal discussions, traditional newspapers, television, online newspapers, and social media). We then look into the knowledge gap hypothesis, investigating how different communication channels can either widen or narrow the gap in knowledge between social classes. Television was found to function as a "knowledge leveler," narrowing the gap between highly and less educated South Koreans. The role of online newspapers in science learning is pronounced in our research. Reading newspapers online indicated a positive relationship to all three measures of knowledge. Contrary to the knowledge-leveling effect of television viewing, reading online newspapers was found to increase, rather than decrease, the gap in knowledge. Implications of our findings are discussed in detail.

Mind the gap - do we need more geoscientific expertise for developing R?

NASA Astrophysics Data System (ADS)

Dietze, Michael; Kreutzer, Sebastian; Korup, Oliver

2017-04-01

R has reached a high level of acceptance and usage among geoscientists worldwide, including both users and developers. These two groups are not mutually exclusive but overlap strongly. This is a favourable situation to promote the implementation of new functionalities as packages and shared scripts. Despite this positive trend there is a series of missing functionalities. Likewise, other languages, such as Python, Matlab, C++ or FORTRAN, provide similar possibilities like R and have been used for addressing needs for such missing functionalities already long ago. R allows in principal to implement such lacking functionalities - but only if they have been identified and communicated amongst the community in a transparent way. Our session addresses this challenge. The PICO presentation gives a brief overview of the directions of R functionalities in the field of geosciences and identifies major gaps, from the viewpoint of us session conveners and most importantly based on the input of participating scientists. We invite all scientists to discuss and contribute knowledge to this topic based on their experiences and requirements. The suggestions will be broadcast as live updates during the PICO session and beyond. We intend to work towards building an active community of interacting developers and users to fill identified gaps to develop new powerful functionalities in the R environment.

We’re only in it for the knowledge? A problem solving turn in environment and health expert elicitation

PubMed Central

2012-01-01

Background The FP6 EU HENVINET project aimed at synthesizing the scientific information available on a number of topics of high relevance to policy makers in environment and health. The goal of the current paper is to reflect on the methodology that was used in the project, in view of exploring the usefulness of this and similar methodologies to the policy process. The topics investigated included health impacts of the brominated flame retardants decabrominated diphenylether (decaBDE) and hexabromocyclododecane (HBCD), phthalates highlighting di(2-ethylhexyl)phthalate (DEHP), the pesticide chlorpyrifos (CPF), nanoparticles, the impacts of climate change on asthma and other respiratory disorders, and the influence of environment health stressors on cancer induction. Methods Initially the focus was on identifying knowledge gaps in the state of the art in scientific knowledge. Literature reviews covered all elements that compose the causal chain of the different environmental health issues from emissions to exposures, to effects and to health impacts. Through expert elicitation, knowledge gaps were highlighted by assessing expert confidence using calibrated confidence scales. During this work a complementary focus to that on knowledge gaps was developed through interdisciplinary reflections. By extending the scope of the endeavour from only a scientific perspective, to also include the more problem solving oriented policy perspective, the question of which kind of policy action experts consider justifiable was addressed. This was addressed by means of a questionnaire. In an expert workshop the results of both questionnaires were discussed as a basis for policy briefs. Results The expert elicitation, the application of the calibrated confidence levels and the problem solving approach were all experienced as being quite challenging for the experts involved, as these approaches did not easily relate to mainstream environment and health scientific practices. Even so, most experts were quite positive about it. In particular, the opportunity to widen one’s own horizon and to interactively exchange knowledge and debate with a diversity of experts seemed to be well appreciated in this approach. Different parts of the approach also helped in focussing on specific relevant aspects of scientific knowledge, and as such can be considered of reflective value. Conclusions The approach developed by HENVINET was part of a practice of learning by doing and of interdisciplinary cooperation and negotiation. Ambitions were challenged by unforeseen complexities and difference of opinion and as no Holy Grail approach was at hand to copy or follow, it was quite an interesting but also complicated endeavour. Perfection, if this could be defined, seemed out of reach all the time. Nevertheless, many involved were quite positive about it. It seems that many felt that it fitted some important needs in current science when addressing the needs of policy making on such important issues, without anyone really having a clue on how to actually do this. Challenging questions remain on the quality of such approach and its product. Practice tells us that there probably is no best method and that the best we can do is dependent on contextual negotiation and learning from experiences that we think are relevant. PMID:22759503

Addressing knowledge gaps and prevention for tuberculosis-infected Indian adults: a vital part of elimination.

PubMed

DeLuca, Andrea; Dhumal, Gauri; Paradkar, Mandar; Suryavanshi, Nishi; Mave, Vidya; Kohli, Rewa; Shivakumar, Shri Vijay Bala Yogendra; Hulyolkar, Vidula; Gaikwad, Archana; Nangude, Ashwini; Pardeshi, Geeta; Kadam, Dileep; Gupta, Amita

2018-05-02

India plans to eliminate tuberculosis (TB) by 2025, and has identified screening and prevention as key activities. Household contacts (HHCs) of index TB cases are a high-risk population that would benefit from rapid implementation of these strategies. However, best practices for TB prevention and knowledge gaps among HHCs have not been studied. We evaluated TB knowledge and understanding of prevention among tuberculin skin-test (TST) positive HHCs. While extensive information is available in other high-burden settings regarding TB knowledge gaps, identifying how Indian adult contacts view their transmission risk and prevention options may inform novel screening algorithms and education efforts that will be part of the new elimination plan. We approached adult HHC to administer a questionnaire on TB knowledge and understanding of infection. Over 1 year, 100 HHC were enrolled at a tertiary hospital in Pune, India. The study population was 61% (n = 61) female, with a mean age of 36.6 years (range 18-67, SD = 12). Education levels were high, with 78 (78%) having at least a high school education, and 23 (24%) had at least some college education. Four (4%) of our participants were HIV-infected. General TB knowledge among HHC was low, with a majority of participants believing that you can get TB from sharing dishes (70%) or touching something that has been coughed on (52%). Understanding of infection was also low, with 42% believing that being skin-test positive means you have disease. To assess readiness for preventive therapy, we asked participants whether they are at a higher risk of progressing to active disease because of their LTBI status. Fifty-four (55%) felt that they are at higher risk. Only 8% had heard of preventive therapy. Our TB knowledge survey among HHCs with evidence of recent exposure found that knowledge is poor and families are confused about transmission in the household. It is imperative that the Indian program develop tools and incentives that can be used to educate TB cases and their families on what infected HHCs can do to prevent disease, including preventive therapy.

Pain Assessment and Management in Nursing Education Using Computer-based Simulations.

PubMed

Romero-Hall, Enilda

2015-08-01

It is very important for nurses to have a clear understanding of the patient's pain experience and of management strategies. However, a review of the nursing literature shows that one of the main barriers to proper pain management practice is lack of knowledge. Nursing schools are in a unique position to address the gap in pain management knowledge by facilitating the acquisition and use of knowledge by the next generation of nurses. The purpose of this article is to discuss the role of computer-based simulations as a reliable educational technology strategy that can enhance the learning experience of nursing students acquiring pain management knowledge and practice. Computer-based simulations provide a significant number of learning affordances that can help change nursing students' attitudes and behaviors toward and practice of pain assessment and management. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

From dental science to clinical practice: Knowledge translation and evidence-based dentistry principles.

PubMed

Afrashtehfar, Kelvin I; Assery, Mansour K

2017-07-01

It has been claimed that in order to decrease the gap between what we know and what we do, research findings must be translated from knowledge to action. Such practices better enable dentists to make evidence-based decisions instead of personal ideas and judgments. To this end, this literature review aims to revisit the concepts of knowledge translation and evidence-based dentistry (EBD) and depict their role and influence within dental education. It addresses some possible strategies to facilitate knowledge translation (KT), encourage dental students to use EBD principles, and to encourage dental educators to create an environment in which students become self-directed learners. It concludes with a call to develop up-to-date and efficient online platforms that could grant dentists better access to EBD sources in order to more efficiently translate research evidence into the clinic.

US female college students' breast health knowledge, attitudes, and determinants of screening practices: new implications for health education.

PubMed

Early, Jody; Armstrong, Shelley Nicole; Burke, Sloane; Thompson, Doris Lee

2011-01-01

This study examined female college students' knowledge, attitudes, and breast cancer screening and determined significant predictors of breast self-examination, clinical breast examination, and mammography among this population. A convenience sample of 1,074 college women from 3 universities participated in the research. Respondents completed an online version of the Toronto Breast Self-examination Instrument as well as questions developed by the authors. Descriptive statistics showed gaps in college women's knowledge of breast health and negative attitudes toward screening that were relative to age. Multiple linear and logistic regression analyses revealed that knowledge, attitudes, and copay were significant predictors of screening, whereas family history and ethnicity were not. This study supported previous smaller-sample studies that showed college women to be a priority population for breast health education and revealed new significant factors that should be addressed in health education for this group.

Exploring arts-based knowledge translation: sharing research findings through performing the patterns, rehearsing the results, staging the synthesis.

PubMed

Rieger, Kendra; Schultz, Annette S H

2014-04-01

Cultivation of knowledge translation (KT) strategies that actively engage health professionals in critical reflection of their practice and research-based evidence are imperative to address the research-practice gap. While research-based evidence is exponentially growing, our ability to facilitate uptake by nurses and other health professionals has not kept pace. Innovative approaches that extend epistemological bias beyond a singular standpoint of postpositivism, such as the utilization of arts-based methods, expand the possibility to address the complexities of context, engage audience members, promote dissemination within communities of practice, and foster new audiences interested in research findings. In this paper, we address the importance of adopting a social constructivist epistemological stance to facilitate knowledge translation to diverse audiences, explore various arts-based knowledge translation (ABKT) strategies, and open a dialogue concerning evaluative tenets of ABKT. ABKT utilizes various art forms to disseminate research knowledge to diverse audiences and promote evidence-informed practice. ABKT initiatives translate knowledge not based upon a linear model, which views knowledge as an objective entity, but rather operate from the premise that knowledge is socially situated, which demands acknowledging and engaging the learner within their context. Theatre, dance, photography, and poetry are art forms that are commonly used to communicate research findings to diverse audiences. Given the emerging interest and importance of utilizing this KT strategy situated within a social constructivist epistemology, potential challenges and plausible evaluative criteria specific to ABKT are presented. ABKT is an emerging KT strategy that is grounded in social constructivist epistemological tenets, and holds potential for meaningfully sharing new research knowledge with diverse audiences. ABKT is an innovative and synergistic approach to traditional dissemination strategies. This creative KT approach is emerging as potent transformational learning tools that are congruent with the relational nature of nursing practice. ABKT facilitates learning about new research findings in an engaging and critical reflective manner that promotes learning within communities of practice. © 2014 Sigma Theta Tau International.

The Association of HIV Stigma and HIV/STD Knowledge With Sexual Risk Behaviors Among Adolescent and Adult Men Who Have Sex With Men in Ghana, West Africa.

PubMed

Nelson, LaRon E; Wilton, Leo; Agyarko-Poku, Thomas; Zhang, Nanhua; Aluoch, Marilyn; Thach, Chia T; Owiredu Hanson, Samuel; Adu-Sarkodie, Yaw

2015-06-01

Ghanaian men who have sex with men (MSM) have a high HIV seroprevalence, but despite a critical need to address this public health concern, research evidence has been extremely limited on influences on sexual risk behavior among MSM in Ghana. To investigate associations between HIV/STD knowledge, HIV stigma, and sexual behaviors in a sample of MSM in Ghana, we conducted a secondary data analysis of cross-sectional survey data from a non-probability sample of Ghanaian MSM (N = 137). Nearly all the men (93%) had more than one current sex partner (M = 5.11, SD = 7.4). Of those reported partners, the average number of current female sexual partners was 1.1 (SD = 2.6). Overall, knowledge levels about HIV and STDs were low, and HIV stigma was high. There was no age-related difference in HIV stigma. Younger MSM (≤25 years) used condoms less often for anal and vaginal sex than did those over 25. Relative frequency of condom use for oral sex was lower in younger men who had higher STD knowledge and also was lower in older men who reported high HIV stigma. Knowledge and stigma were not associated with condom use for anal or vaginal sex in either age group. These descriptive data highlight the need for the development of intervention programs that address HIV/STD prevention knowledge gaps and reduce HIV stigma in Ghanaian communities. Intervention research in Ghana should address age-group-specific HIV prevention needs of MSM youth. © 2015 Wiley Periodicals, Inc.

Collecting Sexual Orientation and Gender Identity Data in Suicide and Other Violent Deaths: A Step Towards Identifying and Addressing LGBT Mortality Disparities

PubMed Central

Lane, Andrew

2015-01-01

Abstract Sexual orientation and gender identity (SO/GI) are not systematically recorded at time of death, limiting identification of mortality disparities in lesbian, gay, bisexual, and transgender (LGBT) people. LGBT populations are thought to have elevated risk of suicide based on high rates of reported lifetime suicide attempts. Lack of data on suicide deaths, however, hinders understanding of the prevalence and patterns of suicide among LGBT populations and development of targeted interventions and prevention programs. This report describes recent efforts to address this knowledge gap by systematically collecting SO/GI information in the investigation of suicide and other violent deaths. PMID:26790023

Collecting Sexual Orientation and Gender Identity Data in Suicide and Other Violent Deaths: A Step Towards Identifying and Addressing LGBT Mortality Disparities.

PubMed

Haas, Ann P; Lane, Andrew

2015-03-01

Sexual orientation and gender identity (SO/GI) are not systematically recorded at time of death, limiting identification of mortality disparities in lesbian, gay, bisexual, and transgender (LGBT) people. LGBT populations are thought to have elevated risk of suicide based on high rates of reported lifetime suicide attempts. Lack of data on suicide deaths, however, hinders understanding of the prevalence and patterns of suicide among LGBT populations and development of targeted interventions and prevention programs. This report describes recent efforts to address this knowledge gap by systematically collecting SO/GI information in the investigation of suicide and other violent deaths.

Computational toxicology: Its essential role in reducing drug attrition.

PubMed

Naven, R T; Louise-May, S

2015-12-01

Predictive toxicology plays a critical role in reducing the failure rate of new drugs in pharmaceutical research and development. Despite recent gains in our understanding of drug-induced toxicity, however, it is urgent that the utility and limitations of our current predictive tools be determined in order to identify gaps in our understanding of mechanistic and chemical toxicology. Using recently published computational regression analyses of in vitro and in vivo toxicology data, it will be demonstrated that significant gaps remain in early safety screening paradigms. More strategic analyses of these data sets will allow for a better understanding of their domain of applicability and help identify those compounds that cause significant in vivo toxicity but which are currently mis-predicted by in silico and in vitro models. These 'outliers' and falsely predicted compounds are metaphorical lighthouses that shine light on existing toxicological knowledge gaps, and it is essential that these compounds are investigated if attrition is to be reduced significantly in the future. As such, the modern computational toxicologist is more productively engaged in understanding these gaps and driving investigative toxicology towards addressing them. © The Author(s) 2015.

Concussion diagnosis and management

PubMed Central

Mann, Aneetinder; Tator, Charles H.; Carson, James D.

2017-01-01

Abstract Objective To assess the knowledge of, attitudes toward, and learning needs for concussion diagnosis and management among family medicine residents. Design E-mail survey. Setting University of Toronto in Ontario. Participants Family medicine residents (N = 348). Main outcome measures To describe relationships between awareness of concussion management and lifestyle, education background, and residency placement, t tests and 2 tests were used as appropriate. Linear regression was used to compare self-reported concussion knowledge with knowledge scores. Thematic analysis was used to interpret answers to the qualitative question asking residents to describe challenges they foresee physicians facing when diagnosing and managing concussion. Results The residents who responded (n = 73, response rate 21%) correctly answered an average of 5.2 questions out of 9 (58%) regarding the diagnosis and management of concussion. Postgraduate year, sex, personal history of concussion, and clinical exposure to concussion were not significant factors in predicting the number of correct answers. Several misconceptions and knowledge gaps were revealed. Of residents who responded, 71% did not recognize chronic traumatic encephalopathy and only 63% recognized second-impact syndrome as consequences of repetitive concussions. Moreover, 32% of residents did not think that every individual with a concussion should see a physician as part of management. Knowledge scores did not predict self-reported concussion knowledge. Thematic analysis revealed 4 themes related to the challenges of concussion diagnosis and management: the nonspecificity and vagueness of symptoms, lack of formal diagnostic criteria, patient compliance with management, and counseling patients with respect to return to play, work, or learning. Conclusion We found substantial gaps in knowledge surrounding concussion diagnosis and management among family medicine residents. This lack of knowledge should be addressed at both the undergraduate medical education level and the residency training level to improve concussion-related care and patient outcomes. PMID:28615399

Improvements to sample processing and measurement to enable more widespread environmental application of tritium

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

Moran, James; Alexander, Thomas; Aalseth, Craig

2017-08-01

Previous measurements have demonstrated the wealth of information that tritium (T) can provide on environmentally relevant processes. We present modifications to sample preparation approaches that enable T measurement by proportional counting on small sample sizes equivalent to 120 mg of water and demonstrate the accuracy of these methods on a suite of standardized water samples. This enhanced method should provide the analytical flexibility needed to address persistent knowledge gaps in our understanding of T behavior in the environment.

The Nanotoxicology Research Program in NIOSH

NASA Astrophysics Data System (ADS)

Castranova, Vincent

2009-01-01

The National Institute for Occupational Safety and Health through its Nanotechnology Research Center has developed a Strategic Plan for Nanotechnology Safety and Health Research. This Strategic Plan identified knowledge gaps and critical issues, which must be addressed to protect the health and safety of workers producing nanoparticles as well as those incorporating nanoparticles into commercial products or using nanomaterials in novel applications. This manuscript lists the projects that comprise the Nanotoxicology Program in NIOSH and provides a brief description of the goals and accomplishments of these projects.

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

Cort, Katherine A.; Hostick, Donna J.; Belzer, David B.

The purpose of this report is to compile information and conclusions gathered as part of three separate tasks undertaken as part of the overall project, “Modeling EERE Deployment Programs,” sponsored by the Planning, Analysis, and Evaluation office within the Department of Energy’s Office of Energy Efficiency and Renewable Energy (EERE). The purpose of the project was to identify and characterize the modeling of deployment programs within the EERE Technology Development (TD) programs, address improvements to modeling in the near term, and note gaps in knowledge where future research is needed.

Human Factors Integration Requirements for Armoured Fighting Vehicles (AFVs). Part 1: Guidance on Addressing the Human System Integration (HSI) Content of Statements of Operational Requirements (SORs)

DTIC Science & Technology

1999-12-01

based on a systematic analysis of future systems, within the context of future scenarios and operational/support concepts . It is recognized, however...INFORMATION DISTRIBUTION CONCEPTS 2 6 IDENTIFY GAPS IN EXISTING KNOWLEDGE 2 7 DEVEWP FUTURE R&D PROGRAM ····· . 1 1 ...... 2 . . 2...stems Incorporated Annex B. Soldier’s Day Concept Page I ... mounted soldier performance can therefore be improved, and mounted/ dismounted

Identifying How Patient Portals May Be Effectively Used Among Mental Health Populations to Support Digital Inclusion: A Study Protocol.

PubMed

Strudwick, Gillian; Booth, Richard; Strauss, John

2018-01-01

Patient portals are secure online websites that allow patients access to their medical information from a particular healthcare organization. Currently, it is unknown how this technology can best be used to support patients with mental illness, and what types of indicators of portal adoption are meaningful to these patients. This study addresses this gap in our knowledge by obtaining the perspectives on this topic from patients, family members and Peer Support Workers.

Diet and Obesity Issues in the Underserved.

PubMed

Mejia de Grubb, Maria C; Levine, Robert S; Zoorob, Roger J

2017-03-01

The goal of this article is to inform new directions for addressing inequalities associated with obesity by reviewing current issues about diet and obesity among socioeconomically vulnerable and underserved populations. It highlights recent interventions in selected high-risk populations, as well as gaps in the knowledge base. It identifies future directions in policy and programmatic interventions to expand the role of primary care providers, with an emphasis on those aimed at preventing obesity and promoting healthy weight. Copyright © 2016 Elsevier Inc. All rights reserved.

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

PubMed

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

2016-02-01

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

Using the knowledge-to-action framework to guide the timing of dialysis initiation.

PubMed

Sood, Manish M; Manns, Braden; Nesrallah, Gihad

2014-05-01

The optimal time at which to initiate chronic dialysis remains unknown. Using a contemporary knowledge translation approach (the knowledge-to-action framework), a pan-Canadian collaboration (CANN-NET) set out to study the scope of the problem, then develop and disseminate evidence-based guidelines addressing the timing of dialysis initiation. The purpose of this review is to summarize the key findings and describe the planned Canadian knowledge translation strategy for improving knowledge and practices pertaining to the timing dialysis initiation. New research has provided considerable insights regarding the initiation of dialysis. A Canadian cohort study identified significant variation in the estimated glomerular filtration rate level at dialysis initiation, and a survey of providers identified related knowledge gaps that might be amenable to knowledge translation interventions. A recent knowledge synthesis/guideline concluded that early dialysis initiation is costly, and provides no measureable clinical benefits. A systematic knowledge translation intervention including a multifaceted approach may aid in reducing variation in practice and improving the quality of care. Utilizing the knowledge-to-action framework, we identified practice variation and key barriers to the optimal timing for dialysis initiation that may be amenable to knowledge translation strategies.

Assessing knowledge about acupuncture: A survey of people with back pain in the UK.

PubMed

Greville-Harris, Maddy; Hughes, John; Lewith, George; Liossi, Christina; White, Peter; Graham, Cynthia A; Bishop, Felicity L

2016-12-01

Despite the prevalence of acupuncture treatment in the UK, and the increasing evidence of safety and effectiveness, the information presented to patients by practitioners frequently contains inaccuracies. As knowledge of treatment affects both patient decision-making and treatment outcomes, this study aimed to establish what is known about acupuncture in a sample of people who had, and had not, previously experienced acupuncture. A 15-item questionnaire was constructed to assess knowledge of acupuncture. Online survey of people with a history of back pain. 202 participants completed the questionnaire. 66.8% of the sample was female and 33.2% male, with a mean age of 35 years (range 18-74 years). 87.6% had back pain in the past six months, 44.1% currently. 21.8% had previously received acupuncture, and 69.8% had previously read or heard information about acupuncture. On average participants answered 11.03 of 15 questions about acupuncture correctly (SD=2.64). Items relating to common concerns about acupuncture, acupuncture efficacy, and types of acupuncture were correctly answered by ≥80% of participants. Participants possessed less knowledge of accessibility, Government legislation, and methods of administration. The study identified key gaps in knowledge about acupuncture among patients. In particular, many participants were unaware that acupuncture is available from the UK National Health Service and that acupuncturists are not subject to statutory regulation in the UK. These knowledge gaps should be addressed in order to increase people's understanding of and access to acupuncture. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Understanding the digital divide in the clinical setting: the technology knowledge gap experienced by US safety net patients during teleretinal screening.

PubMed

George, Sheba; Moran, Erin; Fish, Allison; Ogunyemi, Lola

2013-01-01

Differential access to everyday technology and healthcare amongst safety net patients is associated with low technological and health literacies, respectively. These low rates of literacy produce a complex patient "knowledge gap" that influences the effectiveness of telehealth technologies. To understand this "knowledge gap", six focus groups (2 African-American and 4 Latino) were conducted with patients who received teleretinal screenings in U.S. urban safety-net settings. Findings indicate that patients' "knowledge gap" is primarily produced at three points: (1) when patients' preexisting personal barriers to care became exacerbated in the clinical setting; (2) through encounters with technology during screening; and (3) in doctor-patient follow-up. This "knowledge gap" can produce confusion and fear, potentially affecting patients' confidence in quality of care and limiting their disease management ability. In rethinking the digital divide to include the consequences of this knowledge gap faced by patients in the clinical setting, we suggest that patient education focus on both their disease and specific telehealth technologies deployed in care delivery.

Quasi-experimental evaluation of a substance use awareness educational intervention for nursing students.

PubMed

Cadiz, David M; O'Neill, Chris; Butell, Sue S; Epeneter, Beverly J; Basin, Basilia

2012-07-01

This article reports on a study that evaluated the effectiveness of an educational intervention, Addressing Nurse Impairment, for addressing nursing students' knowledge acquisition, changes in self-efficacy to intervene, and changes in substance abuse stigma. A gap exists in nursing students' education regarding the risks of addiction within the profession and how to handle a colleague suspected of having a substance use disorder. The seminar was adapted from an existing evidence-based prevention program called Team Awareness, as well as information from focus groups and a pilot test. A quasi-experimental pretest-posttest design was used to evaluate the effect of the seminar. When the control and experimental groups were compared, the results indicated that the seminar significantly affected knowledge and self-efficacy to intervene but did not significantly affect stigma. This research contributes to the body of evidence related to educational interventions for nursing students regarding substance abuse in the nursing profession. Copyright 2012, SLACK Incorporated.

Lessons From Biodiversity—The Value of Nontraditional Species to Advance Reproductive Science, Conservation, and Human Health

PubMed Central

WILDT, DAVID E.; COMIZZOLI, PIERRE; PUKAZHENTHI, BUDHAN; SONGSASEN, NUCHARIN

2014-01-01

SUMMARY Reproduction is quintessential to species survival. But what is underappreciated for this discipline is the wondrous array of reproductive mechanisms among species—variations as diverse as the morphology of the species themselves (more than 55,000 vertebrate and 1.1 million invertebrate types). We have investigated only a tiny fraction of these species in reproductive science. Besides the need to fill enormous gaps in a scholarly database, this knowledge has value for recovering and genetically managing rare species as well as addressing certain reproductive issues in humans. This article provides examples, first to advise against oversimplifying reproduction and then to show how such knowledge can have practical use for managing whole animals, populations, or even saving an entire species. We also address the expected challenges and opportunities that could lead to creative shifts in philosophy and effective actions to benefit more species as well as a future generation of reproductive scientists. PMID:19967718

Adaptive Biomedical Innovation: Evolving Our Global System to Sustainably and Safely Bring New Medicines to Patients in Need

PubMed Central

Trusheim, M; Cobbs, E; Bala, M; Garner, S; Hartman, D; Isaacs, K; Lumpkin, M; Lim, R; Oye, K; Pezalla, E; Saltonstall, P; Selker, H

2016-01-01

The current system of biomedical innovation is unable to keep pace with scientific advancements. We propose to address this gap by reengineering innovation processes to accelerate reliable delivery of products that address unmet medical needs. Adaptive biomedical innovation (ABI) provides an integrative, strategic approach for process innovation. Although the term “ABI” is new, it encompasses fragmented “tools” that have been developed across the global pharmaceutical industry, and could accelerate the evolution of the system through more coordinated application. ABI involves bringing stakeholders together to set shared objectives, foster trust, structure decision‐making, and manage expectations through rapid‐cycle feedback loops that maximize product knowledge and reduce uncertainty in a continuous, adaptive, and sustainable learning healthcare system. Adaptive decision‐making, a core element of ABI, provides a framework for structuring decision‐making designed to manage two types of uncertainty – the maturity of scientific and clinical knowledge, and the behaviors of other critical stakeholders. PMID:27626610

Analogs and the BHP Risk Reduction Strategy for Future Spaceflight Missions

NASA Technical Reports Server (NTRS)

Whitmire, Sandra; Leveton, Lauren

2011-01-01

In preparation for future exploration missions to distant destinations (e.g., Moon, Near Earth Objects (NEO), and Mars), the NASA Human Research Program s (HRP) Behavioral Health and Performance Element (BHP) conducts and supports research to address four human health risks: Risk of Behavioral Conditions; Risk of Psychiatric Conditions; Risk of Performance Decrements Due to Inadequate Cooperation, Coordination, Communication, and Psychosocial Adaptation within a Team; and Risk of Performance Errors due to Sleep Loss, Fatigue, Circadian Desynchronization, and Work Overload (HRP Science Management Plan, 2008). BHP Research, in collaboration with internal and external research investigators, as well as subject matter experts within NASA operations including flight surgeons, astronauts, and mission planners and others within the Mission Operations Directorate (MOD), identifies knowledge and technology gaps within each Risk. BHP Research subsequently manages and conducts research tasks to address and close the gaps, either through risk assessment and quantification, or the development of countermeasures and monitoring technologies. The resulting deliverables, in many instances, also support current Medical Operations and/or Mission Operations for the International Space Station (ISS).

Skier and Snowboarder Motivations and Knowledge Related to Voluntary Environmental Programs at an Alpine Ski Area

NASA Astrophysics Data System (ADS)

Little, Christopher M.; Needham, Mark D.

2011-11-01

Many alpine ski areas have recently adopted voluntary environmental programs (VEPs) such as using recycling, renewable energy, and biofuels to help reduce their environmental impacts. Studies have addressed the performance of these VEPs in mitigating environmental impacts of this industry, but little is known about visitor awareness and perceptions of these programs. This article addresses this knowledge gap by exploring skier and snowboarder knowledge of VEPs at a ski area and the influence of these programs on their motivations to visit this area currently and behavioral intentions to visit again in the future. Data were obtained from an onsite survey at the Mt. Bachelor ski area in Oregon, USA ( n = 429, 89.7% response rate). Few skiers and snowboarders were knowledgeable of VEPs at this area and fewer than 20% were motivated to visit on their current trip because of these programs. Other attributes such as scenery, snow conditions, and access were more important for influencing visitation. Up to 38% of skiers and snowboarders, however, intend to visit this ski area more often if it adopts and promotes more VEPs. Managers can use these results to inform communication and marketing of their environmental programs and performance to visitors. Additional implications for management and future research are discussed.

Skier and snowboarder motivations and knowledge related to voluntary environmental programs at an alpine ski area.

PubMed

Little, Christopher M; Needham, Mark D

2011-11-01

Many alpine ski areas have recently adopted voluntary environmental programs (VEPs) such as using recycling, renewable energy, and biofuels to help reduce their environmental impacts. Studies have addressed the performance of these VEPs in mitigating environmental impacts of this industry, but little is known about visitor awareness and perceptions of these programs. This article addresses this knowledge gap by exploring skier and snowboarder knowledge of VEPs at a ski area and the influence of these programs on their motivations to visit this area currently and behavioral intentions to visit again in the future. Data were obtained from an onsite survey at the Mt. Bachelor ski area in Oregon, USA (n = 429, 89.7% response rate). Few skiers and snowboarders were knowledgeable of VEPs at this area and fewer than 20% were motivated to visit on their current trip because of these programs. Other attributes such as scenery, snow conditions, and access were more important for influencing visitation. Up to 38% of skiers and snowboarders, however, intend to visit this ski area more often if it adopts and promotes more VEPs. Managers can use these results to inform communication and marketing of their environmental programs and performance to visitors. Additional implications for management and future research are discussed.

Police Training to Align Law Enforcement and HIV Prevention: Preliminary Evidence From the Field

PubMed Central

Agrawal, Alpna; Moreau, Bruce; Kumar, Pratima; Weiss-Laxer, Nomi; Heimer, Robert

2011-01-01

Having identified gaps in implementation of Rhode Island's syringe access law and police occupational safety education, public health and police professionals developed police training to boost legal knowledge, improve syringe access attitudes, and address needlestick injuries. Baseline data (94 officers) confirmed anxiety about needlestick injuries, poor legal knowledge, and occupational risk overestimation. Before training, respondents believed that syringe access promotes drug use (51%), increases likelihood of police needlestick injuries (58%), and fails to reduce epidemics (38%). Pretraining to posttraining evaluation suggested significant shifts in legal and occupational safety knowledge; changes in attitudes toward syringe access were promising. Training that combines occupational safety with syringe access content can help align law enforcement with public health goals. Additional research is needed to assess street-level effect and to inform intervention tailoring. PMID:21940924

Closing the gap in travel medicine: reframing research questions for a new era.

PubMed

Chen, Lin H; Leder, Karin; Wilson, Mary E

2017-07-01

Travel medicine needs are changing. New patterns of travel, including greater travel by individuals from emerging economies with different values in costs, risks and benefits, must be considered. This review aims to (1) highlight selected studies that have been published that address previously identified gaps in knowledge; (2) propose possible ways to consider questions regarding travel medicine practice for travelers from emerging economies, underscoring priorities for research focusing on these important populations; (3) highlight potential deficiencies in relevance of current international guidelines as they pertain to travelers from emerging economies; (4) frame research questions for travelers from emerging economies and (5) consider roles for ISTM in closing the gap. We reviewed past travel medicine research priorities published in 2010 to identify publications that responded to some research questions posed. We also reviewed CDC and WHO recommendations and assessed their applicability to travelers from emerging economies. Recent publications have responded to some research questions, but gaps remain and new questions have emerged. Re-framing of several key research questions is needed for travelers from emerging economies. A new challenge looms for traditional travel medicine fields to identify and attend to knowledge and guideline gaps, particularly to rethink questions regarding travel medicine to make them relevant for travelers from emerging economies. The International Society of Travel Medicine is well positioned to assist emerging economies assess their resources and needs, formulate research priorities and tailor the development of travel medicine into a framework aligned to their requirements. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Commentary: Reconsidering the Role of Context in Diabetes Prevention

PubMed Central

Mezuk, Briana; Concha, Jeannie B.; Perrin, Paul; Green, Tiffany

2017-01-01

A substantial gap remains between what we know about type 2 diabetes prevention and our ability to apply that knowledge in socially disadvantaged populations at highest risk. This gap results, in part, from a lack of integration between epidemiologic science and social psychology theory, particularly regarding the intersections of stress, self-regulatory health behaviors, and the biological mechanisms underlying the development of diabetes. In this commentary, we describe the utility of a theoretical framework that focuses on the intersection of biological, psychosocial, and environmental contexts as they apply to diabetes disparities, and how such a framework could inform a translational research agenda to reorient prevention efforts to address these inequalities. Such reorientation is needed to ensure that the implementation of prevention efforts does not inadvertently widen diabetes disparities. PMID:28115823

Development of a Pilot Learning Module on Water Energy Nexus Using a Data-Analytic and Hypothesis-Driven Approach

NASA Astrophysics Data System (ADS)

Eldardiry, H. A.; Unruh, H. G., Sr.; Habib, E. H.; Tidwell, V. C.

