Sample records for common challenges facing

  1. An Exploration of Challenges Facing Division III Athletic Directors

    ERIC Educational Resources Information Center

    Engbers, Jeffrey L.

    2011-01-01

    The purpose of this study was to establish a basic understanding of the challenges associated with directing athletic programs at NCAA Division III Institutions. Specifically, this study identified the frequency, intensity, and time allocated to common challenges facing the position of the NCAA Division III AD. The challenges were examined using…

  2. School Supplies on a Budget

    ERIC Educational Resources Information Center

    Dyrli, Kurt O.

    2008-01-01

    This article reports on the challenge that parents, teachers, and district administrators face in continuing to provide essential school supplies to their students despite budget cuts. At the Verona Area (Wisconsin) School District, administrators, teachers, and parents have recently faced this common challenge. Increasingly dependent on funding…

  3. Multi-Institution Research Centers: Planning and Management Challenges

    ERIC Educational Resources Information Center

    Spooner, Catherine; Lavey, Lisa; Mukuka, Chilandu; Eames-Brown, Rosslyn

    2016-01-01

    Funding multi-institution centers of research excellence (CREs) has become a common means of supporting collaborative partnerships to address specific research topics. However, there is little guidance for those planning or managing a multi-institution CRE, which faces specific challenges not faced by single-institution research centers. We…

  4. Common Challenges Faced by Women of Color in Physics, and Actions Faculty Can Take to Minimize Those Challenges

    NASA Astrophysics Data System (ADS)

    Johnson, Angela; Ong, Maria; Ko, Lily T.; Smith, Janet; Hodari, Apriel

    2017-09-01

    Women of color are deeply underrepresented in physics. Between 2002 and 2012, only 1% of graduating physics majors were Black women and another 1% were Latinas; only 61 American Indian women total completed degrees in physics in those years (out of 48,000 physics majors). This isolation can lead to additional obstacles that women of color majoring in physics must face above and beyond the challenging material. In this article we draw on qualitative findings to describe common obstacles women of color face. However, departments can take deliberate steps so that underrepresentation need not turn into loneliness and isolation. We describe the characteristics of a department where women of color report that they are thriving. We end with concrete steps physics faculty can take to support women physics majors of color.

  5. A Rural County Journeys to the Common Core

    ERIC Educational Resources Information Center

    Ceballos, Pansy T.

    2012-01-01

    Small, rural school districts face a special challenge when implementing the next generation of academic standards known as the Common Core State Standards. This is the task facing the instructional consultants with the Tulare County Office of Education. The county, located in central California with its dominant agricultural economy, has 45…

  6. Assessing Student Performance and Perceptions in Lecture Capture vs. Face-to-Face Course Delivery

    ERIC Educational Resources Information Center

    Euzent, Patricia; Martin, Thomas; Moskal, Patrick; Moskal, Patsy

    2011-01-01

    Public universities are currently facing a challenge in determining how to deliver quality instruction in the face of severe fiscal constraints. With recent technological advances, courses streamed over the Internet (i.e., lecture capture) are now becoming common. However, little research has been published that specifically examines student…

  7. Children at Risk of Neglect: Challenges Faced by Child Protection Practitioners in Guatemala City

    ERIC Educational Resources Information Center

    Coope, Caroline M.; Theobald, Sally

    2006-01-01

    Objectives: The objectives were to (1) delineate the definition, common forms, and perceived risk factors contributing to child neglect in Guatemala from the perspective of different stakeholders and (2) identify the challenges faced by child protection practitioners in identifying children at risk of neglect within the context of Guatemala.…

  8. From the Field: Learning Leaders

    ERIC Educational Resources Information Center

    Weigel, Kathleen; Jones, Richard

    2015-01-01

    Leadership is essential to successful schools. One of the ways to support effective school leadership is to share ideas and best practices to address the common challenges faced by school leaders. This question and response format addresses common challenges and questions from practicing school leaders in the manner that a mentor might respond to…

  9. College Students with Children Are Common and Face Many Challenges in Completing Higher Education. Briefing Paper #C404

    ERIC Educational Resources Information Center

    Nelson, Bethany; Froehner, Megan; Gault, Barbara

    2013-01-01

    This paper discusses the challenges college students with children face, as well as the steps colleges, universities, and the surrounding communities must take to help students succeed in their work as both students and parents. The role of parenthood in postsecondary settings needs greater focus from the higher education reform community. Unless…

  10. Common Challenges Faced by Rural Principals: A Review of the Literature

    ERIC Educational Resources Information Center

    Preston, Jane P.; Jakubiec, Brittany A. E.; Kooymans, Robin

    2013-01-01

    Within this article, we thematically present common challenges associated with the role of the rural principal. In this literature review, we delimit our search to work published from 2003-2013. A limitation of this study is that it represents data predominantly from American, Canadian, and Australian rural settings, restricting a global…

  11. Lost in Translation: Adapting a Face-to-Face Course Into an Online Learning Experience.

    PubMed

    Kenzig, Melissa J

    2015-09-01

    Online education has grown dramatically over the past decade. Instructors who teach face-to-face courses are being called on to adapt their courses to the online environment. Many instructors do not have sufficient training to be able to effectively move courses to an online format. This commentary discusses the growth of online learning, common challenges faced by instructors adapting courses from face-to-face to online, and best practices for translating face-to-face courses into online learning opportunities. © 2015 Society for Public Health Education.

  12. Documenting Sociolinguistic Variation in Lesser-Studied Indigenous Communities: Challenges and Practical Solutions

    ERIC Educational Resources Information Center

    Mansfield, John; Stanford, James

    2017-01-01

    Documenting sociolinguistic variation in lesser-studied languages presents methodological challenges, but also offers important research opportunities. In this paper we examine three key methodological challenges commonly faced by researchers who are outsiders to the community. We then present practical solutions for successful variationist…

  13. NASA Space Rocket Logistics Challenges

    NASA Technical Reports Server (NTRS)

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

    2014-01-01

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

  14. Leading Change for the Implementation of Common Core State Standards in Rural School Districts

    ERIC Educational Resources Information Center

    Lopez, Paul; Wise, Donald

    2015-01-01

    Rural school districts across the nation, with their limited resources, face daunting challenges posed by the implementation of the Common Core State Standards. This article presents a recent study of 13 rural school districts in the Central Valley of California and how these districts are responding to those challenges. A total of 352 teachers…

  15. How distinct is the coding of face identity and expression? Evidence for some common dimensions in face space.

    PubMed

    Rhodes, Gillian; Pond, Stephen; Burton, Nichola; Kloth, Nadine; Jeffery, Linda; Bell, Jason; Ewing, Louise; Calder, Andrew J; Palermo, Romina

    2015-09-01

    Traditional models of face perception emphasize distinct routes for processing face identity and expression. These models have been highly influential in guiding neural and behavioural research on the mechanisms of face perception. However, it is becoming clear that specialised brain areas for coding identity and expression may respond to both attributes and that identity and expression perception can interact. Here we use perceptual aftereffects to demonstrate the existence of dimensions in perceptual face space that code both identity and expression, further challenging the traditional view. Specifically, we find a significant positive association between face identity aftereffects and expression aftereffects, which dissociates from other face (gaze) and non-face (tilt) aftereffects. Importantly, individual variation in the adaptive calibration of these common dimensions significantly predicts ability to recognize both identity and expression. These results highlight the role of common dimensions in our ability to recognize identity and expression, and show why the high-level visual processing of these attributes is not entirely distinct. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Mental Health and Military-Connected Students on Campus: Culture, Challenges, and Success

    ERIC Educational Resources Information Center

    Bonar, Ted C.

    2016-01-01

    This chapter provides an overview of common challenges faced by military-connected students on university campuses. The characteristics, culture, and experiences of service members and veterans are described through vignettes based on military-connected students.

  17. Showing Your Students You Care: Seeing the Individual Trees in the Classroom Forest

    ERIC Educational Resources Information Center

    Philipp, Randolph A.; Thanheiser, Eva

    2010-01-01

    Teaching is a complex profession, and although every context is unique, teachers face common challenges. The authors have identified two challenges that nearly every teacher encounters: (1) managing a classroom of students; and (2) addressing the needs of individual students. Although these are not teachers' only challenges, the authors highlight…

  18. Vocational and Technical Education in Lebanon: Strategic Issues and Challenges

    ERIC Educational Resources Information Center

    Karam, Gebran

    2006-01-01

    The current status of the Lebanese vocational and technical education (VTE) system is assessed and the strategic issues and challenges facing it are identified. In addition to the economic and social challenges that are common to many developing countries, the Lebanese system suffers from idiosyncratic problems, which may require innovative and…

  19. Revisiting Interpretation of Canonical Correlation Analysis: A Tutorial and Demonstration of Canonical Commonality Analysis

    ERIC Educational Resources Information Center

    Nimon, Kim; Henson, Robin K.; Gates, Michael S.

    2010-01-01

    In the face of multicollinearity, researchers face challenges interpreting canonical correlation analysis (CCA) results. Although standardized function and structure coefficients provide insight into the canonical variates produced, they fall short when researchers want to fully report canonical effects. This article revisits the interpretation of…

  20. Developing Academic Literacy and Voice: Challenges Faced by a Mature ESL Student and Her Instructors (Desarrollo del discurso académico y la voz: retos de una estudiante de inglés como segunda lengua y sus profesores)

    ERIC Educational Resources Information Center

    Correa, Doris

    2010-01-01

    Drawing on critical, socio-cultural and sociolinguistic theories of writing, text and voice, this ethnographic study examines the challenges that a mature ESL student and her instructors in a university course on Spanish Language Media face as they co-construct a common understanding of academic literacy and voice in an undergraduate General…

  1. Missed Opportunities for Science Learning: Unacknowledged Unscientific Arguments in Asynchronous Online and Face-to-Face Discussions

    NASA Astrophysics Data System (ADS)

    Callis-Duehl, Kristine; Idsardi, Robert; Humphrey, Eve A.; Gougis, Rebekka Darner

    2018-02-01

    We explored the scientific argumentation that occurs among university biology students during an argumentation task implemented in two environments: face-to-face in a classroom and online in an asynchronous discussion. We observed 10 student groups, each composed of three students. Our analysis focused on how students respond to their peers' unscientific arguments, which we define as assertions, hypotheses, propositions, or explanations that are inaccurate or incomplete from a scientific perspective. Unscientific arguments provide opportunities for productive dissent, scientific argumentation, and conceptual development of scientifically desirable conceptions. We found that students did not respond to the majority of unscientific arguments in both environments. Challenges to unscientific arguments were expressed as a question or through explanation, although the latter was more common online than face-to-face. Students demonstrated significantly more epistemic distancing in the face-to-face environment than the online environment. We discuss the differences in discourse observed in both environments and teaching implications. We also provide direction for future research seeking to address the challenges of engaging students in productive scientific argumentation in both face-to-face and online environments.

  2. Playing with Mathematics: How Play Supports Learning and the Common Core State Standards

    ERIC Educational Resources Information Center

    Zosh, Jennifer Mary; Hassinger-Das, Brenna; Toub, Tamara Spiewak; Hirsh-Pasek, Kathy; Golinkof, Roberta

    2016-01-01

    International rankings show children in the United States perform well below average in mathematics. There are also large mathematics achievement gaps between children of lower- and higher-socioeconomic status. As today's teachers face these challenges, they are also faced with the pressures of sweeping educational reforms that arrived with the…

  3. Working together in community care.

    PubMed

    Statham, D

    1994-01-01

    Health and social services professionals face major challenges in making the community care reforms work. Not least is the need to improve inter-agency collaboration. Many of the problems facing them are common to both professions, writes Daphne Statham. Instead of accusing the professions of inflexibility and tribalism, employers should support and invest in their professional staff.

  4. Teaching Spelling, Writing, and Reading for Writing; Powerful Evidence Based Practices

    ERIC Educational Resources Information Center

    Harris, Karen R.; Graham, Steve; Aitken, A. Angelique; Barkel, Ashley; Houston, Julia; Ray, Amber

    2017-01-01

    Students with disabilities often find writing extremely challenging (Harris & Graham, 2016). Special educators can, however, promote tremendous gains in students' ability to write by understanding common challenges students face and mastering specific teaching techniques. Students' writing success depends on reducing how much attention and…

  5. Knowledge management and informatics considerations for comparative effectiveness research: a case-driven exploration.

    PubMed

    Embi, Peter J; Hebert, Courtney; Gordillo, Gayle; Kelleher, Kelly; Payne, Philip R O

    2013-08-01

    As clinical data are increasingly collected and stored electronically, their potential use for comparative effectiveness research (CER) grows. Despite this promise, challenges face those wishing to leverage such data. In this paper we aim to enumerate some of the knowledge management and informatics issues common to such data reuse. After reviewing the current state of knowledge regarding biomedical informatics challenges and best practices related to CER, we then present 2 research projects at our institution. We analyze these and highlight several common themes and challenges related to the conduct of CER studies. Finally, we represent these emergent themes. The informatics challenges commonly encountered by those conducting CER studies include issues related to data information and knowledge management (eg, data reuse, data preparation) as well as those related to people and organizational issues (eg, sociotechnical factors and organizational factors). Examples of these are described in further detail and a formal framework for describing these findings is presented. Significant challenges face researchers attempting to use often diverse and heterogeneous datasets for CER. These challenges must be understood in order to be dealt with successfully and can often be overcome with the appropriate use of informatics best practices. Many research and policy questions remain to be answered in order to realize the full potential of the increasingly electronic clinical data available for such research.

  6. Quality palliative care for cancer and dementia in five European countries: some common challenges

    PubMed Central

    Davies, Nathan; Maio, Laura; van Riet Paap, Jasper; Mariani, Elena; Jaspers, Birgit; Sommerbakk, Ragni; Grammatico, Daniela; Manthorpe, Jill; Ahmedzai, Sam; Vernooij-Dassen, Myrra; Iliffe, Steve

    2013-01-01

    Objectives There is a growing consensus worldwide that palliative care needs to be both more inclusive of conditions other than cancer and to improve. This paper explores some common challenges currently faced by professionals providing palliative care for patients with either cancer or dementia across five countries. Method One focus group (n = 7) and 67 interviews were conducted in 2012 across five countries: England, Germany, Italy, the Netherlands and Norway, with professionals from dementia, cancer and palliative care settings. Results The interviews revealed five common challenges faced across the five countries: communication difficulties (between services; and between professionals, and patients and their families); the variable extent of structural/functional integration of services; the difficulties in funding of palliative care services; problematic processes of care (boundaries, definitions, knowledge, skills and inclusiveness) and, finally, time constraints. Conclusion These are not problems distinct to palliative care, but they may have different origins and explanations compared to other areas of health care. This paper explored deeper themes hidden behind a discourse about barriers and facilitators to improving care. PMID:24131061

  7. Enhancing Teacher Efficacy for Urban STEM Teachers Facing Challenges to Their Teaching

    ERIC Educational Resources Information Center

    Seals, Christopher; Mehta, Swati; Berzina-Pitcher, Inese; Graves-Wolf, Leigh

    2017-01-01

    This paper explores challenges of teaching in relation to teachers' efficacy for 49 teachers who were part of a year-long teacher development program (PD) called the UrbanSTEM program. This program took place in an urban school district that serves over 300,000 students. This research asked if there are common challenges that urban teachers face…

  8. Challenges and Solutions When Using Technologies in the Classroom

    ERIC Educational Resources Information Center

    Johnson, Amy M.; Jacovina, Matthew E.; Russell, Devin G.; Soto, Christian M.

    2016-01-01

    The purpose of this chapter is to present common challenges faced by educators when attempting to integrate technology in the classroom, and offer potential solutions to those problems. Examination of these issues should be valuable to current and future educators, school administrators, as well as educational technology researchers. The chapter…

  9. Setting Clear Learning Targets to Guide Instruction for All Students

    ERIC Educational Resources Information Center

    Konrad, Moira; Keesey, Susan; Ressa, Virginia A.; Alexeeff, Maggie; Chan, Paula E.; Peters, Mary T.

    2014-01-01

    As more states adopt the Common Core State Standards, teachers face new challenges. Teachers must unpack these standards and develop explicit learning targets to make these rigorous standards accessible to their students. This task can be especially challenging for special educators who must balance standards-based education with individualized…

  10. The Development and Implementation of Outdoor-Based Secondary School Integrated Programs

    ERIC Educational Resources Information Center

    Comishin, Kelly; Dyment, Janet E.; Potter, Tom G.; Russell, Constance L.

    2004-01-01

    Four teachers share the challenges they faced when creating and running outdoor-focused secondary school integrated programs in British Columbia, Canada. The five most common challenges were funding constraints, insufficient support from administrators and colleagues, time constraints, liability and risk management, and inadequate skills and…

  11. Infusing Evaluative Thinking as Process Use: The Case of the International Development Research Centre (IDRC)

    ERIC Educational Resources Information Center

    Carden, Fred; Earl, Sarah

    2007-01-01

    Until the recent introduction of a dynamic interview-based process, the International Development Research Centre (IDRC), a Canadian development research funding agency, faced a challenge: project completion reports (PCRs) were not being completed in a timely and quality manner. This is a common problem many organizations face in completing…

  12. Hybrid Spanish Programs: A Challenging and Successful Endeavor

    ERIC Educational Resources Information Center

    Hermosilla, Luis

    2014-01-01

    Several types of hybrid Spanish programs have been developed in US colleges and universities for more than ten years, but the most common structure consists of a course in which the instruction combines face-to-face time with an instructor and the use of an online platform. Studies have demonstrated that a well-developed hybrid Spanish program can…

  13. Parents' Role in the Academic Motivation of Students with Gifts and Talents

    ERIC Educational Resources Information Center

    Garn, Alex C.; Matthews, Michael S.; Jolly, Jennifer L.

    2012-01-01

    Parents play a key role in developing their children's academic motivation, and parents of children with gifts and talents also may face additional parenting challenges that are less commonly faced by parents of average-ability learners whose needs are more readily met in the school setting. School psychologists may be charged with addressing…

  14. Campus Commons? What Faculty, Financial Officers and Others Think About Controlling College Costs

    ERIC Educational Resources Information Center

    Immerwahr, John; Johnson, Jean; Gasbarra, Paul

    2009-01-01

    There is emerging consensus that the United States faces major higher education challenges, including: (1) America's fall from first to tenth place internationally in the percentage of the population with higher education degrees at a time when the country faces increased global economic competition in a knowledge-intensive economy; (2) Education…

  15. Successful Transitions from Two-Year to Four-Year Institutions

    ERIC Educational Resources Information Center

    Grites, Thomas J.

    2013-01-01

    This chapter provides an analysis of a set of conditions that transfer students will most likely face in their transition to a new institution. The specific focus is on transfer from two-year to four-year institutions. This chapter will identify many of the common challenges transfer students face simply because they are entering a new learning…

  16. The Leap into 4th Grade

    ERIC Educational Resources Information Center

    Anderson, Mike

    2011-01-01

    Fourth grade is a pivotal year, in which students commonly face increased academic demands. According to Anderson, teachers can help students make a smooth transition to 4th grade by introducing these new challenges in ways that are in line with 4th graders' common developmental characteristics: incredible energy and emotion, industriousness and…

  17. Nitrogen Goes Around

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

    Yu, Jianping

    Variation in nutrient availability is a common challenge facing living organisms. Analysis of metabolomic and fluxomic responses in cyanobacteria to changes in nitrogen availability has led to the discovery of an ornithine-ammonia cycle.

  18. Leadership, Governance, and Sustainability of Black Colleges and Universities

    ERIC Educational Resources Information Center

    Ezzell, Jack L., Jr.; Schexnider, Alvin J.

    2010-01-01

    A topic of continuing interest in American higher education and society is the future of historically black colleges and universities, commonly referred to as HBCUs. The nation's public and private black institutions of higher education have proved their mettle, and yet they face persistent challenges to survive. A huge part of the challenge black…

  19. Education for Life and Work: Developing Transferable Knowledge and Skills in the 21st Century

    ERIC Educational Resources Information Center

    Pellegrino, James W., Ed.; Hilton, Margaret L., Ed.

    2012-01-01

    Americans have long recognized that investments in public education contribute to the common good, enhancing national prosperity and supporting stable families, neighborhoods, and communities. Education is even more critical today, in the face of economic, environmental, and social challenges. Today's children can meet future challenges if their…

  20. Sickle Cell Disease: Management Options and Challenges in Developing Countries

    PubMed Central

    Ansong, Daniel; Akoto, Alex Osei; Ocloo, Delaena; Ohene-Frempong, Kwaku

    2013-01-01

    Sickle Cell Disease (SCD) is the most common genetic disorder of haemoglobin in sub-Saharan Africa. This commentary focuses on the management options available and the challenges that health care professionals in developing countries face in caring for patients with SCD. In a developing countries like Ghana, new-born screening is now about to be implemented on a national scale. Common and important morbidities associated with SCD are vaso-occlusive episodes, infections, Acute Chest Syndrome (ACS), Stroke and hip necrosis. Approaches to the management of these morbidities are far advanced in the developed countries. The differences in setting and resource limitations in developing countries bring challenges that have a major influence in management options in developing countries. Obviously clinicians in developing countries face challenges in managing SCD patients. However understanding the disease, its progression, and instituting the appropriate preventive methods are paramount in its management. Emphasis should be placed on early counselling, new-born screening, anti-microbial prophylaxis, vaccination against infections, and training of healthcare workers, patients and caregivers. These interventions are affordable in developing countries. PMID:24363877

  1. Intended and Unintended Consequences of Student Use of an Online Questioning Environment

    ERIC Educational Resources Information Center

    Ng'ambi, Dick; Brown, Irwin

    2009-01-01

    While supplementation of face-to-face (F2F) teaching with online engagement is increasingly common, the educators' challenge of teaching F2F personalities and facilitating online personalities has not been widely explored. In this paper, we report on a project in which 1st-year students attended F2F sessions and engaged with an anonymous online…

  2. Oral Communication Skills Assessment in a Synchronous Hybrid MBA Programme: Does Attending Face-to-Face Matter for US and International Students?

    ERIC Educational Resources Information Center

    Butz, Nikolaus T.; Askim-Lovseth, Mary K.

    2015-01-01

    The ability to communicate effectively is an essential skill for graduates of Masters of Business Administration (MBA) programmes; however, as synchronous hybrid learning becomes more common, business schools may find it challenging to assess students' proficiency in this core area. An additional layer of complexity is added by the burgeoning…

  3. Managing childhood chronic illness: parent perspectives and implications for parent-provider relationships.

    PubMed

    Kratz, Lyn; Uding, Nancy; Trahms, Cristine M; Villareale, Nanci; Kieckhefer, Gail M

    2009-12-01

    When children have special health care needs, parents assume the roles of care coordinator, medical expert, and systems advocate as well as their typical parenting roles. They face many challenges in managing their child's chronic condition in the context of everyday life. Health care providers are uniquely positioned to assist parents in meeting those challenges and to promote parent competency and confidence in their child's care. The data for this analysis were collected during classes for parents of children with chronic conditions who took part in a randomized controlled study of a curriculum's effectiveness. During facilitated discussions, parents discussed challenges they faced and generated strategies they found helpful. Qualitative data analysis revealed dominant themes across subject areas. Challenges included social isolation, strained relationships and ongoing frustrations with health care and educational systems. Helpful strategies focused on being prepared, connecting with peers, becoming an advocate, developing partnerships and caring for one's self. Implications for health care providers include: understanding common challenges parents face; promoting parent-to-parent connections; and building partnerships with parents and their children with special needs.

  4. Mentoring and social skills training: ensuring better outcomes for youth in foster care.

    PubMed

    Williams, Charles A

    2011-01-01

    Youth in foster care face significant life challenges that make it more likely that they will face negative outcomes (i.e., school failure, homelessness, and incarceration). While the reason(s) for out-of-home placement (i.e., family violence, abuse, neglect and/or abandonment) provide some context for negative outcomes, such negative outcomes need not be a foregone conclusion. In fact, interventions created to serve at-risk youth could ostensibly address the needs of youth in foster care as well, given that they often face similar social, emotional, and other challenges. Specifically, the author posits that supporting foster care youth through the use ofmentoring and social skills training could reduce the negative outcomes far too common for many of these youth.

  5. Developing Social Justice Literacy: An Open Letter to Our Faculty Colleagues

    ERIC Educational Resources Information Center

    Sensoy, Ozlem; DiAngelo, Robin

    2009-01-01

    Just agreeing that social justice is important is not enough. Educators must practice social justice or else the concept is meaningless. The author presents four vignettes to illustrate common challenges faced by professors who explicitly teach social justice-oriented education courses, provides a glossary of common terms, and offers…

  6. Poststroke Depression: Social Workers' Role in Addressing an Underrecognized Psychological Problem for Couples Who Have Experienced Stroke

    ERIC Educational Resources Information Center

    McCarthy, Michael J.; Powers, Laurie E.; Lyons, Karen S.

    2011-01-01

    Depression is the most common psychological challenge faced by many individuals and families following stroke. Fortunately, poststroke depression is treatable, and even preventable, if social work and other rehabilitation practitioners understand the most common risk factors and become familiar with measures for assessing for depression among…

  7. Year 3 of Implementing the Common Core State Standards: Transitioning to CCSS-Aligned Curriculum and Assessments for Students with Disabilities

    ERIC Educational Resources Information Center

    Frizzell, Matthew

    2013-01-01

    This report, based on a spring 2013 survey of state education agency officials in Common Core-adopting states, focuses on state efforts to prepare students with disabilities for the Common Core State Standards. The report also addresses the challenges states face with supporting teachers of students with disabilities and state plans for assessing…

  8. Special Considerations in the Treatment of College Students with Bipolar Disorder

    ERIC Educational Resources Information Center

    Lejeune, Simon M. W.

    2011-01-01

    Bipolar disorder is a relatively common mental disorder that often has its onset during the college years. This means that students simultaneously face both the challenge of late adolescent development and the challenge of adapting to a major mental illness. As a further complication, the college environment is not well suited to the kinds of…

  9. Fuels planning: science synthesis and integration; social issues fact sheet 11: Challenges to collaboration

    Treesearch

    Christine Esposito

    2006-01-01

    Bringing the right people into a collaborative process can be difficult. Potential collaborators must all feel they have something to gain to justify investing resources, sharing knowledge, and perhaps compromising on goals and actions. This fact sheet discusses some of the common challenges that individuals, communities, and institutions face in collaboration.

  10. What Would Terri Want? On the Psychological Challenges of Surrogate Decision Making

    ERIC Educational Resources Information Center

    Ditto, Peter H

    2006-01-01

    The Terri Schiavo case was unique in the media attention it garnered, but the decision making challenges faced by Terri's family are common ones encountered by all families who must make choices about the use of life-sustaining medical treatment for an incapacitated loved one. This article highlights three key issues that were particularly…

  11. Harmonizing professional, personal, and social responsibilities: Indian women dentists' perspectives.

    PubMed

    Nagda, Suhasini Jayantilal

    2015-05-01

    Women in Indian culture have a paradoxical status: on the one hand, goddesses are worshipped for power and prosperity; on the other hand, working women face challenges due to age-old beliefs and sociocultural norms. With 60% of the students enrolled in undergraduate dental education currently being women, there is a need to study the challenges these women are facing and how they tackle them. The aim of this survey study was to assess the barriers women dentists face in career advancement and how successfully they balance the personal, professional, and social aspects of their lives. Questionnaires, consisting of four qualitative and 24 quantitative items, were distributed to 500 women dentists: postgraduate residents and faculty members in dental colleges of Mumbai and Navi Mumbai, as well as private dental practitioners. Of the 500 women, 210 returned the survey, for an overall response rate of 42%. The results showed that 95% of the respondents believed they successfully balance the various spheres of their lives, but the most common challenges they faced continued to be traditional gender bias, dual professional and home responsibilities, and preconceived ideas about women.

  12. Effect of bariatric surgery on future general surgical procedures.

    PubMed

    Kini, Subhash; Kannan, Umashankkar

    2011-04-01

    Bariatric surgery is now accepted as a safe and effective procedure for morbid obesity. The frequency of bariatric procedures is increasing with the adoption of the laparoscopic approach. The general surgeons will be facing many more of such patients presenting with common general surgical problems. Many of the general surgeons, faced with such situations, may not be aware of the changes in the gastrointestinal anatomy following bariatric procedures and management of these clinical situations will therefore present diagnostic and therapeutic challenges. We hereby present a review of management of few common general surgical problems in patients with a history of bariatric surgery.

  13. The role of assisted self-help in services for alcohol-related disorders.

    PubMed

    Kavanagh, David J; Proctor, Dawn M

    2011-06-01

    Potentially harmful substance use is common, but many affected people do not receive treatment. Brief face-to-face treatments show impact, as do strategies to assist self-help remotely, by using bibliotherapies, computers or mobile phones. Remotely delivered treatments offer more sustained and multifaceted support than brief interventions, and they show a substantial cost advantage as users increase in number. They may also build skills, confidence and treatment fidelity in providers who use them in sessions. Engagement and retention remain challenges, but electronic treatments show promise in engaging younger populations. Recruitment may be assisted by integration with community campaigns or brief opportunistic interventions. However, routine use of assisted self-help by standard services faces significant challenges. Strategies to optimize adoption are discussed. Copyright © 2011. Published by Elsevier Ltd.

  14. The new productivity challenge.

    PubMed

    Drucker, P F

    1991-01-01

    "The single greatest challenge facing managers in the developed countries of the world is to raise the productivity of knowledge and service workers," writes Peter F. Drucker in "The New Productivity Challenge." Productivity, says Drucker, ultimately defeated Karl Marx; it gave common laborers the chance to earn the wages of skilled workers. Now five distinct steps will raise the productivity of knowledge and service workers--and not only stimulate new economic growth but also defuse rising social tensions.

  15. Working with Families Living with Autism: Potential Contributions of Marriage and Family Therapists

    ERIC Educational Resources Information Center

    Neely, Jason; Amatea, Ellen S.; Echevarria-Doan, Silvia; Tannen, Tina

    2012-01-01

    This article introduces marriage and family therapists (MFT) to some of the common issues faced by families that have a child with autism spectrum disorder (ASD). First, autism is defined and common myths surrounding it are discussed. Next, relational challenges are presented that families report experiencing during early childhood through the…

  16. Leading Change: Transitioning to the Common Core

    ERIC Educational Resources Information Center

    Brandt, Brian

    2012-01-01

    For many school districts in the United States, making the transition to the Common Core State Standards (CCSS) is proving to be a challenge at a time when they are already facing many obstacles, not the least of which is dwindling financial resources. A change of this magnitude cannot be made haphazardly; to be successful in its goal of helping…

  17. Meeting the Needs of Urban Youths in Columbus City Schools

    ERIC Educational Resources Information Center

    Deglau, Dena A.; Barnes, Diane

    2009-01-01

    With 55 percent of the 53,400 students on free and reduced lunch programs, a 78 percent mobility rate, and a diverse population, Columbus City Schools (CCS) in Ohio faces the challenges common to other urban districts. In spite of the challenges, CCS has made a long-term commitment to engage students in high-quality physical education and physical…

  18. Online Professional Development for High-School Biology Teachers: Effects on Teachers' and Students' Knowledge

    ERIC Educational Resources Information Center

    Goldenberg, Lauren B.; Culp, Katherine McMillan; Clements, Margaret; Pasquale, Marian; Anderson, Alice

    2014-01-01

    One chronic challenge facing professional development providers is the need to convene and support groups of role-alike K-12 teachers who require similar kinds of discipline-and grade-level-specific training. Online courses have become an increasingly common way to meet this challenge. This article reports on a randomized control trial that tested…

  19. Challenges and Opportunities Faced by Biofield Practitioners in Global Health and Medicine: A White Paper

    PubMed Central

    King, Rauni Prittinen

    2015-01-01

    Biofield therapies (BTs) are increasingly employed in contemporary healthcare. In this white paper, we review specific challenges faced by biofield practitioners resulting from a lack of (1) a common scientific definition of BT; (2) common educational standards for BT training (including core competencies for clinical care); (3) collaborative team care education in complementary and alternative medicine (CAM) and in integrative health and medicine (IHM); (4) a focused agenda in BT research; and (5) standardized devices and scientifically validated mechanisms in biofield research. We present a description of BT and discuss its current status and challenges as an integrative healthcare discipline. To address the challenges cited and to enhance collaboration across disciplines, we propose (1) standardized biofield education that leads to professional licensure and (2) interprofessional education (IPE) competencies in BT training required for licensed healthcare practitioners and encouraged for other practitioners using these therapies. Lastly, we discuss opportunities for growth and a potential strategic agenda to achieve these goals. The Academy of Integrative Health and Medicine (AIHM) provides a unique forum to facilitate development of this emerging discipline, to facilitate IPE, and to further increase the availability of BT to patients. PMID:26665047

  20. Abnormal GABAergic function and face processing in schizophrenia: A pharmacologic-fMRI study.

    PubMed

    Tso, Ivy F; Fang, Yu; Phan, K Luan; Welsh, Robert C; Taylor, Stephan F

    2015-10-01

    The involvement of the gamma-aminobutyric acid (GABA) system in schizophrenia is suggested by postmortem studies and the common use of GABA receptor-potentiating agents in treatment. In a recent study, we used a benzodiazepine challenge to demonstrate abnormal GABAergic function during processing of negative visual stimuli in schizophrenia. This study extended this investigation by mapping GABAergic mechanisms associated with face processing and social appraisal in schizophrenia using a benzodiazepine challenge. Fourteen stable, medicated schizophrenia/schizoaffective patients (SZ) and 13 healthy controls (HC) underwent functional MRI using the blood oxygenation level-dependent (BOLD) technique while they performed the Socio-emotional Preference Task (SePT) on emotional face stimuli ("Do you like this face?"). Participants received single-blinded intravenous saline and lorazepam (LRZ) in two separate sessions separated by 1-3weeks. Both SZ and HC recruited medial prefrontal cortex/anterior cingulate during the SePT, relative to gender identification. A significant drug by group interaction was observed in the medial occipital cortex, such that SZ showed increased BOLD signal to LRZ challenge, while HC showed an expected decrease of signal; the interaction did not vary by task. The altered BOLD response to LRZ challenge in SZ was significantly correlated with increased negative affect across multiple measures. The altered response to LRZ challenge suggests that abnormal face processing and negative affect in SZ are associated with altered GABAergic function in the visual cortex, underscoring the role of impaired visual processing in socio-emotional deficits in schizophrenia. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. How diet modification challenges are magnified in vulnerable or marginalized people with diabetes and heart disease: a systematic review and qualitative meta-synthesis.

    PubMed

    Vanstone, M; Giacomini, M; Smith, A; Brundisini, F; DeJean, D; Winsor, S

    2013-01-01

    Diet modification is an important part of self-management for patients with diabetes and/or heart disease (including coronary artery disease, heart failure, and atrial fibrillation). Many health care providers and community-based programs advise lifestyle and diet modification as part of care for people with these conditions. This report synthesizes qualitative information on how patients respond differently to the challenges of diet modification. Qualitative and descriptive evidence can illuminate challenges that may affect the success and equitable impact of dietary modification interventions. To (a) examine the diet modification challenges faced by diabetes and/or heart disease patients; and (b) compare and contrast the challenges faced by patients who are members of vulnerable and nonvulnerable groups as they change their diet in response to clinical recommendations. This report synthesizes 65 primary qualitative studies on the topic of dietary modification challenges encountered by patients with diabetes and/or heart disease. Included papers were published between 2002 and 2012 and studied adult patients in North America, Europe, and Australia/New Zealand. Qualitative meta-synthesis was used to integrate findings across primary research studies. Analysis identified 5 types of challenges that are common to both vulnerable and nonvulnerable patients: self-discipline, knowledge, coping with everyday stress, negotiating with family members, and managing the social significance of food. Vulnerable patients may experience additional barriers, many of which can magnify or exacerbate those common challenges. While qualitative insights are robust and often enlightening for understanding experiences and planning services in other settings, they are not intended to be generalizable. The findings of the studies reviewed here--and of this synthesis--do not strictly generalize to the Ontario (or any specific) population. This evidence must be interpreted and applied carefully, in light of expertise and the experiences of the relevant community. Diet modification is not simply a matter of knowing what to eat and making the rational choice to change dietary practices. Rather, diet and eating practices should be considered as part of the situated lives of patients, requiring an individualized approach that is responsive to the conditions in which each patient is attempting to make a change. Common challenges include self-discipline, knowledge, coping with everyday stress, negotiating with family members, and managing the social significance of food. An individualized approach is particularly important when working with patients who have vulnerabilities. Health care providers often encourage people with diabetes and/or heart disease to change their diet. They advise people with diabetes to eat less sugar, starch, and fat. They advise people with heart disease to eat less fat and salt. However, many patients find it difficult to change what they eat. This report examines the challenges people may face when making such changes. It also examines the special challenges faced by people who are vulnerable due to other factors, such as poverty, lack of education, and difficulty speaking English. Five themes were common to all people who make diet changes: self-discipline, knowledge, coping with stress, negotiating with family members, and managing the social aspect of food. Members of vulnerable groups also reported other challenges, such as affording fresh fruit and vegetables or understanding English instructions. This report may help health care providers work with patients more effectively to make diet changes.

  2. How Diet Modification Challenges Are Magnified in Vulnerable or Marginalized People With Diabetes and Heart Disease

    PubMed Central

    Vanstone, M; Giacomini, M; Smith, A; Brundisini, F; DeJean, D; Winsor, S

    2013-01-01

    Background Diet modification is an important part of self-management for patients with diabetes and/or heart disease (including coronary artery disease, heart failure, and atrial fibrillation). Many health care providers and community-based programs advise lifestyle and diet modification as part of care for people with these conditions. This report synthesizes qualitative information on how patients respond differently to the challenges of diet modification. Qualitative and descriptive evidence can illuminate challenges that may affect the success and equitable impact of dietary modification interventions. Objectives To (a) examine the diet modification challenges faced by diabetes and/or heart disease patients; and (b) compare and contrast the challenges faced by patients who are members of vulnerable and nonvulnerable groups as they change their diet in response to clinical recommendations. Data Sources This report synthesizes 65 primary qualitative studies on the topic of dietary modification challenges encountered by patients with diabetes and/or heart disease. Included papers were published between 2002 and 2012 and studied adult patients in North America, Europe, and Australia/New Zealand. Review Methods Qualitative meta-synthesis was used to integrate findings across primary research studies. Results Analysis identified 5 types of challenges that are common to both vulnerable and nonvulnerable patients: self-discipline, knowledge, coping with everyday stress, negotiating with family members, and managing the social significance of food. Vulnerable patients may experience additional barriers, many of which can magnify or exacerbate those common challenges. Limitations While qualitative insights are robust and often enlightening for understanding experiences and planning services in other settings, they are not intended to be generalizable. The findings of the studies reviewed here—and of this synthesis—do not strictly generalize to the Ontario (or any specific) population. This evidence must be interpreted and applied carefully, in light of expertise and the experiences of the relevant community. Conclusions Diet modification is not simply a matter of knowing what to eat and making the rational choice to change dietary practices. Rather, diet and eating practices should be considered as part of the situated lives of patients, requiring an individualized approach that is responsive to the conditions in which each patient is attempting to make a change. Common challenges include self-discipline, knowledge, coping with everyday stress, negotiating with family members, and managing the social significance of food. An individualized approach is particularly important when working with patients who have vulnerabilities. Plain Language Summary Health care providers often encourage people with diabetes and/or heart disease to change their diet. They advise people with diabetes to eat less sugar, starch, and fat. They advise people with heart disease to eat less fat and salt. However, many patients find it difficult to change what they eat. This report examines the challenges people may face when making such changes. It also examines the special challenges faced by people who are vulnerable due to other factors, such as poverty, lack of education, and difficulty speaking English. Five themes were common to all people who make diet changes: self-discipline, knowledge, coping with stress, negotiating with family members, and managing the social aspect of food. Members of vulnerable groups also reported other challenges, such as affording fresh fruit and vegetables or understanding English instructions. This report may help health care providers work with patients more effectively to make diet changes. PMID:24228077

  3. Common Challenges Faced by Women of Color in Physics, and Actions Faculty Can Take to Minimize Those Challenges

    ERIC Educational Resources Information Center

    Johnson, Angela; Ong, Maria; Ko, Lily T.; Smith, Janet; Hodari, Apriel

    2017-01-01

    Women of color are deeply underrepresented in physics. Between 2002 and 2012, only 1% of graduating physics majors were Black women and another 1% were Latinas; only 61 American Indian women total completed degrees in physics in those years (out of 48,000 physics majors). This isolation can lead to additional obstacles that women of color majoring…

  4. Barriers, Challenges, and Decision-Making in the Letter Writing Process for Gender Transition.

    PubMed

    Budge, Stephanie L; Dickey, Lore M

    2017-03-01

    This article addresses the challenges that clinicians face in writing letters of support for transgender and gender-diverse clients. It addresses common but challenging clinical representations to help the reader understand the nuances associated with writing letters. Three cases are presented. The first addresses systemic challenges, the second addresses management of care, and the third addresses co-occurring mental health concerns. Recommendations for practice are provided based on the experiences included within the 3 case examples. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Workshop on Advanced Technologies for Planetary Instruments, part 1

    NASA Technical Reports Server (NTRS)

    Appleby, John F. (Editor)

    1993-01-01

    This meeting was conceived in response to new challenges facing NASA's robotic solar system exploration program. This volume contains papers presented at the Workshop on Advanced Technologies for Planetary Instruments on 28-30 Apr. 1993. This meeting was conceived in response to new challenges facing NASA's robotic solar system exploration program. Over the past several years, SDIO has sponsored a significant technology development program aimed, in part, at the production of instruments with these characteristics. This workshop provided an opportunity for specialists from the planetary science and DoD communities to establish contacts, to explore common technical ground in an open forum, and more specifically, to discuss the applicability of SDIO's technology base to planetary science instruments.

  6. Forming Effective Partnerships to Facilitate Inclusion of Students with Vision Impairments: Perceptions of a Regular Classroom Teacher and an Itinerant Teacher

    ERIC Educational Resources Information Center

    Sharma, Umesh; Moore, Dennis; Furlonger, Brett; King, Brian Smyth; Kaye, Linda; Constantinou, Olga

    2010-01-01

    This qualitative study reports on the perceptions of a regular classroom teacher and an itinerant teacher about the challenges they faced in including a student with vision impairment in regular school in New South Wales, Australia. Some of the common strategies employed by both these teachers to address these challenges are discussed. (Contains 1…

  7. Sedation and Analgesia in Transportation of Acutely and Critically Ill Patients.

    PubMed

    Johnston, Dawn; Franklin, Kevin; Rigby, Paul; Bergman, Karen; Davidson, Scott B

    2016-06-01

    Transportation of acutely or critically ill patients is a challenge for health care providers. Among the difficulties that providers face is the balance between adequate sedation and analgesia for the transportation event and maintaining acceptable respiratory and physiologic parameters of the patient. This article describes common challenges in providing sedation and analgesia during various phases of transport. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Where the Cloud Meets the Commons

    ERIC Educational Resources Information Center

    Ipri, Tom

    2011-01-01

    Changes presented by cloud computing--shared computing services, applications, and storage available to end users via the Internet--have the potential to seriously alter how libraries provide services, not only remotely, but also within the physical library, specifically concerning challenges facing the typical desktop computing experience.…

  9. Supporting Immersion Teachers: An Autoethnography

    ERIC Educational Resources Information Center

    Speece, Lauren

    2017-01-01

    Immersion programs face a variety of challenges that are common to the field, such as lack of materials appropriate for students' language abilities, assessment, teacher recruitment and retention, balancing content and language, and relevant, high quality professional development for teachers. However, within specific micro-contexts, other issues…

  10. Colleges Must Get Used to Collaborating with Congress

    ERIC Educational Resources Information Center

    Trible, Paul

    2005-01-01

    Differences in political ideology between college and university administrators and federal legislators have brought about lack of communication, mistrust, and indifference between Congress and higher education. This article discusses the bridging of these differences through common understanding and collaboration to meet the challenges faced by…

  11. Dietary Supplements: Regulatory Challenges and Research Resources.

    PubMed

    Dwyer, Johanna T; Coates, Paul M; Smith, Michael J

    2018-01-04

    Many of the scientific and regulatory challenges that exist in research on the safety, quality and efficacy of dietary supplements are common to all countries as the marketplace for them becomes increasingly global. This article summarizes some of the challenges in supplement science and provides a case study of research at the Office of Dietary Supplements at the National Institutes of Health, USA, along with some resources it has developed that are available to all scientists. It includes examples of some of the regulatory challenges faced and some resources for those who wish to learn more about them.

  12. Dietary Supplements: Regulatory Challenges and Research Resources

    PubMed Central

    Dwyer, Johanna T.; Coates, Paul M.; Smith, Michael J.

    2018-01-01

    Many of the scientific and regulatory challenges that exist in research on the safety, quality and efficacy of dietary supplements are common to all countries as the marketplace for them becomes increasingly global. This article summarizes some of the challenges in supplement science and provides a case study of research at the Office of Dietary Supplements at the National Institutes of Health, USA, along with some resources it has developed that are available to all scientists. It includes examples of some of the regulatory challenges faced and some resources for those who wish to learn more about them. PMID:29300341

  13. Undergraduate medical education in the U.S. and Israel: contrasts and common challenges.

    PubMed

    Feldman, Arthur M

    2015-01-01

    In 2014, the Israeli Council for Higher Education (CHE) commissioned an international panel of outstanding educators to prepare an ad hoc report reviewing the four established medical schools in Israel. The report described the strengths, weaknesses and challenges facing medical education in Israel with a focus on three specific areas: workforce planning, the structure of the curriculum and the financing of medical education. There are interesting parallels between the challenges facing medical education in the U.S. and in Israel: a lack of clarity regarding the optimal size for the workforce and the optimal method for enhancing the number of primary care physicians; an absence of methodologies for evaluating innovations in medical education and a lack of transparency in funds flow. However, there are also important differences, one of the most important being an absence in Israel of students' hands-on responsibility for their patients until year six of their undergraduate medical education. The presence of a small number of medical schools with common funding and geographic proximity, in a relative sense, provides the Israeli medical schools with a unique opportunity to evaluate innovations in medical education and to set a high bar for inter-school collaboration and cooperation.

  14. Breast prosthesis: Management of patients after plastic surgery

    PubMed Central

    Bassetti, E.; Pediconi, F.; Luciani, M.L.; Santucci, E.; Miglio, E.; Candreva, R.

    2011-01-01

    Breast augmentation and breast reconstruction are increasingly common operations. All radiologists need to be able to recognize the normal appearances of the more commonly used implants on various imaging modalities and breast radiologists in particular are facing new challenges when imaging the women involved. This work aims to review the normal and abnormal findings in women undergoing breast implant surgery using ultrasonography, mammography, and magnetic resonance imaging. PMID:23396957

  15. Behind the scenes of the Patient Protection and Affordable Care Act: the making of a health care co-op.

    PubMed

    Giaimo, Susan

    2013-06-01

    A primary goal of the Patient Protection and Affordable Care Act (PPACA) is to reduce the number of uninsured by making health insurance more affordable for small businesses and individuals. Toward that end, the PPACA encourages the creation of nonprofit, member-owned health insurance cooperatives to operate inside each state exchange. Co-ops face significant challenges in entering mature insurance markets, but they also possess unique characteristics that may help them survive and thrive. Using Common Ground Healthcare Cooperative in Wisconsin as a case study, this article traces the origins of co-ops in health care reform at national and state levels and analyzes the political and technical challenges and opportunities facing these organizations.

  16. [Primary health care: challenges for implementation in Latin America].

    PubMed

    Giraldo Osorio, Alexandra; Vélez Álvarez, Consuelo

    2013-01-01

    A development process, marked by the re-appearance of the primary health care as the core of health systems, has emerged in Latin America. Governments have made a commitment to renew this strategy as the basis of their health systems. However, these health systems are mainly faced with re-introducing equity values, and there are common challenges such as providing the health systems with trained human resources in sufficient numbers, overcoming the fragmentation/segmentation of the systems, ensuring financial sustainability, improving governance, quality of care and information systems, expanding coverage, preparing to face the consequences of an aging population, the changing epidemiological profile, and increase in the response capacity of the public health system. This article is intended to provide a comprehensive view of the progress and challenges of the inclusion of primary care health systems in Latin American countries. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  17. Challenges Facing Global Health Networks: The NCD Alliance Experience Comment on "Four Challenges that Global Health Networks Face".

