Sample records for barrier issues external
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Derose, Kathryn Pitkin; Werber, Laura; Palar, Kartika; Kanouse, David E.; Mata, Michael
2013-01-01
This paper examines facilitators and barriers to HIV activities within religious congregations, the relative internal or external sources of these influences, and suggestive differences across congregational types. Results are based on in-depth interviews with clergy and lay leaders (n = 57) from 14 congregations in Los Angeles County, California, purposively selected to reflect diversity in racial-ethnic composition, denomination, size, and HIV activity level. Many common facilitators and barriers were related to norms and attitudes, only a few of which appeared overtly associated with theological orientations. Clergy support was a facilitator particularly prevalent among congregations having higher HIV activity levels, indicating its importance in sustaining and expanding HIV programs. Resource issues were also prominent, with material resource barriers more frequently mentioned by smaller congregations and human resource barriers more among larger congregations. Organizational structure issues were mostly centered on external linkages with various social service, public health, and faith-based entities. Analysis of internal versus external sources highlights the roles of different stakeholders within and outside congregations in promoting HIV activities. Potential differences across congregational types represent fruitful areas for future research. PMID:23990037
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Barriers to blood glucose monitoring in a multiethnic community.
Zgibor, Janice C; Simmons, David
2002-10-01
We studied a multiethnic community to determine factors associated with blood glucose monitoring (BGM) and to determine the independent association between barriers to diabetes care and BGM. A total of 323 participants (35.6% European, 32.2% Maori, and 32.2% Pacific Islander) from the South Auckland Diabetes Project (free of major complications by self-report) completed a qualitative survey to determine barriers to diabetes care. Five barriers to diabetes care categories were generated including internal psychological (self efficacy/health beliefs), external psychological (psychosocial environment), internal physical (comorbidities/side effects of treatment), external physical (finance/access to care), and educational (knowledge of diabetes/services) barriers. Characteristics associated with BGM greater than or equal to twice weekly were female sex, HbA(1c) >8%, higher diabetes knowledge scores, and insulin use. Multivariate analyses demonstrated that those reporting external physical barriers (OR 0.47, 95% CI 0.26-0.84), external psychological barriers (0.55, 0.30-1.0), and internal psychological barriers (0.56, 0.32-1.0) were less likely to perform BGM independent of ethnicity, insulin use, age, sex, diabetes knowledge, and glycemic control. Further multivariate analyses demonstrated that those reporting external physical barriers, particularly related to personal finance, were less likely to perform BGM. These data demonstrate that patient-reported barriers to diabetes care are associated with BGM, particularly in relation to financial, psychosocial, and self-efficacy issues. Understanding these barriers and overcoming them within the context of the patient's ethnic environment may lead to increased participation in self-care.
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Notes from the Margins: Integrating Lesbian Experience into the Vocational Psychology of Women.
ERIC Educational Resources Information Center
Fassinger, Ruth E.
1996-01-01
Explores internal and external barriers to women's career choice, implementation, and adjustment, especially how such barriers function for lesbians. Examines issues related to coming out, workplace discrimination, and the home-work interface. (SK)
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Denhart, Hazel
2008-01-01
This phenomenological study investigated barriers to higher education faced by 11 college students labeled with learning disabilities (LD) using their voice as the primary data. Data were analyzed and interpreted through a disability theory perspective revealing barriers stemmed largely from external social causes rather than individual pathology. Barriers included being misunderstood by faculty, being reluctant to request accommodations for fear of invoking stigma, and having to work considerably longer hours than nonlabeled peers. Findings indicated barriers could be overcome through raising faculty awareness about LD issues, engaging the assistance of the college LD specialist, and participation in a LD democratic empowerment community on campus.
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Untapped ethical resources for neurodegeneration research
2011-01-01
Background The research community has a mandate to discover effective treatments for neurodegenerative disorders. The ethics landscape surrounding this mandate is in a constant state of flux, and ongoing challenges place ever greater demands on investigators to be accountable to the public and to answer questions about the implications of their work for health care, society, and policy. Methods We surveyed US-based investigators involved in neurodegenerative diseases research about how they value ethics-related issues, what motivates them to give consideration to those issues, and the barriers to doing so. Using the NIH CRISP database we identified 1,034 researchers with relevant, active grants and invited them to complete an online questionnaire. We received 193 responses. We used exploratory factor analysis to transform individual survey questions into a smaller set of factors, and linear regression to understand the effect of key variables of interest on the factor scores. Results Ethics-related issues clustered into two groups: research ethics and external influences. Heads of research groups viewed issues of research ethics to be more important than the other respondents. Concern about external influences was related to overall interest in ethics. Motivators clustered into five groups: ensuring public understanding, external forces, requirements, values, and press and public. Heads of research groups were more motivated to ensure public understanding of research than the other respondents. Barriers clustered into four groups: lack of resources, administrative burden, relevance to the research, and lack of interest. Perceived lack of ethics resources was a particular barrier for investigators working in drug discovery. Conclusions The data suggest that senior level neuroscientists working in the field of neurodegeneration (ND), and drug discovery specifically, are motivated to consider ethics issues related to their work, but the perceived lack of ethics resources thwarts their efforts. With bioethics centres at more than 50% of the institutions at which these respondents reside, the neuroscience and bioethics communities appear to be disconnected. Dedicated ethical, legal and social implications (ELSI) programs, such as those fully integrated into genetics and regenerative medicine, provide models for achieving meaningful partnerships not yet adequately realized for scholars and trainees interested in drug discovery for ND. PMID:21635769
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Governance and sustainability at a municipal scale: the challenge of water conservation.
Furlong, Kathryn; Bakker, Karen
2011-01-01
Municipal water conservation is increasingly promoted as a key dimension of environmental sustainability at the municipal scale. Progress toward municipal water conservation in Canada has, however, been poor. This paper examines the governance dimension of water conservation, and presents evidence in support of the argument that conservation efforts on the part of water utilities (and sometimes municipalities) are often constrained by factors external to their jurisdiction. To explore these issues, this paper presents a case study of municipal water conservation in Canada. The analysis identifies governance-related barriers to water conservation and explores the relationship between these barriers and broader issues stemming from the multi-scalar, fragmented nature of environmental governance in Canada.
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Third Mission Activities: University Managers' Perceptions on Existing Barriers
ERIC Educational Resources Information Center
Koryakina, Tatyana; Sarrico, Cláudia S.; Teixeira, Pedro N.
2015-01-01
In the context of increased international competition and financial austerity, an economic development mission has become an important strategic and policy issue for European higher education. This paper aims to contribute to knowledge regarding universities' engagement with the external environment and its impact on internal governance and…
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Bhattarai, Y
2018-06-01
The gastrointestinal barrier and the blood brain barrier represent an important line of defense to protect the underlying structures against harmful external stimuli. These host barriers are composed of epithelial and endothelial cells interconnected by tight junction proteins along with several other supporting structures. Disruption in host barrier structures has therefore been implicated in various diseases of the gastrointestinal tract and the central nervous system. While there are several factors that influence host barrier, recently there is an increasing appreciation of the role of gut microbiota and their metabolites in regulating barrier integrity. In the current issue of Neurogastroenterology and Motility, Marungruang et al. describe the effect of gastrointestinal barrier maturation on gut microbiota and the blood brain barrier adding to the growing evidence of microbiota-barrier interactions. In this mini-review I will discuss the effect of gut microbiota on host epithelial barriers and its implications for diseases associated with disrupted gut-brain axis. © 2018 John Wiley & Sons Ltd.
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Introduction for the special issue on recent advances in drug delivery across tissue barriers.
Mrsny, Randall J; Brayden, David J
2016-01-01
This special issue of Tissue Barriers contains a series of reviews with the common theme of how biological barriers established at epithelial tissues limit the uptake of macromolecular therapeutics. By improving our functional understanding of these barriers, the majority of the authors have highlighted potential strategies that might be applied to the non-invasive delivery of biopharmaceuticals that would otherwise require an injection format for administration. Half of the articles focus on the potential of particular technologies to assist oral delivery of peptides, proteins and other macromolecules. These include use of prodrug chemistry to improve molecule stability and permeability, and the related potential for oral delivery of poorly permeable agents by cell-penetrating peptides and dendrimers. Safety aspects of intestinal permeation enhancers are discussed, along with the more recent foray into drug-device combinations as represented by intestinal microneedles and externally-applied ultrasound. Other articles highlight the crossover between food research and oral delivery based on nanoparticle technology, while the final one provides a fascinating interpretation of the physiological problems associated with subcutaneous insulin delivery and how inefficient it is at targeting the liver.
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External Barriers Experienced by Gifted and Talented Girls and Women.
ERIC Educational Resources Information Center
Reis, Sally M.
2001-01-01
This article discusses current statistics about women and work and external barriers to achievement. Barriers include parental influences, media stereotypes, stereotyping in school, sexism in colleges and universities, and the burden of responsibilities females shoulder at home. Recommendations to help gifted girls address external barriers are…
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Smith, Christopher M; Lim Choi Keung, Sarah N; Khan, Mohammed O; Arvanitis, Theodoros N; Fothergill, Rachael; Hartley-Sharpe, Christopher; Wilson, Mark H; Perkins, Gavin D
2017-10-01
Public access defibrillation initiatives make automated external defibrillators available to the public. This facilitates earlier defibrillation of out-of-hospital cardiac arrest victims and could save many lives. It is currently only used for a minority of cases. The aim of this systematic review was to identify barriers and facilitators to public access defibrillation. A comprehensive literature review was undertaken defining formal search terms for a systematic review of the literature in March 2017. Studies were included if they considered reasons affecting the likelihood of public access defibrillation and presented original data. An electronic search strategy was devised searching MEDLINE and EMBASE, supplemented by bibliography and related-article searches. Given the low-quality and observational nature of the majority of articles, a narrative review was performed. Sixty-four articles were identified in the initial literature search. An additional four unique articles were identified from the electronic search strategies. The following themes were identified related to public access defibrillation: knowledge and awareness; willingness to use; acquisition and maintenance; availability and accessibility; training issues; registration and regulation; medicolegal issues; emergency medical services dispatch-assisted use of automated external defibrillators; automated external defibrillator-locator systems; demographic factors; other behavioural factors. In conclusion, several barriers and facilitators to public access defibrillation deployment were identified. However, the evidence is of very low quality and there is not enough information to inform changes in practice. This is an area in urgent need of further high-quality research if public access defibrillation is to be increased and more lives saved. PROSPERO registration number CRD42016035543. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.
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Barriers to Effective Municipal Solid Waste Management in a Rapidly Urbanizing Area in Thailand.
Yukalang, Nachalida; Clarke, Beverley; Ross, Kirstin
2017-09-04
This study focused on determining the barriers to effective municipal solid waste management (MSWM) in a rapidly urbanizing area in Thailand. The Tha Khon Yang Subdistrict Municipality is a representative example of many local governments in Thailand that have been facing MSWM issues. In-depth interviews with individuals and focus groups were conducted with key informants including the municipality staff, residents, and external organizations. The major influences affecting waste management were categorized into six areas: social-cultural, technical, financial, organizational, and legal-political barriers and population growth. SWOT analysis shows both internal and external factors are playing a role in MSWM: There is good policy and a reasonably sufficient budget. However, there is insufficient infrastructure, weak strategic planning, registration, staff capacity, information systems, engagement with programs; and unorganized waste management and fee collection systems. The location of flood prone areas has impacted on location and operation of landfill sites. There is also poor communication between the municipality and residents and a lack of participation in waste separation programs. However, external support from government and the nearby university could provide opportunities to improve the situation. These findings will help inform municipal decision makers, leading to better municipal solid waste management in newly urbanized areas.
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Barriers to Effective Municipal Solid Waste Management in a Rapidly Urbanizing Area in Thailand
Yukalang, Nachalida; Clarke, Beverley
2017-01-01
This study focused on determining the barriers to effective municipal solid waste management (MSWM) in a rapidly urbanizing area in Thailand. The Tha Khon Yang Subdistrict Municipality is a representative example of many local governments in Thailand that have been facing MSWM issues. In-depth interviews with individuals and focus groups were conducted with key informants including the municipality staff, residents, and external organizations. The major influences affecting waste management were categorized into six areas: social-cultural, technical, financial, organizational, and legal-political barriers and population growth. SWOT analysis shows both internal and external factors are playing a role in MSWM: There is good policy and a reasonably sufficient budget. However, there is insufficient infrastructure, weak strategic planning, registration, staff capacity, information systems, engagement with programs; and unorganized waste management and fee collection systems. The location of flood prone areas has impacted on location and operation of landfill sites. There is also poor communication between the municipality and residents and a lack of participation in waste separation programs. However, external support from government and the nearby university could provide opportunities to improve the situation. These findings will help inform municipal decision makers, leading to better municipal solid waste management in newly urbanized areas. PMID:28869572
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Wibowo, Yosi; Sunderland, Bruce; Hughes, Jeffery
2016-05-01
To explore perspectives of physicians and pharmacists on diabetes service delivery within community pharmacies in Indonesia. In depth interviews were conducted with 10 physicians and 10 community pharmacists in Surabaya, Indonesia, using a semi-structured interview guide. Nvivo version 9 was used to facilitate thematic content analysis to identify barriers/facilitators for community pharmacists to provide diabetes services. The identified themes indicating barriers/facilitators for diabetes service delivery within Indonesian community pharmacies included: (1) pharmacist factors - i.e. positive views (facilitator) and perceived lack of competence (barrier); (2) pharmacist-physician relationships - i.e. physicians' lack of support and accessibility (barriers); (3) pharmacist-patient relationships - i.e. perceived patients' lack of support and accessibility (barriers); (4) pharmacy environment - i.e. business orientation (barrier), lack of staff and poor pharmacist availability (barriers), and availability of supporting resources, such as counselling areas/rooms, procedures/protocols and IT systems for labelling and patient records (facilitators); and (5) external environment - i.e. a health system to support pharmacist roles, remuneration, marketing and professional assistance (facilitators). Issues related to the pharmacist-physician-patient relationships, pharmacy environment and external environment need to be addressed before Indonesian community pharmacists can provide additional pharmacy services for type 2 diabetes patients. Collaboration between the Government, Ikatan Apoteker Indonesia (Indonesian Pharmacists Association) and Ikatan Dokter Indonesia (Indonesian Medical Association) is required to improve the pharmacy professional environment and facilities. © 2015 Royal Pharmaceutical Society.
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Efficacy of Tantalum Tungsten Alloys for Diffusion Barrier Applications
NASA Astrophysics Data System (ADS)
Smathers, D. B.; Aimone, P. R.
2017-12-01
Traditionally either Niobium, Tantalum or a combination of both have been used as diffusion barriers in Nb3Sn Multi-filament wire. Vanadium has also been used successfully but the ultimate RRR of the copper is limited unless an external shell of Niobium is included. Niobium is preferred over Tantalum when alternating current losses are not an issue as the Niobium will react to form Nb3Sn. Pure Tantalum tends to deform irregularly requiring extra starting thickness to ensure good barrier qualities. Our evaluations showed Tantalum lightly alloyed with 3 wt% Tungsten is compatible with the wire drawing process while deforming as well as or better than pure Niobium. Ta3wt%W has been processed as a single barrier and as a distributed barrier to fine dimensions. In addition, the higher modulus and strength of the Tantalum Tungsten alloy improves the overall tensile properties of the wire.
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Coleman, Brandon G; Johnson, Thomas M; Erley, Kenneth J; Topolski, Richard; Rethman, Michael; Lancaster, Douglas D
2016-10-01
In recent years, evidence-based dentistry has become the ideal for research, academia, and clinical practice. However, barriers to implementation are many, including the complexity of interpreting conflicting evidence as well as difficulties in accessing it. Furthermore, many proponents of evidence-based care seem to assume that good evidence consistently exists and that clinicians can and will objectively evaluate data so as to apply the best evidence to individual patients' needs. The authors argue that these shortcomings may mislead many clinicians and that students should be adequately prepared to cope with some of the more complex issues surrounding evidence-based practice. Cognitive biases and heuristics shape every aspect of our lives, including our professional behavior. This article reviews literature from medicine, psychology, and behavioral economics to explore the barriers to implementing evidence-based dentistry. Internal factors include biases that affect clinical decision making: hindsight bias, optimism bias, survivor bias, and blind-spot bias. External factors include publication bias, corporate bias, and lack of transparency that may skew the available evidence in the peer-reviewed literature. Raising awareness of how these biases exert subtle influence on decision making and patient care can lead to a more nuanced discussion of addressing and overcoming barriers to evidence-based practice.
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Perry, Rebecca Anne; Daniels, Lynne Anne; Bell, Lucinda; Magarey, Anthea Margaret
2017-01-01
To describe the qualitative research methods used in the Parenting Eating and Activity for Child Health (PEACH) randomized controlled trial and to examine parent-reported facilitators and barriers to the achievement of program goals. Qualitative study using semistructured interviews. Parents enrolled in the Australian PEACH randomized controlled trial, a family-focused child weight management program conducted blinded for review. A total of 95 parents of overweight children aged 5-10 years participated in face-to-face semistructured interviews. Factors external to the PEACH intervention that facilitated or inhibited their success. Interviews were recorded, transcribed, and analyzed using thematic analysis techniques. Three facilitator themes were identified: (1) internal locus of parental control, (2) external locus of parental control, and (3) child factors. Six barrier themes were identified: (1) internal locus of parental control, (2) external locus of parental control, and (3) child factors; (4) maintenance and managing special occasions; (5) time management challenges; and (6) inconsistencies or lack of support. The social and environmental barriers and time pressures identified by parents are a common feature of Western family life such that many parents are raising families in stressful situations. Insights provided by this qualitative research provide an important understanding of these experiences. Consideration of such issues in the design and implementation of future child weight management interventions may help to increase the acceptability and effectiveness of such programs. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
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ERIC Educational Resources Information Center
Hunter, Tanesha N.
2013-01-01
The purpose of this research study was to compare male and female assistant superintendents and their descriptions of Internal Barriers, External Barriers, Internal Motivators, External Motivators, Stressors, and Discriminatory Acts they anticipated encountering on the route to the superintendency in Suffolk and Nassau Counties on Long Island, New…
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Barriers to Breast and Cervical Cancer Screening in Singapore: a Mixed Methods Analysis.
Malhotra, Chetna; Bilger, Marcel; Liu, Joy; Finkelstein, Eric
2016-01-01
In order to increase breast and cervical cancer screening uptake in Singapore, women's perceived barriers to screening need to be identified and overcome. Using data from both focus groups and surveys, we aimed to assess perceived barriers and motivations for breast and cervical cancer screening. We conducted 8 focus groups with 64 women, using thematic analysis to identify overarching themes related to women's attitudes towards screening. Based on recurring themes from focus groups, several hypotheses regarding potential barriers and motivations to screen were generated and tested through a national survey of 801 women aged 25-64. Focus group participants had misconceptions related to screening, believing that the procedures were painful. Cost was an issue, as well as efficacy and fatalism. By identifying barriers to and motivators for screening through a mixed-method design that has both nuance and external validity, this study offers valuable suggestions to policymakers to improve breast and cervical cancer screening uptake in Singapore.
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Strategic Insights. Volume 10, Issue 1, Spring 2011
2011-01-01
stated, Chinn and Frankel put the exact year as 1872. Table 1 shows that the United States had the largest economy and the fastest rate of growth...The system attempted to lower trade barriers by reconciling exchange rate stability and domestic economic autonomy by creating an explicit code of...Monetary Fund website, https://www.imf.org/external/pubs/ft/weo/2010/01/weodata/index.aspx, (accessed June 3, 2010). 41 Michael Mussa, " Exchange Rate
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Extermophylic microorganisms: issue of interplanetary transfer on external spacecraft surfaces.
NASA Astrophysics Data System (ADS)
Novikova, N.; Deshevaya, E.; Polykarpov, N.; Svistunova, Y.; Grigoriev, A.
Interplanetary transfer of terrestrial microbes capable of surviving in extreme environments and planetary protection from accidental biocontamination by them are the issues of major practical rather than hypothetical value The natural resistance of microbes to extreme environments and a possibility of their transfer beyond geographical barriers of Earth on external spacecraft surfaces have brought forward a need in profound research into the likelihood of their survival in outer space Hardware and a program have been developed at the State Scientific Research Center of the Russian Federation -- Institute for Biomedical Problems with the goal of carrying out a space experiment Biorisk The experiment was aimed at assessing the possibility of long-term comparable with the duration of the Martian flight survival of microorganisms in outer space on materials used in space industry Samples of materials were contaminated with test cultures of bacteria Bacillus and fungi Aspergillus Penicillium Cladosporium known to be common residents of various environments on Earth and resistant to multiple alternation of high and low temperatures Materials used in the construction of external spacecraft surfaces such as steel aluminium alloy heat-insulating coating were chosen as test samples for the experiment Containers with materials and test microorganisms were placed on the external side of the Russian segment of the ISS Unique data have been accumulated after a 204 day exposure on the external side of the ISS which have proved that
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McFarlane, K; Judd, J; Devine, S; Watt, K
2016-08-01
Issue addressed Primary healthcare settings are important providers of health promotion approaches. However, organisational challenges can affect their capacity to deliver these approaches. This review identified the common enablers and barriers health organisations faced and it aimed to explore the experiences health organisations, in particular Aboriginal organisations, had when increasing their health promotion capacity. Methods A systematic search of peer-reviewed literature was conducted. Articles published between 1990-2014 that focused on a health care-settings approach and discussed factors that facilitated or hindered an organisation's ability to increase health promotion capacity were included. Results Twenty-five articles met the inclusion criteria. Qualitative (n=18) and quantitative (n=7) study designs were included. Only one article described the experiences of an Aboriginal health organisation. Enablers included: management support, skilled staff, provision of external support to the organisation, committed staffing and financial resources, leadership and the availability of external partners to work with. Barriers included: lack of management support, lack of dedicated health promotion staff, staff lacking skills or confidence, competing priorities and a lack of time and resources allocated to health promotion activities. Conclusions While the literature highlighted the importance of health promotion work, barriers can limit the delivery of health promotion approaches within primary healthcare organisations. A gap in the literature exists about how Aboriginal health organisations face these challenges. So what? Primary healthcare organisations wanting to increase their health promotion capacity can pre-empt the common barriers and strengthen identified enablers through the shared learnings outlined in this review.
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Enablers of and barriers to abortion training.
Guiahi, Maryam; Lim, Sahnah; Westover, Corey; Gold, Marji; Westhoff, Carolyn L
2013-06-01
Since the legalization of abortion services in the United States, provision of abortions has remained a controversial issue of high political interest. Routine abortion training is not offered at all obstetrics and gynecology (Ob-Gyn) training programs, despite a specific training requirement by the Accreditation Council for Graduate Medical Education. Previous studies that described Ob-Gyn programs with routine abortion training either examined associations by using national surveys of program directors or described the experience of a single program. We set out to identify enablers of and barriers to Ob-Gyn abortion training in the context of a New York City political initiative, in order to better understand how to improve abortion training at other sites. We conducted in-depth qualitative interviews with 22 stakeholders from 7 New York City public hospitals and focus group interviews with 62 current residents at 6 sites. Enablers of abortion training included program location, high-capacity services, faculty commitment to abortion training, external programmatic support, and resident interest. Barriers to abortion training included lack of leadership continuity, leadership conflict, lack of second-trimester abortion services, difficulty obtaining mifepristone, optional rather than routine training, and antiabortion values of hospital personnel. Supportive leadership, faculty commitment, and external programmatic support appear to be key elements for establishing routine abortion training at Ob-Gyn residency training programs.
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Clinical trials: the challenge of recruitment and retention of participants.
Gul, Raisa B; Ali, Parveen A
2010-01-01
This article, based on the available literature, attempts to discuss the importance of recruitment and retention of research participants, the associated barriers and challenges, and various strategies to overcome these barriers. The inability to recruit and retain the required participants in a research project poses serious threats to both the internal and the external validity of a research study. Despite serious implications, the issues of recruitment and retention do not receive due attention in research and publications. Literature suggests a lack of coordinated efforts to collect information on the outcomes of recruitment experiences in clinical trials and population studies. Studies often mention the number of participants who refuse to participate; however, the majority of the studies often fail to mention the specific reasons insufficient recruitment or retention of the participants. A methodological paper. Various participant-, context-, environment- and research-related factors are examined that affect the phenomenon of recruitment and retention of the participants in a study. Delayed or inefficient recruitment also has financial and ethical implications. Although there are many pieces of information scattered throughout academic journals on recruitment and retention of participants in research, few authors have dealt with the issue holistically. It is imperative for researchers to understand the importance of recruitment and retention of research participants, the associated barriers and challenges, and various strategies to overcome these barriers. Appropriate recording and reporting of the problems faced while recruiting and retaining the participants in research studies can help not only in understating the challenge, but will also help in devising the strategies to overcome this problem. This article was an attempt to synthesise and review the available literature on recruitment and retention issues, which demand extensive theoretical and conceptual thinking as part of the research design. An understanding of the challenges and issues related to recruitment and retention can help researchers to think ahead about the strategies to overcome these issues and consequently save the time and energy of the participants, researchers and funding agencies.
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Kjelle, Elin; Lysdahl, Kristin Bakke; Olerud, Hilde Merete; Myklebust, Aud Mette
2018-04-25
In order to meet the future challenges posed by ageing populations, new technology, telemedicine and a more personalized healthcare system are needed. Earlier research has shown mobile radiography services to be highly beneficial for nursing home residents in addition to being cost-effective. Despite the benefits, mobile radiography services are uncommon in Europe and Norway. The purpose of this study was to explore success criteria and barriers in the process of implementing mobile radiography services, from the point of view of the hospital and municipal managers. Eleven semi-structured interviews were conducted with managers from five hospitals and six municipalities in Norway where mobile radiography services had been implemented. Core issues in the interview guide were barriers and facilitators in the different phases of implementation. The framework method for thematic analysis was used for analysing the data inductively in a research team. Five main categories were developed through the success criteria and barriers experienced by the participants: national health policy, regional and municipal policy and conditions, inter-organizational implementation projects, experienced outcome, and professional skills and personal characteristics. The categories were allocated into three higher-order classifications: macro, meso and micro levels. The main barriers experienced by the managers were financial, procedural and structural. In particular, the reimbursement system, lack of management across healthcare levels and the lack of compatible information systems acted as barriers. The main facilitators were external funding, enthusiastic individuals in the organizations and good collaboration between hospitals and municipalities. The managers experienced financial, structural and procedural barriers. The main success criteria in the process were external funding, and the support and engagement from the individuals in the organizations. This commitment was mainly facilitated by the intuitive appeal of mobile radiography. Changes in healthcare management and in the financial system might facilitate services across healthcare levels. In addition, compatible information systems across healthcare levels are needed in order to facilitate the use of new technology and mobile services.
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Justine, Maria; Azizan, Azliyana; Hassan, Vaharli; Salleh, Zoolfaiz; Manaf, Haidzir
2013-10-01
INTRODUCTION Although the benefits of physical activity and exercise are widely acknowledged, many middle-aged and elderly individuals remain sedentary. This cross-sectional study aimed to identify the external and internal barriers to physical activity and exercise participation among middle-aged and elderly individuals, as well as identify any differences in these barriers between the two groups. METHODS Recruited individuals were categorised into either the middle-aged (age 45-59 years, n = 60) or elderly (age ≥ 60 years, n = 60) group. Data on demographics, anthropometry, as well as external and internal barriers to participation in physical activity and exercise were collected. RESULTS Analysis showed no significant differences in the total scores of all internal barriers between the two groups (p > 0.05). The total scores for most external barriers between the two groups also showed no significant differences (p > 0.05); only 'cost' (p = 0.045) and 'exercise interferes with social/family activities' (p = 0.011) showed significant differences. The most common external barriers among the middle-aged and elderly respondents were 'not enough time' (46.7% vs. 48.4%), 'no one to exercise with' (40.0% vs. 28.3%) and 'lack of facilities' (33.4% vs. 35.0%). The most common internal barriers for middle-aged respondents were 'too tired' (48.3%), 'already active enough' (38.3%), 'do not know how to do it' (36.7%) and 'too lazy' (36.7%), while those for elderly respondents were 'too tired' (51.7%), 'lack of motivation' (38.4%) and 'already active enough' (38.4%). CONCLUSION Middle-aged and elderly respondents presented with similar external and internal barriers to physical activity and exercise participation. These factors should be taken into account when healthcare policies are being designed and when interventions such as the provision of facilities to promote physical activity and exercise among older people are being considered.
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Using qualitative psychology to investigate HACCP implementation barriers.
Taylor, Eunice; Taylor, Joanne Zaida
2004-02-01
Hazard Analysis Critical Control Point (HACCP) is a system of food safety management that in the last few decades has become an increasing part of national government and international strategy to reduce the prevalence of food borne disease. Yet despite wide dissemination and scientific support of its principles, successful HACCP implementation has been limited. There has been very little in-depth consideration of the reasons behind this, and qualitative psychological research examining the interplay of factors involved is almost non-existent. For this study therefore, four in-depth narrative interviews were carried out with small business owners attempting to implement HACCP. Non-prescriptive analysis of their interviews was carried out, and this revealed five key themes acting as 'barriers' to successful implementation. These were of HACCP as difficult, burdensome and unnecessary, and hindered by staff and external problems. The analysis showed furthermore the complexity of issues underpinning problems with HACCP implementation and the way in which they operate at knowledge, attitude and behavioural levels. From this, essential issues to be addressed in order for successful HACCP to be achieved are put forward.
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Environmental Barrier Coatings for Ceramics and Ceramic Composites
NASA Technical Reports Server (NTRS)
Lee, Kang N.; Fox, Dennis; Eldridge, Jeffrey; Robinson, R. Craig; Bansal, Narottam
2004-01-01
One key factor that limits the performance of current gas turbine engines is the temperature capability of hot section structural components. Silicon-based ceramics, such as SiC/SiC composites and monolithic Si3N4, are leading candidates to replace superalloy hot section components in the next generation gas turbine engines due to their excellent high temperature properties. A major stumbling block to realizing Si-based ceramic hot section components is the recession of Si-based ceramics in combustion environments due to the volatilization of silica scale by water vapor. An external environmental barrier coating (EBC) is the most promising approach to preventing the recession. Current EBCs are based on silicon, mullite (3A12O3-2SiO2) and BSAS (barium strontium aluminum silicate with celsian structure). Volatility of BSAS, BSAS-silica chemical reaction, and low melting point of silicon limit the durability and temperature capability of current EBCs. Research is underway to develop EBCs with longer life and enhanced temperature capability. Understanding key issues affecting the performance of current EBCs is necessary for successful development of advanced EBCs. These issues include stress, chemical compatibility, adherence, and water vapor stability. Factors that affect stress are thermal expansion mismatch, phase stability, chemical stability, elastic modulus, etc. The current understanding on these issues will be discussed.
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Change Management in Dental Education: A Professional Learning Community.
Palatta, Anthony M
2018-06-01
Professional learning communities (PLCs) are defined as "a group of people sharing and critically interrogating their practice in an ongoing, reflective, collaborative, inclusive, learning-oriented, growth-promoting way." PLCs have been found to be an effective change management strategy in business and education when confronted by rapid change. The American Dental Education Association's Commission on Change and Innovation in Dental Education new national program-ADEA CCI 2.0-includes the development of a PLC. By employing an "engage and learn" model PLC centered on continuous quality improvement and systems thinking, dental faculty can identify internal and external barriers to change that could lead to innovative solutions to complex issues. This article argues that a PLC is a viable change management strategy to counteract the effect of multiple external forces impacting dental education and thus to develop future-ready faculty.
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Measuring Perceived Barriers to Physical Activity in Adolescents.
Gunnell, Katie E; Brunet, Jennifer; Wing, Erin K; Bélanger, Mathieu
2015-05-01
Perceived barriers to moderate-to-vigorous physical activity (PA) may contribute to the low rates of moderate-to-vigorous PA in adolescents. We examined the psychometric properties of scores from the perceived barriers to moderate-to-vigorous PA scale (PB-MVPA) by examining composite reliability and validity evidence based on the internal structure of the PB-MVPA and relations with other variables. This study was a cross-sectional analysis of data collected in 2013 from adolescents (N = 507; Mage = 12.40, SD = .62) via self-report scales. Using exploratory and confirmatory factor analyses, we found that perceived barriers were best represented as two factors representing internal (e.g., "I am not interested in physical activity") and external (e.g., "I need equipment I don't have") dimensions. Composite reliability was over .80. Using multiple regression to examine the relationship between perceived barriers and moderate-to-vigorous PA, we found that perceived internal barriers were inversely related to moderate-to-vigorous PA (β = -.32, p < .05). Based on results of the analysis of variances, there were no known-group sex differences for perceived internal and external barriers (p > .26). The PB-MVPA scale demonstrated evidence of score reliability and validity. To improve the understanding of the impact of perceived barriers on moderate-to- vigorous PA in adolescents, researchers should examine internal and external barriers separately.
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Influence of the geometry of protective barriers on the propagation of shock waves
NASA Astrophysics Data System (ADS)
Sochet, I.; Eveillard, S.; Vinçont, J. Y.; Piserchia, P. F.; Rocourt, X.
2017-03-01
The protection of industrial facilities, classified as hazardous, against accidental or intentional explosions represents a major challenge for the prevention of personal injury and property damage, which also involves social and economic issues. We consider here the use of physical barriers against the effects of these explosions, which include the pressure wave, the projection of fragments and the thermal flash. This approach can be recommended for the control of major industrial risks, but no specific instructions are available for its implementation. The influence of a protective barrier against a detonation-type explosion is studied in small-scale experiments. The effects of overpressure are examined over the entire path of the shock wave across the barrier and in the downstream zone to be protected. Two series of barrier structures are studied. The first series (A) of experiments investigates two types of barrier geometry with dimensions based on NATO recommendations. These recommendations stipulate that the barrier should be 2 m higher than the charge height, the thickness at the crest should be more than 0.5 m, while its length should be equal to twice the protected structure length and the bank slope should be equivalent to the angle of repose of the soil. The second series (B) of experiments investigates the influence of geometrical parameters of the barrier (thickness at the crest and inclination angles of the front and rear faces) on its protective effects. This project leads to an advance in our understanding of the physical phenomena involved in the propagation of blast waves resulting from an external explosion, in the area around a protective physical barrier. The study focuses on the dimensioning of protective barriers against overpressure effects arising from detonation and shows the advantage of using a barrier with a vertical front or rear face.
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ERIC Educational Resources Information Center
Lavrijsen, Jeroen; Nicaise, Ides
2017-01-01
Comparative research has often emphasized the importance of external barriers (e.g. enrolment costs) to explain inequalities in lifelong learning participation. However, individuals, in particular the low educated, are often not only prevented from participation by external barriers, but also by negative psychological dispositions about learning.…
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Patient-centered knowledge sharing in healthcare organizations: Identifying the external barriers.
Zhou, Lihong
2017-12-01
This paper reports on a research study, which aims to identify, qualify, and theorize the external barriers that prevent and hinder the exercises and activities of patient-centered knowledge sharing (KS) in healthcare organizations. The project adopted a qualitative secondary analysis approach as the overarching methodology to guide the analysis of data collected in a previously completed research study. Specifically, 46 semi-structured interview data were included and analyzed using a thematic analysis approach. The secondary analysis showed that healthcare KS is strongly influenced and hindered by five external barriers: social belief and preference, cultural values, healthcare education structure, political decisions, and economic environment and constraints. Moreover, the research findings suggest that these external barriers cannot be overlooked in KS implementation and operation in healthcare organizations and should be carefully assessed beginning in the early stages of KS design and strategic planning. Based on the secondary analysis, this paper proposes a conceptual model, which will contribute to the development of hypotheses in the future for building a generalized knowledge. The case study used is Chinese healthcare, but the KS problems studied can be shared across international borders.
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Role of external torque in the formation of ion thermal internal transport barriers
NASA Astrophysics Data System (ADS)
Jhang, Hogun; Kim, S. S.; Diamond, P. H.
2012-04-01
We present an analytic study of the impact of external torque on the formation of ion internal transport barriers (ITBs). A simple analytic relation representing the effect of low external torque on transport bifurcations is derived based on a two field transport model of pressure and toroidal momentum density. It is found that the application of an external torque can either facilitate or hamper bifurcation in heat flux driven plasmas depending on its sign relative to the direction of intrinsic torque. The ratio between radially integrated momentum (i.e., external torque) density to power input is shown to be a key macroscopic control parameter governing the characteristics of bifurcation.
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A survey of the barriers associated with academic-based cancer research commercialization.
Vanderford, Nathan L; Weiss, L Todd; Weiss, Heidi L
2013-01-01
Commercialization within the academic setting is associated with many challenges and barriers. Previous studies investigating these challenges/barriers have, in general, broadly focused on multiple disciplines and, oftentimes, several institutions simultaneously. The goal of the study presented here was to analyze a range of barriers that may be broadly associated with commercializing academic-based cancer research. This goal was addressed via a study of the barriers associated with cancer research commercialization at the University of Kentucky (UK). To this end, a research instrument in the form of an electronic survey was developed. General demographic information was collected on study participants and two research questions were addressed: 1) What are the general barriers inhibiting cancer research commercialization at UK? and 2) Would mitigation of the barriers potentially enhance faculty engagement in commercialization activities? Descriptive and statistical analysis of the data reveal that multiple barriers likely inhibit cancer research commercialization at UK with expense, time, infrastructure, and lack of industry partnerships being among the most commonly cited factors. The potential alleviation of these factors in addition to revised University policies/procedures, risk mitigation, more emphasis on commercialization by academia research field, and increased information on how to commercialize significantly correlated with the potential for increased commercialization activity. Furthermore, multivariate logistic regression modeling demonstrated that research commercialization would incrementally increase as barriers to the process are removed and that PhD-holding respondents and respondents in commercialization-supportive research fields would be more likely to commercialize their research upon barrier removal. Overall, as with other disciplines, these data suggest that for innovations derived from academic cancer-research to move more effectively and efficiently into the marketplace, university administrators and external agents, such as policymakers, need to address what are well-documented and defined issues.
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A Survey of the Barriers Associated with Academic-based Cancer Research Commercialization
Vanderford, Nathan L.; Weiss, L. Todd; Weiss, Heidi L.
2013-01-01
Commercialization within the academic setting is associated with many challenges and barriers. Previous studies investigating these challenges/barriers have, in general, broadly focused on multiple disciplines and, oftentimes, several institutions simultaneously. The goal of the study presented here was to analyze a range of barriers that may be broadly associated with commercializing academic-based cancer research. This goal was addressed via a study of the barriers associated with cancer research commercialization at the University of Kentucky (UK). To this end, a research instrument in the form of an electronic survey was developed. General demographic information was collected on study participants and two research questions were addressed: 1) What are the general barriers inhibiting cancer research commercialization at UK? and 2) Would mitigation of the barriers potentially enhance faculty engagement in commercialization activities? Descriptive and statistical analysis of the data reveal that multiple barriers likely inhibit cancer research commercialization at UK with expense, time, infrastructure, and lack of industry partnerships being among the most commonly cited factors. The potential alleviation of these factors in addition to revised University policies/procedures, risk mitigation, more emphasis on commercialization by academia research field, and increased information on how to commercialize significantly correlated with the potential for increased commercialization activity. Furthermore, multivariate logistic regression modeling demonstrated that research commercialization would incrementally increase as barriers to the process are removed and that PhD-holding respondents and respondents in commercialization-supportive research fields would be more likely to commercialize their research upon barrier removal. Overall, as with other disciplines, these data suggest that for innovations derived from academic cancer-research to move more effectively and efficiently into the marketplace, university administrators and external agents, such as policymakers, need to address what are well-documented and defined issues. PMID:23991077
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External electric field effects on Schottky barrier at Gd3N@C80/Au interface
NASA Astrophysics Data System (ADS)
Onishi, Koichi; Nakashima, Fumihiro; Jin, Ge; Eto, Daichi; Hattori, Hayami; Miyoshi, Noriko; Kirimoto, Kenta; Sun, Yong
2017-08-01
The effects of the external electric field on the height of the Schottky barrier at the Gd3N@C80/Au interface were studied by measuring current-voltage characteristics at various temperatures from 200 K to 450 K. The Gd3N@C80 sample with the conduction/forbidden/valence energy band structure had a face-centered cubic crystal structure with the average grain size of several nanometers. The height of the Gd3N@C80/Au Schottky barrier was confirmed to be 400 meV at a low electric field at room temperature. Moreover, the height decreases with the increasing external electric field through a change of permittivity in the Gd3N@C80 sample due to a polarization of the [Gd3] 9 +-[N3 -+("separators="|C80 ) 6 -] dipoles in the Gd3N@C80 molecule. The field-dependence of the barrier height can be described using a power math function of the electric field strength. The results of the field-dependent barrier height indicate that the reduction in the Schottky barrier is due to an image force effect of the transport charge carrier at the Gd3N@C80/Au interface.
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ERIC Educational Resources Information Center
Thornberg, Robert
2014-01-01
The aim of this study, conducted in Sweden, was to investigate the cultural barriers between school personnel (teachers and principals) and nonschool personnel (a resource team), who were external to the school system, regarding consultation about challenging or difficult-to-teach students. Focus groups with teachers, principals, and the resource…
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A systematic review: Students with mental health problems--a growing problem.
Storrie, Kim; Ahern, Kathy; Tuckett, Anthony
2010-02-01
The number of university students with a serious mental illness has risen significantly over the past few years. A systematic review was conducted that addressed emotional and or mental health problems of university students worldwide. In total, 572 articles were identified, of which 11 met inclusion criteria. Issues identified included types of problems experienced by students, how staff dealt with these students, barriers to seeking help, tools that facilitated help-seeking and epidemiological trends in the university student population. Recommendations include (i) providing better links between the university and external mental health providers, and (ii) increasing students' awareness of existing support services within and external to the university. As it is unrealistic to expect all academic staff to have the expertise required to deal with students with emotional problems, it is also recommended that (iii) policies and personnel with expertise in mental health are available to provide guidance for staff.
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Swedish nurses encounter barriers when promoting healthy habits in children.
Ljungkrona-Falk, Lena; Brekke, Hilde; Nyholm, Maria
2014-12-01
To increase the understanding of difficulties in promoting healthy habits to parents, we explore barriers in health-care provision. The aim of this study is to describe nurses' perceived barriers when discussing with parents regarding healthy food habits, physical activity and their child's body weight. A mixed method approach was chosen. Nurses (n = 76) working at 29 different Child Health Care Centers' in an area in west Sweden were included in the study. Three focus group interviews were conducted and 17 nurses were selected according to maximum variation. Data were categorized and qualitative content analysis was the chosen analysis method. In the second method, data were obtained from a questionnaire distributed to all 76 nurses. The latent content was formulated into a theme: even with encouragement and support, the nurses perceive barriers of both an external and internal nature. The results identified four main barriers: experienced barriers in the workplace-internal and external; the nurse's own fear and uncertainty; perceived obstacles in nurse-parent interactions and modern society impedes parents' ability to promote healthy habits. The nurses' perceived barriers were confirmed by the results from 62 of the nurses who completed the questionnaire. Despite education and professional support, the health professionals perceived both external and internal barriers in promoting healthy habits to parents when implementing a new method of health promotion in primary care. Further qualitative studies are needed to gain deeper understanding of the perceived barriers when promoting healthy habits to parents. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
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Cooke, Ian J; Jeremiah, Rohan D; Moore, Nataka J; Watson, Karriem; Dixon, Michael A; Jordan, Gregory L; Murray, Marcus; Keeter, Mary K; Hollowell, Courtney M P; Murphy, Adam B
2016-01-01
In the United States, African-Americans' (AAs) HIV infection rates are higher than any other racial group, and AA men who have sex with women (MSW) are a significant proportion of new cases. There is little research into AA MSW HIV/AIDS knowledge, barriers, and facilitators of HIV testing in Chicago. We enrolled a convenience sample of AA MSW from a community health clinic who completed self-administered surveys assessing HIV knowledge and testing-related barriers and facilitators. The survey was a combination of questions from several validated instruments, and additional questions were written based on key informant interviews with social scientists to tailor the questionnaire for AA men living on the South Side of Chicago. We recruited 20 AA MSW (mean age 47.4 years). Sixty-five percent had incomes <$10,000/year, 30% were insured, and 50% had post-secondary education. Despite low socioeconomic status, their HIV literacy was relatively high. The identified major barriers to testing were low perceived HIV risk, concerns over privacy, and external stigma at testing sites. Future efforts should focus on educating AA MSW on actual risk for HIV and address issues of privacy and stigma at testing sites.
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A Hybrid Process Fidelity Assessment in a Home-based Randomized Clinical Trial
WILDE, MARY H.; LIEBEL, DIANNE; FAIRBANKS, EILEEN; WILSON, PAULA; LASH, MARGARET; SHAH, SHIVANI; McDONALD, MARGARET V.; BRASCH, JUDITH; ZHANG, FENG; SCHEID, EILEEN; McMAHON, JAMES M.
2016-01-01
A process fidelity assessment was conducted as a nested study within a home-based randomized clinical trial teaching self-management to 101 long-term indwelling urinary catheter users in the treatment group. Our hybrid model combined external assessments (outside observations and tape recordings) with internal evaluation methods (through study nurse forms and notes) for a comprehensive process fidelity assessment. Barriers, patient-related issues, and nurse perspectives were identified demonstrating the complexity in home care intervention research. The complementary and synergistic approaches provided in depth information about the context of the delivery and the impact of the intervention on study outcomes. PMID:25894688
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Removing Barriers to Humaneness in the High School.
ERIC Educational Resources Information Center
Saylor, J. Galen, Ed.; Smith, Joshua L., Ed.
The 1970 ASCD conference identified some of the major barriers to implementation of humaneness in contemporary secondary schools. In part I of this conference report, "The Barriers--and the Way Out," the following papers are presented: James B. Macdonald, "A Vision of a Humane School"; Douglas D. Dillenbeck, "External Management as a Barrier to…
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Zardo, Pauline; Collie, Alex; Livingstone, Charles
2014-05-01
This study examined external factors affecting policy and program decision-making in a specific public health policy context: injury prevention and rehabilitation compensation in the Australian state of Victoria. The aim was twofold: identify external factors that affect policy and program decision-making in this specific context; use this evidence to inform targeting of interventions aimed at increasing research use in this context. Qualitative interviews were undertaken from June 2011 to January 2012 with 33 employees from two state government agencies. Key factors identified were stakeholder feedback and action, government and ministerial input, legal feedback and action, injured persons and the media. The identified external factors were able to significantly influence policy and program decision-making processes: acting as both barriers and facilitators, depending on the particular issue at hand. The factors with the most influence were the Minister and government, lawyers, and agency stakeholders, particularly health providers, trade unions and employer groups. This research revealed that interventions aimed at increasing use of research in this context must target and harness the influence of these groups. This research provides critical insights for researchers seeking to design interventions to increase use of research in policy environments and influence decision-making in Victorian injury prevention and rehabilitation compensation. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Clement, Laurence
2016-12-01
Although a majority of under-represented minority (URM) students begin their postsecondary education at community colleges, little is known about barriers to success and retention for transfer-bound science students. This study focuses on some of the barriers that affect these students' ability to study adequately for a community college "gateway" course. It tests whether instructors' expectations of study time were realistic for community college students and whether students reported facing external barriers, such as job and family responsibilities, or internal barriers to studying, such as lack of motivational, cognitive, and metacognitive abilities, all of which have been shown to impact academic success and retention. It also tests whether students who faced such barriers were less likely to succeed in and complete the course, as well as whether time spent studying was related to course success. The findings reported here show that community college students do not have enough available time to study and that external and internal barriers are both prevalent among these students. In addition, students who faced such barriers are more likely to fail or drop the class. Results also show that study time is positively correlated with retention, but not performance, as well as with some motivational, cognitive, and metacognitive dimensions of self-regulated learning. These findings lead to new questions, including whether student success in a community college class is associated with the use of cognitive and metacognitive learning strategies for students with no prior degrees, and whether increased course structure may improve success for college students with lower self-regulated abilities.
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Clement, Laurence
2016-01-01
Although a majority of under-represented minority (URM) students begin their postsecondary education at community colleges, little is known about barriers to success and retention for transfer-bound science students. This study focuses on some of the barriers that affect these students’ ability to study adequately for a community college “gateway” course. It tests whether instructors’ expectations of study time were realistic for community college students and whether students reported facing external barriers, such as job and family responsibilities, or internal barriers to studying, such as lack of motivational, cognitive, and metacognitive abilities, all of which have been shown to impact academic success and retention. It also tests whether students who faced such barriers were less likely to succeed in and complete the course, as well as whether time spent studying was related to course success. The findings reported here show that community college students do not have enough available time to study and that external and internal barriers are both prevalent among these students. In addition, students who faced such barriers are more likely to fail or drop the class. Results also show that study time is positively correlated with retention, but not performance, as well as with some motivational, cognitive, and metacognitive dimensions of self-regulated learning. These findings lead to new questions, including whether student success in a community college class is associated with the use of cognitive and metacognitive learning strategies for students with no prior degrees, and whether increased course structure may improve success for college students with lower self-regulated abilities. PMID:28101261
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The current and ideal state of mental health training: pediatric resident perspectives.
Hampton, Elisa; Richardson, Joshua E; Bostwick, Susan; Ward, Mary J; Green, Cori
2015-01-01
PHENOMENON: Mental health (MH) problems are prevalent in the pediatric population, and in a setting of limited resources, pediatricians need to provide MH care in the primary medical home yet are uncomfortable doing so citing a lack of training during residency as one barrier. The purpose of this study is to describe pediatric residents' experiences and perspectives on the current and ideal states of MH training and ideas for curriculum development to bridge this gap. A qualitative study using focus groups of pediatric residents from an urban academic medical center was performed. Audio recordings were transcribed and analyzed using a grounded theory approach. Twenty-six residents participated in three focus groups, which is when thematic saturation was achieved. The team generated five major themes: capabilities, comfort, organizational capacity, coping, and education. Residents expressed uncertainty at every step of an MH visit. Internal barriers identified included low levels of comfort and negative emotional responses. External barriers included a lack of MH resources and mentorship in MH care, or an inadequate organizational capacity. These internal and external barriers resulted in a lack of perceived capability in handling MH issues. In response, residents reported inadequate coping strategies, such as ignoring MH concerns. To build knowledge and skills, residents prefer educational modalities including didactics, experiential learning through collaborations with MH specialists, and tools built into patient care flow. Insights: Pediatric residency programs need to evolve in order to improve resident training in MH care. The skills and knowledge requested by residents parallel the American Academy of Pediatrics statement on MH competencies. Models of collaborative care provide similar modalities of learning requested by residents. These national efforts have not been operationalized in training programs yet may be useful for curriculum development and dissemination to enhance trainees' MH knowledge and skills to provide optimal MH care for children.
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Role of lipids in the formation and maintenance of the cutaneous permeability barrier.
Feingold, Kenneth R; Elias, Peter M
2014-03-01
The major function of the skin is to form a barrier between the internal milieu and the hostile external environment. A permeability barrier that prevents the loss of water and electrolytes is essential for life on land. The permeability barrier is mediated primarily by lipid enriched lamellar membranes that are localized to the extracellular spaces of the stratum corneum. These lipid enriched membranes have a unique structure and contain approximately 50% ceramides, 25% cholesterol, and 15% free fatty acids with very little phospholipid. Lamellar bodies, which are formed during the differentiation of keratinocytes, play a key role in delivering the lipids from the stratum granulosum cells into the extracellular spaces of the stratum corneum. Lamellar bodies contain predominantly glucosylceramides, phospholipids, and cholesterol and following the exocytosis of lamellar lipids into the extracellular space of the stratum corneum these precursor lipids are converted by beta glucocerebrosidase and phospholipases into the ceramides and fatty acids, which comprise the lamellar membranes. The lipids required for lamellar body formation are derived from de novo synthesis by keratinocytes and from extra-cutaneous sources. The lipid synthetic pathways and the regulation of these pathways are described in this review. In addition, the pathways for the uptake of extra-cutaneous lipids into keratinocytes are discussed. This article is part of a Special Issue entitled The Important Role of Lipids in the Epidermis and their Role in the Formation and Maintenance of the Cutaneous Barrier. Guest Editors: Kenneth R. Feingold and Peter Elias. Published by Elsevier B.V.
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Applications and non-idealities of submicron Al-AlOx-Nb tunnel junctions
NASA Astrophysics Data System (ADS)
Julin, J. K.; Maasilta, I. J.
2016-10-01
We have developed a technique to fabricate sub-micron, 0.6 μ {{m}}× 0.6 μ {{m}} Al-AlOx-Nb tunnel junctions using a standard e-beam resist, angle evaporation and double oxidation of the tunneling barrier, resulting in high quality niobium, as determined by the the high measured values of the critical temperature {T}{{C}}˜ 7.5 K and the gap {{Δ }}˜ 1.3 meV. The devices show great promise for local nanoscale thermometry in the temperature range 1-7.5 K. Electrical characterization of the junctions was performed at sub-Kelvin temperatures both with and without an external magnetic field, which was used to suppress superconductivity in Al and thus bring the junction into a normal-metal-insulator-superconductor configuration. We observed excess sub-gap current, which could not be explained by the standard tunneling theory. Evidence points towards materials science issues of the barrier or Nb/AlOx interface as the culprit.
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Espeland, Ansgar; Baerheim, Anders
2003-03-24
General practitioners often diverge from clinical guidelines regarding spine radiography. This study aimed to identify and describe A) factors general practitioners consider may affect their decisions about ordering plain radiography for back pain and B) barriers to guideline adherence suggested by such factors. Focus group interviews regarding factors affecting ordering decisions were carried out on a diverse sample of Norwegian general practitioners and were analysed qualitatively. Results of this study and two qualitative studies from the Netherlands and USA on use of spine radiography were interpreted for barriers to guideline adherence. These were compared with an existing barrier classification system described by Dr Cabana's group. The factors which Norwegian general practitioners considered might affect their decisions about ordering plain radiography for back pain concerned the following broader issues: clinical ordering criteria, patients' wishes for radiography and the general practitioner's response, uncertainty, professional dignity, access to radiology services, perception of whether the patient really was ill, sense of pressure from other health care providers/social security, and expectations about the consequences of ordering radiography. The three studies suggested several attitude-related and external barriers as classified in a previously reported system described by Dr Cabana in another study. Identified barriers not listed in this system were: lack of expectancy that guideline adherence will lead to desired health care process, emotional difficulty with adherence, improper access to actual/alternative health care services, and pressure from health care providers/organisations. Our findings may help implement spine radiography guidelines. They also indicate that Cabana et al.'s barrier classification system needs extending. A revised system is proposed.
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Espeland, Ansgar; Baerheim, Anders
2003-01-01
Background General practitioners often diverge from clinical guidelines regarding spine radiography. This study aimed to identify and describe A) factors general practitioners consider may affect their decisions about ordering plain radiography for back pain and B) barriers to guideline adherence suggested by such factors. Methods Focus group interviews regarding factors affecting ordering decisions were carried out on a diverse sample of Norwegian general practitioners and were analysed qualitatively. Results of this study and two qualitative studies from the Netherlands and USA on use of spine radiography were interpreted for barriers to guideline adherence. These were compared with an existing barrier classification system described by Dr Cabana's group. Results The factors which Norwegian general practitioners considered might affect their decisions about ordering plain radiography for back pain concerned the following broader issues: clinical ordering criteria, patients' wishes for radiography and the general practitioner's response, uncertainty, professional dignity, access to radiology services, perception of whether the patient really was ill, sense of pressure from other health care providers/social security, and expectations about the consequences of ordering radiography. The three studies suggested several attitude-related and external barriers as classified in a previously reported system described by Dr Cabana in another study. Identified barriers not listed in this system were: lack of expectancy that guideline adherence will lead to desired health care process, emotional difficulty with adherence, improper access to actual/alternative health care services, and pressure from health care providers/organisations. Conclusions Our findings may help implement spine radiography guidelines. They also indicate that Cabana et al.'s barrier classification system needs extending. A revised system is proposed. PMID:12659640
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Williams, J.V.
1984-04-26
Disclosed is a locking device for eliminating external control of a secured space formed by fixed and movable barriers. The locking device uses externally and internally controlled locksets and a movable strike, operable from the secured side of the movable barrier, to selectively engage either lockset. A disengagement device, for preventing forces from being applied to the lock bolts is also disclosed. In this manner, a secured space can be controlled from the secured side as a safe-haven. 4 figures.
