Diversity Digest. Volume 9, Number 3

ERIC Educational Resources Information Center

Musil, Caryn McTighe, Ed.; Hovland, Kevin, Ed.

2006-01-01

This issue of "Diversity Digest" grows out of one recent effort to raise the visibility of science in diversity and global learning initiatives. Articles in this issue include: (1) Science, Diversity, and Global Learning: Untangling Complex Problems (Kevin Hovland); (2) Breaking the Pyramid: Putting Science in the Core (Darcy Kelley);…

From scientific literacy to sustainability literacy: An ecological framework for education

NASA Astrophysics Data System (ADS)

Colucci-Gray, Laura; Camino, Elena; Barbiero, Giuseppe; Gray, Donald

2006-03-01

In this paper, we report some reflections on science and education, in relation to teaching and research in the field of complex and controversial socio-environmental issues. Starting from an examination of the literature on the epistemological aspects of the science of controversial issues, and introducing the perspective of complexity, the article argues for a complexity of content, context, and method in understanding current problems. Focusing on a model of learning which includes dialogical and reflective approaches, the final part of the article reports on aspect of the authors' experimental practice with role-play for dealing with complex issues. The review of the literature and our experience of action-research introduce a view of education which promotes young people's awareness of multiple points of view, an ability to establish relationships between processes, scales, and contexts which may be nonlinearly related, and practice with creative and nonviolent forms of interrelations with others. Such an approach in science education is coherent with a scenario of planet sustainability based on ecological webs and equity principles.

International space station wire program

NASA Technical Reports Server (NTRS)

May, Todd

1995-01-01

Hardware provider wire systems and current wire insulation issues for the International Space Station (ISS) program are discussed in this viewgraph presentation. Wire insulation issues include silicone wire contamination, Tefzel cold temperature flexibility, and Russian polyimide wire insulation. ISS is a complex program with hardware developed and managed by many countries and hundreds of contractors. Most of the obvious wire insulation issues are known by contractors and have been precluded by proper selection.

Emerging Environmental Justice Issues in Nuclear Power and Radioactive Contamination

PubMed Central

Kyne, Dean; Bolin, Bob

2016-01-01

Nuclear hazards, linked to both U.S. weapons programs and civilian nuclear power, pose substantial environment justice issues. Nuclear power plant (NPP) reactors produce low-level ionizing radiation, high level nuclear waste, and are subject to catastrophic contamination events. Justice concerns include plant locations and the large potentially exposed populations, as well as issues in siting, nuclear safety, and barriers to public participation. Other justice issues relate to extensive contamination in the U.S. nuclear weapons complex, and the mining and processing industries that have supported it. To approach the topic, first we discuss distributional justice issues of NPP sites in the U.S. and related procedural injustices in siting, operation, and emergency preparedness. Then we discuss justice concerns involving the U.S. nuclear weapons complex and the ways that uranium mining, processing, and weapons development have affected those living downwind, including a substantial American Indian population. Next we examine the problem of high-level nuclear waste and the risk implications of the lack of secure long-term storage. The handling and deposition of toxic nuclear wastes pose new transgenerational justice issues of unprecedented duration, in comparison to any other industry. Finally, we discuss the persistent risks of nuclear technologies and renewable energy alternatives. PMID:27420080

The Internationalisation of Curricula: The Complexity and Diversity of Meaning in and beyond Japanese Universities

ERIC Educational Resources Information Center

Takagi, Hiroyuki

2015-01-01

The interpretation and implementation of ideas about the internationalisation of curricula (IoC) are complicated and multi-faceted. The complex and diverse perspectives on IoC reflect two concepts: "internationalisation" and "curriculum". These concepts embody contrasting perspectives on issues, including the competition-type…

It's more complicated than that Comment on "Translating evidence into healthcare policy and practice: single versus multi-faceted implementation strategies - is there a simple answer to a complex question?".

PubMed

Rycroft-Malone, Jo

2015-03-17

In this commentary the findings from a systematic review that concluded there is no compelling evidence to suggest that implementing complicated, multi-faceted interventions is more effective than simple, single component interventions to changing healthcare professional's behaviour are considered through the lens of Harvey and Kitson's editorial. Whilst an appealing conclusion, it is one that hides a myriad of complexities. These include issues concerning how best to tailor interventions and how best to evaluate such efforts. These are complex issues that do not have simple solutions. © 2015 by Kerman University of Medical Sciences.

Accessible information for people with complex communication needs.

PubMed

Owens, Janet S

2006-09-01

Information can be empowering if it is accessible. While a number of known information access barriers have been reported for the broader group of people with disabilities, specific information issues for people with complex communication needs have not been previously reported. In this consumer-focused study, the accessibility of information design and dissemination practices were discussed by 17 people with complex communication needs; by eight parents, advocates, therapists, and agency representatives in focus groups; and by seven individuals in individual interviews. Participants explored issues and made recommendations for content, including language, visual and audio supports; print accessibility; physical access; and human support for information access. Consumer-generated accessibility guidelines were an outcome of this study.

Integration of Work Experience and Learning for International Students: From Harmony to Inequality

ERIC Educational Resources Information Center

Tran, Ly Thi; Soejatminah, Sri

2017-01-01

The integration of work experience and learning in tertiary education is a complex issue for different stakeholders, including students, institutions, and employers. The provision of course-related work experience for international students is far more challenging as it involves issues of visa status, different cultural expectations,…

Is the biggest security threat to medical information simply a lack of understanding?

PubMed

Williams, Patricia A H

2011-01-01

Connecting Australian health services and the e-health initiative is a major focus in the current health environment. Many issues are presented as key to its success including solving issues with confidentiality and privacy. However, the main problem may not be these issues in sharing information but the fact that the point of origin of such records is still relatively insecure. This paper highlights why this may be the case. Research into the security of medical information has shown that many primary healthcare providers are unable to create an environment with effective information security. Numerous factors contribute to this complex situation including a trustful environment, the resultant security culture and the capability of individual healthcare organisations. Further, the growing importance of new directions in the use of patient information is considered. This paper discusses these issues and positions them within the complex environment that is healthcare. In our current health system infrastructure, the points of origin of patient information are our most vulnerable. This entwined with progressively new uses of this information expose additional security concerns, such as re-identification of information, that require attention.

Making Sense of Education Change at Thistle College: The Existence of Witchcraft, Witches and Shamans.

ERIC Educational Resources Information Center

Grant, Kevin

2003-01-01

Discusses a complex and charged change program and its management at a Scottish higher education institution. Discusses the difficulties of the educational change process in higher education, the complexities surrounding notions of organizational cultures and communities of practice, and issues of power and management including the new…

Technical and Practical Issues in the Structure and Clinical Invariance of the Wechsler Scales: A Rejoinder to Commentaries

ERIC Educational Resources Information Center

Weiss, Lawrence G.; Keith, Timothy Z.; Zhu, Jianjun; Chen, Hsinyi

2013-01-01

This discussion article addresses issues related to expansion of the Wechsler model from four to five factors; multiple broad CHC abilities measured by the Arithmetic subtest; advantages and disadvantages of including complex tasks requiring integration of multiple broad abilities when measuring intelligence; limitations of factor analysis, which…

Gender identity and sport: is the playing field level?

PubMed

Reeser, J C

2005-10-01

This review examines gender identity issues in competitive sports, focusing on the evolution of policies relating to female gender verification and transsexual participation in sport. The issues are complex and continue to challenge sport governing bodies, including the International Olympic Committee, as they strive to provide a safe environment in which female athletes may compete fairly and equitably.

Petroleum accounting principles, procedures, and issues

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

Brock, H.R.; Klingstedt, J.P.; Jones, D.M.

1985-01-01

This book begins with the basics and leads one through the complexities of accounting and reporting for the industry. It presents the material one needs as an accountant in the petroleum industry. Examples deal with real problems and issues. It also includes numerous illustrations and examples, as well as sample forms, lease agreements, and industry and governmental regulations.

Introduction Wind farms in complex terrains: an introduction

PubMed Central

Alfredsson, P. H.; Segalini, A.

2017-01-01

Wind energy is one of the fastest growing sources of sustainable energy production. As more wind turbines are coming into operation, the best locations are already becoming occupied by turbines, and wind-farm developers have to look for new and still available areas—locations that may not be ideal such as complex terrain landscapes. In these locations, turbulence and wind shear are higher, and in general wind conditions are harder to predict. Also, the modelling of the wakes behind the turbines is more complicated, which makes energy-yield estimates more uncertain than under ideal conditions. This theme issue includes 10 research papers devoted to various fluid-mechanics aspects of using wind energy in complex terrains and illustrates recent progress and future developments in this important field. This article is part of the themed issue ‘Wind energy in complex terrains’. PMID:28265020

Diabetes and end of life: ethical and methodological issues in gathering evidence to guide care.

PubMed

Dunning, Trisha; Duggan, Nicole; Savage, Sally; Martin, Peter

2013-03-01

Providing palliative care for people with diabetes at the end of life is part of the chronic disease care trajectory, but end of life care is complex and the presence of diabetes further complicates management. The aim of the paper is to discuss the ethical and methodological issues encountered when undertaking research to develop guidelines for managing diabetes at the end of life and the strategies used to address the issues. The issues emerged as we developed guidelines for managing diabetes at the end of life, which included conducting individual interviews with 14 people with diabetes requiring palliative care and 10 family members. A reflexive researcher journal was maintained throughout the guideline development process. The interview transcripts and researcher's journal were analysed to determine key methodological, ethical and researcher-related issues. Key themes were vulnerability of the sampling population, methodological issues included recruiting participants and ensuring rigor, ethical issues concerned benefit and risk, justice, autonomy, privacy, professional boundaries and informed consent. Researcher-related issues were identified such as managing participant distress and their own emotional distress. People were willing to discuss end of life diabetes management preferences. Undertaking research with people at the end of life is complex because of their vulnerability and the ethical issues involved. However, the ethical principles of autonomy and justice apply and people should be given the relevant information and opportunity to decide whether to participate or not. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

Understanding Current Safety Issues for Trajectory Based Operations

NASA Technical Reports Server (NTRS)

Feary, Michael; Stewart, Michael

2016-01-01

Increases in procedural complexity were investigated as a possible contributor to flight path deviations in airline operations. Understanding current operational issues and their causes must be embraced to maintain current safety standards while increasing future functionality. ASRS data and expert narratives were used to discover factors relating to pilot deviations. Our investigation pointed to ATC intervention, automation confusion, procedure design, and mixed equipment as primary issues. Future work will need to include objective data and mitigation strategies.

Knowledge as an Asset--A View from Industry.

ERIC Educational Resources Information Center

Thomas, Grant

1992-01-01

Discusses issues related to the value of knowledge to corporations, including technological change, increased competition, and global complexity. Implications for training programs and educational institutions are considered, and a strategic knowledge plan that includes four fields of activity is presented: corporate knowledge engineering,…

77 FR 53164 - Railroad Workplace Safety; Adjacent-Track On-Track Safety for Roadway Workers

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-31

...-0059, Notice No. 6] RIN 2130-AC37 Railroad Workplace Safety; Adjacent-Track On-Track Safety for Roadway... complex issues raised in both the petitions for reconsideration of the final rule published November 30... issues. One of the Petitions included a request for a delay in the effective date of the final rule until...

From Policy to Practice: Supporting Students with Diverse Needs in Thailand: Critical Issues and Implications

ERIC Educational Resources Information Center

Opartkiattikul, Watinee; Arthur-Kelly, Michael; Dempsey, Ian

2014-01-01

A commitment to maximizing learning outcomes for all students is an axiom of most educational systems around the world. However this goal is sometimes compromised by factors that can be complex and difficult to address. Student behavior problems are one of the major issues challenging educators in many countries including Thailand. Recently, laws…

Gender and Schooling in the Early Years. Research on Women and Education

ERIC Educational Resources Information Center

Koch, Janice, Ed.; Irby, Beverly, Ed.

2005-01-01

In this volume, gender and schooling in the early years addresses a broad range of issues including, but not limited, to gender equity in education. We explore, for example, the complex world of play in Fromberg's chapter and are reminded that for young children, play involves issues of power and hierarchy in ways that parallel the role of gender…

Large system change challenges: addressing complex critical issues in linked physical and social domains

NASA Astrophysics Data System (ADS)

Waddell, Steve; Cornell, Sarah; Hsueh, Joe; Ozer, Ceren; McLachlan, Milla; Birney, Anna

2015-04-01

Most action to address contemporary complex challenges, including the urgent issues of global sustainability, occurs piecemeal and without meaningful guidance from leading complex change knowledge and methods. The potential benefit of using such knowledge is greater efficacy of effort and investment. However, this knowledge and its associated tools and methods are under-utilized because understanding about them is low, fragmented between diverse knowledge traditions, and often requires shifts in mindsets and skills from expert-led to participant-based action. We have been engaged in diverse action-oriented research efforts in Large System Change for sustainability. For us, "large" systems can be characterized as large-scale systems - up to global - with many components, of many kinds (physical, biological, institutional, cultural/conceptual), operating at multiple levels, driven by multiple forces, and presenting major challenges for people involved. We see change of such systems as complex challenges, in contrast with simple or complicated problems, or chaotic situations. In other words, issues and sub-systems have unclear boundaries, interact with each other, and are often contradictory; dynamics are non-linear; issues are not "controllable", and "solutions" are "emergent" and often paradoxical. Since choices are opportunity-, power- and value-driven, these social, institutional and cultural factors need to be made explicit in any actionable theory of change. Our emerging network is sharing and building a knowledge base of experience, heuristics, and theories of change from multiple disciplines and practice domains. We will present our views on focal issues for the development of the field of large system change, which include processes of goal-setting and alignment; leverage of systemic transitions and transformation; and the role of choice in influencing critical change processes, when only some sub-systems or levels of the system behave in purposeful ways, while others are undeniably and unavoidably deterministic.

Capturing the experiences of patients across multiple complex interventions: a meta-qualitative approach

PubMed Central

Webster, Fiona; Christian, Jennifer; Mansfield, Elizabeth; Bhattacharyya, Onil; Hawker, Gillian; Levinson, Wendy; Naglie, Gary; Pham, Thuy-Nga; Rose, Louise; Schull, Michael; Sinha, Samir; Stergiopoulos, Vicky; Upshur, Ross; Wilson, Lynn

2015-01-01

Objectives The perspectives, needs and preferences of individuals with complex health and social needs can be overlooked in the design of healthcare interventions. This study was designed to provide new insights on patient perspectives drawing from the qualitative evaluation of 5 complex healthcare interventions. Setting Patients and their caregivers were recruited from 5 interventions based in primary, hospital and community care in Ontario, Canada. Participants We included 62 interviews from 44 patients and 18 non-clinical caregivers. Intervention Our team analysed the transcripts from 5 distinct projects. This approach to qualitative meta-evaluation identifies common issues described by a diverse group of patients, therefore providing potential insights into systems issues. Outcome measures This study is a secondary analysis of qualitative data; therefore, no outcome measures were identified. Results We identified 5 broad themes that capture the patients’ experience and highlight issues that might not be adequately addressed in complex interventions. In our study, we found that: (1) the emergency department is the unavoidable point of care; (2) patients and caregivers are part of complex and variable family systems; (3) non-medical issues mediate patients’ experiences of health and healthcare delivery; (4) the unanticipated consequences of complex healthcare interventions are often the most valuable; and (5) patient experiences are shaped by the healthcare discourses on medically complex patients. Conclusions Our findings suggest that key assumptions about patients that inform intervention design need to be made explicit in order to build capacity to better understand and support patients with multiple chronic diseases. Across many health systems internationally, multiple models are being implemented simultaneously that may have shared features and target similar patients, and a qualitative meta-evaluation approach, thus offers an opportunity for cumulative learning at a system level in addition to informing intervention design and modification. PMID:26351182

Introduction Wind farms in complex terrains: an introduction.

PubMed

Alfredsson, P H; Segalini, A

2017-04-13

Wind energy is one of the fastest growing sources of sustainable energy production. As more wind turbines are coming into operation, the best locations are already becoming occupied by turbines, and wind-farm developers have to look for new and still available areas-locations that may not be ideal such as complex terrain landscapes. In these locations, turbulence and wind shear are higher, and in general wind conditions are harder to predict. Also, the modelling of the wakes behind the turbines is more complicated, which makes energy-yield estimates more uncertain than under ideal conditions. This theme issue includes 10 research papers devoted to various fluid-mechanics aspects of using wind energy in complex terrains and illustrates recent progress and future developments in this important field.This article is part of the themed issue 'Wind energy in complex terrains'. © 2017 The Author(s).

Ethical Considerations in Tissue Engineering Research: Case Studies in Translation

PubMed Central

Baker, Hannah B.; McQuilling, John P.

2016-01-01

Tissue engineering research is a complex process that requires investigators to focus on the relationship between their research and anticipated gains in both knowledge and treatment improvements. The ethical considerations arising from tissue engineering research are similarly complex when addressing the translational progression from bench to bedside, and investigators in the field of tissue engineering act as moral agents at each step of their research along the translational pathway, from early benchwork and preclinical studies to clinical research. This review highlights the ethical considerations and challenges at each stage of research, by comparing issues surrounding two translational tissue engineering technologies: the bioartificial pancreas and a tissue engineered skeletal muscle construct. We present relevant ethical issues and questions to consider at each step along the translational pathway, from the basic science bench to preclinical research to first-in-human clinical trials. Topics at the bench level include maintaining data integrity, appropriate reporting and dissemination of results, and ensuring that studies are designed to yield results suitable for advancing research. Topics in preclinical research include the principle of “modest translational distance” and appropriate animal models. Topics in clinical research include key issues that arise in early-stage clinical trials, including selection of patient-subjects, disclosure of uncertainty, and defining success. The comparison of these two technologies and their ethical issues brings to light many challenges for translational tissue engineering research and provides guidance for investigators engaged in development of any tissue engineering technology. PMID:26282436

Ethical considerations in tissue engineering research: Case studies in translation.

PubMed

Baker, Hannah B; McQuilling, John P; King, Nancy M P

2016-04-15

Tissue engineering research is a complex process that requires investigators to focus on the relationship between their research and anticipated gains in both knowledge and treatment improvements. The ethical considerations arising from tissue engineering research are similarly complex when addressing the translational progression from bench to bedside, and investigators in the field of tissue engineering act as moral agents at each step of their research along the translational pathway, from early benchwork and preclinical studies to clinical research. This review highlights the ethical considerations and challenges at each stage of research, by comparing issues surrounding two translational tissue engineering technologies: the bioartificial pancreas and a tissue engineered skeletal muscle construct. We present relevant ethical issues and questions to consider at each step along the translational pathway, from the basic science bench to preclinical research to first-in-human clinical trials. Topics at the bench level include maintaining data integrity, appropriate reporting and dissemination of results, and ensuring that studies are designed to yield results suitable for advancing research. Topics in preclinical research include the principle of "modest translational distance" and appropriate animal models. Topics in clinical research include key issues that arise in early-stage clinical trials, including selection of patient-subjects, disclosure of uncertainty, and defining success. The comparison of these two technologies and their ethical issues brings to light many challenges for translational tissue engineering research and provides guidance for investigators engaged in development of any tissue engineering technology. Copyright © 2015 Elsevier Inc. All rights reserved.

Frustration across the periodic table: heterolytic cleavage of dihydrogen by metal complexes.

PubMed

Bullock, R Morris; Chambers, Geoffrey M

2017-08-28

This perspective examines frustrated Lewis pairs (FLPs) in the context of heterolytic cleavage of H 2 by transition metal complexes, with an emphasis on molecular complexes bearing an intramolecular Lewis base. FLPs have traditionally been associated with main group compounds, yet many reactions of transition metal complexes support a broader classification of FLPs that includes certain types of transition metal complexes with reactivity resembling main group-based FLPs. This article surveys transition metal complexes that heterolytically cleave H 2 , which vary in the degree that the Lewis pairs within these systems interact. Many of the examples include complexes bearing a pendant amine functioning as the base with the metal functioning as the hydride acceptor. Consideration of transition metal compounds in the context of FLPs can inspire new innovations and improvements in transition metal catalysis.This article is part of the themed issue 'Frustrated Lewis pair chemistry'. © 2017 The Author(s).

76 FR 53531 - Environmental Impact Statement: Hancock County, MS

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-26

... wetland resources. Alternatives under consideration include (1) taking no action and (2) build..., due to the complexity of the project and a high number of sensitive wetland and water issues, it was...

Is cognitive science usefully cast as complexity science?

PubMed

Van Orden, Guy; Stephen, Damian G

2012-01-01

Readers of TopiCS are invited to join a debate about the utility of ideas and methods of complexity science. The topics of debate include empirical instances of qualitative change in cognitive activity and whether this empirical work demonstrates sufficiently the empirical flags of complexity. In addition, new phenomena discovered by complexity scientists, and motivated by complexity theory, call into question some basic assumptions of conventional cognitive science such as stable equilibria and homogeneous variance. The articles and commentaries that appear in this issue also illustrate a new debate style format for topiCS. Copyright © 2011 Cognitive Science Society, Inc.

