IMPROVEMENT OF WATER MAIN INSPECTION TECHNOLOGY
This document is a handout of a slide presentation that addresses improvement of water main inspection technology. The slide presentation addresses the need for improved inspection technology (e.g., 237,000 main breaks/yr); the limits on main break prevention; and, the adverse ...
Development of the Community Health Improvement Navigator Database of Interventions.
Roy, Brita; Stanojevich, Joel; Stange, Paul; Jiwani, Nafisa; King, Raymond; Koo, Denise
2016-02-26
With the passage of the Patient Protection and Affordable Care Act, the requirements for hospitals to achieve tax-exempt status include performing a triennial community health needs assessment and developing a plan to address identified needs. To address community health needs, multisector collaborative efforts to improve both health care and non-health care determinants of health outcomes have been the most effective and sustainable. In 2015, CDC released the Community Health Improvement Navigator to facilitate the development of these efforts. This report describes the development of the database of interventions included in the Community Health Improvement Navigator. The database of interventions allows the user to easily search for multisector, collaborative, evidence-based interventions to address the underlying causes of the greatest morbidity and mortality in the United States: tobacco use and exposure, physical inactivity, unhealthy diet, high cholesterol, high blood pressure, diabetes, and obesity.
Development of the Community Health Improvement Navigator Database of Interventions
Roy, Brita; Stanojevich, Joel; Stange, Paul; Jiwani, Nafisa; King, Raymond; Koo, Denise
2016-01-01
Summary With the passage of the Patient Protection and Affordable Care Act, the requirements for hospitals to achieve tax-exempt status include performing a triennial community health needs assessment and developing a plan to address identified needs. To address community health needs, multisector collaborative efforts to improve both health care and non–health care determinants of health outcomes have been the most effective and sustainable. In 2015, CDC released the Community Health Improvement Navigator to facilitate the development of these efforts. This report describes the development of the database of interventions included in the Community Health Improvement Navigator. The database of interventions allows the user to easily search for multisector, collaborative, evidence-based interventions to address the underlying causes of the greatest morbidity and mortality in the United States: tobacco use and exposure, physical inactivity, unhealthy diet, high cholesterol, high blood pressure, diabetes, and obesity. PMID:26917110
PARTNERING TO IMPROVE HUMAN EXPOSURE METHODS
Methods development research is an application-driven scientific area that addresses programmatic needs. The goals are to reduce measurement uncertainties, address data gaps, and improve existing analytical procedures for estimating human exposures. Partnerships have been develop...
2016-09-01
Congress. Consequently, as prepared now, this report does not help DOD leaders identify assets that could be used in a cyber crisis scenario...Guidance. GAO-13-128. Washington, D.C.: October 24, 2012. Defense Cyber Efforts: Management Improvements Needed to Enhance Programs Protecting the...DEFENSE CIVIL SUPPORT DOD Needs to Identify National Guard’s Cyber Capabilities and Address Challenges in Its
DOE Office of Scientific and Technical Information (OSTI.GOV)
Juengst, E.T.
1994-01-01
This essay reviews the efforts of the US Human Genome Project to anticipate and address the ethical, legal, and social implications of new advances in human genetics. Since 1990, approximately $10 million has been awarded by the National Institutes of Health and the DOE, in support of 65 research, education, and public discussion projects. These projects address four major areas of need: (1) the need for both client-centered assessments of new genetic services and for improved knowledge of the psychosocial and ethnocultural factors that shape clients' clinical genetic experiences; (2) the need for clear professional policies regarding human-subject research, clinicalmore » practical standards, and public health goals in human genetics; (3) the need for social policy protection against unfair access to and use of personal genetic information; (4) the need for improved public and professional understanding and discussion of these issues. The Human Genome Project's goal is to have defined, by 1995, policy options and programs capable of addressing these needs. 47 refs.« less
The Need for Comprehensive Health Care Quality Measures for Older Adults.
MacLeod, Stephanie; Schwebke, Kay; Hawkins, Kevin; Ruiz, Joann; Hoo, Emma; Yeh, Charlotte S
2017-10-24
Research indicates that older adults receive only about half of their recommended care, with varying quality and limited attention to social issues impacting their health through the most commonly used quality measures. Additionally, many existing measures neglect to address nonclinical social determinants of health. Evidence of the need for more comprehensive measures for seniors is growing. The primary purpose of this article, which is supported by a limited review of literature, is to describe gaps among current quality measures in addressing certain nonclinical needs of older adults, including key social determinants of health. In doing so, the authors describe their position on the need for expanded measures to incorporate these factors to improve care and quality of life. The authors conducted a limited review of the literature to inform this article, focusing specifically on selected measures for older adults rather than a broader systematic review of all measures. Most research identified was related to clinical practice guidelines rather than quality measures of care as applied to older adults. Furthermore, the literature reviewed reflected limited evidence of efforts to tailor quality measures for the unique social needs of older adults, confirming a potential gap in this area. A growing need exists for improved quality measures specifically designed to help providers address the unique social needs of older adults. Filling this gap will improve overall understanding of seniors and help them to achieve optimal health and successful aging.
Aoun, Samar M; Deas, Kathleen; Kristjanson, Linda J; Kissane, David W
2017-02-01
Family caregivers of people with motor neurone disease (MND) experience adverse health outcomes as a result of their caregiving experience. This may be alleviated if their support needs are identified and addressed in a systematic and timely manner. The objective of the present study was to assess the feasibility and relevance of the Carer Support Needs Assessment Tool (CSNAT) in home-based care during the period of caregiving from the perspectives of the family caregivers of people with MND and their service providers. The study was conducted during 2014 in Western Australia. Some 30 family caregivers and 4 care advisors participated in trialing the CSNAT intervention, which involved two visits from care advisors (6-8 weeks apart) to identify and address support needs. The feedback from family caregivers was obtained via telephone interviews and that of care advisors via a self-administered questionnaire. A total of 24 caregivers completed the study (80% completion rate) and identified the highest support priorities as "knowing what to expect in the future," "knowing who to contact if concerned," and "equipment to help care." The majority found that this assessment process adequately addressed their needs and gave them a sense of validation, reassurance, and empowerment. Care advisors advocated the CSNAT approach as an improvement over standard practice, allowing them to more clearly assess needs, to offer a more structured follow-up, and to focus on the caregiver and family. The CSNAT approach for identifying and addressing family caregivers' support needs was found to be relevant and feasible by MND family caregivers and care advisors. The tool provided a formal structure to facilitate discussions with family caregivers and thus enable needs to be addressed. Such discussions can also inform an evidence base for the ongoing development of services, ensuring that new and improved services are designed to meet the explicit needs of the family caregivers of people with a motor neurone disease.
Slack, Catherine M.
2014-01-01
There has been debate about sponsor-investigator ethical responsibilities to address participants’ medical needs in trials in resource-constrained contexts. Certain ethical guidelines make detailed recommendations. This study explored whether ethical guideline recommendations for care in HIV vaccine trials were being met, and whether stakeholders were facing difficulties addressed by guidelines. It sampled key stakeholders involved in two trials across five sites in South Africa, and reviewed relevant documentation. It concluded that sites were largely meeting guideline recommendations for addressing needs, with some exceeding these. Recommendations for writing protocols were only partially achieved. Recommendations for engaging participating community were mostly met, except for “moral negotiation” recommendations. Suggestions are made to strengthen practices, and to improve guidelines so they address empirical concerns. PMID:24572086
Slack, Catherine M
2014-02-01
There has been debate about sponsor-investigator ethical responsibilities to address participants' medical needs in trials in resource-constrained contexts. Certain ethical guidelines make detailed recommendations. This study explored whether ethical guideline recommendations for care in HIV vaccine trials were being met, and whether stakeholders were facing difficulties addressed by guidelines. It sampled key stakeholders involved in two trials across five sites in South Africa, and reviewed relevant documentation. It concluded that sites were largely meeting guideline recommendations for addressing needs, with some exceeding these. Recommendations for writing protocols were only partially achieved. Recommendations for engaging participating community were mostly met, except for "moral negotiation" recommendations. Suggestions are made to strengthen practices, and to improve guidelines so they address empirical concerns.
Medical Interpreting: Improving Communication with Your Patients.
ERIC Educational Resources Information Center
Tebble, Helen
The guide is designed for physicians and other medical practitioners who need to work with medical interpreters to improve communication with patients. Special attention is given to the Australian context. An introductory section discusses the need for medical interpreters and explains the guide's organization. Subsequent sections address these…
Griggs, Jennifer; Maingi, Shail; Blinder, Victoria; Denduluri, Neelima; Khorana, Alok A; Norton, Larry; Francisco, Michael; Wollins, Dana S; Rowland, Julia H
2017-07-01
ASCO is committed to addressing the needs of sexual and gender minority (SGM) populations as a diverse group at risk for receiving disparate care and having suboptimal experiences, including discrimination, throughout the cancer care continuum. This position statement outlines five areas of recommendations to address the needs of both SGM populations affected by cancer and members of the oncology workforce who identify as SGM: (1) patient education and support; (2) workforce development and diversity; (3) quality improvement strategies; (4) policy solutions; and (5) research strategies. In making these recommendations, the Society calls for increased outreach and educational support for SGM patients; increased SGM cultural competency training for providers; improvement of quality-of-care metrics that include sexual orientation and gender information variables; and increased data collection to inform future work addressing the needs of SGM communities.
On Adopting Solutions to Improve Population Health: Do We Have the Political Will?
ERIC Educational Resources Information Center
Galea, Sandro
2016-01-01
In this column, Sandro Galea addresses what would be required to identify and implement solutions that can improve the health of populations. Galea suggests that two perspectives need to inform solutions that might prove successful. First, solutions that aim to improve the health of populations need to be grounded in clarity of purpose, aiming to…
Wilmshurst, Jo M; Guekht, Alla; Secco, Mary; Helen Cross, J; Perucca, Emilio
2018-06-01
In May 2015 the World Health Assembly (WHA) approved the Resolution on the Global Burden of Epilepsy. This report addresses how the Resolution can be leveraged to improve the care of children with epilepsy worldwide. Children with epilepsy have unique needs and face unique challenges from stigma at all levels of society. Children lack a voice to lobby for their own needs, including their right to have access to education. Effective leadership and governance should be enhanced through the support of stakeholders empowered to counsel, advise, and lobby for appropriate care. National health care plans should integrate primary and specialist care, and they need to be adapted to local specificities. Antiepileptic medicines should be widely accessible in appropriate, sustained, and affordable ways. Public awareness initiatives are needed to improve the inclusion of affected children in society and to reduce stigma. Cost-effective interventions are also needed to address preventable causes of epilepsy. Without greater investment in research, evidence-based interventions cannot be implemented. Through all of this, civil society must be engaged to ensure that the multivariate dimensions from the clinic to the community are addressed to fulfil the needs of children with epilepsy.
Fazalullasha, Fatima; Taras, Jillian; Morinis, Julia; Levin, Leo; Karmali, Karima; Neilson, Barbara; Muskat, Barbara; Bloch, Gary; Chan, Kevin; McDonald, Maureen; Makin, Sue; Ford-Jones, E Lee
2014-04-01
Previous research has highlighted the importance of addressing the social determinants of health to improve child health outcomes. However, significant barriers exist that limit the paediatrician's ability to properly address these issues. Barriers include a lack of clinical time, resources, training and education with regard to the social determinants of health; awareness of community resources; and case-management capacity. General practice recommendations to help the health care provider link patients to the community are insufficient. The objective of the current article was to present options for improving the link between the office and the community, using screening questions incorporating physician-based tools that link community resources. Simple interventions, such as routine referral to early-year centres and selected referral to public health home-visiting programs, may help to address populations with the greatest needs.
Fazalullasha, Fatima; Taras, Jillian; Morinis, Julia; Levin, Leo; Karmali, Karima; Neilson, Barbara; Muskat, Barbara; Bloch, Gary; Chan, Kevin; McDonald, Maureen; Makin, Sue; Ford-Jones, E Lee
2014-01-01
Previous research has highlighted the importance of addressing the social determinants of health to improve child health outcomes. However, significant barriers exist that limit the paediatrician’s ability to properly address these issues. Barriers include a lack of clinical time, resources, training and education with regard to the social determinants of health; awareness of community resources; and case-management capacity. General practice recommendations to help the health care provider link patients to the community are insufficient. The objective of the current article was to present options for improving the link between the office and the community, using screening questions incorporating physician-based tools that link community resources. Simple interventions, such as routine referral to early-year centres and selected referral to public health home-visiting programs, may help to address populations with the greatest needs. PMID:24855416
ERIC Educational Resources Information Center
Menard, Lauren A.
2011-01-01
Obstacles to the classroom implementation of the fourth grade Math component of Louisiana's web-based testing tutorial were addressed in this informal pilot. Technology integration improved standardized test preparation for students with special needs. Supplemental test preparation sessions give the benefits of (a) increased familiarity with…
Integration of Palliative Care in the Context of Rapid Response
Nelson, Judith E.; Mathews, Kusum S.; Weissman, David E.; Brasel, Karen J.; Campbell, Margaret; Curtis, J. Randall; Frontera, Jennifer A.; Gabriel, Michelle; Hays, Ross M.; Mosenthal, Anne C.; Mulkerin, Colleen; Puntillo, Kathleen A.; Ray, Daniel E.; Weiss, Stefanie P.; Bassett, Rick; Boss, Renee D.; Lustbader, Dana R.
2015-01-01
Rapid response teams (RRTs) can effectively foster discussions about appropriate goals of care and address other emergent palliative care needs of patients and families facing life-threatening illness on hospital wards. In this article, The Improving Palliative Care in the ICU (IPAL-ICU) Project brings together interdisciplinary expertise and existing data to address the following: special challenges for providing palliative care in the rapid response setting, knowledge and skills needed by RRTs for delivery of high-quality palliative care, and strategies for improving the integration of palliative care with rapid response critical care. We discuss key components of communication with patients, families, and primary clinicians to develop a goal-directed treatment approach during a rapid response event. We also highlight the need for RRT expertise to initiate symptom relief. Strategies including specific clinician training and system initiatives are then recommended for RRT care improvement. We conclude by suggesting that as evaluation of their impact on other outcomes continues, performance by RRTs in meeting palliative care needs of patients and families should also be measured and improved. PMID:25644909
Using technology to support HIV self-testing among MSM.
LeGrand, Sara; Muessig, Kathryn E; Horvath, Keith J; Rosengren, Anna L; Hightow-Weidman, Lisa B
2017-09-01
Technology-based HIV self-testing (HST) interventions have the potential to improve access to HIV testing among gay, bisexual, and other MSM, as well as address concerns about HST use, including challenges with linkage to appropriate follow-up services. This review examines studies that use technology-based platforms to increase or improve the experience of HST among MSM. Seven published studies and eight funded studies were included in this review. Comprehensive prevention interventions with free HST kit distribution and interventions that provide free HST kits and support the HST process address a greater number of barriers (e.g., access, correct use of testing kits, and correct interpretation of results) than studies that only distribute free HST kits through technology-based platforms. By addressing HIV-testing barriers and specific HST concerns, these interventions address a critical need to improve first time and repeat testing rates among MSM. Additional research is needed to determine the efficacy of recent formative HST interventions. If proven efficacious, scale-up of these strategies have the potential to increase HIV testing among MSM via expanded HST uptake.
DOT National Transportation Integrated Search
2013-01-01
The Exploratory Advanced Research (EAR) Program addresses the need for longer term, higher risk research with the potential for longterm improvements to transportation systems-improvements in planning, building, renewing, and operating safe, congesti...
Linking Obesity Prevention and Mental Health Promotion to Address Health Disparities.
Claydon, Elizabeth; Austin, Anna; Smith, Megan V
2016-05-01
Considerable racial health disparities exist, especially in mental health and obesity. However, few approaches exist to address obesity and mental health simultaneously in minority groups. An intervention to address mental health in a low-income, minority group of urban mothers was designed using results from a needs assessment. Participating women were asked to rank their top health concerns and personal goals. Along with mental health concerns and basic needs, the majority of mothers desired assistance with improving their physical well-being. These results are surprising, but lend credence to creating interventions that aim to address both mental health and obesity concerns simultaneously.
Needs Assessment: Who Needs It?
ERIC Educational Resources Information Center
Hays, Donald G.; Linn, Joan K.
This monograph addresses the issue of needs assessment in the educational process and how it applies to the school counselor's role. The authors provide information on the process of needs assessment, from the initial step of obtaining commitment to the final outcome of improved program planning and development. Using an example common to many…
Mending the Rift between Full and Part-Time Faculty.
ERIC Educational Resources Information Center
Tyree, Larry W.; Grunder, Pat; O'Connell, April
2000-01-01
Addresses the need to improve the working conditions of part-time faculty by referring to Maslow's Hierarchy of Human Needs (1954), which includes physiological, safety and security, love and belongingness, esteem, cognitive, aesthetic, and self-actualizing needs. Calls for "overarching initiatives" that need to be undertaken on behalf…
Promoting oral health among the inner city homeless: a community-academic partnership.
Lashley, Mary
2008-09-01
Oral health care resources for the homeless are scarce, underfunded, and generally inadequate to meet the oral health needs of this population. The purpose of this program was to improve oral health among the urban homeless in a faith-based inner city mission through education, screening, and improved access to oral health care. The program provided for expanded delivery of oral health care services to the homeless while preparing students in the health professions for community-based practice with at-risk and vulnerable populations. By proactively addressing oral health needs through prevention and earlier diagnosis and treatment, morbidity, quality of life, and cost can be positively affected. Innovative, cross-disciplinary, community delivery models that involve key stakeholders at all levels are needed to address the oral health needs of the homeless and underserved adequately.
Three Big Ideas for Reforming Acquisition: Evidence-Based Propositions for Transformation
2015-04-30
specific ideas for improving key aspects of defense acquisition reforming the process for managing capabilities, addressing technology insertion, and...offers three specific ideas for improving key aspects of defense acquisition: reforming the process for managing capabilities, addressing technology...and process changes need to be made for any significant change to be seen. This paper offers reform ideas in three specific areas: achieving the
Khoury, Muin J.; Bowen, Michael S.; Burke, Wylie; Coates, Ralph J.; Dowling, Nicole F.; Evans, James P.; Reyes, Michele; St. Pierre, Jeannette
2017-01-01
In spite of accelerating human genome discoveries in a wide variety of diseases of public health significance, the promise of personalized health care and disease prevention based on genomics has lagged behind. In a time of limited resources, public health agencies must continue to focus on implementing programs that can improve health and prevent disease now. Nevertheless, public health has an important and assertive leadership role in addressing the promise and pitfalls of human genomics for population health. Such efforts are needed not only to implement what is known in genomics to improve health but also to reduce potential harm and create the infrastructure needed to derive health benefits in the future. PMID:21406285
ERIC Educational Resources Information Center
Alshehry, Amel
2018-01-01
Professional development has a major role in addressing the skill gaps of teachers. Recently, much effort has been focused on improving teaching practices in Saudi Arabia. Here we aim to determine Saudi teachers professional development needs in the higher educational system. We also focus on skill needs, training programs, factors affecting…
Addressing poverty, education, and gender equality to improve the health of women worldwide.
Tyer-Viola, Lynda A; Cesario, Sandra K
2010-01-01
The Millennium Development Goals (MDG) that target alleviating poverty, improving primary education, and fostering gender equity are important as a foundation to promote world health. Achieving these goals will create an environment for healthy lives for women and children. Poverty, education, and gender equality, although undeniably linked, need to be addressed individually. Nurses have the capacity and political will to address MDGs and to contribute to the health and well-being of the world population. © 2010 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.
Administration Planning for Tomorrow.
ERIC Educational Resources Information Center
Murray, Albert
After defining administrative planning and outlining deficits and gains of the past 20 years in American schooling, this address underlines the necessity for educational restructuring. Specifically, educational leaders need to: (1) gather data determining the status quo and suggest incremental improvements; (2) address new solvable challenges and…
Improving medical graduates’ training in palliative care: advancing education and practice
Head, Barbara A; Schapmire, Tara J; Earnshaw, Lori; Chenault, John; Pfeifer, Mark; Sawning, Susan; Shaw, Monica A
2016-01-01
The needs of an aging population and advancements in the treatment of both chronic and life-threatening diseases have resulted in increased demand for quality palliative care. The doctors of the future will need to be well prepared to provide expert symptom management and address the holistic needs (physical, psychosocial, and spiritual) of patients dealing with serious illness and the end of life. Such preparation begins with general medical education. It has been recommended that teaching and clinical experiences in palliative care be integrated throughout the medical school curriculum, yet such education has not become the norm in medical schools across the world. This article explores the current status of undergraduate medical education in palliative care as published in the English literature and makes recommendations for educational improvements which will prepare doctors to address the needs of seriously ill and dying patients. PMID:26955298
ERIC Educational Resources Information Center
Davis, Deborah; Krasnoff, Basha; Moilanen, Carolyn; Sather, Susan; Kushman, James
2007-01-01
This study examines the systems of technical assistance and support that Northwest Region states implemented during 2005-2006 for schools in need of improvement. By highlighting key characteristics and differences among state systems, the intent is to stimulate an analysis of what states can do and what issues they might address to move schools…
Breaking Down Barriers: Hospice Palliative Care as a Human Right in Canada
ERIC Educational Resources Information Center
Freeman, Shannon; Heckman, George; Naus, Peter J.; Marston, Hannah R.
2013-01-01
The need to attend to terminally ill persons and provide improved quality of living and dying should be a national priority in Canada. Hospice palliative care (HPC), a person-centered approach that addresses the needs of the whole person, improves the quality of living and dying of persons facing a life-threatening illness. To ensure Canadians are…
Existential and spiritual needs in mental health care: an ethical and holistic perspective.
Koslander, Tiburtius; da Silva, António Barbosa; Roxberg, Asa
2009-03-01
This study illuminates how existential needs and spiritual needs are connected with health care ethics and individuals' mental health and well-being. The term existential needs is defined as the necessity of experiencing life as meaningful, whereas the term spiritual needs is defined as the need of deliverance from despair, guilt and/or sin, and of pastoral care. It discusses whether or not patients' needs are holistically addressed in Western health care systems that neglect patients' existential and spiritual needs, because of their biomedical view of Man which recognizes only patients' physical needs. It excludes a holistic health care which considers all needs, expressed by patients in treatment of mental illness. Addressing all needs is important for patients' improvement and recovery. For some patients, this is the only way to regain their mental health and well-being.
Khodyakov, Dmitry; Williams, Pluscedia; Bromley, Elizabeth; Chung, Bowen; Wells, Kenneth
Depression quality improvement programs based on chronic disease management models have been shown to improve depression outcomes. Nonetheless, access to and the use of such programs is limited in minority, under-resourced communities. We report on the outcomes of a Delphi-based consensus exercise conducted by our partnership at a community-wide conference in Los Angeles. Participants identified and prioritized the needs of depressed individuals that should be addressed in a county-wide Health Neighborhood Initiative designed to increase existing mental health, substance use, healthcare, and social services for individuals with low socioeconomic position. Participants agreed that housing is the number one priority. Delphi results also illustrate the importance of addressing social, spiritual, and healthcare access needs of depressed individuals. Our study shows how to systematically engage community-based organizations, patients, families, and community members in the process of improving the design of community-wide health policy initiatives.
Comparing maternal child health problems and outcomes across public health nursing agencies.
Monsen, Karen A; Fulkerson, Jayne A; Lytton, Amy B; Taft, Lila L; Schwichtenberg, Linda D; Martin, Karen S
2010-05-01
To use aggregated data from health informatics systems to identify needs of maternal and child health (MCH) clients served by county public health agencies and to demonstrate outcomes of services provided. Participating agencies developed and implemented a formal standardized classification data comparison process using structured Omaha System data. An exploratory descriptive analysis of the data was performed. Summary reports of aggregated and analyzed data from records of clients served and discharged in 2005 were compared. Client problems and outcomes were found to be similar across agencies, with behavioral, psychosocial, environmental and physiological problems identified and addressed. Differential improvement was noted by problem, outcome measure, and agency; and areas for enhancing intervention strategies were prioritized. Problems with greatest improvement across agencies were Antepartum/postpartum and Family planning, and least improvement across agencies were Neglect and Substance use. Findings demonstrated that public health nurses address many serious health-related problems with low-income high-risk MCH clients. MCH client needs were found to be similar across agencies. Public health nurse home visiting services addressed important health issues with MCH clients, and statistically significant improvement in client health problems occurred consistently across agencies. The data comparison processes developed in this project were useful for MCH programs, and may be applicable to other program areas using structured client data for evaluation purposes. Using informatics tools and data facilitated needs assessment, program evaluation, and outcomes management processes for the agencies, and will continue to play an integral role in directing practice and improving client outcomes.
Improving Teacher Quality for Colorado Science Teachers in High Need Schools
ERIC Educational Resources Information Center
Stevenson, Mark; Stevenson, Cerissa; Cooner, Donna
2015-01-01
This article describes the evaluation of an online professional development program funded by the State of Colorado to address the need for highly qualified science teachers in high need and/or rural school districts. Recruitment and the retention of highly qualified educators in high need and/or rural school districts is a critical factor…
Handbook for Conducting School Climate Improvement Projects.
ERIC Educational Resources Information Center
Howard, Eugene; And Others
This book discusses practical ways to improve a school's climate by increasing both productivity and satisfaction concurrently. Chapter 1, "Defining School Climate," identifies the overarching goals of school climate improvement, the basic human needs that school climate must address, the factors that make up a school's climate and…
Interventions for Family Members of Adolescents with Disruptive Behavior Disorders
Draucker, Claire; Alkhattab, Halima; Knopf, Amy; Mazurcyk, Jill
2014-01-01
PROBLEM The family members of adolescents diagnosed with Disruptive Behavior Disorders (DBD) experience profound stress and burden. Despite the need for empirically supported interventions that address the challenges faced by these family members, few such interventions are available. METHODS In this qualitative descriptive study, we conducted in-depth interviews with 15 families of adolescents diagnosed with DBD. We asked the family members to identify what types of mental health services they needed and to describe the ‘ideal” program that would best address their concerns. FINDINGS Family members identified several intervention modalities that would fit their needs including multi-family groups, family therapy, individual therapy, and community-based hotlines. They indicated that programs should address the following topics: family communication, conflict resolution, education about DBD, and strategies to improve interactions with child service agencies. CONCLUSIONS Clinicians should recognize that all family members may need support to manage the stressors associated with caring for or living with adolescents with DBD. When working with families, clinicians should provide information about the etiology and management of DBD, help navigate interactions with child service agencies, and employ strategies to improve family communication and functioning. PMID:24934181
Development and Face Validation of Strategies for Improving Consultation Skills
ERIC Educational Resources Information Center
Lefroy, Janet; Thomas, Adam; Harrison, Chris; Williams, Stephen; O'Mahony, Fidelma; Gay, Simon; Kinston, Ruth; McKinley, R. K.
2014-01-01
While formative workplace based assessment can improve learners' skills, it often does not because the procedures used do not facilitate feedback which is sufficiently specific to scaffold improvement. Provision of pre-formulated strategies to address predicted learning needs has potential to improve the quality and automate the provision of…
Improving data collection, documentation, and workflow in a dementia screening study.
Read, Kevin B; LaPolla, Fred Willie Zametkin; Tolea, Magdalena I; Galvin, James E; Surkis, Alisa
2017-04-01
A clinical study team performing three multicultural dementia screening studies identified the need to improve data management practices and facilitate data sharing. A collaboration was initiated with librarians as part of the National Library of Medicine (NLM) informationist supplement program. The librarians identified areas for improvement in the studies' data collection, entry, and processing workflows. The librarians' role in this project was to meet needs expressed by the study team around improving data collection and processing workflows to increase study efficiency and ensure data quality. The librarians addressed the data collection, entry, and processing weaknesses through standardizing and renaming variables, creating an electronic data capture system using REDCap, and developing well-documented, reproducible data processing workflows. NLM informationist supplements provide librarians with valuable experience in collaborating with study teams to address their data needs. For this project, the librarians gained skills in project management, REDCap, and understanding of the challenges and specifics of a clinical research study. However, the time and effort required to provide targeted and intensive support for one study team was not scalable to the library's broader user community.
What are the needs of adolescents and young adults after a cancer treatment? A Delphi study.
Galán, S; de la Vega, R; Tomé Pires, C; Racine, M; Solé, E; Jensen, M P; Miró, J
2017-03-01
Advances in the early detection of cancer and the development of more effective treatments have resulted in a larger number of adolescents and young adults (AYAs), becoming cancer survivors. However, knowledge regarding their needs and if those needs are adequately addressed remains limited. The aims of this study were to: (1) better understand the needs of AYAs after cancer treatment; (2) analyse the importance of those needs; (3) determine which needs are not adequately addressed; and (4) test the hypothesis that AYA cancer survivors have different needs than adult survivors. Twenty-nine health oncology professionals, 17 AYA survivors and 12 relatives of AYA survivors participated in the Delphi study. The needs identified could be classified into six categories, and all were rated as highly important by all participants. The category perceived as least adequately addressed across the three groups was 'Counselling and psychological support.' The findings provide important new information regarding the needs of AYA cancer survivors that can inform the development of interventions to improve the quality of life of these individuals. © 2016 John Wiley & Sons Ltd.
Loeslie, Vicki; Abcejo, Ma Sunnimpha; Anderson, Claudia; Leibenguth, Emily; Mielke, Cathy; Rabatin, Jeffrey
Substantial evidence in critical care literature identifies a lack of quality and quantity of communication between patients, families, and clinicians while in the intensive care unit. Barriers include time, multiple caregivers, communication skills, culture, language, stress, and optimal meeting space. For patients who are chronically critically ill, the need for a structured method of communication is paramount for discussion of goals of care. The objective of this quality improvement project was to identify barriers to communication, then develop, implement, and evaluate a process for semistructured family meetings in a 9-bed respiratory care unit. Using set dates and times, family meetings were offered to patients and families admitted to the respiratory care unit. Multiple avenues of communication were utilized to facilitate attendance. Utilizing evidence-based family meeting literature, a guide for family meetings was developed. Templates were developed for documentation of the family meeting in the electronic medical record. Multiple communication barriers were identified. Frequency of family meeting occurrence rose from 31% to 88%. Staff satisfaction with meeting frequency, meeting length, and discussion of congruent goals of care between patient/family and health care providers improved. Patient/family satisfaction with consistency of message between team members; understanding of medications, tests, and dismissal plan; and efficacy to address their concerns with the medical team improved. This quality improvement project was implemented to address the communication gap in the care of complex patients who require prolonged hospitalizations. By identifying this need, engaging stakeholders, and developing a family meeting plan to meet to address these needs, communication between all members of the patient's care team has improved.
Total Pancreatectomy With Islet Autotransplantation
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
Research strategies for addressing uncertainties
Busch, David E.; Brekke, Levi D.; Averyt, Kristen; Jardine, Angela; Welling, Leigh; Garfin, Gregg; Jardine, Angela; Merideth, Robert; Black, Mary; LeRoy, Sarah
2013-01-01
Research Strategies for Addressing Uncertainties builds on descriptions of research needs presented elsewhere in the book; describes current research efforts and the challenges and opportunities to reduce the uncertainties of climate change; explores ways to improve the understanding of changes in climate and hydrology; and emphasizes the use of research to inform decision making.
ERIC Educational Resources Information Center
Dolezel, Diane M.; Morrison, Eileen E.
2017-01-01
Health information management (HIM) professionals must address ethical challenges in their role as guardians of patients' personal information and organizations' proprietary information. Because of this need, HIM educators strive prepare their students to address these challenges. Unfortunately, little evidence exists about specific areas of…
ERIC Educational Resources Information Center
Basic Skills Agency, 2006
2006-01-01
The first in a series of five, module 1 provides everything one will need to run sharply focused, practical staff development training sessions for adult and Post 16 literacy, language and numeracy teachers. Each module addresses aspects of teaching and learning commonly identified as areas in need of improvement and can be used individually or as…
Quantifying tropical dry forest type and succession: substantial improvement with LiDAR
Sebastian Martinuzzi; William A. Gould; Lee A. Vierling; Andrew T. Hudak; Ross F. Nelson; Jeffrey S. Evans
2012-01-01
Improved technologies are needed to advance our knowledge of the biophysical and human factors influencing tropical dry forests, one of the worldâs most threatened ecosystems. We evaluated the use of light detection and ranging (LiDAR) data to address two major needs in remote sensing of tropical dry forests, i.e., classification of forest types and delineation of...
Henderson, Zsakeba T; Ernst, Kelly; Simpson, Kathleen Rice; Berns, Scott; Suchdev, Danielle B; Main, Elliott; McCaffrey, Martin; Lee, Karyn; Rouse, Tara Bristol; Olson, Christine K
2018-03-01
State Perinatal Quality Collaboratives (PQCs) are networks of multidisciplinary teams working to improve maternal and infant health outcomes. To address the shared needs across state PQCs and enable collaboration, Centers for Disease Control and Prevention (CDC), in partnership with March of Dimes and perinatal quality improvement experts from across the country, supported the development and launch of the National Network of Perinatal Quality Collaboratives (NNPQC). This process included assessing the status of PQCs in this country and identifying the needs and resources that would be most useful to support PQC development. National representatives from 48 states gathered for the first meeting of the NNPQC to share best practices for making measurable improvements in maternal and infant health. The number of state PQCs has grown considerably over the past decade, with an active PQC or a PQC in development in almost every state. However, PQCs have some common challenges that need to be addressed. After its successful launch, the NNPQC is positioned to ensure that every state PQC has access to key tools and resources that build capacity to actively improve maternal and infant health outcomes and healthcare quality.
Henderson, Zsakeba T; Ernst, Kelly; Simpson, Kathleen Rice; Berns, Scott D; Suchdev, Danielle B; Main, Elliott; McCaffrey, Martin; Lee, Karyn; Rouse, Tara Bristol; Olson, Christine K
2018-02-01
State Perinatal Quality Collaboratives (PQCs) are networks of multidisciplinary teams working to improve maternal and infant health outcomes. To address the shared needs across state PQCs and enable collaboration, Centers for Disease Control and Prevention, in partnership with March of Dimes and perinatal quality improvement experts from across the country, supported the development and launch of the National Network of PQCs National Network of Perinatal Quality Collaboratives (NNPQC). This process included assessing the status of PQCs in this country and identifying the needs and resources that would be most useful to support PQC development. National representatives from 48 states gathered for the first meeting of the NNPQC to share best practices for making measurable improvements in maternal and infant health. The number of state PQCs has grown considerably over the past decade, with an active PQC or a PQC in development in almost every state. However, PQCs have some common challenges that need to be addressed. After its successful launch, the NNPQC is positioned to ensure that every state PQC has access to key tools and resources that build capacity to actively improve maternal and infant health outcomes and healthcare quality.
Stakeholder-Driven Quality Improvement: A Compelling Force for Clinical Practice Guidelines.
Rosenfeld, Richard M; Wyer, Peter C
2018-01-01
Clinical practice guideline development should be driven by rigorous methodology, but what is less clear is where quality improvement enters the process: should it be a priority-guiding force, or should it enter only after recommendations are formulated? We argue for a stakeholder-driven approach to guideline development, with an overriding goal of quality improvement based on stakeholder perceptions of needs, uncertainties, and knowledge gaps. In contrast, the widely used topic-driven approach, which often makes recommendations based only on randomized controlled trials, is driven by epidemiologic purity and evidence rigor, with quality improvement a downstream consideration. The advantages of a stakeholder-driven versus a topic-driven approach are highlighted by comparisons of guidelines for otitis media with effusion, thyroid nodules, sepsis, and acute bacterial rhinosinusitis. These comparisons show that stakeholder-driven guidelines are more likely to address the quality improvement needs and pressing concerns of clinicians and patients, including understudied populations and patients with multiple chronic conditions. Conversely, a topic-driven approach often addresses "typical" patients, based on research that may not reflect the needs of high-risk groups excluded from studies because of ethical issues or a desire for purity of research design.
Improving Assessment Tasks through Addressing Our Unconscious Limits to Change
ERIC Educational Resources Information Center
Joughin, Gordon; Dawson, Phillip; Boud, David
2017-01-01
Despite widespread recognition of the need to improve assessment in higher education, assessment tasks in individual courses are too often dominated by conventional methods. While changing assessment depends on many factors, improvements to assessment ultimately depend on the decisions and actions of individual educators. This paper considers…
76 FR 78967 - Second Tier Environmental Impact Statement: Jackson County, MO
Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-20
... determine an improvement strategy for the corridor to address the following needs: Improve safety, reduce.... Various concepts were combined to develop 15 initial strategies that were screened down to four first tier strategies. These four strategies included the No-Build Strategy, Improve Key Bottlenecks Strategy, Add...
Value for money of changing healthcare services? Economic evaluation of quality improvement
Severens, J
2003-01-01
There are many instances of perceived or real inefficiencies in health service delivery. Both healthcare providers and policy makers need to know the impact and cost of applying strategies to change the behaviour of individuals or organisations. Quality improvement or implementation research is concerned with evaluating the methods of behavioural change. Addressing inefficiencies in healthcare services raises a series of issues, beginning with how inefficiency itself should be defined. The basic concepts of cost analysis and economic evaluations are explained and a model for working through the economic issues of quality improvement is discussed. This model combines the costs and benefits of corrected inefficiency with the costs and degree of behavioural change achieved by a quality improvement method in the policy maker's locality. It shows why it may not always be cost effective for policy makers to address suboptimal behaviour. Both the interpretation of quality improvement research findings and their local application need careful consideration. The limited availability of applicable quality improvement research may make it difficult to provide robust advice on the value for money of many behavioural quality improvement strategies. PMID:14532369
How Can We Improve School Discipline?
ERIC Educational Resources Information Center
Osher, David; Bear, George G.; Sprague, Jeffrey R.; Doyle, Walter
2010-01-01
School discipline addresses schoolwide, classroom, and individual student needs through broad prevention, targeted intervention, and development of self-discipline. Schools often respond to disruptive students with exclusionary and punitive approaches that have limited value. This article surveys three approaches to improving school discipline…
Improving America's Schools Act
NASA Technical Reports Server (NTRS)
Cradler, John; Bridgforth, Elizabeth
1995-01-01
The Improving America's Schools ACT (IASA) emphasizes coherent systemic education reform, with Goals 2000 setting common standards for IASA and the recently authorized School-to-Work Program. IASA addresses the need to raise academic achievement, increase opportunities to learn, improve professional development, increase community involvement, utilize instructional applications of technology, and improve assessment, and allow more local flexibility in the use of funds.
Assessing and addressing the library needs of health care personnel in a large regional hospital.
Crabtree, A B; Crawford, J H
1997-01-01
A needs assessment survey was conducted by the Medical Library staff of St. John's Health System, Inc., in Springfield, Missouri, to document the library needs of non-physician health care personnel. The intended use of the survey was threefold: first, to collect baseline data from non-physician health care employees; second, to gather recommendations from both library users and non-users to be included in library planning and improvements; and third, to promote the library during the survey process. Study results, along with an implementation report detailing actions taken to enhance strengths and address weaknesses identified in the needs assessment survey, are presented. Opportunities for further investigation of library needs are also reported. PMID:9160154
Steinfeld, Bradley; Scott, Jennifer; Vilander, Gavin; Marx, Larry; Quirk, Michael; Lindberg, Julie; Koerner, Kelly
2015-10-01
To effectively implement evidence-based practices (EBP) in behavioral health care, an organization needs to have operating structures and processes that can address core EBP implementation factors and stages. Lean, a widely used quality improvement process, can potentially address the factors crucial to successful implementation of EBP. This article provides an overview of Lean and the relationship between Lean process improvement steps, and EBP implementation models. Examples of how Lean process improvement methodologies can be used to help plan and carry out implementation of EBP in mental health delivery systems are presented along with limitations and recommendations for future research and clinical application.
Policy directions in urban health in developing countries--the slum improvement approach.
Harpham, T; Stephens, C
1992-07-01
The urban development, or housing, sector has a longer experience of addressing the problems of the urban poor in developing countries than the health sector. In recent years the policy of 'slum improvement', which involves both sectors, has attracted the support of international donors. This article documents the development of the slum improvement approach and addresses key issues of the approach which have implications for health planning: covering the poorest dwellers; relocation; land tenure; gentrification; debt burdens and the impact on women. Questions about the approach which still need answering are defined and a summary of the constraints in slum improvement and potential solutions is presented.
Medical-Legal Partnerships: Addressing Competency Needs Through Lawyers
Paul, Edward; Fullerton, Danya Fortess; Cohen, Ellen; Lawton, Ellen; Ryan, Anne; Sandel, Megan
2009-01-01
Background Many low- and moderate-income individuals and families have at least one unmet legal need (for example, unsafe housing conditions, lack of access to food and/or income support, lack of access to health care), which, if left unaddressed, can have harmful consequences on health. Eighty unique medical-legal partnership programs, serving over 180 clinics and hospitals nationwide, seek to combine the strengths of medical and legal professionals to address patients' legal needs before they become crises. Each partnership is adapted to serve the specific needs of its own patient base. Intervention This article describes innovative, residency-based medical-legal partnership educational experiences in pediatrics, internal medicine, and family medicine at 3 different sites (Boston, Massachusetts; Newark, New Jersey; and Tucson, Arizona). This article addresses how these 3 programs have been designed to meet the Accreditation Council for Graduate Medical Education's 6 competencies, along with suggested methods for evaluating the effectiveness of these programs. Training is a core component of medical-legal partnership, and most medical-legal partnerships have developed curricula for resident education in a variety of formats, including noon conferences, grand rounds, poverty simulations and day-long special sessions. Discussion Medical-legal partnerships combine the skill sets of medical professionals and lawyers to teach social determinants of health by training residents and attending physicians to identify and help address unmet legal needs. Medical-legal partnership doctors and lawyers treat health disparities and improve patient health and well-being by ensuring that public programs, regulations, and laws created to benefit health and improve access to health care are implemented and enforced. PMID:21975996
A survey of the health needs of hospital staff: implications for health care managers.
Jinks, Annette M; Lawson, Valerie; Daniels, Ruth
2003-09-01
Developing strategies to address the health needs of the National Health Services (NHS) workforce are of concern to many health care managers. Focal to the development of such strategies are of being in receipt of baseline information about employees expressed health needs and concerns. This article addresses obtaining such baseline information and presents the findings of a health needs survey of acute hospital staff in a trust in North Wales. The total population of trust employees were surveyed (n = 2300) and a 44% (n = 1021) response rate was achieved. A number of positive findings are given. Included are that the majority of those surveyed stated that their current health status is good, are motivated to improve their health further, do not smoke and their alcohol consumption is within recommended levels. There appears, however, to be a number of areas where trust managers can help its staff improve their health. Included are trust initiatives that focus on weight control and taking more exercise. In addition, there appears to be a reported lack of knowledge and positive health behaviour amongst the male respondents surveyed that would imply the trust needs to be more effective in promoting well man type issues. Finally there appears to be a general lack of pride in working for the trust and a pervasive feeling that the trust does not care about its employees that needs to be addressed. It is concluded that the findings of this survey have implications for management practices in the trust where the survey was conducted and also wider applicability to the management of health care professionals. For example, addressing work-related psychological and physical problems of employees are of importance to all health care managers. This is especially so when considering recruitment and retention issues.
Beyond "Autopsy Data": Bolstering Teacher Leadership, Morale, and School Improvement
ERIC Educational Resources Information Center
Sterrett, William; Irizarry, Eric
2015-01-01
Teacher working conditions surveys provide biennial, comprehensive data regarding school leadership. This case describes how a Title I middle school principal proactively addresses end-of-year data to address identified needs and growth areas in a collaborative manner in her middle school. The principal works in a concerted manner with an…
Building a Village through Data: A Research-Practice Partnership to Improve Youth Outcomes
ERIC Educational Resources Information Center
Biag, Manuelito
2017-01-01
There is growing recognition that the traditional research paradigm fails to address the needs of school practitioners. As such, more collaborative and participatory approaches are being encouraged. Yet few articles examine the structures, processes, and dynamics of research-practice partnerships. To address this gap, this essay analyzes a…
Dietary supplements and disease prevention — a global overview
USDA-ARS?s Scientific Manuscript database
Dietary supplements are widely used and offer the potential to improve health if appropriately targeted to those in need. Inadequate nutrition and micronutrient deficiencies are prevalent conditions that adversely affect global health. Although improvements in diet quality are essential to address t...