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Massoud, May A; Makarem, N; Ramadan, W; Nakkash, R
2015-03-01
This research attempts to provide an understanding of the Lebanese pharmaceutical industries' environmental management strategies, priorities, and perceptions as well as drivers, barriers, and incentives regarding the implementation of the voluntary ISO 14001 Environmental Management System. Accordingly, a semistructured in-depth interview was conducted with the pharmaceutical industries. The findings revealed a significant lack of knowledge about the standard among the industries. The main perceived drivers for adopting the ISO 14001 are improving the companies' image and overcoming international trade. The main perceived barriers for acquiring the standard are the lack of government support and the fact that ISO 14001 is not being legally required or enforced by the government. Moreover, results revealed that adopting the ISO 14001 standard is not perceived as a priority for the Lebanese pharmaceutical industries. Although the cost of certification was not considered as a barrier for the implementation of ISO 14001, the majority of the pharmaceutical industries are neither interested nor willing to adopt the Standard if they are not exposed to any regulatory pressure or external demand. They are more concerned with quality and safety issues with the most adopted international standard among the industries being the ISO 9001 quality management system. This study highlights the aspect that financial barriers are not always the hurdles for implementing environmental management strategies in developing countries and underscores the need for regulatory frameworks and enforcement.
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Stimulated emission of surface plasmons by electron tunneling in metal-barrier-metal structures
NASA Technical Reports Server (NTRS)
Siu, D. P.; Gustafson, T. K.
1978-01-01
It is shown that correlation currents arising from the superposition of pairs of states on distinct sides of a potential barrier in metal-barrier-metal structures can result in inelastic tunneling through the emission of surface plasmons. Net gain of an externally excited plasmon field is possible.
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ERIC Educational Resources Information Center
Denhart, Hazel
2008-01-01
This phenomenological study investigated barriers to higher education faced by 11 college students labeled with learning disabilities (LD) using their voice as the primary data. Data were analyzed and interpreted through a disability theory perspective revealing barriers stemmed largely from external social causes rather than individual pathology.…
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Che, Fanglin; Zhang, Renqin; Hensley, Alyssa J; Ha, Su; McEwen, Jean-Sabin
2014-02-14
To provide a basis for understanding the reactive processes on nickel surfaces at fuel cell anodes, we investigate the influence of an external electric field on the dehydrogenation of methyl species on a Ni(111) surface using density functional theory calculations. The structures, adsorption energies and reaction barriers for all methyl species dissociation on the Ni(111) surface are identified. Our results show that the presence of an external electric field does not affect the structures and favorable adsorption sites of the adsorbed species, but causes the adsorption energies of the CHx species at the stable site to fluctuate around 0.2 eV. Calculations give an energy barrier of 0.692 eV for CH3* → CH2* + H*, 0.323 eV for CH2* → CH* + H* and 1.373 eV for CH* → C* + H*. Finally, we conclude that the presence of a large positive electric field significantly increases the energy barrier of the CH* → C* + H* reaction more than the other two reactions, suggesting that the presence of pure C atoms on Ni(111) are impeded in the presence of an external positive electric field.
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Identifying emerging issues in forestry as a tool for research planning.
Hans M. Gregersen; Allen L. Lundgren; Pamela J. Jakes; David N. Bengston
1989-01-01
A Delphi exercise is used to identify emerging issues in National Forest management and use, the relative importance of the issues, and barriers to resolving issues. USDA Forest Service managers agree on the importance of the 11 issues identified; however, researchers and National Forest managers do not always agree on the importance of issues or barriers.
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NASA Astrophysics Data System (ADS)
Kirley, M. P.; Novakovic, B.; Sule, N.; Weber, M. J.; Knezevic, I.; Booske, J. H.
2012-03-01
We report experiments and analysis of field emission from metallic knife-edge cathodes, which are sputter-coated with thin films of lanthanum hexaboride (LaB6), a low-work function material. The emission current is found to depend sensitively on the thickness of the LaB6 layer. We find that films thinner than 10 nm greatly enhance the emitted current. However, cathodes coated with a thicker layer of LaB6 are observed to emit less current than the uncoated metallic cathode. This result is unexpected due to the higher work function of the bare metal cathode. We show, based on numerical calculation of the electrostatic potential throughout the structure, that the external (LaB6/vacuum) barrier is reduced with respect to uncoated samples for both thin and thick coatings. However, this behavior is not exhibited at the internal (metal/LaB6) barrier. In thinly coated samples, electrons tunnel efficiently through both the internal and external barrier, resulting in current enhancement with respect to the uncoated case. In contrast, the thick internal barrier in thickly coated samples suppresses current below the value for uncoated samples in spite of the lowered external barrier. We argue that this coating thickness variation stems from a relatively low (no higher than 1018 cm-3) free carrier density in the sputtered polycrystalline LaB6.
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Wrobel, Gretchen Miller; Grotevant, Harold D.; Samek, Diana R.; Von Korff, Lynn
2013-01-01
The Adoption Communication Pathway(ACP) model was used to test the potential mediating effect of curiosity on adoption information seeking in a sample of 143 emerging adult adoptees (mean age = 25.0 years) who were adopted as infants within the United States by parents of the same race. Adoptees were interviewed about their intentions and actions taken to gather new information about their birth mothers and fathers. As expected, level of curiosity was positively associated with information seeking behavior. Moreover, level of curiosity was influenced by adoptees’ perceptions of barriers and facilitators toward information-dseeking. In fact, curiosity partially mediated the impact of internal and external barriers on information seeking about birth mothers. Curiosity fully mediated the impact of external barriers and partially mediated external facilitators on birth father information seeking. This study provides important support for the ACP, which describes context, motivation, and behavior relating to seeking new adoption-related information. PMID:24376288
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NASA Technical Reports Server (NTRS)
Ashpis, David E.; Laun, Matthew C.
2016-01-01
Results of characterization of Dielectric Barrier Discharge (DBD) plasma actuators without external flow are presented. The results include aerodynamic and electric performance of the actuators without external flow for different geometrical parameters, dielectric materials and applied voltage level and wave form.
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Ferrinho, Paulo; Dramé, Mohammed; Tumusiime, Prosper
2013-01-01
Chad is one of the countries supported by the GAVI-Alliance that remains with unsatisfactory vaccination coverage. This paper tries to understand the main barriers to better coverage. These barriers were categorised as up or downstream against the health system building blocks as proposed by WHO and compared with barriers and activities identified by the country in its health system's strengthening grant proposal as approved by the GAVI Alliance in 2007. Data were collected using a modified Delphi system and by analysis of grant and annual report documents. Most of the activities anticipated under the GAVI health system's strengthening proposal are activities targeting downstream barriers (the neglect of upstream issues is of major importance in a decentralised state like Chad) and aligned with, not complementary to, immunization services strengthening activities. Further, both set of cash grants are blind to important recommendations such as the need to address barriers at the level of leadership and governance and at the level of the financing system and also about initiatives to promote community demand of vaccination services. IN CHAD SLOW VACCINATION PROGRESS IS AGGRAVATED BY SEVERAL CONTEXTUAL BARRIERS: the size of the country, the low population density, the nomadic nature of a significant part of its peoples, the recent civil war, associated with civil unrest and political instability and its geographical localization. In this situation it would be important to sustain downstream operations (the major focus of the ISS grant) while taking a long term view of the needs of the health system. The GAVI effectively supports downstream operations, but neglects the long term view.
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Ferrinho, Paulo; Dramé, Mohammed; Tumusiime, Prosper
2013-01-01
Introduction Chad is one of the countries supported by the GAVI-Alliance that remains with unsatisfactory vaccination coverage. This paper tries to understand the main barriers to better coverage. Methods These barriers were categorised as up or downstream against the health system building blocks as proposed by WHO and compared with barriers and activities identified by the country in its health system's strengthening grant proposal as approved by the GAVI Alliance in 2007. Data were collected using a modified Delphi system and by analysis of grant and annual report documents. Results Most of the activities anticipated under the GAVI health system's strengthening proposal are activities targeting downstream barriers (the neglect of upstream issues is of major importance in a decentralised state like Chad) and aligned with, not complementary to, immunization services strengthening activities. Further, both set of cash grants are blind to important recommendations such as the need to address barriers at the level of leadership and governance and at the level of the financing system and also about initiatives to promote community demand of vaccination services. Conclusion In Chad slow vaccination progress is aggravated by several contextual barriers: the size of the country, the low population density, the nomadic nature of a significant part of its peoples, the recent civil war, associated with civil unrest and political instability and its geographical localization. In this situation it would be important to sustain downstream operations (the major focus of the ISS grant) while taking a long term view of the needs of the health system. The GAVI effectively supports downstream operations, but neglects the long term view. PMID:24106572
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Sterdt, E; Liersch, S; Henze, V; Röbl, M; Suermann, T; Krauth, C; Walter, U
2015-04-01
The objective was to determine to what extent daily physical education can be implemented in primary schools, what barriers exist and how to overcome the mentioned barriers. Moreover, it was analysed to what extent daily physical education is accepted by teachers, external trainers, parents and students. Semi-structured interviews with parents (n=7), teachers (n=5) and external trainers (n=6) of the intervention schools. The intervention students (n=44) were surveyed within focus groups. All surveyed groups appraised the implementation of daily school sports as successful. The cooperation between the schools and the sports club should be maintained during a comprehensive implementation of daily physical education. Besides an improved lessons quality teachers and external trainers reported an improved social behaviour of the children. Parents perceived positive effects on the child development. All groups believe that daily physical education increases the enjoyment of children in sports. As a certain barrier a lack of resources (e. g., facilities, equipment, financial resources) in the schools were mentioned. The cooperation between the schools and the sports club proved to be an applicable model to implement daily physical education. The combination of teachers and external trainers can contribute to a higher lesson quality. Considering the perceived potentials of daily physical education by all surveyed groups, a comprehensive implementation of systematic daily physical activity promotion in the primary school setting should be tapped more strongly in future. © Georg Thieme Verlag KG Stuttgart · New York.
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Masculinity and urogenital cancer: sensitive issues in health care.
Nobis, Regina; Sand, Inger; Elofsson, Kristina
2007-02-01
The aim of this literature review was to analyse the approaches adopted by patients, health professionals, spouses and other care-givers towards sensitive issues related to male urogenital cancer, and to describe how these findings can be applied in health care practice. The findings revealed five identifiable domains, namely 'the barrier to talking', 'the barrier of sensitivity', 'the barrier of masculinity', 'the barrier to seeking health care' and 'the communicative barrier'. The conclusion was that the phenomenon of a barrier is strongly connected with hegemonic masculinity. The review of literature confirmed that, for many men, talking about genitally-related health problems is not easy and that health care professionals need to learn more about gender and masculinity in order to address urogenitally sensitive issues.
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McWhirter, Ellen Hawley; Ramos, Karina; Medina, Cynthia
2013-07-01
Latina/o high school students without documentation face a challenging situation when they graduate from high school, with pathways to work and postsecondary education stymied by their immigration status. We examined the effects of anticipated barriers associated with immigration status, age, and sex on the dependent variables of vocational outcome expectations, anticipated external and internal barriers, and postsecondary schooling plans in a sample of 475 Latina/o high school students. Findings include that students anticipating immigration status problems had lower vocational outcome expectations and anticipated more external barriers to pursuing their postsecondary plans. Latina girls and older high school students anticipating immigration status problems were more likely to plan to attend 2-year rather than 4-year colleges, and less likely to plan on postsecondary education, respectively. Implications for practice, policy, and research are discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved.
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Alagappan, Valliappan; Hefferan, Albert; Parivallal, Aarthi
2018-04-01
Right to access in the built environment creates equal and nondiscriminatory opportunities to a person with disabilities in order to move freely around and interact positively without hindrance and barriers. The objective of the study is to understand the existing accessibility related issues and implementation of guidelines and standards for public buildings. The technical verification using onsite and offsite access audit format for current provision of facilities in the internal and external environment has been carried out with the format prepared in reference to Central Public Works Department (CPWD) accessibility guidelines for mobility impaired and elderly and American Disability Act (ADA) guidelines. The access audit format included parameters like accessibility, safety, security, comfort and convenience and it addresses the barriers faced by wheel chair users, people with crutches, prosthetics and with non-assistive devices. The study addressed accessibility compliance in three zones of the building with initiation from parking area zone, inside the building, and area outside the building premises. The findings highlight the environmental barriers encountered by mobility impaired people and represented graphically in the layout plan and physical effort required to overcome the challenges in the built environment. The overall accessibility compliance is 42% in the interstate bus terminal. Implications for rehabilitation The study identifies the environmental limitations, human and technologically facilitators with the help of Central Public Works Department (CPWD) and American Disability Act (ADA) guidelines (1990). It highlights barriers for mobility-impaired users, by demonstrating in a spatial layout and the means to facilitate easy access with minimal frustration, stress and with less physical effort. It demonstrates the need for preparation of separate guidelines for making the existing types of buildings to be access and disabled-friendly. New accessibility guidelines shall be prepared by incorporating concepts like such as relative accessibility into new bus terminal buildings. Guidelines help the disabled in the process of rehabilitation and develop inclusiveness not rather than alienation.
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Ferrinho, Paulo; Dramé, Mohamed; Biai, Sidu; Lopes, Orlando; Sousa, Fernando de; Van Lerberghe, Wim
2013-01-01
Although many countries have improved vaccination coverage in recent years, some, including Guinea-Bissau, failed to meet expected targets. This paper tries to understand the main barriers to better vaccination coverage in the context of the GAVI-Alliance (The Global Alliance for Vaccines and Immunisation) cash-based support provided to Guinea-Bissau. The analysis is based on a document analysis and a three round Delphi study with a final consensus meeting. Consensus attributed about 25% of the failure to perform better to implementation problems; and about 10% to governance and also 10% to scarce resources. The qualitative analysis validates the importance of implementation issues and upgraded the relevance of the human resources crisis as an important drawback. The recommendations were balanced in their upstream-downstream focus but were blind to health information issues and logistical difficulties. It is commendable that such a fragile state, with all sorts of barriers, manages to sustain a slow steady growth of its vaccination coverage. Not reaching the targets set reflects the inappropriateness of those targets rather than a lack of commitment of the health workforce. In the unstable context of countries such as Guinea-Bissau, the predictability of the funds from global health initiatives like the GAVI-Alliance seem to make all the difference in achieving small consistent health gains even in the presence of other major bottlenecks.
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Technical Insights for Saltstone PA Maintenance
DOE Office of Scientific and Technical Information (OSTI.GOV)
Flach, G.; Sarkar, S.; Mahadevan, S.
2011-07-20
The Cementitious Barriers Partnership (CBP) is a collaborative program sponsored by the US DOE Office of Waste Processing. The objective of the CBP is to develop a set of computational tools to improve understanding and prediction of the long-term structural, hydraulic, and chemical performance of cementitious barriers and waste forms used in nuclear applications. CBP tools are expected to better characterize and reduce the uncertainties of current methodologies for assessing cementitious barrier performance and increase the consistency and transparency of the assessment process, as the five-year program progresses. In September 2009, entering its second year of funded effort, the CBPmore » sought opportunities to provide near-term tangible support to DOE Performance Assessments (PAs). The Savannah River Saltstone Disposal Facility (SDF) was selected for the initial PA support effort because (1) cementitious waste forms and barriers play a prominent role in the performance of the facility, (2) certain important long-term behaviors of cementitious materials composing the facility are uncertain, (3) review of the SDF PA by external stakeholders is ongoing, and (4) the DOE contractor responsible for the SDF PA is open to receiving technical assistance from the CBP. A review of the current (SRR Closure & Waste Disposal Authority 2009) and prior Saltstone PAs (e.g., Cook et al. 2005) suggested five potential opportunities for improving predictions. The candidate topics considered were (1) concrete degradation from external sulfate attack, (2) impact of atmospheric exposure to concrete and grout before closure, such as accelerated slag and Tc-99 oxidation, (3) mechanistic prediction of geochemical conditions, (4) concrete degradation from rebar corrosion due to carbonation, and (5) early age cracking from drying and/or thermal shrinkage. The candidate topics were down-selected considering the feasibility of addressing each issue within approximately six months, and compatibility with existing CBP expertise and already-planned activities. Based on these criteria, the five original topics were down-selected to two: external sulfate attack and mechanistic geochemical prediction. For each of the selected topics, the CBP communicated with the PA analysts and subject matter experts at Savannah River to acquire input data specific to the Saltstone facility and related laboratory experiments. Simulations and analyses were performed for both topics using STADIUM (SIMCO 2008), LeachXS/ORCHESTRA (ECN 2007, Meeussen 2003), and other software tools. These supplemental CBP analyses produced valuable technical insights that can be used to strengthen the Saltstone PA using the ongoing PA maintenance process. This report in part summarizes key information gleaned from more comprehensive documents prepared by Sarkar et al. (2010), Samson (2010), and Sarkar (2010).« less
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Higgins, Agnes; Downes, Carmel; Monahan, Mark; Gill, Ailish; Lamb, Stephen A; Carroll, Margaret
2018-01-03
To explore barriers to midwives and nurses addressing mental health issues with women during the perinatal period. Perinatal mental health is considered an important public health issue with health policy internationally identifying the importance of psychological support for women in the perinatal period. Midwives and primary care nurses are ideally positioned to detect mental distress early, but evidence suggests that they are reluctant to discuss mental health issues with women during pregnancy or in the postnatal period. The research used a descriptive design. A total of 809 midwives and nurses completed an anonymous, online or hard copy survey. Designed by the research team, the survey listed 26 potential barriers to the provision of perinatal mental health care. Participants identified organisational factors as presenting the greatest barriers. Organisational barriers included lack of perinatal mental health services, absence of care pathways, heavy workload, lack of time, lack of privacy and not seeing women regularly enough to build a relationship. Over 50% of participants identified practitioner-related barriers, such as lack of knowledge on perinatal mental health and cultural issues; lack of skill, in particular, skills to respond to a disclosure of a mental health issue; and fears of causing women offence and distress. Findings also indicated that the context of care and education influenced the degree to which participants perceived certain items as barriers. Midwives and primary care nurses encounter many organisational- and practitioner-related barriers that negatively impact on their ability to incorporate mental health care into their practice. Midwifery and nursing services need to develop strategies to address system- and practitioner-related barriers, including the development of services and care pathways, and the provision of culturally sensitive education on perinatal mental health in order to support practitioners to address issues with confidence and competence. © 2018 John Wiley & Sons Ltd.
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Zhao, Tian-Yu; Su, Li-Ping; Ma, Chun-Ye; Zhai, Xiao-Han; Duan, Zhi-Jun; Zhu, Ying; Zhao, Gang; Li, Chun-Yan; Wang, Li-Xia; Yang, Dong
2015-07-08
Intestinal barrier dysfunction is not only the consequence of liver cirrhosis, but also an active participant in the development of liver cirrhosis. Previous studies showed that external administration of insulin-like growth factor 1 (IGF-1) improved intestinal barrier function in liver cirrhosis. However, the mechanism of IGF-1 on intestinal barrier in liver cirrhosis is not fully elucidated. The present study aims to investigate the mechanisms of IGF-1 improving intestinal barrier function via regulating tight junctions in intestines. We used carbon tetrachloride induced liver cirrhotic rats to investigate the effect of IGF-1 on intestinal claudin-1 and occludin expressions, serum alanine transaminase (ALT) and aspartate transaminase (AST) levels, severity of liver fibrosis, portal pressures, enterocytic apoptosis and lipopolysaccharides (LPS) levels in portal vein. The changes of IGF-1 in serum during the development of rat liver cirrhosis were also evaluated. Additionally, we assessed the effect of IGF-1 on claudin-1 and occludin expressions, changes of transepithelial electrical resistance (TEER) and apoptosis in Caco-2 cells to confirm in vivo findings. Serum IGF-1 levels were decreased in the development of rat liver cirrhosis, and external administration of IGF-1 restored serum IGF-1 levels. External administration of IGF-1 reduced serum ALT and AST levels, severity of liver fibrosis, LPS levels in portal vein, enterocytic apoptosis and portal pressure in cirrhotic rats. External administration of IGF-1 increased the expressions of claudin-1 and occludin in enterocytes, and attenuated tight junction dysfunction in intestines of cirrhotic rats. LPS decreased TEER in Caco-2 cell monolayer. LPS also decreased claudin-1 and occludin expressions and increased apoptosis in Caco-2 cells. Furthermore, IGF-1 attenuated the effect of LPS on TEER, claudin-1 expression, occludin expression and apoptosis in Caco-2 cells. Tight junction dysfunction develops during the development of liver cirrhosis, and endotoxemia will develop subsequently. Correspondingly, increased endotoxin in portal system worsens tight junction dysfunction via decreasing intestinal occludin and claudin-1 expressions and increasing enterocytic apoptosis. Endotoxemia and intestinal barrier dysfunction form a vicious circle. External administration of IGF-1 breaks this vicious circle. Improvement of tight junctions might be one possible mechanism of the restoration of intestinal barrier function mediated by IGF-1.
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Implementing Cardiopulmonary Resuscitation Training Programs in High Schools: Iowa's Experience.
Hoyme, Derek B; Atkins, Dianne L
2017-02-01
To understand perceived barriers to providing cardiopulmonary resuscitation (CPR) education, implementation processes, and practices in high schools. Iowa has required CPR as a graduation requirement since 2011 as an unfunded mandate. A cross-sectional study was performed through multiple choice surveys sent to Iowa high schools to collect data about school demographics, details of CPR programs, cost, logistics, and barriers to implementation, as well as automated external defibrillator training and availability. Eighty-four schools responded (26%), with the most frequently reported school size of 100-500 students and faculty size of 25-50. When the law took effect, 51% of schools had training programs already in place; at the time of the study, 96% had successfully implemented CPR training. Perceived barriers to implementation were staffing, time commitment, equipment availability, and cost. The average estimated startup cost was <$1000 US, and the yearly maintenance cost was <$500 with funds typically allocated from existing school resources. The facilitator was a school official or volunteer for 81% of schools. Average estimated training time commitment per student was <2 hours. Automated external defibrillators are available in 98% of schools, and 61% include automated external defibrillator training in their curriculum. Despite perceived barriers, school CPR training programs can be implemented with reasonable resource and time allocations. Copyright © 2016 Elsevier Inc. All rights reserved.
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Implementing Cardiopulmonary Resuscitation Training Programs in High Schools: Iowa's Experience
Hoyme, Derek B.; Atkins, Dianne L.
2017-01-01
Objective To understand perceived barriers to providing cardiopulmonary resuscitation (CPR) education, implementation processes, and practices in high schools. Study design Iowa has required CPR as a graduation requirement since 2011 as an unfunded mandate. A cross-sectional study was performed through multiple choice surveys sent to Iowa high schools to collect data about school demographics, details of CPR programs, cost, logistics, and barriers to implementation, as well as automated external defibrillator training and availability. Results Eighty-four schools responded (26%), with the most frequently reported school size of 100-500 students and faculty size of 25-50. When the law took effect, 51% of schools had training programs already in place; at the time of the study, 96% had successfully implemented CPR training. Perceived barriers to implementation were staffing, time commitment, equipment availability, and cost. The average estimated startup cost was <$1000 US, and the yearly maintenance cost was <$500 with funds typically allocated from existing school resources. The facilitator was a school official or volunteer for 81% of schools. Average estimated training time commitment per student was <2 hours. Automated external defibrillators are available in 98% of schools, and 61% include automated external defibrillator training in their curriculum. Conclusions Despite perceived barriers, school CPR training programs can be implemented with reasonable resource and time allocations. PMID:27852456
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Schmitz, Susan; Wyte-Lake, Tamar; Dobalian, Aram
2017-09-13
This study sought to understand facilitators and barriers faced by local US Department of Veterans Affairs Medical Center (VAMC) emergency managers (EMs) when collaborating with non-VA entities. Twelve EMs participated in semi-structured interviews lasting 60 to 90 minutes discussing their collaboration with non-VAMC organizations. Sections of the interview transcripts concerning facilitators and barriers to collaboration were coded and analyzed. Common themes were organized into 2 categories: (1) internal (ie, factors affecting collaboration from within VAMCs or by VA policy) and (2) external (ie, interagency or interpersonal factors). Respondents reported a range of facilitators and barriers to collaboration with community-based agencies. Internal factors facilitating collaboration included items such as leadership support. An internal barrier example included lack of clarity surrounding the VAMC's role in community disaster response. External factors noted as facilitators included a shared goal across organizations while a noted barrier was a perception that potential partners viewed a VAMC partnership with skepticism. Federal institutions are important partners for the success of community disaster preparedness and response. Understanding the barriers that VAMCs confront, as well as potential facilitators to collaboration, should enhance the development of VAMC-community partnerships and improve community health resilience. (Disaster Med Public Health Preparedness. 2017; page 1 of 6).
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Perceived Barriers by University Students in the Practice of Physical Activities
Gómez-López, Manuel; Gallegos, Antonio Granero; Extremera, Antonio Baena
2010-01-01
The main goal of this research is to study in detail the main characteristics of university students in order to find out the reasons why they have adopted an inactive lifestyle. In order to do so, a questionnaire on the analysis of sports habits and lifestyle was given to 323 students. They were taken from a representative sample of 1834 students. These 323 students had pointed out at the moment of the fieldwork, not having practiced any sport in their spare time. Our findings point out that there are diverse reasons for this. On one hand, reasons referred to as external barriers such as lack of time, on the other hand, internal barriers such as not liking the physical activity, not seeing its practicality or usefulness, feeling lazy or with apathy, or thinking that they are not competent in this type of activities. Other reasons such as the lack of social support are grouped within the external barriers. Finally, it is important to stress that there are also differences based on gender with respect to motivation. Key points External barriers prevail in university students. The lack of time is among the most highlighted ones. Statistically significant results have been found regarding the gender variable. The results are very important since they are considered to be valuable information for university institutions when guiding and diversifying their offer of physical and sport activities. Also as a guide in the design of support policies and national sport management guidelines. PMID:24149629
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Perceived barriers by university students in the practice of physical activities.
Gómez-López, Manuel; Gallegos, Antonio Granero; Extremera, Antonio Baena
2010-01-01
The main goal of this research is to study in detail the main characteristics of university students in order to find out the reasons why they have adopted an inactive lifestyle. In order to do so, a questionnaire on the analysis of sports habits and lifestyle was given to 323 students. They were taken from a representative sample of 1834 students. These 323 students had pointed out at the moment of the fieldwork, not having practiced any sport in their spare time. Our findings point out that there are diverse reasons for this. On one hand, reasons referred to as external barriers such as lack of time, on the other hand, internal barriers such as not liking the physical activity, not seeing its practicality or usefulness, feeling lazy or with apathy, or thinking that they are not competent in this type of activities. Other reasons such as the lack of social support are grouped within the external barriers. Finally, it is important to stress that there are also differences based on gender with respect to motivation. Key pointsExternal barriers prevail in university students. The lack of time is among the most highlighted ones.Statistically significant results have been found regarding the gender variable.The results are very important since they are considered to be valuable information for university institutions when guiding and diversifying their offer of physical and sport activities. Also as a guide in the design of support policies and national sport management guidelines.
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Adeniyi, Ade F; Anjana, Ranjit M; Weber, Mary B
2016-01-01
With diabetes rates escalating globally, there is the need for a better integration of all aspects of diabetes care for improved population outcomes. An understanding, not only of regional but global literature on physical activity barriers and its facilitators is important if healthcare providers and policy makers are to create programs tailored to their populations. Herein, we report the results of a narrative review of the global barriers and facilitators of physical activity for patients with diabetes mellitus. An in-depth literature search was conducted to identify English-language studies that examined physical activity barriers and associated facilitators among patients with diabetes mellitus. Major electronic literature databases that were searched included Google Scholar, PubMed, Hub-Med, and Highwire. Studies were available from Africa, Asia, Australia, Europe, and, predominantly North America. A total of 34 predominantly internal barriers emerged globally. The most commonly reported were time constrains, fear of provoking additional disorders, exercise venue and weather related barriers. Facilitators of physical activity were reported for most of the internal barriers (e.g. time constraints, lack of knowledge etc) while the external barriers (e.g. weather, environmental pollution etc) received only a minimal attention. Globally, patients with diabetes are confronted with an enormous number of physical activity barriers. Unlike the robust solutions proffered for the internal barriers, the literature is largely silent about solutions to the external barriers, which though fewer, may be highly influential. Additional data is needed to better understand physical activity behaviors in populations outside of North America.
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Zhong, Wei-Ping; Belić, Milivoj R
2010-05-01
We report on the nonlinear tunneling effects of spatial solitons of the generalized nonlinear Schrödinger equation with distributed coefficients in an external harmonic potential. By using the homogeneous balance principle and the F-expansion technique we find the spatial bright and dark soliton solutions. We then display tunneling effects of such solutions occurring under special conditions; specifically when the spatial solitons pass unchanged through the potential barriers and wells affected by special choices of the diffraction and/or the nonlinearity coefficients. Our results show that the solitons display tunneling effects not only when passing through the nonlinear potential barriers or wells but also when passing through the diffractive barriers or wells. During tunneling the solitons may also undergo a controllable compression.
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Hill, Lauren M; Maman, Suzanne; Holness, David; Moodley, Dhayendre
2016-01-22
The rights of women and people living with HIV (PLHIV) are protected under South African law, yet there is a gap in the application of these laws. While there are numerous systemic and social barriers to women's and PLHIV's exercise of their legal rights and rights to access social services, there has been little effort to document these barriers as well as legal needs and knowledge in this context. 1480 HIV-positive and HIV-negative women recruited from an antenatal clinic in Umlazi Township completed a questionnaire on legal knowledge, experience of legal issues, assistance seeking for legal issues, and barriers to seeking assistance. We compared the legal knowledge and experience of legal issues of HIV-positive and HIV-negative women, and described assistance seeking and barriers to assistance seeking among all women. Both HIV-positive and HIV-negative women had high levels of knowledge of their legal rights. There were few important differences in legal knowledge and experience of legal issues by HIV status. The most common legal issues women experienced were difficulty obtaining employment (11 %) and identification documents (7 %). A minority of women who had ever experienced a legal issue had sought assistance for this issue (38 %), and half (50 %) of assistance sought was from informal sources such as family and friends. Women cited lack of time and government bureaucracy as the major barriers to seeking assistance. These results indicate few differences in legal knowledge and needs between HIV-positive and HIV-negative women in this context, but rather legal needs common among women of reproductive age. Legal knowledge may be a less important barrier to seeking assistance for legal issues than time, convenience, and cost. Expanding the power of customary courts to address routine legal issues, encouragement of pro bono legal assistance, and introduction of legal navigators could help to address these barriers.
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ERIC Educational Resources Information Center
Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2012
2012-01-01
This issue of "Issues in Prevention" focuses on overcoming barriers in implementing effective off-campus party intervention. This issue contains the following articles: (1) Confronting the Problems Associated With Off-Campus Parties With Evidence-Based Strategies (John D. Clapp); (2) Overview of Research on Effective Off-Campus Party…
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Graphene-based stretchable and transparent moisture barrier
NASA Astrophysics Data System (ADS)
Won, Sejeong; Van Lam, Do; Lee, Jin Young; Jung, Hyun-June; Hur, Min; Kim, Kwang-Seop; Lee, Hak-Joo; Kim, Jae-Hyun
2018-03-01
We propose an alumina-deposited double-layer graphene (2LG) as a transparent, scalable, and stretchable barrier against moisture; this barrier is indispensable for foldable or stretchable organic displays and electronics. Both the barrier property and stretchability were significantly enhanced through the introduction of 2LG between alumina and a polymeric substrate. 2LG with negligible polymeric residues was coated on the polymeric substrate via a scalable dry transfer method in a roll-to-roll manner; an alumina layer was deposited on the graphene via atomic layer deposition. The effect of the graphene layer on crack generation in the alumina layer was systematically studied under external strain using an in situ micro-tensile tester, and correlations between the deformation-induced defects and water vapor transmission rate were quantitatively analyzed. The enhanced stretchability of alumina-deposited 2LG originated from the interlayer sliding between the graphene layers, which resulted in the crack density of the alumina layer being reduced under external strain.
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Perinatal postmortems: what is important to parents and how do they decide?
Breeze, Andrew C G; Statham, Helen; Hackett, Gerald A; Jessop, Flora A; Lees, Christoph C
2012-03-01
Falling consent rates for postmortems, regardless of age of death, have been widely reported in recent years. The aim of this study was to explore parental attitudes to, and decision-making about, a perinatal postmortem after termination for fetal abnormality, late miscarriage, or stillbirth. A prospective self-completion questionnaire was given to 35 women and their partners. The participants had experienced second or third trimester pregnancy loss in a single fetal medicine and delivery unit in the United Kingdom and were making decisions about having a postmortem. They were asked to complete a questionnaire about their attitudes to, and expectations of, a perinatal postmortem. Thirty-one questionnaires were received from parents of 17 babies (49% of those asked; 16 from mothers, 15 from fathers). Parents of nine babies (53%) said they would agree to a full postmortem, of three babies to a limited postmortem, and of four babies to an external examination only; one couple were undecided. The most important issues for the parents in this study that related to their decisions about a postmortem centered on the need for information, both for future planning and about what had happened. Moderately important issues related to altruism, which is, improving medical knowledge and helping other parents experiencing similar bereavement. Among the lowest scoring issues were potential barriers, such as concerns about cultural or religious acceptability of a postmortem, funeral delays, and what would happen to the baby's body. Bereaved parents who participated in this study, where postmortem consent rates were relatively high, thought that their need for knowledge eclipsed assumed barriers when deciding whether or not to have a postmortem for their baby. © 2012, Copyright the Authors. Journal compilation © 2012, Wiley Periodicals, Inc.
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Barriers to Occupational Achievement.
ERIC Educational Resources Information Center
Gurman, Ernest B.
The under-representation of women in prestigious occupations and the lower average pay women earn has been of concern for many years. This study investigated two alternative explanations for this under-representation of females in prestigious and higher paying occupations. The first explanation was external barriers such as discrimination, and the…
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Labat, Francoise; Sharma, Anjali
2016-01-01
Objective To identify potential barriers to patient safety (PS) interventions from the perspective of surgical team members working in an operating theatre in Eastern Democratic Republic of Congo (DRC). Design In-depth interviews were conducted and analysed using qualitative content analysis. Setting Governmental referral teaching hospital in Eastern DRC. Participants We purposively selected 2–4 national and expatriate surgical team members from each specialisation. Of the 31 eligible surgical health workers (HWs), 17 volunteered to be interviewed. Results Economics issues affected PS throughout the entire health system, from human resources and hospital management, to access to healthcare for patients. Surgical team members seemed embedded in a paternalistic organisational structure and blame culture accompanied by perceived inefficient support services and low salaries. The armed conflict did not only worsen these system failures, it also carried direct threats to patients and HWs, and resulted in complex indirect consequences compromising PS. The increased corruption within health organisations, and population impoverishment and substance abuse among health staff adversely altered safe care. Simultaneously, HWs’ reported resilience and resourcefulness to address barrier to PS. Participants had varying views on external aid depending on its relevance. Conclusions The complex links between war and PS emphasise the importance of a comprehensive approach including occupational health to strengthen HWs' resilience, external clinical audits to limit corruption, and educational programmes in PS to support patient-centred care and address blame culture. Finally, improvement of equity in the health financing system seems essential to ensure access to healthcare and safe perioperative outcomes for all. PMID:27113232
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Breaking Barriers, Building Bridges: Critical Discussion of Social Issues.
ERIC Educational Resources Information Center
Moss, Joy
Noting that picture books can invite students to engage in critical discussion of complex issues of race, class, and gender, this lesson plan helps students to confront the injustice of barriers that separate human beings from one another and to examine the role of prejudice and stereotypes in sustaining these barriers. During the five 45-minute…
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Facilitators and barriers to exercising among people with osteoarthritis: a phenomenological study.
Petursdottir, Unnur; Arnadottir, Solveig A; Halldorsdottir, Sigridur
2010-07-01
Evidence indicates that regular exercise improves the well-being of individuals with osteoarthritis (OA). However, these individuals seem to exercise less frequently than the general population and seem to have limited adherence to exercising. The purposes of this study were: (1) to increase knowledge and understanding of the experience of exercising among individuals with OA and (2) to determine what they perceive as facilitators and barriers to exercising. This study used a qualitative method, based on the Vancouver School of doing phenomenology, involving purposive sampling of 12 individuals and 16 interviews. The participants, 9 women and 3 men, were 50 to 82 years of age. Extended information on exercise behavior among people with OA is presented in a model in which internal and external facilitators and barriers to exercising are delineated. Based on this model, a checklist is proposed for physical therapists' assessment of these factors. Internal factors include individual attributes and personal experience of exercising, whereas external factors include the social and physical environment. The participants expressed how each of these internal and external factors could act both as a facilitator and a barrier to exercise participation and the pattern of exercising; for example, the presence of pain was an important aspect concerning internal barriers to exercising, whereas the hope of less pain was one of the main facilitators. Increased knowledge and understanding of the factors influencing exercise behavior in people with OA can help physical therapists and other health care professionals support them in initiating and maintaining a healthy exercise routine and, consequently, achieving a better quality of life.
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Palliative Care for Latino Patients and Their Families: “Whenever We Prayed, She Wept”
Smith, Alexander K.; Sudore, Rebecca L.; Pérez-Stable, Eliseo J.
2009-01-01
Latinos account for 15% of the US population, a proportion projected to grow to 30% by the year 2050. Although there is tremendous diversity within this community, commonalities of language, beliefs, attitudes, and behaviors unite Latinos, making them more similar than different. For non-Latino and non-Spanish-speaking clinicians, communication barriers and cultural misunderstandings can impede the care of dying Latino patients and their families. We present the case of a young, pregnant, Spanish-speaking woman from Guatemala diagnosed with a fatal leukemia. As illustrated by this case, Latino immigrants face a number of external challenges to optimal end-of-life care: (1) geographic distance as well as political and economic realities often separate patients from their valued families; (2) undocumented immigrants are frequently uninsured, and fear of deportation may create a barrier to accessing health services; (3) language and literacy barriers; and (4) concerns about discrimination. Other Latino issues that may be more pronounced in end-of-life settings include cultural themes and religious and spiritual influences. We recommend that professional interpreters must be used for discussions about goals of care with Spanish-speaking patients and families, or when negotiating conflict between the patient, family, and the health care team. Concrete suggestions are provided for clinicians in working with interpreters, eliciting culturally-based attitudes and beliefs, and implementing universal strategies for clear health communication. PMID:19278947
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2013-01-01
Universal access to antiretroviral treatment (ART) in Chad was officially declared in December 2006. This presidential initiative was and is still funded 100% by the country’s budget and external donors’ financial support. Many factors have triggered the spread of AIDS. Some of these factors include the existence of norms and beliefs that create or increase exposure, the low-level education that precludes access to health information, social unrest, and population migration to areas of high economic opportunities and gender-based discrimination. Social forces that influence the distribution of dimensions of well-being and shape risks for infection also determine the persistence of access barriers to ART. The universal access policy is quite revolutionary but should be informed by the systemic barriers to access so as to promote equity. It is not enough to distribute ARVs and provide health services when health systems are poorly organized and managed. Comprehensive access to ART raises many organizational, ethical and policy problems that need to be solved to achieve equity in access. This paper argues that the persistence of access barriers is due to weak health systems and a poor public health leadership. AIDS has challenged health systems in a manner that is essentially different from other health problems. PMID:23902732
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Vocal Fold Epithelial Barrier in Health and Injury: A Research Review
ERIC Educational Resources Information Center
Levendoski, Elizabeth Erickson; Leydon, Ciara; Thibeault, Susan L.
2014-01-01
Purpose: Vocal fold epithelium is composed of layers of individual epithelial cells joined by junctional complexes constituting a unique interface with the external environment. This barrier provides structural stability to the vocal folds and protects underlying connective tissue from injury while being nearly continuously exposed to potentially…
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O’Neill, Joseph; Feusner, Jamie D
2015-01-01
This article reviews issues related to a major challenge to the field for obsessive–compulsive disorder (OCD): improving access to cognitive-behavioral therapy (CBT). Patient-related barriers to access include the stigma of OCD and reluctance to take on the demands of CBT. Patient-external factors include the shortage of trained CBT therapists and the high costs of CBT. The second half of the review focuses on one partial, yet plausible aid to improve access – prediction of long-term response to CBT, particularly using neuroimaging methods. Recent pilot data are presented revealing a potential for pretreatment resting-state functional magnetic resonance imaging and magnetic resonance spectroscopy of the brain to forecast OCD symptom severity up to 1 year after completing CBT. PMID:26229514
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Barriers to Leisure-Time Physical Activities in Individuals with Spinal Cord Injury.
Hwang, Eric J; Groves, Mary D; Sanchez, Jacqueline N; Hudson, Cassandra E; Jao, Rachel G; Kroll, Meghan E
2016-07-01
This study investigated the personal, environmental, and activity barriers to leisure-time physical activities (LTPAs) among individuals with spinal cord injury (SCI). A survey instrument was administered to 85 participants with SCI. Personal barriers to LTPAs included issues involving motivation, pain, scheduling, and financial resources. Environmental barriers marked the issues regarding availability and accessibility to specialized programs, activities, and professional services. Activity barriers included limitations in equipment, training, and personal skills required by the selected activities. Significant negative correlations were found between these barriers and the levels of physical activity and satisfaction with physical activity. While working with clients with SCI, occupational therapists should identify those LTPA barriers and possible solutions in order to establish individualized action plans for enhancing participation in LTPAs.
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ERIC Educational Resources Information Center
Mamboleo, George Isaboke
2009-01-01
Disability rights issues are an emerging area of discourse in Kenya. Persons with disabilities in Kenya face many barriers to integration into the larger Kenyan society possibly due to barriers such as societal negative attitudes. Research has indicated that the greatest barrier to rehabilitation of persons with disabilities is negative attitudes…
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A review of privacy and usability issues in mobile health systems: Role of external factors.
Katusiime, Jane; Pinkwart, Niels
2017-10-01
The increased penetration of mobile devices has created opportunities in the health sector and led to emerging of mobile health systems. As much as the mobile health systems have registered tremendous progress, they have been faced with privacy and usability issues. Due to the sensitivity of health information, there is an ethical need to equip mobile health systems with adequate privacy measures. However, these systems should also be useable by the intended users. Even though many researchers are working on solutions, the issues still persist. External factors such as cultural differences have also contributed to the issues, yet they have been under researched. In this article, we conduct a systematic literature review of 22 articles, categorize and present privacy and usability issues and possible solutions. We then discuss the relevance and implications of external factors to the findings on privacy and usability. We end with recommendations to address these external factors.
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Giant enhancement of fluctuation in small biological systems under external fields
NASA Astrophysics Data System (ADS)
Hayashi, Kumiko; Hasegawa, Shin; Tsunoda, Satoshi P.
2016-05-01
The giant enhancement (GE) of fluctuation under an external field is a universal phenomenon predicted by the theoretical analysis given in (Reimann et al 2001 Phys. Rev. Lett.). Here, we propose the application of the theory of the GE of fluctuation to estimate the energy barrier of a biomolecule that exhibits its function subject to thermal noise. The rotary motor protein F1 was used as a model, which is a component of FoF1 adenosine triphosphate (ATP)-synthase. In the single-molecule experiment on F1, the diffusion coefficients of a rotary probe attached to F1, which characterised the fluctuation of the system, were measured under the influence of an electro-rotary field. These diffusion coefficients were then used to estimate a high-energy barrier of the rotary potential of F1 based on the theory of the GE of fluctuation. Furthermore, the ion channel protein channelrhodopsin (ChR) was used as another research model. The current fluctuations of ions moving through ChR were numerically investigated using a simulation model of the protein in the presence of an external voltage. The energy barrier for ion conduction is discussed based on the current fluctuations.
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School Teachers' Experiences of Science Curriculum Reform
NASA Astrophysics Data System (ADS)
Ryder, Jim; Banner, Indira
2013-02-01
We examine teachers' experiences of a major reform of the school science curriculum for 14-16-year olds in England. This statutory reform enhances the range of available science courses and emphasises the teaching of socio-scientific issues and the nature of science, alongside the teaching of canonical science knowledge. This paper examines teachers' experiences of the reform and the factors that condition these experiences. A designed sample of 22 teachers discussed their experiences of the reform within a semi-structured interview. Our analysis considers how the external and internal structures within which teachers work interact with the personal characteristics of teachers to condition their experiences of the curriculum reform. In many cases, personal/internal/external contexts of teachers' work align, resulting in an overall working context that is supportive of teacher change. However, in other cases, tensions within these contexts result in barriers to change. We also explore cases in which external curriculum reform has stimulated the development of new contexts for teachers' work. We argue that curriculum reformers need to recognise the inevitability of multiple teaching goals within a highly differentiated department and school workplace. We also show how experiences of curriculum reform can extend beyond the learning of new knowledge and associated pedagogies to involve challenges to teachers' professional identities. We argue for the extended use of teacher role models within local communities of practice to support such 'identity work'.
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van Dijk-de Vries, Anneke; van Dongen, Jerôme Jean Jacques; van Bokhoven, Marloes Amantia
2017-03-01
The significance of effective interprofessional teamwork to improve the quality of care has been widely recognised. Effective interprofessional teamwork calls on good collaboration between professionals and patients, coordination between professionals, and the development of teamwork over time. Effective development of teams also requires support from the wider organisational context. In a Dutch village, healthcare professionals work closely together, and mutual consultations as well as interprofessional meetings take place on a regular basis. The network was created as a precondition for sustainable interprofessional teamwork in elderly care. However, several external barriers were experienced regarding the supportive structure and cooperative attitude of the healthcare insurer and municipality. The aim of the article is to examine these experience-based issues regarding internal organisation, perspective, and definition of effective teamwork. Complicating factors refer to finding the right key figures, and the different perspectives on team development and team effectiveness. Our conclusion is that the organisation of healthcare insurance companies needs to implement fundamental changes to facilitate an interprofessional care approach. Furthermore, municipalities should work on their vision of the needs and benefits of a fruitful collaboration with interprofessional healthcare teams. The challenge for healthcare teams is to learn to speak the language of external partners. To support the development of interprofessional teams, external parties need to recognise and trust in a shared aim to provide quality of care in an efficient and effective way.
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Ceramic with preferential oxygen reactive layer
NASA Technical Reports Server (NTRS)
Wang, Hongyu (Inventor); Luthra, Krishan Lal (Inventor)
2001-01-01
An article comprises a silicon-containing substrate and an external environmental/thermal barrier coating. The external environmental/thermal barrier coating is permeable to diffusion of an environmental oxidant and the silicon-containing substrate is oxidizable by reaction with oxidant to form at least one gaseous product. The article comprises an intermediate layer/coating between the silicon-containing substrate and the environmental/thermal barrier coating that is oxidizable to a nongaseous product by reaction with the oxidant in preference to reaction of the silicon-containing substrate with the oxidant. A method of forming an article, comprises forming a silicon-based substrate that is oxidizable by reaction with oxidant to at least one gaseous product and applying an intermediate layer/coating onto the substrate, wherein the intermediate layer/coating is oxidizable to a nongaseous product by reaction with the oxidant in preference to reaction of the silicon-containing substrate with the oxidant.
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Teaching Climate Change Science in Senior Secondary School: Issues, Barriers and Opportunities
ERIC Educational Resources Information Center
Bunten, Rod; Dawson, Vaille
2014-01-01
This paper argues that, despite its difficulties, climate change can (and perhaps needs to) be taught rigorously to students by enquiry rather than through transmission and that such a method will enable students to make judgments on other issues of scientific controversy. It examines the issues and barriers to the teaching of climate change,…
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NASA Astrophysics Data System (ADS)
Li, Wenjuan; Gu, Zhenyu; Teng, Fuhua; Lu, Jianhai; Dong, Shibi; Miao, Xiaoping; Wu, Zhongbiao
2018-06-01
The degradation of xylene in the dielectric barrier discharge plasma and photocatalyst process was studied, focusing on the synergetic effect of UV rays from plasma process and external UV lamps on the decomposition of xylene. The results showed that xylene could be decomposed by the discharge process in plasma system, whereas the UV rays from plasma process was very weak. After adding TiO2, the removal efficiency of xylene and energy yield in plasma process were enhanced since energetic particles activated the catalysis of TiO2. The removal efficiency of xylene and energy field in plasma and photocatalyst process combined with external UV lamps were further enhanced attributed to the degradation effect of plasma, the catalysis of TiO2 activated by plasma, the photolysis of UV rays and the photocatalysis of photocatalyst. The synergetic effect of UV rays from external UV lamps was obvious.
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The Teacher Technology Integration Experience: Practice and Reflection in the Classroom
ERIC Educational Resources Information Center
Ruggiero, Dana; Mong, Christopher J.
2015-01-01
Previous studies indicated that the technology integration practices of teachers in the classroom often did not match their teaching styles. Researchers concluded that this was due, at least partially, to external barriers that prevented teachers from using technology in ways that matched their practiced teaching style. Many of these barriers,…
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Fan, Kaimin; Tang, Jing; Wu, Shiyun; Yang, Chengfu; Hao, Jiabo
2016-12-21
The adsorption and diffusion behaviors of lithium (Li) in a graphene/blue-phosphorus (G/BP) heterostructure have been investigated using a first principles method based on density functional theory (DFT). The effect of an external electric field on the adsorption and diffusion behaviors has also been investigated. The results show that the adsorption energy of Li on the graphene side of the G/BP heterostructure is higher than that on monolayer graphene, and Li adsorption on the BP side of the G/BP/Li system is slightly stronger than that on monolayer BP (BP/Li). The adsorption energy of Li reaches 2.47 eV, however, the energy barriers of Li diffusion decrease in the interlayer of the G/BP heterostructure. The results mentioned above suggest that the rate performance of the G/BP heterostructure is better than that of monolayer graphene. Furthermore, the adsorption energies of Li atoms in the three different most stable sites, i.e., H G , T P and H 1 sites, increase by about 0.49 eV, 0.26 eV, and 0.13 eV, respectively, as the electric field intensity reaches 0.6 V Å -1 . The diffusion energy barrier is significantly decreased by an external electric field. It is demonstrated that the external electric field can not only enhance the adsorption but can also modulate the diffusion barriers of Li atoms in the G/BP heterostructure.
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The impact of aging on epithelial barriers.
Parrish, Alan R
2017-10-02
The epithelium has many critical roles in homeostasis, including an essential responsibility in establishing tissue barriers. In addition to the fundamental role in separating internal from external environment, epithelial barriers maintain nutrient, fluid, electrolyte and metabolic waste balance in multiple organs. While, by definition, barrier function is conserved, the structure of the epithelium varies across organs. For example, the skin barrier is a squamous layer of cells with distinct structural features, while the lung barrier is composed of a very thin single cell to minimize diffusion space. With the increased focus on age-dependent alterations in organ structure and function, there is an emerging interest in the impact of age on epithelial barriers. This review will focus on the impact of aging on the epithelial barrier of several organs, including the skin, lung, gastrointestinal tract and the kidney, at a structural and functional level.
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Barriers to vocational effectiveness in ACT: staff perspectives.
Waynor, William R; Pratt, Carlos W
2011-01-01
Assertive community treatment (ACT), for persons with serious mental illness, includes a vocational focus as an important aspect of community integration. Nevertheless, research suggests that ACT does not assist significant numbers of consumers in achieving employment goals. A two-step survey of New Jersey ACT team members was designed to identify the key issues that hinder ACT staff members in assisting consumers with obtaining employment. Survey items were categorized into three sections: (a) staff attitudes, (b) consumer barriers, and (c) staff barriers to working on employment. The initial survey asked staff members to rate items in each of these categories. Highly rated items were used in a subsequent paired comparison survey to determine the relative importance of each. This method highlighted the following issues: four staff attitude items-(a) returning to work is positive, (b) employment is key to recovery, (c) abstinence from substance abuse is needed to work, and (d) consumers are too ill to work; four consumer barrier items-(a) fear of loss of Social Security Administration benefits, (b) symptoms related to the illness, (c) lack of motivation, and (d) poor social skills; and three barriers to working on employment issues items-(a) clinical issues take priority, (b) other case management issues takes priority, and (c) too many emergencies. The implications for staff training are discussed.
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Griva, K; Ng, H J; Loei, J; Mooppil, N; McBain, H; Newman, S P
2013-01-01
Although adherence to hemodialysis (HD) regimes is important to maximise good clinical outcomes, it remains suboptimal and not well understood, particularly for those in non-Western settings and patients from Asian cultures. This qualitative study sought to explore cultural perspectives on facilitators and barriers to treatment adherence in HD patients. A descriptive exploratory design was used for the study, incorporating individual semi-structured interviews (n = 17) and three focus groups (n = 20). Each interview/focus group was audio-taped and transcribed verbatim, and coding was conducted by two coders using an iterative process. Study participants identified personal and social/contextual factors as major barriers or facilitators of treatment adherence. Barriers include time consumption, forgetfulness, concerns about safety, poor knowledge/understanding, poor communication and lack of control/social pressure. Participants also identified facilitators, both internal (self-initiated) and external (initiated by family, health care professional and peers) to ensure treatment adherence. These included support from family members and social obligation towards others, risk perception, establishment of routines and peer support. Internal and external factors can hinder or facilitate adherence to diet, fluid and medications in the context of dialysis. Several of these barriers/facilitators can be effectively addressed in the context of interventions and psycho-educational programmes.
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75 FR 17829 - Motorcyclist Advisory Council to the Federal Highway Administration
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-07
... FHWA, on infrastructure issues of concern to motorcyclists, including: (1) Barrier design; (2) road design, construction, and maintenance practices; and (3) the architecture and implementation of... Administrator on infrastructure issues of concern to motorcyclists, including-- (1) Barrier design; (2) Road...
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Barriers to return to work after burn injuries.
Esselman, Peter C; Askay, Shelley Wiechman; Carrougher, Gretchen J; Lezotte, Dennis C; Holavanahalli, Radha K; Magyar-Russell, Gina; Fauerbach, James A; Engrav, Loren H
2007-12-01
To identify barriers to return to work after burn injury as identified by the patient. A cohort study with telephone interview up to 1 year. Hospital-based burn centers at 3 national sites. Hospitalized patients (N=154) meeting the American Burn Association criteria for major burn injury, employed at least 20 hours a week at the time of injury, and with access to a telephone after discharge. Patients were contacted via telephone every 2 weeks up to 4 months, then monthly up to 1 year after discharge. A return to work survey was used to identify barriers that prevented patients from returning to work. A graphic rating scale determined the impact of each barrier. By 1 year, 79.7% of patients returned to work. Physical and wound issues were barriers early after discharge. Although physical abilities continued to be a significant barrier up to 1 year, working conditions (temperature, humidity, safety) and psychosocial factors (nightmares, flashbacks, appearance concerns) became important issues in those with long-term disability. The majority of patients return to work after a burn injury. Although physical and work conditions are important barriers, psychosocial issues need to be evaluated and treated to optimize return to work.
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Spin-dependent dwell times of electron tunneling through double- and triple-barrier structures
NASA Astrophysics Data System (ADS)
Erić, Marko; Radovanović, Jelena; Milanović, Vitomir; Ikonić, Zoran; Indjin, Dragan
2008-04-01
We have analyzed the influence of Dresselhaus and Rashba spin-orbit couplings (caused by the bulk inversion asymmetry and the structural asymmetry, respectively) on electron tunneling through a double- and triple-barrier structures, with and without an externally applied electric field. The results indicate that the degree of structural asymmetry and external electric field can greatly affect the dwell times of electrons with opposite spin orientation. This opens up the possibilities of obtaining efficient spin separation in the time domain. The material system of choice is AlxGa1-xSb, and the presented model takes into account the position dependence of material parameters, as well as the effects of band nonparabolicity.
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Labat, Francoise; Sharma, Anjali
2016-04-25
To identify potential barriers to patient safety (PS) interventions from the perspective of surgical team members working in an operating theatre in Eastern Democratic Republic of Congo (DRC). In-depth interviews were conducted and analysed using qualitative content analysis. Governmental referral teaching hospital in Eastern DRC. We purposively selected 2-4 national and expatriate surgical team members from each specialisation. Of the 31 eligible surgical health workers (HWs), 17 volunteered to be interviewed. Economics issues affected PS throughout the entire health system, from human resources and hospital management, to access to healthcare for patients. Surgical team members seemed embedded in a paternalistic organisational structure and blame culture accompanied by perceived inefficient support services and low salaries. The armed conflict did not only worsen these system failures, it also carried direct threats to patients and HWs, and resulted in complex indirect consequences compromising PS. The increased corruption within health organisations, and population impoverishment and substance abuse among health staff adversely altered safe care. Simultaneously, HWs' reported resilience and resourcefulness to address barrier to PS. Participants had varying views on external aid depending on its relevance. The complex links between war and PS emphasise the importance of a comprehensive approach including occupational health to strengthen HWs' resilience, external clinical audits to limit corruption, and educational programmes in PS to support patient-centred care and address blame culture. Finally, improvement of equity in the health financing system seems essential to ensure access to healthcare and safe perioperative outcomes for all. 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/
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Everyday ethics in internal medicine resident clinic: an opportunity to teach.