2016-12-01

Recent community initiatives have identified key foundational knowledge gaps that need to be addressed before transformative solutions can be made in the area of Food, Energy and Water (FEW) nexus. In addition, knowledge gaps also exist in the area of FEW education and needs to be addressed before we can make an impact on building the next generation FEW workforces. This study reports on the development of a pilot learning-module that focuses on two elements of the FEW nexus, Energy and Water. The module follows an active-learning approach to develop a set of student-centered learning activities using FEW datasets situated in real-world settings in the contiguous US. The module is based on data-driven learning exercises that incorporate different geospatial layers and manipulate datasets at a watershed scale representing the eight-digit Hydrologic Unit Code (HUC8). Examples of such datasets include water usage by different demand sectors (available from the US Geological Survey, USGS), and power plants stratified by energy source, cooling technology, and plant capacity (available from the US Energy Information Administration, EIA). The module is structured in three sections: (1) introduction to the water and energy systems, (2) quantifying stresses on water system at a catchment scale, and (3) scenario-based analysis on the interdependencies in the water-energy systems. Following a data-analytic framework, the module guides students to make different assumptions about water use growth rates and see how these new water demands will impinge on freshwater supplies. The module engages students in analysis that examines how thermoelectric water use would depend on assumptions about future demand for electricity, power plant fuel source, cooling type, and carbon sequestration. Students vary the input parameters, observe and assess the effect on water use, and address gaps via non-potable water resources (e.g., municipal wastewater). The module is implemented using a web-based platform where datasets, lesson contents, and student learning activities are presented within a geo-spatial context. The presentation will share insight on how the dynamics of FEW systems can be taught using meaningful educational experiences that promote students' understanding of FEW systems and their complex inter-connections.

DCS: A Case Study of Identification of Knowledge and Disposition Gaps Using Principles of Continuous Risk Management

NASA Technical Reports Server (NTRS)

Norcross, Jason; Steinberg, Susan; Kundrot, Craig; Charles, John

2011-01-01

The Human Research Program (HRP) is formulated around the program architecture of Evidence-Risk-Gap-Task-Deliverable. Review of accumulated evidence forms the basis for identification of high priority risks to human health and performance in space exploration. Gaps in knowledge or disposition are identified for each risk, and a portfolio of research tasks is developed to fill them. Deliverables from the tasks inform the evidence base with the ultimate goal of defining the level of risk and reducing it to an acceptable level. A comprehensive framework for gap identification, focus, and metrics has been developed based on principles of continuous risk management and clinical care. Research towards knowledge gaps improves understanding of the likelihood, consequence or timeframe of the risk. Disposition gaps include development of standards or requirements for risk acceptance, development of countermeasures or technology to mitigate the risk, and yearly technology assessment related to watching developments related to the risk. Standard concepts from clinical care: prevention, diagnosis, treatment, monitoring, rehabilitation, and surveillance, can be used to focus gaps dealing with risk mitigation. The research plan for the new HRP Risk of Decompression Sickness (DCS) used the framework to identify one disposition gap related to establishment of a DCS standard for acceptable risk, two knowledge gaps related to DCS phenomenon and mission attributes, and three mitigation gaps focused on prediction, prevention, and new technology watch. These gaps were organized in this manner primarily based on target for closure and ease of organizing interim metrics so that gap status could be quantified. Additional considerations for the knowledge gaps were that one was highly design reference mission specific and the other gap was focused on DCS phenomenon.

Role of Leadership in Narrowing the Gap between Science and Practice: Improving Treatment Outcomes at the Systems Level.

PubMed

Saeed, Sy Atezaz; Bloch, Richard M; Silver, Stuart

2015-09-01

It's been well documented that health care does not reliably transfer what we know from science into clinical practice. As a result, Americans do not always receive the care suggested by the scientific evidence. Despite the best intentions of a dedicated and skilled healthcare workforce, this can often lead to poor clinical outcomes. As research and technology rapidly advance, this gap between science and practice appears to be widening. There is an increasing public concern about a lack of access to appropriate treatment, pervasiveness of unsafe practices, and wasteful uses of precious health care resources leading to suboptimum treatment outcomes. Leadership has a critical role in creating and sustaining the environment that supports health services for individuals and populations that increase the likelihood of desired health outcomes and are consistent with current professional knowledge. Leadership has some responsibility to improve outcomes by insuring effective use of evidence-based treatment guidelines; measurement-based care; knowledge and skills management; care coordination; and information technologies. This paper addresses leadership issues in these components of a system's ability to improve treatment outcomes.

Vector-borne diseases of small companion animals in Namibia: Literature review, knowledge gaps and opportunity for a One Health approach.

PubMed

Noden, Bruce H; Soni, Minty

2015-11-06

Namibia has a rich history in veterinary health but little is known about the vector-borne diseases that affect companion dogs and cats. The aim of this review is to summarise the existing published and available unpublished literature, put it into a wider geographical context, and explore some significant knowledge gaps. To date, only two filarial pathogens (Dirofilaria repens and Acanthocheilonema dracunculoides) and three tick-borne pathogens (Babesia canis vogeli, Hepatozoon canis and Ehrlichia canis) have been reported. Most studies have focused solely on dogs and cats in the urban Windhoek and surrounding areas, with almost nothing reported in rural farming areas, in either the populous northern regions or the low-income urban areas where animal owners have limited access to veterinary services. With the development of several biomedical training programmes in the country, there is now an excellent opportunity to address zoonotic vector-borne diseases through a One Health approach so as to assess the risks to small companion animals as well as diseases of public health importance.

Development and Validation of a Cross-Cultural Knowledge, Attitudes, and Practices Survey Instrument for Chronic Kidney Disease in a Swahili-Speaking Population

PubMed Central

Stanifer, John W.; Karia, Francis; Voils, Corrine I.; Turner, Elizabeth L.; Maro, Venance; Shimbi, Dionis; Kilawe, Humphrey; Lazaro, Matayo; Patel, Uptal D.

2015-01-01

Introduction Non-communicable diseases are a growing global burden, and structured surveys can identify critical gaps to address this epidemic. In sub-Saharan Africa, there are very few well-tested survey instruments measuring population attributes related to non-communicable diseases. To meet this need, we have developed and validated the first instrument evaluating knowledge, attitudes and practices pertaining to chronic kidney disease in a Swahili-speaking population. Methods and Results Between December 2013 and June 2014, we conducted a four-stage, mixed-methods study among adults from the general population of northern Tanzania. In stage 1, the survey instrument was constructed in English by a group of cross-cultural experts from multiple disciplines and through content analysis of focus group discussions to ensure local significance. Following translation, in stage 2, we piloted the survey through cognitive and structured interviews, and in stage 3, in order to obtain initial evidence of reliability and construct validity, we recruited and then administered the instrument to a random sample of 606 adults. In stage 4, we conducted analyses to establish test-retest reliability and known-groups validity which was informed by thematic analysis of the qualitative data in stages 1 and 2. The final version consisted of 25 items divided into three conceptual domains: knowledge, attitudes and practices. Each item demonstrated excellent test-retest reliability with established content and construct validity. Conclusions We have developed a reliable and valid cross-cultural survey instrument designed to measure knowledge, attitudes and practices of chronic kidney disease in a Swahili-speaking population of Northern Tanzania. This instrument may be valuable for addressing gaps in non-communicable diseases care by understanding preferences regarding healthcare, formulating educational initiatives, and directing development of chronic disease management programs that incorporate chronic kidney disease across sub-Saharan Africa. PMID:25811781

A needs assessment survey of dental public health graduate education in Saudi Arabia

PubMed Central

Al Agili, Dania Ebrahim

2015-01-01

Objectives The Faculty of Dentistry at King Abdulaziz University (KAU) is planning to develop a master’s program in dental public health (DPH). To develop a curriculum for this program, a needs assessment was conducted in order to identify the level of DPH expertise that currently exists in Saudi Arabia, to identify gaps in knowledge, and to explore current perceptions regarding this type of program. Methods A competency-based survey instrument was administered to private and government affiliated dental practitioners in Jeddah, Saudi Arabia. Participants’ knowledge, attitudes, and competencies in DPH were assessed. In addition, questions were submitted that addressed preferred strategies of teaching, curriculum delivery methods, course content, and prerequisites for DPH. These data were combined with data previously collected from dentists holding academic positions at KAU (n = 146) and were analyzed using Statistical Analysis System version 9.3 software. Mean values and frequencies were calculated for the study variables. Proportional odds ratios and 95% confidence intervals were estimated to assess differences in educational preferences and DPH competencies according to age, gender, and qualification. Results Most of the participants (95%) reported a need for a DPH graduate program. The respondents had a basic knowledge of DPH and moderate experience in DPH competencies. A variety of preferred educational strategies and methods were identified and differences in educational preferences according to age, gender, and qualification of the respondents were identified. The responses obtained also acknowledged skills and competencies that the participants considered most important for a DPH practice and that would be important for students accepted into a DPH graduate program. Conclusions This needs assessment survey represents a preliminary step in establishing a DPH graduate program that addresses current gaps in knowledge and in the practice of public health dentistry. This survey also provided valuable feedback regarding the development of course content for a graduate education program in DPH. PMID:26236128

Perceptions of malaria and acceptance of rapid diagnostic tests and related treatment practises among community members and health care providers in Greater Garissa, North Eastern Province, Kenya.

PubMed

Diggle, Emma; Asgary, Ramin; Gore-Langton, Georgia; Nahashon, Erupe; Mungai, James; Harrison, Rebecca; Abagira, Abdullahi; Eves, Katie; Grigoryan, Zoya; Soti, David; Juma, Elizabeth; Allan, Richard

2014-12-17

Conventional diagnosis of malaria has relied upon either clinical diagnosis or microscopic examination of peripheral blood smears. These methods, if not carried out exactly, easily result in the over- or under-diagnosis of malaria. The reliability and accuracy of malaria RDTs, even in extremely challenging health care settings, have made them a staple in malaria control programmes. Using the setting of a pilot introduction of malaria RDTs in Greater Garissa, North Eastern Province, Kenya, this study aims to identify and understand perceptions regarding malaria diagnosis, with a particular focus on RDTs, and treatment among community members and health care workers (HCWs). The study was conducted in five districts of Garissa County. Focus group discussions (FGD) were performed with community members that were recruited from health facilities (HFs) supported by the MENTOR Initiative. In-depth interviews (IDIs) and FGDs with HCWs were also carried out. Interview transcripts were then coded and analysed for major themes. Two researchers reviewed all codes, first separately and then together, discussed the specific categories, and finally characterized, described, and agreed upon major important themes. Thirty-four FGDs were carried out with a range of two to eight participants (median of four). Of 157 community members, 103 (65.6%) were women. The majority of participants were illiterate and the highest level of education was secondary school. Some 76% of participants were of Somali ethnicity. Whilst community members and HCWs demonstrated knowledge of aspects of malaria transmission, prevention, diagnosis, and treatment, gaps and misconceptions were identified. Poor adherence to negative RDT results, unfamiliarity and distrust of RDTs, and an inconsistent RDT supply were the main challenges to become apparent in FGDs and IDIs. Gaps in knowledge or incorrect beliefs exist in Greater Garissa and have the potential to act as barriers to complete and correct malaria case management. Addressing these knowledge gaps requires comprehensive education campaigns and a reliable and constant RDT supply. The results of this study highlight education and supply chain as key factors to be addressed in order to make large scale roll out of RDTs as successful and effective as possible.

Addressing social barriers and closing the gender knowledge gap: exposure to road shows is associated with more knowledge and more positive beliefs, attitudes and social norms regarding exclusive breastfeeding in rural Zimbabwe.

PubMed

Jenkins, Alison L; Tavengwa, Naume V; Chasekwa, Bernard; Chatora, Kumbirai; Taruberekera, Noah; Mushayi, Wellington; Madzima, Rufaro C; Mbuya, Mduduzi N N

2012-10-01

Exclusive breastfeeding (EBF) is rarely practiced despite its significant child survival benefits. A key constraint to increasing EBF rates in Zimbabwe and most of the developing world is that key decision makers (fathers/partners and other family members) are often poorly informed about EBF and do not attend antenatal clinics where health information is routinely provided. Informed by formative research, a district-wide campaign was conducted in rural Zimbabwe to encourage EBF and expressing and heat treating (EHT) breast milk as a means to maintain EBF. The campaign combined traditional strategies of education, counselling and outreach through health service delivery with a novel road show 'edutainment' intervention to reach men and other community members. A post campaign evaluation measured the association of road show exposure with 20 knowledge items and summative scores of social norms, beliefs and attitudes obtained through exploratory factor analysis. In adjusted models, road show exposure was associated with correct EBF knowledge (β=1.0, 0.001), EHT knowledge (β=1.3, P<0.001) and greater perceived benefits of condom use during pregnancy and breastfeeding (β=0.5, P<0.001), and more positive EBF social norms (β=0.6, P<0.001), EBF beliefs and attitudes (β=1.0, P<0.001) and attitudes towards condom use during breastfeeding (β=0.6, P<0.001). Road show exposure was more strongly associated with EBF knowledge among men (P-value for gender×exposure group interaction=0.03), suggesting that it also closed the knowledge gap between men and women. Longitudinal studies will determine whether road shows were associated with changes in EBF practices. © 2011 Blackwell Publishing Ltd.

A multi-biome gap in understanding of crop and ecosystem responses to elevated CO2.

PubMed

Leakey, Andrew D B; Bishop, Kristen A; Ainsworth, Elizabeth A

2012-06-01

A key finding from elevated [CO(2)] field experiments is that the impact of elevated [CO(2)] on plant and ecosystem function is highly dependent upon other environmental conditions, namely temperature and the availability of nutrients and soil moisture. In addition, there is significant variation in the response to elevated [CO(2)] among plant functional types, species and crop varieties. However, experimental data on plant and ecosystem responses to elevated [CO(2)] are strongly biased to economically and ecologically important systems in the temperate zone. There is a multi-biome gap in experimental data that is most severe in the tropics and subtropics, but also includes high latitudes. Physiological understanding of the environmental conditions and species found at high and low latitudes suggest they may respond differently to elevated [CO(2)] than well-studied temperate systems. Addressing this knowledge gap should be a high priority as it is vital to understanding 21st century food supply and ecosystem feedbacks on climate change. Published by Elsevier Ltd.

Fetal alcohol spectrum disorder in Africa.

PubMed

Adnams, Colleen M

2017-03-01

This review aims to summarize data published in the scientific literature and available on official websites on fetal alcohol spectrum disorder (FASD) in Africa. There is a paucity of published literature and evidence-based information on prenatal exposure to alcohol in the African continent and the majority of the continent's literature on FASD emanates from South Africa. A small number of scientific publications document FASD and drinking in pregnancy in other Sub-Saharan African countries and these findings provide evidence that FASD occurs across the continent. Further evidence shows that the world's highest reported rates of FASD occur in South Africa and that this confers a significant public health and neurodevelopmental disability burden on the region. There is an established body of epidemiological, diagnostic, neurobehavioral and neuroscientific knowledge from studies in South Africa. Universal and indicated case method preventions are effective in reducing maternal alcohol consumption in high-risk areas. Throughout Africa, a policy and service implementation gap exists that impedes translation of generated knowledge into effective prevention and intervention strategies. FASD is likely a widely occurring and largely unrecognized neurodevelopmental disability in Africa. A key future direction for global agencies and research partnerships is to collaboratively address evidence gaps and knowledge translation through scalable approaches and strategies that aim to ameliorate the burden of FASD in African and other countries.

Health Care Providers' Knowledge and Practice Gap towards Joint Zoonotic Disease Surveillance System: Challenges and Opportunities, Gomma District, Southwest Ethiopia.

PubMed

Gemeda, Desta Hiko; Sime, Abiot Girma; Hajito, Kifle Woldemichael; Gelalacha, Benti Deresa; Tafese, Wubit; Gebrehiwot, Tsegaye Tewelde

2016-01-01

Background. Health care providers play a crucial role for realization of joint zoonotic diseases surveillance by human and animal health sectors, yet there is limited evidence. Hence, this study aimed to determine knowledge and practice gap of health care providers towards the approach for Rabies and Anthrax in Southwest Ethiopia. Methods. A cross-sectional survey was conducted from December 16, 2014, to January 14, 2015. Eligible health care providers were considered for the study. Data were entered in to Epi-data version 3.1 and analyzed using SPSS version 20. Results. A total of 323 (92.02%) health care providers participated in the study. Three hundred sixteen (97.8%) of participants reported that both human and animal health sectors can work together for zoonotic diseases while 96.9% of them replied that both sectors can jointly conduct surveillance. One hundred seventeen (36.2%) of them reported that their respective sectors had conducted joint surveillance for zoonotic diseases. Their involvement was, however, limited to joint outbreak response. Conclusion. There is good opportunity in health care providers' knowledge even though the practice was unacceptably low and did not address all surveillance components. Therefore, formal joint surveillance structure should be in place for optimal implementation of surveillance.

Leadership in Nursing Homes: Directors of Nursing Aligning Practice With Regulations.

PubMed

Siegel, Elena O; Bettega, Kristen; Bakerjian, Debra; Sikma, Suzanne

2018-06-01

Nursing homes use team nursing, with minimal RN presence, leaving the majority of direct care to licensed practical/vocational nurses (LPNs/LVNs) and unlicensed assistive personnel (UAP), including medication aides. The current article describes challenges faced by nursing home directors of nursing (DONs) leading and managing a team nursing approach, including consideration of scope of practice, delegation and supervision regulations, and related policy implications. A secondary data analysis was performed of qualitative data from a study to develop and test DON guidelines for delegation in nursing home practice. A convenience sample (N = 29) of current or previous DONs and other nursing home leaders with knowledge and expertise in the DON role participated in in-depth, guided interviews. The findings highlight a core concern to nursing licensure policy and regulation: knowledge and practice gaps related to scope of practice and delegation and supervision among DONs, RNs, and LPNs/LVNs, as well as administrators, and the role of nursing leaders in supporting appropriate delegation practices. The findings offer directions for research and practice in addressing challenges in aligning team nursing practices with regulatory standards as well as the related gaps in knowledge among DONs, administrators, and nursing staff. [Journal of Gerontological Nursing, 44(6), 10-14.]. Copyright 2018, SLACK Incorporated.

What we know and don't know about mental health problems among immigrants in Norway.

PubMed

Abebe, Dawit Shawel; Lien, Lars; Hjelde, Karin Harsløf

2014-02-01

Mental health problems have been regarded as one of the main public health challenges of immigrants in several countries. Understanding and generating research-based knowledge on immigrant health problems is highly relevant for planning preventive interventions, as well as guiding social and policy actions. This review aims to map the available knowledge on immigrants' mental health status and its associated risk factors in Norway. The reviewed literature about mental health problems among immigrant populations in Norway was found through databases, such as PUBMED, EMBASE, PsychINFO and MEDLINE. About 41 peer-reviewed original articles published since 1990s were included. In the majority of the studies, the immigrant populations, specifically adult immigrants from low and middle income countries, have been found with a higher degree of mental health problems compared to Norwegians and the general population. Increased risk for mental illness is primarily linked to a higher risk for acculturative stress, poor social support, deprived socioeconomic conditions, multiple negative life events, experiences of discrimination and traumatic pre-migration experiences. However, research in this field has been confronted by a number of gaps and methodological challenges. The available knowledge indicates a need for preventive interventions. Correspondingly, it strongly recommends a comprehensive research program that addresses gaps and methodological challenges.

Mitigating the Mathematical Knowledge Gap between High School and First Year University Chemical Engineering Mathematics Course

ERIC Educational Resources Information Center

Basitere, Moses; Ivala, Eunice

2015-01-01

This paper reports on a study carried out at a University of Technology, South Africa, aimed at identifying the existence of the mathematical knowledge gap and evaluating the intervention designed to bridge the knowledge gap amongst students studying first year mathematics at the Chemical Engineering Extended Curriculum Program (ECP). In this…

From "sit and listen" to "shake it out yourself": Helping urban middle school students to bridge personal knowledge to scientific knowledge through a collaborative environmental justice curriculum

NASA Astrophysics Data System (ADS)

Sadeh, Shamu Fenyvesi

Science education and environmental education are not meeting the needs of marginalized communities such as urban, minority, and poor communities (Seller, 2001; U.S. Environmental Protection Agency [EPA], 1996). There exists an equity gap characterized by the racial and socioeconomic disparities in: levels of participation in scientific and environmental careers and environmental organizations (Lewis & James, 1995; Sheppard, 1995), access to appropriate environmental education programs (U.S. EPA, 1996), exposure to environmental toxins (Bullard, 1993), access to environmental amenities and legal protections (Bullard, 1993), and in grades and standardized test scores in K-12 science (Jencks & Phillips, 1998; Johnston & Viadero, 2000). Researchers point to the cultural divide between home and school culture as one of the reasons for the equity gap in science education (Barton, 2003; Delpit, 1995; Seiler, 2001). This study is designed to address the equity gap by helping students connect personal/cultural knowledge to scientific knowledge. A collaborative action research study was conducted in 8th-grade science classrooms of low-income African American and Latino students. The participating teacher and the researcher developed, enacted and evaluated a curriculum that elicited students' personal and cultural knowledge in the investigation of local community issues. Using qualitative methods, data were collected through student and teacher interviews, observation, and written documents. Data were analyzed to answer questions on student participation and learning, bridging between personal and scientific knowledge, and student empowerment. The most compelling themes from the data were described as parts of three stories: tensions between the empire of school and the small student nation, bridging between the two nations, and students gaining empowerment. This study found that the bridging the curriculum intended was successful in that many students brought personal knowledge to class and started to bring scientific knowledge into their personal worlds. Students translated between scientific language and their own language, displayed an understanding of community environmental health issues, and expressed a sense of empowerment as students and community members. Recommendations to science educators and researchers included: eliciting students' personal and cultural knowledge in the classroom, helping students to create new ways of participating in science, and engaging in collaborative research efforts.

A systematic review of ethics knowledge in audiology (1980-2010).

PubMed

Naudé, Alida Maryna; Bornman, Juan

2014-06-01

The purpose of this research was to apply multiple perspectives as part of a systematic review to analyze literature regarding ethics in audiology. Audiologists are particularly vulnerable to the changing requirements of the discipline that compel them to straddle both professional obligations and business principles, creating a hybrid professional. The authors used a 2-phase mixed-method approach to analyze publications. Publications were sorted into categories, namely, ethics approach, author, decade, role of the audiologist, component of morality, and common themes. The sample consisted of peer-reviewed articles cited in MEDLINE, CINAHL, ERIC, MasterFILE Premier, E-Journals, Africa-Wide Information, and Academic Search Premier electronic databases and non-peer-reviewed articles in Seminars in Hearing. The publications were predominantly philosophical, focused on the rehabilitative role of the audiologist, and addressed the moral judgment component of moral behavior. Despite the fact that knowledge of ethics grew between 1980 and 2010, this retrospective analysis identified gaps in current knowledge. Research is needed to address the unique ethical problems commonly encountered in all 8 roles of the audiologist; patient perspectives on ethics; ethical approaches; factors affecting moral judgment, sensitivity, motivation, and courage; and cultural dimensions of ethical practice in audiology.

Epilepsy and AED-induced decreased libido - The unasked psychosocial comorbidity.

PubMed

Kaufman, Kenneth R; Wong, Stephen; Sivaraaman, Kartik; Anim, Candy; Delatte, David

2015-11-01

Therapeutic treatment for persons with epilepsy (PWE) should address seizure control and the broad spectrum of associated comorbidities. Since both epilepsy and antiepileptic drugs (AEDs) can induce decreased libido, sexual health assessment is an important aspect of quality care in PWE as well as other patients receiving AEDs. This paper presents findings from a pilot quality initiative conducted in the ambulatory care epilepsy, pain management, and psychiatric services (N=15 clinicians) which addressed two themes: 1) whether libido is routinely questioned with/without the electronic medical record (EMR) and 2) clinicians' knowledge that both epilepsy and AEDs can induce decreased libido. All clinicians used the EMR, 40% used the GU-ROS section, but only 1 clinician (6.67%) questioned patients regarding libido. Of the clinicians, 26.7% demonstrated knowledge that both AEDs and epilepsy can cause decreased libido. Our results suggest that a treatment gap for epilepsy-induced and AED-induced decreased libido may be related to systems issues (duration of clinical visit, billing codes, EMR template) and physician barriers including decreased knowledge. Further research in this field and replication of this pilot quality initiative are indicated. Copyright © 2015 Elsevier Inc. All rights reserved.

Metabolomics for Assessment of Nutritional Status

PubMed Central

Zivkovic, Angela M.; German, J. Bruce

2010-01-01

Purpose of review The current rise in diet-related diseases continues to be one of the most significant health problems facing both the developed and the developing world. The use of metabolomics – the accurate and comprehensive measurement of a significant fraction of important metabolites in accessible biological fluids – for the assessment of nutritional status, is a promising way forward. The basic toolset, targets, and knowledge are all being developed in the emerging field of metabolomics, yet important knowledge and technology gaps will need to be addressed in order to bring such assessment to practice. Recent findings Dysregulation within the principal metabolic organs (e.g. intestine, adipose, skeletal muscle, liver) are at the center of a diet-disease paradigm that includes metabolic syndrome, type 2 diabetes, and obesity. The assessment of both essential nutrient status, and the more comprehensive systemic metabolic response to dietary, lifestyle, and environmental influences (e.g. metabolic phenotype) are necessary for the evaluation of status in individuals that can identify the multiple targets of intervention needed to address metabolic disease. Summary The first proofs of principle building the knowledge to bring actionable metabolic diagnostics to practice through metabolomics are now appearing. PMID:19584717

An Assessment of Environmental Health Needs

NASA Technical Reports Server (NTRS)

Macatangay, Ariel V.

2013-01-01

Environmental health fundamentally addresses the physical, chemical, and biological risks external to the human body that can impact the health of a person by assessing and controlling these risks in order to generate and maintain a health-supportive environment. In manned spacecraft, environmental health risks are mitigated by a multi-disciplinary effort, employing several measures including active and passive controls, by establishing environmental standards (SMACs, SWEGs, microbial and acoustics limits), and through environmental monitoring. Human Health and Performance (HHP) scientists and Environmental Control and Life Support (ECLS) engineers consider environmental monitoring a vital component to an environmental health management strategy for maintaining a healthy crew and achieving mission success. ECLS engineers use environmental monitoring data to monitor and confirm the health of ECLS systems, whereas HHP scientists use the data to manage the health of the human system. Because risks can vary between missions and change over time, environmental monitoring is critical. Crew health risks associated with the environment were reviewed by agency experts with the goal of determining risk-based environmental monitoring needs for future NASA manned missions. Once determined, gaps in environmental health knowledge and technology, required to address those risks, were identified for various types of exploration missions. This agency-wide assessment of environmental health needs will help guide the activities/hardware development efforts to close those gaps and advance the knowledge required to meet NASA manned space exploration objectives. Details of the roadmap development and findings are presented in this paper.

A measure of knowledge flow between specific fields: Implications of interdisciplinarity for impact and funding

PubMed Central

Solomon, Gregg E. A.; Youtie, Jan; Porter, Alan L.

2017-01-01

Encouraging knowledge flow between mutually relevant disciplines is a worthy aim of research policy makers. Yet, it is less clear what types of research promote cross-disciplinary knowledge flow and whether such research generates particularly influential knowledge. Empirical questions remain as to how to identify knowledge-flow mediating research and how to provide support for this research. This study contributes to addressing these gaps by proposing a new way to identify knowledge-flow mediating research at the individual research article level, instead of at more aggregated levels. We identify journal articles that link two mutually relevant disciplines in three ways—aggregating, bridging, and diffusing. We then examine the likelihood that these papers receive subsequent citations or have funding acknowledgments. Our case study of cognitive science and educational research knowledge flow suggests that articles that aggregate knowledge from multiple disciplines are cited significantly more often than are those whose references are drawn primarily from a single discipline. Interestingly, the articles that meet the criteria for being considered knowledge-flow mediators are less likely to reflect funding, based on reported acknowledgements, than were those that did not meet these criteria. Based on these findings, we draw implications for research policymakers. PMID:29016631

Media use and HIV/AIDS knowledge: a knowledge gap perspective.

PubMed

Bekalu, Mesfin Awoke; Eggermont, Steven

2014-12-01

Despite the widespread utilization of the mass media in HIV/AIDS prevention, little is known about the knowledge gap that results from disparities in mass media use. This study examined the relationship between HIV/AIDS-related mass media use and HIV/AIDS-related knowledge among urban and rural residents of northwestern Ethiopia. A hierarchical regression analysis indicated that HIV/AIDS-related mass media use has both sequestering and mainstreaming effects in certain segments of the study population, although it was not a significant predictor of HIV/AIDS-related knowledge in the total population. The knowledge gaps between individuals with high and low education and between individuals who experience high and low levels of interpersonal communication about HIV/AIDS narrowed as HIV/AIDS-related media use increased, but the gap between urban and rural residents widened. The widening gap could be explained by differences in perceptions of information salience and several theoretical assumptions. Current mass media information campaigns, which are often prepared and broadcast from urban centers, may not only fail to improve the HIV/AIDS knowledge of the rural populace but also put rural populations at a disadvantage relative to their urban counterparts. Communication interventions informed by socioecological models might be helpful to redress and/or narrow the widening knowledge gap between urban and rural residents. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Herbaceous species composition and richness of mesophytic cove forests in the southern Appalachians: synthesis and knowledge gaps

Treesearch

Katherine J. Elliott; James M. Vose; Duke Rankin

2014-01-01

We synthesized the current information on mesophytic cove forests in the southern Appalachians, assessed the range of variation in herb species composition and diversity in stands with different disturbance histories and environmental conditions, identified key knowledge gaps, and suggested approaches to fill these knowledge gaps. The purpose of this synthesis was to...

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

PubMed

2016-09-01

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

Policy impacts of ecosystem services knowledge

PubMed Central

Posner, Stephen M.; McKenzie, Emily; Ricketts, Taylor H.

2016-01-01

Research about ecosystem services (ES) often aims to generate knowledge that influences policies and institutions for conservation and human development. However, we have limited understanding of how decision-makers use ES knowledge or what factors facilitate use. Here we address this gap and report on, to our knowledge, the first quantitative analysis of the factors and conditions that explain the policy impact of ES knowledge. We analyze a global sample of cases where similar ES knowledge was generated and applied to decision-making. We first test whether attributes of ES knowledge themselves predict different measures of impact on decisions. We find that legitimacy of knowledge is more often associated with impact than either the credibility or salience of the knowledge. We also examine whether predictor variables related to the science-to-policy process and the contextual conditions of a case are significant in predicting impact. Our findings indicate that, although many factors are important, attributes of the knowledge and aspects of the science-to-policy process that enhance legitimacy best explain the impact of ES science on decision-making. Our results are consistent with both theory and previous qualitative assessments in suggesting that the attributes and perceptions of scientific knowledge and process within which knowledge is coproduced are important determinants of whether that knowledge leads to action. PMID:26831101

Distinctive fingerprints of erosional regimes in terrestrial channel networks

NASA Astrophysics Data System (ADS)

Grau Galofre, A.; Jellinek, M.

2017-12-01

Satellite imagery and digital elevation maps capture the large scale morphology of channel networks attributed to long term erosional processes, such as fluvial, glacial, groundwater sapping and subglacial erosion. Characteristic morphologies associated with each of these styles of erosion have been studied in detail, but there exists a knowledge gap related to their parameterization and quantification. This knowledge gap prevents a rigorous analysis of the dominant processes that shaped a particular landscape, and a comparison across styles of erosion. To address this gap, we use previous morphological descriptions of glaciers, rivers, sapping valleys and tunnel valleys to identify and measure quantitative metrics diagnostic of these distinctive styles of erosion. From digital elevation models, we identify four geometric metrics: The minimum channel width, channel aspect ratio (longest length to channel width at the outlet), presence of undulating longitudinal profiles, and tributary junction angle. We also parameterize channel network complexity in terms of its stream order and fractal dimension. We then perform a statistical classification of the channel networks using a Principal Component Analysis on measurements of these six metrics on a dataset of 70 channelized systems. We show that rivers, glaciers, groundwater seepage and subglacial meltwater erode the landscape in rigorously distinguishable ways. Our methodology can more generally be applied to identify the contributions of different processes involved in carving a channel network. In particular, we are able to identify transitions from fluvial to glaciated landscapes or vice-versa.

Bridging the semantic gap in sports

NASA Astrophysics Data System (ADS)

Li, Baoxin; Errico, James; Pan, Hao; Sezan, M. Ibrahim

2003-01-01

One of the major challenges facing current media management systems and the related applications is the so-called "semantic gap" between the rich meaning that a user desires and the shallowness of the content descriptions that are automatically extracted from the media. In this paper, we address the problem of bridging this gap in the sports domain. We propose a general framework for indexing and summarizing sports broadcast programs. The framework is based on a high-level model of sports broadcast video using the concept of an event, defined according to domain-specific knowledge for different types of sports. Within this general framework, we develop automatic event detection algorithms that are based on automatic analysis of the visual and aural signals in the media. We have successfully applied the event detection algorithms to different types of sports including American football, baseball, Japanese sumo wrestling, and soccer. Event modeling and detection contribute to the reduction of the semantic gap by providing rudimentary semantic information obtained through media analysis. We further propose a novel approach, which makes use of independently generated rich textual metadata, to fill the gap completely through synchronization of the information-laden textual data with the basic event segments. An MPEG-7 compliant prototype browsing system has been implemented to demonstrate semantic retrieval and summarization of sports video.

Prevention of MSD within OHSMS/IMS: a systematic review of risk assessment strategies.