Modifying Risk Factors in the Management of Erectile Dysfunction: A Review
DeLay, Kenneth J; Haney, Nora
2016-01-01
Erectile dysfunction (ED) is prevalent among men and its presence is often an indicator of systemic disease. Risk factors for ED include cardiovascular disease, hypertension, diabetes mellitus (DM), tobacco use, hyperlipidemia, hypogonadism, lower urinary tract symptoms, metabolic syndrome, and depression. Addressing the modifiable risk factors frequently improves a patient's overall health and increases lifespan. The literature suggests that smoking cessation, treatment of hyperlipidemia, and increasing physical activity will improve erectile function in many patients. How the treatment of DM, depression, and hypogonadism impacts erectile function is less clear. Clinicians need to be aware that certain antihypertensive agents can adversely impact erectile function. The treatment of men with ED needs to address the underlying risk factors to ameliorate the disease process. PMID:27574592
Provision of integrated psychosocial services for cancer survivors post-treatment
Recklitis, Christopher J; Syrjala, Karen L
2018-01-01
Meeting the psychosocial needs of patients with cancer has been recognised as a priority within oncology care for several decades. Many approaches that address these needs have been developed and described; however, until recently much of this work had focused on patients during treatment and end-of-life care. With continued improvement in therapies, the population of cancer survivors who can expect to live for 5 or more years after cancer diagnosis has increased dramatically, as have associated concerns about how to meet their medical, psychosocial, and health behaviour needs after treatment. Guidelines and models for general survivorship care routinely address psychosocial needs, and similar guidelines for psychosocial care of patients with cancer are being extended to address the needs of survivors. In this Series paper, we summarise the existing recommendations for the provision of routine psychosocial care to survivors, as well as the challenges present in providing this care. We make specific recommendations for the integration of psychosocial services into survivorship care. PMID:28049576
Meteorology Research in DOE's Atmosphere to Electrons (A2e) Program
NASA Astrophysics Data System (ADS)
Cline, J.; Haupt, S. E.; Shaw, W. J.
2017-12-01
DOE's Atmosphere to electrons (A2e) program is performing cutting edge research to allow optimization of wind plants. This talk will summarize the atmospheric science portion of A2e, with an overview of recent and planned observation and modeling projects designed to bridge the terra incognita between the mesoscale and the microscales that affect wind plants. Introduction A2e is a major focus of the Wind Energy Technologies Office (WETO) within the Office of Energy Efficiency & Renewable Energy (EERE) at the DOE. The overall objective of A2e is to optimize wind power production and integrates improved knowledge of atmospheric inflow (fuel), turbine and plant aerodynamics, and control systems. The atmospheric component of the work addresses both the need for improved forecasting of hub-height winds and the need for improved turbulence characterization for turbine inflows under realistic atmospheric conditions and terrain. Several projects will be discussed to address observations of meteorological variables in regions not typically observed. The modelling needs are addressed through major multi-institutional integrated studies comprising both theoretical and numerical advances to improve models and field observations for physical insight. Model improvements are subjected to formal verification and validation, and numerical and observational data are archived and disseminated to the public through the A2e Data Archive and Portal (DAP; http://a2e.energy.gov). The overall outcome of this work will be increased annual energy production from wind plants and improved turbine lifetimes through a better understanding of atmospheric loading. We will briefly describe major components of the atmospheric part of the A2e strategy and work being done and planned.
ERIC Educational Resources Information Center
Scott, Caitlin; Ostler, Nora
2016-01-01
The five states in the Regional Educational Laboratory (REL) Northwest Region have many rural schools that have been designated as in need of improvement. And all five states had rural schools in the first cohort of federal School Improvement Grant (SIG) recipients. To address school improvement, the majority of those schools implemented the…
Vu, Cecilia; Rothman, Emily; Kistin, Caroline J; Barton, Kelly; Bulman, Barb; Budzak-Garza, Ann; Olson-Dorff, Denyse; Bair-Merritt, Megan H
The patient-centered medical home (PCMH) seeks to improve population health. However, PCMH models often focus on improving treatment of chronic diseases rather than on addressing psychosocial adversity. We sought to gather key stakeholder input about how PCMHs might feasibly and sustainably address psychosocial adversity within their patient populations. We conducted 25 semistructured interviews with key stakeholders, such as physicians, nurses, medical assistants, and patients. The audiorecorded interviews focused on participants' perceptions of the best ways to modify the PCMH to address patients' psychosocial adversity. To facilitate information gathering, a fictional patient case was presented. Analyses were conducted using a 3-stage content-analysis process. Participants identified provider-related and systems-level changes necessary for addressing these psychosocial adversities effectively. On the provider level, participants thought that practitioners should foster trusting relationships with patients and should be emotionally present as patients describe their life experiences. Participants also emphasized that providers need to have sensitive conversations about adversity and resilience. On a systems level, participants discussed that documentation must balance privacy and include relevant information in the medical record. In addition, care should be delivered not by a single provider but by a team that has a longitudinal relationship with the patient; this care team should include behavioral health support. Participants provided practical strategies and highlighted provider and systems level changes to adequately address patients' prior psychosocial adversity. Future studies need to assess the degree to which such a trauma-informed approach improves patient access, outcomes, and care quality, and reduces cost. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
Emerging drugs for diabetic peripheral neuropathy and neuropathic pain.
Papanas, Nikolaos; Ziegler, Dan
2016-12-01
Diabetic sensorimotor polyneuropathy (DSPN) is a common complication of diabetes. Areas covered: In this review, the authors discuss the emerging drugs for DSPN, which aim either at improving alleviation of neuropathic pain or addressing the putative mechanisms underlying diabetic neuropathy. Expert Opinion: Current treatment does not address the sensory deficits and pathogenesis underlying DSPN, so there is an unmet need for treatment options targeting the natural history of the condition. Some of these pathogenetic therapies have demonstrated clinically relevant improvements in neuropathic endpoints in recent randomised controlled trials. Since any effective analgesic monotherapy is known to induce a clinically meaningful response in only some 50% of the patients, there remains a substantial unmet need in patients with neuropathic pain. Advanced knowledge in the neurobiology of neuropathic pain and improved phenotypic profiling have led to a burst of research into novel pharmaceutical approaches. An array of promising molecular entities have reached the clinical stage of development, which should improve our therapeutic armamentarium in the fight against DSPN and neuropathic pain in the foreseeable future.
Improving data collection, documentation, and workflow in a dementia screening study
Read, Kevin B.; LaPolla, Fred Willie Zametkin; Tolea, Magdalena I.; Galvin, James E.; Surkis, Alisa
2017-01-01
Background A clinical study team performing three multicultural dementia screening studies identified the need to improve data management practices and facilitate data sharing. A collaboration was initiated with librarians as part of the National Library of Medicine (NLM) informationist supplement program. The librarians identified areas for improvement in the studies’ data collection, entry, and processing workflows. Case Presentation The librarians’ role in this project was to meet needs expressed by the study team around improving data collection and processing workflows to increase study efficiency and ensure data quality. The librarians addressed the data collection, entry, and processing weaknesses through standardizing and renaming variables, creating an electronic data capture system using REDCap, and developing well-documented, reproducible data processing workflows. Conclusions NLM informationist supplements provide librarians with valuable experience in collaborating with study teams to address their data needs. For this project, the librarians gained skills in project management, REDCap, and understanding of the challenges and specifics of a clinical research study. However, the time and effort required to provide targeted and intensive support for one study team was not scalable to the library’s broader user community. PMID:28377680
Federal metering data analysis needs and existing tools
DOE Office of Scientific and Technical Information (OSTI.GOV)
Henderson, Jordan W.; Fowler, Kimberly M.
2015-07-01
Agencies have been working to improve their metering data collection, management, and analysis efforts over the last decade (since EPAct 2005) and will continue to address these challenges as new requirements and data needs come into place. Unfortunately there is no “one-size-fits-all” solution. As agencies continue to expand their capabilities to use metered consumption data to reducing resource use and improve operations, the hope is that shared knowledge will empower others to follow suit. This paper discusses the Federal metering data analysis needs and some existing tools.
24 CFR 905.10 - Capital Fund formula (CFF).
Code of Federal Regulations, 2013 CFR
2013-04-01
... projects; (ii) Vacancy reduction; (iii) Addressing deferred maintenance needs and the replacement of obsolete utility systems and dwelling equipment; (iv) Planned code compliance; (v) Management improvements...
24 CFR 905.10 - Capital Fund formula (CFF).
Code of Federal Regulations, 2012 CFR
2012-04-01
... projects; (ii) Vacancy reduction; (iii) Addressing deferred maintenance needs and the replacement of obsolete utility systems and dwelling equipment; (iv) Planned code compliance; (v) Management improvements...
What's an Adult Numeracy Teacher to Teach? Negotiating the Complexity of Adult Numeracy Instruction
ERIC Educational Resources Information Center
Ginsburg, Lynda
2017-01-01
In this Forum article, the author addresses how to assist adults in improving mathematics and numeracy literacy. Ginsburg observes educators who strive to address their learners' educational gaps and needs are finding themselves in an environment of competing priorities and expectations that can be expressed as mathematics numeracy education. What…
ERIC Educational Resources Information Center
Johnson, David P.
2017-01-01
The education sector is at high risk for information security (InfoSec) breaches and in need of improved security practices. Achieving data protections cannot be through technical means alone. Addressing the human behavior factor is required. Security education, training, and awareness (SETA) programs are an effective method of addressing human…
Geriatrics in family practice residency education: an unmet challenge.
Gazewood, John D; Vanderhoff, Bruce; Ackermann, Richard; Cefalu, Charles
2003-01-01
The aging of the US population poses one of the greatest future challenges for family practice residency graduates. At a time when our discipline should be strengthening geriatric education to address the needs of our aging population, the Group on Geriatric Education of the Society of Teachers of Family Medicine believes that recent guidelines from important family medicine organizations suggest that our discipline's interest in geriatric education may be waning. Barriers to improving geriatric education in family practice residencies include limited geriatric faculty, changes in geriatric fellowship training, competing curricular demands, and limited diversity of geriatric training sites. Improving geriatric education in family practice residencies will require greater emphasis on faculty development and integration of geriatric principles throughout family practice residency education. The Residency Review Committee for Family Practice should review the Program Requirements for Residency Education to ensure that geriatric training requirements are consistent with current educational needs. The leadership of family medicine organizations should collaboratively address the need for continued improvement in training our residents to care for older patients and the chronically ill.
Total Pancreatectomy With Islet Auto-Transplantation (TPIAT): Summary of an NIDDK Workshop
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
Provision of Patient-Centered Transgender Care.
Selix, Nancy W; Rowniak, Stefan
2016-11-01
Transgender individuals have unique health care needs and experience health disparities. There is an increased need for transgender health care services and primary care for this underserved population. However, provision of appropriate health care services for transgender persons requires cultural competency and skill on the part of the health care provider, and providers need specific skills to address the needs of this population. A review of the literature was performed by accessing CINAHL, PsycINFO, and PubMed databases. Pertinent research was extracted and reviewed for relevance. References in these publications were reviewed to identify additional publications that address primary prevention, secondary prevention, and tertiary care of transgender individuals. Articles that include prevention, screening, and treatment of health problems of transgender persons were identified. Research on the health needs of the transgender population is limited. Whenever available, research findings that address this unique population should be incorporated into clinical practice. When research evidence is not available to address the unique needs of transgender individuals, research and clinical care guidelines from the general population may be applied for health screening and maintenance. This article provides information about primary care services for transgender individuals and seeks to improve awareness of the health disparities this underserved population experiences. Simple solutions to modify clinical settings to enhance care are provided. © 2016 by the American College of Nurse-Midwives.
Patient handover in orthopaedics, improving safety using Information Technology.
Pearkes, Tim
2015-01-01
Good inpatient handover ensures patient safety and continuity of care. An adjunct to this is the patient list which is routinely managed by junior doctors. These lists are routinely created and managed within Microsoft Excel or Word. Following the merger of two orthopaedic departments into a single service in a new hospital, it was felt that a number of safety issues within the handover process needed to be addressed. This quality improvement project addressed these issues through the creation and implementation of a new patient database which spanned the department, allowing trouble free, safe, and comprehensive handover. Feedback demonstrated an improved user experience, greater reliability, continuity within the lists and a subsequent improvement in patient safety.
Designing a Clinical Data Warehouse Architecture to Support Quality Improvement Initiatives.
Chelico, John D; Wilcox, Adam B; Vawdrey, David K; Kuperman, Gilad J
2016-01-01
Clinical data warehouses, initially directed towards clinical research or financial analyses, are evolving to support quality improvement efforts, and must now address the quality improvement life cycle. In addition, data that are needed for quality improvement often do not reside in a single database, requiring easier methods to query data across multiple disparate sources. We created a virtual data warehouse at NewYork Presbyterian Hospital that allowed us to bring together data from several source systems throughout the organization. We also created a framework to match the maturity of a data request in the quality improvement life cycle to proper tools needed for each request. As projects progress in the Define, Measure, Analyze, Improve, Control stages of quality improvement, there is a proper matching of resources the data needs at each step. We describe the analysis and design creating a robust model for applying clinical data warehousing to quality improvement.
Designing a Clinical Data Warehouse Architecture to Support Quality Improvement Initiatives
Chelico, John D.; Wilcox, Adam B.; Vawdrey, David K.; Kuperman, Gilad J.
2016-01-01
Clinical data warehouses, initially directed towards clinical research or financial analyses, are evolving to support quality improvement efforts, and must now address the quality improvement life cycle. In addition, data that are needed for quality improvement often do not reside in a single database, requiring easier methods to query data across multiple disparate sources. We created a virtual data warehouse at NewYork Presbyterian Hospital that allowed us to bring together data from several source systems throughout the organization. We also created a framework to match the maturity of a data request in the quality improvement life cycle to proper tools needed for each request. As projects progress in the Define, Measure, Analyze, Improve, Control stages of quality improvement, there is a proper matching of resources the data needs at each step. We describe the analysis and design creating a robust model for applying clinical data warehousing to quality improvement. PMID:28269833
Improving Disability Awareness among Extension Agents
ERIC Educational Resources Information Center
Mahadevan, Lakshmi; Peterson, Rick L.; Grenwelge, Cheryl
2014-01-01
Increasing prevalence rates and legislative mandates imply that educators, parents, and Extension agents will need better tools and resources to meet the needs of special populations. The Texas A&M AgriLife Extension Service addresses this issue by using e-learning tools. Extension agents can take advantage of these courses to gain critical…
2017-02-01
19As defined in generally accepted government auditing standards, information technology controls...Financial Improvement and Audit Readiness (FIAR) Plan Status Report, while DOD continues to make progress in addressing information technology ...DOD FINANCIAL MANAGEMENT Significant Efforts Still Needed for Remediating Audit Readiness Deficiencies Report to
Ward, Marie; McDonald, Nick; Morrison, Rabea; Gaynor, Des; Nugent, Tony
2010-02-01
Aircraft maintenance is a highly regulated, safety critical, complex and competitive industry. There is a need to develop innovative solutions to address process efficiency without compromising safety and quality. This paper presents the case that in order to improve a highly complex system such as aircraft maintenance, it is necessary to develop a comprehensive and ecologically valid model of the operational system, which represents not just what is meant to happen, but what normally happens. This model then provides the backdrop against which to change or improve the system. A performance report, the Blocker Report, specific to aircraft maintenance and related to the model was developed gathering data on anything that 'blocks' task or check performance. A Blocker Resolution Process was designed to resolve blockers and improve the current check system. Significant results were obtained for the company in the first trial and implications for safety management systems and hazard identification are discussed. Statement of Relevance: Aircraft maintenance is a safety critical, complex, competitive industry with a need to develop innovative solutions to address process and safety efficiency. This research addresses this through the development of a comprehensive and ecologically valid model of the system linked with a performance reporting and resolution system.
ERIC Educational Resources Information Center
Wilkerson, Stephanie B.; Shannon, Lisa C.; Styers, Mary K.; Grant, Billie-Jo
2012-01-01
Success in Sight focuses on the interrelated parts of an education system. This systemic school improvement intervention is designed to address schools' specific needs while building their capacities to plan, implement, and evaluate school improvement practices. It is intended to help schools, leadership teams, and teachers systemically engage in…
Betancourt, Joseph R; Tan-McGrory, Aswita; Kenst, Karey S; Phan, Thuy Hoai; Lopez, Lenny
2017-06-01
Leaders of health care organizations need to be prepared to improve quality and achieve equity in today's health care environment characterized by a focus on achieving value and addressing disparities in a diverse population. To help address this need, the Disparities Solutions Center at Massachusetts General Hospital launched the Disparities Leadership Program in 2007. The leadership program is an ongoing, year-long, executive education initiative that trains leaders from hospitals, health plans, and health centers to improve quality and eliminate racial and ethnic disparities in health care. Feedback from participating organizations demonstrates that health care leaders seem to possess knowledge about what disparities are and about what should be done to eliminate them. Data collection, performance measurement, and multifaceted interventions remain the tools of the trade. However, the barriers to success are lack of leadership buy-in, organizational prioritization, energy, and execution, which can be addressed through organizational change management strategies. Project HOPE—The People-to-People Health Foundation, Inc.
Impact of Addressing Accountability Demands in the United States
ERIC Educational Resources Information Center
Banta, Trudy W.
2010-01-01
Since 1970, quality assurance, or outcomes assessment, has provided guidance for improving pedagogy, curricula and student support programmes in the US. But evidence that student learning has improved remains elusive. Large-scale long-term studies are needed to demonstrate the effects of outcomes assessment on learning.
The Evolution of U.S.-Turkish Relations in a Transatlantic Context
2008-04-01
THE EVOLUTION OF U.s.-TURKIsH RELATIONs IN A TRANsATLANTIC CONTEXT Colloquium Report Frances G. Burwell Editor April 2008 This publication is a work ...PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) U.S. Army War College,Strategic Studies...need to continue addressing the issues identified. vi Such work should prove valuable to policymakers of both countries in their efforts to improve
Using Local Data to Address Abandoned Property: Lessons Learned From a Community Health Partnership.
Teixeira, Samantha; Kolke, Demi
A growing body of research highlights the role of the built environment in promoting or impeding health. This research suggests that environmental issues like abandoned properties exact a toll on physical and mental health. We describe a community partnership aimed at improving community health through equitable land use policies and blight remediation. A collaboration between the University of Pittsburgh and Operation Better Block, Inc. (OBB), a community development corporation in Pittsburgh, was formed. We implemented an intervention to address property abandonment using data-driven techniques. In addition to successful advocacy for city-wide policies addressing abandonment, 80% of the properties that were part of our intervention were improved or addressed by the city. Balancing the needs of community and academic partners can be challenging, but our experiences suggest that community health partnerships to address built environmental issues may be an important conduit to health promotion.
... provider needs to confirm the individual has a fundamental understanding of the information exchange, i.e. more ... the patient improve his or her own self management. Full Text Health care systems can also address ...
Easing the Burden of External Reporting
ERIC Educational Resources Information Center
LoGrasso, Marc F.
2015-01-01
In this chapter, the author presents suggestions for improving the effectiveness of external reporting while minimizing burden. Recommendations include repurposing existing internal reports to address the needs of external reports.
Busolo, David S; Woodgate, Roberta L
2016-06-01
Cancer incidence and mortality are increasing in Africa, which is leading to greater demands for palliative care. There has been little progress in terms of research, pain management, and policies related to palliative care. Palliative care in Africa is scarce and scattered, with most African nations lacking the basic services. To address these needs, a guiding framework that identifies care needs and directs palliative care services could be utilized. Therefore, using the supportive care framework developed by Fitch (Fitch, 2009), we here review the literature on palliative care for patients diagnosed with cancer in Africa and make recommendations for improvement. The PubMed, Scopus, CINAHL, Web of Science, Embase, PsycINFO, Social Sciences Citation Index, and Medline databases were searched. Some 25 English articles on research from African countries published between 2004 and 2014 were selected and reviewed. The reviewed literature was analyzed and presented using the domains of the supportive care framework. Palliative care patients with cancer in Africa, their families, and caregivers experience increasing psychological, physical, social, spiritual, emotional, informational, and practical needs. Care needs are often inadequately addressed because of a lack of awareness as well as deficient and scattered palliative care services and resources. In addition, there is sparse research, education, and policies that address the dire situation in palliative care. Our review findings add to the existing body of knowledge demonstrating that palliative care patients with cancer in Africa experience disturbing care needs in all domains of the supportive care framework. To better assess and address these needs, holistic palliative care that is multidomain and multi-professional could be utilized. This approach needs to be individualized and to offer better access to services and information. In addition, research, education, and policies around palliative care for cancer patients in Africa could be more comprehensive if they were based on the domains of the supportive care framework.
Integrating Literacy, Culture, and Language to Improve Health Care Quality for Diverse Populations
Andrulis, Dennis P.; Brach, Cindy
2016-01-01
Objective To understand the interrelationship of literacy, culture, and language and the importance of addressing their intersection. Methods Health literacy, cultural competence, and linguistic competence strategies to quality improvement were analyzed. Results Strategies to improve health literacy for low-literate individuals are distinct from strategies for culturally diverse and individuals with limited English proficiency (LEP). The lack of integration results in health care that is unresponsive to some vulnerable groups’ needs. A vision for integrated care is presented. Conclusion Clinicians, the health care team, and health care organizations have important roles to play in addressing challenges related to literacy, culture, and language. PMID:17931131
Partnership 2000: Improving the Workforce through Partnerships. Monograph.
ERIC Educational Resources Information Center
Fujimoto, Jack
Partnership 2000 is a joint collaborative effort of labor, education, and industry in California created to address the needs of employees through vocational and technical education provided by community colleges and affiliated training institutions. Partnership 2000's long-range goals are to: (1) improve student access to vocational education…
Assessment, Improvement, and Cooperation: The Challenge of Reform in Higher Education.
ERIC Educational Resources Information Center
Fincher, Cameron
This monograph contains a collection of six national commission reports that address the nation's need to improve undergraduate education. The reports present findings and recommendations that target policy (public and institutional), programs (college and university), and constructive changes in institutions of higher education, as well as their…
Continuous Improvement in State Funded Preschool Programs
ERIC Educational Resources Information Center
Jackson, Sarah L.
2012-01-01
State funded preschool programs were constantly faced with the need to change in order to address internal and external demands. As programs engaged in efforts towards change, minimal research was available on how to support continuous improvement efforts within the context unique to state funded preschool programs. Guidance available had…
DOE Office of Scientific and Technical Information (OSTI.GOV)
G.A. Kotsyuba; M.I. Alpatov; Y.G. Shapoval
The need for new and revised standards for coke production in Ukraine and Russia is outlined. Such standards should address improvements in plant operation, working conditions, environmental protection, energy conservation, fire and explosion safety, and economic indices.
34 CFR 200.52 - LEA improvement.
Code of Federal Regulations, 2011 CFR
2011-07-01
... through 200.20; (v) Address— (A) The fundamental teaching and learning needs in the schools of the LEA... effective methods and instructional strategies grounded in scientifically based research; and (ii) Address...
34 CFR 200.52 - LEA improvement.
Code of Federal Regulations, 2013 CFR
2013-07-01
... through 200.20; (v) Address— (A) The fundamental teaching and learning needs in the schools of the LEA... effective methods and instructional strategies grounded in scientifically based research; and (ii) Address...
34 CFR 200.52 - LEA improvement.
Code of Federal Regulations, 2014 CFR
2014-07-01
... through 200.20; (v) Address— (A) The fundamental teaching and learning needs in the schools of the LEA... effective methods and instructional strategies grounded in scientifically based research; and (ii) Address...
34 CFR 200.52 - LEA improvement.
Code of Federal Regulations, 2012 CFR
2012-07-01
... through 200.20; (v) Address— (A) The fundamental teaching and learning needs in the schools of the LEA... effective methods and instructional strategies grounded in scientifically based research; and (ii) Address...
Fiedler, Julie M.; McGreevy, Paul D.
2016-01-01
Simple Summary Although often highly rewarding, human-horse interactions can also be dangerous. Using examples from equine and other contexts, this article acknowledges the growing public awareness of animal welfare, work underway towards safer equestrian workplaces, and the potential for adapting large animal rescue skills for the purposes of horse event incident management. Additionally, we identity the need for further research into communication strategies that address animal welfare and safety issues that arise when humans and horses interact in the workplace. Abstract Human-horse interactions have a rich tradition and can be highly rewarding, particularly within sport and recreation pursuits, but they can also be dangerous or even life-threatening. In parallel, sport and recreation pursuits involving animals, including horses, are facing an increased level of public scrutiny in relation to the use of animals for these purposes. However, the challenge lies with event organisers to reconcile the expectations of the public, the need to meet legal requirements to reduce or eliminate risks to paid and volunteer workers, and address horse welfare. In this article we explore incident management at horse events as an example of a situation where volunteers and horses can be placed at risk during a rescue. We introduce large animal rescue skills as a solution to improving worker safety and improving horse welfare outcomes. Whilst there are government and horse industry initiatives to improve safety and address animal welfare, there remains a pressing need to invest in a strong communication plan which will improve the safety of workplaces in which humans and horses interact. PMID:26927189
S.A. Wilhelm Stanis; I.E. Schneider; K.J. Sinew; D.J. Chavez; M.C. Vogel
2009-01-01
Both legislation and professional organizations call for parks and recreation agencies to address the need for greater physical activity among those living in the United States. A greater understanding of factors that facilitate and constrain physical activity in parks and recreation areas may improve agenciesâ ability to address obesity and sedentary lifestyles. This...
ERIC Educational Resources Information Center
Wearmouth, Janice
2004-01-01
Recently the DfES has issued guidance on ways to address the needs of students who experience difficulties in literacy through Wave Three provision in the National Literacy Strategy (DfES, 2002). This guidance raises the issue of what kind of programmes might be initiated in mainstream schools that will improve what is available generally for…
ERIC Educational Resources Information Center
Van Damme, Dirk
2015-01-01
In this paper, I argue for more and better learning metrics in higher education, eventually through an international, comparative assessment of students' learning outcomes. Better learning measures may help to improve transparency in the system by addressing the information asymmetry problem. If not addressed adequately, the lack of transparency…
ERIC Educational Resources Information Center
Paulsell, Diane; Nogales, Renee; Cohen, Julie
To address the increasing child care needs of low-income families in the wake of welfare reform, federal and state governments have responded with increased funding for child care and for initiatives to improve quality. Some of these initiatives have been designed specifically to address the unique challenges of infant-toddler care. This report…
ERIC Educational Resources Information Center
Green, Julie M.; Hughes, Elizabeth M.; Ryan, Joseph B.
2011-01-01
A growing literature base suggests the need for positive interventions to help individuals with intellectual disabilities improve their time management skills. Time management is a crucial area that must be addressed in the effort to equip adults with the skills necessary to achieve independence, success in employment, and improved quality of…
Air Force Training: Further Analysis and Planning Needed to Improve Effectiveness
2016-09-01
training, and (3) established virtual training plans that include desirable characteristics of a comprehensive strategy. GAO reviewed Air Force training...requirements may not reflect current and emerging training needs, because the Air Force has not comprehensively reassessed the assumptions underlying them...include all desirable characteristics of a comprehensive strategy, such as a risk-based investment strategy or a time line for addressing training needs
Supporting Adults to Address Their Literacy Needs Using E-Learning
ERIC Educational Resources Information Center
Fletcher, Jo; Nicholas, Karen; Davis, Niki
2011-01-01
Many adults need help with literacy learning. This is extremely challenging for the tertiary education sector and workplace-situated learning organisations. E-learning may be an effective and efficient way to improve the delivery of teaching of basic skills to learners. Our research study included five embedded case studies within one tertiary…
Insights from Spanish-Speaking Employees in the Iowa Horticultural Industry
ERIC Educational Resources Information Center
Justen, Emilie; Haynes, Cynthia; VanDerZanden, Ann Marie; Grudens-Schuck, Nancy
2011-01-01
Addressing the needs of Latino workers can help improve working conditions, job satisfaction, and productivity of both employees and the companies hiring Latino workers. The study reported here assessed educational needs, communication gaps, and technical skills of Latino workers working in the horticultural industry in Iowa--an ethnic group that…
ERIC Educational Resources Information Center
Bierema, Andrea M.-K.; Schwarz, Christina V.; Stoltzfus, Jon R.
2017-01-01
National calls for improving science education (e.g., "Vision and Change") emphasize the need to learn disciplinary core ideas through scientific practices. To address this need, we engaged small groups of students in developing diagrammatic models within two (one large-enrollment and one medium-enrollment) undergraduate introductory…
ERIC Educational Resources Information Center
Roszkowski, Beth; Reynolds, Gretchen
2013-01-01
This article highlights an assessment of library instruction needs among graduate students in the social sciences. The article addresses the development and implementation of the assessment and the application of assessment results to an established set of library instruction workshops. The article provides a detailed summary of assessment…
An Exploration of Challenges Facing Principals in Leading Differentiated Teaching Practices
ERIC Educational Resources Information Center
Patton Corley, Myrna Loy
2017-01-01
The need to improve student academic performance and school reform continue to receive national attention, but there is limited empirical data that explicates the positive impact of programs that are designed to address this phenomenon. Educators are presented with seemingly herculean challenges in meeting the needs of students from cultural…
Electronic Health Records and US Public Health: Current Realities and Future Promise
Parrish, R. Gibson; Ross, David A.
2013-01-01
Electronic health records (EHRs) could contribute to improving population health in the United States. Realizing this potential will require understanding what EHRs can realistically offer to efforts to improve population health, the requirements for obtaining useful information from EHRs, and a plan for addressing these requirements. Potential contributions of EHRs to improving population health include better understanding of the level and distribution of disease, function, and well-being within populations. Requirements are improved population coverage of EHRs, standardized EHR content and reporting methods, and adequate legal authority for using EHRs, particularly for population health. A collaborative national effort to address the most pressing prerequisites for and barriers to the use of EHRs for improving population health is needed to realize the EHR’s potential. PMID:23865646
Service and Methods Demonstration Program Annual Report
DOT National Transportation Integrated Search
1978-07-01
The Urban Mass Transportation Administration's Service and Methods Demonstration (SMD) Program addresses the national need to improve the quality, quantity, and efficiency of public transportation services of innovative transit operating techniques a...
Service and Methods Demonstration Program Annual Report
DOT National Transportation Integrated Search
1977-04-01
The Urban Mass Transportation Administration's Service and Methods Demonstration (SMD) Program addresses the national need to improve the quality, quantity, and efficiency of public transportation services of innovative transit operating techniques a...
Sachdeva, Ajit K
2007-11-01
Health care is going through immense change, and concerns regarding the quality of patient care and patient safety continue to be expressed in many national forums. A variety of stakeholders are demanding greater accountability from the health care profession. Education is key to supporting surgeons' efforts to provide high-quality patient care during these challenging times. Educational programs for surgeons should be founded on principles of continuous professional development (CPD) and practice-based learning and improvement (PBLI). CPD focuses on the specific needs of individual surgeons and involves lifelong learning throughout a surgeon's career. It needs to form the basis of PBLI efforts. PBLI involves a cycle of four steps--identifying areas for improvement, engaging in learning, applying new knowledge and skills to practice, and checking for improvement. Ongoing involvement in PBLI activities to address specific learning needs should positively impact a surgeon's practice and improve outcomes of surgical care.
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
The practice of neurology: Looking ahead by looking back.
Ringel, Steven P
2015-05-19
Over the last 50 years, there have been many improvements in therapy for individuals with neurologic disorders. Simultaneously, the complexity and cost of care have increased. The delivery of neurologic services is inefficient. The needs of both patients and neurologists are not being optimally addressed. Although greater attention is on the quality, safety, and value of the care, there remains a need for fundamental redesign in the way neurologic services are provided. The future practice of neurology will likely be interdisciplinary and provide both easy access and efficient coordination of services. No matter what changes in financing of health care are adopted, focus needs to be on reducing health care costs. Patients seeking neurologic care will expect seamless, innovative, and cost-effective services and to be active participants in their care. The proposed modifications address current demands and advocate for prospective innovative solutions. The changes proposed to improve care for patients will simultaneously make the careers of neurologists more gratifying and less stressful. © 2015 American Academy of Neurology.
ERIC Educational Resources Information Center
BROWN, KENNETH E.; SNADER, DANIEL W.
A CONFERENCE OF EDUCATORS WAS CALLED TO DEAL WITH THE NEED FOR IMPROVED HIGH SCHOOL MATHEMATICS TEACHING. SPECIFICALLY THE CONFERENCE CONSIDERED THE NEED FOR INSERVICE EDUCATION FOR TEACHING NEW IMPROVED PROGRAMS, THE KINDS OF PROGRAMS NOW IN PROGRESS, AND THE ROLE OF SCHOOL ADMINISTRATORS IN IMPLEMENTING THEM. INCLUDED ARE THE ADDRESSES AND THE…
Machine learning and deep analytics for biocomputing: call for better explainability.
Petkovic, Dragutin; Kobzik, Lester; Re, Christopher
2018-01-01
The goals of this workshop are to discuss challenges in explainability of current Machine Leaning and Deep Analytics (MLDA) used in biocomputing and to start the discussion on ways to improve it. We define explainability in MLDA as easy to use information explaining why and how the MLDA approach made its decisions. We believe that much greater effort is needed to address the issue of MLDA explainability because of: 1) the ever increasing use and dependence on MLDA in biocomputing including the need for increased adoption by non-MLD experts; 2) the diversity, complexity and scale of biocomputing data and MLDA algorithms; 3) the emerging importance of MLDA-based decisions in patient care, in daily research, as well as in the development of new costly medical procedures and drugs. This workshop aims to: a) analyze and challenge the current level of explainability of MLDA methods and practices in biocomputing; b) explore benefits of improvements in this area; and c) provide useful and practical guidance to the biocomputing community on how to address these challenges and how to develop improvements. The workshop format is designed to encourage a lively discussion with panelists to first motivate and understand the problem and then to define next steps and solutions needed to improve MLDA explainability.
EAR Program Research Results : Updated through 2013
DOT National Transportation Integrated Search
2013-12-31
The Exploratory Advanced Research (EAR) Program addresses the need for longer term, higher risk research with the potential for long-term improvements to transportation systemsimprovements in planning, building, renewing, and operating safe, conge...
EAR Program Research Results: Updated through 2014
DOT National Transportation Integrated Search
2014-12-31
The Exploratory Advanced Research (EAR) Program addresses the need for longer term, higher risk research with the potential for long-term improvements to transportation systemsimprovements in planning, building, renewing, and operating safe, conge...
EAR Program Research Results: Updated through 2016
DOT National Transportation Integrated Search
2016-12-31
The Exploratory Advanced Research (EAR) Program addresses the need for longer term, higher risk research with the potential for long-term improvements to transportation systemsimprovements in planning, building, renewing, and operating safe, conge...
Tailoring Professional Development to Improve Literacy Instruction in Urban Schools
ERIC Educational Resources Information Center
De La Garza, Tammy Oberg
2011-01-01
To address the need for improving instructional practice in literacy, this paper examines whole school, teacher uptake of a professional development initiative over a four-year project. The study takes place in an urban, PK-6 school in a predominantly Mexican-American community. Measuring and analyzing teacher enactment of a professional…
Neuromodulation and Neurorehabilitation for Treatment of Functional Deficits after TBI Plus PTSD
2017-10-01
or not these changes correlate with improving neurobehavioral function. Aim III will examine the effect of rTMS on white fiber tracts and whether or...not the rTMS-related effects correlate with improving neurobehavioral function. Aim IV addresses the need to confirm rTMS safety for severe TBI. 15
A Web-Based Framework for Improving Geriatric Education
ERIC Educational Resources Information Center
Hirth, Victor A.; Hajjar, Ihab
2004-01-01
Despite the growth in the elderly population, physicians with special geriatric training and certification number only 9,000 out of 650,000 doctors in the United States. The flexibility and increasing availability of the Internet makes it an ideal avenue for addressing the educational needs of health care providers to improve the health and care…
An evidence-based strategy for transitioning patients from the hospital to the community.
Watkins, Lynn
2012-01-01
Improving transitional care from hospital to home requires comprehensive and highly coordinated intervention during the immediate days following discharge. The Hospital to Home Program addresses both medical and social needs, prevents unnecessary readmissions, promotes improvements in patient perceptions of physical and mental health, and results in excellent patient satisfaction.
NASA Astrophysics Data System (ADS)
Gillen, Mathew
2014-03-01
The speaker will address policy changes and improvements in visa processing that help scientists and students to visit and study in the United States. The speaker will also discuss challenges involved with balancing the needs of U.S. science with national security interests.
Biology Faculty at Large Research Institutions: The Nature of Their Pedagogical Content Knowledge
ERIC Educational Resources Information Center
Hill, Kathleen M.
2013-01-01
To address the need of scientists and engineers in the United States workforce and ensure that students in higher education become scientifically literate, research and policy has called for improvements in undergraduate education in the sciences. One particular pathway for improving undergraduate education in the science fields is to reform…
Improving Human Services: Methods for Systematic Planning, Evaluation, and Staff Development.
ERIC Educational Resources Information Center
Jones, G. Brian; And Others
This monograph speaks to the basic problems confronting human services programs, and offers suggestions for improving guidance services. Specific concerns addressed are: (1) the need for more systematic program planning and evaluation; (2) an approach to effective planning and evaluation; (3) development of staff skills for use in the…
LLVM Infrastructure and Tools Project Summary
DOE Office of Scientific and Technical Information (OSTI.GOV)
McCormick, Patrick Sean
2017-11-06
This project works with the open source LLVM Compiler Infrastructure (http://llvm.org) to provide tools and capabilities that address needs and challenges faced by ECP community (applications, libraries, and other components of the software stack). Our focus is on providing a more productive development environment that enables (i) improved compilation times and code generation for parallelism, (ii) additional features/capabilities within the design and implementations of LLVM components for improved platform/performance portability and (iii) improved aspects related to composition of the underlying implementation details of the programming environment, capturing resource utilization, overheads, etc. -- including runtime systems that are often not easilymore » addressed by application and library developers.« less
Applications of process improvement techniques to improve workflow in abdominal imaging.
Tamm, Eric Peter
2016-03-01
Major changes in the management and funding of healthcare are underway that will markedly change the way radiology studies will be reimbursed. The result will be the need to deliver radiology services in a highly efficient manner while maintaining quality. The science of process improvement provides a practical approach to improve the processes utilized in radiology. This article will address in a step-by-step manner how to implement process improvement techniques to improve workflow in abdominal imaging.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hanna, Philippe; Vanclay, Frank, E-mail: frank.vanclay@rug.nl; Langdon, Esther Jean
The number of environmental licence applications for projects affecting Indigenous peoples in Brazil has increased since the implementation of a major infrastructure program (Programa de Aceleração do Crescimento) in 2007. This increase has caused problems for Brazilian agencies involved in environmental licensing procedures (IBAMA, FUNAI and others). We analyze the Brazilian environmental licensing procedure for situations involving Indigenous peoples, Maroons (Quilombolas) or other traditional communities in order to identify potential improvements for Brazil and potentially other countries. Although Brazilian procedures are consistent with international best practice in environmental licensing, in practice social impacts are inadequately addressed, mitigation measures are poorlymore » implemented, and there is a lack of enforcement and compliance. The paper is based on document analysis and interviews with key actors in governmental and non-governmental organizations and Indigenous leaders. We suggest that Free, Prior and Informed Consent (FPIC) processes need to be conducted at the earliest stages of project planning, and that Indigenous peoples should actively participate in impact assessment, monitoring and evaluation processes. In order to achieve a social licence to operate, there needs to be full recognition of traditional knowledge and acceptance of Indigenous values and concepts. We also recommend increased involvement of social experts and mediators as well as improved accountability, enforcement and grievance mechanisms in the licensing process. - Highlights: • The Brazilian environmental licensing system needs to address social impacts better. • Communities need to be consulted at the earliest stage possible. • Indigenous peoples need to be invited to participate in impact assessment teams. • Independent Indigenous committees to monitor implementation of mitigation measures. • Accountability, enforcement and grievance mechanisms need to be improved.« less
How can developing countries harness biotechnology to improve health?
Daar, Abdallah S; Berndtson, Kathryn; Persad, Deepa L; Singer, Peter A
2007-01-01
Background The benefits of genomics and biotechnology are concentrated primarily in the industrialized world, while their potential to combat neglected diseases in the developing world has been largely untapped. Without building developing world biotechnology capacity to address local health needs, this disparity will only intensify. To assess the potential of genomics to address health needs in the developing world, the McLaughlin-Rotman Centre for Global Health, along with local partners, organized five courses on Genomics and Public Health Policy in the developing world. The overall objective of the courses was to collectively explore how to best harness genomics to improve health in each region. This article presents and analyzes the recommendations from all five courses. Discussion In this paper we analyze recommendations from 232 developing world experts from 58 countries who sought to answer how best to harness biotechnology to improve health in their regions. We divide their recommendations into four categories: science; finance; ethics, society and culture; and politics. Summary The Courses' recommendations can be summarized across the four categories listed above: Science - Collaborate through national, regional, and international networks - Survey and build capacity based on proven models through education, training, and needs assessments Finance - Develop regulatory and intellectual property frameworks for commercialization of biotechnology - Enhance funding and affordability of biotechnology - Improve the academic-industry interface and the role of small and medium enterprise Ethics, Society, Culture - Develop public engagement strategies to inform and educate the public about developments in genomics and biotechnology - Develop capacity to address ethical, social and cultural issues - Improve accessibility and equity Politics - Strengthen understanding, leadership and support at the political level for biotechnology - Develop policies outlining national biotechnology strategy These recommendations provide guidance for all those interested in supporting science, technology, and innovation to improve health in the developing world. Applying these recommendations broadly across sectors and regions will empower developing countries themselves to harness the benefits of biotechnology and genomics for billions who have long been excluded. PMID:18053180
How can developing countries harness biotechnology to improve health?
Daar, Abdallah S; Berndtson, Kathryn; Persad, Deepa L; Singer, Peter A
2007-12-03
The benefits of genomics and biotechnology are concentrated primarily in the industrialized world, while their potential to combat neglected diseases in the developing world has been largely untapped. Without building developing world biotechnology capacity to address local health needs, this disparity will only intensify. To assess the potential of genomics to address health needs in the developing world, the McLaughlin-Rotman Centre for Global Health, along with local partners, organized five courses on Genomics and Public Health Policy in the developing world. The overall objective of the courses was to collectively explore how to best harness genomics to improve health in each region. This article presents and analyzes the recommendations from all five courses. In this paper we analyze recommendations from 232 developing world experts from 58 countries who sought to answer how best to harness biotechnology to improve health in their regions. We divide their recommendations into four categories: science; finance; ethics, society and culture; and politics. The Courses' recommendations can be summarized across the four categories listed above: SCIENCE: - Collaborate through national, regional, and international networks- Survey and build capacity based on proven models through education, training, and needs assessments FINANCE: - Develop regulatory and intellectual property frameworks for commercialization of biotechnology- Enhance funding and affordability of biotechnology- Improve the academic-industry interface and the role of small and medium enterprise ETHICS, SOCIETY, CULTURE: - Develop public engagement strategies to inform and educate the public about developments in genomics and biotechnology- Develop capacity to address ethical, social and cultural issues- Improve accessibility and equity POLITICS: - Strengthen understanding, leadership and support at the political level for biotechnology- Develop policies outlining national biotechnology strategyThese recommendations provide guidance for all those interested in supporting science, technology, and innovation to improve health in the developing world. Applying these recommendations broadly across sectors and regions will empower developing countries themselves to harness the benefits of biotechnology and genomics for billions who have long been excluded.
Nøhr, Christian; Botin, Lars; Zhu, Xinxin
2017-01-01
This paper discusses how health information technologies like tele-care, tele-health and tele-medicine can improve the condition for high-need patients, specifically in relation to access. The paper addresses specifically the values of timeliness and equity and how tele technological solutions can support and enhance these values. The paper introduces to the concept of scaffolding, which constitutes the framework for dynamic, appropriate, caring and embracing approaches for engaging and involving high-need patients that are vulnerable and exposed. A number of specific considerations for designing tele-technologies for high-need patients are derived, and the paper concludes that ethical and epistemological criterions for design are needed in order to meet the needs and requirements of the weak and exposed.
Finding a New Way: Reinventing a Sixth-Grade Reading Program
ERIC Educational Resources Information Center
Ahrens, Brooke Carey
2005-01-01
The author found that the reading program at her school did not address the needs of struggling readers and that reading teachers lacked the materials and knowledge needed to make improvements. As part of an action research project, she redesigned the reading program and introduced her colleagues to research-based teaching methods. The author…
A Need for a Competency Based Teacher Education for Native Americans. Position Paper.