Carrese, Joseph A; McDonald, Erin L; Moon, Margaret; Taylor, Holly A; Khaira, Kiran; Catherine Beach, Mary; Hughes, Mark T
2011-07-01
Being a good doctor requires competency in ethics. Accordingly, ethics education during residency training is important. We studied the everyday ethics-related issues (i.e. ordinary ethics issues commonly faced) that internal medical residents encounter in their out-patient clinic and determined whether teaching about these issues occurred during faculty preceptor-resident interactions. This study involved a multi-method qualitative research design combining observation of preceptor-resident discussions with preceptor interviews. The study was conducted in two different internal medicine training programme clinics over a 2-week period in June 2007. Fifty-three residents and 19 preceptors were observed, and 10 preceptors were interviewed. Transcripts of observer field notes and faculty interviews were carefully analysed. The analysis identified several themes of everyday ethics issues and determined whether preceptors identified and taught about these issues. Everyday ethics content was considered present in 109 (81%) of the 135 observed case presentations. Three major thematic domains and associated sub-themes related to everyday ethics issues were identified, concerning: (i) the Doctor-Patient Interaction (relationships; communication; shared decision making); (ii) the Resident as Learner (developmental issues; challenges and conflicts associated with training; relationships with colleagues and mentors; interactions with the preceptor), and; (iii) the Doctor-System Interaction (financial issues; doctor-system issues; external influences; doctor frustration related to system issues). Everyday ethics issues were explicitly identified by preceptors (without teaching) in 18 of 109 cases (17%); explicit identification and teaching occurred in only 13 cases (12%). In this study a variety of everyday ethics issues were frequently encountered as residents cared for patients. Yet, faculty preceptors infrequently explicitly identified or taught these issues during their interactions with residents. Ethics education is important and residents may regard teaching about the ethics-related issues they actually encounter to be highly relevant. A better understanding of the barriers to teaching is needed in order to promote education about everyday ethics in the out-patient setting. © Blackwell Publishing Ltd 2011.
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Everyday ethics in internal medicine resident clinic: an opportunity to teach
Carrese, Joseph A; McDonald, Erin L; Moon, Margaret; Taylor, Holly A; Khaira, Kiran; Beach, Mary Catherine; Hughes, Mark T
2011-01-01
OBJECTIVES Being a good doctor requires competency in ethics. Accordingly, ethics education during residency training is important. We studied the everyday ethics-related issues (i.e. ordinary ethics issues commonly faced) that internal medical residents encounter in their out-patient clinic and determined whether teaching about these issues occurred during faculty preceptor–resident interactions. METHODS This study involved a multi-method qualitative research design combining observation of preceptor-resident discussions with preceptor interviews. The study was conducted in two different internal medicine training programme clinics over a 2-week period in June 2007. Fifty-three residents and 19 preceptors were observed, and 10 preceptors were interviewed. Transcripts of observer field notes and faculty interviews were carefully analysed. The analysis identified several themes of everyday ethics issues and determined whether preceptors identified and taught about these issues. RESULTS Everyday ethics content was considered present in 109 (81%) of the 135 observed case presentations. Three major thematic domains and associated sub-themes related to everyday ethics issues were identified, concerning: (i) the Doctor–Patient Interaction (relationships; communication; shared decision making); (ii) the Resident as Learner (developmental issues; challenges and conflicts associated with training; relationships with colleagues and mentors; interactions with the preceptor), and; (iii) the Doctor–System Interaction (financial issues; doctor–system issues; external influences; doctor frustration related to system issues). Everyday ethics issues were explicitly identified by preceptors (without teaching) in 18 of 109 cases (17%); explicit identification and teaching occurred in only 13 cases (12%). CONCLUSIONS In this study a variety of everyday ethics issues were frequently encountered as residents cared for patients. Yet, faculty preceptors infrequently explicitly identified or taught these issues during their interactions with residents. Ethics education is important and residents may regard teaching about the ethics-related issues they actually encounter to be highly relevant. A better understanding of the barriers to teaching is needed in order to promote education about everyday ethics in the out-patient setting. PMID:21649704
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Colbert, Alison M; Goshin, Lorie S; Durand, Vanessa; Zoucha, Rick; Sekula, L Kathleen
2016-12-01
Health priorities of women after incarceration remain poorly understood, constraining development of interventions targeted at their health during that time. We explored the experience of health and health care after incarceration in a focused ethnography of 28 women who had been released from prison or jail within the past year and were living in community corrections facilities. The women's outlook on health was rooted in a newfound core optimism, but this was constrained by their pressing health-related issues; stress and uncertainty; and the pressures of the criminal justice system. These external forces threatened to cause collapse of women's core optimism. Findings support interventions that capitalize on women's optimism and address barriers specific to criminal justice contexts. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
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Jerman, Jenna; Frohwirth, Lori; Kavanaugh, Megan L.; Blades, Nakeisha
2018-01-01
CONTEXT Abortion availability and accessibility vary by state. Especially in areas where services are restricted or limited, some women travel to obtain abortion services in other states. Little is known about the experience of travel to obtain abortion. METHODS In January and February 2015, in-depth interviews were conducted with 29 patients seeking abortion services at six facilities in Michigan and New Mexico. Eligible women were 18 or older, spoke English, and had traveled either across state lines or more than 100 miles within the state. Respondents were asked to describe their experience from pregnancy discovery to the day of the abortion procedure. Barriers to accessing abortion care and consequences of these barriers were identified through inductive and deductive analysis. RESULTS Respondents described 15 barriers to abortion care while traveling to obtain services, and three major consequences of experiencing those barriers. Barriers were grouped into five categories: travel-related logistical issues, system navigation issues, limited clinic options, financial issues, and state or clinic restrictions. Consequences were delays in care, negative mental health impacts and considering self-induction. The experience of barriers complicated the process of obtaining an abortion, but the effect of any individual barrier was unclear. Instead, the experience of multiple barriers appeared to have a compounding effect, resulting in negative consequences for women traveling for abortion. CONCLUSION The amalgamation of barriers to abortion care experienced simultaneously can have significant consequences for patients. PMID:28394463
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Telemedicine: legal and licensure issues
NASA Astrophysics Data System (ADS)
Wood, Michael B.; Whelan, Leo J.
1995-10-01
The National Information Infrastructure program offers a great opportunity for the United States to capitalize on remarkable technological advancements over a broad range of applications benefiting society. One such application, telemedicine, has the potential to offer widespread access to sophisticated medical care, curtailed health care delivery costs, and homogeneous health and health-related educational opportunities. However, there are a variety of barriers to widespread application of telemedicine once the technical infrastructure of the information highway is well established and ubiquitous. These barriers include technical limitations, reimbursement issues, equipment and networking costs, and appropriate scientific studies to document efficacy and cost effectiveness. These issues may prove to be only transient disincentives which can be surmounted. Additional barriers exist, however, that may not be as readily resolved by traditional methods of analysis and more widespread practice applications. These political and regulatory obstacles will require clarification of the issues and solutions based on national consensus. It is the purpose of this discussion to amplify on these particular barriers which include licensure and tort jurisdiction.
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The policy context of patient centered medical homes: perspectives of primary care providers.
Alexander, Jeffrey A; Cohen, Genna R; Wise, Christopher G; Green, Lee A
2013-01-01
Interest in the patient centered medical home (PCMH) model has increased significantly in recent years. Despite this attention, information is limited regarding the influence of policy context on implementation of the PCMH model. Using comparative, qualitative data, we identify several key policy impediments to PCMH implementation, and propose practical guidelines for addressing these issues. Qualitative, semi-structured in-person interviews with representatives of physician organizations and primary care practices pursuing PCMH. Practitioners and staff at 16 physician practices in Michigan, as well as key leaders of physician organizations. We identified five primary policy issues cited by physicians and physician organization leaders as most impactful on their efforts to adopt PCMH: misalignment of current reimbursement schemes, administrative burden, conflicting criteria for PCMH designation, workforce policy issues, and uncertainty of health care reform. These policies were largely seen as barriers to their ability to implement PCMH. Providers' motivation to embrace PCMH, and their level of confidence regarding the results of such change, are greatly influenced by their perception of the external environment and the control they believe they have over this environment. Having policies in place that shape the path to PCMH in a manner that makes it as easy as possible for providers to accomplish the desired changes could well make the difference in whether successful transformation is achieved.
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Victims' barriers to discussing domestic violence in clinical consultations: a qualitative enquiry.
Othman, Sajaratulnisah; Goddard, Chris; Piterman, Leon
2014-05-01
Victims of domestic violence frequently attend health care facilities. In many cases, their abusive experience is neither disclosed nor discussed during clinical consultations. This study examined the barriers faced by women when discussing abuse with health care providers, specifically in cases involving Malaysian women with a history of domestic violence. A qualitative study using in-depth interviews was conducted with 10 women with a history of domestic violence residing at a shelter. Purposive sampling was conducted until data saturation. Using the grounded theory approach of analysis, themes that emerged from these interviews were then further analyzed to examine the barriers faced by these women. Women who experienced domestic violence faced multiple barriers while discussing their accounts of abuse with others. Values placed on the privacy of domestic violence; upholding the traditional gender roles; preserving the family unity; minimizing the abuse, the feeling of shame, self-blame; and fearing their abuser generally create internal barriers when discussing their encounters of abuse with health care providers. The perceived unknown role of health care professionals when dealing with patients experiencing domestic violence as well as the previous negative experiences in clinical consultations acted as external barriers for discussing abuse with health care providers. Women with domestic violence experiences faced internal and external barriers to discussing their abuse during clinical consultations. Physicians and health care providers must consider domestic violence in consultations with female patients. A good doctor-patient relationship that encompasses empathy, confidence, trust, support, assurance, confidentiality, and guidance can help patients with abusive backgrounds overcome these barriers, leading to the disclosure and discussion of their abusive encounters. Proper education, guidelines, and support for health care providers are required to help them assist women with histories of domestic violence.
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Weissenborn, Marina; Haefeli, Walter E; Peters-Klimm, Frank; Seidling, Hanna M
2017-06-01
Background While collaboration between community pharmacists (CPs) and general practitioners (GPs) is essential to provide comprehensive patient care, their communication often is scarce and hampered by multiple barriers. Objective We aimed to assess both professions' perceptions of interprofessional communication with regard to content and methods of communication as a basis to subsequently develop best-practice recommendations for information exchange. Setting Ambulatory care setting in Germany. Method CPs and GPs shared their experience in focus groups and in-depth interviews which were conducted using a semi-structured interview guideline. Transcribed recordings were assessed using qualitative content analysis according to Mayring. Main outcome measure Specification of existing barriers, CPs'/GPs' general perceptions of interprofessional communication and similarities and differences regarding prioritization of specific information items and how to best communicate with each other. Results Four focus groups and fourteen interviews were conducted. Seven internal (e.g. professions were not personally known to one another) and nine external barriers (e.g. mutual accessibility) were identified. Ten organizational, eight medication-related, and four patient-related information items were identified requiring interprofessional communication. Their relevance varied between the professions, e.g. CPs rated organizational issues higher than GPs. Both professions indicated communication via phone to be the most frequently used method of communication. Conclusion CPs and GPs opinions often differ. However, communication between CPs and GPs is perceived as crucial suggesting that a future concept has to offer standardized recommendations, while leaving CPs and GPs room to adjust it to their individual needs.
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Method for preparing a sodium/sulfur cell
Weiner, Steven A.
1978-01-01
A method for preparing a sodium/sulfur cell comprising (A) inserting a solid sodium slug, adapted to be connected to an external circuit, into the anodic reaction zone of a cell subassembly maintained within an inert atmosphere, said cell subassembly comprising a cell container and a tubular cation-permeable barrier disposed within said container such that a first reaction zone is located within cation-permeable barrier and a second reaction zone is located between the outer surface of said cation-permeable barrier and the inner surface of said container, one of said reaction zones being said anodic reaction zone and the other of said reaction zone being a cathodic reaction zone containing a precast composite cathodic reactant comprising a sulfur impregnated porous conductive material connected to said cation permeable barrier and adapted to be connected to said external circuit; and (B) providing closure means for said subassembly and sealing the same to said subassembly at a temperature less than about 100.degree. C. The method of the invention overcomes deficiencies of the prior art methods by allowing preparation of a sodium/sulfur cell without the use of molten reactants and the fill spouts which are required when the cell is filled with molten reactants.
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ERIC Educational Resources Information Center
Williams, Howard
This paper describes issues, experiences, and strategies used in developing successful multisectoral partnerships to advance girls' education, using Guinea and Morocco as examples. Chapter 1 introduces the issue, discussing barriers to girls' education and describing the multisectoral response to interrelated barriers. Chapter 2 defines the…
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Photoneutron radiation field of ducts in barrier of 15 MV medical electron accelerators
NASA Astrophysics Data System (ADS)
Deng, Lei; Zhou, Ning; Chen, Yi-shui; Tu, Yu
2017-11-01
Shielding body of the high-energy medical electron accelerators is always penetrated by ducts, which would influence the shielding capability of local barrier. In order to quantitatively analyze the duct's impact on shielding of the photoneutron from 15 MV accelerators, the ambient dose equivalent rate and energy spectrum at the center of a typical duct and the external mouth of duct were calculated based on MCNP program for the first time. The results demonstrate that leakage neutrons at the external mouth of duct are mainly thermal neutron, and its dose rate is decreased with the increase of the intersection angle between duct and wall as well as the reduction of duct diameter. When a duct in a diameter no more than 30 cm penetrates the wall unidirectionally and the inclined Angle (θ) is 60°, neutron dose rate at the external mouth of duct could meet the requirements of protection. At last, according to the calculation results, some suggestions are proposed for the shielding design of ducts in walls.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Dutta, Akshita; Tymi?ska, Nina; Zhu, Guanghui
In this paper, the interaction between hydrogen sulfide and ZIF-8 was studied via structural characterizations and guest molecule diffusion measurements. It was found that hydrogen sulfide reacts with the ZIF-8 external particle surface to form a surface barrier that excludes the uptake of larger molecules (ethanol) and slows down the uptake of smaller molecules (carbon dioxide). Nonetheless, bulk transport properties were unaltered, as supported by pulsed field gradient nuclear magnetic resonance studies. Dispersion-corrected density functional theory calculations revealed that H 2S is consumed by reactions occurring at the ZIF external surface. These reactions result in water and defect formation, bothmore » of which were found to be exothermic and independent of both crystallographic facets ({001} and {110}) and surface termination. Finally, we concluded that these surface reactions lead to structural and chemical changes to the ZIF-8 external surface that generate surface barriers to molecular transport.« less
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Dutta, Akshita; Tymi?ska, Nina; Zhu, Guanghui; ...
2018-03-09
In this paper, the interaction between hydrogen sulfide and ZIF-8 was studied via structural characterizations and guest molecule diffusion measurements. It was found that hydrogen sulfide reacts with the ZIF-8 external particle surface to form a surface barrier that excludes the uptake of larger molecules (ethanol) and slows down the uptake of smaller molecules (carbon dioxide). Nonetheless, bulk transport properties were unaltered, as supported by pulsed field gradient nuclear magnetic resonance studies. Dispersion-corrected density functional theory calculations revealed that H 2S is consumed by reactions occurring at the ZIF external surface. These reactions result in water and defect formation, bothmore » of which were found to be exothermic and independent of both crystallographic facets ({001} and {110}) and surface termination. Finally, we concluded that these surface reactions lead to structural and chemical changes to the ZIF-8 external surface that generate surface barriers to molecular transport.« less
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Jerman, Jenna; Frohwirth, Lori; Kavanaugh, Megan L; Blades, Nakeisha
2017-06-01
Abortion availability and accessibility vary by state. Especially in areas where services are restricted or limited, some women travel to obtain abortion services in other states. Little is known about the experience of travel to obtain abortion. In January and February 2015, in-depth interviews were conducted with 29 patients seeking abortion services at six facilities in Michigan and New Mexico. Eligible women were 18 or older, spoke English, and had traveled either across state lines or more than 100 miles within the state. Respondents were asked to describe their experience from pregnancy discovery to the day of the abortion procedure. Barriers to accessing abortion care and consequences of these barriers were identified through inductive and deductive analysis. Respondents described 15 barriers to abortion care while traveling to obtain services, and three major consequences of experiencing those barriers. Barriers were grouped into five categories: travel-related logistical issues, system navigation issues, limited clinic options, financial issues, and state or clinic restrictions. Consequences were delays in care, negative mental health impacts and considering self-induction. The experience of barriers complicated the process of obtaining an abortion, but the effect of any individual barrier was unclear. Instead, the experience of multiple barriers appeared to have a compounding effect, resulting in negative consequences for women traveling for abortion. The amalgamation of barriers to abortion care experienced simultaneously can have significant consequences for patients. © 2017 The Authors. Perspectives on Sexual and Reproductive Health published by Wiley Periodicals, Inc., on behalf of the Guttmacher Institute.
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Nuclear reactor insulation and preheat system
Wampole, Nevin C.
1978-01-01
An insulation and preheat system for preselected components of a fluid cooled nuclear reactor. A gas tight barrier or compartment of thermal insulation surrounds the selected components and includes devices to heat the internal atmosphere of the compartment. An external surface of the compartment or enclosure is cooled, such as by a circulating fluid. The heating devices provide for preheating of the components, as well as maintenance of a temperature sufficient to ensure that the reactor coolant fluid will not solidify during shutdown. The external cooling limits the heat transferred to other plant structures, such as supporting concrete and steel. The barrier is spaced far enough from the surrounded components so as to allow access for remote or manual inspection, maintenance, and repair.
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NASA Astrophysics Data System (ADS)
Patzelt, A.; Sterry, W.; Lademann, J.
2010-12-01
A major function of the skin is to provide a protective barrier at the interface between external environment and the organism. For skin barrier measurement, a multiplicity of methods is available. As standard methods, the determination of the transepidermal water loss (TEWL) as well as the measurement of the stratum corneum hydration, are widely accepted, although they offer some obvious disadvantages such as increased interference liability. Recently, new optical and spectroscopic methods have been introduced to investigate skin barrier properties in vivo. Especially, laser scanning microscopy has been shown to represent an excellent tool to study skin barrier integrity in many areas of relevance such as cosmetology, occupation, diseased skin, and wound healing.
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FAST TRACK COMMUNICATION: Interlayer exchange coupling across a ferroelectric barrier
NASA Astrophysics Data System (ADS)
Zhuravlev, M. Ye; Vedyayev, A. V.; Tsymbal, E. Y.
2010-09-01
A new magnetoelectric effect is predicted originating from the interlayer exchange coupling between two ferromagnetic layers separated by an ultrathin ferroelectric barrier. It is demonstrated that ferroelectric polarization switching driven by an external electric field leads to a sizable change in the interlayer exchange coupling. The effect occurs in asymmetric ferromagnet/ferroelectric/ferromagnet junctions due to a change in the electrostatic potential profile across the junction affecting the interlayer coupling. The predicted phenomenon indicates the possibility of switching the magnetic configuration by reversing the polarization of the ferroelectric barrier layer.
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Cultural Barriers to Change in Assessment Practices in Higher Education
ERIC Educational Resources Information Center
Jenkins, Deborah Bainer
2007-01-01
The culture at the authors' institution raised barriers to changing from traditional assessment to portfolio assessment in the doctoral program. A Culture of Independence presented barriers of time and functional inadequacy. A Culture of Compliance raised trust, group process, and membership issues. These barriers were managed and overcome using…
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Marzolini, Susan; Balitsky, Amaris; Jagroop, David; Corbett, Dale; Brooks, Dina; Grace, Sherry L; Lawrence, Danielle; Oh, Paul I
2016-01-01
The aim of this study was to determine the factors affecting attendance at an adapted cardiac rehabilitation program for individuals poststroke. A convenience sample of ambulatory patients with hemiparetic gait rated 20 potential barriers to attendance on a 5-point Likert scale upon completion of a 6-month program of 24 prescheduled weekly sessions. Sociodemographic characteristics, depressive symptoms, cardiovascular fitness, and comorbidities were collected by questionnaire or medical chart. Sixty-one patients attended 77.3 ± 12% of the classes. The longer the elapsed time from stroke, the lower the attendance rate (r = -.34, P = .02). The 4 greatest barriers influencing attendance were severe weather, transportation problems, health problems, and traveling distance. Health problems included hospital readmissions (n = 6), influenza/colds (n = 6), diabetes and cardiac complications (n = 4), and musculoskeletal issues (n = 2). Of the top 4 barriers, people with lower compared to higher income had greater transportation issues (P = .004). Greater motor deficits of the stroke-affected leg were associated with greater barriers related to health issues (r = .7, P = .001). The only sociodemographic factor associated with a higher total mean barrier score was non-English as the primary language spoken at home (P = .002); this factor was specifically related to the barriers of cost (P = .007), family responsibilities (P = .018), and lack of social support (P = .001). No other associations were observed. Barriers to attendance were predominantly related to logistic/transportation and health issues. People who were more disadvantaged socioeconomically (language, finances), and physically (stroke-related deficits) were more affected by these barriers. Strategies to reduce these barriers, including timely referral to exercise programs, need to be investigated. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.
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Access to health care for persons with disabilities in rural South Africa.
Vergunst, R; Swartz, L; Hem, K-G; Eide, A H; Mannan, H; MacLachlan, M; Mji, G; Braathen, S H; Schneider, M
2017-11-17
Global research suggests that persons with disabilities face barriers when accessing health care services. Yet, information regarding the nature of these barriers, especially in low-income and middle-income countries is sparse. Rural contexts in these countries may present greater barriers than urban contexts, but little is known about access issues in such contexts. There is a paucity of research in South Africa looking at "triple vulnerability" - poverty, disability and rurality. This study explored issues of access to health care for persons with disabilities in an impoverished rural area in South Africa. The study includes a quantitative survey with interviews with 773 participants in 527 households. Comparisons in terms of access to health care between persons with disabilities and persons with no disabilities were explored. The approach to data analysis included quantitative data analysis using descriptive and inferential statistics. Frequency and cross tabulation, comparing and contrasting the frequency of different phenomena between persons with disabilities and persons with no disabilities, were used. Chi-square tests and Analysis of Variance tests were then incorporated into the analysis. Persons with disabilities have a higher rate of unmet health needs as compared to non-disabled. In rural Madwaleni in South Africa, persons with disabilities faced significantly more barriers to accessing health care compared to persons without disabilities. Barriers increased with disability severity and was reduced with increasing level of education, living in a household without disabled members and with age. This study has shown that access to health care in a rural area in South Africa for persons with disabilities is more of an issue than for persons without disabilities in that they face more barriers. Implications are that we need to look beyond the medical issues of disability and address social and inclusion issues as well.
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ERIC Educational Resources Information Center
Heller, Monica L.; Cassady, Jerrell C.
2017-01-01
The current study explored the impact of internal and external barriers (e.g., academic anxiety, employment) that place subgroups of college students at risk for academic failure in the first year. The mitigating potential of academic resource management strategies (e.g., time-study environment) was also examined. In a sample of 885 first-semester…
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Lysosomal storage diseases and the blood-brain barrier.
Begley, David J; Pontikis, Charles C; Scarpa, Maurizio
2008-01-01
The blood-brain barrier becomes a crucial issue in neuronopathic lysosomal storage diseases for three reasons. Firstly, the function of the blood-brain barrier may be compromised in many of the lysosomal storage diseases and this barrier dysfunction may contribute to the neuropathology seen in the diseases and accelerate cell death. Secondly, the substrate reduction therapies, which successfully reduce peripheral lysosomal storage, because of the blood-brain barrier may not have as free an access to brain cells as they do to peripheral cells. And thirdly, enzyme replacement therapy appears to have little access to the central nervous system as the mannose and mannose-6-phosphate receptors involved in their cellular uptake and transport to the lysosome do not appear to be expressed at the adult blood-brain barrier. This review will discuss in detail these issues and their context in the development of new therapeutic strategies.
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Galvin, Kathleen T; Petford, Nick; Ajose, Frances; Davies, Dai
2011-01-01
Background: The effectiveness of malaria control programs is determined by an array of complex factors, including the acceptability and sustained use of preventative measures such as the bed net. A small-scale exploratory study was conducted in several locations in the Niger Delta region, Nigeria, to discover barriers against the use of bed nets, in the context of a current drive to scale up net use in Nigeria. Methods: A qualitative approach with a convenience sample was used. One to one interviews with mostly male adult volunteers were undertaken which explored typical living and sleeping arrangements, and perceptions about and barriers against the use of the mosquito prevention bed net. Results: Several key issues emerged from the qualitative data. Bed nets were not reported as widely used in this small sample. The reasons reported for lack of use included issues of convenience, especially net set up and dismantling; potential hazard and safety concerns; issues related to typical family composition and nature of accommodation; humid weather conditions; and perceptions of cost and effectiveness. Most barriers to net use concerned issues about everyday practical living and sleeping arrangements and perceptions about comfort. Interviewees identified were aware of malaria infection risks, but several also indicated certain beliefs that were barriers to net use. Conclusions: Successful control of malaria and scale up of insecticide-treated net coverage relies on community perceptions and practice. This small study has illuminated a number of important everyday life issues, which remain barriers to sustained net use, and has clarified further questions to be considered in net design and in future research studies. The study highlights the need for further research on the human concerns that contribute to sustained use of nets or, conversely, present significant barriers to their use. PMID:21544249
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Dissipative tunnelling by means of scaled trajectories
NASA Astrophysics Data System (ADS)
Mousavi, S. V.; Miret-Artés, S.
2018-06-01
Dissipative quantum tunnelling through an inverted parabolic barrier is considered in the presence of an electric field. A Schrödinger-Langevin or Kostin quantum-classical transition wave equation is used and applied resulting in a scaled differential equation of motion. A Gaussian wave packet solution to the resulting scaled Kostin nonlinear equation is assumed and compared to the same solution for the scaled linear Caldirola-Kanai equation. The resulting scaled trajectories are obtained at different dynamical regimes and friction cases, showing the gradual decoherence process in this open dynamics. Theoretical results show that the transmission probabilities are always higher in the Kostin approach than in the Caldirola-Kanai approach in the presence or not of an external electric field. This discrepancy should be understood due to the presence of an environment since the corresponding open dynamics should be governed by nonlinear quantum equations, whereas the second approach is issued from an effective Hamiltonian within a linear theory.
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Momentum dependence in pair production by an external field
NASA Astrophysics Data System (ADS)
Asakawa, M.
1992-08-01
The transverse and the longitudinal momentum dependences of the pair production under an adiabatically exerted uniform abelian external field are calculated with their importance in models for the production of quark-gluon plasma in ultrarelativistic heavy ion collisions in mind. The importance of the initial condition is revealed. We show that superposition of acceleration by the external field and barrier penetration is reflected in the longitudinal momentum dependence. The peculiar nature of the boost invariant system which is expected to be approximately realized in ultrarelativistic nuclear collisions is pointed out.
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Simms, Rebecca A; Yelland, Andrew; Ping, Helen; Beringer, Antonia J; Draycott, Timothy J; Fox, Robert
2014-06-01
Risk management is a core part of healthcare practice, especially within maternity services, where litigation and societal costs are high. There has been little investigation into the experiences and opinions of those staff directly involved in risk management: lead obstetricians and specialist risk midwives, who are ideally placed to identify how current implementation of risk management strategies can be improved. A qualitative study of consultant-led maternity units in an English region. Semistructured interviews were conducted with the obstetric and midwifery risk management leads for each unit. We explored their approach to risk management, particularly their opinions regarding quality monitoring and related barriers/issues. Interviews were recorded, transcribed and thematically analysed. Twenty-seven staff from 12/15 maternity units participated. Key issues identified included: concern for the accuracy and validity of their local data, potential difficulties related to data collation, the negative impact of external interference by national regulatory bodies on local clinical priorities, the influence of the local culture of the maternity unit on levels of engagement in the risk management process, and scepticism about the value of benchmarking of maternity units without adjustment for population characteristics. Local maternity risk managers may provide valuable, clinically relevant insights into current issues in clinical data monitoring. Improvements should focus on the accuracy and ease of data collation with a need for an agreed maternity indicators set, populated from validated databases, and not reliant on data collection systems that distract clinicians from patient activity and quality improvement. It is clear that working relationships between risk managers, their own clinical teams and external national bodies require improvement and alignment. Further discussion regarding benchmarking between maternity units is required prior to implementation. These findings are likely to be relevant to other clinical specialties. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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Herbeck, Diane M; Brecht, Mary-Lynn; Christou, Dayna; Lovinger, Katherine
2014-01-01
To better understand methamphetamine (MA) use patterns and the process of recovery, qualitative interviews were conducted with adult MA users (n = 20), comparing a sample that received substance abuse treatment with those who had not received treatment. Respondents provided detailed information on why and how they changed from use to abstinence and factors they considered to be barriers to abstinence. Audio recordings and transcripts were reviewed for common themes. Participants reported a range of mild/moderate to intensely destructive problems, including loss of important relationships and profound changes to who they felt they were at their core; e.g., "I didn't realize how dark and mean I was … I was like a different person." Initial abstinence was often facilitated by multiple external forces (e.g., drug testing, child custody issues, prison, relocation), but sustained abstinence was attributed to shifts in thinking and salient realizations about using. The treatment group reported using more and different resources to maintain their abstinence than the no-treatment group. Findings indicate individualized interventions and multiple, simultaneous approaches and resources were essential in reaching stable abstinence. Understanding long-term users' experiences with MA use, addiction, and abstinence can inform strategies for engaging and sustaining MA users in treatment and recovery.
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Herbeck, Diane M.; Brecht, Mary-Lynn; Christou, Dayna; Lovinger, Katherine
2014-01-01
To better understand methamphetamine (MA) use patterns and the process of recovery, qualitative interviews were conducted with adult MA users (n=20), comparing a sample that received substance abuse treatment with those who had not received treatment. Respondents provided detailed information on why and how they changed from use to abstinence, and factors they considered to be barriers to abstinence. Audio recordings and transcripts were reviewed for common themes. Participants reported a range of mild/moderate to intensely destructive problems, including loss of important relationships and profound changes to who they felt they were at their core, e.g., “I didn’t realize how dark and mean I was... I was like a different person.” Initial abstinence was often facilitated by multiple external forces (e.g., drug testing, child custody issues, prison, relocation), but sustained abstinence was attributed to shifts in thinking and salient realizations about using. The treatment group reported using more and different resources to maintain their abstinence than the no treatment group. Findings indicate individualized interventions and multiple, simultaneous approaches and resources were essential in reaching stable abstinence. Understanding long-term users’ experiences with MA use, addiction and abstinence can inform strategies for engaging and sustaining MA users in treatment and recovery. PMID:25052880
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Environmental Barrier Coatings for Ceramic Matrix Composites - An Overview
NASA Technical Reports Server (NTRS)
Lee, Kang; van Roode, Mark; Kashyap, Tania; Zhu, Dongming; Wiesner, Valerie
2017-01-01
SiC/SiC Ceramic Matrix Composites (CMCs) are increasingly being considered as structural materials for advanced power generation equipment because of their light weight, higher temperature capability, and oxidation resistance. Limitations of SiC/SiC CMCs include surface recession and component cracking and associated chemical changes in the CMC. The solutions pursued to improve the life of SiC/SiC CMCs include the incorporation of coating systems that provide surface protection, which has become known as an Environmental Barrier Coating (EBC). The development of EBCs for the protection of gas turbine hot section CMC components was a continuation of coating development work for corrosion protection of silicon-based monolithics. Work on EBC development for SiC/SiC CMCs has been ongoing at several national laboratories and the original gas turbine equipment manufacturers. The work includes extensive laboratory, rig and engine testing, including testing of EBC coated SiC/SiC CMCs in actual field applications. Another EBC degradation issue which is especially critical for CMC components used in aircraft engines is the degradation from glassy deposits of calcium-magnesium-aluminosilicate (CMAS) with other minor oxides. This paper addresses the need for and properties of external coatings on SiC/SiC CMCs to extend their useful life in service and the retention of their properties.
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Verloigne, Maïté; Veitch, Jenny; Carver, Alison; Salmon, Jo; Cardon, Greet; De Bourdeaudhuij, Ilse; Timperio, Anna
2014-09-18
This study aimed to investigate how parental and peer variables are associated with moderate- to-vigorous intensity physical activity (MVPA) on week- and weekend days among Australian adolescents (13-15 y), and whether perceived internal barriers (e.g. lack of time), external barriers (e.g. lack of others to be physically active with) and self-efficacy mediated these associations. Cross-sectional data were drawn from the Health, Eating and Play Study, conducted in Melbourne, Australia. Adolescents (mean age = 14.11 ± 0.59 years, 51% girls) and one of their parents completed a questionnaire and adolescents wore an ActiGraph accelerometer for a week (n = 134). Mediating effects of perceived barriers and self-efficacy were tested using MacKinnon's product-of-coefficients test based on multilevel linear regression analyses. Parental logistic support was positively related to MVPA on weekdays (τ = 0.035) and weekend days (τ = 0.078), peer interest (τ =0.036) was positively related to MVPA on weekdays, and parental control (τ = -0.056) and parental concern (τ = -0.180) were inversely related to MVPA on weekdays. Internal barriers significantly mediated the association between parental logistic support and MVPA on weekdays (42.9% proportion mediated). Self-efficacy and external barriers did not mediate any association. Interventions aiming to increase adolescents' MVPA should involve parents, as parental support may influence MVPA on weekdays by reducing adolescents' perceived internal barriers. Longitudinal and experimental research is needed to confirm these findings and to investigate other personal mediators.
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Quality of herbal medicines: challenges and solutions.
Zhang, Junhua; Wider, Barbara; Shang, Hongcai; Li, Xuemei; Ernst, Edzard
2012-01-01
The popularity of herbal medicines has risen worldwide. This increase in usage renders safety issues important. Many adverse events of herbal medicines can be attributed to the poor quality of the raw materials or the finished products. Different types of herbal medicines are associated with different problems. Quality issues of herbal medicines can be classified into two categories: external and internal. In this review, external issues including contamination (e.g. toxic metals, pesticides residues and microbes), adulteration and misidentification are detailed. Complexity and non-uniformity of the ingredients in herbal medicines are the internal issues affecting the quality of herbal medicines. Solutions to the raised problems are discussed. The rigorous implementation of Good Agricultural and Collection Practices (GACP) and Good Manufacturing Practices (GMP) would undoubtedly reduce the risk of external issues. Through the use of modern analytical methods and pharmaceutical techniques, previously unsolved internal issues have become solvable. Standard herbal products can be manufactured from the standard herbal extracts. Copyright © 2011 Elsevier Ltd. All rights reserved.
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75 FR 12670 - Airworthiness Directives; The Boeing Company Model 767 Airplanes
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-17
... joints, the skin at certain external approved repairs, the skin around external features such as antennas... antennas, and at locations where external decals had been cut. We are issuing this AD to detect and correct... skin at certain external approved repairs, the skin around external features such as antennas, and the...
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Cummings, Marvin; Shirato, Nozomi; Kersell, Heath
Here, the effect of a local external electric field on the barrier potential of a tunneling gap is studied utilizing an emerging technique, synchrotron x-ray scanning tunneling microscopy. Here, we demonstrate that the shape of the potential barrier in the tunneling gap can be altered by a localized external electric field, generated by voltages placed on the metallic outer shield of a nanofabricated coaxial metal-insulator-metal tip, resulting in a controlled linear modulation of the tunneling current. Experiments at hard and soft x-ray synchrotron beamlines reveal that both the chemical contrast and magnetic contrast signals measured by the tip can bemore » drastically enhanced, resulting in improved local detection of chemistry and magnetization at the surface.« less
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Cummings, Marvin; Shirato, Nozomi; Kersell, Heath; ...
2017-01-05
Here, the effect of a local external electric field on the barrier potential of a tunneling gap is studied utilizing an emerging technique, synchrotron x-ray scanning tunneling microscopy. Here, we demonstrate that the shape of the potential barrier in the tunneling gap can be altered by a localized external electric field, generated by voltages placed on the metallic outer shield of a nanofabricated coaxial metal-insulator-metal tip, resulting in a controlled linear modulation of the tunneling current. Experiments at hard and soft x-ray synchrotron beamlines reveal that both the chemical contrast and magnetic contrast signals measured by the tip can bemore » drastically enhanced, resulting in improved local detection of chemistry and magnetization at the surface.« less
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49 CFR Appendix A to Part 395 - Electronic On-Board Recorder Performance Specifications
Code of Federal Regulations, 2011 CFR
2011-10-01
... (to home office or wireless service provider). External Sensor Issue NO_ECM no ECM data No sensory information received from vehicle's Engine Control Module (ECM). External Sensor Issue ECM_ID ECM ID number mismatch ECM identification/serial number mismatch (with preprogrammed information). 2. Communications...
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Revival of cloaking effect in a driven bilayer graphene vector barrier
NASA Astrophysics Data System (ADS)
Maiti, S.; Panigrahi, A.; Biswas, R.; Sinha, C.
2018-05-01
Transmission profiles in bilayer graphene are studied theoretically through a rectangular vector potential (magnetic) barrier with and without the presence of an oscillatory potential. Unlike the electrostatic barrier, the Fano resonances (FR) are noted in the transmission spectra both for normal and glancing incidences due to non-conservation of chirality for a static vector barrier. The results for normal incidence indicate that the cloaking effect is a manifestation of the chirality conservation in charge transport through bilayer graphene scalar barriers. It is also noted that the aforesaid FR for a static vector barrier might disappear (photon induced electronic cloaking effect) due to the predominant photon exchange processes in presence of an external oscillating potential. The study of Fano resonances in transmission spectrum is in high demand in respect of localization of charge carriers in graphene nano structures for its potential applications in digital device fabrications.
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Devlin, Alison M; McGee-Lennon, Marilyn; O’Donnell, Catherine A; Bouamrane, Matt-Mouley; Agbakoba, Ruth; O’Connor, Siobhan; Grieve, Eleanor; Finch, Tracy; Wyke, Sally; Watson, Nicholas; Browne, Susan
2016-01-01
Objective To identify implementation lessons from the United Kingdom Delivering Assisted Living Lifestyles at Scale (dallas) program—a large-scale, national technology program that aims to deliver a broad range of digital services and products to the public to promote health and well-being. Materials and Methods Prospective, longitudinal qualitative research study investigating implementation processes. Qualitative data collected includes semi-structured e-Health Implementation Toolkit–led interviews at baseline/mid-point (n = 38), quarterly evaluation, quarterly technical and barrier and solutions reports, observational logs, quarterly evaluation alignment interviews with project leads, observational data collected during meetings, and ethnographic data from dallas events (n > 200 distinct pieces of qualitative data). Data analysis was guided by Normalization Process Theory, a sociological theory that aids conceptualization of implementation issues in complex healthcare settings. Results Five key challenges were identified: 1) The challenge of establishing and maintaining large heterogeneous, multi-agency partnerships to deliver new models of healthcare; 2) The need for resilience in the face of barriers and set-backs including the backdrop of continually changing external environments; 3) The inherent tension between embracing innovative co-design and achieving delivery at pace and at scale; 4) The effects of branding and marketing issues in consumer healthcare settings; and 5) The challenge of interoperability and information governance, when commercial proprietary models are dominant. Conclusions The magnitude and ambition of the dallas program provides a unique opportunity to investigate the macro level implementation challenges faced when designing and delivering digital health and wellness services at scale. Flexibility, adaptability, and resilience are key implementation facilitators when shifting to new digitally enabled models of care. PMID:26254480
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Devlin, Alison M; McGee-Lennon, Marilyn; O'Donnell, Catherine A; Bouamrane, Matt-Mouley; Agbakoba, Ruth; O'Connor, Siobhan; Grieve, Eleanor; Finch, Tracy; Wyke, Sally; Watson, Nicholas; Browne, Susan; Mair, Frances S
2016-01-01
To identify implementation lessons from the United Kingdom Delivering Assisted Living Lifestyles at Scale (dallas) program-a large-scale, national technology program that aims to deliver a broad range of digital services and products to the public to promote health and well-being. Prospective, longitudinal qualitative research study investigating implementation processes. Qualitative data collected includes semi-structured e-Health Implementation Toolkit-led interviews at baseline/mid-point (n = 38), quarterly evaluation, quarterly technical and barrier and solutions reports, observational logs, quarterly evaluation alignment interviews with project leads, observational data collected during meetings, and ethnographic data from dallas events (n > 200 distinct pieces of qualitative data). Data analysis was guided by Normalization Process Theory, a sociological theory that aids conceptualization of implementation issues in complex healthcare settings. Five key challenges were identified: 1) The challenge of establishing and maintaining large heterogeneous, multi-agency partnerships to deliver new models of healthcare; 2) The need for resilience in the face of barriers and set-backs including the backdrop of continually changing external environments; 3) The inherent tension between embracing innovative co-design and achieving delivery at pace and at scale; 4) The effects of branding and marketing issues in consumer healthcare settings; and 5) The challenge of interoperability and information governance, when commercial proprietary models are dominant. The magnitude and ambition of the dallas program provides a unique opportunity to investigate the macro level implementation challenges faced when designing and delivering digital health and wellness services at scale. Flexibility, adaptability, and resilience are key implementation facilitators when shifting to new digitally enabled models of care. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.
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A developing country perspective on implementing sustainable energy programs
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ul Haq, Z.; James, J.A.; Kamal, S.
1997-12-31
Bangladesh is a developing country faced with many challenges such as high population growth rate, low literacy levels, and poverty. One of its most difficult tasks is providing the infrastructure necessary to sustain a growing population with a finite resource base. There is a need to develop a long term energy strategy that relies on sustainable resources while reducing environmental harm. Solar energy has the potential to meet these requirements and presents a highly attractive energy source for Bangladesh. Bangladesh is fortunate enough to have a significant amount of solar irradiance. A number of projects have been started in Bangladeshmore » to exploit renewable energy resources. This paper will highlight the current status of these projects. Major interest and activity is directed towards development of photovoltaic and wind resources. The market for renewable technologies is vast in Bangladesh where a significant portion of the population is off-grid and in need of energy. Although this is not an affluent market technology costs have come down sufficiently such that it is becoming accessible to rural populations with credit schemes. While developing sustainable energy is a worthwhile goal and much encouraged by donor agencies, Bangladesh`s perspective on attempting to develop this sector suggests that it is not an easy road to follow, due to numerous internal and external barriers. A discussion of the barriers to the commercialization of renewables will be included in this paper. The objective of this paper is to shed some light on these issues and to stimulate discussions on how to overcome the barriers and encourage the dissemination of renewables in developing countries.« less
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Numerical investigation of dielectric barrier discharges
NASA Astrophysics Data System (ADS)
Li, Jing
1997-12-01
A dielectric barrier discharge (DBD) is a transient discharge occurring between two electrodes in coaxial or planar arrangements separated by one or two layers of dielectric material. The charge accumulated on the dielectric barrier generates a field in a direction opposite to the applied field. The discharge is quenched before an arc is formed. It is one of the few non-thermal discharges that operates at atmospheric pressure and has the potential for use in pollution control. In this work, a numerical model of the dielectric barrier discharge is developed, along with the numerical approach. Adaptive grids based on the charge distribution is used. A self-consistent method is used to solve for the electric field and charge densities. The Successive Overrelaxation (SOR) method in a non-uniform grid spacing is used to solve the Poisson's equation in the cylindrically-symmetric coordinate. The Flux Corrected Transport (FCT) method is modified to solve the continuity equations in the non-uniform grid spacing. Parametric studies of dielectric barrier discharges are conducted. General characteristics of dielectric barrier discharges in both anode-directed and cathode-directed streamer are studied. Effects of the dielectric capacitance, the applied field, the resistance in external circuit and the type of gases (O2, air, N2) are investigated. We conclude that the SOR method in an adaptive grid spacing for the solution of the Poisson's equation in the cylindrically-symmetric coordinate is convergent and effective. The dielectric capacitance has little effect on the g-factor of radical production, but it determines the strength of the dielectric barrier discharge. The applied field and the type of gases used have a significant role on the current peak, current pulse duration and radical generation efficiency, discharge strength, and microstreamer radius, whereas the external series resistance has very little effect on the streamer properties. The results are helpful in further understanding the ozone generation and pollution control process in a dielectric barrier discharge.
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Tight junctions and the modulation of barrier function in disease
2008-01-01
Tight junctions create a paracellular barrier in epithelial and endothelial cells protecting them from the external environment. Two different classes of integral membrane proteins constitute the tight junction strands in epithelial cells and endothelial cells, occludin and members of the claudin protein family. In addition, cytoplasmic scaffolding molecules associated with these junctions regulate diverse physiological processes like proliferation, cell polarity and regulated diffusion. In many diseases, disruption of this regulated barrier occurs. This review will briefly describe the molecular composition of the tight junctions and then present evidence of the link between tight junction dysfunction and disease. PMID:18415116
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Lamyian, M; Hydarnia, A; Ahmadi, F; Faghihzadeh, S; Aguilar-Vafaie, M E
2007-01-01
This study used qualitative methodology to understand Iranian women's views about barriers to and factors facilitating screening for early detection of breast cancer. Using grounded theory with in-depth interviews of 31 participants, themes emerged from the data in 2 main categories (internal and external) with 3 sub-categories: women's attitudes, feelings and beliefs; women's social network experiences; and accessibility. Facilitating factors for screening were self-care, fear, proactive coping, state of mind and advocacy. Barriers were negligence, cancer-related fear, low self-efficacy, fatalism, misinformation, ineffective health communication and competing priorities.
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Beyond access: barriers to internet health information seeking among the urban poor
Okechukwu, Cassandra A; Sorensen, Glorian; Viswanath, K
2016-01-01
Objective Communication inequalities deepen health disparities even when internet access is achieved. The goal of this study is to understand how a range of barriers may inhibit individuals from low socioeconomic position (SEP) from engaging with online health information even when it is freely available. Materials and methods Detailed data were collected from 118 low-SEP individuals from a randomized controlled trial providing internet access. Measures triangulated the health-seeking experience through internet use tracked in real-time, call log data, and self-reported barriers. Negative binomial regression models were fitted with technology and perceived predictors, and our outcome, health information seeking, and then stratified by medical status. Results Participants experienced a median of two computer issues (median 6 days) and two internet issues (median 6.5 days). Duration of internet problems was associated with a decrease in the rate of internet health information seeking by a factor of 0.990 (P = .03) for each additional day. Participants with a medical problem who were frustrated in their search for health information had half the rate of health information seeking of those who were not frustrated (incidence rate ratio = 0.395, P = .030). Discussion Despite IT support, participants still experienced internet connectivity issues that negatively impacted their health information seeking. Frustration in their search to find information may serve as an additional barrier to those who have medical issues. Conclusion After initial internet access, a second-level digital divide emerged due to connectivity issues, highlighting the need to understand the complex network of barriers experienced by low-SEP internet users. PMID:27206459
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Helping Homeless Families Overcome Barriers to Successful Functioning
ERIC Educational Resources Information Center
Swick, Kevin J.
2005-01-01
The author articulates key stressors in the lives of families who are homeless. These stresses often combine with barriers such as lack of job opportunities and/or insensitive professionals. Strategies for helping homeless families overcome these barriers and related issues are presented.
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Key barriers to the use of modern contraceptives among women in Albania: a qualitative study.
Kragelund Nielsen, Karoline; Nielsen, Siff Malue; Butler, Robb; Lazarus, Jeffrey V
2012-12-01
In spite of a number of communication campaigns since 1999 promoting modern contraceptives in Albania, their use remains low. In this paper we identify and analyse key barriers to the use of modern contraception among women in Albania. Semi-structured interviews with 11 stakeholders from organisations involved in promoting modern contraception, and four focus group discussions with 40 women from Tirana and a rural village in the periphery of Tirana, divided according to age and residence, were also conducted. Content analysis was used to analyse both the interviews and focus group discussions. Barriers identified included socio-cultural issues such as status of the relationship with partners and the importance of virginity, problems talking about sexual issues and contraception being taboo, health care issues--especially cost and availability--and individual issues such as unfavourable social attitudes towards contraceptives and a lack of knowledge about the use and benefits of modern contraception. To promote contraceptive use in the future, campaigns should address these barriers and expand from a focus on women of reproductive age only to target youth, men, health care providers, parents and schoolteachers as well. Copyright © 2012 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
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Magnetic targeting of nanoparticles across the intact blood–brain barrier
Kong, Seong Deok; Lee, Jisook; Ramachandran, Srinivasan; Eliceiri, Brian P.; Shubayev, Veronica I.; Lal, Ratnesh; Jin, Sungho
2015-01-01
Delivery of therapeutic or diagnostic agents across an intact blood–brain barrier (BBB) remains a major challenge. Here we demonstrate in a mouse model that magnetic nanoparticles (MNPs) can cross the normal BBB when subjected to an external magnetic field. Following a systemic administration, an applied external magnetic field mediates the ability of MNPs to permeate the BBB and accumulate in a perivascular zone of the brain parenchyma. Direct tracking and localization inside endothelial cells and in the perivascular extracellular matrix in vivo was established using fluorescent MNPs. These MNPs were inert and associated with low toxicity, using a non-invasive reporter for astrogliosis, biochemical and histological studies. Atomic force microscopy demonstrated that MNPs were internalized by endothelial cells, suggesting that trans-cellular trafficking may be a mechanism for the MNP crossing of the BBB observed. The silica-coated magnetic nanocapsules (SiMNCs) allow on-demand drug release via remote radio frequency (RF) magnetic field. Together, these results establish an effective strategy for regulating the biodistribution of MNPs in the brain through the application of an external magnetic field. PMID:23063548
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Systems Perspectives on External Quality Assurance: Implications for Micro-States
ERIC Educational Resources Information Center
Houston, Don; Maniku, Ahmed Ali
2005-01-01
Quality assurance in higher education is a mess: the "problem" of quality is embedded in complex sets of interacting issues that are of concern to many and varied stakeholders. Developing higher education systems that have responded to issues of quality through a "best practice" model of external quality assurance has produced…
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Bryant, Keneshia; Greer-Williams, Nancy; Willis, Nathaniel; Hartwig, Mary
2013-07-01
Mental health disparities exist for rural African-Americans regarding the early detection of depression and its effective treatment. Disparities that are evident in rural communities include limited mental health resources and the stigma of depression. The faith community has a long-standing history of being the initial source of help to those who experience depression. The purpose of this qualitative study was to examine how rural African-American faith communities view the barriers to diagnosis and treatment of depression. A convenience sample of 24 persons (N = 24) participated in focus groups and interviews. Four internal barriers were identified: personal business, "mindset," "denial," and "put on a front." Additionally,four external barriers were identified: "spiritual beliefs," "lack of medical resources," "lack of education about depression," and "stigma." The identified barriers supported the results from previous studies, but they also highlighted other less acknowledged barriers. In conclusion, interventions are needed to overcome these barriers in order to eliminate the depression disparities experienced by this population.
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Smart Markets for Transferable Pumping Rights
NASA Astrophysics Data System (ADS)
Brozovic, N.; Young, R.
2016-12-01
While no national policy on groundwater use exists in the United States, local groundwater management is emerging across the country in response to concerns and conflicts over declining well yields, land subsidence, and the depletion of hydrologically connected surface waters. Management strategies include well drilling moratoria, pumping restrictions, and restrictions on the expansion of irrigated land. To provide flexibility to groundwater users, local regulatory authorities increasingly have begun to allow the transfer of groundwater rights as a cost-effective management tool. Markets can be a versatile risk management tool, helping communities to cope with scarcity, to meet goals for sustainability, and to grow resilient local economies. For example, active groundwater rights transfers exist in the High Plains region of the United States. Yet, several barriers to trade exist: high search costs for interested parties, complicated requirements for regulatory compliance, and reluctance to share sensitive financial information. Additionally, groundwater pumping leads to several kinds of spatial and intertemporal externalities such as stream depletion. Indeed, groundwater management schemes that reallocate water between alternate pumping locations are often explicitly designed to change the distribution and magnitude of pumping externalities. Reallocation may be designed to minimize unwanted impacts on third parties or to encourage trades that reduce the magnitude of externalities. We discuss how smart markets can deal with complex biophysical constraints while also encouraging active trading, therefore ensuring local goals for aquifer sustainability while growing local economies. Smart markets address these issues by providing a centralized hub for trading, automating the process of regulatory compliance by only matching buyers and sellers eligible to trade as specified in the regulations, and maintaining anonymous, confidential bidding.
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Western Wind Strategy: Addressing Critical Issues for Wind Deployment
DOE Office of Scientific and Technical Information (OSTI.GOV)
Douglas Larson; Thomas Carr
2012-03-30
The goal of the Western Wind Strategy project was to help remove critical barriers to wind development in the Western Interconnection. The four stated objectives of this project were to: (1) identify the barriers, particularly barriers to the operational integration of renewables and barriers identified by load-serving entities (LSEs) that will be buying wind generation, (2) communicate the barriers to state officials, (3) create a collaborative process to address those barriers with the Western states, utilities and the renewable industry, and (4) provide a role model for other regions. The project has been on the forefront of identifying and informingmore » state policy makers and utility regulators of critical issues related to wind energy and the integration of variable generation. The project has been a critical component in the efforts of states to push forward important reforms and innovations that will enable states to meet their renewable energy goals and lower the cost to consumers of integrating variable generation.« less
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Informing watershed connectivity barrier prioritization decisions: A synthesis
McKay, S. K.; Cooper, A. R.; Diebel, M.W.; Elkins, D.; Oldford, G.; Roghair, C.; Wieferich, Daniel J.
2017-01-01
Water resources and transportation infrastructure such as dams and culverts provide countless socio-economic benefits; however, this infrastructure can also disconnect the movement of organisms, sediment, and water through river ecosystems. Trade-offs associated with these competing costs and benefits occur globally, with applications in barrier addition (e.g. dam and road construction), reengineering (e.g. culvert repair), and removal (e.g. dam removal and aging infrastructure). Barrier prioritization provides a unique opportunity to: (i) restore and reconnect potentially large habitat patches quickly and effectively and (ii) avoid impacts prior to occurrence in line with the mitigation hierarchy (i.e. avoid then minimize then mitigate). This paper synthesizes 46 watershed-scale barrier planning studies and presents a procedure to guide barrier prioritization associated with connectivity for aquatic organisms. We focus on practical issues informing prioritization studies such as available data sets, methods, techniques, and tools. We conclude with a discussion of emerging trends and issues in barrier prioritization and key opportunities for enhancing the body of knowledge.
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NASA Astrophysics Data System (ADS)
Hahm, T. S.
2010-06-01
The 12th International Workshop on H-mode Physics and Transport Barriers was held at the Princeton Plasma Physics Laboratory, Princeton, New Jersey, USA between September 30 and October 2, 2009. This meeting was the continuation of a series of previous meetings which was initiated in 1987 and has been held bi-annually since then. Following the recent tradition at the last few meetings, the program was sub- divided into six sessions. At each session, an overview talk was presented, followed by two or three shorter oral presentations which supplemented the coverage of important issues. These talks were followed by discussion periods and poster sessions of contributed papers. The sessions were: Physics of Transition to/from Enhanced Confinement Regimes, Pedestal and Edge Localized Mode Dynamics, Plasma Rotation and Momentum Transport, Role of 3D Physics in Transport Barriers, Transport Barriers: Theory and Simulations and High Priority ITER Issues on Transport Barriers. The diversity of the 90 registered participants was remarkable, with 22 different nationalities. US participants were in the majority (36), followed by Japan (14), South Korea (7), and China (6). This special issue of Nuclear Fusion consists of a cluster of 18 accepted papers from submitted manuscripts based on overview talks and poster presentations. The paper selection procedure followed the guidelines of Nuclear Fusion which are essentially the same as for regular articles with an additional requirement on timeliness of submission, review and revision. One overview paper and five contributed papers report on the H-mode pedestal related results which reflect the importance of this issue concerning the successful operation of ITER. Four papers address the rotation and momentum transport which play a crucial role in transport barrier physics. The transport barrier transition condition is the main focus of other four papers. Finally, four additional papers are devoted to the behaviour and control of Edge Localized Modes. The selection of topics and overview speakers and the scientific programme were carried out by the International Advisory Committee, consisting of: R. Groebner (GA, USA), T.S. Hahm (PPPL, USA--Chair), A. Hubbard (MIT, USA), K. Ida (NIFS, Japan), S. Lebedev (Ioffe Institute, Russia), N. Oyama (JAEA, Japan), G. Saibene (F4E, EU) and W. Suttrop (IPP, Germany). Their work, advice, and participation contributed to the success of the meeting. Finally, I would like to express deep gratitude to J. Jones and B. Sarfaty who took care of numerous issues relating to the organization of the meeting, and to J.K. Park and several graduate students of the Princeton University Plasma Physics Program for helping with the transportation of participants.