The role of nurses in comprehensive care management of pregnant women with drug addiction.

PubMed

McKeever, Amy E; Spaeth-Brayton, Sylvia; Sheerin, Sarah

2014-01-01

Drug addiction during pregnancy is a complex health and social issue that requires an interdisciplinary health care team providing nonjudgmental, comprehensive care. Critical challenges include onset of and attendance at prenatal care, potential obstetric complications, transition to extrauterine life and potential neonatal abstinence syndrome for the neonate, newborn feeding issues, postpartum depression and risk of relapse for women. © 2014 AWHONN.

Next-generation digital camera integration and software development issues

NASA Astrophysics Data System (ADS)

Venkataraman, Shyam; Peters, Ken; Hecht, Richard

1998-04-01

This paper investigates the complexities associated with the development of next generation digital cameras due to requirements in connectivity and interoperability. Each successive generation of digital camera improves drastically in cost, performance, resolution, image quality and interoperability features. This is being accomplished by advancements in a number of areas: research, silicon, standards, etc. As the capabilities of these cameras increase, so do the requirements for both hardware and software. Today, there are two single chip camera solutions in the market including the Motorola MPC 823 and LSI DCAM- 101. Real time constraints for a digital camera may be defined by the maximum time allowable between capture of images. Constraints in the design of an embedded digital camera include processor architecture, memory, processing speed and the real-time operating systems. This paper will present the LSI DCAM-101, a single-chip digital camera solution. It will present an overview of the architecture and the challenges in hardware and software for supporting streaming video in such a complex device. Issues presented include the development of the data flow software architecture, testing and integration on this complex silicon device. The strategy for optimizing performance on the architecture will also be presented.

Creating political priority for micronutrient deficiencies: a qualitative case study from Senegal

PubMed Central

Balarajan, Yarlini

2014-01-01

Objectives To examine what factors influence the agenda-setting process and level of political priority afforded to micronutrient deficiencies (MNDs). Design Qualitative case study employing process tracing, informed by primary data collected from semistructured interviews with policymakers. Setting Dakar, Senegal. Results Several facilitating and impeding factors affecting the level of political prioritisation for MNDs were identified. Facilitating factors included multiple stakeholders using aligned framing to collectively advocate for MNDs; availability of indicators to quantify issue severity and raise awareness; and transnational advocacy activities around micronutrients. Impeding factors included lack of awareness among policymakers and civil society about MNDs; issue complexity, with the need for coordinated multisectoral response to deliver a complex package of solutions; lack of resources trapping the issue in a ‘low-priority’ cycle; lack of a policy champion to advocate for the issue and the challenge of demonstrating the effectiveness of interventions to support advocacy efforts. Conclusions This study gives insight into the political prioritisation process for MNDs from the perspective of key stakeholders working at the national level in Senegal. In doing so, the study offers some explanation as to why the issue of MNDs has struggled to gain political attention and make it onto the national policy agenda. Moving forward, greater awareness of the factors affecting agenda setting for MNDs may help to devise political strategies to champion this development issue in countries with high burdens of micronutrient deficiencies. PMID:25107435

Animal welfare: a complex domestic and international public-policy issue--who are the key players?

PubMed

Bayvel, A C David; Cross, Nicki

2010-01-01

Animal-welfare issues are usually portrayed in the media in a black-and-white fashion, with simple, single-perspective solutions proposed for what are often, in fact, complex policy issues. In this article, we argue that animal welfare is a multifaceted international and domestic public-policy issue that must take account of not only scientific, ethical, and economic issues but also religious, cultural, and international trade policy considerations. Management of animal welfare at a government policy level also requires an approach based on incremental change. Such change must be both science based and ethically principled, and the rate of change must recognize both the expectations of society and the constraints on the animal user. Ideally, such change should involve full ownership and buy-in from the affected animal user group. The range of stakeholders involved in the animal-welfare debate includes industry and producer groups, science bodies, and animal-welfare non-governmental organizations and professional groups, including the veterinary and legal professions. The veterinary profession, in particular, is expected to play an animal-welfare leadership role, and we discuss expectation versus reality at both a national and an international level. This latter discussion includes specific reference to the role of the World Organisation for Animal Health (the OIE) as an intergovernmental organization representing 175 countries and details some of the major achievements since the OIE assumed its international animal-welfare standard-setting role in 2002. We also address the role of the veterinary profession at national, regional, and international levels.

Partial androgen insensitivity syndrome

MedlinePlus

... depending on the extent of genital ambiguity. However, gender assignment is a complex issue and must be considered carefully. Possible treatments for PAIS include: For those assigned as males, surgery may be done to reduce breasts, repair undescended ...

Ethical, legal, and social issues in the translation of genomics into health care.

PubMed

Badzek, Laurie; Henaghan, Mark; Turner, Martha; Monsen, Rita

2013-03-01

The rapid continuous feed of new information from scientific discoveries related to the human genome makes translation and incorporation of information into the clinical setting difficult and creates ethical, legal, and social challenges for providers. This article overviews some of the legal and ethical foundations that guide our response to current complex issues in health care associated with the impact of scientific discoveries related to the human genome. Overlapping ethical, legal, and social implications impact nurses and other healthcare professionals as they seek to identify and translate into practice important information related to new genomic scientific knowledge. Ethical and legal foundations such as professional codes, human dignity, and human rights provide the framework for understanding highly complex genomic issues. Ethical, legal, and social concerns of the health provider in the translation of genomic knowledge into practice including minimizing harms, maximizing benefits, transparency, confidentiality, and informed consent are described. Additionally, nursing professional competencies related to ethical, legal, and social issues in the translation of genomics into health care are discussed. Ethical, legal, and social considerations in new genomic discovery necessitate that healthcare professionals have knowledge and competence to respond to complex genomic issues and provide appropriate information and care to patients, families, and communities. Understanding the ethical, legal, and social issues in the translation of genomic information into practice is essential to provide patients, families, and communities with competent, safe, effective health care. © 2013 Sigma Theta Tau International.

Using Multicriteria Analysis in Issues Concerning Adaptation of Historic Facilities for the Needs of Public Utility Buildings with a Function of a Theatre

NASA Astrophysics Data System (ADS)

Obracaj, Piotr; Fabianowski, Dariusz

2017-10-01

Implementations concerning adaptation of historic facilities for public utility objects are associated with the necessity of solving many complex, often conflicting expectations of future users. This mainly concerns the function that includes construction, technology and aesthetic issues. The list of issues is completed with proper protection of historic values, different in each case. The procedure leading to obtaining the expected solution is a multicriteria procedure, usually difficult to accurately define and requiring designer’s large experience. An innovative approach has been used for the analysis, namely - the modified EA FAHP (Extent Analysis Fuzzy Analytic Hierarchy Process) Chang’s method of a multicriteria analysis for the assessment of complex functional and spatial issues. Selection of optimal spatial form of an adapted historic building intended for the multi-functional public utility facility was analysed. The assumed functional flexibility was determined in the scope of: education, conference, and chamber spectacles, such as drama, concerts, in different stage-audience layouts.

Managing the integration and harmonization of national airspace for unmanned and manned systems

NASA Astrophysics Data System (ADS)

Mumm, Hans

This dissertation examines the leadership challenge created by the requirement to integrate unmanned aerial vehicles (UAVs) into the national airspace system (NAS). The lack of UAV-related federal rules and regulations is a primary factor prolonging this integration. This effort focuses primarily on the leadership portion of the solution and not the technological requirements. The research explores an adaptation of the complexity theory that offers a potential leadership framework for the government, industry, and academia to use for achieving the full integration of UAVs into the NAS. Due to the large number of stakeholders and the multitude of interrelated issues, a complexity-theory-leadership methodology was created and examined as a potential way to help the FAA accelerate their rule-making efforts. This dissertation focuses on United States UAV issues. The United States is one of the leaders in the unmanned systems arena, to include the first significant use of recoverable autonomous weaponized systems in combat. Issues such as airspace, airworthiness, social issues, privacy issues, regulations, and the lack of policies, procedures, or governance are universal for all countries that are active in this technology area. This qualitative dissertation makes use of the grounded theory methodology as it combines a literature review and research along with interviews with subject matter experts, and information gained from attending UAV related gatherings/discussions. The investigation uncovered significant FAA process impediments as well as some possible break through concepts that could work well with the complexity-theory-leadership methodology. Keywords: Complexity theory, leadership, change management, UAV, unmanned aerial vehicle, National Airspace, NAS, FAA, Federal Aviation Administration.

78 FR 58311 - Complex Issues in Developing Drug and Biological Products for Rare Diseases; Public Workshop...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-23

...] Complex Issues in Developing Drug and Biological Products for Rare Diseases; Public Workshop; Request for... Issues in Developing Drug and Biological Products for Rare Diseases.'' The purpose of the public workshop is twofold: To discuss complex issues in clinical trials for developing drug and biological products...

Validating Computational Human Behavior Models: Consistency and Accuracy Issues

DTIC Science & Technology

2004-06-01

includes a discussion of SME demographics, content, and organization of the datasets . This research generalizes data from two pilot studies and two base...meet requirements for validating the varied and complex behavioral models. Through a series of empirical studies , this research identifies subject...meet requirements for validating the varied and complex behavioral models. Through a series of empirical studies , this research identifies subject

Can Parent-Teacher Groups Work for All Students?

ERIC Educational Resources Information Center

Woyshner, Christine; Cucchiara, Maia

2017-01-01

Who benefits from parent-teacher organizations in schools? Which parents are included, and which are excluded? How can school leaders work with them? In this article, an historian and a sociologist review the complex history of parent-teacher organizing and examine current issues in parental efforts to improve schools, including concerns about…

Building Good New Ideas; Mixing Metaphors and Media: A Digital and Analog Elixir.

ERIC Educational Resources Information Center

McKenzie, Jamie

2001-01-01

Includes two articles. Topics include skills needed to teach young people how to build their own good ideas instead of cutting and pasting the ideas of others; and the trend toward false dichotomies and the dangers created when separating complex issues into two contrasting sides or choices. (LRW)

Poz-itively Transformational: Sex Workers and HIV/AIDS Education

ERIC Educational Resources Information Center

Hill, Robert J.

2005-01-01

HIV and AIDS are complex events that offer numerous opportunities for adult education. However, mainstream education on this issue has often not been relevant to a number of subpopulations, including sex workers. This chapter explores sources and content of HIV/AIDS education in the sex work industry (including art and the Internet) and suggests…

The composite complex span: French validation of a short working memory task.

PubMed

Gonthier, Corentin; Thomassin, Noémylle; Roulin, Jean-Luc

2016-03-01

Most studies in individual differences in the field of working memory research use complex span tasks to measure working memory capacity. Various complex span tasks based on different materials have been developed, and these tasks have proven both reliable and valid; several complex span tasks are often combined to provide a domain-general estimate of working memory capacity with even better psychometric properties. The present work sought to address two issues. Firstly, having participants perform several full-length complex span tasks in succession makes for a long and tedious procedure. Secondly, few complex span tasks have been translated and validated in French. We constructed a French working memory task labeled the Composite Complex Span (CCS). The CCS includes shortened versions of three classic complex span tasks: the reading span, symmetry span, and operation span. We assessed the psychometric properties of the CCS, including test-retest reliability and convergent validity, with Raven's Advanced Progressive Matrices and with an alpha span task; the CCS demonstrated satisfying qualities in a sample of 1,093 participants. This work provides evidence that shorter versions of classic complex span tasks can yield valid working memory estimates. The materials and normative data for the CCS are also included.

Occupational safety and health as an element of a complex compensation system evaluation within an organization.

PubMed

Beck-Krala, Ewa; Klimkiewicz, Katarzyna

2016-12-01

Occupational safety and health (OSH) plays a significant role in today's organizations, because it helps in attracting and retaining employees as well as molding their attitudes and behaviors at work. This is why the issue of OSH is stressed in a comprehensive approach to employee rewards: the total reward concept. This article explains how OSH may be included in a complex evaluation process of the compensation system. Although the literature on the effectiveness of employee compensation refers mainly to financial and non-financial components, there is a need for inclusion of working conditions in such analyses. An evaluation of the compensation system that incorporates OSH can drive many benefits for both the organization and employees. Obtaining such benefits, however, requires systematic evaluation of the reward system, including OSH. Incorporation of OSH issue within the comprehensive analysis of compensation systems promotes responsible behavior of all stakeholders.

Gynaecological issues affecting the obese adolescent.

PubMed

Wood, Paul L; Bauman, Dvora

2015-05-01

The implications of obesity in childhood and adolescence resonate into adulthood and have implications at different levels that include psychosocial and health issues that impact beyond reproductive performance. This chapter explores the various facets and consequences on gynaecological issues of increased Body Mass Index in childhood, including the link with puberty, pubertal menorrhagia (also affecting children with complex needs) and the all too common problems surrounding hyperandrogenism, insulin resistance and the polycystic ovarian syndrome in particular which need to be seen in the specific context of the adolescent years. The wider ramifications of obesity on the psychosocial welfare of adolescents merits special attention. Finally management strategies are considered in the context of the needs of adolescents. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Filicide in the United States

PubMed Central

Resnick, Phillip J.

2016-01-01

In the United States the Accreditation Council of Graduate Medical Education determines the curriculum required for fellows in forensic psychiatry to become board certified as a subspecialist. Areas that must be covered during the one year fellowship include criminal issues, such as insanity; civil issues, such as tort law and Workers’ Compensation; legal regulation of psychiatry, such as confidentiality and involuntary hospitalization; and correctional psychiatry issues, such as dual agency and prisoner's rights. Fellows are also expected to have knowledge about juvenile courts, the structure of the legal system, and child custody issues. In addition, fellows are required to analyze complex cases and write forensic reports which are well reasoned. Teaching methods include lectures, storytelling, use of video vignettes, and mock trials. Additional teaching methodologies include group supervision of fellows in their report writing and direct observation of giving testimony. During the year we see fellows evolve and shift their orientation from being an advocate for patients to perceiving their role as serving justice. PMID:28216771

Issues with RNA-seq analysis in non-model organisms: A salmonid example.

PubMed

Sundaram, Arvind; Tengs, Torstein; Grimholt, Unni

2017-10-01

High throughput sequencing (HTS) is useful for many purposes as exemplified by the other topics included in this special issue. The purpose of this paper is to look into the unique challenges of using this technology in non-model organisms where resources such as genomes, functional genome annotations or genome complexity provide obstacles not met in model organisms. To describe these challenges, we narrow our scope to RNA sequencing used to study differential gene expression in response to pathogen challenge. As a demonstration species we chose Atlantic salmon, which has a sequenced genome with poor annotation and an added complexity due to many duplicated genes. We find that our RNA-seq analysis pipeline deciphers between duplicates despite high sequence identity. However, annotation issues provide problems in linking differentially expressed genes to pathways. Also, comparing results between approaches and species are complicated due to lack of standardized annotation. Copyright © 2017 Elsevier Ltd. All rights reserved.

USMC Ground Surveillance Robot (GSR): Lessons Learned

NASA Astrophysics Data System (ADS)

Harmon, S. Y.

1987-02-01

This paper describes the design of an autonomous vehicle and the lessons learned during the implementation of that complex robot. The major problems encountered to which solutions were found include sensor processing bandwidth limitations, coordination of the interactions between major subsystems, sensor data fusion and system knowledge representation. Those problems remaining unresolved include system complexity management, the lack of powerful system monitoring and debugging tools, exploratory implementation of a complex system and safety and testing issues. Many of these problems arose from working with underdeveloped and continuously evolving technology and will probably be resolved as the technological resources mature and stabilize. Unfortunately, other problems will continue to plague developers throughout the evolution of autonomous system technology.

Building the Digital Library Infrastructure: A Primer.

ERIC Educational Resources Information Center

Tebbetts, Diane R.

1999-01-01

Provides a framework for examining the complex infrastructure needed to successfully implement a digital library. Highlights include database development, online public-access catalogs, interactive technical services, full-text documents, hardware and wiring, licensing, access, and security issues. (Author/LRW)

Heart Failure: From Research to Clinical Practice.

PubMed

Islam, Md Shahidul

2018-01-01

"Heart failure: from research to clinical practice", a collection of selected reviews, which comes out also as a book, covers essentially all important aspects of heart failure, including the pathogenesis, clinical features, biomarkers, imaging techniques, medical treatment and surgical treatments, use of pacemakers and implantable cardioverter defibrillators, and palliative care. The reviews include essential background information, state of the art, critical and in-depth analysis, and directions for future researches for elucidation of the unresolved issues. Everyone interested in heart failure is expected to find this compilation helpful for a deeper understanding of some of the complex issues.

Capturing the experiences of patients across multiple complex interventions: a meta-qualitative approach.

PubMed

Webster, Fiona; Christian, Jennifer; Mansfield, Elizabeth; Bhattacharyya, Onil; Hawker, Gillian; Levinson, Wendy; Naglie, Gary; Pham, Thuy-Nga; Rose, Louise; Schull, Michael; Sinha, Samir; Stergiopoulos, Vicky; Upshur, Ross; Wilson, Lynn

2015-09-08

The perspectives, needs and preferences of individuals with complex health and social needs can be overlooked in the design of healthcare interventions. This study was designed to provide new insights on patient perspectives drawing from the qualitative evaluation of 5 complex healthcare interventions. Patients and their caregivers were recruited from 5 interventions based in primary, hospital and community care in Ontario, Canada. We included 62 interviews from 44 patients and 18 non-clinical caregivers. Our team analysed the transcripts from 5 distinct projects. This approach to qualitative meta-evaluation identifies common issues described by a diverse group of patients, therefore providing potential insights into systems issues. This study is a secondary analysis of qualitative data; therefore, no outcome measures were identified. We identified 5 broad themes that capture the patients' experience and highlight issues that might not be adequately addressed in complex interventions. In our study, we found that: (1) the emergency department is the unavoidable point of care; (2) patients and caregivers are part of complex and variable family systems; (3) non-medical issues mediate patients' experiences of health and healthcare delivery; (4) the unanticipated consequences of complex healthcare interventions are often the most valuable; and (5) patient experiences are shaped by the healthcare discourses on medically complex patients. Our findings suggest that key assumptions about patients that inform intervention design need to be made explicit in order to build capacity to better understand and support patients with multiple chronic diseases. Across many health systems internationally, multiple models are being implemented simultaneously that may have shared features and target similar patients, and a qualitative meta-evaluation approach, thus offers an opportunity for cumulative learning at a system level in addition to informing intervention design and modification. 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.

Intertextuality for Handling Complex Environmental Issues

ERIC Educational Resources Information Center

Byhring, Anne Kristine; Knain, Erik

2016-01-01

Nowhere is the need for handling complexity more pertinent than in addressing environmental issues. Our study explores students' situated constructs of complexity in unfolding discourses on socio-scientific issues. Students' dialogues in two group-work episodes are analysed in detail, with tools from Systemic Functional Linguistics. We identify…

Understanding Crew Decision-Making in the Presence of Complexity: A Flight Simulation Experiment

NASA Technical Reports Server (NTRS)

Young, Steven D.; Daniels, Taumi S.; Evans, Emory; deHaag, Maarten Uijt; Duan, Pengfei

2013-01-01

Crew decision making and response have long been leading causal and contributing factors associated with aircraft accidents. Further, it is anticipated that future aircraft and operational environments will increase exposure to risks related to these factors if proactive steps are not taken to account for ever-increasing complexity. A flight simulation study was designed to collect data to help in understanding how complexity can, or may, be manifest. More specifically, an experimental apparatus was constructed that allowed for manipulation of information complexity and uncertainty, while also manipulating operational complexity and uncertainty. Through these manipulations, and the aid of experienced airline pilots, several issues have been discovered, related most prominently to the influence of information content, quality, and management. Flight crews were immersed in an environment that included new operational complexities suggested for the future air transportation system as well as new technological complexities (e.g. electronic flight bags, expanded data link services, synthetic and enhanced vision systems, and interval management automation). In addition, a set of off-nominal situations were emulated. These included, for example, adverse weather conditions, traffic deviations, equipment failures, poor data quality, communication errors, and unexpected clearances, or changes to flight plans. Each situation was based on one or more reference events from past accidents or incidents, or on a similar case that had been used in previous developmental tests or studies. Over the course of the study, 10 twopilot airline crews participated, completing over 230 flights. Each flight consisted of an approach beginning at 10,000 ft. Based on the recorded data and pilot and research observations, preliminary results are presented regarding decision-making issues in the presence of the operational and technological complexities encountered during the flights.

75 FR 9869 - Silicon Metal From the People's Republic of China: Extension of Time Limit for the Preliminary...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-04

... information pertaining to complex issues, including surrogate value information relating to certain raw material inputs. Therefore, in accordance with section 751(a)(3)(A) of the Act, the Department is extending...