ERIC Educational Resources Information Center
Miller, Louise
This paper addresses: (a) problems in the education of native Americans caused by prejudice and the coercive assimilation policy of the federal government, and (b) the need for improvement of education for Indians. The prime requisites for change must be generated in a climate of willingness on the part of educational institutions to assume…
ERIC Educational Resources Information Center
General Accounting Office, Washington, DC.
A General Accounting Office (GAO) study evaluated the Bureau of Indian Affairs' (BIA) new facilities management information system (FMIS). Specifically, the study examined whether the new FMIS addresses the old system's weaknesses and meets BIA's management needs, whether BIA has finished validating the accuracy of data transferred from the old…
ERIC Educational Resources Information Center
Humphrey, Neil; Lendrum, Ann; Barlow, Alexandra; Wigelsworth, Michael; Squires, Garry
2013-01-01
Students with special educational needs and disabilities (SEND) are at a greatly increased risk of experiencing poor psychosocial outcomes. Developing effective interventions that address the cause of these outcomes has therefore become a major policy priority in recent years. We report on a national evaluation of the Achievement for All (AfA)…
ERIC Educational Resources Information Center
Perez, Maria; Shambaugh, Larisa S.; Parrish, Tom
2008-01-01
California currently faces an opportunity to develop an effective data system that can assist in improving the state's future understanding of the educational progress of English learners (ELs). This policy brief outlines the needs for good data on ELs and makes recommendations for creating an effective longitudinal data system for ELs. It…
ERIC Educational Resources Information Center
Saqr, Youssra; Braun, Erika; Porter, Kyle; Barnette, Debra; Hanks, Christopher
2018-01-01
Little has been reported about how to improve health care access and delivery for adolescents and adults with autism spectrum disorder. To understand the contributions to the health disparities in the autism spectrum disorder population, we conducted two independent research approaches to learn about current medical needs. A retrospective chart…
A School Improvement Model for Motivating Adolescents to Achieve Success in Middle School
ERIC Educational Resources Information Center
Hutchinson, Stuart R.
2012-01-01
Effectively addressing the unique developmental and academic needs of adolescents is a challenge that educators have been grappling with since the mid-1960's when school systems began to convert junior high schools into middle schools. While educators have recognized the need to create developmentally responsive schools that help children to form…
The Role of Food Banks in Addressing Food Insecurity: A Systematic Review.
Bazerghi, Chantelle; McKay, Fiona H; Dunn, Matthew
2016-08-01
Food banks play a major role in the food aid sector by distributing donated and purchased groceries directly to food insecure families. The public health implications of food insecurity are significant, particularly as food insecurity has a higher prevalence among certain population groups. This review consolidates current knowledge about the function and efficacy of food banks to address food insecurity. A systematic review was conducted. Thirty-five publications were reviewed, of which 14 examined food security status, 13 analysed nutritional quality of food provided, and 24 considered clients' needs in relation to food bank use. This review found that while food banks have an important role to play in providing immediate solutions to severe food deprivation, they are limited in their capacity to improve overall food security outcomes due to the limited provision of nutrient-dense foods in insufficient amounts, especially from dairy, vegetables and fruits. Food banks have the potential to improve food security outcomes when operational resources are adequate, provisions of perishable food groups are available, and client needs are identified and addressed.
The University-Public Health Partnership for Public Health Research Training in Quebec, Canada.
Paradis, Gilles; Hamelin, Anne-Marie; Malowany, Maureen; Levy, Joseph; Rossignol, Michel; Bergeron, Pierre; Kishchuk, Natalie
2017-01-01
Enhancing effective preventive interventions to address contemporary public health problems requires improved capacity for applied public health research. A particular need has been recognized for capacity development in population health intervention research to address the complex multidisciplinary challenges of developing, implementing, and evaluating public health practices, intervention programs, and policies. Research training programs need to adapt to these new realities. We have presented an example of a 2003 to 2015 training program in transdisciplinary research on public health interventions that embedded doctoral and postdoctoral trainees in public health organizations in Quebec, Canada. This university-public health partnership for research training is an example of how to link science and practice to meet emerging needs in public health.
Preliminary national rail plan.
DOT National Transportation Integrated Search
2009-10-15
The Passenger Rail Investment and Improvement Act of 2008 (PRIIA) directed the Administrator of the Federal Railroad Administration (FRA) to develop a Preliminary National Rail Plan (PNRP or Preliminary Plan) to address the rail needs of the Nation. ...
Louisiana CVO/ITS business plan : technical summary.
DOT National Transportation Integrated Search
1998-06-01
Louisiana seeks to improve the efficiency and effectiveness of CVO business and operational functions in the state. This overall mission includes three discrete elements designed to address priority needs as identified by state and industry stakehold...
Evaluation of Michigan's engineering improvements for older drivers.
DOT National Transportation Integrated Search
2015-09-01
In 2004, the Michigan Department of Transportation (MDOT) began a comprehensive program : to implement engineering countermeasures to address the needs of older drivers. The : countermeasures included the use of Clearview Font on Guide Signs (freeway...
Implementing active traffic management strategies in the U.S.
DOT National Transportation Integrated Search
2010-10-01
Limited public funding for roadway expansion and improvement projects, coupled with continued growth in travel along congested urban freeway corridors, creates a pressing need for innovative congestion management approaches. Strategies to address con...
Ensuring Sustainable Data Interoperability Across the Natural and Social Sciences
NASA Astrophysics Data System (ADS)
Downs, R. R.; Chen, R. S.
2015-12-01
Both the natural and social science data communities are attempting to address the long-term sustainability of their data infrastructures in rapidly changing research, technological, and policy environments. Many parts of these communities are also considering how to improve the interoperability and integration of their data and systems across natural, social, health, and other domains. However, these efforts have generally been undertaken in parallel, with little thought about how different sustainability approaches may impact long-term interoperability from scientific, legal, or economic perspectives, or vice versa, i.e., how improved interoperability could enhance—or threaten—infrastructure sustainability. Scientific progress depends substantially on the ability to learn from the legacy of previous work available for current and future scientists to study, often by integrating disparate data not previously assembled. Digital data are less likely than scientific publications to be usable in the future unless they are managed by science-oriented repositories that can support long-term data access with the documentation and services needed for future interoperability. We summarize recent discussions in the social and natural science communities on emerging approaches to sustainability and relevant interoperability activities, including efforts by the Belmont Forum E-Infrastructures project to address global change data infrastructure needs; the Group on Earth Observations to further implement data sharing and improve data management across diverse societal benefit areas; and the Research Data Alliance to develop legal interoperability principles and guidelines and to address challenges faced by domain repositories. We also examine emerging needs for data interoperability in the context of the post-2015 development agenda and the expected set of Sustainable Development Goals (SDGs), which set ambitious targets for sustainable development, poverty reduction, and environmental stewardship by 2030. These efforts suggest the need for a holistic approach towards improving and implementing strategies, policies, and practices that will ensure long-term sustainability and interoperability of scientific data repositories and networks across multiple scientific domains.
Collins, John M; Reizes, Ofer; Dempsey, Michael K
2016-01-01
Academic investigators are generating a plethora of insights and technologies that have the potential to significantly improve patient care. However, to address the imperative to improve the quality, cost and access to care with ever more constrained funding, the efficiency and the consistency with which they are translated into cost effective products and/or services need to improve. Healthcare commercialization programs (HCPs) are described and proposed as an option that institutions can add to their portfolio to improve translational research. In helping teams translate specific healthcare innovations into practice, HCPs expand the skillset of investigators and enhance an institution's innovation capacity. Lessons learned are shared from configuring and delivering HCPs, which build on the fundamentals of the National Science Foundation's Innovation Corps program, to address the unique challenges in supporting healthcare innovations and innovators.
Nano clay-enhanced calcium phosphate cements and hydrogels for biomedical applications
NASA Astrophysics Data System (ADS)
Jammalamadaka, Udayabhanu
Biomaterials are used as templates for drug delivery, scaffolds in tissue engineering, grafts in surgeries, and support for tissue regeneration. Novel biomaterial composites are needed to meet multifaceted requirements of compatibility, ease of fabrication and controlled drug delivery. Currently used biomaterials in orthopedics surgeries suffer limitations in toxicity and preventing infections. Polymethyl methacrylate (PMMA) used as bone cement suffers from limitations of thermal necrosis and monomer toxicity calls for development of better cementing biomaterials. A biodegradable/bioresorbable cement with good mechanical properties is needed to address this short coming. Metal implants used in fixing fractures or total joint replacement needs improvements in preventing biofilm formation and better tissue integration. This research addressed the above mentioned research gaps by formulating novel biomaterial composites. Calcium phosphate cements are the alternative bone cements that are bioresorbable and promote tissue integration. These cements lack sufficient mechanical strengths to be used in load bearing sites. The addition of nanoparticles is hypothesized to improve the mechanical properties without inducing toxicity to the tissue. This hypothesis was tested by evaluating compression and flexural strengths in addition to cytocompatibility tests. Results indicate that addition of nano-clay particles (halloysites nanotubes) improved the compressive strength and osteoinductive properties of calcium phosphate cements. To address the research need of preventing implant failure due to infection and aseptic loosening, novel coatings are needed. Hydrogels are well establish for their ability to mimic in vivo environment, promote cell viability and as drug delivery vehicles. Use of composites of hydrogels and drug-loaded nanoparticles to prevent infection was evaluated. Cytocompatibility results indicate good cell viability. Antibacterial results show sustained release of antibiotics from composite hydrogels and good zones of inhibition on agar plates inoculated with bacterial cultures. Fabricating a complex three-dimensional (3D) scaffold for tissue engineering was a huge challenge. With advancements in additive manufacturing, this research gap was addressed. Methods are needed to fabricate patient specific grafts made from biocompatible biomaterials. In this research, 3D printing was used as a platform to explore new biomaterials as grafts or scaffolds for tissue engineering. Computerized tomography scans were used to fabricate patient-specific grafts. The use of calcium cements to fabricate three-dimensionally complex scaffold or grafts reported in this research holds potential in personalized medicine.
Climate Change and Water Working Group - User Needs to Manage Hydrclimatic Risk from Days to Decades
NASA Astrophysics Data System (ADS)
Raff, D. A.; Brekke, L. D.; Werner, K.; Wood, A.; White, K. D.
2012-12-01
The Federal Climate Change Water Working Group (CCAWWG) provides engineering and scientific collaborations in support of water management. CCAWWG objectives include building working relationships across federal science and water management agencies, provide a forum to share expertise and leverage resources, develop education and training forums, to work with water managers to understand scientific needs and to foster collaborative efforts across the Federal and non-Federal water management and science communities to address those needs. Identifying and addressing water management needs has been categorized across two major time scales: days to a decade and multi-decadal, respectively. These two time periods are termed "Short-Term" and "Long-Term" in terms of the types of water management decisions they support where Short-Term roughly correlates to water management operations and Long-Term roughly correlates to planning activities. This presentation will focus on portraying the identified water management user needs across these two time periods. User Needs for Long-Term planning were identified in the 2011 Reclamation and USACE "Addressing Climate Change in Long-Term Water Resources Planning and Management: User Needs for Improving Tools and Information." User needs for Long-Term planning are identified across eight major categories: Summarize Relevant Literature, Obtain Climate Change Information, Make Decisions About How to Use the Climate Change Information, Assess Natural Systems Response, Assess Socioeconomic and Institutional Response, Assess System Risks and Evaluate Alternatives, Assess and Characterize Uncertainties, and Communicating Results and Uncertainties to Decisionmakers. User Needs for Short-Term operations are focused on needs relative to available or desired monitoring and forecast products from the hydroclimatic community. These needs are presenting in the 2012 USACE, Reclamation, and NOAA - NWS "Short-Term Water Management Decisions: User Needs for Improved Climate, Weather, and Hydrologic Information." Identified needs are presented in four categories: Monitoring, Forecasting, Understanding on Product Relationships and Utilization in Water Management, and Information Services Enterprise. These needs represent everything from continuation and enhancement of in situ monitoring products such as USGS water gages and precipitation networks to supporting product maintenance and evolution to accommodate newly developed technologies.
Care of the family in the surgical intensive care unit.
Tyrie, Leslie Steele; Mosenthal, Anne Charlotte
2011-04-01
In the surgical intensive care unit (SICU), the stress of having a critically ill loved one creates significant bereavement and emotional needs for family members. Surgical palliative care has expanded; clinicians do not just treat the patient, but now include the family within the scope of care. Understanding and treating complicated grief, and the emotional and educational needs of the family improves family outcome, improves the surrogate family's ability to act as decision makers, and ultimately may positively affect patient survivor outcome. Care of families in the SICU requires interdisciplinary teams and palliative care processes to appropriately address their needs. Copyright © 2011 Elsevier Inc. All rights reserved.
Medication Adherence in Older Adults: A Qualitative Study
ERIC Educational Resources Information Center
Holt, Elizabeth W.; Rung, Ariane L.; Leon, Kyla A.; Firestein, Catherine; Krousel-Wood, Marie
2014-01-01
To effectively address medication adherence and improve cardiovascular health among older adults, a deeper understanding is needed of the barriers that this age group faces and of approaches that would be most effective and feasible for improving adherence. We conducted a focus group study (n = 25) in a diverse population of older adults with…
Strong Performers and Successful Reformers in Education: Education Policy Advice for Greece
ERIC Educational Resources Information Center
OECD Publishing (NJ1), 2011
2011-01-01
The future of Greece's well-being will depend on improving educational performance to boost productivity and improve social outcomes. In the current economic context, with the need to get best value for spending, Greece must and can address inefficiencies in its education system. The challenges are significant. For example, Greece lags behind many…
Investigators share improved understanding of the North American carbon cycle
Richard A. Birdsey; Robert Cook; Scott Denning; Peter Griffith; Beverly Law; Jeffrey Masek; Anna Michalak; Stephen Ogle; Dennis Ojima; Yude Pan; Christopher Sabine; Edwin Sheffner; Eric Sundquist
2007-01-01
The U.S. North American Carbon Program (NACP) sponsored an "all-scientist" meeting to review progress in understanding the dynamics of the carbon cycle of North American and adjacent oceans, and to chart a course for improved integration across scientifi c disciplines, scales, and Earth system boundaries. The meeting participants also addressed the need for...
Social Problems and America's Youth: Why School Reform Won't Work.
ERIC Educational Resources Information Center
Rittenmeyer, Dennis C.
1987-01-01
Using the schools to achieve racial balance, eliminate poverty, fight drug abuse, prevent pregnancy, and reduce youth suicide is too large a task. Teachers and principals should address educational issues, not unmet social needs. To improve the educational performance of the schools, the quality of life for youth must first be improved. (MSE)
ERIC Educational Resources Information Center
Brown, Michelle J.
2018-01-01
The Biggest Mover Program, an educational program to improve daily exercise and healthy eating was developed to address the learning needs of students with intellectual and developmental disabilities and physical challenges. The program was part of a three-part program to improve the knowledge of students, staff, and teachers through the use of…
Improving Performance through HEI-Industry Engagements in the Built Environment
ERIC Educational Resources Information Center
Underwood, Jason; Williams, Aled; Thurairajah, Niraj
2009-01-01
The poor performance and inefficiencies of the construction industry are well recognized and documented. Through a variety of combined industry and government initiatives there has been a continual expression in the UK over the last decade of the urgent need to address the fragmented nature of the industry to improve its performance. A major…
Towards Improving the Quality of Work Life in Education.
ERIC Educational Resources Information Center
Wood, J. M.
Addressing the need to consider ways in which the quality of educator work life can be improved, the author uses J. Walton's eight-point definition of the quality of work life as a framework for discussion. The eight points include (1) adequate and fair compensation, in which financial incentives are provided for advanced coursework; (2) safe and…
PESTICIDE SCREENING RESULTS FROM EIGHT DAYCARE CENTERS
To improve assessments of children's exposures to pesticides in support of the Food Quality Protection Act, priority research and data needs include: pesticide use patterns, pesticide residue distributions, and dermal exposure assessment approaches. To address these gaps, the ...
Addressing College Readiness Gaps at the College Door
ERIC Educational Resources Information Center
Friedmann, Elizabeth; Kurlaender, Michal; van Ommeren, Alice
2016-01-01
This chapter examines the Early Assessment Program, which provides California high school students with early signals about their college readiness and allows them to improve their skills and reduce the need for developmental education in college.
Aviation Safety: FAA Oversight of Repair Stations Needs Improvement
DOT National Transportation Integrated Search
1997-10-24
This report by the General Accounting Office examines the Federal Aviation : Administration's (FAA) oversight of the aviation repair station industry. : Specifically, this report addresses the following questions: (1) What is the : nature and scope o...
5 CFR 412.401 - Continuing executive development.
Code of Federal Regulations, 2011 CFR
2011-01-01
... participation in short-term and longer-term experiences, meet organizational needs for leadership, managerial improvement, and organizational results; (2) Address enhancement of existing executive competencies and such other competencies as will strengthen the executive's performance; (3) Outline developmental...
Building systemic capacity for nutrition: training towards a professionalised workforce for Africa.
Ellahi, Basma; Annan, Reginald; Sarkar, Swrajit; Amuna, Paul; Jackson, Alan A
2015-11-01
The fundamental role played by good nutrition in enabling personal, social and economic development is now widely recognised as presenting a fundamental global challenge that has to be addressed if major national and international problems are to be resolved in the coming decades. The recent focus provided by the Millennium Development Goals and the Scaling-Up-Nutrition (SUN) movement has been towards reducing the extent of nutrition-related malnutrition in high-burden countries. This has served to emphasise that there is a problem of inadequate professional capacity in nutrition that is sufficiently widespread to severely limit all attempts at the effective delivery and sustainability of nutrition-related and nutrition-enabling interventions that have impact at scale. Many high-burden countries are in sub-Saharan Africa where there is a high dependency on external technical support to address nutrition-related problems. We have sought to explore the nature and magnitude of the capacity needs with a particular focus on achieving levels of competency within standardised professional pre-service training which is fit-for-purpose to meet the objectives within the SUN movement in Africa. We review our experience of engaging with stakeholders through workshops, a gap analysis of the extent of the problem to be addressed, and a review of current efforts in Africa to move the agenda forward. We conclude that there are high aspirations but severely limited human resource and capacity for training that is fit-for-purpose at all skill levels in nutrition-related subjects in Africa. There are no structured or collaborative plans within professional groups to address the wide gap between what is currently available, the ongoing needs and the future expectations for meeting local technical and professional capability. Programmatic initiatives encouraged by agencies and other external players, will need to be matched by improved local capabilities to address the serious efforts required to meet the needs for sustained improvements related to SUN in high-burden countries. Importantly, there are pockets of effort which need to be encouraged within a context in which experience can be shared and mutual support provided.
Five policies to promote palliative care for patients with ESRD.
Tamura, Manjula Kurella; Meier, Diane E
2013-10-01
Patients with ESRD experience complex and costly care that does not always meet their needs. Palliative care, which focuses on improving quality of life and relieving suffering for patients with serious illnesses, could address a large unmet need among patients with ESRD. Strengthening palliative care is a top policy priority for health reform efforts based on strong evidence that palliative care improves value. This commentary outlines palliative care policies for patients with ESRD and is directed at policymakers, dialysis providers, nephrology professional societies, accreditation organizations, and funding agencies who play a key role in the delivery and determination of quality of ESRD care. Herein we suggest policies to promote palliative care for patients with ESRD by addressing key barriers, including the lack of access to palliative care, lack of capacity to deliver palliative care, and a limited evidence base. We also provide examples of how these policies could be implemented within the existing ESRD care infrastructure.
Fox, Geraldine S; Stock, Saundra; Briscoe, Gregory W; Beck, Gary L; Horton, Rita; Hunt, Jeffrey I; Liu, Howard Y; Partner Rutter, Ashley; Sexson, Sandra; Schlozman, Steven C; Stubbe, Dorothy E; Stuber, Margaret L
2012-11-01
A new Child and Adolescent Psychiatry in Medical Education (CAPME) Task Force, sponsored by the Association for Directors of Medical Student Education in Psychiatry (ADMSEP), has created an inter-organizational partnership between child and adolescent psychiatry (CAP) educators and medical student educators in psychiatry. This paper outlines the task force design and strategic plan to address the long-standing dearth of CAP training for medical students. The CAPME ADMSEP Task Force, formed in 2010, identified common challenges to teaching CAP among ADMSEP's CAPME Task Force members, utilizing focus-group discussions and a needs-assessment survey. The Task Force was organized into five major sections, with inter-organizational action plans to address identified areas of need, such as portable modules and development of benchmark CAP competencies. The authors predict that all new physicians, regardless of specialty, will be better trained in CAP. Increased exposure may also improve recruitment into this underserved area.
The State of Research on Communication and Literacy in Deafblindness.
Bruce, Susan M; Nelson, Catherine; Perez, Angel; Stutzman, Brent; Barnhill, Brooke A
2016-01-01
In a synthesis of the research, the authors present findings from communication and literacy studies conducted with children and youth with deafblindness, ages 0-22 years, and published in peer-reviewed journals, 1990-2015. Findings are organized within the structure of the four aspects of communication: form, function, content, context. The studies implemented child-guided and systematic instructional approaches. Studies on form addressed tangible representations, gestures, pictures, and technologies to increase expressive communication rates, and included research focusing on specific functions. Most of the research on context addressed the coaching of adult communication partners to improve responsiveness. Research on communication by children who are deafblind has focused almost exclusively on improving expressive communication. Therefore, there is a need for research on receptive communication and comprehension. In the area of literacy, studies are needed on emergent literacy and reading and writing interventions for children who are deafblind.
Exploring the business case for improving the quality of health care for children.
Homer, Charles
2004-01-01
A recent examination of the business case for improving quality in health care found few financial incentives (and sizable barriers) for health care organizations interested in investing in quality improvement. That analysis did not consider the special case of children's health care. To address this gap, an expert panel delineated aspects of children's health care-such as the need for care, patterns of use, and how care is organized and financed-that differ from adult care. It then identified barriers and solutions specific to children's health care, to ensure that children's unique needs are not lost in the debate.
Managed behavioral healthcare in the private sector.
Jeffrey, M; Riley, J
2000-09-01
Employers, in their search for cost containment and quality improvement, have driven the development of the behavioral health managed care vendor. More specifically, the behavioral health carve-out is an innovation that was developed to respond to employer and, more recently, health plan needs. Now that the product has matured, it is increasingly being asked to justify its existence. Costs have certainly been maintained, but improvements in quality have not always been evident. The issues the authors address include, as cost pressures continue, can the industry deliver on its promise to improve care? Will it need to evolve to yet another level, with new or different features?
Perry, Courtney D; Degeneffe, Dennis; Davey, Cynthia; Kollannoor-Samuel, Grace; Reicks, Marla
2016-05-25
Women tend to gain weight at midlife (40-60 years) increasing risk of obesity-related chronic diseases. Within specific eating occasions, needs related to the physical and social environment may result in less healthy eating behavior, which can lead to weight gain over time. The purpose of this study was to determine if a dietitian-delivered nutrition counseling intervention tailored to eating occasion needs could improve diet and prevent weight gain among midlife women over two years. A randomized controlled trial was conducted with healthy midlife women (n = 354) in one U.S. metropolitan area. The intervention group (n = 185) received ten hours of individual nutrition counseling from dietitians over six months, while women in a control group (n = 169) received no counseling. Measured height, weight and waist circumference, and dietary intakes were collected at baseline and every six months over two years. Mixed linear models were used to test for intervention effect on change in outcome variables over time. Dietary intakes of fruit, reduced/low-fat dairy foods and refined grains were significantly improved over time in the intervention compared to control group. However, the intervention had no effect on weight over time (p = 0.48). Nutrition counseling tailored to address eating occasion needs improved self-reported diet but did not significantly affect weight change.
Mabhaudhi, Tafadzwanashe; Chibarabada, Tendai; Modi, Albert
2016-01-01
Whereas sub-Saharan Africa’s (SSA) water scarcity, food, nutrition and health challenges are well-documented, efforts to address them have often been disconnected. Given that the region continues to be affected by poverty and food and nutrition insecurity at national and household levels, there is a need for a paradigm shift in order to effectively deliver on the twin challenges of food and nutrition security under conditions of water scarcity. There is a need to link water use in agriculture to achieve food and nutrition security outcomes for improved human health and well-being. Currently, there are no explicit linkages between water, agriculture, nutrition and health owing to uncoordinated efforts between agricultural and nutrition scientists. There is also a need to develop and promote the use of metrics that capture aspects of water, agriculture, food and nutrition. This review identified nutritional water productivity as a suitable index for measuring the impact of a water-food-nutrition-health nexus. Socio-economic factors are also considered as they influence food choices in rural communities. An argument for the need to utilise the region’s agrobiodiversity for addressing dietary quality and diversity was established. It is concluded that a model for improving nutrition and health of poor rural communities based on the water-food-nutrition-health nexus is possible. PMID:26751464
Stanhope, Victoria; Henwood, Benjamin F
2014-08-01
One of the primary goals of health care reform is improving the quality and reducing the costs of care for people with co-morbid mental health and physical health conditions. One strategy is to integrate primary and behavioral health care through care coordination and patient activation. This qualitative study using community based participatory research methods informs the development of integrated care by presenting the perspectives of those with lived experience of chronic illnesses and homelessness. Themes presented include the internal and external barriers to addressing health needs and the key role of peer support in overcoming these barriers.
Partnering With Patients in the Development and Lifecycle of Medicines
Anderson, James; Boutin, Marc; Dewulf, Lode; Geissler, Jan; Johnston, Graeme; Joos, Angelika; Metcalf, Marilyn; Regnante, Jeanne; Sargeant, Ifeanyi; Schneider, Roslyn F.; Todaro, Veronica; Tougas, Gervais
2015-01-01
The purpose of medicines is to improve patients' lives. Stakeholders involved in the development and lifecycle management of medicines agree that more effective patient involvement is needed to ensure that patient needs and priorities are identified and met. Despite the increasing number and scope of patient involvement initiatives, there is no accepted master framework for systematic patient involvement in industry-led medicines research and development, regulatory review, or market access decisions. Patient engagement is very productive in some indications, but inconsistent and fragmentary on a broader level. This often results in inefficient drug development, increasing evidence requirements, lack of patient-centered outcomes that address unmet medical needs and facilitate adherence, and consequently, lack of required therapeutic options and high costs to society and involved parties. Improved patient involvement can drive the development of innovative medicines that deliver more relevant and impactful patient outcomes and make medicine development faster, more efficient, and more productive. It can lead to better prioritization of early research; improved resource allocation; improved trial protocol designs that better reflect patient needs; and, by addressing potential barriers to patient participation, enhanced recruitment and retention. It may also improve trial conduct and lead to more focused, economically viable clinical trials. At launch and beyond, systematic patient involvement can also improve the ongoing benefit-risk assessment, ensure that public funds prioritize medicines of value to patients, and further the development of the medicine. Progress toward a universal framework for patient involvement requires a joint, precompetitive, and international approach by all stakeholders, working in true partnership to consolidate outputs from existing initiatives, identify gaps, and develop a comprehensive framework. It is essential that all stakeholders participate to drive adoption and implementation of the framework and to ensure that patients and their needs are embedded at the heart of medicines development and lifecycle management. PMID:26539338
ERIC Educational Resources Information Center
Ainscow, Mel; Dyson, Alan; Weiner, Saira
2013-01-01
The idea that schools can impact positively on student outcomes is a crucial driver in the rise of interest in school improvement research and practice. This review focuses on "from exclusion to inclusion." With a specific focus on children with special educational needs (SEN), this review addresses the forms of classroom practice that…
Methods to Improve Establishment and Growth of Bottomland Hardwood Artificial Regeneration
Callie Jo Schweitzer; Emile S. Gardiner; John A. Stanturf; Andrew W. Ezell
1999-01-01
With ongoing attempts to reforest both cut-over and abandoned agricultural land in the lower Mississippi alluvial plain, it has become evident that there exists a need for an efficient regeneration system that makes biological and economic sense. Also, there is a need to address how to minimize oomoetitkm from invading weeds, to deter predation by small mammals, and...
ERIC Educational Resources Information Center
Matter, M. Kevin
This paper presents strategies that address the needs of the school district assessment office for standardized procedures to support reliable and efficient test processing and reporting and that meet the needs of school staff for test administration guidelines. The key to test administration and processing quality is a knowledgeable test…
ERIC Educational Resources Information Center
McKenzie, Floretta Dukes
This paper examines the current and future roles of organizations such as education laboratories in serving the changing needs of urban education. Concerns for greater effectiveness in support services stem from the growing need to effectively deal with some of the complex, lingering issues which to data have been only marginally addressed. Urban…
Vision for the Future of Lws TR&T
NASA Astrophysics Data System (ADS)
Schwadron, N.; Mannucci, A. J.; Antiochos, S. K.; Bhattacharjee, A.; Gombosi, T. I.; Gopalswamy, N.; Kamalabadi, F.; Linker, J.; Pilewskie, P.; Pulkkinen, A. A.; Spence, H. E.; Tobiska, W. K.; Weimer, D. R.; Withers, P.; Bisi, M. M.; Kuznetsova, M. M.; Miller, K. L.; Moretto, T.; Onsager, T. G.; Roussev, I. I.; Viereck, R. A.
2014-12-01
The Living With a Star (LWS) program addresses acute societal needs for understanding the effects of space weather and developing scientific knowledge to support predictive capabilities. Our society's heavy reliance on technologies affected by the space environment, an enormous number of airline customers, interest in space tourism, and the developing plans for long-duration human exploration space missions are clear examples that demonstrate urgent needs for space weather models and detailed understanding of space weather effects and risks. Since its inception, the LWS program has provided a vehicle to innovate new mechanisms for conducting research, building highly effective interdisciplinary teams, and ultimately in developing the scientific understanding needed to transition research tools into operational models that support the predictive needs of our increasingly space-reliant society. The advances needed require broad-based observations that cannot be obtained by large missions alone. The Decadal Survey (HDS, 2012) outlines the nation's needs for scientific development that will build the foundation for tomorrow's space weather services. Addressing these goals, LWS must develop flexible pathways to space utilizing smaller, more diverse and rapid development of observational platforms. Expanding utilization of ground-based assets and shared launches will also significantly enhance opportunities to fulfill the growing LWS data needs. Partnerships between NASA divisions, national/international agencies, and with industry will be essential for leveraging resources to address increasing societal demand for space weather advances. Strengthened connections to user communities will enhance the quality and impact of deliverables from LWS programs. Thus, we outline the developing vision for the future of LWS, stressing the need for deeper scientific understanding to improve forecasting capabilities, for more diverse data resources, and for project deliverables that address the growing needs of user communities.
Naccarella, Lucio; Biuso, Catuscia; Jennings, Amanda; Patsamanis, Harry
2018-05-29
Evidence exists for the association between health literacy and heart health outcomes. Cardiac rehabilitation is critical for recovery from heart attack and reducing hospital readmissions. Despite this, <30% of people participate in a program. Significant patient, hospital and health system challenges exist to improve recovery through increased heart health literacy. This brief case study reflects and documents practice-based initiatives by Heart Foundation Victoria to improve access to recovery information for patients with low literacy levels. Three key initiatives, namely the Six Steps To Cardiac Recovery resource, the Love Your Heart book and the nurse ambassador program, were implemented informed by mixed methods that assessed need and capacity at the individual, organisational and systems levels. Key outcomes included increased access to recovery information for patients with low health literacy, nurse knowledge and confidence to engage with patients on recovery information, improved education of patients and improved availability and accessibility of information for patients in diverse formats. Given the challenges involved in addressing heart health literacy, multifaceted practice-based approaches are essential to improve access to recovery information for patients with low literacy levels. What is known about the topic? Significant challenges exist for patients with lower health literacy receiving recovery information after a heart attack in hospitals. What does this paper add? This case study provides insights into a practice-based initiative by Heart Foundation Victoria to improve access to recovery information for patients with low literacy levels. What are the implications for practitioners? Strategies to improve recovery through increased heart health literacy must address the needs of patients, nursing staff and the health system within hospitals. Such strategies need to be multifaceted and designed to build the capacity of nurses, heart patients and their carers, as well as support from hospital management.
Berkowitz, Seth A; Hulberg, A Catherine; Hong, Clemens; Stowell, Brian J; Tirozzi, Karen J; Traore, Carine Y; Atlas, Steven J
2016-03-01
Unmet basic resource needs, such as difficulty affording healthcare, medications, food and housing, may contribute to worse healthcare quality indicators, but interventions are hampered by lack of specific knowledge regarding the distribution of unmet basic resource needs and their association with priority clinical conditions and health service use patterns. Cross-sectional study of primary care patients in two urban academic practices from 1 October 2013 to 30 April 2014. Patients were screened for unmet needs and enrolled in a programme to link them with community resources. Key measures included patient report of unmet basic resource needs, clinical conditions prioritised by quality improvement programmes (hypertension, diabetes and depression), and health service use patterns such as frequent emergency department (ED) visits (>2 in the preceding year) and frequent clinic 'no-shows' (>1 in the preceding year). 416 patients with unmet needs were included, and compared with 2750 patients who did not report needs. The most common types of needs reported were: difficulties affording healthcare (46.5%), food (40.1%) and utilities (36.3%). Patients who reported unmet needs were more likely to have depression (17.8% vs 9.5%, p<0.0001), diabetes (32.7% vs 20.4%, p<0.0001), hypertension (54.3% vs 46.3%, p=0.002), be frequent ED users (11.3% vs 5.4%, p<0.0001), and have frequent 'no-shows' to clinic (21.6% vs 11.9%, p<0.0001). Difficulty affording healthcare and food are particularly common needs among patients with priority conditions. Strategies to identify and address unmet needs as part of routine care may be an important way to improve healthcare quality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Carey, Mariko; Sanson-Fisher, Rob; Oldmeadow, Christopher; Mansfield, Elise; Walsh, Justin
2016-01-01
Introduction General practitioners have a key role in reducing cancer risk factors, screening for cancer and managing depression. Given the time-limited nature of consultations, a new and more time-efficient approach is needed which addresses multiple health needs simultaneously, and encourages patient self-management to address health risks. The aim of this cluster randomised controlled trial is to test the effectiveness of a patient feedback intervention in improving patient self-management of health needs related to smoking, risky alcohol consumption and underscreening for cancers at 1 month follow-up. Methods and analysis Adult general practice patients will be invited to participate in a baseline survey to assess cancer risk factors, screening needs and depression. A total of 360 participants identified by the baseline survey as having at least one health need (a self-reported cancer risk factor, underscreening for cancer, or an elevated depression score) will be randomised to an intervention or control group. Participants in the intervention group will receive tailored printed feedback summarising their identified health needs and recommended self-management actions to address these. All participants will be invited to complete a telephone interview 1 month following recruitment to assess self-management actions taken in relation to health needs identified in the baseline survey. Control group participants will receive tailored printed feedback on their identified health needs after their follow-up interview. A logistic regression model, with group allocation as the main predictor, will be used to assess the impact of the intervention on self-management actions. Ethical considerations and dissemination Participants identified as being at risk of depression will be advised to speak with their doctor. Results will be disseminated via publication in peer-reviewed journals. The study has been approved by the University of Newcastle Human Research Ethics Committee. Trial registration number ACTRN12616001443482. PMID:27864255
National plan to enhance aviation safety through human factors improvements
NASA Technical Reports Server (NTRS)
Foushee, Clay
1990-01-01
The purpose of this section of the plan is to establish a development and implementation strategy plan for improving safety and efficiency in the Air Traffic Control (ATC) system. These improvements will be achieved through the proper applications of human factors considerations to the present and future systems. The program will have four basic goals: (1) prepare for the future system through proper hiring and training; (2) develop a controller work station team concept (managing human errors); (3) understand and address the human factors implications of negative system results; and (4) define the proper division of responsibilities and interactions between the human and the machine in ATC systems. This plan addresses six program elements which together address the overall purpose. The six program elements are: (1) determine principles of human-centered automation that will enhance aviation safety and the efficiency of the air traffic controller; (2) provide new and/or enhanced methods and techniques to measure, assess, and improve human performance in the ATC environment; (3) determine system needs and methods for information transfer between and within controller teams and between controller teams and the cockpit; (4) determine how new controller work station technology can optimally be applied and integrated to enhance safety and efficiency; (5) assess training needs and develop improved techniques and strategies for selection, training, and evaluation of controllers; and (6) develop standards, methods, and procedures for the certification and validation of human engineering in the design, testing, and implementation of any hardware or software system element which affects information flow to or from the human.
Report #2004-P-00021, June 22, 2004. EPA and the U.S. Department of Justice have developed and implemented an integrated refinery compliance strategy that addresses the most important noncompliance problems.
Report #09-P-0088, January 28, 2009. The P2 Program’s data provided in response to the OMB PART assessment generally addressed the PART questions and supported the moderately effective rating received.
DOT National Transportation Integrated Search
1997-01-01
This Government Accounting Office report addresses the reliability of the cost information critical to capital investment decision-making on air traffic control projects. Specifically, the GAO evaluated the Federal Aviation Administration's processes...
ENGINEERED STORMWATER MANAGEMENT FOR LOW-INCOME URBAN COMMUNITIES
This project addresses issues related to water quality and quantity in New Jersey’s urbanized watersheds and targets the need for improved environmental quality as a form of prosperity for the people in low-income urban communities.
Hull, Helia Garrido
2016-01-01
This Article addresses the need to reform the ADA to prevent vexatious litigation and to promote the underlying goals of the Act. Part I of this Article introduces the topic of vexatious litigation and the importance of remedying the effects of exploitation of the ADA. Part II provides an overview of the ADA and its efforts to increase accessibility to individuals with disabilities, emphasizing the provisions of the Act that create incentives to engage in vexatious litigation. Part III examines and analyzes the judiciary's response to vexatious litigation under the ADA, and sanctions that have been issued to limit exploitation. Finally, Part IV provides recommendations to reform the ADA and state disability law counterparts, suggests corrective actions to address vexatious litigation, and identifies methods to promote equality for individuals with disabilities.
Lombard, Wendy; Burke, Jodi; Waddell, Sandra; Franke, Arthur
2015-08-01
This research note underscores the importance of including strategies to address gender-based disparities when planning and implementing community health improvement programs. Working in collaboration with the Inkster Partnership for a Healthier Community (IPHC), the National Kidney Foundation of Michigan conducted a gender-based analysis as part of its broader community health needs assessment efforts in Inkster, MI. The findings from these studies revealed significant challenges impacting women that were not being adequately addressed within the community. In response to these findings, the IPHC created a strategic action plan to respond to the highest priority needs by increasing community awareness of and linkages to resources that provide supportive services for low-income African-American women. Copyright © 2014 Elsevier Ltd. All rights reserved.
The Feasibility of "oscar" as AN Information System for Sustainable Rehabilitation of Built Heritage
NASA Astrophysics Data System (ADS)
Farmer, C.; Rouillard, C.
2017-08-01
This paper aims to examine the feasibility of the Online Sustainable Conservation Assistance Resource (OSCAR) as an information system and framework to help find appropriate ways to improve the sustainable performance of heritage buildings in North America. The paper reviews the need for holistic comprehensive authoritative information in the field of sustainable conservation, how OSCAR addresses this gap, the OSCAR workflow, and how it was used in two case studies. It was found that OSCAR has potential to become a practical educational tool and design aide to address the sustainable performance of heritage buildings. The paper contributes to the discourse on sustainable conservation by examining resources and tools which address the need for holistic retrofit approaches. The findings will be useful to educators and professionals in the fields of sustainable design and heritage conservation.
Case Managers' Perspectives On What They Need To Do Their Job
Eack, Shaun M.; Greeno, Catherine G.; Christian-Michaels, Stephen; Dennis, Amy; Anderson, Carol M.
2013-01-01
Objective To identify the perceived training needs of case managers working on community support teams in a community mental health center serving a semi-rural/suburban area. Methods Semi-structured interviews were conducted with 18 case managers and 3 supervisors to inquire about areas of training need in case management. Interviews were coded and analyzed for common themes regarding training needs and methods of training improvement. Results Identified training needs called for a hands-on, back to basics approach that included education on the symptoms of severe mental illness, co-morbid substance use problems, and methods of engaging consumers. A mentoring model was proposed as a potential vehicle for disseminating knowledge in these domains. Conclusions Case managers identify significant training needs that would address their basic understanding of severe mental illness. Programs targeting these needs may result in improved outcomes for case managers and the individuals with psychiatric disabilities. PMID:19346211
Gomez-Castillo, Blanca J; Hirsch, Rosemarie; Groninger, Hunter; Baker, Karen; Cheng, M Jennifer; Phillips, Jayne; Pollack, John; Berger, Ann M
2015-11-01
Spirituality is a patient need that requires special attention from the Pain and Palliative Care Service team. This quality improvement project aimed to provide spiritual assessment for all new outpatients with serious life-altering illnesses. Percentage of new outpatients receiving spiritual assessment (Faith, Importance/Influence, Community, Address/Action in care, psychosocial evaluation, chaplain consults) at baseline and postinterventions. Interventions included encouraging clinicians to incorporate adequate spiritual assessment into patient care and implementing chaplain covisits for all initial outpatient visits. The quality improvement interventions increased spiritual assessment (baseline vs. postinterventions): chaplain covisits (25.5% vs. 50%), Faith, Importance/Influence, Community, Address/Action in care completion (49% vs. 72%), and psychosocial evaluation (89% vs. 94%). Improved spiritual assessment in an outpatient palliative care clinic setting can occur with a multidisciplinary approach. This project also identifies data collection and documentation processes that can be targeted for improvement. Published by Elsevier Inc.
Reizes, Ofer; Dempsey, Michael K.
2016-01-01
Academic investigators are generating a plethora of insights and technologies that have the potential to significantly improve patient care. However, to address the imperative to improve the quality, cost and access to care with ever more constrained funding, the efficiency and the consistency with which they are translated into cost effective products and/or services need to improve. Healthcare commercialization programs (HCPs) are described and proposed as an option that institutions can add to their portfolio to improve translational research. In helping teams translate specific healthcare innovations into practice, HCPs expand the skillset of investigators and enhance an institution’s innovation capacity. Lessons learned are shared from configuring and delivering HCPs, which build on the fundamentals of the National Science Foundation’s Innovation Corps program, to address the unique challenges in supporting healthcare innovations and innovators. PMID:27766188
Powell, Rhea E; Doty, Amanda; Casten, Robin J; Rovner, Barry W; Rising, Kristin L
2016-09-20
Healthcare systems increasingly engage interprofessional healthcare team members such as case managers, social workers, and community health workers to work directly with patients and improve population health. This study elicited perspectives of interprofessional healthcare team members regarding patient barriers to health and suggestions to address these barriers. This is a qualitative study employing focus groups and semi-structured interviews with 39 interprofessional healthcare team members in Philadelphia to elicit perceptions of patients' needs and experiences with the health system, and suggestions for positioning health care systems to better serve patients. Themes were identified using a content analysis approach. Three focus groups and 21 interviews were conducted with 26 hospital-based and 13 ambulatory-based participants. Three domains emerged to characterize barriers to care: social determinants, health system factors, and patient trust in the health system. Social determinants included insurance and financial shortcomings, mental health and substance abuse issues, housing and transportation-related limitations, and unpredictability associated with living in poverty. Suggestions for addressing these barriers included increased financial assistance from the health system, and building a workforce to address these determinants directly. Health care system factors included poor care coordination, inadequate communication of hospital discharge instructions, and difficulty navigating complex systems. Suggestions for addressing these barriers included enhanced communication between care sites, patient-centered scheduling, and improved patient education especially in discharge planning. Finally, factors related to patient trust of the health system emerged. Participants reported that patients are often intimidated by the health system, mistrusting of physicians, and fearful of receiving a serious diagnosis or prognosis. A suggestion for mitigating these issues was increased visibility of the health system within communities to foster trust and help providers gain a better understanding of unique community needs. This work explored interprofessional healthcare team members' perceptions of patient barriers to healthcare engagement. Participants identified barriers related to social determinants of health, complex system organization, and patient mistrust of the health system. Participants offered concrete suggestions to address these barriers, with suggestions supporting current healthcare reform efforts that aim at addressing social determinants and improving health system coordination and adding new insight into how systems might work to improve patient and community trust.