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Mori, T; Ishida, K; Mukumoto, S; Yamada, Y; Imokawa, G; Kabashima, K; Kobayashi, M; Bito, T; Nakamura, M; Ogasawara, K; Tokura, Y
2010-01-01
Background Two types of atopic dermatitis (AD) have been proposed, with different pathophysiological mechanisms underlying this seemingly heterogeneous disorder. The extrinsic type shows high IgE levels presumably as a consequence of skin barrier damage and feasible allergen permeation, whereas the intrinsic type exhibits normal IgE levels and is not mediated by allergen-specific IgE. Objectives To investigate the relationship between pruritus perception threshold and skin barrier function of patients with AD in a comparison between the extrinsic and intrinsic types. Methods Enrolled in this study were 32 patients with extrinsic AD, 17 with intrinsic AD and 24 healthy individuals. The barrier function of the stratum corneum was assessed by skin surface hydration and transepidermal water loss (TEWL), and pruritus perception was evaluated by the electric current perception threshold (CPT) of sensory nerves upon neuroselective transcutaneous electric stimulation. Results Skin surface hydration was significantly lower and TEWL was significantly higher in extrinsic AD than intrinsic AD or normal controls. Although there was no statistically significant difference in CPT among extrinsic AD, intrinsic AD and normal controls, CPT was significantly correlated with skin surface hydration and inversely with TEWL in intrinsic AD and normal controls, but not extrinsic AD. Finally, CPT was correlated with the visual analogue scale of itch in the nonlesional skin of patients with extrinsic but not intrinsic AD. Conclusions Patients with extrinsic AD have an impaired barrier, which increases the pre-existing pruritus but rather decreases sensitivity to external stimuli. In contrast, patients with intrinsic AD retain a normal barrier function and sensory reactivity to external pruritic stimuli.
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Barriers to Providing the Sexuality Education That Teachers Believe Students Need
ERIC Educational Resources Information Center
Eisenberg, Marla E.; Madsen, Nikki; Oliphant, Jennifer A.; Sieving, Renee E.
2013-01-01
Background: Sexuality education teachers' perspectives are important to gain a full understanding of the issues surrounding teaching this subject. This study uses a statewide sample of public school teachers to examine what sexuality education content is taught, what barriers teachers face, and which barriers are associated with teaching specific…
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ERIC Educational Resources Information Center
Laferrière, T.; Hamel, C.; Searson, M.
2013-01-01
Representing issues discussed at the EduSummIT 2011 relative to essential conditions and barriers to successful technology integration, this article presents a systemic analysis of barriers that needed to be overcome for an information technology initiative (Remote Networked School project) to be successfully implemented. The analysis was…
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-27
... 221: Aircraft Secondary Barriers and Alternative Flight Deck Security Procedures. AGENCY: Federal... Secondary Barriers and Alternative Flight Deck Security Procedures. SUMMARY: The FAA is issuing this notice... Alternative Flight Deck Security Procedures. DATES: The meeting will be held June 15-16, 2010. June 15th from...
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Kirchner, Elizabeth; Ruffing, Victoria
2017-02-01
For as long as there have been immunizations, there have been barriers to them. Immunization rates in the United States are below target. Rheumatologists and rheumatology practitioners need to understand the issues of immunizations in patients with autoimmune inflammatory disease to identify and overcome barriers to immunization. Several strategies for overcoming these barriers are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.
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Wang, Deli; Xu, Wei; Zhao, Xiangrong
2016-03-01
This paper aims to deal with the stationary responses of a Rayleigh viscoelastic system with zero barrier impacts under external random excitation. First, the original stochastic viscoelastic system is converted to an equivalent stochastic system without viscoelastic terms by approximately adding the equivalent stiffness and damping. Relying on the means of non-smooth transformation of state variables, the above system is replaced by a new system without an impact term. Then, the stationary probability density functions of the system are observed analytically through stochastic averaging method. By considering the effects of the biquadratic nonlinear damping coefficient and the noise intensity on the system responses, the effectiveness of the theoretical method is tested by comparing the analytical results with those generated from Monte Carlo simulations. Additionally, it does deserve attention that some system parameters can induce the occurrence of stochastic P-bifurcation.
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Attitudes and beliefs regarding cardiovascular risk factors among Bangladeshi immigrants in the US.
Patel, Mihir; Phillips-Caesar, Erica; Boutin-Foster, Carla
2014-10-01
The US has increasingly growing Bangladeshi population, a South Asian sub-ethnic group with a high prevalence of cardiovascular disease (CVD). We conducted a qualitative study using individual in-depth interviews to explore attitudes towards and difficulties with modifying CVD related behaviors among a Bangladeshi cohort. We interviewed 55 patients before reaching data saturation. Bangladeshis discussed the meaning of health and heart disease in the context of how disease can potentially impact their ability to care for their family. Behavioral and psychological factors were discussed as the causes of CVD. Internal forces and external forces were brought up to explain difficulties addressing the causes of CVD. Bangladeshi individuals in our study were aware of CVD, but felt unable to address behavioral risk factors. They cite a combination of internal and external factors as barriers to lifestyle modification. Interventions to address these barriers must simultaneously addressing self-efficacy and work-life balance.
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2003-06-07
KENNEDY SPACE CENTER, FLA. - KSC External Relations and Business Development Director JoAnn Morgan speaks to attendees of The Florida Commission on the Status of Women held June 7 at the Debus Conference Facility. Morgan is a member of the group’s Hall of Fame. The commission, through coordinating, researching, communicating, and encouraging legislation, is dedicated to empowering women from all walks of life in achieving their fullest potential, to eliminating barriers to that achievement, and to recognizing women’s accomplishments.
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Attitudes and Beliefs Regarding Cardiovascular Risk Factors Among Bangladeshi Immigrants in the US
Phillips-Caesar, Erica; Boutin-Foster, Carla
2015-01-01
The US has increasingly growing Bangladeshi population, a South Asian sub-ethnic group with a high prevalence of cardiovascular disease (CVD). We conducted a qualitative study using individual in-depth interviews to explore attitudes towards and difficulties with modifying CVD related behaviors among a Bangladeshi cohort. We interviewed 55 patients before reaching data saturation. Bangladeshis discussed the meaning of health and heart disease in the context of how disease can potentially impact their ability to care for their family. Behavioral and psychological factors were discussed as the causes of CVD. Internal forces and external forces were brought up to explain difficulties addressing the causes of CVD. Bangladeshi individuals in our study were aware of CVD, but felt unable to address behavioral risk factors. They cite a combination of internal and external factors as barriers to lifestyle modification. Interventions to address these barriers must simultaneously addressing self-efficacy and work-life balance. PMID:23861069
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Dual Control of Giant Field-like Spin Torque in Spin Filter Tunnel Junctions
Tang, Y. -H.; Chu, F. -C.; Kioussis, Nicholas
2015-01-01
We predict a giant field-like spin torque, , in spin-filter (SF) barrier tunnel junctions in sharp contrast to existing junctions based on nonmagnetic passive barriers. We demonstrate that has linear bias behavior, is independent of the SF thickness, and has odd parity with respect to the SF’s exchange splitting. Thus, it can be selectively controlled via external bias or external magnetic field which gives rise to sign reversal of via magnetic field switching. The underlying mechanism is the interlayer exchange coupling between the noncollinear magnetizations of the SF and free ferromagnetic electrode via the nonmagnetic insulating (I) spacer giving rise to giant spin-dependent reflection at the SF/I interface. These findings suggest that the proposed field-like-spin-torque MRAM may provide promising dual functionalities for both ‘reading’ and ‘writing’ processes which require lower critical current densities and faster writing and reading speeds. PMID:26095146
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An open platform for personal health record apps with platform-level privacy protection.
Van Gorp, P; Comuzzi, M; Jahnen, A; Kaymak, U; Middleton, B
2014-08-01
One of the main barriers to the adoption of Personal Health Records (PHR) systems is their closed nature. It has been argued in the literature that this barrier can be overcome by introducing an open market of substitutable PHR apps. The requirements introduced by such an open market on the underlying platform have also been derived. In this paper, we argue that MyPHRMachines, a cloud-based PHR platform recently developed by the authors, satisfies these requirements better than its alternatives. The MyPHRMachines platform leverages Virtual Machines as flexible and secure execution sandboxes for health apps. MyPHRMachines does not prevent pushing hospital- or patient-generated data to one of its instances, nor does it prevent patients from sharing data with their trusted caregivers. External software developers have minimal barriers to contribute innovative apps to the platform, since apps are only required to avoid pushing patient data outside a MyPHRMachines cloud. We demonstrate the potential of MyPHRMachines by presenting two externally contributed apps. Both apps provide functionality going beyond the state-of-the-art in their application domain, while they did not require any specific MyPHRMachines platform extension. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Özbek, Emel; Bongers, Ilja L; Lobbestael, Jill; van Nieuwenhuizen, Chijs
2015-12-01
This study investigated the relationship between acculturation and psychological problems in Turkish and Moroccan young adults living in the Netherlands. A sample of 131 healthy young adults aged between 18 and 24 years old, with a Turkish or Moroccan background was recruited using snowball sampling. Data on acculturation, internalizing and externalizing problems, beliefs about psychological problems, attributions of psychological problems and barriers to care were collected and analyzed using Latent Class Analysis and multinomial logistic regression. Three acculturation classes were identified in moderately to highly educated, healthy Turkish or Moroccan young adults: integration, separation and diffusion. None of the participants in the sample were marginalized or assimilated. Young adults reporting diffuse acculturation reported more internalizing and externalizing problems than those who were integrated or separated. Separated young adults reported experiencing more practical barriers to care than integrated young adults. Further research with a larger sample, including young adult migrants using mental health services, is required to improve our understanding of acculturation, psychological problems and barriers to care in this population. Including experiences of discrimination in the model might improve our understanding of the relationship between different forms of acculturation and psychological problems.
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Shaw, C D
2000-06-01
This paper is a summary of the operation, findings and conclusions of a European Union project on external peer review techniques, termed 'ExPeRT', to research the scope, mechanisms and use of external quality mechanisms in the improvement of health care. Many of the themes outlined are described in detail in other papers that have been prepared specifically for this issue of The International Journal for Quality in Health Care. Although the emphasis of this project and of this issue of the Journal is on Europe, the conclusions are more widely relevant.
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2012-01-01
Background The UK general practitioner (GP) appraisal system is deemed to be an inadequate source of performance evidence to inform a future medical revalidation process. A long-running voluntary model of external peer review in the west of Scotland provides feedback by trained peers on the standard of GP colleagues' core appraisal activities and may 'add value' in strengthening the robustness of the current system in support of revalidation. A significant minority of GPs has participated in the peer feedback model, but a clear majority has yet to engage with it. We aimed to explore the views of non-participants to identify barriers to engagement and attitudes to external peer review as a means to inform the current appraisal system. Methods We conducted semi-structured interviews with a sample of west of Scotland GPs who had yet to participate in the peer review model. A thematic analysis of the interview transcriptions was conducted using a constant comparative approach. Results 13 GPs were interviewed of whom nine were males. Four core themes were identified in relation to the perceived and experienced 'value' placed on the topics discussed and their relevance to routine clinical practice and professional appraisal: 1. Value of the appraisal improvement activity. 2. Value of external peer review. 3. Value of the external peer review model and host organisation and 4. Attitudes to external peer review. Conclusions GPs in this study questioned the 'value' of participation in the external peer review model and the national appraisal system over the standard of internal feedback received from immediate work colleagues. There was a limited understanding of the concept, context and purpose of external peer review and some distrust of the host educational provider. Future engagement with the model by these GPs is likely to be influenced by policy to improve the standard of appraisal and contractual related activities, rather than a self-directed recognition of learning needs. PMID:22443714
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Curnock, Esther; Bowie, Paul; Pope, Lindsey; McKay, John
2012-03-23
The UK general practitioner (GP) appraisal system is deemed to be an inadequate source of performance evidence to inform a future medical revalidation process. A long-running voluntary model of external peer review in the west of Scotland provides feedback by trained peers on the standard of GP colleagues' core appraisal activities and may 'add value' in strengthening the robustness of the current system in support of revalidation. A significant minority of GPs has participated in the peer feedback model, but a clear majority has yet to engage with it. We aimed to explore the views of non-participants to identify barriers to engagement and attitudes to external peer review as a means to inform the current appraisal system. We conducted semi-structured interviews with a sample of west of Scotland GPs who had yet to participate in the peer review model. A thematic analysis of the interview transcriptions was conducted using a constant comparative approach. 13 GPs were interviewed of whom nine were males. Four core themes were identified in relation to the perceived and experienced 'value' placed on the topics discussed and their relevance to routine clinical practice and professional appraisal: 1. Value of the appraisal improvement activity. 2. Value of external peer review. 3. Value of the external peer review model and host organisation and 4. Attitudes to external peer review. GPs in this study questioned the 'value' of participation in the external peer review model and the national appraisal system over the standard of internal feedback received from immediate work colleagues. There was a limited understanding of the concept, context and purpose of external peer review and some distrust of the host educational provider. Future engagement with the model by these GPs is likely to be influenced by policy to improve the standard of appraisal and contractual related activities, rather than a self-directed recognition of learning needs.
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Bryant, Keneshia; Greer-Williams, Nancy; Willis, Nathaniel; Hartwig, Mary
2014-01-01
Mental health disparities exist for rural African-Americans regarding the early detection of depression and its effective treatment. Disparities that are evident in rural communities include limited mental health resources and the stigma of depression. The faith community has a long-standing history of being the initial source of help to those who experience depression. The purpose of this qualitative study was to examine how rural African-American faith communities view the barriers to diagnosis and treatment of depression. A convenience sample of 24 persons (N = 24) participated in focus groups and interviews. Four internal barriers were identified: personal business, “mind-set,” “denial,” and “put on a front.” Additionally, four external barriers were identified: “spiritual beliefs,” “lack of medical resources,” “lack of education about depression,” and “stigma.” The identified barriers supported the results from previous studies, but they also highlighted other less acknowledged barriers. In conclusion, interventions are needed to overcome these barriers in order to eliminate the depression disparities experienced by this population. PMID:24218871
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Environmental Scanning and External Tendencies Affecting American Higher Education.
ERIC Educational Resources Information Center
Montgomery, Bruce A.; Hesse, Martin L.
1990-01-01
The use of environmental scanning to link the external environment to institutional strategic planning is exemplified in Michigan State University's approach. The university's program is described, and in an appended section, 25 external tendencies are presented and related issues, trends, and events outlined. (MSE)
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Features of current-voltage characteristic of nonequilibrium trench MOS barrier Schottky diode
NASA Astrophysics Data System (ADS)
Mamedov, R. K.; Aslanova, A. R.
2018-06-01
The trench MOS barrier Schottky diodes (TMBS diode) under the influence of the voltage drop of the additional electric field (AEF) appearing in the near-contact region of the semiconductor are in a nonequilibrium state and their closed external circuit flows currents in the absence of an external voltage. When an external voltage is applied to the TMBS diode, the current transmission is described by the thermionic emission theory with a specific feature. Both forward and reverse I-V characteristics of the TMBS diode consist of two parts. In the initial first part of the forward I-V characteristic there are no forward currents, but reverse saturation currents flow, in its subsequent second part the currents increase exponentially with the voltage. In the initial first part of the reverse I-V characteristic, the currents increase in an abrupt way and in the subsequent second part the saturation currents flow under the action of the image force. The mathematical expressions for forward and reverse I-V characteristic of the TMBS diode and also narrow or nanostructure Schottky diode are proposed, which are in good agreement with the results of experimental and calculated I-V characteristics.
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Effect of temperature and magnetic field on disorder in semiconductor structures
DOE Office of Scientific and Technical Information (OSTI.GOV)
Agrinskaya, N. V., E-mail: nina.agrins@mail.ioffe.ru; Kozub, V. I.
We present the results of consistent theoretical analysis of various factors that may lead to influence of temperature and external magnetic field on disorder in semiconductor structures. Main attention is paid to quantum well (QW) structures in which only QWs or both QW and barriers are doped (the doping level is assumed to be close to the value corresponding to the metal–insulator transition). The above factors include (i) ionization of localized states to the region of delocalized states above the mobility edge, which is presumed to exist in the impurity band; (ii) the coexistence in the upper and lower Hubbardmore » bands (upon doping of QWs as well as barriers); in this case, in particular, the external magnetic field determines the relative contribution of the upper Hubbard band due to spin correlations at doubly filled sites; and (iii) the contribution of the exchange interaction at pairs of sites, in which the external magnetic field can affect the relation between ferromagnetic and antiferromagnetic configurations. All these factors, which affect the structure and degree of disorder, lead to specific features in the temperature dependence of resistivity and determine specific features of the magnetoresistance. Our conclusions are compared with available experimental data.« less
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Fitness and Independence after SCI: Defining Meaningful Change and Thresholds
2017-10-01
would you prefer to get this report from a health care provider, like a Doctor or Physical Therapist, or would you prefer to be able to get this...month. Lack of participant transportation and cancellations secondary to health issues are the primary barriers. MIA has over N=200 screen passes. The...3 update: Accrual rates at both centers are below target secondary to participation barriers, primarily transportation and short term health issues
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NASA Astrophysics Data System (ADS)
Raju, Thokala Soloman; Pal, Ritu
2018-05-01
We derive the analytical rogue wave solutions for the generalized inhomogeneous nonlinear Schrödinger-Maxwell-Bloch (GINLS-MB) equation describing the pulse propagation in erbium-doped fibre system. Then by suitably choosing the inhomogeneous parameters, we delineate the tunneling properties of rogue waves through dispersion and nonlinearity barriers or wells. Finally, we demonstrate the propagating characteristics of optical solitons by considering their tunneling through periodic barriers by the proper choice of external potential.
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Electron transport in electrically biased inverse parabolic double-barrier structure
NASA Astrophysics Data System (ADS)
M, Bati; S, Sakiroglu; I, Sokmen
2016-05-01
A theoretical study of resonant tunneling is carried out for an inverse parabolic double-barrier structure subjected to an external electric field. Tunneling transmission coefficient and density of states are analyzed by using the non-equilibrium Green’s function approach based on the finite difference method. It is found that the resonant peak of the transmission coefficient, being unity for a symmetrical case, reduces under the applied electric field and depends strongly on the variation of the structure parameters.
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FUNGIBLE AND COMPATIBLE BIOFUELS: LITERATURE SEARCH, SUMMARY, AND RECOMMENDATIONS
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bunting, Bruce G; Bunce, Michael; Barone, Teresa L
2011-04-01
The purpose of the study described in this report is to summarize the various barriers to more widespread distribution of bio-fuels through our common carrier fuel distribution system, which includes pipelines, barges and rail, fuel tankage, and distribution terminals. Addressing these barriers is necessary to allow the more widespread utilization and distribution of bio-fuels, in support of a renewable fuels standard and possible future low-carbon fuel standards. These barriers can be classified into several categories, including operating practice, regulatory, technical, and acceptability barriers. Possible solutions to these issues are discussed; including compatibility evaluation, changes to bio-fuels, regulatory changes, and changesmore » in the distribution system or distribution practices. No actual experimental research has been conducted in the writing of this report, but results are used to develop recommendations for future research and additional study as appropriate. This project addresses recognized barriers to the wider use of bio-fuels in the areas of development of codes and standards, industrial and consumer awareness, and materials compatibility issues.« less
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Membrane pore formation in atomistic and coarse-grained simulations.
Kirsch, Sonja A; Böckmann, Rainer A
2016-10-01
Biological cells and their organelles are protected by ultra thin membranes. These membranes accomplish a broad variety of important tasks like separating the cell content from the outer environment, they are the site for cell-cell interactions and many enzymatic reactions, and control the in- and efflux of metabolites. For certain physiological functions e.g. in the fusion of membranes and also in a number of biotechnological applications like gene transfection the membrane integrity needs to be compromised to allow for instance for the exchange of polar molecules across the membrane barrier. Mechanisms enabling the transport of molecules across the membrane involve membrane proteins that form specific pores or act as transporters, but also so-called lipid pores induced by external fields, stress, or peptides. Recent progress in the simulation field enabled to closely mimic pore formation as supposed to occur in vivo or in vitro. Here, we review different simulation-based approaches in the study of membrane pores with a focus on lipid pore properties such as their size and energetics, poration mechanisms based on the application of external fields, charge imbalances, or surface tension, and on pores that are induced by small molecules, peptides, and lipids. This article is part of a Special Issue entitled: Biosimulations edited by Ilpo Vattulainen and Tomasz Róg. Copyright © 2015 Elsevier B.V. All rights reserved.
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ERIC Educational Resources Information Center
Beachler, Judith
This document is the second in a series of summary reports outlining Key Issues for Planning useful to staff throughout the Los Rios Community College District (CA) for the 1999-2000 academic year and beyond. The 1999 Environmental Scan of Greater Sacramento provides a comprehensive look at the external environment. It outlines changes in the…
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Odorant transfer characteristics of white bread during baking.
Onishi, Masanobu; Inoue, Michiko; Araki, Tetsuya; Iwabuchi, Hisakatsu; Sagara, Yasuyuki
2011-01-01
The potent odorants in the crust and crumb of white bread were identified and quantified by gas chromatography-mass spectrometry and gas chromatography/olfactometry. The weight loss ratio of the samples baked at 220 °C was controlled in the range of 0-28%. The odorants were classified into 5 types by the transfer characteristics: i) All amounts of odorant transferred from the crust to external space (type-I). ii) All transferred from the crust to the crumb and external space (type-II). iii) Certain amount remaining in the crust and the rest transferred to the crumb and external space (type-III). iv) All transferred from the crumb to external space (type-IV). v) Certain amount remaining in the crumb and the rest transferred to the crust and external space (type-V). The odorants of type-IV were not apparent after the crust had formed. The results indicate that the crust could be a barrier to prevent the odorants from being transferred to external space.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Singh, Ravindra; Reilly, James T.; Wang, Jianhui
Electric distribution utilities encounter many challenges to successful deployment of Distribution Management Systems (DMSs). The key challenges are documented in this report, along with suggestions for overcoming them. This report offers a recommended list of activities for implementing a DMS. It takes a strategic approach to implementing DMS from a project management perspective. The project management strategy covers DMS planning, procurement, design, building, testing, Installation, commissioning, and system integration issues and solutions. It identifies the risks that are associated with implementation and suggests strategies for utilities to use to mitigate them or avoid them altogether. Attention is given to commonmore » barriers to successful DMS implementation. This report begins with an overview of the implementation strategy for a DMS and proceeds to put forward a basic approach for procuring hardware and software for a DMS; designing the interfaces with external corporate computing systems such as EMS, GIS, OMS, and AMI; and implementing a complete solution.« less
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The Future of Low-Carbon Transportation Fuels
NASA Astrophysics Data System (ADS)
Yang, Christopher; Yeh, Sonia
2011-11-01
Petroleum fuel uses make up essentially all of transportation fuel usage today and will continue to dominate transportation fuel usage well into future without any major policy changes. This chapter focuses on low-carbon transportation fuels, specifically, biofuels, electricity and hydrogen, that are emerging options to displace petroleum based fuels. The transition to cleaner, lower carbon fuel sources will need significant technology advancement, and sustained coordination efforts among the vehicle and fuel industry and policymakers/regulators over long period of time in order to overcome market barriers, consumer acceptance, and externalities of imported oil. We discuss the unique infrastructure challenges, and compare resource, technology, economics and transitional issues for each of these fuels. While each fuel type has important technical and implementation challenges to overcome (including vehicle technologies) in order to contribute a large fraction of our total fuel demand, it is important to note that a portfolio approach will give us the best chance of meeting stringent environmental and energy security goals for a sustainable transportation future.
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Researching from within: External and Internal Ethical Engagement
ERIC Educational Resources Information Center
Floyd, Alan; Arthur, Linet
2012-01-01
This article examines the superficial and deep ethical and moral dilemmas confronting "insider" researchers, which we term external and internal ethical engagement. External ethical engagement refers to the traditional, easily identifiable ethical issues that insider researchers attend to by submitting their application for ethical approval to…
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Cohen-Mansfield, Jiska; Thein, Khin; Marx, Marcia S; Dakheel-Ali, Maha
2012-05-01
Behavioral symptoms are common in persons with dementia, and nonpharmacological interventions are recommended as the first line of therapy. We describe barriers to conducting nonpharmacological interventions for behavioral symptoms. A descriptive study of barriers to intervention delivery in a controlled trial. The study was conducted in six nursing homes in Maryland. Participants were 89 agitated nursing home residents with dementia. Personalized interventions were developed using the Treatment Routes for Exploring Agitation decision tree protocol. Trained research assistants prepared and delivered the interventions. Feasibility of the interventions was determined. Barriers to Intervention Delivery Assessment, activities of daily living, cognitive functioning, depressed affect, pain, observed agitation, and observed affect. Barriers were observed for the categories of resident barriers (specifically, unwillingness to participate; resident attributes, such as unresponsive), barriers related to resident unavailability (resident asleep or eating), and external barriers (staff-related barriers, family-related barriers, environmental barriers, and system process variables). Interventions pertaining to food/drink and to 1-on-1 socializing were found to have the fewest barriers, whereas higher numbers of barriers occurred with puzzles/board games and arts and crafts activities. Moreover, when successful interventions were presented to participants after the feasibility period, we noted fewer barriers, presumably because barrier identification had been used to better tailor interventions to each participant and to the environment. Knowledge of barriers provides a tool by which to tailor interventions so as to anticipate or circumvent barriers, thereby maximizing intervention delivery. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.
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ERIC Educational Resources Information Center
Butler, Rosemary
2013-01-01
The Presiding Officer of the National Assembly for Wales, Rosemary Butler AM, has put the issue of barriers to women in public life at the top of the political agenda in Wales. She has held sessions with women across Wales to find out what those barriers are and how they can be tackled. On International Women's Day in February, she invited…
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Gate Modulation of Graphene-ZnO Nanowire Schottky Diode.
Liu, Ren; You, Xu-Chen; Fu, Xue-Wen; Lin, Fang; Meng, Jie; Yu, Da-Peng; Liao, Zhi-Min
2015-05-06
Graphene-semiconductor interface is important for the applications in electronic and optoelectronic devices. Here we report the modulation of the electric transport properties of graphene/ZnO nanowire Schottky diode by gate voltage (Vg). The ideality factor of the graphene/ZnO nanowire Schottky diode is ~1.7, and the Schottky barrier height is ~0.28 eV without external Vg. The Schottky barrier height is sensitive to Vg due to the variation of Fermi level of graphene. The barrier height increases quickly with sweeping Vg towards the negative value, while decreases slowly towards the positive Vg. Our results are helpful to understand the fundamental mechanism of the electric transport in graphene-semiconductor Schottky diode.
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Market and policy barriers to deployment of energy storage
Sioshansi, Ramteen; Denholm, Paul; Jenkin, Thomas
2012-04-01
There has recently been resurgent interest in energy storage, due to a number of developments in the electricity industry. Despite this interest, very little storage, beyond some small demonstration projects, has been deployed recently. While technical issues, such as cost, device efficiency, and other technical characteristics are often listed as barriers to storage, there are a number of non-technical and policy-related issues. This paper surveys some of these main barriers and proposes some potential research and policy steps that can help address them. Furthermore, while the discussion is focused on the United States, a number of the findings and observationsmore » may be more broadly applicable.« less
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The Financial Sector and Sustainable Development
NASA Astrophysics Data System (ADS)
Rusko, Miroslav; Korauš, Anton
2010-01-01
Growing load and deterioration of the environment can be interpreted as a result of some external effects interventions. While the positive externalities influence the positive productional and utilizational functions of other subjects, the negative externalities influence the negative ones. Both types of external effects can act as parcial or global externalities. Linking the environmental issues to economy and finance is an important sphere. Coimplementation of both marketing and environmental audits is an important element of this sphere too.
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Characteristics of an external employee assistance programme in Japan.
Muto, Takashi; Fujimori, Yuiko; Suzuki, Keiko
2004-12-01
Mental health care is now a major occupational health issue in Japan. Although realizing effective use of external employee assistance programmes (EAPs) has been identified as crucial for mental health care, few scientific papers describe or analyse the characteristics of EAPs in Japan. This study sought to clarify the characteristics of an external EAP in Japan. The characteristics of an external EAP were clarified in terms of programme description and utilization. A total of 10,260 counselling sessions from 1996 to 2000 were used for utilization analysis. The EAP studied had contracts with 133 organizations, half of which were health insurance societies. The EAP provided employees and family members with free, confidential counselling. Annual mean utilization rate per 1000 individuals increased from 1.3 in 1996 to 2.7 in 2000. Less than one-third of counselling sessions were for work-related mental health issues, and male users (30%) consulted significantly more often than female users (14%) for such problems. Among men, career development issues were most common, while job dissatisfaction was highest among women. Absenteeism, depression and fatigue were the most frequently observed problems in both sexes. EAP use in Japan is rising. The majority of its use is for non-work-related health issues. Male users were more likely to consult for work-related mental health problems.
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Lee, Sang Eun; Lee, Seung Hun
2018-06-01
Epidermal barrier formation and the maintenance of barrier homeostasis are essential to protect us from the external environments and organisms. Moreover, impaired keratinocytes differentiation and dysfunctional skin barrier can be the primary causes or aggravating factors for many inflammatory skin diseases including atopic dermatitis and psoriasis. Therefore, understanding the regulation mechanisms of keratinocytes differentiation and skin barrier homeostasis is important to understand many skin diseases and establish an effective treatment strategy. Calcium ions (Ca 2+ ) and their concentration gradient in the epidermis are essential in regulating many skin functions, including keratinocyte differentiation, skin barrier formation, and permeability barrier homeostasis. Recent studies have suggested that the intracellular Ca 2+ stores such as the endoplasmic reticulum (ER) are the major components that form the epidermal calcium gradient and the ER calcium homeostasis is crucial for regulating keratinocytes differentiation, intercellular junction formation, antimicrobial barrier, and permeability barrier homeostasis. Thus, both Ca 2+ release from intracellular stores, such as the ER and Ca 2+ influx mechanisms are important in skin barrier. In addition, growing evidences identified the functional existence and the role of many types of calcium channels which mediate calcium flux in keratinocytes. In this review, the origin of epidermal calcium gradient and their role in the formation and regulation of skin barrier are focused. We also focus on the role of ER calcium homeostasis in skin barrier. Furthermore, the distribution and role of epidermal calcium channels, including transient receptor potential channels, store-operated calcium entry channel Orai1, and voltage-gated calcium channels in skin barrier are discussed.
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Influence of the dynamic lattice strain on the transport behavior of oxide heterojunctions
NASA Astrophysics Data System (ADS)
Wang, J.; Hu, F. X.; Chen, L.; Zhao, Y. Y.; Lu, H. X.; Sun, J. R.; Shen, B. G.
2013-01-01
All-perovskite oxide heterojunctions composed of electron-doped titanate LaxSr1 - xTiO3 (x = 0.1, 0.15) and hole-doped manganite La0.67Ca0.33MnO3 films were fabricated on piezoelectric substrate of (001)-0.7Pb(Mg1/3Nb2/3)O3-0.3PbTiO3 (PMN-PT). Taking advantage of the excellent converse piezoelectric effect of PMN-PT, we investigated the influence of the dynamic lattice strain on transport properties of the heterojunctions by applying external bias electric fields on the PMN-PT substrate. Photovoltaic experiments were carried out to characterize the interfacial barrier of the heterojunction. A linear reduction in the barrier height was observed with the increase of the bias field applied on PMN-PT. The value of the barrier height reduces from ˜1.55 (˜1.30) to 1.02 (1.08) eV as the bias field increases from 0 to 12 kV/cm for the junction of La0.10Sr0.9TiO3/La0.67Ca0.33MnO3 (La0.15Sr0.85TiO3/La0.67Ca0.33MnO3). The observed dependency of barrier height on external field can be ascribed to the increasing release of trapped carriers by strain modulation, which results in a suppression of the depletion layer and increases the opportunity for electron tunneling across the depletion area.
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Howard-Drake, E J; Halliday, V
2016-03-01
Headteachers of primary schools in England are a crucial partner for childhood obesity prevention. Understanding how this works in practice is limited by their views being underrepresented or missing from the evidence base. The aim of this study was to explore primary school headteachers' perspectives on childhood obesity and the perceived barriers and facilitators of prevention. A qualitative study with a purposive sample of 14 primary school headteachers from the Yorkshire and Humber region of England was conducted. Semi-structured interviews were audio-taped, transcribed and analysed using an inductive thematic approach. An extensive range of barriers and facilitators emerged within four key themes; understanding childhood obesity, primary school setting, the role of parents and external partners. A lack of knowledge, awareness and skills to deal with the sensitivity and complexity of childhood obesity across all school stakeholders presents the most significant barrier to effective action. Headteachers recognize primary schools are a crucial setting for childhood obesity prevention; however their school's often do not have the capability, capacity and confidence to make a meaningful and sustainable impact. To increase headteachers' ability and desire to prevent childhood obesity, schools require specialist and tailored training, resources and support from external partners such as public health teams and school nursing services. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Sexuality education in Malaysia: perceived issues and barriers by professionals.
Khalaf, Zahra Fazli; Low, Wah Yun; Merghati-Khoei, Effat; Ghorbani, Behzad
2014-07-01
This research explored the perspectives of Malaysian professionals on the issues and barriers affecting the implementation of sexuality education in Malaysia. This qualitative study involved in-depth interviews with 15 key professionals working in the field of sexuality and reproductive health in Malaysia. Thematic analysis was selected to analyze data. Barriers to sexuality education were perceived from 5 aspects: feasibility, acceptability, accountability, strategies, and community unawareness. Respondents believed that implementing national sexuality education is a time-consuming project. They regarded Malaysian multicultural society as a barrier to national sexuality education, and they believed that school-based sexuality education is not easily accomplished in Malaysia; also abstinence-only policy restricts the access of young people to accurate information. Lack of community involvement was perceived as a key concern to sexuality education. Campaigning to promote awareness of families, teachers, community leaders, and policy makers are recommended to help establishing national sexuality education in Malaysia. © 2014 APJPH.
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Gidengil, Courtney A; Rusinak, Donna; Allred, Norma J; Luff, Donna; Lee, Grace M; Lieu, Tracy A
2009-06-01
To describe the factors that affect the use of new combination vaccines, the authors conducted qualitative interviews with pediatricians (n = 7), state immunization program managers (n = 7), and health insurance plan representatives (n = 6 plans). Respondents from each group identified reduction in pain and potentially increased immunization coverage as key benefits of new combination vaccines. For several pediatricians, low reimbursement for cost of vaccine doses and potential loss of fees for vaccine administration were barriers to using combination vaccines. For most state immunization programs, the higher cost of combination vaccines relative to separate vaccines was an important consideration but not a barrier to adoption. Most insurers were not aware of the financial issues for providers, but some had changed or were willing to change reimbursement to support the use of new combination vaccines. Financial issues for pediatric practices that purchase and provide vaccines for children may be an important barrier to offering combination vaccines.
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Recommendations for Constructing Roadside Vegetation Barriers to Improve Near-Road Air Quality
Recommendations for external partners planting roadside vegetation. Intended for broad use, but immediate use will be to provide to project partners on the RESES roadside vegetation project and as an attachment to the RESES project QAPP
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Implementation of a Non-Metallic Barrier in an Electric Motor
NASA Technical Reports Server (NTRS)
M?Sadoques, George; Carra, Michael; Beringer, Woody
2012-01-01
Electric motors that run in pure oxygen must be sealed, or "canned," for safety reasons to prevent the oxygen from entering into the electrical portion of the motor. The current canning process involves designing a metallic barrier around the rotor to provide the separation. This metallic barrier reduces the motor efficiency as speed is increased. In higher-speed electric motors, efficiency is greatly improved if a very thin, nonmetallic barrier can be utilized. The barrier thickness needs to be approximately 0.025-in. (.0.6-mm) thick and can be made of a brittle material such as glass. The motors, however, designed for space applications are typically subject to high-vibration environments. A fragile, non-metallic barrier can be utilized in a motor assembly if held in place by a set of standard rubber O-ring seals. The O-rings provide the necessary sealing to keep oxygen away from the electrical portion of the motor and also isolate the fragile barrier from the harsh motor vibration environment. The compliance of the rubber O-rings gently constrains the fragile barrier and isolates it from the harsh external motor environment. The use of a non-metallic barrier greatly improves motor performance, especially at higher speeds, while isolating the electronics from the working fluid with an inert liner.
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Oncologists' strategies and barriers to effective communication about the end of life.
Granek, Leeat; Krzyzanowska, Monika K; Tozer, Richard; Mazzotta, Paolo
2013-07-01
Communicating about the end of life with patients has been reported as one of the most difficult and stressful part of the work of oncologists. Despite this fact, oncologists receive little training in this area, and many do not communicate effectively with patients. The purpose of this analysis, part of a larger study examining oncologists' experiences of patient loss, was to explore oncologists' communication strategies and communication barriers when discussing end-of-life issues with patients. Twenty oncologists were interviewed at three hospitals about their communication strategies on end-of-life issues with patients. The data were analyzed using the grounded theory method. The findings revealed the strategies to effective communication about the end of life included: being open and honest; having ongoing, early conversations; communicating about modifying treatment goals; and balancing hope and reality. Barriers to implementing these strategies fell broadly into three domains, including physician factors, patient factors, and institutional factors. Physician factors included difficulty with treatment and palliation, personal discomfort with death and dying, diffusion of responsibility among colleagues, using the "death-defying mode," lack of experience, and lack of mentorship. Patient factors included, patients and/or families being reluctant to talk about the end of life, language barriers, and younger age. Institutional factors included stigma around palliative care, lack of protocol about end-of-life issues; and lack of training for oncologists on how to talk with patients about end-of-life issues. We conclude by drawing implications from our study and suggest that further research and intervention are necessary to aid oncologists in achieving effective communication about end-of-life issues.
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-26
.... Description of Request: Pacific Gas and Electric Company (licensee) is proposing to change the design of an... issued August 25, 2009. Rather than locating the barrier on top of the Asbury Diversion Dam, the barrier would be located approximately 500 feet downstream of the diversion dam. The fish barrier would be a...
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Sun, Wenjun; Chen, Karen; Terhaar, Abigail; Wiegmann, Douglas A; Heidrich, Susan M; Tevaarwerk, Amye J; Sesto, Mary E
2016-01-01
Research has identified barriers and facilitators affecting cancer survivors' return to work (RTW) following the end of active treatment (surgery, chemotherapy and/or radiation therapy). However, few studies have focused on barriers and facilitators that cancer survivors experience while working during active treatment. Strategies used by cancer survivors to solve work-related problems during active treatment are underexplored. The aim of this study was to describe factors that impact, either positively or negatively, breast cancer survivors' work activities during active treatment. Semi-structured, recorded interviews were conducted with 35 breast cancer survivors who worked during active treatment. Transcripts of interviews were analyzed using inductive content analysis to identify themes regarding work-related barriers, facilitators and strategies. Barriers identified included symptoms, emotional distress, appearance change, time constraints, work characteristics, unsupportive supervisors and coworkers, family issues and other illness. Facilitators included positive aspects of work, support outside of work, and coworker and supervisor support. Strategies included activities to improve health-related issues and changes to working conditions and tasks. Breast cancer survivors encounter various barriers during active treatment. Several facilitators and strategies can help survivors maintain productive work activities.
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Sun, Wenjun; Chen, Karen; Terhaar, Abigail; Wiegmann, Douglas A.; Heidrich, Susan M.; Tevaarwerk, Amye J.; Sesto, Mary E.
2017-01-01
BACKGROUND Research has identified barriers and facilitators affecting cancer survivors’ return to work (RTW) following the end of active treatment (surgery, chemotherapy and/or radiation therapy). However, few studies have focused on barriers and facilitators that cancer survivors experience while working during active treatment. Strategies used by cancer survivors to solve work-related problems during active treatment are underexplored. OBJECTIVE The aim of this study was to describe factors that impact, either positively or negatively, breast cancer survivors’ work activities during active treatment. METHODS Semi-structured, recorded interviews were conducted with 35 breast cancer survivors who worked during active treatment. Transcripts of interviews were analyzed using inductive content analysis to identify themes regarding work-related barriers, facilitators and strategies. RESULTS Barriers identified included symptoms, emotional distress, appearance change, time constraints, work characteristics, unsupportive supervisors and coworkers, family issues and other illness. Facilitators included positive aspects of work, support outside of work, and coworker and supervisor support. Strategies included activities to improve health-related issues and changes to working conditions and tasks. CONCLUSIONS Breast cancer survivors encounter various barriers during active treatment. Several facilitators and strategies can help survivors maintain productive work activities. PMID:28059814
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Rosman, A N; Vlemmix, F; Fleuren, M A H; Rijnders, M E; Beuckens, A; Opmeer, B C; Mol, B W J; van Zwieten, M C B; Kok, M
2014-03-01
external cephalic version (ECV) is a relatively simple and safe manoeuvre and a proven effective approach in the reduction of breech presentation at term. There is professional consensus that ECV should be offered to all women with a fetus in breech presentation, but only up to 70% of women eligible for ECV undergo an ECV attempt. The aim of the study was to identify barriers and facilitators for ECV among professionals and women with a breech presentation at term. qualitative study with semi-structured interviews. Dutch hospitals. pregnant women with a breech presentation who had decided on ECV, and midwives and gynaecologists treating women with a breech presentation. on the basis of national guidelines and expert opinions, we developed topic lists to guide the interviews and discuss barriers and facilitators in order to decide on ECV (pregnant women) or advice on ECV (midwives and gynaecologists). among pregnant women the main barriers were fear, the preference to have a planned caesarean section (CS), incomplete information and having witnessed birth complications within the family or among friends. The main facilitators were the wish for a home birth, the wish for a vaginal delivery and confidence of the safety of ECV. Among professionals the main barriers were a lack of knowledge to fully inform and counsel patients on ECV, and the inability to counsel women who preferred a primary CS. The main facilitator was an unambiguous policy on (counselling for) ECV within the region. we identified several barriers and facilitators possibly explaining the suboptimal implementation of ECV for breech presentation in the Netherlands. This knowledge should be taken into account in designing implementation strategies for ECV to improve the uptake of ECV by professionals and patients. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Hawkins, Alice K; Creighton, Susan; Hayden, Michael R
2013-02-01
Predictive testing (PT) for Huntington disease (HD) requires several in-person appointments. This requirement may be a barrier to testing so that at risk individuals do not realize the potential benefits of PT. To understand the obstacles to PT in terms of the accessibility of services, as well as exploring mechanisms by which this issue may be addressed, we conducted an interview study of individuals at risk for HD throughout British Columbia, Canada. Results reveal that the accessibility of PT can be a barrier for two major reasons: distance and the inflexibility of the testing process. Distance is a structural barrier, and relates to the time and travel required to access PT, the financial and other opportunity costs associated with taking time away from work and family to attend appointments and the stress of navigating urban centers. The inflexibility of the testing process barrier relates to the emotional and psychological accessibility of PT. The results of the interview study reveal that there are access barriers to PT that deter individuals from receiving the support, information and counseling they require. What makes accessibility of PT services important is not just that it may result in differences in quality of life and care, but because these differences may be addressed with creative and adaptable solutions in the delivery of genetic services. The study findings underscore the need for us to rethink and personalize the way we deliver such services to improve access issues to prevent inequities in the health care system.
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A Sociological Framework to Address Gender Equity in the Geosciences
NASA Astrophysics Data System (ADS)
Holmes, Mary Anne
2017-04-01
Lack of equity in the science workforce is a sociological problem; those wishing to seek its amelioration can benefit by viewing the issue with a sociological lens (and a sociologist). One useful framework that we have used to think strategically about how to lower barriers to equity is Barbara Risman's (2004): this framework views barriers to equity as individual, interpersonal ("interactional"), and institutional. Any given barrier may fit into one or more of these frames. Individual barriers include those intrinsic to an individual and may include: lack of access to vital networks and mentors, lack of preparation, etc. Such barriers can be addressed through mentoring programs and attention to building networks (e.g., through professional society memberships). Interpersonal or "interactional" barriers are those that arise from how we perceive and treat one another. Implicit bias underlies many of these barriers, including whether we perceive women as scientists, as competent, as dedicated (etc) as men. Such barriers can be reduced through implicit bias awareness. Institutional barriers arise from the structure and history of the academy itself, from its policies and procedures. Many such policies and procedures have a differential impact on men or women, generally without that intention. Policies that reduce equity barriers include family leave, childcare facilities, search committee training, clearly articulated practices for evaluation of applications and personnel reviews, equal starting pay and startup packages, equable canvassing for names to consider for nominations for honors and awards, to name a few. By viewing the issue through such a framework, the appropriate response can be generated for a more effective result.
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Wang, Wenyi; Kim, Marlene T.; Sedykh, Alexander
2015-01-01
Purpose Experimental Blood–Brain Barrier (BBB) permeability models for drug molecules are expensive and time-consuming. As alternative methods, several traditional Quantitative Structure-Activity Relationship (QSAR) models have been developed previously. In this study, we aimed to improve the predictivity of traditional QSAR BBB permeability models by employing relevant public bio-assay data in the modeling process. Methods We compiled a BBB permeability database consisting of 439 unique compounds from various resources. The database was split into a modeling set of 341 compounds and a validation set of 98 compounds. Consensus QSAR modeling workflow was employed on the modeling set to develop various QSAR models. A five-fold cross-validation approach was used to validate the developed models, and the resulting models were used to predict the external validation set compounds. Furthermore, we used previously published membrane transporter models to generate relevant transporter profiles for target compounds. The transporter profiles were used as additional biological descriptors to develop hybrid QSAR BBB models. Results The consensus QSAR models have R2=0.638 for fivefold cross-validation and R2=0.504 for external validation. The consensus model developed by pooling chemical and transporter descriptors showed better predictivity (R2=0.646 for five-fold cross-validation and R2=0.526 for external validation). Moreover, several external bio-assays that correlate with BBB permeability were identified using our automatic profiling tool. Conclusions The BBB permeability models developed in this study can be useful for early evaluation of new compounds (e.g., new drug candidates). The combination of chemical and biological descriptors shows a promising direction to improve the current traditional QSAR models. PMID:25862462
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Godfrey, Linda; Scott, Dianne; Trois, Cristina
2013-03-01
Empirical research shows that good waste management practice in South Africa is not always under the volitional control of those tasked with its implementation. While intention to act may exist, external factors, within the distal and proximal context, create barriers to waste behaviour. In addition, these barriers differ for respondents in municipalities, private industry and private waste companies. The main barriers to implementing good waste management practice experienced by respondents in municipalities included insufficient funding for waste management and resultant lack of resources; insufficient waste knowledge; political interference in decision-making; a slow decision-making process; lack of perceived authority to act by waste staff; and a low priority afforded to waste. Barriers experienced by respondents in private industry included insufficient funding for waste and the resultant lack of resources; insufficient waste knowledge; and government bureaucracy. Whereas, barriers experienced in private waste companies included increasing costs; government bureaucracy; global markets; and availability of waste for recycling. The results suggest that respondents in public and private waste organizations are subject to different structural forces that shape, enable and constrain waste behaviour.
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Ramsey, Alex; Lord, Sarah; Torrey, John; Marsch, Lisa; Lardiere, Michael
2016-01-01
This study aimed to identify barriers to use of technology for behavioral health care from the perspective of care decision makers at community behavioral health organizations. As part of a larger survey of technology readiness, 260 care decision makers completed an open-ended question about perceived barriers to use of technology. Using the Consolidated Framework for Implementation Research (CFIR), qualitative analyses yielded barrier themes related to characteristics of technology (e.g., cost and privacy), potential end users (e.g., technology literacy and attitudes about technology), organization structure and climate (e.g., budget and infrastructure), and factors external to organizations (e.g., broadband accessibility and reimbursement policies). Number of reported barriers was higher among respondents representing agencies with lower annual budgets and smaller client bases relative to higher budget, larger clientele organizations. Individual barriers were differentially associated with budget, size of client base, and geographic location. Results are discussed in light of implementation science frameworks and proactive strategies to address perceived obstacles to adoption and use of technology-based behavioral health tools.
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Ramsey, Alex; Lord, Sarah; Torrey, John; Marsch, Lisa; Lardiere, Michael
2014-01-01
This study aimed to identify barriers to use of technology for behavioral health care from the perspective of care decision-makers at community behavioral health organizations. As part of a larger survey of technology readiness, 260 care decision-makers completed an open-ended question about perceived barriers to use of technology. Using the Consolidated Framework for Implementation Research (CFIR), qualitative analyses yielded barrier themes related to characteristics of technology (e.g., cost, privacy), potential end-users (e.g., technology literacy, attitudes about technology), organization structure and climate (e.g., budget, infrastructure), and factors external to organizations (e.g., broadband accessibility, reimbursement policies). Number of reported barriers was higher among respondents representing agencies with lower annual budgets and smaller client bases relative to higher budget, larger clientele organizations. Individual barriers were differentially associated with budget, size of client base, and geographic location. Results are discussed in light of implementation science frameworks and proactive strategies to address perceived obstacles to adoption and use of technology-based behavioral health tools. PMID:25192755
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ERIC Educational Resources Information Center
Camodeca, Marina; Taraschi, Emanuela
2015-01-01
This work considers a still uninvestigated research issue-namely, whether parents' moral disengagement affected preschool children's externalizing behavior. Participants were 245 children (126 girls and 119 boys) aged 3-6 years. Parents' moral disengagement was assessed in terms of their externalization of blame and their indifference in reactions…
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Distribution of apple fruit epidermal non-polar metabolites
USDA-ARS?s Scientific Manuscript database
Apple peel epidermis provides a resilient protective barrier against external stimuli while, also, comprising much of what is considered as fruit appearance and related phenotypic components. This dynamic structure is subject to many changes throughout the production and supply chain that can impac...
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Gifted European American Woman.
ERIC Educational Resources Information Center
Kitano, Margie K.; Perkins, Carol O.
2000-01-01
This article describes factors affecting the achievement of 15 highly accomplished European American women in the fields of business, higher education, and law and government. Findings indicate participants tended to attribute their success to external factors while simultaneously employing proactive strategies to overcome potential barriers.…
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Greenwood, Nan; Habibi, Ruth; Smith, Raymond; Manthorpe, Jill
2015-01-01
As populations age, the numbers of carers overall and numbers of carers from minority ethnic groups in particular are rising. Evidence suggests that carers from all sections of the community and particularly carers from minority groups often fail to access care services. This may relate to barriers in accessing services and service dissatisfaction. The aim of this systematic review was to identify and summarise minority ethnic carers' perceptions of barriers to accessing community social care services and their satisfaction with these services if accessed. The following databases were searched from their start until July 2013: Social Care Online, Social Policy and Research, Scopus, PsychINFO, HMIC, ASSIA, MEDLINE, Embase, CINAHL Plus and AMED. Thirteen studies met the inclusion criteria. Most investigated either barriers to access or satisfaction levels, although three explored both. Only 4 studies investigated minority ethnic carers' satisfaction with social care, although 12 studies reported perceived barriers to accessing services. Few studies compared minority ethnic carers' perceptions with majority ethnic groups, making it difficult to identify issues specific to minority groups. Most barriers described were potentially relevant to all carers, irrespective of ethnic group. They included attitudinal barriers such as not wanting to involve outsiders or not seeing the need for services and practical barriers such as low awareness of services and service availability. Issues specific to minority ethnic groups included language barriers and concerns about services' cultural or religious appropriateness. Studies investigating satisfaction with services reported a mixture of satisfaction and dissatisfaction. Barriers common to all groups should not be underestimated and a better understanding of the relationship between perceived barriers to accessing services and dissatisfaction with services is needed before the experiences of all carers can be improved. PMID:25135207
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2012-03-06
Proceedings Executive Summary 3. DATES COVERED (From - To) 3/25/2010-3/26/2010 4. TITLE AND SUBTITLE Stigma and Barriers To Care: Caring for Those...Health and National Security, directed to addressing stigma and barriers to care, brought together a diverse group of leaders in order to expand our...researchers and health care planners across mental health, health care systems, military and disaster care and the specific issues of stigma and barriers
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Barriers and Strategies in Guideline Implementation—A Scoping Review
Fischer, Florian; Lange, Kerstin; Klose, Kristina; Greiner, Wolfgang; Kraemer, Alexander
2016-01-01
Research indicates that clinical guidelines are often not applied. The success of their implementation depends on the consideration of a variety of barriers and the use of adequate strategies to overcome them. Therefore, this scoping review aims to describe and categorize the most important barriers to guideline implementation. Furthermore, it provides an overview of different kinds of suitable strategies that are tailored to overcome these barriers. The search algorithm led to the identification of 1659 articles in PubMed. Overall, 69 articles were included in the data synthesis. The content of these articles was analysed by using a qualitative synthesis approach, to extract the most important information on barriers and strategies. The barriers to guideline implementation can be differentiated into personal factors, guideline-related factors, and external factors. The scoping review revealed the following aspects as central elements of successful strategies for guideline implementation: dissemination, education and training, social interaction, decision support systems and standing orders. Available evidence indicates that a structured implementation can improve adherence to guidelines. Therefore, the barriers to guideline implementation and adherence need to be analysed in advance so that strategies that are tailored to the specific setting and target groups can be developed. PMID:27417624
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Vocal Fold Epithelial Barrier in Health and Injury A Research Review
Levendoski, Elizabeth Erickson; Leydon, Ciara; Thibeault, Susan L.
2015-01-01
Purpose Vocal fold epithelium is composed of layers of individual epithelial cells joined by junctional complexes constituting a unique interface with the external environment. This barrier provides structural stability to the vocal folds and protects underlying connective tissue from injury while being nearly continuously exposed to potentially hazardous insults including environmental or systemic-based irritants such as pollutants and reflux, surgical procedures, and vibratory trauma. Small disruptions in the epithelial barrier may have a large impact on susceptibility to injury and overall vocal health. The purpose of this article is to provide a broad-based review of our current knowledge of the vocal fold epithelial barrier. Methods A comprehensive review of the literature was conducted. Details of the structure of the vocal fold epithelial barrier are presented and evaluated in the context of function in injury and pathology. The importance of the epithelial-associated vocal fold mucus barrier is also introduced. Results/Conclusions Information presented in this review is valuable for clinicians and researchers as it highlights the importance of this understudied portion of the vocal folds to overall vocal health and disease. Prevention and treatment of injury to the epithelial barrier is a significant area awaiting further investigation. PMID:24686981
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Issues Management and the Role of Strategic Planning. AIR 1985 Annual Forum Paper.
ERIC Educational Resources Information Center
Lozier, G. Gregory; Chittipeddi, Kumar
The integration of issues management into the institutional strategic planning process at Pennsylvania State University is discussed. The significance of issues management as an organizational process is also considered. Stages of the issues management process are: (1) scanning the external environment to identify strategic issues; (2) analyzing…
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Detection of non-Gaussian fluctuations in a quantum point contact.
Gershon, G; Bomze, Yu; Sukhorukov, E V; Reznikov, M
2008-07-04
An experimental study of current fluctuations through a tunable transmission barrier, a quantum point contact, is reported. We measure the probability distribution function of transmitted charge with precision sufficient to extract the first three cumulants. To obtain the intrinsic quantities, corresponding to voltage-biased barrier, we employ a procedure that accounts for the response of the external circuit and the amplifier. The third cumulant, obtained with a high precision, is found to agree with the prediction for the statistics of transport in the non-Poissonian regime.
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Detection of Non-Gaussian Fluctuations in a Quantum Point Contact
NASA Astrophysics Data System (ADS)
Gershon, G.; Bomze, Yu.; Sukhorukov, E. V.; Reznikov, M.
2008-07-01
An experimental study of current fluctuations through a tunable transmission barrier, a quantum point contact, is reported. We measure the probability distribution function of transmitted charge with precision sufficient to extract the first three cumulants. To obtain the intrinsic quantities, corresponding to voltage-biased barrier, we employ a procedure that accounts for the response of the external circuit and the amplifier. The third cumulant, obtained with a high precision, is found to agree with the prediction for the statistics of transport in the non-Poissonian regime.
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Pathways to lean software development: An analysis of effective methods of change
NASA Astrophysics Data System (ADS)
Hanson, Richard D.
This qualitative Delphi study explored the challenges that exist in delivering software on time, within budget, and with the original scope identified. The literature review identified many attempts over the past several decades to reform the methods used to develop software. These attempts found that the classical waterfall method, which is firmly entrenched in American business today was to blame for this difficulty (Chatterjee, 2010). Each of these proponents of new methods sought to remove waste, lighten out the process, and implement lean principles in software development. Through this study, the experts evaluated the barriers to effective development principles and defined leadership qualities necessary to overcome these barriers. The barriers identified were issues of resistance to change, risk and reward issues, and management buy-in. Thirty experts in software development from several Fortune 500 companies across the United States explored each of these issues in detail. The conclusion reached by these experts was that visionary leadership is necessary to overcome these challenges.
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Muraoka, Koko
2015-08-01
Amyotrophic lateral sclerosis (ALS) is a particularly serious intractable neurological disease. Patients with ALS have high mortality rates if they are not put on an artificial respirator. Even with an artificial respirator, individuals with ALS are forced to witness their own physical deterioration. Because 24 hour care is usually required, an intense relationship ofter develops between patients with ALS and family caregivers. This relationship forms an invisible barrier and can impede a smooth introduction of external services. As a result, there can be a degradation in the quality of care. The purpose of this paper is to describe the voluntary efforts of patients and family caregivers in order to break down this barrier and to discuss what types of care support are available to promote barrier-free minds.