PubMed

Yazdani, Amin; Wells, Richard

2012-01-01

The purpose of this systematic review was to identify and summarize the research evidence on prevention of Musculoskeletal Disorders (MSD) within Occupational Health and Safety Management Systems (OHSMS) and Integrated Management Systems (IMS). Databases in business, management, engineering and health and safety were systematically searched and relevant publications were synthesized. The number of papers that could address the research questions was small. However, the review revealed that many of the techniques to address MSD hazards require substantial background knowledge and training. This may limit employees' involvement in the technical aspects of the risk assessment process. Also these techniques did not usually fit into techniques used by companies to address other risk factors within their management systems. This could result in MSD prevention becoming a separate issue that cannot be managed with company-wide tools. In addition, this review also suggested that there is a research gap concerning the MSD prevention within companies' management systems.

What is This Thing Called Sensemaking?: A Theoretical Framework for How Physics Students Resolve Inconsistencies in Understanding

NASA Astrophysics Data System (ADS)

Odden, Tor Ole B.

Students often emerge from introductory physics courses with a feeling that the concepts they have learned do not make sense. In recent years, science education researchers have begun to attend to this type of problem by studying the ways in which students make sense of science concepts. However, although many researchers agree intuitively on what sensemaking looks like, the literature on sensemaking is both theoretically fragmented and provides few guidelines for how to encourage and support the process. In this dissertation, I address this challenge by proposing a theoretical framework to describe students' sensemaking processes. I base this framework both on the science education research literature on sensemaking and on a series of video-recorded cognitive, clinical interviews conducted with introductory physics students enrolled in a course on electricity and magnetism. Using the science education research literature on sensemaking as well as a cognitivist, dynamic network model of mind as a theoretical lens, I first propose a coherent definition of sensemaking. Then, using this definition I analyze the sensemaking processes of these introductory physics students during episodes when they work to articulate and resolve gaps or inconsistencies in their understanding. Based on the students' framing, gestures, and dialogue I argue that the process of sensemaking unfolds in a distinct way, which we can describe as an epistemic game in which students first build a framework of knowledge, then identify a gap or inconsistency in that framework, iteratively build an explanation to resolve the gap or inconsistency, and (sometimes) successfully resolve it. I further argue that their entry into the sensemaking frame is facilitated by a specific question, which is in turn motivated by a gap or inconsistency in knowledge that I call the vexation point. I also investigate the results of sensemaking, arguing that students may use the technique of conceptual blending to both "defragment" their knowledge and resolve their vexation points.

Data warehouse governance programs in healthcare settings: a literature review and a call to action.

PubMed

Elliott, Thomas E; Holmes, John H; Davidson, Arthur J; La Chance, Pierre-Andre; Nelson, Andrew F; Steiner, John F

2013-01-01

Given the extensive data stored in healthcare data warehouses, data warehouse governance policies are needed to ensure data integrity and privacy. This review examines the current state of the data warehouse governance literature as it applies to healthcare data warehouses, identifies knowledge gaps, provides recommendations, and suggests approaches for further research. A comprehensive literature search using five data bases, journal article title-search, and citation searches was conducted between 1997 and 2012. Data warehouse governance documents from two healthcare systems in the USA were also reviewed. A modified version of nine components from the Data Governance Institute Framework for data warehouse governance guided the qualitative analysis. Fifteen articles were retrieved. Only three were related to healthcare settings, each of which addressed only one of the nine framework components. Of the remaining 12 articles, 10 addressed between one and seven framework components and the remainder addressed none. Each of the two data warehouse governance plans obtained from healthcare systems in the USA addressed a subset of the framework components, and between them they covered all nine. While published data warehouse governance policies are rare, the 15 articles and two healthcare organizational documents reviewed in this study may provide guidance to creating such policies. Additional research is needed in this area to ensure that data warehouse governance polices are feasible and effective. The gap between the development of data warehouses in healthcare settings and formal governance policies is substantial, as evidenced by the sparse literature in this domain.

Knowledge Gaps and Misconceptions About Coronary Heart Disease Among U.S. South Asians

PubMed Central

Kandula, Namratha R.; Tirodkar, Manasi A.; Lauderdale, Diane S.; Khurana, Neerja R.; Makoul, Gregory; Baker, David W.

2010-01-01

Background: Although South Asians are at higher risk for coronary heart disease (CHD) than most other U.S. racial/ethnic groups, very little research has addressed this disparity. Purpose: As a first step in developing culturally targeted CHD prevention messages for this rapidly growing community, this study examined South Asians' knowledge and beliefs about CHD. Methods: Analyses, conducted in 2009, were based on data collected from January–July 2008 in a cross-sectional study population of 270 South Asian adults in Illinois. Interviews were conducted in English, Hindi, or Urdu using a standardized questionnaire. Multivariate regression models were used to examine the associations between sociodemographics and CHD knowledge and attitudes about preventability. Results: Eighty-one percent of respondents had one or more CHD risk factors. Most participants (89%) said they knew little or nothing about CHD. Stress was the most frequently mentioned risk factor (44%). Few mentioned controlling blood pressure (11%), cholesterol (10%), and diabetes (5%) for prevention. Fifty-three percent said that heart attacks are not preventable. Low education level, being interviewed in Urdu or Hindi, and low level of acculturation were associated with less knowledge and believing that CHD is not preventable. Conclusions: A majority of South Asians in this study believed that CHD is not preventable and had low awareness of modifiable risk factors. As a first step, CHD education should target the knowledge gaps that may affect risk factor control and behavior change. Education messages may need to be somewhat different for subgroups (e.g., by education and language) to be maximally effective. PMID:20307813

Knowledge Management Assessment Trends

DTIC Science & Technology

2011-01-01

Recommendations for strategies and approaches to close the gaps An action plan with practical and operational solutions, along with a pilot and evaluation...access to a continuity book or a formal program to orient them to the organization. The BCKS assessment team has helped organizations close these gaps ...managers, and employees in the organization. The Knowledge Assessment identifies: • Knowledge and performance gaps • The causes or factors

Survivor experience of a child sexual abuse prevention program: a pilot study.

PubMed

Barron, Ian G; Topping, Keith J

2013-09-01

Addressing gaps in the research, the current study assesses the impact of a community-based child sexual abuse prevention program on known survivor knowledge/skills, disclosures, and subjective experience. Methodologically, novel measures of program fidelity and implementation cost are applied. A pre- posttest wait-list control design was utilized with intervention (n = 10) and comparison groups (n = 10). Measures included a standardized knowledge/skill questionnaire, coding of disclosures, subjective experience questionnaires, in-depth interviews, video analysis of program adherence, and a measure of cost. Analysis involved nonparametric tests and thematic analysis of interview and video data. Cost was calculated for the group and per survivor. Survivors achieved significant gains in knowledge/skills, made further disclosures, and were positive about their program experience. No gains were identified in the control group. Costs were small. Future studies need to explore survivor experience of programs delivered in classrooms.

Jamesian pragmatism: a framework for working towards unified diversity in nursing knowledge development.

PubMed

McCready, Jason S

2010-07-01

Abstract Nursing is frequently described as practical or pragmatic and there are many parallels between nursing and pragmatism, the school of thought. Pragmatism is often glancingly referenced by nursing authors, but few have conducted in-depth discussions about its applicability to nursing; and few have identified it as a significant theoretical basis for nursing research. William James's pragmatism has not been discussed substantially in the nursing context, despite obvious complementarities. James's theme of pluralism fits with nursing's diversity and plurality; his emphasis on social conscience in our actions matches nursing's fundamental purpose of improving the lives of others; his continuous testing of pluralistic truths in critically reflective practice pairs well with nursing's focus on developing best-available, holistic evidence; and his conceptualization of truth as being born in practice and becoming an instrument in practice is entirely compatible with nursing's theory-practice identity. The oft-discussed theory-practice gap is seen to hinder the development of nursing knowledge. If nursing is to find its identity in knowledge development and potentiate the knowledge developed, it is imperative to identify and address that which is impeding progress. By way of the pragmatic tenets of William James, I will argue that a significant part of the theory-practice gap lies in how nursing knowledge development is operationalized, creating a false dichotomy between practice and research. I will also argue that the research-practice schism has been widened by continued philosophical and methodological infighting in the research community. I will describe how Jamesian pragmatism can be 'what works' for rebuilding relationships and supporting an engaged plurality within nursing research and bring research and practice together into a collaborative and iterative process of developing nursing knowledge.

Evaluation of water, sanitation and hygiene program outcomes shows knowledge-behavior gaps in Coast Province, Kenya.

PubMed

Schlegelmilch, Michael Paul; Lakhani, Amyn; Saunders, Leslie Duncan; Jhangri, Gian Singh

2016-01-01

Water related diseases constitute a significant proportion of the burden of disease in Kenya. Water, sanitation and hygiene (WASH) programs are in operation nation-wide to address these challenges. This study evaluated the impact of the Sombeza Water and Sanitation Improvement Program (SWASIP) in Coast Province, Kenya. This study is a cluster randomized, follow-up evaluation that compared baseline (2007) to follow-up (2013) indicators from 250 households. Twenty-five villages were selected with probability proportional to size sampling, and ten households were selected randomly from each village. Follow-up data were collected by in-person interviews using pre-tested questionnaires, and analyzed to compare indicators collected at baseline. Cross-sectional results from the follow-up data were also reported. Statistically significant improvements from baseline were observed in the proportions of respondents with latrine access at home, who washed their hands after defecation, who treated their household drinking water and the average time to collect water in the dry season. However, this study also observed significant decreases in the proportion of respondents who washed their hands before preparing their food, or feeding their children, and after attending to a child who has defecated. The analysis also revealed a knowledge-behavior gap in WASH behaviors. SWASIP contributed to improvements from baseline, but further progress still needs to be seen. The findings challenge the assumption that providing infrastructure and knowledge will result in behavior change. Further understanding of specific, non-knowledge predictors of WASH related behavior is needed.

The Integrated Skin Exam film: an educational intervention to promote early detection of melanoma by medical students.

PubMed

Garg, Amit; Wang, Joyce; Reddy, Shalini B; Powers, Jennifer; Jacob, Reza; Powers, Michael; Biello, Katie; Cayce, Rachael; Savory, Stephanie; Belazarian, Leah; Domingues, Erik; Korzenko, Adam; Wilson, Lindsay; Grant-Kels, Jane M; George, Paul; Robinson-Bostom, Leslie; Trotter, Shannon C; Geller, Alan C

2014-01-01

Knowledge of the skin cancer examination (SCE) and its practice remain relevant competency gaps among medical students. We elaborate on a method of SCE known as the Integrated Skin Exam and discuss the development of an instructional film that illustrates its principles. We assess the tool's effect on knowledge, attitudes, and perceptions related to the SCE. Second-year students among 8 randomized schools viewed the film and completed pre-post questionnaires. After viewing The Integrated Skin Exam film, students demonstrated improved melanoma knowledge, including identification of high-risk demographic groups (61% vs 42.9%, P < .001), high-risk anatomic sites in women (88.6% vs 46.5%, P < .001) and men (92.1% vs 34.8%, P < .001), and the ABCDEs of melanoma (98.4% vs 91.2%, P < .001). Students demonstrated increased confidence in the SCE (66.93% vs 16.40%, P < .001) and augmented intentions to practice it (99.05% vs 13.9%, P < .001). A greater proportion (70.4% vs 41.9%, P < .001) of students thought less than 3 minutes were required to integrate SCE into the routine examination. Longitudinal impact of the film was not assessed. The Integrated Skin Exam film introduces an integrated approach to the SCE that addresses knowledge gaps, mitigates perceived barriers, and augments intention related to practice of the SCE. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Implementing Thrombosis Guidelines in Cancer Patients: A Review

PubMed Central

Farge-Bancel, Dominique; Bounameaux, Henri; Brenner, Benjamin; Büller, Harry R.; Kakkar, Ajay; Pabinger, Ingrid; Streiff, Michael; Debourdeau, Philippe

2014-01-01

Venous thromboembolism is a frequent and serious complication in patients with cancer. It is an independent prognostic factor of death in cancer patients and the second leading cause of death, but physicians often underestimate its importance, as well as the need for adequate prevention and treatment. Management of venous thromboembolism in patients with cancer requires the coordinated efforts of a wide range of clinicians, highlighting the importance of a multidisciplinary approach. However, a lack of consensus among various national and international clinical practice guidelines has contributed to knowledge and practice gaps among practitioners, and inconsistent approaches to venous thromboembolism. The 2013 international guidelines for thrombosis in cancer have sought to address these gaps by critically re-evaluating the evidence coming from clinical trials and synthesizing a number of guidelines documents. An individualized approach to prophylaxis is recommended for all patients. PMID:25386357

Young Women in Science: Impact of a Three-Year Program on Knowledge of and Attitudes Toward Science

NASA Astrophysics Data System (ADS)

Schumacher, Mitzi M.; Johnson, Michelle Natasya; Floyd, Sondra R.; Reid, Caroline E.; Noland, Melody Powers; Leukefeld, Carl G.

Addressing the factors that discourage high school girls from pursuing careers in science, this intervention targeted young women from rural Appalachia, urging them to pursue scientific careers in drug and alcohol research. This three-year program, for 49 young women entering ninth grade in 12 southeastern Kentucky counties, included a summer camp, Saturday Academies (educational seminars held in their communities), and mentoring by university faculty and community leaders. As hypothesized, findings from analyses of baseline and postsummer session data show a reduction in participants' anxiety regarding science. Participants' scientific knowledge also increased. In turn, their science knowledge scores correlated with their third summer posttest confidence in their ability to learn science and motivation for science as well as the belief that teachers can help. The success of such a program demonstrates that the gender gap in science, technology, engineering, and mathematics can be ameliorated. Participants' first steps toward successful scientific careers included improving their attitudes toward science as well as increasing their knowledge.

Bordetella pertussis pathogenesis: current and future challenges.

PubMed

Melvin, Jeffrey A; Scheller, Erich V; Miller, Jeff F; Cotter, Peggy A

2014-04-01

Pertussis, also known as whooping cough, has recently re-emerged as a major public health threat despite high levels of vaccination against the aetiological agent Bordetella pertussis. In this Review, we describe the pathogenesis of this disease, with a focus on recent mechanistic insights into B. pertussis virulence-factor function. We also discuss the changing epidemiology of pertussis and the challenges facing vaccine development. Despite decades of research, many aspects of B. pertussis physiology and pathogenesis remain poorly understood. We highlight knowledge gaps that must be addressed to develop improved vaccines and therapeutic strategies.

Bordetella pertussis pathogenesis: current and future challenges

PubMed Central

Melvin, Jeffrey A.; Scheller, Erich V.; Miller, Jeff F.; Cotter, Peggy A.

2014-01-01

Pertussis, or whooping cough, has recently reemerged as a major public health threat despite high levels of vaccination against the etiological agent, Bordetella pertussis. In this Review, we describe the pathogenesis of this disease, with a focus on recent mechanistic insights into virulence factor function. We also discuss the changing epidemiology of pertussis and the challenges of vaccine development. Despite decades of research, many aspects of B. pertussis physiology and pathogenesis remain poorly understood. We highlight knowledge gaps that must be addressed to develop improved vaccines and therapeutic strategies. PMID:24608338

Subsurface Microbes Expanding the Tree of Life

ScienceCinema

Banfield, Jillian

2018-02-14

Jillian Banfield, Ph.D., UC Berkeley Professor and Berkeley Lab Earth Sciences Division staff scientist and long-time user of the DOE Joint Genome Institute’s resources shares her perspective on how the DOE JGI helps advance her research addressing knowledge gaps related to the roles of subsurface microbial communities in biogeochemical cycling. The video was filmed near the town of Rifle, Colorado at the primary field site for Phase I of the Subsurface Systems Scientific Focus Area 2.0 sponsored by the DOE Office of Biological and Environmental Research.

Rationale for Further Medical and Health Research on High-Potency Sweeteners

PubMed Central

2012-01-01

High-potency or artificial sweeteners have historically been considered inert compounds without physiological consequences other than taste sensations. However, recent data suggest that some of these sweeteners have biological effects that may impact human health. Furthermore, there are significant gaps in our current knowledge of the pharmacokinetics of these sweeteners, their potential for “sweetener–drug interactions” and their impact on appetite and body weight regulation. Nine research needs are described that address some of the major unknown issues associated with ingestion of high-potency sweeteners. PMID:22539626

Pharmaceutical R&D in the spotlight: why is there still unmet medical need?

PubMed

Schmid, Esther F; Smith, Dennis A

2007-12-01

Huge amounts of money and knowledge have been poured into biomedical research for decades. Yet, in some disease areas next to no progress has been made in providing medical treatment. Importantly, it is not only neglected diseases where unmet medical need remains, but many diseases of 'rich' countries are also affected. Occasionally, new therapies exacerbate the medical need gap, such as in cancer. Our paper discusses some of the reasons why this might be and why all of society needs to find solutions to address unmet medical need.

Genome-wide transcriptional profiling data from chronic cutaneous lupus erythematosus (CCLE) peripheral blood.

PubMed

Dey-Rao, R; Sinha, A A

2015-03-01

The disease Lupus erythematosus (LE), exhibits a variety of clinical manifestations with potentially wide-ranging multi-organ damage to joints, tendons, kidney, lung, heart, blood vessels, central nervous system and skin [1,2] Systemic changes are likely to trigger organ specific manifestation of the disease. Here, we provide the data examined to address the gap in knowledge regarding causes and mechanisms contributing to the autoimmune attack on skin in chronic cutaneous lupus erythematosus (CCLE). The raw gene expression data files (CEL files) are provided with this article [3].

Rationale for further medical and health research on high-potency sweeteners.

PubMed

Schiffman, Susan S

2012-10-01

High-potency or artificial sweeteners have historically been considered inert compounds without physiological consequences other than taste sensations. However, recent data suggest that some of these sweeteners have biological effects that may impact human health. Furthermore, there are significant gaps in our current knowledge of the pharmacokinetics of these sweeteners, their potential for "sweetener-drug interactions" and their impact on appetite and body weight regulation. Nine research needs are described that address some of the major unknown issues associated with ingestion of high-potency sweeteners.

Efforts to Bridge the Gap between Research and Practice in Social Work: Precedents and Prospects: Keynote Address at the Bridging the Gap Symposium

ERIC Educational Resources Information Center

Rubin, Allen

2015-01-01

This keynote address discusses previous and ongoing efforts to reduce the persistent gap between research and practice in social work and offers recommendations for further bridging that gap. Key among those recommendations is the need to conduct descriptive outcome studies of efforts to adapt research-supported interventions in everyday practice…

Acquisition of Simple and Complex Knowledge; A Knowledge Gap Perspective

ERIC Educational Resources Information Center

Le Heron, Judy; Sligo, Frank

2005-01-01

This paper assesses university students' acquisition of simple and complex knowledge, in exploring whether the knowledge gap hypothesis (KGH) with its origins in community-based research into people's informal learning from mass media, provides insights into students' acquisition and retention of information. The KGH posits that attempts to…

Health system preparedness for integration of mental health services in rural Liberia.

PubMed

Gwaikolo, Wilfred S; Kohrt, Brandon A; Cooper, Janice L

2017-07-27

There are increasing efforts and attention focused on the delivery of mental health services in primary care in low resource settings (e.g., mental health Gap Action Programme, mhGAP). However, less attention is devoted to systematic approaches that identify and address barriers to the development and uptake of mental health services within primary care in low-resource settings. Our objective was to prepare for optimal uptake by identifying barriers in rural Liberia. The country's need for mental health services is compounded by a 14-year history of political violence and the largest Ebola virus disease outbreak in history. Both events have immediate and lasting mental health effects. A mixed-methods approach was employed, consisting of qualitative interviews with 22 key informants and six focus group discussions. Additional qualitative data as well as quantitative data were collected through semi-structured assessments of 19 rural primary care health facilities. Data were collected from March 2013 to March 2014. Potential barriers to development and uptake of mental health services included lack of mental health knowledge among primary health care staff; high workload for primary health care workers precluding addition of mental health responsibilities; lack of mental health drugs; poor physical infrastructure of health facilities including lack of space for confidential consultation; poor communication support including lack of electricity and mobile phone networks that prevent referrals and phone consultation with supervisors; absence of transportation for patients to facilitate referrals; negative attitudes and stigma towards people with severe mental disorders and their family members; and stigma against mental health workers. To develop and facilitate effective primary care mental health services in a post-conflict, low resource setting will require (1) addressing the knowledge and clinical skills gap in the primary care workforce; (2) improving physical infrastructure of health facilities at care delivery points; and (3) implementing concurrent interventions designed to improve attitudes towards people with mental illness, their family members and mental health care providers.

Robotic Reconnaissance Missions to Small Bodies and Their Potential Contributions to Human Exploration

NASA Technical Reports Server (NTRS)

Abell, P. A.; Rivkin, A. S.

2015-01-01

Introduction: Robotic reconnaissance missions to small bodies will directly address aspects of NASA's Asteroid Initiative and will contribute to future human exploration. The NASA Asteroid Initiative is comprised of two major components: the Grand Challenge and the Asteroid Mission. The first component, the Grand Challenge, focuses on protecting Earth's population from asteroid impacts by detecting potentially hazardous objects with enough warning time to either prevent them from impacting the planet, or to implement civil defense procedures. The Asteroid Mission involves sending astronauts to study and sample a near- Earth asteroid (NEA) prior to conducting exploration missions of the Martian system, which includes Phobos and Deimos. The science and technical data obtained from robotic precursor missions that investigate the surface and interior physical characteristics of an object will help identify the pertinent physical properties that will maximize operational efficiency and reduce mission risk for both robotic assets and crew operating in close proximity to, or at the surface of, a small body. These data will help fill crucial strategic knowledge gaps (SKGs) concerning asteroid physical characteristics that are relevant for human exploration considerations at similar small body destinations. Small Body Strategic Knowledge Gaps: For the past several years NASA has been interested in identifying the key SKGs related to future human destinations. These SKGs highlight the various unknowns and/or data gaps of targets that the science and engineering communities would like to have filled in prior to committing crews to explore the Solar System. An action team from the Small Bodies Assessment Group (SBAG) was formed specifically to identify the small body SKGs under the direction of the Human Exploration and Operations Missions Directorate (HEOMD), given NASA's recent interest in NEAs and the Martian moons as potential human destinations [1]. The action team organized the SKGs into four broad themes: 1) Identify human mission targets; 2) Understand how to work on and interact with the small body surface; 3) Understand the small body environment and its potential risk/benefit to crew, systems, and operational assets; and 4) Understand the small body resource potential. Each of these themes were then further subdivided into categories to address specific SKG issues. Robotic Precursor Contributions to SKGs: Robotic reconnaissance missions should be able to address specific aspects related to SKG themes 1 through 4. Theme 1 deals with the identification of human mission targets within the NEA population. The current guideline indicates that human missions to fastspinning, tumbling, or binary asteroids may be too risky to conduct successfully from an operational perspective. However, no spacecraft mission has been to any of these types of NEAs before. Theme 2 addresses the concerns about interacting on the small body surface under microgravity conditions, and how the surface and/or sub-surface properties affect or restrict the interaction for human exploration. The combination of remote sensing instruments and in situ payloads will provide good insight into the asteroid's surface and subsurface properties. SKG theme 3 deals with the environment in and around the small body that may present a nuisance or hazard to any assets operating in close proximity. Impact and surface experiments will help address issues related to particle size, particle longevity, internal structure, and the near-surface mechanical stability of the asteroid. Understanding or constraining these physical characteristics are important for mission planning. Theme 4 addresses the resource potential of the small body. This is a particularly important aspect of human exploration since the identification and utilization of resources is a key aspect for deep space mission architectures to the Martian system (i.e., Phobos and Deimos). Conclusions: Robotic reconnaissance of small bodies can provide a wealth of information relevant to the science and planetary defense of NEAs. However, such missions to investigate NEAs can also provide key insights into small body strategic knowledge gaps and contribute to the overall success for human exploration missions to asteroids.

Selection of an Alternative Production Part Approval Process to Improve Weapon Systems Production Readiness

DTIC Science & Technology

2017-09-01

production outcomes: 1) knowledge gaps in technology, 2) design instability and 3) manufacturing knowledge gaps. Only manufacturing knowledge gaps...ability to produce at a desired production rate. Each item produced under this manufacturing development is to meet that item’s design requirements. The...represented with respect to assessing manufacturing design and development with a verification and demonstration. DOD acquisition waits to assess production

Improving access to care for children with mental disorders: a global perspective.

PubMed

Patel, Vikram; Kieling, Christian; Maulik, Pallab K; Divan, Gauri

2013-05-01

Developmental disabilities, emotional disorders and disruptive behaviour disorders are the leading mental health-related causes of the global burden of disease in children aged below 10 years. This article aims to address the treatment gap for child mental disorders through synthesising three bodies of evidence: the global evidence base on the treatment of these priority disorders; the barriers to implementation of this knowledge; and the innovative approaches taken to address these barriers and improve access to care. Our focus is on low-resource settings, which are mostly found in low- and middle-income countries (LMIC). Despite the evidence base on the burden of child mental disorders and their long-term consequences, and the recent mental health Gap Action Programme guidelines which testify to the effectiveness of a range of pharmacological and psychosocial interventions for these disorders, the vast majority of children in LMIC do not have access to these interventions. We identify three major barriers for the implementation of efficacious treatments: the lack of evidence on delivery of the treatments, the low levels of detection of child mental disorders and the shortage of skilled child mental health professionals. The evidence based on implementation, although weak, supports the use of screening measures for detection of probable disorders, coupled with a second-stage diagnostic assessment and the use of non-specialist workers in community and school settings for the delivery of psychosocial interventions. The most viable strategy to address the treatment gap is through the empowerment of existing human resources who are most intimately concerned with child care, including parents, through innovative technologies, such as mobile health, with the necessary skills for the detection and treatment of child mental disorders.

Customizing Laboratory Information Systems: Closing the Functionality Gap.

PubMed

Gershkovich, Peter; Sinard, John H

2015-09-01

Highly customizable laboratory information systems help to address great variations in laboratory workflows, typical in Pathology. Often, however, built-in customization tools are not sufficient to add all of the desired functionality and improve systems interoperability. Emerging technologies and advances in medicine often create a void in functionality that we call a functionality gap. These gaps have distinct characteristics—a persuasive need to change the way a pathology group operates, the general availability of technology to address the missing functionality, the absence of this technology from your laboratory information system, and inability of built-in customization tools to address it. We emphasize the pervasive nature of these gaps, the role of pathology informatics in closing them, and suggest methods on how to achieve that. We found that a large number of the papers in the Journal of Pathology Informatics are concerned with these functionality gaps, and an even larger proportion of electronic posters and abstracts presented at the Pathology Informatics Summit conference each year deal directly with these unmet needs in pathology practice. A rapid, continuous, and sustainable approach to closing these gaps is critical for Pathology to provide the highest quality of care, adopt new technologies, and meet regulatory and financial challenges. The key element of successfully addressing functionality gaps is gap ownership—the ability to control the entire pathology information infrastructure with access to complementary systems and components. In addition, software developers with detailed domain expertise, equipped with right tools and methodology can effectively address these needs as they emerge.

Transforming practice into clinical scholarship.

PubMed

Limoges, Jacqueline; Acorn, Sonia

2016-04-01

The aims of this paper were to explicate clinical scholarship as synonymous with the scholarship of application and to explore the evolution of scholarly practice to clinical scholarship. Boyer contributed an expanded view of scholarship that recognized various approaches to knowledge production beyond pure research (discovery) to include the scholarship of integration, application and teaching. There is growing interest in using Boyer's framework to advance knowledge production in nursing but the discussion of clinical scholarship in relation to Boyer's framework is sparse. Discussion paper. Literature from 1983-2015 and Boyer's framework. When clinical scholarship is viewed as a synonym for Boyer's scholarship of application, it can be aligned to this well established framework to support knowledge generated in clinical practice. For instance, applying the three criteria for scholarship (documentation, peer review and dissemination) can ensure that the knowledge produced is rigorous, available for critique and used by others to advance nursing practice and patient care. Understanding the differences between scholarly practice and clinical scholarship can promote the development of clinical scholarship. Supporting clinical leaders to identify issues confronting nursing practice can enable scholarly practice to be transformed into clinical scholarship. Expanding the understanding of clinical scholarship and linking it to Boyer's scholarship of application can assist nurses to generate knowledge that addresses clinical concerns. Further dialogue about how clinical scholarship can address the theory-practice gap and how publication of clinical scholarship could be expanded given the goals of clinical scholarship is warranted. © 2016 John Wiley & Sons Ltd.

An integrated science-based methodology to assess potential ...

EPA Pesticide Factsheets

There is an urgent need for broad and integrated studies that address the risks of engineered nanomaterials (ENMs) along the different endpoints of the society, environment, and economy (SEE) complex adaptive system. This article presents an integrated science-based methodology to assess the potential risks of engineered nanomaterials. To achieve the study objective, two major tasks are accomplished, knowledge synthesis and algorithmic computational methodology. The knowledge synthesis task is designed to capture “what is known” and to outline the gaps in knowledge from ENMs risk perspective. The algorithmic computational methodology is geared toward the provision of decisions and an understanding of the risks of ENMs along different endpoints for the constituents of the SEE complex adaptive system. The approach presented herein allows for addressing the formidable task of assessing the implications and risks of exposure to ENMs, with the long term goal to build a decision-support system to guide key stakeholders in the SEE system towards building sustainable ENMs and nano-enabled products. The following specific aims are formulated to achieve the study objective: (1) to propose a system of systems (SoS) architecture that builds a network management among the different entities in the large SEE system to track the flow of ENMs emission, fate and transport from the source to the receptor; (2) to establish a staged approach for knowledge synthesis methodo

Solutions for filling gaps in accountable care measure sets.

PubMed

Valuck, Tom; Dugan, Donna; Dubois, Robert W; Westrich, Kimberly; Penso, Jerry; McClellan, Mark

2015-10-01

A primary objective of accountable care is to support providers in reforming care to improve outcomes and lower costs. Gaps in accountable care measure sets may cause missed opportunities for improvement and missed signals of problems in care. Measures to balance financial incentives may be particularly important for high-cost conditions or specialty treatments. This study explored gaps in measure sets for specific conditions and offers strategies for more comprehensive measurement that do not necessarily require more measures. A descriptive analysis of measure gaps in accountable care programs and proposed solutions for filling the gaps. We analyzed gaps in 2 accountable care organization measure sets for 20 high-priority clinical conditions by comparing the measures in those sets with clinical guidelines and assessing the use of outcome measures. Where we identified gaps, we looked for existing measures to address the gaps. Gaps not addressed by existing measures were considered areas for measure development or measurement strategy refinement. We found measure gaps across all 20 conditions, including those conditions that are commonly addressed in current measure sets. In addition, we found many gaps that could not be filled by existing measures. Results across all 20 conditions informed recommendations for measure set improvement. Addressing all gaps in accountable care measure sets with more of the same types of measures and approaches to measurement would require an impractical number of measures and would miss the opportunity to use better measures and innovative approaches. Strategies for effectively filling measure gaps include using preferred measure types such as cross-cutting, outcome, and patient-reported measures. Program implementers should also apply new approaches to measurement, including layered and modular models.

Effect of Performance Feedback on Perceived Knowledge and Likelihood to Pursue Continuing Education

ERIC Educational Resources Information Center

Eberman, Lindsey E.; Tripp, Brady L.

2011-01-01

Context: For practicing health care professionals, waiting for a teachable moment to identify a gap in knowledge could prove critical. Other methods are needed to help health care professionals identify their knowledge gaps. Objective: To assess the effect of performance feedback on Athletic Trainers' (AT) perceived knowledge (PK) and likelihood…

Factors Associated with HIV Related Stigma among College Students in the Midwest

PubMed Central

Kingori, Caroline; Nkansah, Mavis Adwoa; Haile, Zelalem; Darlington, Kay-Anne; Basta, Tania

2017-01-01

In general, U.S. college students have low perceived susceptibility of acquiring HIV infection while 15–25 percent of youth have had negative perceptions towards HIV positive individuals. Factors associated with HIV stigma among college students were examined in a convenience sample of 200 students. Descriptive and inferential statistics were utilized to summarize the data. Only four percent of participants responded correctly to HIV transmission knowledge items. HIV transmission knowledge scores were significantly higher for participants who were single with partner and those who resided outside university residential dorms (p < 0.05). There was a significant negative correlation between composite HIV knowledge scores and stigma scores r = −0.18 (p < 0.05). After adjusting for confounders, a marginal significant negative linear relationship emerged (β = −0.09, p = 0.06) between HIV knowledge and stigma. HIV prevention education among college students needs to be addressed with nuance to minimize HIV knowledge gaps, stigma and student risk perception that impacts HIV prevention and stigma against those living with HIV. PMID:29546222

Developmental dysplasia of the hip: addressing evidence gaps with a multicentre prospective international study.

PubMed

Schaeffer, Emily K; Study Group, Ihdi; Mulpuri, Kishore

2018-05-07

There is a lack of high quality evidence available to guide clinical practice in the treatment and management of developmental dysplasia of the hip (DDH). Evidence has been limited by persistent confusion on diagnostic and classification terminology, variability in surgeon decision making and a reliance on single centre, retrospective studies with small patient numbers. To address gaps in knowledge regarding screening, diagnosis and management of DDH, the International Hip Dysplasia Institute began a multicentre, international prospective study on infants with hips dislocated at rest. This review discusses the current state of screening, diagnostic and management practices in DDH and addresses important unanswered questions that will be critical in identifying best practices and optimising patient outcomes. There is insufficient evidence to support universal ultrasound screening; instead, selective screening should be performed by 6-8 weeks of age on infants with risk factors of breech presentation, family history, or history of clinical hip instability. Follow-up of infants with risk factors and normal initial screening should be considered to at least 6 months of age. Brace treatment is a sensible first-line treatment for management of dislocated hips at rest in infants < 6 months of age. Early operative reduction may be considered as there is insufficient evidence to support a protective role for the ossific nucleus in the development of avascular necrosis.