Mullinx, Cassandra; Phillips, Scott; Shenk, Kelly; Hearn, Paul; Devereux, Olivia
2009-01-01
The Chesapeake Bay Program (CBP) is attempting to more strategically implement management actions to improve the health of the Nation’s largest estuary. In 2007 the U.S. Geological Survey (USGS) and U.S. Environmental Protection Agency (USEPA) CBP office began a joint effort to develop a suite of Internetaccessible decision-support tools and to help meet the needs of CBP partners to improve water quality and habitat conditions in the Chesapeake Bay and its watersheds. An adaptive management framework is being used to provide a structured decision process for information and individual tools needed to implement and assess practices to improve the condition of the Chesapeake Bay ecosystem. The Chesapeake Online Adaptive Support Toolkit (COAST) is a collection of web-based analytical tools and information, organized in an adaptive management framework, intended to aid decisionmakers in protecting and restoring the integrity of the Bay ecosystem. The initial version of COAST is focused on water quality issues. During early and mid- 2008, initial ideas for COAST were shared and discussed with various CBP partners and other potential user groups. At these meetings, test cases were selected to help improve understanding of the types of information and analytical functionality that would be most useful for specific partners’ needs. These discussions added considerable knowledge about the nature of decisionmaking for Federal, State, local and nongovernmental partners. Version 1.0 of COAST, released in early winter of 2008, will be further reviewed to determine improvements needed to address implementation and assessment of water quality practices. Future versions of COAST may address other aspects of ecosystem restoration, including restoration of habitat and living resources and maintaining watershed health.
Radiative Transport Modelling of Thermal Barrier Coatings
2017-03-24
of being able to extract useful data. To account for this deficiency, the purpose of this project is to improve models for use in OCT measurements ...PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Lumium optical precision measurement solutions...coefficients. Further, the model will need to take into account the effects of interface reflections and a multilayer structure. Such a model is of
2001-12-01
addition, the Defense Nuclear Facilities Safety Board warned in 1997 that, given likely future reductions in DOE’s budget, the department needed to...future leaders of the acquisition workforce. The Defense Nuclear Facilities Safety Board’s 2000 report credited DOE with taking steps to improve the...technical capabilities of personnel at its defense nuclear facilities , but pointed out the need for DOE’s leadership to pay increased attention to this
ERIC Educational Resources Information Center
Frayne, Daniel J.
2017-01-01
As U.S. infant mortality remains relatively unchanged and maternal mortality is rising, it is increasingly clear that service providers need to address many of the modifiable risks that determine birth outcomes prior to pregnancy. Health professionals have promoted preconception care for decades as a way to improve women's and infant's health. Yet…
ERIC Educational Resources Information Center
McCombs, Jennifer Sloan; Orr, Nate; Bodilly, Susan J.; Naftel, Scott; Constant, Louay; Scherer, Ethan; Gershwin, Daniel
2010-01-01
High-quality out-of-school-time (OST) programs have a positive effect on youth development, but many cities have found it difficult to address the challenges of expanding and improving the quality of programs offered to underserved and high-need students. In response, The Wallace Foundation sponsored an initiative to help five cities increase…
U.S. Forest Service Region 1 Lake Chemistry, NADP, and IMPROVE air quality data analysis
Jill Grenon; Mark Story
2009-01-01
This report was developed to address the need for comprehensive analysis of U.S. Forest Service (USFS) Region 1 air quality monitoring data. The monitoring data includes Phase 3 (long-term data) lakes, National Atmospheric Deposition Program (NADP), and Interagency Monitoring of Protected Visual Environments (IMPROVE). Annual and seasonal data for the periods of record...
ERIC Educational Resources Information Center
Ruedel, Kristin; Nelson, Gena; Bailey, Tessie; Bradley-Black, Katherine
2018-01-01
North Carolina Department of Public Instruction (NCDPI) is focused on improving the 5-year graduation rates for all students with disabilities. To make progress toward the state-identified measurable result (SIMR), the state recognized that a single evidence-based practice (EBP) would not address the diverse needs of all the local entities across…
ERIC Educational Resources Information Center
National Board for Professional Teaching Standards, 2010
2010-01-01
Over the past decade, Montgomery County Public Schools (MCPS) in Maryland has focused on improving teacher capacity as a strategy to address achievement gaps and promote "college-ready" standards in what has become an "urban suburb" with significant pockets of high-need students. As part of this focus on quality teaching, the…
Team-Based Care with Pharmacists to Improve Blood Pressure: a Review of Recent Literature.
Kennelty, Korey A; Polgreen, Linnea A; Carter, Barry L
2018-01-18
We review studies published since 2014 that examined team-based care strategies and involved pharmacists to improve blood pressure (BP). We then discuss opportunities and challenges to sustainment of team-based care models in primary care clinics. Multiple studies presented in this review have demonstrated that team-based care including pharmacists can improve BP management. Studies highlighted the cost-effectiveness of a team-based pharmacy intervention for BP control in primary care clinics. Little information was found on factors influencing sustainability of team-based care interventions to improve BP control. Future work is needed to determine the best populations to target with team-based BP programs and how to implement team-based approaches utilizing pharmacists in diverse clinical settings. Future studies need to not only identify unmet clinical needs but also address reimbursement issues and stakeholder engagement that may impact sustainment of team-based care interventions.
Beyond bankable dollars: establishing a business case for improving health care.
Bailit, Michael; Dyer, Mary Beth
2004-09-01
To address widespread deficiencies in the quality of health care, the authors argue that health care organizations need to be able to make a "business case" for improving quality--a compelling rationale for financial investment in quality improvement programs. The authors' framework for such a business case is organized around three broad areas: direct financial considerations, strategic considerations, and internal organizational considerations. Within these categories, they offer a total of 10 specific business case arguments, with examples, for investing in quality improvement.
Singh, I P; Shiva, M
1994-06-01
Even though India was the first country to address population, it is behind those who came later. The government of India framed population within the context of health, but it eventually shifted the approach to health and family planning. Compartmentalism and adhoc-ism removed the programs far from the people. Eventually family welfare replaced family planning. The 8 Five Year Plan document provides a framework for appropriate, positive change in addressing the population issue. Yet, contraceptive intervention, particularly tubectomy, remains the core of population issues. In fact, tubectomy increased from about 11% of total sterilizations in the late 1960s to 96% in 1994. Women remain the target of population control. In fact, female-targeted contraceptive technology has produced IUDs, oral contraceptives, tubectomy, subdermal contraceptive implants, and the injectable contraceptive. Improvement of women's health services, their status, and their economic independence has not been attempted. Before improvement can occur, female literacy; skill development; meeting of basic needs of food, water, and health care for children to survive; and safe living and working conditions are needed. Male responsibility has risen somewhat over time. India needs to work towards a shift from contraception-oriented population control to reducing births by choice (RBBC), making RBBC a grassroots movement, a holistic approach, coordination between various government agencies, addressing demographic fundamentalism (e.g., son preference and child marriage), provision of primary health care, and equitable distribution of local and global resources. Population policy must be human.
ERIC Educational Resources Information Center
Lewallen, Theresa C.; Hunt, Holly; Potts-Datema, William; Zaza, Stephanie; Giles, Wayne
2015-01-01
Background: The Whole Child approach and the coordinated school health (CSH) approach both address the physical and emotional needs of students. However, a unified approach acceptable to both the health and education communities is needed to assure that students are healthy and ready to learn. Methods: During spring 2013, the ASCD (formerly known…
ERIC Educational Resources Information Center
O'Callaghan, Anne
2013-01-01
This paper aims to draw attention to and provide insights into an area that is of educational significance for clinical teachers, namely the need to acknowledge and respond appropriately to the emotional context of both learning and health encounters in order to improve the outcomes of both. This need has been highlighted by recent calls for more…
Review of 11 national policies for rare diseases in the context of key patient needs.
Dharssi, Safiyya; Wong-Rieger, Durhane; Harold, Matthew; Terry, Sharon
2017-03-31
Rare diseases collectively exert a global public health burden in the severity of their manifestations and the total number of people they afflict. For many patients, considerable barriers exist in terms of access to appropriate care, delayed diagnosis and limited or non-existing treatment options. Motivated by these challenges, the rare disease patient community has played a critical role, elevating the patient voice and mobilizing legislation to support the development of programs that address the needs of patients with rare diseases.The US Orphan Drug Act of 1983 served as a key milestone in this journey, providing a roadmap for other countries to introduce and implement similar orphan drug legislation; more recently, the European Union (EU) has gone further to encourage the widespread adoption and implementation of rare disease plans or strategies designed to more adequately address the comprehensive needs of patients with rare diseases. Despite these legislative efforts and the growing contributions of patient advocacy groups in moving forward implementation and adoption of rare disease programs, gaps still exist across the policy landscape for several countries. To gain deeper insights into the challenges and opportunities to address key needs of rare disease patients, it is critical to define the current status of rare disease legislation and policy across a geographically and economically diverse selection of countries. We analyzed the rare disease policy landscape across 11 countries: Germany, France, the United Kingdom, Canada, Bulgaria, Turkey, Argentina, Mexico, Brazil, China, and Taiwan. The status and implementation of policy was evaluated for each country in the context of key patient needs across 5 dimensions: improving coordination of care, diagnostic resources, access to treatments, patient awareness and support, and promoting innovative research. Our findings highlight the continuing role of the patient community in driving the establishment and adoption of legislation and programs to improve rare disease care. Further, we found that while national rare disease plans provide important guidance for improving care, implementation of plans is uneven across countries. More research is needed to demonstrate the effect of specific elements of rare disease plans on patient outcomes.
Information adaptive system of NEEDS. [of NASA End to End Data System
NASA Technical Reports Server (NTRS)
Howle, W. M., Jr.; Kelly, W. L.
1979-01-01
The NASA End-to-End Data System (NEEDS) program was initiated by NASA to improve significantly the state of the art in acquisition, processing, and distribution of space-acquired data for the mid-1980s and beyond. The information adaptive system (IAS) is a program element under NEEDS Phase II which addresses sensor specific processing on board the spacecraft. The IAS program is a logical first step toward smart sensors, and IAS developments - particularly the system components and key technology improvements - are applicable to future smart efforts. The paper describes the design goals and functional elements of the IAS. In addition, the schedule for IAS development and demonstration is discussed.
Milton Friedman: "TECHNOS" Interview.
ERIC Educational Resources Information Center
TECHNOS, 1996
1996-01-01
This interview with Milton Friedman addresses his economic policies and how they might improve American public education. Highlights include teachers' unions and their negative impact on education, private schools and tax relief, the Edison Project, privatization of educational services, special needs students, California's Educational Freedom…
Code of Federal Regulations, 2013 CFR
2013-01-01
... address the critical needs of the specialty crop industry by developing and disseminating science-based... over the long term (including specialty crop policy and marketing). (4) New innovations and technology, including improved mechanization and technologies that delay or inhibit ripening. (5) Methods to prevent...
Code of Federal Regulations, 2012 CFR
2012-01-01
... address the critical needs of the specialty crop industry by developing and disseminating science-based... over the long term (including specialty crop policy and marketing). (4) New innovations and technology, including improved mechanization and technologies that delay or inhibit ripening. (5) Methods to prevent...
Code of Federal Regulations, 2014 CFR
2014-01-01
... address the critical needs of the specialty crop industry by developing and disseminating science-based... over the long term (including specialty crop policy and marketing). (4) New innovations and technology, including improved mechanization and technologies that delay or inhibit ripening. (5) Methods to prevent...
Highway safety in black/African-American communities : issues and strategies
DOT National Transportation Integrated Search
2002-09-17
As traffic safety needs and problems differ across populations, so are the strategies required to address them. Efforts to improve traffic safety in the Black community have been handicapped, however, by a lack of information on communication strateg...
ERIC Educational Resources Information Center
Leptien, Jennifer R.
2015-01-01
This chapter addresses strengths and difficulties encountered in implementing transfer learning community models and how efficacy is supported through transfer learning community programming. Transfer programming best practices and recommendations for program improvements are presented.
Wilson, C; Rouse, L; Rae, S; Kar Ray, M
2018-04-01
WHAT IS KNOWN ON THE SUBJECT?: Restraint has negative psychological, physical and relational consequences for mental health patients and staff. Restraint reduction interventions have been developed (e.g., "Safewards"). Limited qualitative research has explored suggestions on how to reduce physical restraint (and feasibility issues with implementing interventions) from those directly involved. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This paper explores mental health patients' and staff members' suggestions for reducing physical restraint, whilst addressing barriers to implementing these. Findings centred on four themes: improving communication and relationships; staffing factors; environment and space; and activities and distraction. Not all suggestions are addressed by currently available interventions. Barriers to implementation were identified, centring on a lack of time and/or resources; with the provision of more time for staff to spend with patients and implement interventions seen as essential to reducing physical restraint. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Improving communication and relationships between staff/patients, making staffing-related changes, improving ward environments and providing patient activities are central to restraint reduction in mental healthcare. Fundamental issues related to understaffing, high staff turnover, and lack of time and resources need addressing in order for suggestions to be successfully implemented. Introduction Physical restraint has negative consequences for all involved, and international calls for its reduction have emerged. Some restraint reduction interventions have been developed, but limited qualitative research explores suggestions on how to reduce physical restraint (and feasibility issues with implementation) from those directly involved. Aims To explore mental health patients' and staff members' suggestions for reducing physical restraint. Methods Interviews were conducted with 13 inpatients and 22 staff members with experience of restraint on adult mental health inpatient wards in one UK National Health Service Trust. Results Findings centred on four overarching themes: improving communication and relationships between staff/patients; making staff-related changes; improving ward environments/spaces; and having more activities. However, concerns were raised around practicalities/feasibility of their implementation. Discussion Continued research is needed into best ways to reduce physical restraint, with an emphasis on feasibility/practicality and how to make time in busy ward environments. Implications for Practice Improving communication and relationships between staff/patients, making staffing-related changes, improving ward environments and providing patient activities are central to restraint reduction in mental healthcare. However, fundamental issues related to understaffing, high staff turnover and lack of time/resources need addressing in order for these suggestions to be successfully implemented. © 2018 John Wiley & Sons Ltd.
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
Public Library Staff as Community Health Partners: Training Program Design and Evaluation.
Morgan, Anna U; D'Alonzo, Bernadette A; Dupuis, Roxanne; Whiteman, Eliza D; Kallem, Stacey; McClintock, Autumn; Fein, Joel A; Klusaritz, Heather; Cannuscio, Carolyn C
2018-05-01
Public libraries are free and open to all-and accessed at high rates by vulnerable populations-which positions them to be key public health allies. However, library staff themselves often feel ill-equipped to address the health and social concerns of their patrons. To fill this gap, we developed a case-based training curriculum to help library staff recognize, engage, and refer vulnerable patrons to appropriate resources. Topics addressed in the training, including homelessness, mental health and substance use disorders, immigration, and trauma, were selected based on findings from a prior community needs assessment. Using a modified measure of self-efficacy, participants ( n = 33) were surveyed before and after each session. Several participants ( n = 7) were also interviewed 4 months after the training was completed. Overall, staff reported significant increases in comfort, confidence, and preparedness in assisting vulnerable patrons across all topic areas. Qualitative findings reflected positive perceived impact and value of the trainings. Staff felt training resources should be made more readily accessible. Improving library staff capacity to address the health and social needs of their patrons can further establish public libraries as partners in improving population health.
Beaupin, Lynda K.; Demark-Wahnefried, Wendy; Fasciano, Karen; Ganz, Patricia A.; Hayes-Lattin, Brandon; Hudson, Melissa M.; Nevidjon, Brenda; Oeffinger, Kevin C.; Rechis, Ruth; Richardson, Lisa C.; Seibel, Nita L.; Smith, Ashley W.
2015-01-01
Cancer is the leading disease-related cause of death in adolescents and young adults (AYAs). This population faces many short- and long-term health and psychosocial consequences of cancer diagnosis and treatment, but many programs for cancer treatment, survivorship care, and psychosocial support do not focus on the specific needs of AYA cancer patients. Recognizing this health care disparity, the National Cancer Policy Forum of the Institute of Medicine convened a public workshop to examine the needs of AYA patients with cancer. Workshop participants identified many gaps and challenges in the care of AYA cancer patients and discussed potential strategies to address these needs. Suggestions included ways to improve access to care for AYAs, to deliver cancer care that better meets the medical and psychosocial needs of AYAs, to develop educational programs for providers who care for AYA cancer survivors, and to enhance the evidence base for AYAs with cancer by facilitating participation in research. PMID:25568146
Mobile Multicast in Hierarchical Proxy Mobile IPV6
NASA Astrophysics Data System (ADS)
Hafizah Mohd Aman, Azana; Hashim, Aisha Hassan A.; Mustafa, Amin; Abdullah, Khaizuran
2013-12-01
Mobile Internet Protocol Version 6 (MIPv6) environments have been developing very rapidly. Many challenges arise with the fast progress of MIPv6 technologies and its environment. Therefore the importance of improving the existing architecture and operations increases. One of the many challenges which need to be addressed is the need for performance improvement to support mobile multicast. Numerous approaches have been proposed to improve mobile multicast performance. This includes Context Transfer Protocol (CXTP), Hierarchical Mobile IPv6 (HMIPv6), Fast Mobile IPv6 (FMIPv6) and Proxy Mobile IPv6 (PMIPv6). This document describes multicast context transfer in hierarchical proxy mobile IPv6 (H-PMIPv6) to provide better multicasting performance in PMIPv6 domain.
HDX Workbench: Software for the Analysis of H/D Exchange MS Data
NASA Astrophysics Data System (ADS)
Pascal, Bruce D.; Willis, Scooter; Lauer, Janelle L.; Landgraf, Rachelle R.; West, Graham M.; Marciano, David; Novick, Scott; Goswami, Devrishi; Chalmers, Michael J.; Griffin, Patrick R.
2012-09-01
Hydrogen/deuterium exchange mass spectrometry (HDX-MS) is an established method for the interrogation of protein conformation and dynamics. While the data analysis challenge of HDX-MS has been addressed by a number of software packages, new computational tools are needed to keep pace with the improved methods and throughput of this technique. To address these needs, we report an integrated desktop program titled HDX Workbench, which facilitates automation, management, visualization, and statistical cross-comparison of large HDX data sets. Using the software, validated data analysis can be achieved at the rate of generation. The application is available at the project home page http://hdx.florida.scripps.edu.
van der Meer, Frank; Clancy, Eoin; Thomas, Adam; Kutz, Susan; Hatfield, Jennifer; Orsel, Karin
2015-01-01
The Maasai pastoralists in sub-Saharan Africa depend on their livestock for income and food. Livestock production can be significantly improved by addressing animal health concerns. We explored the use of photovoice, a participatory action research method, to strengthen our understanding of the Maasai's animal health needs. Nine interviewees, representing warriors, elders, and women, identified animal, social, and human health themes. The use of photography provided a new medium for Maasai to express their needs and a focus for researcher-participant communications, thereby facilitating new insights across language and cultural barriers.
ERIC Educational Resources Information Center
National Comprehensive Center for Teacher Quality, 2009
2009-01-01
The National Comprehensive Center for Teacher Quality (TQ Center) is a resource to which the regional comprehensive centers, states, and other education stakeholders turn for strengthening the quality of teaching--especially in high-poverty, low-performing, and hard-to-staff schools--and for finding guidance in addressing specific needs, thereby…
Rethinking Global Water Governance for the 21st Century
NASA Astrophysics Data System (ADS)
Ajami, N. K.; Cooley, H.
2012-12-01
Growing pressure on the world's water resources is having major impacts on our social and economic well-being. According to the United Nations, today, at least 1.1 billion people do not have access to clean drinking water. Pressures on water resources are likely to continue to worsen in response to decaying and crumbling infrastructure, continued population growth, climate change, degradation of water quality, and other challenges. If these challenges are not addressed, they pose future risks for many countries around the world, making it urgent that efforts are made to understand both the nature of the problems and the possible solutions that can effectively reduce the associated risks. There is growing understanding of the need to rethink governance to meet the 21st century water challenges. More and more water problems extend over traditional national boundaries and to the global community and the types and numbers of organizations addressing water issues are large and growing. Economic globalization and transnational organizations and activities point to the need for improving coordination and integration on addressing water issues, which are increasingly tied to food and energy security, trade, global climate change, and other international policies. We will present some of the key limitations of global water governance institutions and provide recommendations for improving these institutions to address 21st century global water challenges more effectively.
NASA Technical Reports Server (NTRS)
1994-01-01
This study provides a set of recommendations for improving the effectiveness of our nation's aeronautics and space facilities. The study plan considers current and future government and commercial needs as well as DOD and NASA mission requirements through the year 2023. It addresses shortfalls in existing capabilities, new facility requirements, upgrades, consolidations, and phase-out of existing facilities. If the recommendations are implemented, they will provide world-class capability where it is vital to our country's needs and make us more efficient in meeting future needs.
Mental Health, Behavioral and Developmental Issues for Youth in Foster Care.
Deutsch, Stephanie A; Lynch, Amy; Zlotnik, Sarah; Matone, Meredith; Kreider, Amanda; Noonan, Kathleen
2015-10-01
Youth in foster care represent a unique population with complex mental and behavioral health, social-emotional, and developmental needs. For this population with special healthcare needs, the risk for adverse long-term outcomes great if needs go unaddressed or inadequately addressed while in placement. Although outcomes are malleable and effective interventions exist, there are barriers to optimal healthcare delivery. The general pediatrician as advocate is paramount to improve long-term outcomes. Copyright © 2015 Mosby, Inc. All rights reserved.
Nyman, Samuel R; Szymczynska, Paulina
2016-03-01
Dementia is being increasingly recognised as a major public health issue for our ageing populations. A critical aspect of supporting people with dementia is facilitating their participation in meaningful activities. However, research to date has not drawn on theories of ageing from developmental psychology that would help undergird the importance of such meaningful activity. For the first time, we connect existing activity provision for people with dementia with developmental psychology theories of ageing. We reviewed the literature in two stages: first, we narratively searched the literature to demonstrate the relevance of psychological theories of ageing for provision of meaningful activities for people with dementia, and in particular focused on stage-based theories of adult development (Carl Jung and Erik Erikson), gerotranscendence (Tornstam), selective optimisation with compensation (Baltes and Baltes), and optimisation in primary and secondary control (Heckhausen and Schulz). Second, we systematically searched PubMed and PsycINFO for studies with people with dementia that made use of the aforementioned theories. The narrative review highlights that activity provision for people with dementia goes beyond mere pleasure to meeting fundamental psychological needs. More specifically, that life review therapy and life story work address the need for life review; spiritual/religious activities address the need for death preparation; intergenerational activities address the need for intergenerational relationships; re-acquaintance with previously conducted leisure activities addresses the need for a sense of control and to achieve life goals; and pursuit of new leisure activities addresses the need to be creative. The systematic searches identified two studies that demonstrated the utility of applying Erikson's theory of psychosocial development to dementia care. We argue for the importance of activity provision for people with dementia to help promote wellbeing among an increasing proportion of older people. © Royal Society for Public Health 2016.
Recommendations for sexual expression management in long-term care: a qualitative needs assessment
Syme, Maggie L.; Lichtenberg, Peter; Moye, Jennifer
2017-01-01
Aims To conduct a qualitative needs assessment of Directors of Nursing regarding challenges and recommendations for addressing sexual expression and consent. Background Sexual expression management among long-term care residents is a complex issue for nursing home staff. Little guidance is available for those wanting to follow a person-centred approach. Policies and procedures are needed, and must be usable across long-term care settings. Design Qualitative design for in-depth exploration. Methods Semi-structured interviews were conducted with 20 Directors of Nursing in the spring and summer of 2013, representing a range of regions, facility sizes and resident populations. Interview questions prompted them to identify recommendations that address challenges to improving sexual expression management in long-term care settings. Results Comparative thematic analysis resulted in several codes, which were grouped into eight overall categories. Recommendation categories that addressed key challenges included: address the issue, make environmental changes, identify staff expertise, provide education and training, assess sexuality initially and recurrently, establish policies/procedures for sexual expression management, develop assessment tools for sexual expression and consent, and clarify legal issues. The recommendation to develop national guidelines was observed across categories. Discussion Directors of Nursing report several challenges to sexual expression management in their facilities, and perceive their current methods to be ad hoc. A proactive approach to policy and procedure development is needed. PMID:27188413
PDC cutters improve drilling in harsh environments
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mensa-Wilmot, G.
2000-02-01
Improvements in polycrystalline diamond compact (PDC) cutter technology have contributed immensely to the industry's acceptance of PDC bits as effective drilling tools. These cutters are being engineered to address the needs and requirements of different drilling programs. Extensive research and developments efforts have been dedicated to the analysis of the diamond table/tungsten carbide interface. The paper describes PDC cutter development, operational challenges, offset performance, and field experiences.
ERIC Educational Resources Information Center
Center for Mental Health in Schools at UCLA, 2011
2011-01-01
This brief underscores the need to rethink the proliferation of school teams, work groups, and committees. While such mechanisms are essential to enhancing school improvement, they must be designed in a delimited way to carry out fundamental functions and must be fully integrated with each other. From a functional perspective, because of current…
DOE Office of Scientific and Technical Information (OSTI.GOV)
None
Since its creation in 1946, Argonne National Laboratory has addressed the nation’s most pressing challenges in science, energy, the environment, and national security. United by a common goal – to improve the world – Argonne continues to drive the scientific and technological breakthroughs needed to ensure a sustainable future.
Aviation rulemaking : further reform is needed to address long-standing problems
DOT National Transportation Integrated Search
2001-07-01
The U.S. General Accounting Office (GAO) was requested to conduct a review of the Federal Aviation Administration's (FAA's) rulemaking process in order to identify ways to improve its efficiency. GAO established 3 research questions: (1) What are the...
Employer-Led Quality Assurance
ERIC Educational Resources Information Center
Tyszko, Jason A.
2017-01-01
Recent criticism of higher education accreditation has prompted calls for reform and sparked interest in piloting alternative quality assurance methods that better address student learning and employment outcomes. Although this debate has brought much needed attention to improving the outcomes of graduates and safeguarding federal investment in…
Commercial vehicle travel time and delay at U.S. border crossings
DOT National Transportation Integrated Search
2002-06-01
One of the Federal Highway Administrations (FHWAs) strategic goals is to help improve the economic efficiency of the U.S. transportation system and, thereby, enhance the nations position in the global economy. One way to address this need is...
A Curricular Innovation to Promote Interprofessional Collaboration
ERIC Educational Resources Information Center
Liston, Beth W.; Wagner, Janet; Miller, Jackie
2013-01-01
Background: Interprofessional teamwork is a crucial competency in health professions education which improves patient care. However, interprofessional education is not a widespread practice in medical schools. To address this need, we developed an educational pilot utilizing a standardized patient simulation to teach interprofessional…
A personal connection: Promoting positive attitudes towards teaching and learning.
Lujan, Heidi L; DiCarlo, Stephen E
2017-09-01
Students' attitudes towards teaching and learning must be addressed with the same seriousness and effort as we address content. Establishing a personal connection and addressing our students' basic psychological needs will produce positive attitudes towards teaching and learning and develop life-long learners. It will also promote constructive student-teacher relationships that have a profound influence on our students' approach towards school. To begin this process, consider the major tenets of the Self-Determination Theory. The Self-Determination Theory of human motivation focuses on our students' innate psychological needs and the degree to which an individual's behavior is self-motivated and self-determined. Faculty can satisfy the innate psychological needs by addressing our students' desire for relatedness, competence and autonomy. Relatedness refers to our students' need to feel connected to others, to be a member of a group, to have a sense of communion and to develop close relationships with others. Competence is believing our students can succeed , challenging them to do so and imparting that belief in them. Autonomy involves considering the perspectives of the student and providing relevant information and opportunities for student choice and initiating and regulating their own behaviors. Establishing a personal connection and addressing our students' basic psychological needs will improve our teaching, inspire and engage our students and promote positive attitudes towards teaching and learning while reducing competition and increasing compassion. These are important goals because unless students are inspired and motivated and have positive attitudes towards teaching and learning our efforts will fail to meet their full potential. Anat Sci Educ 10: 503-507. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mendell, D.
This talk addresses the impact that future price uncertainty and current low oil and gas prices have on the conduct and management of R&D in the upstream business. Uncertainty in future prices underscores the need to develop technology that will improve our ability to reduce technical uncertainties in investment decisions, to lower all costs and to operate in a flawless way. Low current prices result in a need to be more efficient and cost conscious in everything we do, including R&D. Since the price environment provides little tolerance for mistakes, we need the best possible definition of the hydrocarbon resourcesmore » that we find before committing to development. Furthermore, we must find and define the resource at the lowest possible cost, and develop it in an efficient way that is cost effective, safe and environmentally acceptable. The vital role of research includes improving tools for reconstructing basin histories, predicting hydrocarbon generation, migration and trapping, and improving the quality of seismic data and attribute analysis while reducing acquisition cost. Improved methods for interpreting the data and for integrating it into the evaluation and decision making process also facilitates success. We need to continually strive for the competitive advantage provided by leading edge research, while making maximum use of outsourcing and leveraging to get the most out of every research dollar spent. Systematic prioritization and highgrading of our research portfolio is particularly important in achieving this balance. Exxon understands the importance of R&D to the upstream business, and we are committed to managing our resources to provide the value added research needed to address today`s needs as well as those we know will be there down the road. Exxon has been a successful player in this industry for many decades and we believe that our future success is closely tied to our ability to continually generate key research breakthroughs in an efficient way.« less
School nurse perceptions of barriers and supports for children with diabetes.
Nabors, Laura; Troillett, Amanda; Nash, Tiffany; Masiulis, Barbara
2005-04-01
Adolescents with type 1 diabetes are likely attending most middle and high schools. These youth often do not receive the support needed to manage their diabetes during or after school. Nurses (n=110) from 3 states responded to a survey examining perceptions of barriers to and supports for diabetes management during school and after school activities. Results indicated that adolescents need more support at school. Support could be facilitated by education of school staff; improved communication among youth, parents, school nurses, teachers, and physicians; and more communication from adolescents to others about what they need to manage well in school. Open-ended questions allowed nurses to provide recommendations for supporting youth and ideas for addressing barriers to management at school. Future studies should address ways to enable adolescents to communicate about their diabetes and ways to educate the school team.
A Near Real-time Decision Support System Improving Forest Management in the Tropics
NASA Astrophysics Data System (ADS)
Tabor, K.; Musinsky, J.; Ledezma, J.; Rasolohery, A.; Mendoza, E.; Kistler, H.; Steininger, M.; Morton, D. C.; Melton, F. S.; Manwell, J.; Koenig, K.
2013-12-01
Conservation International (CI) has a decade of experience developing near real-time fire and deforestation monitoring and forecasting systems that channel monitoring information from satellite observations directly to national and sub-national government agencies, Non-Government Organizations (NGOs), and local communities. These systems are used to strengthen forest surveillance and monitoring, fire management and prevention, protected areas management and sustainable land use planning. With support from a NASA Wildland Fires grant, in September 2013 CI will launch a brand new near real-time alert system (FIRECAST) to better meet the outstanding needs and challenges users face in addressing ecosystem degradation from wildland fire and illegal forest activities. Outreach efforts and user feedback have indicated the need for seasonal fire forecasts for effective land use planning, faster alert delivery to enhance response to illegal forest activities, and expanded forest monitoring capabilities that enable proactive responses and that strengthen forest conservation and sustainable development actions. The new FIRECAST system addresses these challenges by integrating the current fire alert and deforestation systems and adding improved ecological forecasting of fire risk; expanding data exchange capabilities with mobile technologies; and delivering a deforestation alert product that can inform policies related to land use management and Reduced Emissions from Deforestation and forest Degradation (REDD+). In addition to demonstrating the capabilities of this new real-time alert system, we also highlight how coordination with host-country institutions enhances the system's capacity to address the implementation needs of REDD+ forest carbon projects, improve tropical forest management, strengthen environmental law enforcement, and facilitate the uptake of near real-time satellite monitoring data into business practices of these national/sub-national institutions.
Henke, Rachel Mosher; Chou, Ann F; Chanin, Johann C; Zides, Amanda B; Scholle, Sarah Hudson
2008-01-01
Background Few individuals with depression treated in the primary care setting receive care consistent with clinical treatment guidelines. Interventions based on the chronic care model (CCM) have been promoted to address barriers and improve the quality of care. A current understanding of barriers to depression care and an awareness of whether physicians believe interventions effectively address those barriers is needed to enhance the success of future implementation. Methods We conducted semi-structured interviews with 23 primary care physicians across the US regarding their experience treating patients with depression, barriers to care, and commonly promoted CCM-based interventions. Themes were identified from interview transcripts using a grounded theory approach. Results Six barriers emerged from the interviews: difficulty diagnosing depression, patient resistance, fragmented mental health system, insurance coverage, lack of expertise, and competing demands and other responsibilities as a primary care provider. A number of interventions were seen as helpful in addressing these barriers – including care managers, mental health integration, and education – while others received mixed reviews. Mental health consultation models received the least endorsement. Two systems-related barriers, the fragmented mental health system and insurance coverage limitations, appeared incompletely addressed by the interventions. Conclusion CCM-based interventions, which include care managers, mental health integration, and patient education, are most likely to be implemented successfully because they effectively address several important barriers to care and are endorsed by physicians. Practices considering the adoption of interventions that received less support should educate physicians about the benefit of the interventions and attend to physician concerns prior to implementation. A focus on interventions that address systems-related barriers is needed to overcome all barriers to care. PMID:18826646
An evaluation of perinatal mental health interventions: An integrative literature review.
Lavender, Theressa J; Ebert, Lyn; Jones, Donovan
2016-10-01
National statistics related specifically to the mental health of women in the perinatal period is poorly acknowledged in Australia. Maternal deaths related to mental health in the perinatal period can be attributed to a lack of appropriate treatment and/or support. A barrier to women's help-seeking behaviors is the lack of discrete, perinatal specific interventions where women can self-assess and access support. This review examines original research evaluating perinatal mental health interventions used by women to improve mental health. An integrative literature review was undertaken. A comprehensive search strategy using 5 electronic databases resulted in the retrieval of 1898 articles. Use of an inclusion and exclusion criteria and Critical Appraisal Skills Program tools resulted in 4 original research papers. Thematic analysis identified universal themes. Cognitive Behavioral Therapy, Behavioral Activation and Mindfulness-based interventions, specifically adapted to meet the needs of women in the perinatal period, demonstrate an overall improvement in mental health. Women involved in the interventions experienced both improvements in symptoms of anxiety and depression as well as secondary benefits from participating in the research. To improve perinatal mental health outcomes, innovative modes of providing effective perinatal mental health interventions that address the unique needs of women in the perinatal period are needed. Future development of perinatal mental health interventions require adaptions of Cognitive Behavioral Therapy, Behavioral Activation and/or Mindfulness-based methods to address mental health outcomes for women in the perinatal period. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
Curriculum-Based Handwriting Programs: A Systematic Review With Effect Sizes
Engel, Courtney; Lillie, Kristin; Zurawski, Sarah; Travers, Brittany G.
2018-01-01
Challenges with handwriting can have a negative impact on academic performance, and these challenges are commonly addressed by occupational therapy practitioners in school settings. This systematic review examined the efficacy of curriculum-based interventions to address children’s handwriting difficulties in the classroom (preschool to second grade). We reviewed and computed effect sizes for 13 studies (11 Level II, 2 Level III) identified through a comprehensive database search. The evidence shows that curriculum-based handwriting interventions resulted in small- to medium-sized improvements in legibility, a commonly reported challenge in this age group. The evidence for whether these interventions improved speed is mixed, and the evidence for whether they improved fluency is insufficient. No clear support was found for one handwriting program over another. These results suggest that curriculum-based interventions can lead to improvements in handwriting legibility, but Level I research is needed to validate the efficacy of these curricula. PMID:29689170
Robotics in Orthopedics: A Brave New World.
Parsley, Brian S
2018-02-16
Future health-care projection projects a significant growth in population by 2020. Health care has seen an exponential growth in technology to address the growing population with the decreasing number of physicians and health-care workers. Robotics in health care has been introduced to address this growing need. Early adoption of robotics was limited because of the limited application of the technology, the cumbersome nature of the equipment, and technical complications. A continued improvement in efficacy, adaptability, and cost reduction has stimulated increased interest in robotic-assisted surgery. The evolution in orthopedic surgery has allowed for advanced surgical planning, precision robotic machining of bone, improved implant-bone contact, optimization of implant placement, and optimization of the mechanical alignment. The potential benefits of robotic surgery include improved surgical work flow, improvements in efficacy and reduction in surgical time. Robotic-assisted surgery will continue to evolve in the orthopedic field. Copyright © 2018 Elsevier Inc. All rights reserved.
ERIC Educational Resources Information Center
General Accounting Office, Washington, DC.
In response to the need of military leaders to be better prepared to plan, support, and conduct joint (multi-service and multi-national) operations, Congress enacted the Goldwater- Nichols Department of Defense Reorganization Act of 1986. Positive steps were taken to implement provisions in the Act that address the education, assignment, and…
2017-06-01
automation, and digitalization technologies. Siemens’s products include gas, steam, and wind turbines , integrated power plant solutions, power grid...Quick Reaction responds to urgent technology needs and solves problems for warfighters. Existing systems refers to projects responsive to immediate...polymer, chemical and biological science to help address many of the world’s most challenging problems , such as the need for fresh food, safer and
Identification of new epilepsy treatments: issues in preclinical methodology.
Galanopoulou, Aristea S; Buckmaster, Paul S; Staley, Kevin J; Moshé, Solomon L; Perucca, Emilio; Engel, Jerome; Löscher, Wolfgang; Noebels, Jeffrey L; Pitkänen, Asla; Stables, James; White, H Steve; O'Brien, Terence J; Simonato, Michele
2012-03-01
Preclinical research has facilitated the discovery of valuable drugs for the symptomatic treatment of epilepsy. Yet, despite these therapies, seizures are not adequately controlled in a third of all affected individuals, and comorbidities still impose a major burden on quality of life. The introduction of multiple new therapies into clinical use over the past two decades has done little to change this. There is an urgent demand to address the unmet clinical needs for: (1) new symptomatic antiseizure treatments for drug-resistant seizures with improved efficacy/tolerability profiles, (2) disease-modifying treatments that prevent or ameliorate the process of epileptogenesis, and (3) treatments for the common comorbidities that contribute to disability in people with epilepsy. New therapies also need to address the special needs of certain subpopulations, that is, age- or gender-specific treatments. Preclinical development in these treatment areas is complex due to heterogeneity in presentation and etiology, and may need to be formulated with a specific seizure, epilepsy syndrome, or comorbidity in mind. The aim of this report is to provide a framework that will help define future guidelines that improve and standardize the design, reporting, and validation of data across preclinical antiepilepsy therapy development studies targeting drug-resistant seizures, epileptogenesis, and comorbidities. Wiley Periodicals, Inc. © 2012 International League Against Epilepsy.
Identification of new treatments for epilepsy: issues in preclinical methodology
Galanopoulou, Aristea S.; Buckmaster, Paul S.; Staley, Kevin J.; Moshé, Solomon L.; Perucca, Emilio; Engel, Jerome; Löscher, Wolfgang; Noebels, Jeffrey L.; Pitkänen, Asla; Stables, James; White, Steve H.; O’Brien, Terence J.; Simonato, Michele
2013-01-01
Summary Preclinical research has facilitated the discovery of valuable drugs for the symptomatic treatment of epilepsy. Yet, despite these therapies, seizures are not adequately controlled in a third of all affected individuals, and comorbidities still impose a major burden on quality of life. The introduction of multiple new therapies into clinical use over the past two decades has done little to change this. There is an urgent demand to address the unmet clinical needs for: (a) new symptomatic anti-seizure treatments for drug-resistant seizures with improved efficacy/tolerability profiles, (b) disease modifying treatments that prevent or ameliorate the epileptogenic state, and (c) treatments for the common comorbidities that contribute to disability in people with epilepsy. New therapies also need to address the special needs of certain subpopulations, i.e. age- or gender-specific treatments. Preclinical development in these treatment areas is complex due to heterogeneity in presentation and etiology, and may need to be formulated with a specific seizure, epilepsy syndrome or comorbidity in mind. The aim of this report is to provide a framework that will help define future guidelines that improve and standardize the design, reporting, and validation of data across preclinical anti-epilepsy therapy development studies targeting drug-resistant seizures, epileptogenesis and comorbidities. PMID:22292566
Schulz-Baldes, Annette; Delmonico, Francis L
2007-11-01
The number of kidney transplants from live donors is increasing worldwide, yet donor needs have not been satisfactorily addressed in either developed or developing countries. This paper argues that unmet donor needs are unfair to live kidney donors in two ways. First, when safeguards against the risks of donation are insufficient, live donation can impair the donor's health and thus his or her fair opportunities to access jobs and offices and to function as a free and equal citizen more generally. Secondly, when the financial costs of donation are not fully compensated, operational fairness (associated with the nephrectomy event) is compromised for the donor. The donor assumes the risks of a nontherapeutic intervention--for the good of the recipient and society--and should not have to incur costs for donating. Based on a systematic analysis of unmet donor needs in developed and developing countries, context-relative measures to improve institutional fairness to live kidney donors are delineated in this paper. The identified ways of safeguarding donation risks and compensating donation costs are not merely means to removing disincentives for donation and increasing donation rates. They are essential for preserving institutional fairness in the health care of the live kidney donor.
Aoun, Samar; Deas, Kathleen; Toye, Chris; Ewing, Gail; Grande, Gunn; Stajduhar, Kelli
2015-06-01
The Carer Support Needs Assessment Tool encompasses the physical, psychological, social, practical, financial, and spiritual support needs that government policies in many countries emphasize should be assessed and addressed for family caregivers during end-of-life care. To describe the experience of family caregivers of terminally ill people of the Carer Support Needs Assessment Tool intervention in home-based palliative care. This study was conducted during 2012-2014 in Silver Chain Hospice Care Service in Western Australia. This article reports on one part of a three-part evaluation of a stepped wedge cluster trial. All 233 family caregivers receiving the Carer Support Needs Assessment Tool intervention provided feedback on their experiences via brief end-of-trial semi-structured telephone interviews. Data were subjected to a thematic analysis. The overwhelming majority reported finding the Carer Support Needs Assessment Tool assessment process straightforward and easy. Four key themes were identified: (1) the practicality and usefulness of the systematic assessment; (2) emotional responses to caregiver reflection; (3) validation, reassurance, and empowerment; and (4) accessing support and how this was experienced. Family caregivers appreciated the value of the Carer Support Needs Assessment Tool intervention in engaging them in conversations about their needs, priorities, and solutions. The Carer Support Needs Assessment Tool presented a simple, yet potentially effective intervention to help palliative care providers systematically assess and address family caregivers' needs. The Carer Support Needs Assessment Tool provided a formal structure to facilitate discussions with family caregivers to enable needs to be addressed. Such discussions can also inform an evidence base for the ongoing development of services for family caregivers, ensuring that new or improved services are designed to meet the explicit needs of family caregivers. © The Author(s) 2015.
Page-Reeves, Janet; Kaufman, Will; Bleecker, Molly; Norris, Jeffrey; McCalmont, Kate; Ianakieva, Veneta; Ianakieva, Dessislava; Kaufman, Arthur
2016-01-01
Although it is known that the social determinants of health have a larger influence on health outcomes than health care, there currently is no structured way for primary care providers to identify and address nonmedical social needs experienced by patients seen in a clinic setting. We developed and piloted WellRx, an 11-question instrument used to screen 3048 patients for social determinants in 3 family medicine clinics over a 90-day period. Results showed that 46% of patients screened positive for at least 1 area of social need, and 63% of those had multiple needs. Most of these needs were previously unknown to the clinicians. Medical assistants and community health workers then offered to connect patients with appropriate services and resources to address the identified needs. The WellRx pilot demonstrated that it is feasible for a clinic to implement such an assessment system, that the assessment can reveal important information, and that having information about patients' social needs improves provider ease of practice. Demonstrated feasibility and favorable outcomes led to institutionalization of the WellRx process at a university teaching hospital and influenced the state department of health to require managed care organizations to have community health workers available to care for Medicaid patients. © Copyright 2016 by the American Board of Family Medicine.
Improving Community-Based Mental Health Care for Children: Translating Knowledge into Action
Haine-Schlagel, Rachel; Brookman-Frazee, Lauren; Baker-Ericzen, Mary; Trask, Emily; Fawley-King, Kya
2013-01-01
There is urgent need for improvement in community-based mental health care for children and families. Multiple studies have documented serious limitations in the effectiveness of “usual care.” Fortunately, many empirically-supported strategies to improve care have been developed, and thus there is now a great deal of knowledge available to address this significant public health problem. The goal of this selective review is to highlight and synthesize that empirically-supported knowledge to stimulate and facilitate the needed translation of knowledge into action. The review provides a sound foundation for constructing improved services by consolidating descriptive data on the status quo in children’s mental health care, as well as evidence for an array of promising strategies to improve (a) Service access and engagement; (b) Delivery of evidence-based practices; and (c) Outcome accountability. A multi-level framework is used to highlight recommended care improvement targets. PMID:23212902
The New Problem of Staff Development.