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Investigation of ionic transport in sodium scandium phosphate (NSP) and related compounds
NASA Astrophysics Data System (ADS)
Bhat, Kaustubh; Blügel, Stefan; Lustfeld, Hans
Sodium ionic conductors offer significant advantages for application in large scale energy storage systems. In this study, we investigate the different pathways available for sodium ion conduction in NSP and calculate energy barriers for ionic transport using Density Functional Theory (DFT) and the Nudged Elastic Band Method. We identify the structural parameters that reduce the energy barrier, by calculating the influence of positive and negative external pressure on the energy barrier. Lattice strain can be introduced by cation or anion substitution within the NASICON structure. We substitute the scandium atom with other trivalent atoms such as aluminium and yttrium, and calculate the resulting energy barriers. Sodium thiophosphate (Na3PS4) has previously shown about two orders of magnitude higher ionic conductivity than sodium phosphate (Na3PO4). We investigate the effect of substituting oxygen with sulphur in NSP. We acknowledge discussions with our experimental colleagues F. Tietz and M. Guin toward this work
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Advanced Environmental Barrier Coatings Developed for SiC/SiC Composite Vanes
NASA Technical Reports Server (NTRS)
Lee, Kang N.; Fox, Dennis S.; Eldridge, Jeffrey I.; Zhu, Dongming; Bansal, Narottam P.; Miller, Robert A.
2003-01-01
Ceramic components exhibit superior high-temperature strength and durability over conventional component materials in use today, signifying the potential to revolutionize gas turbine engine component technology. Silicon-carbide fiber-reinforced silicon carbide ceramic matrix composites (SiC/SiC CMCs) are prime candidates for the ceramic hotsection components of next-generation gas turbine engines. A key barrier to the realization of SiC/SiC CMC hot-section components is the environmental degradation of SiC/SiC CMCs in combustion environments. This is in the form of surface recession due to the volatilization of silica scale by water vapor. An external environmental barrier coating (EBC) is a logical approach to achieve protection and long-term durability.
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Confronting Barriers, Creating Solutions: Parental Leave for Junior Colleagues
NASA Astrophysics Data System (ADS)
Helfand, David J.
2013-01-01
Barriers to instituting parental leave policies for graduate students and postdoctoral fellows are present at the departmental, university/institute, and federal levels. Within departments, collegial persuasion involving both those affected and senior leadership can be successful in overcoming sociological resistance, although financial constraints may be harder to surmount. Universities are constrained by internal policies and the structure of their fringe benefits pools which are in turn limited by reimbursement rates that must be negotiated with their federal oversight agencies. Federal effort-reporting rules also complicate the situation. I will describe the type of creative solutions that can work at the departmental level, as well as discussing the actions the Society is pursuing in an attempt to lower the external barriers to local action.
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Ye, Huilin; Shen, Zhiqiang; Wei, Mei; Li, Ying
2018-01-01
A large number of nanoparticles (NPs) have been raised for diverse biomedical applications and some of them have shown great potential in treatment and imaging of diseases. Design of NPs is essential for delivery efficacy due to a number of biophysical barriers, which prevents the circulation of NPs in vascular flow and their accumulation at tumour sites. The physiochemical properties of NPs, so-called ‘4S’ parameters, such as size, shape, stiffness and surface functionalization, play crucial roles in their life journey to be delivered to tumour sites. NPs can be modified in various ways to extend their blood circulation time and avoid their clearance by phagocytosis, and efficiently diffuse into tumour cells. However, it is difficult to overcome these barriers simultaneously by a simple combination of ‘4S’ parameters for NPs. At this moment, external triggerings are necessary to guide the movement of NPs, which include light, ultrasound, magnetic field, electrical field and chemical interaction. The delivery system can be constructed to be sensitive to these external stimuli which can reduce the non-specific toxicity and improve the efficacy of the drug-delivery system. From a mechanics point of view, we discuss how different forces play their roles in the margination of NPs in blood flow and tumour microvasculature. PMID:29662344
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NASA Astrophysics Data System (ADS)
Ye, Huilin; Shen, Zhiqiang; Yu, Le; Wei, Mei; Li, Ying
2018-03-01
A large number of nanoparticles (NPs) have been raised for diverse biomedical applications and some of them have shown great potential in treatment and imaging of diseases. Design of NPs is essential for delivery efficacy due to a number of biophysical barriers, which prevents the circulation of NPs in vascular flow and their accumulation at tumour sites. The physiochemical properties of NPs, so-called `4S' parameters, such as size, shape, stiffness and surface functionalization, play crucial roles in their life journey to be delivered to tumour sites. NPs can be modified in various ways to extend their blood circulation time and avoid their clearance by phagocytosis, and efficiently diffuse into tumour cells. However, it is difficult to overcome these barriers simultaneously by a simple combination of `4S' parameters for NPs. At this moment, external triggerings are necessary to guide the movement of NPs, which include light, ultrasound, magnetic field, electrical field and chemical interaction. The delivery system can be constructed to be sensitive to these external stimuli which can reduce the non-specific toxicity and improve the efficacy of the drug-delivery system. From a mechanics point of view, we discuss how different forces play their roles in the margination of NPs in blood flow and tumour microvasculature.
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Barriers to the implementation of research perceived by nurses from Osakidetza.
Cidoncha-Moreno, M Ángeles; Ruíz de Alegría-Fernandez de Retana, Begoña
To understand the barriers to implementing nursing research findings into practice, as perceived by the nurses working in Osakidetza and to analyze if the workplace factor and time worked affect the perception of these barriers. Cross-sectional study. BARRIERS Scale questionnaire was given to a representative sample of 1,572 Basque Health Service nurses, stratified and randomized, according to scope of work and job responsibility (response rate: 43.76%). According to the research results, the first important barrier was "insufficient time on the job to implement new ideas". Nurses have perceived the organizational factor as the most important barrier in their practice. Nurses in "Special hospital departments" perceived more barriers in the "quality of research" factor than those working in "Primary Care". Years of service showed a slight influence. The nurses stated that external factors related to the organization principally interfered in implementing results into clinical practice. They placed lack of critical reading training second. Working environment and seniority mark differences in the perception of barriers. This study may help to develop strategies for planning training programs to facilitate the use of research in clinical practice, in order to provide quality care. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
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Effect of electric barrier on passage and physical condition of juvenile and adult rainbow trout
Layhee, Megan J.; Sepulveda, Adam; Shaw, Amy; Smuckall, Matthew; Kapperman, Kevin; Reyes, Alejandro
2016-01-01
Electric barriers can inhibit passage and injure fish. Few data exist on electric barrier parameters that minimize these impacts and on how body size affects susceptibility, especially to nontarget fish species. The goal of this study was to determine electric barrier voltage and pulse-width settings that inhibit passage of larger bodied rainbow trout Oncorhynchus mykiss (215–410 mm fork length) while allowing passage of smaller bodied juvenile rainbow trout (52–126 mm) in a static laboratory setting. We exposed rainbow trout to 30-Hz pulsed-direct current voltage gradients (0.00–0.45 V cm−1) and pulse widths (0.0–0.7 ms) and recorded their movement, injury incidence, and mortality. No settings tested allowed all juveniles to pass while impeding all adult passage. Juvenile and adult rainbow trout avoided the barrier at higher pulse widths, and fewer rainbow trout passed the barrier at 0.7-ms pulse width compared to 0.1 ms and when the barrier was turned off. We found no effect of voltage gradient on fish passage. No mortality occurred, and we observed external bruising in 5 (7%) juvenile rainbow trout and 15 (21%) adult rainbow trout. This study may aid managers in selecting barrier settings that allow for increased juvenile passage.
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NASA Astrophysics Data System (ADS)
Chakraverty, Devasmita
Women in medicine and biomedical research often face challenges to their retention, promotion, and advancement to leadership positions (McPhillips et al., 2007); they take longer to advance their careers, tend to serve at less research-intensive institutions and have shorter tenures compared to their male colleagues (White, McDade, Yamagata, & Morahan, 2012). Additionally, Blacks and Hispanics are the two largest minority groups that are vastly underrepresented in medicine and biomedical research in the United States (AAMC, 2012; NSF, 2011). The purpose of this study is to examine specific barriers reported by students and post-degree professionals in the field through the following questions: 1. How do women who are either currently enrolled or graduated from biomedical research or medical programs define and make meaning of gender-roles as academic barriers? 2. How do underrepresented groups in medical schools and biomedical research institutions define and make meaning of the academic barriers they face and the challenges these barriers pose to their success as individuals in the program? These questions were qualitatively analyzed using 146 interviews from Project TrEMUR applying grounded theory. Reported gender-role barriers were explained using the "Condition-Process-Outcome" theoretical framework. About one-third of the females (across all three programs; majority White or Black between 25-35 years of age) reported gender-role barriers, mostly due to poor mentoring, time constraints, set expectations and institutional barriers. Certain barriers act as conditions, causing gender-role issues, and gender-role issues influence certain barriers that act as outcomes. Strategies to overcome barriers included interventions mostly at the institutional level (mentor support, proper specialty selection, selecting academia over medicine). Barrier analysis for the two largest URM groups indicated that, while Blacks most frequently reported racism, gender barriers, mentoring, and personal barriers, Hispanics most frequently reported economic barriers, language barriers, institutional and workplace environment barriers, and gender-role barriers. Examining barriers using the "Individual-Institutional" theoretical framework indicated that barriers do not occur in isolation, but due to an interaction between the individual and its institution. Additionally, the barriers of the two groups are qualitatively different and the "one size fits all" approach may not be suitable for interventions. Implications and recommendations were stated.
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External Validity in the Study of Human Development: Theoretical and Methodological Issues
ERIC Educational Resources Information Center
Hultsch, David F.; Hickey, Tom
1978-01-01
An examination of the concept of external validity from two theoretical perspectives: a traditional mechanistic approach and a dialectical organismic approach. Examines the theoretical and methodological implications of these perspectives. (BD)
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2003-06-07
KENNEDY SPACE CENTER, FLA. - KSC External Relations and Business Development Director JoAnn Morgan (sixth from right) joins other attendees of The Florida Commission on the Status of Women held June 7 at the Debus Conference Facility. Morgan is a member of the group’s Hall of Fame. The commission, through coordinating, researching, communicating, and encouraging legislation, is dedicated to empowering women from all walks of life in achieving their fullest potential, to eliminating barriers to that achievement, and to recognizing women’s accomplishments.
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NASA Astrophysics Data System (ADS)
Sands, Brian; Schmidt, Jacob; Ganguly, Biswa; Scofield, James
2014-10-01
Atomic oxygen production is studied in a capillary dielectric barrier plasma jet that is externally grounded and driven with a 20-ns risetime positive unipolar pulsed voltage at pulse repetition rates up to 25 kHz. The power coupled to the discharge can be easily increased by increasing the pulse repetition rate. At a critical turnover frequency, determined by the net energy density coupled to the discharge, the plasma chemistry abruptly changes. This is indicated by increased plasma conductance and a transition in reactive oxygen species production from an ozone-dominated production regime below the turnover frequency to atomic-oxygen-dominated production at higher pulse rates. Here, we characterize atomic oxygen production scaling using spatially- and temporally-resolved two-photon absorption laser-induced-fluorescence (TALIF). Quantitative results are obtained via calibration with xenon using a similar laser excitation and collection system. These results are compared with quantitative ozone and discharge power measurements using a helium gas flow with oxygen admixtures up to 3%.
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Dynamics of near-surface electric discharges and mechanisms of their interaction with the airflow
NASA Astrophysics Data System (ADS)
Leonov, Sergey B.; Adamovich, Igor V.; Soloviev, Victor R.
2016-12-01
The main focus of the review is on dynamics and kinetics of near-surface discharge plasmas, such as surface dielectric barrier discharges sustained by AC and repetitively pulsed waveforms, pulsed DC discharges, and quasi-DC discharges, generated in quiescent air and in the airflow. A number of technical issues related to plasma flow control applications are discussed in detail, including discharge development via surface ionization waves, charge transport and accumulation on dielectric surface, discharge contraction, different types of flow perturbations generated by surface discharges, and effect of high-speed flow on discharge dynamics. In the first part of the manuscript, plasma morphology and results of electrical and optical emission spectroscopy measurements are discussed. Particular attention is paid to dynamics of surface charge accumulation and dissipation, both in diffuse discharges and during development of ionization instabilities resulting in discharge contraction. Contraction leads to significant increase of both the surface area of charge accumulation and the energy coupled to the plasma. The use of alternating polarity pulse waveforms accelerates contraction of surface dielectric barrier discharges and formation of filamentary plasmas. The second part discusses the interaction of discharge plasmas with quiescent air and the external airflow. Four major types of flow perturbations have been identified: (1) low-speed near-surface jets generated by electrohydrodynamic interaction (ion wind); (2) spanwise and streamwise vortices formed by both electrohydrodynamic and thermal effects; (3) weak shock waves produced by rapid heating in pulsed discharges on sub-microsecond time scale; and (4) near-surface localized stochastic perturbations, on sub-millisecond time, detected only recently. The mechanism of plasma-flow interaction remains not fully understood, especially in filamentary surface dielectric barrier discharges. Localized quasi-DC surface discharges sustained in a high-speed flow are discussed in the third part of the review. Although dynamics of this type of the discharge is highly transient, due to its strong interaction with the flow, the resultant flow structure is stationary, including the oblique shock and the flow separation region downstream of the discharge. The oblique shock is attached to a time-averaged, wedge-shaped, near-wall plasma layer, with the shock angle controlled by the discharge power, which makes possible changing the flow structure and parameters in a controlled way. Finally, unresolved and open-ended issues are discussed in the summary.
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14 CFR 133.17 - Requirements for issuance of a rotorcraft external-load operator certificate.
Code of Federal Regulations, 2014 CFR
2014-01-01
... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Requirements for issuance of a rotorcraft external-load operator certificate. 133.17 Section 133.17 Aeronautics and Space FEDERAL AVIATION... §§ 133.19, 133.21, and 133.23, the Administrator issues a Rotorcraft External-Load Operator Certificate...
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14 CFR 133.17 - Requirements for issuance of a rotorcraft external-load operator certificate.
Code of Federal Regulations, 2013 CFR
2013-01-01
... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Requirements for issuance of a rotorcraft external-load operator certificate. 133.17 Section 133.17 Aeronautics and Space FEDERAL AVIATION... §§ 133.19, 133.21, and 133.23, the Administrator issues a Rotorcraft External-Load Operator Certificate...
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ERIC Educational Resources Information Center
Steinfatt, Thomas M.
1991-01-01
Responds to an article in the same issue of this journal which defends the applied value of laboratory studies to managers. Agrees that external validity is often irrelevant, and maintains that the problem of making inferences from any subject sample in management communication is one that demands internal, not external, validity. (SR)
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External tank space debris considerations
NASA Technical Reports Server (NTRS)
Elfer, N.; Baillif, F.; Robinson, J.
1992-01-01
Orbital debris issues associated with maintaining a Space Shuttle External Tank (ET) on orbit are presented. The first issue is to ensure that the ET does not become a danger to other spacecraft by generating space debris, and the second is to protect the pressurized ET from penetration by space debris or meteoroids. Tests on shield designs for penetration resistance showed that when utilized with an adequate bumper, thermal protection system foam on the ET is effective in preventing penetration.
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'We can't get anything done because...': making sense of 'barriers' to Practice-based Commissioning.
Checkland, Kath; Coleman, Anna; Harrison, Stephen; Hiroeh, Urara
2009-01-01
To investigate the issues raised by participants as 'barriers' to the development of Practice-based Commissioning (PBC) in 'early adopter' sites in England. Detailed case studies of five PBC consortia in three Primary Care Trusts (PCTs). Data collection included interviews with a wide range of respondents (46 in total), including general practitioners, PCT employees, Local Authority employees and patient representatives, observation of many different types of meetings (68 in total), and analysis of documents tabled at meetings and circulated at other times. It has been claimed that progress in developing PBC has been slow. Our respondents articulated a number of factors that they felt were holding them back, which could have been identified as 'barriers' preventing change. The issues raised were consistent across our sites (lack of time, resources and personnel, and difficult relationships with the PCT), but observation suggested that these issues arose out of very different organizational 'sensemaking', and as a result the apparent 'barriers' had different meanings in different organizational contexts. Weick's concept of 'organizational sensemaking' provides a useful framework within which to explore the problems encountered when implementing policy. Observational methods are a powerful tool in understanding sensemaking. The variations in sensemaking that we observed suggest that the use of 'barrier' metaphors in descriptions of implementation problems risks homogenizing the portrayal of situations that differ greatly in reality. This implies that top-down or centrally driven solutions to such situations will often be inappropriate.
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Australian Football League concussion guidelines: what do community players think?
White, Peta E; Donaldson, Alex; Sullivan, S John; Newton, Joshua; Finch, Caroline F
2016-01-01
Preventing concussion in sport is a global challenge. To assess community-level adult male Australian Football players' views on following the Australian Football League's (AFL) concussion guidelines. 3 focus groups, each comprising 6 players from 1 regional league, were conducted until saturation of issues raised. Discussions followed a semistructured script and were audio-recorded and transcribed verbatim. Thematic analysis was conducted by 2 coders independently. Identified advantages of the guidelines included highlighting the seriousness of concussion; changing the culture around playing with concussion and shifting return-to-play decision responsibility from players to others. Disadvantages included players being removed from play unnecessarily; removal of players' rights to decide if they are fit to play and players changing their behaviours to avoid being removed from play. Identified facilitators to guideline use included local league enforcement; broad information dissemination and impartial medically trained staff to assess concussion. Identified barriers to guideline use included players' desire to play at all costs; external pressure that encouraged players to return to play prematurely; and inconvenience and cost. Players generally understand that the AFL concussion guidelines protect their long-term welfare. However, their desire to play at all costs and help their team win is a common barrier to reporting concussion and adhering to guidelines. Leagues should take a lead role by mandating and enforcing the use of the guidelines and educating coaches, game day medical providers and players. The return-to-play component of the guidelines is complex and needs further consideration in the context of community sport.
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A generalized force-modified potential energy surface (G-FMPES) for mechanochemical simulations
Subramanian, Gopinath; Mathew, Nithin; Leiding, Jeffery A.
2015-10-05
We describe the modifications that a spatially varying external load produces on a Born-Oppenheimer potential energy surface (PES) by calculating static quantities of interest. The effects of the external loads are exemplified using electronic structure calculations (at the HF/6-31G** level) of two different molecules: ethane and hexahydro-1,3,5-trinitro-s-triazine (RDX). The calculated transition states and The Hessian matrices of stationary points show that spatially varying external loads shift the stationary points and modify the curvature of the PES, thereby affecting the harmonic transition rates by altering both the energy barrier as well as the prefactor. The harmonic spectra of both molecules aremore » blue-shifted with increasing compressive “pressure.” Some stationary points on the RDX-PES disappear under application of the external load, indicating the merging of an energy minimum with a saddle point.« less
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Effect of External Electric Field on Substrate Transport of a Secondary Active Transporter.
Zhang, Ji-Long; Zheng, Qing-Chuan; Yu, Li-Ying; Li, Zheng-Qiang; Zhang, Hong-Xing
2016-08-22
Substrate transport across a membrane accomplished by a secondary active transporter (SAT) is essential to the normal physiological function of living cells. In the present research, a series of all-atom molecular dynamics (MD) simulations under different electric field (EF) strengths was performed to investigate the effect of an external EF on the substrate transport of an SAT. The results show that EF both affects the interaction between substrate and related protein's residues by changing their conformations and tunes the timeline of the transport event, which collectively reduces the height of energy barrier for substrate transport and results in the appearance of two intermediate conformations under the existence of an external EF. Our work spotlights the crucial influence of external EFs on the substrate transport of SATs and could provide a more penetrating understanding of the substrate transport mechanism of SATs.
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Smith, Ronald W; Altman, Jennifer K; Meeks, Suzanne; Hinrichs, Kate Lm
2018-06-07
To assess mental health providers' experience with LGBT older adults in long-term care (LTC) settings and perceived barriers to quality care. Providers (N = 57) completed an online survey on demographics and practice characteristics. They were also asked about: number of LGBT residents they've worked with, relevance of LGBT issues to their practice, preparedness, willingness to learn, hours of formal/informal training, and barriers to providing care to LGBT patients. Respondents were 63% psychologists, 16% social workers, 14% psychiatrists, and 5% nurses, most of whom practiced in LTC consulting roles. Most providers felt working with LGBT issues was relevant to their practice and felt well-prepared and willing to learn, though they were unaware of evidence based practices (EBTs), especially for LTC settings. They had little coursework on LGBT issues, and identified lack of training, stigma, and residents concealing their identity as the greatest barriers to quality care. Mental health providers in LTC facilities would benefit from more training in LGBT-specific mental health problems and evidence-based treatments, and efforts to destigmatize LGBT identities in these settings might improve access to mental health care. LGBT-specific training and EBTs are needed. Facilities need to address stigma with residents and providers.
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Co-ordinated action between youth-care and sports: facilitators and barriers.
Hermens, Niels; de Langen, Lisanne; Verkooijen, Kirsten T; Koelen, Maria A
2017-07-01
In the Netherlands, youth-care organisations and community sports clubs are collaborating to increase socially vulnerable youths' participation in sport. This is rooted in the idea that sports clubs are settings for youth development. As not much is known about co-ordinated action involving professional care organisations and community sports clubs, this study aims to generate insight into facilitators of and barriers to successful co-ordinated action between these two organisations. A cross-sectional study was conducted using in-depth semi-structured qualitative interview data. In total, 23 interviews were held at five locations where co-ordinated action between youth-care and sports takes place. Interviewees were youth-care workers, representatives from community sports clubs, and Care Sport Connectors who were assigned to encourage and manage the co-ordinated action. Using inductive coding procedures, this study shows that existing and good relationships, a boundary spanner, care workers' attitudes, knowledge and competences of the participants, organisational policies and ambitions, and some elements external to the co-ordinated action were reported to be facilitators or barriers. In addition, the participants reported that the different facilitators and barriers influenced the success of the co-ordinated action at different stages of the co-ordinated action. Future research is recommended to further explore the role of boundary spanners in co-ordinated action involving social care organisations and community sports clubs, and to identify what external elements (e.g. events, processes, national policies) are turning points in the formation, implementation and continuation of such co-ordinated action. © 2017 John Wiley & Sons Ltd.
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Klein, Michelle E; Parvez, Md Masud; Shin, Jae-Gook
2017-09-01
Clinical implementation of pharmacogenomics (PGx) leads to personalized medicine, which improves the efficacy, safety, and cost-effectiveness of treatments. Although PGx-based research has been conducted for more than a decade, several barriers have slowed down its widespread implementation in clinical practice. Globally, there is an imbalance in programs and solutions required to empower the clinical implementation of PGx between countries. Therefore, we aimed to review these issues comprehensively, determine the major barriers, and find the best solutions. Through an extensive review of ongoing clinical implementation programs, scientific, educational, ethical, legal, and social issues, information technology, and reimbursement were identified as the key barriers. The pace of global implementation of genomic medicine coincided with the resource limitations of each country. The key solutions identified for the earlier mentioned barriers are as follows: building of secure and suitable information technology infrastructure with integrated clinical decision support systems along with increasing PGx evidence, more regulations, reimbursement strategies for stakeholder's acceptance, incorporation of PGx education in all institutions and clinics, and PGx promotion to all health care professionals and patients. In conclusion, this review will be helpful for the better understanding of common barriers and solutions pertaining to the clinical application of PGx. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
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Free energy and hidden barriers of the β-sheet structure of prion protein.
Paz, S Alexis; Abrams, Cameron F
2015-10-13
On-the-fly free-energy parametrization is a new collective variable biasing approach akin to metadynamics with one important distinction: rather than acquiring an accelerated distribution via a history-dependent bias potential, sampling on this distribution is achieved from the beginning of the simulation using temperature-accelerated molecular dynamics. In the present work, we compare the performance of both approaches to compute the free-energy profile along a scalar collective variable measuring the H-bond registry of the β-sheet structure of the mouse Prion protein. Both methods agree on the location of the free-energy minimum, but free-energy profiles from well-tempered metadynamics are subject to a much higher degree of statistical noise due to hidden barriers. The sensitivity of metadynamics to hidden barriers is shown to be a consequence of the history dependence of the bias potential, and we detail the nature of these barriers for the prion β-sheet. In contrast, on-the-fly parametrization is much less sensitive to these barriers and thus displays improved convergence behavior relative to that of metadynamics. While hidden barriers are a frequent and central issue in free-energy methods, on-the-fly free-energy parametrization appears to be a robust and preferable method to confront this issue.
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Technology-driven dietary assessment: a software developer’s perspective
Buday, Richard; Tapia, Ramsey; Maze, Gary R.
2015-01-01
Dietary researchers need new software to improve nutrition data collection and analysis, but creating information technology is difficult. Software development projects may be unsuccessful due to inadequate understanding of needs, management problems, technology barriers or legal hurdles. Cost overruns and schedule delays are common. Barriers facing scientific researchers developing software include workflow, cost, schedule, and team issues. Different methods of software development and the role that intellectual property rights play are discussed. A dietary researcher must carefully consider multiple issues to maximize the likelihood of success when creating new software. PMID:22591224
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Product qualification: a barrier to point-of-care microfluidic-based diagnostics?
Tantra, Ratna; van Heeren, Henne
2013-06-21
One of the most exciting applications of microfluidics-based diagnostics is its potential use in next generation point-of-care (POC) devices. Many prototypes are already in existence, but, as of yet, few have achieved commercialisation. In this article, we consider the issue surrounding product qualification as a potential barrier to market success. The study discusses, in the context of POC microfluidics-based diagnostics, what the generic issues are and potential solutions. Our findings underline the need for a community-based effort that is necessary to speed up the product qualification process.
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Social workers in pediatric primary care: communication, gender, and scope of practice.
Lynch, Sean
2014-01-01
While many child mental health issues manifest themselves in primary care, few pediatricians have received mental health training, and their communication with social workers may be limited due to unfamiliarity with mental health professions. The purpose of this study was to use ethnographic interviews to investigate factors affecting communication satisfaction between social workers and pediatricians. The study found that scope of practice issues were a communication barrier. This barrier is significant because health reform may lead social workers and pediatricians to collaborate more frequently in the future.
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Evaluation of median barrier safety issues.
DOT National Transportation Integrated Search
2008-01-01
The objective of this study was to evaluate the effectiveness of the Brifen TL-4 and Trinity CASS median cable barrier systems in preventing cross-median collisions on sections of I-64, I-71, and I-265 (Brifen system) and I-265 (Trinity system) in Je...
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Barriers to Teaching Introductory Physical Geography Online
ERIC Educational Resources Information Center
Ritter, Michael E.
2012-01-01
Learning geography online is becoming an option for more students but not without controversy. Issues of faculty resources, logistics, professional recognition, and pedagogical concerns are cited as barriers to teaching online. Offering introductory physical geography online presents special challenges. As a general education course, an…
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Motivational Enhancement Career Intervention for Youth with Disabilities
ERIC Educational Resources Information Center
Sheftel, Anya; Lindstrom, Lauren; McWhirter, Benedict
2014-01-01
Youth with disabilities face both internal and external barriers to career development and often experience poor post school outcomes in comparison to their nondisabled peers. The purpose of this study was to design, implement, and evaluate a motivational interviewing-based group career intervention--Motivational Enhancement Group Intervention…
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40 CFR 63.7957 - What definitions apply to this subpart?
Code of Federal Regulations, 2010 CFR
2010-07-01
... (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Site Remediation Other Requirements and... by forming a continuous barrier over the remediation material managed in a unit. A cover may have... system, valve, and connector used in remediation material service at a facility. External floating roof...
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ERIC Educational Resources Information Center
Hayden, Mary F., Ed.; Ward, Nancy, Ed.
1994-01-01
This feature issue newsletter looks at issues the self-advocacy movement is raising and the contributions it is making to the lives of people with developmental disabilities. Articles by self-advocates and advisors to self-advocacy organizations talk about their self-advocacy experiences, barriers to self-advocacy, and ways to support it. Primary…
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Barriers to Liposomal Gene Delivery: from Application Site to the Target.
Saffari, Mostafa; Moghimi, Hamid Reza; Dass, Crispin R
2016-01-01
Gene therapy is a therapeutic approach to deliver genetic material into cells to alter their function in entire organism. One promising form of gene delivery system (DDS) is liposomes. The success of liposome-mediated gene delivery is a multifactorial issue and well-designed liposomal systems might lead to optimized gene transfection particularly in vivo. Liposomal gene delivery systems face different barriers from their site of application to their target, which is inside the cells. These barriers include presystemic obstacles (epithelial barriers), systemic barriers in blood circulation and cellular barriers. Epithelial barriers differ depending on the route of administration. Systemic barriers include enzymatic degradation, binding and opsonisation. Both of these barriers can act as limiting hurdles that genetic material and their vector should overcome before reaching the cells. Finally liposomes should overcome cellular barriers that include cell entrance, endosomal escape and nuclear uptake. These barriers and their impact on liposomal gene delivery will be discussed in this review.
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Role of Primary Health Care in Ensuring Access to Medicines
Sambala, Evanson Z; Sapsed, Susan; Mkandawire, Mercy L
2010-01-01
To examine ways of ensuring access to health services within the framework of primary health care (PHC), since the goal of PHC to make universal health care available to all people has become increasingly neglected amid emerging themes of globalization, trade, and foreign policy. From a public health point of view, we argue that the premise of PHC can unlock barriers to health care services and contribute greatly to determining collective health through the promotion of universal basic health services. PHC has the most sophisticated and organized infrastructure, theories, and political principles, with which it can deal adequately with the issues of inequity, inequality, and social injustice which emerge from negative economic externalities and neo-liberal economic policies. Addressing these issues, especially the complex social and political influences that restrict access to medicines, may require the integration of different health initiatives into PHC. Based on current systems, PHC remains the only conventional health delivery service that can deal with resilient public health problems adequately. However, to strengthen its ability to do so, we propose the revitalization of PHC to incorporate scholarship that promotes human rights, partnerships, research and development, advocacy, and national drug policies. The concept of PHC can improve access; however, this will require the urgent interplay among theoretical, practical, political, and sociological influences arising from the economic, social, and political determinants of ill health in an era of globalization. PMID:20564760
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2011-01-01
Background Considering the fact that a significant proportion of high-risk pregnancies are currently referred to tertiary level hospitals; and that a large proportion of low obstetric risk women still seek care in these hospitals, it is important to explore the factors that influence the childbirth experience in these hospitals, particularly, the concept of humanized birth care. The aim of this study was to explore the organizational and cultural factors, which act as barriers or facilitators in the provision of humanized obstetrical care in a highly specialized, university-affiliated hospital in Quebec province, in Canada. Methods A single case study design was chosen. The study sample included 17 professionals and administrators from different disciplines, and 157 women who gave birth in the hospital during the study. The data was collected through semi-structured interviews, field notes, participant observations, a self-administered questionnaire, documents, and archives. Both descriptive and qualitative deductive content analyses were performed and ethical considerations were respected. Results Both external and internal dimensions of a highly specialized hospital can facilitate or be a barrier to the humanization of birth care practices in such institutions, whether independently, or altogether. The greatest facilitating factors found were: caring and family- centered model of care, professionals' and administrators' ambient for the provision of humanized birth care besides the medical interventional care which is tailored to improve safety, assurance, and comfort for women and their children, facilities to provide a pain-free birth, companionship and visiting rules, dealing with the patients' spiritual and religious beliefs. The most cited barriers were: the shortage of health care professionals, the lack of sufficient communication among the professionals, the stakeholders' desire for specialization rather than humanization, over estimation of medical performance, finally the training environment of the hospital leading to the presence of too many health care professionals, and consequently, a lack of privacy and continuity of care. Conclusion The argument of medical intervention and technology at birth being an opposing factor to the humanization of birth was not seen to be an issue in the studied highly specialized university affiliated hospital. PMID:22114870
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Garg, Sachin K; Lyles, Courtney R; Ackerman, Sara; Handley, Margaret A; Schillinger, Dean; Gourley, Gato; Aulakh, Veenu; Sarkar, Urmimala
2016-02-06
Text messaging is an affordable, ubiquitous, and expanding mobile communication technology. However, safety net health systems in the United States that provide more care to uninsured and low-income patients may face additional financial and infrastructural challenges in utilizing this technology. Formative evaluations of texting implementation experiences are limited. We interviewed safety net health systems piloting texting initiatives to study facilitators and barriers to real-world implementation. We conducted telephone interviews with various stakeholders who volunteered from each of the eight California-based safety net systems that received external funding to pilot a texting-based program of their choosing to serve a primary care need. We developed a semi-structured interview guide based partly on the Consolidated Framework for Implementation Research (CFIR), which encompasses several domains: the intervention, individuals involved, contextual factors, and implementation process. We inductively and deductively (using CFIR) coded transcripts, and categorized themes into facilitators and barriers. We performed eight interviews (one interview per pilot site). Five sites had no prior texting experience. Sites applied texting for programs related to medication adherence and monitoring, appointment reminders, care coordination, and health education and promotion. No site texted patient-identifying health information, and most sites manually obtained informed consent from each participating patient. Facilitators of implementation included perceived enthusiasm from patients, staff and management belief that texting is patient-centered, and the early identification of potential barriers through peer collaboration among grantees. Navigating government regulations that protect patient privacy and guide the handling of protected health information emerged as a crucial barrier. A related technical challenge in five sites was the labor-intensive tracking and documenting of texting communications due to an inability to integrate texting platforms with electronic health records. Despite enthusiasm for the texting programs from the involved individuals and organizations, inadequate data management capabilities and unclear privacy and security regulations for mobile health technology slowed the initial implementation and limited the clinical use of texting in the safety net and scope of pilots. Future implementation work and research should investigate how different texting platform and intervention designs affect efficacy, as well as explore issues that may affect sustainability and the scalability.
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Cooke, S J; Lapointe, N W R; Martins, E G; Thiem, J D; Raby, G D; Taylor, M K; Beard, T D; Cowx, I G
2013-10-01
Generating awareness of environmental conservation issues among the public is essential if there is an expectation of them to alter their behaviour, facilitate informed decisions and engage governments or regulatory authorities to take action. There are, however, exceedingly few public engagement success stories related to inland fishes and fisheries policy and resource allocation decisions. Inland aquatic resources and their associated fisheries provide employment, recreation, culture and, in developing regions, a considerable proportion of human nutrition and food security. Freshwater fishes are incredibly diverse but are among the most endangered organisms globally. Many threats to inland fisheries are driven largely by externalities to inland fisheries. The purpose of this paper is to draw attention to the role and plight of inland fishes and fisheries, and the need to generate the public and political will necessary to promote meaningful conservation. With this paper, the extent to which the scientific and environmental management communities have failed to engage the public in issues related to inland fishes and fisheries is characterized. Next, the barriers or factors that serve as the basis for the problem with public engagement are identified. The paper concludes by identifying strategies, including those focused on environmental education initiatives, for building the public and political will necessary to promote meaningful conservation of inland fishes and fisheries in developed and developing countries. Scientists, environmental managers, non-governmental organizations, politicians, regulatory authorities and the media all have important roles to play in overcoming challenges to inland fisheries. Failure to engage the public in freshwater conservation and management issues will impede efforts to stem the loss of freshwater habitats, fisheries and aquatic biodiversity. Thankfully, there are opportunities to learn from success stories related to other environmental issues and initiatives that have been successful in marine fish conservation. © 2013 The Fisheries Society of the British Isles.
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Integrating Religion and Spirituality into Counselor Education: Barriers and Strategies
ERIC Educational Resources Information Center
Adams, Christopher M.; Puig, Ana; Baggs, Adrienne; Wolf, Cheryl Pence
2015-01-01
Despite a professionally recognized need for training in religion/spirituality, literature indicates that religious and spirituality issues continue to be inconsistently addressed in counselor education. Ten experts were asked to identify potential barriers to integrating religion and spirituality into counselor education and indicate strategies…
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Near-road air quality is an issue of emerging concern, with field studies consistently showing elevated air pollutant concentrations adjacent to major roads, usually decreasing to background levels within several hundred meters. Roadside barriers, both vegetative and structural, ...
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ERIC Educational Resources Information Center
Spoor, Dana L.
1997-01-01
Argues that barrier-free designs should be incorporated in the first steps of school facility planning to avoid the difficulties in meeting Americans with Disabilities Act (ADA) guidelines during renovations. Explains why not all barriers need be removed to make a facility accessible to everyone. Discusses issues involving ADA guidelines and child…
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The Relationship between Barrier Courses and Persistence in Engineering
ERIC Educational Resources Information Center
Suresh, Radhika
2007-01-01
Attrition in engineering programs continues to be an important issue for universities across the country. This study examined the connection between student performance in barrier courses and persistence in engineering. Quantitative results showed that high school academic experience, student behaviors (including study habits, work habits, coping…
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Harvey, Gill; Llewellyn, Sue; Maniatopoulos, Greg; Boyd, Alan; Procter, Rob
2018-05-10
Accelerating the implementation of new technology in healthcare is typically complex and multi-faceted. One strategy is to charge a national agency with the responsibility for facilitating implementation. This study examines the role of such an agency in the English National Health Service. In particular, it compares two different facilitation strategies employed by the agency to support the implementation of insulin pump therapy. The research involved an empirical case study of four healthcare organisations receiving different levels of facilitation from the national agency: two received active hands-on facilitation; one was the intended recipient of a more passive, web-based facilitation strategy; the other implemented the technology without any external facilitation. The primary method of data collection was semi-structured qualitative interviews with key individuals involved in implementation. The integrated-PARIHS framework was applied as a conceptual lens to analyse the data. The two sites that received active facilitation from an Implementation Manager in the national agency made positive progress in implementing the technology. In both sites there was a high level of initial receptiveness to implementation. This was similar to a site that had successfully introduced insulin pump therapy without facilitation support from the national agency. By contrast, a site that did not have direct contact with the national agency made little progress with implementation, despite the availability of a web-based implementation resource. Clinicians expressed differences of opinion around the value and effectiveness of the technology and contextual barriers related to funding for implementation persisted. The national agency's intended roll out strategy using passive web-based facilitation appeared to have little impact. When favourable conditions exist, in terms of agreement around the value of the technology, clinician receptiveness and motivation to change, active facilitation via an external agency can help to structure the implementation process and address contextual barriers. Passive facilitation using web-based implementation resources appears less effective. Moving from initial implementation to wider scale-up presents challenges and is an issue that warrants further attention.
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Formation of superheavy elements in the capture of very heavy ions at high excitation energies
NASA Astrophysics Data System (ADS)
Royer, G.
2013-05-01
The potential barriers governing the reactions 58Fe+244Pu, 238U+64Ni, and 238U+72Ge have been determined from a liquid-drop model taking into account the proximity energy, shell energies, rotational energy, and deformation of the incoming nuclei in the quasimolecular shape valley. Double-humped potential barriers appear in these entrance channels. The external saddle-point corresponds to two touching ellipsoidal nuclei when the shell and pairing effects are taken into account, while the inner barrier is due to the shell effects at the vicinity of the spherical shape of the composite system. Between them, a large potential pocket exists and persists at very high angular momenta allowing the capture of very heavy ions at high excitation energies.
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NASA Astrophysics Data System (ADS)
Zhang, F.; Can, N.; Hafiz, S.; Monavarian, M.; Das, S.; Avrutin, V.; Özgür, Ü.; Morkoç, H.
2015-05-01
The effect of δ-doping of In0.06Ga0.94N barriers with Mg on the quantum efficiency of blue light-emitting-diodes (LEDs) with active regions composed of 6 (hex) 3-nm In0.15Ga0.85N is investigated. Compared to the reference sample, δ-doping of the first barrier on the n-side of the LED structure improves the peak external quantum efficiency (EQE) by 20%, owing to the increased hole concentration in the wells adjacent to the n-side, as confirmed by numerical simulations of carrier distributions across the active region. Doping the second barrier, in addition to the first one, did not further enhance the EQE, which likely indicates compensation of improved hole injection by degradation of the active region quality due to Mg doping. Both LEDs with Mg δ-doped barriers effectively suppress the drop of efficiency at high injection when compared to the reference sample, and the onset of EQE peak roll-off shifts from ˜80 A/cm2 in the reference LED to ˜120 A/cm2 in the LEDs with Mg δ-doped barriers.
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Moll, Sandra E
2014-02-08
There is a high rate of stress and mental illness among healthcare workers, yet many continue to work despite symptoms that affect their performance. Workers with mental health issues are typically ostracized and do not get the support that they need. If issues are not addressed, however, they could become worse and compromise the health and safety, not only of the worker, but his/her colleagues and patients. Early identification and support can improve work outcomes and facilitate recovery, but more information is needed about how to facilitate this process in the context of healthcare work. The purpose of this study was to explore the key individual and organizational forces that shape early intervention and support for healthcare workers who are struggling with mental health issues, and to identify barriers and opportunities for change. A qualitative, case study in a large, urban healthcare organization was conducted in order to explore the perceptions and experiences of employees across the organization. In-depth interviews were conducted with eight healthcare workers who had experienced mental health issues at work as well as eight workplace stakeholders who interacted with workers who were struggling (managers, coworkers, union leaders). An online survey was completed by an additional 67 employees. Analysis of the interviews and surveys was guided by a process of interpretive description to identify key barriers to early intervention and support. There were many reports of silence and inaction in response to employee mental health issues. Uncertainty in identifying mental health problems, stigma regarding mental ill health, a discourse of professional competence, social tensions, workload pressures, confidentiality expectations and lack of timely access to mental health supports were key forces in preventing employees from getting the help that they needed. Although there were a few exceptions, the overall study findings point to many barriers to supporting employees with mental health issues. In order to address the complex knowledge, attitudinal, interpersonal and organizational barriers to action, a multi-layered knowledge translation strategy is needed, that considers not only mental health literacy and anti-stigma interventions, but addresses the unique context of the work environment that can act as a barrier to change.
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2014-01-01
Background There is a high rate of stress and mental illness among healthcare workers, yet many continue to work despite symptoms that affect their performance. Workers with mental health issues are typically ostracized and do not get the support that they need. If issues are not addressed, however, they could become worse and compromise the health and safety, not only of the worker, but his/her colleagues and patients. Early identification and support can improve work outcomes and facilitate recovery, but more information is needed about how to facilitate this process in the context of healthcare work. The purpose of this study was to explore the key individual and organizational forces that shape early intervention and support for healthcare workers who are struggling with mental health issues, and to identify barriers and opportunities for change. Methods A qualitative, case study in a large, urban healthcare organization was conducted in order to explore the perceptions and experiences of employees across the organization. In-depth interviews were conducted with eight healthcare workers who had experienced mental health issues at work as well as eight workplace stakeholders who interacted with workers who were struggling (managers, coworkers, union leaders). An online survey was completed by an additional 67 employees. Analysis of the interviews and surveys was guided by a process of interpretive description to identify key barriers to early intervention and support. Results There were many reports of silence and inaction in response to employee mental health issues. Uncertainty in identifying mental health problems, stigma regarding mental ill health, a discourse of professional competence, social tensions, workload pressures, confidentiality expectations and lack of timely access to mental health supports were key forces in preventing employees from getting the help that they needed. Although there were a few exceptions, the overall study findings point to many barriers to supporting employees with mental health issues. Conclusions In order to address the complex knowledge, attitudinal, interpersonal and organizational barriers to action, a multi-layered knowledge translation strategy is needed, that considers not only mental health literacy and anti-stigma interventions, but addresses the unique context of the work environment that can act as a barrier to change. PMID:24507543
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NASA Astrophysics Data System (ADS)
Ferrar, K. J.; Malone, S.; Kelso, M.; Lenker, B.
2013-12-01
The inability to translate data to scientific information that can readily be incorporated by citizens into the public arena is an obstacle for science-based advocacy. This issue is particularly poignant for shale oil and natural gas development via hydraulic fracturing, as the issue has become highly politicized. Barriers to engaging in policy debate are different but highly related for community members and scientists. For citizens and interest groups, barriers including accessibility, public awareness and data presentation limit the motivation for community involvement in political interactions. To overcome such barriers, social researchers call for public engagement to move upstream and many call for a broad engagement of scientists in science-based advocacy. Furthermore surveys have shown that citizens, interest groups, and decision-makers share a broad desire for scientists to engage in environmental policy development. Regardless, scientists face a number of perceived barriers, with academics expressing the most resistance to overcoming the tension created by adherence to the scientific method and the need to engage with the broader society, described by Schneider (1990) as the 'double ethical bind'. For the scientific community the appeal of public dissemination of information beyond the scope of academic journals is limited for a number of reasons. Barriers include preservation of credibility, peer attitudes, training, and career trajectory. The result is a lack of translated information available to the public. This systematic analysis of the FracTracker platform provides an evaluation of where the features of the public engagement, GIS platform has been successful at overcoming these barriers to public dissemination, where the platform needs further development or is ill-suited to address these issues, and the development of FracTracker as an outlet for scientific researchers to engage with citizens. The analysis will also provide insight into what information the public is most interested in concerning hydraulic fracturing and unconventional oil and natural gas development. The evaluations in consideration of these core barriers to public engagement and science-based advocacy will provide insight into the future development of programs, as well as the improvement of the FracTracker platform.
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Andrasik, Michele Peake; Yoon, Ro; Mooney, Jessica; Broder, Gail; Bolton, Marcus; Votto, Teress; Davis-Vogel, Annet
2014-06-01
Observed seroincidence and prevalence rates in male-to-female (MTF) transgender individuals highlight the need for effective targeted HIV prevention strategies for this community. In order to develop an effective vaccine that can be used by transgender women, researchers must understand and address existing structural issues that present barriers to this group's participation in HIV vaccine clinical trials. Overcoming barriers to participation is important for ensuring HIV vaccine acceptability and efficacy for the MTF transgender community. To explore barriers and facilitators to MTF transgender participation in preventive HIV vaccine clinical trials, the HIV Vaccine Trials Network conducted focus groups among transgender women in four urban areas (Atlanta, Boston, Philadelphia, and San Francisco). Barriers and facilitators to engagement of transgender women in preventive HIV vaccine clinical trials led to the following recommendations: (a) transgender cultural competency training, (b) creating trans-friendly environments, (c) true partnerships with local trans-friendly organizations and health care providers, (d) protocols that focus on transgender specific issues, and (e) data collection and tracking of transgender individuals. These results have implications for the conduct of HIV vaccine trials, as well as engagement of transgender women in research programs in general.
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Barriers to employment for drug dependent postpartum women.
Bowden, Kelley; Goodman, Daisy
2015-01-01
Employment represents the key to independence for women, and equal opportunity has been an elusive goal. For women with substance dependence, employment is strongly linked to the ability to sustain recovery. Unfortunately, for postpartum mothers with substance use disorders, gender-based barriers are magnified. A case analysis is provided to illustrate the interaction of multiple barriers to employment success in one postpartum woman's experience. To elucidate the complex factors involved in return to employment for postpartum women being treated for substance use disorders. A review of the current literature on employment, substance use, and the postpartum period was performed. Themes identified in the literature were applied to analyze a representative case. Postpartum women with substance use disorders face a variety of challenges to employment success. Lack of education and job skills are common barriers to successful employment of women in addiction recovery. These barriers may be complicated by emotional or logistical challenges, or related to external factors such as stigma and/or previous criminal history. Assessment of employment history, marketable skills, and barriers should be an essential component of substance abuse treatment programs. Professionals working to increase employment opportunities for postpartum women with substance use disorders should be particularly aware of the multiple barriers they face and integrate employment assessment and skills training into the early stages of treatment programs.
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Counseling Gifted Women: Becoming the Heroes of Our Own Stories.
ERIC Educational Resources Information Center
Noble, Kathleen D.
1989-01-01
Many gifted women are unaware of or ambivalent about their potential, due to interpersonal obstacles, socio-cultural barriers, and intrapersonal factors. Guidelines and resources are offered for counseling gifted women to recognize and externalize cultural and familial devaluation and to envision new possibilities for personal fulfillment.…
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Understanding Deaf Bilingual Education from the inside: A SWOT Analysis
ERIC Educational Resources Information Center
Munoz-Baell, Irma M.; Alvarez-Dardet, Carlos; Ruiz-Cantero, M.; Ferreiro-Lago, Emilio; Aroca-Fernandez, Eva
2011-01-01
This article reports on a Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis using a nominal group process undertaken to identify and tackle significant factors, both internal and external, affecting those current Deaf bilingual practices in Spain which promote or prevent the processes through which more inclusive (barrier-free)…
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Occasional Papers in Distance Education. Number 9.
ERIC Educational Resources Information Center
Roberts, David, Ed.; Meacham, David, Ed.
This collection of documents contains four papers: (1) "An Orientation Seminar for Prospective Wine Science and Viticulture Students" (A. V. Hood), which describes an innovation organized by staff involved in the external teaching of wine science and viticulture who sought to break down the barriers and concerns of prospective students…
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The Career Development of Women: Helping Cinderella Lose Her Complex.
ERIC Educational Resources Information Center
Borman, Christopher A.; Guido-DiBrito, Florence
1986-01-01
Describes the current status of women in the workplace, the internal and external variables that are related specifically to the career development of women, and several effective counseling strategies, programs, and resources that might be used in assisting women to overcome barriers in the career development process. (CT)
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USDA-ARS?s Scientific Manuscript database
Ingestion of nanoparticles from products such as agricultural chemicals, processed food, and nutritional supplements is nearly unavoidable. The gastrointestinal tract serves as a critical interface and a barrier between the body and the external environment, and is the site of essential nutrient abs...
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Modified Pressure Imaging for Egg Crack Detection and Resulting Egg Quality
USDA-ARS?s Scientific Manuscript database
Cracks in the shell surface impair the primary barrier for external microbial contamination of the egg. Microcracks are very small cracks in the shell surface which are difficult to detect by human graders. New technology has been developed which utilizes modified pressure and imaging to detect mi...
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Educational Planning for the Gifted. Overcoming Cultural, Geographic and Socioeconomic Barriers
ERIC Educational Resources Information Center
Baldwin, Alexinia Y., Ed.; And Others
The book presents theoretical considerations and practical recommendations concerned with school planning for gifted children who might not be identified nor have an opportunity to develop their mental capacities because of external influences such as cultural diversity, socioeconomic status, or geographic isolation. Six different approaches to…
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Assessing the Fragile X Syndrome Newborn Screening Landscape.
Riley, Catharine; Wheeler, Anne
2017-06-01
Fragile X syndrome (FXS) is the most common known inherited form of intellectual disability. Early identification is an important step in linking FXS individuals with appropriate and timely medical and social services. Newborn screening (NBS) is 1 approach that has been used for other conditions to facilitate early identification. A literature review was conducted to identify issues, barriers, challenges, and approaches to addressing challenges related to NBS for FXS. Search terms included: fragile X syndrome, FMR1, newborn screening, screening, and genetic testing. To supplement the literature review, 9 key informant interviews were conducted. Information gathered through these interviews supplemented what was identified in the literature. Information from both the literature review and supplemental interviews was reviewed by 3 researchers who discussed and came to consensus on thematic areas and categorization of issues. The barriers and challenges related to NBS for FXS identified in the literature and by experts and stakeholders are categorized into 5 thematic areas: public health burden, treatment, timing, screening/testing methodologies, and translating results. Summaries of these issues and barriers are provided, along with potential approaches to addressing them. The issues and barriers described in this article highlight limited areas of knowledge that need be addressed to improve our understanding of FXS and the potential benefit of NBS. The landscape of NBS for FXS could be influenced by a series of research findings over time or a larger breakthrough that demonstrates an effective targeted treatment that has to be implemented early in life. Copyright © 2017 by the American Academy of Pediatrics.
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Coated article and method of making
NASA Technical Reports Server (NTRS)
Wang, Hongyu (Inventor); Lee, Kang Neung (Inventor)
2003-01-01
An article includes a silicon-containing substrate and a modified mullite coating. The modified mullite coating comprises mullite and a modifier component that reduces cracks in the modified mullite coating. The article can further comprise a thermal barrier coating applied to the modified mullite coating. The modified mullite coating functions as a bond coating between the external environmental/thermal barrier coating and the silicon-containing substrate. In a method of forming an article, a silicon-containing substrate is formed and a modified mullite coating is applied. The modified mullite coating comprises mullite and a modifier component that reduces cracks in the modified mullite coating.
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Coated article and method of making
NASA Technical Reports Server (NTRS)
Wang, Hongyu (Inventor); Lee, Kang Neung (Inventor)
2002-01-01
An article includes a silicon-containing substrate and a modified mullite coating. The modified mullite coating comprises mullite and a modifier component that reduces cracks in the modified mullite coating. The article can further comprise a thermal barrier coating applied to the modified mullite coating. The modified mullite coating functions as a bond coating between the external environmental/thermal barrier coating and the silicon-containing substrate. In a method of forming an article, a silicon-containing substrate is formed and a modified mullite coating is applied. The modified mullite coating comprises mullite and a modifier component that reduces cracks in the modified mullite coating.
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Scaffolding proteins in the development and maintenance of the epidermal permeability barrier.
Crawford, Melissa; Dagnino, Lina
2017-10-02
The skin of mammals and other terrestrial vertebrates protects the organism against the external environment, preventing heat, water and electrolyte loss, as well as entry of chemicals and pathogens. Impairments in the epidermal permeability barrier function are associated with the genesis and/or progression of a variety of pathological conditions, including genetic inflammatory diseases, microbial and viral infections, and photodamage induced by UV radiation. In mammals, the outside-in epidermal permeability barrier is provided by the joint action of the outermost cornified layer, together with assembled tight junctions in granular keratinocytes found in the layers underneath. Tight junctions serve as both outside-in and inside-out barriers, and impede paracellular movements of ions, water, macromolecules and microorganisms. At the molecular level, tight junctions consist of integral membrane proteins that form an extracellular seal between adjacent cells, and associate with cytoplasmic scaffold proteins that serve as links with the actin cytoskeleton. In this review, we address the roles that scaffold proteins play specifically in the establishment and maintenance of the epidermal permeability barrier, and how various pathologies alter or impair their functions.
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Lorenz, Timo; Frischling, Cora; Cuadros, Raphael; Heinitz, Kathrin
2016-01-01
The aim of this study was to discover how individuals with autism succeed in entering the job market. We therefore sought to identify expected and occurred barriers, keeping them from taking up and staying in employment as well as to identify the solutions used to overcome these barriers. Sixty-six employed individuals with autism–17 of them with autism-specific employment–participated in an online survey. Results showed a variety of possible barriers. Individuals in autism-specific employment named formality problems–problems with organizational and practical process-related aspects of the job entry–most frequently while individuals in non-autism-specific employment mentioned social problems–obstacles concerning communication and human interaction–most. In terms of solutions, both groups used their own resources as much as external help, but differed in their specific strategies. In addition, correlations of an autism-specific employment with general and occupational self-efficacy as well as life and job satisfaction were examined. Possible implications of the results are discussed with regard to problem solving behavior and the use of strengths. PMID:26766183
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Resilient actions in the diagnostic process and system performance.
Smith, Michael W; Davis Giardina, Traber; Murphy, Daniel R; Laxmisan, Archana; Singh, Hardeep
2013-12-01
Systemic issues can adversely affect the diagnostic process. Many system-related barriers can be masked by 'resilient' actions of frontline providers (ie, actions supporting the safe delivery of care in the presence of pressures that the system cannot readily adapt to). We explored system barriers and resilient actions of primary care providers (PCPs) in the diagnostic evaluation of cancer. We conducted a secondary data analysis of interviews of PCPs involved in diagnostic evaluation of 29 lung and colorectal cancer cases. Cases covered a range of diagnostic timeliness and were analysed to identify barriers for rapid diagnostic evaluation, and PCPs' actions involving elements of resilience addressing those barriers. We rated these actions according to whether they were usual or extraordinary for typical PCP work. Resilient actions and associated barriers were found in 59% of the cases, in all ranges of timeliness, with 40% involving actions rated as beyond typical. Most of the barriers were related to access to specialty services and coordination with patients. Many of the resilient actions involved using additional communication channels to solicit cooperation from other participants in the diagnostic process. Diagnostic evaluation of cancer involves several resilient actions by PCPs targeted at system deficiencies. PCPs' actions can sometimes mitigate system barriers to diagnosis, and thereby impact the sensitivity of 'downstream' measures (eg, delays) in detecting barriers. While resilient actions might enable providers to mitigate system deficiencies in the short run, they can be resource intensive and potentially unsustainable. They complement, rather than substitute for, structural remedies to improve system performance. Measures to detect and fix system performance issues targeted by these resilient actions could facilitate diagnostic safety.