Recent advances to address European Union Health Security from cross border chemical health threats.

PubMed

Duarte-Davidson, R; Orford, R; Wyke, S; Griffiths, M; Amlôt, R; Chilcott, R

2014-11-01

The European Union (EU) Decision (1082/2013/EU) on serious cross border threats to health was adopted by the European Parliament in November 2013, in recognition of the need to strengthen the capacity of Member States to coordinate the public health response to cross border threats, whether from biological, chemical, environmental events or events which have an unknown origin. Although mechanisms have been in place for years for reporting cross border health threats from communicable diseases, this has not been the case for incidents involving chemicals and/or environmental events. A variety of collaborative EU projects have been funded over the past 10 years through the Health Programme to address gaps in knowledge on health security and to improve resilience and response to major incidents involving chemicals. This paper looks at the EU Health Programme that underpins recent research activities to address gaps in resilience, planning, responding to and recovering from a cross border chemical incident. It also looks at how the outputs from the research programme will contribute to improving public health management of transnational incidents that have the potential to overwhelm national capabilities, putting this into context with the new requirements as the Decision on serious cross border threats to health as well as highlighting areas for future development. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Evaluation of the first open-access hepatitis B and safe injection online training course for health professionals in China.

PubMed

Wang, Jing; Feng, Qiming; Tam, Andrew; Sun, Tong; Zhou, Peijing; So, Samuel

2016-03-08

Despite the high prevalence of chronic hepatitis B virus (HBV) infection in China, HBV infection prevention and long-term care knowledge of health professionals is inadequate. To address this knowledge gap, we developed an open-access evidence-based online training course, "KnowHBV", to train health professionals on prevention of HBV transmission and safe injections. We conducted an evaluation of the course with health professionals in China to examine its effectiveness in improving knowledge and learner's satisfaction of the course. Between July and December 2011, 1015 health professionals from selected hospitals and disease control institutions of Shandong province registered for the course and 932 (92 %) completed the three-module course. Participants' demographic information, pre- and post-course knowledge test results and learner's feedback were collected through the course website. Pre-course knowledge assessment confirmed gaps in HBV transmission routes, prevention and long-term care knowledge. Only 50.4 % of participants correctly identified all of the transmission routes of HBV, and only 40.7 % recognized all of the recommended tests to monitor chronically infected persons. The number of participants that answered all six multi-part multiple-choice knowledge questions correctly increased from 183 (19.7 %) before taking the course to 395 (42.4 %) on their first attempt upon completion of the course. Over 90 % of the 898 participants who completed the learner-feedback questionnaire rated the course as 'good' or 'very good'; over 94 % found the course instructional design helpful; 57.5 %, 65.7 % and 68.5 % reported that half or more than half of the course content in modules 1, 2 and 3 respectively provided new information; and 93.2 % of the participants indicated they preferred the online learning over traditional face-to-face classroom learning. The "KnowHBV" online training course appears to be an effective online training tool to improve HBV prevention and care knowledge of the health professionals in China.

Time for chronic disease care and management

PubMed Central

Montague, Terrence J; Gogovor, Amédé; Krelenbaum, Marilyn

2007-01-01

To manage the future costs and quality of care, a health strategy must move beyond the individual, acute care model and address the care of older people with chronic, and often multiple, diseases. This strategy must address the issue of care gaps, ie, the differences between best care and usual care. It should also embrace broad partnerships in which providers may be a cross-disciplinary team of nurses, physicians and pharmacists; the patient partners may include all patients in the community with a disease or group of diseases; and the system managers should work with all to seek improved long-term care and share the governance of interventions and resources. This partnership is activated by repeated and widely communicated measurements of actual practices and outcomes, facilitating rapid knowledge gain and translation, including unmasking the invisible wait list of unmeasured care gaps. It drives continuous improvement in practices and outcomes. The time is right for such care models. There is increasing evidence of their clinical and financial benefits. There is a clear and immediate opportunity to evaluate them as part of a health strategy for effective chronic care in our aging society. Things can be better. PMID:17932573

Patient Privacy, Consent, and Identity Management in Health Information Exchange

PubMed Central

Hosek, Susan D.; Straus, Susan G.

2013-01-01

Abstract The Military Health System (MHS) and the Veterans Health Administration (VHA) have been among the nation's leaders in health information technology (IT), including the development of health IT systems and electronic health records that summarize patients' care from multiple providers. Health IT interoperability within MHS and across MHS partners, including VHA, is one of ten goals in the current MHS Strategic Plan. As a step toward achieving improved interoperability, the MHS is seeking to develop a research roadmap to better coordinate health IT research efforts, address IT capability gaps, and reduce programmatic risk for its enterprise projects. This article contributes to that effort by identifying gaps in research, policy, and practice involving patient privacy, consent, and identity management that need to be addressed to bring about improved quality and efficiency of care through health information exchange. Major challenges include (1) designing a meaningful patient consent procedure, (2) recording patients' consent preferences and designing procedures to implement restrictions on disclosures of protected health information, and (3) advancing knowledge regarding the best technical approaches to performing patient identity matches and how best to monitor results over time. Using a sociotechnical framework, this article suggests steps for overcoming these challenges and topics for future research. PMID:28083296

A conceptual model of Verbal Exchange Health Literacy

PubMed Central

Harrington, Kathleen F.; Valerio, Melissa A.

2014-01-01

Objective To address a gap in understanding of verbal exchange (oral and aural) health literacy by describing the systematic development of a verbal exchange health literacy (VEHL) definition and model which hypothesizes the role of VEHL in health outcomes. Methods Current health literacy and communication literature was systematically reviewed and combined with qualitative patient and provider data that were analyzed using a grounded theory approach. Results Analyses of current literature and formative data indicated the importance of verbal exchange in the clinical setting and revealed various factors associated with the patient-provider relationship and their characteristics that influence decision making and health behaviors. VEHL is defined as the ability to speak and listen that facilitates exchanging, understanding, and interpreting of health information for health-decision making, disease management and navigation of the healthcare system. A model depiction of mediating and influenced factors is presented. Conclusion A definition and model of VEHL is a step towards addressing a gap in health literacy knowledge and provides a foundation for examining the influence of VEHL on health outcomes. Practice Implications VEHL is an extension of current descriptions of health literacy and has implications for patient-provider communication and health decision making. PMID:24291145

Time for chronic disease care and management.

PubMed

Montague, Terrence J; Gogovor, Amédé; Krelenbaum, Marilyn

2007-10-01

To manage the future costs and quality of care, a health strategy must move beyond the individual, acute care model and address the care of older people with chronic, and often multiple, diseases. This strategy must address the issue of care gaps, ie, the differences between best care and usual care. It should also embrace broad partnerships in which providers may be a cross-disciplinary team of nurses, physicians and pharmacists; the patient partners may include all patients in the community with a disease or group of diseases; and the system managers should work with all to seek improved long-term care and share the governance of interventions and resources. This partnership is activated by repeated and widely communicated measurements of actual practices and outcomes, facilitating rapid knowledge gain and translation, including unmasking the invisible wait list of unmeasured care gaps. It drives continuous improvement in practices and outcomes. The time is right for such care models. There is increasing evidence of their clinical and financial benefits. There is a clear and immediate opportunity to evaluate them as part of a health strategy for effective chronic care in our aging society. Things can be better.

Body of Knowledge for Silicon Carbide Power Electronics

NASA Technical Reports Server (NTRS)

Boomer, Kristen; Lauenstein, Jean-Marie; Hammoud, Ahmad

2016-01-01

Wide band gap semiconductors, such as silicon carbide (SiC), have emerged as very promising materials for future electronic components due to the tremendous advantages they offer in terms of power capability, extreme temperature tolerance, and high frequency operation. This report documents some issues pertaining to SiC technology and its application in the area of power electronics, in particular those geared for space missions. It also serves as a body of knowledge (BOK) in reference to the development and status of this technology obtained via literature and industry survey as well as providing a listing of the major manufacturers and their capabilities. Finally, issues relevant to the reliability of SiC-based electronic parts are addressed and limitations affecting the full utilization of this technology are identified.

The experience of physicians in pharmacogenomic clinical decision support within eight German university hospitals.

PubMed

Hinderer, Marc; Boeker, Martin; Wagner, Sebastian A; Binder, Harald; Ückert, Frank; Newe, Stephanie; Hülsemann, Jan L; Neumaier, Michael; Schade-Brittinger, Carmen; Acker, Till; Prokosch, Hans-Ulrich; Sedlmayr, Brita

2017-06-01

The aim of this study was to assess the physicians' attitude, their knowledge and their experience in pharmacogenomic clinical decision support in German hospitals. We conducted an online survey to address physicians of 13 different medical specialties across eight German university hospitals. In total, 564 returned questionnaires were analyzed. The remaining knowledge gap, the uncertainty of test reimbursement and the physicians' lack of awareness of existing pharmacogenomic clinical decision support systems (CDSS) are the major barriers for implementing pharmacogenomic CDSS into German hospitals. Furthermore, pharmacogenomic CDSS are most effective in the form of real-time decision support for internists. Physicians in German hospitals require additional education of both genetics and pharmacogenomics. They need to be provided with access to relevant pharmacogenomic CDSS.

A problem-solving approach to effective insulin injection for patients at either end of the body mass index.

PubMed

Juip, Micki; Fitzner, Karen

2012-06-01

People with diabetes require skills and knowledge to adhere to medication regimens and self-manage this complex disease. Effective self-management is contingent upon effective problem solving and decision making. Gaps existed regarding useful approaches to problem solving by individuals with very low and very high body mass index (BMI) who self-administer insulin injections. This article addresses those gaps by presenting findings from a patient survey, a symposium on the topic of problem solving, and recent interviews with diabetes educators to facilitate problem-solving approaches for people with diabetes with high and low BMI who inject insulin and/or other medications. In practice, problem solving involves problem identification, definition, and specification; goal and barrier identification are a prelude to generating a set of potential strategies for problem resolution and applying these strategies to implement a solution. Teaching techniques, such as site rotation and ensuring that people with diabetes use the appropriate equipment, increase confidence with medication adherence. Medication taking is more effective when people with diabetes are equipped with the knowledge, skills, and problem-solving behaviors to effectively self-manage their injections.

Potential uses of Bayesian networks as tools for synthesis of systematic reviews of complex interventions.

PubMed

Stewart, G B; Mengersen, K; Meader, N

2014-03-01

Bayesian networks (BNs) are tools for representing expert knowledge or evidence. They are especially useful for synthesising evidence or belief concerning a complex intervention, assessing the sensitivity of outcomes to different situations or contextual frameworks and framing decision problems that involve alternative types of intervention. Bayesian networks are useful extensions to logic maps when initiating a review or to facilitate synthesis and bridge the gap between evidence acquisition and decision-making. Formal elicitation techniques allow development of BNs on the basis of expert opinion. Such applications are useful alternatives to 'empty' reviews, which identify knowledge gaps but fail to support decision-making. Where review evidence exists, it can inform the development of a BN. We illustrate the construction of a BN using a motivating example that demonstrates how BNs can ensure coherence, transparently structure the problem addressed by a complex intervention and assess sensitivity to context, all of which are critical components of robust reviews of complex interventions. We suggest that BNs should be utilised to routinely synthesise reviews of complex interventions or empty reviews where decisions must be made despite poor evidence. Copyright © 2013 John Wiley & Sons, Ltd.

Avoiding a knowledge gap in a multiethnic statewide social marketing campaign: is cultural tailoring sufficient?

PubMed

Buchthal, O Vanessa; Doff, Amy L; Hsu, Laura A; Silbanuz, Alice; Heinrich, Katie M; Maddock, Jay E

2011-03-01

In 2007, the State of Hawaii, Healthy Hawaii Initiative conducted a statewide social-marketing campaign promoting increased physical activity and nutrition. The campaign included substantial formative research to develop messages tailored for Hawaii's multiethnic Asian and Pacific Islander populations. The authors conducted a statewide random digital dialing telephone survey to assess the campaign's comparative reach among individuals with different ethnicities and different levels of education and income. This analysis suggests that the intervention was successful in reaching its target ethnic audiences. However, a knowledge gap related to the campaign appeared among individuals with incomes less than 130% of the poverty level and those with less than a high school education. These results varied significantly by message and the communication channel used. Recall of supermarket-based messages was significantly higher among individuals below 130% of the poverty level and those between 18 and 35 years of age, 2 groups that showed consistently lower recall of messages in other channels. Results suggest that cultural tailoring for ethnic audiences, although important, is insufficient for reaching low-income populations, and that broad-based social marketing campaigns should consider addressing socioeconomic status-related channel preferences in formative research and campaign design.

Pharmacological, psychological, and patient education interventions for patients with neck pain: results of an international survey.

PubMed

Carlesso, Lisa C; Gross, Anita R; MacDermid, Joy C; Walton, David M; Santaguida, P Lina

2015-01-01

Examination of practice patterns compared to existing evidence identifies knowledge to practice gaps. To describe the utilization of pharmacological, patient education, primary psychological interventions and relaxation therapies in patients with neck pain by clinicians. An international cross-sectional survey was conducted to determine the use of these interventions amongst 326 clinicians treating patients with neck pain. Nineteen countries participated. Results were analyzed by usage amongst physical therapists (39%) and chiropractors (35%), as they were the predominant respondents. Patient education (95%) and relaxation therapies (59%) were the most utilized interventions. Tests of subgroup differences determined that physical therapists used patient education significantly more than chiropractors. Use of medications and primary psychological interventions were reported by most to be outside of scope of practice. The high rate of patient education is consistent with supporting evidence. However, usage of relaxation therapies is contrary to evidence suggesting no benefit for improved pain or function for chronic neck pain. This survey indicates that patient education and relaxation therapies are common treatments provided by chiropractors and physical therapists for patients with neck pain. Future research should address gaps associated with variable practice patterns and knowledge translation to reduce usage of interventions shown to be ineffective.

The intermingled history of occupational therapy and anatomical education: A retrospective exploration.

PubMed

Carroll, Melissa A; Lawson, Katherine

2014-01-01

Few research articles have addressed the anatomical needs of entry-level occupational therapy students. Given this paucity of empirical evidence, there is a lack of knowledge regarding anatomical education in occupational therapy. This article will primarily serve as a retrospective look at the inclusion of anatomical education in the occupational therapy curriculum. Focusing on the historical inclusion is the first step to address the gap in existing knowledge. Examining the history of anatomy in occupational therapy provides an educational context for curricular developments and helps current anatomical educators understand the evolution of occupational therapy as a profession. Exploring the educational history also offers anatomy educators an identity, as significant contributors, in the training and preparedness of entry-level professionals while focusing on the ideals of occupational therapy. However, there is a critical need for empirical evidence of best teaching practices in occupational therapy and anatomical education. This manuscript provides a foundation and a starting point for further investigation into the anatomical competencies for entry-level occupational therapists. © 2014 American Association of Anatomists.

Teachers' instructional goals for science practice: Identifying knowledge gaps using cultural-historical activity theory (CHAT)

NASA Astrophysics Data System (ADS)

Farrar, Cynthia Hamen

In AP Biology, the course goal, with respect to scientific acts and reasoning, has recently shifted toward a reform goal of science practice, where the goal is for students to have a scientific perspective that views science as a practice of a community rather than a body of knowledge. Given this recent shift, this study is interested in the gaps that may exist between an individual teacher's instructional goal and the goals of the AP Biology course. A Cultural-Historical Activity Theory (CHAT) methodology and perspective is used to analyze four teachers' knowledge, practice, and learning. Teachers have content knowledge for teaching, a form of knowledge that is unique for teaching called specialized content knowledge. This specialized content knowledge (SCK) defines their instructional goals, the student outcomes they ultimately aim to achieve with their students. The study employs a cultural-historical continuum of scientific acts and reasoning, which represents the development of the AP Biology goal over time, to study gaps in their instructional goal. The study also analyzes the contradictions within their teaching practice and how teachers address those contradictions to shift their instructional practice and learn. The findings suggest that teachers have different interpretations of the AP Biology goals of science practice, placing their instructional goal at different points along the continuum. Based on the location of their instructional goal, different micro-communities of teachers exist along the continuum, comprised of teachers with a shared goal, language, and culture of their AP Biology teaching. The in-depth study of one teacher's AP Biology teaching, using a CHAT perspective, provides a means for studying the mechanisms that connect SCK to classroom actions and ultimately to instructional practice. CHAT also reveals the nature and importance of contradictions or cognitive dissonance in teacher learning and the types of support teachers need to recognize contradictions and to internalize and set their instructional goal, facilitating their learning. Without recognition of contradictions, some of these micro-communities are not aware that their instruction is not in line with the AP Biology goal of science practice. An in-depth look at teacher learning revealed the criticality of reflective practice and the need for an "expert" within a teacher's community to facilitate = learning and develop SCK to incorporate science practice in classroom instruction.

Crystal River 3 Cable Materials for Thermal and Gamma Radiation Aging

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

Fifield, Leonard S.; Correa, Miguel; Zwoster, Andy

The Expanded Materials Degradation Assessment Volume 5: Aging of Cables and Cable Systems (EMDA) summarizes the state of knowledge of materials, constructions, operating environments, and aging behavior of low voltage and medium cables in nuclear power plants (NPPs) and identifies potential knowledge gaps with regard to cable operation beyond 60 years. The greatest area of uncertainty relates to how well the accelerated aging used in the original equipment qualification (EQ) processes predicts the performance of cable materials in extended operation. General opinion and utility experience have indicated that actual operating environments of in-plant cables are not as severe, however, asmore » the operating and design basis environments used in the qualification process. Better understanding of the long term aging behavior of cable insulation materials in service conditions and the analysis of actual cable operating environments are the objectives of ongoing research to support subsequent license renewal activities in particular and long term cable aging management in general. A key component of the effort to better understand cable material aging behavior is the availability of representative samples of cables that have been installed in operating light water reactors and have experienced long term service. Unique access to long term service cables, including relatively rich information on cable identity and history, occurred in 2016 through the assistance of the Electric Power Research Institute (EPRI). EPRI facilitated DOE receipt of harvested cables from the decommissioned Crystal River Unit 3 (CR3) pressurized water reactor representing six of the nine most common low voltage cable manufacturers (EPRI 103841R1): Rockbestos, Anaconda Wire and Cable Company (Anaconda), Boston Insulated Wire (BIW), Brand-Rex, Kerite and Okonite. Cable samples received had been installed in the operating plant for durations ranging from 10 years to 36 years. These cables provide the opportunity to assess actual in-plant material aging and compare it to the expectations for service aging implied in original equipment qualification. The received samples are from cables manufactured as early as 1971 and as late as 1998. Of the original manufacturers, BIW, Anaconda and Kerite no longer supply low-voltage cables to the nuclear industry. Okonite, Rockbestos, and Brand-Rex do still supply nuclear-grade low-voltage cables, but most cable insulation formulations have changed over the years. Thus the availability of the CR3 samples representative of cables installed in existing U.S. NPPs also presents the opportunity for additional aging studies on the most relevant insulation and jacketing materials. This report describes the cables received from CR3 through EPRI assistance, some of the specific knowledge gaps that study of these cable materials can be used to address, and experimental plans for addressing those gaps using these materials. Harvested cables from CR3 and other NPPs that have experienced long term service, new old stock cables (manufactured before 2000, but never put in service), and relevant modern nuclear cables and materials from cable manufacturers are enabling research to address identified knowledge gaps and better understand long term aging behavior for cable materials currently installed in NPPs. This research, combined with refined understanding of actual service environments and conditions, will both support subsequent licensing activities and more efficient plant cable aging management.« less

Ten-year assessment of the 100 priority questions for global biodiversity conservation.

PubMed

Jucker, Tommaso; Wintle, Bonnie; Shackelford, Gorm; Bocquillon, Pierre; Geffert, Jan Laurens; Kasoar, Tim; Kovacs, Eszter; Mumby, Hannah S; Orland, Chloé; Schleicher, Judith; Tew, Eleanor R; Zabala, Aiora; Amano, Tatsuya; Bell, Alexandra; Bongalov, Boris; Chambers, Josephine M; Corrigan, Colleen; Durán, América P; Duvic-Paoli, Leslie-Anne; Emilson, Caroline; da Silva, Jéssica Fonseca; Garnett, Emma E; Green, Elizabeth J; Guth, Miriam K; Hacket-Pain, Andrew; Hinsley, Amy; Igea, Javier; Kunz, Martina; Luke, Sarah H; Lynam, William; Martin, Philip A; Nunes, Matheus H; Ockendon, Nancy; Pavitt, Aly; Payne, Charlotte L R; Plutshack, Victoria; Rademacher, Tim T; Robertson, Rebecca J; Rose, David C; Serban, Anca; Simmons, Benno I; Emilson, Erik J S; Tayleur, Catherine; Wordley, Claire F R; Mukherjee, Nibedita

2018-06-20

In 2008, a group of conservation scientists compiled a list of 100 priority questions for the conservation of the world's biodiversity [Sutherland et al. (2009) Conservation Biology, 23, 557-567]. However, now almost a decade later, no one has yet published a study gauging how much progress has been made in addressing these 100 high-priority questions in the peer-reviewed literature. Here we take a first step toward re-examining the 100 questions and identify key knowledge gaps that still remain. Through a combination of a questionnaire and a literature review, we evaluated each of the 100 questions on the basis of two criteria: relevance and effort. We defined highly-relevant questions as those which - if answered - would have the greatest impact on global biodiversity conservation, while effort was quantified based on the number of review publications addressing a particular question, which we used as a proxy for research effort. Using this approach we identified a set of questions that, despite being perceived as highly relevant, have been the focus of relatively few review publications over the past ten years. These questions covered a broad range of topics but predominantly tackled three major themes: the conservation and management of freshwater ecosystems, the role of societal structures in shaping interactions between people and the environment, and the impacts of conservation interventions. We see these questions as important knowledge gaps that have so far received insufficient attention and may need to be prioritised in future research. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Let's Talk About B: Barriers to Hepatitis B Screening and Vaccination Among Asian and South Asian Immigrants in British Columbia.

PubMed

Zibrik, Lindsay; Huang, Alan; Wong, Vivian; Novak Lauscher, Helen; Choo, Queenie; Yoshida, Eric M; Ho, Kendall

2018-03-19

Chronic hepatitis B (HBV) is prevalent among Asian immigrants in Canada with high morbidity and mortality rates. While some studies have identified barriers to health care and information access, few have studied the impact of culturally relevant information and addressed challenges with recommendations for effective public education and outreach programs. Culturally tailored HBV education workshops were delivered over a 12-month period to Chinese, Filipino, Korean and Punjabi immigrants in Lower Mainland, British Columbia (BC). Data from pre- and post-workshop surveys and 2-week and 1-month follow-up interviews were collected and analyzed to evaluate knowledge gaps and challenges around HBV prevention and screening. Barriers, health care service gaps and facilitators identified in the interviews were coded and analyzed. Data were collected from 827 workshop participants. Our results show that targeted immigrants in Lower Mainland, BC face many barriers to accessing HBV screening and vaccination. Limited knowledge and awareness of HBV vaccination/prevention/treatment, limited English proficiency and eLiteracy skills, system and provider level barriers to accessing HBV care, and immigration related barriers are among the reported challenges. More than half of participants who took part in the HBV education workshops engaged in actions related to HBV prevention or management. Study findings support the need for culturally tailored HBV public education and outreach programs to further advance HBV immunization and awareness in BC. Addressing barriers and developing targeted programmatic strategies identified in this study will promote more effective HBV education programming and improve uptake of HBV screening and vaccination in BC's immigrant populations.

Ovarian Cancer: Deaf and Hearing Women’s Knowledge Before and After an Educational Video

PubMed Central

Jensen, Lindsay G.; Nakaji, Melanie; Harry, Kadie M.; Gallegos, Nick; Malcarne, Vanessa L.; Sadler, Georgia Robins

2013-01-01

Members of the Deaf community report language and cultural barriers to accessing health information and care. This study evaluated whether an ovarian cancer education video in American Sign Language with English captioning and voiceover could close the anticipated knowledge gap between Deaf and hearing women’s cancer knowledge. Consented Deaf (n = 55) and hearing (n = 52) women’s General, Ovarian, and Total Cancer Knowledge were assessed before and after viewing the video. At baseline, hearing women demonstrated significantly higher General, Ovarian, and Total Cancer Knowledge scores than Deaf women. By the post-test, all of Deaf women’s knowledge scores had increased, closing the baseline gap. However, hearing women’s post-video knowledge had also increased, thereby creating a new knowledge gap. The ovarian cancer education video offers an effective method to increase ovarian and general cancer knowledge for Deaf and hearing women. PMID:23975658

Implementing Implementation Science: An Approach for HIV Prevention, Care and Treatment Programs.

PubMed

Lambdin, Barrot H; Cheng, Ben; Peter, Trevor; Mbwambo, Jessie; Apollo, Tsitsi; Dunbar, Megan; Udoh, Ifeoma C; Cattamanchi, Adithya; Geng, Elvin H; Volberding, Paul

2015-01-01

Though great progress has been realized over the last decade in extending HIV prevention, care and treatment in some of the least resourced settings of the world, a substantial gap remains between what we know works and what we are actually achieving in HIV programs. To address this, leaders have called for the adoption of an implementation science framework to improve the efficiency and effectiveness of HIV programs. Implementation science (IS) is a multidisciplinary scientific field that seeks generalizable knowledge about the magnitude of, determinants of and strategies to close the gap between evidence and routine practice for health in real-world settings. We propose an IS approach that is iterative in nature and composed of four major components: 1) Identifying Bottlenecks and Gaps, 2) Developing and Implementing Strategies, 3) Measuring Effectiveness and Efficiency, and 4) Utilizing Results. With this framework, IS initiatives draw from a variety of disciplines including qualitative and quantitative methodologies in order to develop new approaches responsive to the complexities of real world program delivery. In order to remain useful for the changing programmatic landscape, IS research should factor in relevant timeframes and engage the multi-sectoral community of stakeholders, including community members, health care teams, program managers, researchers and policy makers, to facilitate the development of programs, practices and polices that lead to a more effective and efficient global AIDS response. The approach presented here is a synthesis of approaches and is a useful model to address IS-related questions for HIV prevention, care and treatment programs. This approach, however, is not a panacea, and we will continue to learn new ways of thinking as we move forward to close the implementation gap.

Implementing Implementation Science: An Approach for HIV Prevention, Care and Treatment Programs

PubMed Central

Lambdin, Barrot H.; Cheng, Ben; Peter, Trevor; Mbwambo, Jessie; Apollo, Tsitsi; Dunbar, Megan; Udoh, Ifeoma C.; Cattamanchi, Adithya; Geng, Elvin H.; Volberding, Paul

2015-01-01

Though great progress has been realized over the last decade in extending HIV prevention, care and treatment in some of the least resourced settings of the world, a substantial gap remains between what we know works and what we are actually achieving in HIV programs. To address this, leaders have called for the adoption of an implementation science framework to improve the efficiency and effectiveness of HIV programs. Implementation science (IS) is a multidisciplinary scientific field that seeks generalizable knowledge about the magnitude of, determinants of and strategies to close the gap between evidence and routine practice for health in real-world settings. We propose an IS approach that is iterative in nature and composed of four major components: 1) Identifying Bottlenecks and Gaps, 2) Developing and Implementing Strategies, 3) Measuring Effectiveness and Efficiency, and 4) Utilizing Results. With this framework, IS initiatives draw from a variety of disciplines including qualitative and quantitative methodologies in order to develop new approaches responsive to the complexities of real world program delivery. In order to remain useful for the changing programmatic landscape, IS research should factor in relevant timeframes and engage the multi-sectoral community of stakeholders, including community members, health care teams, program managers, researchers and policy makers, to facilitate the development of programs, practices and polices that lead to a more effective and efficient global AIDS response. The approach presented here is a synthesis of approaches and is a useful model to address IS-related questions for HIV prevention, care and treatment programs. This approach, however, is not a panacea, and we will continue to learn new ways of thinking as we move forward to close the implementation gap. PMID:25986374

An exploratory analysis of the nature of informal knowledge underlying theories of planned action used for public health oriented knowledge translation.

PubMed

Kothari, Anita; Boyko, Jennifer A; Campbell-Davison, Andrea

2015-09-09

Informal knowledge is used in public health practice to make sense of research findings. Although knowledge translation theories highlight the importance of informal knowledge, it is not clear to what extent the same literature provides guidance in terms of how to use it in practice. The objective of this study was to address this gap by exploring what planned action theories suggest in terms of using three types of informal knowledge: local, experiential and expert. We carried out an exploratory secondary analysis of the planned action theories that informed the development of a popular knowledge translation theory. Our sample included twenty-nine (n = 29) papers. We extracted information from these papers about sources of and guidance for using informal knowledge, and then carried out a thematic analysis. We found that theories of planned action provide guidance (including sources of, methods for identifying, and suggestions for use) for using local, experiential and expert knowledge. This study builds on previous knowledge translation related work to provide insight into the practical use of informal knowledge. Public health practitioners can refer to the guidance summarized in this paper to inform their decision-making. Further research about how to use informal knowledge in public health practice is needed given the value being accorded to using informal knowledge in public health decision-making processes.

The trend in mental health-related mortality rates in Australia 1916-2004: implications for policy

PubMed Central

2010-01-01

Background This study determines the trend in mental health-related mortality (defined here as the aggregation of suicide and deaths coded as "mental/behavioural disorders"), and its relative numerical importance, and to argue that this has importance to policy-makers. Its results will have policy relevance because policy-makers have been predominantly concerned with cost-containment, but a re-appraisal of this issue is occurring, and the trade-off between health expenditures and valuable gains in longevity is being emphasised now. This study examines longevity gains from mental health-related interventions, or their absence, at the population level. The study sums mortality data for suicide and mental/behavioural disorders across the relevant ICD codes through time in Australia for the period 1916-2004. There are two measures applied to the mortality rates: the conventional age-standardised headcount; and the age-standardised Potential Years of Life Lost (PYLL), a measure of premature mortality. Mortality rates formed from these data are analysed via comparisons with mortality rates for All Causes, and with circulatory diseases, cancer and motor vehicle accidents, measured by both methods. Results This study finds the temporal trend in mental health-related mortality rates (which reflects the longevity of people with mental illness) has worsened through time. There are no gains. This trend contrasts with the (known) gains in longevity from All Causes, and the gains from decreases achieved in previously rising mortality rates from circulatory diseases and motor vehicle accidents. Also, PYLL calculation shows mental health-related mortality is a proportionately greater cause of death compared with applying headcount metrics. Conclusions There are several factors that could reverse this trend. First, improved access to interventions or therapies for mental disorders could decrease the mortality analysed here. Second, it is important also that new efficacious therapies for various mental disorders be developed. Furthermore, it is also important that suicide prevention strategies be implemented, particularly for at-risk groups. To bring the mental health sector into parity with many other parts of the health system will require knowledge of the causative factors that underlie mental disorders, which can, in turn, lead to efficacious therapies. As in any case of a knowledge deficit, what is needed are resources to address that knowledge gap. Conceiving the problem in this way, ie as a knowledge gap, indicates the crucial role of research and development activity. This term implies a concern, not simply with basic research, but also with applied research. It is commonplace in other sectors of the economy to emphasise the trichotomy of invention, innovation and diffusion of new products and processes. This three-fold conception is also relevant to addressing the knowledge gap in the mental health sector. PMID:20145728

Development of STEADI: a fall prevention resource for health care providers.

PubMed

Stevens, Judy A; Phelan, Elizabeth A

2013-09-01

Falls among people aged ≥65 years are the leading cause of both injury deaths and emergency department visits for trauma. Research shows that many falls are preventable. In the clinical setting, an effective fall intervention involves assessing and addressing an individual's fall risk factors. This individualized approach is recommended in the American and British Geriatrics Societies' (AGS/BGS) practice guideline. This article describes the development of STEADI (Stopping Elderly Accidents, Deaths, and Injuries), a fall prevention tool kit that contains an array of health care provider resources for assessing and addressing fall risk in clinical settings. As researchers at the Centers for Disease Control and Prevention's Injury Center, we reviewed relevant literature and conducted in-depth interviews with health care providers to determine current knowledge and practices related to older adult fall prevention. We developed draft resources based on the AGS/BGS guideline, incorporated provider input, and addressed identified knowledge and practice gaps. Draft resources were reviewed by six focus groups of health care providers and revised. The completed STEADI tool kit, Preventing Falls in Older Patients-A Provider Tool Kit, is designed to help health care providers incorporate fall risk assessment and individualized fall interventions into routine clinical practice and to link clinical care with community-based fall prevention programs.

Development of STEADI: A Fall Prevention Resource for Health Care Providers

PubMed Central

Stevens, Judy A.; Phelan, Elizabeth A.

2015-01-01

Falls among people aged ≥65 years are the leading cause of both injury deaths and emergency department visits for trauma. Research shows that many falls are preventable. In the clinical setting, an effective fall intervention involves assessing and addressing an individual’s fall risk factors. This individualized approach is recommended in the American and British Geriatrics Societies’ (AGS/BGS) practice guideline. This article describes the development of STEADI (Stopping Elderly Accidents, Deaths, and Injuries), a fall prevention tool kit that contains an array of health care provider resources for assessing and addressing fall risk in clinical settings. As researchers at the Centers for Disease Control and Prevention’s Injury Center, we reviewed relevant literature and conducted in-depth interviews with health care providers to determine current knowledge and practices related to older adult fall prevention. We developed draft resources based on the AGS/BGS guideline, incorporated provider input, and addressed identified knowledge and practice gaps. Draft resources were reviewed by six focus groups of health care providers and revised. The completed STEADI tool kit, Preventing Falls in Older Patients—A Provider Tool Kit, is designed to help health care providers incorporate fall risk assessment and individualized fall interventions into routine clinical practice and to link clinical care with community-based fall prevention programs. PMID:23159993

The Achievement Gap in Reading: Complex Causes, Persistent Issues, Possible Solutions

ERIC Educational Resources Information Center

Horowitz, Rosalind, Ed.; Samuels, S. Jay, Ed.