Issues in Designing Assessments of Historical Thinking

ERIC Educational Resources Information Center

Ercikan, Kadriye; Seixas, Peter

2015-01-01

Similar to educators in mathematics, science, and reading, history educators around the world have mobilized curricular reform movements toward including complex thinking in history education, advancing historical thinking, developing historical consciousness, and teaching competence in historical sense making. These reform movements, including…

Raising Awareness of Pre-Symptomatic Genetic Testing

ERIC Educational Resources Information Center

Boerwinkel, Dirk Jan; Knippels, Marie-Christine; Waarlo, Arend Jan

2011-01-01

Presymptomatic genetic testing generates socioscientific issues in which decision making is complicated by several complexity factors. These factors include weighing of advantages and disadvantages, different interests of stakeholders, uncertainty of genetic information and conflicting values. Education preparing students for future decision…

The Importance of Training for Environmental Management.

ERIC Educational Resources Information Center

Furtado, Jose I.

1984-01-01

Discusses an appropriate framework for sustainable development in the Third World that concurrently addresses the efficient utilization and management of natural resources. Areas considered include: human dimension; sustainable development; complexity of inputs; kinds of training; indigenous scientific capability; transnational issues;…

The Kept University.

ERIC Educational Resources Information Center

Press, Eyal; Washburn, Jennifer

2000-01-01

Examines the trend of increasing collaboration between American universities and corporations, including issues such as the academic-industrial complex, secrecy and science, the university as a business/commercial enterprise, who controls the research agenda, downsizing the humanities, and on-line marketing of course material. Expresses concerns…

Problematisations of Complexity: On the Notion and Production of Diverse Complexities in Healthcare Interventions and Evaluations

PubMed Central

Broer, Tineke; Bal, Roland; Pickersgill, Martyn

2017-01-01

Abstract Within the literature on the evaluation of health (policy) interventions, complexity is a much-debated issue. In particular, many claim that so-called ‘complex interventions’ pose different challenges to evaluation studies than apparently ‘simple interventions’ do. Distinct ways of doing evaluation entail particular ontologies and epistemologies of complexity. They differ in terms of whether they define complexity as a quantitative trait of interventions, whether they see evaluation as part of or outside the intervention, and whether complexity can be regarded as an emergent property of the intervention and its evaluation. In practice, evaluators and commissioners of large health care improvement programmes rely on different, sometimes contradictory, repertoires about what it means to conduct a ‘good’ evaluation. This is an ongoing matter negotiated between and among commissioners, researchers, and—sometimes—programme managers. In particular, notions of evaluability, usefulness and distance/independence are problematised in different ways and with diverse consequences, which, in turn, produce other notions and layers of complexity such as temporal, institutional and affective complexities. When (social science) researchers claim that one method or another is better able to grasp complexity, they elide the issue that any methodological choice emphasises some complexities and lets others fade into the background. Analysing the practicalities and emotions involved in evaluation studies opens up the notion of complexity to analytical scrutiny, and suggests a basis for co-theorising between biomedical, public health and social scientists (including Science and Technology Studies scholars). PMID:28515573

A 50-Year-Old Woman Addicted to Heroin

PubMed Central

O’Brien, Charles P.

2011-01-01

Heroin addiction is a complicated medical and psychiatric issue, with well-established as well as newer modes of treatment. The case of Ms W, a 50-year-old woman with a long history of opiate addiction who has been treated successfully with methadone for 9 years and who now would like to consider newer alternatives, illustrates the complex issues of heroin addiction. The treatment of heroin addiction as a chronic disease is reviewed, including social, medical, and cultural issues and pharmacologic treatment with methadone and the more experimental medication options of buprenorphine and naltrexone. PMID:18594026

Prescriptive authority for advanced practice nurses: current and future perspectives.

PubMed

McDermott, K C

1995-09-01

To present an overview of the issues related to prescriptive authority and advanced practice nurses (APNs) in oncology. Professional journals and books, print media, and professional and government releases. Discussion of issues related to complex political, educational, economic, and healthcare environmental factors. Strategies to achieve increased recognition for APN prescriptive authority include increasing APNs' knowledge about the effects of the political process on prescriptive authority, educating legislators and consumers, promoting standardization of pharmacology curricula, and encouraging formation of coalitions. Failure to pass a national healthcare plan, escalating managed-care markets, and the reform efforts of individual states to forge their own healthcare initiatives will challenge the APN's ability to practice and prescribe. The subject of prescriptive authority highlights the controversies and debates that APNs encounter in a dynamic healthcare environment. These include the complexity of state-to-state regulations, non-nursing professions making key decisions regarding scope of practice and prescriptive authority, and the challenge for APNs to carve out new roles while overcoming state regulatory inconsistencies and market-reform barriers. If not resolved, these issues will continue to prevent qualified APNs from providing appropriate and comprehensive care to patients with cancer.

A comparison of ethical issues in nursing practice across nursing units.

PubMed

Park, Mihyun; Jeon, Sang Hee; Hong, Hyun-Ja; Cho, Sung-Hyun

2014-08-01

The complexity and variety of ethical issues in nursing is always increasing, and those issues lead to special concerns for nurses because they have critical impacts on nursing practice. The purpose of this study was to gather comprehensive information about ethical issues in nursing practice, comparing the issues in different types of nursing units including general units, oncology units, intensive care units, operating rooms, and outpatient departments. The study used a descriptive research design. Ethics/human rights issues encountered by nurses in their daily nursing practice were identified by using the Ethical Issues Scale. The study sample included 993 staff nurses working in a university hospital in South Korea. This study was approved by the University Institutional Review Board. Completed questionnaires were returned sealed with signed informed consent. The most frequently and disturbingly encountered issues across nursing units were "conflicts in the nurse-physician relationship," "providing care with a possible risk to your health," and "staffing patterns that limit patient access to nursing care." The findings of this study showed that nurses from different nursing units experienced differences in the types or frequency of ethical issues. In particular, intensive care units had the greatest means of all the units in all three component scales including end-of-life treatment issues, patient care issues, and human rights issues. Nurses experienced various ethical challenges in their daily practice. Of the ethical issues, some were distinctively and frequently experienced by nurses in a specific unit. This study suggested that identifying and understanding specific ethical issues faced by nurses in their own areas may be an effective educational approach to motivate nurses and to facilitate nurses' reflection on their experiences. © The Author(s) 2014.

Computational Modeling of Liquid and Gaseous Control Valves

NASA Technical Reports Server (NTRS)

Daines, Russell; Ahuja, Vineet; Hosangadi, Ashvin; Shipman, Jeremy; Moore, Arden; Sulyma, Peter

2005-01-01

In this paper computational modeling efforts undertaken at NASA Stennis Space Center in support of rocket engine component testing are discussed. Such analyses include structurally complex cryogenic liquid valves and gas valves operating at high pressures and flow rates. Basic modeling and initial successes are documented, and other issues that make valve modeling at SSC somewhat unique are also addressed. These include transient behavior, valve stall, and the determination of flow patterns in LOX valves. Hexahedral structured grids are used for valves that can be simplifies through the use of axisymmetric approximation. Hybrid unstructured methodology is used for structurally complex valves that have disparate length scales and complex flow paths that include strong swirl, local recirculation zones/secondary flow effects. Hexahedral (structured), unstructured, and hybrid meshes are compared for accuracy and computational efficiency. Accuracy is determined using verification and validation techniques.

The Growing Complexity of Sino-Indian Ties

DTIC Science & Technology

2014-06-01

with a record of dealing with North Korea , Iran , and Libya, reflects China’s growing diplomatic confidence and underscores its view of Pakistan as a...issues. Dr. Pant’s most recent books include The US-India Nuclear Pact: Policy, Process and Great Power Politics (Oxford Univer- sity Press, 2011...membership at the United Nations (UN) but also opposed attempts to condemn the PRC for its actions in Korea . Yet, the issue of Tibet soon emerged as the

Key Scientific Issues in the Health Risk Assessment of Trichloroethylene

PubMed Central

Chiu, Weihsueh A.; Caldwell, Jane C.; Keshava, Nagalakshmi; Scott, Cheryl Siegel

2006-01-01

Trichloroethylene (TCE) is a common environmental contaminant at hazardous waste sites and in ambient and indoor air. Assessing the human health risks of TCE is challenging because of its inherently complex metabolism and toxicity and the widely varying perspectives on a number of critical scientific issues. Because of this complexity, the U.S. Environmental Protection Agency (EPA) drew upon scientific input and expertise from a wide range of groups and individuals in developing its 2001 draft health risk assessment of TCE. This scientific outreach, which was aimed at engaging a diversity of perspectives rather than developing consensus, culminated in 2000 with 16 state-of-the-science articles published together as an Environmental Health Perspectives supplement. Since that time, a substantial amount of new scientific research has been published that is relevant to assessing TCE health risks. Moreover, a number of difficult or controversial scientific issues remain unresolved and are the subject of a scientific consultation with the National Academy of Sciences coordinated by the White House Office of Science and Technology Policy and co-sponsored by a number of federal agencies, including the U.S. EPA. The articles included in this mini-monograph provide a scientific update on the most prominent of these issues: the pharmacokinetics of TCE and its metabolites, mode(s) of action and effects of TCE metabolites, the role of peroxisome proliferator–activated receptor in TCE toxicity, and TCE cancer epidemiology. PMID:16966103

Exploring: Microbes.

ERIC Educational Resources Information Center

Brand, Judith, Ed.

1997-01-01

This issue of Exploratorium Magazine focuses on microbes. Different types of microorganisms are introduced based on their living environments or whether they are harmful or beneficial. Contents include: (1) "It's a Small World" (Blake Edgar); (2) "The Human Body: A Complex Ecosystem" (Nik Walter); (3) "The Hills That…

Fort Collins Science Center Ecosystem Dynamics branch--interdisciplinary research for addressing complex natural resource issues across landscapes and time

USGS Publications Warehouse

Bowen, Zachary H.; Melcher, Cynthia P.; Wilson, Juliette T.

2013-01-01

The Ecosystem Dynamics Branch of the Fort Collins Science Center offers an interdisciplinary team of talented and creative scientists with expertise in biology, botany, ecology, geology, biogeochemistry, physical sciences, geographic information systems, and remote-sensing, for tackling complex questions about natural resources. As demand for natural resources increases, the issues facing natural resource managers, planners, policy makers, industry, and private landowners are increasing in spatial and temporal scope, often involving entire regions, multiple jurisdictions, and long timeframes. Needs for addressing these issues include (1) a better understanding of biotic and abiotic ecosystem components and their complex interactions; (2) the ability to easily monitor, assess, and visualize the spatially complex movements of animals, plants, water, and elements across highly variable landscapes; and (3) the techniques for accurately predicting both immediate and long-term responses of system components to natural and human-caused change. The overall objectives of our research are to provide the knowledge, tools, and techniques needed by the U.S. Department of the Interior, state agencies, and other stakeholders in their endeavors to meet the demand for natural resources while conserving biodiversity and ecosystem services. Ecosystem Dynamics scientists use field and laboratory research, data assimilation, and ecological modeling to understand ecosystem patterns, trends, and mechanistic processes. This information is used to predict the outcomes of changes imposed on species, habitats, landscapes, and climate across spatiotemporal scales. The products we develop include conceptual models to illustrate system structure and processes; regional baseline and integrated assessments; predictive spatial and mathematical models; literature syntheses; and frameworks or protocols for improved ecosystem monitoring, adaptive management, and program evaluation. The descriptions in this fact sheet provide snapshots of our three research emphases, followed by descriptions of select current projects.

Capacity planning in a transitional economy: What issues? Which models?

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

Mubayi, V.; Leigh, R.W.; Bright, R.N.

1996-03-01

This paper is devoted to an exploration of the important issues facing the Russian power generation system and its evolution in the foreseeable future and the kinds of modeling approaches that capture those issues. These issues include, for example, (1) trade-offs between investments in upgrading and refurbishment of existing thermal (fossil-fired) capacity and safety enhancements in existing nuclear capacity versus investment in new capacity, (2) trade-offs between investment in completing unfinished (under construction) projects based on their original design versus investment in new capacity with improved design, (3) incorporation of demand-side management options (investments in enhancing end-use efficiency, for example)more » within the planning framework, (4) consideration of the spatial dimensions of system planning including investments in upgrading electric transmission networks or fuel shipment networks and incorporating hydroelectric generation, (5) incorporation of environmental constraints and (6) assessment of uncertainty and evaluation of downside risk. Models for exploring these issues include low power shutdown (LPS) which are computationally very efficient, though approximate, and can be used to perform extensive sensitivity analyses to more complex models which can provide more detailed answers but are computationally cumbersome and can only deal with limited issues. The paper discusses which models can usefully treat a wide range of issues within the priorities facing decision makers in the Russian power sector and integrate the results with investment decisions in the wider economy.« less

President's Remarks. More about Animals in Research.

ERIC Educational Resources Information Center

Bird, Stephanie J.

1990-01-01

Discussed is the complexity of the issue concerning the use of live animals as subjects in laboratory tests. Included is a column written by Dr. Suzanne L. Epstein that discusses some of the advantages and disadvantages of use of tissue culture to replace laboratory animals. (CW)

Professional Ethics in Teaching: Towards the Development of a Code of Practice.

ERIC Educational Resources Information Center

Campbell, Elizabeth

2000-01-01

Provides a theoretical discussion about the process of creating a professional code of ethics for educators. Discusses six key issues and questions, introducing the development of a code of professional ethics and the complexities the code should address. Includes references. (CMK)

Practising Conservation Biology in a Virtual Rainforest World

ERIC Educational Resources Information Center

Schedlbauer, Jessica L.; Nadolny, Larysa; Woolfrey, Joan

2016-01-01

The interdisciplinary science of conservation biology provides undergraduate biology students with the opportunity to connect the biological sciences with disciplines including economics, social science and philosophy to address challenging conservation issues. Because of its complexity, students do not often have the opportunity to practise…

Is Your Sick Leave Bank in Good Health?

ERIC Educational Resources Information Center

Hoover, James P.

2012-01-01

Sick leave banks are a common staple of teacher contracts. Although these banks may benefit employees, they expose school districts to a variety of complications and unintended consequences, including administrative complexity, potential cash flow implications, cost disparities, increased absenteeism, instructional instability, privacy issues, and…

Complexity and performance of on-chip biochemical assays

NASA Astrophysics Data System (ADS)

Kopf-Sill, Anne R.; Nikiforov, Theo; Bousse, Luc J.; Nagle, Rob; Parce, J. W.

1997-03-01

The use of microchips for performing biochemical processes has the potential to reduce reagent use and thus assay costs, increase throughput, and automate complex processes. We are building a multifunctional platform that provides sensing and actuation functions for a variety of microchip- based biochemical and analytical processes. Here we describe recent experiments that include on-chip dilution, reagent mixing, reaction, separation, and detection for important classes of biochemical assays. Issues in chip design and control are discussed.

Complexity in electronic negotiation support systems.

PubMed

Griessmair, Michele; Strunk, Guido; Vetschera, Rudolf; Koeszegi, Sabine T

2011-10-01

It is generally acknowledged that the medium influences the way we communicate and negotiation research directs considerable attention to the impact of different electronic communication modes on the negotiation process and outcomes. Complexity theories offer models and methods that allow the investigation of how pattern and temporal sequences unfold over time in negotiation interactions. By focusing on the dynamic and interactive quality of negotiations as well as the information, choice, and uncertainty contained in the negotiation process, the complexity perspective addresses several issues of central interest in classical negotiation research. In the present study we compare the complexity of the negotiation communication process among synchronous and asynchronous negotiations (IM vs. e-mail) as well as an electronic negotiation support system including a decision support system (DSS). For this purpose, transcripts of 145 negotiations have been coded and analyzed with the Shannon entropy and the grammar complexity. Our results show that negotiating asynchronically via e-mail as well as including a DSS significantly reduces the complexity of the negotiation process. Furthermore, a reduction of the complexity increases the probability of reaching an agreement.

Dispersal and fallout simulations for urban consequences management (u)

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

Grinstein, Fernando F; Wachtor, Adam J; Nelson, Matt

2010-01-01

Hazardous chemical, biological, or radioactive releases from leaks, spills, fires, or blasts, may occur (intentionally or accidentally) in urban environments during warfare or as part of terrorist attacks on military bases or other facilities. The associated contaminant dispersion is complex and semi-chaotic. Urban predictive simulation capabilities can have direct impact in many threat-reduction areas of interest, including, urban sensor placement and threat analysis, contaminant transport (CT) effects on surrounding civilian population (dosages, evacuation, shelter-in-place), education and training of rescue teams and services. Detailed simulations for the various processes involved are in principle possible, but generally not fast. Predicting urban airflowmore » accompanied by CT presents extremely challenging requirements. Crucial technical issues include, simulating turbulent fluid and particulate transport, initial and boundary condition modeling incorporating a consistent stratified urban boundary layer with realistic wind fluctuations, and post-processing of the simulation results for practical consequences management. Relevant fluid dynamic processes to be simulated include, detailed energetic and contaminant sources, complex building vortex shedding and flows in recirculation zones, and modeling of particle distributions, including particulate fallout, as well as deposition, re-suspension and evaporation. Other issues include, modeling building damage effects due to eventual blasts, addressing appropriate regional and atmospheric data reduction.« less

A Professional Development School Partnership: Conflict and Collaboration.

ERIC Educational Resources Information Center

Campoy, Renee W.

This book describes complex issues involved in an elementary Professional Development School (PDS) partnership. Section one presents contextual information on the nature of the PDS phenomenon. It includes three chapters: (1) "Introduction and PDS as a Reform Initiative"; (2) "Methodology of the Case Study"; and (3)…

Toward Adaptability: Where to from Here?

ERIC Educational Resources Information Center

Parsons, Seth A.; Vaughn, Margaret

2016-01-01

In this article, the collection of articles in this issue are synthesized to discuss conceptualizations of adaptive teaching as a means to foster spaces for adaptive teaching in today's complex educational system. Themes that exist across this collection of articles include adaptive teachers as constructivists, adaptive teachers as knowledgeable…

Does Your Graphing Software Real-ly Work?

ERIC Educational Resources Information Center

Marchand, R. J.; McDevitt, T. J.; Bosse, Michael J.; Nandakumar, N. R.

2007-01-01

Many popular mathematical software products including Maple, Mathematica, Derive, Mathcad, Matlab, and some of the TI calculators produce incorrect graphs because they use complex arithmetic instead of "real" arithmetic. This article expounds on this issue, provides possible remedies for instructors to share with their students, and demonstrates…

Ecological Stewardship and Gifted Children

ERIC Educational Resources Information Center

McHardy, Roberta J.; Blanchard, Pamela B.; de Wet, Catharina F.

2009-01-01

In even the earliest studies of giftedness in young children (Burks, Jensen, & Terman, 1930; Hollingworth, 1926), researchers noted distinct character traits among gifted students, which included global awareness, sensitivity to complex issues, and a tendency to worry about injustice and dangers that often are beyond a child's control.…

Food for Thought.

ERIC Educational Resources Information Center

Given, Barbara K.

1998-01-01

What and how students eat can profoundly affect their ability to learn. Children require a high-protein breakfast for alertness, and a balanced diet, including complex carbohydrates throughout the day. Chronic stress causes the brain and body to deplete available nutrients. Nutrition is an important issue; better school food equals better school…

Managing Curriculum Change and "Ontological Uncertainty" in Tertiary Education

ERIC Educational Resources Information Center

Keesing-Styles, Linda; Nash, Simon; Ayres, Robert

2014-01-01

Curriculum reform at institutional level is a challenging endeavour. Those charged with leading this process will encounter both enthusiasm and multiple obstacles to teacher engagement including the particularly complex issue of confronting existing teacher identities. At Unitec Institute of Technology (Unitec), the "Living Curriculum"…

Ethical learning on international medical electives: a case-based analysis of medical student learning experiences.

PubMed

Bowsher, Gemma; Parry-Billings, Laura; Georgeson, Anna; Baraitser, Paula

2018-04-11

Students on international medical electives face complex ethical issues when undertaking clinical work. The variety of elective destinations and the culturally specific nature of clinical ethical issues suggest that pre-elective preparation could be supplemented by in-elective support. An online, asynchronous, case-based discussion was piloted to support ethical learning on medical student electives. We developed six scenarios from elective diaries to stimulate peer-facilitated discussions during electives. We evaluated the transcripts to assess whether transformative, experiential learning took place, assessing specifically for indications that 1) critical reflection, 2) reflective action and 3) reflective learning were taking place. We also completed a qualitative thematic content analysis of the discussions. Of forty-one extended comments, nine responses showed evidence of transformative learning (Mezirow stage three). The thematic analysis identified five themes: adopting a position on ethical issues without overt analysis; presenting issues in terms of their effects on students' ability to complete tasks; describing local contexts and colleagues as "other"; difficulty navigating between individual and structural issues, and overestimation of the impact of individual action on structures and processes. Results suggest a need to: frame ethical learning on elective so that it builds on earlier ethical programmes in the curriculum, and encourages students to adopt structured approaches to complex ethical issues including cross-cultural negotiation and to enhance global health training within the curriculum.