    PubMed

    Dain, Katie

    2017-08-07

    Successful prevention and control of the epidemic of noncommunicable diseases (NCDs) cannot be achieved by the health sector alone: a wide range of organisations from multiple sectors and across government must also be involved. This requires a new, inclusive approach to advocacy and to coordinating, convening and catalysing action across civil society, best achieved by a broad-based network. This comment maps the experience of the NCD Alliance (NCDA) on to Shiffman's challenges for global health networks - framing (problem definition and positioning), coalition-building and governance - and highlights some further areas overlooked in his analysis. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  18. Hair restoration surgery: challenges and solutions

    PubMed Central

    Rose, Paul T

    2015-01-01

    Hair loss is a common problem affecting both men and women. The most frequent etiology is androgenetic alopecia, but other causes of hair loss such as trauma, various dermatologic diseases, and systemic diseases can cause alopecia. The loss of hair can have profound effects on one’s self esteem and emotional well-being, as one’s appearance plays a role in the work place and interpersonal relationships. It is therefore not surprising that means to remedy hair loss are widely sought. Hair transplant surgery has become increasingly popular, and the results that we are able to create today are quite remarkable, providing a natural appearance when the procedure is performed well. In spite of this, hair transplant surgery is not perfect. It is not perfect because the hair transplant surgeon is still faced with challenges that prevent the achievement of optimal results. Some of these challenges include a limit to donor hair availability, hair survival, and ways to conceal any evidence of a surgical procedure having taken place. This article examines some of the most important challenges facing hair restoration surgery today and possible solutions to these challenges. PMID:26203266

  19. Sustainable Chemistry, the Spinning Tube-in-Tube (STT(R)) Reactor and GREENSCOPE: Innovation and Industrial Partnerships

    EPA Science Inventory

    The chemical industry faces environmental, social and health challenges that are common across all economic sectors. From worker exposure to toxic substances, to product design and use, to the cost and handling of waste disposal, the industry must overcome numerous complex hurdle...

  20. Coordinating the Commons: Diversity & Dynamics in Open Collaborations

    ERIC Educational Resources Information Center

    Morgan, Jonathan T.

    2013-01-01

    The success of Wikipedia demonstrates that open collaboration can be an effective model for organizing geographically-distributed volunteers to perform complex, sustained work at a massive scale. However, Wikipedia's history also demonstrates some of the challenges that large, long-term open collaborations face: the core community of Wikipedia…

  1. Differing Circumstances, Shared Challenges: Finding Common Ground between Urban and Rural Schools

    ERIC Educational Resources Information Center

    Truscott, Diane M.; Truscott, Stephen D.

    2005-01-01

    The shared struggles facing urban and rural schools, such as changing cultural and linguistic classroom profiles, increased childhood poverty, and residential segregation patterns, influence financial inequities between people and communities thus contributing to gaps in academic achievement and teacher shortages in both settings. The…

  2. Distance Synchronous Information Systems Course Delivery

    ERIC Educational Resources Information Center

    Peslak, Alan R.; Lewis, Griffith R.; Aebli, Fred

    2014-01-01

    Teaching computer information systems via distance education is a challenge for both student and faculty. Much research work has been performed on methods of teaching via distance education. Today we are faced with a variety of options for course delivery. Asynchronous delivery via online or lesson instruction still remains most common. But…

  3. EFFECTS OF HABITAT LOSS ON POPULATIONS OF WHITE-FOOTED MICE: MATRIX MODEL PREDICTIONS WITH LANDSCAPE-SCALE PERTURBATION EXPERIMENTS

    EPA Science Inventory

    Habitat loss is the leading cause of decline in wildlife diversity and abundance throughout the world, and understanding its impacts on animal populations is a critical challenge facing conservation biologists. Population viability analysis (PVA) is a commonly used tool for pred...

  4. Getting a Bead on It

    ERIC Educational Resources Information Center

    Ferrucci, Beverly J.; McDougall, Jennifer; Carter, Jack

    2009-01-01

    One challenge that middle school teachers commonly face is finding insightful, hands-on applications when teaching basic mathematical concepts. One concept that is a foundation of middle school mathematics is the notion of "linear functions." Although a variety of models can be used for linear equations, such as temperature conversions,…

  5. Gifted Students with Disabilities: "Twice Exceptionality" in the Music Classroom

    ERIC Educational Resources Information Center

    Abramo, Joseph Michael

    2015-01-01

    Many music educators teach students who are both gifted and possess a learning disability--what is commonly referred to as "twice exceptionality." This article describes some characteristics of twice-exceptional students, the challenges these students often face in school, and some strategies music educators can use to properly…

  6. Bringing Out Eveyone's Best: Ten Psychological Tips for Academic Department Leaders.

    ERIC Educational Resources Information Center

    Chambliss, Catherine

    Promoting academic departmental productivity requires vision, passion, and sensitivity while coping with the rapid pace of change. This paper presents 10 proven strategies for managing some common challenges faced by academic department chairs: (1) building a sense of family purpose; (2) establishing mechanisms to assure accountability; (3)…

  7. Superintendents for the 21st Century: It's Not Just a Job, It's a Calling.

    ERIC Educational Resources Information Center

    Houston, Paul

    2001-01-01

    The 21st-century superintendent faces several challenges: changing demographics (growing diversity), the divide between haves and have-nots, devaluation of children (reliance on remediation over prevention), de-emphasis on education for citizenship, deregulation, devolution of power, "demassification" (fewer common information sources),…

  8. Schools Get Smart about Energy

    ERIC Educational Resources Information Center

    Hoff, Randy

    2011-01-01

    Regardless of size or community served, school districts across California and the nation face one common challenge--a reduction in funding. Becoming more efficient in managing precious taxpayer dollars has become the highest priority for districts in order to minimize or avoid staff reductions or the elimination of student programs. Dozens of…

  9. Balancing the professional and personal.

    PubMed

    Armstrong, Alicia Y; Alvero, Ruben J; Dunlow, Susan; Nace, Mary Catherine; Baker, Valerie; Stewart, Elizabeth A

    2009-01-01

    To review the common roles that physicians pursue away from work and identify related challenges and potential solutions, so that individuals can develop a personalized plan for success in each of the areas. Literature review. University-based and university-affiliated medical centers. No subjects were involved in this literature review. Literature searches in Entrez PubMed and the following Websites: http://www.apgo.org, http://www.psychiatrictimes.com, as well as other data sources. Results of physician surveys and summaries of strategies for achieving work-personal life balance. According to surveys of physicians in various specialties, a majority of physicians have high levels of job, marital, and parental satisfaction. However, professional and personal challenges faced by physicians include struggle with time management, lack of mentorship, and difficulty maintaining intimate relationships. Multiple potentially effective strategies have been described in the literature, including exerting control over hours worked, taking a long view of life that acknowledges the need for changing priorities over time, developing communication skills, seeking counseling services if needed that focus on physician relationships, and simplifying home life whenever possible. Although there are unique challenges in being a physician, partner, and parent, many of the professional challenges faced by physicians are common to many adults in the United States. Self-assessment may help individuals to clarify priorities and develop strategies that can lead to improved personal satisfaction.

  10. High precision automated face localization in thermal images: oral cancer dataset as test case

    NASA Astrophysics Data System (ADS)

    Chakraborty, M.; Raman, S. K.; Mukhopadhyay, S.; Patsa, S.; Anjum, N.; Ray, J. G.

    2017-02-01

    Automated face detection is the pivotal step in computer vision aided facial medical diagnosis and biometrics. This paper presents an automatic, subject adaptive framework for accurate face detection in the long infrared spectrum on our database for oral cancer detection consisting of malignant, precancerous and normal subjects of varied age group. Previous works on oral cancer detection using Digital Infrared Thermal Imaging(DITI) reveals that patients and normal subjects differ significantly in their facial thermal distribution. Therefore, it is a challenging task to formulate a completely adaptive framework to veraciously localize face from such a subject specific modality. Our model consists of first extracting the most probable facial regions by minimum error thresholding followed by ingenious adaptive methods to leverage the horizontal and vertical projections of the segmented thermal image. Additionally, the model incorporates our domain knowledge of exploiting temperature difference between strategic locations of the face. To our best knowledge, this is the pioneering work on detecting faces in thermal facial images comprising both patients and normal subjects. Previous works on face detection have not specifically targeted automated medical diagnosis; face bounding box returned by those algorithms are thus loose and not apt for further medical automation. Our algorithm significantly outperforms contemporary face detection algorithms in terms of commonly used metrics for evaluating face detection accuracy. Since our method has been tested on challenging dataset consisting of both patients and normal subjects of diverse age groups, it can be seamlessly adapted in any DITI guided facial healthcare or biometric applications.

  11. Communication Challenges and Strategies of U.S. Health Professionals Caring for Seriously Ill South Asian Patients and Their Families.

    PubMed

    Khosla, Nidhi; Washington, Karla T; Shaunfield, Sara; Aslakson, Rebecca

    2017-06-01

    While effective communication is important in the care of seriously ill patients, little is known about communication challenges faced by healthcare providers serving U.S. patients of South Asian origin, one of the fastest growing demographic groups in the United States. Researchers sought to examine communication challenges faced by healthcare providers serving seriously ill South Asian patients and their families and present strategies recommended by providers for effective communication. Researchers conducted a thematic analysis of qualitative data obtained through focus groups and individual interviews with 57 healthcare providers, including physicians, social workers, nurses, chaplains, and others drawn from different healthcare settings in one Midwestern city. While acknowledging the considerable diversity within the U.S. South Asian community, participants discussed three types of communication challenges they often encounter when serving this population: ensuring effective interpretation, identifying a spokesperson, and challenges posed by different cultural norms. Participants shared strategies to address these challenges such as proactively inquiring about patients' and families' preferences and encouraging early appointment of a spokesperson. While providers should avoid stereotyping patients, an awareness of common challenges and adoption of recommended strategies to address these challenges may enhance the provision of culturally responsive person-centered services for seriously ill South Asian patients and their families receiving care in the United States.

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

    PubMed

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

    2015-01-01

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

  13. An Overview and Empirical Comparison of Distance Metric Learning Methods.

    PubMed

    Moutafis, Panagiotis; Leng, Mengjun; Kakadiaris, Ioannis A

    2016-02-16

    In this paper, we first offer an overview of advances in the field of distance metric learning. Then, we empirically compare selected methods using a common experimental protocol. The number of distance metric learning algorithms proposed keeps growing due to their effectiveness and wide application. However, existing surveys are either outdated or they focus only on a few methods. As a result, there is an increasing need to summarize the obtained knowledge in a concise, yet informative manner. Moreover, existing surveys do not conduct comprehensive experimental comparisons. On the other hand, individual distance metric learning papers compare the performance of the proposed approach with only a few related methods and under different settings. This highlights the need for an experimental evaluation using a common and challenging protocol. To this end, we conduct face verification experiments, as this task poses significant challenges due to varying conditions during data acquisition. In addition, face verification is a natural application for distance metric learning because the encountered challenge is to define a distance function that: 1) accurately expresses the notion of similarity for verification; 2) is robust to noisy data; 3) generalizes well to unseen subjects; and 4) scales well with the dimensionality and number of training samples. In particular, we utilize well-tested features to assess the performance of selected methods following the experimental protocol of the state-of-the-art database labeled faces in the wild. A summary of the results is presented along with a discussion of the insights obtained and lessons learned by employing the corresponding algorithms.

  14. Now It's Necessary: Virtual Reference Services at Washington State University, Pullman

    ERIC Educational Resources Information Center

    Nicol, Erica Carlson; Crook, Linda

    2013-01-01

    While virtual reference services (VRS) are becoming more and more common in academic libraries, implementing and maintaining well-used and effective VRS can be a challenge in the face of competing demands on time, staffing, and funding. Between 2011 and 2012, librarians at Washington State University, Pullman (WSU) have overhauled and reorganized…

  15. Using common gardens and AFLP analyses to identify metapopulations of indigenous plant materials for rangeland revegetation in western USA

    USDA-ARS?s Scientific Manuscript database

    Semiarid rangelands in the western USA are facing unprecedented challenges related to past mismanagement, invasive weedy species, wildfires, and climatic change. A diversity of plant species are needed to effectively revegetate these rangelands. Legumes indigenous to western North America are of p...

  16. Caught in a Vise: The Challenges Facing Teacher Preparation in an Era of Accountability

    ERIC Educational Resources Information Center

    Ginsberg, Rick; Kingston, Neal

    2014-01-01

    Background: Despite polling data that suggests that teachers are well respected by the general public, criticism of teacher preparation by various organizations and interest groups is common, often highlighting the perceived need for increasing their rigor and performance. A number of studies and reports have critiqued teacher preparation, and…

  17. Using Design Experiments to Understand Secondary Classroom Comprehension Practices

    ERIC Educational Resources Information Center

    Vaughn, Sharon; Simmons, Deborah; Wanzek, Jeanne

    2013-01-01

    Adolescents in the United States and their teachers face an enormous academic challenge with respect to reading comprehension. College and career readiness standards outlined in the Common Core (2012) place increased emphasis on preparing students to read increasingly complex text across a range of disciplinary content areas. At issue is how to…

  18. Oh Canada! Too Many Children in Poverty for Too Long

    ERIC Educational Resources Information Center

    Rothman, Laurel

    2007-01-01

    Canada faces steep, yet surmountable challenges in its efforts to significantly reduce child and family poverty. Most recent data indicate that more than one million Canadian children and their families live in low-income households. Although the House of Commons unanimously resolved to "seek to achieve the goal of eliminating poverty among…

  19. Sexual Orientation and School Discipline: New Evidence from a Population-Based Sample

    ERIC Educational Resources Information Center

    Mittleman, Joel

    2018-01-01

    Sexual minorities' risk for exclusionary discipline is a commonly cited indicator of the challenges that these students face. The current study addresses this issue by introducing a new data source for research on sexual minority students: the Fragile Families and Childhood Wellbeing Study. In this geographically diverse, population-based sample,…

  20. Addressing Three Common Issues in Research on Youth Activities: An Integrative Approach for Operationalizing and Analyzing Involvement

    ERIC Educational Resources Information Center

    Busseri, Michael A.; Rose-Krasnor, Linda

    2010-01-01

    Youth activity involvement has been operationalized and analyzed using a wide range of approaches. Researchers face the challenges of distinguishing between the effects of involvement versus noninvolvement and intensity of involvement in a particular activity, accounting simultaneously for cumulative effects of involvement, and addressing multiple…

  1. Technology, Togetherness, and Adolescents: Creating a Meaningful Adolescent Learning Community in the Digital Age

    ERIC Educational Resources Information Center

    Moudry, Ben

    2016-01-01

    Ben Moudry has written a comprehensive overview of the current challenges facing parents, schools, administrators, and students regarding what he calls "handheld computers," commonly known as smart phones. His annotated statistics and description of American society in 2015 are frightening in their clarity, while the percentages and…

  2. Great Assistant Principals and the (Great) Principals Who Mentor Them: A Practical Guide

    ERIC Educational Resources Information Center

    Goodman, Carole C.; Berry, Christopher S.

    2011-01-01

    Written for principals and assistant principals to read and reflect on together, this book describes the most common challenges facing today's assistant principals--and provides practical solutions. Authors Carole Goodman and Christopher Berry examine how principals and assistant principals can develop the kinds of relationships that serve to meet…

  3. Engaging Mission: Applying the Catholic Social Tradition to Investing and Licensing

    ERIC Educational Resources Information Center

    Purcell, Bill; Rose, Margarita

    2018-01-01

    Faced with economic and demographic challenges, Catholic colleges and universities use endowment and licensing revenues to supplement tuition income in order to serve their missions of educating students of all socio-economic classes to promote the common good through their professional careers and service to the community. Licensees sometimes…

  4. Technology in the Trenches: Using Standards To Improve the Quality of Instruction.

    ERIC Educational Resources Information Center

    Soine, Robin

    New approaches to teaching and learning are common, but nothing will change unless these ideas are brought to the frontlines of the classroom. Facing the challenge to incorporate varied innovative teaching and learning strategies, set statewide and schoolwide goals, and implement standards, schools need a systematic, consistent framework and high…

  5. The Game Changer

    ERIC Educational Resources Information Center

    Mellon, Ericka

    2012-01-01

    Before the sun rises most days, Dwight D. Jones is at the office. Since becoming superintendent of the Clark County School District (CCSD) in Nevada last December, 4:30 a.m. arrivals are common. To be sure, the challenges facing the nation's fifth-largest school district are great. The recession not just hit, but smacked, Nevada, and the Clark…

  6. Counterterrorism: U.S. Agencies Face Challenges Countering the Use of Improvised Explosive Devices in the Afghanistan/Pakistan Region

    DTIC Science & Technology

    2012-07-12

    make IEDs. According to DOD, other products available in Pakistan—such as potassium chlorate , used in making matches, and urea, another commonly used...IED precursor chemicals. According to State officials, other substitutes for CAN, including potassium chlorate and urea, are exported by countries

  7. Rivers Run Through It: Discovering the Interior Columbia River Basin.

    ERIC Educational Resources Information Center

    Davis, Shelley; Wojtanik, Brenda Lincoln; Rieben, Elizabeth

    1998-01-01

    Explores the Columbia River Basin, its ecosystems, and challenges faced by natural resource managers. By studying the basin's complexity, students can learn about common scientific concepts such as the power of water and effects of rain shadows. Students can also explore social-scientific issues such as conflicts between protecting salmon runs and…

  8. Function-Based Approach to Designing an Instructional Environment

    ERIC Educational Resources Information Center

    Park, Kristy; Pinkelman, Sarah

    2017-01-01

    Teachers are faced with the challenge of selecting interventions that are most likely to be effective and best matched to the function of problem behavior. This article will define aspects of the instructional environment and describe a decision-making logic to select environmental variables. A summary of commonly used function-based interventions…

  9. Embracing Non-Tenure Track Faculty: Changing Campuses for the New Faculty Majority

    ERIC Educational Resources Information Center

    Kezar, Adrianna, Ed.

    2012-01-01

    The nature of the higher education faculty workforce is radically and fundamentally changing from primarily full-time tenured faculty to non-tenure track faculty. This new faculty majority faces common challenges, including short-term contracts, limited support on campus, and lack of a professional career track. "Embracing Non-Tenure Track…

  10. Prosthetic Aortic Valves: Challenges and Solutions

    PubMed Central

    Musumeci, Lucia; Jacques, Nicolas; Hego, Alexandre; Nchimi, Alain; Lancellotti, Patrizio; Oury, Cécile

    2018-01-01

    Aortic Valve Disease (AVD) is the most common Valvular Heart Disease (VHD), affecting millions of people worldwide. Severe AVD is treated in most cases with prosthetic aortic valve replacement, which involves the substitution of the native aortic valve with a prosthetic one. In this review we will discuss the different types of prosthetic aortic valves available for implantation and the challenges faced by patients, medical doctors, researchers and manufacturers, as well as the approaches that are taken to overcome them. PMID:29868612

  11. A modified active appearance model based on an adaptive artificial bee colony.

    PubMed

    Abdulameer, Mohammed Hasan; Sheikh Abdullah, Siti Norul Huda; Othman, Zulaiha Ali

    2014-01-01

    Active appearance model (AAM) is one of the most popular model-based approaches that have been extensively used to extract features by highly accurate modeling of human faces under various physical and environmental circumstances. However, in such active appearance model, fitting the model with original image is a challenging task. State of the art shows that optimization method is applicable to resolve this problem. However, another common problem is applying optimization. Hence, in this paper we propose an AAM based face recognition technique, which is capable of resolving the fitting problem of AAM by introducing a new adaptive ABC algorithm. The adaptation increases the efficiency of fitting as against the conventional ABC algorithm. We have used three datasets: CASIA dataset, property 2.5D face dataset, and UBIRIS v1 images dataset in our experiments. The results have revealed that the proposed face recognition technique has performed effectively, in terms of accuracy of face recognition.

  12. Nursing student's evaluation of a virtual classroom experience in support of their learning Bioscience.

    PubMed

    O'Flaherty, Jacqueline A; Laws, Thomas A

    2014-11-01

    Face-to-face communication with students remains the gold standard in teaching; the effectiveness of this approach to learning is commonly and regularly assessed by students' evaluation of teaching and peer reviews of teaching. Critics note that increases in on-line education are driven more by economic forces than consistent evidence to show their long-term effectiveness or acceptance by students. Numerous studies report that students in higher education found their external studies comparatively more challenging than face-to-face delivery. Identifying how educators might best provide sufficient and effective personal support for students studying in the external mode continues to challenge educators. Opportunities do exist for blending on-line course work with synchronous interactions between students and their teachers but evaluations of these innovations rarely appear in the literature. In this study, a web-based virtual classroom simulated the synchronous face-to-face discussions that occur between Bachelor of Nursing students and tutors. First year students enrolled externally in a biological science course interacted in a virtual classroom for 13 weeks completing an 'evaluation of experience' survey following their final assessment. A comparison was made between 'on-campus' and 'external to campus' students to determine the relationship between i) overall satisfaction with the course and ii) final grades, as well as their experience of the virtual class. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  13. Strengths and challenges faced by school-aged children with unilateral CP described by the Five To Fifteen parental questionnaire.

    PubMed

    Forsman, Lea; Eliasson, Ann-Christin

    2016-12-01

    The purpose of this study was to describe motor and non-motor (e.g. cognitive, social, and behavioral) challenges faced in daily life by children with unilateral cerebral palsy (UCP). In this cross-sectional study, parents completed the Five to Fifteen questionnaire and provided demographic information for 46 children aged 6-15 years (mean 11.01 ± 2.89 SD). Most children were reported to have problems in both motor and non-motor domains, ranging from 20 to 92% depending on the domain. Perception and learning were the non-motor functions most commonly reported as challenging (63 and 65%, respectively). The total number of problems was significantly higher in age groups above 9 years. The correlation between all domains was high, but was consistently higher with the fine motor sub-domain, which could be used to predict executive function, perception, memory, and learning outcomes (R 2 =0.502, 0.642, 0.192, 0.192). Most children with CP have everyday challenges beyond their primary motor deficiencies.

  14. Midwifery: "at the edge of history".

    PubMed

    Dahlen, H

    2006-03-01

    The paper focuses on possible future pathways in maternity care for midwives and nations to consider. The paper blends personal and professional experiences to outline priority areas facing midwives in the future. It begins by examining maternal mortality and morbidity in the developing world and considering the potential of the ten high priority action messages (1997) in helping to improve the plight of women and children in the future. The paper then examines major issues facing midwives in the developed world including: the way birth is viewed; the medical-midwifery divide; marketing midwifery; and finally the challenge of dealing with fear around birth. The third part of the paper examines a part of society where the two worlds meet and there are issues from both the developed and developing world to consider. The paper focuses on women from culturally and linguistically diverse communities, Aboriginal and Torres Strait Islander women and women birthing in remote and rural areas. By looking at these three worlds separately the paper examines different concerns facing midwives in the future but also draws on common issues that face us all as citizens of this planet and particularly as predominantly women. The paper challenges midwives to be politically active and dare to change the world.

  15. Consumers or Citizens? Whose Voice Will Healthwatch Represent and Will It Matter? Comment on "Challenges Facing Healthwatch, a New Consumer Champion in England".

    PubMed

    Wright, Brad

    2016-06-22

    Efforts to achieve effective and meaningful patient and public involvement (PPI) in healthcare have existed for nearly a century, albeit with limited success. This brief commentary discusses a recent paper by Carter and Martin exploring the "Challenges Facing Healthwatch, a New Consumer Champion in England," and places these challenges in the context of the broader struggle to give a voice to healthcare consumers and citizens. With an overview of what can go right and-perhaps more importantly-what can go wrong, the question remains: will Healthwatch-and other PPI efforts in healthcare-represent the voice of consumers or citizens and will it matter? © 2016 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  16. Guide to Cybersecurity, Resilience, and Reliability for Small and Under-Resourced Utilities

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

    Ingram, Michael; Martin, Maurice

    Small electricity utilities -- those with less than 100 employees or 50,000 meters -- provide essential services to large parts of the United States while facing a number of challenges unique to their mission. For instance, they often serve areas that are sparsely populated, meaning that their per-customer cost to provide service is higher. At the same time, they often serve customers that have moderate or fixed incomes, meaning that they are under strong pressure to keep costs down. This pressure puts them on a strict budget and creates a need for innovative solutions to common problems. Further, their servicemore » areas may include extreme climates, making severe weather events more frequent and their aftermaths more expensive to address. This guide considers challenges that small utilities face while ensuring the reliability, resilience, and cybersecurity of their electric service; approaches to address those challenges using existing guidance documents; ways that the federal government could provide support in these areas.« less

  17. The Hidden Work of Exiting Homelessness: Challenges of Housing Service Use and Strategies of Service Recipients

    PubMed Central

    Mayberry, Lindsay S.

    2015-01-01

    This study explored the experiences of parents attempting to re-attain housing after a shelter stay. Eighty parents participated in semistructured face-to-face interviews approximately six months after being recruited from shelters in four states across the U.S. Qualitative analyses identified common challenges of service use, strategies of service recipients, and characteristics of positive and negative service experiences. Challenges of service use included “catch-22s” resulting from incongruity between service policies/procedures and participants’ contexts and/or requirements of other services, confusion and uncertainty resulting from absent or insufficient communication about services, and long waitlists. Participants demonstrated persistence and determination, networked with service providers, and activated formal resources. Positive service experiences were tailored to families’ needs and marked by clear and consistent communication between providers and with service recipients. Findings suggest effective health communication tactics should be applied to housing services. Providers should collaborate to ensure service attainment does not impede other pathways to stability. PMID:26997682

  18. Computational pan-genomics: status, promises and challenges.

    PubMed

    2018-01-01

    Many disciplines, from human genetics and oncology to plant breeding, microbiology and virology, commonly face the challenge of analyzing rapidly increasing numbers of genomes. In case of Homo sapiens, the number of sequenced genomes will approach hundreds of thousands in the next few years. Simply scaling up established bioinformatics pipelines will not be sufficient for leveraging the full potential of such rich genomic data sets. Instead, novel, qualitatively different computational methods and paradigms are needed. We will witness the rapid extension of computational pan-genomics, a new sub-area of research in computational biology. In this article, we generalize existing definitions and understand a pan-genome as any collection of genomic sequences to be analyzed jointly or to be used as a reference. We examine already available approaches to construct and use pan-genomes, discuss the potential benefits of future technologies and methodologies and review open challenges from the vantage point of the above-mentioned biological disciplines. As a prominent example for a computational paradigm shift, we particularly highlight the transition from the representation of reference genomes as strings to representations as graphs. We outline how this and other challenges from different application domains translate into common computational problems, point out relevant bioinformatics techniques and identify open problems in computer science. With this review, we aim to increase awareness that a joint approach to computational pan-genomics can help address many of the problems currently faced in various domains. © The Author 2016. Published by Oxford University Press.

  19. 48 CFR 1480.903 - Award in the face of challenge.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Award in the face of challenge. 1480.903 Section 1480.903 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR... Award in the face of challenge. (a) Award of a contract in the face of challenge may be made on the...

  20. 48 CFR 1480.903 - Award in the face of challenge.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Award in the face of challenge. 1480.903 Section 1480.903 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR... Award in the face of challenge. (a) Award of a contract in the face of challenge may be made on the...

  1. Rating Scale Analysis and Psychometric Properties of the Caregiver Self-Efficacy Scale for Transfers

    ERIC Educational Resources Information Center

    Cipriani, Daniel J.; Hensen, Francine E.; McPeck, Danielle L.; Kubec, Gina L. D.; Thomas, Julie J.

    2012-01-01

    Parents and caregivers faced with the challenges of transferring children with disability are at risk of musculoskeletal injuries and/or emotional stress. The Caregiver Self-Efficacy Scale for Transfers (CSEST) is a 14-item questionnaire that measures self-efficacy for transferring under common conditions. The CSEST yields reliable data and valid…

  2. Setting the Bar for High-Ability Students

    ERIC Educational Resources Information Center

    Greene, Buck; Cross, Tracy L.

    2013-01-01

    Secondary school principals face no shortage of issues and challenges when it comes to ensuring that their teachers and students are ready for the Common Core State Standards. With so many issues competing for scarce time and resources, it is understandable that for many school leaders, the needs of high-ability and high-potential students are not…

  3. Improvement Efforts in Rural Schools: Experiences of Nine Schools Receiving School Improvement Grants

    ERIC Educational Resources Information Center

    Rosenberg, Linda; Christianson, Megan Davis; Hague Angus, Megan

    2015-01-01

    Low-performing schools in rural settings can face challenges common to all struggling schools, such as low student motivation and maintaining a qualified teaching staff. However, aspects of rural schools' settings, such as the distance from urban areas and the commute between the schools and the students' and teachers' homes, can exacerbate the…

  4. Vital Signs Screening for Alcohol Misuse in a Rural Primary Care Clinic: A Feasibility Study

    ERIC Educational Resources Information Center

    Seale, J. Paul; Guyinn, Monique R.; Matthews, Michael; Okosun, Ike; Dent, M. Marie

    2008-01-01

    Context: Alcohol misuse is more common in rural areas, and rural problem drinkers are less likely to seek alcohol treatment services. Rural clinics face unique challenges to implementing routine alcohol screening and intervention. Purpose: To assess the feasibility of using the single alcohol screening question (SASQ) during routine nursing vital…

  5. Sales force can lead to dollars for OH (occupational health) services.

    PubMed

    Snow, J L

    1991-02-01

    As hospitals enter the 1990s, one of the challenges they will face is finding additional sources of revenue. Occupational Health (OH) programs offer an opportunity for increased dollars--but only for hospitals willing to use sales tactics common to corporate America. In the following article, the author tells how an institution can sell OH services.

  6. Cold in the common garden: comparative low-temperature tolerance of boreal and temperate conifer foliage

    Treesearch

    G. Richard Strimbeck; Trygve D. Kjellsen; Paul G. Schaberg; Paula F. Murakami

    2007-01-01

    Because they maintain green foliage throughout the winter season, evergreen conifers may face special physiological challenges in a warming world. We assessed the midwinter low-temperature (LT) tolerance of foliage from eight temperate and boreal species in each of the genera Abies, Picea, and Pinus growing in an arboretum in...

  7. Tailoring a Web-Based Weight Maintenance Intervention for Northern Plains American Indian Public University Students

    ERIC Educational Resources Information Center

    Hemmingson, Kaitlyn; Lucchesi, Roxanne; Droke, Elizabeth; Kattelmann, Kendra K.

    2016-01-01

    Objective: High levels of obesity-related health disparities are common among US American Indian (AI) populations. AI public university students often face unique challenges that may contribute to weight gain and related consequences. Few weight maintenance interventions have been developed that meet the needs of AI public university students. The…

  8. Experiences Faced by Diabetic Teenagers of Diepkloof Soweto: A Systematic Review

    ERIC Educational Resources Information Center

    Malatji, Mahlodi; Nkomo, Thobeka

    2016-01-01

    Background: Diabetes is a metabolic disorder which presents itself with symptoms such as blurry vision, thirst and weight loss. It is a disease that is more common in childhood whereby the body cannot produce enough insulin. Objectives: To explore the challenges experienced by diabetic teenagers. Results: Checking of sugar levels and injecting of…

  9. Random Assignment within Schools: Lessons Learned from the Teach for America Experiment

    ERIC Educational Resources Information Center

    Glazerman, Steven

    2012-01-01

    Randomized trials are a common way to provide rigorous evidence on the impacts of education programs. This article discusses the trade-offs associated with study designs that involve random assignment of students within schools and describes the experience from one such study of Teach for America (TFA). The TFA experiment faced challenges with…

  10. Sisyphus Had It Easy: Reflections of Two Decades of Teaching the Sociological Imagination

    ERIC Educational Resources Information Center

    Dandaneau, Steven P.

    2009-01-01

    "The Sociological Imagination" is among the most recognized books in the history of American Sociology. Yet, the sociological imagination as such, a radical form of self-consciousness, is not commonly well understood nor easily acquired. This essay examines the challenges thus faced by instructors who seek to accurately impart what Mills…

  11. The Use of Learning Journals to Foster Textbook Reading in the Community College Psychology Class

    ERIC Educational Resources Information Center

    Bartolomeo-Maida, Maria

    2016-01-01

    Across disciplines, faculty members face a common challenge of finding methods to get their students to complete assigned course readings. It becomes an even larger task to develop strategies whereby students are also engaging in deep reading that promotes critical thinking. Reading positively impacts students on a number of variables, and when…

  12. Co-Creating Desired Outcomes and Strengthening the Resilience of Multi-Challenged Families

    ERIC Educational Resources Information Center

    Mešl, Nina; Kodele, Tadeja

    2016-01-01

    Families facing poverty suffer from many other stresses, with children's school performance being one of the common topics. A life of poverty and the related unfavourable circumstances should not define children's life stories. Ensuring this is not the case is partly the responsibility of professionals working with families. It is important to…

  13. Journey to Planet Earth: Land of Plenty, Land of Want. The Public Television Series. [Videotape].

    ERIC Educational Resources Information Center

    1999

    This videotape gives students the opportunity to view farming practices in four distinctly different countries: Zimbabwe, France, China, and the United States. By viewing farming methods throughout the world and studying the different challenges facing the world's farmers, students will be able to appreciate the commonality of all farmers--they…

  14. Power Distance and Group Dynamics of an International Project Team: A Case Study

    ERIC Educational Resources Information Center

    Paulus, Trena M.; Bichelmeyer, Barbara; Malopinsky, Larissa; Pereira, Maura; Rastogi, Polly

    2005-01-01

    Project-based team activities are commonly used in higher education. Teams comprised of members from different national cultures can be faced with unique challenges during the creative process. Hofstede's (1991) cultural dimension of power distance was used to examine one such design team's intra- and inter-group interactions in a graduate-level…

  15. Best from the Best: Distinguished Principals Offer Nine Instructional Leadership Practices That Work

    ERIC Educational Resources Information Center

    Principal, 2012

    2012-01-01

    The term "best practice" is commonly used to describe "what works" in a specific situation or environment. When principals face a thorny challenge, they turn to their colleagues in the principalship for ideas about which strategies, activities, and approaches have proved to be effective and efficient in addressing the issue.…

  16. Travelling Teens: A Parents' Guide to Family Relocation

    ERIC Educational Resources Information Center

    Linke, Pam

    2005-01-01

    Moving house is becoming a more common aspect of modern life; but this does not make it any easier to cope with the many issues that arise--from the everyday practicalities, to the social and emotional challenges involved. Families who are required to relocate face the potentially difficult task of settling each family member into the new…

  17. Using Academic Language to Level the Playing Field for English-Language Learners in Physical Education: Part 1

    ERIC Educational Resources Information Center

    Constantinou, Phoebe; Wuest, Deborah A.

    2015-01-01

    With the common core emphasis on English language art and mathematics skills, physical educators are faced with a challenging task. Educators, in general, are expected to identifying the language demands of their discipline and develop academic language skills within each disciplinary area. In other words, educators are expected to prepare…

  18. International Primary Science: What's in It for Us?

    ERIC Educational Resources Information Center

    Dunne, Mick; Maklad, Rania

    2013-01-01

    It is all too common, given the considerable day-to-day challenges facing those involved in education, to focus on the here and now rather than look further afield. The authors of this article have been fortunate enough to see "primary science" in a wide range of international settings, from Nigeria to Chile, North America and Canada,…

  19. A Test of the Intergenerational Congruence in Immigrant Families-Child Scale with Southeast Asian Americans

    ERIC Educational Resources Information Center

    Ying, Yu-Wen; Han, Meekyung

    2007-01-01

    A common challenge facing immigrant families is intergenerational-intercultural conflict. Social workers are in need of an easy-to-use but psychometrically sound measure to assess this phenomenon and evaluate treatment effectiveness. The Intergenerational Congruence in Immigrant Families (ICIF) Scale was created for this purpose. The ICIF has two…

  20. From Homemaking to Solidarity: Global Engagement as Common Good in an Age of Global Populism

    ERIC Educational Resources Information Center

    Toms, Cynthia

    2018-01-01

    The challenging and rapidly evolving times in which we live require that students understand, analyze, and address the complex realities facing their nation and world. However, efforts in global learning have primarily focused on expansion of programs rather than student learning and meaningful community engagement. Building on Bouma-Prediger and…

  1. The Face of Private Tutoring in Russia: Evidence from Online Marketing by Private Tutors

    ERIC Educational Resources Information Center

    Kozar, Olga

    2013-01-01

    Private tutoring is a common and worldwide phenomenon. However, there is a dearth of up-to-date research on private tutoring compared with that on institutional one-to-one teaching, which could be explained by challenges associated with data collection. This article proposes using publicly available online advertisements of private tutors as a…

  2. The Chicago Handbook for Teachers: A Practical Guide to the College Classroom.

    ERIC Educational Resources Information Center

    Brinkley, Alan; Dessants, Betty; Flamm, Michael; Fleming, Cynthia; Forcey, Charles; Rothschild, Eric

    This book is designed to offer practical advice to beginning, as well as experienced, teachers of college courses on navigating many of the common challenges faced both in and outside the classroom. Chapters include "Getting Ready," which covers three discrete components of course design: deciding what you want students to learn, choosing…

  3. The Effect of Outsourcing on the Performance of Public Schools

    ERIC Educational Resources Information Center

    Rivera, Lonny J.

    2009-01-01

    Public education in the 21st century is faced with many difficult challenges. The first and probably most common issue is related to finance. As the economy continues to worsen, school districts are forced to find new revenue streams while at the same time reducing expenditures. In the current economic climate, it is becoming more difficult for…

  4. Why Learning Common Fractions Is Uncommonly Difficult: Unique Challenges Faced by Students with Mathematical Disabilities

    ERIC Educational Resources Information Center

    Berch, Daniel B.

    2017-01-01

    In this commentary, I examine some of the distinctive, foundational difficulties in learning fractions and other types of rational numbers encountered by students with a mathematical learning disability and how these differ from the struggles experienced by students classified as low achieving in math. I discuss evidence indicating that students…

  5. Quality labeled faces in the wild (QLFW): a database for studying face recognition in real-world environments

    NASA Astrophysics Data System (ADS)

    Karam, Lina J.; Zhu, Tong

    2015-03-01

    The varying quality of face images is an important challenge that limits the effectiveness of face recognition technology when applied in real-world applications. Existing face image databases do not consider the effect of distortions that commonly occur in real-world environments. This database (QLFW) represents an initial attempt to provide a set of labeled face images spanning the wide range of quality, from no perceived impairment to strong perceived impairment for face detection and face recognition applications. Types of impairment include JPEG2000 compression, JPEG compression, additive white noise, Gaussian blur and contrast change. Subjective experiments are conducted to assess the perceived visual quality of faces under different levels and types of distortions and also to assess the human recognition performance under the considered distortions. One goal of this work is to enable automated performance evaluation of face recognition technologies in the presence of different types and levels of visual distortions. This will consequently enable the development of face recognition systems that can operate reliably on real-world visual content in the presence of real-world visual distortions. Another goal is to enable the development and assessment of visual quality metrics for face images and for face detection and recognition applications.

  6. Epilepsy Genetics—Past, Present, and Future

    PubMed Central

    Poduri, Annapurna; Lowenstein, Daniel

    2014-01-01

    Human epilepsy is a common and heterogeneous condition in which genetics play an important etiological role. We begin by reviewing the past history of epilepsy genetics, a field that has traditionally included studies of pedigrees with epilepsy caused by defects in ion channels and neurotransmitters. We highlight important recent discoveries that have expanded the field beyond the realm of channels and neurotransmitters and that have challenged the notion that single genes produce single disorders. Finally, we project toward an exciting future for epilepsy genetics as large-scale collaborative phenotyping studies come face to face with new technologies in genomic medicine. PMID:21277190

  7. The adaptation challenge in the Arctic

    NASA Astrophysics Data System (ADS)

    Ford, James D.; McDowell, Graham; Pearce, Tristan

    2015-12-01

    It is commonly asserted that human communities in the Arctic are highly vulnerable to climate change, with the magnitude of projected impacts limiting their ability to adapt. At the same time, an increasing number of field studies demonstrate significant adaptive capacity. Given this paradox, we review climate change adaptation, resilience and vulnerability research to identify and characterize the nature and magnitude of the adaptation challenge facing the Arctic. We find that the challenge of adaptation in the Arctic is formidable, but suggest that drivers of vulnerability and barriers to adaptation can be overcome, avoided or reduced by individual and collective efforts across scales for many, if not all, climate change risks.

  8. From Online Student to Online Instructor: Assistive Strategies

    ERIC Educational Resources Information Center

    McKnight, Jodi

    2012-01-01

    With the influx of online learning opportunities, online students and instructors are faced with a variety of challenges. Online students face the same challenges as do face-to-face learners, but by facing them in an online context, the interpretations of those challenges can lead to the success or failure of their overall educational experience.…

  9. The most common problem facing by the maintenance department: A case Study between Universiti Tun Hussein Onn Malaysia (UTHM) and Universiti Teknologi Malaysia (UTM)

    NASA Astrophysics Data System (ADS)

    Norazam Yasin, Mohd; Mohamad Zin, Rosli; Halid Abdullah, Abd; Shafiq Mahmad, Muhammad; Fikri Hasmori, Muhammad

    2017-11-01

    From time to time, the maintenance works become more challenging due to construction of new building and also aging of the existing buildings. University buildings without any exception require proper maintenance services to support their function requirements and this can be considered as major responsibilities to be fulfilled by the maintenance department in the universities. Maintenance department specifically will face various kinds of problems in their operation works and thus this might influence the maintenance work operations itself. This study purposely to identify the common problem facing by the maintenance department and also to examine the current status of the maintenance department. In addition, this study would also propose any suitable approach that could be implemented to overcome the problem facing by the maintenance department. To achieve the objectives of this study, a combination of deep literature study and carrying out a survey is necessary. Literature study aimed to obtain deeper information about this study, meanwhile a survey aimed at identifying the common problem facing by the maintenance department and also to provide the information of the maintenance department’s organization. Several methods will be used in analyzing the data obtained through the survey, including Microsoft Office Excel and also using mean index formula. This study has identified three categories of problem in the maintenance department, which are management problems, human resource problem, and technical problems. Following the findings, several solutions being proposed which can be implemented as the solution to the problem facing. These suggestions have the potential to improve the maintenance department work efficiency, thus could help to increase the department productivity.

  10. Current issues and challenges in the management of bariatric patients.

    PubMed

    Bell, Sue Ellen

    2005-01-01

    Morbid obesity is an increasingly common healthcare problem, and providers and patients currently face numerous challenges in dealing with this problem effectively. Issues addressed in this article include the effect of stigma, the need for more evidence regarding effective management options, and the declining insurance coverage for bariatric surgery. The role of bariatric surgery in effective management of morbid obesity is discussed, along with the effect on and possible reasons for declining coverage. A comparison between benefits and coverage for bariatric surgery and angioplasty/stent placement is included.

  11. Hit discovery and hit-to-lead approaches.

    PubMed

    Keseru, György M; Makara, Gergely M

    2006-08-01

    Hit discovery technologies range from traditional high-throughput screening to affinity selection of large libraries, fragment-based techniques and computer-aided de novo design, many of which have been extensively reviewed. Development of quality leads using hit confirmation and hit-to-lead approaches present their own challenges, depending on the hit discovery method used to identify the initial hits. In this paper, we summarize common industry practices adopted to tackle hit-to-lead challenges and review how the advantages and drawbacks of different hit discovery techniques could affect the various issues hit-to-lead groups face.

  12. Benefits of exercise therapy in peripheral arterial disease.

    PubMed

    Osinbowale, Olusegun O; Milani, Richard V

    2011-01-01

    Peripheral arterial disease (PAD) is a common disorder caused largely by atherosclerosis. Although it is associated with increased morbidity and cardiovascular mortality, PAD remains underdiagnosed. Traditional PAD care has involved cardiovascular risk factor modification, use of antiplatelet agents, and revascularization. For those individuals who are eligible and willing to perform exercise therapy (ET), a significant benefit may be recognized. Despite this, ET faces several challenges to implementation. Notably, the lack of reimbursement by third party payers remains the major challenge to routine use of ET. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Refugee Health: An Ongoing Commitment and Challenge

    PubMed Central

    Efird, Jimmy T.; Bith-Melander, Pollie

    2018-01-01

    Refugees represent a diverse group of displaced individuals with unique health issues and disease risks. The obstacles facing this population have their origins in war, violence, oppression, exploitation, and fear of persecution. Regardless of country of origin, a common bond exists, with refugees often confronting inadequate healthcare resources, xenophobia, discrimination, and a complex web of legal barriers in their new homelands. In many cases, the plight of refugees is multigenerational, manifesting as mental health issues, abuse, poverty, and family disruption. The health trajectory of refugees remains an ongoing commitment and challenge. PMID:29342831

  14. Challenges faced by health-care providers offering infant-feeding counseling to HIV-positive women in sub-Saharan Africa: a review of current research.

    PubMed

    Tuthill, Emily L; Chan, Jessica; Butler, Lisa M

    2015-01-01

    Exclusive breastfeeding (EBF) has been identified as the optimal nutrition and critical behavior in attaining human immunodeficiency virus (HIV)-free infant survival in resource-limited settings. Health-care providers (HCPs) in clinic- and community-settings throughout sub-Saharan Africa (sSA) provide infant-feeding counseling. However, rates of EBF at 6 months of age are suboptimal. HCPs are uniquely positioned to educate HIV-positive mothers and provide support by addressing known barriers to EBF. However, limited evidence exists on the experiences faced by HCPs in providing counseling on infant feeding to HIV-positive women. Our objective is to describe experiences faced by HCPs when delivering infant-feeding counseling in the context of HIV in program settings in sSA. We searched a range of electronic databases, including PubMed, CINAHL, and PsycINFO from January 1990 to February 2013, in addition to hand-searching, cross-reference searching, and personal communications. The search was limited to publications in English. Empirical studies of HCP experiences providing infant-feeding counseling in the prevention of mother-to-child transmission (PMTCT) of HIV programs in sSA were selected. We identified 10 peer-reviewed articles reporting HCP challenges in infant-feeding counseling that met inclusion criteria. Articles included qualitative, cross-sectional and mixed-method studies, and cumulatively reported 31 challenges faced by HCPs. Among the challenges identified, the most commonly reported were personal beliefs held by the HCPs toward infant feeding in the context of HIV, contradictory messages, staff workload, directive counseling styles, and a lack of practical strategies to offer mothers, often leading to improvised counseling approaches. Counseling strategies need to be developed that are relevant, meaningful, and responsive to the needs of both HCPs and mothers.

  15. Caring for transgender patients with epilepsy.

    PubMed

    Johnson, Emily L; Kaplan, Peter W

    2017-10-01

    Approximately 25 million individuals older than age 15 identify as transgender, representing about 0.3-0.9% of the world's population. The aim of this paper is to identify and describe important medical and social considerations facing transgender persons with epilepsy. We performed literature searches on the following terms: transgender AND epilepsy, transgender AND neurology, gender dysphoria AND epilepsy, gender dysphoria AND neurology. We also performed literature searches for common feminizing or masculinizing treatment regimens, and searched for interactions of those treatment regimens with antiepileptic drugs (AEDs) and with seizures. There are multiple bidirectional interactions between AEDs and the commonly used treatments for aligning external sex characteristics with identified gender. The scope of the transgender population with epilepsy remains to be elucidated. Transgender patients with epilepsy face significant social and medical challenges. Interactions between medical gender-affirming treatments and AEDs are common, and management must depend on knowledge of these interactions to provide appropriate treatment. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  16. Cold Calling and Web Postings: Do They Improve Students' Preparation and Learning in Statistics?