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Cho, L Y; Lau, W L; Lo, T K; Tang, Helen H T; Leung, W C
2012-02-01
To study the success rate, predictors for success, and pregnancy outcomes after external cephalic version. Historical cohort study. Regional hospital, Hong Kong. All women who had singleton term breech pregnancies at term and opted for external cephalic version during 2001 and 2009. Their demographic data, clinical and ultrasound findings, procedure details, complications, and delivery outcomes were analysed. Predictive factors for successful external cephalic version. A total of 209 external cephalic versions were performed during the 9-year period. The success rate was 63% (75% for multiparous and 53% for nulliparous women). There was no significant complication. On univariate analysis, predictors of successful external cephalic version were: multiparity, unengaged presenting part, higher amniotic fluid index (≥ 10 cm), thin abdominal wall, low uterine tone, and easily palpable fetal head (subjective assessment by practitioners before external cephalic version). On multivariate analysis, only multiparity, non-engagement of the fetal buttock and thin maternal abdomen were associated with successful external cephalic version. In all, 69% of those who had successful external cephalic version succeeded in the first roll (P<0.001), and 82% of the women with successful external cephalic versions had vaginal deliveries (93% in multiparous and 69% in nulliparous women). Uptake rate of external cephalic version was studied in the latter part of the study period (2006-2009). Whilst 735 women were eligible for external cephalic version, 131 women chose to have the procedure resulting in an uptake rate of 18%. External cephalic version was effective in reducing breech presentations at term and corresponding caesarean section rates, but the uptake rate was low. Further work should address the barriers to the low acceptance of external cephalic version. The results of this study could encourage women to opt for external cephalic version.
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Lighting issues in the 1980's. Summary and proceedings
DOE Office of Scientific and Technical Information (OSTI.GOV)
Rubin, A. I.
1980-01-01
The Lighting Roundtable described in this report was conducted to foster an open discussion of the goals, issues, and responsibilities of the lighting community. It was not a problem-solving session, but rather a time to examine the long-term aspirations and objectives of lighting and the barriers that may stand in the way of achieving them. Eight major issues were addressed by nine panelists and a number of invited auditors. The issues are as follows: (1) The Public Image of the Lighting Community; (2) US Role in the Worldwide Lighting Community; (3) Factors Affecting Human Activities in the Built Environment; (4)more » Effect of Lighting on Environmental Quality; (5) Effects of Barriers; (6) Establishment of Illuminance Levels; (7) Integration of Subsystems; and (8) Professional Development and Lighting Education. Two parts presented are: (1) a summary of the proceedings; and (2) a complete transcript.« less
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NASA Astrophysics Data System (ADS)
Amin, M. A. Mohd; Abas, N. H.; Shahidan, S.; Rahmat, M. H.; Suhaini, N. A.; Nagapan, S.; Rahim, R. Abdul
2017-11-01
Malaysia considers the construction industry as one of the main contributors to its Gross Domestic Product (GDP). However, there are some unresolved issues arising from the ongoing and widespread adoption of the conventional method of construction such as the resultant fragmentation of the industry itself; delays in production and delivery time of unnecessary wastages and lack of sustainability practice. Malaysian Government has been continuously encouraging the industry to use, partly or if not wholly, the Industrialized Building System (IBS), which is considered to be an important part of sustainable construction initiative. IBS was introduced to Malaysia as the solution to issues related to dependencies of foreign workers, raising demand for affordable accommodations and improving image, quality and productivity of construction industry. However, the IBS adoption in Malaysia remains low. This paper presents the review of the current issues and barriers of IBS adoption in Malaysian construction industry.
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12 CFR 630.6 - Funding Corporation committees.
Code of Federal Regulations, 2010 CFR
2010-01-01
... Corporation committees. (a) System Audit Committee. The Funding Corporation must establish and maintain a System Audit Committee (SAC) by adopting a written charter describing the committee's composition..., compensation, and retention of external auditors issuing System-wide audit reports; (B) Review the external...
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Greenwood, Nan; Habibi, Ruth; Smith, Raymond; Manthorpe, Jill
2015-01-01
As populations age, the numbers of carers overall and numbers of carers from minority ethnic groups in particular are rising. Evidence suggests that carers from all sections of the community and particularly carers from minority groups often fail to access care services. This may relate to barriers in accessing services and service dissatisfaction. The aim of this systematic review was to identify and summarise minority ethnic carers' perceptions of barriers to accessing community social care services and their satisfaction with these services if accessed. The following databases were searched from their start until July 2013: Social Care Online, Social Policy and Research, Scopus, PsychINFO, HMIC, ASSIA, MEDLINE, Embase, CINAHL Plus and AMED. Thirteen studies met the inclusion criteria. Most investigated either barriers to access or satisfaction levels, although three explored both. Only 4 studies investigated minority ethnic carers' satisfaction with social care, although 12 studies reported perceived barriers to accessing services. Few studies compared minority ethnic carers' perceptions with majority ethnic groups, making it difficult to identify issues specific to minority groups. Most barriers described were potentially relevant to all carers, irrespective of ethnic group. They included attitudinal barriers such as not wanting to involve outsiders or not seeing the need for services and practical barriers such as low awareness of services and service availability. Issues specific to minority ethnic groups included language barriers and concerns about services' cultural or religious appropriateness. Studies investigating satisfaction with services reported a mixture of satisfaction and dissatisfaction. Barriers common to all groups should not be underestimated and a better understanding of the relationship between perceived barriers to accessing services and dissatisfaction with services is needed before the experiences of all carers can be improved. © 2014 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd.
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Stuck in a Loop: Individual and System Barriers for Job Seekers with Disabilities
ERIC Educational Resources Information Center
Hall, Jean P.; Parker, Kathy
2010-01-01
Research conducted within Temporary Assistance to Needy Families (Personal Responsibility and Work Opportunity Reconciliation Act of 1996) and Workforce Investment Act of 1998 systems indicates pervasive issues hindering program effectiveness for job seekers with disabilities. This population frequently experiences employment barriers beyond those…
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78 FR 5860 - Eighth Meeting: RTCA Next Gen Advisory Committee (NAC)
Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-28
...] Preliminary report to identify and mitigate barriers to implementing PBN. Issues associated with Implementing RNAV/RNP [cir] An open discussion by the Committee of Non-technical barriers of PBN procedures... NextGen. Cat Ex 2 Task Group [cir] Preliminary report on the recommendation for implementing new...
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Overcoming Barriers to Engaging in College Academics
ERIC Educational Resources Information Center
Hensley, Lauren; Shaulskiy, Stephanie; Zircher, Andrew; Sanders, Megan
2015-01-01
Underprepared college students face transition issues that prevent full academic engagement. The written responses of 176 students in a learning-strategies course were used to develop a grounded model of overcoming barriers to academic engagement. Findings revealed contexts in which academic engagement involved high costs (i.e., effort, trade-off,…
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Overcoming Barriers to the Sexual Expression of Women with Developmental Disabilities.
ERIC Educational Resources Information Center
Stinson, Jennifer; Christian, LeeAnn; Dotson, Lori Ann
2002-01-01
This article discusses barriers to sexual fulfillment faced by women with developmental disabilities, including: access to gynecological healthcare, limited choices regarding reproductive issues, lack of sex education, and prevailing negative stereotypes that affect the way women are viewed by others and the way they view themselves.…
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Population Growth and Global Security: Toward an American Strategic Commitment.
ERIC Educational Resources Information Center
Mumford, Steven
1981-01-01
Addresses the world population problem by highlighting three crucial areas: the relationship between population growth control and national security issues, the role of American leadership in resolving the problem, and the barriers to effective action. One barrier discussed in detail is the Roman Catholic Church's stand on abortion and…
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MO-A-BRB-02: Considerations and Issues in Electronic Charting for Brachytherapy
DOE Office of Scientific and Technical Information (OSTI.GOV)
Richardson, S.
2015-06-15
The process of converting to an electronic chart for radiation therapy can be daunting. It requires a dedicated committee to first research and choose appropriate software, to review the entire documentation policy and flow of the clinic, to convert this system to electronic form or if necessary, redesign the system to more easily conform to the electronic process. Those making the conversion and those who already use electronic charting would benefit from the shared experience of those who have been through the process in the past. Therefore TG262 was convened to provide guidance on electronic charting for external beam radiationmore » therapy and brachytherapy. This course will present the results of an internal survey of task group members on EMR practices in External Beam Radiation Therapy as well as discuss important issues in EMR development and structure for both EBRT and brachytherapy. Learning Objectives: Be familiarized with common practices and pitfalls in development and maintenance of an electronic chart in Radiation Oncology Be familiarized with important issues related to electronic charting in External Beam Radiation Therapy Be familiarized with important issues related to electronic charting in Brachytherapy.« less
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Sociocultural Paradoxes and Issues in E-Learning Use in Higher Education Africa
ERIC Educational Resources Information Center
Njenga, James Kariuki
2018-01-01
Sociocultural issues are major contributing factors in mass acceptance and effective use of technology. These issues are often perceived to contradict the benefits the technology brings about. E-learning use in higher education in Africa, as a technology, faces some sociocultural barriers that contradict its promise and benefits. This paper…
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ERIC Educational Resources Information Center
Phipps, Christa Brown
2017-01-01
Low income male preschoolers with externalizing behaviors have continued behavior issues throughout elementary school, middle school, high school, and into adulthood and create stress for their teachers. Because of this, it is important to detect externalizing behaviors early and implement an appropriate intervention. A single subject reversal…
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Reducing barriers associated with delivering health care services to migratory agricultural workers.
Schmalzried, Hans D; Fallon, L Fleming
2012-01-01
Between one and two million migratory agricultural workers (MAWs), primarily from Mexico and Central America, leave their homes each year to plant, cultivate, harvest and pack fruits, vegetables, and nuts in the USA. While in the USA, most lack health insurance, a permanent residence, and a regular healthcare provider. Publications over the past two decades in the USA have reported that a majority of MAWs encounter barriers to receiving medical services. Migratory agricultural workers experience high rates of occupational illness and injury. Poor access to medical care continues to exacerbate health problems among members of this population related to their working environments. In most studies concerning healthcare access issues for this population, researchers collected their information from healthcare service providers; rarely have they included input from migratory agricultural workers. This study was different in that opinions about healthcare access issues were collected directly from MAWs. The primary purpose of this study was to describe issues related to barriers associated with the delivery of healthcare services to migratory agricultural workers. A secondary purpose was to suggest strategies for reducing these barriers. In this study, data from focus group sessions were used to develop a survey questionnaire. Four certified bilingual interpreters were trained to administer the questionnaire. A total of 157 usable questionnaires were returned from MAWs living in employer-provided camps in Northwest Ohio. The statistical analyses were primarily descriptive. The most significant barriers hampering access to medical services among the 157 respondents were cost (n=113; 72.0%), crop demands (n=102; 65.0%), the lack of an interpreter (n=98; 62.4%), travel distance (n=88; 56.1%) and transportation (n=82; 52.2%). Approximately half (n=82; 52.2%) said that they had access to transportation for traveling to a medical clinic. As a group, respondents were willing to travel an average of 29.1 km (18.1 miles) (range 0-129 km [0-80 miles]) to obtain medical services. Female heads of households had significantly less access to transportation compared with male heads of households (t=2.35; df=74; p<0.05). Three general categories of barriers to health care for MAWs surfaced in this study: (1) work environment; (2) migratory agricultural worker resources; and (3) healthcare clinic practices. Work environment issues relate mostly to the employers. Resources are barriers for MAWs because they are poor and have limited funds for the cost of transportation to clinics and the fees associated with accessing health care. Most of the barriers identified related to healthcare clinic practices. Some strategies to address healthcare clinic practice barriers were developed by the group conducting the study. By listening to what MAWs described as barriers to health care, providers can help improve access which can reduce the use of high cost hospital emergency room care.
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Gill, Robert E.; Tibbitts, T.L.; Douglas, David C.; Handel, Colleen M.; Mulcahy, D.M.; Gottschalck, J.C.; Warnock, N.; McCaffery, B.J.; Battley, Phil F.; Piersma, Theunis
2009-01-01
Mountain ranges, deserts, ice fields and oceans generally act as barriers to the movement of land-dependent animals, often profoundly shaping migration routes. We used satellite telemetry to track the southward flights of bar-tailed godwits (Limosa lapponica baueri), shorebirds whose breeding and non-breeding areas are separated by the vast central Pacific Ocean. Seven females with surgically implanted transmitters flew non-stop 8117-11680km (10153??1043 s.d.) directly across the Pacific Ocean; two males with external transmitters flew non-stop along the same corridor for 7008-7390km. Flight duration ranged from 6.0 to 9.4 days (7.8??1.3 s.d.) for birds with implants and 5.0 to 6.6 days for birds with externally attached transmitters. These extraordinary non-stop flights establish new extremes for avian flight performance, have profound implications for understanding the physiological capabilities of vertebrates and how birds navigate, and challenge current physiological paradigms on topics such as sleep, dehydration and phenotypic flexibility. Predicted changes in climatic systems may affect survival rates if weather conditions at their departure hub or along the migration corridor should change. We propose that this transoceanic route may function as an ecological corridor rather than a barrier, providing a wind-assisted passage relatively free of pathogens and predators. ?? 2008 The Royal Society.
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Gill, Robert E.; Tibbitts, T. Lee; Douglas, David C.; Handel, Colleen M.; Mulcahy, Daniel M.; Gottschalck, Jon C.; Warnock, Nils; McCaffery, Brian J.; Battley, Philip F.; Piersma, Theunis
2008-01-01
Mountain ranges, deserts, ice fields and oceans generally act as barriers to the movement of land-dependent animals, often profoundly shaping migration routes. We used satellite telemetry to track the southward flights of bar-tailed godwits (Limosa lapponica baueri), shorebirds whose breeding and non-breeding areas are separated by the vast central Pacific Ocean. Seven females with surgically implanted transmitters flew non-stop 8117–11 680 km (10 153±1043 s.d.) directly across the Pacific Ocean; two males with external transmitters flew non-stop along the same corridor for 7008–7390 km. Flight duration ranged from 6.0 to 9.4 days (7.8±1.3 s.d.) for birds with implants and 5.0 to 6.6 days for birds with externally attached transmitters. These extraordinary non-stop flights establish new extremes for avian flight performance, have profound implications for understanding the physiological capabilities of vertebrates and how birds navigate, and challenge current physiological paradigms on topics such as sleep, dehydration and phenotypic flexibility. Predicted changes in climatic systems may affect survival rates if weather conditions at their departure hub or along the migration corridor should change. We propose that this transoceanic route may function as an ecological corridor rather than a barrier, providing a wind-assisted passage relatively free of pathogens and predators. PMID:18974033
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Barriers to telemedicine: survey of current users in acute care units.
Rogove, Herbert J; McArthur, David; Demaerschalk, Bart M; Vespa, Paul M
2012-01-01
The present study of current telemedicine users is a unique attempt to understand the barriers and motivational factors related to the utilization of telemedicine. A survey of emergency and critical care remote presence telemedicine users was conducted to determine the factors that motivate and the barriers that impede the acceptance and maintenance of a robotic telemedicine (RTM) program. The majority of the survey users were in the Emergency Department or in the Intensive Care Unit. E-mail invitations were sent to 483 individuals representing 63 healthcare institutions and groups in North America and Europe. Respondents were directed to a Web-based survey. The survey consisted of 96 separate questions, addressing user familiarity and 5-point Likert scales, addressing issues spanning the conceptual and practical issues surrounding adoption of telemedicine. A total of 106 surveys were completed, representing an individual response rate of 21.9% but an institutional response rate of 60.3%. More than two-thirds of the respondents were physicians who participated in active RTM programs. Across seven different topics related to barriers to implementing RTM, the majority of all respondents indicated that cultural issues did not constitute meaningful hurdles, technological matters were generally favorable, and that most personnel were agreeable to both achieving the buy-in to start an RTM program and to maintaining RTM once started. However, respondents proclaimed that RTM's success was still hampered by licensing, credentialing, and malpractice protection, as well as costs, billing, and reimbursement issues. Achieving immediate patient access, overcoming service gaps, improving quality, providing clinical support, maintaining patient satisfaction, and adhering to practice guidelines were viewed as significant motives for RTM implementation. The leading applications of RTM included emergency response and consultation. The patients, physicians, nurses, nor hospital executives served as barriers to implementation. However, licensing, costs for technology, and reimbursement for RTM continue to impede progress.
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Aparcana, Sandra
2017-03-01
The Municipal Solid Waste Management (MSWM) sector represents a major challenge for low-and middle-income countries due to significant environmental and socioeconomic issues involving rapid urbanization, their MSWM systems, and the existence of the informal waste sector. Recognizing its role, several countries have implemented various formalization measures, aiming to address the social problems linked to this sector. However, regardless of these initiatives, not all attempts at formalization have proved successful due to the existence of barriers preventing their implementation in the long term. Along with this, there is a frequent lack of knowledge or understanding regarding these barriers and the kind of measures that may enable formalization, thereby attaining a win-win situation for all the stakeholders involved. In this context, policy- and decision-makers in the public and private sectors are frequently confronted with the dilemma of finding workable approaches to formalization, adjusted to their particular MSWM contexts. Building on the review of frequently implemented approaches to formalization, including an analysis of the barriers to and enabling measures for formalization, this paper aims to address this gap by explaining to policy- and decision-makers, and to waste managers in the private sector, certain dynamics that can be observed and that should be taken into account when designing formalization strategies that are adapted to their particular socioeconomic and political-institutional context. This includes possible links between formalization approaches and barriers, the kinds of barriers that need to be removed, and enabling measures leading to successful formalization in the long term. This paper involved a literature review of common approaches to formalization, which were classified into three categories: (1) informal waste workers organized in associations or cooperatives; (2) organized in CBOs or MSEs; and (3) contracted as individual workers by the formal waste sector. This was followed by the identification and subsequent classification of measures for removing common barriers to formalization into five categories: policy/legal, institutional/organizational, technical, social, and economic/financial. The approaches to formalization, as well as the barrier categories, were validated through the assessment of twenty case studies of formalization. Building on the assessment, the paper discussed possible links between formalization approaches and barriers, the 'persistent' challenges that represent barriers to formalization, as well as key enabling factors improving the likelihood of successful formalization. Regardless of the type of approach adopted to formalization, the review identifies measures to remove barriers in all five categories, with a stronger link between the approaches 1 and 2 and the existence of measures in the policy, institutional, and financial categories. Regarding persistent barriers, the review identified ones arising from the absence of measures to address a particular issue before formalization or due to specific country- or sector-related conditions, and their interaction with the MSWM context. 75% of the case studies had persistent barriers in respect of policy/legal issues, 50% of institutional/organizational, 45% of financial/economic, and 40%, and 35% of social and technical issues respectively. This paper concludes that independently of the formalization approach, the lack of interventions or measures in any of the five categories of barriers may lead formalization initiatives to fail, as unaddressed barriers become 'persistent' after formalization is implemented. Furthermore, 'persistent barriers' may also appear due to unfavorable country-specific conditions. The success of a formalization initiative does not depend on a specific approach, but most likely on the inclusion of country-appropriate measures at the policy, economic and institutional levels. The empowerment of informal waste-workers is again confirmed as a further key success factor for their formalization. Copyright © 2016 Elsevier Ltd. All rights reserved.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Alekseev, A.A.
The article examines exchange rate modeling for two cases: (a) when the trading partners have mutual interests and (b) when the trading partners have antogonistic interests. Exchange rates in world markets are determined by supply and demand for the currency of each state, and states may control the exchange rate of their currency by changing the interest rate, the volume of credit, and product prices in both domestic and export markets. Abstracting from issues of production and technology in different countries and also ignoring various trade, institutional, and other barriers, we consider in this article only the effect of exportmore » and import prices on the exchange rate, we propose a new criterion of external trade activity: each trading partner earns a profit which is proportional to the volume of benefits enjoyed by the other partner. We consider a trading cycle that consists of four stages: (a) purchase of goods in the domestic market with the object of selling them abroad; (b) sale of the goods in foreign markets; (c) purchase of goods abroad with the object of selling them in the domestic market; (d) sale of the goods domestically.« less
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Hard ceramic coatings: an experimental study on a novel damping treatment
NASA Astrophysics Data System (ADS)
Patsias, Sophoclis; Tassini, Nicola; Stanway, Roger
2004-07-01
This paper describes a novel damping treatment, namely hard ceramic coatings. These materials can be applied on almost any surface (internal or external) of a component. Their effect is the significant reduction of vibration levels and hence the extension of life expectancy of the component. The damping features of air-plasma-sprayed ceramic coatings (for example amplitude dependence, influence of initial amplitude) are discussed and the experimental procedure employed for testing and characterising such materials is also described. This test procedure is based around a custom-developed rig that allows one to measure the damping (internal friction) of specimens at controlled frequencies, strain amplitudes and, if required, various temperatures. A commonly used Thermal Barrier Coating, Yttria Stabilised Zirconia (8%), is used to demonstrate the above mentioned features. The damping effectiveness of this coating is then compared against two established damping treatments: polymer Free Layer Damping (FLD) and Constrained Layer Damping (CLD). The paper discusses the major issues in characterising ceramic damping coatings and their damping effectiveness when compared against the "traditional" approaches. Finally, the paper concludes with suggestions for further research.
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Hospital-physician relations: overcoming barriers to cooperation.
Orr, S R; Siegal, J T
1986-01-01
In the September-October 1986 issue of Physician Executive, we discussed the application of strategic business units (SBUs) to health care. SBUs are those corporate entities that market similar products to one or more target populations with similar characteristics. Examples of SBUs in health care are obstetrics, cardiology, orthopedics, etc. When the services within each SBU are linked together, they might resemble a vertically integrated health care system. In the case of obstetrics, a woman may have contact with physicians, a hospital, home care nurses, house-cleaning services, birthing teachers, and maternity clothing boutiques. Each of these are products/services within the SBU of obstetrics. Strategy development by SBU implies an external focus on the marketplace in terms of the specific mission of the SBU (clinical specialty). It also implies responding to the needs of consumers for whom the historical and present divisiveness between hospitals and physicians is immaterial and irrelevant. In this article, we will focus on ways to stabilize the relationship between hospitals and physicians within an SBU context in order to compete more successfully as a team in today's health care environment.
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Chrast, Roman; Saher, Gesine; Nave, Klaus-Armin; Verheijen, Mark H G
2011-03-01
The integrity of central and peripheral nervous system myelin is affected in numerous lipid metabolism disorders. This vulnerability was so far mostly attributed to the extraordinarily high level of lipid synthesis that is required for the formation of myelin, and to the relative autonomy in lipid synthesis of myelinating glial cells because of blood barriers shielding the nervous system from circulating lipids. Recent insights from analysis of inherited lipid disorders, especially those with prevailing lipid depletion and from mouse models with glia-specific disruption of lipid metabolism, shed new light on this issue. The particular lipid composition of myelin, the transport of lipid-associated myelin proteins, and the necessity for timely assembly of the myelin sheath all contribute to the observed vulnerability of myelin to perturbed lipid metabolism. Furthermore, the uptake of external lipids may also play a role in the formation of myelin membranes. In addition to an improved understanding of basic myelin biology, these data provide a foundation for future therapeutic interventions aiming at preserving glial cell integrity in metabolic disorders.
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Lipid metabolism in myelinating glial cells: lessons from human inherited disorders and mouse models
Chrast, Roman; Saher, Gesine; Nave, Klaus-Armin; Verheijen, Mark H. G.
2011-01-01
The integrity of central and peripheral nervous system myelin is affected in numerous lipid metabolism disorders. This vulnerability was so far mostly attributed to the extraordinarily high level of lipid synthesis that is required for the formation of myelin, and to the relative autonomy in lipid synthesis of myelinating glial cells because of blood barriers shielding the nervous system from circulating lipids. Recent insights from analysis of inherited lipid disorders, especially those with prevailing lipid depletion and from mouse models with glia-specific disruption of lipid metabolism, shed new light on this issue. The particular lipid composition of myelin, the transport of lipid-associated myelin proteins, and the necessity for timely assembly of the myelin sheath all contribute to the observed vulnerability of myelin to perturbed lipid metabolism. Furthermore, the uptake of external lipids may also play a role in the formation of myelin membranes. In addition to an improved understanding of basic myelin biology, these data provide a foundation for future therapeutic interventions aiming at preserving glial cell integrity in metabolic disorders. PMID:21062955
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Enhancing the diversity of the pediatrician workforce.
Friedman, Aaron L
2007-04-01
This policy statement describes the key issues related to diversity within the pediatrician and health care workforce to identify barriers to enhancing diversity and offer policy recommendations to overcome these barriers in the future. The statement addresses topics such as health disparities, affirmative action, recent policy developments and reports on workforce diversity, and research on patient and provider diversity. It also broadens the discussion of diversity beyond the traditional realms of race and ethnicity to include cultural attributes that may have an effect on the quality of health care. Although workforce diversity is related to the provision of culturally effective pediatric care, it is a discrete issue that merits separate discussion and policy formulation. At the heart of this policy-driven action are multiorganizational and multispecialty collaborations designed to address substantive educational, financial, organizational, and other barriers to improved workforce diversity.
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Corriero, Rosemary; Redmon, Ginger
Before participating in a project funded by the Centers for Disease Control and Prevention, most state and local health departments (LHDs) were not seeking reimbursement or being fully reimbursed by insurance plans for the cost of immunization services (including vaccine costs and administration fees) they provided to insured patients. Centers for Disease Control and Prevention's Billables Project was designed to enable state and LHDs to bill public and private insurance plans for immunization services provided to insured patients. Identify and describe key barriers state and LHDs may encounter while planning and implementing a billing program, as well as possible solutions for overcoming those barriers. This study used reports from Billables Project participants to explore barriers they encountered when planning and implementing a billing program and steps taken to address those barriers. Thirty-eight state immunization programs. Based on project participants' reports, barriers were noted in 7 categories: (1) funding and costs, (2) staff, (3) health department characteristics, (4) third-party payers and insurance plans, (5) software, (6) patient insurance status, and (7) other barriers. Possible solutions for overcoming those barriers included hiring or seeking external help, creating billing guides and training modules, streamlining workflows, and modifying existing software systems. Overcoming barriers during planning and implementation of a billing program can be challenging for state and LHDs, but the experiences and suggestions of past Billables Project participants can help guide future billing program efforts.
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Meurer, William J; Majersik, Jennifer J; Frederiksen, Shirley M; Kade, Allison M; Sandretto, Annette M; Scott, Phillip A
2011-05-06
Only 1-3% of ischemic stroke patients receive thrombolytic therapy. Provider barriers to adhering with guidelines recommending tPA delivery in acute stroke are not well known. The main objective of this study was to describe barriers to thrombolytic use in acute stroke care. Twenty-four hospitals were randomly selected and matched into 12 pairs. Barrier assessment occurred at intervention sites only, and utilized focus groups and structured interviews. A pre-specified taxonomy was employed to characterize barriers. Two investigators independently assigned themes to transcribed responses. Seven facilitators (three emergency physicians, two nurses, and two study coordinators) conducted focus groups and interviews of emergency physicians (65), nurses (62), neurologists (15), radiologists (12), hospital administrators (12), and three others (hospitalists and pharmacist). The following themes represented the most important external barriers: environmental and patient factors. Important barriers internal to the clinician included familiarity with and motivation to adhere to the guidelines, lack of self-efficacy and outcome expectancy. The following themes were not substantial barriers: lack of awareness of the existence of acute stroke guidelines, presence of conflicting guidelines, and lack of agreement with the guidelines. Healthcare providers perceive environmental and patient-related factors as the primary barriers to adherence with acute stroke treatment guidelines. Interventions focused on increasing physician familiarity with and motivation to follow guidelines may be of highest yield in improving adherence. Improving self-efficacy in performing guideline concordant care may also be useful.
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Multimedia Learning: Beyond Modality. Commentary.
ERIC Educational Resources Information Center
Reimann, P.
2003-01-01
Identifies and summarizes instructional messages in the articles in this theme issue and also identifies central theoretical issues, focusing on: (1) external representations; (2) dual coding theory; and (3) the effects of animations on learning. (SLD)
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Engine technology challenges for a 21st century high speed civil transport
NASA Technical Reports Server (NTRS)
Shaw, Robert J.
1991-01-01
Recent NASA funded studies by Boeing and Douglas suggest an opportunity exists for a 21st Century High Speed Civil Transport (HSCT) to become part of the international air transportation system. However, before this opportunity for high speed travel can be realized, certain environmental and and economic barrier issues must be overcome. These challenges are outlined. Research activities which NASA has planned to address these barrier issues and to provide a technology base to allow U.S. manufacturers to make an informed go/no go decision on developing the HSCT are discussed.
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Overcoming barriers to public understanding of climate change
NASA Astrophysics Data System (ADS)
Hayhoe, K.
2012-12-01
Humans are interfering with global climate, increasing the risk of serious consequences for human society and the natural environment. As the scientific evidence builds, however, so does the public controversy surrounding this issue. Why is climate change so contentious? What makes it so hard to comprehend? I argue that there is no single reason for this, but rather a perfect storm of multiple confounding factors; scientific, historical, ideological, psychological and even physiological in nature. Education—of both the messengers and the audience—can play a critical role in surmounting many of the common barriers to understanding, accepting, and acting this important issue.
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Thomas, Manoj A; Narayan, Poornima
2017-04-01
Reproductive tract infections (RTIs) are the cause of severe gynecological and maternal morbidity in India. In marginalized communities, women persevere quietly when faced with a culturally sensitive health issue such as an RTI. To hypothesize on the differential health behavior and low levels of reported incidents among women living in marginalized communities, we undertake an exploratory study in a coastal fishermen community in South India. We identify barriers influencing decisions to seek curative and preventive medical care. Public health practitioners and social workers may find our recommendations relevant for addressing health issues in marginalized communities.
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NASA Astrophysics Data System (ADS)
Gooh Pattader, Partho Sarathi
There are enumerable examples of natural processes which fall in the class of non-equilibrium stochastic dynamics. In the literature it is prescribed that such a process can be described completely using transition probability that satisfy the Fokker Planck equation. The analytical solutions of transition probability density function are difficult to obtain and are available for linear systems along with few first order nonlinear systems. We studied such nonlinear stochastic systems and tried to identify the important parameters associated with the dynamics and energy dissipative mechanism using statistical tools. We present experimental study of macroscopic systems driven away far from equilibrium with an applied bias and external mechanical noise. This includes sliding of small solid object, gliding of a liquid drop or a rolling of a rigid sphere. We demonstrated that the displacement statistics are non-Gaussian at short observation time, but they tend towards a Gaussian behavior at long time scale. We also found that, the drift velocity increases sub-linearly, but the diffusivity increases super-linearly with the strength of the noise. These observations reflect that the underlying non-linear friction controls the stochastic dynamics in each of these cases. We established a new statistical approach to determine the underlying friction law and identified the operating range of linear and nonlinear friction regime. In all these experiments source of the noise and the origin of the energy dissipation mechanism (i.e. friction) are decoupled. Naturally question arises whether the stochastic dynamics of these athermal systems are amenable to Einstein's Fluctuation dissipation theorem which is valid strictly for a closed thermodynamic system. We addressed these issues by comparing Einstein's ratio of Diffusivity and mobility which are measurable quantities in our experimental systems. As all our experimental systems exhibit substantial negative fluctuations of displacement that diminishes with observation time scale, we used another approach of integrated fluctuation theorem to identify athermal temperature of the system by characterizing a persistence time of negative fluctuations in terms of the measurable quantity. Specific experiments have also been designed to study the crossing of a small object over a physical barrier assisted by an external noise and a bias force. These results mimic the classical Arrhenius behavior from which another effective temperature may be deduced. All these studies confer that the nonlinear system does not possess any unique temperature. Detachment of a solid sphere as well as a liquid drop from a structured rubber surface during subcritical motion in presence of external noise was examined in the light of Arrhenius' activated rate equation. Drift velocity of small drops of water-glycerin solution behaves nonlinearly with viscosity which is reminiscence of Kramers' turn over theory of activated rate. In a designed experiment of barrier crossing of liquid drops we satisfactorily verified the Kramers' formalism of activated rate at the low friction limit.
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Rasmussen, Charlotte Diana Nørregaard; Lindberg, Naja Klærke; Ravn, Marie Højbjerg; Jørgensen, Marie Birk; Søgaard, Karen; Holtermann, Andreas
2017-01-01
This study aimed to investigate the processes of a participatory ergonomics program among 594 eldercare workers with emphasis on identified risk factors for low back pain and solutions, and reveal barriers and facilitators for implementation. Sixty-nine per cent of the identified risk factors were physical ergonomic, 24% were organisational and 7% were psychosocial risk factors. Most solutions were organisational (55%), followed by physical (43%) and psychosocial solutions (2%). Internal factors (e.g. team or management) constituted 47% of the barriers and 75% of the facilitators. External factors (e.g. time, financial resources, collaboration with resident or relatives) constituted 53% of the barriers and 25% of the facilitators. This study revealed the processes and implementation of a participatory ergonomics program among eldercare workers. The findings can be transferred to workers, workplaces, health and safety professionals, and researchers to improve future participatory ergonomics programs. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
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Barriers to Seeking Mental Health Services among Adolescents in Military Families
Becker, Sara J.; Swenson, Rebecca; Esposito-Smythers, Christianne; Cataldo, Andrea; Spirito, Anthony
2014-01-01
Military families with adolescents experience high levels of stress associated with parental deployment, but many of these families do not seek or utilize mental health services. The current qualitative study was designed to better understand barriers to mental health treatment experienced by adolescents in military families. Focus groups and individual interviews were conducted with military adolescents (n = 13), military (non-enlisted) parents (n = 12), and mental health service providers who treat adolescents in military families (n = 20). Discussions primarily explored barriers to seeking treatment, with supplemental questions assessing the ideal elements of mental health services for this population. Seven barriers to engaging in mental health services were identified: four internal (confidentiality concerns, stigma, ethic of self-reliance, lack of perceived relevance) and three external (time and effort concerns, logistical concerns, financial concerns). Challenges engaging military adolescents in mental health services are discussed and several recommendations are offered for service providers attempting to work with this population. PMID:25574070
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Brown, Heidi Wendell; Wise, Meg E.; Westenberg, Danielle; Schmuhl, Nicholas B.; Brezoczky, Kelly Lewis; Rogers, Rebecca G.; Constantine, Melissa L.
2017-01-01
Introduction and hypothesis Fewer than 30% of women with accidental bowel leakage (ABL) seek care, despite the existence of effective, minimally invasive therapies. We developed and validated a condition-specific instrument to assess barriers to care-seeking for ABL in women. Methods Adult women with ABL completed an electronic survey about condition severity, patient activation, previous care-seeking, and demographics. The Barriers to Care-seeking for Accidental Bowel Leakage (BCABL) instrument contained 42 potential items completed at baseline and again 2 weeks later. Paired t tests evaluated test–retest reliability. Factor analysis evaluated factor structure and guided item retention. Cronbach’s alpha evaluated internal consistency. Within and across factor item means generated a summary BCABL score used to evaluate scale validity with six external criterion measures. Results Among 1,677 click-throughs, 736 (44%) entered the survey; 95% of eligible female respondents (427 out of 458) provided complete data. Fifty-three percent of respondents had previously sought care for their ABL; median age was 62 years (range 27–89); mean Vaizey score was 12.8 (SD = 5.0), indicating moderate to severe ABL. Test–retest reliability was excellent for all items. Factor extraction via oblique rotation resulted in the final structure of 16 items in six domains, within which internal consistency was high. All six external criterion measures correlated significantly with BCABL score. Conclusions The BCABL questionnaire, with 16 items mapping to six domains, has excellent criterion validity and test–retest reliability when administered electronically in women with ABL. The BCABL can be used to identify care-seeking barriers for ABL in different populations, inform targeted interventions, and measure their effectiveness. PMID:28236039
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ERIC Educational Resources Information Center
Yoshinobu, Stan; Jones, Matthew G.
2012-01-01
A significant issue mathematics instructors face is how to cover all the material. Mathematics teachers of all levels have some external and internal pressures to "get through" all the required material. The authors define "the coverage issue" to be the set of difficulties that arise in attempting to cover a lengthy list of topics. Principal among…
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Bain, Lorna; Sangrar, Ruheena; Bornstein, Carolyn; Lukmanji, Sara; Hapuhennedige, Sandani; Thorne, Carter; Beattie, Karen A
2016-09-01
Therapeutic Education Programs (TEPs) grounded in self-management principles have been shown to improve quality of life of patients with chronic conditions and reduce patient-related healthcare costs. Though these programs are becoming more readily available, patients often experience barriers in participating. This study sought to identify barriers faced by inflammatory arthritis (IA) patients in attending a TEP and understand how patients overcame perceived barriers. A mixed-method study design was used. Questionnaires were distributed to individuals with IA who were invited to attend a TEP between 2010 and 2013. Respondents were those that chose not to attend (group A), individuals who attended ≤4 of 10 sessions (group B), individuals who attended ≥5 of 10 sessions prior to May 2013 (group C), and individuals who attended ≥5 of 10 sessions from June 2013 to November 2013 (group D). Individuals in group D were also invited to participate in focus groups to discuss how they had overcome perceived barriers. Real barriers identified by individuals in groups A and B included time, distance, and cost associated with attendance. Individuals who overcame perceived barriers (groups C and D) discussed strategies they used to do so. Aspects of the overall program experience and access to clinic and program also contributed to patients being able to overcome barriers. Time, distance, and cost are external barriers that prevented individuals from utilizing self-management education opportunities. These barriers were overcome if and when individuals had resources available to them. Readiness for behavior change also influenced commitment to participate in the program.
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2003-10-01
In the Orbiter Processing Facility, Harrell Watts (left), with United Space Alliance, removes a tile from the thermal barrier around the umbilical areas, the external tank attach points, on the underside of Atlantis. The umbilical areas are closed off after ET separation by a door, seen here. The exposed area of each closed door is covered with reusable surface insulation.
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Strategies That Address Internal and External Barriers to Effective Educational Functioning.
ERIC Educational Resources Information Center
Alexander, Michael L.
Englewood Learning Center in Chicago provides programs for severely and profoundly handicapped children (5 to 17 years old) in an urban area where many families live in subpoverty conditions. The program requires families to be involved in the individualized education program process and in the whole range of educational services. The program…
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46 CFR 38.10-15 - Safety relief valves-TB/ALL.
Code of Federal Regulations, 2011 CFR
2011-10-01
.... plus the maximum flow rate of the cargo filling pipes or, (2) The vapors generated under fire exposure..., constructed and flow tested for capacity in conformance with subpart 162.017 or 162.018 of subchapter Q... excessive external pressure. (f) Void spaces between the primary and secondary barriers of nonpressure...
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46 CFR 38.10-15 - Safety relief valves-TB/ALL.
Code of Federal Regulations, 2014 CFR
2014-10-01
.... plus the maximum flow rate of the cargo filling pipes or, (2) The vapors generated under fire exposure..., constructed and flow tested for capacity in conformance with subpart 162.017 or 162.018 of subchapter Q... excessive external pressure. (f) Void spaces between the primary and secondary barriers of nonpressure...
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46 CFR 38.10-15 - Safety relief valves-TB/ALL.
Code of Federal Regulations, 2012 CFR
2012-10-01
.... plus the maximum flow rate of the cargo filling pipes or, (2) The vapors generated under fire exposure..., constructed and flow tested for capacity in conformance with subpart 162.017 or 162.018 of subchapter Q... excessive external pressure. (f) Void spaces between the primary and secondary barriers of nonpressure...
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46 CFR 38.10-15 - Safety relief valves-TB/ALL.
Code of Federal Regulations, 2013 CFR
2013-10-01
.... plus the maximum flow rate of the cargo filling pipes or, (2) The vapors generated under fire exposure..., constructed and flow tested for capacity in conformance with subpart 162.017 or 162.018 of subchapter Q... excessive external pressure. (f) Void spaces between the primary and secondary barriers of nonpressure...
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2016-03-02
Somewhat Good Very good Extremely good 9. My gender (circle one): Male Female 10. This is my (circle one): 1st...Health Stigma One significant barrier to seeking mental health care is one’s perception of external stereotypes and prejudices about people who seek
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Regionalism and Development in Early Nineteenth Century Spanish America.
ERIC Educational Resources Information Center
Friedman, Douglas
An understanding of regionalism in early 19th century Spanish America is crucial to any understanding of this region's economic development. Regionalism became the barrier to the kind of integrated national economy that some writers claim could have been implemented had it not been for the imposition of dependency by external forces. This…
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ERIC Educational Resources Information Center
Ellis, Wendy Taylor
2010-01-01
This qualitative study investigated the internal and external protective factors that serve to ameliorate barriers to academic achievement posed by the cultural factors of poverty, minority status, and rural residence for high-ability students, rendering them academically resilient. While there has been ample research on underachievement among…
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Teacher Beliefs and Technology Integration Practices: A Critical Relationship
ERIC Educational Resources Information Center
Ertmer, Peggy A.; Ottenbreit-Leftwich, Anne T.; Sadik, Olgun; Sendurur, Emine; Sendurur, Polat
2012-01-01
Early studies indicated that teachers' enacted beliefs, particularly in terms of classroom technology practices, often did not align with their espoused beliefs. Researchers concluded this was due, at least in part, to a variety of external barriers that prevented teachers from using technology in ways that aligned more closely with their beliefs.…
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Human Resource Management Careers: Different Paths for Men and Women?
ERIC Educational Resources Information Center
Ackah, Carol; Heaton, Norma
2003-01-01
Responses from individuals with postgraduate human resource management qualifications (n=52, 60% women, 40% men) indicated that men received more internal promotions, women sought career advancement externally and received lower salaries. Women were much more likely to perceive career barriers such as lack of role models or self-confidence.…
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The Evaluation of an Early Childhood Teacher Preparation Program: An Action Research Project
ERIC Educational Resources Information Center
Ragno, Kerry Sullivan
2013-01-01
The purpose of this dissertation was to evaluate the effectiveness of an Early Childhood Development Associate of Applied Science (AAS) degree program at one community college as part of an ongoing action research project. Prior to this dissertation study, external and internal barriers prevented the associate degree program stakeholders from…
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Challenges, Not Barriers: The Work and Family Issues of Women Superintendents
ERIC Educational Resources Information Center
Reecks-Rodgers, Debra Ann
2013-01-01
Prior studies have indicated that qualified female administrators have not applied for superintendency positions because of possible work/family conflicts, but little research has been done on the work/family issues encountered by women in the superintendency or on the strategies they use to resolve these issues. In response, this study is an…
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ERIC Educational Resources Information Center
Doraiswamy, Nithya
2015-01-01
This qualitative case study focused on the multifaceted issue of exploring science teacher leaders understanding and addressing of issues of diversity and equity with peers through professional development. The purpose of the study was to highlight the opportunities and barriers to the addressing of issues of diversity and equity through the work…
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Skin Immune Landscape: Inside and Outside the Organism.
Abdallah, Florence; Mijouin, Lily; Pichon, Chantal
2017-01-01
The skin is an essential organ to the human body protecting it from external aggressions and pathogens. Over the years, the skin was proven to have a crucial immunological role, not only being a passive protective barrier but a network of effector cells and molecular mediators that constitute a highly sophisticated compound known as the "skin immune system" (SIS). Studies of skin immune sentinels provided essential insights of a complex and dynamic immunity, which was achieved through interaction between the external and internal cutaneous compartments. In fact, the skin surface is cohabited by microorganisms recognized as skin microbiota that live in complete harmony with the immune sentinels and contribute to the epithelial barrier reinforcement. However, under stress, the symbiotic relationship changes into a dysbiotic one resulting in skin disorders. Hence, the skin microbiota may have either positive or negative influence on the immune system. This review aims at providing basic background information on the cutaneous immune system from major cellular and molecular players and the impact of its microbiota on the well-coordinated immune responses in host defense.
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Kinetics of molecular transitions with dynamic disorder in single-molecule pulling experiments
NASA Astrophysics Data System (ADS)
Zheng, Yue; Li, Ping; Zhao, Nanrong; Hou, Zhonghuai
2013-05-01
Macromolecular transitions are subject to large fluctuations of rate constant, termed as dynamic disorder. The individual or intrinsic transition rates and activation free energies can be extracted from single-molecule pulling experiments. Here we present a theoretical framework based on a generalized Langevin equation with fractional Gaussian noise and power-law memory kernel to study the kinetics of macromolecular transitions to address the effects of dynamic disorder on barrier-crossing kinetics under external pulling force. By using the Kramers' rate theory, we have calculated the fluctuating rate constant of molecular transition, as well as the experimentally accessible quantities such as the force-dependent mean lifetime, the rupture force distribution, and the speed-dependent mean rupture force. Particular attention is paid to the discrepancies between the kinetics with and without dynamic disorder. We demonstrate that these discrepancies show strong and nontrivial dependence on the external force or the pulling speed, as well as the barrier height of the potential of mean force. Our results suggest that dynamic disorder is an important factor that should be taken into account properly in accurate interpretations of single-molecule pulling experiments.
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Nair, Madhavan; Guduru, Rakesh; Liang, Ping; Hong, Jeongmin; Sagar, Vidya; Khizroev, Sakhrat
2013-01-01
Although highly active anti-retroviral therapy has resulted in remarkable decline in the morbidity and mortality in AIDS patients, inadequately low delivery of anti-retroviral drugs across the blood-brain barrier results in virus persistence. The capability of high-efficacy-targeted drug delivery and on-demand release remains a formidable task. Here we report an in vitro study to demonstrate the on-demand release of azidothymidine 5'-triphosphate, an anti-human immunodeficiency virus drug, from 30 nm CoFe2O4@BaTiO3 magneto-electric nanoparticles by applying a low alternating current magnetic field. Magneto-electric nanoparticles as field-controlled drug carriers offer a unique capability of field-triggered release after crossing the blood-brain barrier. Owing to the intrinsic magnetoelectricity, these nanoparticles can couple external magnetic fields with the electric forces in drug-carrier bonds to enable remotely controlled delivery without exploiting heat. Functional and structural integrity of the drug after the release was confirmed in in vitro experiments with human immunodeficiency virus-infected cells and through atomic force microscopy, spectrophotometry, Fourier transform infrared and mass spectrometry studies.
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Work Integration Issues Go beyond the Nature of the Communication Disorder.
ERIC Educational Resources Information Center
Garcia, Linda J.; Laroche, Chantal; Barrette, Jacques
2002-01-01
A study gathered perceptions from persons with communication disorders (CD) (n=78), 13 service providers, and 22 employers on barriers to work integration. Results show many barriers are common across types of CD, including noise, tasks requiring speed, having to speak to groups of persons, and attitudes of others. (Contains references.)…
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Accessing Science Courses in Rural BC: A Cultural Border-Crossing Metaphor
ERIC Educational Resources Information Center
Nielsen, Wendy S.; Nashon, Samson Madera
2007-01-01
Students in small rural schools in British Columbia face barriers to accessing senior science courses. A case study employing questionnaire and interview methods sought the perspectives of principals, teachers, and students in the affected schools on this issue. Interpretive data analysis revealed the following barriers as key factors that affect…
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Permeable iron reactive barriers have become a popular way to remediate contaminated ground water. Although this technology has been in use for about a decade, there is still little knowledge about long-term performance issues (l). One of the biggest concerns is the corrosion of ...
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Harnessing the Barriers That Impact on Students' English Language Learning (ELL)
ERIC Educational Resources Information Center
Liton, Hussain Ahmed
2016-01-01
This study strives to single out the barriers and obstacles in terms of academic, course curriculum system and socio-cultural issues that impact on students' learning English language adversely in the prep year level at Jazan University, Saudi Arabia. This paper especially focuses on the factors affecting EFL ("English as a Foreign…
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Training as an E-Commerce Enabler.
ERIC Educational Resources Information Center
Darch, Helen; Lucas, Trevor
2002-01-01
An investigation into lack of skills and awareness as barriers to the use of electronic commerce by 20 small- to medium enterprises within the food industry in Queensland, Australia, found that lack of knowledge and technical skills and structural issues are barriers. A range of training and development strategies are needed. (Contains 20…
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Issues of Financial Assurance of Economy Greening in the Regions
ERIC Educational Resources Information Center
Shekhova, Natalia V.; Kireeva, Ekaterina E.; Nazarov, Michael A.; Peskova, Dinara R.; Gusakova, Elena P.; Dorozhkin, Vladimir E.
2016-01-01
The relevance of the analyzed issue is caused by the need to internalize environmental externalities in the modern world. The purpose of the article is to examine the issue of financial support of the green economy using the example of the regions included in the Volga Federal District (VFD). The leading methods to the study of this issue is a…
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Hamaideh, Shaher H
2017-07-01
The purposes of this study were to identify the sources of knowledge for nursing practices and to identify the barriers of using "evidence-based practice" (EBP). Descriptive cross-sectional design was used to collect data from 164 Saudi mental health nurses by completing the Development of Evidence-Based Practice Questionnaire. The most frequently used sources of knowledge were relied on social interactions and the nurses' own experiences, while the least frequently used sources were external sources of knowledge and research evidences. Insufficient time to find research reports, difficulty in understanding research reports, and insufficient resources for evidences were the barriers of using EBP. The organizations should encourage using EBP by providing adequate time, resources, knowledge, and skills for mental health nurses through conducting workshops and mentoring. © 2016 Wiley Periodicals, Inc.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Sata, Yohta; Moriya, Rai, E-mail: moriyar@iis.u-tokyo.ac.jp, E-mail: tmachida@iis.u-tokyo.ac.jp; Morikawa, Sei
2015-07-13
We demonstrate a vertical field-effect transistor based on a graphene/MoSe{sub 2} van der Waals (vdW) heterostructure. The vdW interface between the graphene and MoSe{sub 2} exhibits a Schottky barrier with an ideality factor of around 1.3, suggesting a high-quality interface. Owing to the low density of states in graphene, the position of the Fermi level in the graphene can be strongly modulated by an external electric field. Therefore, the Schottky barrier height at the graphene/MoSe{sub 2} vdW interface is also modulated. We demonstrate a large current ON-OFF ratio of 10{sup 5}. These results point to the potential high performance ofmore » the graphene/MoSe{sub 2} vdW heterostructure for electronics applications.« less
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Alharthi, Hana; Sultana, Nahid; Al-Amoudi, Amjaad; Basudan, Afrah
2015-01-01
Pharmacy barcode scanning is used to reduce errors during the medication dispensing process. However, this technology has rarely been used in hospital pharmacies in Saudi Arabia. This article describes the barriers to successful implementation of a barcode scanning system in Saudi Arabia. A literature review was conducted to identify the relevant critical success factors (CSFs) for a successful dispensing barcode system implementation. Twenty-eight pharmacists from a local hospital in Saudi Arabia were interviewed to obtain their perception of these CSFs. In this study, planning (process flow issues and training requirements), resistance (fear of change, communication issues, and negative perceptions about technology), and technology (software, hardware, and vendor support) were identified as the main barriers. The analytic hierarchy process (AHP), one of the most widely used tools for decision making in the presence of multiple criteria, was used to compare and rank these identified CSFs. The results of this study suggest that resistance barriers have a greater impact than planning and technology barriers. In particular, fear of change is the most critical factor, and training is the least critical factor.
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Diaz, Francis L; Tweardy, Lisa; Shellock, Frank G
2010-02-15
Laboratory investigation, ex vivo. Currently, no studies have addressed the magnetic resonance imaging (MRI) issues for cervical external immobilization devices at 3-Tesla. Under certain conditions significant heating may occur, resulting in patient burns. Furthermore, artifacts can be substantial and prevent the diagnostic use of MRI. Therefore, the objective of this investigation was to evaluate MRI issues for 4 different cervical external immobilization devices at 3-Tesla. Excessive heating and substantial artifacts are 2 potential complications associated with performing MRI at 3-Tesla in patients with cervical external immobilization devices. Using ex vivo testing techniques, MRI-related heating and artifacts were evaluated for 4 different cervical devices during MRI at 3-Tesla. Four cervical external immobilization devices (Generation 80, Resolve Ring and Superstructure, Resolve Ring and Jerome Vest/Jerome Superstructure, and the V1 Halo System; Ossur Americas, Aliso Viejo, CA) underwent MRI testing at 3-Tesla. All devices were made from nonmetallic or nonmagnetic materials. Heating was determined using a gelled-saline-filled skull phantom with fluoroptic thermometry probes attached to the skull pins. MRI was performed at 3-Tesla, using a high level of RF energy. Artifacts were assessed at 3-Tesla, using standard cervical imaging techniques. The Generation 80 and V1 Halo devices exhibited substantial temperature rises (11.6 degrees C and 8.5 degrees C, respectively), with "sparking" evident for the Generation 80 during the MRI procedure. Artifacts were problematic for these devices, as well. By comparison, the 2 Resolve Ring-based cervical external immobilization devices showed little or no heating (< or = 0.6 degrees C) and the artifacts were acceptable for diagnostic MRI examinations. The low degree of heating and minor artifacts associated with the Resolve-based cervical external immobilization devices indicated that these products are safe for patients undergoing MRI at 3-Tesla.
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Choo, Min Soo; Jeong, Seong Jin; Cho, Sung Yong; Yoo, Changwon; Jeong, Chang Wook; Ku, Ja Hyeon; Oh, Seung-June
2017-04-01
We aimed to externally validate the prediction model we developed for having bladder outlet obstruction (BOO) and requiring prostatic surgery using 2 independent data sets from tertiary referral centers, and also aimed to validate a mobile app for using this model through usability testing. Formulas and nomograms predicting whether a subject has BOO and needs prostatic surgery were validated with an external validation cohort from Seoul National University Bundang Hospital and Seoul Metropolitan Government-Seoul National University Boramae Medical Center between January 2004 and April 2015. A smartphone-based app was developed, and 8 young urologists were enrolled for usability testing to identify any human factor issues of the app. A total of 642 patients were included in the external validation cohort. No significant differences were found in the baseline characteristics of major parameters between the original (n=1,179) and the external validation cohort, except for the maximal flow rate. Predictions of requiring prostatic surgery in the validation cohort showed a sensitivity of 80.6%, a specificity of 73.2%, a positive predictive value of 49.7%, and a negative predictive value of 92.0%, and area under receiver operating curve of 0.84. The calibration plot indicated that the predictions have good correspondence. The decision curve showed also a high net benefit. Similar evaluation results using the external validation cohort were seen in the predictions of having BOO. Overall results of the usability test demonstrated that the app was user-friendly with no major human factor issues. External validation of these newly developed a prediction model demonstrated a moderate level of discrimination, adequate calibration, and high net benefit gains for predicting both having BOO and requiring prostatic surgery. Also a smartphone app implementing the prediction model was user-friendly with no major human factor issue.
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Barriers to childhood immunisation: Findings from the Longitudinal Study of Australian Children.
Pearce, Anna; Marshall, Helen; Bedford, Helen; Lynch, John
2015-06-26
To examine barriers to childhood immunisation experienced by parents in Australia. Cross-sectional analysis of secondary data. Nationally representative Longitudinal Study of Australian Children (LSAC). Five thousand one hundred seven infants aged 3-19 months in 2004. Maternal report of immunisation status: incompletely or fully immunised. Overall, 9.3% (473) of infants were incompletely immunised; of these just 16% had mothers who disagreed with immunisation. Remaining analyses focussed on infants whose mother did not disagree with immunisation (N=4994) (of whom 8% [398] were incompletely immunised). Fifteen variables representing potential immunisation barriers and facilitators were available in LSAC; these were entered into a latent class model to identify distinct clusters (or 'classes') of barriers experienced by families. Five classes were identified: (1) 'minimal barriers', (2) 'lone parent, mobile families with good support', (3) 'low social contact and service information; psychological distress', (4) 'larger families, not using formal childcare', (5) 'child health issues/concerns'. Compared to infants from families experiencing minimal barriers, all other barrier classes had a higher risk of incomplete immunisation. For example, the adjusted risk ratio (RR) for incomplete immunisation was 1.51 (95% confidence interval: 1.08-2.10) among those characterised by 'low social contact and service information; psychological distress', and 2.47 (1.87-3.25) among 'larger families, not using formal childcare'. Using the most recent data available for examining these issues in Australia, we found that the majority of incompletely immunised infants (in 2004) did not have a mother who disagreed with immunisation. Barriers to immunisation are heterogeneous, suggesting a need for tailored interventions. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
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Resilient Actions in the Diagnostic Process and System Performance
Smith, Michael W.; Giardina, Traber Davis; Murphy, Daniel R.; Laxmisan, Archana; Singh, Hardeep
2013-01-01
Objectives Systemic issues can adversely affect the diagnostic process. Many system-related barriers can be masked by ‘resilient’ actions of frontline providers (ie, actions supporting the safe delivery of care in the presence of pressures that the system cannot readily adapt to). We explored system barriers and resilient actions of primary care providers (PCPs) in the diagnostic evaluation of cancer. Methods We conducted a secondary data analysis of interviews of PCPs involved in diagnostic evaluation of 29 lung and colorectal cancer cases. Cases covered a range of diagnostic timeliness and were analyzed to identify barriers for rapid diagnostic evaluation, and PCPs’ actions involving elements of resilience addressing those barriers. We rated these actions according to whether they were usual or extraordinary for typical PCP work. Results Resilient actions and associated barriers were found in 59% of the cases, in all ranges of timeliness, with 40% involving actions rated as beyond typical. Most of the barriers were related to access to specialty services and coordination with patients. Many of the resilient actions involved using additional communication channels to solicit cooperation from other participants in the diagnostic process. Discussion Diagnostic evaluation of cancer involves several resilient actions by PCPs targeted at system deficiencies. PCPs’ actions can sometimes mitigate system barriers to diagnosis, and thereby impact the sensitivity of ‘downstream’ measures (eg, delays) in detecting barriers. While resilient actions might enable providers to mitigate system deficiencies in the short run, they can be resource intensive and potentially unsustainable. They complement, rather than substitute for, structural remedies to improve system performance. Measures to detect and fix system performance issues targeted by these resilient actions could facilitate diagnostic safety. PMID:23813210
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Naweed, Anjum; Chapman, Janine; Allan, Matthew; Trigg, Joshua
2017-03-01
This study aimed to examine the impacts of key barriers to improving the occupational health status of Australian train drivers. From May to June, 2015, five semi-structured qualitative focus groups were conducted with 29 train drivers from South Australian, Victorian, and New South Wales-based rail organizations in Australia. Occupational health was impeded by multiple barriers regarding sleep (patterns/fatigue), diet (planning/context), mental health (occupational stress), rostering (low autonomy), sedentary time, low fitness motivation, and family/social life conflicts. Work organizational barriers included communication issues, low organizational support, and existing social norms. Job design barriers included rostering, fatigue, stimulant reliance, and family/social life imbalances. Self-regulatory barriers included dietary and exercise patterns habits and patterns. Occupational health interventions for Australian train drivers must address work organizational, job design, and self-regulatory barriers to healthier lifestyle behaviors.