ERIC Educational Resources Information Center
Spear, Martin B.; And Others
1992-01-01
Argues that community college development activities which focus exclusively on improving instruction weaken and fragment curricular disciplines and contribute to the disintegration of corporate faculty. Emphasizes the need for models which address the culture of college faculty and provide surrogates for the strong disciplinary culture of…
Upper Mississippi River and Illinois Waterways : non-structural measures cost-benefit study
DOT National Transportation Integrated Search
2003-05-01
These analyses support the U.S. Army Corps of Engineers study of navigation in the Upper Mississippi River (UMR) and Illinois Waterway (IWW) and address the need to examine the potential of non-structural measures to improve efficiency in th...
The UIC Therapeutic Partnership Project. Final Report.
ERIC Educational Resources Information Center
Lawlor, Mary C.; Cada, Elizabeth A.
This interdisciplinary inservice training project at the University of Illinois at Chicago was designed to improve early childhood occupational and physical therapy services by developing, implementing, evaluating, and disseminating a comprehensive training model. The competency-based program was designed to address the developmental needs of…
Rethinking Environmental Protection: Meeting the Challenges of a Changing World
Despite significant and lasting success in improving and protecting the air, water, and land in ways that have resulted in significant public health benefits, we may need new tools and approaches to fully address and achieve sustainable solutions to today’s environmental challeng...
Report #15-P-0280, September 16, 2015. By tracking environmental results, the EPA can show how the $32 billion that communities are spending to address discharges of untreated sewage and contaminated storm water improves water quality.
Engaging Faculty in Community Engagement
ERIC Educational Resources Information Center
Fitzgerald, Glynis A.
2012-01-01
Researchers endorse the integration of community engagement (CE) into higher education as a way to improve the relevance of education, address community needs, and forge university-community partnerships (Zlotkowski, 1996). CE can help create stronger ties between universities and their communities and provide students with experiential learning…
School Desegregation and Community Education: Effects and Opportunities.
ERIC Educational Resources Information Center
Nance, Everette E.; Dixon, James D., II
1991-01-01
Community education must address issues that affect a variety of cultures at different levels. Public school desegregation processes offer opportunities for restructuring schools to be more responsive to community needs, for enhancing race relations, and for improving the economic viability of a community. (JOW)
BCG Approaches for Improved Management of Estuaries
Estuaries and other complex aquatic systems are exposed to a variety of stressors that act at several scales, but are managed piecemeal - - often resulting in a “death by 1000 cuts” caused by cumulative impacts to these valued resources. To address this, managers need tools that...
Field verification of geogrid properties for base course reinforcement applications : final report.
DOT National Transportation Integrated Search
2013-11-01
The proposed field study is a continuation of a recently concluded, ODOT-funded project titled: Development of ODOT Guidelines for the Use of Geogrids in Aggregate Bases, which is aimed at addressing the need for improved guidelines for base reinforc...
Report: Border 2012 Program Needs to Improve Program Management to Ensure Results
Report #08-P-0245, September 3, 2008. The current organizational structure of the Border 2012 Program allows it to achieve a collaborative relationship at the U.S.- Mexico border and address enviro and public health issues unique to the border region.
Training Innovations for Economic Development
ERIC Educational Resources Information Center
Breeden, Kenneth H.
2002-01-01
This article talks about Certified Manufacturing Specialist (CMS), a Georgia training program that has successfully addressed the needs of both students and partners in business and industry. The program helped business reduce the learning curve for new employees; improved productivity, quality, and safety; reduced material waste; eased the…
Science Literacy for All Students.
ERIC Educational Resources Information Center
Brown, Peggy, Ed.
1982-01-01
Selected college programs designed to increase students' science literacy are described, and perspectives on science education are addressed in an article by E. James Rutherford, "Sputnik, Halley's Comet, and Science Education." The article suggests that leadership and consensus are needed at the national level to improve science…
Sophia: A Expedient UMLS Concept Extraction Annotator.
Divita, Guy; Zeng, Qing T; Gundlapalli, Adi V; Duvall, Scott; Nebeker, Jonathan; Samore, Matthew H
2014-01-01
An opportunity exists for meaningful concept extraction and indexing from large corpora of clinical notes in the Veterans Affairs (VA) electronic medical record. Currently available tools such as MetaMap, cTAKES and HITex do not scale up to address this big data need. Sophia, a rapid UMLS concept extraction annotator was developed to fulfill a mandate and address extraction where high throughput is needed while preserving performance. We report on the development, testing and benchmarking of Sophia against MetaMap and cTAKEs. Sophia demonstrated improved performance on recall as compared to cTAKES and MetaMap (0.71 vs 0.66 and 0.38). The overall f-score was similar to cTAKES and an improvement over MetaMap (0.53 vs 0.57 and 0.43). With regard to speed of processing records, we noted Sophia to be several fold faster than cTAKES and the scaled-out MetaMap service. Sophia offers a viable alternative for high-throughput information extraction tasks.
Sophia: A Expedient UMLS Concept Extraction Annotator
Divita, Guy; Zeng, Qing T; Gundlapalli, Adi V.; Duvall, Scott; Nebeker, Jonathan; Samore, Matthew H.
2014-01-01
An opportunity exists for meaningful concept extraction and indexing from large corpora of clinical notes in the Veterans Affairs (VA) electronic medical record. Currently available tools such as MetaMap, cTAKES and HITex do not scale up to address this big data need. Sophia, a rapid UMLS concept extraction annotator was developed to fulfill a mandate and address extraction where high throughput is needed while preserving performance. We report on the development, testing and benchmarking of Sophia against MetaMap and cTAKEs. Sophia demonstrated improved performance on recall as compared to cTAKES and MetaMap (0.71 vs 0.66 and 0.38). The overall f-score was similar to cTAKES and an improvement over MetaMap (0.53 vs 0.57 and 0.43). With regard to speed of processing records, we noted Sophia to be several fold faster than cTAKES and the scaled-out MetaMap service. Sophia offers a viable alternative for high-throughput information extraction tasks. PMID:25954351
Littlewood, Richard; Gilman, Mark; McLoughlin, Sharon
2018-04-27
Housing is an important factor for individuals addressing substance use disorders (SUD). This work compared aims and outcomes for new housing services and made suggestions for improvement. 16 new services were assessed over 6 months activity against factors identified as important. Services defined expected standards including (1) engagement with treatment for SUD, (2) restrictions on continuing substance use by tenants. After 6 months, 9 (56%) housing projects did not achieve planned standards and lowered criteria for inclusion. When setting up housing for people with SUD it is important to define clearly the nature of the intended service. Different types of housing programs in a network are needed to meet the evolving behaviour of tenants. One size does not fit all. Stable housing is important for people addressing SUD and these suggestions may increase the chance of providing a suitable foundation for people in need.
Doctor, Henry V; Olatunji, Alabi; Jumare, Abdul'azeez
2012-01-01
Maternal and child health indicators are generally poor in Nigeria with the northern part of the country having the worst indicators than the southern part. Efforts to address maternal and health challenges in Nigeria include, among others, improvement in health and management information systems. We report on the experience of mobile phone technology in supporting the activities of a health and demographic surveillance system in northern Nigeria. Our experience calls for the need for the Nigerian Government, the mobile network companies, and the international community at large to consolidate their efforts in addressing the mobile network coverage and power supply challenges in order to create an enabling environment for socio-economic development particularly in rural and disadvantaged areas. Unless power and mobile network challenges are addressed, health interventions that rely on mobile phone technology will not have a significant impact in improving maternal and child health.
Policy Concerns Raised by the Growing U.S. Population Aging with Disability
Iezzoni, Lisa I.
2014-01-01
Narrative Summary The number of Americans aging with disabilities will grow substantially in coming decades. Promulgating policies and practices to improve their independent functioning within communities and participation in daily life is therefore imperative, but the most effective approaches for meeting various needs are generally unknown. Historically, research addressing approaches targeting elderly individuals have differed in important ways (e.g., underlying models of disability) from studies involving younger persons aging with disabilities. Participants in a conference addressing this discordance identified six major areas requiring study: (1) resources to support independent living; (2) improving quality of life and participation in daily activities; (3) performing activities of daily living (ADL) and instrumental ADLs; (4) role of families; (5) medical care; and (6) concerns transcending sectors. As these investigations move forward, bridging the divide between approaches addressing elderly individuals versus persons with disabilities will be critical. PMID:24456688
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.
Aoun, Samar M; Grande, Gunn; Howting, Denise; Deas, Kathleen; Toye, Chris; Troeung, Lakkhina; Stajduhar, Kelli; Ewing, Gail
2015-01-01
Family caregiving towards the end-of-life entails considerable emotional, social, financial and physical costs for caregivers. Evidence suggests that good support can improve caregiver psychological outcomes. The primary aim of this study was to investigate the impact of using the carer support needs assessment tool (CSNAT), as an intervention to identify and address support needs in end of life home care, on family caregiver outcomes. A stepped wedge design was used to trial the CSNAT intervention in three bases of Silver Chain Hospice Care in Western Australia, 2012-14. The intervention consisted of at least two visits from nurses (2-3 weeks apart) to identify, review and address caregivers' needs. The outcome measures for the intervention and control groups were caregiver strain and distress as measured by the Family Appraisal of Caregiving Questionnaire (FACQ-PC), caregiver mental and physical health as measured by SF-12v2, and caregiver workload as measured by extent of caregiver assistance with activities of daily living, at baseline and follow up. Total recruitment was 620. There was 45% attrition for each group between baseline and follow-up mainly due to patient deaths resulting in 322 caregivers completing the study (233 in the intervention group and 89 in the control group). At follow-up, the intervention group showed significant reduction in caregiver strain relative to controls, p=0.018, d=0.348 (95% CI 0.25 to 0.41). Priority support needs identified by caregivers included knowing what to expect in the future, having time for yourself in the day and dealing with your feelings and worries. Despite the challenges at the clinician, organisational and trial levels, the CSNAT intervention led to an improvement in caregiver strain. Effective implementation of an evidence-informed and caregiver-led tool represents a necessary step towards helping palliative care providers better assess and address caregiver needs, ensuring adequate family caregiver support and reduction in caregiver strain.
NASA Astrophysics Data System (ADS)
Mertens, C. J.; Kress, B. T.; Wiltberger, M. J.; Tobiska, W.; Xu, X.
2011-12-01
The Nowcast of Atmospheric Ionizing Radiation for Aviation Safety (NAIRAS) is a prototype operational model for predicting commercial aircraft radiation exposure from galactic and solar cosmic rays. NAIRAS predictions are currently streaming live from the project's public website, and the exposure rate nowcast is also available on the SpaceWx smartphone app for iPhone, IPad, and Android. Cosmic rays are the primary source of human exposure to high linear energy transfer radiation at aircraft altitudes, which increases the risk of cancer and other adverse health effects. Thus, the NAIRAS model addresses an important national need with broad societal, public health and economic benefits. The processes responsible for the variability in the solar wind, interplanetary magnetic field, solar energetic particle spectrum, and the dynamical response of the magnetosphere to these space environment inputs, strongly influence the composition and energy distribution of the atmospheric ionizing radiation field. During the development of the NAIRAS model, new science questions were identified that must be addressed in order to obtain a more reliable and robust operational model of atmospheric radiation exposure. Addressing these science questions require improvements in both space weather modeling and observations. The focus of this talk is to present these science questions, the proposed methodologies for addressing these science questions, and the anticipated improvements to the operational predictions of atmospheric radiation exposure. The overarching goal of this work is to provide a decision support tool for the aviation industry that will enable an optimal balance to be achieved between minimizing health risks to passengers and aircrew while simultaneously minimizing costs to the airline companies.
Dowler, Elizabeth
2008-08-01
Members of low-income households in the UK are more likely to have patterns of food and nutrient intakes that are less inclined to lead to good health outcomes in the short and long term. Health inequalities, including the likelihood of child and adulthood obesity, have long been documented in the UK and show little sign of improving so far, despite 10 years of attention from a government that has committed itself to addressing them. Following the Acheson Inquiry into Inequalities in Health (1998) in England a number of initiatives to tackle inequalities in food and diet were established, both nationally and within the devolved nations of Scotland, Wales and Northern Ireland. Nevertheless, until recently, there has been no overall strategic policy addressing the food and nutritional needs of low-income households. The present paper reviews how the problems have been constructed and understood and how they have been addressed, briefly drawing on recent evaluations of food and nutrition policies in Scotland and Wales. The contemporary challenge is to frame cross-cutting policy initiatives that move beyond simple targeting and local actions, encompass a life-course approach and recognise both the diversity of households that fall into 'low-income' categories and the need for 'upstream' intervention.
Tupasi, T; Garfin, A M C G; Mangan, J M; Orillaza-Chi, R; Naval, L C; Balane, G I; Basilio, R; Golubkov, A; Joson, E S; Lew, W-J; Lofranco, V; Mantala, M; Pancho, S; Sarol, J N; Blumberg, A; Burt, D; Kurbatova, E V
2017-01-01
Patients who initiated treatment for multidrug-resistant tuberculosis (MDR-TB) at 15 Programmatic Management of Drug-resistant Tuberculosis (PMDT) health facilities in the Philippines between July and December 2012. To describe patients' views of current interventions, and suggest changes likely to reduce MDR-TB loss to follow-up. In-depth interviews were conducted between April and July 2014 with MDR-TB patients who were undergoing treatment, had finished treatment at the time of the interview (controls), or had been lost to follow-up (LTFU). Responses were thematically analyzed. Interviews were conducted with 182 patients who were undergoing or had completed treatment and 91 LTFU patients. Views and suggestions could be thematically categorized as approaches to facilitate adherence or address barriers to adherence. The top themes were the need for transportation assistance or improvements to the current transportation assistance program, food assistance, and difficulties patients encountered related to their medications. These themes were addressed by respectively 63%, 60%, and 32% of the participants. A more patient-centered approach is needed to improve MDR-TB treatment adherence. Programs should strive to provide assistance that considers patient preferences, is adequate to cover actual costs or needs, and is delivered in a timely, uninterrupted manner.
Tendon Tissue Engineering: Progress, Challenges, and Translation to the Clinic
Shearn, Jason T.; Kinneberg, Kirsten R.C.; Dyment, Nathaniel A.; Galloway, Marc T.; Kenter, Keith; Wylie, Christopher; Butler, David L.
2013-01-01
The tissue engineering field has made great strides in understanding how different aspects of tissue engineered constructs (TECs) and the culture process affect final tendon repair. However, there remain significant challenges in developing strategies that will lead to a clinically effective and commercially successful product. In an effort to increase repair quality, a better understanding of normal development, and how it differs from adult tendon healing, may provide strategies to improve tissue engineering. As tendon tissue engineering continues to improve, the field needs to employ more clinically relevant models of tendon injury such as degenerative tendons. We need to translate successes to larger animal models to begin exploring the clinical implications of our treatments. By advancing the models used to validate our TECs, we can help convince our toughest customer, the surgeon, that our products will be clinically efficacious. As we address these challenges in musculoskeletal tissue engineering, the field still needs to address the commercialization of products developed in the laboratory. TEC commercialization faces numerous challenges because each injury and patient is unique. This review aims to provide tissue engineers with a summary of important issues related to engineering tendon repairs and potential strategies for producing clinically successful products. PMID:21625053
ERIC Educational Resources Information Center
Santelli, John; Morreale, Madlyn; Wigton, Alyssa; Grason, Holly
Recognizing that school-based health centers are one of the most promising recent innovations to address the health and related needs of adolescents, this report provides information on these centers as a strategy to improve the access of adolescents to primary care. The report is intended to assist state and local Maternal and Child Health (MCH)…
ERIC Educational Resources Information Center
Davies, Emma L.; Morys-Carter, Wakefield L.; Paltoglou, Aspasia E.
2015-01-01
Students often struggle with learning about statistics, which encompass a large proportion of a psychology degree. This pilot study explored how first- and final-year students reflected on their experiences of being taught this topic, in order to identify needs that could be addressed in a project to improve their learning. First-year students…
Use of wetlands for water quality improvement under the USEPA Region V Clean Lakes Program
NASA Astrophysics Data System (ADS)
Landers, Judith C.; Knuth, Barbara A.
1991-03-01
The United States Environmental Protection Agency (USEPA) Region V Clean Lakes Program employs artificial and modified natural wetlands in an effort to improve the water quality of selected lakes. We examined use of wetlands at seven lake sites and evaluated the physical and institutional means by which wetland projects are implemented and managed, relative to USEPA program goals and expert recommendations on the use of wetlands for water quality improvement. Management practices recommended by wetlands experts addressed water level and retention, sheet flow, nutrient removal, chemical treatment, ecological and effectiveness monitoring, and resource enhancement. Institutional characteristics recommended included local monitoring, regulation, and enforcement and shared responsibilities among jurisdictions. Institutional and ecological objectives of the National Clean Lakes Program were met to some degree at every site. Social objectives were achieved to a lesser extent. Wetland protection mechanisms and appropriate institutional decentralization were present at all sites. Optimal management techniques were employed to varying degrees at each site, but most projects lack adequate monitoring to determine adverse ecological impacts and effectiveness of pollutant removal and do not extensively address needs for recreation and wildlife habitat. There is evidence that the wetland projects are contributing to improved lake water quality; however, more emphasis needs to be placed on wetland protection and long-term project evaluation.
Fallah, Parisa Nicole; Bernstein, Mark
2017-09-07
Access to adequate surgical care is limited globally, particularly in low- and middle-income countries (LMICs). To address this issue, surgeons are becoming increasingly involved in international surgical teaching collaborations (ISTCs), which include educational partnerships between surgical teams in high-income countries and those in LMICs. The purpose of this study is to determine a framework for unifying, systematizing, and improving the quality of ISTCs so that they can better address the global surgical need. A convenience sample of 68 surgeons, anesthesiologists, physicians, residents, nurses, academics, and administrators from the U.S., Canada, and Norway was used for the study. Participants all had some involvement in ISTCs and came from multiple specialties and institutions. Qualitative methodology was used, and participants were interviewed using a pre-determined set of open-ended questions. Data was gathered over two months either in-person, over the phone, or on Skype. Data was evaluated using thematic content analysis. To organize and systematize ISTCs, participants reported a need for a centralized/systematized process with designated leaders, a universal data bank of current efforts/progress, communication amongst involved parties, full-time administrative staff, dedicated funds, a scholarly approach, increased use of technology, and more research on needs and outcomes. By taking steps towards unifying and systematizing ISTCs, the quality of ISTCs can be improved. This could lead to an advancement in efforts to increase access to surgical care worldwide.
Crowd Sourcing to Improve Urban Stormwater Management
NASA Astrophysics Data System (ADS)
Minsker, B. S.; Band, L. E.; Heidari Haratmeh, B.; Law, N. L.; Leonard, L. N.; Rai, A.
2017-12-01
Over half of the world's population currently lives in urban areas, a number predicted to grow to 60 percent by 2030. Urban areas face unprecedented and growing challenges that threaten society's long-term wellbeing, including poverty; chronic health problems; widespread pollution and resource degradation; and increased natural disasters. These are "wicked" problems involving "systems of systems" that require unprecedented information sharing and collaboration across disciplines and organizational boundaries. Cities are recognizing that the increasing stream of data and information ("Big Data"), informatics, and modeling can support rapid advances on these challenges. Nonetheless, information technology solutions can only be effective in addressing these challenges through deeply human and systems perspectives. A stakeholder-driven approach ("crowd sourcing") is needed to develop urban systems that address multiple needs, such as parks that capture and treat stormwater while improving human and ecosystem health and wellbeing. We have developed informatics- and Cloud-based collaborative methods that enable crowd sourcing of green stormwater infrastructure (GSI: rain gardens, bioswales, trees, etc.) design and management. The methods use machine learning, social media data, and interactive design tools (called IDEAS-GI) to identify locations and features of GSI that perform best on a suite of objectives, including life cycle cost, stormwater volume reduction, and air pollution reduction. Insights will be presented on GI features that best meet stakeholder needs and are therefore most likely to improve human wellbeing and be well maintained.
Understanding consumer preference and willingness to pay for improved cookstoves in Bangladesh.
Rosenbaum, Julia; Derby, Elisa; Dutta, Karabi
2015-01-01
The USAID/WASHplus project conducted a comprehensive assessment to understand consumer needs and preferences as they relate to increasing the uptake and consistent, exclusive, and correct use of improved cookstoves (ICSs) in Bangladesh. The assessment included household ICS trials, fuel and stove use monitoring, and consumers' perceived value of and willingness to pay for ICSs. Results showed that cooks appreciated and liked the ICS, but that no models met consumer needs sufficiently to replace traditional stoves. Initially, many preferred ICSs over traditional stoves, but this preference decreased over the 3-week trial period. Complaints and suggestions for improvement fell into two general categories: those that can be addressed through fairly simple modifications to the stove design, and those more appropriately addressed through point-of-purchase consumer education and follow-up from service agents or health outreach workers. Most households using the ICS realized fuel use reductions, although these were lower than expected, partly because of continued parallel traditional stove use. When given the option to purchase the stoves at market value, only one of 105 households did so; however, a separate assessment showed that 80% of participants (12 of 15 households) preferred to keep the stove rather than receive a cash buyout at market value. This indicates that users value the ICS when acquisition barriers are removed and highlights the need for better financing options.
Mazzocato, Pamela; Stenfors-Hayes, Terese; von Thiele Schwarz, Ulrica; Hasson, Henna
2016-01-01
Objectives Kaizen, or continuous improvement, lies at the core of lean. Kaizen is implemented through practices that enable employees to propose ideas for improvement and solve problems. The aim of this study is to describe the types of issues and improvement suggestions that hospital employees feel empowered to address through kaizen practices in order to understand when and how kaizen is used in healthcare. Methods We analysed 186 structured kaizen documents containing improvement suggestions that were produced by 165 employees at a Swedish hospital. Directed content analysis was used to categorise the suggestions into following categories: type of situation (proactive or reactive) triggering an action; type of process addressed (technical/administrative, support and clinical); complexity level (simple or complex); and type of outcomes aimed for (operational or sociotechnical). Compliance to the kaizen template was calculated. Results 72% of the improvement suggestions were reactions to a perceived problem. Support, technical and administrative, and primary clinical processes were involved in 47%, 38% and 16% of the suggestions, respectively. The majority of the kaizen documents addressed simple situations and focused on operational outcomes. The degree of compliance to the kaizen template was high for several items concerning the identification of problems and the proposed solutions, and low for items related to the test and implementation of solutions. Conclusions There is a need to combine kaizen practices with improvement and innovation practices that help staff and managers to address complex issues, such as the improvement of clinical care processes. The limited focus on sociotechnical aspects and the partial compliance to kaizen templates may indicate a limited understanding of the entire kaizen process and of how it relates to the overall organisational goals. This in turn can hamper the sustainability of kaizen practices and results. PMID:27473953
Study on the supply chain of an enterprise based on axiomatic design
NASA Astrophysics Data System (ADS)
Fan, Shu-hai; Lin, Chao-qun; Ji, Chun; Zhou, Ce; Chen, Peng
2018-06-01
This paper first expounds the basic theoretical knowledge of axiomatic design, and then designs and improves the enterprise supply chain through two design axioms (axiom of independence and information axiom). In the axiomatic design of the axiom of independence, the user needs to determine the needs and problems to be solved, to determine the top total goals, the total goal decomposition, and to determine their own design equations. In the application of information axiom, the concept of cloud is used to quantify the amount of information, and the two schemes are evaluated and compared. Finally, through axiomatic design, we can get the best solution for the improvement of supply chain design. Axiomatic design is a generic, systematic and sophisticated approach to design that addresses the needs of different customers. Using this method to improve the level of supply chain management is creative. As a mature method, it will make the process efficient and convenient.
Companion Animals, Natural Disasters and the Law: An Australian Perspective.
White, Steven
2012-08-27
This article examines the regulation of companion animal welfare during disasters, with some context provided by two recent major disaster events in Australia. Important general lessons for improved disaster management were identified in subsequent inquiries. However, the interests of companion animals continue to be inadequately addressed. This is because key assumptions underpinning disaster planning for companion animals-the primacy of human interests over animal interests and that individuals will properly address companion animal needs during times of disaster-are open to question. In particular these assumptions fail to recognise the inherent value of companion animals, underestimate the strong bond shared by some owners and their animals and, at the same time, overestimate the capacity of some owners to adequately meet the needs of their animals.
Content and Outcomes of Social Work Consultation for Patients with Diabetes in Primary Care.
Rabovsky, Andrew J; Rothberg, Michael B; Rose, Susannah L; Brateanu, Andrei; Kou, Lei; Misra-Hebert, Anita D
Social workers are positioned to address social determinants of health (SDHs), but their specific roles in outpatient primary care practice have not been well described. We aimed to describe needs of patients with diabetes addressed during social work (SW) consultations and their impact on disease control. This study was a retrospective review of electronic medical records of 977 patients with diabetes with a SW consultation at 3 primary care internal medicine sites in 2014. Diabetes and cardiovascular (CV) risk factor control were assessed before and after the SW encounter. Patient subgroups with uncontrolled diabetes or CV risk factors were compared with propensity-matched patients without a SW encounter. Of the 977 records, 300 were randomly selected for abstraction of needs addressed at the SW consultation using SDH categories established by Wilkinson and Marmot. Patient insurance status included 52% Medicare and 32% Medicaid. The SDHs most often addressed were social gradient (67%; obtaining medications or health insurance) and social support (25%). Among our total population, there were no significant improvements in glycosylated hemoglobin (HbA 1c ), low-density lipoprotein (LDL) cholesterol, systolic blood pressure, or body mass index at least 3 months after the first SW consultation. For patients with uncontrolled diabetes (HbA 1c >9% or LDL cholesterol >130 mg/dl), HbA 1c improved by 1.5 versus 1.1% for matched controls (P = .03) and LDL improved by 37.7 versus 21.3 mg/dl for matched controls (P = .002). In this sample with a preponderance of Medicare and Medicaid patients, social workers most often assisted patients with diabetes in obtaining medications or health insurance. For patients with uncontrolled diabetes or cholesterol, a temporal association between SW consultation and improved disease control was noted. © Copyright 2017 by the American Board of Family Medicine.
ERIC Educational Resources Information Center
Marine Corps Inst., Washington, DC.
This student guide, one of a series of correspondence training courses designed to improve the job performance of members of the Marine Corps, deals with the skills needed by engineer equipment chiefs. Addressed in the five individual units of the course are the following topics: construction management (planning, scheduling, and supervision);…
A Collaborative Approach to Aiding a Woman Returning to College.
ERIC Educational Resources Information Center
Chickering, Joanne Nelson; Obstfeld, Lisa
1982-01-01
Addresses the issue of serving the needs of nontraditional learners using a case study of a reentry woman. Used a collaborative approach to help the student improve her assertive skills and develop some test taking strategies. Also used role playing, flooding, and mnemonic strategies. (JAC)
ERIC Educational Resources Information Center
Jacobs, Richard M.
1996-01-01
Discusses the participation of a Pennsylvania Catholic elementary school faculty in an inservice training program designed to improve the school's capacity to meet the needs of its students. Indicates that the program was intended to foster the faculty's Catholic identity as the primary means of addressing problems affecting its students. (MAB)
Access to the Common Core for All
ERIC Educational Resources Information Center
McLaughlin, Margaret J.
2012-01-01
Too often under the various state-developed standards and assessments, accommodations for students with disabilities--a heterogeneous group with varied characteristics and needs--have not been adequately addressed or have been ignored. The Common Core State Standards (CCSS) initiative provides an historic opportunity to improve access to rigorous…
76 FR 71287 - Public Housing Energy Audits
Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-17
...-AC84 Public Housing Energy Audits AGENCY: Office of the Assistant Secretary for Public and Indian Housing, HUD. ACTION: Proposed rule. SUMMARY: This rule proposes to revise HUD's energy audit requirements... identifying energy-efficient measures that need to be addressed in the audit and procedures for improved...
USDA-ARS?s Scientific Manuscript database
USDA ARS National Peanut Research Laboratory has a very diverse scientific staff conducting research to address the needs of the United States peanut industry. Research is conducted in the fields of mycology, chemistry, biochemistry, molecular biology, breeding, agronomy, economics, and engineering....
USDA-ARS?s Scientific Manuscript database
USDA ARS National Peanut Research Laboratory has a very diverse scientific staff conducting research to address the needs of the United States peanut industry. Research is conducted in the fields of mycology, chemistry, biochemistry, molecular biology, breeding, agronomy, economics, and engineering....
USDA-ARS?s Scientific Manuscript database
USDA ARS National Peanut Research Laboratory has a very diverse scientific staff conducting research to address the needs of the United States peanut industry. Research is conducted in the fields of mycology, chemistry, biochemistry, molecular biology, breeding, agronomy, economics, and engineering....
van der Meer, Frank; Clancy, Eoin; Thomas, Adam; Kutz, Susan; Hatfield, Jennifer; Orsel, Karin
2015-01-01
The Maasai pastoralists in sub-Saharan Africa depend on their livestock for income and food. Livestock production can be significantly improved by addressing animal health concerns. We explored the use of photovoice, a participatory action research method, to strengthen our understanding of the Maasai’s animal health needs. Nine interviewees, representing warriors, elders, and women, identified animal, social, and human health themes. The use of photography provided a new medium for Maasai to express their needs and a focus for researcher–participant communications, thereby facilitating new insights across language and cultural barriers. PMID:26664973
DOE Office of Scientific and Technical Information (OSTI.GOV)
James S. Tulenko; Carl D. Crane III
The University Research Program in Robotics (URPR) Implementation Plan is an integrated group of universities performing fundamental research that addresses broad-based robotics and automation needs of the NNSA Directed Stockpile Work (DSW) and Campaigns. The URPR mission is to provide improved capabilities of robotics science and engineering to meet the future needs of all weapon systems and other associated NNSA/DOE activities.
2011-06-01
Coast Guard Academies Have Taken Steps to Address Incidents of Sexual Harassment and Assault, but Greater Federal Oversight Is Needed, GAO-08-296...provided through multiple sources and vary annually relative to other programmatic priorities. According to the Army Sexual Harassment /Assault...2.1 million it received from the Army’s Sexual Harassment /Assault Response and Prevention program in fiscal year 2010 for the improvement of sexual
ERIC Educational Resources Information Center
Alkhawaldeh, Ahmad Mokbel
2017-01-01
This qualitative study addressed the English language learning needs and challenges expressed by a sample of 22 postgraduate students from diversified faculties in the University of Jordan. These students were required to take the Alternative National English course. They wrote a self-report reflecting on their English language learning needs and…
Anthropology in Agricultural Health and Safety Research and Intervention.
Arcury, Thomas
2017-01-01
Agriculture remains a dangerous industry, even as agricultural science and technology continue to advance. Research that goes beyond technological changes to address safety culture and policy are needed to improve health and safety in agriculture. In this commentary, I consider the potential for anthropology to contribute to agricultural health and safety research by addressing three aims: (1) I briefly consider what the articles in this issue of the Journal of Agromedicine say about anthropologists in agricultural health and safety; (2) I discuss what anthropologists can add to agricultural health and safety research; and (3) I examine ways in which anthropologists can participate in agricultural health and safety research. In using their traditions of rigorous field research to understand how those working in agriculture perceive and interpret factors affecting occupational health and safety (their "emic" perspective), and translating this perspective to improve the understanding of occupational health professionals and policy makers (an "etic" perspective), anthropologists can expose myths that limit improvements in agricultural health and safety. Addressing significant questions, working with the most vulnerable agricultural communities, and being outside establishment agriculture provide anthropologists with the opportunity to improve health and safety policy and regulation in agriculture.
The research agenda in ICU telemedicine: a statement from the Critical Care Societies Collaborative.
Kahn, Jeremy M; Hill, Nicholas S; Lilly, Craig M; Angus, Derek C; Jacobi, Judith; Rubenfeld, Gordon D; Rothschild, Jeffrey M; Sales, Anne E; Scales, Damon C; Mathers, James A L
2011-07-01
ICU telemedicine uses audiovisual conferencing technology to provide critical care from a remote location. Research is needed to best define the optimal use of ICU telemedicine, but efforts are hindered by methodological challenges and the lack of an organized delivery approach. We convened an interdisciplinary working group to develop a research agenda in ICU telemedicine, addressing both methodological and knowledge gaps in the field. To best inform clinical decision-making and health policy, future research should be organized around a conceptual framework that enables consistent descriptions of both the study setting and the telemedicine intervention. The framework should include standardized methods for assessing the preimplementation ICU environment and describing the telemedicine program. This framework will facilitate comparisons across studies and improve generalizability by permitting context-specific interpretation. Research based on this framework should consider the multidisciplinary nature of ICU care and describe the specific program goals. Key topic areas to be addressed include the effect of ICU telemedicine on the structure, process, and outcome of critical care delivery. Ideally, future research should attempt to address causation instead of simply associations and elucidate the mechanism of action in order to determine exactly how ICU telemedicine achieves its effects. ICU telemedicine has significant potential to improve critical care delivery, but high-quality research is needed to best inform its use. We propose an agenda to advance the science of ICU telemedicine and generate research with the greatest potential to improve patient care.
The Research Agenda in ICU Telemedicine
Hill, Nicholas S.; Lilly, Craig M.; Angus, Derek C.; Jacobi, Judith; Rubenfeld, Gordon D.; Rothschild, Jeffrey M.; Sales, Anne E.; Scales, Damon C.; Mathers, James A. L.
2011-01-01
ICU telemedicine uses audiovisual conferencing technology to provide critical care from a remote location. Research is needed to best define the optimal use of ICU telemedicine, but efforts are hindered by methodological challenges and the lack of an organized delivery approach. We convened an interdisciplinary working group to develop a research agenda in ICU telemedicine, addressing both methodological and knowledge gaps in the field. To best inform clinical decision-making and health policy, future research should be organized around a conceptual framework that enables consistent descriptions of both the study setting and the telemedicine intervention. The framework should include standardized methods for assessing the preimplementation ICU environment and describing the telemedicine program. This framework will facilitate comparisons across studies and improve generalizability by permitting context-specific interpretation. Research based on this framework should consider the multidisciplinary nature of ICU care and describe the specific program goals. Key topic areas to be addressed include the effect of ICU telemedicine on the structure, process, and outcome of critical care delivery. Ideally, future research should attempt to address causation instead of simply associations and elucidate the mechanism of action in order to determine exactly how ICU telemedicine achieves its effects. ICU telemedicine has significant potential to improve critical care delivery, but high-quality research is needed to best inform its use. We propose an agenda to advance the science of ICU telemedicine and generate research with the greatest potential to improve patient care. PMID:21729894
Hoge, Michael A; Stuart, Gail W; Morris, John; Flaherty, Michael T; Paris, Manuel; Goplerud, Eric
2013-11-01
The mental health and addiction workforce has long been plagued by shortages, high turnover, a lack of diversity, and concerns about its effectiveness. This article presents a framework to guide workforce policy and practice, emphasizing the need to train other health care providers as well as individuals in recovery to address behavioral health needs; strengthen recruitment, retention, and training of specialist behavioral health providers; and improve the financial and technical assistance infrastructure to better support and sustain the workforce. The pressing challenge is to scale up existing plans and strategies and to implement them in ways that have a meaningful impact on the size and effectiveness of the workforce. The aging and increasing diversity of the US population, combined with the expanded access to services that will be created by health reform, make it imperative to take immediate action.
Miguel, Caroline San; Rogan, Fran; Kilstoff, Kathleen; Brown, Di
2006-09-01
This paper reports on the design, delivery and evaluation of an innovative oral communication skills program for first year students in a Bachelor of Nursing degree at an Australian university. This program was introduced in 2004 to meet the needs of first year undergraduate students from non-English speaking backgrounds who had experienced difficulties with spoken English while on clinical placement. The program consisted of early identification of students in need of communication development, a series of classes incorporated into the degree program to address students' needs, followed by a clinical placement block. This paper describes the structure of the program, discusses some of the major problems encountered by students in the clinical setting and presents some of the teaching strategies used to address these problems. Evaluations of the program suggest that students' communication skills and confidence improved, resulting in a more positive clinical experience for the majority of students.
Changing the paradigm of emergency response: The need for first-care providers.
Bobko, Joshua P; Kamin, Richard
2015-01-01
There is a major gap in the security of the critical infrastructure - civilian medical response to atypical emergencies. Clear evidence demonstrates that, despite ongoing improvements to the first-responder system, there exists an inherent delay in the immediate medical care at the scene of an emergency. This delay can only be reduced through a societal shift in reliance on police and fire response and by extending the medical system into all communities. Additionally, through analysis of military data, it is known that immediately addressing the common injury patterns following a traumatic event will save lives. The predictable nature of these injuries, coupled with an unavoidable delay in the arrival of first responders, necessitates the need for immediate care on scene. Initial care is often rendered by bystanders, typically armed only with basic first-aid training based on medical emergencies and does not adequately address the traumatic injury patterns seen in disasters. Implementing an approach similar to the American Cardiac Arrest Act can improve outcomes to traumatic events. This paper analyses the latest data on active shooter incidents and proposes that the creation of a network of trauma-trained medic extenders would improve all communities' resilience to catastrophic disaster.
NASA Astrophysics Data System (ADS)
Browning, S.
2014-12-01
The Math You Need (TMYN) modules were introduced at Baylor University in fall 2012 to address issues of math anxiety common among freshmen non-majors completing their lab science requirement, and to reduce lab time spent reviewing basic math concepts. Modules and associated assessment questions commonly use geoscience examples to illustrate the mathematical principles involved, reinforcing topics addressed in lab. Large enrollments in the course selected for these modules necessitate multiple graduate teaching assistants in the lab, making the online nature of the modules and minimal required involvement of the teaching assistants even more valuable. Students completed three selected modules before encountering associated topics in lab, as well as a pre and post-test to gauge improvement. This presentation will review lessons learned and changes made in the first two years of TMYN at Baylor. Results indicate continued increases in mean pre to post test scores (e.g. 3.2% in fall 2012 to 11.9% in spring 2014), percentage of student pre to post- test improvement (59% in fall 2012 to 72% in spring 2014) and student participation (95 in fall 2012 to 186 in spring 2014). Continued use of these modules is anticipated.
Caceres, Billy A; Bub, Linda; Negrete, Maria Isabel; Giraldo Rodríguez, Liliana; Squires, Allison P
2018-03-01
To describe healthcare professionals' perceptions of neglect of older people in Mexico. Mistreatment of older people, particularly neglect, has emerged as a significant public health concern worldwide. However, few studies have been conducted to examine neglect of older people in low- and middle-income countries. Most research has focused on estimating the prevalence of neglect in older populations with little emphasis on the perceptions of healthcare professionals and their role in addressing neglect of older people. Qualitative secondary analysis. The parent study consisted of nine focus groups conducted with healthcare professionals at five public hospitals in Mexico. The purpose of the parent study was to perform a needs assessment to determine the feasibility of adapting the Nurses Improving Care for Healthsystem Elders programme to Mexico. A qualitative secondary analysis with directed content analysis approach was used to extract data related to neglect of older people. A total of 89 participants representing healthcare professionals from several disciplines were interviewed. Three themes emerged: (i) The main point is not here; (ii) We feel hopeless; and (iii) We need preparation. Participants reported distress and hopelessness related to neglect of older people. Lack of community-based resources was noted as contributing to neglect. Increased education regarding care of older people for both caregivers and healthcare professionals and greater interdisciplinary collaboration were identified as potential solutions to combat neglect. Community-based services and resource allocation need to be re-evaluated to improve the care of older Mexicans. Interdisciplinary models of care should be developed to address concerns related to neglect of older people. Neglect negatively impacts healthcare professionals' ability to adequately care for older patients. There is a need to invest in community-based services and models of care to address these concerns. © 2017 John Wiley & Sons Ltd.
Antoine, Valéry; de Wazières, Benoît; Houédé, Nadine
2015-02-01
Coordination of a multidisciplinary and multi-professional intervention is a key issue in the management of elderly cancer patients to improve health status and quality of life. Optimizing the links between professionals is needed to improve care planning, health and social services utilization. Descriptive study in a French University Hospital. A 6-item structured questionnaire was addressed to professionals involved in global and supportive cares of elderly cancer patients (name, location, effective health care and services offered, needs to improve the quality of their intervention). After the analysis of answers, definition of propositions to improve cares and services utilization. The 37 respondents identified a total of 166 needs to improve quality of care in geriatric oncology. Major expectations were concerning improvement of global/supportive cares and health care services utilization, a better coordination between geriatric teams and oncologists. Ten propositions, including a model of in-hospital health care planning, were defined to answer to professional's needs with the aim of optimizing cancer treatment and global cares. Identification of effective services and needs can represent a first step in a continuous program to improve quality of cares, according to the French national cancer plan 2014-2019. It allows federating professionals for a coordination effort, a better organization of the clinical activity in geriatric oncology, to optimize clinical practice and global cares. Copyright © 2014 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.
Child Health Disparities: What Can a Clinician Do?
Cheng, Tina L; Emmanuel, Mickey A; Levy, Daniel J; Jenkins, Renee R
2015-11-01
Pediatric primary and specialty practice has changed, with more to do, more regulation, and more family needs than in the past. Similarly, the needs of patients have changed, with more demographic diversity, family stress, and continued health disparities by race, ethnicity, and socioeconomic status. How can clinicians continue their dedicated service to children and ensure health equity in the face of these changes? This article outlines specific, practical, actionable, and evidence-based activities to help clinicians assess and address health disparities in practice. These tools may also support patient-centered medical home recognition, national and state cultural and linguistic competency standards, and quality benchmarks that are increasingly tied to payment. Clinicians can play a critical role in (1) diagnosing disparities in one's community and practice, (2) innovating new models to address social determinants of health, (3) addressing health literacy of families, (4) ensuring cultural competence and a culture of workplace equity, and (5) advocating for issues that address the root causes of health disparities. Culturally competent care that is sensitive to the needs, health literacy, and health beliefs of families can increase satisfaction, improve quality of care, and increase patient safety. Clinical care approaches to address social determinants of health and interrupting the intergenerational cycle of disadvantage include (1) screening for new health "vital signs" and connecting families to resources, (2) enhancing the comprehensiveness of services, (3) addressing family health in pediatric encounters, and (4) moving care outside the office into the community. Health system investment is required to support clinicians and practice innovation to ensure equity. Copyright © 2015 by the American Academy of Pediatrics.
Hughes, Anne K; Woodward, Amanda T; Fritz, Michele C; Reeves, Mathew J
2018-02-01
Strokes impact over 800,000 people every year. Stroke care typically begins with inpatient care and then continues across an array of healthcare settings. These transitions are difficult for patients and caregivers, with psychosocial needs going unmet. Our team developed a case management intervention for acute stroke patients and their caregivers aimed at improving stroke transitions. The intervention focusses on four aspects of a successful care transition: support, preparedness, identifying and addressing unmet needs, and stroke education. This paper describes the development and implementation of this program, and is an example of the synergy created between neuroscience and clinical practice.
Palliative care for respiratory disease: An education model of care.
Bowman, Brynn; Meier, Diane E
2018-02-01
That palliative care improves quality of life for seriously ill patients and their families is well known - but how can healthcare providers ensure that the palliative needs of all patients are being assessed and addressed? A growing number of curricula in core palliative care practices have been developed to ensure that clinicians from all specialties and disciplines have the necessary training to manage pain and symptoms and discuss care goals with patients and families. Through broad-based training in core palliative care skills, combined with referral to specialty palliative care for high-need patients, providers can improve quality of life for their patients with respiratory disease.
Johnson, Kay
2012-08-01
High rates of maternal mortality, infant mortality, and preterm births, as well as continuing disparities in pregnancy outcomes, have prompted a number of state Medicaid agencies to focus on improving the quality and continuity of care delivered to women of childbearing age. As part of a peer-to-peer learning project, seven Medicaid agencies worked to develop the programs, policies, and infrastructures needed to identify and reduce women's health risks either prior to or between pregnancies. The states also identified public health strategies. These strategies led to a policy checklist to help leaders in other states identify improvement opportunities that fit within their programs' eligibility requirements, quality improvement objectives, and health system resources. Many of the identified programs and policies may help states use the upcoming expansion of the Medicaid program to improve women's health and thereby reduce adverse birth outcomes.