    ERIC Educational Resources Information Center

    Levy, Dan

    2014-01-01

    Getting students to prepare well for class is a common challenge faced by instructors all over the world. This study investigates the effects that two frequently used techniques to increase student preparation--web postings and cold calling--have on student outcomes. The study is based on two experiments and a qualitative study conducted in a…

  17. A Tangled Web of Terms: The Overlap and Unique Contribution of Involvement, Engagement, and Integration to Understanding College Student Success

    ERIC Educational Resources Information Center

    Wolf-Wendel, Lisa; Ward, Kelly; Kinzie, Jillian

    2009-01-01

    Established theories and constructs long associated with student success, including involvement, engagement, and integration, provide common language and a body of knowledge to inform understanding of the challenges currently facing higher education. This paper examines how the theories and terms have evolved, explores how the terms are currently…

  18. A Values Base for the Norwegian Kindergarten: Common Ground across Cultural Affiliations?

    ERIC Educational Resources Information Center

    Hovdelien, Olav

    2013-01-01

    One of the major challenges facing modern-day secular states is the issue of social integration. The issue discussed in this article is how it is possible to arrive at unifying values in a multicultural society that is characterised by secularisation and disintegration of the Christian hegemony of former times on the one hand and by the emergence…

  19. Promoting independence for children on long-term ventilation.

    PubMed

    Lawrence, Sue

    2011-12-01

    It is the responsibility of children's nurses to enable children and young people who are on long-term ventilation (LTV) to live independent and varied lives. This article considers the common challenges faced by such children and reflects on personal experience in planning and undertaking a respite week for a young person on LTV with Duchenne's muscular dystrophy without his parents.

  20. The Role of High School and College Counselors in Supporting the Psychosocial and Emotional Needs of Latinx First-Generation College Students

    ERIC Educational Resources Information Center

    Tello, Angelica M.; Lonn, Marlise R.

    2017-01-01

    Latinx first-generation college students (FGCS) are a growing population faced with unique challenges for college retention and graduation. Because their parents did not attend postsecondary education, this group of college students has not inherited the social or cultural capital common to many traditional college freshmen. Both high school and…

  1. Living Education Law in 2017: How Facebook, Prayer, Toilets, and Guns Impact Today's Teachers

    ERIC Educational Resources Information Center

    Oltman, Gretchen; Surface, Jeanne L.

    2017-01-01

    Survival for public school teachers goes beyond curriculum design, discipline and other skills. School law is critical for teachers to face the areas of challenge that are currently present. There are two types of common legal mistakes made by teachers: a) failing to take disciplinary action when they should, and b) unintentionally violating…

  2. Development, Implementation, and Analysis of Desktop-Scale Model Industrial Equipment and a Critical Thinking Rubric for Use in Chemical Engineering Education

    ERIC Educational Resources Information Center

    Golter, Paul B.

    2011-01-01

    In order to address some of the challenges facing engineering education, namely the demand that students be better prepared to practice professional as well as technical skills, we have developed an intervention consisting of equipment, assessments and a novel pedagogy. The equipment consists of desktop-scale replicas of common industrial…

  3. Improving School Experiences for Adolescents with Type 1 Diabetes

    ERIC Educational Resources Information Center

    Kise, Saori S.; Hopkins, Amanda; Burke, Sandra

    2017-01-01

    Background: Diabetes mellitus (diabetes) is one of the most common metabolic diseases in children worldwide and the incidence of type 1 diabetes (T1D) is growing. T1D is complicated to manage and adolescents with diabetes face unique, age-specific challenges. The purpose of this article is to discuss ways in which schools can create a positive…

  4. Using internet-based approaches to collect qualitative data from vulnerable groups: reflections from the field.

    PubMed

    Neville, Stephen; Adams, Jeffery; Cook, Catherine

    2016-12-01

    Undertaking qualitative research with vulnerable populations is a complex and challenging process for researchers. Traditional and common modes of collecting qualitative data with these groups have been via face-to-face recorded interviews. This article reports on three internet-based data collection methods; email and synchronous online interviews, as well as online qualitative survey. The key characteristics of using email, sychronous online interviews and an online qualitative survey including the strengths and limitations of each are presented. Reflections and insights on the use of these internet-based data collection methods are provided to encourage researchers to embrace technology and move away from using traditional face-to-face interviews when researching with vulnerable populations. Using the internet to collect qualitative data offers additional ways to gather qualitative data over traditional data collection methods. The use of alternative interview methods may encourage participation of vulnerable participants.

  5. Church leaders' tobacco opinions: send materials, not money.

    PubMed

    Reinert, Bonita; Carver, Vivien; Range, Lillian; Pike, Chris

    2008-01-01

    In addition to personnel challenges,faith-based organizations (FBOs) face tangible challenges to implementing tobacco use prevention programs, such as finding materials that fit within their mission and financial backing to support the program. The present project surveyed 71 FBO leaders about these challenges with two open-ended questions that asked what would help and hinder them from delivering a tobacco prevention program, and Likert questionnaires on advocacy, efficacy, impact, policy, burnout, and morality. On what would help them deliver a tobacco prevention program, the most common answer was materials; about half of present FBO leaders gave this answer. On what would interfere, the most common answer was nothing, with about one quarter giving this answer; and, the next most common answer was not having materials with about one sixth giving this answer. The survey was brief (2 pages), and the sample size was small (71). Having the appropriate tobacco prevention materials was clearly a concern for present, mostly African American faith-based leaders, who reported that they needed materials more than they needed money, volunteers, or other forms of assistance.

  6. Church leaders' tobacco opinions: send materials, not money.

    PubMed

    Reinert, Bonita; Carver, Vivien; Range, Lillian; Pike, Chris

    2008-01-01

    In addition to personnel challenges,faith-based organizations (FBOs) face tangible challenges to implementing tobacco use prevention programs, such as finding materials that fit within their mission and financial backing to support the program. The present project surveyed 71 FBO leaders about these challenges with two open-ended questions that asked what would help and hinder them from delivering a tobacco prevention program, and Likert questionnaires on advocacy, efficacy, impact, policy, burnout, and morality. On what would help them deliver a tobacco prevention program, the most common answer was materials, about half of present FBO leaders gave this answer. On what would interfere, the most common answer was nothing, with about one quarter giving this answer; and, the next most common answer was not having materials with about one sixth giving this answer. The survey was brief (2 pages), and the sample size was small (71). Having the appropriate tobacco prevention materials was clearly a concern for present, mostly African American faith-based leaders, who reported that they needed materials more than they needed money, volunteers, or other forms of assistance.

  7. The US/Mexico Border: A Binational Approach to Framing Challenges and Constructing Solutions for Improving Farmworkers’ Lives

    PubMed Central

    Rosales, Cecilia; Ortega, Maria Isabel; De Zapien, Jill Guernsey; Paniagua, Alma Delia Contreras; Zapien, Antonio; Ingram, Maia; Aranda, Patricia

    2012-01-01

    Mexican migrant and seasonal farmworkers in the US-Mexico border region face health hazards and occupational risks and are becoming commonly known in the public health literature. According to several studies, farmworkers have high levels of chronic diseases such as diabetes and respiratory problems, are at risk for infectious diseases, and experience among the highest incidences of work-related injuries of any profession. The findings from two studies are considered and presented with the objective of contributing to an overall understanding of migrant farmworkers as a workforce moving across national boundaries and affected by the work environments and health stressors both shared and unique to each context. We propose a binational approach to comprehensively address the health problems and socioeconomic challenges faced by migrant and seasonal farmworkers. In this paper we present the results of two distinct but complementary studies of farmworker health on the Arizona-Sonora border. PMID:22829796

  8. CE: Epilepsy Update, Part 1: Refining Our Understanding of a Complex Disease.

    PubMed

    Smith, Gigi; Wagner, Janelle L; Edwards, Jonathan C

    2015-05-01

    Epilepsy is a serious, common neurologic disease that affects people of all ages. As underscored in the 2012 Institute of Medicine report Epilepsy Across the Spectrum: Promoting Health and Understanding, the millions of people living with epilepsy in the United States face the challenges of seeking out high-quality, coordinated health care and community services; overcoming epilepsy misinformation and stigma; and finding understanding and support in their communities. This article, the first in a two-part series, discusses new research that has increased our understanding of epilepsy's etiology and pathophysiology, new definitions that are changing the ways we evaluate and treat this disease, conditions that frequently present with epilepsy, and psychosocial challenges faced by people with epilepsy. Part 2, which will appear in next month's issue, reviews comprehensive nursing care and evidence-based treatment for epilepsy and presents resources for people with epilepsy and their families.

  9. A Modified Active Appearance Model Based on an Adaptive Artificial Bee Colony

    PubMed Central

    Othman, Zulaiha Ali

    2014-01-01

    Active appearance model (AAM) is one of the most popular model-based approaches that have been extensively used to extract features by highly accurate modeling of human faces under various physical and environmental circumstances. However, in such active appearance model, fitting the model with original image is a challenging task. State of the art shows that optimization method is applicable to resolve this problem. However, another common problem is applying optimization. Hence, in this paper we propose an AAM based face recognition technique, which is capable of resolving the fitting problem of AAM by introducing a new adaptive ABC algorithm. The adaptation increases the efficiency of fitting as against the conventional ABC algorithm. We have used three datasets: CASIA dataset, property 2.5D face dataset, and UBIRIS v1 images dataset in our experiments. The results have revealed that the proposed face recognition technique has performed effectively, in terms of accuracy of face recognition. PMID:25165748

  10. Primary health care centers, extent of challenges and demand for oral health care in Riyadh, Saudi Arabia.

    PubMed

    Al-Jaber, Abeer; Da'ar, Omar B

    2016-11-04

    As primary health care (PHC) centers in Saudi Arabia provide standardized preventive and curative oral health care (OHC) services, challenges remain. In addition, evidence of determinants of OHC seeking behavior is unknown. The aim of this study was to identify common challenges faced by patients seeking OHC in PHC centers and assess determinants of demand for OHC in Riyadh. After institutional approval and piloting, 320 adult patients were sampled at two large PHC centers in October 2015. Using a modified version of General Practice Assessment (GAPQ) and New York State Department of Health (NYSDOH) Questionnaires, information about cumulative number of visits to a dentist, patient profiles, provider characteristics, and challenges were collected. We used descriptive statistics to summarize data and employed ordinal regression for analyzing extent of effects of challenges and determinants of demand for OHC. Oral health condition was reported to be good in 31 % of the patients, very good in 25 % of the patients, and fair in 20 % of the patients. More than half (53 %) of patients visited a dentist in the past 12 months once, 20 % twice, and 25 % at least three times. High cost of private clinic and unavailability of dentists were reported as the most common difficulties in seeing a dentist. Patients who were very satisfied with dental care and treatment plan, those with less than excellent oral health conditions and male patients had less number of cumulative visits to a dentist compared with patients with less satisfaction, patients with perceived excellent oral health, and female patients respectively. Our findings provide a strong evidence of challenges faced by patients and determinants of demand for OHC seeking behavior. The findings can inform policy maker not only in patient satisfaction of OHC, but also implications on facilities and health care systems. We conclude with recommendations for future research, especially on oral health preventive measures in PHC centers that correct inherent dental problems and other underlying challenges.

  11. Challenges and Opportunities in the Provision of Surgical Care in Vanuatu: A Mixed Methods Analysis.

    PubMed

    Young, S; Perry, W R G; Leodoro, B; Nosa, V; Bissett, I; Windsor, J A; Dare, A J

    2016-08-01

    The Pacific island nation of Vanuatu faces a number of challenges in delivering surgical care to its population. We aimed to understand and document the barriers, opportunities and required actions to improve surgical care in the country using a mixed methods analysis which incorporated the perspectives of local health stakeholders. A baseline quantitative assessment of surgical capacity in Vanuatu was carried out using the WHO situational analysis tool. Twenty semi-structured interviews were then conducted on the two main islands (Efate and Espiritu Santo) with surgeons, allied health staff, health managers, policy-makers and other key stakeholders, using a grounded theory qualitative case study methodology. Initial informants were identified by purposive sampling followed by snowball sampling until theoretical saturation was reached. Interviews were open and axially coded with subsequent thematic analysis. Vanuatu faces deficits in surgical infrastructure, equipment and human resources, especially in the rural provinces. Geographic isolation, poverty and culture-including the use of traditional medicine and low health literacy-all act as barriers to patients accessing timely surgical care. Issues with governance, human resourcing and perioperative care were commonly identified by stakeholders as key challenges facing surgical services. Increasing outreach clinics, developing efficient referral systems, building provincial surgical capacity and undertaking locally led research were identified as key actions that can improve surgical care. Documenting locally identified challenges and opportunities for surgical care in Vanuatu is an important first step towards developing formal strategies for improving surgical services at the country level.

  12. The Impact of Living with Klinefelter Syndrome: A Qualitative Exploration of Adolescents and Adults.

    PubMed

    Turriff, Amy; Macnamara, Ellen; Levy, Howard P; Biesecker, Barbara

    2017-08-01

    Klinefelter syndrome (XXY) is a common yet significantly underdiagnosed condition with considerable medical, psychological and social implications. Many health care providers lack familiarity with XXY, resulting in medical management challenges and a limited understanding of the personal impact of the condition. Genetic counselors benefit from understanding the challenges adolescents and men with XXY face to effectively address their medical and psychosocial needs. The purpose of this study was to understand the impact of living with XXY as an adolescent or an adult. Individuals aged 14 to 75 years with self-reported XXY were recruited from online support networks to complete a web-based survey that included open-ended questions. Open-ended responses were coded and analyzed thematically (n = 169 to 210 for each open-ended question). Over half of respondents to the open-ended questions reported challenges in finding health care providers who are knowledgeable about XXY, with many describing an extensive diagnostic odyssey and relief when receiving a diagnosis. Individuals sought support coping with the challenges they face and acknowledgement of the positive aspects of XXY. Recommendations are made for how genetic counseling can enhance quality of life for individuals living with XXY.

  13. Taking it Global: Structuring Global Health Education in Residency Training.

    PubMed

    Arora, Gitanjli; Ripp, Jonathan; Evert, Jessica; Rabin, Tracy; Tupesis, Janis P; Hudspeth, James

    2017-05-01

    To meet the demand by residents and to provide knowledge and skills important to the developing physician, global health (GH) training opportunities are increasingly being developed by United States (U.S.) residency training programs. However, many residency programs face common challenges of developing GH curricula, offering safe and mentored international rotations, and creating GH experiences that are of service to resource-limiting settings. Academic GH partnerships allow for the opportunity to collaborate on education and research and improve health care and health systems, but must ensure mutual benefit to U.S. and international partners. This article provides guidance for incorporating GH education into U.S. residency programs in an ethically sound and sustainable manner, and gives examples and solutions for common challenges encountered when developing GH education programs.

  14. Collaboration challenges in systematic reviews: a survey of health sciences librarians

    PubMed Central

    Nicholson, Joey; McCrillis, Aileen; Williams, Jeff D.

    2017-01-01

    Objective: While many librarians have been asked to participate in systematic reviews with researchers, often these researchers are not familiar with the systematic review process or the appropriate role for librarians. The purpose of this study was to identify the challenges and barriers that librarians face when collaborating on systematic reviews. To take a wider view of the whole process of collaborating on systematic reviews, the authors deliberately focused on interpersonal and methodological issues other than searching itself. Methods: To characterize the biggest challenges that librarians face while collaborating on systematic review projects, we used a web-based survey. The thirteen-item survey included seventeen challenges grouped into two categories: methodological and interpersonal. Participants were required to indicate the frequency and difficulty of the challenges listed. Open-ended questions allowed survey participants to describe challenges not listed in the survey and to describe strategies used to overcome challenges. Results: Of the 17 challenges listed in the survey, 8 were reported as common by over 40% of respondents. These included methodological issues around having too broad or narrow research questions, lacking eligibility criteria, having unclear research questions, and not following established methods. The remaining challenges were interpersonal, including issues around student-led projects and the size of the research team. Of the top 8 most frequent challenges, 5 were also ranked as most difficult to handle. Open-ended responses underscored many of the challenges included in the survey and revealed several additional challenges. Conclusions: These results suggest that the most frequent and challenging issues relate to development of the research question and general communication with team members. Clear protocols for collaboration on systematic reviews, as well as a culture of mentorship, can help librarians prevent and address these challenges. PMID:28983202

  15. Collaboration challenges in systematic reviews: a survey of health sciences librarians.

    PubMed

    Nicholson, Joey; McCrillis, Aileen; Williams, Jeff D

    2017-10-01

    While many librarians have been asked to participate in systematic reviews with researchers, often these researchers are not familiar with the systematic review process or the appropriate role for librarians. The purpose of this study was to identify the challenges and barriers that librarians face when collaborating on systematic reviews. To take a wider view of the whole process of collaborating on systematic reviews, the authors deliberately focused on interpersonal and methodological issues other than searching itself. To characterize the biggest challenges that librarians face while collaborating on systematic review projects, we used a web-based survey. The thirteen-item survey included seventeen challenges grouped into two categories: methodological and interpersonal. Participants were required to indicate the frequency and difficulty of the challenges listed. Open-ended questions allowed survey participants to describe challenges not listed in the survey and to describe strategies used to overcome challenges. Of the 17 challenges listed in the survey, 8 were reported as common by over 40% of respondents. These included methodological issues around having too broad or narrow research questions, lacking eligibility criteria, having unclear research questions, and not following established methods. The remaining challenges were interpersonal, including issues around student-led projects and the size of the research team. Of the top 8 most frequent challenges, 5 were also ranked as most difficult to handle. Open-ended responses underscored many of the challenges included in the survey and revealed several additional challenges. These results suggest that the most frequent and challenging issues relate to development of the research question and general communication with team members. Clear protocols for collaboration on systematic reviews, as well as a culture of mentorship, can help librarians prevent and address these challenges.

  16. Tackling drug and alcohol misuse in Brazil: priorities and challenges for nurses.

    PubMed

    Rassool, G H; Villar-Luis, M

    2004-12-01

    To provide an overview of the extent of drug and alcohol misuse in Brazil and the policies and approaches in tackling substance misuse. An examination of the challenges facing the nursing profession in working with substance misusers is presented. Alcohol, cocaine, and cannabis are the most commonly misused psychoactive substances in Brazil. One of the biggest public health problems is the interface between the misuse of psychoactive substances and HIV prevalence and other sexually transmitted diseases. Findings from a recent study suggest that undergraduate nurses in Brazil are not adequately prepared in the care and management of substance misuse problems. The nursing profession in Brazil faces numerous challenges in the development of professional competence of nurses in this field. A strategy proposed is the creation of regional centres in Brazil to study the integration of substance use and misuse in the nursing undergraduate curriculum and the giving of specific support in teaching and research to nurse teachers. Nurses have a key role to play in the early recognition, assessment, prevention, and treatment of substance misuse.

  17. Some imminent but overlooked preanalytical and analytical challenges currently facing biomarkers and companion diagnostics.

    PubMed

    Halim, Abdel-Baset

    2015-06-01

    An incredibly high failure rate in the pharmaceutical industry has positioned personalized medicine with its prerequisite drug-diagnostic codevelopment, commonly known as companion diagnostics (CDx), in the frontline as an potential rescuer. This hopefulness is potentiated by the recent major advances and competitiveness in molecular diagnostics, making laboratory tests widely accessible at affordable prices. If executed correctly, biomarkers and CDx can potentially help the drug industry by enhancing the probability of success and possibly accelerating time to market; help the diagnostics industry develop tests utilizing precious, clinically annotated human samples; and, more importantly, benefit patients by supporting accurate diagnosis and selection of the most efficacious and least toxic therapies. However, this spectacular road is not yet paved, and it faces an enormous number of challenges. This paper will list these challenges and highlight some critical problems with representative examples of imminent but still overlooked preanalytical and analytical variables that can defeat the whole purpose of biomarkers and CDx and mislead drug developers and clinicians. The paper will provide some suggestions for mitigation. © 2015 New York Academy of Sciences.

  18. Implementation of genomics research in Africa: challenges and recommendations

    PubMed Central

    Adebamowo, Sally N.; Francis, Veronica; Tambo, Ernest; Diallo, Seybou H.; Landouré, Guida; Nembaware, Victoria; Dareng, Eileen; Muhamed, Babu; Odutola, Michael; Akeredolu, Teniola; Nerima, Barbara; Ozumba, Petronilla J.; Mbhele, Slee; Ghanash, Anita; Wachinou, Ablo P.; Ngomi, Nicholas

    2018-01-01

    ABSTRACT Background: There is exponential growth in the interest and implementation of genomics research in Africa. This growth has been facilitated by the Human Hereditary and Health in Africa (H3Africa) initiative, which aims to promote a contemporary research approach to the study of genomics and environmental determinants of common diseases in African populations. Objective: The purpose of this article is to describe important challenges affecting genomics research implementation in Africa. Methods: The observations, challenges and recommendations presented in this article were obtained through discussions by African scientists at teleconferences and face-to-face meetings, seminars at consortium conferences and in-depth individual discussions. Results: Challenges affecting genomics research implementation in Africa, which are related to limited resources include ill-equipped facilities, poor accessibility to research centers, lack of expertise and an enabling environment for research activities in local hospitals. Challenges related to the research study include delayed funding, extensive procedures and interventions requiring multiple visits, delays setting up research teams and insufficient staff training, language barriers and an underappreciation of cultural norms. While many African countries are struggling to initiate genomics projects, others have set up genomics research facilities that meet international standards. Conclusions: The lessons learned in implementing successful genomics projects in Africa are recommended as strategies to overcome these challenges. These recommendations may guide the development and application of new research programs in low-resource settings. PMID:29336236

  19. Future challenges for vection research: definitions, functional significance, measures, and neural bases

    PubMed Central

    Palmisano, Stephen; Allison, Robert S.; Schira, Mark M.; Barry, Robert J.

    2015-01-01

    This paper discusses four major challenges facing modern vection research. Challenge 1 (Defining Vection) outlines the different ways that vection has been defined in the literature and discusses their theoretical and experimental ramifications. The term vection is most often used to refer to visual illusions of self-motion induced in stationary observers (by moving, or simulating the motion of, the surrounding environment). However, vection is increasingly being used to also refer to non-visual illusions of self-motion, visually mediated self-motion perceptions, and even general subjective experiences (i.e., “feelings”) of self-motion. The common thread in all of these definitions is the conscious subjective experience of self-motion. Thus, Challenge 2 (Significance of Vection) tackles the crucial issue of whether such conscious experiences actually serve functional roles during self-motion (e.g., in terms of controlling or guiding the self-motion). After more than 100 years of vection research there has been surprisingly little investigation into its functional significance. Challenge 3 (Vection Measures) discusses the difficulties with existing subjective self-report measures of vection (particularly in the context of contemporary research), and proposes several more objective measures of vection based on recent empirical findings. Finally, Challenge 4 (Neural Basis) reviews the recent neuroimaging literature examining the neural basis of vection and discusses the hurdles still facing these investigations. PMID:25774143

  20. Implementation of genomics research in Africa: challenges and recommendations.

    PubMed

    Adebamowo, Sally N; Francis, Veronica; Tambo, Ernest; Diallo, Seybou H; Landouré, Guida; Nembaware, Victoria; Dareng, Eileen; Muhamed, Babu; Odutola, Michael; Akeredolu, Teniola; Nerima, Barbara; Ozumba, Petronilla J; Mbhele, Slee; Ghanash, Anita; Wachinou, Ablo P; Ngomi, Nicholas

    2018-01-01

    There is exponential growth in the interest and implementation of genomics research in Africa. This growth has been facilitated by the Human Hereditary and Health in Africa (H3Africa) initiative, which aims to promote a contemporary research approach to the study of genomics and environmental determinants of common diseases in African populations. The purpose of this article is to describe important challenges affecting genomics research implementation in Africa. The observations, challenges and recommendations presented in this article were obtained through discussions by African scientists at teleconferences and face-to-face meetings, seminars at consortium conferences and in-depth individual discussions. Challenges affecting genomics research implementation in Africa, which are related to limited resources include ill-equipped facilities, poor accessibility to research centers, lack of expertise and an enabling environment for research activities in local hospitals. Challenges related to the research study include delayed funding, extensive procedures and interventions requiring multiple visits, delays setting up research teams and insufficient staff training, language barriers and an underappreciation of cultural norms. While many African countries are struggling to initiate genomics projects, others have set up genomics research facilities that meet international standards. The lessons learned in implementing successful genomics projects in Africa are recommended as strategies to overcome these challenges. These recommendations may guide the development and application of new research programs in low-resource settings.

  1. Assessment of Institutional and Personnel-Related Challenges Facing Educational Programme for the Mentally Challenged Persons at Kaimosi Special School, Kenya

    ERIC Educational Resources Information Center

    Mmbwanga, Daniel M.; Matemba, Collins K.; Bota, Kennedy N.

    2015-01-01

    The mentally challenged child (MC) can achieve a lot if the right environment and curriculum are designed for him/her. However, the realization of the desirable outcomes faces many challenges. The objective of the study was to examine institutional and personnel-related challenges facing education programs for the MC persons at Kaimosi Special…

  2. What Are the Professional, Political, and Ethical Challenges of Co-Creating Health Care Systems?

    PubMed

    Singh, Guddi; Owens, John; Cribb, Alan

    2017-11-01

    Co-creation is seen by many as a means of meeting the multiple challenges facing contemporary health care systems by involving institutions, professionals, patients, and stakeholders in new roles, relationships, and collaborative practices. While co-creation has the potential to positively transform health care systems, it generates a number of political and ethical challenges that should not be overlooked. We suggest that those involved in envisioning and implementing co-creation initiatives pay close attention to significant questions of equity, power, and justice and to the fundamental challenge of securing a common vision of the aims of and agendas for health care systems. While such initiatives present significant opportunities for improvement, they need to be viewed in light of their accompanying professional, political, and ethical challenges. © 2017 American Medical Association. All Rights Reserved.

  3. Supporting College and University Students with Invisible Disabilities: A Guide for Faculty and Staff Working with Students with Autism, AD/HD, Language Processing Disorders, Anxiety, and Mental Illness

    ERIC Educational Resources Information Center

    Oslund, Christy

    2013-01-01

    With increasing numbers of students with invisible disabilities attending college and university, faculty and staff find themselves faced with new challenges. This practical handbook provides lecturers, tutors, disability services, and administrative staff with an overview of the invisible disabilities they may encounter, dispelling common myths…

  4. Trends and Innovations in Higher Education Reform: Worldwide, Latin America and in the Caribbean. Research & Occasional Paper Series: CSHE.12.10

    ERIC Educational Resources Information Center

    Segrera, Francisco Lopez

    2010-01-01

    Universities in Latin America and in the Caribbean (LAC), and throughout the world, are facing one of the most challenging eras in their history. Globalization presents many important opportunities for higher education, but also poses serious problems and raises questions about how best to serve the common good. The traditional values of…

  5. A Glossary of Research Terms for Out-of-School Time Program Practitioners. Research-to-Results Fact Sheet. Publication #2007-02

    ERIC Educational Resources Information Center

    Bronte-Tinkew, Jacinta; Horowitz, Allison; Redd, Zakia; Moore, Kristin A.; Valladares, Sherylls

    2007-01-01

    This glossary of common research and evaluation terms can serve as a quick reference guide for out-of school time practitioners as they face the challenges posed in this new era of program accountability. Subsequent briefs will provide more detailed information on particular types of research and evaluation designs. A list of additional resources…

  6. The Influence of Causal Knowledge on the Willingness to Change Attitude towards Climate Change: Results from an Empirical Study

    ERIC Educational Resources Information Center

    Tasquier, Giulia; Pongiglione, Francesca

    2017-01-01

    Climate change is one of the significant global challenges currently facing humanity. Even though its seriousness seems to be common knowledge among the public, the reaction of individuals to it has been slow and uncertain. Many studies assert that simply knowing about climate change is not enough to generate people's behavioural response. They…

  7. The Role of Urban Primary and Secondary Schools in Minimizing Disease Outbreak Caused by Environmental Contamination: A Case of Chinhoyi, Zimbabwe

    ERIC Educational Resources Information Center

    Mutungwe, Edlight; Tsvere, Maria; Dondo, Beauty; Munikwa, Simbarashe

    2011-01-01

    Waste management is a major challenge facing urban councils in Zimbabwe and Chinhoyi Municipality is no exception. Lack of resources and technical and administrative know-how is hindering proper waste management. Raw sewage and industrial waste flow into streams and rivers and uncollected rubbish bins and strewn litter is a common feature in the…

  8. Cases on Challenges Facing E-Learning and National Development: Institutional Studies and Practices. e-Learning Practices. Volume II

    ERIC Educational Resources Information Center

    Demiray, Ugur, Ed.

    2010-01-01

    E-Learning offers many opportunities for individuals and institutions all over the world. Individuals can access to education they need almost anytime and anywhere they are ready to. Institutions are able to provide more cost-effective training to their employees. E-learning context is very important. It is common to find educators who perceive…

  9. Cases on Challenges Facing E-Learning and National Development: Institutional Studies and Practices. e-Learning Practices. Volume I

    ERIC Educational Resources Information Center

    Demiray, Ugur, Ed.

    2010-01-01

    E-Learning offers many opportunities for individuals and institutions all over the world. Individuals can access to education they need almost anytime and anywhere they are ready to. Institutions are able to provide more cost-effective training to their employees. E-learning context is very important. It is common to find educators who perceive…

  10. Effects of Differential Reinforcement of Short Latencies on Response Latency, Task Completion, and Accuracy of an Adolescent with Autism

    ERIC Educational Resources Information Center

    Donohue, Melanie M.; Casey, Laura Baylot; Bicard, David F.; Bicard, Sara E.

    2012-01-01

    Children with Autism Spectrum Disorder (ASD) are faced with many challenging behaviors that could impede their learning. One commonly reported problem behavior is noncompliance, which is often defined as a delay in response (latency), decrease in rate of responding (fluency), or failure to complete a task. This failure to comply in an appropriate…

  11. The Role of Language and Literacy in College- and Career-Ready Standards: Rethinking Policy and Practice in Support of English Language Learners. Policy Brief

    ERIC Educational Resources Information Center

    Haynes, Mariana

    2012-01-01

    The Common Core State Standards spell out the sophisticated language competencies that students will need to perform in academic and technical subject areas. English language learners (ELLs) face a double challenge--they must learn grade-level content while simultaneously building their language proficiency. This policy brief discusses these…

  12. Introducing the Medical Ethics Bowl.

    PubMed

    Merrick, Allison; Green, Rochelle; Cunningham, Thomas V; Eisenberg, Leah R; Hester, D Micah

    2016-01-01

    Although ethics is an essential component of undergraduate medical education, research suggests that current medical ethics curricula face considerable challenges in improving students' ethical reasoning. This article discusses these challenges and introduces a promising new mode of graduate and professional ethics instruction for overcoming them. We begin by describing common ethics curricula, focusing in particular on established problems with current approaches. Next, we describe a novel method of ethics education and assessment for medical students that we have devised: the Medical Ethics Bowl (MEB). Finally, we suggest the pedagogical advantages of the MEB when compared to other ethics curricula.

  13. Assessing intern handover processes.

    PubMed

    Habicht, Robert; Block, Lauren; Silva, Kathryn Novello; Oliver, Nora; Wu, Albert; Feldman, Leonard

    2016-06-01

    New standards for resident work hours set in 2011 changed the landscape of patient care in teaching hospitals, and resulted in new challenges for US residency training programmes to overcome. One such challenge was a dramatic increase in the number of patient handovers performed by residents. As a result, there is a renewed focus for clinical teachers to develop educational strategies to optimise the patient handover process and improve the quality of patient care and safety. In order to investigate current gaps in resident handovers, we examined the handover processes performed by medicine interns at two academic medical centres in Baltimore, Maryland, USA. We used trained observers to collect data on whether handovers were conducted face to face, with questions asked, in private locations, with written documentation, and without distractions or interruptions. Results were analysed using chi-square tests, and adjusted for clustering at the observer and intern levels. Interns successfully conducted handovers face to face (99.5%), asked questions (85.3%), used private locations (91%), included written handover documentation (95.8%) and did not experience distractions for the majority of the time (87.7%); however, interruptions were pervasive, occurring 41.3 per cent of the time. In order to investigate current gaps in resident handovers, we examined the handover processes performed by medicine interns Interns conducted patient handovers face to face, with questions asked, in private locations, with written documentation and without distractions the majority of the time; however, interruptions during the handover process were common. Exploring gaps at the individual programme level is a critical first step to develop effective teaching strategies to optimise handovers in residency. © 2015 John Wiley & Sons Ltd.

  14. Understanding Leadership in Schools Facing Challenging Circumstances: A Chilean Case Study

    ERIC Educational Resources Information Center

    Ahumada, Luis; Galdames, Sergio; Clarke, Simon

    2016-01-01

    During the last 10 years, research into schools facing challenging circumstances has attracted the attention of researchers around the world. The aim of this study was to understand the challenges that school leaders face as they per form their work, the nature of the context in which these challenges arise, the strategies school leaders adopt to…

  15. Challenges faced by former child soldiers in the aftermath of war in Uganda.

    PubMed

    Vindevogel, Sofie; De Schryver, Maarten; Broekaert, Eric; Derluyn, Ilse

    2013-06-01

    Warfare takes a profound toll of all layers of society, creating multiple and multilevel challenges that impinge on the psychosocial well-being of affected individuals. This study aims to assess the scope and salience of challenges confronting former child soldiers and at identifying additional challenges they face compared to non-recruited young people in war-affected northern Uganda. The study was carried out with a stratified random sample of northern Ugandan adolescents (n = 1,008), of whom a third had formerly been recruited (n = 330). The mixed-method comparison design consisted of a constrained free listing task to determine the challenges; a free sorting task to categorize them into clusters; and statistical analysis of their prevalence among formerly recruited youth and of how they compare with those of nonrecruited youth. Altogether, 237 challenges were identified and clustered into 15 categories, showing that formerly recruited participants mainly identified "emotional" and "training and skills"-related challenges. Compared with nonrecruited counterparts, they reported significantly more "emotional" and fewer "social and relational" challenges, with the exception of stigmatization. Overall, there was similarity between the challenges reported by both groups. The challenges confronting formerly recruited youths reach well beyond the effects of direct war exposure and emerge mainly from multiple influence spheres surrounding them. These challenges are largely shared in common with nonrecruited youths. This multidimensional and collective character of challenges calls for comprehensive psychosocial interventions through which healing the psychological wounds of war is complemented by mending the war-affected surroundings at all levels and in all life areas. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  16. Visions of Restoration in Fire-Adapted Forest Landscapes: Lessons from the Collaborative Forest Landscape Restoration Program.

    PubMed

    Urgenson, Lauren S; Ryan, Clare M; Halpern, Charles B; Bakker, Jonathan D; Belote, R Travis; Franklin, Jerry F; Haugo, Ryan D; Nelson, Cara R; Waltz, Amy E M

    2017-02-01

    Collaborative approaches to natural resource management are becoming increasingly common on public lands. Negotiating a shared vision for desired conditions is a fundamental task of collaboration and serves as a foundation for developing management objectives and monitoring strategies. We explore the complex socio-ecological processes involved in developing a shared vision for collaborative restoration of fire-adapted forest landscapes. To understand participant perspectives and experiences, we analyzed interviews with 86 respondents from six collaboratives in the western U.S., part of the Collaborative Forest Landscape Restoration Program established to encourage collaborative, science-based restoration on U.S. Forest Service lands. Although forest landscapes and group characteristics vary considerably, collaboratives faced common challenges to developing a shared vision for desired conditions. Three broad categories of challenges emerged: meeting multiple objectives, collaborative capacity and trust, and integrating ecological science and social values in decision-making. Collaborative groups also used common strategies to address these challenges, including some that addressed multiple challenges. These included use of issue-based recommendations, field visits, and landscape-level analysis; obtaining support from local agency leadership, engaging facilitators, and working in smaller groups (sub-groups); and science engagement. Increased understanding of the challenges to, and strategies for, developing a shared vision of desired conditions is critical if other collaboratives are to learn from these efforts.

  17. Visions of Restoration in Fire-Adapted Forest Landscapes: Lessons from the Collaborative Forest Landscape Restoration Program

    NASA Astrophysics Data System (ADS)

    Urgenson, Lauren S.; Ryan, Clare M.; Halpern, Charles B.; Bakker, Jonathan D.; Belote, R. Travis; Franklin, Jerry F.; Haugo, Ryan D.; Nelson, Cara R.; Waltz, Amy E. M.

    2017-02-01

    Collaborative approaches to natural resource management are becoming increasingly common on public lands. Negotiating a shared vision for desired conditions is a fundamental task of collaboration and serves as a foundation for developing management objectives and monitoring strategies. We explore the complex socio-ecological processes involved in developing a shared vision for collaborative restoration of fire-adapted forest landscapes. To understand participant perspectives and experiences, we analyzed interviews with 86 respondents from six collaboratives in the western U.S., part of the Collaborative Forest Landscape Restoration Program established to encourage collaborative, science-based restoration on U.S. Forest Service lands. Although forest landscapes and group characteristics vary considerably, collaboratives faced common challenges to developing a shared vision for desired conditions. Three broad categories of challenges emerged: meeting multiple objectives, collaborative capacity and trust, and integrating ecological science and social values in decision-making. Collaborative groups also used common strategies to address these challenges, including some that addressed multiple challenges. These included use of issue-based recommendations, field visits, and landscape-level analysis; obtaining support from local agency leadership, engaging facilitators, and working in smaller groups (sub-groups); and science engagement. Increased understanding of the challenges to, and strategies for, developing a shared vision of desired conditions is critical if other collaboratives are to learn from these efforts.

  18. Face recognition in the thermal infrared domain

    NASA Astrophysics Data System (ADS)

    Kowalski, M.; Grudzień, A.; Palka, N.; Szustakowski, M.

    2017-10-01

    Biometrics refers to unique human characteristics. Each unique characteristic may be used to label and describe individuals and for automatic recognition of a person based on physiological or behavioural properties. One of the most natural and the most popular biometric trait is a face. The most common research methods on face recognition are based on visible light. State-of-the-art face recognition systems operating in the visible light spectrum achieve very high level of recognition accuracy under controlled environmental conditions. Thermal infrared imagery seems to be a promising alternative or complement to visible range imaging due to its relatively high resistance to illumination changes. A thermal infrared image of the human face presents its unique heat-signature and can be used for recognition. The characteristics of thermal images maintain advantages over visible light images, and can be used to improve algorithms of human face recognition in several aspects. Mid-wavelength or far-wavelength infrared also referred to as thermal infrared seems to be promising alternatives. We present the study on 1:1 recognition in thermal infrared domain. The two approaches we are considering are stand-off face verification of non-moving person as well as stop-less face verification on-the-move. The paper presents methodology of our studies and challenges for face recognition systems in the thermal infrared domain.

  19. Challenges Facing a Deaf Family Member Concerning a Loved One’s Dying

    PubMed Central

    Kehl, Karen A.; Gartner, Constance M.

    2010-01-01

    Individuals who are Deaf face challenges both similar and unique from those faced by hearing individuals when a family member is dying. This study was guided by the question “What are the challenges faced by a Deaf family member when a loved one is dying?” Methods - This qualitative study is guided by critical theory and an interpretive perspective. Robert, a college-educated older adult who has been Deaf from birth was interviewed in American Sign Language using a death history format. Results – There are challenges for Deaf family members that affect communication with both the dying person and health care professionals. Patient-family communication issues included physical challenges and financial challenges. Lack of cultural competence concerning the Deaf community created challenges communicating with professionals. Decision-making was also a challenge. Conclusions These findings provide a framework for future research concerning the needs of Deaf individuals facing the end of life and provide guidance for clinicians. PMID:19910395

  20. Bioprofiling of unknown antibiotics in herbal extracts: Development of a streamlined direct bioautography using Bacillus subtilis linked to mass spectrometry.

    PubMed

    Jamshidi-Aidji, Maryam; Morlock, Gertrud E

    2015-11-13

    Working in the field of profiling and identification of bioactive compounds in herbal extracts is faced with the challenge that common chromatographic methods do not directly link to bioactive compounds. Direct bioautography, the combination of TLC/HPTLC with bioassays, linked to structure elucidating techniques is demonstrated to overcome this challenge. The combination of TLC and Bacillus subtilis bioassay was already demonstrated to detect the antibiotics in samples. However, previous studies in this field were faced with some challenges, like being time-consuming, leading not to a homogenous plate background or being restricted to a non-acidic mobile phase. In this study, these aspects were investigated and a streamlined HPTLC-B. subtilis bioassay was developed that generated a homogenous plate background, which was crucial to yield a good baseline for biodensitometry. Two commonly used broths for B. subtilis and a self-designed medium were compared with regard to their capability of detection and baseline noise. The workflow developed allowed the use of acidic mobile phases for the first time. To prove this, 20 herbal extracts were screened for antimicrobial substances developed in parallel with an acidic mobile phase. The main antimicrobial substance in Salvia officinalis tincture detected was further characterized by microchemical reactions, Aliivibrio fischeri, β-glucosidase and acetylcholinesterase (bio)assays as well as mass spectrometry. Scientists looking for new herbal-based medicine may benefit from this time-saving and streamlined bioactivity profiling. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Medical Systems Engineering to Support Mars Mission Crew Autonomy

    NASA Technical Reports Server (NTRS)

    Antonsen, Erik; Mindock, Jennifer

    2017-01-01

    Human spaceflight missions to Mars face exceptionally challenging resource limitations that far exceed those faced before. Increasing transit times, decreasing opportunity for resupply, communications challenges, and extended time to evacuate a crew to definitive medical care dictate a level of crew autonomy in medical care that is beyond the current medical model. To approach this challenge, a medical systems engineering approach is proposed that relies on a clearly articulated Concept of Operations and risk analysis tools that are in development at NASA. This paper proposes an operational clinical model with key terminology and concepts translated to a controls theory paradigm to frame a common language between clinical and engineering teams. This common language will be used for design and validation of an exploration medical system that is fully integrated into a Mars transit vehicle. This approach merges medical simulation, human factors evaluation techniques, and human-in-the-loop testing in ground based analogs to tie medical hardware and software subsystem performance and overall medical system functionality to metrics of operational medical autonomy. Merging increases in operational clinical autonomy with a more restricted vehicle system resource scenario in interplanetary spaceflight will require an unprecedented level of medical and engineering integration. Full integration of medical capabilities into a Mars vehicle system may require a new approach to integrating medical system design and operations into the vehicle Program structure. Prior to the standing-up of a Mars Mission Program, proof of concept is proposed through the Human Research Program.

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

    PubMed Central

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

    2015-01-01

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

  3. Results From a Pressure Sensitive Paint Test Conducted at the National Transonic Facility on Test 197: The Common Research Model

    NASA Technical Reports Server (NTRS)

    Watkins, A. Neal; Lipford, William E.; Leighty, Bradley D.; Goodman, Kyle Z.; Goad, William K.; Goad, Linda R.

    2011-01-01

    This report will serve to present results of a test of the pressure sensitive paint (PSP) technique on the Common Research Model (CRM). This test was conducted at the National Transonic Facility (NTF) at NASA Langley Research Center. PSP data was collected on several surfaces with the tunnel operating in both cryogenic mode and standard air mode. This report will also outline lessons learned from the test as well as possible approaches to challenges faced in the test that can be applied to later entries.

  4. Improving the asthma disparity gap with legal advocacy? A qualitative study of patient-identified challenges to improve social and environmental factors that contribute to poorly controlled asthma.

    PubMed

    Harris, Drew A; Mainardi, Anne; Iyamu, Osatohamwen; Rosenthal, Marjorie S; Bruce, R Douglas; Pisani, Margaret A; Redlich, Carrie A

    2017-09-05

    To identify challenges that disadvantaged adults with asthma face in mitigating social and environmental factors associated with poor symptom control. Using a community-engaged approach, we partnered with a community health center in New Haven, CT to conduct in-person interviews and a written survey of asthmatic adults with poor symptom control. Using the constant comparative method, we analyzed participant interviews to establish emerging themes and identify common barriers to improved outcomes. Through a written survey utilizing clinically validated questions, we assessed information on access to medical care, asthma control, and selected social and environmental risk factors. Twenty-one patients (mean age 47, 62% female, 71% Black, 95% insured by Medicaid) participated. The average Asthma Control Test (ACT) score was 11.6. Seventy-six percent of participants were currently employed and of those, 75% reported work-related symptoms. Among participants currently in housing, 59% reported exposure to domiciliary mice and 47% to mold. We identified three themes that summarize the challenges the study participants face: 1) Lack of knowledge about home and workplace asthma triggers; 2) Lack of awareness of legal rights or resources available to mitigate adverse conditions in the home or work environment; and 3) Fear of retaliation from landlords or employers, including threats of eviction, sexual assault, and job loss. Patients with poorly controlled asthma in a disadvantaged urban northeast community identified common barriers in both the domestic and work environments that impeded attainment of symptom control. These challenges may be best addressed through legal advocacy for those most at risk.

  5. Enhancing Creativity and Innovation at All Levels of Education and Training to Face New Economic and Social Challenges

    ERIC Educational Resources Information Center

    Berlinguer, Luigi

    2012-01-01

    The digital revolution is transforming the ways in which knowledge and culture are produced, accessed, and, most of all, created and re-created. And as the Internet is nowadays generally acknowledged to be a public or a common good, this leads us to re-think the laws written for the 20th century technology, economy, and culture. Moreover, the…

  6. Reorientation of health services: enablers and barriers faced by organisations when increasing health promotion capacity.

    PubMed

    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.

  7. Homeland Security. Management Challenges Facing Federal Leadership

    DTIC Science & Technology

    2002-12-01

    Security Management Challenges Facing Federal Leadership 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...including attention to management practices and key success factors. HOMELAND SECURITY Management Challenges Facing Federal Leadership www.gao.gov/cgi...significant management and coordination challenges if it is to provide this leadership and be successful in preventing and responding to any future

  8. Delegation in Correctional Nursing Practice.

    PubMed

    Tompkins, Frances

    2016-07-01

    Correctional nurses face daily challenges as a result of their work environment. Common challenges include availability of resources for appropriate care delivery, negotiating with custody staff for access to patients, adherence to scope of practice standards, and working with a varied staffing mix. Professional correctional nurses must consider the educational backgrounds and competency of other nurses and assistive personnel in planning for care delivery. Budgetary constraints and varied staff preparation can be a challenge for the professional nurse. Adequate care planning requires understanding the educational level and competency of licensed and unlicensed staff. Delegation is the process of assessing patient needs and transferring responsibility for care to appropriately educated and competent staff. Correctional nurses can benefit from increased knowledge about delegation. © The Author(s) 2016.

  9. Does Cultural Adaptation Have a Role in Substance Abuse Treatment?

    PubMed Central

    Burlew, A. Kathleen; Copeland, Valire Carr; Ahuama-Jonas, Chizara; Calsyn, Donald A.

    2013-01-01

    The changing ethnic composition of the nation and increasing requirements to use evidence-based treatments (EBTs) challenge mental health professionals to adapt treatments and interventions to be appropriate for their clients. This article applies the available information on cultural adaptation to substance abuse. The authors’ review suggests that the most common approaches for adapting substance use interventions include some combination of either community involvement in the adaptation, existing research and literature, and/or consultation from experts to adapt EBTs. The challenges facing the development of culturally adapted interventions include the need for additional research to determine which specific EBTs warrant adaptation, the responsibility of maintaining the balance between fidelity and adaptation, and the challenge of intragroup diversity. PMID:23731430

  10. Identifying the challenges and facilitators of implementing a COPD care bundle.

    PubMed

    Lennox, Laura; Green, Stuart; Howe, Cathy; Musgrave, Hannah; Bell, Derek; Elkin, Sarah

    2014-01-01

    Care bundles have been shown to improve outcomes, reduce hospital readmissions and reduce length of hospital stay; therefore increasing the speed of uptake and delivery of care bundles should be a priority in order to deliver more timely improvements and consistent high-quality care. Previous studies have detailed the difficulties of obtaining full compliance to bundle elements but few have described the underlying reasons for this. In order to improve future implementation this paper investigates the challenges encountered by clinical teams implementing a chronic obstructive pulmonary disease (COPD) care bundle and describes actions taken to overcome these challenges. An initial retrospective documentary analysis of data from seven clinical implementation teams was undertaken to review the challenges faced by the clinical teams. Three focus groups with healthcare professionals and managers explored solutions to these challenges developed during the project. Documentary analysis identified 28 challenges which directly impacted implementation of the COPD care bundle within five themes; staffing, infrastructure, process, use of improvement methodology and patient and public involvement. Focus groups revealed that the five most significant challenges for all groups were: staff too busy, staff shortages, lack of staff engagement, added workload of the bundle and patient coding issues. The participants shared facilitating factors used to overcome issues including: shifting perceptions to improve engagement, further education sessions to increase staff participation and gaining buy-in from managers through payment frameworks. Maximising the impact of a care bundle relies on its successful and timely implementation. Teams implementing the COPD care bundle encountered challenges that were common to all teams and sites. Understanding and learning from the challenges faced by previous endeavours and identifying the facilitators to overcoming these barriers provides an opportunity to mitigate issues that waste time and resources, and ensures that training can be tailored to the anticipated challenges.