Some thoughts on the management of large, complex international space ventures

NASA Technical Reports Server (NTRS)

Lee, T. J.; Kutzer, Ants; Schneider, W. C.

1992-01-01

Management issues relevant to the development and deployment of large international space ventures are discussed with particular attention given to previous experience. Management approaches utilized in the past are labeled as either simple or complex, and signs of efficient management are examined. Simple approaches include those in which experiments and subsystems are developed for integration into spacecraft, and the Apollo-Soyuz Test Project is given as an example of a simple multinational approach. Complex approaches include those for ESA's Spacelab Project and the Space Station Freedom in which functional interfaces cross agency and political boundaries. It is concluded that individual elements of space programs should be managed by individual participating agencies, and overall configuration control is coordinated by level with a program director acting to manage overall objectives and project interfaces.

78 FR 20661 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-05

... Category: For a food additive petition without complex chemistry, manufacturing, efficacy, or safety issues...) Complex Category: For a food additive petition with complex chemistry, manufacturing, efficacy, and/or... additive file without complex chemistry, manufacturing, efficacy, or safety issues, the estimated time...

Metabolic and nutritional aspects of cancer.

PubMed

Krawczyk, Joanna; Kraj, Leszek; Ziarkiewicz, Mateusz; Wiktor-Jędrzejczak, Wiesław

2014-08-22

Cancer, being in fact a generalized disease involving the whole organism, is most frequently associated with metabolic deregulation, a latent inflammatory state and anorexia of various degrees. The pathogenesis of this disorder is complex, with multiple dilemmas remaining unsolved. The clinical consequences of the above-mentioned disturbances include cancer-related cachexia and anorexia-cachexia syndrome. These complex clinical entities worsen the prognosis, and lead to deterioration of the quality of life and performance status, and thus require multimodal treatment. Optimal therapy should include nutritional support coupled with pharmacotherapy targeted at underlying pathomechanisms of cachexia. Nevertheless, many issues still need explanation, and efficacious and comprehensive therapy of cancer-related cachexia remains a future objective.

Stem cell research as innovation: expanding the ethical and policy conversation.

PubMed

Dresser, Rebecca

2010-01-01

Research using human embryonic stem cells raises an array of complex ethical issues, including, but by no means limited to, the moral status of developing human life. Unfortunately much of the public discussion fails to take into account this complexity. Advocacy for liberal and conservative positions on human embryonic stem cell research can be simplistic and misleading. Ethical concepts such as truth-telling, scientific integrity, and social justice should be part of the debate over federal support for human embryonic stem cell research. Moreover, the debate should be conducted in accord with principles of deliberative democracy, including respect for people holding competing views.

Coaching: a different approach to the nursing dilemma.

PubMed

Stedman, Martha E; Nolan, Thomas L

2007-01-01

While the current nursing shortage continues, many new approaches from sign-on bonuses to "fast track training" are being suggested and implemented to ameliorate the situation. Yet, even with these expanded opportunities turnover is still too high. Recent studies suggest embedded factors called fit, links, and sacrifice exist between the employer and employees including nurses that account for current employees staying on their job. Creating a better understanding of embedded issues and creating an open but confidential environment to deal with conflict issues and job problems is suggested as a way to reduce turnover. A specific issue such as an unfavorable job assignment or more complex issues such as unmet expectations can cause conflict and job dissatisfaction. It is suggested that a coaching model can be used to understand the issues that create conflict and provide a method for resolution of job dissatisfaction.

Developing Character and Values for Global Citizens: Analysis of pre-service science teachers' moral reasoning on socioscientific issues

NASA Astrophysics Data System (ADS)

Lee, Hyunju; Chang, Hyunsook; Choi, Kyunghee; Kim, Sung-Won; Zeidler, Dana L.

2012-04-01

Character and values are the essential driving forces that serve as general guides or points of reference for individuals to support decision-making and to act responsibly about global socioscientific issues (SSIs). Based on this assumption, we investigated to what extent pre-service science teachers (PSTs) of South Korea possess character and values as global citizens; these values include ecological worldview, socioscientific accountability, and social and moral compassion. Eighteen PSTs participated in the SSI programs focusing on developing character and values through dialogical and reflective processes. SSIs were centered on the use of nuclear power generation, climate change, and embryonic stem cell research. The results indicated that PSTs showed three key elements of character and values, but failed to apply consistent moral principles on the issues and demonstrated limited global perspectives. While they tended to approach the issues with emotion and sympathy, they nonetheless failed to perceive themselves as major moral agents who are able to actively resolve large-scale societal issues. This study also suggests that the SSI programs can facilitate socioscientific reasoning to include abilities such as recognition of the complexity of SSIs, examine issues from multiple perspectives, and exhibit skepticism about information.

Biosimilar therapeutics-what do we need to consider?

PubMed

Schellekens, Huub

2009-01-01

Patents for the first generation of approved biopharmaceuticals have either expired or are about to expire. Thus the market is opening for generic versions, referred to as 'biosimilars' (European Union) or 'follow-on protein products' (United States). Healthcare professionals need to understand the critical issues surrounding the use of biosimilars to make informed treatment decisions.The complex high-molecular-weight three-dimensional structures of biopharmaceuticals, their heterogeneity and dependence on production in living cells makes them different from classical chemical drugs. Current analytical methods cannot characterize these complex molecules sufficiently to confirm structural equivalence with reference molecules. Verification of the similarity of biosimilars to innovator biopharmaceuticals remains a key challenge. Furthermore, a critical safety issue, the immunogenicity of biopharmaceuticals, has been highlighted in recent years, confirming a need for comprehensive immunogenicity testing prior to approval and extended post-marketing surveillance.Biosimilars present a new set of challenges for regulatory authorities when compared with conventional generics. While the demonstration of a pharmacokinetic similarity is sufficient for conventional, small-molecule generic agents, a number of issues will make the approval of biosimilars more complicated. Documents recently published by the European Medicines Agency (EMEA) outlining requirements for the market approval of biosimilars provide much-needed guidance. The EMEA has approved a number of biosimilar products in a scientifically rigorous and balanced process. Outstanding issues include the interchangeability of biosimilars and innovator products, the possible need for unique naming to differentiate the various biopharmaceutical products, and more comprehensive labelling for biosimilars to include relevant clinical data.

Fostering Ecological Literacy: A Case Study of the Saint John Harbour in Two High School English Language Arts Classrooms

NASA Astrophysics Data System (ADS)

Douglas, Velta

Integrating environmental education into curriculum in a way that tackles the holistic and complicated nature of multi-dimensional issues continues to be a challenge for educators and administrators. There is potential in using ecological literacy to introduce local environmental case studies into English Language Arts high school classrooms. This research examines the experiences of two ELA classrooms in one Saint John, NB, high school with a two-week unit based on stakeholder relationships within the Saint John Harbour. Through presentations by guest speakers and research sourced from local community groups, students learned about the highly complex environmental issues that inform management decisions for the Harbour. Using these materials as background, students participated in a mock stakeholders meeting. Case study methodology was used to explore student learning in both a higher-level and a lower-level grade 10 ELA class. Data for the analysis included: cognitive mapping exercises; oral and written classroom assignments and activities; a videotape of the mock stakeholder meetings; a focus group interview with selected students; and researcher field notes. Data demonstrated significant student learning about environmental issues including increased sophistication in describing links between and among environmental issues affecting the harbour, and much more complex understandings of the positions and roles of the various stakeholder groups. Some important areas of resistance to new learning were also evident. Implications for practice and policy and recommendations for future research are discussed.

Remote Sensing of Complex Flows by Doppler Wind Lidar: Issues and Preliminary Recommendations

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

Clifton, Andrew; Boquet, Matthieu; Burin Des Roziers, Edward

Remote sensing of winds using lidar has become popular and useful in the wind energy industry. Extensive experience has been gained with using lidar for applications including land-based and offshore resource assessment, plant operations, and turbine control. Prepared by members of International Energy Agency Task 32, this report describes the state of the art in the use of Doppler wind lidar for resource assessment in complex flows. The report will be used as input for future recommended practices on this topic.

Active Control of Combustion Instability in a Ramjet Using Large-Eddy Simulations

DTIC Science & Technology

1992-09-01

model is also used to determine the turbulent subgrid fluxes appearing in the momentum equations. Thus, the subgrid stresses in the momentum transport...flows and in flows with complex geometries. To include the effect of walls, an additional correction has been used to ensure that the subgrid stress ...subgrid stress Ty varies as y+3 near the wall. A major issue for LES of complex flows is whether the primary assumption that the subgrid scales are

Into the void: Regulating pesticide use in Colorado's commercial cannabis markets.

PubMed

Subritzky, Todd; Pettigrew, Simone; Lenton, Simon

2017-04-01

In 2014, Colorado implemented the world's first seed-to-sale recreational cannabis market under a commercial model. This paper aims to provide a thick descriptive account that gives insight into the issues and complexities of Colorado's pioneering and evolving attempt to regulate the use of pesticides on commercial cannabis plantations. The paper examines multiple data sets including: (i) Colorado State Government documents; (ii) recreational cannabis regulations; (iii) mass and niche media publications (n=175); (iv) face-to-face interviews with key stakeholders, including seniors, regulators and industry executives (n=8); and (v) field notes from relevant conferences and cultivation facility tours in Denver in October, 2016. Two key issues are identified. First, a public safety threat has arisen relating to application of pesticides on cannabis with intensified toxicity in concentrated products of particular concern. Second, as a pioneering jurisdiction, Colorado faces a considerable knowledge gap. To expand collective learning on this issue, for which no regulatory template and little research exists, state regulators tapped industry and other stakeholder expertise while attempting to ensure public safety goals were achieved and regulatory capture by industry was limited. Four years since the recreational cannabis market in Colorado was legalised, the State continues to grapple with the pesticide issue as testing regulations and cultivation standards are yet to be finalised. While more work is needed, Colorado has made significant progress in developing regulations relating to this complex matter. As governments of countries such as Canada and US states, including California, contemplate changes to recreational cannabis laws, Colorado's experience can assist regulators in other jurisdictions considering policy change. Copyright © 2017 Elsevier B.V. All rights reserved.

Making sense in a complex landscape: how the Cynefin Framework from Complex Adaptive Systems Theory can inform health promotion practice.

PubMed

Van Beurden, Eric K; Kia, Annie M; Zask, Avigdor; Dietrich, Uta; Rose, Lauren

2013-03-01

Health promotion addresses issues from the simple (with well-known cause/effect links) to the highly complex (webs and loops of cause/effect with unpredictable, emergent properties). Yet there is no conceptual framework within its theory base to help identify approaches appropriate to the level of complexity. The default approach favours reductionism--the assumption that reducing a system to its parts will inform whole system behaviour. Such an approach can yield useful knowledge, yet is inadequate where issues have multiple interacting causes, such as social determinants of health. To address complex issues, there is a need for a conceptual framework that helps choose action that is appropriate to context. This paper presents the Cynefin Framework, informed by complexity science--the study of Complex Adaptive Systems (CAS). It introduces key CAS concepts and reviews the emergence and implications of 'complex' approaches within health promotion. It explains the framework and its use with examples from contemporary practice, and sets it within the context of related bodies of health promotion theory. The Cynefin Framework, especially when used as a sense-making tool, can help practitioners understand the complexity of issues, identify appropriate strategies and avoid the pitfalls of applying reductionist approaches to complex situations. The urgency to address critical issues such as climate change and the social determinants of health calls for us to engage with complexity science. The Cynefin Framework helps practitioners make the shift, and enables those already engaged in complex approaches to communicate the value and meaning of their work in a system that privileges reductionist approaches.

Higher Education and Development in the Lower Gulf States.

ERIC Educational Resources Information Center

Shaw, K. E.

1993-01-01

The complex issues concerning expansion of higher education in the smaller states bordering the Persian Gulf (Kuwait, Qatar, Bahrain, United Arab Emirates, and Oman) are examined, including who provides higher education and why, cultural vs. national identity, the role of mass education, and the difference between growth and development. (MSE)

Modelling dishes and exploring culinary 'precisions': the two issues of molecular gastronomy.

PubMed

This, Hervé

2005-04-01

The scientific strategy of molecular gastronomy includes modelling 'culinary definitions' and experimental explorations of 'culinary precisions'. A formalism that describes complex dispersed systems leads to a physical classification of classical sauces, as well as to the invention of an infinite number of new dishes.

HIV Education in the Formal Curriculum

ERIC Educational Resources Information Center

Nsubuga, Yusuf K.; Bonnet, Sandrine

2009-01-01

The AIDS epidemic presents a complex of issues that require global answers, involving entire societies. The only sustainable solution is to include all sectors of society in a multidisciplinary collaboration, within which the formal education system plays a key role in delivering a comprehensive response to the disease at the national level.…

Student Aid Research. A Manual for Financial Aid Administrators.

ERIC Educational Resources Information Center

Davis, Jerry Sheehan, Ed.

This manual contains nine articles intended to assist student financial aid professionals in conducting research. Initial chapters provide basic information for those starting to do such research while later chapters deal with more complex issues. Some chapters include appendices that provide examples of the techniques under consideration. from…

We Can't Change What We Don't Recognize: Understanding the Special Needs of Gifted Females.

ERIC Educational Resources Information Center

Reis, Sally M.

1987-01-01

The article considers major issues, questions, and problems related to gifted females including underachievement, creative productivity, male dominance in mathematics and science, cultural stereotyping, sex roles and mixed messages, lack of planning, the perfection complex, the impostor syndrome, and counseling. (Author/CB)

Fumonisins, Tortillas and Neural Tube Defects: Untangling a Complex Issue

USDA-ARS?s Scientific Manuscript database

Fumonisin mycotoxins are found in corn and corn-based foods. Fumonisin B1 (FB1), the most common, disrupts sphingolipid metabolism thereby causing species-specific diseases in animals that include cancer in rodents and (birth) neural tube defects (NTD) in LM/Bc mice. Fumonisins’ affect on human heal...

Curriculum Change and Climate Change: Inside outside Pressures in Higher Education

ERIC Educational Resources Information Center

Fahey, Shireen J.

2012-01-01

In higher education today, institutions are facing a number of challenges--including the challenge to create future-proof graduates. Higher education institutions have a particular mandate to develop future leaders and decision-makers capable of understanding and providing solutions to complex, global issues. Education programmes that focus on…

The Complexity-Adaptability Paradox: Issues for Combat Aircraft Development

DTIC Science & Technology

2011-02-16

to Darwin in many sources, including being engraved in stone on the floor of the California Academy of Science, it is most widely attributed to...showing laser -guided bombs guiding down elevator shafts. Observers have described this combination of precision and stealth as having a ―revolutionary

A Country Report Project for an International Economics Class.

ERIC Educational Resources Information Center

Abdalla, Adil E. A.

1993-01-01

Asserts that international economics textbooks pay too little attention to the complexity of issues and problems facing individual nations. Describes a country report project included as part of a college-level international or development economics course. Provides two student instruction sheets and a sample country report. (CFR)

Music Education: Cultural Values, Social Change and Innovation

ERIC Educational Resources Information Center

Walker, Robert

2007-01-01

This is an important work that addresses the complex issues surrounding musical meaning and experience, and the Western traditional justification for including music in education. The chapters in this volume examine the important subjects of tradition, innovation, social change, the music curriculum, music in the twentieth century, social strata,…

Economic Thinking for Strategic Leaders

DTIC Science & Technology

2011-03-24

unprepared to analyze certain complex, ambiguous issues and craft informed decisions. 15. SUBJECT TERMS Behavioral Economics, Public Choice Theory ...COUNT: 7,668 PAGES: 38 KEY TERMS: Behavioral Economics, Public Choice Theory , Army Profession CLASSIFICATION: Unclassified Military senior...various economic fields, including Identity Economics, Neoclassical Economics, Behavioral Economics, and Public Choice Economics. Finally, it

Communication Fact Sheets for Parents.

ERIC Educational Resources Information Center

Stremel, Kathleen; Bixler, Betsy; Morgan, Susanne; Layton, Kristen

This booklet contains 28 fact sheets on communication written primarily for parents and families with a child who is deaf-blind. They attempt to address fundamental but complex issues related to the communication needs of children with vision and hearing impairments. Each fact sheet targets a specific area, including: (1) communication; (2)…

Decision Making/The Chesapeake Bay. An Interdisciplinary Environmental Education Curriculum Unit.

ERIC Educational Resources Information Center

Maryland Univ., College Park. Science Teaching Center.

This multidisciplinary, self-contained curriculum unit focuses on the management of the Chesapeake Bay, a threatened and complex environmental system. Major unit goals include identifying and analyzing conflicting interests, issues, and public policies concerning the Bay, and determining their effects on people and the environment. The unit…

What's Stopping You? Classroom Censorship for Better or Worse

ERIC Educational Resources Information Center

Patterson, Nancy C.

2010-01-01

Censorship is a complex question. Studies show a number of reasons teachers refrain from teaching controversial issues. These include: (1) The general "chilling effects" in school and community contexts, characterized by fear of reprisal; (2) Standards and high stakes testing; (3) Insufficient teacher preparation to teach about…

Advancing Transdisciplinary and Translational Research Practice: Issues and Models of Doctoral Education in Public Health

ERIC Educational Resources Information Center

Neuhauser, Linda; Richardson, Dawn; Mackenzie, Sonja; Minkler, Meredith

2007-01-01

Finding solutions to complex health problems, such as obesity, violence, and climate change, will require radical changes in cross-disciplinary education, research, and practice. The fundamental determinants of health include many interrelated factors such as poverty, culture, education, environment, and government policies. However, traditional…

School Dropout Indicators, Trends, and Interventions for School Counselors

ERIC Educational Resources Information Center

Dockery, Donna J.

2012-01-01

School counselors are expected to develop programs that promote academic success for all students, including those at risk for dropping out of school. Knowledge of key indicators of potential dropouts and current trends in dropout prevention research may assist school counselors in better understanding this complex issue. Implementing recommended…

Gender Tracing and Literacy Narratives.

ERIC Educational Resources Information Center

Kuhne, Michael

A good way "to get at gender" is to ask students to write about their literacy because literacy is a good catalyst for discussion and analysis regarding the complexities of gender. A number of recent articles connect composition studies with issues of gender, including those by Elizabeth Flynn, Geoff Sirc, Linda Peterson, Don Kraemer…

Development and application of incrementally complex tools for wind turbine aerodynamics

NASA Astrophysics Data System (ADS)

Gundling, Christopher H.

Advances and availability of computational resources have made wind farm design using simulation tools a reality. Wind farms are battling two issues, affecting the cost of energy, that will make or break many future investments in wind energy. The most significant issue is the power reduction of downstream turbines operating in the wake of upstream turbines. The loss of energy from wind turbine wakes is difficult to predict and the underestimation of energy losses due to wakes has been a common problem throughout the industry. The second issue is a shorter lifetime of blades and past failures of gearboxes due to increased fluctuations in the unsteady loading of waked turbines. The overall goal of this research is to address these problems by developing a platform for a multi-fidelity wind turbine aerodynamic performance and wake prediction tool. Full-scale experiments in the field have dramatically helped researchers understand the unique issues inside a large wind farm, but experimental methods can only be used to a limited extent due to the cost of such field studies and the size of wind farms. The uncertainty of the inflow is another inherent drawback of field experiments. Therefore, computational fluid dynamics (CFD) predictions, strategically validated using carefully performed wind farm field campaigns, are becoming a more standard design practice. The developed CFD models include a blade element model (BEM) code with a free-vortex wake, an actuator disk or line based method with large eddy simulations (LES) and a fully resolved rotor based method with detached eddy simulations (DES) and adaptive mesh refinement (AMR). To create more realistic simulations, performance of a one-way coupling between different mesoscale atmospheric boundary layer (ABL) models and the three microscale CFD solvers is tested. These methods are validated using data from incrementally complex test cases that include the NREL Phase VI wind tunnel test, the Sexbierum wind farm and the Lillgrund offshore wind farm. By cross-comparing the lowest complexity free-vortex method with the higher complexity methods, a fast and accurate simulation tool has been generated that can perform wind farm simulations in a few hours.

Stakeholders' perspective on issues and challenges associated with care and treatment of aging-related cognitive impairment disorders in Singapore.