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Barriers to education of overseas doctors in paediatrics: a qualitative study in South Yorkshire.
Mahajan, J; Stark, P
2007-03-01
To explore the factors that may influence the progress of doctors who come from the Indian subcontinent to train in paediatrics in the UK. Overseas doctors training in paediatrics in Rotherham, Sheffield and Doncaster participated in the study. Focus groups were used to collect data; two focus groups, each with 4-5 participants, were conducted at 6-week intervals. Semistructured, one-to-one interviews were conducted to add more understanding and depth to issues highlighted in the focus groups. The focus groups and interviews were audiotaped; the tapes were transcribed and data were analysed using the Grounded Theory; open codes were formed and concepts identified using microanalysis, and initial theories were built. Lack of information about the National Health Service (NHS)/Royal Colleges, inappropriate communication skills, difficulties in team working, difficulties in preparing for Royal College examinations, visa and job hunting, and social and cultural isolation were identified as major barriers. Problems arose not only from difficulties with language but also from use of local and colloquial words, different accents and difficulty in communicating sensitive issues. Lack of understanding of role in teams and difficulties in working in multiprofessional setting all contributed to the problems. Cultural differences inside and outside the workplace, and social isolation were also highlighted. Induction programmes, mentoring, awareness of the issues within the teams, and courses in communication specifically directed at overseas doctors were identified as means to overcome these barriers. Several intercultural factors were identified that could act as barriers to the progress of overseas doctors training in paediatrics in the UK. Increased awareness of these factors within the teams would be the first step in resolving some of the issues.
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Giraldo, Priscila; Corbella, Josep; Rodrigo, Carmen; Comas, Mercè; Sala, Maria; Castells, Xavier
2016-01-01
To identify opportunities for disclosing information on medical errors in Spain and issuing an apology, as well as legal-ethical barriers. A cross-sectional study was conducted through a questionnaire sent to health law and bioethics experts (n=46). A total of 39 experts (84.7%) responded that health providers should always disclose adverse events and 38 experts (82.6%) were in favour of issuing an apology. Thirty experts (65.2%) reported that disclosure of errors would not lead to professional liability. The main opportunity for increasing disclosure was by enhancing trust in the physician-patient relationship and the main barrier was fear of the outcomes of disclosing medical errors. There is a broad agreement on the lack of liability following disclosure/apology on adverse events and the need to develop a strategy for disclosure among support for physicians. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.
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Life Prediction Issues in Thermal/Environmental Barrier Coatings in Ceramic Matrix Composites
NASA Technical Reports Server (NTRS)
Shah, Ashwin R.; Brewer, David N.; Murthy, Pappu L. N.
2001-01-01
Issues and design requirements for the environmental barrier coating (EBC)/thermal barrier coating (TBC) life that are general and those specific to the NASA Ultra-Efficient Engine Technology (UEET) development program have been described. The current state and trend of the research, methods in vogue related to the failure analysis, and long-term behavior and life prediction of EBCITBC systems are reported. Also, the perceived failure mechanisms, variables, and related uncertainties governing the EBCITBC system life are summarized. A combined heat transfer and structural analysis approach based on the oxidation kinetics using the Arrhenius theory is proposed to develop a life prediction model for the EBC/TBC systems. Stochastic process-based reliability approach that includes the physical variables such as gas pressure, temperature, velocity, moisture content, crack density, oxygen content, etc., is suggested. Benefits of the reliability-based approach are also discussed in the report.
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Holthe, Asle; Larsen, Torill; Samdal, Oddrun
2011-07-01
The main goal of the present study was to investigate the barriers to implementing the Norwegian national guidelines for healthy school meals as perceived by principals, project leaders, teachers and students. This study employed a multiple-case design using an explorative approach. Data were collected at three secondary schools in Norway participating in the intervention project Physical activity and healthy school meals. Individual interviews were conducted with school principals and project leaders, and focus group interviews were conducted separately with teachers and students. Four categories of barriers were identified: (1) lack of adaptation of the guidelines to the target group; (2) lack of resources and funding; (3) conflicting values and goals; and (4) access to unhealthy food outside school. The research identified differences in perceived barriers between the staff responsible for implementation and the students as the target group of the measures. All staff groups perceived barriers relating to both resources, and conflicting values and goals. The teachers were more concerned about issues of relevance for adaptation to the target groups than were the principals and project leaders. The students were concerned mostly with issues directly affecting their experience with items offered in the canteen. © 2010 Blackwell Publishing Ltd.
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Australian Football League concussion guidelines: what do community players think?
White, Peta E; Donaldson, Alex; Sullivan, S John; Newton, Joshua
2016-01-01
Background Preventing concussion in sport is a global challenge. To assess community-level adult male Australian Football players’ views on following the Australian Football League's (AFL) concussion guidelines. Methods 3 focus groups, each comprising 6 players from 1 regional league, were conducted until saturation of issues raised. Discussions followed a semistructured script and were audio-recorded and transcribed verbatim. Thematic analysis was conducted by 2 coders independently. Results Identified advantages of the guidelines included highlighting the seriousness of concussion; changing the culture around playing with concussion and shifting return-to-play decision responsibility from players to others. Disadvantages included players being removed from play unnecessarily; removal of players’ rights to decide if they are fit to play and players changing their behaviours to avoid being removed from play. Identified facilitators to guideline use included local league enforcement; broad information dissemination and impartial medically trained staff to assess concussion. Identified barriers to guideline use included players’ desire to play at all costs; external pressure that encouraged players to return to play prematurely; and inconvenience and cost. Conclusions Players generally understand that the AFL concussion guidelines protect their long-term welfare. However, their desire to play at all costs and help their team win is a common barrier to reporting concussion and adhering to guidelines. Leagues should take a lead role by mandating and enforcing the use of the guidelines and educating coaches, game day medical providers and players. The return-to-play component of the guidelines is complex and needs further consideration in the context of community sport. PMID:28890801
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Oral intake of beet extract provides protection against skin barrier impairment in hairless mice.
Kawano, Ken-Ichi; Umemura, Kazuo
2013-05-01
The epidermis acts as a functional barrier against the external environment. Disturbances in the function of this barrier cause water loss and increase the chances of penetration by various irritable stimuli, leading to skin diseases such as dry skin, atopic dermatitis, and psoriasis. Ceramides are a critical natural element of the protective epidermal barrier. The aim of this study was to evaluate whether the oral intake of beet (Beta vulgaris) extract, a natural product rich in glucosylceramide (GlcCer), may prevent disturbance in skin barrier function. When HR-1 hairless mice were fed a special diet (HR-AD), transepidermal water loss (TEWL) from the dorsal skin increased, with a compensatory increase in water intake after 5 weeks. Mice fed with HR-AD had dry skin with erythema and showed increased scratching behaviour. Histological examinations revealed a remarkable increase in the thickness of the skin at 8 weeks. Supplemental addition of beet extract, which contained GlcCer at a final concentration of 0.1%, significantly prevented an increase TEWL, water intake, cumulative scratching time, and epidermal thickness at 8 weeks. These results indicate that oral intake of beet extract shows potential for preventing skin diseases associated with impaired skin barrier function. Copyright © 2012 John Wiley & Sons, Ltd.
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Potgieter-Groot, Lucia; Visser, Maretha; Lubbe-de Beer, Carien
2012-07-01
The interaction between teachers, classroom strategies and learners experiencing emotional and behavioural barriers to learning and development in a system of inclusive education results in multiple dynamics on different levels. Many teachers in mainstream education lack training to deal with learners experiencing emotional and behavioural barriers. Resistance towards inclusive education is therefore evident. This paper describes the process of developing an in-service training programme for teachers who deal with learners with emotional and behavioural barriers in their classrooms. A process of action research was used to allow the researcher, in collaboration with 47 teachers from 2 primary schools, to develop a training programme to address the specific needs of teachers in dealing with learners experiencing emotional and behavioural barriers in their classes. Qualitative feedback from teachers and observations by the researcher and external observers were used to evaluate the appropriateness of the training. Teachers experienced that appropriate classroom management strategies made a significant difference in the behaviour of learners experiencing emotional and behavioural barriers. The training affected teachers' attitudes, teacher-learner interaction, learner behaviour and school organisation. In-service training for teachers can affect the effective implementation of inclusive education. This programme can be adapted to address the needs of teachers in other areas.
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Membrane Transport across Polarized Epithelia.
Garcia-Castillo, Maria Daniela; Chinnapen, Daniel J-F; Lencer, Wayne I
2017-09-01
Polarized epithelial cells line diverse surfaces throughout the body forming selective barriers between the external environment and the internal milieu. To cross these epithelial barriers, large solutes and other cargoes must undergo transcytosis, an endocytic pathway unique to polarized cell types, and significant for the development of cell polarity, uptake of viral and bacterial pathogens, transepithelial signaling, and immunoglobulin transport. Here, we review recent advances in our knowledge of the transcytotic pathway for proteins and lipids. We also discuss briefly the promise of harnessing the molecules that undergo transcytosis as vehicles for clinical applications in drug delivery. Copyright © 2017 Cold Spring Harbor Laboratory Press; all rights reserved.
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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.
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Transition Behaviors of Configurations of Colloidal Particles at a Curved Oil-Water Interface
Lee, Mina; Xia, Ming; Park, Bum Jun
2016-01-01
We studied the transition behaviors of colloidal arrangements confined at a centro-symmetrically curved oil-water interface. We found that assemblies composed of several colloidal particles at the curved interface exhibit at least two unique patterns that can be attributed to two factors: heterogeneity of single-colloid self-potential and assembly kinetics. The presence of the two assembly structures indicates that an essential energy barrier between the two structures exists and that one of the structures is kinetically stable. This energy barrier can be overcome via external stimuli (e.g., convection and an optical force), leading to dynamic transitions of the assembly patterns. PMID:28773263
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Pulicherla, K K; Verma, Mahendra Kumar
2015-04-01
Cerebral tissues possess highly selective and dynamic protection known as blood brain barrier (BBB) that regulates brain homeostasis and provides protection against invading pathogens and various chemicals including drug molecules. Such natural protection strictly monitors entry of drug molecules often required for the management of several diseases and disorders including cerebral vascular and neurological disorders. However, in recent times, the ischemic cerebrovascular disease and clinical manifestation of acute arterial thrombosis are the most common causes of mortality and morbidity worldwide. The management of cerebral Ischemia requires immediate infusion of external thrombolytic into systemic circulation and must cross the blood brain barrier. The major challenge with available thrombolytic is their poor affinity towards the blood brain barrier and cerebral tissue subsequently. In the clinical practice, a high dose of thrombolytic often prescribed to deliver drugs across the blood brain barrier which results in drug dependent toxicity leading to damage of neuronal tissues. In recent times, more emphasis was given to utilize blood brain barrier transport mechanism to deliver drugs in neuronal tissue. The blood brain barrier expresses a series of receptor on membrane became an ideal target for selective drug delivery. In this review, the author has given more emphasis molecular biology of receptor on blood brain barrier and their potential as a carrier for drug molecules to cerebral tissues. Further, the use of nanoscale design and real-time monitoring for developed therapeutic to encounter drug dependent toxicity has been reviewed in this study.
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Providers issue brief: automated external defibrillators.
Rothouse, M
1999-06-25
With expanded access to automatic external defibrillators, hundreds of lives could be saved on a daily basis. By training nonphysician providers, such as emergency medical service personnel or first responders, this life-saving medical equipment could help improve the survival rates for people suffering from cardiac arrest. During the last two years, state lawmakers have begun to enact legislation that develops training standards and provides immunity from civil liability for automatic external defibrillator users.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Mechalakos, J.
The process of converting to an electronic chart for radiation therapy can be daunting. It requires a dedicated committee to first research and choose appropriate software, to review the entire documentation policy and flow of the clinic, to convert this system to electronic form or if necessary, redesign the system to more easily conform to the electronic process. Those making the conversion and those who already use electronic charting would benefit from the shared experience of those who have been through the process in the past. Therefore TG262 was convened to provide guidance on electronic charting for external beam radiationmore » therapy and brachytherapy. This course will present the results of an internal survey of task group members on EMR practices in External Beam Radiation Therapy as well as discuss important issues in EMR development and structure for both EBRT and brachytherapy. Learning Objectives: Be familiarized with common practices and pitfalls in development and maintenance of an electronic chart in Radiation Oncology Be familiarized with important issues related to electronic charting in External Beam Radiation Therapy Be familiarized with important issues related to electronic charting in Brachytherapy.« less
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Barriers to Cataract Surgery in Africa: A Systematic Review.
Aboobaker, Shaheer; Courtright, Paul
2016-01-01
Cataract remains the leading cause of blindness in Africa. We performed a systematic literature search of articles reporting barriers to cataract surgery in Africa. PubMed and Google Scholar databases were searched with the terms "barriers, cataract, Africa, cataract surgery, cataract surgical coverage (CSC), and rapid assessment of avoidable blindness (RAAB)." The review covered from 1999 to 2014. In RAAB studies, barriers related to awareness and access were more commonly reported than acceptance. Other type of studies reported cost as the most common barrier. Some qualitative studies tended to report community and family dynamics as barriers to cataract surgery. CSC was lower in females in 88.2% of the studies. The variability in outcomes of studies of barriers to cataract surgery could be due to context and the type of data collection. It is likely that qualitative data will provide a deeper understanding of the complex social, family, community, financial and gender issues relating to barriers to uptake of cataract surgery in Africa.
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Barriers to Employment for Transition-age Youth with Developmental and Psychiatric Disabilities.
Noel, Valerie A; Oulvey, Eugene; Drake, Robert E; Bond, Gary R
2017-05-01
Youth with developmental and psychiatric disabilities encounter significant vocational challenges, even when they receive supported employment services. We examined the barriers to employment for 280 transition-age youth with disabilities enrolled in supported employment in eight community rehabilitation centers. Employment team members identified each youth's top three barriers to employment using a 21-item checklist. Lack of work experience, transportation problems, and program engagement issues represented common barriers for both youth with developmental disabilities (53, 36, and 25%) and youth with psychiatric disabilities (20, 33, and 26%). Additional common barriers among youth with developmental disabilities included cognitive problems (32%) and lack of social skills (23%) and among youth with psychiatric disabilities included poor control of psychiatric symptoms (23%). Despite receiving evidence-based employment services, youth with disabilities encounter many barriers to employment. Awareness of typical barriers for transition-age youth, including those specific to different disability groups, may help employment programs anticipate challenges and develop strategies that avoid these barriers and their effects on employment opportunities.
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Vranken, Marjolein J M; Mantel-Teeuwisse, Aukje K; Schutjens, Marie-Hélène D B; Scholten, Willem K; Jünger, Saskia; Medic, Dr Rer; Leufkens, Hubert G M
2018-04-06
In 2011-2013, >95% of the global opioid analgesics consumption occurred in three regions, accounting for 15% of the world population. Despite abundant literature on barriers to access, little is known on the correlation between actual access to opioid analgesics and barriers to access, including legal and regulatory barriers. This study aimed to evaluate the correlation between access to strong opioid analgesics and barriers to access in national legislation and regulations in 11 central and eastern European countries that participated in the Access to Opioid Medication in Europe (ATOME) project. Two variables were contrasted to assess their correlation: the country level of access to strong opioid analgesics indicated by the Adequacy of Consumption Measure (ACM) and the number of potential legal and regulatory barriers identified by an external review of legislation and regulations. A linear correlation was evaluated using a squared linear correlation coefficient. Evaluation of the correlation between the ACM and the number of potential barriers produces an R 2 value of 0.023 and a correlation plot trend line gradient of -0.075, indicating no correlation between access to strong opioid analgesics and the number of potential barriers in national legislation and regulations in the countries studied. No correlation was found, which indicates that other factors besides potential legal and regulatory barriers play a critical role in withholding prescribers and patients essential pain medication in the studied countries. More research is needed toward better understanding of the complex interplay of factors that determine access to strong opioid analgesics.
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2011-01-01
Background Only 1-3% of ischemic stroke patients receive thrombolytic therapy. Provider barriers to adhering with guidelines recommending tPA delivery in acute stroke are not well known. The main objective of this study was to describe barriers to thrombolytic use in acute stroke care. Methods Twenty-four hospitals were randomly selected and matched into 12 pairs. Barrier assessment occurred at intervention sites only, and utilized focus groups and structured interviews. A pre-specified taxonomy was employed to characterize barriers. Two investigators independently assigned themes to transcribed responses. Seven facilitators (three emergency physicians, two nurses, and two study coordinators) conducted focus groups and interviews of emergency physicians (65), nurses (62), neurologists (15), radiologists (12), hospital administrators (12), and three others (hospitalists and pharmacist). Results The following themes represented the most important external barriers: environmental and patient factors. Important barriers internal to the clinician included familiarity with and motivation to adhere to the guidelines, lack of self-efficacy and outcome expectancy. The following themes were not substantial barriers: lack of awareness of the existence of acute stroke guidelines, presence of conflicting guidelines, and lack of agreement with the guidelines. Conclusions Healthcare providers perceive environmental and patient-related factors as the primary barriers to adherence with acute stroke treatment guidelines. Interventions focused on increasing physician familiarity with and motivation to follow guidelines may be of highest yield in improving adherence. Improving self-efficacy in performing guideline concordant care may also be useful. Trial Registration ClinicalTrials.gov identifier: NCT00349479 PMID:21548943
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-01
... Laboratory Accreditation for External Dosimetry AGENCY: Office of Health, Safety and Security, Department of... Department) is issuing Technical Standard DOE-STD-1095-2011, Department of Energy Laboratory Accreditation... part, to determine whether to accredit dosimetry programs in accordance with the DOE Laboratory...
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The Importance of External Advisory Boards
ERIC Educational Resources Information Center
Olson, Gary A.
2008-01-01
In a recent Internet discussion among academic deans, the topic was whether departments and other academic units should create external advisory boards. The dean who raised the issue asked his colleagues whether they maintained boards, if they were genuinely beneficial, and what the ideal board would look like. Some administrators are only now…
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A Multi-Level Approach to Outreach for Geologic Sequestration Projects
Greenberg, S.E.; Leetaru, H.E.; Krapac, I.G.; Hnottavange-Telleen, K.; Finley, R.J.
2009-01-01
Public perception of carbon capture and sequestration (CCS) projects represents a potential barrier to commercialization. Outreach to stakeholders at the local, regional, and national level is needed to create familiarity with and potential acceptance of CCS projects. This paper highlights the Midwest Geological Sequestration Consortium (MGSC) multi-level outreach approach which interacts with multiple stakeholders. The MGSC approach focuses on external and internal communication. External communication has resulted in building regional public understanding of CCS. Internal communication, through a project Risk Assessment process, has resulted in enhanced team communication and preparation of team members for outreach roles. ?? 2009 Elsevier Ltd. All rights reserved.
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Low-bias flat band-stop filter based on velocity modulated gaussian graphene superlattice
NASA Astrophysics Data System (ADS)
Sattari-Esfahlan, S. M.; Shojaei, S.
2018-05-01
Transport properties of biased planar Gaussian graphene superlattice (PGGSL) with Fermi velocity barrier is investigated by transfer matrix method (TMM). It is observed that enlargement of bias voltage over miniband width breaks the miniband to WSLs leads to suppressing resonant tunneling. Transmission spectrum shows flat wide stop-band property controllable by external bias voltage with stop-band width of near 200 meV. The simulations demonstrate that strong velocity barriers prevent tunneling of Dirac electrons leading to controllable enhancement of stop-band width. By increasing ratio of Fermi velocity in barriers to wells υc stop-band width increase. As wide transmission stop-band width (BWT) of filter is tunable from 40 meV to 340 meV is obtained by enhancing ratio of υc from 0.2 to 1.5, respectively. Proposed structure suggests easy tunable wide band-stop electronic filter with a modulated flat stop-band characteristic by height of electrostatic barrier and structural parameters. Robust sensitivity of band width to velocity barrier intensity in certain bias voltages and flat band feature of proposed filter may be opens novel venue in GSL based flat band low noise filters and velocity modulation devices.
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Wholegrain Food Acceptance in Young Singaporean Adults
Neo, Jia En; Brownlee, Iain A.
2017-01-01
Previous epidemiological evidence suggests that habitual consumption of whole grains is associated with reduction of disease risk. While wholegrain food consumption appears to be increasing in Singapore, it is still low, with more infrequent consumption noted in younger Singaporeans. Therefore, the primary objective of this study is to determine the knowledge of whole grains and barriers to consumption of wholegrain foods. Thirty participants (age range 21–26 year, 19 females) took part in two focus groups separated by a 2-week period in which participants trialled a range of wholegrain foods. Barriers towards whole grain consumption and experiences of products during this familiarization period were discussed during the focus groups and knowledge of whole grains was assessed by questionnaire. Potential barriers such as personal factors, product-specific factors and external factors were identified with sensory and habitual being stronger barriers. The whole grain familiarization period did not alter the taste expectations of the consumers but it did manage to increase acceptance for four of the wholegrain products tested (muesli, cookies, granola bars and wholewheat pasta). These findings suggest existing barriers to wholegrain food consumption should be considered by public health agencies and manufacturing companies. PMID:28397752
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Superficial Immunity: Antimicrobial Responses Are More Than Skin Deep.
Mack, Madison R; Kim, Brian S
2016-07-19
The skin barrier is essential for host defense, but how the skin provides protection when the barrier is breached is not well understood. In this issue of Immunity, Gallo and colleagues report that keratinocytes integrate signals from antimicrobial peptides via MAVS signaling to amplify their antiviral immune response. Copyright © 2016 Elsevier Inc. All rights reserved.
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ERIC Educational Resources Information Center
Bajracharya, Srijana M.; Wigglesworth, Janet K.
2013-01-01
Background: Early detection through routine screening is critical in reducing the incidence rate of colorectal cancer (CRC). Purpose: The purpose of this study was to examine college and university employees' knowledge of CRC issues, their perceptions of the benefits of and barriers to CRC screening, and their intentions toward it. Methods: This…
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Perceived Barriers to Health Care Access Among Rural Older Adults: A Qualitative Study
ERIC Educational Resources Information Center
Goins, R. Turner; Williams, Kimberly A.; Carter, Mary W.; Spencer, S. Melinda; Solovieva, Tatiana
2005-01-01
Context: Many rural elders experience limited access to health care. The majority of what we know about this issue has been based upon quantitative studies, yet qualitative studies might offer additional insight into individual perceptions of health care access. Purpose: To examine what barriers rural elders report when accessing needed health…
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Perceived Barriers to Health Care Access among Rural Older Adults: A Qualitative Study
ERIC Educational Resources Information Center
Goins, R. Turner; Williams, Kimberly A.; Carter, Mary W.; Spencer, S. Melinda; Solovieva, Tatiana
2005-01-01
Context: Many rural elders experience limited access to health care. The majority of what we know about this issue has been based upon quantitative studies, yet qualitative studies might offer additional insight into individual perceptions of health care access. Purpose: To examine what barriers rural elders report when accessing needed health…
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-08-12
... (2011 SPS Report) and the 2011 Report on Technical Barriers to Trade (2011 TBT Report) respectively. The TPSC invites written comments from the public on issues that USTR should examine in preparing the NTE..., Technical Barriers to Trade, USTR (202-395-4498). SUPPLEMENTARY INFORMATION: The NTE sets out an inventory...
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Barriers Encountered in the Transfer of Educational Training to Workplace Practice in Saudi Arabia
ERIC Educational Resources Information Center
Almannie, Mohamed
2015-01-01
This study introduces a critical issue in the practicality of training programs, not only in Saudi Arabia, but also in other developing countries where billions of dollars are spent on training human resources without evaluation of these programs on workplace practice and organization development. This study investigates barriers encountered in…
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Service Delivery to Young Handicapped Children in Rural Areas: A Review of Issues and Practices.
ERIC Educational Resources Information Center
Nash, Tina Eaton; And Others
The paper examines barriers faced by educators and administrators in serving young handicapped children in rural areas and suggests approaches to overcoming these barriers. Among problems identified are transportation; funding shortages due to a lower tax base and higher levels of poverty; unemployment, and seasonal employment; staff shortages;…
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Breaking the Communication Barrier: Guidelines to Aid Communication within Pair Programming
ERIC Educational Resources Information Center
Zarb, Mark; Hughes, Janet
2015-01-01
Pair programming is a software development technique with many cited benefits in learning and teaching. However, it is reported that novice programmers find several barriers to pairing up, typically due to the added communication that is required of this approach. This paper will present a literature review discussing the issue of communication,…
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Physical and Social Barriers to Social Relationships: Voices of Rural Disabled Women in the USA
ERIC Educational Resources Information Center
Taub, Diane E.; McLorg, Penelope A.; Bartnick, April K.
2009-01-01
Through exploring the lived experiences of disabled women, this study investigates how physical and social barriers affect their social relationships. In-depth tape-recorded interviews investigating a variety of social and interpersonal issues were conducted with 24 women with physical or visual impairments who lived in a rural region of the…
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ERIC Educational Resources Information Center
Al-Alawneh, Muhammad K.
2014-01-01
Employing computer's technology that includes e-learning system in the field of Engineering is a vital issue which needs to be discussed. Therefore, this study purposed to examine e-learning barriers as perceived by faculty members of engineering in three major universities in Jordan (Yarmouk University, Jordan University of Science and…
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Wei, Yumei; Yang, Huixia
2018-04-18
Hyperglycemia is one of the most common medical conditions women encounter during pregnancy. Hyperglycemia in pregnancy (HIP) is an issue of increasing concern to both obstetricians and administrators and it brings health issues for both mothers and offspring, not only early complications, but also long-term effects. HIP may either have been pre-gestational diabetes mellitus (pGDM), or gestational diabetes mellitus (GDM). After two-child policy fully carried out in China, the incidence of HIP would be increased further. There are many important issues such as the high prevalence of DM misdiagnosis, the diagnostic criteria of GDM, the strategies of GDM management in China need to deal with. We would focus on the barriers and challenges of diagnostic strategies for hyperglycemia in pregnancy in China. Copyright © 2018. Published by Elsevier B.V.
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Qureshi, Rubab I; Zha, Peijia; Kim, Suzanne; Hindin, Patricia; Naqvi, Zoon; Holly, Cheryl; Dubbs, William; Ritch, Wendy
2018-01-01
The purpose of this study was to explore prevalent health issues, perceived barriers to seeking health care, and utilization of health care among lesbian, gay, bisexual, and transgender (LGBT) populations in New Jersey. A cross-sectional online survey was administered to 438 self-identified LGBT people. Results identified health needs, which included management of chronic diseases, preventive care for risky behaviors, mental health issues, and issues related to interpersonal violence. Barriers to seeking health care included scarceness of health professionals competent in LGBT health, inadequate health insurance coverage and lack of personal finances, and widely dispersed LGBT inclusive practices making transportation difficult. There is a need for better preparation of health care professionals who care for LGBT patients, to strengthen social services to improve access and for better integration of medical and social services.
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Abusive behavior is barrier to high-reliability health care systems, culture of patient safety.
Cassirer, C; Anderson, D; Hanson, S; Fraser, H
2000-11-01
Addressing abusive behavior in the medical workplace presents an important opportunity to deliver on the national commitment to improve patient safety. Fundamentally, the issue of patient safety and the issue of abusive behavior in the workplace are both about harm. Undiagnosed and untreated, abusive behavior is a barrier to creating high reliability service delivery systems that ensure patient safety. Health care managers and clinicians need to improve their awareness, knowledge, and understanding of the issue of workplace abuse. The available research suggests there is a high prevalence of workplace abuse in medicine. Both administrators at the blunt end and clinicians at the sharp end should consider learning new approaches to defining and treating the problem of workplace abuse. Eliminating abusive behavior has positive implications for preventing and controlling medical injury and improving organizational performance.
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Parkinson's disease in Jordan: Barriers and motivators to exercise.
Khalil, Hanan; Nazzal, Mohammad; Al-Sheyab, Nihaya
2016-10-01
Perceived barriers to engaging in exercise in people with Parkinson's disease (PD) are becoming more defined in countries such as the UK and the US. This, however, may vary by culture and environment. This study aimed to explore the perceptions of exercise and barriers that may affect participation in people with PD from Jordan. Two focus groups and seven individual interviews were conducted with people with PD. Additionally, individual interviews were conducted with two neurologists. Conversations were digitally recorded and transcribed. Transcripts were analyzed using thematic analysis and validated via researcher triangulation and peer checking. Most of the PD participants lacked previous participation in any disease-specific exercises. Several barriers were perceived by PD participants for such lack of participation. Barriers included difficulty of diagnosis, lack of informational support provided by neurologists, lack of referral to physiotherapy services, disease-specific issues, and setting-related issues. Neurologists indicated a number of barriers in counseling their PD patients on exercise including lack of time and lack of health system resources. Motivators to participate in future exercise included outcome expectations and family support. Findings of the study shed light into large areas of unmet needs of supporting exercise and physiotherapy for people with PD in developing countries as per Jordan. For better patient outcomes, findings of the study suggest that it is crucial to raise awareness among all PD-related stakeholders on the benefits of early referrals to physiotherapy and early engagement in exercise programs.
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ERIC Educational Resources Information Center
Heath, Robert L.
1990-01-01
Demonstrates how corporate culture stifled adaptive efforts of strategic planners, operations managers, industrial hygienists, and issue monitors in the asbestos industry thereby leading it to the brink of bankruptcy. (MG)
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Rethinking Social Barriers to Effective Adaptive Management
NASA Astrophysics Data System (ADS)
West, Simon; Schultz, Lisen; Bekessy, Sarah
2016-09-01
Adaptive management is an approach to environmental management based on learning-by-doing, where complexity, uncertainty, and incomplete knowledge are acknowledged and management actions are treated as experiments. However, while adaptive management has received significant uptake in theory, it remains elusively difficult to enact in practice. Proponents have blamed social barriers and have called for social science contributions. We address this gap by adopting a qualitative approach to explore the development of an ecological monitoring program within an adaptive management framework in a public land management organization in Australia. We ask what practices are used to enact the monitoring program and how do they shape learning? We elicit a rich narrative through extensive interviews with a key individual, and analyze the narrative using thematic analysis. We discuss our results in relation to the concept of `knowledge work' and Westley's 2002) framework for interpreting the strategies of adaptive managers—`managing through, in, out and up.' We find that enacting the program is conditioned by distinct and sometimes competing logics—scientific logics prioritizing experimentation and learning, public logics emphasizing accountability and legitimacy, and corporate logics demanding efficiency and effectiveness. In this context, implementing adaptive management entails practices of translation to negotiate tensions between objective and situated knowledge, external experts and organizational staff, and collegiate and hierarchical norms. Our contribution embraces the `doing' of learning-by-doing and marks a shift from conceptualizing the social as an external barrier to adaptive management to be removed to an approach that situates adaptive management as social knowledge practice.
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Research culture and capacity in community health services: results of a structured survey of staff.
Friesen, Emma L; Comino, Elizabeth J
2017-05-01
Developing research capacity is recognised as an important endeavour. However, little is known about the current research culture, capacity and supports for staff working in community-based health settings. A structured survey of Division of Community Health staff was conducted using the research capacity tool. The survey was disseminated by email and in paper format. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed thematically. In total, 109 usable responses were received, giving a response rate of 26%. Respondents were predominately nurses (n=71, 65.7%), with ~50% reporting post-graduate vocational qualifications. The highest levels of skills or organisational success were in using evidence to plan, promote and guide clinical practice. Most participants were unsure of organisational and team level skills and success at generating research. Few reported recent experience in research-generating activities. Barriers to undertaking research included lack of skills, time and access to external support and funding. Lack of skills and success in accessing external funding and resources to protect research time or to 'buy-in' technical expertise appeared to exacerbate these barriers. Community health staff have limited capacity to generate research with current levels of skill, funding and time. Strategies to increase research capacity should be informed by knowledge of clinicians' research experience and interests, and target development of skills to generate research. Resources and funding are needed at the organisational and team levels to overcome the significant barriers to research generation reported.
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Rethinking Social Barriers to Effective Adaptive Management.
West, Simon; Schultz, Lisen; Bekessy, Sarah
2016-09-01
Adaptive management is an approach to environmental management based on learning-by-doing, where complexity, uncertainty, and incomplete knowledge are acknowledged and management actions are treated as experiments. However, while adaptive management has received significant uptake in theory, it remains elusively difficult to enact in practice. Proponents have blamed social barriers and have called for social science contributions. We address this gap by adopting a qualitative approach to explore the development of an ecological monitoring program within an adaptive management framework in a public land management organization in Australia. We ask what practices are used to enact the monitoring program and how do they shape learning? We elicit a rich narrative through extensive interviews with a key individual, and analyze the narrative using thematic analysis. We discuss our results in relation to the concept of 'knowledge work' and Westley's (2002) framework for interpreting the strategies of adaptive managers-'managing through, in, out and up.' We find that enacting the program is conditioned by distinct and sometimes competing logics-scientific logics prioritizing experimentation and learning, public logics emphasizing accountability and legitimacy, and corporate logics demanding efficiency and effectiveness. In this context, implementing adaptive management entails practices of translation to negotiate tensions between objective and situated knowledge, external experts and organizational staff, and collegiate and hierarchical norms. Our contribution embraces the 'doing' of learning-by-doing and marks a shift from conceptualizing the social as an external barrier to adaptive management to be removed to an approach that situates adaptive management as social knowledge practice.
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Chelvakumar, Gayathri; Ford, Nancy; Kapa, Hillary M; Lange, Hannah L H; McRee, Annie-Laurie; Bonny, Andrea E
2017-06-01
Homeless and runaway youth are at disproportionate risk for adverse health outcomes. Many barriers to accessing healthcare have been documented; however, the relative impact of discrete barriers on homeless youth healthcare utilization behavior is not firmly established. We administered a survey examining reported barriers and healthcare utilization among adolescents and young adults accessing services at three community centers for homeless and runaway youth. Of 180 respondents, 57 % were male, 80 % non-White, and 21 % identified as a sexual minority. Stepwise logistic regression models, controlling for age and study site, explored associations between barriers and 3 healthcare utilization outcomes (doctor visit in past 12 months; regular care provider; frequent emergency department (ED) visits). The most commonly reported barriers were "don't have a ride" (27.2 %), "no insurance" (23.3 %), and "costs too much" (22.8 %). All fear-based barriers (e.g., "I don't trust the doctors") were reported by <5 % of surveyed youth. Significant predictors of having seen a doctor in the past 12 months included sexual minority status (OR 2.8, p = 0.04) and possession of health insurance (OR 4.9, p < 0.001). Female sex (OR 5.2, p < 0.001) and reported external barriers other than health insurance (OR 0.2, p < 0.001) were associated with having a regular care provider. Fear-based concerns were associated (OR 3.8, p = 0.02) with frequent ED visits, as was being insured (OR 2.2, p = 0.03). These results underscore the need to clearly define healthcare outcomes when investigating barriers to care among homeless and runaway youth as the impact of discrete barriers varies depending on outcome of focus.
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Fernando, Antonio T; Consedine, Nathan S
2017-06-01
Compassion is an expectation of patients, regulatory bodies, and physicians themselves. Most research has, however, studied compassion fatigue rather than compassion itself and has concentrated on the role of the physician. The Transactional Model of Physician Compassion suggests that physician, patient, external environment, and clinical factors are all relevant. Because these factors vary both across different specialities and among physicians with differing degrees of experience, barriers to compassion are also likely to vary. We describe barriers to physician compassion as a function of specialization (psychiatry, general practice, surgery, internal medicine, and pediatrics) and physician experience. We used a cross-sectional study using demographic data, specialization, practice parameters, and the Barriers to Physician Compassion Questionnaire. Nonrandom convenience sampling was used to recruit 580 doctors, of whom 444 belonged to the targeted speciality groups. The sample was characterized before conducting a factorial Multivariate Analysis of Covariance and further post hoc analyses. A 5 (speciality grouping) × 2 (more vs. less physician experience) Multivariate Analysis of Covariance showed that the barriers varied as a function of both speciality and experience. In general, psychiatrists reported lower barriers, whereas general practitioners and internal medicine specialists generally reported greater barriers. Barriers were generally greater among less experienced doctors. Documenting and investigating barriers to compassion in different speciality groups have the potential to broaden current foci beyond the physician and inform interventions aimed at enhancing medical compassion. In addition, certain aspects of the training or practice of psychiatry that enhance compassion may mitigate barriers to compassion in other specialities. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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School as a Loosely Coupled Organization? An Empirical Examination Using National SASS 2003-04 Data
ERIC Educational Resources Information Center
Shen, Jianping; Gao, Xingyuan; Xia, Jiangang
2017-01-01
The notion of schools as "loosely coupled" organizations has been widely discussed in the research literature. Many argue it is either a protective mechanism for schools to buffer external pressure or a barrier for implementing new reforms. Against the backdrop of systemic change and accountability, we applied a two-level hierarchical…
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ERIC Educational Resources Information Center
Cassell, Aba DeLynda
2012-01-01
Female student affairs leaders who also have family responsibilities find that a primary challenge they encounter is society's expectations concerning their roles and responsibilities in both realms. Research discovers that women experience internal and external barriers that hinder their advancement opportunities however; women's…
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Defense.gov - Special Report - Fall of the Berlin Wall - 20th Anniversary
barrier followed. On Nov. 9, 1989, after East Germany promised greater freedom of travel, protestors . The Iron Curtain that divided Europe for decades finally fell, ushering in a new era of freedom and Berlin visit. June 12, 1987 About This Site Freedom of Information Privacy & Security External Link
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USDA-ARS?s Scientific Manuscript database
The intestinal epithelium is a critical barrier between the internal and external milieux of the mammalian host. Epithelial interactions between these two host environments have been shown to be modulated by several different, cross-communicating cell types residing in the gut mucosa. These includ...
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USDA-ARS?s Scientific Manuscript database
The intestinal epithelium is a critical barrier between the internal and external milieux of the mammalian host. Epithelial interactions between these two host environments have been shown to be modulated by several different, cross-communicating cell types residing in the gut mucosa. These include ...
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Success in Gateway Business Courses: What Matters and What Can We Do?
ERIC Educational Resources Information Center
Berry, Tom; Cook, Lori; Hill, Nancy Thorley; Stevens, Kevin T.
2013-01-01
Introductory business classes, particularly those with a quantitative emphasis, can often serve as a barrier to students rather than as a gateway. This study looks at how study skills, aptitude, and external factors affect classroom performance. We examine whether, when, how, and how much students read their textbook. We also look at selected deep…
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Issues in healthcare services in Malaysia as experienced by Japanese retirees.
Kohno, Ayako; Musa, Ghazali; Nik Farid, Nik Daliana; Abdul Aziz, Norlaili; Nakayama, Takeo; Dahlui, Maznah
2016-05-05
Worldwide, international retirement migration is growing in its popularity and Japanese retirees choose Malaysia as their most preferred destination. This study examines the pertinent issues related to healthcare services as experienced by Japanese retirees in this country. From January to March 2015, we conducted focus group discussions with 30 Japanese retirees who live in Kuala Lumpur and Ipoh. Guided by the social-ecological model, we discovered seven pertinent themes: 'language barriers','healthcare decisions', 'medical check-ups','healthcare insurance', 'nursing and palliative care', 'trust and distrust of healthcare services', and 'word-of-mouth information'. We identified seven pertinent issues related to healthcare services among Japanese retirees in Malaysia, of which four are especially important. These issues are explained as integrated themes within the social-ecological model. Language barriers prohibit them from having difficulty accessing to healthcare in Malaysia, but lack of will to improve their language skills exist among them. For that reason, they rely heavily on word-of-mouth information when seeking for healthcare. As a consequence, some develop feelings of trust and distrust of healthcare services. In addition, we have identified the needs for provide nursing and palliative care among Japanese retirees in Malaysia. Based on the magnitude of the discussion, we concluded that there are four crucial healthcare issues among Japanese retirees; 'language barriers', 'trust and distrust of healthcare services', 'word-of-mouth information' and 'nursing and palliative care'. We propose that further dialogue by healthcare stakeholders should be carried out to improve further the healthcare service provisions for Japanese retirees in Malaysia.
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Smith, Kylie M; Crookes, Patrick A; Else, Fabienne; Crookes, Ellie
2012-03-01
This paper discusses the issues facing the nursing academic workforce and the development of a project at the University of Wollongong in Australia which attempts to address this problem. The project draws on Boyer's work around 'scholarship reconsidered' to enable new ways of thinking about the nature of 'research' and how the work of a diversifying workforce can be recognized and rewarded within institutions. We conducted a series of interviews with senior university staff to identify key issues around academic promotion processes. Feedback from these interviews, along with extensive internal and external consultation and benchmarking, will be used to redraft promotion documentation that includes discipline-specific performance expectations. Interviews revealed a number of perceived and actual barriers to promotion of academic staff who did not conform to a 'traditional' view of research expectations. It was widely felt that unspoken expectations about research performance were being used to judge applications for promotion, and that this disadvantaged people from practice or professional backgrounds, or people who had heavy administrative or clinical roles. Internal university processes need to reflect the reality of a diversified workforce. Practice and professional disciplines have responsibilities beyond meeting traditional research output measurements. More flexible and transparent expectation guidelines and career development pathways are needed to build holistic schools and faculty and enable maximum staff productivity. By redefining scholarship, schools and faculties are able to meet the multiple demands of the government, the institution, individual staff, students and the profession. Not everyone can do traditional research all the time, and staff involved in other scholarly work should be able to rewarded and promoted. By taking the lead in this issue, nursing as a discipline can set its own agenda, and pave the way for other disciplines. It can also go a long way to solving issues around the dwindling academic workforce. © 2012 Blackwell Publishing Ltd.
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Barriers and Motives to PA in South Asian Indian Immigrant Women.
Daniel, Manju; Abendroth, Maryann; Erlen, Judith A
2017-03-01
The high prevalence of chronic illnesses in South Asian Indian immigrant women underscores the need for identifying factors that could influence their PA. The purpose of this qualitative study was to examine the perspectives of South Asian Indian immigrant women related to barriers to and motives for lifestyle PA within the PA Framework for South Asian Indian Immigrants. Forty women participated in focus groups that were conducted in English and Hindi. Focus group questions were open-ended and semistructured. Transcribed and de-identified audiotaped sessions were coded and analyzed using Atlas.ti software. Role expectation was a core theme for barriers with four subthemes: lack of time, loss of interest, diminished social support, and environmental constraints. Self-motivation was a core theme for motives with three subthemes: optimal physical and psychological health, emphasis on external beauty, and strong social support. Future PA interventions need to target these culturally sensitive factors.
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On the mechanism of pattern formation in glow dielectric barrier discharge
DOE Office of Scientific and Technical Information (OSTI.GOV)
Qiao, Yajun; Li, Ben; Ouyang, Jiting, E-mail: jtouyang@bit.edu.cn
2016-01-15
The formation mechanism of pattern in glow dielectric barrier discharge is investigated by two-dimensional fluid modeling. Experimental results are shown for comparison. The simulation results show that the non-uniform distribution of space charges makes the discharge be enhanced in the high-density region but weakened in its neighborhood, which is considered as an activation-inhibition effect. This effect shows through during a current pulse (one discharge event) but also in a certain period of time after discharge that determines a driving frequency range for the non-uniformity of space charges to be enhanced. The effects of applied voltage, surface charge, electrode boundary, andmore » external field are also discussed. All these factors affect the formation of dielectric-barrier-discharge pattern by changing the distribution or the dynamics of space charges and hence the activation-inhibition effect of non-uniform space charges.« less
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Das, Bhibha M; Evans, Ellen M
2014-01-01
To examine weight management barriers, using the Health Belief Model, in first-year college students. First-year college students (n = 45), with data collected in April, May, and November 2013. Nominal group technique sessions (n = 8) were conducted. First-year students recognize benefits to weight management beyond physical attractiveness to quality-of-life domains, including social (eg, bonding opportunities and energy to socially engage) and mental health (eg, stress management). Men believe that weight management is important for career/financial reasons, whereas women voiced that it will allow them to live a full, independent life with a high level of multitasking. Men believed that their barriers were external (eg, campus resources/programs), whereas females perceived their barriers to be internal (eg, poor time management). College students are challenged by weight management and want the institution to provide resources, including curriculum, to help them manage their physical activity and nutrition behaviors.
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NASA Astrophysics Data System (ADS)
Li, Wei; Wang, Tian-Xing; Dai, Xian-Qi; Wang, Xiao-Long; Ma, Ya-Qiang; Chang, Shan-Shan; Tang, Ya-Nan
2017-04-01
Using density functional theory calculations, we investigate the electronic properties of arsenene/graphene van der Waals (vdW) heterostructures by applying external electric field perpendicular to the layers. It is demonstrated that weak vdW interactions dominate between arsenene and graphene with their intrinsic electronic properties preserved. We find that an n-type Schottky contact is formed at the arsenene/graphene interface with a Schottky barrier of 0.54 eV. Moreover, the vertical electric field can not only control the Schottky barrier height but also the Schottky contacts (n-type and p-type) and Ohmic contacts (n-type) at the interface. Tunable p-type doping in graphene is achieved under the negative electric field because electrons can transfer from the Dirac point of graphene to the conduction band of arsenene. The present study would open a new avenue for application of ultrathin arsenene/graphene heterostructures in future nano- and optoelectronics.
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Wildenbos, G A; Peute, Linda; Jaspers, Monique
2018-06-01
With the growing population of older adults as a potential user group of mHealth, the need increases for mHealth interventions to address specific aging characteristics of older adults. The existence of aging barriers to computer use is widely acknowledged. Yet, usability studies show that mHealth still fails to be appropriately designed for older adults and their expectations. To enhance designs of mHealth aimed at older adult populations, it is essential to gain insight into aging barriers that impact the usability of mHealth as experienced by these adults. This study aims to synthesize literature on aging barriers to digital (health) computer use, and explain, map and visualize these barriers in relation to the usability of mHealth by means of a framework. We performed a scoping review to synthesize and summarize reported physical and functional age barriers in relation to digital (mobile) health applications use. Aging barriers reported in the literature were mapped onto usability aspects categorized by Nielsen to explain their influence on user experience of mHealth. A framework (MOLD-US) was developed summarizing the evidence on the influence of aging barriers on mHealth use experienced by older adults. Four key categories of aging barriers influencing usability of mHealth were identified: cognition, motivation, physical ability and perception. Effective and satisfactory use of mHealth by older adults is complicated by cognition and motivation barriers. Physical ability and perceptual barriers further increase the risk of user errors and fail to notice important interaction tasks. Complexities of medical conditions, such as diminished eye sight related to diabetes or deteriorated motor skills as a result of rheumatism, can cause errors in user interaction. This research provides a novel framework for the exploration of aging barriers and their causes influencing mHealth usability in older adults. This framework allows for further systematic empirical testing and analysis of mHealth usability issues, as it enables results to be classified and interpreted based on impediments intrinsic to usability issues experienced by older adults. Importantly, the paper identifies a key need for future research on motivational barriers impeding mhealth use of older adults. More insights are needed in particular to disaggregating normal age related functional changes from specific medical conditions that influence experienced usefulness of mHealth by these adults. Copyright © 2018 Elsevier B.V. All rights reserved.
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Why physicians and nurses ask (or don't) about partner violence: a qualitative analysis.
Beynon, Charlene E; Gutmanis, Iris A; Tutty, Leslie M; Wathen, C Nadine; MacMillan, Harriet L
2012-06-21
Intimate partner violence (IPV) against women is a serious public health issue and is associated with significant adverse health outcomes. The current study was undertaken to: 1) explore physicians' and nurses' experiences, both professional and personal, when asking about IPV; 2) determine the variations by discipline; and 3) identify implications for practice, workplace policy and curriculum development. Physicians and nurses working in Ontario, Canada were randomly selected from recognized discipline-specific professional directories to complete a 43-item mailed survey about IPV, which included two open-ended questions about barriers and facilitators to asking about IPV. Text from the open-ended questions was transcribed and analyzed using inductive content analysis. In addition, frequencies were calculated for commonly described categories and the Fisher's Exact Test was performed to determine statistical significance when examining nurse/physician differences. Of the 931 respondents who completed the survey, 769 (527 nurses, 238 physicians, four whose discipline was not stated) provided written responses to the open-ended questions. Overall, the top barriers to asking about IPV were lack of time, behaviours attributed to women living with abuse, lack of training, language/cultural practices and partner presence. The most frequently reported facilitators were training, community resources and professional tools/protocols/policies. The need for additional training was a concern described by both groups, yet more so by nurses. There were statistically significant differences between nurses and physicians regarding both barriers and facilitators, most likely related to differences in role expectations and work environments. This research provides new insights into the complexities of IPV inquiry and the inter-relationships among barriers and facilitators faced by physicians and nurses. The experiences of these nurses and physicians suggest that more supports (e.g., supportive work environments, training, mentors, consultations, community resources, etc.) are needed by practitioners. These findings reflect the results of previous research yet offer perspectives on why barriers persist. Multifaceted and intersectoral approaches that address individual, interpersonal, workplace and systemic issues faced by nurses and physicians when inquiring about IPV are required. Comprehensive frameworks are needed to further explore the many issues associated with IPV inquiry and the interplay across these issues.
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Why physicians and nurses ask (or don’t) about partner violence: a qualitative analysis
2012-01-01
Background Intimate partner violence (IPV) against women is a serious public health issue and is associated with significant adverse health outcomes. The current study was undertaken to: 1) explore physicians’ and nurses’ experiences, both professional and personal, when asking about IPV; 2) determine the variations by discipline; and 3) identify implications for practice, workplace policy and curriculum development. Methods Physicians and nurses working in Ontario, Canada were randomly selected from recognized discipline-specific professional directories to complete a 43-item mailed survey about IPV, which included two open-ended questions about barriers and facilitators to asking about IPV. Text from the open-ended questions was transcribed and analyzed using inductive content analysis. In addition, frequencies were calculated for commonly described categories and the Fisher’s Exact Test was performed to determine statistical significance when examining nurse/physician differences. Results Of the 931 respondents who completed the survey, 769 (527 nurses, 238 physicians, four whose discipline was not stated) provided written responses to the open-ended questions. Overall, the top barriers to asking about IPV were lack of time, behaviours attributed to women living with abuse, lack of training, language/cultural practices and partner presence. The most frequently reported facilitators were training, community resources and professional tools/protocols/policies. The need for additional training was a concern described by both groups, yet more so by nurses. There were statistically significant differences between nurses and physicians regarding both barriers and facilitators, most likely related to differences in role expectations and work environments. Conclusions This research provides new insights into the complexities of IPV inquiry and the inter-relationships among barriers and facilitators faced by physicians and nurses. The experiences of these nurses and physicians suggest that more supports (e.g., supportive work environments, training, mentors, consultations, community resources, etc.) are needed by practitioners. These findings reflect the results of previous research yet offer perspectives on why barriers persist. Multifaceted and intersectoral approaches that address individual, interpersonal, workplace and systemic issues faced by nurses and physicians when inquiring about IPV are required. Comprehensive frameworks are needed to further explore the many issues associated with IPV inquiry and the interplay across these issues. PMID:22721371
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Energy barrier analysis of Nd-Fe-B thin films
NASA Astrophysics Data System (ADS)
Goto, R.; Okamoto, S.; Kikuchi, N.; Kitakami, O.
2015-05-01
The magnetization reversal mechanism of a permanent magnet has long been a controversial issue, which is closely related to the so-called coercivity problem. It is well known that the energy barrier for magnetization reversal contains essential information on reversal process. In this study, we propose a method to analyze the energy barrier function for the magnetization reversal. Preferentially (001) oriented Nd-Fe-B films with and without a Nd overlayer are used as model magnets. By combining the magnetic viscosity and time dependent coercivity measurements, the barrier function has been successfully evaluated. As a result, although the Nd-Fe-B films with and without Nd overlayer exhibit different magnetic behaviors, the power indices for their energy barrier are almost the same, suggesting that the magnetization reversal proceeds in a similar mode.
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[Advance in studies on food allergy mechanism based on gut barrier].
Wang, Juan-hong; Li, Huan-zhou; Li, Meng; Pan, Su-hua
2015-04-01
Food allergies, as a type of adverse immune-mediated reactions to ingested food proteins, have become a serious public health issue that harms children and adults health, with increasing incidence year by year. However, without effective therapy for food allergies, doctors-have mostly advised to avoid allergens and provided symptomatic treatment. According to the findings of many studies, allergic diseases are correlated with intestinal barrier function injury, as evidenced by the significant increase in the intestinal permeability among patients with food allergies. In this paper, recent studies on correlations between food allergies and intestinal barrier functions, intestinal barrier function injury mechanisms of allergic foods and food allergy intervention strategies based on intestinal barrier functions were summarized to provide reference for laboratory researches and clinical treatment of food allergic diseases.
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Mental illness-related stigma in healthcare
Mantler, Ed; Szeto, Andrew
2017-01-01
Mental illness-related stigma, including that which exists in the healthcare system and among healthcare providers, creates serious barriers to access and quality care. It is also a major concern for healthcare practitioners themselves, both as a workplace culture issue and as a barrier for help seeking. This article provides an overview of the main barriers to access and quality care created by stigmatization in healthcare, a consideration of contributing factors, and a summary of Canadian-based research into promising practices and approaches to combatting stigma in healthcare environments. PMID:28929889
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Building an award-winning women's health ambulatory service and beyond.
Allen, Lisa W; Maxwell, Susan; Greene, John F
2003-01-01
Many barriers exist for the provision of high-quality health care to inner-city minority women. The barriers include access to care, compliance problems, financial concerns, system navigation issues, as well as language barriers. This article describes the transition of the Women's Ambulatory Health Services at Hartford Hospital from a traditional clinic model to a culturally sensitive private practice model. The road to transition was paved by valuable input from staff as well as patients. The final product was a much more efficient, inviting model that catered to the needs of the community.
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It isn't all about language: communication barriers for Latinas using contraceptives.
Campo, Shelly; Kohler, Connie; Askelson, Natoshia M; Ortiz, Cristina; Losch, Mary
2015-11-01
Little is known about barriers that Latinas in the United States face in preventing unintended pregnancies beyond those of language and cost. This study examined factors inhibiting contraceptive use among 18- to 30-year-old Latinas in the Midwest. Individual interviews (N = 31) were conducted in Spanish with Latinas residing across the state. The interview protocol included questions about contraceptives and unintended pregnancies. Interviews were recorded, transcribed, translated, and coded for themes related to barriers. The majority of the barriers were related to communication but not English proficiency. Respondents talked about specific situations and experiences in which communication presented obstacles to using contraceptives. While language and cost are important barriers, attention needs to be paid to the other communication issues that women face related to culture, religion, partners, family, and spontaneity. Health care providers need to address the range of communication barriers that affect Latinas' contraceptive use. © The Author(s) 2014.