  11. Simple thermal to thermal face verification method based on local texture descriptors

    NASA Astrophysics Data System (ADS)

    Grudzien, A.; Palka, Norbert; Kowalski, M.

    2017-08-01

    Biometrics is a science that studies and analyzes physical structure of a human body and behaviour of people. Biometrics found many applications ranging from border control systems, forensics systems for criminal investigations to systems for access control. Unique identifiers, also referred to as modalities are used to distinguish individuals. One of the most common and natural human identifiers is a face. As a result of decades of investigations, face recognition achieved high level of maturity, however recognition in visible spectrum is still challenging due to illumination aspects or new ways of spoofing. One of the alternatives is recognition of face in different parts of light spectrum, e.g. in infrared spectrum. Thermal infrared offer new possibilities for human recognition due to its specific properties as well as mature equipment. In this paper we present the scheme of subject's verification methodology by using facial images in thermal range. The study is focused on the local feature extraction methods and on the similarity metrics. We present comparison of two local texture-based descriptors for thermal 1-to-1 face recognition.

  12. E-Mentoring the Online Doctoral Student from the Dissertation Prospectus through Dissertation Completion

    ERIC Educational Resources Information Center

    Black, Ronald

    2017-01-01

    Faculty who mentor online doctoral candidates face many of the same challenges and opportunities as those mentoring doctoral candidates in traditional, face-to-face modalities. The main difference is that E-Mentoring is based on interacting in the online space rather than interacting face-to-face, which may present challenges for both the…

  13. But I Don't Understand You: One Faculty's Observations of the Challenges Facing International Healthcare Students

    ERIC Educational Resources Information Center

    DuBose, Cheryl O.

    2017-01-01

    International students face many challenges when pursuing a degree in higher education. Communication and cultural differences are typically cited as the most challenging aspects of any study abroad program. Students attempting to complete a healthcare program face sometimes insurmountable issues, as communication, cultural differences, and…

  14. The Sisters of Mercy in the Crimean War: Lessons for Catholic health care

    PubMed Central

    Paradis, Mary Raphael; Hart, Edith Mary; O’Brien, Mary Judith

    2017-01-01

    In 1856, an appeal went out to nurses in both England and Ireland, and especially to religious nurses, to care for the troops fighting in the Crimean War. The Sisters of Mercy, founded in 1831 by Venerable Catherine McAuley, answered that call. This article describes the enormous challenges the Sisters faced in that mission, which was a test of their nursing skills, flexibility, organizational ability, and their spirit of mercy. The challenges they faced professionally and as religious Sisters, the manner in which they faced those challenges, and their spiritual lives as religious women shaped their ability to give comprehensive care. Some applications are made to the challenges which religious communities and organizations working in health care face in our country at this time. Summary: This article describes the challenges faced by a group of Sisters of Mercy from England and Ireland who volunteered to serve as nurses in the Crimean War from 1856 to 1858. Applications are made to challenges which are faced by religious communities and organizations in the current secular healthcare environment. PMID:28392597

  15. The Sisters of Mercy in the Crimean War: Lessons for Catholic health care.

    PubMed

    Paradis, Mary Raphael; Hart, Edith Mary; O'Brien, Mary Judith

    2017-02-01

    In 1856, an appeal went out to nurses in both England and Ireland, and especially to religious nurses, to care for the troops fighting in the Crimean War. The Sisters of Mercy, founded in 1831 by Venerable Catherine McAuley, answered that call. This article describes the enormous challenges the Sisters faced in that mission, which was a test of their nursing skills, flexibility, organizational ability, and their spirit of mercy. The challenges they faced professionally and as religious Sisters, the manner in which they faced those challenges, and their spiritual lives as religious women shaped their ability to give comprehensive care. Some applications are made to the challenges which religious communities and organizations working in health care face in our country at this time. Summary: This article describes the challenges faced by a group of Sisters of Mercy from England and Ireland who volunteered to serve as nurses in the Crimean War from 1856 to 1858. Applications are made to challenges which are faced by religious communities and organizations in the current secular healthcare environment.

  16. The challenge of localizing the anterior temporal face area: a possible solution.

    PubMed

    Axelrod, Vadim; Yovel, Galit

    2013-11-01

    Humans recognize faces exceptionally well. However, the neural correlates of face recognition are still elusive. Accumulated evidence in recent years suggests that the anterior temporal lobe (ATL), in particular face-selective region in the ATL, is a probable locus of face recognition. Unfortunately, functional MRI (fMRI) studies encounter severe signal drop-out in the ventral ATL, where that ATL face area resides. Consequently, all previous studies localized this region in no more than half of the subjects and its volume was relatively small. Thus, a systematic exploration of the properties of the ATL face area is scarce. In the current high-resolution fMRI study we used coronal slice orientation, which permitted us to localize the ATL face area in all the subjects. Furthermore, the volume of the area was much larger than was reported in previous studies. Direct within subjects comparison with data collected with the commonly used axial slice orientation confirmed that the advantage of the coronal slice orientation in revealing a reliable and larger face-selective area in the ATL. Finally, by displaying the face-selective activations resultant from coronal and axial scanning together, we demonstrate an organization principle of a chain of face-selective regions along the posterior-anterior axis in the ventral temporal lobe that is highly reproducible across all subjects. By using the procedure proposed here, a significant progress can be made in studying the neural correlates of face recognition. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Logistical Challenges and Opportunities for Conducting Peer Nomination Research in Schools.

    PubMed

    Mayeux, Lara; Kraft, Caroline

    2017-09-01

    Although conducting psychological research within schools has always required effort, persistence, and the careful navigation of various interests, there is a consensus among child and adolescent researchers that, over the past 2 decades, it has become increasingly difficult to collect data within schools. In this chapter, we lay out common and consistent difficulties, frustrations, and obstacles that researchers face when attempting to conduct peer nomination research in schools. Many of these difficulties are faced not only by researchers conducting peer nominations but by any investigator attempting to do school-based research, and we discuss these issues more broadly. We also focus on the specific challenges associated with sociometric methods. We present suggestions and solutions for overcoming these issues and consider ways that researchers can give back to schools and establish long-term partnerships that benefit the students, teachers, and administrators of participating schools, as well as the researchers themselves. Such partnerships have the potential to make data collection easier and to open doors to new research opportunities. © 2017 Wiley Periodicals, Inc.

  18. Establishing and sustaining a biorepository network in Israel: challenges and progress.

    PubMed

    Cohen, Yehudit; Almog, Ronit; Onn, Amir; Itzhaki-Alfia, Ayelet; Meir, Karen

    2013-12-01

    Over the past 5 years, using European and North American biobanks as models, the grass-roots establishment of independently operating biobanks has occurred virtually simultaneously in large Israeli teaching hospitals. The process of establishing a national biorepository network in Israel has progressed slowly, sustained mainly by a few proponents working together on a personal level. Slow progress has been due to limited funding and the lack of a legal framework specific to biobanking activities. Recently, due to increasing pressure from the scientific community, the government has earmarked funds for a national biorepository network, and the structure is now being established. In forming a network, Israel's biobanks face certain difficulties, particularly lack of support. Additional challenges include harmonization of standard operating procedures, database centralization, and use of a common informed consent form. In this article, we highlight some of the issues faced by Israel's biobank managers in establishing and sustaining a functional biobank network, information that could provide guidance for other small countries with limited resources.

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

    PubMed

    Lexa, Frank James; Lexa, Frank J

    2005-07-01

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

  20. Meanings, Mechanisms, and Measures of Holistic Processing

    PubMed Central

    Richler, Jennifer J.; Palmeri, Thomas J.; Gauthier, Isabel

    2012-01-01

    Few concepts are more central to the study of face recognition than holistic processing. Progress toward understanding holistic processing is challenging because the term “holistic” has many meanings, with different researchers addressing different mechanisms and favoring different measures. While in principle the use of different measures should provide converging evidence for a common theoretical construct, convergence has been slow to emerge. We explore why this is the case. One challenge is that “holistic processing” is often used to describe both a theoretical construct and a measured effect, which may not have a one-to-one mapping. Progress requires more than greater precision in terminology regarding different measures of holistic processing or different hypothesized mechanisms of holistic processing. Researchers also need to be explicit about what meaning of holistic processing they are investigating so that it is clear whether different researchers are describing the same phenomenon or not. Face recognition differs from object recognition, and not all meanings of holistic processing are equally suited to help us understand that important difference. PMID:23248611

  1. Meanings, mechanisms, and measures of holistic processing.

    PubMed

    Richler, Jennifer J; Palmeri, Thomas J; Gauthier, Isabel

    2012-01-01

    Few concepts are more central to the study of face recognition than holistic processing. Progress toward understanding holistic processing is challenging because the term "holistic" has many meanings, with different researchers addressing different mechanisms and favoring different measures. While in principle the use of different measures should provide converging evidence for a common theoretical construct, convergence has been slow to emerge. We explore why this is the case. One challenge is that "holistic processing" is often used to describe both a theoretical construct and a measured effect, which may not have a one-to-one mapping. Progress requires more than greater precision in terminology regarding different measures of holistic processing or different hypothesized mechanisms of holistic processing. Researchers also need to be explicit about what meaning of holistic processing they are investigating so that it is clear whether different researchers are describing the same phenomenon or not. Face recognition differs from object recognition, and not all meanings of holistic processing are equally suited to help us understand that important difference.

  2. When health systems are barriers to health care: challenges faced by uninsured Mexican kidney patients.

    PubMed

    Kierans, Ciara; Padilla-Altamira, Cesar; Garcia-Garcia, Guillermo; Ibarra-Hernandez, Margarita; Mercado, Francisco J

    2013-01-01

    Chronic Kidney Disease disproportionately affects the poor in Low and Middle Income Countries (LMICs). Mexico exemplifies the difficulties faced in supporting Renal Replacement Therapy (RRT) and providing equitable patient care, despite recent attempts at health reform. The objective of this study is to document the challenges faced by uninsured, poor Mexican families when attempting to access RRT. The article takes an ethnographic approach, using interviewing and observation to generate detailed accounts of the problems that accompany attempts to secure care. The study, based in the state of Jalisco, comprised interviews with patients, their caregivers, health and social care professionals, among others. Observations were carried out in both clinical and social settings. In the absence of organised health information and stable pathways to renal care, patients and their families work extraordinarily hard and at great expense to secure care in a mixed public-private healthcare system. As part of this work, they must navigate challenging health and social care environments, negotiate treatments and costs, resource and finance healthcare and manage a wide range of formal and informal health information. Examining commonalities across pathways to adequate healthcare reveals major failings in the Mexican system. These systemic problems serve to reproduce and deepen health inequalities. A system, in which the costs of renal care are disproportionately borne by those who can least afford them, faces major difficulties around the sustainability and resourcing of RRTs. Attempts to increase access to renal therapies, therefore, need to take into account the complex social and economic demands this places on those who need access most. This paper further shows that ethnographic studies of the concrete ways in which healthcare is accessed in practice provide important insights into the plight of CKD patients and so constitute an important source of evidence in that effort.

  3. Sex and gender: the challenges for epidemiologists.

    PubMed

    Doyal, Lesley

    2003-01-01

    Gender issues are now receiving more attention on global and national health agendas. However, the evidence base for policy and practice in this area remains limited and conceptual confusion is still common. This article reviews the challenges facing epidemiologists and other researchers who aim to make their work more "gender sensitive." It begins by exploring the concepts of biological "sex" and social "gender" and assesses their implications for the health of both women and men. It then reviews a range of strategies for mainstreaming sex and gender into health research. The article concludes with brief comments on the links between gender equity and wider equality concerns.

  4. Community in Online Higher Education: Challenges and Opportunities

    ERIC Educational Resources Information Center

    Arasaratnam-Smith, Lily A.; Northcote, Maria

    2017-01-01

    Exploring the challenges and opportunities associated with the concepts of community and communication in online higher education, this paper reconsiders the intention to replicate face-to-face learning and teaching strategies in online learning environments. Rather than beginning with the assumption that face-to-face education is the prototype…

  5. Integrating International Engineering Organizations For Successful ISS Operations

    NASA Technical Reports Server (NTRS)

    Blome, Elizabeth; Duggan, Matt; Patten, L.; Pieterek, Hhtrud

    2006-01-01

    The International Space Station (ISS) is a multinational orbiting space laboratory that is built in cooperation with 16 nations. The design and sustaining engineering expertise is spread worldwide. As the number of Partners with orbiting elements on the ISS grows, the challenge NASA is facing as the ISS integrator is to ensure that engineering expertise and data are accessible in a timely fashion to ensure ongoing operations and mission success. Integrating international engineering teams requires definition and agreement on common processes and responsibilities, joint training and the emergence of a unique engineering team culture. ISS engineers face daunting logistical and political challenges regarding data sharing requirements. To assure systematic information sharing and anomaly resolution of integrated anomalies, the ISS Partners are developing multi-lateral engineering interface procedures. Data sharing and individual responsibility are key aspects of this plan. This paper describes several examples of successful multilateral anomaly resolution. These successes were used to form the framework of the Partner to Partner engineering interface procedures, and this paper describes those currently documented multilateral engineering processes. Furthermore, it addresses the challenges experienced to date, and the forward work expected in establishing a successful working relationship with Partners as their hardware is launched.

  6. International Symposium on Grids and Clouds (ISGC) 2017

    NASA Astrophysics Data System (ADS)

    2017-03-01

    The International Symposium on Grids and Clouds (ISGC) 2017 will be held at Academia Sinica in Taipei, Taiwan from 5-10 March 2017, with co- located events and workshops. The main theme of ISGC 2017 is "Global Challenges: From Open Data to Open Science". The unprecedented progress in ICT has transformed the way education is conducted and research is carried out. The emerging global e-Infrastructure, championed by global science communities such as High Energy Physics, Astronomy, and Bio- medicine, must permeate into other sciences. Many areas, such as climate change, disaster mitigation, and human sustainability and well-being, represent global challenges where collaboration over e-Infrastructure will presumably help resolve the common problems of the people who are impacted. Access to global e-Infrastructure helps also the less globally organized, long-tail sciences, with their own collaboration challenges. Open data are not only a political phenomenon serving government transparency; they also create an opportunity to eliminate access barriers to all scientific data, specifically data from global sciences and regional data that concern natural phenomena and people. In this regard, the purpose of open data is to improve sciences, accelerating specifically those that may benefit people. Nevertheless, to eliminate barriers to open data is itself a daunting task and the barriers to individuals, institutions and big collaborations are manifold. Open science is a step beyond open data, where the tools and understanding of scientific data must be made available to whoever is interested to participate in such scientific research. The promotion of open science may change the academic tradition practiced over the past few hundred years. This change of dynamics may contribute to the resolution of common challenges of human sustainability where the current pace of scientific progress is not sufficiently fast. ISGC 2017 created a face-to-face venue where individual communities and national representatives can present and share their contributions to the global puzzle and contribute thus to the solution of global challenges.

  7. Nurse Perspectives on the Practical, Emotional, and Professional Impacts of Living and Working in Post-earthquake Canterbury, New Zealand.

    PubMed

    Johal, Sarbjit S; Mounsey, Zoe; Brannelly, Petula; Johnston, David M

    2016-02-01

    This report explores nurses' perspectives following the Canterbury (New Zealand) 2010-2011 earthquake sequence and the subsequent recovery process. Problem Little is known about the experiences of health care professionals during a disaster recovery process, and this research generates insights about the challenges faced. Qualitative semi-structured interviews were undertaken with 11 nurses from the Christchurch (New Zealand) area to explore the challenges faced by the nurses during and following the earthquakes. The interviews took place three years after the start of the earthquake experience to enable exploration of longer term aspects of the recovery process. The interview transcripts were analyzed and coded using a grounded theory approach. The data analysis identified that the nurses had faced a number of challenges and these were characterized as practical, emotional, and professional. While some of the challenges were short-lived in the aftermath of the earthquakes, some were long-lasting due to the extended nature of the recovery process. Dealing with house damage, insurance negotiations, and working in damaged environments had a negative impact on the nurses. The nurses experienced a range of emotions, both negative and positive, after the disaster, though many had needed time to elapse before feeling able to reflect on their experiences. The findings suggest that secondary stressors have a negative impact on the psychosocial recovery process. The nurses recognized that they received support from others and were also required to focus on others. Keeping busy appeared to be the most common coping strategy. This lack of reflection on their experiences may have resulted in delayed emotional responses. Some of the nurses changed their work role, hours, and responsibilities suggesting that working in this environment was having a detrimental impact. The research indicates the challenges faced by nurses in the initial impact of the earthquakes and during the longer term recovery process. There is a need to consider the psychosocial impact of working and living in a post-disaster context and to develop support packages to ensure the health and well-being of nurses in this environment.

  8. The University Rover Challenge: A competition highlighting Human and Robotic partnerships for exploration

    NASA Astrophysics Data System (ADS)

    Smith, Heather; Duncan, Andrew

    2016-07-01

    The University Rover Challenge began in 2006 with 4 American college teams competing, now in it's 10th year there are 63 teams from 12 countries registered to compete for the top rover designed to assist humans in the exploration of Mars. The Rovers compete aided by the University teams in four tasks (3 engineering and 1 science) in the Mars analog environment of the Utah Southern Desert in the United States. In this presentation we show amazing rover designs with videos demonstrating the incredible ingenuity, skill and determination of the world's most talented college students. We describe the purpose and results of each of the tasks: Astronaut Assistant, Rover Dexterity, Terrain maneuvering, and Science. We explain the evolution of the competition and common challenges faced by the robotic explorers

  9. Challenges of Virtual School Leadership

    ERIC Educational Resources Information Center

    Richardson, Jayson W.; LaFrance, Jason; Beck, Dennis

    2015-01-01

    The purpose of this case study was to examine challenges faced by virtual school leaders in the United States. Through semistructured interviews, the researchers explored challenges faced by eighteen leaders of fully online or blended online programs. Analysis revealed six main challenges: funding, staff, accountability, time, parents, and…

  10. Issues in access to safe drinking water and basic hygiene for persons with physical disabilities in rural Cambodia.

    PubMed

    MacLeod, Marin; Pann, Mala; Cantwell, Ray; Moore, Spencer

    2014-12-01

    An estimated 1.6 million people die from diarrheal diseases each year due to lack of access to safe water and sanitation, and persons with physical disabilities face additional barriers. In Cambodia, approximately 5% of the population is disabled, presenting substantial obstacles in accessing these basic services. The purpose of this study was twofold: first, to identify the challenges facing persons with physical disabilities in accessing safe household water and basic hygiene in rural Cambodia; and, second, to use these results to generate policy and practice recommendations for the water and sanitation hygiene sector implementing water treatment system interventions in rural settings. Fifteen field interviews were conducted with persons with physical disabilities. Thematic analysis was used to identify six main themes. The results indicated that environmental barriers to access were greater in the workplace than household settings and those persons with disabilities had greater awareness about safe drinking water compared to basic hygiene. Additionally, lack of physical strength, distance to water, and lack of financial means were noted as common access barriers. The findings support ongoing research and offer insight into the particular challenges facing persons with physical disabilities in rural areas in accessing safe drinking water and basic hygiene.

  11. Challenges Faced by Female-Students in Engineering-Education

    ERIC Educational Resources Information Center

    Madara, Diana Starovoytova; Cherotich, Sharon

    2016-01-01

    Gender-related challenges in learning technical courses are universal phenomenon. These challenges could restrain female students from achieving their fullest potential. The main focus of this study, therefore, is to examine self-recognized challenges faced by undergraduate female students in pursuing engineering at the School of Engineering…

  12. Perinatal issues for women with high functioning autism spectrum disorder.

    PubMed

    Rogers, Cath; Lepherd, Laurence; Ganguly, Rahul; Jacob-Rogers, Sebastian

    2017-04-01

    Autistic Spectrum Disorder (ASD) is an increasingly commonly diagnosed disability. People with ASD commonly report challenges in social interaction and a heightened sensory perception. These challenges may be particularly difficult for women during pregnancy, birthing and beyond. Very little is known about the experiences and needs of birthing women who have ASD. There is a large body of literature about women who have autistic children, but almost nothing about women who may have this disability themselves. Internet blogs provide some insights and suggest that birthing women with ASD may have particular challenges related to communication, decision making and sensory overload. This study explores the particular issues and experiences of birthing women who have ASD, through pregnancy, birth and early mothering. This qualitative research used a case study approach, with in-depth interviewing and email exchange providing the data for the study. This data was verified, transcribed and analysed thematically. The findings of this case study identified three key issues: communication and service difficulties; sensory stress and parenting challenges. Findings suggest that women with ASD may face particular challenges during pregnancy, birthing and early mothering. These challenges evolve from perceptions of the woman about her midwives and other caregivers. If a woman perceives that her midwife is judgemental about her, then she may withdraw from the care and support she and her baby need. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  13. Computer-mediated communication and time pressure induce higher cardiovascular responses in the preparatory and execution phases of cooperative tasks.

    PubMed

    Costa Ferrer, Raquel; Serrano Rosa, Miguel Ángel; Zornoza Abad, Ana; Salvador Fernández-Montejo, Alicia

    2010-11-01

    The cardiovascular (CV) response to social challenge and stress is associated with the etiology of cardiovascular diseases. New ways of communication, time pressure and different types of information are common in our society. In this study, the cardiovascular response to two different tasks (open vs. closed information) was examined employing different communication channels (computer-mediated vs. face-to-face) and with different pace control (self vs. external). Our results indicate that there was a higher CV response in the computer-mediated condition, on the closed information task and in the externally paced condition. These role of these factors should be considered when studying the consequences of social stress and their underlying mechanisms.

  14. Challenges Faced by Maine School Districts in Providing High Quality Public Education. Research Brief

    ERIC Educational Resources Information Center

    Silvernail, David L.; Linet, Sarah R.

    2014-01-01

    The goal of this study was to: (1) identify challenges faced by Maine school districts in providing high quality public education; (2) describe the magnitude of the challenges; and (3) identify areas where school districts were experiencing some success in meeting these challenges. The School Districts Challenge Survey was distributed online to…

  15. Nurse Perceptions of Pain in Pediatric Traumatic Brain Injury: A Pilot Study.

    PubMed

    McCaa, Robin

    2017-01-01

    Pain assessment in the pediatric population is challenging because of age, developmental stage, and patient cooperation. Cognitive impairment, impaired communication, and physical disability that may accompany traumatic brain injury (TBI) further complicate pain assessments. A pilot descriptive qualitative research study was conducted to investigate nurse perceptions of pain in pediatric patients diagnosed with TBI. Specifically, this study sought to answer the following questions: a) Is pain accurately assessed in this population? b) Is pain adequately treated in this population? and c) What obstacles exist, if any, to the assessment and treatment of pain? A convenience sample of three registered nurses employed in a pediatric neurosurgery setting participated in this study. Each nurse participated in one individual, semi-structured, face-to-face interview lasting approximately 30 minutes. Interviews were transcribed verbatim and analyzed for common themes. Common themes identified across all interviews were a) challenging assessments; b) limited, although effective, treatments; and c) communication as an area of opportunity for improvement. Implications for practice and policy include a need for more sensitive pain assessment tools to improve the objectivity and accuracy of pain assessment, clarification of care priorities and organization of care from clinical and management perspectives, and additional research in alternative pain treatments for this population. Findings from this study will guide the development of a larger, more comprehensive study, with the aim of improving practice and policy in pain management for this population.

  16. The first Latin American workshop on professional skills for young female scientists

    NASA Astrophysics Data System (ADS)

    Ávila, A.; Meza-Montes, Lilia; Ponce-Dawson, Silvina

    2015-12-01

    To effectively build capacity for research and training in science, technology, engineering, and mathematics (STEM) across Latin America and the Caribbean, a gender perspective must be factored in. Working from an awareness of the gender situation as well as of the multiple personal challenges experienced due to gender disparity, a group of Latin American female scientists organized a workshop with the goal of empowering young female scientists and assessing the challenges they face. In this paper we summarize the outcomes of the workshop, highlighting the barriers that are common in the region. Among other aspects, the workshop stressed the need for resource platforms for finding technical and professional networks, jobs, and scholarships.

  17. “I was thinking too much”: experiences of HIV-positive adults with common mental disorders and poor adherence to antiretroviral therapy in Zimbabwe

    PubMed Central

    Kidia, Khameer; Machando, Debra; Bere, Tarisai; Macpherson, Kirsty; Nyamayaro, Primrose; Potter, Lucy; Makadzange, Tariro; Munjoma, Ronald; Marufu, Marshall; Araya, Ricardo; Safren, Steven; O'Cleirgh, Conall; Chibanda, Dixon; Abas, Melanie

    2015-01-01

    Objective To document the lived experiences of people with both poor mental health and suboptimal adherence to antiretroviral therapy in high HIV prevalence settings. Methods In-depth qualitative interviews were conducted with 47 (female =31) HIV-positive adults who scored above the cut-point on a locally-validated scale for common mental disorders. Purposive sampling was used to recruit participants with evidence of poor adherence. Six additional key informant interviews (female = 6) were conducted with healthcare workers. Data were collected and analysed inductively by an interdisciplinary coding team. Results The major challenges faced by participants were stressors (poverty, stigma, marital problems) and symptoms of common mental disorders (“thinking too much”, changes to appetite and sleep, “burdened heart”, and low energy levels). Thinking too much, which appears closely related to rumination, was the symptom with the greatest negative impact on adherence to antiretroviral therapy among HIV-positive adults with common mental disorders. In turn, thinking too much was commonly triggered by the stressors faced by people living with HIV/AIDS, especially poverty. Finally, participants desired private counselling, access to income generating activities, and family engagement in mental health care. Conclusions Better understanding of the local expression of mental disorders and of underlying stressors can inform the development of culturally sensitive interventions to reduce common mental disorders and poor adherence to antiretroviral therapy. PMID:25754063

  18. Challenges Facing Teachers New to Working in Schools Overseas

    ERIC Educational Resources Information Center

    Halicioglu, Margaret L.

    2015-01-01

    This article considers the potential challenges facing teachers moving abroad for the first time, both professional challenges in their school and personal challenges in their private life. It suggests that such teachers embarking on a professional adventure overseas would benefit from careful consideration of the kind of school they will thrive…

  19. The Challenges Facing School Governing Bodies in England: A "Perfect Storm"?

    ERIC Educational Resources Information Center

    James, Chris; Brammer, Steve; Connolly, Michael; Spicer, David Eddy; James, Jane; Jones, Jeff

    2013-01-01

    The governing bodies of publicly funded schools in England are currently facing a number of substantive challenges of various kinds. Many of the challenges are long-standing, while others relate to the current context for governing wrought by recent education policy developments initiated by central government. A number of the challenges are…

  20. Challenges of International Students in a Japanese University: Ethnographic Perspectives

    ERIC Educational Resources Information Center

    Lee, Ju Seong

    2017-01-01

    The author investigates what challenges four international students (Vietnamese, Filipino, Brazilian, and Chinese) faced and how they coped with these dilemmas in a Japanese language program during the first semester in 2014. Multiple apparatuses (e.g., field notes, face-to-face oral interviews, focal group conversations, and semi-structured…

  1. Identifying the challenges and facilitators of implementing a COPD care bundle

    PubMed Central

    Lennox, Laura; Green, Stuart; Howe, Cathy; Musgrave, Hannah; Bell, Derek; Elkin, Sarah

    2014-01-01

    Background Care bundles have been shown to improve outcomes, reduce hospital readmissions and reduce length of hospital stay; therefore increasing the speed of uptake and delivery of care bundles should be a priority in order to deliver more timely improvements and consistent high-quality care. Previous studies have detailed the difficulties of obtaining full compliance to bundle elements but few have described the underlying reasons for this. In order to improve future implementation this paper investigates the challenges encountered by clinical teams implementing a chronic obstructive pulmonary disease (COPD) care bundle and describes actions taken to overcome these challenges. Methods An initial retrospective documentary analysis of data from seven clinical implementation teams was undertaken to review the challenges faced by the clinical teams. Three focus groups with healthcare professionals and managers explored solutions to these challenges developed during the project. Results Documentary analysis identified 28 challenges which directly impacted implementation of the COPD care bundle within five themes; staffing, infrastructure, process, use of improvement methodology and patient and public involvement. Focus groups revealed that the five most significant challenges for all groups were: staff too busy, staff shortages, lack of staff engagement, added workload of the bundle and patient coding issues. The participants shared facilitating factors used to overcome issues including: shifting perceptions to improve engagement, further education sessions to increase staff participation and gaining buy-in from managers through payment frameworks. Conclusions Maximising the impact of a care bundle relies on its successful and timely implementation. Teams implementing the COPD care bundle encountered challenges that were common to all teams and sites. Understanding and learning from the challenges faced by previous endeavours and identifying the facilitators to overcoming these barriers provides an opportunity to mitigate issues that waste time and resources, and ensures that training can be tailored to the anticipated challenges. PMID:25478183

  2. Syphilis testing practices in the Americas.

    PubMed

    Trinh, Thuy T; Kamb, Mary L; Luu, Minh; Ham, D Cal; Perez, Freddy

    2017-09-01

    To present the findings of the Pan American Health Organization's 2014 survey on syphilis testing policies and practices in the Americas. Representatives of national/regional reference and large, lower-level laboratories from 35 member states were invited to participate. A semi-structured, electronically administered questionnaire collected data on syphilis tests, algorithms, equipment/commodities, challenges faced and basic quality assurance (QA) strategies employed (i.e. daily controls, standard operating procedures, technician training, participating in external QA programmes, on-site evaluations). The 69 participating laboratories from 30 (86%) member states included 41 (59%) national/regional reference and 28 (41%) lower-level laboratories. Common syphilis tests conducted were the rapid plasma reagin (RPR) (62% of surveyed laboratories), venereal disease research laboratory (VDRL) (54%), fluorescent treponemal antibody absorption (FTA-ABS) (41%) and Treponema pallidum haemagglutination assay (TPHA) (32%). Only three facilities reported using direct detection methods, and 28 (41% overall, 32% of lower-level facilities) used rapid tests. Most laboratories (62%) used only traditional testing algorithms (non-treponemal screening and treponemal confirmatory testing); however, 12% used only a reverse sequence algorithm (treponemal test first), and 14% employed both algorithms. Another nine (12%) laboratories conducted only one type of serologic test. Although most reference (97%) and lower-level (89%) laboratories used at least one QA strategy, only 16% reported using all five basic strategies. Commonly reported challenges were stock-outs of essential reagents or commodities (46%), limited staff training (73%) and insufficient equipment (39%). Many reference and clinical laboratories in the Americas face challenges in conducting appropriate syphilis testing and in ensuring quality of testing. © 2017 John Wiley & Sons Ltd The Pan-American Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  3. Teaching giant african pouched rats to find landmines: operant conditioning with real consequences.

    PubMed

    Poling, Alan; Weetjens, Bart J; Cox, Christophe; Beyene, Negussie; Bach, Håvard; Sully, Andrew

    2010-01-01

    Giant African pouched rats recently have been used as mine-detection animals in Mozambique. To provide an example of the wide range of problems to which operant conditioning procedures can be applied and to illustrate the common challenges often faced in applying those procedures, this manuscript briefly describes how the rats are trained and used operationally. To date, the rats have performed well and it appears they can play a valuable role in humanitarian demining.

  4. GLIMMPSE Lite: Calculating Power and Sample Size on Smartphone Devices

    PubMed Central

    Munjal, Aarti; Sakhadeo, Uttara R.; Muller, Keith E.; Glueck, Deborah H.; Kreidler, Sarah M.

    2014-01-01

    Researchers seeking to develop complex statistical applications for mobile devices face a common set of difficult implementation issues. In this work, we discuss general solutions to the design challenges. We demonstrate the utility of the solutions for a free mobile application designed to provide power and sample size calculations for univariate, one-way analysis of variance (ANOVA), GLIMMPSE Lite. Our design decisions provide a guide for other scientists seeking to produce statistical software for mobile platforms. PMID:25541688

  5. National Conference on the Development of Statewide Preservation Programs. Report of a Conference on the Current Status and Future Directions of Statewide Programs for the Preservation of Our Intellectual Heritage (Washington, D.C., March 1-3, 1989).

    ERIC Educational Resources Information Center

    Morrow, Carolyn Clark, Ed.

    This report presents some of the prominent features of a national invitational conference whose goal was to provide a national forum to discuss ongoing preservation efforts in individual states; describe the preservation challenge faced by all states in common; review the kinds of materials at risk; and alert administrators to the opportunities…

  6. Muslims in America: Identity, Diversity and the Challenge of Understanding. 2001 Carnegie Challenge.

    ERIC Educational Resources Information Center

    Afridi, Sam

    This paper discusses challenges and opportunities facing Muslims in the United States, where between 5 to 8 million Muslims live (the fastest growing religion in the country). American Muslims face many challenges, and the public has little understanding of the teachings and practice of Islam. Muslims are prone to negative stereotypes, ethnic…

  7. 'Everyone has a secret they keep close to their hearts': challenges faced by adolescents living with HIV infection at the Kenyan coast.

    PubMed

    Abubakar, Amina; Van de Vijver, Fons J R; Fischer, Ronald; Hassan, Amin S; K Gona, Joseph; Dzombo, Judith Tumaini; Bomu, Grace; Katana, Khamis; Newton, Charles R

    2016-02-29

    The upsurge in the uptake of antiretroviral therapy (ART) has led to a significant increase in the survival of vertically acquired HIV infected children, many of whom are currently living into adolescence and early adulthood. However little if anything is known of the lived experiences and the challenges faced by HIV positive adolescents in the African context. We set out to investigate psychosocial challenges faced by HIV infected adolescents on the Kenyan coast. A total of 44 participants (12 HIV-infected adolescents, 7 HIV uninfected adolescents, and 25 key informants) took part in this qualitative study, using individually administered in-depth interviews. A framework approach was used to analyze the data using NVIVO software. We observed that the challenges faced by adolescents in rural Kenya could be placed into six major themes: poverty, poor mental and physical health, the lack of a school system that is responsive to their needs, challenges in how to disclose to peers and family members, high levels of stigma in its various forms, and challenges of medical adherence leading to the need for close monitoring. In this African community, vertically acquired HIV-infected adolescents face a complex set of social, economic and medical challenges. Our study points to the urgent need to develop multisectorial intervention support programmes to fully address these challenges.

  8. Emergency neurological care of strokes and bleeds.

    PubMed

    Birenbaum, Dale

    2010-01-01

    Ischemic stroke and brain hemorrhage are common and challenging problems faced by emergency physicians. In this article, important details in the diagnosis and clinical management of these neurological emergencies are presented with the following goals: 1) To provide a more comprehensive understanding of the approach to the identification and management of patients who have sustained ischemic and hemorrhagic strokes; 2) to explain the importance and application of commonly used national stroke scoring and outcome scales; 3) to improve the ability to recognize important aspects in the approach and comprehensive treatment of ruptured and unruptured intracranial aneurysms; and 4) to demonstrate the difficulties in the neurological, neurosurgical, and endovascular treatment of these catastrophic diseases.

  9. Army Communicator. Volume 32, Number 3, Summer 2007

    DTIC Science & Technology

    2007-01-01

    goal of bringing people from across the Army together to talk about the issues and challenges they are experiencing in the field and try to work out...actually facing the challenges . Each work- shop had a mediator who collected information on issues being faced and suggested solutions to these problems...these possible items that Signal Center actions may be put forth to bring about resolutions to the challenges facing the warfighter in the field. “I

  10. Head pose estimation in computer vision: a survey.

    PubMed

    Murphy-Chutorian, Erik; Trivedi, Mohan Manubhai

    2009-04-01

    The capacity to estimate the head pose of another person is a common human ability that presents a unique challenge for computer vision systems. Compared to face detection and recognition, which have been the primary foci of face-related vision research, identity-invariant head pose estimation has fewer rigorously evaluated systems or generic solutions. In this paper, we discuss the inherent difficulties in head pose estimation and present an organized survey describing the evolution of the field. Our discussion focuses on the advantages and disadvantages of each approach and spans 90 of the most innovative and characteristic papers that have been published on this topic. We compare these systems by focusing on their ability to estimate coarse and fine head pose, highlighting approaches that are well suited for unconstrained environments.

  11. Exploring the challenges faced by polytechnic students

    NASA Astrophysics Data System (ADS)

    Matore, Mohd Effendi @ Ewan Mohd; Khairani, Ahmad Zamri

    2015-02-01

    This study aims to identify other challenges besides those already faced by students, in seven polytechnics in Malaysia as a continuation to the previous research that had identified 52 main challenges faced by students using the Rasch Model. The explorative study focuses on the challenges that are not included in the Mooney Problem Checklist (MPCL). A total of 121 polytechnic students submitted 183 written responses through the open questions provided. Two hundred fifty two students had responded from a students' perspective on the dichotomous questions regarding their view on the challenges faced. The data was analysed qualitatively using the NVivo 8.0. The findings showed that students from Politeknik Seberang Perai (PSP) gave the highest response, which was 56 (30.6%) and Politeknik Metro Kuala Lumpur (PMKL) had the lowest response of 2 (1.09%). Five dominant challenges were identified, which were the English language (32, 17.5%), learning (14, 7.7%), vehicles (13, 7.1%), information technology and communication (ICT) (13, 7.1%), and peers (11, 6.0%). This article, however, focus on three apparent challenges, namely, English language, vehicles, as well as computer and ICT, as the challenges of learning and peers had been analysed in the previous MPCL. The challenge of English language that had been raised was regarding the weakness in commanding the aspects of speech and fluency. The computer and ICT challenge covered the weakness in mastering ICT and computers, as well as computer breakdowns and low-performance computers. The challenge of vehicles emphasized the unavailability of vehicles to attend lectures and go elsewhere, lack of transportation service in the polytechnic and not having a valid driving license. These challenges are very relevant and need to be discussed in an effort to prepare polytechnics in facing the transformational process of polytechnics.

  12. Challenges and Changes Faced by Rural Superintendents

    ERIC Educational Resources Information Center

    Lamkin, Marcia L.

    2006-01-01

    This research study was designed to build grounded theory about the challenges faced by rural superintendents. Participating rural superintendents identified five areas that presented a challenge but that also applied to superintendents in other settings: school law, finance, personnel, government mandates, and district or board policies. Further,…

  13. Finding a Trans-Affirmative Provider: Challenges Faced by Trans and Gender Diverse Psychologists and Psychology Trainees.

    PubMed

    Dickey, Lore M; Singh, Anneliese A

    2017-08-01

    This article explores some of the challenges faced by trans and gender diverse (TGD) individuals who not only are attempting to access trans-affirmative care, but who are also members of the very profession from which they are seeking services. The authors explore challenges related to finding supervision, accessing care for assessment services, and finding a provider for personal counseling. With each example, the authors unpack the challenges and also address the implications for training for all involved. Based on these challenges that TGD psychologists and trainees face in attempting to access care, the authors provide recommendations related to trans-affirmative training for psychologists. © 2017 Wiley Periodicals, Inc.

  14. The Invisible Army

    PubMed Central

    2017-01-01

    ABSTRACT The “invisible army” of clinical microbiologists is facing major changes and challenges. The rate of change in both the science and technology is accelerating with no end in sight, putting pressure on our army to learn and adapt as never before. Health care funding in the United States is undergoing dramatic change which will require a new set of assumptions about how clinical microbiology is practiced here. A major challenge facing the discipline is the replacement of a generation of clinical microbiologists. In my opinion, it is incumbent on us in the invisible army to continue to work with the American Society for Microbiology (ASM) in meeting the future challenges faced by our discipline. In this commentary, I will first discuss some recent history of clinical microbiology within ASM and then some current challenges we face. PMID:28659316

  15. Children at Risk: Global Views on Challenges Facing Children

    ERIC Educational Resources Information Center

    Neugebauer, Roger

    2011-01-01

    Members of the World Forum community were invited to respond to the question: "What is the most urgent challenge facing young children in your country?" Here are some of their responses. Jamils Richard Achunji Anguaseh mentions that in Cameroon, young children face lots of insecurity, both from health hazards and poor parenting practices. There…

  16. Challenges in the management of community pharmacies in Malaysia

    PubMed Central

    2017-01-01

    Background: The provision of professional pharmacy services by community pharmacists continues to be limited, particularly in low and middle income countries. It was postulated that multiple management challenges faced by community pharmacists contribute to this situation. Objective: The primary aim of the research was to determine the challenges faced in the management of community pharmacies in Sarawak (the largest state in Malaysia), and practical strategies to cope and overcome the challenges. Methods: Semi-structured interviews were carried out with community pharmacists practising in Sarawak. Purposive and snowball sampling were employed to ensure a diverse group of informants. The interviews were audio-recorded and transcribed verbatim, with the resultant data analysed using thematic analysis. Data collection, coding, interpretation were carried out iteratively until theoretical saturation. Results: Twenty respondents from different demographic characteristics were recruited. Six major themes were identified. Management challenges faced by community pharmacists traverse five major domains: market competition, legislative issues, customers’ knowledge and expectations, macroeconomic impacts and operational challenges. Most of these challenges require government intervention to be resolved. In the meantime, improving customer service and expanding the range of professional services were seen as the most viable strategies to cope with existing challenges. The main concern is that current legislative and economic landscape may hinder these strategies. Enactment of dispensing separation and more protective measures against market competition were suggested to alleviate the challenges faced. Conclusion: Numerous management challenges faced by community pharmacists that distract them from delivering professional pharmacy services have been highlighted. Urgent affirmative actions by the government are warranted in supporting community pharmacists to realise and maximise their potentials. PMID:28690697

  17. Big Events and Risks to Global Substance Using Populations: Unique Threats and Common Challenges.

    PubMed

    Mackey, Tim K; Strathdee, Steffanie A

    2015-01-01

    In this commentary, we review a set of "Big Events" from around the world that have adversely impacted substance using populations by first identifying common thematic areas between them, and then describing the unique challenges faced by the diverse and vulnerable populations impacted. The Big Events reviewed are multifaceted and complex in nature, and include the recent global financial crisis, economic and trade sanctions, political transition and its impact on ethnic minorities, colonialism and indigenous communities, and ecological disasters. All have led to immense trauma, displacement, and disruption to critical healthcare services/treatment for people who use drugs, populations who are left underserved in the midst of these crises. It is our hope that through this comparative assessment, global policymakers will proactively identify Big Events and prioritize the development of interventions and policy that meet the unique and immediate needs of substance using population in order to mitigate the significant negative short- and long-term impacts on global public health.

  18. Implementation successes and challenges in participating in a pragmatic study to improve colon cancer screening: perspectives of health center leaders.

    PubMed

    Coronado, Gloria D; Schneider, Jennifer L; Petrik, Amanda; Rivelli, Jennifer; Taplin, Stephen; Green, Beverly B

    2017-09-01

    Little is known about the challenges faced by community clinics who must address clinical priorities first when participating in pragmatic studies. We report on implementation challenges faced by the eight community health centers that participated in Strategies and Opportunities to STOP Colon Cancer in Priority Populations (STOP CRC), a large comparative effectiveness cluster-randomized trial to evaluate a direct-mail program to increase the rate of colorectal cancer (CRC) screening. We conducted interviews, at the onset of implementation and 1 year later, with center leaders to identify challenges with implementing and sustaining an electronic medical record (EMR)-driven mailed program to increase CRC screening rates. We used the Consolidated Framework for Implementation Research to thematically analyze the content of meeting discussions and identify anticipated and experienced challenges. Common early concerns were patients' access to colonoscopy, patients' low awareness of CRC screening, time burden on clinic staff to carry out the STOP CRC program, inability to accurately identify eligible patients, and incompatibility of the program's approach with the patient population or organizational culture. Once the program was rolled out, time burden remained a primary concern and new organizational capacity and EMR issues were raised (e.g., EMR staffing resources and turnover in key leadership positions). Cited program successes were improved CRC screening processes and rates, more patients reached, reduced costs, and improved patient awareness, engagement, or satisfaction. These findings may inform any clinic considering mailed fecal testing programs and future pragmatic research efforts in community health centers.

  19. When Health Systems Are Barriers to Health Care: Challenges Faced by Uninsured Mexican Kidney Patients

    PubMed Central

    Kierans, Ciara; Padilla-Altamira, Cesar; Garcia-Garcia, Guillermo; Ibarra-Hernandez, Margarita; Mercado, Francisco J.

    2013-01-01

    Background Chronic Kidney Disease disproportionately affects the poor in Low and Middle Income Countries (LMICs). Mexico exemplifies the difficulties faced in supporting Renal Replacement Therapy (RRT) and providing equitable patient care, despite recent attempts at health reform. The objective of this study is to document the challenges faced by uninsured, poor Mexican families when attempting to access RRT. Methods The article takes an ethnographic approach, using interviewing and observation to generate detailed accounts of the problems that accompany attempts to secure care. The study, based in the state of Jalisco, comprised interviews with patients, their caregivers, health and social care professionals, among others. Observations were carried out in both clinical and social settings. Results In the absence of organised health information and stable pathways to renal care, patients and their families work extraordinarily hard and at great expense to secure care in a mixed public-private healthcare system. As part of this work, they must navigate challenging health and social care environments, negotiate treatments and costs, resource and finance healthcare and manage a wide range of formal and informal health information. Conclusions Examining commonalities across pathways to adequate healthcare reveals major failings in the Mexican system. These systemic problems serve to reproduce and deepen health inequalities. A system, in which the costs of renal care are disproportionately borne by those who can least afford them, faces major difficulties around the sustainability and resourcing of RRTs. Attempts to increase access to renal therapies, therefore, need to take into account the complex social and economic demands this places on those who need access most. This paper further shows that ethnographic studies of the concrete ways in which healthcare is accessed in practice provide important insights into the plight of CKD patients and so constitute an important source of evidence in that effort. PMID:23349868

  20. Challenges and coping strategies of parents of children with autism on the Kenyan coast.

    PubMed

    Gona, Joseph K; Newton, Charles R; Rimba, Kenneth K; Mapenzi, Rachel; Kihara, Michael; Vijver, Fonns V; Abubakar, Amina

    2016-01-01

    Research on the challenges of raising a child with autism is mostly conducted in Europe, North America and Australia, and has revealed that parents have to come to terms with living with a lifelong developmental disability. In addition, parents are faced with numerous concerns, such as caring burdens, poor prognosis, and negative public attitudes. Virtually no research has been conducted in Africa on this subject. Thirty-seven interviews and eight focus group discussions were conducted with parents of children with autism and professionals in regular contact with these parents from rural and urban counties of the Kenyan coast. The study investigated challenges faced by parents and how they cope with those challenges. A purposive-convenience sampling procedure was used in selecting the study participants. A digital recorder was used to record all the interviews and focus group discussions. Transcriptions were done in Swahili, translated into English, and then imported to the NVivo software program for content analysis. The results indicate that parents of children with autism on the Kenyan coast experience common challenges including stigma, lack of appropriate treatment, financial and caring burdens regardless of their religious and cultural backgrounds. Coping strategies applied by parents comprised problem-focused aspects that involve diet management and respite care, and emotion-focused aspects that consist of beliefs in supernatural powers, prayers and spiritual healing. This qualitative study reveals a range of challenges that could have significant impact when caring for a child with autism. Coping strategies applied by parents target the physical health of the child and the psychological wellbeing of the parent. Consideration of these outcomes is vital as they could impact the initiation of a community-based rehabilitation service delivery in rural settings where parents play an active role.