PubMed

Setia, Monika; Islam, Amina M; Thompson, James P; Matchar, David B

2011-11-01

An expanding elderly population poses challenges for the provision of care and treatment for age-related physical and mental disorders. Cognitive impairment (CI)/dementia is one such mental disorder that is on the rise in Singapore and has concomitant implications for social and health systems. The objective of this study is to understand the perspectives of prominent stakeholders about current and future issues and challenges associated with CI/dementia among the elderly in Singapore. Using indepth interviews, this qualitative study obtained the views of multiple stakeholders on issues and challenges associated with CI/dementia in Singapore. The 30 individuals interviewed as part of the study included clinicians, policy-makers, researchers, community workers, administrators, and caregivers. Using a framework approach, interview texts were indexed into domains and issues by utilizing NVivo 9.0 software. The stakeholders expressed concerns related to multiple domains of the CI/dementia care system: attitude and awareness, economics, education, family caregiving, inputs to care system, living arrangements, prevention, screening and diagnosis, and treatment and management of care. Within each domain, multiple issues and challenges were identified by respondents. The study identifies a complex set of inter-related issues and challenges that are associated with the care and treatment of people with CI/dementia. The results suggest that CI and dementia profoundly affect patients, families, and communities and that the issues related to the two disorders are truly system-wide. These findings lay the foundation for utilization of a systems approach to studying CI/dementia and provide an analytic framework for future research on complex health care issues.

Treatments for common psychiatric conditions among adults during acute, rehabilitation, and reintegration phases.

PubMed

Difede, Joann; Cukor, Judith; Lee, Francis; Yurt, Roger

2009-12-01

Common and pernicious adult psychiatric disorders consequent to burn injury include post-traumatic stress disorder (PTSD), major depressive disorder (MDD), and new-onset substance abuse disorder. Diagnosing and treating these disorders is complicated by the complex psychosocial issues associated with burns including grief, pain, role impairment, disfigurement, dysfunction, stigma, as well as financial and legal issues. Additionally, pre-morbid psychiatric and neurological illnesses are risk factors for burns, adding to the challenge of diagnosis and treatment. This article will focus on the diagnosis and treatment of PTSD and MDD consequent to burn trauma, as these are the major psychiatric outcomes, addressing the attendant psychosocial problems as threads in this post-trauma tapestry.

Complex Case Conferences Associated with Reduced Hospital Admissions for High-Risk Patients with Multiple Comorbidities

PubMed Central

Tuso, Philip; Watson, Heather L; Garofalo-Wright, Lynn; Lindsay, Gail; Jackson, Ana; Taitano, Maria; Koyama, Sandra; Kanter, Michael

2014-01-01

Objectives: Reducing avoidable hospital readmissions presents an opportunity to improve health care quality and reduce avoidable costs. We studied the effect person-focused care may have on reducing avoidable admissions to the hospital. Methods: Among patients with heart failure discharged from the hospital, we evaluated the effect on 30-day readmissions of transitions-in-care interventions: home health visits, follow-up phone calls, and physician office visits. We also used a standardized diagnostic tool to interview readmitted patients to identify social reasons that may have contributed to the readmission. Finally, we used the learnings from both interventions to develop a new intervention: a single complex disease case conference that included the entire health care team. We measured hospital admissions for 21 patients during the 6 months before and after their complex case conferences. Results: Observed-over-expected hospital readmission rates were lowest for patients receiving a postdischarge visit with a home health nurse and a follow-up visit with their physician (0.54), compared with solely a physician visit (0.81), home health visit (1.2), or phone call (1.55). Various social issues may contribute to hospital readmissions, including caregiver knowledge, ability to care for oneself at home, and issues related to medications (adherence, ability to pay, and knowledge about potential side effects). Substantially fewer hospital admissions occurred after complex case conferences. Conclusions: Complex case conferences with disease-focused and person-focused interventions may be associated with reduced hospital admissions for patients with heart failure and multiple comorbidities. PMID:24626071

Women's perspectives on the ethical implications of non-invasive prenatal testing: a qualitative analysis to inform health policy decisions.

PubMed

Vanstone, Meredith; Cernat, Alexandra; Nisker, Jeff; Schwartz, Lisa

2018-04-16

Non-Invasive Prenatal Testing (NIPT) is a technology which provides information about fetal genetic characteristics (including sex) very early in pregnancy by examining fetal DNA obtained from a sample of maternal blood. NIPT is a morally complex technology that has advanced quickly to market with a strong push from industry developers, leaving many areas of uncertainty still to be resolved, and creating a strong need for health policy that reflects women's social and ethical values. We approach the need for ethical policy-making by studying the use of NIPT and emerging policy in the province of Ontario, Canada. Using an adapted version of constructivist grounded theory, we conducted interviews with 38 women who have had personal experiences with NIPT. We used an iterative process of data collection and analysis and a staged coding strategy to conduct a descriptive analysis of ethics issues identified implicitly and explicitly by women who have been affected by this technology. The findings of this paper focus on current ethical issues for women seeking NIPT, including place in the prenatal pathway, health care provider counselling about the test, industry influence on the diffusion of NIPT, consequences of availability of test results. Other issues gain relevance in the context of future policy decisions regarding NIPT, including funding of NIPT and principles that may govern the expansion of the scope of NIPT. These findings are not an exhaustive list of all the potential ethical issues related to NIPT, but rather a representation of the issues which concern women who have personal experience with this test. Women who have had personal experience with NIPT have concerns and priorities which sometimes contrast dramatically with the theoretical ethics literature. These findings suggest the importance of engaging patients in ethical deliberation about morally complex technologies, and point to the need for more deliberative patient engagement work in this area.

Is the destabilization of the cournot equilibrium a good business strategy in cournot-puu duopoly?

PubMed

Canovas, Jose S

2011-10-01

It is generally acknowledged that the medium influences the way we communicate and negotiation research directs considerable attention to the impact of different electronic communication modes on the negotiation process and outcomes. Complexity theories offer models and methods that allow the investigation of how pattern and temporal sequences unfold over time in negotiation interactions. By focusing on the dynamic and interactive quality of negotiations as well as the information, choice, and uncertainty contained in the negotiation process, the complexity perspective addresses several issues of central interest in classical negotiation research. In the present study we compare the complexity of the negotiation communication process among synchronous and asynchronous negotiations (IM vs. e-mail) as well as an electronic negotiation support system including a decision support system (DSS). For this purpose, transcripts of 145 negotiations have been coded and analyzed with the Shannon entropy and the grammar complexity. Our results show that negotiating asynchronically via e-mail as well as including a DSS significantly reduces the complexity of the negotiation process. Furthermore, a reduction of the complexity increases the probability of reaching an agreement.

Making transboundary risks governable: reducing complexity, constructing spatial identity, and ascribing capabilities.

PubMed

Lidskog, Rolf; Uggla, Ylva; Soneryd, Linda

2011-03-01

Environmental problems that cross national borders are attracting increasing public and political attention; regulating them involves coordinating the goals and activities of various governments, which often presupposes simplifying and standardizing complex knowledge, and finding ways to manage uncertainty. This article explores how transboundary environmental problems are dealt with to render complex issues governable. By discussing oil pollution in the Baltic Sea and the gas pipeline between Russia and Germany, we elucidate how boundaries are negotiated to make issues governable. Three processes are found to be particularly relevant to how involved actors render complex issues governable: complexity reduction, construction of a spatial identity for an issue, and ascription of capabilities to new or old actor constellations. We conclude that such regulation is always provisional, implying that existing regulation is always open for negotiation and criticism.

Methodological considerations in using complex survey data: an applied example with the Head Start Family and Child Experiences Survey.

PubMed

Hahs-Vaughn, Debbie L; McWayne, Christine M; Bulotsky-Shearer, Rebecca J; Wen, Xiaoli; Faria, Ann-Marie

2011-06-01

Complex survey data are collected by means other than simple random samples. This creates two analytical issues: nonindependence and unequal selection probability. Failing to address these issues results in underestimated standard errors and biased parameter estimates. Using data from the nationally representative Head Start Family and Child Experiences Survey (FACES; 1997 and 2000 cohorts), three diverse multilevel models are presented that illustrate differences in results depending on addressing or ignoring the complex sampling issues. Limitations of using complex survey data are reported, along with recommendations for reporting complex sample results. © The Author(s) 2011

Everyday value conflicts and integrative complexity of thought.

PubMed

Myyry, Liisa

2002-12-01

This study examined the value pluralism model in everyday value conflicts, and the effect of issue context on complexity of thought. According to the cognitive manager model we hypothesized that respondents would obtain a higher level of integrative complexity on personal issues that on professional and general issues. We also explored the relations of integrative complexity to value priorities, measured by the Schwartz Value Survey, and to emotional empathy. The value pluralism model was not supported by the data collected from 126 university students from social science, business and technology. The cognitive manager model was partially confirmed by data from females but not from males. Concerning value priorities, more complex respondents had higher regard for self-transcendence values, and less complex respondents for self-enhancement values Emotional empathy was also significantly related to complexity score.

Managing Complex Problems in Rangeland Ecosystems

USDA-ARS?s Scientific Manuscript database

Management of rangelands, and natural resources in general, has become increasingly complex. There is an atmosphere of increasing expectations for conservation efforts associated with a variety of issues from water quality to endangered species. We argue that many current issues are complex by their...

Homeostatis and Complexity as Integrating Tools in Gerontological Education.

ERIC Educational Resources Information Center

Richardson, Daniel; McCulloch, B. Jan; Rowles, Graham D.

2001-01-01

A gerontology doctoral program used the concepts of homeostasis and complexity to present biomedical and psychosocial issues. Data from 14 students showed that homeostasis was more useful for biomedical than psychosocial issues. Complexity helped in understanding interactions between the two. (SK)

Challenges in the analysis of complex systems: introduction and overview

NASA Astrophysics Data System (ADS)

Hastings, Harold M.; Davidsen, Jörn; Leung, Henry

2017-12-01

One of the main challenges of modern physics is to provide a systematic understanding of systems far from equilibrium exhibiting emergent behavior. Prominent examples of such complex systems include, but are not limited to the cardiac electrical system, the brain, the power grid, social systems, material failure and earthquakes, and the climate system. Due to the technological advances over the last decade, the amount of observations and data available to characterize complex systems and their dynamics, as well as the capability to process that data, has increased substantially. The present issue discusses a cross section of the current research on complex systems, with a focus on novel experimental and data-driven approaches to complex systems that provide the necessary platform to model the behavior of such systems.

Ethical Issues in Online Education

ERIC Educational Resources Information Center

Anderson, Bill; Simpson, Mary

2007-01-01

Teaching at a distance raises ethical issues particular to the distance context. When distance teaching is also online teaching, the situation is even more complex. Online teaching environments amplify the ethical issues faced by instructors and students. Online sites support complex discourses and multiple relationships; they cross physical,…

Critical Issues in the Lives of Children and Youth Who Are Deafblind.

PubMed

Nelson, Catherine; Bruce, Susan M

2016-01-01

The coeditors of an American Annals of the Deaf special issue on deaf-blindness introduce readers to critical issues surrounding children and youth who are deafblind. These issues-early identification, communication, social-emotional needs, family and multicultural issues, universal design and assistive technology, transition planning, and personnel preparation-are explored further in the articles that follow. By way of introduction, the present article provides definitions of deafblindness and a discussion of the heterogeneous nature of the population. The history of the field of deafblindness is then explored in terms of three distinct population shifts, from (a) individuals of the 18th and 19th centuries who became deafblind due to illness, to (b) the influx of individuals with congenital rubella syndrome in the 1960s who had disabilities besides deafblindness, and (c) the current population of children and youth with deafblindness, which includes individuals with other complex disabilities.

Medicolegal Issues in Traumatic Brain Injury.

PubMed

Zasler, Nathan D; Bigler, Erin

2017-05-01

The role of the physiatrist in provision of medicolegal expert testimony in cases involving traumatic brain injury is challenging and complex. This article provides an overview of how such work should be conducted from a practical perspective including discussion of ethical, legal, medical, and business aspects of such activities. Additionally, pointers are provided with regards to how information including preinjury, injury, and postinjury (including neuroimaging and neuropsychological data) should be considered and integrated into medicolegal opinions and testimony. Copyright © 2016 Elsevier Inc. All rights reserved.

Using complexity science and negotiation theory to resolve boundary-crossing water issues

NASA Astrophysics Data System (ADS)

Islam, Shafiqul; Susskind, Lawrence

2018-07-01

Many water governance and management issues are complex. The complexity of these issues is related to crossing of multiple boundaries: political, social and jurisdictional, as well as physical, ecological and biogeochemical. Resolution of these issues usually requires interactions of many parties with conflicting values and interests operating across multiple boundaries and scales to make decisions. The interdependence and feedback among interacting variables, processes, actors and institutions are hard to model and difficult to forecast. Thus, decision-making related to complex water problems needs be contingent and adaptive. This paper draws on a number of ideas from complexity science and negotiation theory that may make it easier to cope with the complexities and difficulties of managing boundary crossing water disputes. It begins with the Water Diplomacy Framework that was developed and tested over the past several years. Then, it uses three key ideas from complexity science (interdependence and interconnectedness; uncertainty and feedback; emergence and adaptation) and three from negotiation theory (stakeholder identification and engagement; joint fact finding; and value creation through option generation) to show how application of these ideas can help enhance effectiveness of water management.

Building a measurement framework of burden of treatment in complex patients with chronic conditions: a qualitative study.

PubMed

Eton, David T; Ramalho de Oliveira, Djenane; Egginton, Jason S; Ridgeway, Jennifer L; Odell, Laura; May, Carl R; Montori, Victor M

2012-01-01

Burden of treatment refers to the workload of health care as well as its impact on patient functioning and well-being. We set out to build a conceptual framework of issues descriptive of burden of treatment from the perspective of the complex patient, as a first step in the development of a new patient-reported measure. We conducted semistructured interviews with patients seeking medication therapy management services at a large, academic medical center. All patients had a complex regimen of self-care (including polypharmacy), and were coping with one or more chronic health conditions. We used framework analysis to identify and code themes and subthemes. A conceptual framework of burden of treatment was outlined from emergent themes and subthemes. Thirty-two patients (20 female, 12 male, age 26-85 years) were interviewed. Three broad themes of burden of treatment emerged including: the work patients must do to care for their health; problem-focused strategies and tools to facilitate the work of self-care; and factors that exacerbate the burden felt. The latter theme encompasses six subthemes including challenges with taking medication, emotional problems with others, role and activity limitations, financial challenges, confusion about medical information, and health care delivery obstacles. We identified several key domains and issues of burden of treatment amenable to future measurement and organized them into a conceptual framework. Further development work on this conceptual framework will inform the derivation of a patient-reported measure of burden of treatment.

"Cane" and Its Discontents.

ERIC Educational Resources Information Center

Dyck, Reginald

2000-01-01

Explores how the issue of race is enmeshed in a complex web of social relations that also include love, sex, gender, economics, and violence. Suggests how a consideration of modernist primitivism and Sigmund Freud's ideas on the individual's relationship to society can provide frameworks for further analysis of two of the stories in Jean Toomer's…

Commentary on "Management Education and the Base of the Pyramid"

ERIC Educational Resources Information Center

Rosile, Grace Ann

2008-01-01

This commentary asks some critical questions concerning the article "Management Education and the Base of the Pyramid" included in this special issue. Are "bottom of the pyramid" (BOP) multidisciplinary action project (MAP) students prepared to critically assess the impact of their interventions beyond a narrow definition of profit in complex and…

State Analysis: A Control Architecture View of Systems Engineering

NASA Technical Reports Server (NTRS)

Rasmussen, Robert D.

2005-01-01

A viewgraph presentation on the state analysis process is shown. The topics include: 1) Issues with growing complexity; 2) Limits of common practice; 3) Exploiting a control point of view; 4) A glimpse at the State Analysis process; 5) Synergy with model-based systems engineering; and 6) Bridging the systems to software gap.

Teachers' Perceived Likelihood of Intervening in Bullying Situations: Individual Characteristics and Institutional Environments

ERIC Educational Resources Information Center

VanZoeren, Sarah; Weisz, Arlene N.

2018-01-01

Complex issues such as bullying have brought to light the importance of expanding school prevention efforts to include interventions focused on multiple levels of practice. Utilizing data gathered from middle-school teachers across the state of Michigan, this study examines how both individual and organizational characteristics influence teacher…

Ethical Challenges and Complexities of Including People with Intellectual Disability as Participants in Research

ERIC Educational Resources Information Center

Iacono, Teresa

2006-01-01

The aim of this article is to consider the implications for research involving people with intellectual disability--a vulnerable group--of ethics committees' attempts to apply these guidelines. The issue explored is whether committees such as Human Research Ethics Committees (HRECS) and Institutional Review Boards (IRBs) are becoming increasingly…

Mind and Inferiority: Reflections on "English" as a University Discipline in a Black Context.

ERIC Educational Resources Information Center

Aitken, Richard

1987-01-01

The social/political issues facing university English departments in South Africa include problems of identity and definition, the need for instruction within the context of social and political history, the problems of cultural relativism, the corrosive implications of Black subordination, and the complex alternatives of private and public…

Natural areas and urban populations: communication and environmental education challenges and actions in outdoor recreation

Treesearch

Deborah J. Chavez

2005-01-01

Challenges, opportunities, and actions exist in areas where large urban populations interface with natural areas, such as outdoor recreation sites in southern California. Challenges in the interface include intense recreation use, public safety issues, and complex information strategies. Research results on communications and environmental education offer opportunities...

The State of the World's Children 1998: Focus on Nutrition.

ERIC Educational Resources Information Center

Bellamy, Carol

This report on the well-being of the world's children focuses on the issue of malnutrition and its impact on children's lives. Chapter 1: (1) discusses the incidence of malnutrition and the complex interplay of factors that cause malnutrition, including poor health services and discrimination against women; (2) presents several approaches to…

Unmet Needs of Children with Special Health Care Needs in a Specialized Day School Setting

ERIC Educational Resources Information Center

Aruda, Mary M.; Kelly, Mary; Newinsky, Karina

2011-01-01

Children with Special Health Care Needs (CSHCN) represent a significant component of the pediatric population. They often present to schools with multiple and increasingly complex health issues, including medical technology dependency. Their daily variation in health status requires close monitoring and communication among caregivers. Limited…

Statistics and Data Interpretation for Social Work

ERIC Educational Resources Information Center

Rosenthal, James A.

2011-01-01

Written by a social worker for social work students, this is a nuts and bolts guide to statistics that presents complex calculations and concepts in clear, easy-to-understand language. It includes numerous examples, data sets, and issues that students will encounter in social work practice. The first section introduces basic concepts and terms to…

Leadership and Organization in Education: Time for a Re-Orientation?

ERIC Educational Resources Information Center

Glatter, Ron

2006-01-01

The article raises issues about the current direction of the field of educational leadership and management. It argues that we should consider a re-orientation of the field in order to renew its concern with ideas connected with organization, which include viewing organizations as complex adaptive systems and taking an institutional perspective.…

Integrating Medical and Environmental Sociology with Environmental Health: Crossing Boundaries and Building Connections through Advocacy

ERIC Educational Resources Information Center

Brown, Phil

2013-01-01

This article reviews the personal and professional processes of developing an interdisciplinary approach to understanding the complex issues of environmental health in their community, political-economic, social science, and scientific contexts. This interdisciplinary approach includes a synthesis of research, policy work, and advocacy. To examine…

The Basics of Long-Term Debt Issuance and Management

ERIC Educational Resources Information Center

Van Meter, Christine M.

2011-01-01

Issuing long-term debt can be a complex, multifaceted process. Although the process varies by stare, typically the school business official and the district solicitor work with the financing ream, which includes a financial adviser, bond counsel, underwriter, raring agency, and possibly a bond insurance agent, paying agent, and architect.…

Guidance Counselling as a Whole School Responsibility in the Irish Post Primary Sector

ERIC Educational Resources Information Center

Hearne, Lucy; Geary, Tom; Martin, Noelle

2017-01-01

This paper will deliberate upon the relevance of guidance counselling as a "whole school" responsibility in the context of recent policy and practice changes in the Irish post primary sector since the Government of Ireland Budget 2012. Pertinent issues including the complexities of delivering a whole school approach to guidance…

Island Explorations: Discovering Effects of Environmental Research-Based Lab Activities on Analytical Chemistry Students

ERIC Educational Resources Information Center

Tomasik, Janice Hall; LeCaptain, Dale; Murphy, Sarah; Martin, Mary; Knight, Rachel M.; Harke, Maureen A.; Burke, Ryan; Beck, Kara; Acevedo-Polakovich, I. David

2014-01-01

Motivating students in analytical chemistry can be challenging, in part because of the complexity and breadth of topics involved. Some methods that help encourage students and convey real-world relevancy of the material include incorporating environmental issues, research-based lab experiments, and service learning projects. In this paper, we…

Catalyzing sustainability: Cornell University's field practicum in conservation and sustainable development

Treesearch

John Schelhas

2000-01-01

Human society is increasingly facing a variety of complex, intertwined environmental conservation and rural development issues. For example, national park objectives have expanded from the conservation of biological diversity to also include contributing to the livelihood and development needs of local people. Human settlements in fragile uplands create conflicts...

Interventions in randomised controlled trials in surgery: issues to consider during trial design.