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Is It Possible? Investigating the Influence of External Quality Audit on University Performance
ERIC Educational Resources Information Center
Carr, Sarah; Hamilton, Emma; Meade, Phil
2005-01-01
This paper explores whether it is possible to isolate independent effects of external quality audit (EQA) and concludes that effectiveness evaluations have a stronger foundation when the combined effects of university governance and management initiatives and government initiatives are examined together with EQA. The issue of how successful these…
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ERIC Educational Resources Information Center
Toral, Sergio Luis; Bessis, Nik; Martinez-Torres, Maria del Rocio
2013-01-01
Purpose: During recent decades, research institutions have increased collaboration with other institutions since it is recognized as a good practice that improves their performance. However, they do not usually consider external collaborations as a strategic issue despite their benefits. The purpose of this paper consists of identifying different…
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The Internet as an External Economy: The Emergence of the Invisible Hand.
ERIC Educational Resources Information Center
Brownrigg, Edwin B.
1991-01-01
Discusses the Internet, an interconnected array of scientific research networks. The role of libraries in the Internet is discussed; the Coalition for Networked Information (CNI) and Advanced Network Services (ANS) are described; and economic issues of the Internet are raised, including external economy and public good. (eight references) (LRW)
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-18
... doing internal eddy current inspections, or repairing the crack. As an alternative to the external eddy current inspections, the AD provides for internal eddy current and detailed inspections for cracks in the... 5, 2011, we issued Emergency AD 2011-08-51, which requires repetitive external eddy current...
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NASA Astrophysics Data System (ADS)
Lebiedz, Dirk; Brandt-Pollmann, Ulrich
2004-09-01
Specific external control of chemical reaction systems and both dynamic control and signal processing as central functions in biochemical reaction systems are important issues of modern nonlinear science. For example nonlinear input-output behavior and its regulation are crucial for the maintainance of the life process that requires extensive communication between cells and their environment. An important question is how the dynamical behavior of biochemical systems is controlled and how they process information transmitted by incoming signals. But also from a general point of view external forcing of complex chemical reaction processes is important in many application areas ranging from chemical engineering to biomedicine. In order to study such control issues numerically, here, we choose a well characterized chemical system, the CO oxidation on Pt(110), which is interesting per se as an externally forced chemical oscillator model. We show numerically that tuning of temporal self-organization by input signals in this simple nonlinear chemical reaction exhibiting oscillatory behavior can in principle be exploited for both specific external control of dynamical system behavior and processing of complex information.
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ERIC Educational Resources Information Center
Baker, Cheryl B.
2011-01-01
Rural educators face many barriers when trying to participate in high quality professional development, including isolation, funding issues, distance, and lack of temporary replacements. Technological solutions can assist rural educators in overcoming these barriers. Participating in on-line professional learning communities can provide New…
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ERIC Educational Resources Information Center
Zanjani, Faika; Rowles, Graham D.
2012-01-01
Geographical, economic, social and cultural barriers to accessing services in rural areas are widely reported. Less widely discussed are dilemmas posed by individual and community reluctance to address sensitive health issues. This article, focusing on the highly sensitive area of mental health, and employing a participatory action approach,…
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ERIC Educational Resources Information Center
Roll-Pettersson, Lise; Olsson, Ingrid; Ala'i-Rosales, Shahla
2016-01-01
The present study examined proximal and distal barriers and supports within the Swedish service system that may affect implementation of early and intensive behavioral intervention (EIBI) for children with autism. A case study approach with roots in ethnography was chosen to explore this issue. Two preschools exemplifying "high quality…
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The relationship between skin function, barrier properties, and body-dependent factors.
Dąbrowska, A K; Spano, F; Derler, S; Adlhart, C; Spencer, N D; Rossi, R M
2018-05-01
Skin is a multilayer interface between the body and the environment, responsible for many important functions, such as temperature regulation, water transport, sensation, and protection from external triggers. This paper provides an overview of principal factors that influence human skin and describes the diversity of skin characteristics, its causes and possible consequences. It also discusses limitations in the barrier function of the skin, describing mechanisms of absorption. There are a number of in vivo investigations focusing on the diversity of human skin characteristics with reference to barrier properties and body-dependent factors. Skin properties vary among individuals of different age, gender, ethnicity, and skin types. In addition, skin characteristics differ depending on the body site and can be influenced by the body-mass index and lifestyle. Although one of the main functions of the skin is to act as a barrier, absorption of some substances remains possible. Various factors can alter human skin properties, which can be reflected in skin function and the quality of everyday life. Skin properties and function are strongly interlinked. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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The electrical characteristics of the dielectric barrier discharges
DOE Office of Scientific and Technical Information (OSTI.GOV)
Yehia, Ashraf, E-mail: yehia30161@yahoo.com; Department of Physics, Faculty of Science, Assiut University, Assiut 71516
2016-06-15
The electrical characteristics of the dielectric barrier discharges have been studied in this paper under different operating conditions. The dielectric barrier discharges were formed inside two reactors composed of electrodes in the shape of two parallel plates. The dielectric layers inside these reactors were pasted on the surface of one electrode only in the first reactor and on the surfaces of the two electrodes in the second reactor. The reactor under study has been fed by atmospheric air that flowed inside it with a constant rate at the normal temperature and pressure, in parallel with applying a sinusoidal ac voltagemore » between the electrodes of the reactor. The amount of the electric charge that flows from the reactors to the external circuit has been studied experimentally versus the ac peak voltage applied to them. An analytical model has been obtained for calculating the electrical characteristics of the dielectric barrier discharges that were formed inside the reactors during a complete cycle of the ac voltage. The results that were calculated by using this model have agreed well with the experimental results under the different operating conditions.« less
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Spin Transfer Torque in Graphene
NASA Astrophysics Data System (ADS)
Lin, Chia-Ching; Chen, Zhihong
2014-03-01
Graphene is an idea channel material for spin transport due to its long spin diffusion length. To develop graphene based spin logic, it is important to demonstrate spin transfer torque in graphene. Here, we report the experimental measurement of spin transfer torque in graphene nonlocal spin valve devices. Assisted by a small external in-plane magnetic field, the magnetization reversal of the receiving magnet is induced by pure spin diffusion currents from the injector magnet. The magnetization switching is reversible between parallel and antiparallel configurations by controlling the polarity of the applied charged currents. Current induced heating and Oersted field from the nonlocal charge flow have also been excluded in this study. Next, we further enhance the spin angular momentum absorption at the interface of the receiving magnet and graphene channel by removing the tunneling barrier in the receiving magnet. The device with a tunneling barrier only at the injector magnet shows a comparable nonlocal spin valve signal but lower electrical noise. Moreover, in the same preset condition, the critical charge current density for spin torque in the single tunneling barrier device shows a substantial reduction if compared to the double tunneling barrier device.
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Smith, I M; Baker, A; Arneborg, N; Jespersen, L
2015-11-01
The human gastrointestinal epithelium makes up the largest barrier separating the body from the external environment. Whereas invasive pathogens cause epithelial barrier disruption, probiotic micro-organisms modulate tight junction regulation and improve epithelial barrier function. In addition, probiotic strains may be able to reduce epithelial barrier disruption caused by pathogenic species. The aim of this study was to explore non-Saccharomyces yeast modulation of epithelial cell barrier function in vitro. Benchmarking against established probiotic strains, we evaluated the ability of four nonpathogenic yeast species to modulate transepithelial electrical resistance (TER) across a monolayer of differentiated human colonocytes (Caco-2 cells). Further, we assessed yeast modulation of a Salmonella Typhimurium-induced epithelial cell barrier function insult. Our findings demonstrate distinct patterns of non-Saccharomyces yeast modulation of epithelial cell barrier function. While the established probiotic yeast Saccharomyces boulardii increased TER across a Caco-2 monolayer by 30%, Kluyveromyces marxianus exhibited significantly stronger properties of TER enhancement (50% TER increase). In addition, our data demonstrate significant yeast-mediated modulation of Salmonella-induced epithelial cell barrier disruption and identify K. marxianus and Metschnikowia gruessii as two non-Saccharomyces yeasts capable of protecting human epithelial cells from pathogen invasion. This study demonstrates distinct patterns of non-Saccharomyces yeast modulation of epithelial cell barrier function in vitro. Further, our data demonstrate significant yeast-mediated modulation of Salmonella Typhimurium-induced epithelial cell barrier disruption and identify Kluyveromyces marxianus and Metschnikowia gruessii as two non-Saccharomyces yeasts capable of protecting human epithelial cells from pathogen invasion. This study is the first to demonstrate significant non-Saccharomyces yeast-mediated epithelial cell barrier protection from Salmonella invasion, thus encouraging future efforts aimed at confirming the observed effects in vivo and driving further strain development towards novel yeast probiotics. © 2015 The Society for Applied Microbiology.
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NASA Astrophysics Data System (ADS)
Chang, H. L.; Zhuang, W. Z.; Huang, W. C.; Huang, J. Y.; Huang, K. F.; Chen, Y. F.
2011-09-01
We report on a widely tunable passively Q-switched photonic crystal fiber (PCF) laser with wavelength tuning range up to 80 nm. The PCF laser utilizes an AlGaInAs quantum well/barrier structure as a saturable absorber and incorporates an external-cavity optical parametric oscillator (OPO) to achieve wavelength conversion. Under a pump power of 13.1 W at 976 nm, the PCF laser generated 1029-nm radiation with maximum output energy of 750 μJ and was incident into an external-cavity OPO. The output energy and peak power of signal wave was found to be 138 μJ and 19 kW, respectively. By tuning the temperature of nonlinear crystal, periodically poled lithium niobate (PPLN), in the OPO, the signal wavelength in eye-safe regime from 1513 to 1593 nm was obtained.
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Barriers to health care for people with hearing loss: a review of the literature.
Scheier, Donna B
2009-01-01
Deaf individuals face many barriers when trying to access health care. The reasons why barriers are encountered, difficulties met as a result of the barriers, and ways that health professionals and others working with deaf people can overcome obstacles are included in this review of the literature. A brief summary of Deaf culture and history gives background information to better understand the problems. Misunderstandings by d/Deaf patients and hearing health professionals are addressed, as well as issues related to medical interpreters. This paper aims to make health professionals more aware of the needs and cultural differences that must be considered when providing care to the d/Deaf population.
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Kocman, Andreas; Fischer, Linda; Weber, Germain
2018-01-01
Obtaining employment is among the most important ambitions of people with intellectual disability. Progress towards comprehensive inclusive employment is hampered by numerous barriers. Limited research is available on these barriers and strategies to overcome them. A mixed method approach in a sample of 30 HR-managers was used to assess (i) differences in perceived barriers for employment of people with specific disabilities and mental disorders; (ii) barriers specific to employing people with intellectual disability; (iii) strategies to overcome these barriers. Employers perceive more barriers for hiring people with intellectual disability and mental disorders than for physical disabilities. Employment for this population is hampered by a perceived lack of skills and legal issues. Strategies perceived as beneficial are supplying information, changes in organizational strategies and legal changes. Employers' differentiated expectations and reservations towards hiring individuals with specific disabilities need to be taken into account to increase employment for people with intellectual disability. © 2017 John Wiley & Sons Ltd.
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Sexual Harassment and Dual-Career Issues: The Case of Megan.
ERIC Educational Resources Information Center
Perrone, Kristin M.
2002-01-01
Presents a case example of an application of an ecological model of career development in a woman with sexual harassment issues in the workplace and challenges related to being part of a dual-career marriage. Suggests career counseling strategies and discusses potential barriers to effective counseling. (GCP)
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Avoiding the Issue of Gender in Japanese Science Education
ERIC Educational Resources Information Center
Scantlebury, Kathryn; Baker, Dale; Sugi, Ayumi; Yoshida, Atsushi; Uysal, Sibel
2007-01-01
This paper describes how the patriarchal structure of Japanese society and its notions of women, femininity, and gendered stereotypes produced strong cultural barriers to increasing the participation of females in science education. Baseline data on attitudes toward science and the perceptions of gender issues in science education, academic major…
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[Liquidation of barriers: realization issues and legislative aspects].
Półchłopek, T
1998-01-01
Designing for the handicapped persons, aiming at the liquidation of the barriers is actually an essential part of the architects activity. It results from the fact that the handicapped persons issue became the interdisciplinary one. The architect, being responsible for the living space and environment creation, is to design the friendly environment for the handicapped persons. The space favourable for the handicapped is favourable for all. There are many aspects of the designing for the handicapped; legislative or execution issues are the examples. The legislative aspect is presented in this paper on the base of the contemporary legal rules of the Polish Republic, whereas the execution aspect is introduced and discussed on the basis of the two projects designed by the Design Bureau in Cracow and being currently in realization. These are: housing & service unit (Boruty-Spiechowicza Str., Cracow) and the Faculty of Philosophy complex at the Jesuits College (Kopernika Str., Cracow).
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Checchia, Carmen; Badura-Lotter, Gisela; Kilian, Reinhold; Becker, Thomas; Krumm, Silvia
2016-11-01
Study aims: Analysis of mental health professionals' attitudes to reproductive issues among psychiatric patients. Method: 31 problem-centered semi-structured interviews with psychiatric professionals were conducted and analyzed by content analysis methods. Results: Outside of psychotherapeutic treatment the desire for children is generally assessed as less important in the context of mental health care, it is often limited to effective birth control with regard to drug treatment. Mental health professionals perceive moral concerns, lack of expertise among professionals and individual doubts as barriers when dealing with reproductive issues. Discussion: In order to meet psychiatric patients' reproductive needs, perceptions of barriers among mental health professionals in dealing with reproductive issues should be reflected and discussed. Recommendations could support professionals and help ensure adequate support for psychiatric patients. © Georg Thieme Verlag KG Stuttgart · New York.
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Supporting patients with mental illness: Deconstructing barriers to community pharmacist access.
Calogero, Samantha; Caley, Charles F
To discuss the barriers faced by individuals with mental health conditions attempting to access their community pharmacists and to propose solutions toward deconstructing those barriers. Given the prevalence of mental illness and the frequency at which psychotropic medications are dispensed, community pharmacists have a daily opportunity to engage patients with mental illness and be active participants in community-based mental health care. Yet multiple barriers affect patient access to community pharmacists. Some barriers, such as heavy dispensing workload, can be considered as "external" to the pharmacist. Other barriers, such as negative attitudes about mental illness, are considered to be "internal." Research about mental illness stigma in pharmacy often reports that community pharmacists are uncomfortable with, or have little time for, mental health patients. Patients also report experiencing stigma from pharmacists and pharmacy staff. Expanded efforts are needed by the pharmacy profession to deconstruct barriers that patients with mental illness are faced with in community pharmacy, especially related to stigma. Specifically, these efforts should include critically evaluating and addressing the quality of didactic and experiential opportunities in psychiatric pharmacotherapy for pharmacy students, transforming the physical layout of community pharmacies to offer true counseling privacy, educating community pharmacists and pharmacy staff about mental illness, and educating patients about what to expect from community pharmacists. There are opportunities for community pharmacy to improve its impact on mental health treatment outcomes by resolving mental illness stigma and other barriers that prevent patients with mental illness from accessing their community pharmacist. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
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Malaria vaccine development and how external forces shape it: an overview.
Lorenz, Veronique; Karanis, Gabriele; Karanis, Panagiotis
2014-06-30
The aim of this paper is to analyse the current status and scientific value of malaria vaccine approaches and to provide a realistic prognosis for future developments. We systematically review previous approaches to malaria vaccination, address how vaccine efforts have developed, how this issue may be fixed, and how external forces shape vaccine development. Our analysis provides significant information on the various aspects and on the external factors that shape malaria vaccine development and reveal the importance of vaccine development in our society.
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Cleavage of transmembrane junction proteins and their role in regulating epithelial homeostasis
Nava, Porfirio; Kamekura, Ryuta; Nusrat, Asma
2013-01-01
Epithelial tissues form a selective barrier that separates the external environment from the internal tissue milieu. Single epithelial cells are densely packed and associate via distinct intercellular junctions. Intercellular junction proteins not only control barrier properties of the epithelium but also play an important role in regulating epithelial homeostasis that encompasses cell proliferation, migration, differentiation and regulated shedding. Recent studies have revealed that several proteases target epithelial junction proteins during physiological maturation as well as in pathologic states such as inflammation and cancer. This review discusses mechanisms and biological consequences of transmembrane junction protein cleavage. The influence of junction protein cleavage products on pathogenesis of inflammation and cancer is discussed. PMID:24665393
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Mechanically flexible organic electroluminescent device with directional light emission
Duggal, Anil Raj; Shiang, Joseph John; Schaepkens, Marc
2005-05-10
A mechanically flexible and environmentally stable organic electroluminescent ("EL") device with directional light emission comprises an organic EL member disposed on a flexible substrate, a surface of which is coated with a multilayer barrier coating which includes at least one sublayer of a substantially transparent organic polymer and at least one sublayer of a substantially transparent inorganic material. The device includes a reflective metal layer disposed on the organic EL member opposite to the substrate. The reflective metal layer provides an increased external quantum efficiency of the device. The reflective metal layer and the multilayer barrier coating form a seal around the organic EL member to reduce the degradation of the device due to environmental elements.
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Modeling the migration of platinum nanoparticles on surfaces using a kinetic Monte Carlo approach
Li, Lin; Plessow, Philipp N.; Rieger, Michael; ...
2017-02-15
We propose a kinetic Monte Carlo (kMC) model for simulating the movement of platinum particles on supports, based on atom-by-atom diffusion on the surface of the particle. The proposed model was able to reproduce equilibrium cluster shapes predicted using Wulff-construction. The diffusivity of platinum particles was simulated both purely based on random motion and assisted using an external field that causes a drift velocity. The overall particle diffusivity increases with temperature; however, the extracted activation barrier appears to be temperature independent. Additionally, this barrier was found to increase with particle size, as well as, with the adhesion between the particlemore » and the support.« less
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Threshold self-powered gamma detector for use as a monitor of power in a nuclear reactor
LeVert, Francis E.; Cox, Samson A.
1978-01-01
A self-powered gamma monitor for placement near the core of a nuclear reactor comprises a lead prism surrounded by a coaxial thin nickel sheet, the combination forming a collector. A coaxial polyethylene electron barrier encloses the collector and is separated from the nickel sheet by a vacuum region. The electron barrier is enclosed by a coaxial stainless steel emitter which, in turn, is enclosed within a lead casing. When the detector is placed in a flux of gamma rays, a measure of the current flow in an external circuit between emitter and collector provides a measure of the power level of the reactor.
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NASA Astrophysics Data System (ADS)
Rubinstein, Dorit
2007-12-01
This dissertation examines how administrative agencies deal with multiple and conflicting accountability pressures. Drawing on an empirical study of six agencies, the telecommunications and electricity regulators of the UK, France and Sweden, it describes how the agencies legitimized their behavior in relation to three major issues, network pricing, universal service and retail competition. I find that agencies use different forms of accountability in different circumstances, and suggest a classification of accountability strategies along two dimensions: internalizing v. externalizing authority, and the breadth of the target audience. What explains variations along these dimensions is the task characteristics of the issue an agency is dealing with, and specifically, its informational aspects and the degree of political controversy associated with it. The more an issue requires expertise, the more an agency will seek to rely on its professional judgment. The more an issue can be addressed only in terms of the values surrounding it, the more an agency will seek to externalize authority and defer to other actors. Also, the more politically controversial an issue, the broader the target audience before whom an agency will try to justify itself.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Smith, F.; Brown, K.; Flach, G.
The goal of the Cementitious Barriers Partnership (CBP) is to develop a reasonable and credible set of software tools to predict the structural, hydraulic, and chemical performance of cement barriers used in nuclear applications over extended time frames (greater than 100 years for operating facilities and greater than 1000 years for waste management). The simulation tools will be used to evaluate and predict the behavior of cementitious barriers used in near surface engineered waste disposal systems including waste forms, containment structures, entombments, and environmental remediation. These cementitious materials are exposed to dynamic environmental conditions that cause changes in material propertiesmore » via (i) aging, (ii) chloride attack, (iii) sulfate attack, (iv) carbonation, (v) oxidation, and (vi) primary constituent leaching. A set of state-of-the-art software tools has been selected as a starting point to capture these important aging and degradation phenomena. Integration of existing software developed by the CBP partner organizations was determined to be the quickest method of meeting the CBP goal of providing a computational tool that improves the prediction of the long-term behavior of cementitious materials. These partner codes were selected based on their maturity and ability to address the problems outlined above. The GoldSim Monte Carlo simulation program (GTG 2010a, GTG 2010b) was chosen as the code integration platform (Brown & Flach 2009b). GoldSim (current Version 10.5) is a Windows based graphical object-oriented computer program that provides a flexible environment for model development (Brown & Flach 2009b). The linking of GoldSim to external codes has previously been successfully demonstrated (Eary 2007, Mattie et al. 2007). GoldSim is capable of performing deterministic and probabilistic simulations and of modeling radioactive decay and constituent transport. As part of the CBP project, a general Dynamic Link Library (DLL) interface was developed to link GoldSim with external codes (Smith III et al. 2010). The DLL uses a list of code inputs provided by GoldSim to create an input file for the external application, runs the external code, and returns a list of outputs (read from files created by the external application) back to GoldSim. In this way GoldSim provides: (1) a unified user interface to the applications, (2) the capability of coupling selected codes in a synergistic manner, and (3) the capability of performing probabilistic uncertainty analysis with the codes. GoldSim is made available by the GoldSim Technology Group as a free 'Player' version that allows running but not editing GoldSim models. The player version makes the software readily available to a wider community of users that would wish to use the CBP application but do not have a license for GoldSim.« less
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Magnetic barriers and their q95 dependence at DIII-D
NASA Astrophysics Data System (ADS)
Volpe, F. A.; Kessler, J.; Ali, H.; Evans, T. E.; Punjabi, A.
2012-05-01
It is well known that externally generated resonant magnetic perturbations (RMPs) can form islands in the plasma edge. In turn, large overlapping islands generate stochastic fields, which are believed to play a role in the avoidance and suppression of edge localized modes (ELMs) at DIII-D. However, large coalescing islands can also generate, in the middle of these stochastic regions, KAM surfaces effectively acting as ‘barriers’ against field-line dispersion and, indirectly, particle diffusion. It was predicted in Ali and Punjabi (2007 Plasma Phys. Control. Fusion 49 1565-82) that such magnetic barriers can form in piecewise analytic DIII-D plasma equilibria. In this work, the formation of magnetic barriers at DIII-D is corroborated by field-line tracing calculations using experimentally constrained EFIT (Lao et al 1985 Nucl. Fusion 25 1611) DIII-D equilibria perturbed to include the vacuum field from the internal coils utilized in the experiments. According to these calculations, the occurrence and location of magnetic barriers depend on the edge safety factor q95. It was thus suggested that magnetic barriers might contribute to narrowing the edge stochastic layer and play an indirect role in the RMPs failing to control ELMs for certain values of q95. The analysis of DIII-D discharges where q95 was varied, however, does not show anti-correlation between barrier formation and ELM suppression.
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Whelan, Jessica J; Willis, Karen
2007-01-01
Access to safe drinking water is essential to human life and wellbeing, and is a key public health issue. However, many communities in rural and regional parts of Australia are unable to access drinking water that meets national standards for protecting human health. The aim of this research was to identify the key issues in and barriers to the provision and management of safe drinking water in rural Tasmania, Australia. Semi-structured interviews were conducted with key local government employees and public health officials responsible for management of drinking water in rural Tasmania. Participants were asked about their core public health duties, regulatory responsibilities, perceptions and management of risk, as well as the key barriers that may be affecting the provision of safe drinking water. This research highlights the effect of rural locality on management and safety of fresh water in protecting public health. The key issues contributing to problems with drinking water provision and quality identified by participants included: poor and inadequate water supply infrastructure; lack of resources and staffing; inadequate catchment monitoring; and the effect of competing land uses, such as forestry, on water supply quality. This research raises issues of inequity in the provision of safe drinking water in rural communities. It highlights not only the increasing need for greater funding by state and commonwealth government for basic services such as drinking water, but also the importance of an holistic and integrated approach to managing drinking water resources in rural Tasmania.
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NASA Astrophysics Data System (ADS)
Samarin, Viacheslav
2014-03-01
Time-dependent Schrödinger equation is numerically solved by difference method for external neutrons of nuclei 6He, 18O, 48Са, 238U at their grazing collisions with energies in the vicinity of a Coulomb barrier. The spin-orbital interaction and Pauli's exclusion principle were taken into consideration during the solution.
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2003-10-01
KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, Ryan Levann, with United Space Alliance, checks data on the tile removed from the thermal barrier around the umbilical areas, the external tank attach points, on the underside of Atlantis. The umbilical areas are closed off after ET separation by a door, seen here. The exposed area of each closed door is covered with reusable surface insulation.
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What Disability? I Am a Leader! Understanding Leadership in HE from a Disability Perspective
ERIC Educational Resources Information Center
Emira, Mahmoud; Brewster, Stephanie; Duncan, Neil; Clifford, Angela
2018-01-01
This article is based on the findings of an externally funded, mixed-methods research project conducted at one English university. This small-scale project aimed to examine leadership, barriers to becoming a leader and the support needed to overcome them, from the perspectives of disabled staff. An online questionnaire was sent to all 66 members…
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ERIC Educational Resources Information Center
Bagner, Daniel M.; Graziano, Paulo A.
2013-01-01
The purpose of this study was to examine the effect of cumulative risk on dropout and treatment outcome in parent training. Participants were 44 families of young children (mean age of 49.59 months) who presented with elevated externalizing behavior problems and developmental delay or borderline developmental delay. All families were offered to…
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ERIC Educational Resources Information Center
Leggatt, Simon
2016-01-01
This case study describes the development process of a model using readily-available technology to facilitate collaboration, moderation and the dissemination of best practice in initial teacher training in the UK. Students, mentors, tutors and external examiners from a number of educational institutions in a UK, higher education-led Lifelong…
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Factors influencing nurses' attitudes toward simulation-based education.
Decarlo, Deborah; Collingridge, Dave S; Grant, Carrie; Ventre, Kathleen M
2008-01-01
To identify barriers to nurses' participation in simulation, and to determine whether prior simulation exposure, professional experience, and practice location influence their tendency to perceive specific issues as barriers. We also sought to identify nurses' educational priorities, and to determine whether these were influenced by years of experience or practice location. We surveyed full-time and part-time nurses in a university-affiliated children's hospital to gather data on professional demographics, simulation exposure, perceived barriers to participation in simulation, and training priorities. A total of 523 of 936 (56%) eligible nurses completed the survey. Binary logistic regression analysis revealed that "simulation is 'not the real thing'" was selected as a barrier more often by nurses with prior simulation experience (P = 0.02), fewer years in practice (P = 0.02), and employment in non-acute care areas of the hospital (P = 0.03). "Unfamiliarity with equipment" was reported more often by nurses with less experience (P = 0.01). "Stressful or intimidating environment" was selected more often by those who work in non-acute care areas (P < 0.01). "Providing opportunities to manage rare events" was suggested as a training priority by nurses with less experience (P = 0.08) and by those practicing in acute care areas (P = 0.03). We identified several barriers to nurses' participation in simulation training. Nurses' tendency to name specific issues as barriers is related to prior simulation exposure, years of experience, and area of hospital practice. Rehearsing rare event management is a priority for less-experienced nurses and those in acute care areas.
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Overview and introduction: The blood–brain barrier in health and disease
Abbott, N. Joan; Friedman, Alon
2013-01-01
Summary This article introduces the special issue on “Blood–Brain Barrier and Epilepsy.” We review briefly current understanding of the structure and function of the blood–brain barrier (BBB), including its development and normal physiology, and ways in which it can be affected in pathology. The BBB formed by the endothelium of cerebral blood vessels is one of three main barrier sites protecting the central nervous system (CNS). The barrier is not a rigid structure, but a dynamic interface with a range of interrelated functions, resulting from extremely effective tight junctions, transendothelial transport systems, enzymes, and regulation of leukocyte permeation, which thereby generates the physical, transport, enzymatic, and immune regulatory functions of the BBB. The brain endothelial cells are important components of a “modular” structure, the neurovascular unit (NVU), with several associated cell types and extracellular matrix components. Modern methods have helped in identifying a range of proteins involved in barrier structure and function, and recent studies have revealed important stages, cell types, and signaling pathways important in BBB development. There is a growing list of CNS pathologies showing BBB dysfunction, with strong evidence that this can play a major role in certain disease etiologies. The articles that follow in this issue summarize in more detail reports and discussions of the recent international meeting on “BBB in Neurological Dysfunctions,” which took place recently at Ben-Gurion University of the Negev Desert Campus (Beer-Sheva, Israel), focusing on the link between experimental and clinical studies, and the ways in which these lead to improved drug treatments. PMID:23134489
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Knowledge and attitudes towards disability in Moldova: A qualitative study of young people's views.
McLean, Kenneth A; Hardie, Samantha; Paul, Abigail; Paul, Gary; Savage, Iain; Shields, Paul; Symes, Rebecca; Wilson, Joanna; Winstanley, Catherine; Harden, Jeni
2017-10-01
People with disabilities in the Republic of Moldova continue to experience considerable discrimination and social exclusion. The Moldovan government recently affirmed their commitment to promote community integration. However, there remains limited evidence to facilitate understanding of these issues, and barriers to the integrative process. This study explored the knowledge and attitudes towards disability of young people within Moldova. A qualitative approach was adopted and 3 semi-structured focus group interviews were conducted with schoolchildren (n = 12), aged 13-15 years. These interviews focussed on different aspects of disability, and community integration. Pictorial and written vignettes were used to stimulate discussion. The interviews were conducted and recorded in Romanian, and were subsequently translated into English to facilitate thematic data analysis. Identified themes included: (1) Knowledge and understanding of disability. The young people's knowledge was limited and framed by the medical model of disability; (2) Attitudes towards community integration. A bias against long-term care institutions, but differing views regarding integration; (3) Perceptions of barriers to community integration: (i) Cultural barriers. Negative, even hostile attitudes towards disability; (ii) Policy barriers. Poor support services; and (iii) Physical barriers. Ongoing issues regarding accessibility. People with disabilities in Moldova experience negative cultural attitudes linked to an outdated conception of disability itself. There are inadequate community support services and infrastructure which act as barriers to inclusion. At present, there can be limited interaction and participation of people with disabilities within local communities, and so few opportunities to refute persistent stereotypes and stigma surrounding disability. Copyright © 2017 Elsevier Inc. All rights reserved.
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Blando, James; Ridenour, Marilyn; Hartley, Daniel; Casteel, Carri
2015-01-01
Effective workplace violence (WPV) prevention programs are essential, yet challenging to implement in healthcare. The aim of this study was to identify major barriers to implementation of effective violence prevention programs. After reviewing the related literature, the authors describe their research methods and analysis and report the following seven themes as major barriers to effective implementation of workplace violence programs: a lack of action despite reporting; varying perceptions of violence; bullying; profit-driven management models; lack of management accountability; a focus on customer service; and weak social service and law enforcement approaches to mentally ill patients. The authors discuss their findings in light of previous studies and experiences and offer suggestions for decreasing WPV in healthcare settings. They conclude that although many of these challenges to effective implementation of workplace violence programs are both within the program itself and relate to broader industry and societal issues, creative innovations can address these issues and improve WPV prevention programs.
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Blando, James; Ridenour, Marilyn; Hartley, Daniel; Casteel, Carri
2014-12-04
Effective workplace violence (WPV) prevention programs are essential, yet challenging to implement in healthcare. The aim of this study was to identify major barriers to implementation of effective violence prevention programs. After reviewing the related literature, the authors describe their research methods and analysis and report the following seven themes as major barriers to effective implementation of workplace violence programs: a lack of action despite reporting; varying perceptions of violence; bullying; profit-driven management models; lack of management accountability; a focus on customer service; and weak social service and law enforcement approaches to mentally ill patients. The authors discuss their findings in light of previous studies and experiences and offer suggestions for decreasing WPV in healthcare settings. They conclude that although many of these challenges to effective implementation of workplace violence programs are both within the program itself and relate to broader industry and societal issues, creative innovations can address these issues and improve WPV prevention programs.
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78 FR 25436 - SFIREG Environmental Quality Issues Committee; Notice of Public Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-01
... human health, environmental exposure to pesticides, and insight into EPA's decision-making process. You.... SUMMARY: The Association of American Pesticide Control Officials (AAPCO)/State FIFRA Issues Research and... External Affairs Division (7506P), Office of Pesticide Programs, Environmental Protection Agency, 1200...
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Issue Scanning: Finding the Future...Maybe.
ERIC Educational Resources Information Center
Plog, Michael; Sweeney, Jim; Weiss, Barry
Issue Scanning, sometimes called Environmental Scanning, is used in many business, government, educational, and nonprofit organizations. The technique is supposed to monitor the "pulse" of the external environment. The scanning process should lessen the randomness of the information used in decision making, and it should alert managers…
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Homelessness and the Public's Health: Legal Responses.
Hodge, James G; DiPietro, Barbara; Horton-Newell, Amy E
2017-03-01
This commentary addresses public health issues underlying homelessness and related law, policy, and advocacy options. After framing public health issues for affected individuals and the community, legal and policy approaches and related barriers are assessed. Major topics include deficits in housing availability, the role of state-based Medicaid programs, criminalization of homelessness, and the use of emergency declarations seeking to address particular issues related to homelessness in select states and localities.
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Using e-Health to Enable Culturally Appropriate Mental Healthcare in Rural Areas
Marks, Shayna; Hilty, Don; Shore, Jay H.
2008-01-01
Abstract The objective of this study was to review relevant research issues in the provision of culturally appropriate e-mental healthcare and make recommendations for expanding and prioritizing research efforts in this area. A workshop was convened by the Office of Rural Mental Health Research (ORMHR) at the National Institute of Mental Health (NIMH), the Center for Reducing Health Disparities at the University of California, Davis, the California Telemedicine and e-Health Center, and the California Endowment in December 2005, during which papers were presented concerning culture and e-mental health. Relevant literature was reviewed and research questions were developed. Major issues in the provision of culturally appropriate e-mental healthcare were defined, as were the barriers to the provision of such care in rural areas and interventions to overcome these barriers. Rural areas have increased barriers to culturally appropriate mental healthcare because of increased rates of poverty, increasingly large ethnic minority populations, and various degrees of geographical isolation and cultural factors specific to rural communities. Although culture and language are major barriers to receiving appropriate mental healthcare, including e-mental healthcare, they cannot be separated from other related influential variables, such as poverty and geography. Each of these critical issues must be taken into account when planning technologically enabled rural mental health services. This review describes one in a series of ORMHR/NIMH efforts aimed at stimulating research using culturally appropriate e-mental health strategies that address unique characteristics of various racial/ethnic groups, as well as rural and frontier populations. PMID:18578685
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Nicholas, Lisa G; Pond, C Dimity; Roberts, David C K
2003-04-01
Effective patient nutrition management can both improve people's health and reduce the cost of health care. In Australia, general practitioners (GPs) and dietitians are in a position to provide this service. However, there is a lack of information available on what influences the provision of the service. The objective was to determine qualitative factors that influence nutrition management by GPs and dietitians. A convenience sample of GPs and dietitians was surveyed using a qualitative questionnaire. The questionnaire related to issues including influences on the GP's decision to initiate nutrition management, barriers to providing nutrition counseling, influences on the GP's decision to refer to a dietitian, and barriers to referral. Fourteen of 20 GPs and 15 of 30 dietitians responded with usable data. The primary influence on a GP's decision to initiate nutrition management (GPs' and dietitians' responses) was the presentation of a patient who required nutrition advice. Barriers to providing nutrition counseling were time and knowledge (GP response), whereas dietitians saw time and lack of patient interest as issues. The primary influence on the GP's decision to refer to a dietitian was a patient presenting with complicated nutrition requirements (GP response), whereas dietitians considered a patient seeking nutrition knowledge as the key influencer. GPs identified cost to the patient as the main barrier to referring to a dietitian, whereas dietitians saw lack of knowledge of where to refer as the key issue. The differing responses suggest that more research is required to understand what influences patient nutrition management by GPs and dietitians in Australia.
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Martinez, William; Galván, Jorge; Saavedra, Nayelhi; Berenzon, Shoshana
2017-05-01
Despite the high prevalence of mental disorders in Mexico, minimal mental health services are available and there are large gaps in mental health treatment. Community-based primary care settings are often the first contact between patients and the health system and thus could serve as important settings for assessing and treating mental disorders. However, no formal assessment has been undertaken regarding the feasibility of implementing these services in Mexico. Before tools are developed to undertake such an assessment, a more nuanced understanding of the microprocesses affecting mental health service delivery must be acquired. A qualitative study used semistructured interviews to gather information from 25 staff in 19 community-based primary care clinics in Mexico City. Semistructured interviews were analyzed by using the meaning categorization method. In a second phase of coding, emerging themes were compared with an established typology of barriers to health care access. Primary care staff reported a number of significant barriers to implementing mental health services in primary care clinics, an already fragile and underfunded system. Barriers included the following broad thematic categories: service issues, language and cultural issues, care recipient characteristics, and issues with lack of knowledge. Results indicate that the implementation of mental health services in primary care clinics in Mexico will be difficult. However, the information in this study can help inform the integration of mental health into community-based primary care in Mexico through the development of adequate evaluative tools to assess the feasibility and progress of integrating these services.
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Regulation of stem cell-based therapies in Canada: current issues and concerns.
von Tigerstrom, Barbara; Nguyen, Thu Minh; Knoppers, Bartha Maria
2012-09-01
Stem cell therapies offer enormous potential for the treatment of a wide range of diseases and conditions. Despite the excitement over such advances, regulators are faced with the challenge of determining criteria to ensure stem cells and their products are safe and effective for human use. However, stem cell-based products and therapies present unique regulatory challenges because standard drug development models do not wholly apply given the complexity and diversity of these products and therapies. As a result, regulatory requirements are often unclear and ambiguous creating unnecessary barriers for research. In order to better understand the barriers that might affect Canadian stem cell researchers, we sought feedback from stakeholders regarding areas of uncertainty or concern about existing regulatory oversight of cell therapies. A selection of Canadian researchers and clinicians working in the area of stem cell research were interviewed to assess certain key questions: 1) whether current regulatory requirements are easily accessible and well understood; 2) whether regulatory requirements create important challenges or barriers; and 3) whether there is a need for further guidance on the issue. The results of this survey are summarized and compared to issues and concerns experienced in other countries, as reported in the literature, to identify challenges which may be on the horizon and to provide possible solutions for regulatory reform.
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Farooqi, A; Nagra, D; Edgar, T; Khunti, K
2000-08-01
South Asians have a significantly higher risk of mortality from coronary heart disease (CHD) compared with the general population in the UK. There is a lack of evidence on attitudes to and knowledge of risk factors for CHD amongst South Asians. Such information is important for the provision of effective health promotion services. The aim of the study was to identify key issues relating to knowledge of and attitudes to lifestyle risk factors for CHD amongst South Asians aged over 40 years in Leicester, UK. A qualitative focus group analysis was carried out using randomly selected South Asians from GP lists and South Asians attending community centres. Group discussions were taped, translated and transcribed. The transcripts were analysed using qualitative methodology to identify key issues and themes. Participants expressed a range of attitudes to and different levels of knowledge of lifestyle risk factors for CHD. Barriers to improving lifestyle with respect to diet and exercise were identified; these included lack of information (e.g. of how to cook traditional Indian food more healthily) and cultural barriers, such as lack of women-only exercise facilities. Participants perceived stress as an important cause of CHD, and stress directly related to ethnic minority status was described frequently. Language was identified as a key barrier to accessing health services. Health professionals need to provide individually tailored health promotion for South Asians which avoids stereotyping, but recognizes potential cultural obstacles to change. The issue of stress amongst South Asians requires more research and needs to be recognized as an important issue by health professionals. South Asians still face problems accessing health and leisure services due to language and cultural issues.
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Fabric-based alkaline direct formate microfluidic fuel cells.
Domalaon, Kryls; Tang, Catherine; Mendez, Alex; Bernal, Franky; Purohit, Krutarth; Pham, Linda; Haan, John; Gomez, Frank A
2017-04-01
Fabric-based microfluidic fuel cells (MFCs) serve as a novel, cost-efficient alternative to traditional FCs and batteries, since fluids naturally travel across fabric via capillary action, eliminating the need for an external pump and lowering production and operation costs. Building on previous research with Y-shaped paper-based MFCs, fabric-based MFCs mitigate fragility and durability issues caused by long periods of fuel immersion. In this study, we describe a microfluidic fabric-based direct formate fuel cell, with 5 M potassium formate and 30% hydrogen peroxide as the anode fuel and cathode oxidant, respectively. Using a two-strip, stacked design, the optimized parameters include the type of encasement, the barrier, and the fabric type. Surface contact of the fabric and laminate sheet expedited flow and respective chemical reactions. The maximum current (22.83 mA/cm 2 ) and power (4.40 mW/cm 2 ) densities achieved with a 65% cotton/35% polyester blend material are a respective 8.7% and 32% higher than previous studies with Y-shaped paper-based MFCs. In series configuration, the MFCs generate sufficient energy to power a handheld calculator, a thermometer, and a spectrum of light-emitting diodes. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
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Hastings, Amy; McNamara, Niamh; Allan, Jacqueline; Marriott, Mike
2016-12-01
A significant barrier to recovery for individuals with co-morbid eating disorders and type 1 diabetes is the way in which group members self-categorise. Nonetheless, identity issues are neglected during the recovery process. The aim of this paper is to explore how group memberships (and the associated identities) both contribute to and hinder recovery in this cohort. Transcripts from five online focus groups with 13 members of an online support group for individuals with 'Diabulimia' were thematically analysed. Findings suggested that those with whom one shares a recovery identity can be well placed to provide psychological resources necessary for successful recovery although such connections can be damaging if group norms are not managed. Members recognised that other important relationships (including family and friends and health professionals) are also key to recovery; these other group memberships (and the associated identities) can be facilitated through the recovery identity group membership, which allows for external validation of the recovery identity, provides encouragement to disclose the illness to supportive others, and provides information to facilitate positive service interactions. While clinical interventions typically focus on eliminating disordered behaviours, we suggest that these should also include strengthening important group memberships that promote recovery.
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Pedagogical Affordances of Multiple External Representations in Scientific Processes
ERIC Educational Resources Information Center
Wu, Hsin-Kai; Puntambekar, Sadhana
2012-01-01
Multiple external representations (MERs) have been widely used in science teaching and learning. Theories such as dual coding theory and cognitive flexibility theory have been developed to explain why the use of MERs is beneficial to learning, but they do not provide much information on pedagogical issues such as how and in what conditions MERs…
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ERIC Educational Resources Information Center
Galloway, R. L.; Wearn, Katrina
1998-01-01
Attempts to measure perceived quality, based on customers' views within the context of a (British) university faculty office, using a modified SERVQUAL instrument. Internal customers demonstrated that perceived quality is driven by task-focused issues, stressing clarity, accuracy, and reliability. External customers, whose usage is more casual,…
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Application of Terahertz Imaging and Backscatter Radiography to Space Shuttle Foam Inspection
NASA Technical Reports Server (NTRS)
Ussery, Warren
2008-01-01
Two state of the art technologies have been developed for External Fuel Tank foam inspections. Results of POD tests have shown Backscatter Radiography and Terahertz imaging detect critical defects with no false positive issue. These techniques are currently in use on the External Tank program as one component in the foam quality assurance program.
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ERIC Educational Resources Information Center
Piotrowska-Piatek, Agnieszka
2017-01-01
In the context of the ongoing changes in the management systems of higher education, the issue of higher education institutions' (HEIs) relationships with external stakeholders are of key importance. This article discusses this problem from the perspective of Polish higher education system. The aim of it is to answer the following questions: (1)…
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ERIC Educational Resources Information Center
Miller, Dana L.
The external audit is a way of assessing the trustworthiness of a study, attesting to its dependability from a methodological standpoint and to its confirmability by reviewing the data, analysis, and interpretations and assessing whether the findings represent the data accurately. This paper discusses issues in the audit process, drawing on data…
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ERIC Educational Resources Information Center
Hart, Margaret S.; Kelley, Michelle L.
2006-01-01
Relationships between work and family variables and children's internalizing and externalizing behavior are examined in 132 dual-earner couples of preschool-age children. Mothers' and fathers' parenting stress and mothers' work-family conflict predict children's internalizing behavior; mothers' work-family conflict, mothers' and fathers' parenting…
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ERIC Educational Resources Information Center
Beachler, Judith
This document summarizes both the 2000 External Environmental Scan and the 2000 Internal Environmental Scan Report Card for the Los Rios Community College District (LRCCD) (California). LRCCD consists of American River College (ARC), Consummes River College (CRC), and Sacramento City College (SCC). Report highlights include: (1) total headcount…
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External Technical Support for School Improvement: Critical Issues from the Chilean Experience
ERIC Educational Resources Information Center
Osses, Alejandra; Bellei, Cristián; Valenzuela, Juan Pablo
2015-01-01
To what extent school improvement processes can be initiated and sustained from the outside has been a relevant question for policy-makers seeking to increase quality in education. Since 2008, the Chilean Government is strongly promoting the use of external technical support (ETS) services to support school improvement processes, as part of the…
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Barriers and facilitators to implementing cancer survivorship care plans.
Dulko, Dorothy; Pace, Claire M; Dittus, Kim L; Sprague, Brian L; Pollack, Lori A; Hawkins, Nikki A; Geller, Berta M
2013-11-01
To evaluate the process of survivorship care plan (SCP) completion and to survey oncology staff and primary care physicians (PCPs) regarding challenges of implementing SCPs. Descriptive pilot study. Two facilities in Vermont, an urban academic medical center and a rural community academic cancer center. 17 oncology clinical staff created SCPs, 39 PCPs completed surveys, and 58 patients (breast or colorectal cancer) participated in a telephone survey. Using Journey Forward tools, SCPs were created and presented to patients. PCPs received the SCP with a survey assessing its usefulness and barriers to delivery. Oncology staff were interviewed to assess perceived challenges and benefits of SCPs. Qualitative and quantitative data were used to identify challenges to the development and implementation process as well as patient perceptions of the SCP visit. SCP, healthcare provider perception of barriers to completion and implementation, and patient perception of SCP visit. Oncology staff cited the time required to obtain information for SCPs as a challenge. Completing SCPs 3-6 months after treatment ended was optimal. All participants felt advanced practice professionals should complete and review SCPs with patients. The most common challenge for PCPs to implement SCP recommendations was insufficient knowledge of cancer survivor issues. Most patients found the care plan visit very useful, particularly within six months of diagnosis. Creation time may be a barrier to widespread SCP implementation. Cancer survivors find SCPs useful, but PCPs feel insufficient knowledge of cancer survivor issues is a barrier to providing best follow-up care. Incorporating SCPs in electronic medical records may facilitate patient identification, appropriate staff scheduling, and timely SCP creation. Oncology nurse practitioners are well positioned to create and deliver SCPs, transitioning patients from oncology care to a PCP in a shared-care model of optimal wellness. Institution support for the time needed for SCP creation and review is imperative for sustaining this initiative. Accessing complete medical records is an obstacle for completing SCPs. A 3-6 month window to develop and deliver SCPs may be ideal. PCPs perceive insufficient knowledge of cancer survivor issues as a barrier to providing appropriate follow-up care.
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Understanding barriers to implementation of an adaptive land management program
Jacobson, S.K.; Morris, J.K.; Sanders, J.S.; Wiley, E.N.; Brooks, M.; Bennetts, R.E.; Percival, H.F.; Marynowski, S.
2006-01-01
The Florida Fish and Wildlife Conservation Commission manages over 650,000 ha, including 26 wildlife management and environmental areas. To improve management, they developed an objective-based vegetation management (OBVM) process that focuses on desired conditions of plant communities through an adaptive management framework. Our goals were to understand potential barriers to implementing OBVM and to recommend strategies to overcome barriers. A literature review identified 47 potential barriers in six categories to implementation of adaptive and ecosystem management: logistical, communication, attitudinal, institutional, conceptual, and educational. We explored these barriers through a bureau-wide survey of 90 staff involved in OBVM and personal interviews with area managers, scientists, and administrators. The survey incorporated an organizational culture assessment instrument to gauge how institutional factors might influence OBVM implementation. The survey response rate was 69%. Logistics and communications were the greatest barriers to implementing OBVM. Respondents perceived that the agency had inadequate resources for implementing OBVM and provided inadequate information. About one-third of the respondents believed OBVM would decrease their job flexibility and perceived greater institutional barriers to the approach. The 43% of respondents who believed they would have more responsibility under OBVM also had greater attitudinal barriers. A similar percentage of respondents reported OBVM would not give enough priority to wildlife. Staff believed that current agency culture was hierarchical but preferred a culture that would provide more flexibility for adaptive management and would foster learning from land management activities. In light of the barriers to OBVM, we recommend the following: (1) mitigation of logistical barriers by addressing real and perceived constraints of staff, funds, and other resources in a participatory manner; (2) mitigation of communication barriers through interpersonal and electronic communication channels; (3) development of an OBVM external advisory committee; and (4) adoption of characteristics of an organizational culture that promotes flexibility and learning. ??2006 Society for Conservation Biology.
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Understanding barriers to implementation of an adaptive land management program.
Jacobson, Susan K; Morris, Julie K; Sanders, J Scott; Wiley, Eugene N; Brooks, Michael; Bennetts, Robert E; Percival, H Franklin; Marynowski, Susan
2006-10-01
The Florida Fish and Wildlife Conservation Commission manages over 650,000 ha, including 26 wildlife management and environmental areas. To improve management, they developed an objective-based vegetation management (OBVM) process that focuses on desired conditions of plant communities through an adaptive management framework. Our goals were to understand potential barriers to implementing OBVM and to recommend strategies to overcome barriers. A literature review identified 47 potential barriers in six categories to implementation of adaptive and ecosystem management: logistical, communication, attitudinal, institutional, conceptual, and educational. We explored these barriers through a bureau-wide survey of 90 staff involved in OBVM and personal interviews with area managers, scientists, and administrators. The survey incorporated an organizational culture assessment instrument to gauge how institutional factors might influence OBVM implementation. The survey response rate was 69%. Logistics and communications were the greatest barriers to implementing OBVM. Respondents perceived that the agency had inadequate resources for implementing OBVM and provided inadequate information. About one-third of the respondents believed OBVM would decrease their job flexibility and perceived greater institutional barriers to the approach. The 43% of respondents who believed they would have more responsibility under OBVM also had greater attitudinal barriers. A similar percentage of respondents reported OBVM would not give enough priority to wildlife. Staff believed that current agency culture was hierarchical but preferred a culture that would provide more flexibility for adaptive management and would foster learning from land management activities. In light of the barriers to OBVM, we recommend the following: (1) mitigation of logistical barriers by addressing real and perceived constraints of staff, funds, and other resources in a participatory manner; (2) mitigation of communication barriers through interpersonal and electronic communication channels; (3) development of an OBVM external advisory committee; and (4) adoption of characteristics of an organizational culture that promotes flexibility and learning.
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Barriers to female sex addiction treatment in the UK.
Dhuffar, Manpreet K; Griffiths, Mark D
2016-12-01
Background Over the last 20 years, behavioral addictions (e.g., addictions to gambling, playing video games, work, etc.) have become more accepted among both public and scientific communities. Addiction to sex is arguably a more controversial issue, but this does not take away from the fact that some individuals seek professional help for problematic excessive sex, irrespective of how the behavior is conceptualized. Empirical evidence suggests that among treatment seekers, men are more likely than women to seek help for sex addiction (SA). Methods Using the behavioral addiction literature and the authors' own expertise in researching female SA, this paper examines potential barriers to the treatment for female sex addicts. Results Four main types of barriers for female sex addicts not seeking treatment were identified. These comprised (a) individual barriers, (b) social barriers, (c) research barriers, and (d) treatment barriers. Conclusions Further research is needed to either confirm or disconfirm the identified barriers that female sex addicts face when seeking treatment, and if conformation is found, interested stakeholders should provide better awareness and/or see ways in which such barriers can be overcome to aid better uptake of SA services.
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Makaroff, Laura; Chung, Michelle; Lin, Sue C.
2015-01-01
Over the last 50 years, the incidence of cervical cancer has dramatically decreased. However, health disparities in cervical cancer screening (CCS) persist for women from racial and ethnic minorities and those residing in rural and poor communities. For more than 45 years, federally funded health centers (HCs) have been providing comprehensive, culturally competent, and quality primary health care services to medically underserved communities and vulnerable populations. To enhance the quality of care and to ensure more women served at HCs are screened for cervical cancer, over eight HCs received funding to support patient-centered medical home (PCMH) transformation with goals to increase CCS rates. The study conducted a qualitative analysis using Atlas.ti software to describe the barriers and challenges to CCS and PCMH transformation, to identify potential solutions and opportunities, and to examine patterns in barriers and solutions proposed by HCs. Interrater reliability was assessed using Cohen's Kappa. The findings indicated that HCs more frequently described patient-level barriers to CCS, including demographic, cultural, and health belief/behavior factors. System-level barriers were the next commonly cited, particularly failure to use the full capability of electronic medical records (EMRs) and problems coordinating with external labs or providers. Provider-level barriers were least frequently cited. PMID:25685561
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NASA Astrophysics Data System (ADS)
Tuan, Nguyen Anh; Anh, Nguyen Tuan; Nga, Nguyen Tuyet; Tue, Nguyen Anh; Van Cuong, Giap
2016-06-01
The alternating-current (ac) electrical properties of granular-type-barrier magnetic tunnel junctions (GBMTJs) based on Co/Co x (Al2O3)1- x ( t)/Co trilayer structures have been studied using complex impedance spectroscopy (CIS). Their CIS characteristics were investigated in external magnetic fields varying from 0 kOe to 3 kOe as a function of Co composition x at 10 at.%, 25 at.%, and 35 at.%, with barrier layer thickness t of 20 nm to 90 nm. The influence of these factors on the behaviors of the ac impedance response of the GBMTJs was deeply investigated and attributed to the dielectric or conducting nature of the Co-Al2O3 barrier layer. The most remarkable typical phenomena observed in these behaviors, even appearing paradoxical, include lower impedance for thicker t for each given x, a declining trend of Z with increasing x, a clear decrease of Z with H, and especially a partition of Z into zones according to the H value. All these effects are analyzed and discussed to demonstrate that diffusion-type and mass-transfer-type phenomena can be inferred from processes such as spin tunneling and Coulomb or spin blockade in the Co-Al2O3 barrier layer.
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Integrating pharmacists into primary care teams: barriers and facilitators.
Jorgenson, Derek; Laubscher, Tessa; Lyons, Barry; Palmer, Rebecca
2014-08-01
This study evaluated the barriers and facilitators that were experienced as pharmacists were integrated into 23 existing primary care teams located in urban and rural communities in Saskatchewan, Canada. Qualitative design using data from one-on-one telephone interviews with pharmacists, physicians and nurse practitioners from the 23 teams that integrated a new pharmacist role. Four researchers from varied backgrounds used thematic analysis of the interview transcripts to determine key themes. The research team met on multiple occasions to agree on the key themes and received written feedback from an external auditor and two of the original interviewees. Seven key themes emerged describing the barriers and facilitators that the teams experienced during the pharmacist integration: (1) relationships, trust and respect; (2) pharmacist role definition; (3) orientation and support; (4) pharmacist personality and professional experience; (5) pharmacist presence and visibility; (6) resources and funding; and (7) value of the pharmacist role. Teams from urban and rural communities experienced some of these challenges in unique ways. Primary care teams that integrated a pharmacist experienced several common barriers and facilitators. The negative impact of these barriers can be mitigated with effective planning and support that is individualized for the type of community where the team is located. © 2013 Royal Pharmaceutical Society.
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Making the links: do we connect climate change with health? A qualitative case study from Canada.
Cardwell, Francesca S; Elliott, Susan J
2013-03-08
Climate change has been described as the biggest global health threat of the 21st century. Typically framed as an environmental issue, some suggest this view has contributed to public ambivalence and hence a lack of public engagement. The lack of understanding of climate change as a significant environmental health risk on the part of the lay public represents a significant barrier to behaviour change. We therefore need to think about reframing the impact of climate change from an environmental to a health issue. This paper builds on calls for increased understanding of the public's views of human health risks associated with climate change, focusing on facilitators and barriers to behaviour change. Semi-structured in-depth interviews (n = 22) with residents of the Golden Horseshoe region of Southern Ontario were conducted between August 2010 and January 2011. Topics included individual and community health, climate change, and facilitators and barriers to behaviour change. Few participants recognized the role of the environment in the context of either individual and community health. When asked about health concerns specific to their community, however, environmental issues were mentioned frequently. Health effects as possible impacts of global environmental change were mentioned by 77% of participants when prompted, but this link was not described in great detail or within the context of impacting their communities or themselves. Participants were willing to act in environmentally friendly ways, and possible incentives to undertake behaviour change such as decreasing cost were described. Health co-benefits were not identified as incentives to engaging in mitigative or adaptive behaviours. The results support recent calls for reframing the impact of climate change from an environmental to a public health issue in order to increase public engagement in adaptive and mitigative behaviour change. While previous research has touched on public awareness of the human health risks of climate change, we have further explored the attitude-action link through the examination of facilitators and barriers to behaviour change.