  1. Challenges and coping strategies of parents of children with autism on the Kenyan coast

    PubMed Central

    Gona, JK; Newton, CR; Rimba, KK; Mapenzi, R; Kihara, M; Vijver, FV; Abubakar, A

    2017-01-01

    Introduction Research on the challenges of raising a child with autism is mostly conducted in Europe, North America and Australia, and has revealed that parents have to come to terms with living with a lifelong developmental disability. In addition, parents are faced with numerous concerns, such as caring burdens, poor prognosis, and negative public attitudes. Virtually no research has been conducted in Africa on this subject. Methods Thirty-seven interviews and eight focus group discussions were conducted with parents of children with autism and professionals in regular contact with these parents from rural and urban counties of the Kenyan coast. The study investigated challenges faced by parents and how they cope with those challenges. A purposive–convenience sampling procedure was used in selecting the study participants. A digital recorder was used to record all the interviews and focus group discussions. Transcriptions were done in Swahili, translated into English, and then imported to the NVivo software program for content analysis. Results The results indicate that parents of children with autism on the Kenyan coast experience common challenges including stigma, lack of appropriate treatment, financial and caring burdens regardless of their religious and cultural backgrounds. Coping strategies applied by parents comprised problem-focused aspects that involve diet management and respite care, and emotion-focused aspects that consist of beliefs in supernatural powers, prayers and spiritual healing. Conclusions This qualitative study reveals a range of challenges that could have significant impact when caring for a child with autism. Coping strategies applied by parents target the physical health of the child and the psychological wellbeing of the parent. Consideration of these outcomes is vital as they could impact the initiation of a community-based rehabilitation service delivery in rural settings where parents play an active role. PMID:27098766

  2. Challenges When Introducing Electronic Exam

    ERIC Educational Resources Information Center

    Kuikka, Matti; Kitola, Markus; Laakso, Mikko-Jussi

    2014-01-01

    Time pressures often necessitate the use of more efficient exam tools, such as electronic exams (e-exams), instead of traditional paper exams. However, teachers may face challenges when introducing e-exams in a higher education context. This paper describes what kinds of challenges teachers may face when introducing e-exams, based on experiences…

  3. Bridging the Gap: The Challenges of Employing Entrepreneurial Processes within University Settings

    ERIC Educational Resources Information Center

    Wardale, Dorothy; Lord, Linley

    2016-01-01

    In Australia and elsewhere, universities face increasing pressure to improve research output and quality, particularly through partnerships with industry. This raises interesting challenges for academic staff with considerable industry experience who are "new" to academe. Some of these challenges were faced by the authors who have been…

  4. Confronting Unsuccessful Practices: Repositioning Teacher Identities in English Education

    ERIC Educational Resources Information Center

    Vetter, Amy; Hartman, Shana V.; Reynolds, Jeanie M.

    2016-01-01

    Teacher education programs attempt to prepare preservice teachers for the various challenges faced in the classroom. One particular challenge new teachers face is how to handle unsuccessful practices. This paper argues that confronting ineffective practices require that teachers respond to complex and dynamic challenges, making change difficult…

  5. Challenges Faced by Project Competition Participants and Recommended Solutions

    ERIC Educational Resources Information Center

    Demirel, Turgay; Baydas, Ozlem; Yilmaz, Rabia M.; Goktas, Yuksel

    2013-01-01

    The numbers of project competitions and interest in this kind of competition have been steadily increasing in Turkey. Accordingly, it is important to determine what challenges teachers and students may face while preparing themselves for project competitions, so that recommendations may be made to overcome these challenges. This study investigated…

  6. Cardiovascular diseases in mega-countries: the challenges of the nutrition, physical activity and epidemiologic transitions, and the double burden of disease

    PubMed Central

    Barquera, Simon; Pedroza-Tobias, Andrea; Medina, Catalina

    2016-01-01

    Purpose of review There are today 11 mega-countries with more than 100 million inhabitants. Together these countries represent more than 60% of the world's population. All are facing noncommunicable chronic disease (NCD) epidemic where high cholesterol, obesity, diabetes, and cardiovascular diseases are becoming the main public health concerns. Most of these countries are facing the double burden of malnutrition where undernutrition and obesity coexist, increasing the complexity for policy design and implementation. The purpose of this study is to describe diverse sociodemographic characteristics of these countries and the challenges for prevention and control in the context of the nutrition transition. Recent findings Mega-countries are mostly low or middle-income and are facing important epidemiologic, nutrition, and physical activity transitions because of changes in food systems and unhealthy lifestyles. NCDs are responsible of two-thirds of the 57 million global deaths annually. Approximately, 80% of these are in low and middle-income countries. Only developed countries have been able to reduce mortality rates attributable to recognized risk factors for NCDs, in particular high cholesterol and blood pressure. Summary Mega-countries share common characteristics such as complex bureaucracies, internal ethnic, cultural and socioeconomic heterogeneity, and complexities to implement effective health promotion and education policies across population. Priorities for action must be identified and successful lessons and experiences should be carefully analyzed and replicated. PMID:27389629

  7. Inventory on the dietary assessment tools available and needed in africa: a prerequisite for setting up a common methodological research infrastructure for nutritional surveillance, research, and prevention of diet-related non-communicable diseases.

    PubMed

    Pisa, Pedro T; Landais, Edwige; Margetts, Barrie; Vorster, Hester H; Friedenreich, Christine M; Huybrechts, Inge; Martin-Prevel, Yves; Branca, Francesco; Lee, Warren T K; Leclercq, Catherine; Jerling, Johann; Zotor, Francis; Amuna, Paul; Al Jawaldeh, Ayoub; Aderibigbe, Olaide Ruth; Amoussa, Waliou Hounkpatin; Anderson, Cheryl A M; Aounallah-Skhiri, Hajer; Atek, Madjid; Benhura, Chakare; Chifamba, Jephat; Covic, Namukolo; Dary, Omar; Delisle, Hélène; El Ati, Jalila; El Hamdouchi, Asmaa; El Rhazi, Karima; Faber, Mieke; Kalimbira, Alexander; Korkalo, Liisa; Kruger, Annamarie; Ledo, James; Machiweni, Tatenda; Mahachi, Carol; Mathe, Nonsikelelo; Mokori, Alex; Mouquet-Rivier, Claire; Mutie, Catherine; Nashandi, Hilde Liisa; Norris, Shane A; Onabanjo, Oluseye Olusegun; Rambeloson, Zo; Saha, Foudjo Brice U; Ubaoji, Kingsley Ikechukwu; Zaghloul, Sahar; Slimani, Nadia

    2018-01-02

    To carry out an inventory on the availability, challenges, and needs of dietary assessment (DA) methods in Africa as a pre-requisite to provide evidence, and set directions (strategies) for implementing common dietary methods and support web-research infrastructure across countries. The inventory was performed within the framework of the "Africa's Study on Physical Activity and Dietary Assessment Methods" (AS-PADAM) project. It involves international institutional and African networks. An inventory questionnaire was developed and disseminated through the networks. Eighteen countries responded to the dietary inventory questionnaire. Various DA tools were reported in Africa; 24-Hour Dietary Recall and Food Frequency Questionnaire were the most commonly used tools. Few tools were validated and tested for reliability. Face-to-face interview was the common method of administration. No computerized software or other new (web) technologies were reported. No tools were standardized across countries. The lack of comparable DA methods across represented countries is a major obstacle to implement comprehensive and joint nutrition-related programmes for surveillance, programme evaluation, research, and prevention. There is a need to develop new or adapt existing DA methods across countries by employing related research infrastructure that has been validated and standardized in other settings, with the view to standardizing methods for wider use.

  8. Patient support groups in the management of Wilson disease.

    PubMed

    Graper, Mary L; Schilsky, Michael L

    2017-01-01

    Patient support groups serve an important function for those affected by a disease but especially for people with a rare disease. Because of the complexity of Wilson disease there are some unique and difficult problems faced by groups that advocate for these patients. We give a comparative overview of the differences between groups that support people with more common diseases and groups that serve the rare disease population. The history and current status of the Wilson Disease Association and other worldwide Wilson disease groups are described and information about other organizations that support Wilson disease in additional ways is explained. The specific challenges faced in the support of Wilson disease patients are outlined and possible solutions proposed. Drawing from experience in speaking with many patients, we discuss some of the most common questions that are asked by patients who are seeking a possible diagnosis or are already on treatment. There are many options for improving patient advocacy efforts in the future that we hope will be accomplished. © 2017 Elsevier B.V. All rights reserved.

  9. “A room full of strangers every day”: The psychosocial impact of developmental prosopagnosia on children and their families

    PubMed Central

    Dalrymple, Kirsten A.; Fletcher, Kimberley; Corrow, Sherryse; Nair, Roshan das; Barton, Jason J. S.; Yonas, Albert; Duchaine, Brad

    2014-01-01

    Objective Individuals with developmental prosopagnosia (‘face blindness’) have severe face recognition difficulties due to a failure to develop the necessary visual mechanisms for recognizing faces. These difficulties occur in the absence of brain damage and despite normal low-level vision and intellect. Adults with developmental prosopagnosia report serious personal and emotional consequences from their inability to recognize faces, but little is known about the psychosocial consequences in childhood. Given the importance of face recognition in daily life, and the potential for unique social consequences of impaired face recognition in childhood, we sought to evaluate the impact of developmental prosopagnosia on children and their families. Methods We conducted semi-structured interviews with 8 children with developmental prosopagnosia and their parents. A battery of face recognition tests was used to confirm the face recognition impairment reported by the parents of each child. We used thematic analysis to develop common themes among the psychosocial experiences of the children and their parents. Results Three themes were developed from the child reports: 1) awareness of their difficulties, 2) coping strategies, such as using non-facial cues to identify others, and 3) social implications, such as discomfort in, and avoidance of, social situations. These themes were paralleled by the parent reports and highlight the unique social and practical challenges associated with childhood developmental prosopagnosia. Conclusion Our findings indicate a need for increased awareness and treatment of developmental prosopagnosia to help these children manage their face recognition difficulties and to promote their social and emotional wellbeing. PMID:25077856

  10. Challenges of transitioning from a faculty to an administrative role: part 2, moving from individual contributor to group leader.

    PubMed

    Thompson, Cesarina M

    2011-01-01

    Many new nursing leaders assuming deanships, assistant, or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, Jana L. Pressler, PhD, RN, and Carole A. Kenner, PhD, RNC-NIC, FAAN, the editors of this department, address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. In this article, the editors asked guest author, Dr Cesarina Thompson, to discuss the transition process from faculty to administrative role.

  11. Big and disparate data: considerations for pediatric consortia.

    PubMed

    Stingone, Jeanette A; Mervish, Nancy; Kovatch, Patricia; McGuinness, Deborah L; Gennings, Chris; Teitelbaum, Susan L

    2017-04-01

    Increasingly, there is a need for examining exposure disease associations in large, diverse datasets to understand the complex determinants of pediatric disease and disability. Recognizing that children's health research consortia will be important sources of big data, it is crucial for the pediatric research community to be knowledgeable about the challenges and opportunities that they will face. The present review will provide examples of existing children's health consortia, highlight recent pooled analyses conducted by children's health research consortia, address common challenges of pooled analyses, and provide recommendations to advance collective research efforts in pediatric research. Formal consortia and other collective-science initiatives are increasingly being created to share individual data from a set of relevant epidemiological studies to address a common research topic under the concept that the joint effort of many individual groups can accomplish far more than working alone. There are practical challenges to the participation of investigators within consortia that need to be addressed in order for them to work. Researchers who access consortia with data centers will be able to go far beyond their initial hypotheses and potentially accomplish research that was previously thought infeasible or too costly.

  12. EUV tools: hydrogen gas purification and recovery strategies

    NASA Astrophysics Data System (ADS)

    Landoni, Cristian; Succi, Marco; Applegarth, Chuck; Riddle Vogt, Sarah

    2015-03-01

    The technological challenges that have been overcome to make extreme ultraviolet lithography (EUV) a reality have been enormous1. This vacuum driven technology poses significant purity challenges for the gases employed for purging and cleaning the scanner EUV chamber and source. Hydrogen, nitrogen, argon and ultra-high purity compressed dry air (UHPCDA) are the most common gases utilized at the scanner and source level. Purity requirements are tighter than for previous technology node tools. In addition, specifically for hydrogen, EUV tool users are facing not only gas purity challenges but also the need for safe disposal of the hydrogen at the tool outlet. Recovery, reuse or recycling strategies could mitigate the disposal process and reduce the overall tool cost of operation. This paper will review the types of purification technologies that are currently available to generate high purity hydrogen suitable for EUV applications. Advantages and disadvantages of each purification technology will be presented. Guidelines on how to select the most appropriate technology for each application and experimental conditions will be presented. A discussion of the most common approaches utilized at the facility level to operate EUV tools along with possible hydrogen recovery strategies will also be reported.

  13. Barrier properties of cultured retinal pigment epithelium.

    PubMed

    Rizzolo, Lawrence J

    2014-09-01

    The principal function of an epithelium is to form a dynamic barrier that regulates movement between body compartments. Each epithelium is specialized with barrier functions that are specific for the tissues it serves. The apical surface commonly faces a lumen, but the retinal pigment epithelium (RPE) appears to be unique by a facing solid tissue, the sensory retina. Nonetheless, there exists a thin (subretinal) space that can become fluid filled during pathology. RPE separates the subretinal space from the blood supply of the outer retina, thereby forming the outer blood-retinal barrier. The intricate interaction between the RPE and sensory retina presents challenges for learning how accurately culture models reflect native behavior. The challenge is heightened by findings that detail the variation of RPE barrier proteins both among species and at different stages of the life cycle. Among the striking differences is the expression of claudin family members. Claudins are the tight junction proteins that regulate ion diffusion across the spaces that lie between the cells of a monolayer. Claudin expression by RPE varies with species and life-stage, which implies functional differences among commonly used animal models. Investigators have turned to transcriptomics to supplement functional studies when comparing native and cultured tissue. The most detailed studies of the outer blood-retinal barrier have focused on human RPE with transcriptome and functional studies reported for human fetal, adult, and stem-cell derived RPE. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Virtual Academic Community: Online Education Instructors' Social Presence in Association with Freshman Composition Students' Critical Thinking and Argumentation

    ERIC Educational Resources Information Center

    Paquette, Paige Fuller

    2009-01-01

    There is much literature addressing challenges face-to-face freshman composition instructors encounter in developing college courses that foster critical thinking skills crucial to developing written argument. Composition instructors may face challenges in teaching students that writing is a means of making meaning, there are many different…

  15. The Challenges of Adopting the Learning Organisation Philosophy in a Singapore School

    ERIC Educational Resources Information Center

    Retna, Kala S.; Tee, Ng Pak

    2006-01-01

    Purpose: To report on a case study that examines how the Learning Organisation (LO) concept can be applied in a Singapore school and the challenges that the school faces in the process. Design/methodology/approach: A qualitative research inquiry was adopted using ethnographic methods. Data includes in-depth face-to-face interviews, observation of…

  16. Challenges Faced by Undergraduate Military Students at American Public University System

    ERIC Educational Resources Information Center

    Machuca, Ana; Torres, Karin; Morris, Pamela; Whitley, William

    2014-01-01

    This paper will summarize some of challenges faced by military students enrolled in an associate and bachelors online program at American Public University System (APUS). The survey results on which the study is based exposed the following problems faced by military personnel: 48.7% had difficulties working around military obligations, 33.3%…

  17. Applying the Rasch Model to Measure Acculturation Challenges Faced by Saudi Female Students in the United States

    ERIC Educational Resources Information Center

    Hakami, Samah Mohammed

    2012-01-01

    The purpose of this study was to explore the major acculturation challenges faced by Saudi female students who study in the U.S. and to develop a scale to measure potential acculturation challenges. The construction of the scale was based on a table of specification that included nine domains of possible acculturation challenges: (a)…

  18. Online information and support needs of women with advanced breast cancer: a qualitative analysis.

    PubMed

    Kemp, Emma; Koczwara, Bogda; Butow, Phyllis; Turner, Jane; Girgis, Afaf; Schofield, Penelope; Hulbert-Williams, Nicholas; Levesque, Janelle; Spence, Danielle; Vatandoust, Sina; Kichenadasse, Ganessan; Roy, Amitesh; Sukumaran, Shawgi; Karapetis, Christos S; Richards, Caroline; Fitzgerald, Michael; Beatty, Lisa

    2018-04-24

    Women with advanced breast cancer (ABC) face significant adjustment challenges, yet few resources provide them with information and support, and attendance barriers can preclude access to face-to-face psychosocial support. This paper reports on two qualitative studies examining (i) whether information and support-seeking preferences of women with ABC could be addressed in an online intervention, and (ii) how an existing intervention for patients with early stage cancer could be adapted for women with ABC. Women with ABC participated in telephone interviews about their information and support-seeking preferences (N = 21) and evaluated an online intervention focused on early-stage cancer (N = 15). Interviews were transcribed and underwent thematic analysis using the framework method to identify salient themes. Participants most commonly sought medical, lifestyle-related, and practical information/support; however, when presented with an online intervention, participants most commonly gave positive feedback on content on coping with emotional distress. Difficulty finding information and barriers to using common sources of information/support including health professionals, family and friends, and peers were reported; however, some women also reported not wanting information or support. All participants evaluating the existing intervention gave positive feedback on various components, with results suggesting an online intervention could be an effective means of providing information/support to women with ABC, given improved specificity/relevance to ABC and increased tailoring to individual circumstances and preferences. Adaptation of an existing online intervention for early stage cancer appears to be a promising avenue to address the information and support needs of women with ABC.

  19. Actor groups, related needs, and challenges at the climate downscaling interface

    NASA Astrophysics Data System (ADS)

    Rössler, Ole; Benestad, Rasmus; Diamando, Vlachogannis; Heike, Hübener; Kanamaru, Hideki; Pagé, Christian; Margarida Cardoso, Rita; Soares, Pedro; Maraun, Douglas; Kreienkamp, Frank; Christodoulides, Paul; Fischer, Andreas; Szabo, Peter

    2016-04-01

    At the climate downscaling interface, numerous downscaling techniques and different philosophies compete on being the best method in their specific terms. Thereby, it remains unclear to what extent and for which purpose these downscaling techniques are valid or even the most appropriate choice. A common validation framework that compares all the different available methods was missing so far. The initiative VALUE closes this gap with such a common validation framework. An essential part of a validation framework for downscaling techniques is the definition of appropriate validation measures. The selection of validation measures should consider the needs of the stakeholder: some might need a temporal or spatial average of a certain variable, others might need temporal or spatial distributions of some variables, still others might need extremes for the variables of interest or even inter-variable dependencies. Hence, a close interaction of climate data providers and climate data users is necessary. Thus, the challenge in formulating a common validation framework mirrors also the challenges between the climate data providers and the impact assessment community. This poster elaborates the issues and challenges at the downscaling interface as it is seen within the VALUE community. It suggests three different actor groups: one group consisting of the climate data providers, the other two groups being climate data users (impact modellers and societal users). Hence, the downscaling interface faces classical transdisciplinary challenges. We depict a graphical illustration of actors involved and their interactions. In addition, we identified four different types of issues that need to be considered: i.e. data based, knowledge based, communication based, and structural issues. They all may, individually or jointly, hinder an optimal exchange of data and information between the actor groups at the downscaling interface. Finally, some possible ways to tackle these issues are discussed.

  20. Resolution of structural heterogeneity in dynamic crystallography

    PubMed Central

    Ren, Zhong; Chan, Peter W. Y.; Moffat, Keith; Pai, Emil F.; Royer, William E.; Šrajer, Vukica; Yang, Xiaojing

    2013-01-01

    Dynamic behavior of proteins is critical to their function. X-­ray crystallography, a powerful yet mostly static technique, faces inherent challenges in acquiring dynamic information despite decades of effort. Dynamic ‘structural changes’ are often indirectly inferred from ‘structural differences’ by comparing related static structures. In contrast, the direct observation of dynamic structural changes requires the initiation of a biochemical reaction or process in a crystal. Both the direct and the indirect approaches share a common challenge in analysis: how to interpret the structural heterogeneity intrinsic to all dynamic processes. This paper presents a real-space approach to this challenge, in which a suite of analytical methods and tools to identify and refine the mixed structural species present in multiple crystallographic data sets have been developed. These methods have been applied to representative scenarios in dynamic crystallography, and reveal structural information that is otherwise difficult to interpret or inaccessible using conventional methods. PMID:23695239

  1. Climate Change and Health in the Urban Context: The Experience of Barcelona.

    PubMed

    Villalbí, Joan R; Ventayol, Irma

    2016-07-01

    Climate change poses huge challenges for public health, and cities are at the forefront of this process. The purpose of this paper is to present the issues climate change poses for public health in the city of Barcelona, how they are being addressed, and what are the current major challenges, trying to contribute to the development of a baseline understanding of the status of adaptation in cities from a public health perspective. The major issues related to climate change faced by the city are common to other urban centers in a Mediterranean climate: heat waves, water availability and quality, air quality, and diseases transmitted by vectors, and all are reviewed in detail with empirical data. They are not a potential threat for the future, but have actually challenged the city services and infrastructure over the last years, requiring sustainable responses and rigorous planning. © The Author(s) 2016.

  2. Resolution of structural heterogeneity in dynamic crystallography.

    PubMed

    Ren, Zhong; Chan, Peter W Y; Moffat, Keith; Pai, Emil F; Royer, William E; Šrajer, Vukica; Yang, Xiaojing

    2013-06-01

    Dynamic behavior of proteins is critical to their function. X-ray crystallography, a powerful yet mostly static technique, faces inherent challenges in acquiring dynamic information despite decades of effort. Dynamic `structural changes' are often indirectly inferred from `structural differences' by comparing related static structures. In contrast, the direct observation of dynamic structural changes requires the initiation of a biochemical reaction or process in a crystal. Both the direct and the indirect approaches share a common challenge in analysis: how to interpret the structural heterogeneity intrinsic to all dynamic processes. This paper presents a real-space approach to this challenge, in which a suite of analytical methods and tools to identify and refine the mixed structural species present in multiple crystallographic data sets have been developed. These methods have been applied to representative scenarios in dynamic crystallography, and reveal structural information that is otherwise difficult to interpret or inaccessible using conventional methods.

  3. Lorcaserin: drug profile and illustrative model of the regulatory challenges of weight-loss drug development.

    PubMed

    Bays, Harold E

    2011-03-01

    Lorcaserin is a selective 5-hydroxytryptamine receptor 2c agonist developed as a weight-loss drug. Phase II and III clinical trials support lorcaserin as not only reducing adiposity (i.e., fat mass), but also as improving the metabolic diseases commonly associated with adiposopathy (i.e., fat dysfunction). At the time of this writing, regulatory processes continue towards evaluating lorcaserin as a potentially marketed weight-loss and weight-maintenance agent. Some of the challenges facing lorcaserin are similar to the difficulties encountered by all investigational weight-loss therapeutic agents, which include evolving paths towards approval. While important for clinicians to understand approval hurdles for all therapeutics, it is especially critical for researchers and developers to grasp the unique regulatory complexities of anti-obesity agents. This article profiles lorcaserin as an illustrative example of general drug development regulatory processes, and specifically details the unique challenge of weight-loss drug development.

  4. NEEDS AND CHALLENGES OF HOME VISITORS CONDUCTING PERINATAL DEPRESSION SCREENING.

    PubMed

    Doering, Jennifer J; Maletta, Kristyn; Laszewski, Audrey; Wichman, Christina L; Hammel, Jennifer

    2017-07-01

    This article describes the needs and challenges faced by home visitors, supervisors, and clients when conducting perinatal depression screening. Home visitors (n = 11), supervisors (n = 5), and clients (n = 9) representing rural and urban practice settings in Wisconsin were recruited into three separate focus groups. Themes were identified from the transcribed audio-recorded interviews using content analysis. Results indicate that a trusting relationship was leveraged to facilitate depression screening and referral. Home visitors personalized care to a client's context and to protect confidentiality. Home-visiting practice demanded flexibility and negotiation in decision-making with clients and families. Coordinating access to mental health evaluation in areas of limited access was a common challenge. Participants reported a need for further training on safety management. With adequate training and support, home visitors are well-positioned to promote access to mental health services in vulnerable families to support infant mental health. © 2017 Michigan Association for Infant Mental Health.

  5. Implementing the Biopharmaceutics Classification System in Drug Development: Reconciling Similarities, Differences, and Shared Challenges in the EMA and US-FDA-Recommended Approaches.

    PubMed

    Cardot, J-M; Garcia Arieta, A; Paixao, P; Tasevska, I; Davit, B

    2016-07-01

    The US-FDA recently posted a draft guideline for industry recommending procedures necessary to obtain a biowaiver for immediate-release oral dosage forms based on the Biopharmaceutics Classification System (BCS). This review compares the present FDA BCS biowaiver approach, with the existing European Medicines Agency (EMA) approach, with an emphasis on similarities, difficulties, and shared challenges. Some specifics of the current EMA BCS guideline are compared with those in the recently published draft US-FDA BCS guideline. In particular, similarities and differences in the EMA versus US-FDA approaches to establishing drug solubility, permeability, dissolution, and formulation suitability for BCS biowaiver are critically reviewed. Several case studies are presented to illustrate the (i) challenges of applying for BCS biowaivers for global registration in the face of differences in the EMA and US-FDA BCS biowaiver criteria, as well as (ii) challenges inherent in applying for BCS class I or III designation and common to both jurisdictions.

  6. Challenges for Novice School Leaders: Facing Today's Issues in School Administration

    ERIC Educational Resources Information Center

    Beam, Andrea P.; Claxton, Russell L.; Smith, Samuel J.

    2016-01-01

    Challenges for novice school leaders evolve as information is managed differently and as societal and regulatory expectations change. This study addresses unique challenges faced by practicing school administrators (n = 159) during their first three years in a school leadership position. It focuses on their perceptions, how perceptions of present…

  7. Leading Schools Facing Challenging Circumstances: Some Insights from Western Australia

    ERIC Educational Resources Information Center

    Gillett, Jonathan; Clarke, Simon; O'Donoghue, Tom

    2016-01-01

    This paper examines leadership strategies that are most likely to engender success in schools that may be defined as facing challenging circumstances. First, it presents an overview of the relevant literature in order to illustrate distinctive challenges that tend to be encountered in these environments, as well as strategies that are adopted for…

  8. The Value of Conceptual Models in Coping with Complexity and Interdisciplinarity in Environmental Sciences Education

    ERIC Educational Resources Information Center

    Fortuin, Karen P. J.; van Koppen, C. S. A.; Leemans, Rik

    2011-01-01

    Conceptual models are useful for facing the challenges of environmental sciences curriculum and course developers and students. These challenges are inherent to the interdisciplinary and problem-oriented character of environmental sciences curricula. In this article, we review the merits of conceptual models in facing these challenges. These…

  9. CAEP Challenges for a Mid-South U.S. College Teacher Education Program

    ERIC Educational Resources Information Center

    Moffett, David W.

    2016-01-01

    What are the challenges faced by a mid-south liberal arts college teacher education program, in its attempt to successfully meet the new Council for the Accreditation of Educator Preparation (CAEP) accreditation requirements? The Investigator studied the Educator Program Provider (EPP) during academic year 2015-2016. The challenges faced by the…

  10. Challenges of Attending E-Learning Studies in Nigeria

    ERIC Educational Resources Information Center

    Bugi, Stephan Z.

    2012-01-01

    This study set out to find out what challenges the E-leaner faces in the Nigerian environment. Survey research design was used to obtain the opinion of 200 randomly selected E-learners in Kaduna metropolis. Their responses revealed that the most prominent challenges they face are, Inadequate Power supply, Internet connectivity problems, Efficacy…

  11. Challenges and Instructional Approaches Impacting the Literacy Performance of English Language Learners

    ERIC Educational Resources Information Center

    Markham, Paul L.; Gordon, Karen E.

    2007-01-01

    For English Language Learners (ELLs), the process of becoming literate in English is daunting. Not only are these students faced with the same literacy challenges faced by native English-speaking students, but they are also challenged with extensive diversity issues relating to substantial differences in linguistic, cultural, and academic…

  12. Young persons with visual impairment: challenges of participation.

    PubMed

    Salminen, Anna-Liisa; Karhula, Maarit E

    2014-07-01

    To describe the challenges to activity and participation faced by young people with visual impairment within the framework of the International Classification of Functioning (ICF). 14 young persons (aged 16-22 years) with visual impairment and their parents (n = 22) participated in the study. The Canadian Occupational Performance Measure (COPM) was used to describe challenges of participation as perceived by the young persons themselves. Individual interviews with the young persons and their parents were used to investigate in more depth the challenges the young persons face with regard to participation. Young persons with visual impairment face challenges to participation most frequently with regard to mobility, domestic life, interpersonal interaction and relationships, major life areas, and leisure activities. The environment in which they live has a central role as a barrier or facilitator of participation. The challenges related to activities and participation that young persons with visual impairment face are diverse. It is important that these challenges are assessed individually and with the help of subjective measures. Serving as a broad framework for classifying the data, the ICF proved to be a useful tool, but used strictly at category level it may limit the coding of data and narrow interpretation.

  13. Becoming a nurse faculty leader: facing challenges through reflecting, persevering and relating in new ways.

    PubMed

    Horton-Deutsch, Sara; Young, Patricia K; Nelson, Kristine A

    2010-05-01

    The aim of the present study was to explore the experience of becoming a nurse faculty leader. In a recent interpretation of 23 interviews conducted with nurse faculty leaders from across the United States about their experiences of becoming a leader three themes were identified: being thrust into leadership, taking risks and facing challenges. This interpretive phenomenological study further explicates three aspects of how nurse educators faced challenges in becoming and serving as a leader. Facing challenges meant reflecting, persevering through difficulties and learning to relate to others in new ways. Exemplars of participant experiences are provided for concreteness, to assist readers in determining how findings resonate with their own experience and how they can actualize this resonance in their own leadership practice. In the present study, reflecting, persevering through difficulties and learning to relate with others in a new way was how leaders faced challenges. Leadership development opportunities that facilitate self-exploration, caring and thoughtful interactions with others and values clarification serve as the foundation for becoming a nurse faculty leader who is, in turn, able to build leadership capacity in other individuals and organizations.

  14. Joint Symposium of Korean Cancer Association & UICC-ARO-Cross-boundary cancer studies: cancer and Universal Health Coverage (UHC) in Asia.

    PubMed

    Park, Eun-Cheol; Kawahara, Norie; Nozaki, Shinjiro; Thabrany, Hasbullah; Yoshimi, Shunya; Park, Sohee; Lee, Duk Hyoung; Akaza, Hideyuki; Roh, Jae Kyung

    2017-09-01

    On 16 June 2016, the Korean Cancer Association (KCA) and Union for International Cancer Control-Asia Regional Office (UICC-ARO) organized a joint symposium as part of the official program of the 42nd Annual Meeting of the Korean Cancer Association to discuss the topic 'Cross-boundary Cancer Studies: Cancer and Universal Health Coverage (UHC) in Asia.' Universal Health Coverage is included in the Sustainable Development Goals adopted by the United Nations as part of the 2030 Agenda for Sustainable Development. The objectives of UHC are to ensure that all people can receive high-quality medical services, are protected from public health risks, and are prevented from falling into poverty due to medical costs or loss of income arising from illness. The participants discussed the growing cost of cancer in the Asian region and the challenges that this poses to the establishment and deployment of UHC in the countries of Asia, all of which face budgetary and other systemic constraints in controlling cancer in the region. Representatives from Korea, Japan and Indonesia reported on the status of UHC in their countries and the challenges that are being faced, many of which are common to other countries in Asia. In addition to country-specific presentations about the progress of and challenges facing UHC, there were also presentations from WHO Kobe Centre concerning advancing UHC in non-communicable diseases and prospects for further collaboration and research on UHC. A presentation from the University of Tokyo also highlighted the need to focus on multidisciplinary studies in an age of globalization and digitization. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. The value of the WIRHE Scholarship Programme in training health professionals for rural areas: Views of participants

    PubMed Central

    2017-01-01

    Introduction Rural hospitals in South Africa, as elsewhere, face enduring shortages of, and challenges in attracting and retaining, suitably qualified staff. The Wits Initiative for Rural Health Education (WIRHE), based at the University of the Witwatersrand but covering three universities, is a rural scholarship programme established to find local solutions to these challenges in the North West and Mpumalanga provinces. The purpose of this evaluation was to ascertain whether the WIRHE project was achieving its objectives. Methods This article draws from an evaluation commissioned by the Swiss-South African Cooperative Initiative, a major funder of the programme when WIRHE was launched in 2003. Qualitative interviews were conducted either as face-to-face meetings or telephonically with 21 WIRHE students and graduates. Content analysis was undertaken to identify common themes. Results There was a consistency in the findings as the students and graduates reported similar experiences. Many of the participants were overwhelmed by their initial challenges of having to adapt to a different language, an institutional culture and resources that they previously did not have access to. The participants acknowledged the role of WIRHE staff in facilitating the transition from home to university and, in particular, the value of the financial and academic support. The geographic distance to Wits presented a challenge for the Pretoria- and Sefako Makgatho-based students. The holiday work affirmed clinical advantages for WIRHE students and heightened students’ interest in becoming healthcare workers. Conclusion WIRHE’s key success factors are the financial, academic and emotional support offered to students. WIRHE achieved its objectives based on a principled strategic approach and an understanding that students from rural backgrounds are more likely to return to rural areas. The study supports the value of structured support programmes for students of rural origin as they pursue their studies. PMID:29041799

  16. Focusing a Transition: Challenges Facing the New Administration

    DTIC Science & Technology

    2016-09-01

    FOCUSING A TRANSITION Challenges Facing the New Administration A Report by the Defense Business Board 2016 This report, DBB Report FY16-5, is a ...Facing the New Administration A Report by the Defense Business Board 5 Table of Contents INTRODUCTION...While reviewing the budget, the team should develop a list of items to propose for immediate termination. The Board offers the following

  17. Defense Infrastructure: Challenges Increase Risks for Providing Timely Infrastructure Support for Army Installations Expecting Substantial Personnel Growth

    DTIC Science & Technology

    2007-09-01

    Office Why GAO Did This Study Highlights Accountability Integrity Reliability September 2007 DEFENSE INFRASTRUCTURE Challenges Increase Risks for...authority to conduct evaluations on his own initiative. It addresses (1) the challenges and associated risks the Army faces in providing for timely...but it faces several complex implementation challenges that risk late provision of needed infrastructure to adequately support incoming personnel

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

    PubMed

    Zafar, Waleed

    2015-04-01

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

  19. A qualitative exploration of the major challenges facing pharmacovigilance in Saudi Arabia.

    PubMed

    Aljadhey, Hisham; Mahmoud, Mansour A; Alshammari, Thamir M; Al-Dhaeefi, Mohammed; Le Louet, Herve; Perez-Gutthann, Susana; Pitts, Peter J

    2015-09-01

    To explore the challenges facing pharmacovigilance in Saudi Arabia and formulate recommendations to improve it from the perspective of healthcare professionals in Saudi Arabia. This was a qualitative study of 4 focus group discussions with pharmacists, physicians, and academicians held under the auspices of the King Saud University School of Pharmacy and the Center for Medicine in the Public Interest, Riyadh, Saudi Arabia. A total of 29 eligible healthcare professionals were invited to participate in the discussion. The predefined themes of the study were the current practice and major challenges facing pharmacovigilance in regulatory bodies, hospitals, the community, and academia, as well as recommendations to improve pharmacovigilance practice.  Of the 29 participants invited, 27 attended the discussion. Challenges facing regulatory bodies included complicated adverse drug reactions (ADR) reporting forms, lack of feedback on ADRs submitted to the Saudi Food and Drug Authority, lack of decisions from the local authority to withdraw medications, and lack of data on pharmacovigilance. The challenges to pharmacovigilance in hospitals included the lack of knowledge of the significance of ADR reporting, workload, blaming culture, and lack of collaboration between regulatory bodies and hospitals. However, challenges facing pharmaceutical industries included the lack of drug manufacturers in Saudi Arabia and lack of interest in pharmacovigilance. Recommendations to improve pharmacovigilance included the need for communication, stronger regulatory requirements, the need for research, the need for unified ADRs reporting, and continuous education and training.  The study has identified the challenges facing pharmacovigilance in Saudi Arabia and made certain recommendations to overcome them. These recommendations might be helpful for regulatory bodies to enhance spontaneous reporting and promote pharmacovigilance.

  20. Assessing Leading ERP-SAP Implementation in Leading Firms in Indonesia

    NASA Astrophysics Data System (ADS)

    Syaiful, B.; Gunawan, W.

    2017-01-01

    Enterprise resource planning (ERP) enables to bring critical capabilities to an organisation, however, the implementation of such capabilities is often surrounded with problems. The implementing ERP-SAP in Indonesian enterprises are still facing tremendous challenges with the failure rate can reach more than 80% of the cases. The article examines the common problems faced by the consultants whenever they deal with their clients, from the practical perspectives. The article takes the multiple case studies of the leading enterprises in Indonesia, such as: KS (largest steel producer), GEM (large mining producer), and HS (large retailer), with the aim to identify the root of problems of SAP implementation. The outcome of the study is expected to provide the consultants with the guideline to understand the ERP implementation process in their clients and effective solutions to cope with it.

  1. The Difficult Gallbladder: A Safe Approach to a Dangerous Problem.

    PubMed

    Santos, B Fernando; Brunt, L Michael; Pucci, Michael J

    2017-06-01

    Laparoscopic cholecystectomy is a common surgical procedure, and remains the gold standard for the management of benign gallbladder and biliary disease. While this procedure can be technically straightforward, it can also represent one of the most challenging operations facing surgeons. This dichotomy of a routine operation performed so commonly that poses such a hidden risk of severe complications, such as bile duct injury, must keep surgeons steadfast in the pursuit of safety. The "difficult gallbladder" requires strict adherence to the Culture of Safety in Cholecystectomy, which promotes safety first and assists surgeons in managing or avoiding difficult operative situations. This review will discuss the management of the difficult gallbladder and propose the use of subtotal fenestrating cholecystectomy as a definitive option during this dangerous situation.

  2. Controversies in oncologist-patient communication: a nuanced approach to autonomy, culture, and paternalism.

    PubMed

    Cherny, Nathan I

    2012-01-01

    Difficult dialogues with patients facing life-changing decisions are an intrinsic part of oncologic practice and a major source of stress. Having a sophisticated approach to the concepts of autonomy, paternalism, and culture can help in addressing difficult dilemmas that arise around the issues of disclosure and decision making. This article addresses some of the most common major challenges in oncologist-patient communication with a nuanced approach to the concepts of autonomy, paternalism, and culture. It introduces the new concept of"voluntary diminished autonomy" and describes the implications this concept has for the consent process. It also attempts to bring clarity to common problems and misconceptions relating to culture, paternalism, and therapeutic privilege as these pertain to the communication practices of oncologists.

  3. Finding Erich Jantsch's Five Crucial Innovations: A Study of Four Small Colleges

    ERIC Educational Resources Information Center

    MacVie, Leah

    2017-01-01

    Institutions of higher education have faced many challenges over the last few decades. Though many large institutions have the resources needed to respond to these challenges, small institutions have had to be innovative in the ways in which they are adapting. There are similarities between the external challenges that institutions face today and…

  4. The Challenges Faced by Chinese Higher Education as It Expands in Scale

    ERIC Educational Resources Information Center

    Xiaohao, Ding

    2004-01-01

    This article reports the challenges faced by Chinese higher education as it expands in scale. The scale of China's higher education has seen unprecedented expansion in recent years. This article explores the new opportunities and challenges that such expansion brings to China's higher education. The author states that, aside from the many…

  5. Reflecting on the Challenges of Applied Theatre in Kenya

    ERIC Educational Resources Information Center

    Okuto, Maxwel; Smith, Bobby

    2017-01-01

    In this article the authors draw on their own experience and research in applied theatre in Kenya in order to reflect on challenges currently facing practitioners working in the country. In order to outline the range of challenges faced by practitioners, issues related to the wider landscapes of government and politics in Kenya are explored,…

  6. Special Education in Rural Schools: Why Less Takes More

    ERIC Educational Resources Information Center

    Bouck, Emily C.; Albaugh, Diane; Bouck, Mary K.

    2005-01-01

    Everyone can understand the challenges teachers face in organizing and supervising field trips, challenges that are even greater when the students have special needs and live in poverty. But how daunting, the authors ask, are the challenges these students face every day? Very few people who have never tried it are truly aware of all the…

  7. International Graduate Students' Academic Writing Practices in Malaysia: Challenges and Solutions

    ERIC Educational Resources Information Center

    Singh, Manjet Kaur Mehar

    2015-01-01

    This article focuses on the challenges faced by non-native English speaking international graduate students in their academic writing practices while they studied at a university in Malaysia as well as the solutions they employed when faced with the challenges. Academic Literacies Questionnaire was used to collect data. Based on 131 participants,…

  8. A Content Analysis Concerning the Studies on Challenges Faced by Novice Teachers

    ERIC Educational Resources Information Center

    Kozikoglu, Ishak

    2017-01-01

    The purpose of this research is to analyze the studies concerning challenges faced by novice teachers in terms of various aspects and compare challenges according to location of the studies conducted in Turkey and abroad. A total of 30 research studies were included in detailed analysis. This is a descriptive study based on qualitative research…

  9. Mentoring Matters: The Challenge for Teacher Education

    ERIC Educational Resources Information Center

    McCann, Thomas M.; Ed.; Johannessen, Larry, Ed.

    2009-01-01

    Beginning teachers face many challenges and difficulties; as a result, one-third will leave the profession in the first three years and nearly half will be gone within their first five years in the profession. The challenge facing university teacher education programs is to fix the hole in the bottom of the bucket and find strategic new ways to…

  10. Comparative Effectiveness Research in Gynecologic Oncology

    PubMed Central

    Patankar, Sonali; Tergas, Ana I.

    2015-01-01

    The field of gynecologic oncology is faced with a number of challenges including how to incorporate new drugs and procedures into practice, how to balance therapeutic efficacy and toxicity of treatment, how to individualize therapy to particular patients or groups of patients, and how to contain the rapidly rising costs associated with oncologic care. In this chapter we examine three common and highly debated clinical scenarios in gynecologic oncology: the initial management of ovarian cancer, the role of lymphadenectomy in the treatment of endometrial cancer, and the choice of adjuvant therapy for ovarian cancer. PMID:25677027

  11. Acquired pathology of the pediatric spine and spinal cord.

    PubMed

    Palasis, Susan; Hayes, Laura L

    2015-09-01

    Pediatric spine pathology poses a diagnostic challenge for radiologists. Acquired spine pathology often yields nonspecific signs and symptoms in children, especially in the younger age groups, and diagnostic delay can carry significant morbidity. This review is focused on some of the more common diagnostic dilemmas we face when attempting to evaluate and diagnose acquired pediatric spine anomalies in daily practice. An understanding of some of the key differentiating features of these disease processes in conjunction with pertinent history, physical exam, and advanced imaging techniques can indicate the correct diagnosis.

  12. The first international workshop on the role and impact of mathematics in medicine: A collective account

    PubMed Central

    Artzrouni, Marc; Begg, Colin; Chabiniok, Radomir; Clairambault, Jean; Foss, AJE; Hargrove, John; Lee, Eva K; Siggers, Jennifer H; Tindall, Marcus

    2011-01-01

    The First International Workshop on The Role and Impact of Mathematics in Medicine (RIMM) convened in Paris in June 2010. A broad range of researchers discussed the difficulties, challenges and opportunities faced by those wishing to see mathematical methods contribute to improved medical outcomes. Finding mechanisms for interdisciplinary meetings, developing a common language, staying focused on the medical problem at hand, deriving realistic mathematical solutions, obtaining high quality data and seeing things through “by the bedside” are some of the issues discussed by the participants.

  13. Applying Physics: Opportunities in Semiconductor Technology Companies

    NASA Astrophysics Data System (ADS)

    Redinbo, Greg

    2011-03-01

    While many physicists practice in university settings, physics skills can also be applied outside the traditional academic track. ~Identifying these opportunities requires a clear understanding of how your physics training can be used in an industrial setting, understanding what challenges technology companies face, and identifying how your problem solving skills can be broadly applied in technology companies. ~In this talk I will highlight the common features of such companies, discuss what specific skills are useful for an industrial physicist, and explain roles (possibly unfamiliar) that may be available to you.

  14. The development of non-coding RNA ontology.

    PubMed

    Huang, Jingshan; Eilbeck, Karen; Smith, Barry; Blake, Judith A; Dou, Dejing; Huang, Weili; Natale, Darren A; Ruttenberg, Alan; Huan, Jun; Zimmermann, Michael T; Jiang, Guoqian; Lin, Yu; Wu, Bin; Strachan, Harrison J; de Silva, Nisansa; Kasukurthi, Mohan Vamsi; Jha, Vikash Kumar; He, Yongqun; Zhang, Shaojie; Wang, Xiaowei; Liu, Zixing; Borchert, Glen M; Tan, Ming

    2016-01-01

    Identification of non-coding RNAs (ncRNAs) has been significantly improved over the past decade. On the other hand, semantic annotation of ncRNA data is facing critical challenges due to the lack of a comprehensive ontology to serve as common data elements and data exchange standards in the field. We developed the Non-Coding RNA Ontology (NCRO) to handle this situation. By providing a formally defined ncRNA controlled vocabulary, the NCRO aims to fill a specific and highly needed niche in semantic annotation of large amounts of ncRNA biological and clinical data.

  15. Getting to More Effective Weight Management in Antipsychotic-Treated Youth: A Survey of Barriers and Preferences.

    PubMed

    Nicol, Ginger; Worsham, Elizabeth; Haire-Joshu, Debra; Duncan, Alexis; Schweiger, Julia; Yingling, Michael; Lenze, Eric

    2016-02-01

    Mentally ill youth are at risk for developing obesity, especially when they require antipsychotic treatment; moreover, they may face unique challenges in adhering to behavioral weight loss interventions. The aims of this project were to characterize the challenges families of youth with psychiatric disorders face when engaging in weight loss treatment and to gather information on attitudes and preferences for weight management interventions in this population. We devised a telephone survey to evaluate caregiver-perceived barriers/challenges to and preferences for behavioral weight loss treatment in overweight or obese mentally ill youth ages 6-18 treated with an antipsychotic agent in an outpatient setting. A total of 26 parents or primary caregivers completed the survey. The most commonly cited barriers to participation in physical activity (PA) and maintaining a healthy diet were child's dislike of PA and child's preference for energy-dense foods, respectively, which were impacted by psychiatric symptoms. Preferences for weight loss treatment included individualized, prescribed meal plans and shopping lists, and exercise support/demonstration, with a preference for Internet or cell phone applications to help with monitoring food intake and exercise. These results suggest that targets for obesity treatment in this population include individualized, specific support that takes into account the child's motivation, which is effected by psychiatric symptoms. Tools for providing support may include the use of telehealth visits and mobile device applications for self-monitoring.

  16. Isavuconazole treatment for rare fungal diseases and for invasive aspergillosis in patients with renal impairment: Challenges and lessons of the VITAL trial.

    PubMed

    Perfect, John R; Cornely, Oliver A; Heep, Markus; Ostrosky-Zeichner, Luis; Mullane, Kathleen M; Maher, Rochelle; Croos-Dabrera, Rodney; Lademacher, Christopher; Engelhardt, Marc; Chen, Caroline; Marty, Francisco M

    2018-03-23

    Invasive fungal disease (IFD) confers a substantial risk for morbidity and mortality to immunocompromised patients. Invasive aspergillosis (IA) is the most common IFD caused by moulds but the prevalence of other rare mould diseases, such as mucormycosis, hyalohyphomycosis and phaeohyphomycosis, may be increasing. Treatments are available for IA, but evidence to support efficacy and safety of antifungal agents for rare IFDs, or for IFDs in special patient populations, is limited or lacking. The VITAL trial was conducted to assess the efficacy and safety of isavuconazole for the treatment of patients with IA and renal impairment, or with IFDs caused by rare moulds, yeasts or dimorphic fungi. These patients stand to benefit most from a new treatment option but are unlikely to be included in a randomised, controlled trial. In this article, we review the challenges faced in the design and conduct of the VITAL trial. We also review the findings of VITAL, which included evidence of the efficacy and safety of isavuconazole. Finally, we consider the importance of trials such as VITAL to inform therapeutic decision making for clinicians faced with the challenge of treating patients with rare IFDs and as one paradigm of how to determine efficacy and safety of new drugs for rare and resistant infections without a suitable comparator. © 2018 The Authors. Mycoses Published by Blackwell Verlag GmbH.

  17. New Ethical Challenges within Environmental and Sustainability Education: A Response

    ERIC Educational Resources Information Center

    Todd, Sharon

    2016-01-01

    One of the major points to grow out of the four papers presented in this issue is how to think of education in relation to the various challenges facing the biosphere, facing the future of human and other than human life forms, and facing the sheer difficulties of planning what to do about them. The differences in the role of education, of course,…

  18. Performance and accountability : challenges facing the Department of Transportation

    DOT National Transportation Integrated Search

    2001-02-14

    For surface transportation safety, DOT continues to face challenges in improving the safety of highways and pipelines. While the Department of Transportation appears to be making progress on some initiatives to reduce the number of large truck crashe...