2017-01-01

In this volume prominent scholars, experts in their respective fields and highly skilled in the research they conduct, address educational and reading research from varied perspectives and address what it will take to close the achievement gap--with specific attention to reading. The achievement gap is redefined as a level at which all groups can…

The contribution of a gender perspective to the understanding of migrants' health

PubMed Central

Llácer, Alicia; Zunzunegui, María Victoria; del Amo, Julia; Mazarrasa, Lucía; Bolůmar, Francisco

2007-01-01

In 2005 women represented approximately half of all 190 million international migrants worldwide. This paper addresses the need to integrate a gender perspective into epidemiological studies on migration and health, outlines conceptual gaps and discusses some methodological problems. We mainly consider the international voluntary migrant. Women may emigrate as wives or as workers in a labour market in which they face double segregation, both as migrants and as women. We highlight migrant women's heightened vulnerability to situations of violence, as well as important gaps in our knowledge of the possible differential health effects of factors such as poverty, unemployment, social networks and support, discrimination, health behaviours and use of services. We provide an overview of the problems of characterising migrant populations in the health information systems, and of possible biases in the health effects caused by failure to take the triple dimension of gender, social class and ethnicity into account. PMID:18000117

Case Studies in Exercise and Sport Sciences: A Powerful Tool to Bridge the Science-Practice Gap.

PubMed

Halperin, Israel

2018-03-27

Despite the progress made by the scientific exercise community in collaborating and communicating with non-scientist coaches, there is room for improvement. Coaches find research difficult to understand, feel that their interests are not being addressed by exercise research, and rely on peer-discussion to further their coaching knowledge base while consuming little peer-reviewed articles. One useful strategy to bridge the science-practice gap is with case-studies. In addition to furthering our understanding of the physiology, psychology, and training schedules of elite athletes, case studies can serve 1) as a useful communication channel with coaches if presented as narratives and 2) to establish and strengthen relationships between scientists and coaches leading to fruitful research collaborations. The purpose of this invited commentary is to discuss these two less-recognized benefits of case-studies, and propose a way to incorporate case-studies more frequently alongside group-based studies.

Case Studies in Exercise and Sport Sciences: A Powerful Tool to Bridge the Science-Practice Gap.

PubMed

Halperin, Israel

2018-06-21

Despite the progress made by the scientific exercise community in collaborating and communicating with nonscientist coaches, there is room for improvement. Coaches find research difficult to understand, feel that their interests are not being addressed by exercise research, and rely on peer discussion to further their coaching knowledge base while consuming few peer-reviewed articles. One useful strategy to bridge the science-practice gap is with case studies. In addition to furthering our understanding of the physiology, psychology, and training schedules of elite athletes, case studies can serve (1) as a useful communication channel with coaches if presented as narratives and (2) to establish and strengthen relationships between scientists and coaches, leading to fruitful research collaborations. The purpose of this invited commentary is to discuss these 2 less-recognized benefits of case studies and propose a way to incorporate case studies more frequently alongside group-based studies.

An interprofessional consensus of core competencies for prelicensure education in pain management: curriculum application for nursing.

PubMed

Herr, Keela; Marie, Barbara St; Gordon, Debra B; Paice, Judith A; Watt-Watson, Judy; Stevens, Bonnie J; Bakerjian, Debra; Young, Heather M

2015-06-01

Ineffective assessment and management of pain is a significant problem. A gap in prelicensure health science program pain content has been identified for the improvement of pain care in the United States. Through consensus processes, an expert panel of nurses, who participated in the interdisciplinary development of core competencies in pain management for prelicensure health professional education, developed recommendations to address the gap in nursing curricula. Challenges and incentives for implementation of pain competencies in nursing education are discussed, and specific recommendations for how to incorporate the competencies into entry-level nursing curricula are provided. Embedding pain management core competencies into prelicensure nursing education is crucial to ensure that nurses have the essential knowledge and skills to effectively manage pain and to serve as a foundation on which clinical practice skills can be later honed. [J Nurs Educ. 2015;54(6):317-327.]. Copyright 2015, SLACK Incorporated.

Enhancing Diversity in Biomedical Data Science

PubMed Central

Canner, Judith E.; McEligot, Archana J.; Pérez, María-Eglée; Qian, Lei; Zhang, Xinzhi

2017-01-01

The gap in educational attainment separating underrepresented minorities from Whites and Asians remains wide. Such a gap has significant impact on workforce diversity and inclusion among cross-cutting Biomedical Data Science (BDS) research, which presents great opportunities as well as major challenges for addressing health disparities. This article provides a brief description of the newly established National Institutes of Health Big Data to Knowledge (BD2K) diversity initiatives at four universities: California State University, Monterey Bay; Fisk University; University of Puerto Rico, Río Piedras Campus; and California State University, Fullerton. We emphasize three main barriers to BDS careers (ie, preparation, exposure, and access to resources) experienced among those pioneer programs and recommendations for possible solutions (ie, early and proactive mentoring, enriched research experience, and data science curriculum development). The diversity disparities in BDS demonstrate the need for educators, researchers, and funding agencies to support evidence-based practices that will lead to the diversification of the BDS workforce PMID:28439180

Factors Influencing Successful Prescribing by Intern Doctors: A Qualitative Systematic Review

PubMed Central

R. Hansen, Christina; Bradley, Colin P.; Sahm, Laura J.

2016-01-01

As the majority of prescribing in hospital is undertaken by intern doctors, the aims of this systematic review were to compile the evidence of the qualitative literature on the views and experiences of intern doctors and to examine the role of the pharmacist in assisting in prescribing by interns. A systematic review of the qualitative literature was done according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. The findings were synthesized using thematic analysis. Seven publications were included. Factors influencing prescribing behaviour were related to the environment; collaboration in medical teams; hierarchical structures; and patient and individual factors. This review confirmed that interns’ prescribing behaviour is influenced by multiple factors, and further highlighted the need for an educational intervention that supports the intern completing the prescribing task in a complex environment, and not just addresses the presumed knowledge gap(s). PMID:28970397

Factors Influencing Successful Prescribing by Intern Doctors: A Qualitative Systematic Review.

PubMed

R Hansen, Christina; Bradley, Colin P; Sahm, Laura J

2016-08-24

As the majority of prescribing in hospital is undertaken by intern doctors, the aims of this systematic review were to compile the evidence of the qualitative literature on the views and experiences of intern doctors and to examine the role of the pharmacist in assisting in prescribing by interns. A systematic review of the qualitative literature was done according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. The findings were synthesized using thematic analysis. Seven publications were included. Factors influencing prescribing behaviour were related to the environment; collaboration in medical teams; hierarchical structures; and patient and individual factors. This review confirmed that interns' prescribing behaviour is influenced by multiple factors, and further highlighted the need for an educational intervention that supports the intern completing the prescribing task in a complex environment, and not just addresses the presumed knowledge gap(s).

The strategy, organization, and progress of the HUPO Human Proteome Project.

PubMed

Omenn, Gilbert S

2014-04-04

The Human Proteome Project is a major, comprehensive initiative of the Human Proteome Organization. This global collaborative effort aims to identify and characterize at least one protein product and many PTM, SAP, and splice variant isoforms from the 20,300 human protein-coding genes. The deliverables are an extensive parts list and an array of technology platforms, reagents, spectral libraries, and linked knowledge bases that advance the field and facilitate the use of proteomics by a much wider community of life scientists. Such enablement will help address the Grand Challenge of using proteomics to bridge major gaps between evidence of genomic variation and diverse phenotypes. The HUPO Human Proteome Project (HPP) has made an outstanding launch, including a special issue of the Journal of Proteome Research on the Chromosome-centric HPP with a total of 48 articles. This article is part of a Special Issue: Can Proteomics Fill the Gap Between Genomics and Phenotypes? © 2013.

An Interprofessional Consensus of Core Competencies for Prelicensure Education in Pain Management: Curriculum Application for Nursing

PubMed Central

Herr, Keela; St. Marie, Barbara; Gordon, Debra B.; Paice, Judith A.; Watt-Watson, Judy; Stevens, Bonnie J.; Bakerjian, Debra; Young, Heather M.

2015-01-01

Background Ineffective assessment and management of pain is a significant problem. A gap in prelicensure health science program pain content has been identified for the improvement of pain care in the United States. Method Through consensus processes, an expert panel of nurses, who participated in the interdisciplinary development of core competencies in pain management for prelicensure health professional education, developed recommendations to address the gap in nursing curricula. Results Challenges and incentives for implementation of pain competencies in nursing education are discussed, and specific recommendations for how to incorporate the competencies into entry-level nursing curricula are provided. Conclusion Embedding pain management core competencies into prelicensure nursing education is crucial to ensure that nurses have the essential knowledge and skills to effectively manage pain and to serve as a foundation on which clinical practice skills can be later honed. PMID:26057425

The microbiome in allergic disease: Current understanding and future opportunities-2017 PRACTALL document of the American Academy of Allergy, Asthma & Immunology and the European Academy of Allergy and Clinical Immunology.

PubMed

Huang, Yvonne J; Marsland, Benjamin J; Bunyavanich, Supinda; O'Mahony, Liam; Leung, Donald Y M; Muraro, Antonella; Fleisher, Thomas A

2017-04-01

PRACTALL is a joint initiative of the American Academy of Allergy, Asthma & Immunology and the European Academy of Allergy and Clinical Immunology to provide shared evidence-based recommendations on cutting-edge topics in the field of allergy and immunology. PRACTALL 2017 is focused on what has been established regarding the role of the microbiome in patients with asthma, atopic dermatitis, and food allergy. This is complemented by outlining important knowledge gaps regarding its role in allergic disease and delineating strategies necessary to fill these gaps. In addition, a review of progress in approaches used to manipulate the microbiome will be addressed, identifying what has and has not worked to serve as a baseline for future directions to intervene in allergic disease development, progression, or both. Copyright © 2017. Published by Elsevier Inc.

The microbiome in allergic disease: Current understanding and future opportunities—2017 PRACTALL document of the American Academy of Allergy, Asthma & Immunology and the European Academy of Allergy and Clinical Immunology

PubMed Central

Huang, Yvonne J.; Marsland, Benjamin J.; Bunyavanich, Supinda; O’Mahony, Liam; Leung, Donald Y. M.; Muraro, Antonella; Fleisher, Thomas A.

2018-01-01

PRACTALL is a joint initiative of the American Academy of Allergy, Asthma & Immunology and the European Academy of Allergy and Clinical Immunology to provide shared evidence-based recommendations on cutting-edge topics in the field of allergy and immunology. PRACTALL 2017 is focused on what has been established regarding the role of the microbiome in patients with asthma, atopic dermatitis, and food allergy. This is complemented by outlining important knowledge gaps regarding its role in allergic disease and delineating strategies necessary to fill these gaps. In addition, a review of progress in approaches used to manipulate the microbiome will be addressed, identifying what has and has not worked to serve as a baseline for future directions to intervene in allergic disease development, progression, or both. PMID:28257972

Sexual Assault Simulation Course for Healthcare Providers: Enhancing Sexual Assault Education Using Simulation.

PubMed

Scannell, Meredith; Lewis-O'Connor, Annie; Barash, Ashley

2015-01-01

Patients who have been sexually assaulted disproportionately experience gaps in healthcare delivery. Ensuring that healthcare providers who care for this population are adequately prepared is one way of addressing this gap. At the Brigham and Women's Hospital, a 4-hour long interprofessional Sexual Assault Simulation Course for Healthcare Providers (SASH) was developed and conducted at the hospital's Simulation, Training, Research, & Technology Utilization System Center. The SASH is offered using a variety of teaching methodologies including didactics, skill stations comprising how to collect forensic evidence, simulation experience with standardized patient, and debriefing. Using simulation as an educational method allows healthcare professionals to gain hands-on skills in a safe environment. Ultimately, the goal of the SASH is to enhance collaborative practice between healthcare professionals and to improve knowledge, with the purpose of improving care for patients who have been sexually assaulted.

Strategies for Supporting Physician-Scientists in Faculty Roles: A Narrative Review With Key Informant Consultations.

PubMed

Lingard, Lorelei; Zhang, Peter; Strong, Michael; Steele, Margaret; Yoo, John; Lewis, James

2017-10-01

Physician-scientists are a population in decline globally. Solutions to reverse this decline often have focused on the training pipeline. Less attention has been paid to reducing attrition post training, when physician-scientists take up faculty roles. However, this period is a known time of vulnerability because of the pressures of clinical duties and the long timeline to securing independent research funding. This narrative review explored existing knowledge regarding how best to support physician-scientists for success in their faculty roles. The authors searched the Medline, Embase, ERIC, and Cochrane Library databases for articles published from 2000 to 2016 on this topic and interviewed key informants in 2015 to solicit their input on the review results. The authors reviewed 78 articles and interviewed 16 key informants. From the literature, they developed a framework of organizational (facilitate mentorship, foster community, value the physician-scientist role, minimize financial barriers) and individual (develop professional and research skills) strategies for supporting physician-scientists. They also outlined key knowledge gaps representing topics either rarely or never addressed in the reviewed articles (percent research time, structural hypocrisy, objective assessment, group metrics, professional identity). The key informants confirmed the identified strategies and discussed how the gaps were particularly important and impactful. This framework offers a basis for assessing an organization's existing support strategies, identifying outstanding needs, and developing targeted programming. The identified gaps require attention, as they threaten to undermine the benefits of existing support strategies.

Professional Journals as a Source of PCK for Teaching Nature of Science: An Examination of Articles Published in The Science Teacher (TST) (an NSTA Journal), 1995-2010

NASA Astrophysics Data System (ADS)

Aydın, Sevgi; Demirdöğen, Betül; Muslu, Nilay; Hanuscin, Deborah L.

2013-10-01

A number of science education policy documents recommend that students develop an understanding of the enterprise of science and the nature of science (NOS). Despite this emphasis, there is still a gap between policy and practice. Teacher professional literature provides one potential venue for bridging this gap, by providing “activities that work” (Appleton in elementary science teacher education: International perspectives on contemporary issues and practice. Lawrence Erlbaum Associates, Mahwah, NJ, 2006) that can scaffold teachers’ developing pedagogical content knowledge (PCK) for teaching NOS. We analyzed articles published in the NSTA journal The Science Teacher (1995-2010) in terms of the degree to which they provide appropriate model activities and specific information that can support the development of teachers’ PCK for teaching NOS. Our analysis revealed a diversity of NOS aspects addressed by the authors and a wide range of variation in the percent of articles focused on each aspect. Additionally, we found that few articles provided robust information related to all the component knowledge bases of PCK for NOS. In particular, within the extant practitioner literature, there are few models for teaching the aspects of NOS, such as the function and nature of scientific theory. Furthermore, though articles provided information relevant to informing teachers’ knowledge of instructional strategies for NOS, relevant information to inform teachers’ knowledge of assessment in this regard was lacking. We provide recommendations for ways in which the practitioner literature may support teachers’ teaching of NOS through more robust attention to the types of knowledge research indicates are needed in order to teaching NOS effectively.

Development of a training program to support health care professionals to deliver the SPACE for COPD self-management program

PubMed Central

Blackmore, Claire; Johnson-Warrington, Vicki L; Williams, Johanna EA; Apps, Lindsay D; Young, Hannah ML; Bourne, Claire LA; Singh, Sally J

2017-01-01

Background With the growing burden of COPD and associated morbidity and mortality, a need for self-management has been identified. The Self-management Programme of Activity, Coping and Education for Chronic Obstructive Pulmonary Disease (SPACE for COPD) manual was developed to support self-management in COPD patients. Currently, there is no literature available regarding health care professionals’ training needs when supporting patients with COPD on self-management. Aim This study sought to identify these needs to inform, design and develop a training program for health care professionals being trained to deliver a self-management program in COPD. Methods Fourteen health care professionals from both primary and secondary care COPD services participated in face-to-face semistructured interviews. Thematic analysis was used to produce a framework and identify training needs and views on delivery of the SPACE for COPD self-management program. Components of training were web-based knowledge training, with pre-and posttraining knowledge questionnaires, and a 1-day program to introduce the self-management manual. Feedback was given after training to guide the development of the training program. Results Health care professionals were able to identify areas where they required increased knowledge to support patients. This was overwhelming in aspects of COPD seen to be outside of their current clinical role. Skills in goal setting and behavioral change were not elicited as a training need, suggesting a lack of understanding of components of supporting self-management. An increase in knowledge of COPD was demonstrated following the training program. Conclusion Both knowledge and skill gaps existed in those who would deliver self-management. Analysis of this has enabled a training program to be designed to address these gaps and enable health care professionals to support patients in self-management. PMID:28652720

Development of a training program to support health care professionals to deliver the SPACE for COPD self-management program.

PubMed

Blackmore, Claire; Johnson-Warrington, Vicki L; Williams, Johanna Ea; Apps, Lindsay D; Young, Hannah Ml; Bourne, Claire LA; Singh, Sally J

2017-01-01

With the growing burden of COPD and associated morbidity and mortality, a need for self-management has been identified. The Self-management Programme of Activity, Coping and Education for Chronic Obstructive Pulmonary Disease (SPACE for COPD) manual was developed to support self-management in COPD patients. Currently, there is no literature available regarding health care professionals' training needs when supporting patients with COPD on self-management. This study sought to identify these needs to inform, design and develop a training program for health care professionals being trained to deliver a self-management program in COPD. Fourteen health care professionals from both primary and secondary care COPD services participated in face-to-face semistructured interviews. Thematic analysis was used to produce a framework and identify training needs and views on delivery of the SPACE for COPD self-management program. Components of training were web-based knowledge training, with pre-and posttraining knowledge questionnaires, and a 1-day program to introduce the self-management manual. Feedback was given after training to guide the development of the training program. Health care professionals were able to identify areas where they required increased knowledge to support patients. This was overwhelming in aspects of COPD seen to be outside of their current clinical role. Skills in goal setting and behavioral change were not elicited as a training need, suggesting a lack of understanding of components of supporting self-management. An increase in knowledge of COPD was demonstrated following the training program. Both knowledge and skill gaps existed in those who would deliver self-management. Analysis of this has enabled a training program to be designed to address these gaps and enable health care professionals to support patients in self-management.

[Boys' health survey-between gender gap and information backlog].

PubMed

Grundl, S; Kranz, J; Rosellen, J; Steffens, C; Steffens, J

2018-05-02

Early detection examinations take place from birth to the age of 6 years. The youth screening is a continuation of the screening of the "U-series" and should be carried out between the age of 12-15 and 16-17, respectively. Afterwards adolescent girls have good contact with a gynecologist, but adolescent boys usually do not have a medical contact person who they can trust in. To evaluate the state of knowledge on boys' health, a 15-item comprehensive knowledge survey was conducted among ninth grade students at 7 secondary schools (Gymnasien) in North Rhine-Westphalia. The knowledge survey took place at three specified times (before, immediately after and approximately 3 months after adolescent sexual education classes). Only completed questionnaires were analyzed and evaluated in a gender-specific manner. Overall, 459 students participated from March-September 2017. Before sexual education instruction, about half of all questions were answered correctly by the students. Immediately after class, the proportion increased by a factor of 1.5 to a total of 79.24%. Then 2-3 months after the class, the percentage was 69.67%. Considering gender separately, this resulted in an increase of 15.32% for the female students and 16.99% for the male students. The knowledge survey reveals a need to catch up on facts on the subject of boys' health. Despite evidence of an increase in knowledge of both sexes after sexual education instruction, there is a gender gap. Hence, a preventive check-up especially for boys should be established and offered. Issues such as the prevention of sexually transmitted diseases, options for vaccination against human papillomavirus, etc. should be actively addressed.

Local newspapers, drinking water pathways, and dimensions of knowledge: Public awareness amid the hydrofracking debate

NASA Astrophysics Data System (ADS)

Berg, Weston

Studies on determinants of pro-environmental behavior have found environmental knowledge to be a prerequisite for public participation. While much has been written on correlations between media coverage and environmental knowledge in general, a gap exists concerning the linkages between media coverage and knowledge of an individual's local environment. This study measures public awareness of local drinking water supplies in urban communities, using a face-to-face survey of 90 respondents in three upstate New York cities. The findings show no significant correlation between newspaper coverage of local water issues and awareness of one's drinking water source; however, the surveys revealed high correlations between such awareness and home ownership (as opposed to renting) and between awareness and receiving a water bill. In addition, there was a positive correlation between reading about a local water-related issue (in this case, hydraulic fracturing for natural gas in the Marcellus Shale) in a local newspaper and possessing basic knowledge of that issue. These findings contribute to previous research on environmental knowledge, and have practical applications in efforts addressing: civic engagement, public understanding of science, citizen participation, and democratic practices. Keywords: Public understanding, environmental communication, water resources management, hydraulic fracturing, schema theory

"Prince Charming Syndrome?" Gender gap in preferences for defined contribution pensions in Japan.

PubMed

Watanabe, Satoshi P

2017-01-01

Using survey data collected by the Japan Institute of Life Insurance in 2002, this study finds that a significant gender gap existed in defined contribution (DC) pension knowledge among workers employed at small- to medium-sized private firms in Japan. Even with similar DC knowledge, however, men and women reveal different preferences for DC pensions, indicating that their perceptional responses may widely differ from actual behaviors. Apart from the knowledge gap, the result shows evidence of the Prince Charming Syndrome among female employees as a significant source of the gender gap in DC participation rates. Among corporate pension-covered employees, the gender difference in the efficacy of DC portability is a more significant gap-generating factor. DC tax advantage is particularly favored by pension-covered female employees over male counterparts, reducing the DC preference gap. No similar evidence is found for employees with no corporate pension coverage.

Enhanced microbial coalbed methane generation: A review of research, commercial activity, and remaining challenges

USGS Publications Warehouse

Ritter, Daniel J.; Vinson, David S.; Barnhart, Elliott P.; Akob, Denise M.; Fields, Matthew W.; Cunningham, Al B.; Orem, William H.; McIntosh, Jennifer C.

2015-01-01

Coalbed methane (CBM) makes up a significant portion of the world’s natural gas resources. The discovery that approximately 20% of natural gas is microbial in origin has led to interest in microbially enhanced CBM (MECoM), which involves stimulating microorganisms to produce additional CBM from existing production wells. This paper reviews current laboratory and field research on understanding processes and reservoir conditions which are essential for microbial CBM generation, the progress of efforts to stimulate microbial methane generation in coal beds, and key remaining knowledge gaps. Research has been primarily focused on identifying microbial communities present in areas of CBM generation and attempting to determine their function, in-situ reservoir conditions that are most favorable for microbial CBM generation, and geochemical indicators of metabolic pathways of methanogenesis (i.e., acetoclastic or hydrogenotrophic methanogenesis). Meanwhile, researchers at universities, government agencies, and companies have focused on four primary MECoM strategies: 1) microbial stimulation (i.e., addition of nutrients to stimulate native microbes); 2) microbial augmentation (i.e., addition of microbes not native to or abundant in the reservoir of interest); 3) physically increasing microbial access to coal and distribution of amendments; and 4) chemically increasing the bioavailability of coal organics. Most companies interested in MECoM have pursued microbial stimulation: Luca Technologies, Inc., successfully completed a pilot scale field test of their stimulation strategy, while two others, Ciris Energy and Next Fuel, Inc., have undertaken smaller scale field tests. Several key knowledge gaps remain that need to be addressed before MECoM strategies can be implemented commercially. Little is known about the bacterial community responsible for coal biodegradation and how these microorganisms may be stimulated to enhance microbial methanogenesis. In addition, research is needed to understand what fraction of coal is available for biodegradation, and methods need to be developed to determine the extent of in-situ coal biodegradation by MECoM processes for monitoring changes to coal quality. Questions also remain about how well field-scale pilot tests will scale to commercial production, how often amendments will need to be added to maintain new methane generation, and how well MECoM strategies transfer between coal basins with different formation water geochemistries and coal ranks. Addressing these knowledge gaps will be key in determining the feasibility and commercial viability of MECoM technology.

Obesity educational interventions in U.S. medical schools: a systematic review and identified gaps.

PubMed

Vitolins, Mara Z; Crandall, Sonia; Miller, David; Ip, Eddie; Marion, Gail; Spangler, John G

2012-01-01

Obesity is the second leading cause of preventable death in the United States. However, physicians feel poorly trained to address the obesity epidemic. This article examines effective training methods for overweight and obesity intervention in undergraduate medical education. Using indexing terms related to overweight, obesity, and medical student education, we conducted a literature searched PubMed PsycINFO, Cochrane, and ERIC for relevant articles in English. References from articles identified were also reviewed to located additional articles. We included all studies that incorporated process or outcome evaluations of obesity educational interventions for U.S. medical students. Of an initial 168 citations, 40 abstracts were retrieved; 11 studies were found to be pertinent to medical student obesity education, but only 5 included intervention and evaluation elements. Quality criteria for inclusion consisted of explicit evaluation of the educational methods used. Data extraction identified participants (e.g., year of medical students), interventions, evaluations, and results. These 5 studies successfully used a variety of teaching methods including hands on training, didactic lectures, role-playing, and standardized patient interaction to increase medical students' knowledge, attitudes, and skills regarding overweight and obesity intervention. Two studies addressed medical student bias toward overweight and obese patients. No studies addressed health disparities in the epidemiology and bias of obesity. Despite the commonly cited "obesity epidemic," there are very few published studies that report the effectiveness of medical school obesity educational programs. Gaps still exist within undergraduate medical education including specific training that addresses obesity and long-term studies showing that such training is retained.

Future Directions for Dissemination and Implementation Science: Aligning Ecological Theory and Public Health to Close the Research to Practice Gap

PubMed Central

Rusch, Dana; Mehta, Tara G.; Lakind, Davielle

2015-01-01

Dissemination and implementation science (DI) has evolved as a major research model for children’s mental health in response to a longstanding call to integrate science and practice and bridge the elusive research to practice gap. However, to address the complex and urgent needs of the most vulnerable children and families, future directions for DI require a new alignment of ecological theory and public health to provide effective, sustainable, and accessible mental health services. We present core principles of ecological theory to emphasize how contextual factors impact behavior and allow for the reciprocal impact individuals have on the settings they occupy, and an alignment of these principles with a public health model to ensure that services span the prevention to intervention continuum. We provide exemplars from our ongoing work in urban schools, and a new direction for research to address the mental health needs of immigrant Latino families. Through these examples we illustrate how DI can expand its reach by embedding within natural settings to build on local capacity and indigenous resources, incorporating the local knowledge necessary to more substantively address long-standing mental health disparities. This paradigm shift for DI, away from an over-emphasis on promoting program adoption, calls for fitting interventions within settings that matter most to children’s healthy development, and utilizing and strengthening available community resources. In this way, we can meet the challenge of addressing our nation’s mental health burden by supporting the needs and values of families and communities within their own unique social ecologies. PMID:26155972

Data Warehouse Governance Programs in Healthcare Settings: A Literature Review and a Call to Action

PubMed Central

Elliott, Thomas E.; Holmes, John H.; Davidson, Arthur J.; La Chance, Pierre-Andre; Nelson, Andrew F.; Steiner, John F.

2013-01-01

Purpose: Given the extensive data stored in healthcare data warehouses, data warehouse governance policies are needed to ensure data integrity and privacy. This review examines the current state of the data warehouse governance literature as it applies to healthcare data warehouses, identifies knowledge gaps, provides recommendations, and suggests approaches for further research. Methods: A comprehensive literature search using five data bases, journal article title-search, and citation searches was conducted between 1997 and 2012. Data warehouse governance documents from two healthcare systems in the USA were also reviewed. A modified version of nine components from the Data Governance Institute Framework for data warehouse governance guided the qualitative analysis. Results: Fifteen articles were retrieved. Only three were related to healthcare settings, each of which addressed only one of the nine framework components. Of the remaining 12 articles, 10 addressed between one and seven framework components and the remainder addressed none. Each of the two data warehouse governance plans obtained from healthcare systems in the USA addressed a subset of the framework components, and between them they covered all nine. Conclusions: While published data warehouse governance policies are rare, the 15 articles and two healthcare organizational documents reviewed in this study may provide guidance to creating such policies. Additional research is needed in this area to ensure that data warehouse governance polices are feasible and effective. The gap between the development of data warehouses in healthcare settings and formal governance policies is substantial, as evidenced by the sparse literature in this domain. PMID:25848561

Future Directions for Dissemination and Implementation Science: Aligning Ecological Theory and Public Health to Close the Research to Practice Gap.

PubMed

Atkins, Marc S; Rusch, Dana; Mehta, Tara G; Lakind, Davielle

2016-01-01

Dissemination and implementation science (DI) has evolved as a major research model for children's mental health in response to a long-standing call to integrate science and practice and bridge the elusive research to practice gap. However, to address the complex and urgent needs of the most vulnerable children and families, future directions for DI require a new alignment of ecological theory and public health to provide effective, sustainable, and accessible mental health services. We present core principles of ecological theory to emphasize how contextual factors impact behavior and allow for the reciprocal impact individuals have on the settings they occupy, and an alignment of these principles with a public health model to ensure that services span the prevention to intervention continuum. We provide exemplars from our ongoing work in urban schools and a new direction for research to address the mental health needs of immigrant Latino families. Through these examples we illustrate how DI can expand its reach by embedding within natural settings to build on local capacity and indigenous resources, incorporating the local knowledge necessary to more substantively address long-standing mental health disparities. This paradigm shift for DI, away from an overemphasis on promoting program adoption, calls for fitting interventions within settings that matter most to children's healthy development and for utilizing and strengthening available community resources. In this way, we can meet the challenge of addressing our nation's mental health burden by supporting the needs and values of families and communities within their own unique social ecologies.

Understanding and Controlling Lignocellulosic Pyrolysis for the Production of Renewable Fuel and Chemical Precursors

NASA Astrophysics Data System (ADS)

Pecha, Michael Brennan

Pyrolysis is a technology for producing fuels, chemicals, and engineered carbons from renewable feedstocks like lignocellulosic biomass. This work aims to address some of the scientific and technical hurdles that need to be overcome to control the products of pyrolysis. The first section aims to address knowledge gaps regarding primary pyrolysis reactions; in this study, pine wood was acid washed and small amounts of acid were impregnated into the biomass prior to pyrolysis. Results showed that the acid mitigated fragmentation reactions caused by residual metals and had further effect on production of sugars and oligomeric lignin products. The next section aims to address knowledge gaps regarding what reactions occur in the liquid intermediate phase in biomass pyrolysis; in these studies, a novel reactor system was built which could perform thin film fast pyrolysis studies at different pressures from 4 mbar to 1 atm with cellulose, milled wood lignin, and hybrid poplar wood. The reactor was carefully characterized to achieve comparable data between the different pressures. The use of vacuum allowed for control of the residence time of cellobiosan (one of cellulose oligomeric products) in the liquid intermediate. In the vacuum cellulose pyrolysis studies, a high resolution FT-ICR-MS was used for the first time to explore reaction chemistry for this system. The Van-Krevelen diagram of the resulting oligomeric products proved to be a powerful tool to study secondary reactions in the liquid intermediate. Our results show that the secondary reactions in the liquid intermediate are dominated by dehydration, fragmentation, and cross-linking reactions. The final section aims to address single particle external heat transfer problems; in this study, 500 microm long particles of pine and aspen poplar with realistic pore and surface morphologies were modeled in COMSOL to determine how microstructure effects the external heat transfer coefficients in the laminar flow regime. Results showed that microstructure did indeed affect heat transfer and that heat transfer correlations based on basic geometric shapes (sphere, cylinder, slab) were not accurate enough to estimate heat transfer coefficient for the conditions studied.

Wildfire and invasive species in the west: challenges that hinder current and future management and protection of the sagebrush-steppe ecosystem: a Gap Report

USGS Publications Warehouse

Mayer, Kenneth F.; Anderson, Pete; Chambers, Jeanne; Boyd, Chad; Christiansen, Tom; Davis, Dawn; Espinosa, Shawn; Havlina, Doug; Ielmini, Michael; Kemner, Don; Kurth, Laurie; Maestas, Jeremy; Mealor, Brian; Milesneck, Ted; Niell, Lara; Pellant, Mike; Pyke, David A.; Tague, Joe; Vernon, Jason

2013-01-01

The WG will continue to meet on a regular basis to further develop and expand this list of gaps. Additionally, the WG will offer specific options to address the identified gaps. However, the WG recommends that the FWS, possibly through the State/Federal (Western Governors Association) Sage Grouse Task Force or the National Sage-grouse Executive Oversight Committee, establish a Subcommittee to specifically review this Gap Report and develop a multi-agency approach on how to address each gap. The WG will continue to endeavor to establish a priority list and identify the “low hanging fruit” that can be addressed in the short-term to affect the listing decision. Additionally, the WG will propose a longer-term strategy. However, to successfully establish such a strategy it will take buy-in and commitment at the highest levels in federal and state governments. In an effort to provide managers an opportunity to address the most important issues this coming fiscal year, we offer the following top 5 gaps. Beyond these top 5, the WG has identified 17 additional gaps that should be evaluated by both federal and state agencies as a means to help better manage the wildfire/invasive threat in the west.