PubMed

Blencowe, Natalie S; Brown, Julia M; Cook, Jonathan A; Metcalfe, Chris; Morton, Dion G; Nicholl, Jon; Sharples, Linda D; Treweek, Shaun; Blazeby, Jane M

2015-09-04

Until recently, insufficient attention has been paid to the fact that surgical interventions are complex. This complexity has several implications, including the way in which surgical interventions are described and delivered in trials. In order for surgeons to adopt trial findings, interventions need to be described in sufficient detail to enable accurate replication; however, it may be permissible to allow some aspects to be delivered according to local practice. Accumulating work in this area has identified the need for general guidance on the design of surgical interventions in trial protocols and reports. Key issues to consider when designing surgical interventions include the identification of each surgical intervention and their components, who will deliver the interventions, and where and how the interventions will be standardised and monitored during the trial. The trial design (pragmatic and explanatory), comparator and stage of innovation may also influence the extent of detail required. Thoughtful consideration of surgical interventions in this way may help with the interpretation of trial results and the adoption of successful interventions into clinical practice.

Genomic Sequencing: Assessing The Health Care System, Policy, And Big-Data Implications

PubMed Central

Phillips, Kathryn A.; Trosman, Julia; Kelley, Robin K.; Pletcher, Mark J.; Douglas, Michael P.; Weldon, Christine B.

2014-01-01

New genomic sequencing technologies enable the high-speed analysis of multiple genes simultaneously, including all of those in a person's genome. Sequencing is a prominent example of a “big data” technology because of the massive amount of information it produces and its complexity, diversity, and timeliness. Our objective in this article is to provide a policy primer on sequencing and illustrate how it can affect health care system and policy issues. Toward this end, we developed an easily applied classification of sequencing based on inputs, methods, and outputs. We used it to examine the implications of sequencing for three health care system and policy issues: making care more patient-centered, developing coverage and reimbursement policies, and assessing economic value. We conclude that sequencing has great promise but that policy challenges include how to optimize patient engagement as well as privacy, develop coverage policies that distinguish research from clinical uses and account for bioinformatics costs, and determine the economic value of sequencing through complex economic models that take into account multiple findings and downstream costs. PMID:25006153

Genomic sequencing: assessing the health care system, policy, and big-data implications.

PubMed

Phillips, Kathryn A; Trosman, Julia R; Kelley, Robin K; Pletcher, Mark J; Douglas, Michael P; Weldon, Christine B

2014-07-01

New genomic sequencing technologies enable the high-speed analysis of multiple genes simultaneously, including all of those in a person's genome. Sequencing is a prominent example of a "big data" technology because of the massive amount of information it produces and its complexity, diversity, and timeliness. Our objective in this article is to provide a policy primer on sequencing and illustrate how it can affect health care system and policy issues. Toward this end, we developed an easily applied classification of sequencing based on inputs, methods, and outputs. We used it to examine the implications of sequencing for three health care system and policy issues: making care more patient-centered, developing coverage and reimbursement policies, and assessing economic value. We conclude that sequencing has great promise but that policy challenges include how to optimize patient engagement as well as privacy, develop coverage policies that distinguish research from clinical uses and account for bioinformatics costs, and determine the economic value of sequencing through complex economic models that take into account multiple findings and downstream costs. Project HOPE—The People-to-People Health Foundation, Inc.

Operational Shock Complexity Theory

DTIC Science & Technology

2005-05-26

Theory : Recommendations For The National Strategy To Defeat Terrorism.” Student Issue Paper, Center for Strategic Leadership , US Army War College, July...Lens of Complexity Theory : Recommendations For The National Strategy To Defeat Terrorism.” (Student Issue Paper, Center for Strategic Leadership , US... Leadership Complexity theory affects the training of leaders. With the enemy system able to develop its complexity either through interaction with US

Exploring recruitment issues in stroke research: a qualitative study of nurse researchers' experiences.

PubMed

Boxall, Leigh; Hemsley, Anthony; White, Nicola

2016-05-01

To explore the practice of experienced stroke nurse researchers to understand the issues they face in recruiting participants. Participant recruitment is one of the greatest challenges in conducting clinical research, with many trials failing due to recruitment problems. Stroke research is a particularly difficult area in which to recruit; however various strategies can improve participation. Analysis revealed three main types of problems for recruiting participants to stroke research: those related to patients, those related to the nurse researcher, and those related to the study itself. Impairments affecting capacity to consent, the acute recruitment time frame of most stroke trials, paternalism by nurse researchers, and low public awareness were especially pertinent. The disabling nature of a stroke, which often includes functional and cognitive impairments, and the acute stage of illness at which patients are appropriate for many trials, make recruiting patients particularly complex and challenging. An awareness of the issues surrounding the recruitment of stroke patients may help researchers in designing and conducting trials. Future work is needed to address the complexities of obtaining informed consent when patient capacity is compromised.

Prenatal Testing for Adult-Onset Conditions: the Position of the National Society of Genetic Counselors.

PubMed

Hercher, Laura; Uhlmann, Wendy R; Hoffman, Erin P; Gustafson, Shanna; Chen, Kelly M

2016-12-01

Advances in genetic testing and the availability of such testing in pregnancy allows prospective parents to test their future child for adult-onset conditions. This ability raises several complex ethical issues. Prospective parents have reproductive rights to obtain information about their fetus. This information may or may not alter pregnancy management. These rights can be in conflict with the rights of the future individual, who will be denied the right to elect or decline testing. This paper highlights the complexity of these issues, details discussions that went into the National Society of Genetic Counselors (NSGC) Public Policy Task Force's development of the Prenatal testing for Adult-Onset Conditions position statement adopted in November 2014, and cites relevant literature on this topic through December 2015. Issues addressed include parental rights and autonomy, rights of the future child, the right not to know, possible adverse effects on childhood and the need for genetic counseling. This paper will serve as a reference to genetic counselors and healthcare professionals when faced with this situation in clinical practice.

Intraoperative fluorescence angiography: a review of applications and outcomes in war-related trauma.

PubMed

Green, J Marshall; Sabino, Jennifer; Fleming, Mark; Valerio, Ian

2015-03-01

In the recent Iraq and Afghanistan conflicts, survival rates from complex battlefield injuries have continued to improve. The resulting war-related wounds are challenging, with confounding issues making assessment of tissue perfusion subjective and variable. This review discusses the utility of intraoperative fluorescence angiography, and its usefulness as an objective tool to evaluate the perfusion of tissues in the face of complex war-related injuries. A retrospective review of all war-related traumatic and reconstructive cases employing intraoperative indocyanine green laser angiography (ICGLA) was performed. Data analyzed included indication for use, procedure success/failure rates, modifications performed, and perfusion-related complications. Anatomical regions assessed were extremity, head and neck, truncal, and intra-abdominal viscera. The endpoint of specific interest involved the decision for additional debridement of poorly perfused tissue, as based on the ICGLA findings. Over a 3-year period, this study examined 123 extremity soft tissue flaps, 41 extremity injuries including amputation and/or amputation revision cases, 13 craniofacial flaps, and 9 truncal/abdomen/gastrointestinal cases in which ICGLA was utilized to assess tissue perfusion and viability. A total of 35 (18.8%) of cases employing ICGLA required intraoperative modifications to address perfusion-related issues. Intraoperative fluorescent angiography is an objective, useful tool to assess various war-related traumatic injuries. This study expands on prior cited indications for ICGLA to include (1) guiding debridement in heavily contaminated wounds, (2) providing improved assessment of avulsion soft tissue injuries, (3) allowing for rapid detection of vascular and/or microvascular compromise in soft tissue and osseous flap reconstructions, (4) reducing and preventing perfusion-related complications in trauma, amputation closures, and reconstruction procedures, (5) contributing to better outcomes in certain complex orthopedic and composite tissue injuries, and (6) enabling improved postoperative wound and reconstruction assessment in those cases of perfusion-related issues that arise within a delayed setting. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Quality of herbal medicines: challenges and solutions.

PubMed

Zhang, Junhua; Wider, Barbara; Shang, Hongcai; Li, Xuemei; Ernst, Edzard

2012-01-01

The popularity of herbal medicines has risen worldwide. This increase in usage renders safety issues important. Many adverse events of herbal medicines can be attributed to the poor quality of the raw materials or the finished products. Different types of herbal medicines are associated with different problems. Quality issues of herbal medicines can be classified into two categories: external and internal. In this review, external issues including contamination (e.g. toxic metals, pesticides residues and microbes), adulteration and misidentification are detailed. Complexity and non-uniformity of the ingredients in herbal medicines are the internal issues affecting the quality of herbal medicines. Solutions to the raised problems are discussed. The rigorous implementation of Good Agricultural and Collection Practices (GACP) and Good Manufacturing Practices (GMP) would undoubtedly reduce the risk of external issues. Through the use of modern analytical methods and pharmaceutical techniques, previously unsolved internal issues have become solvable. Standard herbal products can be manufactured from the standard herbal extracts. Copyright © 2011 Elsevier Ltd. All rights reserved.

Biosimilar therapeutics—what do we need to consider?

PubMed Central

Schellekens, Huub

2009-01-01

Patents for the first generation of approved biopharmaceuticals have either expired or are about to expire. Thus the market is opening for generic versions, referred to as ‘biosimilars’ (European Union) or ‘follow-on protein products’ (United States). Healthcare professionals need to understand the critical issues surrounding the use of biosimilars to make informed treatment decisions. The complex high-molecular-weight three-dimensional structures of biopharmaceuticals, their heterogeneity and dependence on production in living cells makes them different from classical chemical drugs. Current analytical methods cannot characterize these complex molecules sufficiently to confirm structural equivalence with reference molecules. Verification of the similarity of biosimilars to innovator biopharmaceuticals remains a key challenge. Furthermore, a critical safety issue, the immunogenicity of biopharmaceuticals, has been highlighted in recent years, confirming a need for comprehensive immunogenicity testing prior to approval and extended post-marketing surveillance. Biosimilars present a new set of challenges for regulatory authorities when compared with conventional generics. While the demonstration of a pharmacokinetic similarity is sufficient for conventional, small-molecule generic agents, a number of issues will make the approval of biosimilars more complicated. Documents recently published by the European Medicines Agency (EMEA) outlining requirements for the market approval of biosimilars provide much-needed guidance. The EMEA has approved a number of biosimilar products in a scientifically rigorous and balanced process. Outstanding issues include the interchangeability of biosimilars and innovator products, the possible need for unique naming to differentiate the various biopharmaceutical products, and more comprehensive labelling for biosimilars to include relevant clinical data. PMID:19461855

Recent experience in simultaneous control-structure optimization

NASA Technical Reports Server (NTRS)

Salama, M.; Ramaker, R.; Milman, M.

1989-01-01

To show the feasibility of simultaneous optimization as design procedure, low order problems were used in conjunction with simple control formulations. The numerical results indicate that simultaneous optimization is not only feasible, but also advantageous. Such advantages come at the expense of introducing complexities beyond those encountered in structure optimization alone, or control optimization alone. Examples include: larger design parameter space, optimization may combine continuous and combinatoric variables, and the combined objective function may be nonconvex. Future extensions to include large order problems, more complex objective functions and constraints, and more sophisticated control formulations will require further research to ensure that the additional complexities do not outweigh the advantages of simultaneous optimization. Some areas requiring more efficient tools than currently available include: multiobjective criteria and nonconvex optimization. Efficient techniques to deal with optimization over combinatoric and continuous variables, and with truncation issues for structure and control parameters of both the model space as well as the design space need to be developed.

Ethical analysis in HTA of complex health interventions.

PubMed

Lysdahl, Kristin Bakke; Oortwijn, Wija; van der Wilt, Gert Jan; Refolo, Pietro; Sacchini, Dario; Mozygemba, Kati; Gerhardus, Ansgar; Brereton, Louise; Hofmann, Bjørn

2016-03-22

In the field of health technology assessment (HTA), there are several approaches that can be used for ethical analysis. However, there is a scarcity of literature that critically evaluates and compares the strength and weaknesses of these approaches when they are applied in practice. In this paper, we analyse the applicability of some selected approaches for addressing ethical issues in HTA in the field of complex health interventions. Complex health interventions have been the focus of methodological attention in HTA. However, the potential methodological challenges for ethical analysis are as yet unknown. Six of the most frequently described and applied ethical approaches in HTA were critically assessed against a set of five characteristics of complex health interventions: multiple and changing perspectives, indeterminate phenomena, uncertain causality, unpredictable outcomes, and ethical complexity. The assessments are based on literature and the authors' experiences of developing, applying and assessing the approaches. The Interactive, participatory HTA approach is by its nature and flexibility, applicable across most complexity characteristics. Wide Reflective Equilibrium is also flexible and its openness to different perspectives makes it better suited for complex health interventions than more rigid conventional approaches, such as Principlism and Casuistry. Approaches developed for HTA purposes are fairly applicable for complex health interventions, which one could expect because they include various ethical perspectives, such as the HTA Core Model® and the Socratic approach. This study shows how the applicability for addressing ethical issues in HTA of complex health interventions differs between the selected ethical approaches. Knowledge about these differences may be helpful when choosing and applying an approach for ethical analyses in HTA. We believe that the study contributes to increasing awareness and interest of the ethical aspects of complex health interventions in general.

Introduction to the Issue on Segregation, Desegregation, and Integration: From History, to Policy, to Practice

ERIC Educational Resources Information Center

Diem, Sarah; Brooks, Jeffrey

2013-01-01

The articles in this special issue examine the increasingly complex relationship between segregation, desegregation, and integration in a sociopolitical environment vastly different from that of the initial days of desegregation. These issues are examined from historical and political perspectives, contextualizing the complexities of segregation,…

Should Great Lakes City Build a New Power Plant? How Youth Navigate Socioscientific Issues

ERIC Educational Resources Information Center

Rose, Shari Levine; Calabrese Barton, Angela

2012-01-01

There is a growing consensus that simply learning enough science to decipher public debates on socioscientific issues will not make citizens better equipped to handle the complex and ill-structured problems these controversial issues present. This study highlights the interaction and complex interplay between youth authored and appropriated frames…

Mechanics of additively manufactured biomaterials.

PubMed

Zadpoor, Amir A

2017-06-01

Additive manufacturing (3D printing) has found many applications in healthcare including fabrication of biomaterials as well as bioprinting of tissues and organs. Additively manufactured (AM) biomaterials may possess arbitrarily complex micro-architectures that give rise to novel mechanical, physical, and biological properties. The mechanical behavior of such porous biomaterials including their quasi-static mechanical properties and fatigue resistance is not yet well understood. It is particularly important to understand the relationship between the designed micro-architecture (topology) and the resulting mechanical properties. The current special issue is dedicated to understanding the mechanical behavior of AM biomaterials. Although various types of AM biomaterials are represented in the special issue, the primary focus is on AM porous metallic biomaterials. As a prelude to this special issue, this editorial reviews some of the latest findings in the mechanical behavior of AM porous metallic biomaterials so as to describe the current state-of-the-art and set the stage for the other studies appearing in the issue. Some areas that are important for future research are also briefly mentioned. Copyright © 2017 Elsevier Ltd. All rights reserved.

Beyond information access: Support for complex cognitive activities in public health informatics tools.

PubMed

Sedig, Kamran; Parsons, Paul; Dittmer, Mark; Ola, Oluwakemi

2012-01-01

Public health professionals work with a variety of information sources to carry out their everyday activities. In recent years, interactive computational tools have become deeply embedded in such activities. Unlike the early days of computational tool use, the potential of tools nowadays is not limited to simply providing access to information; rather, they can act as powerful mediators of human-information discourse, enabling rich interaction with public health information. If public health informatics tools are designed and used properly, they can facilitate, enhance, and support the performance of complex cognitive activities that are essential to public health informatics, such as problem solving, forecasting, sense-making, and planning. However, the effective design and evaluation of public health informatics tools requires an understanding of the cognitive and perceptual issues pertaining to how humans work and think with information to perform such activities. This paper draws on research that has examined some of the relevant issues, including interaction design, complex cognition, and visual representations, to offer some human-centered design and evaluation considerations for public health informatics tools.

Hydrology of and Current Monitoring Issues for the Chicago Area Waterway System, Northeastern Illinois

USGS Publications Warehouse

Duncker, James J.; Johnson, Kevin K.

2015-10-28

The Chicago Area Waterway System (CAWS) consists of a combination of natural and manmade channels that form an interconnected navigable waterway of approximately 90-plus miles in the metropolitan Chicago area of northeastern Illinois. The CAWS serves the area as the primary drainage feature, a waterway transportation corridor, and recreational waterbody. The CAWS was constructed by the Metropolitan Water Reclamation District of Greater Chicago (MWRDGC). Completion of the Chicago Sanitary and Ship Canal (initial portion of the CAWS) in 1900 breached a low drainage divide and resulted in a diversion of water from the Lake Michigan Basin. A U.S. Supreme Court decree (Consent Decree 388 U.S. 426 [1967] Modified 449 U.S. 48 [1980]) limits the annual diversion from Lake Michigan. While the State of Illinois is responsible for the diversion, the MWRDGC regulates and maintains water level and water quality within the CAWS by using several waterway control structures. The operation and control of water levels in the CAWS results in a very complex hydraulic setting characterized by highly unsteady flows. The complexity leads to unique gaging requirements and monitoring issues. This report provides a general discussion of the complex hydraulic setting within the CAWS and quantifies this information with examples of data collected at a range of flow conditions from U.S. Geological Survey streamflow gaging stations and other locations within the CAWS. Monitoring to address longstanding issues of waterway operation, as well as current (2014) emerging issues such as wastewater disinfection and the threat from aquatic invasive species, is included in the discussion.

Research ethics consultation: ethical and professional practice challenges and recommendations.

PubMed

Sharp, Richard R; Taylor, Holly A; Brinich, Margaret A; Boyle, Mary M; Cho, Mildred; Coors, Marilyn; Danis, Marion; Havard, Molly; Magnus, David; Wilfond, Benjamin

2015-05-01

The complexity of biomedical research has increased considerably in the last decade, as has the pace of translational research. This complexity has generated a number of novel ethical issues for clinical investigators, institutional review boards (IRBs), and other oversight committees. In response, many academic medical centers have created formal research ethics consultation (REC) services to help clinical investigators and IRBs navigate ethical issues in biomedical research. Key functions of a REC service include assisting with research design and implementation, providing a forum for deliberative exploration of ethical issues, and supplementing regulatory oversight. As increasing numbers of academic research institutions establish REC services, there is a pressing need for consensus about the primary aims and policies that should guide these activities. Establishing clear expectations about the aims and policies of REC services is important if REC programs are to achieve their full potential. Drawing on the experiences of a Clinical and Translational Science Award Research Ethics Consultation Working Group, this article describes three major ethical and professional practice challenges associated with the provision of REC: (1) managing multiple institutional roles and responsibilities, (2) managing sensitive information, and (3) communicating with consultation requestors about how these issues are managed. The paper also presents several practical strategies for addressing these challenges and enhancing the quality of REC services.

Research Ethics Consultation: Ethical and Professional Practice Challenges and Recommendations

PubMed Central

Sharp, Richard R.; Taylor, Holly A.; Brinich, Margaret A.; Boyle, Mary M.; Cho, Mildred; Coors, Marilyn; Danis, Marion; Havard, Molly; Magnus, David; Wilfond, Benjamin

2015-01-01

The complexity of biomedical research has increased considerably in the last decade, as has the pace of translational research. This complexity has generated a number of novel ethical issues for clinical investigators, institutional review boards (IRBs), and other oversight committees. In response, many academic medical centers have created formal research ethics consultation (REC) services to help clinical investigators and IRBs navigate ethical issues in biomedical research. Key functions of a REC service include: assisting with research design and implementation, providing a forum for deliberative exploration of ethical issues, and supplementing regulatory oversight. As increasing numbers of academic research institutions establish REC services, there is a pressing need for consensus about the primary aims and policies that should guide these activities. Establishing clear expectations about the aims and policies of REC services is important if REC programs are to achieve their full potential. Drawing on the experiences of a Clinical Translational Science Award (CTSA) Research Ethics Consultation Working Group, this article describes three major ethical and professional practice challenges associated with the provision of REC: 1) managing multiple institutional roles and responsibilities, 2) managing sensitive information, and 3) communicating with consultation requestors about how these issues are managed. The paper also presents several practical strategies for addressing these challenges and enhancing the quality of REC services. PMID:25607942

Preparing national health systems to cope with the impending tsunami of ageing and its associated complexities: Towards more sustainable health care.

PubMed

Amalberti, René; Nicklin, Wendy; Braithwaite, Jeffrey

2016-06-01

Healthcare systems across the world are experiencing increased financial, organizational and social pressures attributable to a range of critical issues including the challenge of ageing populations. Health systems need to adapt, in order to sustainably provide quality care to the widest range of patients, particularly those with chronic and complex diseases, and especially those in vulnerable and low-income groups. We report on a workshop designed to tackle such issues under the auspices of ISQua, with representatives from Argentina, Australia, Canada, Columbia, Denmark, Emirates, France, Ireland, Jordan, Qatar, Malaysia, Norway, Oman, UK, South Africa and Switzerland. We discuss some of the challenges facing healthcare systems in countries ageing rapidly, to those less so, and touch on current and future reform options. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Bioinformatics: perspectives for the future.