  19. Examining age-related shared variance between face cognition, vision, and self-reported physical health: a test of the common cause hypothesis for social cognition

    PubMed Central

    Olderbak, Sally; Hildebrandt, Andrea; Wilhelm, Oliver

    2015-01-01

    The shared decline in cognitive abilities, sensory functions (e.g., vision and hearing), and physical health with increasing age is well documented with some research attributing this shared age-related decline to a single common cause (e.g., aging brain). We evaluate the extent to which the common cause hypothesis predicts associations between vision and physical health with social cognition abilities specifically face perception and face memory. Based on a sample of 443 adults (17–88 years old), we test a series of structural equation models, including Multiple Indicator Multiple Cause (MIMIC) models, and estimate the extent to which vision and self-reported physical health are related to face perception and face memory through a common factor, before and after controlling for their fluid cognitive component and the linear effects of age. Results suggest significant shared variance amongst these constructs, with a common factor explaining some, but not all, of the shared age-related variance. Also, we found that the relations of face perception, but not face memory, with vision and physical health could be completely explained by fluid cognition. Overall, results suggest that a single common cause explains most, but not all age-related shared variance with domain specific aging mechanisms evident. PMID:26321998

  20. Toward a Social Psychophysics of Face Communication.

    PubMed

    Jack, Rachael E; Schyns, Philippe G

    2017-01-03

    As a highly social species, humans are equipped with a powerful tool for social communication-the face. Although seemingly simple, the human face can elicit multiple social perceptions due to the rich variations of its movements, morphology, and complexion. Consequently, identifying precisely what face information elicits different social perceptions is a complex empirical challenge that has largely remained beyond the reach of traditional methods. In the past decade, the emerging field of social psychophysics has developed new methods to address this challenge, with the potential to transfer psychophysical laws of social perception to the digital economy via avatars and social robots. At this exciting juncture, it is timely to review these new methodological developments. In this article, we introduce and review the foundational methodological developments of social psychophysics, present work done in the past decade that has advanced understanding of the face as a tool for social communication, and discuss the major challenges that lie ahead.

  1. Polycentrism in Global Health Governance Scholarship Comment on "Four Challenges That Global Health Networks Face".

    PubMed

    Tosun, Jale

    2017-05-23

    Drawing on an in-depth analysis of eight global health networks, a recent essay in this journal argued that global health networks face four challenges to their effectiveness: problem definition, positioning, coalition-building, and governance. While sharing the argument of the essay concerned, in this commentary, we argue that these analytical concepts can be used to explicate a concept that has implicitly been used in global health governance scholarship for quite a few years. While already prominent in the discussion of climate change governance, for instance, global health governance scholarship could make progress by looking at global health governance as being polycentric. Concisely, polycentric forms of governance mix scales, mechanisms, and actors. Drawing on the essay, we propose a polycentric approach to the study of global health governance that incorporates coalitionbuilding tactics, internal governance and global political priority as explanatory factors. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  2. Pose-Invariant Face Recognition via RGB-D Images.

    PubMed

    Sang, Gaoli; Li, Jing; Zhao, Qijun

    2016-01-01

    Three-dimensional (3D) face models can intrinsically handle large pose face recognition problem. In this paper, we propose a novel pose-invariant face recognition method via RGB-D images. By employing depth, our method is able to handle self-occlusion and deformation, both of which are challenging problems in two-dimensional (2D) face recognition. Texture images in the gallery can be rendered to the same view as the probe via depth. Meanwhile, depth is also used for similarity measure via frontalization and symmetric filling. Finally, both texture and depth contribute to the final identity estimation. Experiments on Bosphorus, CurtinFaces, Eurecom, and Kiwi databases demonstrate that the additional depth information has improved the performance of face recognition with large pose variations and under even more challenging conditions.

  3. Facilitating the High School-to-College Transition for Students with Psychiatric Disabilities: Information and Strategies for School Counselors

    ERIC Educational Resources Information Center

    Fier, Sara M.; Brzezinski, Lynda G.

    2010-01-01

    The transition from high school to college is challenging for many students. In addition to the typical challenges faced by students starting college, students with previously diagnosed psychiatric disabilities have illness-related challenges to face as they transition to college. This article provides information on the current state of concerns…

  4. College Students with High-Functioning Autism Spectrum Disorder: Best Practices for Successful Transition to the World of Work

    ERIC Educational Resources Information Center

    Dipeolu, Abiola O.; Storlie, Cassandra; Johnson, Carol

    2015-01-01

    The transition from college to work is a challenging time for students with autism spectrum disorder. College counselors who understand the challenges students face adjusting to the world of work can position themselves to be change agents for this population. This article illuminates the challenges facing these students to help close the…

  5. Challenges Faced by Pre-Service Chemistry Teachers Teaching in a Laboratory and Their Solution Proposals

    ERIC Educational Resources Information Center

    Yalcin-Celik, Ayse; Kadayifci, Hakki; Uner, Sinem; Turan-Oluk, Nurcan

    2017-01-01

    This study examines the challenges faced by pre-service chemistry teachers teaching in a laboratory and their proposed solutions to these challenges. The study was conducted in a 13-week-long methodology course. Written statements from participants and observations from researchers were used as data sources. From these data, it was found that the…

  6. Investigation of the Challenges, Mentoring Needs, and Support for Business and Marketing Teachers

    ERIC Educational Resources Information Center

    Yohon, Teresa

    2005-01-01

    The purpose of this study was to determine the challenges that new business/marketing teachers face as well as the current support structures available to them and to determine experienced business/marketing teachers perceptions of the challenges faced by new teachers as well as the types of support that they were willing to provide to new…

  7. Challenges Faced by a Faith-Based School in a Rural, Predominantly Secular Setting: Implications

    ERIC Educational Resources Information Center

    Evangelinou-Yiannakis, Angela

    2016-01-01

    A new, independent Catholic school in rural Australia has had to face significant challenges in relation to its distinct Catholic ethos and curriculum. The challenges have included resistance from parents of the School with regard to the weekly time allocation for Religious Education, the nature of the faith-based curriculum, and the way in which…

  8. [Evaluative designs in public health: methodological considerations].

    PubMed

    López, Ma José; Marí-Dell'Olmo, Marc; Pérez-Giménez, Anna; Nebot, Manel

    2011-06-01

    Evaluation of public health interventions poses numerous methodological challenges. Randomization of individuals is not always feasible and interventions are usually composed of multiple factors. To face these challenges, certain elements, such as the selection of the most appropriate design and the use of a statistical analysis that includes potential confounders, are essential. The objective of this article was to describe the most frequently used designs in the evaluation of public health interventions (policies, programs or campaigns). The characteristics, strengths and weaknesses of each of these evaluative designs are described. Additionally, a brief explanation of the most commonly used statistical analysis in each of these designs is provided. Copyright © 2011 Sociedad Española de Salud Pública y Administración Sanitaria. Published by Elsevier Espana. All rights reserved.

  9. Chemical Approaches to Probe Metabolic Networks

    PubMed Central

    Medina-Cleghorn, Daniel; Nomura, Daniel K.

    2013-01-01

    One of the more provocative realizations that have come out of the genome sequencing projects is that organisms possess a large number of uncharacterized or poorly characterized enzymes. This finding belies the commonly held notion that our knowledge of cell metabolism is nearly complete, underscoring the vast landscape of unannotated metabolic and signaling networks that operate under normal physiological conditions, let alone in disease states where metabolic networks may be rewired, dysregulated, or altered to drive disease progression. Consequently, the functional annotation of enzymatic pathways represents a grand challenge for researchers in the post-genomic era. This review will highlight the chemical technologies that have been successfully used to characterize metabolism, and put forth some of the challenges we face as we expand our map of metabolic pathways. PMID:23296751

  10. Eating For Two: How Metabolism Establishes Interspecies Interactions in the Gut

    PubMed Central

    Fischbach, Michael A.; Sonnenburg, Justin L.

    2011-01-01

    In bacterial communities, ‘tight economic times’ are the norm. Of the many challenges bacteria face in making a living, perhaps none are more important than generating energy, maintaining redox balance, and acquiring carbon and nitrogen to synthesize primary metabolites. The ability of bacteria to meet these challenges depends heavily on the rest of their community. Indeed, the most fundamental way in which bacteria communicate is by importing the substrates for metabolism and exporting metabolic end products. As an illustration of this principle, we will travel down a carbohydrate catabolic pathway common to many species of Bacteroides, highlighting the interspecies interactions established (often inevitably) at its key steps. We also discuss the metabolic considerations in maintaining the stability of host-associated microbial communities. PMID:22018234

  11. Robotics for Nuclear Material Handling at LANL:Capabilities and Needs

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

    Harden, Troy A; Lloyd, Jane A; Turner, Cameron J

    Nuclear material processing operations present numerous challenges for effective automation. Confined spaces, hazardous materials and processes, particulate contamination, radiation sources, and corrosive chemical operations are but a few of the significant hazards. However, automated systems represent a significant safety advance when deployed in place of manual tasks performed by human workers. The replacement of manual operations with automated systems has been desirable for nearly 40 years, yet only recently are automated systems becoming increasingly common for nuclear materials handling applications. This paper reviews several automation systems which are deployed or about to be deployed at Los Alamos National Laboratory formore » nuclear material handling operations. Highlighted are the current social and technological challenges faced in deploying automated systems into hazardous material handling environments and the opportunities for future innovations.« less

  12. Challenges for nurses who work in community mental health centres in the West Bank, Palestine.

    PubMed

    Marie, Mohammad; Hannigan, Ben; Jones, Aled

    2017-01-01

    Nurses in Palestine (occupied Palestinian territory) work in a significantly challenging environment. The mental health care system is underdeveloped and under-resourced. For example, the total number of nurses who work in community mental health centres in the West Bank is seventeen, clearly insufficient in a total population of approximately three million. This research explored daily challenges that Palestinian community mental health nurses (CMHNs) face within and outside their demanding workplaces. An interpretive qualitative design was chosen. Face-to-face interviews were completed with fifteen participants. Thirty-two hours of observations of the day-to-day working environment and workplace routines were conducted in two communities' mental health centres. Written documents relating to practical job-related policies were also collected from various workplaces. Thematic analysis was used across all data sources resulting in four main themes, which describe the challenges faced by CMHNs. These themes consist of the context of unrest, stigma, lack of resources, and organisational or mental health system challenges. The study concludes with a better understanding of challenges in nursing which draws on wider cultural contexts and resilience. The outcomes from this study can be used to decrease the challenges for health professionals and enhance the mental health care system in Palestine.

  13. Ethical challenges in connection with the use of coercion: a focus group study of health care personnel in mental health care.

    PubMed

    Hem, Marit Helene; Molewijk, Bert; Pedersen, Reidar

    2014-12-04

    In recent years, the attention on the use of coercion in mental health care has increased. The use of coercion is common and controversial, and involves many complex ethical challenges. The research question in this study was: What kind of ethical challenges related to the use of coercion do health care practitioners face in their daily clinical work? We conducted seven focus group interviews in three mental health care institutions involving 65 multidisciplinary participants from different clinical fields. The interviews were recorded and transcribed verbatim. We analysed the material applying a 'bricolage' approach. Basic ethical principles for research ethics were followed. We received permission from the hospitals' administrations and all health care professionals who participated in the focus group interviews. Health care practitioners describe ethical dilemmas they face concerning formal, informal and perceived coercion. They provide a complex picture. They have to handle various ethical challenges, not seldom concerning questions of life and death. In every situation, the dignity of the patient is at stake when coercion is considered as morally right, as well as when coercion is not the preferred intervention. The work of the mental health professional is a complicated "moral enterprise". The ethical challenges deserve to be identified and handled in a systematic way. This is important for developing the quality of health care, and it is relevant to the current focus on reducing the use of coercion and increasing patient participation. Precise knowledge about ethical challenges is necessary for those who want to develop ethics support in mental health care. Better communication skills among health care professionals and improved therapeutic relationships seem to be vital. A systematic focus on ethical challenges when dealing with coercion is an important step forward in order to improve health care in the mental health field.

  14. A challenging entanglement: health care providers’ perspectives on caring for ill and injured tourists on Cozumel Island, Mexico

    PubMed Central

    Crooks, Valorie A.; Snyder, Jeremy

    2018-01-01

    ABSTRACT Purpose: Despite established knowledge that tourists often fall ill or are injured abroad, little is known about their treatment. The intent of this study was to explore health care professionals’ treatment provision experiences on Cozumel Island, Mexico. Methods: 13 semi-structured interviews were undertaken with professionals across a number of health care vocations on Cozumel Island. Interviews were transcribed and thematically analysed to determine common challenges faced in the provision of treatment for transnational tourists. Results: Three thematic challenges emerged from the data: human and physical resource deficiencies, medical (mis)perceptions held by patients and complexities surrounding remuneration of care. Health care providers employ unique strategies to mitigate these challenges. Conclusion: Although many of these challenges exist within other touristic and peripheral spaces, we suggest that the challenges experienced by Cozumel Island’s health care professionals, and their mitigation strategies, exist as part of a complex entanglement between the island’s health care sector and its dominant tourism landscape. We call on tangential tourism services to take a larger role in ensuring the ease of access to, and provision of quality health care services for tourists on Cozumel Island. PMID:29869593

  15. A challenging entanglement: health care providers' perspectives on caring for ill and injured tourists on Cozumel Island, Mexico.

    PubMed

    Hoffman, Leon; Crooks, Valorie A; Snyder, Jeremy

    2018-12-01

    Despite established knowledge that tourists often fall ill or are injured abroad, little is known about their treatment. The intent of this study was to explore health care professionals' treatment provision experiences on Cozumel Island, Mexico. 13 semi-structured interviews were undertaken with professionals across a number of health care vocations on Cozumel Island. Interviews were transcribed and thematically analysed to determine common challenges faced in the provision of treatment for transnational tourists. Three thematic challenges emerged from the data: human and physical resource deficiencies, medical (mis)perceptions held by patients and complexities surrounding remuneration of care. Health care providers employ unique strategies to mitigate these challenges. Although many of these challenges exist within other touristic and peripheral spaces, we suggest that the challenges experienced by Cozumel Island's health care professionals, and their mitigation strategies, exist as part of a complex entanglement between the island's health care sector and its dominant tourism landscape. We call on tangential tourism services to take a larger role in ensuring the ease of access to, and provision of quality health care services for tourists on Cozumel Island.

  16. Relationship challenges and relationship maintenance activities following disclosure of transsexualism.

    PubMed

    Alegría, C Aramburu

    2010-12-01

    • Transsexual persons are increasing their visibility in society, and health care providers and others (such as social workers) will be called upon to help with issues that transsexual persons face. Challenges that face transsexual persons often include issues involving relationships. Psychiatric and mental health nurses and other caregivers can increase their therapeutic skills in working with couples that include transsexual persons by becoming aware of these challenges and subsequent activities that can help with them. • This research study looks at couple relationships in which one partner reveals male-to-female transsexual identity. These are relationships that were established as man-woman and now will transition into relationships that include a male-to-female person and a female partner. • Common challenges for these couples include issues related to: (1) sexual identity and relationship uncertainty; (2) male-to-female transition decision making; and (3) presenting in public. • Relationship maintenance activities that helped the couples in the study maintain and strengthen their relationships through these challenges include: (1) communication; (2) self-talk (for example, putting the situation in perspective); (3) social networks; (4) positive interactions; (5) impression management (for example, managing displays of affection in public); and (6) social activism. This qualitative study describes the relational dynamics that help sustain relationships of couples that include male-to-female transsexual persons (MTF) and their natal female partners (NF) following disclosure of transsexualism. Relationship challenges and relationship maintenance activities are identified. Each partner in 17 MTF-NF couples participated in individual surveys and interviews. The data were coded for themes related to relationship challenges and activities. MTF-NF couples experience challenges within the contexts of their relationships and of society. These challenges include: (1) sexual identity and relationship uncertainty; (2) male-to-female transition decision making; and (3) public presentation. Relationship maintenance activities enabled the study couples to maintain and strengthen their relationships through these challenges. These activities include: (1) communication; (2) self-talk; (3) social networks; (4) positivity; (5) impression management; and (6) social activism. Via this report, psychiatric and mental health nurses can increase their therapeutic skills in working with MTF-NF couples. © 2010 Blackwell Publishing.

  17. Oncology nurses’ communication challenges with patients and families: A qualitative study

    PubMed Central

    Banerjee, Smita C.; Manna, Ruth; Coyle, Nessa; Shen, Megan Johnson; Pehrson, Cassandra; Zaider, Talia; Hammonds, Stacey; Krueger, Carol A.; Parker, Patricia A.; Bylund, Carma L.

    2016-01-01

    The benefits of effective communication in an oncology setting are multifold and include the overall well-being of patients and health professionals, adherence to treatment regimens, psychological functioning, and improvements in quality of life. Nevertheless, there are substantial barriers and communication challenges reported by oncology nurses. This study was conducted to present a summary of communication challenges faced by oncology nurses. From November 2012 to March 2014, 121 inpatient nurses working in the oncology setting participated in an online pre-training qualitative survey that asked nurses to describe common communication challenges in communicating empathy and discussing death, dying, and end-of-life (EOL) goals of care. The results revealed six themes that describe the challenges in communicating empathically: dialectic tensions, burden of carrying bad news, lack of skills for providing empathy, perceived institutional barriers, challenging situations, and perceived dissimilarities between the nurse and the patient. The results for challenges in discussing death, dying and EOL goals of care revealed five themes: dialectic tensions, discussing specific topics related to EOL, lack of skills for providing empathy, patient/family characteristics, and perceived institutional barriers. This study emphasizes the need for institutions to provide communication skills training to their oncology nurses for navigating through challenging patient interactions. PMID:26278636

  18. Oncology nurses' communication challenges with patients and families: A qualitative study.

    PubMed

    Banerjee, Smita C; Manna, Ruth; Coyle, Nessa; Shen, Megan Johnson; Pehrson, Cassandra; Zaider, Talia; Hammonds, Stacey; Krueger, Carol A; Parker, Patricia A; Bylund, Carma L

    2016-01-01

    The benefits of effective communication in an oncology setting are multifold and include the overall well-being of patients and health professionals, adherence to treatment regimens, psychological functioning, and improvements in quality of life. Nevertheless, there are substantial barriers and communication challenges reported by oncology nurses. This study was conducted to present a summary of communication challenges faced by oncology nurses. From November 2012 to March 2014, 121 inpatient nurses working in the oncology setting participated in an online pre-training qualitative survey that asked nurses to describe common communication challenges in communicating empathy and discussing death, dying, and end-of-life (EOL) goals of care. The results revealed six themes that describe the challenges in communicating empathically: dialectic tensions, burden of carrying bad news, lack of skills for providing empathy, perceived institutional barriers, challenging situations, and perceived dissimilarities between the nurse and the patient. The results for challenges in discussing death, dying and EOL goals of care revealed five themes: dialectic tensions, discussing specific topics related to EOL, lack of skills for providing empathy, patient/family characteristics, and perceived institutional barriers. This study emphasizes the need for institutions to provide communication skills training to their oncology nurses for navigating through challenging patient interactions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Challenges facing young African scientists in their research careers: A qualitative exploratory study.

    PubMed

    Kumwenda, Save; Niang, El Hadji A; Orondo, Pauline W; William, Pote; Oyinlola, Lateefah; Bongo, Gedeon N; Chiwona, Bernadette

    2017-03-01

    Africa accounts for 14% of world's population, and the economies of most African countries are considered to be growing, but this is not reflected in the amount of research published by Africans. This study aimed at identifying the challenges that young African scientists face in their career development. This was a qualitative exploratory study involving young researchers who attended the Teaching and Research in Natural Sciences for Development (TReND) in Africa scientific writing and communication workshop, which was held in Malawi in September 2015. A semi-structured questionnaire was sent to all workshop participants who consented to taking part in the survey. In total, 28 questionnaires were sent via email and 15 were returned, representing a response rate of 53.6%. Data were analysed using thematic analysis. Young Africans develop their research interests various ways. The most common career-promoting factors identified by the study participants included formal classroom learning, aspirations to attain academic qualifications, work satisfaction, and the desire to fulfill parents' dreams. Challenges cited by survey respondents included a lack of mentorship, funds, and research and writing skills. Lack of interest in research by policymakers, lack of motivation by peers, and heavy workload (leaving little time for research) were also reported as challenges. Respondents suggested that grants specifically targeting young scientists would be beneficial. Participants also urged for the establishment of mentorship programmes, increasing motivation for research, and more frequent training opportunities. There is need for improved funding for institutional and research network strengthening in Africa, with particular attention given to expanding opportunities for young researchers.

  20. Policy challenges and reforms in small EU member state health systems: a narrative literature review.

    PubMed

    Azzopardi-Muscat, Natasha; Funk, Tjede; Buttigieg, Sandra C; Grech, Kenneth E; Brand, Helmut

    2016-12-01

    The EU directive on patients' rights and cross-border care is of particular interest to small states as it reinforces the concept of health system cooperation. An analysis of the challenges faced by small states, as well as a deep evaluation of their health system reform characteristics is timely and justified. This paper identifies areas in which EU level cooperation may bring added value to these countries' health systems. Literature search is based primarily on PUBMED and is limited to English-language papers published between January 2000 and September 2014. Results of 76 original research papers appearing in peer-reviewed journals are summarised in a literature map and narrative review. Primary care, health workforce and medicines emerge as the salient themes in the review. Lack of capacity and small market size are found to be the frequently encountered challenges in governance and delivery of services. These constraints appear to also impinge on the ability of small states to effectively implement health system reforms. The EU appears to play a marginal role in supporting small state health systems, albeit the stimulus for reform associated with EU accession. Small states face common health system challenges which could potentially be addressed through enhanced health system cooperation at EU level. The lessons learned from research on small states may be of relevance to health systems organized at regional level in larger European states. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  1. The Role of Health Volunteers in Training Women Regarding Coping Strategies Using Self-Efficacy Theory: Barriers and Challenges Faced by Health Volunteers in Empowerment of Women

    PubMed

    Kaveh, Mohammad Hossein; Rokhbin, Moslem; Mani, Arash; Maghsoudi, Ahmad

    2017-09-27

    Introduction: Psychological distress is among physical and mental health threats, and health volunteers can play a critical role in empowerment of women. However, evidence has revealed a decline in health volunteers’ activities. Therefore, the present study aimed to investigate the challenges faced by health volunteers in empowerment of women. Methods: The participants’ knowledge level was assessed using a written test. Their perceived skills were also measured using Coping Inventory for Stressful Situations by Endler and Parker and Chesney’s Coping Self-efficacy Scale, respectively. The study data were entered into the SPSS statistical software, version 11.5 and were analyzed using chi-square, sample t-test, and Pearson’s correlation coefficient. Results: The results showed a considerable increase in the intervention group health volunteers’ knowledge about stress, as well as their self-efficacy. Besides, a significant correlation was observed between self-efficacy and task-oriented strategy scores. However, no significant increase was found in this group’s coping strategies. The results also indicated a significant increase in the intervention group women’s knowledge about stress, but no significant change was observed in other constructs. Some challenging factors, such as managerial, personal, and interpersonal factors, were also detected that might have affected the results. Discussion: This study caused no considerable change in coping with stress, except for increasing the women’s knowledge in this regard. Considering the challenges identified in this study, programs should be developed for researchers and health center managers to improve this condition in future. Creative Commons Attribution License

  2. Developmental visual perception deficits with no indications of prosopagnosia in a child with abnormal eye movements.

    PubMed

    Gilaie-Dotan, Sharon; Doron, Ravid

    2017-06-01

    Visual categories are associated with eccentricity biases in high-order visual cortex: Faces and reading with foveally-biased regions, while common objects and space with mid- and peripherally-biased regions. As face perception and reading are among the most challenging human visual skills, and are often regarded as the peak achievements of a distributed neural network supporting common objects perception, it is unclear why objects, which also rely on foveal vision to be processed, are associated with mid-peripheral rather than with a foveal bias. Here, we studied BN, a 9 y.o. boy who has normal basic-level vision, abnormal (limited) oculomotor pursuit and saccades, and shows developmental object and contour integration deficits but with no indication of prosopagnosia. Although we cannot infer causation from the data presented here, we suggest that normal pursuit and saccades could be critical for the development of contour integration and object perception. While faces and perhaps reading, when fixated upon, take up a small portion of central visual field and require only small eye movements to be properly processed, common objects typically prevail in mid-peripheral visual field and rely on longer-distance voluntary eye movements as saccades to be brought to fixation. While retinal information feeds into early visual cortex in an eccentricity orderly manner, we hypothesize that propagation of non-foveal information to mid and high-order visual cortex critically relies on circuitry involving eye movements. Limited or atypical eye movements, as in the case of BN, may hinder normal information flow to mid-eccentricity biased high-order visual cortex, adversely affecting its development and consequently inducing visual perceptual deficits predominantly for categories associated with these regions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Testing the effects of expression, intensity and age on emotional face processing in ASD.

    PubMed

    Luyster, Rhiannon J; Bick, Johanna; Westerlund, Alissa; Nelson, Charles A

    2017-06-21

    Individuals with autism spectrum disorder (ASD) commonly show global deficits in the processing of facial emotion, including impairments in emotion recognition and slowed processing of emotional faces. Growing evidence has suggested that these challenges may increase with age, perhaps due to minimal improvement with age in individuals with ASD. In the present study, we explored the role of age, emotion type and emotion intensity in face processing for individuals with and without ASD. Twelve- and 18-22- year-old children with and without ASD participated. No significant diagnostic group differences were observed on behavioral measures of emotion processing for younger versus older individuals with and without ASD. However, there were significant group differences in neural responses to emotional faces. Relative to TD, at 12 years of age and during adulthood, individuals with ASD showed slower N170 to emotional faces. While the TD groups' P1 latency was significantly shorter in adults when compared to 12 year olds, there was no significant age-related difference in P1 latency among individuals with ASD. Findings point to potential differences in the maturation of cortical networks that support visual processing (whether of faces or stimuli more broadly), among individuals with and without ASD between late childhood and adulthood. Finally, associations between ERP amplitudes and behavioral responses on emotion processing tasks suggest possible neural markers for emotional and behavioral deficits among individuals with ASD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Examining the Roles of the Facilitator in Online and Face-to-Face PD Contexts

    ERIC Educational Resources Information Center

    Park, Gina; Johnson, Heather; Vath, Richard; Kubitskey, Beth; Fishman, Barry

    2013-01-01

    Online teacher professional development has become an alternative to face-to-face professional development. Such a shift from face-to-face to online professional development, however, brings new challenges for professional development facilitators, whose roles are crucial in orchestrating teacher learning. This paper is motivated by the need to…

  5. The Life Story Experience of "Migrant Dentists" in Australia: Potential Implications for Health Workforce Governance and International Cooperation.

    PubMed

    Balasubramanian, Madhan; Spencer, A John; Short, Stephanie D; Watkins, Keith; Chrisopoulos, Sergio; Brennan, David S

    2016-10-10

    The migration of dentists is a major policy challenge facing both developing and developed countries. Dentists from over 120 countries migrate to Australia, and a large proportion are from developing countries. The aim of the study was to assess the life story experience (LSE) of migrant dentists in Australia, in order to address key policy challenges facing dentist migration. A national survey of all migrant dentists resident in Australia was conducted in 2013. Migrant experiences were assessed through a suite of LSE scales, developed through a qualitative-quantitative study. Respondents rated experiences using a five-point Likert scale. A total of 1022 migrant dentists responded to the survey (response rate = 54.5%). LSE1 (health system and general lifestyle concerns in home country), LSE2 (appreciation towards Australian way of life) and LSE3 (settlement concerns in Australia) scales varied by migrant dentist groups, sex, and years since arrival to Australia (chi-square, P < .05). In a logistic regression model, migrants mainly from developing countries (ie, the examination pathway group) faced greater health system and general lifestyle concerns in their home countries (9.32; 3.51-24.72) and greater settlement challenges in Australia (5.39; 3.51-8.28), compared to migrants from well-developed countries, who obtained direct recognition of qualifications. Migrants also are more appreciative towards the Australian way of life if they had lived at least ten years in Australia (1.97; 1.27-3.05), compared to migrants who have lived for less than ten years. Migrant dentists, mainly from developing countries, face challenges both in their home countries and in Australia. Our study offers evidence for multi-level health workforce governance and calls for greater consensus towards an international agenda to address dentist migration. Better integration of dentist migration with the mainstream health workforce governance is a viable and opportunistic way forward. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  6. Challenges and strategies for coping with scleroderma: implications for a scleroderma-specific self-management program.

    PubMed

    Milette, Katherine; Thombs, Brett D; Maiorino, Kristina; Nielson, Warren R; Körner, Annett; Peláez, Sandra

    2018-05-09

    The purpose of this study was to explore challenges faced by patients with systemic sclerosis, also called scleroderma, in coping with their disease and the strategies they used to face those challenges. Five focus groups were held with scleroderma patients (4 groups, n = 34) and health care professionals who have experience treating scleroderma (1 group, n = 8). Participants' discussions were recorded, transcribed and analyzed using thematic analysis. Participants reported challenges accessing information (e.g., knowledgeable specialists), dealing with negative emotions (e.g., stress due to misunderstandings with loved ones), and accessing resources (e.g., helpful products or devices). Strategies for overcoming challenges were also discussed (e.g., advocating for own needs). When faced with significant challenges while coping with scleroderma, patients develop strategies to manage better and improve their quality of life. To help them cope, patients would benefit from easier access to supportive interventions, including tailored scleroderma self-management programs. Although the challenges experienced by patients with scleroderma are unique, findings from this study might help better understand patients' perspectives regarding coping and disease management for other chronic diseases as well. Implications for Rehabilitation People living with rare diseases, including the rare autoimmune disease scleroderma, face unique challenges and often do not have access to disease-specific educational or other support resources. People with scleroderma report that they face challenges in accessing information, including knowledgeable healthcare providers; managing difficult social interactions and negative emotions; and accessing resources. Strategies employed by scleroderma patients to overcome these challenges include seeking connections to other people with scleroderma or scleroderma patient organizations, actively seeking out local resources, and learning to communicate and advocate more effectively. Rehabilitation professionals can support people with scleroderma by providing them with information on connecting with scleroderma patient organizations or by facilitating local patient support networks.

  7. Challenges newly-arrived migrant women in Montreal face when needing maternity care: Health care professionals' perspectives.

    PubMed

    Peláez, Sandra; Hendricks, Kristin N; Merry, Lisa A; Gagnon, Anita J

    2017-01-25

    People who leave their country of origin, or the country of habitual residence, to establish themselves permanently in another country are usually referred to as migrants. Over half of all births in Montreal, Canada are to migrant women. To understand healthcare professionals' attitudes towards migrants that could influence their delivery of care, our objective was to explore their perspectives of challenges newly-arrived migrant women from non-Western countries face when needing maternity care. In this qualitative multiple case study, we conducted face-to-face interviews with 63 health care professionals from four teaching hospitals in Montreal, known for providing maternity care to a high volume of migrant women. Interviews were transcribed and thematically analysed. Physicians, nurses, social workers, and therapists participated; 90% were female; and 17% were themselves migrants from non-Western countries. According to participants, newly-arrived migrant women face challenges at two levels: (a) direct care (e.g., understanding Canadian health care professionals' expectations, communicating effectively with health care professionals), and (b) organizational (e.g., access to appropriate health care). Challenges women face are strongly influenced by the migrant woman's background as well as social position (e.g., general education, health literacy, socio-cultural integration) and by how health care professionals balance women's needs with perceived requirement to adhere to standard procedures and regulations. Health care professionals across institutions agreed that maternity care-related challenges faced by newly-arrived migrant women often are complex in that they are simultaneously driven by conflicting values: those based on migrant women's sociocultural backgrounds versus those related to the implementation of Canadian guidelines for maternity care in which consideration of migrant women's particular needs are not priority.

  8. Scotland: Education, Curriculum and Learning. the Strengths, Challenges and Solutions in Lifelong Learning. IBE Working Papers on Curriculum Issues No. 13

    ERIC Educational Resources Information Center

    Armstrong, Alan

    2014-01-01

    This paper brings together the main strengths and challenges currently facing Scottish education and outlines approaches to the ways forward. Knowledge about how to improve education systems has grown rapidly over the last two decades. One key challenge facing Scotland, and no doubt many other countries, is in ensuring a smooth "learner…

  9. Threat Control through Arms Control. Report to Congress 1994

    DTIC Science & Technology

    1994-07-13

    reduction, chemical weapons’ elimination, or any of the other growing arms control and nonproliferation challenges America faces, ACDA is an essential...nuclear missile reduction, chemical weapons elimination, or any of. the other growing arms control and nonproliferation challenges America faces... challenging . Nonprolif eration agreements are our first line of defense against the creation of a far more unstable and hazardous world than we have ever

  10. Understanding Nutritional Epidemiology and Its Role in Policy12

    PubMed Central

    Satija, Ambika; Yu, Edward; Willett, Walter C; Hu, Frank B

    2015-01-01

    Nutritional epidemiology has recently been criticized on several fronts, including the inability to measure diet accurately, and for its reliance on observational studies to address etiologic questions. In addition, several recent meta-analyses with serious methodologic flaws have arrived at erroneous or misleading conclusions, reigniting controversy over formerly settled debates. All of this has raised questions regarding the ability of nutritional epidemiologic studies to inform policy. These criticisms, to a large degree, stem from a misunderstanding of the methodologic issues of the field and the inappropriate use of the drug trial paradigm in nutrition research. The exposure of interest in nutritional epidemiology is human diet, which is a complex system of interacting components that cumulatively affect health. Consequently, nutritional epidemiology constantly faces a unique set of challenges and continually develops specific methodologies to address these. Misunderstanding these issues can lead to the nonconstructive and sometimes naive criticisms we see today. This article aims to clarify common misunderstandings of nutritional epidemiology, address challenges to the field, and discuss the utility of nutritional science in guiding policy by focusing on 5 broad questions commonly asked of the field. PMID:25593140

  11. Hepatotoxic microcystin removal using pumice embedded monolithic composite cryogel as an alternative water treatment method.

    PubMed

    Gurbuz, Fatma; Ceylan, Şeyda; Odabaşı, Mehmet; Codd, Geoffrey A

    2016-03-01

    Microcystins are the most commonly encountered water-borne cyanotoxins which present short- and long-term risks to human health. Guidelines at international and national level, and legislation in some countries, have been introduced for the effective health risk management of these potent hepatotoxic, tumour-promoters. The stable cyclic structure of microcystins and their common production by cyanobacteria in waterbodies at times of high total dissolved organic carbon content presents challenges to drinking water treatment facilities, with conventional, advanced and novel strategies under evaluation. Here, we have studied the removal of microcystins using three different forms of pumice particles (PPs), which are embedded into macroporous cryogel columns. Macroporous composite cryogel columns (MCCs) are a new generation of separation media designed to face this challenging task. Three different MCCs were prepared by adding plain PPs, Cu(2+)-attached PPs and Fe(3+)-attached PPs to reaction media before the cryogelation step. Column studies showed that MCCs could be successfully used as an alternative water treatment method for successful microcystin removal. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Big data and clinicians: a review on the state of the science.

    PubMed

    Wang, Weiqi; Krishnan, Eswar

    2014-01-17

    In the past few decades, medically related data collection saw a huge increase, referred to as big data. These huge datasets bring challenges in storage, processing, and analysis. In clinical medicine, big data is expected to play an important role in identifying causality of patient symptoms, in predicting hazards of disease incidence or reoccurrence, and in improving primary-care quality. The objective of this review was to provide an overview of the features of clinical big data, describe a few commonly employed computational algorithms, statistical methods, and software toolkits for data manipulation and analysis, and discuss the challenges and limitations in this realm. We conducted a literature review to identify studies on big data in medicine, especially clinical medicine. We used different combinations of keywords to search PubMed, Science Direct, Web of Knowledge, and Google Scholar for literature of interest from the past 10 years. This paper reviewed studies that analyzed clinical big data and discussed issues related to storage and analysis of this type of data. Big data is becoming a common feature of biological and clinical studies. Researchers who use clinical big data face multiple challenges, and the data itself has limitations. It is imperative that methodologies for data analysis keep pace with our ability to collect and store data.

  13. Moving Towards a Common Ground and Flight Data Systems Architecture for NASA's Exploration Missions

    NASA Technical Reports Server (NTRS)

    Rader. Steve; Kearney, Mike; McVittie, Thom; Smith, Dan

    2006-01-01

    The National Aeronautics and Space Administration has embarked on an ambitious effort to return man to the moon and then on to Mars. The Exploration Vision requires development of major new space and ground assets and poses challenges well beyond those faced by many of NASA's recent programs. New crewed vehicles must be developed. Compatible supply vehicles, surface mobility modules and robotic exploration capabilities will supplement the manned exploration vehicle. New launch systems will be developed as well as a new ground communications and control infrastructure. The development must take place in a cost-constrained environment and must advance along an aggressive schedule. Common solutions and system interoperability and will be critical to the successful development of the Exploration data systems for this wide variety of flight and ground elements. To this end, NASA has assembled a team of engineers from across the agency to identify the key challenges for Exploration data systems and to establish the most beneficial strategic approach to be followed. Key challenges and the planned NASA approach for flight and ground systems will be discussed in the paper. The described approaches will capitalize on new technologies, and will result in cross-program interoperability between spacecraft and ground systems, from multiple suppliers and agencies.

  14. Philosophy in medical education: a means of protecting mental health.

    PubMed

    Keller, Eric J

    2014-08-01

    This study sought to identify and examine less commonly discussed challenges to positive mental health faced by medical students, residents, and physicians with hopes of improving current efforts to protect the mental health of these groups. Additionally, this work aimed to suggest an innovative means of preventing poor mental health during medical education. Literature on medical student, resident, and physician mental health was carefully reviewed and a number of psychiatrists who treat physician-patients were interviewed. The culture of medicine, medical training, common physician psychology and identity, and conflicting professional expectations all seem to contribute to poor mental health among medical students, residents, and physicians. Many current efforts may be more successful by better addressing the negative effects of these characteristics of modern medicine. Programs aimed at promoting healthy mental lifestyles during medical education should continue to be developed and supported to mitigate the deleterious effects of the challenging environment of modern medicine. To improve these efforts, educators may consider incorporating philosophical discussions on meaning and fulfillment in life between medical students and faculty. Through medical school faculty members sharing and living out their own healthy outlooks on life, students may emulate these habits and the culture of medicine may become less challenging for positive mental health.

  15. Challenges and Concerns Faced by Doctoral Candidates Seeking Academic Positions.

    ERIC Educational Resources Information Center

    Porter, Dion; Donnell, Chandra; Buck, Tina; Edwards, Yolanda

    A panel discussion offered suggestions and recommendations for faculty and institutions of rehabilitation counseling education on more effective recruitment methods. Strategies were also considered for potential faculty members. Candidates seeking academic positions in rehabilitation counseling education face many challenges. Location of program;…

  16. A review of the changing culture and social context relating to forensic facial depiction of the dead.

    PubMed

    Wilkinson, Caroline

    2014-12-01

    The recognition of a decedent by a family member is commonplace in forensic investigation and is often employed as identity confirmation. However, it is recognised that misidentification from facial recognition is also common and faces of the dead may be extremely difficult to recognise due to decomposition or external damage, and even immediate post-mortem changes may be significant enough to confuse an observer. The depiction of faces of the dead can be a useful tool for promoting recognition leading to identification and post-mortem facial depiction is described as the interpretation of human remains in order to suggest the living appearance of an individual. This paper provides an historical context relating to the changing view of society to the presentation and publication of post-mortem facial depictions and discusses the current ethical, practical and academic challenges associated with these images. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Communication challenges in complex medical environments.

    PubMed

    Lee, Jessica D; Hohler, Anna

    2014-06-01

    The provision of health care is becoming increasingly complex and can involve multiple providers and care setting transitions, particularly as the population is living longer, and often with chronic disease. The Electronic Health Record (EHR) was intended to provide a comprehensive documentation of a patient's health-related information; however, health care systems often function in isolation with EHRs that are unique only to that system. The EHR may also limit face-to-face communication between treating physicians within the same system. It is only with diligent effort that changes in medical management plans are conveyed among providers. When multiple providers are involved in a patient's care, physician-to-patient communication may also suffer, which can impact patient satisfaction and outcome. This article describes a scenario in which several lapses in communication occurred, and it outlines other common pitfalls while providing possible solutions for improving communication across the health care spectrum.

  18. Engineering a Successful Mission: Lessons from the Lunar Reconnaissance Orbiter

    NASA Technical Reports Server (NTRS)

    Everett, David F.

    2011-01-01

    Schedule pressure is common in the commercial world, where late delivery of a product means delayed income and loss of profit. 12 Research spacecraft developed by NASA, on the other hand, tend to be driven by the high cost of launch vehicles and the public scrutiny of failure-- the primary driver is ensuring proper operation in space for a system that cannot be retrieved for repair. The Lunar Reconnaissance Orbiter (LRO) development faced both schedule pressure and high visibility. The team had to balance the strong push to meet a launch date against the need to ensure that this first mission for Exploration succeeded. This paper will provide an overview of the mission from concept through its first year of operation and explore some of the challenges the systems engineering team faced taking a mission from preliminary design review to pre-ship review in 3 years.

  19. Race is gendered: how covarying phenotypes and stereotypes bias sex categorization.

    PubMed

    Johnson, Kerri L; Freeman, Jonathan B; Pauker, Kristin

    2012-01-01

    We argue that race and sex categories are psychologically and phenotypically confounded, affecting social categorizations and their efficiency. Sex categorization of faces was facilitated when the race category shared facial phenotypes or stereotypes with the correct sex category (e.g., Asian women and Black men) but was impaired when the race category shared incompatible phenotypes or stereotypes with the correct sex category (e.g., Asian men and Black women). These patterns were evident in the disambiguation of androgynous faces (Study 1) and the efficiency of judgments (Studies 1, 2, 4, and 5). These patterns emerged due to common facial phenotypes for the categories Black and men (Studies 3 and 5) and due to shared stereotypes among the categories Black and men and the categories Asian and women (Studies 4 and 5). These findings challenge the notion that social categories are perceived independent of one another and show, instead, that race is gendered.

  20. Divergence of Drosophila melanogaster repeatomes in response to a sharp microclimate contrast in Evolution Canyon, Israel

    PubMed Central

    Kim, Young Bun; Oh, Jung Hun; McIver, Lauren J.; Rashkovetsky, Eugenia; Michalak, Katarzyna; Garner, Harold R.; Kang, Lin; Nevo, Eviatar; Korol, Abraham B.; Michalak, Pawel

    2014-01-01

    Repeat sequences, especially mobile elements, make up large portions of most eukaryotic genomes and provide enormous, albeit commonly underappreciated, evolutionary potential. We analyzed repeatomes of Drosophila melanogaster that have been diverging in response to a microclimate contrast in Evolution Canyon (Mount Carmel, Israel), a natural evolutionary laboratory with two abutting slopes at an average distance of only 200 m, which pose a constant ecological challenge to their local biotas. Flies inhabiting the colder and more humid north-facing slope carried about 6% more transposable elements than those from the hot and dry south-facing slope, in parallel to a suite of other genetic and phenotypic differences between the two populations. Nearly 50% of all mobile element insertions were slope unique, with many of them disrupting coding sequences of genes critical for cognition, olfaction, and thermotolerance, consistent with the observed patterns of thermotolerance differences and assortative mating. PMID:25006263

  1. Divergence of Drosophila melanogaster repeatomes in response to a sharp microclimate contrast in Evolution Canyon, Israel.

    PubMed

    Kim, Young Bun; Oh, Jung Hun; McIver, Lauren J; Rashkovetsky, Eugenia; Michalak, Katarzyna; Garner, Harold R; Kang, Lin; Nevo, Eviatar; Korol, Abraham B; Michalak, Pawel

    2014-07-22

    Repeat sequences, especially mobile elements, make up large portions of most eukaryotic genomes and provide enormous, albeit commonly underappreciated, evolutionary potential. We analyzed repeatomes of Drosophila melanogaster that have been diverging in response to a microclimate contrast in Evolution Canyon (Mount Carmel, Israel), a natural evolutionary laboratory with two abutting slopes at an average distance of only 200 m, which pose a constant ecological challenge to their local biotas. Flies inhabiting the colder and more humid north-facing slope carried about 6% more transposable elements than those from the hot and dry south-facing slope, in parallel to a suite of other genetic and phenotypic differences between the two populations. Nearly 50% of all mobile element insertions were slope unique, with many of them disrupting coding sequences of genes critical for cognition, olfaction, and thermotolerance, consistent with the observed patterns of thermotolerance differences and assortative mating.

  2. Adaptation to different noninvasive ventilation masks in critically ill patients*

    PubMed Central

    da Silva, Renata Matos; Timenetsky, Karina Tavares; Neves, Renata Cristina Miranda; Shigemichi, Liane Hirano; Kanda, Sandra Sayuri; Maekawa, Carla; Silva, Eliezer; Eid, Raquel Afonso Caserta

    2013-01-01

    OBJECTIVE: To identify which noninvasive ventilation (NIV) masks are most commonly used and the problems related to the adaptation to such masks in critically ill patients admitted to a hospital in the city of São Paulo, Brazil. METHODS: An observational study involving patients ≥ 18 years of age admitted to intensive care units and submitted to NIV. The reason for NIV use, type of mask, NIV regimen, adaptation to the mask, and reasons for non-adaptation to the mask were investigated. RESULTS: We evaluated 245 patients, with a median age of 82 years. Acute respiratory failure was the most common reason for NIV use (in 71.3%). Total face masks were the most commonly used (in 74.7%), followed by full face masks and near-total face masks (in 24.5% and 0.8%, respectively). Intermittent NIV was used in 82.4% of the patients. Adequate adaptation to the mask was found in 76% of the patients. Masks had to be replaced by another type of mask in 24% of the patients. Adequate adaptation to total face masks and full face masks was found in 75.5% and 80.0% of the patients, respectively. Non-adaptation occurred in the 2 patients using near-total facial masks. The most common reason for non-adaptation was the shape of the face, in 30.5% of the patients. CONCLUSIONS: In our sample, acute respiratory failure was the most common reason for NIV use, and total face masks were the most commonly used. The most common reason for non-adaptation to the mask was the shape of the face, which was resolved by changing the type of mask employed. PMID:24068269

  3. Adaptation to different noninvasive ventilation masks in critically ill patients.

    PubMed

    Silva, Renata Matos da; Timenetsky, Karina Tavares; Neves, Renata Cristina Miranda; Shigemichi, Liane Hirano; Kanda, Sandra Sayuri; Maekawa, Carla; Silva, Eliezer; Eid, Raquel Afonso Caserta

    2013-01-01

    To identify which noninvasive ventilation (NIV) masks are most commonly used and the problems related to the adaptation to such masks in critically ill patients admitted to a hospital in the city of São Paulo, Brazil. An observational study involving patients ≥ 18 years of age admitted to intensive care units and submitted to NIV. The reason for NIV use, type of mask, NIV regimen, adaptation to the mask, and reasons for non-adaptation to the mask were investigated. We evaluated 245 patients, with a median age of 82 years. Acute respiratory failure was the most common reason for NIV use (in 71.3%). Total face masks were the most commonly used (in 74.7%), followed by full face masks and near-total face masks (in 24.5% and 0.8%, respectively). Intermittent NIV was used in 82.4% of the patients. Adequate adaptation to the mask was found in 76% of the patients. Masks had to be replaced by another type of mask in 24% of the patients. Adequate adaptation to total face masks and full face masks was found in 75.5% and 80.0% of the patients, respectively. Non-adaptation occurred in the 2 patients using near-total facial masks. The most common reason for non-adaptation was the shape of the face, in 30.5% of the patients. In our sample, acute respiratory failure was the most common reason for NIV use, and total face masks were the most commonly used. The most common reason for non-adaptation to the mask was the shape of the face, which was resolved by changing the type of mask employed.