Content-oriented Approach to Organization of Theories and Its Utilization

NASA Astrophysics Data System (ADS)

Hayashi, Yusuke; Bourdeau, Jacqueline; Mizoguch, Riichiro

In spite of the fact that the relation between theory and practice is a foundation of scientific and technological development, the trend of increasing the gap between theory and practice accelerates in these years. The gap embraces a risk of distrust of science and technology. Ontological engineering as the content-oriented research is expected to contribute to the resolution of the gap. This paper presents the feasibility of organization of theoretical knowledge on ontological engineering and new-generation intelligent systems based on it through an application of ontological engineering in the area of learning/instruction support. This area also has the problem of the gap between theory and practice, and its resolution is strongly required. So far we proposed OMNIBUS ontology, which is a comprehensive ontology that covers different learning/instructional theories and paradigms, and SMARTIES, which is a theory-aware and standard-compliant authoring system for making learning/instructional scenarios based on OMNIBUS ontology. We believe the theory-awareness and standard-compliance bridge the gap between theory and practice because it links theories to practical use of standard technologies and enables practitioners to easily enjoy theoretical support while using standard technologies in practice. The following goals are set in order to achieve it; computers (1) understand a variety of learning/instructional theories based on the organization of them, (2) utilize the understanding for helping authors' learning/instructional scenario making and (3) make such theoretically sound scenarios interoperable within the framework of standard technologies. This paper suggests an ontological engineering solution to the achievement of these three goals. Although the evaluation is far from complete in terms of practical use, we believe that the results of this study address high-level technical challenges from the viewpoint of the current state of the art in the research area of artificial intelligence not only in education but also in general, and therefore we hope that constitute a substantial contribution for organization of theoretical knowledge in many other areas.

HIV/AIDS stigma and knowledge among predominantly middle-class high school students in New Delhi, India.

PubMed

Pramanik, Suneet; Chartier, Maggie; Koopman, Cheryl

2006-03-01

This study examined stigmatizing attitudes toward HIV/AIDS among predominantly middle-class adolescents in New Delhi high schools. This study was specifically designed to: 1) assess stigmatizing attitudes toward HIV/AIDS and sexuality; HIV/AIDS knowledge, and awareness of HIV-related health resources; and 2) examine whether HIV-related stigma and knowledge are related to one another and to gender, parents' education, and exposure to HIV/AIDS education. In four high schools in New Delhi, 186 students completed a questionnaire assessing stigmatization of HIV/AIDS, stigmatization of sexuality, knowledge of HIV/AIDS, HIV/AIDS education and resources, and demographic characteristics. Adolescents varied in how much they stigmatized persons with HIV/AIDS. They generally lacked accurate knowledge about the disease and of related health resources. However, those with greater exposure to HIV/AIDS education demonstrated significantly greater HIV/AIDS knowledge. Female adolescents demonstrated significantly less knowledge about HIV/AIDS compared with male adolescents, while the males reported significantly greater exposure to HIV/AIDS education compared with the females. These results suggest a need for greater HIV/AIDS education and awareness of health resources, especially among female adolescents. Education must directly address stigmatizing attitudes about HIV/AIDS, gaps in HIV/AIDS knowledge and awareness of HIV-related health resources.

Oral Cancer Knowledge Assessment: Newly Graduated versus Senior Dental Clinicians

PubMed Central

Salgado de Souza, Ricardo; Gallego Arias Pecorari, Vanessa; Lauria Dib, Luciano

2018-01-01

The present study assessed the level of dentists' knowledge regarding oral cancer in the city of São Paulo, Brazil. A questionnaire was used to compare the level of knowledge among newly graduated and senior clinicians. A total of 20,154 e-mails were correctly delivered to the dentists registered in the database of the Regional Dentistry Council of São Paulo, and 477 (2.36%) responses were received. This sample consisted of 84 newly graduated clinicians and 105 senior clinicians. For the statistical analysis, the chi-square test and the logistic regression analysis were performed with α = 0.05, and the results were described herein. According to their knowledge level, the results were statistically different between the groups, since 19% of the newly graduated clinicians were evaluated with knowledge grade A (excellent) in comparison to 6.7% of the senior clinicians. In spite of the results indicated that newly graduated clinicians' knowledge regarding oral cancer was 2.1 times higher, 34.5% of the professionals in this group had regular or poor knowledge on the subject, and several questions relating to clinical characteristics and risk factors indicated that there still exist some knowledge gaps, demonstrating that there is a need for further studies and information activities addressing oral cancer. PMID:29666649

Mapping the knowledge utilization field in nursing from 1945 to 2004: a bibliometric analysis.

PubMed

Scott, Shannon D; Profetto-McGrath, Joanne; Estabrooks, Carole A; Winther, Connie; Wallin, Lars; Lavis, John N

2010-12-01

The field of knowledge utilization has been hampered by several issues including: the synonymous use of multiple terms with little attempt at definition precision; an overexamination of knowledge utilization as product, rather than a process; and a lack of progress to cross disciplinary boundaries to advance knowledge development. In order to address the challenges and current knowledge gaps in the knowledge utilization field in nursing, a comprehensive picture of the current state of the field is required. Bibliometric analyses were used to map knowledge utilization literature in nursing as an international field of study, and to identify the structure of its scientific community. Analyses of bibliographic data for 433 articles from the period 1945-2004 demonstrated three trends: (1) there has been significant recent growth and interest in this field, (2) the structure of the scientific knowledge utilization community is evolving, and (3) the Web of Science does not index the majority of journals where this literature is published. In order to enhance the accessibility and profile of this literature, and nursing's scientific literature at large, we encourage the International Academy of Nursing Editors to work collaboratively to increase the number of journals indexed in the Web of Science. ©2010 Sigma Theta Tau International.

A Twenty-Five-Year Review of Knowledge Gap Research.

ERIC Educational Resources Information Center

Gaziano, Cecilie

Evidence from 34 studies published since a 1983 review of 58 earlier studies underscores knowledge inequalities as an enduring phenomenon and emphasizes that interest in the knowledge gap phenomenon is accelerating. All 10 studies which varied "media publicity" supported the hypothesis. Eleven of 12 studies which varied some aspect of…

Uncertainty and Clinical Psychology: Therapists' Responses.

ERIC Educational Resources Information Center

Bienenfeld, Sheila

Three sources of professional uncertainty have been described: uncertainty about the practitioner's mastery of knowledge; uncertainty due to gaps in the knowledge base itself; and uncertainty about the source of the uncertainty, i.e., the practitioner does not know whether his uncertainty is due to gaps in the knowledge base or to personal…

Gaps in international nutrition and child feeding guidelines: a look at the nutrition and young child feeding education of Ghanaian nurses.

PubMed

Davis, Jennie N; Brown, Helen; Ramsay, Samantha A

2017-08-01

To examine the nutrition and young child feeding (YCF) education and training of nurses in public health clinics of Ghana's Komenda-Edina-Eguafo-Abrem region (KEEA) in relation to global health guidelines, and how nurses served as educators for caregivers with children aged 0-5 years. A qualitative study of semi-structured one-on-one and group interviews (n 21) following a questionnaire of closed- and open-ended questions addressing child feeding, nutrition and global health recommendations. Interviews were conducted in English, audio-recorded, transcribed and coded. Descriptive data were tabulated. Content analysis identified themes from open-ended questions. KEEA public health clinics (n 12). Nurses (n 41) purposefully recruited from KEEA clinics. A model capturing nurses' nutrition and YCF education emerged with five major themes: (i) adequacy of nurses' basic knowledge in breast-feeding, complementary feeding, iron-deficiency anaemia, YCF and hygiene; (ii) nurses' delivery of nutrition and YCF information; (iii) nurses' evaluation of children's health status to measure education effectiveness; (iv) nurses' perceived barriers of caregivers' ability to implement nutrition and YCF education; and (v) a gap in global health recommendations on YCF practices for children aged 2-5 years. Nurses demonstrated adequate nutrition and YCF knowledge, but reported a lack of in-depth nutrition knowledge and YCF education for children 2-5 years of age, specifically education and knowledge of YCF beyond complementary feeding. To optimize child health outcomes, a greater depth of nutrition and YCF education is needed in international health guidelines.

Evaluation of water, sanitation and hygiene program outcomes shows knowledge-behavior gaps in Coast Province, Kenya

PubMed Central

Schlegelmilch, Michael Paul; Lakhani, Amyn; Saunders, Leslie Duncan; Jhangri, Gian Singh

2016-01-01

Introduction Water related diseases constitute a significant proportion of the burden of disease in Kenya. Water, sanitation and hygiene (WASH) programs are in operation nation-wide to address these challenges. This study evaluated the impact of the Sombeza Water and Sanitation Improvement Program (SWASIP) in Coast Province, Kenya. Methods This study is a cluster randomized, follow-up evaluation that compared baseline (2007) to follow-up (2013) indicators from 250 households. Twenty-five villages were selected with probability proportional to size sampling, and ten households were selected randomly from each village. Follow-up data were collected by in-person interviews using pre-tested questionnaires, and analyzed to compare indicators collected at baseline. Cross-sectional results from the follow-up data were also reported. Results Statistically significant improvements from baseline were observed in the proportions of respondents with latrine access at home, who washed their hands after defecation, who treated their household drinking water and the average time to collect water in the dry season. However, this study also observed significant decreases in the proportion of respondents who washed their hands before preparing their food, or feeding their children, and after attending to a child who has defecated. The analysis also revealed a knowledge-behavior gap in WASH behaviors. Conclusion SWASIP contributed to improvements from baseline, but further progress still needs to be seen. The findings challenge the assumption that providing infrastructure and knowledge will result in behavior change. Further understanding of specific, non-knowledge predictors of WASH related behavior is needed. PMID:27279970

A Review and Evaluation of Forest Canopy Epiphyte Roles in the Partitioning and Chemical Alteration of Precipitation

NASA Astrophysics Data System (ADS)

Van Stan, J. T., II; Pypker, T. G.

2015-12-01

Interactions between precipitation and forest canopy elements (bark, leaves, and epiphytes) control the quantity, spatiotemporal patterning, and the chemical concentration, character and constituency of precipitation to soils. Canopy epiphytes are an element that exerts a range of storm-related hydrological and biogeochemical effects due to their diversity of morphological traits and nutrient acquisition mechanisms. We reviewed and evaluated the state of knowledge regarding epiphyte interactions with precipitation partitioning (into interception loss, throughfall, and stemflow) and the chemical alteration of net precipitation fluxes (throughfall and stemflow). As epiphyte species are quite diverse, this review categorized findings by common paraphyletic groups: lichens, bryophytes, and vascular epiphytes. Of these groups, vascular epiphytes have received the least attention and lichens the most. In general, epiphytes decrease throughfall and stemflow and increase interception loss. Epiphytes alter the spatiotemporal pattern of throughfall and increase the overall latent heat fluxes from the canopy. Epiphytes alter biogeochemical processes by impacting the transfer of solutes through the canopy; however, the change in solute concentration varies with epiphyte type and chemical species. We discuss several important knowledge gaps across all epiphyte groups. We also explore innovative methods that currently exist to confront these knowledge gaps and past techniques applied to gain our current understanding. Future research addressing the listed deficiencies will improve our knowledge of epiphyte roles in water and biogeochemical processes coupled within forest canopies—processes crucial to supporting microbe, plant, vertebrate and invertebrate communities within individual epiphytes/epiphyte assemblages, host trees, and even the forest ecosystem as a whole.

Physician Knowledge and Attitudes About Hepatitis A and Current Practices Regarding Hepatitis A Vaccination Delivery.

PubMed

Nelson, Noele P; Allison, Mandy A; Lindley, Megan C; Brtnikova, Michaela; Crane, Lori A; Beaty, Brenda L; Hurley, Laura P; Kempe, Allison

2017-07-01

To assess physicians': 1) knowledge and attitudes about hepatitis A disease and hepatitis A (HepA) vaccine, 2) child care and school HepA vaccine mandates, 3) practices related to HepA vaccine delivery, 4) factors associated with strongly recommending HepA vaccine to all 1- to 2-year-olds, and 5) feasibility of implementing HepA catch-up vaccination at health maintenance visits. A national survey was conducted among representative networks of pediatricians and family medicine physicians (FMs) from March to June, 2014 via e-mail or mail on the basis of provider preference. Response rates were 81% (356 of 440) among pediatricians and 75% (348 of 464) among FMs. Less than 50% correctly identified that hepatitis A virus (HAV) infection is usually asymptomatic in young children and that morbidity from HAV disease increases with age. Ninety-two percent of pediatricians and 59% of FMs strongly recommend HepA vaccine for all 1- to 2-year-olds. In addition to practice specialty, belief that HepA vaccine is required for kindergarten enrollment was the most robust predictor of strong physician recommendation. Gaps in knowledge regarding HAV infection and hepatitis A recommendations and lack of a strong recommendation for routine HepA vaccination of young children among FMs likely contribute to suboptimal coverage. Closing knowledge gaps and addressing barriers that prevent all physicians from strongly recommending HepA vaccine to 1- to 2-year-olds could help increase HepA vaccine coverage and ultimately improve population protection against HAV infection. Published by Elsevier Inc.

Animating Research with Counseling Values: A Training Model to Address the Research-to-Practice Gap

ERIC Educational Resources Information Center

Lee, Kristi A.; Dewell, John A.; Holmes, Courtney M.

2014-01-01

The persistent research-to-practice gap poses a problem for counselor education. The gap may be caused by conflicts between the humanistic values that guide much of counseling and the values that guide research training. In this article, the authors address historical concerns regarding research training for students and the conducting of research…

Information Sharing between the U.S. Department State and the U.S. Army: Using Knowledge Management Technology and Tools to Bridge the Gap

DTIC Science & Technology

2015-06-12

PERSON a. REPORT b. ABSTRACT c. THIS PAGE 19b. PHONE NUMBER (include area code) (U) (U) (U) (U) 88 Standard Form 298 (Rev. 8-98) Prescribed by...with a collection of information if it does not display a currently valid OMB control number . PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1...CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) MAJ Andrew V. Walsh 5d. PROJECT NUMBER 5e. TASK NUMBER 5f

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

Jordan, Amy B.; Boukhalfa, Hakim; Caporuscio, Florie Andre

To gain confidence in the predictive capability of numerical models, experimental validation must be performed to ensure that parameters and processes are correctly simulated. The laboratory investigations presented herein aim to address knowledge gaps for heat-generating nuclear waste (HGNW) disposal in bedded salt that remain after examination of prior field and laboratory test data. Primarily, we are interested in better constraining the thermal, hydrological, and physicochemical behavior of brine, water vapor, and salt when moist salt is heated. The target of this work is to use run-of-mine (RoM) salt; however during FY2015 progress was made using high-purity, granular sodium chloride.

Review and Design of Low-Dose Bacillus anthracis Inhalation ...

EPA Pesticide Factsheets

Report In July 2011, EPA NHSRC sponsored a Review and Design of Low-Dose Bacillus anthracis Inhalation Exposures meeting to review the research done to date and to identify gaps that future research should address regarding low-dose exposures. This effort brought together many organizations across the country, including EPA’s program offices, federal government agencies and laboratories, academia, and the private sector. Participants of the conference shared knowledge, explored differing opinions, and expanded understanding of the current state of research for low-dose exposure and future research needs. This report represents a summary of the presentations and discussions during the meeting.

Science-based regulatory and policy considerations in nutrition.

PubMed

Schneeman, Barbara

2015-05-01

Scientific evidence is necessary for the development of effective and enforceable regulations and government policy. To use scientific information appropriately, a systematic approach is needed for review and evaluation of the evidence. Federal agencies in the United States have developed useful approaches for such a review and evaluation to develop nutrition labeling, including health claims, and for updating of the Dietary Guidelines for Americans. The WHO is using a systematic evaluation process to update its recommendations on diet and health. The results of such reviews also highlight research needs to address relevant gaps in our knowledge. © 2015 American Society for Nutrition.

Updated Review of Planetary Atmospheric Electricity

NASA Astrophysics Data System (ADS)

Yair, Y.; Fischer, G.; Simões, F.; Renno, N.; Zarka, P.

2008-06-01

This paper reviews the progress achieved in planetary atmospheric electricity, with focus on lightning observations by present operational spacecraft, aiming to fill the hiatus from the latest review published by Desch et al. (Rep. Prog. Phys. 65:955 997, 2002). The information is organized according to solid surface bodies (Earth, Venus, Mars and Titan) and gaseous planets (Jupiter, Saturn, Uranus and Neptune), and each section presents the latest results from space-based and ground-based observations as well as laboratory experiments. Finally, we review planned future space missions to Earth and other planets that will address some of the existing gaps in our knowledge.

Updated Review of Planetary Atmospheric Electricity

NASA Astrophysics Data System (ADS)

Yair, Y.; Fischer, G.; Simões, F.; Renno, N.; Zarka, P.

This paper reviews the progress achieved in planetary atmospheric electricity, with focus on lightning observations by present operational spacecraft, aiming to fill the hiatus from the latest review published by Desch et al. (Rep. Prog. Phys. 65:955-997, 2002). The information is organized according to solid surface bodies (Earth, Venus, Mars and Titan) and gaseous planets (Jupiter, Saturn, Uranus and Neptune), and each section presents the latest results from space-based and ground-based observations as well as laboratory experiments. Finally, we review planned future space missions to Earth and other planets that will address some of the existing gaps in our knowledge.

Establishing an International Soil Modelling Consortium

NASA Astrophysics Data System (ADS)

Vereecken, Harry; Schnepf, Andrea; Vanderborght, Jan

2015-04-01

Soil is one of the most critical life-supporting compartments of the Biosphere. Soil provides numerous ecosystem services such as a habitat for biodiversity, water and nutrients, as well as producing food, feed, fiber and energy. To feed the rapidly growing world population in 2050, agricultural food production must be doubled using the same land resources footprint. At the same time, soil resources are threatened due to improper management and climate change. Soil is not only essential for establishing a sustainable bio-economy, but also plays a key role also in a broad range of societal challenges including 1) climate change mitigation and adaptation, 2) land use change 3) water resource protection, 4) biotechnology for human health, 5) biodiversity and ecological sustainability, and 6) combating desertification. Soils regulate and support water, mass and energy fluxes between the land surface, the vegetation, the atmosphere and the deep subsurface and control storage and release of organic matter affecting climate regulation and biogeochemical cycles. Despite the many important functions of soil, many fundamental knowledge gaps remain, regarding the role of soil biota and biodiversity on ecosystem services, the structure and dynamics of soil communities, the interplay between hydrologic and biotic processes, the quantification of soil biogeochemical processes and soil structural processes, the resilience and recovery of soils from stress, as well as the prediction of soil development and the evolution of soils in the landscape, to name a few. Soil models have long played an important role in quantifying and predicting soil processes and related ecosystem services. However, a new generation of soil models based on a whole systems approach comprising all physical, mechanical, chemical and biological processes is now required to address these critical knowledge gaps and thus contribute to the preservation of ecosystem services, improve our understanding of climate-change-feedback processes, bridge basic soil science research and management, and facilitate the communication between science and society . To meet these challenges an international community effort is required, similar to initiatives in systems biology, hydrology, and climate and crop research. We therefore propose to establish an international soil modelling consortium with the aims of 1) bringing together leading experts in modelling soil processes within all major soil disciplines, 2) addressing major scientific gaps in describing key processes and their long term impacts with respect to the different functions and ecosystem services provided by soil, 3) intercomparing soil model performance based on standardized and harmonized data sets, 4) identifying interactions with other relevant platforms related to common data formats, protocols and ontologies, 5) developing new approaches to inverse modelling, calibration, and validation of soil models, 6) integrating soil modelling expertise and state of the art knowledge on soil processes in climate, land surface, ecological, crop and contaminant models, and 7) linking process models with new observation, measurement and data evaluation technologies for mapping and characterizing soil properties across scales. Our consortium will bring together modelers and experimental soil scientists at the forefront of new technologies and approaches to characterize soils. By addressing these aims, the consortium will contribute to improve the role of soil modeling as a knowledge dissemination instrument in addressing key global issues and stimulate the development of translational research activities. This presentation will provide a compelling case for this much-needed effort, with a focus on tangible benefits to the scientific and food security communities.

Managing Uncertainty in Water Infrastructure Design Using Info-gap Robustness

NASA Astrophysics Data System (ADS)

Irias, X.; Cicala, D.

2013-12-01

Info-gap theory, a tool for managing deep uncertainty, can be of tremendous value for design of water systems in areas of high seismic risk. Maintaining reliable water service in those areas is subject to significant uncertainties including uncertainty of seismic loading, unknown seismic performance of infrastructure, uncertain costs of innovative seismic-resistant construction, unknown costs to repair seismic damage, unknown societal impacts from downtime, and more. Practically every major earthquake that strikes a population center reveals additional knowledge gaps. In situations of such deep uncertainty, info-gap can offer advantages over traditional approaches, whether deterministic approaches that use empirical safety factors to address the uncertainties involved, or probabilistic methods that attempt to characterize various stochastic properties and target a compromise between cost and reliability. The reason is that in situations of deep uncertainty, it may not be clear what safety factor would be reasonable, or even if any safety factor is sufficient to address the uncertainties, and we may lack data to characterize the situation probabilistically. Info-gap is a tool that recognizes up front that our best projection of the future may be wrong. Thus, rather than seeking a solution that is optimal for that projection, info-gap seeks a solution that works reasonably well for all plausible conditions. In other words, info-gap seeks solutions that are robust in the face of uncertainty. Info-gap has been used successfully across a wide range of disciplines including climate change science, project management, and structural design. EBMUD is currently using info-gap to help it gain insight into possible solutions for providing reliable water service to an island community within its service area. The island, containing about 75,000 customers, is particularly vulnerable to water supply disruption from earthquakes, since it has negligible water storage and is entirely dependent on four potentially fragile water transmission mains for its day-to-day water supply. Using info-gap analysis, EBMUD is evaluating competing strategies for providing water supply to the island, for example submarine pipelines versus tunnels. The analysis considers not only the likely or 'average' results for each strategy, but also the worst-case performance of each strategy under varying levels of uncertainty. This analysis is improving the quality of the planning process, since it can identify strategies that ensure minimal disruption of water supply following a major earthquake, even if the earthquake and resulting damage fail to conform to our expectations. Results to date are presented, including a discussion of how info-gap analysis complements existing tools for comparing alternative strategies, and how info-gap improves our ability to quantify our tolerance for uncertainty.

An Exploration of the Utility of a Knowledge Utilization Framework to Study the Gap between Reading Disabilities Research and Practice

ERIC Educational Resources Information Center

Davidson, Katherine; Nowicki, Elizabeth

2012-01-01

This pre-pilot study explored the usefulness of a knowledge utilization framework comprised of Knott and Wildavsky's (1980) seven stages of knowledge use and Stone's (2002) three routes to knowledge use to investigate the gap between reading disabilities research and teachers' self-reported use of that research. Semi-structured interviews of ten…

Measuring public opinion on alcohol policy: a factor analytic study of a US probability sample.

PubMed

Latimer, William W; Harwood, Eileen M; Newcomb, Michael D; Wagenaar, Alexander C

2003-03-01

Public opinion has been one factor affecting change in policies designed to reduce underage alcohol use. Extant research, however, has been criticized for using single survey items of unknown reliability to define adult attitudes on alcohol policy issues. The present investigation addresses a critical gap in the literature by deriving scales on public attitudes, knowledge, and concerns pertinent to alcohol policies designed to reduce underage drinking using a US probability sample survey of 7021 adults. Five attitudinal scales were derived from exploratory and confirmatory factor analyses addressing policies to: (1) regulate alcohol marketing, (2) regulate alcohol consumption in public places, (3) regulate alcohol distribution, (4) increase alcohol taxes, and (5) regulate youth access. The scales exhibited acceptable psychometric properties and were largely consistent with a rational framework which guided the survey construction.

Pre-hospital policies for the care of patients with acute coronary syndromes in India: A policy document analysis.

PubMed

Patel, Amisha; Prabhakaran, Dorairaj; Berendsen, Mark; Mohanan, P P; Huffman, Mark D

2017-04-01

Ischemic heart disease is the leading cause of death in India. In high-income countries, pre-hospital systems of care have been developed to manage acute manifestations of ischemic heart disease, such as acute coronary syndrome (ACS). However, it is unknown whether guidelines, policies, regulations, or laws exist to guide pre-hospital ACS care in India. We undertook a nation-wide document analysis to address this gap in knowledge. From November 2014 to May 2016, we searched for publicly available emergency care guidelines and legislation addressing pre-hospital ACS care in all 29 Indian states and 7 Union Territories via Internet search and direct correspondence. We found two documents addressing pre-hospital ACS care. Though India has legislation mandating acute care for emergencies such as trauma, regulations or laws to guide pre-hospital ACS care are largely absent. Policy makers urgently need to develop comprehensive, multi-stakeholder policies for pre-hospital emergency cardiovascular care in India. Copyright © 2016. Published by Elsevier B.V.

Cancer survivorship: a new challenge in comprehensive cancer control.

PubMed

Pollack, Lori A; Greer, Greta E; Rowland, Julia H; Miller, Andy; Doneski, Donna; Coughlin, Steven S; Stovall, Ellen; Ulman, Doug

2005-10-01

Cancer survivors are a growing population in the United States because of earlier cancer diagnosis, the aging of society, and more effective risk reduction and treatment. Concerns about the long-term physical, psychosocial, and economic effects of cancer treatment on cancer survivors and their families are increasingly being recognized and addressed by public, private, and non-profit organizations. The purpose of this paper is to discuss how survivorship fits within the framework of comprehensive cancer control. We summarize three national reports on cancer survivorship and highlight how various organizations and programs are striving to address the needs of cancer survivors through public health planning, including the challenges these groups face and the gaps in knowledge and available services. As cancer survivorship issues are being recognized, many organizations have objectives and programs to address concerns of those diagnosed with cancer. However, better coordination and dissemination may decrease overlap and increase the reach of efforts and there is limited evidence for the effectiveness and impact of these efforts.

Widening the aim of health promotion to include the most disadvantaged: vulnerable adolescents and the social determinants of health.

PubMed

Mohajer, Nicole; Earnest, Jaya

2010-06-01

Growing numbers of adolescents are marginalized by social factors beyond their control, leading to poor health outcomes for their families and future generations. Although the role of the social determinants of health has been recognized for many years, there is a gap in our knowledge about the strategies needed to address these factors in health promotion. Drawing on a review of literature on health promotion for marginalized and out-of-school adolescents, this paper highlights some urgent areas of focus for researchers and policy makers addressing adolescent health. Social determinants of health affecting marginalized adolescents identified by the review were education, gender, identity, homelessness, poverty, family structure, culture, religion and perceived racism, yet there is little solid evidence as to how to best address these factors. More systematic research, evaluation and global debate about long-term solutions to chronic poverty, lack of education and social marginalization are needed to break the cycle of ill health among vulnerable adolescents.

Knowledge and institutional requirements to promote land degradation neutrality in drylands - An analysis of the outcomes of the 3rd UNCCD scientific conference

NASA Astrophysics Data System (ADS)

Akhtar-Schuster, Mariam; Safriel, Uriel; Abraham, Elena; de Vente, Joris; Essahli, Wafa; Escadafal, Richard; Stringer, Lindsay

2015-04-01

Achieving land degradation neutrality (LDN) through sustainable land management (SLM) targets the maintenance or restoration of the productivity of land, and therefore has to include decision-makers, knowledge generators and knowledge holders at the different relevant geographic scales. In order to enhance the implementation of the Convention, the Conference of the Parties (COP) of the United Nations Convention to Combat Desertification therefore decided that each future session of its Committee on Science and Technology (CST) would be organized in a predominantly scientific and technical conference-style format. This contribution will outline the major outcomes of UNCCD's 3rd scientific conference that will be held in Cancún, Mexico, from 9 to 12 March 2015, on addressing desertification, land degradation and drought issues (DLDD) for poverty reduction and sustainable development. The conference follows an exceptional new round table conference format that will allow the various stakeholders to discuss scientific as well as the contribution of traditional knowledge and practices in combating land degradation. This format should provide two-way communication and enable deeper insight into the availability and contribution of all forms of knowledge for achieving LDN through the assessment of: • the vulnerability of lands to DLDD and climate change and the adaptive capacities of socio-ecosystems; • best examples of adapted, knowledge-based practices and technologies; • monitoring and assessment methods to evaluate the effectiveness of adaptation practices and technologies. The outcomes of UNCCD's 3rd scientific conference will serve as a basis for discussing: • contributions of science to diagnose the status of land; • research gaps that need to be addressed to achieve LDN for poverty reduction; • additional institutional requirements to optimally bridge knowledge generation, knowledge maintenance and knowledge implementation at the science-policy interface.

Feasibility and effectiveness of a brief, intensive phylogenetics workshop in a middle-income country.

PubMed

Pollett, S; Leguia, M; Nelson, M I; Maljkovic Berry, I; Rutherford, G; Bausch, D G; Kasper, M; Jarman, R; Melendrez, M

2016-01-01

There is an increasing role for bioinformatic and phylogenetic analysis in tropical medicine research. However, scientists working in low- and middle-income regions may lack access to training opportunities in these methods. To help address this gap, a 5-day intensive bioinformatics workshop was offered in Lima, Peru. The syllabus is presented here for others who want to develop similar programs. To assess knowledge gained, a 20-point knowledge questionnaire was administered to participants (21 participants) before and after the workshop, covering topics on sequence quality control, alignment/formatting, database retrieval, models of evolution, sequence statistics, tree building, and results interpretation. Evolution/tree-building methods represented the lowest scoring domain at baseline and after the workshop. There was a considerable median gain in total knowledge scores (increase of 30%, p<0.001) with gains as high as 55%. A 5-day workshop model was effective in improving the pathogen-applied bioinformatics knowledge of scientists working in a middle-income country setting. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Management of knowledge gaps: concept representation of things we don't know.

PubMed

Bleuer, Juerg P; Talerico, Daniele; Bösch, Kurt; Lampérière, Vincent; Ludwig, Christian A

2010-01-01

Suva (Swiss National Accident Insurance Fund) is the most important carrier of obligatory accident insurance in Switzerland. Its medical division supports doctors working in inpatient and outpatient care with comprehensive case management and with conciliar advice. The Suva hospitals provide inpatient rehabilitation. In 2002, Suva started the InWiM project. InWiM is an acronym and stands for "Integrierte Wissensbasen der Medizin", which can be translated as "Integrated Knowledge Bases in Medicine". Information retrieval within InWiM is achieved by means of the MeSH Index (Medical Subject Headings), the thesaurus of the United States National Library of Medicine (NLM). InWiM has now been extended towards the management not only of publications but also of areas where sound knowledge is missing, so called "knowledge gaps": Knowledge gaps are indexed with MeSH terms in a similar way to publications. This improves knowledge management: In particular it is possible to search and find knowledge gaps and solutions covering the same or a similar topic, thus allowing adequate collating and it prevents duplication of work. Furthermore, literature search strategies for the NML are predefined and do not need every time to be reinvented from scratch.

A Study of Gaps in Network Knowledge Synthesis

DTIC Science & Technology

2016-10-14

Lincoln Laboratory MASSACHUSETTS INSTITUTE OF TECHNOLOGY LEXINGTON, MASSACHUSETTS Technical Report 1195 A Study of Gaps in Network...unlimited. This report is the result of studies performed at Lincoln Laboratory, a federally funded research and development center operated...specifically authorized by the U.S. Government may violate any copyrights that exist in this work. A Study of Gaps in Network Knowledge Synthesis

Toward an understanding of global change: Initial priorities for US contributions to the International Geosphere-Biosphere Program

NASA Technical Reports Server (NTRS)

1988-01-01

A limited number of high-priority research initiatives are recommended for early implementation as part of the U.S. contribution to the preparatory phase of the International Geosphere-Biosphere Program. The recommendations are based on the committee's analysis of the most critical gaps in the scientific knowledge needed to understand the changes that are occurring in the earth system not being addressed by existing programs. The report articulates a number of important key issues and interactions that characterize global change in the geosphere-biosphere system on time scales of decades to centuries; identifies the knowledge that is the most urgently needed to improve understanding of those issues and interactions; and formulates initial priorities for initial U.S. contributions to the IGBP, recognizing the contributions of other ongoing and proposed programs.

Sustainability Tools Inventory Initial Gap Analysis

EPA Science Inventory

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

A knowledge transfer scheme to bridge the gap between science and practice: an integration of existing research frameworks into a tool for practice.

PubMed

Verhagen, Evert; Voogt, Nelly; Bruinsma, Anja; Finch, Caroline F

2014-04-01

Evidence of effectiveness does not equal successful implementation. To progress the field, practical tools are needed to bridge the gap between research and practice and to truly unite effectiveness and implementation evidence. This paper describes the Knowledge Transfer Scheme integrating existing implementation research frameworks into a tool which has been developed specifically to bridge the gap between knowledge derived from research on the one side and evidence-based usable information and tools for practice on the other.

Dissemination: Bringing Translational Research to Completion

PubMed Central

Park, Daniel J.; Burke, Janice P.

2013-01-01

Despite the availability of innovative health care research, a gap exists between research-generated knowledge and the utilization of that knowledge in real-world practice settings. This article examines the transition from research to implementation in the context of the dissemination of A. Jean Ayres’ sensory integration procedures and of the challenges currently facing the University of Southern California Well Elderly Studies research team. Drawing from the emerging field of implementation science, this article discusses how researchers can develop an implementation plan to more easily translate evidence into practice. Such plans should address the intervention’s reach (i.e., its capacity to penetrate into the intended target population), the settings for which it is applicable, the leaders who will encourage practitioner uptake, stakeholder groups, and challenges to dissemination. By taking action to ensure the more effective dissemination of research-generated knowledge, researchers can increase the likelihood that their interventions will lead to improvements in practice and more effective care for consumers. PMID:23433273

Exploring the Hidden Barriers in Knowledge Translation: A Case Study Within an Academic Community.

PubMed

Harvey, Gill; Marshall, Rhianon J; Jordan, Zoe; Kitson, Alison L

2015-11-01

Debates about knowledge translation (KT) typically focus on the research-practice gap, which appears to be premised on the assumption that academics are a homogeneous collective, sharing a common view. We argue that a number of hidden barriers need to be addressed related to the understanding, interpretation, ability, and commitment to translate knowledge within academic communities. We explore this by presenting a qualitative case study in a health sciences faculty. Applying organizational and management theory, we discuss different types of boundaries and the resultant barriers generated, ranging from diversity in understanding and perceptions of KT to varying motivations and incentives to engage in translational activity. We illustrate how we are using the empirical findings to inform the development of a KT strategy that targets the identified barriers. Investing in this internal KT-focused activity is an important step to maximize the potential of future collaborations between producers and users of research in health care. © The Author(s) 2015.