PubMed

Costa, Luciano da Fontoura

2004-12-30

I give here a very personal perspective of Bioinformatics and its future, starting by discussing the origin of the term (and area) of bioinformatics and proceeding by trying to foresee the development of related issues, including pattern recognition/data mining, the need to reintegrate biology, the potential of complex networks as a powerful and flexible framework for bioinformatics and the interplay between bio- and neuroinformatics. Human resource formation and market perspective are also addressed. Given the complexity and vastness of these issues and concepts, as well as the limited size of a scientific article and finite patience of the reader, these perspectives are surely incomplete and biased. However, it is expected that some of the questions and trends that are identified will motivate discussions during the IcoBiCoBi round table (with the same name as this article) and perhaps provide a more ample perspective among the participants of that conference and the readers of this text.

Verification Challenges at Low Numbers

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

Benz, Jacob M.; Booker, Paul M.; McDonald, Benjamin S.

2013-06-01

Many papers have dealt with the political difficulties and ramifications of deep nuclear arms reductions, and the issues of “Going to Zero”. Political issues include extended deterrence, conventional weapons, ballistic missile defense, and regional and geo-political security issues. At each step on the road to low numbers, the verification required to ensure compliance of all parties will increase significantly. Looking post New START, the next step will likely include warhead limits in the neighborhood of 1000 . Further reductions will include stepping stones at1000 warheads, 100’s of warheads, and then 10’s of warheads before final elimination could be considered ofmore » the last few remaining warheads and weapons. This paper will focus on these three threshold reduction levels, 1000, 100’s, 10’s. For each, the issues and challenges will be discussed, potential solutions will be identified, and the verification technologies and chain of custody measures that address these solutions will be surveyed. It is important to note that many of the issues that need to be addressed have no current solution. In these cases, the paper will explore new or novel technologies that could be applied. These technologies will draw from the research and development that is ongoing throughout the national laboratory complex, and will look at technologies utilized in other areas of industry for their application to arms control verification.« less

Collective intelligence of the artificial life community on its own successes, failures, and future.

PubMed

Rasmussen, Steen; Raven, Michael J; Keating, Gordon N; Bedau, Mark A

2003-01-01

We describe a novel Internet-based method for building consensus and clarifying conflicts in large stakeholder groups facing complex issues, and we use the method to survey and map the scientific and organizational perspectives of the artificial life community during the Seventh International Conference on Artificial Life (summer 2000). The issues addressed in this survey included artificial life's main successes, main failures, main open scientific questions, and main strategies for the future, as well as the benefits and pitfalls of creating a professional society for artificial life. By illuminating the artificial life community's collective perspective on these issues, this survey illustrates the value of such methods of harnessing the collective intelligence of large stakeholder groups.

A data-driven approach to quality risk management.

PubMed

Alemayehu, Demissie; Alvir, Jose; Levenstein, Marcia; Nickerson, David

2013-10-01

An effective clinical trial strategy to ensure patient safety as well as trial quality and efficiency involves an integrated approach, including prospective identification of risk factors, mitigation of the risks through proper study design and execution, and assessment of quality metrics in real-time. Such an integrated quality management plan may also be enhanced by using data-driven techniques to identify risk factors that are most relevant in predicting quality issues associated with a trial. In this paper, we illustrate such an approach using data collected from actual clinical trials. Several statistical methods were employed, including the Wilcoxon rank-sum test and logistic regression, to identify the presence of association between risk factors and the occurrence of quality issues, applied to data on quality of clinical trials sponsored by Pfizer. ONLY A SUBSET OF THE RISK FACTORS HAD A SIGNIFICANT ASSOCIATION WITH QUALITY ISSUES, AND INCLUDED: Whether study used Placebo, whether an agent was a biologic, unusual packaging label, complex dosing, and over 25 planned procedures. Proper implementation of the strategy can help to optimize resource utilization without compromising trial integrity and patient safety.

Has the question of e-waste opened a Pandora's box? An overview of unpredictable issues and challenges.

PubMed

Bakhiyi, Bouchra; Gravel, Sabrina; Ceballos, Diana; Flynn, Michael A; Zayed, Joseph

2018-01-01

Despite regulatory efforts and position papers, electrical and electronic waste (e-waste) remains ill-managed as evidenced by the extremely low rates of proper e-waste recycling (e-recycling) worldwide, ongoing illegal shipments to developing countries and constantly reported human health issues and environmental pollution. The objectives of this review are, first, to expose the complexity of e-waste problems, and then to suggest possible upstream and downstream solutions. Exploring e-waste issues is akin to opening a Pandora's box. Thus, a review of prevailing e-waste management practices reveals complex and often intertwined gaps, issues and challenges. These include the absence of any consistent definition of e-waste to date, a prevalent toxic potential still involving already banned or restricted hazardous components such as heavy metals and persistent and bioaccumulative organic compounds, a relentless growth in e-waste volume fueled by planned obsolescence and unsustainable consumption, problematic e-recycling processes, a fragile formal e-recycling sector, sustained and more harmful informal e-recycling practices, and more convoluted and unpredictable patterns of illegal e-waste trade. A close examination of the e-waste legacy contamination reveals critical human health concerns, including significant occupational exposure during both formal and informal e-recycling, and persistent environmental contamination, particularly in some developing countries. However, newly detected e-waste contaminants as well as unexpected sources and environmental fates of contaminants are among the emerging issues that raise concerns. Moreover, scientific knowledge gaps remain regarding the complexity and magnitude of the e-waste legacy contamination, specifically, a comprehensive characterization of e-waste contaminants, information on the scale of legacy contamination in developing countries and on the potential environmental damage in developed countries, and a stronger body of evidence of adverse health effects specifically ascribed to e-waste contaminants. However, the knowledge accumulated to date is sufficient to raise awareness and concern among all stakeholders. Potential solutions to curb e-waste issues should be addressed comprehensively, by focusing on two fronts: upstream and downstream. Potential upstream solutions should focus on more rational and eco-oriented consumer habits in order to decrease e-waste quantities while fostering ethical and sustained commitments from manufacturers, which include a limited usage of hazardous compounds and an optimal increase in e-waste recyclability. At the downstream level, solutions should include suitable and pragmatic actions to progressively reduce the illegal e-waste trade particularly through international cooperation and coordination, better enforcement of domestic laws, and monitoring in both exporting and receiving countries, along with the supervised integration of the informal sector into the recycling system of developing countries and global expansion of formal e-waste collection and recycling activities. Downstream solutions should also introduce stronger reverse logistics, together with upgraded, more affordable, and eco-friendly and worker-friendly e-recycling technologies to ensure that benefits are derived fully and safely from the great economic potential of e-waste. Copyright © 2017 Elsevier Ltd. All rights reserved.

Combination therapeutics in complex diseases.

PubMed

He, Bing; Lu, Cheng; Zheng, Guang; He, Xiaojuan; Wang, Maolin; Chen, Gao; Zhang, Ge; Lu, Aiping

2016-12-01

The biological redundancies in molecular networks of complex diseases limit the efficacy of many single drug therapies. Combination therapeutics, as a common therapeutic method, involve pharmacological intervention using several drugs that interact with multiple targets in the molecular networks of diseases and may achieve better efficacy and/or less toxicity than monotherapy in practice. The development of combination therapeutics is complicated by several critical issues, including identifying multiple targets, targeting strategies and the drug combination. This review summarizes the current achievements in combination therapeutics, with a particular emphasis on the efforts to develop combination therapeutics for complex diseases. © 2016 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

Spotlight on Student Engagement, Motivation, and Achievement. No. 5 in the Harvard Education Letter Spotlight Series

ERIC Educational Resources Information Center

Chauncey, Caroline T., Ed.; Walser, Nancy, Ed.

2009-01-01

Only when students feel engaged both socially and academically can schools and teachers lay the groundwork to motivate achievement. This volume, the fifth in the "Harvard Education Letter" Spotlight series, brings together fifteen seminal articles that examine research and practice on these complex and interrelated issues. Contributors include:…

Advancing the National and Global Knowledge Economy: The Role of Research Universities in Developing Countries

ERIC Educational Resources Information Center

Altbach, Philip G.

2013-01-01

Research universities are a central part of all academic systems. They are the key points of international contact and involvement. Research is produced, disseminated and in many cases imported. For developing countries, the mechanisms for the involvement of research universities in the global knowledge economy is complex, and includes issues of…

Are Methods Enough? Situating English Education Programs within the Multiple Settings of Learning to Teach

ERIC Educational Resources Information Center

Dickson, Randi; Smagorinsky, Peter

2006-01-01

In this article, the authors try to extend the complex and provocative conversations at the Conference on English Education Summit. They argue on several critical programmatic issues, including the need for greater program coherence, the continuing dilemma of the gulf between schools and universities, and both the promise and the problems of…

76 FR 59241 - Foreign Futures and Options Contracts on a Non-Narrow-Based Security Index; Commission...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-26

... controls on trading; information and data relating to the index, including the design, computation and... futures contract raises novel or complex issues that require additional time for review, or if the foreign... composition, computation, or method of selection of component entities of an index referenced and defined in...

Eye Tracking and Early Detection of Confusion in Digital Learning Environments: Proof of Concept

ERIC Educational Resources Information Center

Pachman, Mariya; Arguel, Amaël; Lockyer, Lori; Kennedy, Gregor; Lodge, Jason M.

2016-01-01

Research on incidence of and changes in confusion during complex learning and problem-solving calls for advanced methods of confusion detection in digital learning environments (DLEs). In this study we attempt to address this issue by investigating the use of multiple measures, including psychophysiological indicators and self-ratings, to detect…

Academic and Social Adjustment of High School Refugee Youth in Newfoundland

ERIC Educational Resources Information Center

Li, Xuemei; Grineva, Marina

2016-01-01

This article addresses the complex academic and social adjustment issues of newcomer youth of refugee background at a high school in Newfoundland and Labrador, a province where the newcomer population is small but the percentage of refugees in relation to all newcomers is high. Data for this qualitative study include documents from educational…

Creating a Learner-Centered Environment in Nursing Education: An Immersion Experience

ERIC Educational Resources Information Center

Steiner, Susan H.; Floyd, Evelyn; Hewett, Beverly J.; Lewis, Nicole C.; Walker, Eldon H.

2010-01-01

A call for change in nursing education has been issued in order to prepare the nurse of the future in a changing health care delivery system with increasing complexity. The learning environment is changing, including the faculty role. Innovative research-based pedagogies are suggested as a way to challenge traditional nursing education. The…

Citizenship and Citizenship Education in a Global Age: Politics, Policies, and Practices in China. Global Studies in Education. Volume 2

ERIC Educational Resources Information Center

Law, Wing-Wah

2011-01-01

This book examines issues of citizenship, citizenship education, and social change in China, exploring the complexity of interactions among global forces, the nation-state, local governments, schools, and individuals--including students--in selecting and identifying with elements of citizenship and citizenship education in a multileveled polity.…

The Complex and Elusive Nature of Religious Prosociality: Reply to Myers (2012) and Saroglou (2012)

ERIC Educational Resources Information Center

Galen, Luke W.

2012-01-01

This reply explores issues raised in comments by Myers (2012) and Saroglou (2012) on Galen (2012) regarding whether religiosity has any influence on prosociality. Areas of contention include (a) the distinction between religious belief and other influences, mainly the socialization effects of group behavior; (b) whether behavior largely restricted…

Selecting the Right Educational Setting for High-Ability TCKS: A Mother's Perspective

ERIC Educational Resources Information Center

Yamada, Sylvia

2015-01-01

Meeting the needs of gifted students is challenging even in traditional contexts and settings. Well-known issues include a limited choice of schools, underrepresentation of certain populations, and, often, the lack of facilities and support for high-ability students. Imagine, then, the further complexities of high-ability Third Culture Kids (TCKs)…

Purpose Designed Facilities. School Buildings Planning, Design, and Construction Series No. 4.

ERIC Educational Resources Information Center

Odell, John H.

A school construction guide offers key personnel in school development projects information on the complex task of master planning and construction of schools in Australia. This chapter of the guide provides advice on issues involving school space design and the kinds of spaces required in schools, including lecture spaces and seminar rooms,…

Detroit Business Leadership and Educational Change. Supporting Leaders for Tomorrow, Occasional Paper #7.

ERIC Educational Resources Information Center

Spratling, Cassandra

The growing proclivity of business leaders in some urban communities to become more deeply involved in the complex and politically volatile issue of school governance is assessed in this paper. The troubles facing Detroit public schools include a high dropout rate, illiteracy of graduates, and bad management of money and resources. In 1988,…

Corporate Structure Events Involving Regulated Utilities: The Need for a Multidisciplinary, Multijurisdictional Approach

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

Hempling, Scott

2006-08-15

The repeal of PUHCA has occasioned important questions on the appropriate role for regulation in the area of utility corporate structure, including complex process and jurisdictional issues. There is a disproportionality between the importance of these questions and the lack of attention that has been given them by our regulatory and political communities. (author)

Differential invasion success of salmonids in southern Chile: patterns and hypotheses

Treesearch

Ivan Arismendi; Brooke E. Penaluna; Jason B. Dunham; Carlos Garcia de Leaniz; Doris Soto; Ian A. Fleming; Daniel Gomez-Uchida; Gonzalo Gajardo; Pamela V. Varga; Jorge León-Muñoz

2014-01-01

Biological invasions create complex ecological and societal issues worldwide. Most of the knowledge about invasions comes only from successful invaders, but less is known about which processes determine the differential success of invasions. In this review, we develop a framework to identify the main dimensions driving the success and failure of invaders, including...

Developing and Implementing Quality Inclusive Education in Hong Kong: Implications for Teacher Education

ERIC Educational Resources Information Center

Forlin, Chris

2010-01-01

The government in Hong Kong has mandated that all schools should start to accept children with special educational needs by employing a whole school approach. This is not a simple move for teachers as inclusive education is complex, involving a range of issues including developing appropriate government and school policy; providing relevant…

Recycling Primer: Getting Back to Basics.

ERIC Educational Resources Information Center

Connecticut State Dept. of Environmental Protection, Hartford.

The disposal of garbage is a complex issue. Four strategies have been developed to attack the problem. They deal with: (1) waste reduction; (2) recycling; (3) energy recovery; and (4) land filling. This handbook emphasizes recycling as a method of handling the problem of dealing with solid wastes. Included are a list of the categories and uses of…

Digital telephony analysis model and issues

NASA Astrophysics Data System (ADS)

Keuthan, Lynn M.

1995-09-01

Experts in the fields of digital telephony and communications security have stated the need for an analytical tool for evaluating complex issues. Some important policy issues discussed by experts recently include implementing digital wire-taps, implementation of the 'Clipper Chip', required registration of encryption/decryption keys, and export control of cryptographic equipment. Associated with the implementation of these policies are direct costs resulting from implementation, indirect cost benefits from implementation, and indirect costs resulting from the risks of implementation or factors reducing cost benefits. Presented herein is a model for analyzing digital telephony policies and systems and their associated direct costs and indirect benefit and risk factors. In order to present the structure of the model, issues of national importance and business-related issues are discussed. The various factors impacting the implementation of the associated communications systems and communications security are summarized, and various implementation tradeoffs are compared based on economic benefits/impact. The importance of the issues addressed herein, as well as other digital telephony issues, has greatly increased with the enormous increases in communication system connectivity due to the advance of the National Information Infrastructure.

Advancing migratory bird conservation and management by using radar: An interagency collaboration

USGS Publications Warehouse

Ruth, Janet M.; Barrow, Wylie C.; Sojda, Richard S.; Dawson, Deanna K.; Diehl, Robert H.; Manville, Albert; Green, Michael T.; Krueper, David J.; Johnston, Scott

2005-01-01

Many technical issues make this work difficult, including complex data structures, massive data sets, digital recognition of birds, large areas not covered by weather radar, and model validation; however, progress will only be furthered by tackling the challenge. The new coalition will meets its goals by: (1) facilitating a productive collaboration with NOAA, Department of the Interior bureaus, state wildlife agencies, universities, power companies, and other potential partners; (2) building and strengthening scientific capabilities within USGS; (3) addressing key migratory bird management issues; and (4) ensuring full funding for the collaborative effort.

Benefits and risks of antimicrobial use in food-producing animals

PubMed Central

Hao, Haihong; Cheng, Guyue; Iqbal, Zahid; Ai, Xiaohui; Hussain, Hafiz I.; Huang, Lingli; Dai, Menghong; Wang, Yulian; Liu, Zhenli; Yuan, Zonghui

2014-01-01

Benefits and risks of antimicrobial drugs, used in food-producing animals, continue to be complex and controversial issues. This review comprehensively presents the benefits of antimicrobials drugs regarding control of animal diseases, protection of public health, enhancement of animal production, improvement of environment, and effects of the drugs on biogas production and public health associated with antimicrobial resistance. The positive and negative impacts, due to ban issue of antimicrobial agents used in food-producing animals, are also included in the discussion. As a double-edged sword, use of these drugs in food-animals persists as a great challenge. PMID:24971079

Radiotherapy dosimetry audit: three decades of improving standards and accuracy in UK clinical practice and trials.

PubMed

Clark, Catharine H; Aird, Edwin G A; Bolton, Steve; Miles, Elizabeth A; Nisbet, Andrew; Snaith, Julia A D; Thomas, Russell A S; Venables, Karen; Thwaites, David I

2015-01-01

Dosimetry audit plays an important role in the development and safety of radiotherapy. National and large scale audits are able to set, maintain and improve standards, as well as having the potential to identify issues which may cause harm to patients. They can support implementation of complex techniques and can facilitate awareness and understanding of any issues which may exist by benchmarking centres with similar equipment. This review examines the development of dosimetry audit in the UK over the past 30 years, including the involvement of the UK in international audits. A summary of audit results is given, with an overview of methodologies employed and lessons learnt. Recent and forthcoming more complex audits are considered, with a focus on future needs including the arrival of proton therapy in the UK and other advanced techniques such as four-dimensional radiotherapy delivery and verification, stereotactic radiotherapy and MR linear accelerators. The work of the main quality assurance and auditing bodies is discussed, including how they are working together to streamline audit and to ensure that all radiotherapy centres are involved. Undertaking regular external audit motivates centres to modernize and develop techniques and provides assurance, not only that radiotherapy is planned and delivered accurately but also that the patient dose delivered is as prescribed.

Radiotherapy dosimetry audit: three decades of improving standards and accuracy in UK clinical practice and trials

PubMed Central

Aird, Edwin GA; Bolton, Steve; Miles, Elizabeth A; Nisbet, Andrew; Snaith, Julia AD; Thomas, Russell AS; Venables, Karen; Thwaites, David I

2015-01-01

Dosimetry audit plays an important role in the development and safety of radiotherapy. National and large scale audits are able to set, maintain and improve standards, as well as having the potential to identify issues which may cause harm to patients. They can support implementation of complex techniques and can facilitate awareness and understanding of any issues which may exist by benchmarking centres with similar equipment. This review examines the development of dosimetry audit in the UK over the past 30 years, including the involvement of the UK in international audits. A summary of audit results is given, with an overview of methodologies employed and lessons learnt. Recent and forthcoming more complex audits are considered, with a focus on future needs including the arrival of proton therapy in the UK and other advanced techniques such as four-dimensional radiotherapy delivery and verification, stereotactic radiotherapy and MR linear accelerators. The work of the main quality assurance and auditing bodies is discussed, including how they are working together to streamline audit and to ensure that all radiotherapy centres are involved. Undertaking regular external audit motivates centres to modernize and develop techniques and provides assurance, not only that radiotherapy is planned and delivered accurately but also that the patient dose delivered is as prescribed. PMID:26329469

Management issues in systems engineering

NASA Astrophysics Data System (ADS)

Shishko, Robert; Chamberlain, Robert G.; Aster, Robert; Bilardo, Vincent; Forsberg, Kevin; Mooz, Hal; Polaski, Lou; Wade, Ron

When applied to a system, the doctrine of successive refinement is a divide-and-conquer strategy. Complex systems are sucessively divided into pieces that are less complex, until they are simple enough to be conquered. This decomposition results in several structures for describing the product system and the producing system. These structures play important roles in systems engineering and project management. Many of the remaining sections in this chapter are devoted to describing some of these key structures. Structures that describe the product system include, but are not limited to, the requirements tree, system architecture and certain symbolic information such as system drawings, schematics, and data bases. The structures that describe the producing system include the project's work breakdown, schedules, cost accounts and organization.