  4. Advantages and limitations of Internet-based interventions for common mental disorders

    PubMed Central

    Andersson, Gerhard; Titov, Nickolai

    2014-01-01

    Several Internet interventions have been developed and tested for common mental disorders, and the evidence to date shows that these treatments often result in similar outcomes as in face-to-face psychotherapy and that they are cost-effective. In this paper, we first review the pros and cons of how participants in Internet treatment trials have been recruited. We then comment on the assessment procedures often involved in Internet interventions and conclude that, while online questionnaires yield robust results, diagnoses cannot be determined without any contact with the patient. We then review the role of the therapist and conclude that, although treatments including guidance seem to lead to better outcomes than unguided treatments, this guidance can be mainly practical and supportive rather than explicitly therapeutic in orientation. Then we briefly describe the advantages and disadvantages of treatments for mood and anxiety disorders and comment on ways to handle comorbidity often associated with these disorders. Finally we discuss challenges when disseminating Internet interventions. In conclusion, there is now a large body of evidence suggesting that Internet interventions work. Several research questions remain open, including how Internet interventions can be blended with traditional forms of care. PMID:24497236

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

    Brotz, Jay Kristoffer; Hymel, Ross W; Punnoose, Ratish J.

    One of the greatest challenges facing designers of equipment to be used in a nuclear arms control treaty is how to convince the other party in the treaty to trust its results and functionality. Whether the host provides equipment meant to prove treaty obligations and the inspector needs to gain that trust (commonly referred to as authentication), or the inspector provides this equipment and the host needs to gain this trust (commonly considered to be included in certification), one party generally has higher confidence in the equipment at the start of a treaty regime and the other party needs tomore » gain that confidence prior to use. While we focus on authentication in this document—that is, the inspector gaining confidence in host-provided equipment—our conclusions will likely apply to host certification of inspector-provided equipment.« less

  6. Child Disaster Mental Health Interventions: Therapy Components

    PubMed Central

    Pfefferbaum, Betty; Sweeton, Jennifer L.; Nitiéma, Pascal; Noffsinger, Mary A.; Varma, Vandana; Nelson, Summer D.; Newman, Elana

    2015-01-01

    Children face innumerable challenges following exposure to disasters. To address trauma sequelae, researchers and clinicians have developed a variety of mental health interventions. While the overall effectiveness of multiple interventions has been examined, few studies have focused on the individual components of these interventions. As a preliminary step to advancing intervention development and research, this literature review identifies and describes nine common components that comprise child disaster mental health interventions. This review concluded that future research should clearly define the constituent components included in available interventions. This will require that future studies dismantle interventions to examine the effectiveness of specific components and identify common therapeutic elements. Issues related to populations studied (eg, disaster exposure, demographic and cultural influences) and to intervention delivery (eg, timing and optimal sequencing of components) also warrant attention. PMID:25225954

  7. Data Management Plan and Functional System Design for the Information Management System of the Clinch River Remedial Investigation and Waste Area Grouping 6

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

    Ball, T.; Brandt, C.; Calfee, J.

    1994-03-01

    The Data Management Plan and Functional System Design supports the Clinch River Remedial Investigation (CRRI) and Waste Area Grouping (WAG) 6 Environmental Monitoring Program. The objective of the Data Management Plan and Functional System Design is to provide organization, integrity, security, traceability, and consistency of the data generated during the CRRI and WAG 6 projects. Proper organization will ensure that the data are consistent with the procedures and requirements of the projects. The Information Management Groups (IMGs) for these two programs face similar challenges and share many common objectives. By teaming together, the IMGs have expedited the development and implementationmore » of a common information management strategy that benefits each program.« less

  8. 'I was thinking too much': experiences of HIV-positive adults with common mental disorders and poor adherence to antiretroviral therapy in Zimbabwe.

    PubMed

    Kidia, Khameer; Machando, Debra; Bere, Tarisai; Macpherson, Kirsty; Nyamayaro, Primrose; Potter, Lucy; Makadzange, Tariro; Munjoma, Ronald; Marufu, Marshall; Araya, Ricardo; Safren, Steven; O'Cleirigh, Conall; Chibanda, Dixon; Abas, Melanie

    2015-07-01

    To document the lived experiences of people with both poor mental health and suboptimal adherence to antiretroviral therapy in high HIV prevalence settings. In-depth qualitative interviews were conducted with 47 (female = 31) HIV-positive adults who scored above the cut-point on a locally validated scale for common mental disorders (CMDs). Purposive sampling was used to recruit participants with evidence of poor adherence. Six additional key informant interviews (female = 6) were conducted with healthcare workers. Data were collected and analysed inductively by an interdisciplinary coding team. The major challenges faced by participants were stressors (poverty, stigma, marital problems) and symptoms of CMDs ('thinking too much', changes to appetite and sleep, 'burdened heart' and low energy levels). Thinking too much, which appears closely related to rumination, was the symptom with the greatest negative impact on adherence to antiretroviral therapy among HIV-positive adults with CMDs. In turn, thinking too much was commonly triggered by the stressors faced by people living with HIV/AIDS, especially poverty. Finally, participants desired private counselling, access to income-generating activities and family engagement in mental health care. Better understanding of the local expression of mental disorders and of underlying stressors can inform the development of culturally sensitive interventions to reduce CMDs and poor adherence to antiretroviral therapy. © 2015 John Wiley & Sons Ltd.

  9. Using International Classification of Functioning, Disability and Health to understand challenges in community reintegration of injured veterans.

    PubMed

    Resnik, Linda J; Allen, Susan M

    2007-01-01

    This pilot study used the framework of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) to understand the challenges faced by Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans as they reintegrate into the community. We conducted semistructured interviews with 14 injured veterans, 12 caregivers, and 14 clinicians. We used ICF taxonomy to code data and identify issues. We identified challenges in the following ICF domains: learning and applying knowledge; general tasks and demands; communication; mobility; self-care; domestic life; interpersonal interactions, major life areas; and community, social, and civic life. We found many similarities between the challenges faced by veterans with and without polytraumatic injuries, although veterans with polytraumatic injuries faced challenges of greater magnitude. Identifying community reintegration challenges early and promoting reintegration are important mandates for the Department of Veterans Affairs. The findings of this study are useful in understanding the needs of OEF/OIF veterans.

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

    PubMed Central

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

    2016-01-01

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

  11. Examining the Challenging Hindrances facing in the Construction Projects: South India’s Perspective

    NASA Astrophysics Data System (ADS)

    Subramanyam, K.; Haridharan, M. K.

    2017-07-01

    Developing countries like India require a huge infrastructure to facilitate needs of the people. Construction industry provides several opportunities to the individuals. Construction manager work is to supervise and organize the construction activities in construction projects. Now a day construction manager facing challenges. This paper aimed to study the challenges facing by the construction manager in the perception of construction professionals. 39 variables were taken from the literature review which found to be severe impact on construction managers’ performance. Construction manager, project manager and site engineers are the respondents for this survey. Using SPSS, regression analysis was done and recognized significant challenges. These challenges were classified into 5 domains. In management challenges, resource availability and allocation, risks and uncertainties existing in the project onsite, top management support and cost constraints are the most significant variables. In skills requirement of a construction manager challenges, technical skills required to learn and adapt new technology in the project, decision making and planning according to the situation in site are the most significant variables. In performance challenges, implementation of tasks according to the plan is the important variable whereas in onsite challenges, manage project risks, develop project policies and procedures are the most important.

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

    PubMed

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

    2016-10-29

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

  13. Challenges facing developers of CAD/CAM models that seek to predict human working postures

    NASA Astrophysics Data System (ADS)

    Wiker, Steven F.

    2005-11-01

    This paper outlines the need for development of human posture prediction models for Computer Aided Design (CAD) and Computer Aided Manufacturing (CAM) design applications in product, facility and work design. Challenges facing developers of posture prediction algorithms are presented and discussed.

  14. Challenges Facing Early Childhood Programs Worldwide

    ERIC Educational Resources Information Center

    Neugebauer, Roger

    2008-01-01

    In this article, the author presents the challenges faced by early childhood education in 29 countries, according to the World Forum National Representatives and Global Leaders for Young Children. The countries represented in these responses include: Azerbaijan, Bangladesh, Bolivia, Brazil, Canada, Denmark, Egypt, Fiji, India, Iran, Iraq, Japan,…

  15. Exploring Biotechnology Using Case-Based Multimedia

    ERIC Educational Resources Information Center

    Bergland, Mark; Lundeberg, Mary; Klyczek, Karen; Sweet, Jennifer; Emmons, Jean; Martin, Christine; Marsh, Katherine; Werner, Joy; Jarvis-Uetz, Michelle

    2006-01-01

    Today, teachers face more challenges than ever, and biology teachers face a special challenge. As technology continues to expand, biology teachers have a responsibility to keep students informed of technological and scientific advances. Biology teachers must also address ethical issues associated with these advances. In this paper, the authors…

  16. Development of Critical Thinking Skills through Writing Tasks: Challenges Facing Maritime English Students at Aqaba College, AlBalqa Applied University, Jordan

    ERIC Educational Resources Information Center

    Alidmat, Ali Odeh Hammoud; Ayassrah, Mohamed Ayed

    2017-01-01

    Teaching English for Special Purposes (ESP) in a context where English is taught as a Foreign Language (EFL) is no easy task. There is in fact extensive research reporting on challenges facing both teacher and student in the Foreign Language classroom where language skills must be learnt outside their usual context. Even more challenging is…

  17. Exploring strategies to overcome extra-organisational challenges faced by community pharmacies in Sarawak, Malaysia.

    PubMed

    Kho, Boon Phiaw; Hassali, Mohamed Azmi; Lim, Ching Jou; Saleem, Fahad

    2018-03-15

    The aims of this research were to determine extra-organisational challenges (e.g. market competition, governing policies) faced by community pharmacies in Sarawak, the coping strategies employed to deal with these challenges and explore potential legislative changes that can attenuate the intensity of these challenges. Survey questionnaires (n = 184) were posted to all eligible community pharmacies in Sarawak, Malaysia. The questionnaire included sections on participants' demographic data, extra-organisational challenges faced, coping strategies employed and proposals to improve community pharmacy legislations. Items were constructed based on the findings of a prior qualitative research supplemented with relevant literature about these issues. High levels of homogeneity in responses were recorded on various extra-organisational challenges faced, particularly those economy-oriented. Strategic changes to counter these challenges were focused on pricing and product stocked, rather than services provision. Highly rated strategies included increasing discounts for customers (n = 54; 68%) and finding cheaper suppliers (n = 70; 88%). Legislative changes proposed that might increase their share of the pharmaceutical market were strongly supported by respondents, particularly about making it compulsory for general practitioners to provide patients the option to have their medicines dispensed in community pharmacies (n = 72; 90%). Current legislative conditions and Malaysian consumer mindset may have constrained the strategic choices of community pharmacies to deal with the strong extra-organisational challenges. A long-term multipronged approach to address these issues and increased involvement of community pharmacists themselves in this agenda are required to influence practice change. © 2018 Royal Pharmaceutical Society.

  18. Improving local health through community health workers in Cambodia: challenges and solutions.

    PubMed

    Ozano, Kim; Simkhada, Padam; Thann, Khem; Khatri, Rose

    2018-01-06

    Volunteer community health workers (CHWs) are an important link between the public health system and the community. The 'Community Participation Policy for Health' in Cambodia identifies CHWs as key to local health promotion and as a critical link between district health centres and the community. However, research on the challenges CHWs face and identifying what is required to optimise their performance is limited in the Cambodian context. This research explores the views of CHWs in rural Cambodia, on the challenges they face when implementing health initiatives. Qualitative methodology was used to capture the experiences of CHWs in Kratie and Mondulkiri provinces. Two participatory focus groups with CHWs in Mondulkiri and ten semi-structured interviews in Kratie were conducted. Results from both studies were used to identify common themes. Participants were CHWs, male and female, from rural Khmer and Muslim communities and linked with seven different district health centres. Findings identify that CHWs regularly deliver health promotion to communities. However, systemic, personal and community engagement challenges hinder their ability to function effectively. These include minimal leadership and support from local government, irregular training which focuses on verticalised health programmes, inadequate resources, a lack of professional identity and challenges to achieving behaviour change of community members. In addition, the CHW programme is delivered in a fragmented way that is largely influenced by external aid objectives. When consulted, however, CHWs demonstrate their ability to develop realistic practical solutions to challenges and barriers. The fragmented delivery of the CHW programme in Cambodia means that government ownership is minimal. This, coupled with the lack of defined core training programme or adequate resources, prevents CHWs from reaching their potential. CHWs have positive and realistic ideas on how to improve their role and, subsequently, the health of community members. CHWs presented with the opportunity to share learning and develop ideas in a supportive environment would benefit health initiatives.

  19. Internationalising Teacher Education for a "Glocal" Curriculum: South Koreans Learning to Teach Hong Kong Liberal Studies

    ERIC Educational Resources Information Center

    Jackson, Liz; Han, Ana Yoon Jin

    2016-01-01

    Internationalisation in education facilitates student and teacher mobility. Though Hong Kong has embraced internationalisation in education, international university students can face challenges related to cultural difference. In teacher education, these challenges can be amplified, as student-teachers face expectations to teach schoolchildren…

  20. Anger and Globalization among Young People in India

    ERIC Educational Resources Information Center

    Suchday, Sonia

    2015-01-01

    This article addresses the challenges faced by youth in developing countries. Using India as an example of a fast-globalizing country, this article highlights the experience and challenges faced by adolescents and emerging adults as they search for their interpersonal and professional identities. The difficulties of defining identity in the…

  1. The Challenges Facing Catholic Education in France Today

    ERIC Educational Resources Information Center

    Moog, François

    2016-01-01

    The effects of secularisation on society demand a rethinking of the identity and mission of Catholic schools in France. In 2013, the French bishops published a new directory which offers new approaches, described here, based on the three challenges facing Catholic education in France: linking social responsibility and evangelisation, setting up…

  2. An Inventory and Use Analysis of Information Systems on Small Farms in Pennsylvania

    ERIC Educational Resources Information Center

    Adams, Jean S.

    2007-01-01

    Across the United States, today's farm operators face continuing challenges from global competition, increasing production costs, changing technology, increased regulations, scarce resources, and lower profit margins. To face these challenges, farm operators need to gather and utilize information allowing them to make informed decisions. Several…

  3. Anatomy Education Faces Challenges in Pakistan

    ERIC Educational Resources Information Center

    Memon, Ismail K.

    2009-01-01

    Anatomy education in Pakistan is facing many of the same challenges as in other parts of the world. Roughly, a decade ago, all medical and dental colleges in Pakistan emphasized anatomy as a core basic discipline within a traditional medical science curriculum. Now institutions are adopting problem based learning (PBL) teaching philosophies, and…

  4. Many Faces Have I.

    ERIC Educational Resources Information Center

    Zilliox, Joseph T.; Lowery, Shannon G.

    1997-01-01

    Describes an extended investigation of polygons and polyhedra which was conducted in response to a challenge posed in Focus, a newsletter from the Mathematical Association of America (MAA). Students were challenged to construct a polyhedron with faces that measure more than 13 inches to a side. Outlines the process, including the questions posed…

  5. Women Superintendents in Illinois: Gender Barriers and Challenges

    ERIC Educational Resources Information Center

    VanTuyle, Vicki; Watkins, Sandra G.

    2009-01-01

    Women face unique challenges as superintendents. This study determined barriers women face as superintendents and elicited reasons why these women would consider leaving the superintendent's position. Thirty-nine PreK-12 women superintendents in Illinois participated in a web-based survey in January 2008. Survey items included information…

  6. Plural Societies and the Possibility of Shared Citizenship

    ERIC Educational Resources Information Center

    Merry, Michael S.

    2012-01-01

    As civilization pushes headlong into the twenty-first century, increasingly stringent demands for citizenship issue forth from governments around the world faced with a formidable assortment of challenges. Faced with these challenges, states are exploring ways to elicit civic attachments from their heterogeneous populations, but doing so is…

  7. Challenges Facing Principals in the First Year at Their Schools

    ERIC Educational Resources Information Center

    Bayar, Adem

    2016-01-01

    The aim of this study is to identify key challenges of practice that principals face. In line with this purpose, the researcher has employed a qualitative research methodology, interviewing principals working in Amasya district, over and above doing document analysis to collect detailed information concerning leadership and administration…

  8. Perspectives on Urban Geography in Advanced Placement® Human Geography

    ERIC Educational Resources Information Center

    Benton-Short, Lisa; Monk, Liliana

    2016-01-01

    "Perspectives on Urban Geography" constitutes a major part of the AP Human Geography course outline. In this article, urban core revitalization and rising suburban poverty are considered as two challenges facing cities in developed countries; and industrialization and the growth of megacities as two challenges facing cities in developing…

  9. Homeless Children: Meeting the Educational Challenges. ERIC Digest.

    ERIC Educational Resources Information Center

    Goins, Brad; Cesarone, Bernard

    Difficulties faced by homeless children include depression, low self-esteem, lack of sleep and nutrition, and feelings of shame and embarrassment. Challenges faced by schools in providing education to homeless children include: (1) keeping children in one school despite frequent family moves; (2) ensuring that children's health records are…

  10. The Big Picture and Specifics of College General Education

    ERIC Educational Resources Information Center

    Gan, Yang

    2018-01-01

    In recent years, general education has developed considerably in Chinese universities, but it still faces many challenges and problems. Among the various negative factors, four problems may be the greatest challenges currently faced by Chinese university general education and ordinary undergraduate education: (1) In the era of massified higher…

  11. Autism and Reading: Teaching a Sudanese Refugee Boy

    ERIC Educational Resources Information Center

    Walker-Dalhouse, Doris; Dalhouse, A. Derick

    2015-01-01

    Refugee families in the United States face numerous challenges in becoming acculturated. School-age children of refugees face the additional challenges of acquiring academic language and meeting school expectations for behavior and social interactions while attempting to navigate the school curriculum. This case study examines the school and home…

  12. Additional Insights Into Problem Definition and Positioning From Social Science Comment on "Four Challenges That Global Health Networks Face".

    PubMed

    Quissell, Kathryn

    2017-09-10

    Commenting on a recent editorial in this journal which presented four challenges global health networks will have to tackle to be effective, this essay discusses why this type of analysis is important for global health scholars and practitioners, and why it is worth understanding and critically engaging with the complexities behind these challenges. Focusing on the topics of problem definition and positioning, I outline additional insights from social science theory to demonstrate how networks and network researchers can evaluate these processes, and how these processes contribute to better organizing, advocacy, and public health outcomes. This essay also raises multiple questions regarding these processes for future research. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  13. The Challenges of Participant Photography: A Critical Reflection on Methodology and Ethics in Two Cultural Contexts.

    PubMed

    Murray, Linda; Nash, Meredith

    2017-05-01

    Photovoice and photo-elicitation are two common methods of participant photography used in health research. Although participatory photography has many benefits, this critical reflection provides fellow researchers with insights into the methodological and ethical challenges faced when using such methods. In this article, we critically reflect on two studies that used participatory photography in different cultural contexts. The first study used photo-elicitation to investigate mothers' experiences of infant settling in central Vietnam. The second study used photovoice to explore pregnant embodiment in Australia. Following a discussion of the literature and a detailed overview of the two studies, we examine the methodological challenges in using participant photography before, during and after each study. This is followed by a discussion of ethical concerns that arose in relation to the burden of participation, confidentiality, consent, and the photographing of families and children. To conclude, we highlight implications for using participatory photography in other settings.

  14. Small is challenging; distal femur fracture management in an elderly lady with achondroplastic dwarfism.

    PubMed

    Murphy, Colin G; Chrea, Bopha; Molloy, Alan P; Nicholson, Paul

    2013-03-20

    Achondroplasia is an autosomal dominant dwarfing condition that represents the most common form of skeletal dysplasia. The disease is caused by a mutation in the gene encoding fibroblast growth factor receptor 3 (FGFR3) found at the p16.3 locus on chromosome 4 which results in severe inhibition of subchondral bone growth. Anatomic variations, including articular and periarticular deformities classically seen with this condition, amplify the complexity of fracture fixation. Blood volume loss, age-related bone fragility, component selection and positioning pose serious orthopaedic challenges. Concomitant cardiovascular, respiratory and neurological comorbidities pose additional high-risk perioperative considerations. Despite an estimated prevalence of 1:25 000 in the general population, there is little literature concerning the operative and postoperative treatment challenges faced by orthopaedic surgeons dealing with fracture management on a patient with this condition. We present a case of an intercondylar femoral fracture in an elderly achondroplastic lady successfully treated with percutaneous screw fixation.

  15. The clinical significance of creativity in bipolar disorder

    PubMed Central

    Murray, Greg; Johnson, Sheri L.

    2012-01-01

    Clinical implications of the high rates of creativity within bipolar disorder (BD) have not been explored. The aim of this review is to outline these implications by (i) reviewing evidence for the link between creativity and BD, (ii) developing a provisional model of mechanisms underpinning the creativity–BD link, (iii) describing unique challenges faced by creative-BD populations, and (iv) systematically considering evidence-based psychosocial treatments in the light of this review. While more research into the creativity–BD nexus is urgently required, treatment outcomes will benefit from consideration of this commonly occurring phenotype. PMID:20579791

  16. Stroke Rehabilitation using Virtual Environments

    PubMed Central

    Fu, Michael J.; Knutson, Jayme; Chae, John

    2015-01-01

    Synopsis This review covers the rationale, mechanisms, and availability of commercially available virtual environment-based interventions for stroke rehabilitation. It describes interventions for motor, speech, cognitive, and sensory dysfunction. Also discussed are the important features and mechanisms that allow virtual environments to facilitate motor relearning. A common challenge facing the field is inability to translate success in small trials to efficacy in larger populations. The heterogeneity of stroke pathophysiology has been blamed and experts advocate for the study of multimodal approaches. Therefore, this article also introduces a framework to help define new therapy combinations that may be necessary to address stroke heterogeneity. PMID:26522910

  17. Women with epilepsy: clinically relevant issues

    PubMed Central

    Bangar, Santosh; Shastri, Abhishek; El-Sayeh, Hany; Cavanna, Andrea E.

    2016-01-01

    Summary Women with epilepsy (WWE) face specific challenges throughout their lifespan due to the effects of seizures and antiepileptic drugs on hormonal function, potentially affecting both sexual and reproductive health. This review article addresses the most common issues of practical relevance to clinicians treating WWE: epidemiology and clinical presentations (including catamenial epilepsy), contraception, reproductive and sexual dysfunction, pregnancy, lactation, menopause-related issues (including bone health), and mental health aspects. Awareness of these gender-specific issues and implementation/adaptation of effective interventions for WWE results in significantly improved health-related quality of life in this patient population. PMID:27678205

  18. Cultural differences with end-of-life care in the critical care unit.

    PubMed

    Doolen, Jessica; York, Nancy L

    2007-01-01

    Critical care nurses are providing healthcare for an increasingly multicultural population. This ever-increasing diversity in cultures and subcultures presents a challenge to nurses who want to provide culturally competent care. It is common for patients and families to face difficult decisions about end-of-life care in critical care units, and minority cultures do not always believe in the Westerner's core values of patient autonomy and self-determination. Knowledge of these cultural differences is fundamental if critical care nurses wish to provide appropriate and culturally competent information regarding end-of-life decisions.

  19. Hiring an associate dean of academic affairs.

    PubMed

    Pressler, Jana L; Kenner, Carole A

    2009-01-01

    Many new nursing leaders assuming deanships, assistant deanships, or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.

  20. Effecting change in striving to achieve capacity.

    PubMed

    Pressler, Jana L; Kenner, Carole

    2007-01-01

    Many new nursing leaders assuming deanships and assistant or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.

  1. Embracing new directions in curricula and teaching.

    PubMed

    Pressler, Jana L; Kenner, Carole

    2009-01-01

    Many new nursing leaders assuming deanships or assistant or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.

  2. Addressing the underperformance of faculty and staff.

    PubMed

    Kenner, Carole; Pressler, Jana L

    2006-01-01

    Many new nursing leaders assuming work as deans, assistant deans, or interim deans have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, both deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.

  3. When does outsourcing become a right source for academic excellence?

    PubMed

    Kenner, Carole; Pressler, Jana L

    2006-01-01

    Many new nursing leaders assuming deanships, assistant deanships, or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.

  4. Capitalizing on joint ventures to economize in nursing.

    PubMed

    Pressler, Jana L; Kenner, Carole A

    2010-01-01

    Many new nursing leaders assuming deanships, assistant, or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.

  5. Starting small and early for research funding.

    PubMed

    Pressler, Jana L; Kenner, Carole A

    2009-01-01

    Many new nursing leaders assuming deanships or assistant or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.

  6. The ripple effect: advancing faculty research?

    PubMed

    Kenner, Carole; Pressler, Jana L

    2008-01-01

    Many new nursing leaders assuming deanships or assistant or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.

  7. Performance evaluations and literacy.

    PubMed

    Pressler, Jana L; Kenner, Carole A

    2009-01-01

    Many new nursing leaders assuming deanships or assistant or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.

  8. Complex contribution of combat-related post-traumatic stress disorder to veteran suicide: facing an increasing challenge.

    PubMed

    Lee, Elizabeth A D

    2012-04-01

    The purpose of this case study is to present the complex contribution of combat-related post-traumatic stress disorder (PTSD) to suicide and international standards of treatment among veterans deployed to the Middle East. PTSD carries increased physical and psychological health risk in combat soldiers. Internationally, guidelines for PTSD promote cognitive behavior therapies, specifically exposure therapy, as first line treatment; however, implementation varies among countries. Evidence supports the benefit of exposure-based psychotherapy for combat-related PTSD. Commonly prescribed antidepressants and other psychotherapy treatments may not be as beneficial. © 2011 Wiley Periodicals, Inc.

  9. Organizational change tactics: the evidence base in the literature.

    PubMed

    Packard, Thomas; Shih, Amber

    2014-01-01

    Planned organizational change processes can be used to address the many challenges facing human service organizations (HSOs) and improve organizational outcomes. There is massive literature on organizational change, ranging from popular management books to academic research on specific aspects of change. Regarding HSOs, there is a growing literature, including increasing attention to implementation science and evidence-based practices. However, research which offers generalizable, evidence-based guidelines for implementing change is not common. The purpose of the authors was to assess the evidence base in this organizational change literature to lay the groundwork for more systematic knowledge development in this important field.

  10. Implementation of an ergonomics program for the welding department inside a car assembly company.

    PubMed

    Francisco, Caceres; Edwin, Troya

    2012-01-01

    The premise for this project is to implement an ergonomics program for the welding department of a car assembly company, considering that this area represents the highest occupational risk in relation to musculoskeletal injuries. The project also allows the demonstration of the different implementation processes of an ergonomics program; it also permits the determination of individual risks faced by workers of the welding department, and finally gives a chance of improving common injuries using the sentinel system. The main challenge is to reduce musculoskeletal injuries and absenteeism among welders through actions implemented by the ergonomics program.

  11. Return on investment: an essential economics measure in higher education.

    PubMed

    Pressler, Jana L; Kenner, Carole A

    2014-01-01

    Many new nursing leaders assuming deanships, assistant deanships, or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.

  12. Early career mentoring for translational researchers: mentee perspectives on challenges and issues.

    PubMed

    Keller, Thomas E; Collier, Peter J; Blakeslee, Jennifer E; Logan, Kay; McCracken, Karen; Morris, Cynthia

    2014-01-01

    The education and training of early career biomedical translational researchers often involves formal mentoring by more experienced colleagues. This study investigated the nature of these mentoring relationships from the perspective of mentees. The objective was to understand the challenges and issues encountered by mentees in forming and maintaining productive mentoring relationships. Three focus groups (n=14) were conducted with early career researchers who had mentored career development awards. Thematic analysis identified, categorized, and illustrated the challenges and issues reported by mentees. The range of mentee challenges was reflected in five major categories: (a) network--finding appropriate mentors to meet various needs; (b) access--structuring schedules and opportunities to receive mentoring; (c) expectations--negotiating the mechanics of the mentoring relationship and its purpose; (d) alignment--managing mentor-mentee mismatches regarding interests, priorities, and goals; and (e) skills and supports--developing the institutional supports to be successful. Mentoring relationships created for academic training and career development contend with tasks common to many other relationships, namely, recognizing compatibility, finding time, establishing patterns, agreeing to goals, and achieving aims. Identifying challenges faced by mentees can facilitate the development of appropriate trainings and supports to foster mentoring relationships in academic and career settings.

  13. Perceptions of teaching African American students who succeed during science testing: A hermeneutic phenomenological study

    NASA Astrophysics Data System (ADS)

    Harris, Tevis Tramaine

    The purpose of this hermeneutic phenomenological research was to explore the perceptions of teachers as they instruct African American students who are successful on the North Carolina End-of-Grade Science test. The study identified thoughts, feelings, emotions, and challenges that teachers faced when instructing successful African American students from Title I schools in rural community classrooms. The research study analysis utilized NVivo10RTM software and identified common themes in the data. Five themes emerged from interviews with five fifth- and eighth-grade science teachers. Based on the teachers' perceptions, the findings revealed: (a) teachers experience an emotional journey in high poverty schools; (b) investments encompass sacrificing whatever is needed to help students become successful; (c) relationships should be developed between the teacher and student; (d) intentionality is a part of teachers' daily interaction with students; and (e) teachers encounter a challenging opportunity instructing African American students in science. This study provides valuable data in understanding the experiences of teachers as they instruct successful African American students and the challenges, obstacles, and triumphs teachers face when working with this population of students. The implications of the study suggest that educational leaders provide emotional support to help teachers manage the plethora of emotions experienced on a daily basis. Future study of successful teachers of African American students may further inform the dearth of literature surrounding the experience of successful teachers of minority students.

  14. Migraine Care Challenges and Strategies in US Uninsured and Underinsured Adults: A Narrative Review, Part 1.

    PubMed

    Charleston, Larry; Royce, Jeffrey; Monteith, Teshamae S; Broner, Susan W; O'Brien, Hope L; Manrriquez, Salvador L; Robbins, Matthew S

    2018-04-01

    To review the scope of the problem facing individuals with migraine who are under- or uninsured. In this first of a 2-part narrative review, we will explore migraine epidemiology and the challenges that face this vulnerable population. Implementation of the Affordable Care Act has improved access to health care for many individuals who were previously uninsured, but there are many, particularly those of certain demographics, who are at high risk for worse outcomes. A narrative review was performed after a series of discussions within the Underserved Populations in Headache Medicine Special Interest Section meetings of the American Headache Society. Literature was reviewed for key concepts underpinning conceptual boundaries and a broad overview of the subject matter. Published guidelines, state-specific Medicaid websites, headache quality measurement set, literature review, and expert opinion were used to tailor suggested treatment options and therapeutic strategies. Migraine is common, yet remains underdiagnosed and associated with worse outcomes among those of under-represented backgrounds and those who are underinsured or uninsured. Low socioeconomics may play an important role in the disease progression, characteristics, outcome, and quality of life of patients with migraine and other headache disorders. Other barriers to optimal care include time constraints, lack of access to specialty providers, transportation, and financial limitations. There are many barriers and challenges that affect people with migraine who are underinsured or uninsured, particularly those of under-represented racial backgrounds and of lower socioeconomic status. © 2018 American Headache Society.

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

    Germain, Shawn

    Nuclear Power Plant (NPP) refueling outages create some of the most challenging activities the utilities face in both tracking and coordinating thousands of activities in a short period of time. Other challenges, including nuclear safety concerns arising from atypical system configurations and resource allocation issues, can create delays and schedule overruns, driving up outage costs. Today the majority of the outage communication is done using processes that do not take advantage of advances in modern technologies that enable enhanced communication, collaboration and information sharing. Some of the common practices include: runners that deliver paper-based requests for approval, radios, telephones, desktopmore » computers, daily schedule printouts, and static whiteboards that are used to display information. Many gains have been made to reduce the challenges facing outage coordinators; however; new opportunities can be realized by utilizing modern technological advancements in communication and information tools that can enhance the collective situational awareness of plant personnel leading to improved decision-making. Ongoing research as part of the Light Water Reactor Sustainability Program (LWRS) has been targeting NPP outage improvement. As part of this research, various applications of collaborative software have been demonstrated through pilot project utility partnerships. Collaboration software can be utilized as part of the larger concept of Computer-Supported Cooperative Work (CSCW). Collaborative software can be used for emergent issue resolution, Outage Control Center (OCC) displays, and schedule monitoring. Use of collaboration software enables outage staff and subject matter experts (SMEs) to view and update critical outage information from any location on site or off.« less

  16. Engineers' professional learning: a practice-theory perspective

    NASA Astrophysics Data System (ADS)

    Reich, Ann; Rooney, Donna; Gardner, Anne; Willey, Keith; Boud, David; Fitzgerald, Terry

    2015-07-01

    With the increasing challenges facing professional engineers working in more complex, global and interdisciplinary contexts, different approaches to understanding how engineers practice and learn are necessary. This paper draws on recent research in the social sciences from the field of workplace learning, to suggest that a practice-theory perspective on engineers' professional learning is fruitful. It shifts the focus from the attributes of the individual learner (knowledge, skills and attitudes) to the attributes of the practice (interactions, materiality, opportunities and challenges). Learning is thus more than the technical acquisition and transfer of knowledge, but a complex bundle of activities, that is, social, material, embodied and emerging. The paper is illustrated with examples from a research study of the learning of experienced engineers in the construction industry to demonstrate common practices - site walks and design review meetings - in which learning takes place.

  17. Health and safety strategies in a changing Europe.

    PubMed

    Walters, D

    1998-01-01

    This article presents a synthesis of some of the more significant findings from two recent surveys on working conditions and national strategies for their improvement in the European Union in the 1990s. As patterns and organization of employment have changed in the past decade, the consequences for health and safety present new challenges for legislators, the social partners, the regulatory agencies, and the specialists. These challenges are only partially met in most European member states. Because of the continued deregulation of employment, reduced public expenditure, and reduced trade union presence, the operation of strategies to implement a common framework of E.U. legislation is limited and often incomplete. This issue must be confronted if systems for promoting the well-being of people at work in Europe are to keep up with the rapidly changing nature of the risks that they face.

  18. Technical challenges for the future of high energy lasers

    NASA Astrophysics Data System (ADS)

    LaFortune, K. N.; Hurd, R. L.; Fochs, S. N.; Rotter, M. D.; Pax, P. H.; Combs, R. L.; Olivier, S. S.; Brase, J. M.; Yamamoto, R. M.

    2007-02-01

    The Solid-State, Heat-Capacity Laser (SSHCL) program at Lawrence Livermore National Laboratory is a multi-generation laser development effort scalable to the megawatt power levels with current performance approaching 100 kilowatts. This program is one of many designed to harness the power of lasers for use as directed energy weapons. There are many hurdles common to all of these programs that must be overcome to make the technology viable. There will be a in-depth discussion of the general issues facing state-of-the-art high energy lasers and paths to their resolution. Despite the relative simplicity of the SSHCL design, many challenges have been uncovered in the implementation of this particular system. An overview of these and their resolution are discussed. The overall system design of the SSHCL, technological strengths and weaknesses, and most recent experimental results will be presented.

  19. Ask the experts: the challenges and benefits of flow chemistry to optimize drug development.

    PubMed

    Anderson, Neal; Gernaey, Krist V; Jamison, Timothy F; Kircher, Manfred; Wiles, Charlotte; Leadbeater, Nicholas E; Sandford, Graham; Richardson, Paul

    2012-09-01

    Against a backdrop of a struggling economic and regulatory climate, pharmaceutical companies have recently been forced to develop new ways to provide more efficient technology to meet the demands of a competitive drug industry. This issue, coupled with an increase in patent legislation and a rising generics market, makes these themes common issues in the growth of drug development. As a consequence, the importance of process chemistry and scale-up has never been more under the spotlight. Future Medicinal Chemistry wishes to share the thoughts and opinions of a variety of experts from this field, discussing issues concerning the use of flow chemistry to optimize drug development, the potential regulatory and environmental challenges faced with this, and whether the academic and industrial sectors could benefit from a more harmonized system relevant to process chemistry.

  20. Cloud Computing for Geosciences--GeoCloud for standardized geospatial service platforms (Invited)

    NASA Astrophysics Data System (ADS)

    Nebert, D. D.; Huang, Q.; Yang, C.

    2013-12-01

    The 21st century geoscience faces challenges of Big Data, spike computing requirements (e.g., when natural disaster happens), and sharing resources through cyberinfrastructure across different organizations (Yang et al., 2011). With flexibility and cost-efficiency of computing resources a primary concern, cloud computing emerges as a promising solution to provide core capabilities to address these challenges. Many governmental and federal agencies are adopting cloud technologies to cut costs and to make federal IT operations more efficient (Huang et al., 2010). However, it is still difficult for geoscientists to take advantage of the benefits of cloud computing to facilitate the scientific research and discoveries. This presentation reports using GeoCloud to illustrate the process and strategies used in building a common platform for geoscience communities to enable the sharing, integration of geospatial data, information and knowledge across different domains. GeoCloud is an annual incubator project coordinated by the Federal Geographic Data Committee (FGDC) in collaboration with the U.S. General Services Administration (GSA) and the Department of Health and Human Services. It is designed as a staging environment to test and document the deployment of a common GeoCloud community platform that can be implemented by multiple agencies. With these standardized virtual geospatial servers, a variety of government geospatial applications can be quickly migrated to the cloud. In order to achieve this objective, multiple projects are nominated each year by federal agencies as existing public-facing geospatial data services. From the initial candidate projects, a set of common operating system and software requirements was identified as the baseline for platform as a service (PaaS) packages. Based on these developed common platform packages, each project deploys and monitors its web application, develops best practices, and documents cost and performance information. This paper presents the background, architectural design, and activities of GeoCloud in support of the Geospatial Platform Initiative. System security strategies and approval processes for migrating federal geospatial data, information, and applications into cloud, and cost estimation for cloud operations are covered. Finally, some lessons learned from the GeoCloud project are discussed as reference for geoscientists to consider in the adoption of cloud computing.

  1. Operation and challenges of home-based medical practices in the US: findings from six aggregated case studies.

    PubMed

    Norman, Gregory J; Orton, Kristann; Wade, Amy; Morris, Andrea M; Slaboda, Jill C

    2018-01-27

    Home-based primary care (HBPC) is a multidisciplinary, ongoing care strategy that can provide cost-effective, in-home treatment to meet the needs of the approximately four million homebound, medically complex seniors in the U.S. Because there is no single model of HBPC that can be adopted across all types of health organizations and U.S. geographic regions, we conducted a six-site HBPC practice assessment to better understand different operation structures, common challenges, and approaches to delivering HBPC. Six practices varying in size, care team composition and location agreed to participate. At each site we conducted unstructured interviews with key informants and directly observed practices and procedures in the field and back office. The aggregated case studies revealed important issues focused on team composition, patient characteristics, use of technology and urgent care delivery. Common challenges across the practices included provider retention and unmet community demand for home-based care services. Most practices, regardless of size, faced challenges around using electronic medical records (EMRs) and scheduling systems not designed for use in a mobile practice. Although many practices offered urgent care, practices varied in the methods used to provide care including the use of community paramedics and telehealth technology. Learnings compiled from these observations can inform other HBPC practices as to potential best practices that can be implemented in an effort to improve efficiency and scalability of HBPC so that seniors with multiple chronic conditions can receive comprehensive primary care services in their homes.

  2. Ethical challenges experienced by UK military medical personnel deployed to Sierra Leone (operation GRITROCK) during the 2014-2015 Ebola outbreak: a qualitative study.

    PubMed

    Draper, Heather; Jenkins, Simon

    2017-12-19

    As part of its response to the 2014 Ebola outbreak in west Africa, the United Kingdom (UK) government established an Ebola treatment unit in Sierra Leone, staffed by military personnel. Little is known about the ethical challenges experienced by military medical staff on humanitarian deployment. We designed a qualitative study to explore this further with those who worked in the treatment unit. Semi-structured, face-to-face and telephone interviews were conducted with 20 UK military personnel deployed between October 2014 and April 2015 in one of three roles in the Ebola treatment unit: clinician; nursing and nursing assistant; and other medical support work, including infection control and laboratory and mortuary services. Many participants reported feeling ethically motivated to volunteer for deployment, but for some personal interests were also a consideration. A small minority had negative feelings towards the deployment, others felt that this deployment like any other was part of military service. Almost all had initial concerns about personal safety but were reassured by their pre-deployment 'drills and skills', and personal protective equipment. Risk perceptions were related to perceptions about military service. Efforts to minimise infection risk were perceived to have made good patient care more difficult. Significantly, some thought the humanitarian nature of the mission justified tolerating greater risks to staff. Trust in the military institution and colleagues was expressed; many participants referred to the ethical obligation within the chain of command to protect those under their command. Participants expected resources to be overwhelmed and 'empty beds' presented a significant and pervasive ethical challenge. Most thought more patients could and should have been treated. Points of reference for participants' ethical values were: previous deployment experience; previous UK/National Health Service experience; professional ethics; and, distinctly military values (that might not be shared with non-military workers). We report the first systematic exploration of the ethical challenges face by a Western medical military in the international response to the first major Ebola outbreak. We offer unique insights into the military healthcare workers' experiences of humanitarian deployment. Many participants expressed motivations that gave them common purpose with civilian volunteers.

  3. Barriers in the Delivery of Emergency Obstetric and Neonatal Care in Post-Conflict Africa: Qualitative Case Studies of Burundi and Northern Uganda

    PubMed Central

    Chi, Primus Che; Bulage, Patience; Urdal, Henrik; Sundby, Johanne

    2015-01-01

    Objectives Maternal and neonatal mortality and morbidity rates are particularly grim in conflict, post-conflict and other crisis settings, a situation partly blamed on non-availability and/or poor quality of emergency obstetric and neonatal care (EmONC) services. The aim of this study was to explore the barriers to effective delivery of EmONC services in post-conflict Burundi and Northern Uganda, in order to provide policy makers and other relevant stakeholders context-relevant data on improving the delivery of these lifesaving services. Methods This was a qualitative comparative case study that used 42 face-to-face semi-structured in-depth interviews and 4 focus group discussions for data collection. Participants were 32 local health providers and 37 staff of NGOs working in the area of maternal health. Data was analysed using the framework approach. Results The availability, quality and distribution of EmONC services were major challenges across the sites. The barriers in the delivery of quality EmONC services were categorised into two major themes; human resources-related challenges, and systemic and institutional failures. While some of the barriers were similar, others were unique to specific sites. The common barriers included shortage of qualified staff; lack of essential installations, supplies and medications; increasing workload, burn-out and turnover; and poor data collection and monitoring systems. Barriers unique to Northern Uganda were demoralised personnel and lack of recognition; poor referral system; inefficient drug supply system; staff absenteeism in rural areas; and poor coordination among key personnel. In Burundi, weak curriculum; poor harmonisation and coordination of training; and inefficient allocation of resources were the unique challenges. To improve the situation across the sites, efforts are ongoing to improve the training and recruitment of more staff; harmonise and strengthen the curriculum and training; increase the number of EmONC facilities; and improve staff supervision, monitoring and support. Conclusions Post-conflict health systems face different challenges in the delivery of EmONC services and as such require context-specific interventions to improve the delivery of these services. PMID:26405800

  4. Barriers in the Delivery of Emergency Obstetric and Neonatal Care in Post-Conflict Africa: Qualitative Case Studies of Burundi and Northern Uganda.

    PubMed

    Chi, Primus Che; Bulage, Patience; Urdal, Henrik; Sundby, Johanne

    2015-01-01

    Maternal and neonatal mortality and morbidity rates are particularly grim in conflict, post-conflict and other crisis settings, a situation partly blamed on non-availability and/or poor quality of emergency obstetric and neonatal care (EmONC) services. The aim of this study was to explore the barriers to effective delivery of EmONC services in post-conflict Burundi and Northern Uganda, in order to provide policy makers and other relevant stakeholders context-relevant data on improving the delivery of these lifesaving services. This was a qualitative comparative case study that used 42 face-to-face semi-structured in-depth interviews and 4 focus group discussions for data collection. Participants were 32 local health providers and 37 staff of NGOs working in the area of maternal health. Data was analysed using the framework approach. The availability, quality and distribution of EmONC services were major challenges across the sites. The barriers in the delivery of quality EmONC services were categorised into two major themes; human resources-related challenges, and systemic and institutional failures. While some of the barriers were similar, others were unique to specific sites. The common barriers included shortage of qualified staff; lack of essential installations, supplies and medications; increasing workload, burn-out and turnover; and poor data collection and monitoring systems. Barriers unique to Northern Uganda were demoralised personnel and lack of recognition; poor referral system; inefficient drug supply system; staff absenteeism in rural areas; and poor coordination among key personnel. In Burundi, weak curriculum; poor harmonisation and coordination of training; and inefficient allocation of resources were the unique challenges. To improve the situation across the sites, efforts are ongoing to improve the training and recruitment of more staff; harmonise and strengthen the curriculum and training; increase the number of EmONC facilities; and improve staff supervision, monitoring and support. Post-conflict health systems face different challenges in the delivery of EmONC services and as such require context-specific interventions to improve the delivery of these services.

  5. Voicing the Challenges Faced by an Innovative Teacher Community

    ERIC Educational Resources Information Center

    Moate, Josephine

    2011-01-01

    This research draws on sociocultural theories of learning and activity theory to explore the challenges faced by an innovative community of teachers in Central Finland. The aim of the teacher community was to develop a stream of foreign-language (FL)-mediated teaching and learning in the locality from kindergarten to upper secondary level. To…

  6. Oral Academic Discourse Socialisation: Challenges Faced by International Undergraduate Students in a Malaysian Public University

    ERIC Educational Resources Information Center

    Mahfoodh, Omer Hassan Ali

    2014-01-01

    This paper reports a qualitative study which examines the challenges faced by six international undergraduate students in their socialisation of oral academic discourse in a Malaysian public university. Data were collected employing interviews. Students' presentations were also collected. Semi-structured interviews were transcribed verbatim and…

  7. Connecting Pre-Service Teachers with Contemporary Mathematics Practices: Selecting and Sequencing Students' Work Samples

    ERIC Educational Resources Information Center

    Livy, Sharyn; Muir, Tracey; Downton, Ann

    2017-01-01

    One of the challenges facing teacher educators is providing our pre-service teachers (PSTs) with authentic experiences that cross the boundaries between Initial Teacher Education (ITE) and the classroom. An additional challenge facing the mathematics teacher educator, is addressing and deepening PSTs' mathematical content knowledge (MCK), which…

  8. Information Technology Challenges Facing the Strategic Leaders of Homeland Security in the 21st Century

    DTIC Science & Technology

    2004-05-03

    A special thanks to all of these folks (Glenn Starnes, Lee Gutierrez, Bill Rapp, Joel Hillison, Carlos Gomez, Steve Fraunfelter, Janie Hopkins, Dave ...DiClemente, Joe Nunez, John Bonin , and Steve Nerheim). viii INFORMATION TECHNOLOGY CHALLENGES FACING THE STRATEGIC LEADERS OF HOMELAND SECURITY IN THE 21ST

  9. Strategies for the Challenges Facing Women in Higher Education Administration.

    ERIC Educational Resources Information Center

    Rehnke, Mary Ann

    Women administrators in higher education must deal not only with the usual challenges facing administrators (decision-making, resolving conflict, and advancing professionally), but also with the effects of sex stereotyping. Women are not seen as decision-makers, nor as conflict-resolvers, and are often viewed as supporting personnel rather than…

  10. Tenured Women Counselor Educators at Research Universities: Navigating Multiple Roles and Personal Well-Being

    ERIC Educational Resources Information Center

    Rosenberg, Melissa A.