Optimizing the Office Visit for Adolescents with Special Health Care Needs.
Nathawad, Rita; Hanks, Christopher
2017-08-01
Youth with special health care needs (YSHCN) experience health care disparities and often need additional support to receive optimal medical care, particularly in adolescence as they prepare to transition to adult care. Many medical practices struggle to address their needs. Here, we discuss approaches to improve medical care in office-based settings for YSHCN. Office visits can be optimized by training staff in developmentally appropriate care and ensuring that the physical office space facilitates care. Participating in previsit preparation, including managing patient registries of YSHCN, engaging in regular team huddles, and incorporating previsit planning, can improve preparation and ensure that important needs are not overlooked. Additionally, approaches to improve patient and medical provider comfort with office visits with YSHCN, including approaches to measuring vital signs, examining patients, and communicating with patients with various disabilities, are reviewed. Finally, we discuss methods of supporting adolescents with special health care needs in developing self-management skills that will allow them to be better prepared to enter adult health care settings when appropriate. Although YSHCN can present challenges to medical teams, their care can be improved by developing office-based changes and processes to support improved care for these patients. This may help overcome the health care disparities they experience and increase comfort for all members of the medical team. Copyright © 2017. Published by Elsevier Inc.
NASA Astrophysics Data System (ADS)
Bednarek, A.; Close, S.; Curran, K.; Hudson, C.
2017-12-01
Addressing contemporary sustainability challenges requires attention to the integration of scientific knowledge into decision-making and deliberation. However, this remains a challenge in practice. We contend that careful stewardship of this process of integration can result in positive, durable outcomes by reconciling the production and use of scientific knowledge, and improve its relevance and utility to decision-makers. We will share lessons learned from a grantmaking program that has addressed this challenge through programmatic innovations, including by supporting staff devoted to an intermediary role. Over the past 13 years, the Lenfest Ocean Program served in a boundary spanning role by integrating decision-makers into the scoping and outreach of program supported scientific research grants. Program staff engage with decision-makers and influencers to identify policy-relevant research questions and approaches, ensuring that the research direction addresses users' needs. As research progresses, the staff monitor the grant's progress to improve the match between the research and user needs. The process is resource-intensive, however, and raises interesting questions about the role and development of this kind of specialist within different kinds of institutions, including funding agencies. We suggest that nurturing this role as a practice and profession could ultimately help the scientific community more efficiently respond to sustainability challenges.
Asgary, Ramin
2016-04-01
An innovative curriculum was developed to equip public health students with appropriate attitude and skills to address healthcare of asylum seekers. Implemented in 2005 the curriculum included: (1) didactic sessions covering epidemiology and health sequelae of torture, asylum laws, and approaches to identify survivors' healthcare needs; (2) panel discussions with survivors and advocates; and (3) participating in medico-legal process of asylum seeking. Complementary mixed methods evaluations included pre- and post-curriculum questionnaires, formal curriculum evaluations, final papers and oral presentations. 125 students participated. Students showed improved knowledge regrading sequelae of abuse and survivors' healthcare needs (P < 0.01), improved attitudes towards working with survivors (P < 0.05) and self-efficacy in identifying at-risk populations and addressing healthcare of survivors (P < 0.05). Students reported increased desire to pursue global health and human rights careers. As an advocacy and cultural competency training in public health practice addressing healthcare of refugees domestically, this curriculum was well received and effective, and will also help students better serve other similar populations. Population case-based domestic opportunities to teach global health and health and human rights should be effectively utilized to develop a well-equipped global health corps.
Do Boys Need Different Remedial Reading Instruction from Girls?
ERIC Educational Resources Information Center
Limbrick, Lisa; Wheldall, Kevin; Madelaine, Alison
2012-01-01
Recent inquiries into the underachievement of boys in reading have called into question whether they require different forms of reading instruction from girls. A number of reading programs and initiatives have been developed to address this issue, including programs based on increasing boys' motivation, improving behaviour, embracing the use of…
Report: EPA Needs to Improve Its Efforts to Reduce Air Emissions at U.S. Ports
Report #09-P-0125, March 23, 2009. While EPA has issued air emissions regulations for most port sources, EPA’s actions to address air emissions from large oceangoing vessels in U.S. ports have not yet achieved the goals for protecting human health.
The Case for Comprehensive Counseling Centers at Community Colleges
ERIC Educational Resources Information Center
Dykes-Anderson, Michelle
2013-01-01
This article addresses the need for a comprehensive counseling center to be housed on each campus of community colleges. Counseling helps to improve student academic success and retention, transfer, and graduation rates. Current research also illustrates an increase in psychological and emotional disturbances among college students across the…
Jones, S H
1992-01-01
High attrition rates among black students are a significant factor in the decline in graduation rates from nursing programs. Nursing education needs a program to address problems of anger, frustration, and loneliness and to develop the black student as a whole person.
Functional Context Education. Workshop Resource Notebook.
ERIC Educational Resources Information Center
Sticht, Thomas G.
This notebook contains materials for a workshop to teach participants how to address the needs of youth and adults for improved literacy, employability, and productivity. Chapter 1 provides information about the current state of youth and adult literacy, employability, and productivity in the United States. Chapter 2 presents a conceptual…
Leave No College Student Behind
ERIC Educational Resources Information Center
Smith, Buffy
2004-01-01
In this article, the author talks about the disproportionate gap in the graduation rates in colleges and universities, which highlights the need for the higher education community to rethink strategies for improving the retention of students of color. To increase the graduation rates of students of color, the author suggests addressing the issue…
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.
A Proposal for Excellence in Educational Administration.
ERIC Educational Resources Information Center
Achilles, C. M.
Numerous 1983-84 educational improvement studies emphasized the need for strong principal leadership, yet present reform efforts fail to address adequately principal preparation. This proposal for administrative excellence has a four-category focus: recruitment of those with strong liberal arts degrees; selection of those committed to an 11-month…
Vulnerabilities in the Stafford Student Loan Program.
ERIC Educational Resources Information Center
Thompson, Lawrence H.
This testimony before the House Subcommittee on Postsecondary Education addresses the need for improving student financial aid programs administered by the Department of Education, and in particular, the Stafford Student Loan Programs. The testimony begins with a brief review of the default problems involving student loans. Next, an examination is…
Research Administrative Burden: A Qualitative Study of Local Variations and Relational Effects
ERIC Educational Resources Information Center
Spencer, Thomas; Scott, James
2017-01-01
As research administrators look to define their roles as professionals, the need to address perceived administrative burden becomes a valuable next step in improving research administration. A qualitative investigation into the causes of the perceived burden identifies local variability of research administration as regulatory burden for those…
Science priorities for the human dimensions of global change
NASA Technical Reports Server (NTRS)
1994-01-01
The topics covered include the following: defining research needs; understanding land use change; improving policy analysis -- research on the decision-making process; designing policy instruments and institutions to address energy-related environmental problems; assessing impacts, vulnerability, and adaptation to global changes; and understanding population dynamics and global change.
"Banana Starts with Yellow": Curricular Implications of Preschoolers Missing a Concept
ERIC Educational Resources Information Center
Sylvester, Ruth; Kragler, Sherry
2013-01-01
Despite significant investments over the past decade in the expansion and improvement of preschool programs, too many children, particularly poor children, enter kindergarten behind their peers. Because it is critical that voluntary pre-kindergarten (VPK) classrooms offer educational programs that both address the needs and developmental levels of…
Report on Education for Older Citizens.
ERIC Educational Resources Information Center
Hendrickson, Andrew; Aker, George F.
This second of three institutes for developing and improving educational programs for older persons was composed of 45 administrators, teachers, and counselors from universities, community colleges, and public school systems. Addresses presented were: "Aging--The Need for a Choice" by Dr. Thomas Rich; "The Physiology of Aging" by Dr. Fred B.…
Complex Moving Parts: Assessment Systems and Electronic Portfolios
ERIC Educational Resources Information Center
Larkin, Martha J.; Robertson, Royce L.
2013-01-01
The largest college within an online university of over 50,000 students invested significant resources in translating a complex assessment system focused on continuous improvement and national accreditation into an effective and efficient electronic portfolio (ePortfolio). The team building the system needed a model to address problems met…
New Technologies to Assist Training in Hospitality Sector
ERIC Educational Resources Information Center
Balta, Sabah
2007-01-01
Hospitality sector needs new technological training tools, which can assist to improve sector employees' skills and services quality. The sector might be more interactive when these technological training tools used on the job-training program. This study addresses to issue of illumination of new technologic tools that enforce training in which…
A Collaborative Planning Framework for Teachers Implementing Tiered Instruction
ERIC Educational Resources Information Center
Stuart, Shannon K.; Rinaldi, Claudia
2009-01-01
The recent reauthorization and regulations of the Individuals With Disabilities Education Improvement Act (IDEA 2004) encourage the use of school-wide interventions including response to intervention (RTI; Bradley, Danielson, & Doolittle, 2007). RTI refers to a multi-tiered system that addresses the academic needs of all students by using…
Tools for Measuring and Improving Performance.
ERIC Educational Resources Information Center
Jurow, Susan
1993-01-01
Explains the need for meaningful performance measures in libraries and the Total Quality Management (TQM) approach to data collection. Five tools representing different stages of a TQM inquiry are covered (i.e., the Shewhart Cycle, flowcharts, cause-and-effect diagrams, Pareto charts, and control charts), and benchmarking is addressed. (Contains…
DOT National Transportation Integrated Search
2006-11-01
Although the overall objective of this peer exchange was to review and discuss ways to : improve the NDOT research program, its focus was to: : Look for new ways to identify and address research needs : Look for new ways to provide incentives...
The Office of Solid Waste and Emergency Response (OSWER) has identified the development of improved methods for measuring, monitoring, and characterizing complex wastes in soils, sediments, biota, and groundwater as a priority under GOAL 3: LAND PRESERVATION AND RESTORATION:Prese...
Aiming for Better Employment: A Holistic Analysis from Admission to Labour Market
ERIC Educational Resources Information Center
Chan, Sheng-Ju; Lin, Jing-Wen
2016-01-01
To address the changing needs of the labour market better, higher education institutions have increasingly aimed to enhance their teaching quality and the learning experiences of their students. Therefore, a key concept of the missions of contemporary educational institutions is to improve students' employability after graduation. Although…
Improving Employment Prospects for Soldiers Leaving the Regular Army
2017-01-01
difficulties in the civilian job market . Furthermore, since 2012, the Army has been reducing its active component end strength; this has increased the number...Domains and Focus Domains (Number of Questions) Domain Focus Knowledge (33) Sets of facts and principles needed to address problems and issues that are part
Does phloem loading strategy and capacity alter plant response to elevated atmospheric [CO2]?
USDA-ARS?s Scientific Manuscript database
A better understanding of the interactions between photosynthesis, photoassimilate translocation and sink activity is necessary to improve crop productivity. Rising atmospheric [CO2] perturbs source-sink balance which needs to be addressed to adapt crops to future growing conditions. This project ta...
The Nation's Energy Problem. Forum Report.
ERIC Educational Resources Information Center
Business-Higher Education Forum, Washington, DC.
Some of the essential elements now deficient in national energy programs are identified, and recommendations are offered for business, universities, and government regarding actions that may improve energy-related research and training. Five topics that need to be addressed by professionals are: (1) an energy policy that ensures that targets for…
Report: EPA Oversight and Policy for High Priority Violations of Clean Air Act Need Improvement
Report #10-P-0007, Oct 14, 2009. HPVs were not being addressed in a timely manner as regions and States did not follow the HPV policy, EPA Headquarters did not oversee regional and State HPV performance, and regions did not oversee State HPV performance.
ERIC Educational Resources Information Center
Marine Corps Inst., Washington, DC.
This student guide, one of a series of correspondence training courses designed to improve the job performance of members of the Marine Corps, deals with the skills needed by engineer equipment operators. Addressed in the seven individual units of the course are the following topics: introduction to Military Occupation Specialty (MOS) 1345…
Urban Principals' Second Order Change Leadership
ERIC Educational Resources Information Center
Taylor, Rosemarye T.; La Cava, Gonzalo S.
2011-01-01
Urban school leaders have challenges in continually improving student achievement and making change as quickly as needed. To address this problem 37 non-Title I principals completed an on-line survey, Principal's Actions Survey (PAS), based on the seven responsibilities for second order change identified by Marzano, Waters, and McNulty (2005).…
The Human Side of Quality: Employee Care and Empowerment.
ERIC Educational Resources Information Center
Thor, Linda M.
Frequently, educational institutions seeking to implement Total Quality Management (TQM) as a means to improve institutional effectiveness, overemphasize training in the application of TQM tools and fail to fully address human needs and concerns, such as the critical issue of employee empowerment. Four principal barriers exist to adequately…
Improving the Efficiency of Dialogue in Tutoring
ERIC Educational Resources Information Center
Kopp, Kristopher J.; Britt, M. Anne; Millis, Keith; Graesser, Arthur C.
2012-01-01
The current studies investigated the efficient use of dialogue in intelligent tutoring systems that use natural language interaction. Such dialogues can be relatively time-consuming. This work addresses the question of how much dialogue is needed to produce significant learning gains. In Experiment 1, a full dialogue condition and a read-only…
The Home-School Psychological Contract: Implications for Parental Involvement in Middle Schooling.
ERIC Educational Resources Information Center
Renihan, Patrick J.; Renihan, Frederick J.
1995-01-01
Contends that social change has created a need for parents and teachers to develop strategies to improve communication, mutual understanding, and effective ways to nurture and educate young adolescents. Addresses the psychological contract between school and home, strategies and stances, and considerations and strategies for strengthening the…
Breaking the Fetters of Higher Education in Sub-Saharan Africa
ERIC Educational Resources Information Center
Asamoah, Moses Kumi; Mackin, Eva Esi
2015-01-01
Higher education institutions (HEI) are established to address human resource needs by producing graduates with the relevant knowledge, skills and attitude for the labour market and improving the country's ability to maximize its long-term economic, social and political developments. The fetters of higher education are the challenges bedeviling…
Issues Surrounding the Use of Virtual Reality in Geographic Education
ERIC Educational Resources Information Center
Lisichenko, Richard
2015-01-01
As with all classroom innovations intended to improve geographic education, the adoption of virtual reality (VR) poses issues for consideration prior to endorsing its use. Of these, effectiveness, implementation, and safe use need to be addressed. Traditionally, sense of place, geographic knowledge, and firsthand experiences provided by field…
Chemical and Biological Terrorism: Improvements to Emergency Medical Response.
ERIC Educational Resources Information Center
DeGraffenreid, Jeff Gordon
The challenge facing many emergency medical services (EMS) is the implementation of a comprehensive educational strategy to address emergency responses to terrorism. One such service, Johnson County (Kansas) Medical Action, needed a strategy that would keep paramedics safe and offer the community an effective approach to mitigation. A…
34 CFR 200.77 - Reservation of funds by an LEA.
Code of Federal Regulations, 2011 CFR
2011-07-01
... § 200.48, unless the LEA meets these requirements with non-Title I funds; (d) Address the professional development needs of instructional staff, including— (1) Professional development requirements under § 200.52(a)(3)(iii) if the LEA has been identified for improvement or corrective action; and (2) Professional...
Using the 7C Framework for Teaching & Learning Health Education & Promotion
ERIC Educational Resources Information Center
Becker, Craig M.; Xu, Lei; Chaney, Beth
2016-01-01
Health Professionals are needed to address and improve health status. This paper presents a teaching technique that will help students acquire and develop applied health education and promotion skills. This paper introduces a 7C Framework to encourage teachers to use Challenge, Courage, Commitment, Competence, Connection, Contribution, and…
Persian walnut breeding in California
Charles A. Leslie; Gale H. McGranahan
2004-01-01
For over 50 years the University of California Davis Walnut Breeding Program has worked to address the needs of California walnut growers by identifying genetic approaches to problems and developing improved cultivars. The breeding program is a cooperative endeavor that draws on the efforts and resources of university researchers and facilities, USDA germplasm programs...
Basic Engineer Equipment Mechanic.
ERIC Educational Resources Information Center
Marine Corps Inst., Washington, DC.
This student guide, one of a series of correspondence training courses designed to improve the job performance of members of the Marine Corps, deals with the skills needed by basic engineer equipment mechanics. Addressed in the four individual units of the course are the following topics: mechanics and their tools (mechanics, hand tools, and power…
Using Community Assessments to Improve 4-H Youth Development Programming Efforts
ERIC Educational Resources Information Center
Teuteberg, Dan; Cummins, Melissa M.
2017-01-01
Understanding resources available in a community is essential before any 4-H youth development professional can begin addressing local needs. Conducting a community assessment generates valuable information about the unique components and resources of a specific community. This information then provides a foundation for identifying specific…
A Vision for Nevada. 1994 Annual Report to the Community.
ERIC Educational Resources Information Center
Nevada State Dept. of Education, Carson City.
In Nevada, equity projects funded through the Carl D. Perkins Vocational and Applied Technology Act and administered by the Nevada Department of Education provide program improvement, occupational preparation, training, resources, and activities designed to address the needs of all students. Although the emphasis has been on females, in particular…
Weaving latino cultural concepts into Preparedness Core Competency training.
Riley-Jacome, Mary; Parker, Blanca Angelica Gonzalez; Waltz, Edward C
2014-01-01
The New York • New Jersey Preparedness and Emergency Response Learning Center (NY•NJ PERLC) is one of 14 Centers funded by the Centers for Disease Control and Prevention designed to address the preparedness and response training and education needs of the public health workforce. One of the important niches, or focus areas for the Center, is training to improve the capacity of public health workers to respond with competence to the needs of vulnerable populations. During every phase of a disaster, racial and ethnic minorities, including Latinos, suffer worse outcomes than the general population. Communities with diverse cultural origins and limited English speakers often present more complex issues during public health emergencies. Training that incorporates cultural concepts into the Preparedness Core Competencies may improve the ability of public health workers to engage the Latino community in preparedness activities and ultimately improve outcomes during disasters. This article describes initiatives undertaken by the NY•NJ PERLC to improve the capacity of the public health workforce to respond competently to the needs of Latino populations. In 2012, the Center collaborated with national, state, and local partners to develop a nationwide broadcast founded on the Preparedness Core Competencies, Latinos During Emergencies: Cultural Considerations Impacting Disaster Preparedness. The widely viewed broadcast (497 sites in 47 states and 13 nations) highlighted the commonalities and differences within Latino culture that can impact emergency preparedness and response and outlined practical strategies to enhance participation. The success of the broadcast spurred a number of partner requests for training and technical assistance. Lessons learned from these experiences, including our "undercover" work at local Points of Dispensing, are incorporated into subsequent interactive trainings to improve the competency of public health workers. Participants recommended developing similar training addressing cultural differences, especially for other ethnic groups.
Considerations on Caring for Caregivers in an Aging Society.
Sinha, Dr Samir K
2015-01-01
While it is anticipated that healthcare systems around the world will continue to rely heavily on family members and friends to provide unpaid care especially to meet the needs of our aging population, current assumptions and issues around caregivers need to be challenged and addressed if we are to expect their future support. This paper builds on Williams et al's assertion that many current assumptions and issues around caregivers need to be challenged and addressed if we are to expect their future support. Indeed, with the pool of available caregivers expected to actually shrink in the future, this paper therefore examines four key policy issues in greater depth that we can address to enable individuals to age in place and others to maintain and take on caregiving roles. Through the establishment of policies that support robust and longterm capacity planning; make clear what care recipients and caregivers can expect to receive in the form of government supports; appreciate the increasing diversity that is occurring among those taking on caregiving roles and those requiring care; and recognize the need to invest in strategies that combat social isolation, we may not only improve our future health and well-being but ensure we are also enabled to care for ourselves as we age.
Medicare constrains social workers' and nurses' home care for clients with Alzheimer's disease.
Cabin, William D
2015-01-01
The Medicare home health prospective payment system (PPS) has existed for 13 years, yielding significant profits to providers. However, studies indicate many unresolved questions about whether PPS improves patient quality of care, is cost-effective, and reduces patient levels of unmet need. In addition, PPS has undermined the provision of social work home health services. The article presents the views of 29 home health care nurses regarding the impact ofPPS on their care decisions for people with Alzheimer's disease and their caregivers. The nurses identify Alzheimer's disease symptom management and psychosocial needs as phantoms, omnipresent below the surface but not attended to by home care clinicians. The interviews support the greater involvement of social workers to more adequately address the psychosocial needs of Medicare home health patients. The article contends that the current failure to simultaneously address the cost, needs, and quality-of-life issues of people with Alzheimer's disease who are cared for at home is analogous to the end-of-life care situation before passage of the Medicare Hospice Benefit. A collaborative demonstration project--social work and nursing--is proposed to determine how PPS might better address quality of life and costs of home-based people with Alzheimer's disease and their caregivers.
Customizing Laboratory Information Systems: Closing the Functionality Gap.
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.
ERIC Educational Resources Information Center
Bodilly, Susan J.; McCombs, Jennifer Sloan; Orr, Nate; Scherer, Ethan; Constant, Louay; Gershwin, Daniel
2010-01-01
High-quality out-of-school-time (OST) programs have a positive effect on youth development, but many cities have found it difficult to address the challenges of expanding and improving the quality of programs offered to underserved and high-need students. In response, The Wallace Foundation sponsored an initiative to help five cities increase…
Addressing Children's Oral Health in the New Millennium: Trends in the Dental Workforce
Mertz, Elizabeth; Mouradian, Wendy
2009-01-01
The Surgeon General's Report on Oral Health (SGROH) and the Call to Action to Promote Oral Health outlined the need to increase the diversity, capacity and flexibility of the dental workforce to reduce oral health disparities. This paper provides an update on dental workforce trends since the SGROH in the context of children's oral health needs. Major challenges remain to ensure a workforce that is adequate to address the needs of all children. The dentist to population ratio is declining, while mal-distribution of dentists continues for rural and underserved communities. The diversity of the dental workforce has only improved slightly, while the diversity of the pediatric population has increased substantially. More pediatric dentists have been trained, and dental educational programs are preparing students for practice in underserved areas, but the impact of these efforts on underserved children is uncertain. Other workforce developments with the potential to improve children's oral health include: enhanced training in children's oral health for general dentists; expanded scope of practice for allied dental health professionals; new dental practitioners including the dental health aid therapist; and increased engagement of pediatricians and other medical practitioners in children's oral health. The evidence for increasing caries experience in young children points to the need for continued efforts to bolster the oral health workforce. However, workforce strategies alone will not be sufficient to change this situation. Requisite policy changes, educational efforts and strong partnerships with communities will be needed to effect substantive changes in children's oral health. PMID:19854121
Addressing children's oral health in the new millennium: trends in the dental workforce.
Mertz, Elizabeth; Mouradian, Wendy E
2009-01-01
Oral Health in America: A Report of the Surgeon General (SGROH) and National Call to Action to Promote Oral Health outlined the need to increase the diversity, capacity, and flexibility of the dental workforce to reduce oral health disparities. This paper provides an update on dental workforce trends since the SGROH in the context of children's oral health needs. Major challenges remain to ensure a workforce that is adequate to address the needs of all children. The dentist-to-population ratio is declining while shortages of dentists continue in rural and underserved communities. The diversity of the dental workforce has only improved slightly, and the the diversity of the pediatric population has increased substantially. More pediatric dentists have been trained, and dental educational programs are preparing students for practice in underserved areas, but the impact of these efforts on underserved children is uncertain. Other workforce developments with the potential to improve children's oral health include enhanced training in children's oral health for general dentists, expanded scope of practice for allied dental health professionals, new dental practitioners including the dental health aid therapist, and increased engagement of pediatricians and other medical practitioners in children's oral health. The evidence for increasing caries experience in young children points to the need for continued efforts to bolster the oral health workforce. However, workforce strategies alone will not be sufficient to change this situation. Requisite policy changes, educational efforts, and strong partnerships with communities will be needed to effect substantive changes in children's oral health.
Human resources for the control of road traffic injury.
Mock, Charles; Kobusingye, Olive; Anh, Le Vu; Afukaar, Francis; Arreola-Risa, Carlos
2005-04-01
The definition of the ideal numbers and distribution of human resources required for control of road traffic injury (RTI) is not as advanced as for other health problems. We can nonetheless identify functions that need to be addressed across the spectrum of injury control: surveillance; road safety (including infrastructure, vehicle design, and behaviour); and trauma care. Many low-cost strategies to improve these functions in low- or middle-income countries can be identified. For all these strategies, there is need for adequate institutional capacity, including funding, legal authority, and human resources. Several categories of human resources need to be developed: epidemiologists who can handle injury data, design surveillance systems, and undertake research; engineers and planners versed in safety aspects of road design, traffic flow, urban planning, and vehicle design; police and lawyers who understand the health impact of traffic law; clinicians who can develop cost-effective improvements in the entire system of trauma treatment; media experts to undertake effective behaviour change and social marketing; and economists to assist with cost-effectiveness evaluations. RTI control can be strengthened by enhancing such training in these disciplines, as well as encouraging retention of those who have the needed skills. Mechanisms to enhance collaboration between these different fields need to be promoted. Finally, the burden of RTI is borne disproportionately by the poor; in addition to technical issues, more profound equity issues must be addressed. This mandates that people from all professional backgrounds who work for RTI control should develop skills in advocacy and politics.
Human resources for the control of road traffic injury.
Mock, Charles; Kobusingye, Olive; Anh, Le Vu; Afukaar, Francis; Arreola-Risa, Carlos
2005-01-01
The definition of the ideal numbers and distribution of human resources required for control of road traffic injury (RTI) is not as advanced as for other health problems. We can nonetheless identify functions that need to be addressed across the spectrum of injury control: surveillance; road safety (including infrastructure, vehicle design, and behaviour); and trauma care. Many low-cost strategies to improve these functions in low- or middle-income countries can be identified. For all these strategies, there is need for adequate institutional capacity, including funding, legal authority, and human resources. Several categories of human resources need to be developed: epidemiologists who can handle injury data, design surveillance systems, and undertake research; engineers and planners versed in safety aspects of road design, traffic flow, urban planning, and vehicle design; police and lawyers who understand the health impact of traffic law; clinicians who can develop cost-effective improvements in the entire system of trauma treatment; media experts to undertake effective behaviour change and social marketing; and economists to assist with cost-effectiveness evaluations. RTI control can be strengthened by enhancing such training in these disciplines, as well as encouraging retention of those who have the needed skills. Mechanisms to enhance collaboration between these different fields need to be promoted. Finally, the burden of RTI is borne disproportionately by the poor; in addition to technical issues, more profound equity issues must be addressed. This mandates that people from all professional backgrounds who work for RTI control should develop skills in advocacy and politics. PMID:15868021
Glass, Roger I; Rosenthal, Joshua P
2018-04-01
The global burden of lung disease is substantial, accounting for an estimated 7.5 million deaths per year, approximately 14% of annual deaths worldwide. The prime illnesses include, in descending order, chronic obstructive pulmonary disease, lung cancer, tuberculosis, acute respiratory infections, asthma, and interstitial lung fibrosis. Key risk factors include smoking, both indoor and outdoor air pollution, and occupational exposures. Although the distribution of both the diseases and the risk factors varies greatly by age, geography, and setting, the greatest burden falls on populations living in low- and middle-income countries. Improvements in these metrics will require major public health interventions to curb smoking; improving air quality both in the community and the household; addressing the ever-present burden of infections, including tuberculosis, flu, and the many agents that cause acute respiratory disease; and identifying and protecting workers from the hazards of exposure to toxic substances. Although research over the years has identified many ways to reduce or prevent the enormous burden of disease, a huge gap exists between what we know and what we can do. This "implementation gap" is the greatest challenge we face in this field today. Research on how best to address and implement the changes needed will require not only biomedical advances to improve treatment but also social, economic, and policy research. We still need to elaborate more effective evidence-based policies and interventions to control tobacco use, address ambient and household air pollution, and improve the prevention and treatment of tuberculosis and acute respiratory infections with vaccines and drugs and reduce exposures to environmental and occupational hazards. Until these efforts receive greater prioritization, the burden of disease is unlikely to diminish a great deal more.
1990-04-01
tiltmeters and a few electric field sensors would be useful. Ancillary environmental measurements will also be needed. These should include sensors to...Applied research issues such as sensor development, technological improvements, and signal processing needs are not specifically addressed. This is... sensors of increased sensitivity. A submarine may have static magnetic and electric dipole moments caused by residual mag- netization of the machinery and
Fertility preservation in young cancer patients--too little, too late?
Robbins, Helen Louise; Zahoor, Arooba; Jones, Kevin
2015-12-01
Fertility is an important concern for many younger women with cancer; however, evidence suggests that these matters are often inadequately addressed, potentially with long-term implications for quality of life. Increased confidence in discussing fertility-related matters and an emphasis on early discussion and referral are needed to improve current practice. Further work is needed to better assess current practice and to explore how barriers to discussion about fertility preservation may be best overcome.
Cordts, Grace A; Grant, Marian S; Brandt, Lynsey E; Mears, Simon C
2011-08-08
Despite advances in pain management, little formal teaching is given to practitioners and nurses in its use for postoperative orthopedic patients. The goal of our study was to determine the educational needs for orthopedic pain management of our residents, nurses, and physical therapists using a quantitative and qualitative assessment. The needs analysis was conducted in a 10-bed orthopedic unit at a teaching hospital and included a survey given to 20 orthopedic residents, 9 nurses, and 6 physical therapists, followed by focus groups addressing barriers to pain control and knowledge of pain management. Key challenges for nurses included not always having breakthrough pain medication orders and the gap in pain management between cessation of patient-controlled analgesia and ordering and administering oral medications. Key challenges for orthopedic residents included treating pain in patients with a history of substance abuse, assessing pain, and determining when to use long-acting vs short-acting opioids. Focus group assessments revealed a lack of training in pain management and the need for better coordination of care between nurses and practitioners and improved education about special needs groups (the elderly and those with substance abuse issues). This needs assessment showed that orthopedic residents and nurses receive little formal education on pain management, despite having to address pain on a daily basis. This information will be used to develop an educational program to improve pain management for postoperative orthopedic patients. An integrated educational program with orthopedic residents, nurses, and physical therapists would promote understanding of issues for each discipline. Copyright 2011, SLACK Incorporated.
Rodrigue, Christopher; Seoane, Leonardo; Gala, Rajiv B; Piazza, Janice; Amedee, Ronald G
2012-01-01
Teaching the next generation of physicians requires more than traditional teaching models. The Accreditation Council for Graduate Medical Education's Next Accreditation System places considerable emphasis on developing a learning environment that fosters resident education in quality improvement and patient safety. The goal of this project was to develop a comprehensive and sustainable faculty development program with a focus on teaching quality improvement and patient safety. A multidisciplinary team representing all stakeholders in graduate medical education developed a validated survey to assess faculty and house officer baseline perceptions of their experience with faculty development opportunities, quality improvement tools and training, and resident participation in quality improvement and patient safety programs at our institution. We then developed a curriculum to address these 3 areas. Our pilot survey revealed a need for a comprehensive program to teach faculty and residents the art of teaching. Two other areas of need are (1) regular resident participation in quality improvement and patient safety efforts and (2) effective tools for developing skills and habits to analyze practices using quality improvement methods. Resident and faculty pairs in 17 Ochsner training programs developed and began quality improvement projects while completing the first learning module. Resident and faculty teams also have been working on the patient safety modules and incorporating aspects of patient safety into their individual work environments. Our team's goal is to develop a sustainable and manageable faculty development program that includes modules addressing quality improvement and patient safety in accordance with Accreditation Council for Graduate Medical Education accreditation requirements.
Preventing Chronic Disease in the Workplace: A Workshop Report and Recommendations
Landsbergis, Paul; Hammer, Leslie; Amick, Benjamin C.; Linnan, Laura; Yancey, Antronette; Welch, Laura S.; Goetzel, Ron Z.; Flannery, Kelly M.; Pratt, Charlotte
2011-01-01
Chronic disease is the leading cause of death in the United States. Risk factors and work conditions can be addressed through health promotion aimed at improving individual health behaviors; health protection, including occupational safety and health interventions; and efforts to support the work–family interface. Responding to the need to address chronic disease at worksites, the National Institutes of Health and the Centers for Disease Control and Prevention convened a workshop to identify research priorities to advance knowledge and implementation of effective strategies to reduce chronic disease risk. Workshop participants outlined a conceptual framework and corresponding research agenda to address chronic disease prevention by integrating health promotion and health protection in the workplace. PMID:21778485
Rehabilitation and education are underutilized for mild stroke and TIA sufferers.
Faux, Steven G; Arora, Pooja; Shiner, Christine T; Thompson-Butel, Angelica G; Klein, Linda A
2018-06-01
Transient ischemic attack (TIA) and mild stroke represent a large proportion of cerebrovascular events, at high risk of being followed by recurrent, serious events. The importance of early education addressing risk management, secondary prevention and lifestyle modifications is the centerpiece of further stroke prevention. However, delivering education and rehabilitation to this population can be complex and challenging. Via synthesis of a narrative review and clinical experience, we explore the unique and inherent complexities of rehabilitation management and education provision for patients following mild stroke and TIA. A considerable proportion of TIA/mild stroke survivors have ongoing rehabilitation needs that are poorly addressed. The need for rehabilitation in these patients is often overlooked, and available assessment tools lack the sensitivity to identify common subtle impairments in cognition, mood, language and fatigue. Active and accessible education interventions need to be initiated early after the event, and integrated with ongoing rehabilitation management. Priority areas in need of future development in this field are highlighted and discussed. Implications for rehabilitation Survivors of mild stroke and TIA have ongoing unmet rehabilitation needs and require a unique approach to rehabilitation and education. Rehabilitation needs are difficult to assess and poorly addressed in this cohort, where available assessment tools lack the sensitivity required to identify subtle impairments. Education needs to be initiated early after the event and involve active engagement of the patient in order to improve stroke knowledge, mood and motivate adherence to lifestyle modifications and secondary prevention. Rehabilitation physicians are currently an underutilized resource, who should be more involved in the management of all patients following TIA or mild stroke.
[Improving job morale of nurses despite insurance cost control. 1: Organization assessment].
Haw, Mary Ann; Claus, Eleanor G; Durbin-Lafferty, Ellen; Iversen, Sharon M
2003-04-01
Faced with declining resources for health care and greater pressures to improve productivity of nursing staff, nursing administrators must act now to develop organizational responses to morale problems among nursing staff. As part of a two-part series for JONA, the authors describe low-cost organizational approaches that address nursing morale. Presented in Part 1 is a low-cost diagnostic process for assessing needs of staff and appraising organizational dimensions contributing to morale. Assessment findings provide clear direction for developing organizational approaches for improving morale.
Improving nursing morale in a climate of cost containment. Part 1. Organizational assessment.
Haw, M A; Claus, E G; Durbin-Lafferty, E; Iversen, S M
1984-10-01
Faced with declining resources for health care and greater pressures to improve productivity of nursing staff, nursing administrators must act now to develop organizational responses to morale problems among nursing staff. As part of a two-part series for JONA, the authors describe low-cost organizational approaches that address nursing morale. Presented in Part 1 is a low-cost diagnostic process for assessing needs of staff and appraising organizational dimensions contributing to morale. Assessment findings provide clear direction for developing organizational approaches for improving morale.
A Novel Internet Based Geriatric Education Program for Emergency Medical Services Providers
Shah, Manish N.; Swanson, Peter A.; Nobay, Flavia; Peterson, Lars-Kristofer N.; Caprio, Thomas V.; Karuza, Jurgis
2012-01-01
Despite caring for large numbers of older adults, prehospital emergency medical services (EMS) providers receive minimal geriatrics-specific training while obtaining their certification. Studies have shown that they desire further training to improve their comfort level and knowledge in caring for older adults. However, continuing education programs to address these needs must account for each EMS provider's specific needs, consider each provider's learning styles, and provide an engaging, interactive experience. We developed and implemented a novel, internet-based, video podcast-based geriatric continuing education program for EMS providers and evaluated their perceived value of the program. They found this resource to be highly valuable and were strongly supportive of both the modality and the specific training provided. Technical challenges were reported by some as a barrier, as well as the inability to engage in a discussion to clarify topics. Both were felt to be addressable through programmatic and technological revisions. This study demonstrates the proof of concept of video podcast training to address deficiencies in EMS education regarding the care for older patients. However, further work is needed to demonstrate the educational impact of video podcasts on the knowledge and skills of trainees. PMID:22906239
Invited perspective: Why I am an optimist
NASA Astrophysics Data System (ADS)
Burges, Stephen J.
2011-03-01
I address a range of topics that provide the sociopolitical-technological setting for my professional life. I discuss some influential features of post-World War II world geopolitics, landmark technological developments of that era, and the resulting follow-up technologies that have made it possible to approach various problems in hydrology and water resources. I next address societal needs that have driven developments in hydrology and water resources engineering and follow with a discussion of the modern foundations of our science and what I think are the principal issues in hydrology. I pose three community challenges that when accomplished should advance hydrologic science: data network needs for improving the water budgets at all scales, characterizing subsurface water flow paths, and the information archiving and mining needs from instruments that will generate substantially richer data detail than have been used for most hydrologic work to the present. I then discuss several hydrologic and water resource risk-based decision issues that matter to society to illustrate how such risks have been addressed successfully in the past. I conclude with a long-term community "grand challenge," the coupled modeling of the ocean-atmosphere-landform hydrologic cycle for the purpose of long-lead time hydrologic prediction.
Pipeline for contraceptive development.
Blithe, Diana L
2016-11-01
The high rates of unplanned pregnancy reflect an unmet need for effective contraceptive methods for women, especially for individuals with health risks such as obesity, diabetes, hypertension, and other conditions that may contraindicate use of an estrogen-containing product. Improvements in safety, user convenience, acceptability, and availability of products remain important goals of the contraceptive development program. Another important goal is to minimize the impact of the products on the environment. Development of new methods for male contraception has the potential to address many of these issues of safety for women who have contraindications to effective contraceptive methods but want to protect against pregnancy. It would also address a huge unmet need for men who want to control their fertility. Products under development for men would not introduce ecotoxic hormones into the water system. Published by Elsevier Inc.
Fredriksen-Goldsen, Karen I; Hoy-Ellis, Charles P; Goldsen, Jayn; Emlet, Charles A; Hooyman, Nancy R
2014-01-01
Sexual orientation and gender identity are not commonly addressed in health and human service delivery, or in educational degree programs. Based on findings from Caring and Aging with Pride: The National Health, Aging and Sexuality Study (CAP), the first national federally-funded research project on LGBT health and aging, this article outlines 10 core competencies and aligns them with specific strategies to improve professional practice and service development to promote the well-being of LGBT older adults and their families. The articulation of key competencies is needed to provide a blueprint for action for addressing the growing needs of LGBT older adults, their families, and their communities.
FREDRIKSEN-GOLDSEN, KAREN I.; HOY-ELLIS, CHARLES P.; GOLDSEN, JAYN; EMLET, CHARLES A.; HOOYMAN, NANCY R.
2014-01-01
Sexual orientation and gender identity are not commonly addressed in health and human service delivery, or in educational degree programs. Based on findings from Caring and Aging with Pride: The National Health, Aging and Sexuality Study (CAP), the first national federally-funded research project on LGBT health and aging, this article outlines 10 core competencies and aligns them with specific strategies to improve professional practice and service development to promote the well-being of LGBT older adults and their families. The articulation of key competencies is needed to provide a blueprint for action for addressing the growing needs of LGBT older adults, their families, and their communities. PMID:24571387
Hudson, Benjamin; Hunt, Victoria; Waylen, Andrea; McCune, Catherine Anne; Verne, Julia; Forbes, Karen
2018-05-01
Liver disease represents the third commonest cause of death in adults of working age and is associated with an extensive illness burden towards the end of life. Despite this, patients rarely receive palliative care and are unlikely to be involved in advance care planning discussions. Evidence addressing how existing services meet end-of-life needs, and exploring attitudes of patients and carers towards palliative care, is lacking. To explore the needs of patients and carers with liver disease towards the end of life, evaluate how existing services meet need, and examine patient and carer attitudes towards palliative care. Qualitative study - semi-structured interviews analysed using thematic analysis. Settings/participants: A total of 17 participants (12 patients, 5 bereaved carers) recruited from University Hospitals Bristol. Participants described escalating physical, psychological and social needs as liver disease progressed, including disabling symptoms, emotional distress and uncertainty, addiction, financial hardship and social isolation. End-of-life needs were incompatible with the healthcare services available to address them; these were heavily centred in secondary care, focussed on disease modification at the expense of symptom control and provided limited support after curative options were exhausted. Attitudes towards palliative care were mixed, however, participants valued opportunities to express future care preferences (particularly relating to avoidance of hospital admission towards the end of life) and an increased focus on symptomatic and logistical aspects of care. The needs of patients with liver disease and their carers are frequently incompatible with the healthcare services available to them towards the end of life. Novel strategies, which recognise the life-limiting nature of liver disease explicitly and improve coordination with community services, are required if end-of-life care is to improve.
Colvin, Jeffrey D; Bettenhausen, Jessica L; Anderson-Carpenter, Kaston D; Collie-Akers, Vicki; Plencner, Laura; Krager, Molly; Nelson, Brooke; Donnelly, Sara; Simmons, Julia; Higinio, Valeria; Chung, Paul J
2016-03-01
It is critical that pediatric residents learn to effectively screen families for active and addressable social needs (ie, negative social determinants of health). We sought to determine 1) whether a brief intervention teaching residents about IHELP, a social needs screening tool, could improve resident screening, and 2) how accurately IHELP could detect needs in the inpatient setting. During an 18-month period, interns rotating on 1 of 2 otherwise identical inpatient general pediatrics teams were trained in IHELP. Interns on the other team served as the comparison group. Every admission history and physical examination (H&P) was reviewed for IHELP screening. Social work evaluations were used to establish the sensitivity and specificity of IHELP and document resources provided to families with active needs. During a 21-month postintervention period, every third H&P was reviewed to determine median duration of continued IHELP use. A total of 619 admissions met inclusion criteria. Over 80% of intervention team H&Ps documented use of IHELP. The percentage of social work consults was nearly 3 times greater on the intervention team than on the comparison team (P < .001). Among H&Ps with documented use of IHELP, specificity was 0.96 (95% confidence interval 0.87-0.99) and sensitivity was 0.63 (95% confidence interval 0.50-0.73). Social work provided resources for 78% of positively screened families. The median duration of screening use by residents after the intervention was 8.1 months (interquartile range 1-10 months). A brief intervention increased resident screening and detection of social needs, leading to important referrals to address those needs. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
Colvin, Jeffrey D.; Bettenhausen, Jessica L.; Anderson-Carpenter, Kaston D.; Collie-Akers, Vicki; Plencner, Laura; Krager, Molly; Nelson, Brooke; Donnelly, Sara; Simmons, Julia; Higinio, Valeria; Chung, Paul J.
2015-01-01
Objective It is critical that pediatric residents learn to effectively screen families for active and addressable social needs (i.e., negative social determinants of health.) We sought to determine 1) whether a brief intervention teaching residents about IHELP, a social needs screening tool, could improve resident screening, and 2) how accurately IHELP could detect needs in the inpatient setting. Methods During an 18-month period, interns rotating on one of two otherwise identical inpatient general pediatrics teams were trained in IHELP. Interns on the other team served as the comparison group. Every admission history and physical (H&P) was reviewed for IHELP screening. Social work evaluations were used to establish the sensitivity and specificity of IHELP and document resources provided to families with active needs. During a 21-month post-intervention period, every third H&P was reviewed to determine median duration of continued IHELP use. Results 619 admissions met inclusion criteria. Over 80% of intervention team H&Ps documented use of IHELP. The percentage of social work consults was nearly 3 times greater on the intervention team than on the comparison team (P<0.001). Among H&Ps with documented use of IHELP, specificity was 0.96 (95% CI 0.87–0.99) and sensitivity was 0.63 (95% CI 0.50–0.73). Social work provided resources for 78% of positively screened families. The median duration of screening use by residents after the intervention was 8.1 months (IQR 1–10 months) Conclusions A brief intervention increased resident screening and detection of social needs, leading to important referrals to address those needs. PMID:26183003
Vanneste, Yvonne; van de Loo, Marlou; Feron, Frans; Rots-de Vries, Carin; van de Goor, Ien
2016-01-01
Reducing school absenteeism benefits the health and educational opportunities of young people. The Dutch intervention Medical Advice for Sick-reported Students (abbreviated as MASS) was developed to address school absenteeism due to sickness reporting, also called medical absenteeism. This study is part of a research project on the effectiveness of MASS and explores factors that influence the implementation and dissemination of the intervention, from schools' perspectives. The research questions include reasons schools have to implement MASS, their experiences in the implementation of MASS and their views on what is needed to ensure sustainable implementation. A qualitative research method was used. Semi-structured interviews were held with nine principals and eight special education needs coordinators, working in nine secondary schools that apply MASS. Inductive content analysis was carried out. The main reasons for schools to address medical absenteeism were their concerns about students' well-being and future prospects and their wish to share these concerns with students' parents. Participants also mentioned the wish to raise the threshold for reporting sick. According to the participants, MASS makes it easier for teachers to enter into conversation with students and their parents about medical absence. MASS prevents damage to the relationship with parents and medical problems being missed. In implementing MASS the main obstacles are teachers' dialogue about medical absence with students and their parents, teachers' follow-up of the feedback of the youth health care physicians (YHCPs), and correct registration. The participants were convinced that MASS also improves collaboration with parents regarding the optimization of care for students. MASS allows schools to identify students at risk of dropout at an early stage and to optimise guidance of these students. The intervention matches schools' need to address medical absenteeism by providing a clear framework, an approach from concern rather than control, and socio-medical expertise through the collaboration with YHCPs. MASS can support schools to maximize the number of students graduating and to improve parental involvement in school. These outcomes may help to put the subject of addressing medical absenteeism on the agenda of all schools, and contribute to prioritization, support adoption and secure sustainable implementation and dissemination of MASS.