Flood AI: An Intelligent Systems for Discovery and Communication of Disaster Knowledge

NASA Astrophysics Data System (ADS)

Demir, I.; Sermet, M. Y.

2017-12-01

Communities are not immune from extreme events or natural disasters that can lead to large-scale consequences for the nation and public. Improving resilience to better prepare, plan, recover, and adapt to disasters is critical to reduce the impacts of extreme events. The National Research Council (NRC) report discusses the topic of how to increase resilience to extreme events through a vision of resilient nation in the year 2030. The report highlights the importance of data, information, gaps and knowledge challenges that needs to be addressed, and suggests every individual to access the risk and vulnerability information to make their communities more resilient. This project presents an intelligent system, Flood AI, for flooding to improve societal preparedness by providing a knowledge engine using voice recognition, artificial intelligence, and natural language processing based on a generalized ontology for disasters with a primary focus on flooding. The knowledge engine utilizes the flood ontology and concepts to connect user input to relevant knowledge discovery channels on flooding by developing a data acquisition and processing framework utilizing environmental observations, forecast models, and knowledge bases. Communication channels of the framework includes web-based systems, agent-based chat bots, smartphone applications, automated web workflows, and smart home devices, opening the knowledge discovery for flooding to many unique use cases.

Exploring the need for interventions to manage weight and stress during interconception.

PubMed

Huberty, Jennifer; Leiferman, Jenn A; Kruper, Abbey R; Jacobson, Lisette T; Waring, Molly E; Matthews, Jeni L; Wischenka, Danielle M; Braxter, Betty; Kornfield, Sara L

2017-02-01

Interventions to manage weight and stress during the interconception period (i.e., time immediately following childbirth to subsequent pregnancy) are needed to promote optimal maternal and infant health outcomes. To address this gap, we summarize the current state of knowledge, critically evaluate the research focused on weight and stress management during the interconception period, and provide future recommendations for research in this area. Evidence supports the importance of weight and stress management during the reproductive years and the impact of weight on maternal and child health outcomes. However, evidence-based treatment models that address postpartum weight loss and manage maternal stress during the interconception period are lacking. This problem is further compounded by inconsistent definitions and measurements of stress. Recommendations for future research include interventions that address weight and stress tailored for women in the interconception period, interventions that address healthcare providers' understanding of the significance of weight and stress management during interconception, and long-term follow-up studies that focus on the public health implications of weight and stress management during interconception. Addressing obesity and stress during the interconception period via a reproductive lens will be a starting point for women and their families to live long and healthy lives.

Understanding the Knowledge Gap Experienced by U.S. Safety Net Patients in Teleretinal Screening.

PubMed

George, Sheba M; Hayes, Erin Moran; Fish, Allison; Daskivich, Lauren Patty; Ogunyemi, Omolola I

2016-01-01

Safety-net patients' socioeconomic barriers interact with limited digital and health literacies to produce a "knowledge gap" that impacts the delivery of healthcare via telehealth technologies. Six focus groups (2 African- American and 4 Latino) were conducted with patients who received teleretinal screening in a U.S. urban safety-net setting. Focus groups were analyzed using a modified grounded theory methodology. Findings indicate that patients' knowledge gap is primarily produced at three points during the delivery of care: (1) exacerbation of patients' pre-existing personal barriers in the clinical setting; (2) encounters with technology during screening; and (3) lack of follow up after the visit. This knowledge gap produces confusion, potentially limiting patients' perceptions of care and their ability to manage their own care. It may be ameliorated through delivery of patient education focused on both disease pathology and specific role of telehealth technologies in disease management.

Motivation and the Knowledge Gap: Effects of a Campaign to Reduce Diet-Related Cancer Risk.

ERIC Educational Resources Information Center

Viswanath, K.; And Others

1993-01-01

Examines whether knowledge gaps decrease when motivation to acquire information is similar among more and less educated groups. Compares two groups with differing motivations to acquire cancer and diet information in a community that received a year-long health campaign. Finds evidence of education-based differences in knowledge even among members…

Bridging the Research-to-Practice Gap: A Review of the Literature Focusing on Inclusive Education

ERIC Educational Resources Information Center

Grima-Farrell, Christine R.; Bain, Alan; McDonagh, Sarah H.

2011-01-01

Despite advances in our knowledge of evidence-based inclusive educational practice, much of this knowledge does not reach routine classroom practice. There remains a significant gap between our accumulated knowledge about what can work in classrooms and the extent to which evidence-based practice is used in sustainable ways. This inability to…

Crowdsourcing Knowledge Discovery and Innovations in Medicine

PubMed Central

2014-01-01

Clinicians face difficult treatment decisions in contexts that are not well addressed by available evidence as formulated based on research. The digitization of medicine provides an opportunity for clinicians to collaborate with researchers and data scientists on solutions to previously ambiguous and seemingly insolvable questions. But these groups tend to work in isolated environments, and do not communicate or interact effectively. Clinicians are typically buried in the weeds and exigencies of daily practice such that they do not recognize or act on ways to improve knowledge discovery. Researchers may not be able to identify the gaps in clinical knowledge. For data scientists, the main challenge is discerning what is relevant in a domain that is both unfamiliar and complex. Each type of domain expert can contribute skills unavailable to the other groups. “Health hackathons” and “data marathons”, in which diverse participants work together, can leverage the current ready availability of digital data to discover new knowledge. Utilizing the complementary skills and expertise of these talented, but functionally divided groups, innovations are formulated at the systems level. As a result, the knowledge discovery process is simultaneously democratized and improved, real problems are solved, cross-disciplinary collaboration is supported, and innovations are enabled. PMID:25239002

Crowdsourcing knowledge discovery and innovations in medicine.

PubMed

Celi, Leo Anthony; Ippolito, Andrea; Montgomery, Robert A; Moses, Christopher; Stone, David J

2014-09-19

Clinicians face difficult treatment decisions in contexts that are not well addressed by available evidence as formulated based on research. The digitization of medicine provides an opportunity for clinicians to collaborate with researchers and data scientists on solutions to previously ambiguous and seemingly insolvable questions. But these groups tend to work in isolated environments, and do not communicate or interact effectively. Clinicians are typically buried in the weeds and exigencies of daily practice such that they do not recognize or act on ways to improve knowledge discovery. Researchers may not be able to identify the gaps in clinical knowledge. For data scientists, the main challenge is discerning what is relevant in a domain that is both unfamiliar and complex. Each type of domain expert can contribute skills unavailable to the other groups. "Health hackathons" and "data marathons", in which diverse participants work together, can leverage the current ready availability of digital data to discover new knowledge. Utilizing the complementary skills and expertise of these talented, but functionally divided groups, innovations are formulated at the systems level. As a result, the knowledge discovery process is simultaneously democratized and improved, real problems are solved, cross-disciplinary collaboration is supported, and innovations are enabled.

Anthropogenic Trace Compounds (ATCs) in aquatic habitats - research needs on sources, fate, detection and toxicity to ensure timely elimination strategies and risk management.

PubMed

Gerbersdorf, Sabine U; Cimatoribus, Carla; Class, Holger; Engesser, Karl-H; Helbich, Steffen; Hollert, Henner; Lange, Claudia; Kranert, Martin; Metzger, Jörg; Nowak, Wolfgang; Seiler, Thomas-Benjamin; Steger, Kristin; Steinmetz, Heidrun; Wieprecht, Silke

2015-06-01

Anthropogenic Trace Compounds (ATCs) that continuously grow in numbers and concentrations are an emerging issue for water quality in both natural and technical environments. The complex web of exposure pathways as well as the variety in the chemical structure and potency of ATCs represents immense challenges for future research and policy initiatives. This review summarizes current trends and identifies knowledge gaps in innovative, effective monitoring and management strategies while addressing the research questions concerning ATC occurrence, fate, detection and toxicity. We highlight the progressing sensitivity of chemical analytics and the challenges in harmonization of sampling protocols and methods, as well as the need for ATC indicator substances to enable cross-national valid monitoring routine. Secondly, the status quo in ecotoxicology is described to advocate for a better implementation of long-term tests, to address toxicity on community and environmental as well as on human-health levels, and to adapt various test levels and endpoints. Moreover, we discuss potential sources of ATCs and the current removal efficiency of wastewater treatment plants (WWTPs) to indicate the most effective places and elimination strategies. Knowledge gaps in transport and/or detainment of ATCs through their passage in surface waters and groundwaters are further emphasized in relation to their physico-chemical properties, abiotic conditions and biological interactions in order to highlight fundamental research needs. Finally, we demonstrate the importance and remaining challenges of an appropriate ATC risk assessment since this will greatly assist in identifying the most urgent calls for action, in selecting the most promising measures, and in evaluating the success of implemented management strategies. Copyright © 2015. Published by Elsevier Ltd.

The assessment of the readiness of five countries to implement child maltreatment prevention programs on a large scale.

PubMed

Mikton, Christopher; Power, Mick; Raleva, Marija; Makoae, Mokhantso; Al Eissa, Majid; Cheah, Irene; Cardia, Nancy; Choo, Claire; Almuneef, Maha

2013-12-01

This study aimed to systematically assess the readiness of five countries - Brazil, the Former Yugoslav Republic of Macedonia, Malaysia, Saudi Arabia, and South Africa - to implement evidence-based child maltreatment prevention programs on a large scale. To this end, it applied a recently developed method called Readiness Assessment for the Prevention of Child Maltreatment based on two parallel 100-item instruments. The first measures the knowledge, attitudes, and beliefs concerning child maltreatment prevention of key informants; the second, completed by child maltreatment prevention experts using all available data in the country, produces a more objective assessment readiness. The instruments cover all of the main aspects of readiness including, for instance, availability of scientific data on the problem, legislation and policies, will to address the problem, and material resources. Key informant scores ranged from 31.2 (Brazil) to 45.8/100 (the Former Yugoslav Republic of Macedonia) and expert scores, from 35.2 (Brazil) to 56/100 (Malaysia). Major gaps identified in almost all countries included a lack of professionals with the skills, knowledge, and expertise to implement evidence-based child maltreatment programs and of institutions to train them; inadequate funding, infrastructure, and equipment; extreme rarity of outcome evaluations of prevention programs; and lack of national prevalence surveys of child maltreatment. In sum, the five countries are in a low to moderate state of readiness to implement evidence-based child maltreatment prevention programs on a large scale. Such an assessment of readiness - the first of its kind - allows gaps to be identified and then addressed to increase the likelihood of program success. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Spacecraft Fire Experiment (Saffire) - Objectives, Development and Status

NASA Technical Reports Server (NTRS)

Schoren, William; Ruff, Gary A.; Urban, David L.

2016-01-01

Since 2012, the Spacecraft Fire Experiment (Saffire) has been under development by the Spacecraft Fire Safety Demonstration (SFS Demo) project that is funded by NASA's Advanced Exploration Systems Division in the Human Exploration and Operations Mission Directorate. The overall objective of this project is to reduce the uncertainty and risk associated with the design of spacecraft fire safety systems for NASA's exploration missions. This is accomplished by defining, developing, and conducting experiments that address gaps in spacecraft fire safety knowledge and capabilities identified by NASA's Fire Safety System Maturation Team. This paper describes the three Spacecraft Fire Experiments (Saffire-I, -II, and -III) that were developed at NASA-GRC and that will conduct a series of material flammability tests in low-gravity and at length scales that are realistic for a spacecraft fire. The experiments will be conducted in Orbital ATK's Cygnus vehicle after it has unberthed from the International Space Station. The tests will be fully automated with the data downlinked at the conclusion of the test and before the Cygnus vehicle reenters the atmosphere. The objectives of these experiments are to (1) determine how rapidly a large scale fire grows in low-gravity and (2) investigate the low-g flammability limits compared to those obtained in NASA's normal gravity material flammability screening test. The hardware for these experiments has been completed and is awaiting their respective launches, all planned for 2016. This paper will review the objectives of these experiments and how they address several of the knowledge gaps for NASA's exploration missions. The hardware development will be discussed including several novel approaches that were taken for testing and evaluation of these series payloads. The status of the missions and operational status will also be presented.

New perspectives in ocean acidification research: editor's introduction to the special feature on ocean acidification.

PubMed

Munday, Philip L

2017-09-01

Ocean acidification, caused by the uptake of additional carbon dioxide (CO 2 ) from the atmosphere, will have far-reaching impacts on marine ecosystems (Gattuso & Hansson 2011 Ocean acidification Oxford University Press). The predicted changes in ocean chemistry will affect whole biological communities and will occur within the context of global warming and other anthropogenic stressors; yet much of the biological research conducted to date has tested the short-term responses of single species to ocean acidification conditions alone. While an important starting point, these studies may have limited predictive power because they do not account for possible interactive effects of multiple climate change drivers or for ecological interactions with other species. Furthermore, few studies have considered variation in responses among populations or the evolutionary potential within populations. Therefore, our knowledge about the potential for marine organisms to adapt to ocean acidification is extremely limited. In 2015, two of the pioneers in the field, Ulf Riebesell and Jean-Pierre Gattuso, noted that to move forward as a field of study, future research needed to address critical knowledge gaps in three major areas: (i) multiple environmental drivers, (ii) ecological interactions and (iii) acclimation and adaptation (Riebesell and Gattuso 2015 Nat. Clim. Change 5 , 12-14 (doi:10.1038/nclimate2456)). In May 2016, more than 350 researchers, students and stakeholders met at the 4th International Symposium on the Ocean in a High-CO 2 World in Hobart, Tasmania, to discuss the latest advances in understanding ocean acidification and its biological consequences. Many of the papers presented at the symposium reflected this shift in focus from short-term, single species and single stressor experiments towards multi-stressor and multispecies experiments that address knowledge gaps about the ecological impacts of ocean acidification on marine communities. The nine papers in this Special Feature are from authors who attended the symposium and address cutting-edge questions and emerging topics in ocean acidification research, across the taxonomic spectrum from plankton to top predators. They cover the three streams of research identified as crucial to understanding the biological impacts of ocean acidification: (i) the relationship with other environmental drivers, (ii) the effects on ecological process and species interactions, and (iii) the role that individual variation, phenotypic plasticity and adaptation will have in shaping the impacts of ocean acidification and warming on marine ecosystems. © 2017 The Author(s).

Evaluation of sex- and gender-based medicine training in post-graduate medical education: a cross-sectional survey study.

PubMed

Kling, Juliana M; Rose, Steven H; Kransdorf, Lisa N; Viggiano, Thomas R; Miller, Virginia M

2016-01-01

Addressing healthcare disparities is a national priority for initiatives in precision and individualized medicine. An essential component of precision medicine is the understanding that sex and gender influence health and disease. Whether these issues are addressed in post-graduate medical education curricula is unknown. A questionnaire was designed and administered to residents across the Mayo Clinic enterprise to assess current knowledge of sex and gender medicine in a large program of post-graduate medical education and to identify barriers and preferred teaching methods for addressing sex and gender issues in health and disease. Descriptive and qualitative thematic analyses of the survey responses were compiled and analyzed. Responses were collected from 271 residents (response rate 17.2 %; 54 % female; 46 % male). A broad cross-section of training programs on all Mayo Clinic campuses (Arizona, Minnesota, and Florida) was represented. Sixteen percent of the respondents reported they had never had an instructor or preceptor discuss how a patient's sex or gender impacted their care of a patient; 55 % said this happened only occasionally. Of medical knowledge questions about established sex- and gender-related differences, 48 % were answered incorrectly or "unsure." Qualitative thematic analysis showed that many trainees do not understand the potential impact of sex and gender on their clinical practice and/or believe it does not pertain to their specialty. A higher percentage of female participants agreed it was important to consider a patient's sex and gender when providing patient care (60.4 vs. 38.7 %, p  =  0.02), and more male than female participants had participated in research that included sex and/or gender as a variable (59.6 vs. 39.0 %, p  < 0.01). Curriculum gaps exist in post-graduate medical training regarding sex- and gender-based medicine, and residents often do not fully understand how these concepts impact their patients' care. Reviewing the definition of sex- and gender-based medicine and integrating these concepts into existing curricula can help close these knowledge gaps. As the practice of medicine becomes more individualized, it is essential to equip physicians with an understanding of how a patient's sex and gender impacts their health to provide the highest value care.

Relating Gap Analysis Results to Information Systems Program Attitudes: The Identification of Gap Priorities and Implications

ERIC Educational Resources Information Center

Van Auken, Stuart; Chrysler, Earl; Wells, Ludmilla Gricenko; Simkin, Mark

2011-01-01

The authors utilized a gap analysis approach to assess general IS knowledge and skill voids or overages in a specific program context. The authors asked alumni to reveal the emphasis that should have been given to 10 IS knowledge and skill areas and compared the results with the emphasis that was actually given. They proceed by relating the…

Results of the Lunar Exploration Analysis Group (LEAG) Gap Review: Specific Action Team (SAT), Examination of Strategic Knowledge Gaps (SKGs) for Human Exploration of the Moon

NASA Technical Reports Server (NTRS)

Shearer, C. K.; Eppler, D.; Farrell, W.; Gruener, J.; Lawrence, S.; Pellis, N.; Spudis, P. D.; Stopar, J.; Zeigler, R.; Neal, C;

Confidence-based learning CME: overcoming barriers in irritable bowel syndrome with constipation.

PubMed

Cash, Brooks; Mitchner, Natasha A; Ravyn, Dana

2011-01-01

Performance of health care professionals depends on both medical knowledge and the certainty with which they possess it. Conventional continuing medical education interventions assess the correctness of learners' responses but do not determine the degree of confidence with which they hold incorrect information. This study describes the use of confidence-based learning (CBL) in an activity designed to enhance learners' knowledge, confidence in their knowledge, and clinical competence with regard to constipation-predominant IBS (IBS-C), a frequently underdiagnosed and misdiagnosed condition. The online CBL activity included multiple-choice questions in 2 modules: Burden of Care (BOC; 28 questions) and Patient Scenarios (PS; 9 case-based questions). After formative assessment, targeted feedback was provided, and the learner focused on material with demonstrated knowledge and/or confidence gaps. The process was repeated until 85% of questions were answered correctly and confidently (ie, mastery was attained). Of 275 participants (24% internal medicine, 13% gastroenterology, 32% family medicine, and 31% other), 249 and 167 completed the BOC and PS modules, respectively. Among all participants, 61.8% and 98.2% achieved mastery in the BOC and PS modules, respectively. Baseline mastery levels between specialties were significantly different in the BOC module (p = 0.002); no significant differences were evident between specialties in final mastery levels. Approximately one-third of learners were confident and wrong in topics of epidemiology, defining IBS and constipation, and treatments in the first iteration. No significant difference was observed between specialties for the PS module in either the first or last iterations. Learners achieved mastery in topics pertaining to IBS-C regardless of baseline knowledge or specialty. These data indicate that CME activities employing CBL can be used to address knowledge and confidence gaps. Copyright © 2010 The Alliance for Continuing Medical Education, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

Critical maternal health knowledge gaps in low- and middle-income countries for the post-2015 era.

PubMed

Kendall, Tamil; Langer, Ana

2015-06-05

Effective interventions to promote maternal health and address obstetric complications exist, however 800 women die every day during pregnancy and childbirth from largely preventable causes and more than 90% of these deaths occur in low and middle income countries (LMIC). In 2014, the Maternal Health Task Force consulted 26 global maternal health researchers to identify persistent and critical knowledge gaps to be filled to reduce maternal morbidity and mortality and improve maternal health. The vision of maternal health articulated was comprehensive and priorities for knowledge generation encompassed improving the availability, accessibility, acceptability, and quality of institutional labor and delivery services and other effective interventions, such as contraception and safe abortion services. Respondents emphasized the need for health systems research to identify models that can deliver what is known to be effective to prevent and treat the main causes of maternal death at scale in different contexts and to sustain coverage and quality over time. Researchers also emphasized the development of tools to measure quality of care and promote ongoing quality improvement at the facility, district, and national level. Knowledge generation to improve distribution and retention of healthcare workers, facilitate task shifting, develop and evaluate training models to improve "hands-on" skills and promote evidence-based practice, and increase managerial capacity at different levels of the health system were also prioritized. Interviewees noted that attitudes, behavior, and power relationships between health professionals and within institutions must be transformed to achieve coverage of high-quality maternal health services in LMIC. The increasing burden of non-communicable diseases, urbanization, and the persistence of social and economic inequality were identified as emerging challenges that require knowledge generation to improve health system responses and evaluate progress. Respondents emphasized evaluating effectiveness, feasibility, and equity impacts of health system interventions. A prominent role for implementation science, evidence for policy advocacy, and interdisciplinary collaboration were identified as critical areas for knowledge generation to improve maternal health in the post-2015 era.

Developing a Climate Change Boundary Organization: the Montana Adaptation Knowledge Exchange

NASA Astrophysics Data System (ADS)

Whitlock, C. L.; Brooks, S.; Armstrong, T.; Bryan, B.

2017-12-01

States, like Montana, with small populations and large areas, are challenged by a need to offer timely and relevant climate-science information that addresses diverse and widely dispersed stakeholder groups. In Montana, filling the gap between science and practice has motivated the first Montana Climate Assessment (MCA), released September 2017 with a focus on climate impacts on the agriculture, water and forestry sectors. The MCA is an outcome of a science-stakeholder partnership that has identified critical climate-change information and knowledge gaps for the state through listening sessions and questionnaires. From the initial feedback, it became clear that stakeholder groups were deeply concerned about the challenges posed by rising temperatures and wanted to know how recent and projected warming will affect Montana's natural and managed resources. As part of the next phase of the MCA project, we are now creating the Montana Adaptation Knowledge Exchange (MAKE), a "boundary organization" as described by the National Academy of Sciences. MAKE moves beyond information sharing by bringing scientists and practitioners together to seek solutions related to climate-change adaptation and other pressing environmental and socio-economic concerns. Through a collaborative partnership that involves Montana universities, state and federal agencies, businesses and non-governmental organizations, MAKE is designed to communicate current research findings and support revision and expansion of state-of-the-knowledge assessments like the MCA. Stakeholder partners will provide guidance to the science community to help prioritize research directions and activities of high importance. Significant, but often technical, scientific results will be translated and delivered to stakeholder groups through a variety of print, web, and mobile products. MAKE will support an extensive online database, host an online portal, gather a network of experts in respective fields, and maintain a knowledgeable customer service staff. Boundary organizations, such as MAKE, offer a path to effectively move from science to knowledge to action in the climate change arena while at the same time engaging practitioners and managers in the development of research agendas.

Gaps in the Substance Use Disorder Treatment Referral Process: Provider Perceptions.

PubMed

Blevins, Claire E; Rawat, Nishi; Stein, Michael D

2018-05-07

The demand for substance use disorder treatment is increasing, fueled by the opioid epidemic and the Affordable Care Act mandate to treat substance use disorders. The increased demand for treatment, however, is not being met by a corresponding increase in access to or availability of treatment. This report focuses specifically on the treatment referral process, which we have identified as 1 of the key barriers to timely and effective treatment. Difficulties in referral to substance use disorder treatment are examined through the lens of providers who make referrals (ie, referral source) and individuals who work in substance use disorder facilities (ie, referral recipient). Administrative officials, emergency department physicians, addiction physicians, government officials, providers, insurance officials, and mental health advocates (n = 59) were interviewed on the referral process protocol, challenges for providers and others making referrals, and issues with substance use treatment facility intake procedures. Several main themes were identified as barriers in the process: difficulties in determining patient eligibility, lack of transparency regarding treatment capacity, referral source knowledge/understanding of options, and issues with communication between referral source and recipient. We then proposed several solutions to address specific barriers. Current gaps in the referral process cause delays to care. Improving systems would involve addressing these themes and expanding the use of appropriate treatments for the many patients in need.

Creation and implementation of an emergency medicine education and training program in Turkey: an effective educational intervention to address the practitioner gap.

PubMed

Bellows, Jennifer Whitfield; Douglass, Katherine; Atilla, Ridvan; Smith, Jeffrey; Kapur, G Bobby

2013-07-22

The specialty of Emergency Medicine has enjoyed recognition for nearly 20 years in Turkey. However, the majority of underserved and rural Turkish emergency departments are staffed by general practitioners who lack formal training in the specialty and have few opportunities to increase emergency medicine-specific knowledge and skills. To address this "practitioner gap," the authors developed a four-phase comprehensive emergency medicine education and training program for general practitioners practicing in government hospitals in Turkey. From April 2006 until June 2009, 42 courses were taught by 62 trainers across seven regions in Turkey. A total of 2,262 physicians were trained. The mean course pre-test score for all regions was 42.3 (95% CI 39.8 to 44.7). The mean course post-test score was 70.1 (95% CI 67.2 to 72.9). The difference between the mean scores was 27.8 (95% CI 25.3 to 30.4, P <0.0001), reflecting an improvement of 65.7%. A partnership between an academic emergency medicine department and an emergency medicine society to implement country-wide training of physicians practicing in public emergency departments can serve as a successful model for capacity-building global emergency medicine endeavors.

Patient Privacy, Consent, and Identity Management in Health Information Exchange: Issues for the Military Health System.

PubMed

Hosek, Susan D; Straus, Susan G

2013-01-01

The Military Health System (MHS) and the Veterans Health Administration (VHA) have been among the nation's leaders in health information technology (IT), including the development of health IT systems and electronic health records that summarize patients' care from multiple providers. Health IT interoperability within MHS and across MHS partners, including VHA, is one of ten goals in the current MHS Strategic Plan. As a step toward achieving improved interoperability, the MHS is seeking to develop a research roadmap to better coordinate health IT research efforts, address IT capability gaps, and reduce programmatic risk for its enterprise projects. This article contributes to that effort by identifying gaps in research, policy, and practice involving patient privacy, consent, and identity management that need to be addressed to bring about improved quality and efficiency of care through health information exchange. Major challenges include (1) designing a meaningful patient consent procedure, (2) recording patients' consent preferences and designing procedures to implement restrictions on disclosures of protected health information, and (3) advancing knowledge regarding the best technical approaches to performing patient identity matches and how best to monitor results over time. Using a sociotechnical framework, this article suggests steps for overcoming these challenges and topics for future research.

Opioid Use in Pregnancy, Neonatal Abstinence Syndrome, and Childhood Outcomes: Executive Summary of a Joint Workshop by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, American College of Obstetricians and Gynecologists, American Academy of Pediatrics, Society for Maternal-Fetal Medicine, Centers for Disease Control and Prevention, and the March of Dimes Foundation.

PubMed

Reddy, Uma M; Davis, Jonathan M; Ren, Zhaoxia; Greene, Michael F

2017-07-01

In April 2016, the Eunice Kennedy Shriver National Institute of Child Health and Human Development invited experts to a workshop to address numerous knowledge gaps and to review the evidence for the screening and management of opioid use in pregnancy and neonatal abstinence syndrome. The rising prevalence of opioid use in pregnancy has led to a concomitant dramatic fivefold increase in neonatal abstinence syndrome over the past decade. Experts from diverse disciplines addressed research gaps in the following areas: 1) optimal screening for opioid use in pregnancy; 2) complications of pregnancy associated with opioid use; 3) appropriate treatments for pregnant women with opioid use disorders; 4) the best approaches for detecting, treating, and managing newborns with neonatal abstinence syndrome; and 5) the long-term effects of prenatal opioid exposure on children. Workshop participants identified key scientific opportunities to advance the understanding of opioid use disorders in pregnancy and to improve outcomes for affected women, their children, and their families. This article provides a summary of the workshop presentations and discussions.

Discrepancies in households and other stakeholders viewpoints on the food security experience: a gap to address.

PubMed

Hamelin, Anne-Marie; Mercier, Céline; Bédard, Annie

2010-06-01

This paper reports results from a case study on household food insecurity needs and the interventions that address them. It aimed at comparing households' perceptions on food insecurity experience and vulnerability to those of other stakeholders: community workers, programme managers and representatives from donor agencies. Semi-structured interviews with 55 households and 59 other stakeholders were conducted. Content analysis was performed, using a framework encompassing food sufficiency, characterization of household food insecurity and vulnerability of households to food insecurity. Overall, the results draw attention to a gap between households and the other stakeholders, where the later do not seem always able to assess the realities of food-insecure households. Other areas of divergences include: characteristics of food insecurity, relative importance of various risk factors related to food insecurity and the effectiveness of the community assistance to enhance the households' ability to face food insecurity. These divergent perceptions may jeopardize the implementation of sustainable solutions to food insecurity. Training of stakeholders for a better assessment of households' experience and needs, and systematic evaluation of interventions, appear urgent and highly relevant for an adequate response to households' needs. Collaboration between all stakeholders should lead to knowledge sharing and advocacy for policies dedicated to poverty reduction.

Knowledge Translation for Cardiovascular Disease Research and Management in Japan

PubMed Central

Shommu, Nusrat S

2017-01-01

Knowledge translation is an essential and emerging arena in healthcare research. It is the process of aiding the application of research knowledge into clinical practice or policymaking. Individuals at all levels of the health care system, including patients, healthcare professionals, and policymakers, are affected by the gaps that exist between research evidence and practice; the process of knowledge translation plays a role in bridging these gaps and incorporating high-quality clinical research into decision-making. Cardiovascular disease (CVD) management is a crucial area of healthcare where information gaps are known to exist. Although Japan has one of the lowest risks and mortality rates from CVDs, an increasing trend of cardiovascular incidence and changes in the risk factor conditions have been observed in recent years. This article provides an overview of knowledge translation and its importance in the cardiovascular health of the Japanese population, and describes the key steps of a typical knowledge translation strategy. PMID:28757537

Knowledge Translation for Cardiovascular Disease Research and Management in Japan.

PubMed

Shommu, Nusrat S; Turin, Tanvir C

2017-09-01

Knowledge translation is an essential and emerging arena in healthcare research. It is the process of aiding the application of research knowledge into clinical practice or policymaking. Individuals at all levels of the health care system, including patients, healthcare professionals, and policymakers, are affected by the gaps that exist between research evidence and practice; the process of knowledge translation plays a role in bridging these gaps and incorporating high-quality clinical research into decision-making. Cardiovascular disease (CVD) management is a crucial area of healthcare where information gaps are known to exist. Although Japan has one of the lowest risks and mortality rates from CVDs, an increasing trend of cardiovascular incidence and changes in the risk factor conditions have been observed in recent years. This article provides an overview of knowledge translation and its importance in the cardiovascular health of the Japanese population, and describes the key steps of a typical knowledge translation strategy.

Legal knowledge, needs, and assistance seeking among HIV positive and negative women in Umlazi, South Africa.

PubMed

Hill, Lauren M; Maman, Suzanne; Holness, David; Moodley, Dhayendre

2016-01-22

The rights of women and people living with HIV (PLHIV) are protected under South African law, yet there is a gap in the application of these laws. While there are numerous systemic and social barriers to women's and PLHIV's exercise of their legal rights and rights to access social services, there has been little effort to document these barriers as well as legal needs and knowledge in this context. 1480 HIV-positive and HIV-negative women recruited from an antenatal clinic in Umlazi Township completed a questionnaire on legal knowledge, experience of legal issues, assistance seeking for legal issues, and barriers to seeking assistance. We compared the legal knowledge and experience of legal issues of HIV-positive and HIV-negative women, and described assistance seeking and barriers to assistance seeking among all women. Both HIV-positive and HIV-negative women had high levels of knowledge of their legal rights. There were few important differences in legal knowledge and experience of legal issues by HIV status. The most common legal issues women experienced were difficulty obtaining employment (11 %) and identification documents (7 %). A minority of women who had ever experienced a legal issue had sought assistance for this issue (38 %), and half (50 %) of assistance sought was from informal sources such as family and friends. Women cited lack of time and government bureaucracy as the major barriers to seeking assistance. These results indicate few differences in legal knowledge and needs between HIV-positive and HIV-negative women in this context, but rather legal needs common among women of reproductive age. Legal knowledge may be a less important barrier to seeking assistance for legal issues than time, convenience, and cost. Expanding the power of customary courts to address routine legal issues, encouragement of pro bono legal assistance, and introduction of legal navigators could help to address these barriers.

Core Design Characteristics of the Fluoride Salt-Cooled High Temperature Demonstration Reactor

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

Brown, Nicholas R; Qualls, A L; Betzler, Benjamin R

2016-01-01

Fluoride salt-cooled high temperature reactors (FHRs) are a promising reactor technology option with significant knowledge gaps to implementation. One potential approach to address those technology gaps is via a small-scale demonstration reactor with the goal of increasing the technology readiness level (TRL) of the overall system for the longer term. The objective of this paper is to outline a notional concept for such a system, and to address how the proposed concept would advance the TRL of FHR concepts. Development of the proposed FHR Demonstration Reactor (DR) will enable commercial FHR deployment through disruptive and rapid technology development and demonstration.more » The FHR DR will close remaining gaps to commercial viability. Lower risk technologies are included in the initial FHR DR design to ensure that the reactor can be built, licensed, and operated within an acceptable budget and schedule. Important capabilities that will be demonstrated by building and operating the FHR DR include core design methodologies; fabrication and operation of high temperature reactors; salt procurement, handling, maintenance, and ultimate disposal; salt chemistry control to maximize vessel life; tritium management; heat exchanger performance; pump performance; and reactivity control. The FHR DR is considered part of a broader set of FHR technology development and demonstration efforts, some of which are already underway. Nonreactor test efforts (e.g., heated salt loops or loops using simulant fluids) can demonstrate many technologies necessary for commercial deployment of FHRs. The FHR DR, however, fulfills a crucial role in FHR technology development by advancing the technical maturity and readiness level of the system as a whole.« less

Challenges with Evidence-Based Management of Stable Ischemic Heart Disease.