    2013-01-01

    Women in academia navigate multiple professional and personal roles, and may face unique challenges to integrate their intellectual, emotional, physical, and spiritual selves. The narrative of constraint underscores the disadvantages, challenges, and inequities that women who are mothers and academics face in their lives. This lack of privilege…

  11. Integration and Career Challenges of Newcomer Youth in Newfoundland in Canada

    ERIC Educational Resources Information Center

    Li, Xuemei; Que, Hua

    2016-01-01

    Faced with a labor shortage and low profile of diversity, the province of Newfoundland and Labrador in Canada has been making an effort to attract and retain newcomers. Guided by Bronfenbrenner's (1979) ecological systems theory, this qualitative study investigates the challenges faced by newcomer youth, including permanent residents coming as…

  12. "Accounting Education at a Crossroad in 2010" and "Challenges Facing Accounting Education in Australia"

    ERIC Educational Resources Information Center

    de Lange, Paul; Watty, Kim

    2011-01-01

    Of the various reports released in 2010, two purport to examine the state of accounting education in Australia. These are "Accounting Education at a Crossroad in 2010" and "Challenges Facing Accounting Education in Australia". Both were released as collaborations of the leading academic organisation, the Accounting and Finance…

  13. A Business Intelligence Framework for Sustainability Information Management in Higher Education

    ERIC Educational Resources Information Center

    Scholtz, Brenda; Calitz, Andre; Haupt, Ross

    2018-01-01

    Purpose: Higher education institutions (HEIs) face a number of challenges in effectively managing and reporting on sustainability information, such as siloes of data and a limited distribution of information. Business intelligence (BI) can assist in addressing the challenges faced by organisations. The purpose of this study was to propose a BI…

  14. Active Learning: Engaging Students to Maximize Learning in an Online Course

    ERIC Educational Resources Information Center

    Khan, Arshia; Egbue, Ona; Palkie, Brooke; Madden, Janna

    2017-01-01

    Student engagement is key to successful teaching and learning, irrespective of the content and format of the content delivery mechanism. However, engaging students presents a particular challenge in online learning environments. Unlike face-to-face courses, online courses present a unique challenge as the only social presence between the faculty…

  15. Can Free-Range Students Save Some Schools? A Case Study on a Hybrid Classroom

    ERIC Educational Resources Information Center

    White, Christopher Francis

    2013-01-01

    In the face of budgetary constraints, new marketplace competition, digital innovation and an emerging generation of students with new demands and new needs, higher education in America is challenged as never before. This paper reviews the various challenges facing traditional non-profit educational institutions, considers the potential of an…

  16. Calculus Challenges: An Active Learning Approach

    ERIC Educational Resources Information Center

    Crawford, Pam; Moseley, Daniel; Nancarrow, Mike; Ward, Erika

    2018-01-01

    One of the greatest challenges facing students new to calculus is the ability to persevere in the face of failure. Whether the student is choosing an integration technique or a series test, calculus is often the first course in mathematics where the path to the solution is not prescribed in an algorithmic way. At Jacksonville University we…

  17. Challenges Faced by Institutions of Higher Education in Migrating to Distance Learning.

    ERIC Educational Resources Information Center

    Broskoske, Stephen L.; Harvey, Francis A.

    This paper presents the results of a research study conducted in fall 1999 to examine the challenges facing higher educational institutions in migrating to distance learning. The study consisted of five case studies conducted at higher educational institutions in Pennsylvania. At each institution the researchers interviewed the president and other…

  18. The Complexity of Substantive Reform: A Call for Interdependence among Key Stakeholders.

    ERIC Educational Resources Information Center

    Young, Michelle D.; Petersen, George J.; Short, Paula M.

    The field of educational leadership faces serious challenges in the 21st century, such as the shortage of principals and superintendents, the growing demands for leadership positions, and the struggle for adequate resources. This paper explores the challenges facing this field from the position of university educational leadership preparation. The…

  19. Meeting the Needs of Children and Families: Opportunities and Challenges for School Psychology Training Programs.

    ERIC Educational Resources Information Center

    Curtis, Michael J.; Batsche, George M.

    1991-01-01

    Notes that graduate training programs face challenges, as well as opportunities, in fulfillment of their responsibilities to prepare school psychologists for entry into professional practice. Examines nature and origins of potential changes facing school psychology and discusses adequacy of current training programs. Discusses future implications…

  20. Community Violence Exposure of Southeast Asian American Adolescents

    ERIC Educational Resources Information Center

    Ho, Joyce

    2008-01-01

    Southeast Asian adolescents in the United States face the daily challenge of adjusting to the American culture and their culture of origin. However, little is known about how the patterns of their bicultural adjustment influence psychological symptoms, especially when faced with other challenges such as community violence and negative life events.…

  1. Preserving Guam's Culture with Culturally Responsive Children's Stories

    ERIC Educational Resources Information Center

    Jackson, Marilyn Malloy; Heath, Melissa Allen

    2017-01-01

    Regardless of where schools are located, teachers face the challenge of teaching and mentoring children, not only in academic achievement but in social emotional development. When faced with challenges, young children are especially vulnerable because they lack the life experience and developmental maturity to adequately cope. Relying on the lead…

  2. New Challenges Facing Universities in the Internet-Driven Global Environment

    ERIC Educational Resources Information Center

    Rajasingham, Lalita

    2011-01-01

    This paper explores some new challenges facing universities in a global multimediated Internet-based environment, as they seek alternative paradigms and options to remain true to their core business. At a time of rapid technological change, and contested, complex concepts associated with globalisation, knowledge is becoming a primary factor of…

  3. Curricular Integration and Measurement of Cultural Competence Development in a Group of Physical Therapy Students

    ERIC Educational Resources Information Center

    Palombaro, Kerstin M.; Dole, Robin L.; Black, Jill D.

    2015-01-01

    Introduction and Background: The link between cultural competence and effective physical therapy encounters is established. Physical therapist educational programs face the challenge of fostering the cultural competence of students in effective and meaningful ways within the curriculum. They also face the challenge of measuring the development of…

  4. Career Development with Transgender College Students: Implications for Career and Employment Counselors

    ERIC Educational Resources Information Center

    Scott, David A.; Belke, Stephanie L.; Barfield, Hannah G.

    2011-01-01

    The number of transgender college students continues to increase every year. These students face unique challenges that many college and university career centers are not prepared to handle. This article describes some of the challenges facing transgender students and college career centers. A professional development design is proposed to assist…

  5. Quality Assurance Challenges and Opportunities Faced by Private Universities in Zimbabwe

    ERIC Educational Resources Information Center

    Garwe, Evelyn Chiyevo

    2014-01-01

    The study sought to provide an understanding of the quality assurance challenges and opportunities faced by private universities in Zimbabwe. The study analyzed the factors determining provision of quality higher education in private universities and the resultant effects of failing to achieve the minimum acceptable standards. The author employed…

  6. Challenges and Opportunities Facing Technology Education in Taiwan

    ERIC Educational Resources Information Center

    Lee, Lung-Sheng Steven

    2009-01-01

    The technology education in Taiwan is prescribed in the national curriculum and provided to all students in grades 1-12. However, it faces the following challenges: (1) Lack of worthy image, (2) Inadequate teachers in elementary schools, (3) Deficient teaching vitality in secondary schools, and (4) Diluted technology teacher education programs. In…

  7. Challenges Faced by Teachers Implementing Socio-Scientific Issues as Core Elements in Their Classroom Practices

    ERIC Educational Resources Information Center

    Bossér, Ulrika; Lundin, Mattias; Lindahl, Mats; Linder, Cedric

    2015-01-01

    Teachers may face considerable challenges when implementing socio-scientific issues (SSI) in their classroom practices, such as incorporating student-centred teaching practices and exploring knowledge and values in the context of socioscientific issues. This year-long study explores teachers' reflections on the process of developing their…

  8. Challenges Facing Women Academic Leadership in Secondary Schools of Irbid Educational Area

    ERIC Educational Resources Information Center

    Al-Jaradat, Mahmoud Khaled Mohammad

    2014-01-01

    This study aimed at identifying the challenges facing women academic leadership in secondary schools of Irbid Educational Area. A random sample of 187 female leaders were chosen. They responded to a 49-item questionnaire prepared by the researcher. The items were distributed into four domains: organizational, personal, social and physical…

  9. Executive Leadership: Another Lever in the System?

    ERIC Educational Resources Information Center

    Harris, Alma; Brown, David; Abbott, Ian

    2006-01-01

    The leadership challenges facing most head teachers can at times be daunting but for those leading schools in difficulty, the challenges are acute. This article draws upon the personal experience of an executive leader in a school facing difficult circumstances. It will firstly, outline and analyse this model of leadership and secondly, look at…

  10. TQM in a Multi-Campus Public University.

    ERIC Educational Resources Information Center

    Zargar, Ali M.

    Running a university is fast becoming more challenging than managing a large corporation, in part due to greater quality demands by more groups in the face of shrinking resources and budget cuts. This paper argues against universities conducting business as usual in the face of societal change and increasingly greater challenges, and presents…

  11. Challenges in healthcare delivery in an economic downturn, in the Republic of Ireland.

    PubMed

    Carney, Marie

    2010-07-01

    The purpose of the present study was to discuss some of effects of the downturn in the Irish economy and to demonstrate that in the face of economic difficulties innovation in health care is still occurring. Staff that are managing and delivering healthcare need to know the challenges facing them and have an awareness of the importance of maintaining interest in innovative practice in turbulent times. Information obtained from several sources including government papers, the nursing regulatory board and quality authority documents and current best practice articles. Information was evaluated based on the study's aim. Issues emerging were that current challenges facing Irish health care delivery relate mainly to economic, clinical management, education and information technology factors and further reductions in the cost base of health care delivery remains focused on value for money. In the face of the economic downturn Ireland is achieving health targets and is now sitting in 13th place on the European health index, down from number 28 in 2008. This improvement in position has resulted from several new innovative work practices. As a result of cost reduction measures in place nurse managers will face greater challenges than ever before in meeting the objectives of the healthcare transformation programme.

  12. Web-Based vs. Face-to-Face MBA Classes: A Comparative Assessment Study

    ERIC Educational Resources Information Center

    Brownstein, Barry; Brownstein, Deborah; Gerlowski, Daniel A.

    2008-01-01

    The challenges of online learning include ensuring that the learning outcomes are at least as robust as in the face-to-face sections of the same course. At the University of Baltimore, both online sections and face-to-face sections of core MBA courses are offered. Once admitted to the MBA, students are free to enroll in any combination of…

  13. The How Project: understanding contextual challenges to global surgical care provision in low-resource settings.

    PubMed

    Raykar, Nakul P; Yorlets, Rachel R; Liu, Charles; Goldman, Roberta; Greenberg, Sarah L M; Kotagal, Meera; Farmer, Paul E; Meara, John G; Roy, Nobhojit; Gillies, Rowan D

    2016-01-01

    5 billion people around the world do not have access to safe, affordable, timely surgical care. This series of qualitative interviews was launched by The Lancet Commission on Global Surgery (LCoGS) with the aim of understanding the contextual challenges-the specific circumstances-faced by surgical care providers in low-resource settings who care for impoverished patients, and how those providers overcome these challenges. From January 2014 to February 2015, 20 LCoGS collaborators conducted semistructured interviews with 148 surgical providers in low-resource settings in 21 countries. Stratified purposive sampling was used to include both rural and urban providers, and reputational case selection identified individuals. Interviewers were trained with an implementation manual. Following immersion into de-identified texts from completed interviews, topical coding and further analysis of coded texts was completed by an independent analyst with periodic validation from a second analyst. Providers described substantial financial, geographic and cultural barriers to patient access. Rural surgical teams reported a lack of a trained workforce and insufficient infrastructure, equipment, supplies and banked blood. Urban providers face overcrowding, exacerbated by minimal clinical and administrative support, and limited interhospital care coordination. Many providers across contexts identified national health policies that do not reflect the realities of resource-poor settings. Some findings were region-specific, such as weak patient-provider relationships and unreliable supply chains. In all settings, surgical teams have created workarounds to deliver care despite the challenges. While some differences exist between countries, the barriers to safe surgery and anaesthesia are overall consistent and resource-dependent. Efforts to advance and expand global surgery must address these commonalities, while local policymakers can tailor responses to key contextual differences.

  14. The future of breast cancer systemic therapy: the next 10 years.

    PubMed

    Telli, Melinda L; Sledge, George W

    2015-02-01

    Over the past 50 years, substantial progress has been made in the systemic treatment of early-stage and advanced breast cancer. The use of chemotherapy in the adjuvant and metastatic settings has demonstrated proven efficacy and it has been clearly demonstrated that targeting the estrogen receptor and human growth factor receptor 2 (HER2) is efficacious in early and advanced disease. Despite these advances, vexing clinical challenges remain particularly related to the treatment of triple-negative breast cancer (TNBC; estrogen receptor [ER]-negative, progesterone receptor [PR]-negative, and HER2-negative) where little progress has been made therapeutically in more than a decade. While recurrences of hormone-responsive breast cancer are overall less common, late relapses after cessation of endocrine therapy are a more frequent occurrence in modern times and reflect the problem of underlying tumor dormancy that as yet has not been overcome. Multiple molecular tools are now available to interrogate the biology of breast cancer, though exactly how to make this information meaningful in the clinic has proven challenging, and molecularly driven clinical trials have faced feasibility challenges. In parallel, focus has expanded from tumor to host with the ability to ascertain underlying germline alterations, such as inherited BRCA1 and BRCA2 mutations, which may be responsible for breast cancer carcinogenesis and, importantly, may have implications for treatment. These clinical advances in germline genetics, made possible by both scientific investigation as well as the courts, still face challenges related to increasing encounters with variants of unknown significance and difficulty in predicting risks associated with less well-characterized inherited cancer predisposition syndromes. In this paper, we attempt to predict the next 10 years of breast cancer, in particular focusing on how the past serves as prologue to the future in this disease.

  15. Towards a new paradigm in health research and practice? Collaborations for Leadership in Applied Health Research and Care.

    PubMed

    Martin, Graham P; McNicol, Sarah; Chew, Sarah

    2013-01-01

    Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) are a new UK initiative to promote collaboration between universities and healthcare organisations in carrying out and applying the findings of applied health research. But they face significant, institutionalised barriers to their success. This paper seeks to analyse these challenges and discuss prospects for overcoming them. The paper draws on in-depth qualitative interview data from the first round of an ongoing evaluation of one CLAHRC to understand the views of different stakeholders on its progress so far, challenges faced, and emergent solutions. The breadth of CLAHRCs' missions seems crucial to mobilise the diverse stakeholders needed to succeed, but also produces disagreement about what the prime goal of the Collaborations should be. A process of consensus building is necessary to instil a common vision among CLAHRC members, but deep-seated institutional divisions continue to orient them in divergent directions, which may need to be overcome through other means. This analysis suggests some of the key means by which those involved in joint enterprises such as CLAHRCs can achieve consensus and action towards a current goal, and offers recommendations for those involved in their design, commissioning and performance management.

  16. Relapse Model among Iranian Drug Users: A Qualitative Study.

    PubMed

    Jalali, Amir; Seyedfatemi, Naiemeh; Peyrovi, Hamid

    2015-01-01

    Relapse is a common problem in drug user's rehabilitation program and reported in all over the country. An in-depth study on patients' experiences can be used for exploring the relapse process among drug users. Therefore, this study suggests a model for relapse process among Iranian drug users. In this qualitative study with grounded theory approach, 22 participants with rich information about the phenomenon under the study were selected using purposive, snowball and theoretical sampling methods. After obtaining the informed consent, data were collected based on face-to-face, in-depth, semi-structured interviews. All interviews were analyzed in three stages of axial, selective and open coding methods. Nine main categories emerged, including avoiding of drugs, concerns about being accepted, family atmosphere, social conditions, mental challenge, self-management, self-deception, use and remorse and a main category, feeling of loss as the core variable. Mental challenge has two subcategories, evoking pleasure and craving. Relapse model is a dynamic and systematic process including from cycles of drug avoidance to remorse with a core variable as feeling of loss.  Relapse process is a dynamic and systematic process that needs an effective control. Determining a relapse model as a clear process could be helpful in clinical sessions. RESULTS of this research have depicted relapse process among Iranian drugs user by conceptual model.

  17. Barriers to employment for drug dependent postpartum women.

    PubMed

    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.

  18. One Northwest community - People, salmon, rivers, and the sea: Towards sustainable salmon fisheries

    USGS Publications Warehouse

    MacDonald, Donald D.; Steward, Cleveland R.; Knudsen, E. Eric; Knudsen, E. Eric; Steward, Cleveland R.; MacDonald, Donald; Williams, Jack E.; Reiser, Dudley W.

    1999-01-01

    Pacific salmon management is in crisis. Throughout their range, salmon and steelhead populations are being adversely affected by human activities. Without coordinated, effective, and timely action, the future of the Pacific salmon resource is most certainly in doubt. To address the challenges that are currently facing salmon management, concerned citizens representing a diverse array of government agencies and non-governmental organizations have agreed to cooperate in the development of a Sustainable Fisheries Strategy for west coast salmon and steelhead populations. The Strategy builds on the contents of this book, resulting from the Sustainable Fisheries Conference and subsequent community- and watershed-based citizen forums. This chapter presents the key elements of the Strategy including a common vision for the future, a series of guiding principles, and specific strategies for supporting sustainable fisheries. As such, the Strategy embraces an ecosystem-based approach to managing human activities, rather than the traditional egocentric approach to managing salmonid populations and associated habitats. A system of community-based, watershed-oriented councils, including all stakeholders and agency representatives, is proposed for effective transition to ecosystem-based salmon and steelhead management. It is our hope that everyone involved in Pacific salmon management will embrace both the spirit and the specific elements of the Sustainable Fisheries Strategy as we face the difficult challenges ahead.

  19. Commons Dilemma Choices in Small vs. Large Groups.

    ERIC Educational Resources Information Center

    Powers, Richard B.; Boyle, William

    The purpose of the Commons Game is to teach students how social traps work; that is, that short-term individual gain tends to dominate long-term collective gain. Simulations of Commons Dilemma have grown considerably in the last decade; however, the research has used small face-to-face groups to study behavior in the Commons. To compare the…

  20. Caring for patients on home enteral nutrition: Reported complications by home carers and perspectives of community nurses.

    PubMed

    Lim, Mei Ling; Yong, Bei Yi Paulynn; Mar, Mei Qi Maggie; Ang, Shin Yuh; Chan, Mei Mei; Lam, Madeleine; Chong, Ngian Choo Janet; Lopez, Violeta

    2018-07-01

    To explore the experiences of community nurses and home carers, in caring for patients on home enteral nutrition. The number of patients on home enteral nutrition is on the increase due to advancement in technology and shift in focus of providing care from acute to community care settings. A mixed-method approach was adopted. (i) A face-to-face survey design was used to elicit experience of carers of patients on home enteral nutrition. (ii) Focus group interviews were conducted with community nurses. Ninety-nine carers (n = 99) were recruited. Patient's mean age that they cared for was aged 77.7 years (SD = 11.2), and they had been on enteral feeding for a mean of 29 months (SD = 23.0). Most were bed-bound (90%) and required full assistance with their feeding (99%). Most were not on follow-up with dietitians (91%) and dentists (96%). The three most common reported gastrointestinal complications were constipation (31%), abdominal distension (28%) and vomiting (22%). Twenty community nurses (n = 20) were recruited for the focus group interviews. Four main themes emerged from the analysis: (i) challenge of accessing allied health services in the community; (ii) shorter length of stay in the acute care setting led to challenges in carers' learning and adaptation; (iii) transition gaps between hospital and home care services; and (iv) managing expectations of family. To facilitate a better transition of care for patients, adequate training for carers, standardising clinical practice in managing patients with home enteral nutrition and improving communication between home care services and the acute care hospitals are needed. This study highlighted the challenges faced by community home care nurses and carers. Results of this study would help to inform future policies and practice changes that would improve the quality of care received by patients on home enteral nutrition. © 2018 John Wiley & Sons Ltd.

  1. Discovering Plate Boundaries in Data-integrated Environments: Preservice Teachers' Conceptualization and Implementation of Scientific Practices

    NASA Astrophysics Data System (ADS)

    Sezen-Barrie, Asli; Moore, Joel; Roig, Cara E.

    2015-08-01

    Drawn from the norms and rules of their fields, scientists use variety of practices, such as asking questions and arguing based on evidence, to engage in research that will contribute to our understanding of Earth and beyond. In this study, we explore how preservice teachers' learn to teach scientific practices while teaching plate tectonic theory. In particular, our aim is to observe which scientific practices preservice teachers use while teaching an earth science unit, how do they integrate these practices into their lessons, and what challenges do they face during their first time teaching of an earth science content area integrated with scientific practices. The study is designed as a qualitative, exploratory case study of seven preservice teachers while they were learning to teach plate tectonic theory to a group of middle school students. The data were driven from the video records and artifacts of the preservice teachers' learning and teaching processes as well as written reflections on the teaching. Intertextual discourse analysis was used to understand what scientific practices preservice teachers choose to integrate into their teaching experience. Our results showed that preservice teachers chose to focus on four aspects of scientific practices: (1) employing historical understanding of how the theory emerged, (2) encouraging the use of evidence to build up a theory, (3) observation and interpretation of data maps, and (4) collaborative practices in making up the theory. For each of these practices, we also looked at the common challenges faced by preservice teachers by using constant comparative analysis. We observed the practices that preservice teachers decided to use and the challenges they faced, which were determined by what might have come as in their personal history as learners. Therefore, in order to strengthen preservice teachers' background, college courses should be arranged to teach important scientific ideas through scientific practices. In addition, such practices should also reflect the authentic practices of earth scientists such as use of historical record and differentiating observation versus interpretation.

  2. Game Face

    ERIC Educational Resources Information Center

    Weiner, Jill

    2005-01-01

    In this article, the author discusses "Game Face: Life Lessons Across the Curriculum", a teaching kit that challenges assumptions and builds confidence. Game Face, which is derived from a book and art exhibition, "Game Face: What Does a Female Athlete Look Like?", uses layered and powerful images of women and girls participating in sports to teach…

  3. Exploring medication use by blind patients in Saudi Arabia

    PubMed Central

    Kentab, Basma Y.; Al-Rowiali, Kholuod Z.; Al-Harbi, Rehab A.; Al-Shammari, Nouf H.; Balhareth, Wiam M.; Al-Yazeed, Huda F.

    2014-01-01

    Objective To explore the characteristics of medication use and challenges experienced by the blind patients. Methods This cross-sectional descriptive study included blind persons living in Saudi Arabia who were at least 18 years of age. Participants were recruited through a number of nongovernmental blind associations (in the central, western, eastern regions), universities, social networks, and specialized websites for the blind. A questionnaire was designed and administered via face-to-face meetings with participants and made available online through Google Docs. Results There were a total of 121 respondents of which 26 were excluded based on their ability to visually identify their medications or being <18 years old. The majority of the respondents were 18–29 years old (68%), 49% were male and 51% were female. Around 57% had a college degree while 27% had a high school degree. Diagnosis with a chronic disease was reported by 71 participants (79%, 5 missing). The most common diseases were diabetes and asthma (22%) followed by hypertension (17%). Most blind patients (75%) believed that physicians were the most reliable source of medication information. The medication information and services provided by pharmacists were viewed as inadequate by 46%. The most common challenges encountered by blind patients were linked to drug identification (75%), dose recognition (82%), and identification of expiration date (92%). A large number of patients had to rely on persons with normal vision for dispensing and administering the medications. Conclusions Pharmacists can no longer ignore the medication use problems encountered by the blind people. This study may serve as an initial step for planning improvements in pharmaceutical services provided to blind patients. The government, pharmaceutical companies and pharmacists must work in collaboration to address the special needs of the blind. PMID:25685049

  4. Patient and nurse preferences for nurse handover—using preferences to inform policy: a discrete choice experiment protocol

    PubMed Central

    Spinks, Jean; Chaboyer, Wendy; Bucknall, Tracey; Tobiano, Georgia; Whitty, Jennifer A

    2015-01-01

    Introduction Nursing bedside handover in hospital has been identified as an opportunity to involve patients and promote patient-centred care. It is important to consider the preferences of both patients and nurses when implementing bedside handover to maximise the successful uptake of this policy. We outline a study which aims to (1) identify, compare and contrast the preferences for various aspects of handover common to nurses and patients while accounting for other factors, such as the time constraints of nurses that may influence these preferences.; (2) identify opportunities for nurses to better involve patients in bedside handover and (3) identify patient and nurse preferences that may challenge the full implementation of bedside handover in the acute medical setting. Methods and analysis We outline the protocol for a discrete choice experiment (DCE) which uses a survey design common to both patients and nurses. We describe the qualitative and pilot work undertaken to design the DCE. We use a D-efficient design which is informed by prior coefficients collected during the pilot phase. We also discuss the face-to-face administration of this survey in a population of acutely unwell, hospitalised patients and describe how data collection challenges have been informed by our pilot phase. Mixed multinomial logit regression analysis will be used to estimate the final results. Ethics and dissemination This study has been approved by a university ethics committee as well as two participating hospital ethics committees. Results will be used within a knowledge translation framework to inform any strategies that can be used by nursing staff to improve the uptake of bedside handover. Results will also be disseminated via peer-reviewed journal articles and will be presented at national and international conferences. PMID:26560060

  5. Thermal-to-visible face recognition using partial least squares.

    PubMed

    Hu, Shuowen; Choi, Jonghyun; Chan, Alex L; Schwartz, William Robson

    2015-03-01

    Although visible face recognition has been an active area of research for several decades, cross-modal face recognition has only been explored by the biometrics community relatively recently. Thermal-to-visible face recognition is one of the most difficult cross-modal face recognition challenges, because of the difference in phenomenology between the thermal and visible imaging modalities. We address the cross-modal recognition problem using a partial least squares (PLS) regression-based approach consisting of preprocessing, feature extraction, and PLS model building. The preprocessing and feature extraction stages are designed to reduce the modality gap between the thermal and visible facial signatures, and facilitate the subsequent one-vs-all PLS-based model building. We incorporate multi-modal information into the PLS model building stage to enhance cross-modal recognition. The performance of the proposed recognition algorithm is evaluated on three challenging datasets containing visible and thermal imagery acquired under different experimental scenarios: time-lapse, physical tasks, mental tasks, and subject-to-camera range. These scenarios represent difficult challenges relevant to real-world applications. We demonstrate that the proposed method performs robustly for the examined scenarios.

  6. Two complementary personal medication management applications developed on a common platform: case report.

    PubMed

    Ross, Stephen E; Johnson, Kevin B; Siek, Katie A; Gordon, Jeffry S; Khan, Danish U; Haverhals, Leah M

    2011-07-12

    Adverse drug events are a major safety issue in ambulatory care. Improving medication self-management could reduce these adverse events. Researchers have developed medication applications for tethered personal health records (PHRs), but little has been reported about medication applications for interoperable PHRs. Our objective was to develop two complementary personal health applications on a common PHR platform: one to assist children with complex health needs (MyMediHealth), and one to assist older adults in care transitions (Colorado Care Tablet). The applications were developed using a user-centered design approach. The two applications shared a common PHR platform based on a service-oriented architecture. MyMediHealth employed Web and mobile phone user interfaces. Colorado Care Tablet employed a Web interface customized for a tablet PC. We created complementary medication management applications tailored to the needs of distinctly different user groups using common components. Challenges were addressed in multiple areas, including how to encode medication identities, how to incorporate knowledge bases for medication images and consumer health information, how to include supplementary dosing information, how to simplify user interfaces for older adults, and how to support mobile devices for children. These prototypes demonstrate the utility of abstracting PHR data and services (the PHR platform) from applications that can be tailored to meet the needs of diverse patients. Based on the challenges we faced, we provide recommendations on the structure of publicly available knowledge resources and the use of mobile messaging systems for PHR applications.

  7. Threats to family planning services in Michigan: organizational responses to economic and political challenges.

    PubMed

    Dalton, Vanessa K; Jacobson, Peter D; Berson-Grand, Julie; Weisman, Carol S

    2005-01-01

    Title X is the only federal funding specifically for contraception and family planning services. This study identifies the threats and challenges Title X family planning organizations face in Michigan, and examines organizational responses to these challenges. We hypothesized that organizational responses to current challenges, including recent legislation, would differ between organizational types. We used a multiple case study design to examine safety net providers that received Title X funding in 2001. Cases were selected to represent economic and geographic diversity and included a mix of population densities. Key informants at each organization participated in face-to-face, semistructured interviews. Interviews collected data on current challenges, organizational planning processes, and organizational responses. All Title X organizations reported significant challenges, including rising costs, increasing need, and inadequate funding. Private organizations were more concerned about political challenges, especially recent Michigan legislation, than health departments. Organizational type was associated with the type of response. Health departments tended to close clinics or cut services, whereas private organizations recruited insured populations and increased patient fees. Based on these findings, the family planning safety net in Michigan appears to be undergoing significant change. These changes may decrease the availability of affordable family planning services in Michigan.

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

    PubMed Central

    2001-01-01

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

  9. Reflections of Malaysian parents of children with developmental disabilities on their experiences with AAC.

    PubMed

    Joginder Singh, Susheel; Hussein, Nur Hazirah; Mustaffa Kamal, Rahayu; Hassan, Fatimah Hani

    2017-06-01

    Parents play an important role in the successful implementation of AAC. Previous research has indicated that parents in different countries have varying perceptions about the use of AAC and face different challenges in its implementation. To date, there is limited information about the use of AAC by children in Malaysia or parents' views about its use. The aim of this study was to explore Malaysian parents' perception of AAC and their experience when supporting their children who use AAC. For this study, 12 parents of children with autism spectrum disorder and cerebral palsy were involved in semi-structured individual interviews. Qualitative content analysis was used to analyze interview data. Following analysis, three themes were identified: (a) impact of the use of AAC, (b) challenges faced, and (c) hopes and expectations. Participants reported that the use of AAC had a positive impact on their children, but that they faced challenges related to the child, the settings, and the system itself, as well as a lack of time and support. Findings from this study provide an insight for Malaysian speech therapists about the challenges faced by parents when supporting their children who use AAC, and how important it is to overcome these challenges to ensure successful implementation of AAC.

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

    PubMed

    Abou-Gharbia, Magid; Childers, Wayne E

    2013-07-25

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

  11. Aging and Cognitive Performance: Challenges and Implications for Physicians Practicing in the 21st Century

    ERIC Educational Resources Information Center

    Durning, Steven J.; Artino, Anthony R.; Holmboe, Eric; Beckman, Thomas J.; van der Vleuten, Cees; Schuwirth, Lambert

    2010-01-01

    The demands of physician practice are growing. Some specialties face critical shortages and a significant percentage of physicians are aging. To improve health care it is paramount to understand and address challenges, including cognitive issues, facing aging physicians. In this article, we outline several issues related to cognitive performance…

  12. Raising the Cash: A Study of the Role of Leadership in a Capital Campaign

    ERIC Educational Resources Information Center

    Diaz, Sandra L.

    2013-01-01

    Institutions of higher education are facing a number of challenges as they compete in the new global economy. Many of these institutions face increasing internal and external challenges, all of which involve additional expenses at a time when resources are diminishing. With growing financial uncertainties caused by fluctuating financial markets…

  13. Current Challenges Facing the Future of Secondary Education and Transition Services for Youth with Disabilities in the United States. Discussion Paper

    ERIC Educational Resources Information Center

    National Center on Secondary Education and Transition (NCSET), University of Minnesota, 2004

    2004-01-01

    This paper is intended to promote discussion among professionals, policymakers, employers, parents, and individuals with disabilities concerning current and future challenges facing secondary education and transition services nationally. The issues identified and discussed should not, however, be viewed as inclusive of the full range of possible…

  14. Challenges Faced by Development Partners in Supporting the Growth and Development of Commercial Enterprises in Lira District, Northern Uganda

    ERIC Educational Resources Information Center

    Eton, Marus; Mwirumubi, Richard; Edaku, Charles

    2017-01-01

    Entrepreneurship is defined as the process where an individual discovers, evaluates and exploit opportunities independently. Most countries have embraced entrepreneurship development as ways of creating employment and economic growth and development. The objective of the study was to examine the challenges faced by commercial enterprises in Lira…

  15. On-Line Literature: The Challenge of Integrating Web-Based Materials

    ERIC Educational Resources Information Center

    Ruzich, Constance M.

    2012-01-01

    This classroom research discusses the challenges of integrating face-to-face interactions with the use of on-line resources in secondary English classrooms. Examining the lesson plans of pre-service and early career teachers in the US, I found that the uses of on-line resources were frequently neither coherent nor consistent with the goals and…

  16. The Resonance Factor: Probing the Impact of Video on Student Retention in Distance Learning

    ERIC Educational Resources Information Center

    Geri, Nitza

    2012-01-01

    Teaching and instructing is one of the challenging manifestations of informing, within which distance learning is considered harder than face-to-face instruction. Student retention is one of the major challenges of distance learning. Current innovative technologies enable widespread use of video lectures that may ease the loneliness of the…

  17. Rural Teachers' Views: What Are Gender-Based Challenges Facing Free Primary Education in Lesotho?

    ERIC Educational Resources Information Center

    Morojele, Pholoho

    2013-01-01

    This paper gives prominence to rural teachers' accounts of gender-based challenges facing Free Primary Education in Lesotho. It draws on feminist interpretations of social constructionism to discuss factors within the Basotho communities that affect gender equality in the schools. The inductive analysis offered makes use of the data generated from…

  18. Challenges Facing Canadian Federal Offenders Newly Released to the Community: A Concept Map

    ERIC Educational Resources Information Center

    Brown, Jason D.

    2004-01-01

    The purpose of the study was to describe the needs of newly released Canadian federal offenders as perceived by community parole supervisors. Seventy-four Canadian parole supervisors were asked to answer the following question: "What challenges do parolees face in the first 90 days after release?" The data were analyzed using…

  19. Madrasa Education in South Asia and Southeast Asia: Current Issues and Debates

    ERIC Educational Resources Information Center

    Park, Jaddon; Niyozov, Sarfaroz

    2008-01-01

    Madaris (plural of madrasa) face a multitude of challenges in preparing students for life in rapidly modernising societies and emerging globalised knowledge economies. The complexity of the role and tasks of madaris, which are caught in the interface of modernity and tradition, the challenges they face, and the strategies they develop to address…

  20. Facing the Challenges of Today and the Future: Ensuring Successful Outcomes for Students from Culturally and Linguistically Diverse Backgrounds

    ERIC Educational Resources Information Center

    Bullock, Lyndal M.; Gable, Robert A.; Carrero, Kelly; Lewis, Calli; Collins, Emerald; Zolkowski, Staci; Lusk, Mandy

    2014-01-01

    American schools are witnessing the increasing cultural heterogeneity of our nation's population. Educators are faced with the challenge of ensuring positive educational outcomes for all students, despite the lack of empirical understanding of how to effectively educate culturally and linguistically diverse learners. The purpose of this paper is…

  1. Managing Digital Identity on Twitter: The Case of School Administrators

    ERIC Educational Resources Information Center

    Cho, Vincent; Jimerson, Jo Beth

    2017-01-01

    What does it mean to be and to act like a school leader online? Although many school leaders might be comfortable navigating issues of identity in face-to-face environments, online environments may present new and unprecedented challenges. These challenges may range from concerns about privacy and surveillance to questions about how best to…

  2. The Health Challenges of Urban Latino College Students as Revealed through Student Journaling

    ERIC Educational Resources Information Center

    Rowland, Amy L.

    2008-01-01

    Because of the unique health risks faced by the Hispanic population and the notoriously poor health habits of college students, this study examines the health challenges faced by Latino college students enrolled at an urban commuter institution. A thematic analysis reveals the top themes for males and females as healthy eating, weight management,…

  3. Using an Iterative Mixed-Methods Research Design to Investigate Schools Facing Exceptionally Challenging Circumstances within Trinidad and Tobago

    ERIC Educational Resources Information Center

    De Lisle, Jerome; Seunarinesingh, Krishna; Mohammed, Rhoda; Lee-Piggott, Rinnelle

    2017-01-01

    In this study, methodology and theory were linked to explicate the nature of education practice within schools facing exceptionally challenging circumstances (SFECC) in Trinidad and Tobago. The research design was an iterative quan>QUAL-quan>qual multi-method research programme, consisting of 3 independent projects linked together by overall…

  4. Challenges of Adopting the Use of Technology in Less Developed Countries: The Case of Cambodia

    ERIC Educational Resources Information Center

    Richardson, Jayson W.

    2011-01-01

    Drawing on Everett Rogers's theory of the diffusion of innovations, this article identifies the barriers, challenges, and successes in the adoption of technology training by teacher trainers in Cambodia. The analysis was based on data collected from an open-ended survey, face-to-face interviews, and document analysis. Findings reveal that the…

  5. Introducing Decision Making under Uncertainty and Strategic Considerations in Engineering Design

    ERIC Educational Resources Information Center

    Kosmopoulou, Georgia; Jog, Chintamani; Freeman, Margaret; Papavassiliou, Dimitrios V.

    2010-01-01

    Chemical Engineering graduates will face challenges at the workplace that even their peers who graduated a few years ago were not expected to face. One such major challenge is the management and operation of companies and plants under conditions of uncertainty and the need to make decisions in competitive situations. Modern developments in…

  6. Challenges Beginning Teachers Face in Hong Kong

    ERIC Educational Resources Information Center

    Lam, Bick-Har

    2014-01-01

    By conducting in-depth interviews with new teachers who are about to become full-time teachers and then reinterviewing them two years later, the author of this article presents how beginning teachers think and feel about teaching and describes the challenges they face as beginning teachers in the context of Hong Kong. The stories of the teachers,…

  7. Challenges Faced by Preceptors Serving in Dual Roles as Health Care Providers and Clinical Educators

    ERIC Educational Resources Information Center

    Dodge, Thomas; Mazerolle, Stephanie M.; Bowman, Thomas G.

    2014-01-01

    Context: Preceptors play an integral role in training athletic training students (ATSs). Balancing roles as health care providers and educators can often be challenging. Role strain is a documented concern for the preceptor, yet limited information is available regarding other issues faced while supervising ATSs. Objective: To explore preceptor…

  8. Transition Program: The Challenges Faced by Special Needs Students in Gaining Work Experience

    ERIC Educational Resources Information Center

    Alias, Aliza

    2014-01-01

    Transition program for special needs students is known to open opportunities for students with learning disabilities to gain work experience in actual work environment. The program provides training activities and also an opportunity to go for internship to gain work experience. Therefore, this study is to identify the challenges faced by special…

  9. Accommodating Extension Clients Who Face Language, Vision, or Hearing Challenges

    ERIC Educational Resources Information Center

    Angima, Sam; Etuk, Lena; Maddy, Deborah

    2016-01-01

    A survey-based study explored approaches used by one land-grant university to meet the needs of Extension clients who face language, vision, or hearing challenges. In attempts to serve such clients, the greatest gaps existed for clients whose main language was Spanish, followed by those who had vision impairments and then those who had hearing…

  10. Single Black Working Mothers' Perceptions: The Journey to Achieve Leadership Positions

    ERIC Educational Resources Information Center

    Raglin, Sherrell

    2017-01-01

    Single Black working mothers faced significant challenges in achieving high-level or senior-level leadership positions. The purpose of this qualitative narrative study was to collect, analyze and code the stories told by 10 participants to understand the perceptions and insights of the challenges and barriers single Black working mothers faced in…

  11. Credible Leadership: Exploring Differences in Perception of the Credibility of the Senior Student Affairs Officer among CIC College Presidents and Their Senior Leadership Teams

    ERIC Educational Resources Information Center

    Powers, Wendy A.

    2014-01-01

    Modern higher education institutions face tremendous challenges, including dwindling financial resources, waning public support, demands for greater accountability, and daunting student needs and expectations. Campus presidents simply cannot face these challenges as isolated or solitary leaders. High functioning, inclusive, collaborative, and…

  12. An international virtual medical school (IVIMEDS): the future for medical education?

    PubMed

    Harden, R M; Hart, I R

    2002-05-01

    The introduction of new learning technologies, the exponential growth of Internet usage and the advent of the World Wide Web have the potential of changing the face of higher education. There are also demands in medical education for greater globalization, for the development of a common core curriculum, for improving access to training, for more flexible and student-centred training programmes including programmes with multi-professional elements and for maintaining quality while increasing student numbers and working within financial constraints. An international virtual medical school (IVIMEDS) with a high-quality education programme embodying a hybrid model of a blended curriculum of innovative e-learning approaches and the best of traditional face-to-face teaching is one response to these challenges. Fifty leading international medical schools and institutions are participating in a feasibility study. This is exploring: innovative thinking and approaches to the new learning technologies including e-learning and virtual reality; new approaches to curriculum planning and mapping and advanced instructional design based on the use of 'reusable learning objects'; an international perspective on medical education which takes into account the trend to globalization; a flexible curriculum which meets the needs of different students and has the potential of increasing access to medicine.

  13. Regulatory T-cells in autoimmune diseases: challenges, controversies and--yet--unanswered questions.

    PubMed

    Grant, Charlotte R; Liberal, Rodrigo; Mieli-Vergani, Giorgina; Vergani, Diego; Longhi, Maria Serena

    2015-02-01

    Regulatory T cells (Tregs) are central to the maintenance of self-tolerance and tissue homeostasis. Markers commonly used to define human Tregs in the research setting include high expression of CD25, FOXP3 positivity and low expression/negativity for CD127. Many other markers have been proposed, but none unequivocally identifies bona fide Tregs. Tregs are equipped with an array of mechanisms of suppression, including the modulation of antigen presenting cell maturation and function, the killing of target cells, the disruption of metabolic pathways and the production of anti-inflammatory cytokines. Treg impairment has been reported in a number of human autoimmune conditions and includes Treg numerical and functional defects and conversion into effector cells in response to inflammation. In addition to intrinsic Treg impairment, resistance of effector T cells to Treg control has been described. Discrepancies in the literature are common, reflecting differences in the choice of study participants and the technical challenges associated with investigating this cell population. Studies differ in terms of the methodology used to define and isolate putative regulatory cells and to assess their suppressive function. In this review we outline studies describing Treg frequency and suppressive function in systemic and organ specific autoimmune diseases, with a specific focus on the challenges faced when investigating Tregs in these conditions. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Big Data and Clinicians: A Review on the State of the Science

    PubMed Central

    Wang, Weiqi

    2014-01-01

    Background In the past few decades, medically related data collection saw a huge increase, referred to as big data. These huge datasets bring challenges in storage, processing, and analysis. In clinical medicine, big data is expected to play an important role in identifying causality of patient symptoms, in predicting hazards of disease incidence or reoccurrence, and in improving primary-care quality. Objective The objective of this review was to provide an overview of the features of clinical big data, describe a few commonly employed computational algorithms, statistical methods, and software toolkits for data manipulation and analysis, and discuss the challenges and limitations in this realm. Methods We conducted a literature review to identify studies on big data in medicine, especially clinical medicine. We used different combinations of keywords to search PubMed, Science Direct, Web of Knowledge, and Google Scholar for literature of interest from the past 10 years. Results This paper reviewed studies that analyzed clinical big data and discussed issues related to storage and analysis of this type of data. Conclusions Big data is becoming a common feature of biological and clinical studies. Researchers who use clinical big data face multiple challenges, and the data itself has limitations. It is imperative that methodologies for data analysis keep pace with our ability to collect and store data. PMID:25600256

  15. Challenges of Managing Animals in Disasters in the U.S.

    PubMed Central

    Heath, Sebastian E.; Linnabary, Robert D.

    2015-01-01

    Simple Summary This article describes common challenges to managing animals in disasters in the US, summarizes how some of these challenges are being met and makes recommendations on how to overcome others. Many predictable adverse situations affecting animals and their owners can be prevented when communities develop a comprehensive emergency management strategy that integrates animal care into planning, preparedness, mitigation, and recovery activities, as well as response. Abstract Common to many of the repeated issues surrounding animals in disasters in the U.S. is a pre-existing weak animal health infrastructure that is under constant pressure resulting from pet overpopulation. Unless this root cause is addressed, communities remain vulnerable to similar issues with animals they and others have faced in past disasters. In the US the plight of animals in disasters is frequently viewed primarily as a response issue and frequently handled by groups that are not integrated with the affected community’s emergency management. In contrast, animals, their owners, and communities would greatly benefit from integrating animal issues into an overall emergency management strategy for the community. There is no other factor contributing as much to human evacuation failure in disasters that is under the control of emergency management when a threat is imminent as pet ownership. Emergency managers can take advantage of the bond people have with their animals to instill appropriate behavior amongst pet owners in disasters. PMID:26479228

  16. A comparison of how four countries use health IT to support care for people with chronic conditions.

    PubMed

    Adler-Milstein, Julia; Sarma, Nandini; Woskie, Liana R; Jha, Ashish K

    2014-09-01

    Countries around the globe are investing in health information and communications technologies (ICTs) as critical tools for improving care for chronically ill patients. We profiled four high-income nations with varied health ICT strategies--Australia, Canada, Denmark, and the United States--to describe their use of ICTs to improve chronic care. Our goal was to identify common challenges and opportunities for cross-national learning. We found four key themes. First, although all four countries have a national strategy for health ICT adoption, strategies are implemented and adapted to chronic care needs regionally, which creates the challenge of spreading successful efforts across regions. Second, each country struggles with how to ensure that clinical information follows patients seamlessly between care settings. Third, although each nation is pursuing telehealth solutions as a component of chronic care, the telehealth initiatives are usually stand-alone efforts that are not well integrated into other ICT solutions, such as electronic health records. Finally, countries have made progress in improving patients' access to their clinical data but have not fully succeeded in engaging patients to apply the data to improve care. These common themes suggest that although the four nations have different health care systems and ICT strategies, all of them face a similar set of challenges, creating an opportunity for cross-national learning. Project HOPE—The People-to-People Health Foundation, Inc.

  17. Challenges and opportunities of optimal breastfeeding in the context of HIV option B+ guidelines.

    PubMed

    Marinda, Pamela; Chibwe, Nkandu; Tambo, Ernest; Lulanga, Sidney; Khayeka-Wandabwa, Christopher

    2017-06-02

    In 2013, the World Health Organization released a new set of guidelines widely known as Option B+. Prior to that there were guidelines released in 2010. Option B+ recommends lifelong antiretroviral treatment for all pregnant and breastfeeding women living with Human Immunodeficiency Virus. The study aimed at investigating challenges and opportunities in implementing Infant and Young Child Feeding in the context of Prevention of Mother To Child Transmission (PMTCT) guidelines among HIV positive mothers of children aged 0-24 months. The study also examined implications presented by implementing the 2013 PMTCT consolidated guidelines in the transition phase from the 2010 approach in Zambia. A mixed methods approach was employed in the descriptive cross sectional study utilizing semi structured questionnaires and Focused Group Discussions. Further, data was captured from the Health Information Management System. During the PMTCT transition, associated needs and challenges in institutionalizing the enhanced guidelines from option A and B to option B+ were observed. Nonetheless, there was a decline in Mother to Child Transmission (MTCT) of HIV rates with an average of 4%. Mothers faced challenges in complying with optimal breastfeeding practices owing to lack of community support systems and breast infections due to poor breast feeding occasioned by infants' oral health challenges. Moreover, some mothers were hesitant of lifelong ARVs. Health workers faced programmatic and operational challenges such as compromised counseling services. Despite the ambitious timelines for PMTCT transition, the need to inculcate new knowledge and vary known practice among mothers and the shift in counseling content for health workers, the consolidated guidelines for PMTCT proved effective. Some mothers were hesitant of lifelong ARVs, rationalizing the debated paradigm that prolonged chemotherapy/polypharmacy may be a future challenge in the success of ART in PMTCT. Conflicting breast feeding practices was a common observation across mothers thus underpinning the need to strongly invigorate Infant and Young Child Feeding information sharing across the continuum of heath care from facility level to community and up to the family; for cultural norms, practices and attitudes enshrined within communities play a vital role in child care.

  18. The Challenges of Pharmacy Education in Yemen

    PubMed Central

    2014-01-01

    Pharmacy education in Yemen has faced many challenges since its introduction in the 1980s. Most Yemeni pharmacy schools, especially private ones, are experiencing difficulties in providing the right quality and quantity of clinical educational experiences. Most of these challenges are imbedded in a teaching style and curricula that have failed to respond to the needs of the community and country. The slow shift from traditional drug-dispensing to a patient-centered or focused approach in pharmacy practice requires a fundamental change in the roles and responsibilities of both policymakers and educators. The purpose of this paper is twofold: (1) to discuss the challenges facing the pharmacy education in Yemen; (2) to provided recommendations to overcome challenges. PMID:25386011

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

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

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

  20. Active-comparator design and new-user design in observational studies

    PubMed Central

    Yoshida, Kazuki; Solomon, Daniel H.; Kim, Seoyoung C.

    2015-01-01

    SUMMARY Over the past decade, an increasing number of observational studies have examined the effectiveness or safety of rheumatoid arthritis treatments. However, unlike randomized controlled trials (RCTs), observational studies of drug effects face methodological challenges including confounding by indication. Two design principles - active comparator design and new user design can help mitigate such challenges in observational studies. To improve validity of study findings, observational studies should be designed in such a way that makes them more closely approximate RCTs. The active comparator design compares the drug of interest to another commonly used agent for the same indication, rather than a ‘non-user’ group. This principle helps select treatment groups similar in treatment indications (both measured and unmeasured characteristics). The new user design includes a cohort of patients from the time of treatment initiation, so that it can assess patients’ pretreatment characteristics and capture all events occurring anytime during follow-up. PMID:25800216

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