Feron, Frans; Rots – de Vries, Carin; van de Goor, Ien
2016-01-01
Background Reducing school absenteeism benefits the health and educational opportunities of young people. The Dutch intervention Medical Advice for Sick-reported Students (abbreviated as MASS) was developed to address school absenteeism due to sickness reporting, also called medical absenteeism. This study is part of a research project on the effectiveness of MASS and explores factors that influence the implementation and dissemination of the intervention, from schools’ perspectives. The research questions include reasons schools have to implement MASS, their experiences in the implementation of MASS and their views on what is needed to ensure sustainable implementation. Methods A qualitative research method was used. Semi-structured interviews were held with nine principals and eight special education needs coordinators, working in nine secondary schools that apply MASS. Inductive content analysis was carried out. Findings The main reasons for schools to address medical absenteeism were their concerns about students’ well-being and future prospects and their wish to share these concerns with students’ parents. Participants also mentioned the wish to raise the threshold for reporting sick. According to the participants, MASS makes it easier for teachers to enter into conversation with students and their parents about medical absence. MASS prevents damage to the relationship with parents and medical problems being missed. In implementing MASS the main obstacles are teachers’ dialogue about medical absence with students and their parents, teachers’ follow-up of the feedback of the youth health care physicians (YHCPs), and correct registration. The participants were convinced that MASS also improves collaboration with parents regarding the optimization of care for students. Conclusions MASS allows schools to identify students at risk of dropout at an early stage and to optimise guidance of these students. The intervention matches schools’ need to address medical absenteeism by providing a clear framework, an approach from concern rather than control, and socio-medical expertise through the collaboration with YHCPs. MASS can support schools to maximize the number of students graduating and to improve parental involvement in school. These outcomes may help to put the subject of addressing medical absenteeism on the agenda of all schools, and contribute to prioritization, support adoption and secure sustainable implementation and dissemination of MASS. PMID:26845688
[Proangiogenic cell-based therapy for treatment of ischemic diseases].
Silvestre, Jean-Sébastien
2009-11-01
The application of endothelial progenitor cells (EPC) cell-based therapy for regenerative medicine constitutes a promising therapeutic avenue for the treatment of cardiovascular diseases. Based on experimental studies demonstrating that bone marrow-, blood- or tissue-derived stem/progenitor cells improve the functional recovery after ischemia, clinical trials were initiated to address this new therapeutic concept. Although autolougous cell therapy was shown to improve perfusion and function of ischemic tissues, a number of issues remain to be adressed. The nature of the mobilizing, migratory and homing signals, and the mechanisms of action need to be identified and further defined. In addition, strategies to enhance homing, survival and therapeutic potential of EPC need to be developped to improve therapeutic effect and counteract EPC dysfunction in aged patients with cardiovascular risk factors. The present review article will discuss the mechanisms of action of different types of adult stem cells and several approaches to improve their therapeutic efficiency.
Warfarin therapy: in need of improvement after all these years
Kimmel, Stephen E
2010-01-01
Background Warfarin therapy has been used clinically for over 60 years, yet continues to be problematic because of its narrow therapeutic index and large inter-individual variability in patient response. As a result, warfarin is a leading cause of serious medication-related adverse events, and its efficacy is also suboptimal. Objective To review factors that are responsible for variable response to warfarin, including clinical, environmental, and genetic factors, and to explore some possible approaches to improving warfarin therapy. Results Recent efforts have focused on developing dosing algorithms that included genetic information to try to improve warfarin dosing. These dosing algorithms hold promise, but have not been fully validated or tested in rigorous clinical trials. Perhaps equally importantly, adherence to warfarin is a major problem that should be addressed with innovative and cost-effective interventions. Conclusion Additional research is needed to further test whether interventions can be used to improve warfarin dosing and outcomes. PMID:18345947
ERIC Educational Resources Information Center
Nellis, Leah M.; Sickman, Linda Sue; Newman, Daniel S.; Harman, Deborah R.
2014-01-01
With the increase in schoolwide practices to improve reading instruction for all students and provide supplemental interventions for struggling readers, the need for collaboration among education professionals has become increasingly important. This article focuses on the expanding opportunities for collaboration between school psychologists and…
The Internship Divide: The Promise and Challenges of Internships in the Arts. Special Report
ERIC Educational Resources Information Center
Frenette, Alexandre
2015-01-01
The Strategic National Alumni Project (SNAAP)--an online survey, data management, and institutional improvement system designed to enhance the impact of arts-school education--brings much-needed nuance to assessing the promise and addressing the challenges of the intern economy. In particular, SNAAP data help participants identify historical…
Teaching about Africa. ERIC Digest No. 36.
ERIC Educational Resources Information Center
Merryfield, Merry M.
Recognizing the need to strengthen education about Africa in United States schools and to enable teachers to present complex issues about apartheid, political stability, and cultural conflict, this digest addresses the issue of how teachers can improve their teaching about Africa. The article poses 3 questions: (1) Why is it important to teach…
ERIC Educational Resources Information Center
Holt, Maurice
1995-01-01
The central idea in W. Edwards Deming's approach to quality management is the need to improve process. Outcome-based education's central defect is its failure to address process. Deming would reject OBE along with management-by-objectives. Education is not a product defined by specific output measures, but a process to develop the mind. (MLH)
ERIC Educational Resources Information Center
Caringi, James C.; Lawson, Hal A.; Strolin-Goltzman, Jessica; McCarthy, Mary; Briar-Lawson, Katharine; Claiborne, Nancy
2008-01-01
Workforce turnover in public child welfare is a national problem. Individual, supervisory, and organizational factors, individually and in combination, account for some of the turnover. Complex, comprehensive interventions are needed to address these several factors and their interactions. A research and development team is field testing one such…
A Practical Approach to Using Learning Styles in Math Instruction.
ERIC Educational Resources Information Center
Midkiff, Ruby Bostick; Thomasson, Rebecca Davis
Instruction based on learning styles has received little attention in the recent reform efforts in mathematics education. The purpose of this book is to address the improvement of mathematics instruction through sensitivity to learning styles. The introduction discusses the scope and rationale of the book. Chapter 2 documents the need for…
Exploring Cloud Computing Tools to Enhance Team-Based Problem Solving for Challenging Behavior
ERIC Educational Resources Information Center
Johnson, LeAnne D.
2017-01-01
Data-driven decision making is central to improving success of children. Actualizing the use of data is challenging when addressing the social, emotional, and behavioral needs of children across different types of early childhood programs (i.e., early childhood special education, early childhood family education, Head Start, and childcare).…
Role of Research Universities in Health and Medicine. Go8 Backgrounder 20
ERIC Educational Resources Information Center
Group of Eight (NJ1), 2010
2010-01-01
Universities have much to contribute to the improvement of health delivery, research, and teaching/learning. In progressing health reform, the Government should be mindful of the need to: (1) strengthen high quality medical research; (2) promote translation of research to teaching, population health and health services; and (3) address Health…
Improving Teachers' Teaching with Communication Technology
ERIC Educational Resources Information Center
Chen, Li-Ling
2012-01-01
With the growing needs to address the challenges that new teachers face and the popularity of social networking technology, this study explores how to increase the effectives of teaching through the use of such technology, and how the technology may serve to promote collaboration and open new resources of support in public education. In this…
USDA-ARS?s Scientific Manuscript database
Best management practices (BMPs) have been widely used to address hydrology and water quality issues in both agricultural and urban areas. Increasing numbers of BMPs have been studied in research projects and implemented in watershed management projects, but a gap remains in quantifying their effect...
Measurement Learning Trajectories: A Tool for Professional Development
ERIC Educational Resources Information Center
McCool, Jenni K.
2009-01-01
This study investigated the ways in which a teacher developed conceptions of measurement teaching and learning as she collaborated with a researcher to learn and implement a measurement learning trajectory with two of her students. Teachers need tools that effectively address the content area of measurement and can be used to improve their…
ALL Kids Can Be Readers: The Marriage of Reading First and Inclusive Education
ERIC Educational Resources Information Center
Ashby, Christine; Burns, Janice; Royle, Joan
2014-01-01
As schools attempt to address the needs of an ever more diverse student population, many have turned to intensive interventions to improve reading performance. Reading First grants from the United States Department of Education encouraged schools to implement evidence-based instructional practices in elementary schools. However, for many schools,…
ERIC Educational Resources Information Center
Camden, Chantal; Swaine, Bonnie; Tetreault, Sylvie; Bergeron, Sophie; Lambert, Carole
2013-01-01
This article presents the experience of a rehabilitation program that undertook the challenge to reorganize its services to address accessibility issues and improve service quality. The context in which the reorganization process occurred, along with the relevant literature justifying the need for a new service delivery model, and an historical…
Do Inquiring Minds Have Positive Attitudes? The Science Education of Preservice Elementary Teachers
ERIC Educational Resources Information Center
Riegle-Crumb, Catherine; Morton, Karisma; Moore, Chelsea; Chimonidou, Antonia; LaBrake, Cynthis; Kopp, Sacha
2015-01-01
Owing to their potential impact on students' cognitive and noncognitive outcomes, the negative attitudes toward science held by many elementary teachers are a critical issue that needs to be addressed. This study focuses on the science education of preservice elementary teachers with the goal of improving their attitudes "before" they…
The Importance of Understanding Culture When Improving Education: Learning from Cambodia
ERIC Educational Resources Information Center
Berkvens, Jan B. Y.
2017-01-01
Following Education for All, initiatives like child-friendly schools initiative, are rolled out in many countries, including Cambodia. The child-friendly schools initiative is addressing general and local needs of children in schools, like a safe environment, well-trained teachers and the provision of teaching and materials. But there is also a…
Resources for Change: A Guide to Projects, 1978-79.
ERIC Educational Resources Information Center
Fund for the Improvement of Postsecondary Education (DHEW), Washington, DC.
Descriptions are provided of the 175 projects supported by the Fund for the Improvement of Postsecondary Education in 1978-79. The projects address the broad range of educational needs represented in the proposals submitted to the Fund's Comprehensive Program. About half the projects are newly funded, and half are renewals. Project descriptions…
A Quasi-Experimental Evaluation of an On-Line Formative Assessment and Tutoring System
ERIC Educational Resources Information Center
Koedinger, Kenneth R.; McLaughlin, Elizabeth A.; Heffernan, Neil T.
2010-01-01
ASSISTments is a web-based math tutor designed to address the need for timely student assessment while simultaneously providing instruction, thereby avoiding lost instruction time that typically occurs during assessment. This article presents a quasi-experiment that evaluates whether ASSISTments use has an effect on improving middle school…
ERIC Educational Resources Information Center
Chwalisz, Kathleen
2008-01-01
The literature review and focus group findings that compose the Major Contribution illustrate how counseling psychologists can integrate expertise from various subdisciplines (vocational psychology, health psychology, multicultural psychology) to effectively address the needs of those living with HIV. Given changes in the nature of health problems…
Essential Competencies for Interdisciplinary Graduate Training: Summary Report. GS-10F-0086K
ERIC Educational Resources Information Center
Gamse, Beth C.; Espinosa, Lorelle L.; Roy, Radha
2013-01-01
The Integrative Graduate Education and Research Traineeship (IGERT) program represents a substantial investment by the National Science Foundation (NSF) to improve the quality of graduate education, and ultimately, to increase the number of graduates better prepared to address our nation's 21st century scientific and technological needs. The…
PATHS - Providing Appropriate Training in Head Start: A Grantee Guide.
ERIC Educational Resources Information Center
Riley, Mary Tom; And Others
Designed for Head Start grantees, this book provides training guidelines for improving Head Start staff competency. Chapter I offers a rationale for staff training activities, while chapter II characterizes the Head Start trainee. Chapter III addresses assessment of training needs on program and staff levels. The development of a training plan is…
OR2020: The Operating Room of the Future
2004-05-01
25 3.3 Technical Requirements: Standards and Tools for Improved Operating R oom Process Integration...Image processing and visualization tools must be made available to the operating room. 5. Communications issues must be addressed and aim toward...protocols for effectively performing advanced surgeries and using telecommunications-ready tools as needed. The following recommendations were made
To address the need for improved phytotoxicity testing protocols, we evaluated use of the vegetative vigor test methodology for use in determining effects of low concentrations of chemical herbicides on terrestrial non-crop plant species. Species included native plants from Illi...
Stigma, Obesity, and the Health of the Nation's Children
ERIC Educational Resources Information Center
Puhl, Rebecca M.; Latner, Janet D.
2007-01-01
Preventing childhood obesity has become a top priority in efforts to improve our nation's public health. Although much research is needed to address this health crisis, it is important to approach childhood obesity with an understanding of the social stigma that obese youths face, which is pervasive and can have serious consequences for emotional…
Metal Working and Welding Operations.
ERIC Educational Resources Information Center
Marine Corps Inst., Washington, DC.
This student guide, one of a series of correspondence training courses designed to improve the job performance of members of the Marine Corps, deals with the skills needed by metal workers and welders. Addressed in the six individual units of the course are the following topics: weldable metals and their alloys, arc welding, gas welding,…
Mother Tongue First Multilingual Education among the Tribal Communities in India
ERIC Educational Resources Information Center
MacKenzie, Pamela J.
2009-01-01
India's rich multilingual, multicultural society creates a complex challenge to the Government as it attempts to address the educational needs of its tribal communities. Although access to schools has increased and enrolment rates are improving, the dropout rates are still alarmingly high and achievement levels are low compared to their non-tribal…
ERIC Educational Resources Information Center
Bailey, Alison L.; Heritage, Margaret
2014-01-01
This article addresses theoretical and empirical issues relevant for the development and evaluation of language learning progressions. The authors explore how learning progressions aligned with new content standards can form a central basis of efforts to describe the English language needed in school contexts for learning, instruction, and…
ERIC Educational Resources Information Center
Irvin, P. Shawn; Pilger, Marissa; Sáez, Leilani; Alonzo, Julie
2016-01-01
Identifying and measuring indicators of learning difficulties among young children and implementing effective instructional approaches are complicated, particularly during the transition to kindergarten. Purposeful school-based transition policies and practices support teacher and school decision-making and, thus, can ease the…
ERIC Educational Resources Information Center
Jitendra, Asha K.; Star, Jon R.; Starosta, Kristin; Leh, Jayne M.; Sood, Sheetal; Caskie, Grace; Hughes, Cheyenne L.; Mack, Toshi R.
2009-01-01
The present study evaluated the effectiveness of an instructional intervention (schema-based instruction, SBI) that was designed to meet the diverse needs of middle school students by addressing the research literatures from both special education and mathematics education. Specifically, SBI emphasizes the role of the mathematical structure of…
ERIC Educational Resources Information Center
Lopez, Robert H.
2012-01-01
The problem addressed was the need to maintain data security in the field of information technology. Specifically, the breakdown of communication between business leaders and data security specialists create risks to data security. The purpose of this qualitative phenomenological study was to determine which factors would improve communication…
ERIC Educational Resources Information Center
Hast, Shawn E.
2013-01-01
This study addressed the need to enhance returning adult students' (RAS) educational experience by improving their relationship with traditional students. The purpose of this study was to examine, based upon Schlossberg's transition theory, the interpersonal relationship between RAS and traditional students at a community college that…
A Study of Aboriginal Teachers' Professional Knowledge and Experience in Canadian Schools
ERIC Educational Resources Information Center
St. Denis, Verna
2010-01-01
This qualitative study, initiated by the Canadian Teachers' Federation and its Advisory Committee on Aboriginal Education, explored the professional knowledge and experiences of Aboriginal (First Nations, Mets and Inuit) teachers. The rationale for the study was to address the urgent need to improve and promote Aboriginal education in public…
USDA-ARS?s Scientific Manuscript database
Resource-poor countries and regions require effective, low-cost diagnostic devices for accurate identification and diagnosis of health conditions. Optical detection technologies used for many types of biological and clinical analysis can play a significant role in addressing this need, but must be s...
On Improving Text Readability by Creating a Personal Writing Style
ERIC Educational Resources Information Center
Shen, Yuru
2017-01-01
English writing is one of the four indispensable skills that English learners need to master, but unfortunately, many Chinese college students have much difficulty composing clear, concise and coherent essays although they have studied English for at least over six years. To address the problem, the researchers and teachers in China have tried…
Assessing Faculty Beliefs about the Importance of Various Marketing Job Skills
ERIC Educational Resources Information Center
Hyman, Michael R.; Hu, Jing
2005-01-01
The need to improve the professional skills of those with marketing degrees has spurred surveys of current students, alumni, practitioners, and faculty about the importance of various professional skills; however, previous surveys of marketing faculty have focused only on computer skills. To address this limitation, the goals of this study were…
Regional Gender Equity/Single Parent Workshops Project.
ERIC Educational Resources Information Center
Mount San Antonio Community Coll. District, Walnut, CA.
The 107 California Community Colleges (CCC) are organized into 9 regions, each served by a regional Gender Equity/Single Parent Coordinator. The role of the coordinators is to improve communications and facilitate resource sharing among the colleges within their region in order to address the needs of and expand services provided to single parents…
Evaluation of Smoking Prevention Television Messages Based on the Elaboration Likelihood Model
ERIC Educational Resources Information Center
Flynn, Brian S.; Worden, John K.; Bunn, Janice Yanushka; Connolly, Scott W.; Dorwaldt, Anne L.
2011-01-01
Progress in reducing youth smoking may depend on developing improved methods to communicate with higher risk youth. This study explored the potential of smoking prevention messages based on the Elaboration Likelihood Model (ELM) to address these needs. Structured evaluations of 12 smoking prevention messages based on three strategies derived from…
The Readability of Information Literacy Content on Academic Library Web Sites
ERIC Educational Resources Information Center
Lim, Adriene
2010-01-01
This article reports on a study addressing the readability of content on academic libraries' Web sites, specifically content intended to improve users' information literacy skills. Results call for recognition of readability as an evaluative component of text in order to better meet the needs of diverse user populations. (Contains 8 tables.)
ERIC Educational Resources Information Center
Desimone, Laura M.; Smith, Thomas M.; Ueno, Koji
2006-01-01
Purpose: Policymakers and administrators are increasingly focusing on professional development as a means to improve teaching quality. In this study, the authors examine whether professional development in mathematics is primarily performing an educative function by addressing weak teacher preparation, or a catalytic function by serving mainly…
The Boys in Schools Bulletin: Practical Initiatives Addressing Boys' Needs, 1999.
ERIC Educational Resources Information Center
Fletcher, Richard, Ed.; Browne, Rollo, Ed.
1999-01-01
This document is comprised of volume 2 of a quarterly bulletin for educators in Australia providing a practical focus to improving boys' schooling. The April 1999 issue focuses on the role of school executives, or administrators, on supporting educational initiatives. This issue includes articles describing the development of a program-based…
Tools for Schools: Filtration for Improved Air Quality. Technical Services Bulletin.
ERIC Educational Resources Information Center
2001
This product bulletin addresses air pollution control in educational facilities to enhance educational performance, provides air quality recommendations for schools, and examines the filtration needs of various school areas. The types of air particles typically present are highlighted, and the use of proper filtration to control gases and vapors…
Making Skills Everyone's Business: A Call to Transform Adult Learning in the United States
ERIC Educational Resources Information Center
Strawn, Julie
2015-01-01
To address the need to connect Americans with learning opportunities, the Office of Career, Technical, and Adult Education released the present report. Grounded in evidence and informed by effective and emerging practices, "Making Skills Everyone's Business" offers seven strategies that hold great promise for improving the conditions…
National Assessment of Personnel Shortages and Training Needs in Vocational Rehabilitation.
ERIC Educational Resources Information Center
Pelavin, Diane C.; And Others
To improve the services provided to clients in vocational rehabilitation, a study was conducted to determine what staff shortages exist by occupational discipline and which of them could be addressed by education and training. Data collection involved a questionnaire completed by 95 percent of the 83 directors of state agencies responsible for…
Self-Monitoring: A Behavioral Intervention for Children Attending Head Start
ERIC Educational Resources Information Center
Riggleman, Samantha
2017-01-01
Addressing the needs of preschoolers with behavioral problems is important, as these issues often have long-term impacts on the outcomes of students (Fox et al., 2002). Self-monitoring strategies and techniques have the potential to improve the outcomes of this population of children. Self-monitoring requires students to pay attention to a…
Know Thyself: The Importance of Humanism in Education
ERIC Educational Resources Information Center
Zucca-Scott, Laura
2010-01-01
Current and past reforms have attempted to address the challenges of the educational world. There are undoubtedly reasons for concern as illiteracy and high school dropout rates are still haunting figures in the United States (Institute of Education Sciences, 2010; National Assessment of Literacy, 2010). Thus, the need for improvement in the U.S.…
Skilled and Ready: What Combined Authorities Want from Schools
ERIC Educational Resources Information Center
Hatcher, Richard
2016-01-01
The purpose of combined authorities, driven by government, is economic growth and public sector reform. Economic growth requires improved productivity. The main obstacle, it is claimed, is a "skills deficit," which schools need to address. In this article the evidence for this claim is examined. The real problem, it is argued, is a…
Education Sector Reform: The Ugandan Experience
ERIC Educational Resources Information Center
Penny, Alan; Ward, Michael; Read, Tony; Bines, Hazel
2008-01-01
In 1998 the Government of Uganda (GoU) began implementing an ambitious reform programme called the Education Strategic Investment Plan (ESIP) in order to effect Universal Primary Education (UPE). This paper offers a perspective on how the GoU has met the challenge of financing education reform, addressed the need to improve the quality of basic…
Constructivism and Career Decision Self-Efficacy for Asian Americans and African Americans
ERIC Educational Resources Information Center
Grier-Reed, Tabitha; Ganuza, Zoila M.
2011-01-01
Career development that adequately addresses the needs of multicultural students is important. The authors explored whether a constructivist career course might be a viable mechanism for improving career decision self-efficacy for 81 Asian American and African American college students. Results indicated significant increases in all 5 elements of…
ERIC Educational Resources Information Center
Ostrowski, Christopher P.
2016-01-01
Challenges to obtaining quality academic accommodations for students with visual impairments in postsecondary education hinder accessibility and the success of such students. The limitations of current policies and practices intended to address the needs of students in Canada are examined and potential solutions are discussed. Further systemic…
75 FR 10253 - Environmental Impact Statements and Regulations; Availability of EPA Comments
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-05
... concerns about storage, transportation and disposal of hazardous waste and radioactive wastes. EPA... wastes will need to be addressed as the project progresses. Rating EC2. EIS No. 20090378, ERP No. D-COE.... EIS No. 20100008, ERP No. D-GSA-F65079-00, International Falls Land Port of Entry Improvements Study...
ERIC Educational Resources Information Center
Elsbree, Anne René; Hernández, Ana M.; Daoud, Annette
2014-01-01
The research emphasizes the need for educators to take more ownership of Latino English Learners (ELs) and identify effective lesson differentiation through subject area content (instruction), process (activities), and products (assessments). Based on the literature review, school achievement improves when practices address students' culture,…
What does an e-mail address add? - Doing health and technology at home.
Andreassen, Hege K
2011-02-01
There is increasing interest in using electronic mail and other electronic health technologies (e-health technologies) in patient follow-ups. This study sheds light on patients' reception of provider-initiated e-health in their everyday environments. In a research project carried out in Norway (2005-2007), an electronic address for a hospital dermatology ward was offered to 50 patient families for improved access to expert advice from the patients' homes. Drawing on semi-structured interviews with 12 families, this paper explores how the electronic address was integrated into everyday health practice. The research illuminates how the electronic address did not only represent changes related to treatment procedures and frequency or nature of expert contact; it was also important to other practices in the everyday lives of the families of patients with chronic illness. Once in place on the patients' computers, the electronic address was ascribed at least four different roles: it was used as the intended riverbed for a flow of information, but also as a safety alarm, as a shield to the medical gaze and as a token of competence in care and parenting. The multiplicity in use and reception of an electronic address in patient settings illustrates the need to include patients' everyday practices in current professional and political discussions of e-mail and other e-health technologies. Thus this paper argues that there is a need for research on electronic patient-provider communication that moves beyond frequency of use and questions on how technology will affect medical encounters. Social science equally needs to investigate how provider-initiated e-health technologies gets involved in patients' moral and social performance of health and illness in everyday life. Copyright © 2010 Elsevier Ltd. All rights reserved.
Supportive and palliative care for patients with chronic mental illness including dementia.
Lloyd-Williams, Mari; Abba, Katharine; Crowther, Jacqueline
2014-09-01
People with preexisting mental illness are known to have difficulty accessing healthcare services including palliative care and people with dementia have similar issues accessing palliative care. The review addressed the time period from January 2013 to March 2014. There were few articles addressing issues for palliative and supportive care for patients with preexisting mental health issues. The main factor that would improve care is interdisciplinary working between mental healthcare teams and palliative care teams. In contrast, there were many published articles on the palliative and supportive care needs for people with dementia. These articles included consensus statements, models of care; studies of why models of care, for example Advanced Care Planning were not being implemented; and carer reports of care in the last year of life. Urgent research is required as to how support for people with preexisting mental illness who require palliative care can be improved--excellent liaison between mental health and palliative care teams is essential. There is much research on palliative care needs for people with dementia but an apparent lack of innovative approaches to care including care of people within their family home.
ARPA-E: Creating Practical, Affordable Natural Gas Storage Solutions
Boysen, Dane; Loukus, Josh; Hansen, Rita
2018-05-11
Allowing people to refuel natural gas vehicles at home could revolutionize the way we power our cars and trucks. Currently, our nation faces two challenges in enabling natural gas for transportation. The first is improving the way gas tanks are built for natural gas vehicles; they need to be conformable, allowing them to fit tightly into the vehicle. The second challenge is improving the way those tanks are refueled while maintaining cost-effectiveness, safety, and reliability. This video highlights two ARPA-E project teams with innovative solutions to these challenges. REL is addressing the first challenge by developing a low-cost, conformable natural gas tank with an interconnected core structure. Oregon State University and OnBoard Dynamics are addressing the second challenge by developing a self-refueling natural gas vehicle that integrates a compressor into its engine-using one of the engine's cylinders to compress gas eliminates the need for an expensive at-home refueling system. These two distinct technologies from ARPA-E's MOVE program illustrate how the Agency takes a multi-pronged approach to problem solving and innovation.
Haskell, Rebecca; Graham, Kathryn; Bernards, Sharon; Flynn, Andrea; Wells, Samantha
2016-01-01
Mental health and substance use disorders (MSD) are significant public health concerns that often co-occur with violence. To improve services that address MSD and violence [MSD(V)], it is critical to understand the perspectives of those most affected, people who have sought help for MSD(V) (i.e., "service users"), especially those with co-occurring issues, as well as their family members. We conducted structured interviews with 73 service users and 41 family members of service users in two Ontario communities (one urban, one rural) regarding their goals related to help-seeking, positive and negative experiences, and recommendations for improving systems of care. Overall, participants expressed a need for services that: (1) are respectful, nonjudgmental, and supportive, help service users to feel more 'normal' and include education to reduce stigma; (2) are accessible, varied and publicly funded, thereby meeting individual needs and addressing equity concerns at a systems level; and (3) are coordinated, holistic and inclusive of family members who often support service users. The findings provide a rich understanding of how service users and their families perceive services for MSD(V) issues and identify key ways to better meet their needs.
Tupasi, T.; Garfin, A. M. C. G.; Mangan, J. M.; Orillaza-Chi, R.; Naval, L. C.; Balane, G. I.; Basilio, R.; Golubkov, A.; Joson, E. S.; Lew, W-J.; Lofranco, V.; Mantala, M.; Pancho, S.; Sarol, J. N.; Blumberg, A.; Burt, D.; Kurbatova, E. V.
2017-01-01
SUMMARY SETTING Patients who initiated treatment for multi-drug-resistant tuberculosis (MDR-TB) at 15 Programmatic Management of Drug-resistant Tuberculosis (PMDT) health facilities in the Philippines between July and December 2012. OBJECTIVES To describe patients’ views of current interventions, and suggest changes likely to reduce MDR-TB loss to follow-up. METHODS In-depth interviews were conducted between April and July 2014 with MDR-TB patients who were undergoing treatment, had finished treatment at the time of the interview (controls), or had been lost to follow-up (LTFU). Responses were thematically analyzed. RESULTS Interviews were conducted with 182 patients who were undergoing or had completed treatment and 91 LTFU patients. Views and suggestions could be thematically categorized as approaches to facilitate adherence or address barriers to adherence. The top themes were the need for transportation assistance or improvements to the current transportation assistance program, food assistance, and difficulties patients encountered related to their medications. These themes were addressed by respectively 63%, 60%, and 32% of the participants. CONCLUSIONS A more patient-centered approach is needed to improve MDR-TB treatment adherence. Programs should strive to provide assistance that considers patient preferences, is adequate to cover actual costs or needs, and is delivered in a timely, uninterrupted manner. PMID:28157461
Current perspectives in contaminant hydrology and water resources sustainability
Bradley, Paul M.
2013-01-01
Human society depends on liquid freshwater resources to meet drinking, sanitation and hygiene, agriculture, and industry needs. Improved resource monitoring and better understanding of the anthropogenic threats to freshwater environments are critical to efficient management of freshwater resources and ultimately to the survival and quality of life of the global human population. This book helps address the need for improved freshwater resource monitoring and threat assessment by presenting current reviews and case studies focused on the fate and transport of contaminants in the environment and on the sustainability of groundwater and surface-water resources around the world. It is intended for students and professionals working in hydrology and water resources management.
Control technology for future aircraft propulsion systems
NASA Technical Reports Server (NTRS)
Zeller, J. R.; Szuch, J. R.; Merrill, W. C.; Lehtinen, B.; Soeder, J. F.
1984-01-01
The need for a more sophisticated engine control system is discussed. The improvements in better thrust-to-weight ratios demand the manipulation of more control inputs. New technological solutions to the engine control problem are practiced. The digital electronic engine control (DEEC) system is a step in the evolution to digital electronic engine control. Technology issues are addressed to ensure a growth in confidence in sophisticated electronic controls for aircraft turbine engines. The need of a control system architecture which permits propulsion controls to be functionally integrated with other aircraft systems is established. Areas of technology studied include: (1) control design methodology; (2) improved modeling and simulation methods; and (3) implementation technologies. Objectives, results and future thrusts are summarized.
Doctor, Henry V.; Olatunji, Alabi; Jumare, Abdul’Azeez
2012-01-01
Maternal and child health indicators are generally poor in Nigeria with the northern part of the country having the worst indicators than the southern part. Efforts to address maternal and health challenges in Nigeria include, among others, improvement in health and management information systems. We report on the experience of mobile phone technology in supporting the activities of a health and demographic surveillance system in northern Nigeria. Our experience calls for the need for the Nigerian Government, the mobile network companies, and the international community at large to consolidate their efforts in addressing the mobile network coverage and power supply challenges in order to create an enabling environment for socio-economic development particularly in rural and disadvantaged areas. Unless power and mobile network challenges are addressed, health interventions that rely on mobile phone technology will not have a significant impact in improving maternal and child health. PMID:23569650
DOE Office of Scientific and Technical Information (OSTI.GOV)
James S. Tulenko; Carl D. Crane
The University Research Program in Robotics (URPR) is an integrated group of universities performing fundamental research that addresses broad-based robotics and automation needs of the NNSA Directed Stockpile Work (DSW) and Campaigns. The URPR mission is to provide improved capabilities in robotics science and engineering to meet the future needs of all weapon systems and other associated NNSA/DOE activities.
Phosphorous-Containing Polymers for Regenerative Medicine
Watson, Brendan M.; Kasper, F. Kurtis; Mikos, Antonios G.
2014-01-01
Disease and injury have resulted in a large, unmet need for functional tissue replacements. Polymeric scaffolds can be used to deliver cells and bioactive signals to address this need for regenerating damaged tissue. Phosphorous-containing polymers have been implemented to improve and accelerate the formation of native tissue both by mimicking the native role of phosphorous groups in the body and by attachment of other bioactive molecules. This manuscript reviews the synthesis, properties, and performance of phosphorous-containing polymers that can be useful in regenerative medicine applications. PMID:24565855
ERIC Educational Resources Information Center
Riedel-Lester, Priscilla
Three modules address the objectives and services of the nutrition part of the health services component of the Head Start program. The planning of the nutrition services involves the following issues: (1) identifying the nutritional needs and problems of the children and the families; (2) meeting the daily nutritional needs of the children; (3)…
Process Improvement in a Radically Changing Organization
NASA Technical Reports Server (NTRS)
Varga, Denise M.; Wilson, Barbara M.
2007-01-01
This presentation describes how the NASA Glenn Research Center planned and implemented a process improvement effort in response to a radically changing environment. As a result of a presidential decision to redefine the Agency's mission, many ongoing projects were canceled and future workload would be awarded based on relevance to the Exploration Initiative. NASA imposed a new Procedural Requirements standard on all future software development, and the Center needed to redesign its processes from CMM Level 2 objectives to meet the new standard and position itself for CMMI. The intended audience for this presentation is systems/software developers and managers in a large, research-oriented organization that may need to respond to imposed standards while also pursuing CMMI Maturity Level goals. A set of internally developed tools will be presented, including an overall Process Improvement Action Item database, a formal inspection/peer review tool, metrics collection spreadsheet, and other related technologies. The Center also found a need to charter Technical Working Groups (TWGs) to address particular Process Areas. In addition, a Marketing TWG was needed to communicate the process changes to the development community, including an innovative web site portal.
Anderson, Lynda Lahti; Humphries, Kathy; McDermott, Suzanne; Marks, Beth; Sisarak, Jasmina; Larson, Sheryl
2015-01-01
Historically, people with intellectual and developmental disabilities (IDD) have experienced health disparities related to several factors including: a lack of access to high quality medical care, inadequate preparation of health care providers to meet their needs, the social determinants of health (e.g., poverty, race and gender), and the failure to include people with IDD in public health efforts and other prevention activities. Over the past decade, a greater effort has been made to both identify and begin to address myriad health disparities experienced by people with IDD through a variety of activities including programs that address health lifestyles and greater attention to the training of health care providers. Gaps in the literature include the lack of intervention trials, replications of successful approaches, and data that allow for better comparisons between people with IDD and without IDD living in the same communities. Implications for future research needed to reduce health disparities for people with IDD include: better monitoring and treatment for chronic conditions common in the general population that are also experienced by people with IDD, an enhanced understanding of how to promote health among those in the IDD population who are aging, addressing the health needs of people with IDD who are not part of the disability service system, developing a better understanding of how to include people with IDD in health and wellness programs, and improving methods for addressing the healthcare needs of members of this group in an efficient and cost-effective manner, either through better access to general medical care or specialized programs. PMID:24303825
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.
Indigenous Child Health in Brazil: The Evaluation of Impacts as a Human Rights Issue.
Coates, Anna R; Del Pino Marchito, Sandra; Vitoy, Bernardino
2016-06-01
Improving the health status of indigenous children is a long-standing challenge. Several United Nations committees have identified the health of indigenous peoples as a human rights concern. Addressing the health of indigenous children cannot be separated from their social, cultural, and historic contexts, and any related health program must offer culturally appropriate services and a community perspective broad enough to address the needs of children and the local worlds in which they live. Evaluations of programs must, therefore, address process as well as impacts. This paper assesses interventions addressing indigenous children's health in Brazil, ranging from those explicitly targeting indigenous children's health, such as the targeted immunization program for indigenous peoples, as well as more generalized programs, including a focus upon indigenous children, such as the Integrated Management of Childhood Illness. The paper discusses the tensions and complexities of ethnically targeted health interventions as well as the conceptual and methodological challenge of measuring the processes employed and their impact. The lessons learned, especially the need for countries to more systematically collect data and evaluate impacts using ethnicity as an analytical category, are drawn out with respect to ensuring human rights for all within health sector responses.
Indigenous Child Health in Brazil
del Pino Marchito, Sandra; Vitoy, Bernardino
2016-01-01
Abstract Improving the health status of indigenous children is a long-standing challenge. Several United Nations committees have identified the health of indigenous peoples as a human rights concern. Addressing the health of indigenous children cannot be separated from their social, cultural, and historic contexts, and any related health program must offer culturally appropriate services and a community perspective broad enough to address the needs of children and the local worlds in which they live. Evaluations of programs must, therefore, address process as well as impacts. This paper assesses interventions addressing indigenous children’s health in Brazil, ranging from those explicitly targeting indigenous children’s health, such as the targeted immunization program for indigenous peoples, as well as more generalized programs, including a focus upon indigenous children, such as the Integrated Management of Childhood Illness. The paper discusses the tensions and complexities of ethnically targeted health interventions as well as the conceptual and methodological challenge of measuring the processes employed and their impact. The lessons learned, especially the need for countries to more systematically collect data and evaluate impacts using ethnicity as an analytical category, are drawn out with respect to ensuring human rights for all within health sector responses. PMID:27781012
Primary care renewal: regional faculty development and organizational change.
Quirk, Mark E; Haley, Heather-Lyn; Hatem, David; Starr, Susan; Philbin, Mary
2005-03-01
Many reports, including the Future of Family Medicine, have called for change in primary care, but few have defined, implemented, and evaluated mechanisms to address such change. The regional, interdisciplinary Primary Care Renewal Project was designed to address problems in primary care practice and teaching related to practice management, compensation, increasing responsibility for teaching, and faculty development. Twelve northeastern US medical schools assembled a conference attended by teams of key stakeholders representing both clinical and educational missions. Teams developed and implemented an institutional plan to address identified needs. Outcome data was collected during, and for 1 year after, the conference. Findings demonstrate novel ways of improving learning experiences, coordinating and centralizing planning efforts, and addressing faculty needs. The magnitude of organizational change ranged from establishing new administrative units with significant institutional authority (eg, restructuring dean's office) to enhancing the strategic planning process and refining mission statements to reflect emphasis on primary care. A well-planned, regional interdisciplinary effort that fosters the development of concrete plans can be associated with significant change in medical education. A central theme emerged--that primary care medicine will survive only if institutions align their educational and clinical missions and foster system-wide change.
Sustainable Development Goals for Monitoring Action to Improve Global Health.
Cesario, Sandra K
2016-01-01
Women and children compose the largest segment of the more than 1 billion people worldwide who are unable to access needed health care services. To address this and other global health issues, the United Nations brought together world leaders to address growing health inequities, first by establishing the Millennium Development Goals in 2000 and more recently establishing Sustainable Development Goals, which are an intergovernmental set of 17 goals consisting of 169 targets with 304 indicators to measure compliance; they were designed to be applicable to all countries. Goal number 3, "Good Health and Well-Being: Ensure Heathy Lives and Promote Well-Being for All at All Ages," includes targets to improve the health of women and newborns. © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.
Frezza, E E; Girnys, R P; Silich, R J; Coppa, G F
2000-01-01
Cost containment and quality of care represent the most important objectives of all health care professionals. Because of its progressive growth over the past decade, ambulatory surgery has become an area where these 2 issues need to be addressed. The goal of this paper is to discuss the economic and quality of care challenges faced by hospitals as they strive to become competitive in the 21st century. The quality of care in ambulatory surgery has been improving because of multidisciplinary activities. Hospitals tend to hire the staff on the basis of their expertise in certain areas, and those personnel do not have to cover other hospital roles. Moreover, the hospital staff is able to seek information at any time from coworkers in other areas of specialty. Ambulatory surgery in a hospital offers advantages, such as multiple operating rooms, multiple skilled health care providers, and the ability to stay overnight if needed. The consolidation of supplies makes it easier to contract for a better price. Aggressive contract negotiations and implementation of cost-effective and cost-efficient strategies are the keys to success in the future. Quality improvement (QI) initiatives and quality of care (QC) indicators need to be developed to address various problems in the ambulatory surgery setting such as unnecessary admissions, inadequate staffing, efficient operating room (OR) utilization, quality of care, and assessment outcome. These initiatives should be addressed at regular meetings where opportunities to improve the ambulatory services are discussed. The number of ambulatory surgery procedures performed each year will continue to increase, although perhaps not at the rate we experienced in the past. Procedures that once were performed in an inpatient setting can now be accomplished on an outpatient basis or even in the physician's office. We will continue to see this shift of volume as technologic advancements and anesthetic agents allow more complex procedures to be performed on an outpatient basis.
Feasibility study of a family-focused intervention to improve outcomes for children with FASD.
Reid, Natasha; Dawe, Sharon; Harnett, Paul; Shelton, Doug; Hutton, Lauren; O'Callaghan, Frances
2017-08-01
Growing evidence shows that children with fetal alcohol spectrum disorder (FASD) can benefit from interventions, and specifically interventions focused on improving self-regulation. However, novel ways of improving outcomes for children with FASD need further investigation so that programs target not only the individual child but also the family context, which includes the parent-child relationship. The current study aimed to evaluate the feasibility of an adapted version of the Parents under Pressure (PuP) program that addresses self-regulatory processes, through improving the parent-child relationship and the use of mindfulness-based strategies for both children and parents. This was a mixed methods study. Feasibility was examined by evaluating recruitment, data collection/outcome measures, and intervention procedures. The study used a phenomenological approach to obtain qualitative information from caregivers and a single-case experimental design to evaluate the preliminary participant responses to the intervention. Two out of three families completed treatment. The recruitment and intervention procedures were found to be suitable for and acceptable to the families involved. Some concerns were identified regarding the outcome measures that would need to be addressed in future research. Quantitative and qualitative outcomes were positive. The results provide preliminary support for the feasibility of an adapted version of the PuP program. Thus, offering a potential multi-component option, that aims to improve self-regulatory skills for children with FASD, through focusing on improving the parent-child relationship and incorporating mindfulness-based techniques for both parents and children. Copyright © 2017 Elsevier Ltd. All rights reserved.
Pretorius, Leandri; Gibbs, Andrew; Crankshaw, Tamaryn; Willan, Samantha
2015-01-01
A growing number of young people (ages 10-24) are living with HIV (YPLWH) in sub-Saharan Africa (SSA). These YPLWH have particular needs and challenges related to their sexual and reproductive health and rights (SRHR). Contextual factors including gender inequalities, violence, stigma, and discrimination and lack of tailored services undermine YPLWH's SRHR. Understand the scope and impact of interventions targeting YPLWH to improve SRH-related outcomes in SSA. We undertook a review to synthesise evaluated interventions (qualitative, quantitative, or mixed methods) aimed at improving the SRH outcomes of YPLWH in SSA with outcomes based on a World Health Organization framework of comprehensive SRHR approaches for women living with HIV. Using inclusion criteria, only six interventions were identified. Interventions sought to improve a range of direct and indirect SRH outcomes, including sexual behaviour, adherence, disclosure, and mental health. Four overarching issues emerged: 1) all interventions were structured according to cognitive behavioural therapy theories of behaviour change - while showing promise they do not tackle the wider gender, social, and economic contexts that shape YPLWH's SRH; 2) 'significant others' were included in two of the interventions, but further work needs to consider how to leverage parental/guardian support appropriately; 3) interventions only accessed young people who were already linked to care, participants were likely to have better SRH outcomes than those potentially more vulnerable YPLWH; and 4) none of the interventions explored the sexuality of young people. There have been a limited number of evaluated interventions to strengthen SRH of YPLWH in SSA, and gaps exist in addressing the SRHR needs of YPLWH. Intervention approaches require greater scope and depth, including the need to address structural and contextual challenges.