PubMed

Patel, Amit V; Bangalore, Sripal

2017-02-01

Stable ischemic heart disease (SIHD) is a highly prevalent condition associated with increased costs, morbidity, and mortality. Management goals of SIHD can broadly be thought of in terms of improving prognosis and/or improving symptoms. Treatment options include medical therapy as well as revascularization, either with percutaneous coronary intervention or coronary artery bypass grafting. Herein, we will review the current evidence base for treatment of SIHD as well as its challenges and discuss ongoing studies to help address some of these knowledge gaps. There has been no consistent reduction in death or myocardial infarction (MI) with revascularization vs. medical therapy in patients with SIHD in contemporary trials. Angina and quality of life have been shown to be relieved more rapidly with revascularization vs. optimal medical therapy; however, the durability of these results is uncertain. There have been challenges and limitations in several of the trials addressing the optimal treatment strategy for SIHD due to potential selection bias (due to knowledge of coronary anatomy prior to randomization), patient crossover, and advances in medical therapy and revascularization strategies since trial completion. The challenges inherent to prior trials addressing the optimal management strategy for SIHD have impacted the generalizability of results to real-world cohorts. Until the results of additional ongoing trials are available, the decision for revascularization or medical therapy should be based on patients' symptoms, weighing the risks and benefits of each approach, and patient preference.

Impact of simple conventional and Telehealth solutions on improving mental health in Afghanistan.

PubMed

Khoja, Shariq; Scott, Richard; Husyin, Nida; Durrani, Hammad; Arif, Maria; Faqiri, Faqir; Hedayat, Ebadullah; Yousufzai, Wahab

2016-12-01

For more than a century Afghanistan has been unstable, facing decades of war, social problems, and intense poverty. As a result, many of the population suffer from a variety of mental health problems. The Government recognises the situation and has prioritised mental health, but progress is slow and services outside of Kabul remain poor. An international collaborative implemented a project in Badakshan province of Afghanistan using conventional and simple low-cost e-Health solutions to address the four most common issues: depression, psychosis, post-traumatic stress disorder, and substance abuse. Conventional town hall meetings informed community members to raise awareness and knowledge. In addition, an android-based mobile application used the World Health Organization's Mental Health Gap Action Programme guidelines and protocols to: collect information from community healthcare workers; provide referral services to patients; provide blended learning to improve providers' mental health knowledge, skills, and practice; and to provide store-and-forward and live consultations. Preliminary evaluation of the intervention shows enhanced access to care for remote communities, decreased stigma, and improved quality of health services. Primary care workers are also able to bridge the gap in consultations for rural and remote communities, connecting them with specialists and providing better access to care. © The Author(s) 2016.

Standardization of fluorine-18 manufacturing processes: new scientific challenges for PET.

PubMed

Hjelstuen, Ole K; Svadberg, Anders; Olberg, Dag E; Rosser, Mark

2011-08-01

In [(18)F]fluoride chemistry, the minute amounts of radioactivity taking part in a radiolabeling reaction are easily outnumbered by other reactants. Surface areas become comparably larger and more influential than in standard fluorine chemistry, while leachables, extractables, and other components that normally are considered small impurities can have a considerable influence on the efficiency of the reaction. A number of techniques exist to give sufficient (18)F-tracer for a study in a pre-clinical or clinical system, but the chemical and pharmaceutical understanding has significant gaps when it comes to scaling up or making the reaction more efficient. Automation and standardization of [(18)F]fluoride PET tracers is a prerequisite for reproducible manufacturing across multiple PET centers. So far, large-scale, multi-site manufacture has been established only for [(18)F]FDG, but several new tracers are emerging. In general terms, this transition from small- to large-scale production has disclosed several scientific challenges that need to be addressed. There are still areas of limited knowledge in the fundamental [(18)F]fluoride chemistry. The role of pharmaceutical factors that could influence the (18)F-radiosynthesis and the gaps in precise chemistry knowledge are discussed in this review based on a normal synthesis pattern. Copyright © 2011 Elsevier B.V. All rights reserved.

Towards an understanding of the link between environmental emissions and human body burdens of PCBs using CoZMoMAN.

PubMed

Breivik, Knut; Czub, Gertje; McLachlan, Michael S; Wania, Frank

2010-01-01

Different factors affect how organic contaminants released into the environment over time distribute and accumulate, enter various food-chains, and potentially cause toxic effects in wildlife and humans. A sound chemical risk assessment thus requires the determination of the quantitative relationship between emissions and human exposure. This study aimed to assess the extent of the quantitative and mechanistic understanding of the link between environmental emissions and human body burdens for polychlorinated biphenyls (PCBs) in the western part of the Baltic Sea drainage basin and to identify any remaining knowledge gaps. An integrated, non-steady state model calculating human body burden from environmental emissions (CoZMoMAN) was created by linking the multi-compartment environmental fate model CoZMo-POP 2 with the human food chain bioaccumulation model ACC-HUMAN. CoZMoMAN predicted concentrations of seven PCB congeners in 11 key model compartments to typically within a factor of 2 to 4 of measured values, although larger discrepancies are noted for soils and humans. We conclude that whereas the most important processes which link emissions of PCBs to human body burdens are quite well understood in this region, some critical knowledge gaps related to the time trend of historical emissions remain to be addressed.

DNA barcoding in diverse educational settings: five case studies

PubMed Central

Imondi, Ralph; James, Karen; Spencer, Diana; Steinke, Dirk

2016-01-01

Despite 250 years of modern taxonomy, there remains a large biodiversity knowledge gap. Most species remain unknown to science. DNA barcoding can help address this gap and has been used in a variety of educational contexts to incorporate original research into school curricula and informal education programmes. A growing body of evidence suggests that actively conducting research increases student engagement and retention in science. We describe case studies in five different educational settings in Canada and the USA: a programme for primary and secondary school students (ages 5–18), a year-long professional development programme for secondary school teachers, projects embedding this research into courses in a post-secondary 2-year institution and a degree-granting university, and a citizen science project. We argue that these projects are successful because the scientific content is authentic and compelling, DNA barcoding is conceptually and technically straightforward, the workflow is adaptable to a variety of situations, and online tools exist that allow participants to contribute high-quality data to the international research effort. Evidence of success includes the broad adoption of these programmes and assessment results demonstrating that participants are gaining both knowledge and confidence. There are exciting opportunities for coordination among educational projects in the future. This article is part of the themed issue ‘From DNA barcodes to biomes’. PMID:27481792

Systematically evaluating read-across prediction and ...

EPA Pesticide Factsheets

Read-across is a popular data gap filling technique within category and analogue approaches for regulatory purposes. Acceptance of read-across remains an ongoing challenge with several efforts underway for identifying and addressing uncertainties. Here we demonstrate an algorithmic, automated approach to evaluate the utility of using in vitro bioactivity data (“bioactivity descriptors”, from EPA’s ToxCast program) in conjunction with chemical descriptor information to derive local validity domains (specific sets of nearest neighbors) to facilitate read-across for a number of in vivo repeated dose toxicity study types. Over 3400 different chemical structure descriptors were generated for a set of 976 chemicals and supplemented with the outcomes from 821 in vitro assays. The read-across prediction for a given chemical was based on the similarity weighted endpoint outcomes of its nearest neighbors. The approach enabled a performance baseline for read-across predictions of specific study outcomes to be established. Bioactivity descriptors were often found to be more predictive of in vivo toxicity outcomes than chemical descriptors or a combination of both. The approach shows promise as part of a screening assessment in the absence of prior knowledge. Future work will investigate to what extent encoding expert knowledge leads to an improvement in read-across prediction. Read-across is a popular data gap filling technique within category and analogue approaches

DNA barcoding in diverse educational settings: five case studies.

PubMed

Henter, Heather J; Imondi, Ralph; James, Karen; Spencer, Diana; Steinke, Dirk

2016-09-05

Despite 250 years of modern taxonomy, there remains a large biodiversity knowledge gap. Most species remain unknown to science. DNA barcoding can help address this gap and has been used in a variety of educational contexts to incorporate original research into school curricula and informal education programmes. A growing body of evidence suggests that actively conducting research increases student engagement and retention in science. We describe case studies in five different educational settings in Canada and the USA: a programme for primary and secondary school students (ages 5-18), a year-long professional development programme for secondary school teachers, projects embedding this research into courses in a post-secondary 2-year institution and a degree-granting university, and a citizen science project. We argue that these projects are successful because the scientific content is authentic and compelling, DNA barcoding is conceptually and technically straightforward, the workflow is adaptable to a variety of situations, and online tools exist that allow participants to contribute high-quality data to the international research effort. Evidence of success includes the broad adoption of these programmes and assessment results demonstrating that participants are gaining both knowledge and confidence. There are exciting opportunities for coordination among educational projects in the future.This article is part of the themed issue 'From DNA barcodes to biomes'. © 2016 The Authors.

European Training and Research in Peritoneal Dialysis: scientific objectives, training, implementation and impact of the programme.

PubMed

Foster, Tom L; Ferrantelli, Evelina; van Wier-van der Schaaf, Tanja; Beelen, Robert H J

2014-03-01

Peritoneal dialysis (PD) offers many advantages over hospital-based haemodialysis, including better quality of life. Despite this, there is a general under-utilisation of PD in Europe, which, to some extent, can be attributed to a lack of knowledge and education amongst renal clinicians and nurses. The specific aim of the European Training and Research in Peritoneal Dialysis (EuTRiPD) programme is to address this lack of knowledge, to develop a minimum of five biomarkers that allow the prediction of outcome in PD and three therapeutic treatments to improve outcome in PD. EuTRiPD is a EU-wide consortium with clinical, academic and commercial partners set up to address this knowledge gap. By training through research and close collaboration between academic and commercial entities we hope to improve the outcome and uptake of PD. It is the goal of EuTRiPD to improve the currently hampered diagnostic therapeutic developments in renal replacement therapy (RRT) and structure existing high-quality PD-related research across Europe. It is hoped that EuTRiPD can and will have a significant impact on socio-economic and scientific aspects of PD. It is the aim for EuTRiPD to boost the uptake of PD throughout Europe by making PD the obvious choice for patients. © 2013 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Addressing the Skills Gap in Saudi Arabia: Does Vocational Education Address the Needs of Private Sector Employers?

ERIC Educational Resources Information Center

Baqadir, Abdullah; Patrick, Fiona; Burns, George

2011-01-01

This article reports the findings of data drawn from doctoral research on the extent to which recent changes in vocational training have addressed a perceived skills gap between the needs of private sector employers and potential workers in Saudi Arabia. While the Saudi government has made efforts to enhance the quality of vocational education,…

CO2 Urban Synthesis and Analysis ("CO2-USA") Network

NASA Astrophysics Data System (ADS)

Lin, J. C.; Hutyra, L.; Loughner, C.; Stein, A. F.; Lusk, K.; Mitchell, L.; Gately, C.; Wofsy, S. C.

2017-12-01

Emissions of carbon associated with cities comprise a large component of the anthropogenic source. A number of cities have announced plans to reduce greenhouse gas emissions, but the scientific knowledge to quantitatively track emissions and assess the efficacy of mitigation is lacking. As the global population increasingly resides in urban regions, scientific knowledge about how much, where, and why a particular city emits carbon becomes increasingly important. To address this gap, researchers have initiated studies of carbon emissions and cycling in several U.S. cities, making it timely to develop a collaborative network to exchange information on community standards and common measurements, facilitate data sharing, and create analysis frameworks and cross-city syntheses to catalyze a new generation of researchers and enable new collaborations tackling important objectives that are difficult to address in isolation. We describe initial results from an incipient network focusing initially on cities in the U.S. with low barriers of entry that entrains a cross-section of U.S. urban centers with varying characteristics: size, population density, vegetation, urban form, infrastructure, development rates, climate, and meteorological patterns. Results will be reported that emerge from an initial workshop covering data harmonization & integration, inventory comparison, stakeholder outreach, network design, inverse modeling, and collaboration.

Managing caries: the need to close the gap between the evidence base and current practice.

PubMed

Schwendicke, F; Doméjean, S; Ricketts, D; Peters, M

2015-11-13

Underpinned by a changing knowledge of the aetiology of caries and its sequelae, and assisted by established and advancing dental materials, there is growing evidence supporting less invasive management of dental caries based on the principles of minimal intervention dentistry. This narrative review assesses both the evidence and the adoption of less invasive caries management strategies and describes ways in which the gap between evidence and practice might be overcome. While there is increasing data supporting less invasive management of carious lesions, these are not standard in most dental practices worldwide. Usually, clinical studies focused on efficacy as outcome, and did not take into consideration the views and priorities of other stakeholders, such as primary care dentists, educators, patients and those financing services. Involving these stakeholders into study design and demonstrating the broader advantages of new management strategies might improve translation of research into practice. In theory, clinical dentists can rely on a growing evidence in cariology regarding less invasive management options. In practice, further factors seem to impede adoption of these strategies. Future research should address these factors by involving major stakeholders and investigating their prioritised outcomes to narrow or close the evidence gap.

Knowledge, attitude and practice GAP in family planning usage: an analysis of selected cities of Uttar Pradesh.

PubMed

Singh, Anjali; Singh, K K; Verma, Prashant

2016-01-01

The GAP between the knowledge of contraception and its actual practice is well recognized in the literature of family welfare studies. The present study assessed the relation between the level of knowledge and practice of contraception among the women and sought to explore the reasons behind the Knowledge, Attitude, and Practice - GAP (KAP GAP) regarding contraceptive users in six cities of Uttar Pradesh. Present analysis based on 17,643 currently married women aged 15 to 49. A Bivariate analysis ( χ 2 test) and a multivariable logistic regression were performed for the study. The highest percentages of respondents (women) were in the age group 35-49 (40-45 %) in all the districts considered. Knowledge of contraceptives was almost universal; tubal ligation and pill were the commonly known methods. Information about the contraceptive methods was mostly obtained through the husband. In the present study, there was a highly significant association ( p  < 0.01) of age group, educational status of respondents, the number of living children, the wealth of the respondent, media exposure and husband's education with the variable KAP GAP for all six cities. Health concern issues in all the districts were the most prominent reason for not using contraception. There differences in the socioeconomic and demographic factors exist, which lead to KAP GAP in the family planning (FP) usages. Therefore, in designing effective family planning programme, there is a need to understand the various factors which influence the practice of contraception.

Accessing and integrating data and knowledge for biomedical research.

PubMed

Burgun, A; Bodenreider, O

2008-01-01

To review the issues that have arisen with the advent of translational research in terms of integration of data and knowledge, and survey current efforts to address these issues. Using examples form the biomedical literature, we identified new trends in biomedical research and their impact on bioinformatics. We analyzed the requirements for effective knowledge repositories and studied issues in the integration of biomedical knowledge. New diagnostic and therapeutic approaches based on gene expression patterns have brought about new issues in the statistical analysis of data, and new workflows are needed are needed to support translational research. Interoperable data repositories based on standard annotations, infrastructures and services are needed to support the pooling and meta-analysis of data, as well as their comparison to earlier experiments. High-quality, integrated ontologies and knowledge bases serve as a source of prior knowledge used in combination with traditional data mining techniques and contribute to the development of more effective data analysis strategies. As biomedical research evolves from traditional clinical and biological investigations towards omics sciences and translational research, specific needs have emerged, including integrating data collected in research studies with patient clinical data, linking omics knowledge with medical knowledge, modeling the molecular basis of diseases, and developing tools that support in-depth analysis of research data. As such, translational research illustrates the need to bridge the gap between bioinformatics and medical informatics, and opens new avenues for biomedical informatics research.

Establishing a national knowledge translation and generation network in kidney disease: the CAnadian KidNey KNowledge TraNslation and GEneration NeTwork.

PubMed

Manns, Braden; Barrett, Brendan; Evans, Michael; Garg, Amit; Hemmelgarn, Brenda; Kappel, Joanne; Klarenbach, Scott; Madore, Francois; Parfrey, Patrick; Samuel, Susan; Soroka, Steven; Suri, Rita; Tonelli, Marcello; Wald, Ron; Walsh, Michael; Zappitelli, Michael

2014-01-01

Patients with chronic kidney disease (CKD) do not always receive care consistent with guidelines, in part due to complexities in CKD management, lack of randomized trial data to inform care, and a failure to disseminate best practice. At a 2007 conference of key Canadian stakeholders in kidney disease, attendees noted that the impact of Canadian Society of Nephrology (CSN) guidelines was attenuated given limited formal linkages between the CSN Clinical Practice Guidelines Group, kidney researchers, decision makers and knowledge users, and that further knowledge was required to guide care in patients with kidney disease. The idea for the Canadian Kidney Knowledge Translation and Generation Network (CANN-NET) developed from this meeting. CANN-NET is a pan-Canadian network established in partnership with CSN, the Kidney Foundation of Canada and other professional societies to improve the care and outcomes of patients with and at risk for kidney disease. The initial priority areas for knowledge translation include improving optimal timing of dialysis initiation, and increasing the appropriate use of home dialysis. Given the urgent need for new knowledge, CANN-NET has also brought together a national group of experienced Canadian researchers to address knowledge gaps by encouraging and supporting multicentre randomized trials in priority areas, including management of cardiovascular disease in patients with kidney failure.

A comparison of knowledge of local analgesia, pulp therapy and restoration of primary molar teeth amongst dental students, dentists and dental therapists within a dental hospital setting.

PubMed

Foley, J

2007-06-01

To gain an overview of knowledge of local analgesia, pulpal therapy and restorative procedures in the primary dentition amongst dental undergraduate students (DS), dental therapy students (DTS), recently-qualified dentists (QD) and dental therapists (DT), working within a Dental Hospital setting. A survey undertaken at Dundee Dental Hospital and School, NHS Tayside, United Kingdom to determine current knowledge regarding the use of local analgesia, pulp anatomy and pulp therapy techniques in addition to restoration of primary teeth. Data were available for 24 individuals (DS: 5; QD: 6; DTS: 8; DT: 5). Deficiencies in knowledge regarding the maximum safe dose for local analgesia, pulp canal anatomy, pulp therapy medicaments and the preparation required prior to placement of a pre-formed metal crown were noted in both student and staff groups. The knowledge of basic dental procedures for children amongst a group of dental students, student dental therapists and recently qualified dentists and dental therapists, was found to be imperfect. These findings indicate that more research is needed on the educational procedures used in the transfer of such knowledge and skills. Deficiencies in knowledge were identified in all areas assessed. Courses should be designed at both the pre- and postgraduate level to address and avoid such gaps in knowledge.

Developing a Gap Taxonomy to Address Crew Health Risks in NASA's Human Research Program

NASA Technical Reports Server (NTRS)

Kundrot, Craig E.; Edwards, J. Michelle

2009-01-01

The mission of NASA's Human Research Program (HRP) is to understand and reduce the risk to crew health and performance in exploration missions. The HRP addresses 27 specific risks by identifying and then filling gaps in understanding the risks and in the ability to disposition the risks. The primary bases for identifying gaps have been past experience and requirements definition. This approach has been very effective in identifying some important, relevant gaps, but may be inadequate for identifying gaps outside the past experience base. We are exploring the use of a gap taxonomy as a comprehensive, underlying conceptual framework that allows a more systematic identification of gaps. The taxonomy is based on these stages in medical care: prediction, prevention, detection/diagnosis, treatment, monitoring, rehabilitation, and lifetime surveillance. This gap taxonomy approach identifies new gaps in HRP health risks. Many of the new gaps suggest risk reduction approaches that are more cost effective than present approaches. A major benefit of the gap taxonomy approach is to identify new, economical approaches that reduce the likelihood and/or consequence of a risk.

Health literacy in type 2 diabetes patients: a systematic review of systematic reviews.

PubMed

Caruso, Rosario; Magon, Arianna; Baroni, Irene; Dellafiore, Federica; Arrigoni, Cristina; Pittella, Francesco; Ausili, Davide

2018-01-01

Aim To summarize, critically review, and interpret the evidence related to the systematic reviews on health literacy (HL) amongst type 2 diabetes mellitus (T2DM). Methods The methodology for this study consisted of a systematic review of systematic reviews, using the PRISMA statement and flowchart to select studies, and searching on PubMed, CINAHL, Scopus, and Cochrane. The search covered the period between January 2006 and June 2016. Results From the 115 identified record by the queries, only six systematic reviews were included, following a quality evaluation using AMSTAR. The included systematic reviews content was analyzed by the independent work of two authors, using a narrative synthesis approach. The findings of this study (i.e., main themes) are areas of consensus and gaps in knowledge. Areas of consensus are HL definition, HL measurement tools, and the relationship between T2DM patient knowledge (or literacy) and his/her HL. The gaps in knowledge were the assessment of the relations between HL and health outcomes and self-efficacy, the gender differences, the effectiveness of interventions to improve HL, the cost-effectiveness study of interventions to improve HL, and the understanding of the influence of organizational environment on HL. Conclusion This review provides a current state of knowledge to address clinical practice and research proposals. HL could be useful to personalize patients' follow-up and it should be routinely assessed in its three dimensions (i.e. functional, interactive and critical) to enhance patients' ability to cope with clinical recommendations. Future research should be mainly aimed to test the effectiveness of evidence-based interventions to improve HL amongst T2DM patients.

A qualitative study of the knowledge, attitudes, and behaviors of people exposed to diesel exhaust at the workplace in British Columbia, Canada.

PubMed

Pui, Mandy; Nicol, Anne-Marie; Brauer, Michael; Palad, Farshad; Carlsten, Christopher

2017-01-01

To identify exposure-related knowledge, attitudes and behaviors of individuals occupationally exposed to diesel exhaust (DE); to reveal strengths, knowledge gaps and misperceptions therein. A Mental Models approach was used to gather information about current scientific understanding of DE exposure hazards and the ways in which exposure can be reduced. Thirty individuals in British Columbia who were regularly exposed to occupational DE were interviewed. The audio was recorded and transcribed. Data was grouped together and examined to draw out themes around DE awareness, hazard assessment and risk reduction behaviors. These themes were then compared and contrasted with existing grey and research literature in order to reveal strengths, gaps and misperceptions regarding DE exposure. Study participants were aware and concerned about their exposure to DE but had incomplete and sometimes incorrect understanding of exposure pathways, health effects, and effective strategies to reduce their exposures. The perceived likelihood of exposure to DE was significantly greater compared to that of other work hazards (p<0.01), whereas the difference for their perceived severity of consequences was not significant. There was no universally perceived main source of information regarding DE, and participants generally distrusted sources of information based on their past experience with the source. Most of the actions that were taken to address DE exposure fell into the area of administrative controls such as being aware of sources of DE and avoiding these sources. This study of the knowledge, attitude, and behavior of those occupationally exposed to DE found, most notably, that more education and training and the creation of a health effects inventory regarding DE exposure were desired.

How Can Data Drive Policy and Practice in Child Welfare? Making the Link in Canada.

PubMed

Fallon, Barbara; Filippelli, Joanne; Black, Tara; Trocmé, Nico; Esposito, Tonino

2017-10-14

Formal university-child welfare partnerships offer a unique opportunity to begin to fill the gaps in the child welfare knowledge base and link child welfare services to the realities of practice. With resources from a knowledge mobilization grant, a formal partnership was developed between the University of Toronto, clinicians, policy analysts, and researchers from child welfare agencies across Ontario. The key objectives of the grant included: (1) enhancing the capacity of service providers to access and analyze child welfare data to inform service and policy decisions; (2) integrating clinical expertise in service and policy decisions; and (3) developing a joint research agenda addressing high-priority knowledge gaps. This partnership was an opportunity to advance the evidence base with respect to service provision in Ontario and to create a culture of knowledge and evidence that would eventually support more complex research initiatives. Administrative data was analyzed for this partnership through the Ontario Child Abuse and Neglect Data System (OCANDS)-the first child welfare data system in Ontario to track child welfare-involved children and their families. Child welfare agencies identified recurrence as an important priority and agency-driven analyses were subsequently conducted on OCANDS generated recurrence Service Performance Indicators (SPI's). Using an urgent versus chronic investigative taxonomy for analyses, findings revealed that the majority of cases did not recur within 12 months and cases identified as chronic needs are more likely to return to the attention of child welfare authorities. One of the key outcomes of the partnership - helping agencies to understand their administrative data is described, as are considerations for next steps for future partnerships and research.

A qualitative study of the knowledge, attitudes, and behaviors of people exposed to diesel exhaust at the workplace in British Columbia, Canada

PubMed Central

Nicol, Anne-Marie; Brauer, Michael

2017-01-01

Purpose To identify exposure-related knowledge, attitudes and behaviors of individuals occupationally exposed to diesel exhaust (DE); to reveal strengths, knowledge gaps and misperceptions therein. Methods A Mental Models approach was used to gather information about current scientific understanding of DE exposure hazards and the ways in which exposure can be reduced. Thirty individuals in British Columbia who were regularly exposed to occupational DE were interviewed. The audio was recorded and transcribed. Data was grouped together and examined to draw out themes around DE awareness, hazard assessment and risk reduction behaviors. These themes were then compared and contrasted with existing grey and research literature in order to reveal strengths, gaps and misperceptions regarding DE exposure. Results Study participants were aware and concerned about their exposure to DE but had incomplete and sometimes incorrect understanding of exposure pathways, health effects, and effective strategies to reduce their exposures. The perceived likelihood of exposure to DE was significantly greater compared to that of other work hazards (p<0.01), whereas the difference for their perceived severity of consequences was not significant. There was no universally perceived main source of information regarding DE, and participants generally distrusted sources of information based on their past experience with the source. Most of the actions that were taken to address DE exposure fell into the area of administrative controls such as being aware of sources of DE and avoiding these sources. Conclusions This study of the knowledge, attitude, and behavior of those occupationally exposed to DE found, most notably, that more education and training and the creation of a health effects inventory regarding DE exposure were desired. PMID:28841707

How Can Data Drive Policy and Practice in Child Welfare? Making the Link in Canada

PubMed Central

Filippelli, Joanne; Black, Tara; Trocmé, Nico; Esposito, Tonino

2017-01-01

Formal university–child welfare partnerships offer a unique opportunity to begin to fill the gaps in the child welfare knowledge base and link child welfare services to the realities of practice. With resources from a knowledge mobilization grant, a formal partnership was developed between the University of Toronto, clinicians, policy analysts, and researchers from child welfare agencies across Ontario. The key objectives of the grant included: (1) enhancing the capacity of service providers to access and analyze child welfare data to inform service and policy decisions; (2) integrating clinical expertise in service and policy decisions; and (3) developing a joint research agenda addressing high-priority knowledge gaps. This partnership was an opportunity to advance the evidence base with respect to service provision in Ontario and to create a culture of knowledge and evidence that would eventually support more complex research initiatives. Administrative data was analyzed for this partnership through the Ontario Child Abuse and Neglect Data System (OCANDS)—the first child welfare data system in Ontario to track child welfare-involved children and their families. Child welfare agencies identified recurrence as an important priority and agency-driven analyses were subsequently conducted on OCANDS generated recurrence Service Performance Indicators (SPI’s). Using an urgent versus chronic investigative taxonomy for analyses, findings revealed that the majority of cases did not recur within 12 months and cases identified as chronic needs are more likely to return to the attention of child welfare authorities. One of the key outcomes of the partnership — helping agencies to understand their administrative data is described, as are considerations for next steps for future partnerships and research. PMID:29036894

Bridging the Gap: using an interrupted time series design to evaluate systems reform addressing refugee maternal and child health inequalities.

PubMed

Yelland, Jane; Riggs, Elisha; Szwarc, Josef; Casey, Sue; Dawson, Wendy; Vanpraag, Dannielle; East, Chris; Wallace, Euan; Teale, Glyn; Harrison, Bernie; Petschel, Pauline; Furler, John; Goldfeld, Sharon; Mensah, Fiona; Biro, Mary Anne; Willey, Sue; Cheng, I-Hao; Small, Rhonda; Brown, Stephanie

2015-04-30

The risk of poor maternal and perinatal outcomes in high-income countries such as Australia is greatest for those experiencing extreme social and economic disadvantage. Australian data show that women of refugee background have higher rates of stillbirth, fetal death in utero and perinatal mortality compared with Australian born women. Policy and health system responses to such inequities have been slow and poorly integrated. This protocol describes an innovative programme of quality improvement and reform in publically funded universal health services in Melbourne, Australia, that aims to address refugee maternal and child health inequalities. A partnership of 11 organisations spanning health services, government and research is working to achieve change in the way that maternity and early childhood health services support families of refugee background. The aims of the programme are to improve access to universal health care for families of refugee background and build organisational and system capacity to address modifiable risk factors for poor maternal and child health outcomes. Quality improvement initiatives are iterative, co-designed by partners and implemented using the Plan Do Study Act framework in four maternity hospitals and two local government maternal and child health services. Bridging the Gap is designed as a multi-phase, quasi-experimental study. Evaluation methods include use of interrupted time series design to examine health service use and maternal and child health outcomes over a 3-year period of implementation. Process measures will examine refugee families' experiences of specific initiatives and service providers' views and experiences of innovation and change. It is envisaged that the Bridging the Gap program will provide essential evidence to support service and policy innovation and knowledge about what it takes to implement sustainable improvements in the way that health services support vulnerable populations, within the constraints of existing resources.

Giving what one should: explanations for the knowledge-behavior gap for altruistic giving.

PubMed

Blake, Peter R

2018-04-01

Several studies have shown that children struggle to give what they believe that they should: the so-called knowledge-behavior gap. Over a dozen recent Dictator Game studies find that, although young children believe that they should give half of a set of resources to a peer, they typically give less and often keep all of the resources for themselves. This article reviews recent evidence for five potential explanations for the gap and how children close it with age: self-regulation, social distance, theory of mind, moral knowledge and social learning. I conclude that self-regulation, social distance, and social learning show the most promising evidence for understanding the mechanisms that can close the gap. Copyright © 2017 Elsevier Ltd. All rights reserved.

Workshop on Current Issues in Predictive Approaches to Intelligence and Security Analytics: Fostering the Creation of Decision Advantage through Model Integration and Evaluation

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

Sanfilippo, Antonio P.

2010-05-23

The increasing asymmetric nature of threats to the security, health and sustainable growth of our society requires that anticipatory reasoning become an everyday activity. Currently, the use of anticipatory reasoning is hindered by the lack of systematic methods for combining knowledge- and evidence-based models, integrating modeling algorithms, and assessing model validity, accuracy and utility. The workshop addresses these gaps with the intent of fostering the creation of a community of interest on model integration and evaluation that may serve as an aggregation point for existing efforts and a launch pad for new approaches.

When synthetic chemicals degrade in the environment: What are the absolute fate, effects, and potential risks to humans and the ecosystem?

USGS Publications Warehouse

Boxall, Alistair; Sinclair, C.; Fenner, Kathrin; Kolpin, Dana W.; Maund, S.

2004-01-01

Although some regulatory schemes require information about the impacts of degradates on human and environmental health, that information does not exist for many compounds (25, 26). Pesticides are the exception. In this article, we bring together the available data to address the environmental behavior of degradates and their effects on organisms and discuss how to identify substances of potential concern. In addition, we cite gaps in the current knowledge and make recommendations for future research requirements. While the article focuses on pesticides, we believe these observations can be extended to biologically active compounds and some industrial substances.

Emergency Nursing Experiences in Assisting People With Suicidal Behavior: A Grounded Theory Study.

PubMed

Vedana, Kelly Graziani Giacchero; Magrini, Daniel Fernando; Miasso, Adriana Inocenti; Zanetti, Ana Carolina Guidorizzi; de Souza, Jacqueline; Borges, Tatiana Longo

2017-08-01

To understand emergency nursing experiences in assisting people with suicidal behavior. Grounded theory study with symbolic interactionism conducted in 2015 to 2016 in Brazil with 19 nurses. Assistance for people with suicidal behavior is critical, challenging, evokes different feelings and requires knowledge, skills and emotional control. Nurses did not feel prepared or supported, and identified recurrent gaps and problems. Nurses occupied a limited role, restricted to attending to physical needs. They predominantly manifested opposition, judgments and incomprehension about patients. This study presents key elements to be addressed in interventions and investigations regarding nursing support, training and supervision. Copyright © 2017 Elsevier Inc. All rights reserved.

Developing an Addictions Nursing Competency Framework Within a Canadian Context.

PubMed

Ling, Sara; Watson, Alison; Gehrs, Margaret

Clients with substance use disorders access care in all areas of the health care system, yet the Canadian nursing literature lacks content on the knowledge, skills, and judgment needed by nurses who work with this population. To address this literature gap, two Advanced Practice Nurses adapted the Canadian Centre on Substance Abuse's Technical Competencies for Canada's Substance Abuse Workforce to include nursing content and theory. This article describes the adaptation process and validation method used by the Advanced Practice Nurses at a large, Canadian urban teaching hospital and includes discussion about actual and potential opportunities for practical application of the adapted framework.

Round the bend: a brief history of mental health nursing in Victoria, Australia 1848 to 1950's.

PubMed

Sands, Natisha Marina

2009-06-01

This paper presents a history of mental health nursing in Victoria, Australia from 1848 to the 1950's, or the asylum years to the era of the mental hospital. The research for this historical overview was conducted as part of a literature review for a mental health nursing doctoral thesis, which included an account of the evolution of the profession from asylum attendant to the present time. The literature reviewed for this project revealed a distinct lack of a coherent, chronological account of the historical development of mental health nursing in Victoria, and this paper seeks to address that knowledge gap.

Serious gaming: A tool to educate health care providers about domestic violence.

PubMed

Mason, Robin; Turner, Linda

2018-05-10

Due to many adverse health effects, victims of domestic violence are frequently seen in the health care system. Yet, health care providers may lack the training to assist them. Online curricula can be an effective instructional tool. Our competency-based, serious video game, Responding to Domestic Violence in Clinical Settings, was designed to address health care providers' knowledge gaps through 17 modules, each a half hour in length. Nearly 9,000 participants completed at least one module; nursing students completed the most modules, approximately five hours of instruction. This serious video game-based curriculum is useful in helping health providers and students learn about Domestic Violence.