New perspectives in ecosystem services science as instruments to understand environmental securities
Villa, Ferdinando; Voigt, Brian; Erickson, Jon D.
2014-01-01
As societal demand for food, water and other life-sustaining resources grows, the science of ecosystem services (ES) is seen as a promising tool to improve our understanding, and ultimately the management, of increasingly uncertain supplies of critical goods provided or supported by natural ecosystems. This promise, however, is tempered by a relatively primitive understanding of the complex systems supporting ES, which as a result are often quantified as static resources rather than as the dynamic expression of human–natural systems. This article attempts to pinpoint the minimum level of detail that ES science needs to achieve in order to usefully inform the debate on environmental securities, and discusses both the state of the art and recent methodological developments in ES in this light. We briefly review the field of ES accounting methods and list some desiderata that we deem necessary, reachable and relevant to address environmental securities through an improved science of ES. We then discuss a methodological innovation that, while only addressing these needs partially, can improve our understanding of ES dynamics in data-scarce situations. The methodology is illustrated and discussed through an application related to water security in the semi-arid landscape of the Great Ruaha river of Tanzania. PMID:24535393
Haines, Andy; Smith, Kirk R; Anderson, Dennis; Epstein, Paul R; McMichael, Anthony J; Roberts, Ian; Wilkinson, Paul; Woodcock, James; Woods, Jeremy
2007-10-06
The absence of reliable access to clean energy and the services it provides imposes a large disease burden on low-income populations and impedes prospects for development. Furthermore, current patterns of fossil-fuel use cause substantial ill-health from air pollution and occupational hazards. Impending climate change, mainly driven by energy use, now also threatens health. Policies to promote access to non-polluting and sustainable sources of energy have great potential both to improve public health and to mitigate (prevent) climate disruption. There are several technological options, policy levers, and economic instruments for sectors such as power generation, transport, agriculture, and the built environment. However, barriers to change include vested interests, political inertia, inability to take meaningful action, profound global inequalities, weak technology-transfer mechanisms, and knowledge gaps that must be addressed to transform global markets. The need for policies that prevent dangerous anthropogenic interference with the climate while addressing the energy needs of disadvantaged people is a central challenge of the current era. A comprehensive programme for clean energy should optimise mitigation and, simultaneously, adaption to climate change while maximising co-benefits for health--eg, through improved air, water, and food quality. Intersectoral research and concerted action, both nationally and internationally, will be required.
Assistive technology and home modification for people with neurovisual deficits.
Copolillo, Al; Ivanoff, Synneve Dahlin
2011-01-01
People with neurovisual deficits from acquired brain injuries and other neurological disabilities can benefit from the array of assistive technologies and home modifications available to the larger vision impairment population, especially when symptoms are mild and associated neurological conditions are few. Optics, proper lighting, and magnification to increase the perceived size of both objects and reading material and to improve contrast sensitivity have been shown to be beneficial. Innovative technologies, universally designed for safe independent living and community participation are gradually developing and show promise for addressing the needs of this population. This article highlights technologies that may be useful for people with neurovisual deficits and describes the evidence to support their training and use. The use of various types of eyewear to reduce falls; prisms and telescopic lenses to improve visual attention and minimize the impact of visual field deficits; and technologies to improve computer use, wayfinding, and home safety are discussed. While there remains substantial need for further research and development focusing on the needs of people with vision impairments from neurological conditions, practitioners can use technology with caution to improve functional outcomes.
Bailey, Jacqueline M; Hansen, Vibeke; Wye, Paula M; Wiggers, John H; Bartlem, Kate M; Bowman, Jennifer A
2018-03-27
People with a mental illness experience greater chronic disease morbidity and mortality, and associated reduced life expectancy, compared to those without such an illness. A higher prevalence of chronic disease risk behaviours (inadequate nutrition, inadequate physical activity, tobacco smoking, and harmful alcohol consumption) is experienced by this population. Family carers have the potential to support change in such behaviours among those they care for with a mental illness. This study aimed to explore family carers': 1) experiences in addressing the chronic disease risk behaviours of their family members; 2) existing barriers to addressing such behaviours; and 3) perceptions of potential strategies to assist them to provide risk behaviour change support. A qualitative study of four focus groups (n = 31), using a semi-structured interview schedule, was conducted with carers of people with a mental illness in New South Wales, Australia from January 2015 to February 2016. An inductive thematic analysis was employed to explore the experience of carers in addressing the chronic disease risk behaviours. Two main themes were identified in family carers' report of their experiences: firstly, that health behaviours were salient concerns for carers and that they were engaged in providing support, and secondly that they perceived a bidirectional relationship between health behaviours and mental well-being. Key barriers to addressing behaviours were: a need to attend to carers' own well-being; defensiveness on behalf of the family member; and not residing with their family member; with other behaviour-specific barriers also identified. Discussion around strategies which would assist carers in providing support for health risk behaviours identified a need for improved communication and collaboration between carers and health services accessed by their family members. Additional support from general and mental health services accessed by family members is desired to assist carers to address the barriers to providing behaviour change support. Carers have the potential to support and extend health service interventions aimed at improving the chronic disease risk behaviours of people with a mental illness but may require additional information, and collaboration from services. Further research is needed to explore these constructs in a large representative sample.
Ruxton, Carrie Helen
2016-01-01
This report summarises the proceedings of a conference organised by the Italian Association of Hospital Cardiologists. The aim was to consider the process by which dietary guidelines (DG) are developed and the quality of evidence underpinning these guidelines, as well as debating whether or not this has resulted in DG that are effective in terms of health improvement. Key points were a caution about false positives in research, the importance of holistic DG rather than single nutrient targets, the need for appropriate disease endpoints in studies and control of confounders, a plea for less reliance on observational studies which cannot address cause-and-effect relationships and a need to bear in mind unintended consequences. Options for improving the system and the quality of evidence were discussed.
Effective Usability Engineering in Healthcare: A Vision of Usable and Safer Healthcare IT.
Kushniruk, Andre; Senathirajah, Yalini; Borycki, Elizabeth
2017-01-01
Persistent problems with healthcare IT that is unusable and unsafe have been reported worldwide. In this paper we present our vision for deploying usability engineering in healthcare in a more substantive way in order to improve the current situation. The argument will be made that stronger and more substantial efforts need to be made to bring multiple usability engineering methods to bear on points in both system design and deployment (and not just as a one-time effort restricted to software product development). In addition, improved processes for ensuring the usability of commercial vendor-based systems being implemented in healthcare organizations need to be addressed. A discussion will also be provided on challenges and barriers that will need to be overcome to ensure that the heatlhcare IT that is released is both usable and safe.
Designing the Climate Observing System of the Future
NASA Astrophysics Data System (ADS)
Weatherhead, Elizabeth C.; Wielicki, Bruce A.; Ramaswamy, V.; Abbott, Mark; Ackerman, Thomas P.; Atlas, Robert; Brasseur, Guy; Bruhwiler, Lori; Busalacchi, Antonio J.; Butler, James H.; Clack, Christopher T. M.; Cooke, Roger; Cucurull, Lidia; Davis, Sean M.; English, Jason M.; Fahey, David W.; Fine, Steven S.; Lazo, Jeffrey K.; Liang, Shunlin; Loeb, Norman G.; Rignot, Eric; Soden, Brian; Stanitski, Diane; Stephens, Graeme; Tapley, Byron D.; Thompson, Anne M.; Trenberth, Kevin E.; Wuebbles, Donald
2018-01-01
Climate observations are needed to address a large range of important societal issues including sea level rise, droughts, floods, extreme heat events, food security, and freshwater availability in the coming decades. Past, targeted investments in specific climate questions have resulted in tremendous improvements in issues important to human health, security, and infrastructure. However, the current climate observing system was not planned in a comprehensive, focused manner required to adequately address the full range of climate needs. A potential approach to planning the observing system of the future is presented in this article. First, this article proposes that priority be given to the most critical needs as identified within the World Climate Research Program as Grand Challenges. These currently include seven important topics: melting ice and global consequences; clouds, circulation and climate sensitivity; carbon feedbacks in the climate system; understanding and predicting weather and climate extremes; water for the food baskets of the world; regional sea-level change and coastal impacts; and near-term climate prediction. For each Grand Challenge, observations are needed for long-term monitoring, process studies and forecasting capabilities. Second, objective evaluations of proposed observing systems, including satellites, ground-based and in situ observations as well as potentially new, unidentified observational approaches, can quantify the ability to address these climate priorities. And third, investments in effective climate observations will be economically important as they will offer a magnified return on investment that justifies a far greater development of observations to serve society's needs.
Russell, David; Oberlink, Mia R; Shah, Shivani; Evans, Lauren; Bassuk, Karen
To describe the design and participants of a program that employed health coaches and community health workers to address the social, health, and long-term disaster recovery needs of Rockaway residents roughly 2 years after Hurricane Sandy made landfall. Baseline and exit questionnaires, containing demographic, health, and health care utilization measures, were administered to participants at the start and end of the program. Enrollment and encounter information was captured in program administrative records. Descriptive statistics were used to summarize participant characteristics, personal goals, referrals to local organizations and agencies, and outcomes. Qualitative analyses were used to identify recurring themes in challenges faced by participants and barriers to health and wellness. The program served 732 community residents, of whom 455 (62%) completed baseline and exit questionnaires. Participants were directly and/or indirectly impacted by Hurricane Sandy through property damage, closures of health care facilities, limited employment opportunities, and trouble securing affordable housing. Furthermore, many participants faced considerable adversities and struggled to manage chronic health conditions. Personal goals set by participants included locating health care and other resources (44%), weight management and healthy eating (35%), and self-management of chronic conditions (24%). Health coaches and community health workers engaged participants an average of 4 times-providing counseling and referrals to local organizations and services, including medical and dental services (29%), city-issued identification cards (27%), and health insurance and other entitlements (23%). Comparisons of baseline and exit surveys indicated significant improvements in self-reported health, health care utilization, and confidence managing health issues. No significant improvement was observed in the use of preventive health care services. The program represents a model for engaging vulnerable populations and addressing social and economic barriers to health and wellness during the long-term disaster recovery phase. Health coaches and community health workers may be instrumental in helping to address the health and wellness needs of vulnerable residents living in disaster-affected areas.
Status and Needs of Power Electronics for Photovoltaic Inverters: Summary Document
NASA Astrophysics Data System (ADS)
West, R.; Mauch, K.; Qin, Y. C.; Mohan, N.; Bonn, R.
2002-05-01
Photovoltaic inverters are the most mature of any DER inverter, and their mean time to first failure (MTFF) is about five years. This is an unacceptable MTFF and will inhibit the rapid expansion of PV. With all DER technologies, (solar, wind, fuel cells, and microturbines) the inverter is still an immature product that will result in reliability problems in fielded systems. The increasing need for all of these technologies to have a reliable inverter provides a unique opportunity to address these needs with focused R&D development projects. The requirements for these inverters are so similar that modular designs with universal features are obviously the best solution for a 'next generation' inverter. A 'next generation' inverter will have improved performance, higher reliability, and improved profitability. Sandia National Laboratories has estimated that the development of a 'next generation' inverter could require approximately 20 man-years of work over an 18- to 24-month time frame, and that a government-industry partnership will greatly improve the chances of success.
Swanson, Jonathan O; Plotner, David; Franklin, Holly L; Swanson, David L; Lokomba Bolamba, Victor; Lokangaka, Adrien; Sayury Pineda, Irma; Figueroa, Lester; Garces, Ana; Muyodi, David; Esamai, Fabian; Kanaiza, Nancy; Mirza, Waseem; Naqvi, Farnaz; Saleem, Sarah; Mwenechanya, Musaku; Chiwila, Melody; Hamsumonde, Dorothy; McClure, Elizabeth M; Goldenberg, Robert L; Nathan, Robert O
2016-01-01
ABSTRACT High quality is important in medical imaging, yet in many geographic areas, highly skilled sonographers are in short supply. Advances in Internet capacity along with the development of reliable portable ultrasounds have created an opportunity to provide centralized remote quality assurance (QA) for ultrasound exams performed at rural sites worldwide. We sought to harness these advances by developing a web-based tool to facilitate QA activities for newly trained sonographers who were taking part in a cluster randomized trial investigating the role of limited obstetric ultrasound to improve pregnancy outcomes in 5 low- and middle-income countries. We were challenged by connectivity issues, by country-specific needs for website usability, and by the overall need for a high-throughput system. After systematically addressing these needs, the resulting QA website helped drive ultrasound quality improvement across all 5 countries. It now offers the potential for adoption by future ultrasound- or imaging-based global health initiatives. PMID:28031304
Point-of-care and point-of-procedure optical imaging technologies for primary care and global health
Boppart, Stephen A.; Richards-Kortum, Rebecca
2015-01-01
Leveraging advances in consumer electronics and wireless telecommunications, low-cost, portable optical imaging devices have the potential to improve screening and detection of disease at the point of care in primary health care settings in both low- and high-resource countries. Similarly, real-time optical imaging technologies can improve diagnosis and treatment at the point of procedure by circumventing the need for biopsy and analysis by expert pathologists, who are scarce in developing countries. Although many optical imaging technologies have been translated from bench to bedside, industry support is needed to commercialize and broadly disseminate these from the patient level to the population level to transform the standard of care. This review provides an overview of promising optical imaging technologies, the infrastructure needed to integrate them into widespread clinical use, and the challenges that must be addressed to harness the potential of these technologies to improve health care systems around the world. PMID:25210062
Boppart, Stephen A; Richards-Kortum, Rebecca
2014-09-10
Leveraging advances in consumer electronics and wireless telecommunications, low-cost, portable optical imaging devices have the potential to improve screening and detection of disease at the point of care in primary health care settings in both low- and high-resource countries. Similarly, real-time optical imaging technologies can improve diagnosis and treatment at the point of procedure by circumventing the need for biopsy and analysis by expert pathologists, who are scarce in developing countries. Although many optical imaging technologies have been translated from bench to bedside, industry support is needed to commercialize and broadly disseminate these from the patient level to the population level to transform the standard of care. This review provides an overview of promising optical imaging technologies, the infrastructure needed to integrate them into widespread clinical use, and the challenges that must be addressed to harness the potential of these technologies to improve health care systems around the world. Copyright © 2014, American Association for the Advancement of Science.
Foxon, Timothy J
2010-07-28
This paper addresses the probable levels of investment needed in new technologies for energy conversion and storage that are essential to address climate change, drawing on past evidence on the rate of cost improvements in energy technologies. A range of energy materials and technologies with lower carbon emissions over their life cycle are being developed, including fuel cells (FCs), hydrogen storage, batteries, supercapacitors, solar energy and nuclear power, and it is probable that most, if not all, of these technologies will be needed to mitigate climate change. High rates of innovation and deployment will be needed to meet targets such as the UK's goal of reducing its greenhouse gas emissions by 80 per cent by 2050, which will require significant levels of investment. Learning curves observed for reductions in unit costs of energy technologies, such as photovoltaics and FCs, can provide evidence on the probable future levels of investment needed. The paper concludes by making recommendations for policy measures to promote such investment from both the public and private sectors.
Nurse-physician communication - An integrated review.
Tan, Tit-Chai; Zhou, Huaqiong; Kelly, Michelle
2017-12-01
To present a comprehensive review of current evidence on the factors which impact on nurse-physician communication and interventions developed to improve nurse-physician communication. The challenges in nurse-physician communication persist since the term 'nurse-doctor game' was first used in 1967, leading to poor patient outcomes such as treatment delays and potential patient harm. Inconsistent evidence was found on the factors and interventions which foster or impair effective nurse-physician communication. An integrative review was conducted following a five-stage process: problem identification, literature search, data evaluation, data analysis and presentation. Five electronic databases were searched from 2005 to April 2016 using key search terms: "improve*," "nurse-physician," "nurse," "physician" and "communication" in five electronic databases including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PubMed, Science Direct and Scopus. A total of 22 studies were included in the review. Four themes emerged from the data synthesis, namely communication styles; factors that facilitate nurse-physician communication; barriers to effective nurse-physician communication; and interventions to improve nurse-physician communication. This integrative review suggests that nurse-physician communication still remains ineffective. Current interventions only address information needs of nurses and physicians in limited situations and specific settings but cannot adequately address the interprofessional communication skills that are lacking in practice. The disparate views of nurses and physicians on communication due to differing training backgrounds confound the effectiveness of current interventions or strategies. Cross-training and interprofessional educational from undergraduate to postgraduate programmes will better align the training of nurses and physicians to communicate effectively. Further research is needed to determine the feasibility and generalisability of interventions, such as localising physicians and using communication tools, to improve nurse-physician communication. Organisational and cultural changes are needed to overcome ingrained practices impeding nurse-physician communication. © 2017 John Wiley & Sons Ltd.
Addressing health literacy in patient decision aids
2013-01-01
Background Effective use of a patient decision aid (PtDA) can be affected by the user’s health literacy and the PtDA’s characteristics. Systematic reviews of the relevant literature can guide PtDA developers to attend to the health literacy needs of patients. The reviews reported here aimed to assess: 1. a) the effects of health literacy / numeracy on selected decision-making outcomes, and b) the effects of interventions designed to mitigate the influence of lower health literacy on decision-making outcomes, and 2. the extent to which existing PtDAs a) account for health literacy, and b) are tested in lower health literacy populations. Methods We reviewed literature for evidence relevant to these two aims. When high-quality systematic reviews existed, we summarized their evidence. When reviews were unavailable, we conducted our own systematic reviews. Results Aim 1: In an existing systematic review of PtDA trials, lower health literacy was associated with lower patient health knowledge (14 of 16 eligible studies). Fourteen studies reported practical design strategies to improve knowledge for lower health literacy patients. In our own systematic review, no studies reported on values clarity per se, but in 2 lower health literacy was related to higher decisional uncertainty and regret. Lower health literacy was associated with less desire for involvement in 3 studies, less question-asking in 2, and less patient-centered communication in 4 studies; its effects on other measures of patient involvement were mixed. Only one study assessed the effects of a health literacy intervention on outcomes; it showed that using video to improve the salience of health states reduced decisional uncertainty. Aim 2: In our review of 97 trials, only 3 PtDAs overtly addressed the needs of lower health literacy users. In 90% of trials, user health literacy and readability of the PtDA were not reported. However, increases in knowledge and informed choice were reported in those studies in which health literacy needs were addressed. Conclusion Lower health literacy affects key decision-making outcomes, but few existing PtDAs have addressed the needs of lower health literacy users. The specific effects of PtDAs designed to mitigate the influence of low health literacy are unknown. More attention to the needs of patients with lower health literacy is indicated, to ensure that PtDAs are appropriate for lower as well as higher health literacy patients. PMID:24624970
A Scoping Review to Address the Culture of Concussion in Youth and High School Sports.
Sarmiento, Kelly; Donnell, Zoe; Hoffman, Rosanne
2017-10-01
In 2013, the National Academy of Sciences emphasized the need to develop, implement, and evaluate effective large-scale educational strategies to improve the culture of concussion in youth and high school sports. In support of this recommendation, in this article we summarize research on factors that contribute to the culture of concussion. We conducted the literature search using 7 electronic databases. We used a scoping review method to identify studies that addressed knowledge, attitudes, behaviors, use of educational resources, and interventions related to concussion among young athletes, coaches, and parents. Of the 33 articles identified, most focused on concussion education (N = 15), followed by knowledge (N = 13), behaviors (N = 13), and attitudes (N = 5). Three studies addressed multiple study populations. The rapid spread of concussion education and awareness efforts has outpaced research on effective strategies to improve knowledge, attitudes, and behaviors that contribute to the culture of concussion. Further research is critical to inform the development and implementation of large-scale educational efforts. This research should incorporate rigorous study designs; be inclusive of diverse ages, socioeconomic status, and racial/ethnic groups; and examine opportunities to improve behavioral outcomes around concussion prevention, reporting, and management. © 2017, American School Health Association.
NASA Technical Reports Server (NTRS)
Stackouse, Paul W., Jr.; Renne, D.; Beyer, H.-G.; Wald, L.; Meyers, R.; Perez, R.; Suri, M.
2006-01-01
The GEOSS strategic plan specifically targets the area of improved energy resource management due to the importance of these to the economic and social viability of every nation of the world. With the world s increasing demand for energy resources, the need for new alternative energy resources grows. This paper overviews a new initiative within the International Energy Agency that addresses needs to better manage and develop solar energy resources worldwide. The goal is to provide the solar energy industry, the electricity sector, governments, and renewable energy organizations and institutions with the most suitable and accurate information of the solar radiation resources at the Earth's surface in easily-accessible formats and understandable quality metrics. The scope of solar resource assessment information includes historic data sets and currently derived data products using satellite imagery and other means. Thus, this new task will address the needs of the solar energy sector while at the same time will serve as a model that satisfies GEOSS objectives and goals.
Exploration Life Support Overview and Benefits
NASA Technical Reports Server (NTRS)
Chambliss, Joe P.
2007-01-01
NASA s Exploration Life Support (ELS) Project is providing technology development to address air, water and waste product handling for future exploration vehicles. Existing life support technology and processes need to improve to enable exploration vehicles to meet mission goals. The weight, volume, power and thermal control required, reliability, crew time and life cycle cost are the primary targets for ELS technology development improvements. An overview of the ELS technologies being developed leads into an evaluation of the benefits the ELS technology developments offer.
Global Tobacco Control: An integrated approach to global health policy
RUGER, JENNIFER PRAH
2014-01-01
Following the development discussion in the last volume on the ‘politics of health’, Jennifer Prah Ruger argues that the Framework Convention on Tobacco Control (FCTC) represents a shift in global health policy that recognizes the importance of addressing health needs on multiple fronts and integrating public policies into a comprehensive set of health improvement strategies. She argues that the FCTC provides a model for multifaceted approaches to health improvement that require simultaneous progress on various dimensions. PMID:25598648
High Energy Density Capacitors
DOE Office of Scientific and Technical Information (OSTI.GOV)
None
2010-07-01
BEEST Project: Recapping is developing a capacitor that could rival the energy storage potential and price of today’s best EV batteries. When power is needed, the capacitor rapidly releases its stored energy, similar to lightning being discharged from a cloud. Capacitors are an ideal substitute for batteries if their energy storage capacity can be improved. Recapping is addressing storage capacity by experimenting with the material that separates the positive and negative electrodes of its capacitors. These separators could significantly improve the energy density of electrochemical devices.
Better Tests, Better Care: Improved Diagnostics for Infectious Diseases
Caliendo, Angela M.; Gilbert, David N.; Ginocchio, Christine C.; Hanson, Kimberly E.; May, Larissa; Quinn, Thomas C.; Tenover, Fred C.; Alland, David; Blaschke, Anne J.; Bonomo, Robert A.; Carroll, Karen C.; Ferraro, Mary Jane; Hirschhorn, Lisa R.; Joseph, W. Patrick; Karchmer, Tobi; MacIntyre, Ann T.; Reller, L. Barth; Jackson, Audrey F.
2013-01-01
In this IDSA policy paper, we review the current diagnostic landscape, including unmet needs and emerging technologies, and assess the challenges to the development and clinical integration of improved tests. To fulfill the promise of emerging diagnostics, IDSA presents recommendations that address a host of identified barriers. Achieving these goals will require the engagement and coordination of a number of stakeholders, including Congress, funding and regulatory bodies, public health agencies, the diagnostics industry, healthcare systems, professional societies, and individual clinicians. PMID:24200831
Results from the first 4 years of pay for performance.
DeVore, Susan D
2010-01-01
Some of the lessons hospitals that have participated in the Hospital Quality Incentive Demonstration project have learned include: the need to tie in quality-of-care initiatives to the organization's strategic plan and to incentive plans for all employees, from executives on down; the value in allowing hospital physicians to "own" quality improvement initiatives; the importance of making results of the initiative available to all staff; the benefit of creating best-practice teams to address improvements in specific clinical areas.
Camp, Nadine L; Robert, Rebecca C; Nash, Jessica E; Lichtenstein, Cara B; Dawes, Candice S; Kelly, Katherine Patterson
2017-06-01
We designed a quality improvement (QI) project to address the high prevalence of childhood overweight and obesity (OW/OB) in our patient population and the inconsistencies among primary care providers in recognizing and addressing OW/OB. We used mixed methods data collection approach to evaluate a QI project, the Childhood Healthy Behaviors Intervention (CHBI), to improve provider obesity prevention practice in two low-income, predominantly African American pediatric primary care clinics. Electronic record data were extracted from all 2-9 year well visits pre- and postintervention for frequency of appropriate diagnostic coding of OW/OB. We reviewed a random sample of records for details of health habit assessment and counseling documentation. Focused interviews were conducted to elicit provider responses regarding impressions of the intervention. The preintervention sample of records (n = 267) was extracted from 18 providers and the postsample (n = 253) from 19 providers. Providers showed improvement in the recognition of OW/OB with appropriate diagnostic coding (52% pre, 68% post), improvement in assessment of health habits informed by the habit survey (0% pre, 76% post), improvement in counseling of healthy behaviors (86% pre, 92% post), and improvement in goal setting of healthy behaviors (12% pre, 70% post). Our findings suggest that implementing a time efficient primary care intervention with brief provider training can improve provider recognition of OW/OB, as well as improve provider behavior targeted at childhood obesity prevention. This project contributes needed QI evidence on interventions to prevent and address OW/OB in primary care settings and calls for further work to strengthen implementation in similar contexts.
Mazzocato, Pamela; Stenfors-Hayes, Terese; von Thiele Schwarz, Ulrica; Hasson, Henna; Nyström, Monica Elisabeth
2016-07-29
Kaizen, or continuous improvement, lies at the core of lean. Kaizen is implemented through practices that enable employees to propose ideas for improvement and solve problems. The aim of this study is to describe the types of issues and improvement suggestions that hospital employees feel empowered to address through kaizen practices in order to understand when and how kaizen is used in healthcare. We analysed 186 structured kaizen documents containing improvement suggestions that were produced by 165 employees at a Swedish hospital. Directed content analysis was used to categorise the suggestions into following categories: type of situation (proactive or reactive) triggering an action; type of process addressed (technical/administrative, support and clinical); complexity level (simple or complex); and type of outcomes aimed for (operational or sociotechnical). Compliance to the kaizen template was calculated. 72% of the improvement suggestions were reactions to a perceived problem. Support, technical and administrative, and primary clinical processes were involved in 47%, 38% and 16% of the suggestions, respectively. The majority of the kaizen documents addressed simple situations and focused on operational outcomes. The degree of compliance to the kaizen template was high for several items concerning the identification of problems and the proposed solutions, and low for items related to the test and implementation of solutions. There is a need to combine kaizen practices with improvement and innovation practices that help staff and managers to address complex issues, such as the improvement of clinical care processes. The limited focus on sociotechnical aspects and the partial compliance to kaizen templates may indicate a limited understanding of the entire kaizen process and of how it relates to the overall organisational goals. This in turn can hamper the sustainability of kaizen practices and results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Pregnant adolescents living with HIV: what we know, what we need to know, where we need to go.
Callahan, Tegan; Modi, Surbhi; Swanson, Jennifer; Ng'eno, Bernadette; Broyles, Laura N
2017-08-04
HIV-infected pregnant and breastfeeding adolescents are a particularly vulnerable group that require special attention and enhanced support to achieve optimal maternal and infant outcomes. The objective of this paper is to review published evidence about antenatal care (ANC) service delivery and outcomes for HIV-infected pregnant adolescents in low-income country settings, identify gaps in knowledge and programme services and highlight the way forward to improve clinical outcomes of this vulnerable group. Emerging data from programmes in sub-Saharan Africa highlight that HIV-infected pregnant adolescents have poorer prevention of mother-to-child HIV transmission (PMTCT) service outcomes, including lower PMTCT service uptake, compared to HIV-infected pregnant adults. In addition, the limited evidence available suggests that there may be higher rates of mother-to-child HIV transmission among infants of HIV-infected pregnant adolescents. While the reasons for the inferior outcomes among adolescents in ANC need to be further explored and addressed, there is sufficient evidence that immediate operational changes are needed to address the unique needs of this population. Such changes could include integration of adolescent-friendly services into PMTCT settings or targeting HIV-infected pregnant adolescents with enhanced retention and follow-up activities.
Is there a need for biomedical CBIR systems in clinical practice? Outcomes from a usability study
NASA Astrophysics Data System (ADS)
Antani, Sameer; Xue, Zhiyun; Long, L. Rodney; Bennett, Deborah; Ward, Sarah; Thoma, George R.
2011-03-01
Articles in the literature routinely describe advances in Content Based Image Retrieval (CBIR) and its potential for improving clinical practice, biomedical research and education. Several systems have been developed to address particular needs, however, surprisingly few are found to be in routine practical use. Our collaboration with the National Cancer Institute (NCI) has identified a need to develop tools to annotate and search a collection of over 100,000 cervigrams and related, anonymized patient data. One such tool developed for a projected need for retrieving similar patient images is the prototype CBIR system, called CervigramFinder, which retrieves images based on the visual similarity of particular regions on the cervix. In this article we report the outcomes from a usability study conducted at a primary meeting of practicing experts. We used the study to not only evaluate the system for software errors and ease of use, but also to explore its "user readiness", and to identify obstacles that hamper practical use of such systems, in general. Overall, the participants in the study found the technology interesting and bearing great potential; however, several challenges need to be addressed before the technology can be adopted.
Psychiatric Emergency Services for the U.S. Elderly: 2008 and Beyond
Walsh, Patrick G.; Currier, Glenn; Shah, Manish N.; Lyness, Jeffrey M.; Friedman, Bruce
2008-01-01
In 2011 the oldest baby boomers will turn age 65. Although healthcare researchers have started to examine the future preparedness of the healthcare system for the elderly, psychiatric emergency services (PES) have been widely overlooked. Research is needed to address PES need and demand by older patients, assess the consequences of this need/demand, and establish recommendations to guide PES planning and practice. The authors examined journal articles, review papers, textbooks, and electronic databases related to these topics. We outline the current PES environment in terms of facilities, characteristics, and visits, and discuss current geriatric patient PES use. Factors expected to impact future use are examined, including sociodemographic characteristics, psychiatric illness prevalence, cohort effects, medical comorbidity, mental healthcare resources and utilization, and stigma. Consequences of these on future psychiatric care and well-being of the elderly are then explored, specifically, greater acute services need, more suicide, strained delivery systems, increased hospitalization, and greater costs. The following are proposed to address likely future PES shortcomings: enhance service delivery, increase training, standardize and improve PES, prioritize finances, and promote research. The degree to which the geriatric mental healthcare “crisis” develops will be inversely related to the current system's response to predictable future needs. PMID:18757766
NASA Technical Reports Server (NTRS)
Yudkin, Howard
1988-01-01
The next generation of computer systems are studied by examining the processes and methodologies. The present generation is ok for small projects, but not so good for large projects. They are not good for addressing the iterative nature of requirements, resolution, and implementation. They do not address complexity issues of requirements stabilization. They do not explicitly address reuse opportunities, and they do not help with people shortages. Therefore, there is a need to define and automate improved software engineering processes. Some help may be gained by reuse and prototyping, which are two sides of the same coin. Reuse library parts are used to generate good approximations to desired solutions, i.e., prototypes. And rapid prototype composition implies use of preexistent parts, i.e., reusable parts.
Smallholders' perceptions of goat farming in southern Benin and opportunities for improvement.
Dossa, L H; Wollny, C; Gauly, M
2007-01-01
To be successful, initiatives to improve smallholder's goat production should directly address the needs and objectives of the keepers while promoting rational use of local genetic resources. This paper identifies the objectives, constraints and needs of goat farmers in southern Benin and discusses their relevance to the development of improvement programmes. Between November and December 2005, structured questionnaires, focus group discussions and participant observation were used to collect information from 38 goat farmers in two selected locations. Goats were kept mainly for sale whenever cash was needed. Traits related to reproduction, to behaviour, to health and to meat production were considered equally important and were ranked very highly by goat keepers. Increased net income per flock through increased number of marketable animals is the derived breeding objective from the trait analysis. Disease outbreaks resulting in high mortality, poor housing, and feed shortages were, in descending order, the most important problems. It was concluded that the development of initiatives to improve management practices is an overriding priority. It will lead to increases in productivity in the short term and foster farmers' participation in the development of long-term improvement strategies, which should include selection and controlled mating.
Population health and medicine: Policy and financial drivers.
Lavigne, Jill E; Brown, Jack; Matzke, Gary R
2017-09-15
The financial and policy levers of population health and potential opportunities for pharmacists are described. Three long-standing problems drive the focus on population health: (1) the United States suffers far worse population health outcomes compared with those of other developed nations that spend significantly less on healthcare, (2) the U.S. healthcare system's focus on "sick care" fails to address upstream prevention and population health improvement, and (3) financial incentives for healthcare delivery are poorly aligned with improvements in population health outcomes. The Patient Protection and Affordable Care Act of 2010 (ACA) was arguably the first major healthcare legislation since 1965 and had 3 main strategies for improving population health: expand health insurance coverage, control healthcare costs, and improve the healthcare delivery system. Federal and state legislation as well as Medicare and Medicaid financing strategies have designated mechanisms to reward advances in population outcomes since the passage of the ACA. States are responsible for many of the factors that affect population health, and a bipartisan effort that builds upon state and federal collaboration will likely be needed to implement the necessary health policy initiative. Population health issues affect productivity in the United States; conversely, improvements in population health may increase productivity, helping to offset the rising federal debt. Employers are in a position to improve population health and consequently help reduce the federal debt by addressing lifestyle, chronic disease, poverty, and inequality. National pharmacy organizations, regulatory bodies, and journal editors need to collectively agree to a threshold of quality and rigor for publication and endorsement. Knowledge of the policy and financial drivers of population health may both support pharmacists' efforts to improve population outcomes and identify opportunities for professional advancement. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.
Educator perspectives on the postsecondary transition difficulties of students with autism.
Elias, Rebecca; Muskett, Ashley E; White, Susan W
2017-10-01
Addressing the challenges of adolescents and emerging adults with autism spectrum disorder is crucial to improving the outcomes of these students in the postsecondary setting. Although secondary and postsecondary educators and staff are critical to helping these students access services, there has been little investigation into the perspectives of this stakeholder group, with respect to the needs of postsecondary students with autism spectrum disorder. A series of focus groups was conducted with secondary and postsecondary educators to understand educator perspectives related to the challenges faced by postsecondary students with autism spectrum disorder. Competence, autonomy and independence, and the development and sustainment of interpersonal relationships emerged as primary areas of difficulty and corresponding need. Results suggest that targeted interventions addressing these areas should be implemented, prior to and during enrollment in a postsecondary setting, to facilitate transition in a comprehensive manner.
Aidala, Angela A; Cavaliere, Brittney; Cinnick, Samantha
2018-06-07
A key component of the improvement of public health infrastructure in the United States revolves around public health workforce development and training. Workforce challenges faced by the public health system have long been recognized, but there are additional challenges facing any region-wide or cross-jurisdictional effort to accurately assess priority workforce training needs and develop training resources to address those needs. These challenges include structural variability of public health organizations; diverse population health contexts; capturing both topic-specific skill sets and foundational competencies among public health workers; and reaching/representing the target population despite suspicion, disinterest, and/or assessment "fatigue" among employees asked to participate in workforce development surveys. The purpose of this article is to describe the challenges, strategies to meet those challenges, and lessons learned conducting public health workforce training needs assessments by academic and practice partners of the Region 2 Public Health Training Center (R2/PHTC). The R2/PHTC is hosted by the Mailman School of Public Health at Columbia University and serves New York, New Jersey, Puerto Rico, and the US Virgin Islands within its jurisdiction. Strategies for responding to diverse organizational structures and population health contexts across the region; defining training priorities that address both foundational competencies for public health professionals and content-specific training to address local public health needs; reaching/representing target populations of public health workers; and analysis and report writing to encourage rapid response to identified needs and comprehensive workforce development planning are discussed. Lessons learned are likely instructive to other workforce training needs assessments in complex and ever-changing public health environments.
Human resources management for a hospital pharmacy department.
Chase, P A
1989-06-01
The concepts of human resources management (HRM) are presented, and the application of HRM concepts to a hospital pharmacy department is described. Low salaries and poor working conditions had precipitated a mass exodus of pharmacists from a 650-bed, tertiary-care medical center. The newly hired director of pharmacy sought to rebuild the department by developing a three-stage HRM model consisting of needs forecasting, performance management, and advanced management systems. In the needs-forecasting stage, the strengths and weaknesses of departmental programs were determined through analysis of existing standards of practice, situational analysis, and financial analyses; the strengths and weaknesses of departmental employees were determined through the use of talent inventories, turnover analysis, analysis of time and leave records, reevaluation of the department's job classifications, performance and productivity evaluations, and productivity evaluations, and development of a philosophy of practice and mission statement. Needs and problems were addressed by examining each existing program and developing new policies and procedures, performance standards, quality assurance mechanisms, and productivity expectations. Personnel needs and problems were addressed by designing a system of differentiated career ladders, contracting with pharmacists for career moves, developing the skills of currently employed pharmacists, and implementing a succession planning model. The model has been in place for approximately three years and is beginning to yield the desired results. Application of HRM concepts to a hospital pharmacy department appears to have been successful in improving employee morale and in helping the department to meet goals of expanded and improved services.
Jones, James W; Antle, John M; Basso, Bruno; Boote, Kenneth J; Conant, Richard T; Foster, Ian; Godfray, H Charles J; Herrero, Mario; Howitt, Richard E; Janssen, Sander; Keating, Brian A; Munoz-Carpena, Rafael; Porter, Cheryl H; Rosenzweig, Cynthia; Wheeler, Tim R
2017-07-01
We review the current state of agricultural systems science, focusing in particular on the capabilities and limitations of agricultural systems models. We discuss the state of models relative to five different Use Cases spanning field, farm, landscape, regional, and global spatial scales and engaging questions in past, current, and future time periods. Contributions from multiple disciplines have made major advances relevant to a wide range of agricultural system model applications at various spatial and temporal scales. Although current agricultural systems models have features that are needed for the Use Cases, we found that all of them have limitations and need to be improved. We identified common limitations across all Use Cases, namely 1) a scarcity of data for developing, evaluating, and applying agricultural system models and 2) inadequate knowledge systems that effectively communicate model results to society. We argue that these limitations are greater obstacles to progress than gaps in conceptual theory or available methods for using system models. New initiatives on open data show promise for addressing the data problem, but there also needs to be a cultural change among agricultural researchers to ensure that data for addressing the range of Use Cases are available for future model improvements and applications. We conclude that multiple platforms and multiple models are needed for model applications for different purposes. The Use Cases provide a useful framework for considering capabilities and limitations of existing models and data.
NASA Technical Reports Server (NTRS)
Jones, James W.; Antle, John M.; Basso, Bruno; Boote, Kenneth J.; Conant, Richard T.; Foster, Ian; Godfray, H. Charles J.; Herrero, Mario; Howitt, Richard E.; Janssen, Sander;
2016-01-01
We review the current state of agricultural systems science, focusing in particular on the capabilities and limitations of agricultural systems models. We discuss the state of models relative to five different Use Cases spanning field, farm, landscape, regional, and global spatial scales and engaging questions in past, current, and future time periods. Contributions from multiple disciplines have made major advances relevant to a wide range of agricultural system model applications at various spatial and temporal scales. Although current agricultural systems models have features that are needed for the Use Cases, we found that all of them have limitations and need to be improved. We identified common limitations across all Use Cases, namely 1) a scarcity of data for developing, evaluating, and applying agricultural system models and 2) inadequate knowledge systems that effectively communicate model results to society. We argue that these limitations are greater obstacles to progress than gaps in conceptual theory or available methods for using system models. New initiatives on open data show promise for addressing the data problem, but there also needs to be a cultural change among agricultural researchers to ensure that data for addressing the range of Use Cases are available for future model improvements and applications. We conclude that multiple platforms and multiple models are needed for model applications for different purposes. The Use Cases provide a useful framework for considering capabilities and limitations of existing models and data.
ERIC Educational Resources Information Center
Lim, Cheolil; Song, Hae-Deok; Lee, Yekyung
2012-01-01
Usability is critical to the development of a user-friendly digital textbook platform interface, yet thorough research on interface development based on usability principles is in short supply. This study addresses that need by looking at usability attributes and corresponding design elements from a learning perspective. The researchers used a…
New York City's Strategy for Improving High Schools: An Overview
ERIC Educational Resources Information Center
Alliance for Excellent Education, 2010
2010-01-01
As the nation has embraced the need to graduate every student ready for college and careers, high school reform has emerged at the top of the education agenda. Many local and state leaders are implementing strategies to address low performance and close achievement gaps. As federal policymakers look ahead to opportunities to support this…
ERIC Educational Resources Information Center
Woodrow Wilson National Fellowship Foundation, 2016
2016-01-01
The W. K. Kellogg Foundation's Woodrow Wilson Michigan Teaching Fellowship successfully addressed the challenge of preparing and supporting effective teachers for Michigan's high-need classrooms, while helping transform teacher education across the state for the long term. This report analyzes the efforts of the W. K. Kellogg Foundation's Woodrow…
Cycle-Based Budgeting and Continuous Improvement at Jefferson County Public Schools: Year 1 Report
ERIC Educational Resources Information Center
Yan, Bo
2016-01-01
This report documents the first-year of implementing Cycle-based Budgeting at Jefferson County Public Schools (Louisville, KY). To address the limitations of incremental budgeting and zero-based budgeting, a Cycle-based Budgeting model was developed and implemented in JCPS. Specifically, each new program needs to submit an on-line budget request…
ERIC Educational Resources Information Center
Williams, Christine L.; Molinari, Victor; Bond, Jennifer; Smith, Michael; Hyer, Kathryn; Malphurs, Julie
2006-01-01
There is increasing recognition of the severe consequences of depression in long-term care residents with dementia. Most health care providers are unprepared to recognize and to manage the complexity of depression in dementia. Targeted educational initiatives in nursing homes are needed to address this growing problem. This paper describes the…
ERIC Educational Resources Information Center
Becker, Mallory K.
2011-01-01
Teachers need practices that can be implemented in the classroom to teach children how to address conflict and solve problems proactively. There are curricula available for teachers to use in promoting improvement in the social behavior of students and for further enhancing their ability to self-regulate their behavior (Smith, Lochman, &…
Increasing the Vocabulary Acquisition Rate for Third Grade English Language Learners
ERIC Educational Resources Information Center
Pendergrass, Jennifer D.
2017-01-01
Given the ongoing demographic transformations of U.S classrooms, knowledge of the strategies teachers use to address the vocabulary needs of English language learners (ELLs) is central for improving student outcomes. The problem in a Georgia school system was that ELLs were not building grade-level appropriate vocabulary at a pace comparable to…
Teacher Renewal. Professional Issues, Personal Choices.
ERIC Educational Resources Information Center
Bolin, Frances S., Ed.; Falk, Judith McConnell, Ed.
The 16 essays in this book assesss the problems inherent in the role of the teacher and offer perspectives on issues affecting life in the classroom. The three chapters in part one, "The Teacher and Teaching as a Vocation," are addressed to improving the teacher by attending to the inner needs of the individual. Teachers are seen as persons in…
Effects of Explicit Vocabulary Videos Delivered through iPods on Students with Language Impairments
ERIC Educational Resources Information Center
Lowman, J. Joneen; Dressler, Emily V.
2016-01-01
Poor word learning is a hallmark characteristic of students with specific language impairment (SLI). Explicit vocabulary instruction has shown to positively improve word learning in this population. Mobile technology has many advantages making it conducive for addressing the word learning needs of students with SLI. The current study utilized a…
Critical voids in exposure data and models lead risk assessors to rely on conservative assumptions. Risk assessors and managers need improved tools beyond the screening level analysis to address aggregate exposures to pesticides as required by the Food Quality Protection Act o...
Recent increases in anthropogenic inputs of nitrogen to air, land and water media pose a growing threat to human health and ecosystems. Modeling of air-surface N flux is one area in need of improvement. Implementation of a linked air quality and cropland management system is de...
ERIC Educational Resources Information Center
de Armas, Maria P.
To improve conditions at a nonprofit day care center serving low-income, mainly non-English-speaking families, this practicum addressed the need of recently immigrated parents to increase their knowledge of child development and available community resources. A total of 52 Hispanic parents were given materials at an information distribution area…