Management issues in systems engineering

NASA Technical Reports Server (NTRS)

Shishko, Robert; Chamberlain, Robert G.; Aster, Robert; Bilardo, Vincent; Forsberg, Kevin; Mooz, Hal; Polaski, Lou; Wade, Ron

1993-01-01

When applied to a system, the doctrine of successive refinement is a divide-and-conquer strategy. Complex systems are sucessively divided into pieces that are less complex, until they are simple enough to be conquered. This decomposition results in several structures for describing the product system and the producing system. These structures play important roles in systems engineering and project management. Many of the remaining sections in this chapter are devoted to describing some of these key structures. Structures that describe the product system include, but are not limited to, the requirements tree, system architecture and certain symbolic information such as system drawings, schematics, and data bases. The structures that describe the producing system include the project's work breakdown, schedules, cost accounts and organization.

Acknowledging trade-offs and understanding complexity: exurbanization issues in Macon County, North Carolina

Treesearch

Richard A. Vercoe; M. Welch-Devine; Dean Hardy; J.A. Demoss; S.N. Bonney; K. Allen; Peter Brosius; D. Charles; B. Crawford; S. Heisel; Nik Heynen; R.G. de Jesus-Crespo; N. Nibbelink; L. Parker; Cathy Pringle; A. Shaw; L. Van Sant

2014-01-01

We applied an integrative framework to illuminate and discuss the complexities of exurbanization in Macon County, North Carolina. The case of Macon County, North Carolina, highlights the complexity involved in addressing issues of exurbanization in the Southern Appalachian region. Exurbanization, the process by which urban residents move into rural areas in search of...

A Framework for Teachers' Assessment of Socio-Scientific Argumentation: An Example Using the GMO Issue

ERIC Educational Resources Information Center

Christenson, Nina; Chang Rundgren, Shu-Nu

2015-01-01

Socio-scientific issues (SSI) have proven to be suitable contexts for students to actively reflect on and argue about complex social issues related to science. Research has indicated that explicitly teaching SSI argumentation is a good way to help students develop their argumentation skills and make them aware of the complexity of SSI. However,…

Prescription Drug Monitoring Programs: Ethical Issues in the Emergency Department.

PubMed

Marco, Catherine A; Venkat, Arvind; Baker, Eileen F; Jesus, John E; Geiderman, Joel M

2016-11-01

Prescription drug monitoring programs are statewide databases available to clinicians to track prescriptions of controlled medications. These programs may provide valuable information to assess the history and use of controlled substances and contribute to clinical decisionmaking in the emergency department (ED). The widespread availability of the programs raises important ethical issues about beneficence, nonmaleficence, respect for persons, justice, confidentiality, veracity, and physician autonomy. In this article, we review the ethical issues surrounding prescription drug monitoring programs and how those issues might be addressed to ensure the proper application of this tool in the ED. Clinical decisionmaking in regard to the appropriate use of opioids and other controlled substances is complex and should take into account all relevant clinical factors, including age, sex, clinical condition, medical history, medication history and potential drug-drug interactions, history of addiction or diversion, and disease state. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Genes, race, and psychology in the genome era: an introduction.

PubMed

Anderson, Norman B; Nickerson, Kim J

2005-01-01

The mapping of the human genome has reawakened interest in the topic of race and genetics, especially the use of genetic technology to examine racial differences in complex outcomes such as health and intelligence. Advances in genomic research challenge psychology to address the myriad conceptual, methodological, and analytical issues associated with research on genetics and race. In addition, the field needs to understand the numerous social, ethical, legal, clinical, and policy implications of research in this arena. Addressing these issues should not only benefit psychology but could also serve to guide such thought in other fields, including molecular biology. The purpose of this special issue is to begin a discussion of this issue of race and genetics within the field of psychology. Several scholars who work in the fields of genetics, race, or related areas were invited to write (or had previously submitted) articles sharing their perspectives. (c) 2005 APA

Pediatric Issues in Return of Results and Incidental Findings: Weighing Autonomy and Best Interests.

PubMed

Holm, Ingrid A

2017-03-01

Nowhere are the ethical issues in genomic research more complex than in pediatrics. Balancing the sometime conflicting autonomy of the parent and the child, and the best interest of the family and the child, brings up many challenging issues. Addressing this balance, especially in the context of the child's developing maturity and comprehension, requires deep analysis and discussion. Issues discussed include the impact of genetic information on the family, parental versus the child's autonomy, the best interests of the child versus the family, potential limitations on the parents' right to know or not know information about their child, and changing role of the developing child in return of research results. Finally, a dynamic model will be proposed that takes into consideration the child's evolving role in consenting and return of results that can be adapted in different national contexts.

Relocating alcohol advertising research: examining socially mediated relationships with alcohol.

PubMed

Cherrington, Jane; Chamberlain, Kerry; Grixti, Joe

2006-03-01

This article reviews, critiques and politicises the positivist approaches that presently dominate alcohol advertising health research, and considers the benefits of a culturalist alternative. Positivist research in this area is identified as: (1) atheoretical and methods-driven; (2) restricted in focus, leaving critical issues unconsidered; and (3) inappropriately conceptualizing the 'normal' drinking person as rational and safe. The culturist alternative proposed is argued to present a more adequate framework, which can include and address problematic issues that are presently excluded, including: the pleasures associated with alcohol use, the involvements of 'normal' people in problem drinking, the inadequacy of present risk categories and the complexities of wider mediatory processes about alcohol in society. We argue for the adoption of more informed, culturalist approaches to alcohol advertising research.

Studying the HIT-Complexity Interchange.

PubMed

Kuziemsky, Craig E; Borycki, Elizabeth M; Kushniruk, Andre W

2016-01-01

The design and implementation of health information technology (HIT) is challenging, particularly when it is being introduced into complex settings. While complex adaptive system (CASs) can be a valuable means of understanding relationships between users, HIT and tasks, much of the existing work using CASs is descriptive in nature. This paper addresses that issue by integrating a model for analyzing task complexity with approaches for HIT evaluation and systems analysis. The resulting framework classifies HIT-user tasks and issues as simple, complicated or complex, and provides insight on how to study them.

Developing, delivering and evaluating primary mental health care: the co-production of a new complex intervention.

PubMed

Reeve, Joanne; Cooper, Lucy; Harrington, Sean; Rosbottom, Peter; Watkins, Jane

2016-09-06

Health services face the challenges created by complex problems, and so need complex intervention solutions. However they also experience ongoing difficulties in translating findings from research in this area in to quality improvement changes on the ground. BounceBack was a service development innovation project which sought to examine this issue through the implementation and evaluation in a primary care setting of a novel complex intervention. The project was a collaboration between a local mental health charity, an academic unit, and GP practices. The aim was to translate the charity's model of care into practice-based evidence describing delivery and impact. Normalisation Process Theory (NPT) was used to support the implementation of the new model of primary mental health care into six GP practices. An integrated process evaluation evaluated the process and impact of care. Implementation quickly stalled as we identified problems with the described model of care when applied in a changing and variable primary care context. The team therefore switched to using the NPT framework to support the systematic identification and modification of the components of the complex intervention: including the core components that made it distinct (the consultation approach) and the variable components (organisational issues) that made it work in practice. The extra work significantly reduced the time available for outcome evaluation. However findings demonstrated moderately successful implementation of the model and a suggestion of hypothesised changes in outcomes. The BounceBack project demonstrates the development of a complex intervention from practice. It highlights the use of Normalisation Process Theory to support development, and not just implementation, of a complex intervention; and describes the use of the research process in the generation of practice-based evidence. Implications for future translational complex intervention research supporting practice change through scholarship are discussed.

A beginner's guide to belief revision and truth maintenance systems

NASA Technical Reports Server (NTRS)

Mason, Cindy L.

1992-01-01

This brief note is intended to familiarize the non-TMS audience with some of the basic ideas surrounding classic TMS's (truth maintenance systems), namely the justification-based TMS and the assumption-based TMS. Topics of further interest include the relation between non-monotonic logics and TMS's, efficiency and search issues, complexity concerns, as well as the variety of TMS systems that have surfaced in the past decade or so. These include probabilistic-based TMS systems, fuzzy TMS systems, tri-valued belief systems, and so on.

"What Have the Humanities to Offer 21st-Century Europe?": Reflections of a Note Taker

ERIC Educational Resources Information Center

Parker, Jan

2008-01-01

The Humanities have much to offer 21st-century Europe, in terms of both method and issues which may complement and correct those of Science and Social Science. These include, for instance, humanities' generation of plural narratives and plural explanations, of attention to singularity and complexity, and to others' sensibilities and ways of…

Including Families and Communities in Urban Education. Issues in the Research, Theory, Policy, and Practice of Urban Education

ERIC Educational Resources Information Center

Hands, Catherine, Ed.; Hubbard, Lea, Ed.

2011-01-01

The work of school, family and community partnerships is complex and messy and demands a thoughtful and deep investigation. Currently, parent and community involvement does not draw on school reform and educational change literature and conversely the school change literature often ignores the crucial role that communities play in educational…

Engaging Focus Group Methodology: The 4-H Middle School-Aged Youth Learning and Leading Study

ERIC Educational Resources Information Center

Scott, Siri; Grant, Samantha; Nippolt, Pamela Larson

2015-01-01

With young people, discussing complex issues such as learning and leading in a focus group can be a challenge. To help prime youth for the discussion, we created a focus group approach that featured a fun, interactive activity. This article includes a description of the focus group activity, lessons learned, and suggestions for additional…

Ensuring the Integrity, Accessibility, and Stewardship of Research Data in the Digital Age

ERIC Educational Resources Information Center

National Academies Press, 2009

2009-01-01

As digital technologies are expanding the power and reach of research, they are also raising complex issues. These include complications in ensuring the validity of research data; standards that do not keep pace with the high rate of innovation; restrictions on data sharing that reduce the ability of researchers to verify results and build on…

United States Security and the Soviet Challenge. Report of a Wingspread Briefing (Racine, Wisconsin, June 29, 1978).

ERIC Educational Resources Information Center

McLain, Douglas, Jr.

Six presentations, an introduction, and a summary discussion are included in this publication, which focuses on the various complex factors involved in the negotiation of arms control agreements with the Soviet Union. Titles of the six presentations are: (1) Critical Issues in the United States-Soviet Relationship; (2) Basic Elements of Strategic…

Education for Self Reliance--South Africa's Alternative for Addressing Skills Shortage and Job Creation: A Literature Review

ERIC Educational Resources Information Center

Twalo, T.

2010-01-01

South Africa's democratic state has been clouded by various social and economic ills like joblessness, skills shortage, poverty and crime. These are a result of various complex issues which include the apartheid legacy, misdirected education system and poor planning for long term national priorities. This article looks at the lost opportunities to…

Beginning to Teach the End: The Importance of Including Discharge from Aphasia Therapy in the Curriculum

ERIC Educational Resources Information Center

Hersh, Deborah; Cruice, Madeline

2010-01-01

Background: Discharging clients with long-term aphasia from therapy services constitutes a challenging dilemma for practising clinicians for a multitude of reasons. Although discharge was raised and discussed as a contentious issue in the field of aphasiology ten years ago, it remains an aspect of practice which is complex and underexplored. We…

Education in a Multicultural Environment: Equity Issues in Teaching and Learning in the School System in England

ERIC Educational Resources Information Center

Boyle, Bill; Charles, Marie

2011-01-01

The paper focuses on the auditing and accountancy paradigm that has dominated educational measurement of pupil performance for the last 20 years in England. The advocates of this minimum competency paradigm do not take account of the results of its dominance. These results include ignoring the heterogeneous complexity of groups within societies…

Community Concerns and Extension Youth Programs. Proceedings Regional Conference (February 18-20, 1981). Publication 28.

ERIC Educational Resources Information Center

White, Leigh Cree, Ed.

The 4-H/Community Resource Development workshop was designed to help people conducting Extension 4-H programs on sensitive and complex community issues improve their ability to create a better climate for discussion of alternatives and development of community projects. Topics of the presentations included the role of the 4-H administrator,…

Development and evaluation of a leadership program for veterinary students.

PubMed

Moore, D A; Klingborg, D J

2001-01-01

Leadership skills are important for many facets of professional life, but no known leadership training programs exist in North American veterinary schools. It was the purpose of this project to develop, deliver, and evaluate a leadership program for first-year veterinary students. Leadership attributes emphasized in the course included effective communication, openness to learning from others, self-awareness, commitment beyond self-interest, motivation, decision making, understanding issue complexity, and team building. The five-day course was delivered to 21 new veterinary students randomly selected just prior to their first-year orientation in the fall of 2000. Participants ranked themselves higher than non-participants in a post-course evaluation on their ability to be effective leaders. Participants reported an increase in self-confidence and a clearer understanding of their leadership roles. Participants also noted new support systems among co-participants and expressed a new ability to consider complex issues more broadly. Most reported that they frequently used enhanced skills in giving and receiving feedback and team building. Other leadership tools identified as valuable included negotiation, group dynamics, a structured approach to problem solving, time management, and an awareness of personal learning style preferences as a means to improve communication.

Soft System Methodology as a Tool to Understand Issues of Governmental Affordable Housing Programme of India: A Case Study Approach

NASA Astrophysics Data System (ADS)

Ghosh, Sukanya; Roy, Souvanic; Sanyal, Manas Kumar

2016-09-01

With the help of a case study, the article has explored current practices of implementation of governmental affordable housing programme for urban poor in a slum of India. This work shows that the issues associated with the problems of governmental affordable housing programme has to be addressed to with a suitable methodology as complexities are not only dealing with quantitative data but qualitative data also. The Hard System Methodologies (HSM), which is conventionally applied to address the issues, deals with real and known problems which can be directly solved. Since most of the issues of affordable housing programme as found in the case study are subjective and complex in nature, Soft System Methodology (SSM) has been tried for better representation from subjective points of views. The article explored drawing of Rich Picture as an SSM approach for better understanding and analysing complex issues and constraints of affordable housing programme so that further exploration of the issues is possible.

Joint federal research and development process to meet state and local needs. Part 1. Science and technology and political decision making

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

Wise, H F; Smith, L K; Einsweiler, R C

This part of the handbook addresses the basic how to do it - how states and local governments can identify complex and cross-cutting issues and develop and manage scientific and technical resources in seeking policy solutions to such issues. The following subjects are discussed: background statement of the issue; the research/decision-making process; defining problems and identifying research components; research and decision-making strategies; how to identify existing knowledge or ongoing research in the area of policy concern; and managing multi-disciplinary research. The fourteen agencies involved in this effort include: US Departments of Energy, Agriculture, Transportation, Housing and Urban Development, Environmental Protectionmore » Agency, and National Science Foundation. (PSB)« less

The ethics of creating genetically modified children using genome editing.

PubMed

Ishii, Tetsuya

2017-12-01

To review the recent ethical, legal, and social issues surrounding human reproduction involving germline genome editing. Genome editing techniques, such as CRISPR/Cas9, have facilitated genetic modification in human embryos. The most likely purpose of germline genome editing is the prevention of serious genetic disease in offspring. However, complex issues still remain, including irremediable risks to fetuses and future generations, the role of women, the availability of alternatives, long-term follow-up, health insurance coverage, misuse for human enhancement, and the potential effects on adoption. Further discussions, a broad consensus, and appropriate regulations are required before human germline genome editing is introduced into the global society. Before germline genome editing is used for disease prevention, a broad consensus must be formed by carefully discussing its ethical, legal, and social issues.

The importance of including dynamic social networks when modeling epidemics of airborne infections: does increasing complexity increase accuracy?

PubMed

Blower, Sally; Go, Myong-Hyun

2011-07-19

Mathematical models are useful tools for understanding and predicting epidemics. A recent innovative modeling study by Stehle and colleagues addressed the issue of how complex models need to be to ensure accuracy. The authors collected data on face-to-face contacts during a two-day conference. They then constructed a series of dynamic social contact networks, each of which was used to model an epidemic generated by a fast-spreading airborne pathogen. Intriguingly, Stehle and colleagues found that increasing model complexity did not always increase accuracy. Specifically, the most detailed contact network and a simplified version of this network generated very similar results. These results are extremely interesting and require further exploration to determine their generalizability.

Implications of Biospheric Energization

NASA Astrophysics Data System (ADS)

Budding, Edd; Demircan, Osman; Gündüz, Güngör; Emin Özel, Mehmet

2016-07-01

Our physical model relating to the origin and development of lifelike processes from very simple beginnings is reviewed. This molecular ('ABC') process is compared with the chemoton model, noting the role of the autocatalytic tuning to the time-dependent source of energy. This substantiates a Darwinian character to evolution. The system evolves from very simple beginnings to a progressively more highly tuned, energized and complex responding biosphere, that grows exponentially; albeit with a very low net growth factor. Rates of growth and complexity in the evolution raise disturbing issues of inherent stability. Autocatalytic processes can include a fractal character to their development allowing recapitulative effects to be observed. This property, in allowing similarities of pattern to be recognized, can be useful in interpreting complex (lifelike) systems.

Verification of the CFD simulation system SAUNA for complex aircraft configurations

NASA Astrophysics Data System (ADS)

Shaw, Jonathon A.; Peace, Andrew J.; May, Nicholas E.; Pocock, Mark F.

1994-04-01

This paper is concerned with the verification for complex aircraft configurations of an advanced CFD simulation system known by the acronym SAUNA. A brief description of the complete system is given, including its unique use of differing grid generation strategies (structured, unstructured or both) depending on the geometric complexity of the addressed configuration. The majority of the paper focuses on the application of SAUNA to a variety of configurations from the military aircraft, civil aircraft and missile areas. Mesh generation issues are discussed for each geometry and experimental data are used to assess the accuracy of the inviscid (Euler) model used. It is shown that flexibility and accuracy are combined in an efficient manner, thus demonstrating the value of SAUNA in aerodynamic design.

Moving lips versus moving policy: Can scientists figure out how to do both?

NASA Astrophysics Data System (ADS)

Gleick, P. H.

2009-12-01

Global environmental issues are, well, global. Their complexity and scope make them among the most important issues of our time. Yet they are also among the most difficult to evaluate analytically and to communicate effectively. Scientists, when they choose to communicate with the public or policy makers at all, often find that their messages are often misunderstood, ignored, or simply marginalized, making public communications a less-than rewarding experience. Some methods, however, can prove more effective than others, and in the area of water resources and climate change, two approaches have proven especially effective. The first is to focus on “success stories” as a way to move the discussion from problems to solutions; the second is to focus on regional issues as a way to engage policy makers and the public, for whom the global scope of the challenges may be overwhelming. One additional complexity is how to deal with intentional efforts to obfuscate or misrepresent science. In the climate area, especially, this has long been a challenge, but successful approaches include refusing to let such efforts derail rational policy debates. This requires that scientists understand how science can be misrepresented or misused, and calling attention to such efforts. This presentation will summarize some successful communications efforts in the areas of climate and water from the experience of the Pacific Institute, a leading independent research group addressing these issues.

Same-Sex Domestic Violence: Prevalence, Unique Aspects, and Clinical Implications.

PubMed

Stiles-Shields, Colleen; Carroll, Richard A

2015-01-01

Domestic violence is a significant public health issue. Prevalence rates for same-sex domestic violence vary because of methodological issues related to recruitment and definitions of sexual orientation. However, such prevalence rates are currently considered to be similar to slightly greater than other-sex prevalence rates. Research has identified differences between same-sex domestic violence and other-sex domestic violence, including internalized and externalized stressors associated with being a sexual minority that interact with domestic violence to create or exacerbate vulnerabilities, higher risk for complex trauma experiences, and difficulties accessing services. This review provides a critical review of the literature, focusing upon empirical findings regarding same-sex domestic violence.

Psychiatric disorders and sleep issues.

PubMed

Sutton, Eliza L

2014-09-01

Sleep issues are common in people with psychiatric disorders, and the interaction is complex. Sleep disorders, particularly insomnia, can precede and predispose to psychiatric disorders, can be comorbid with and exacerbate psychiatric disorders, and can occur as part of psychiatric disorders. Sleep disorders can mimic psychiatric disorders or result from medication given for psychiatric disorders. Impairment of sleep and of mental health may be different manifestations of the same underlying neurobiological processes. For the primary care physician, key tools include recognition of potential sleep effects of psychiatric medications and familiarity with treatment approaches for insomnia in depression and anxiety. Copyright © 2014 Elsevier Inc. All rights reserved.

Handheld juggernaut.

PubMed

Hagland, Mark

2010-08-01

Not only are hospital, health system, and medical group ClOs and clinical informaticists deploying handheld mobile devices across their enterprises as clinical computing tools; clinicians, especially physicians, are increasingly bringing their own BlackBerrys, iPhones, iPads, Android devices, and other handhelds, into patient care organizations for their personal clinical use. Not surprisingly, the challenges--as well as the opportunities--are multilayered and complex, and include the strategic planning, infrastructure, clinician preference, clinician workflow, and security issues involved in the emerging mobile handheld revolution. The diversity of approaches among ClOs and other healthcare IT leaders on such issues is striking, and underscores the need for flexibility and nimbleness going forward.

Saudi lung cancer management guidelines 2017

PubMed Central

Jazieh, Abdul Rahman; Al Kattan, Khaled; Bamousa, Ahmed; Al Olayan, Ashwaq; Abdelwarith, Ahmed; Ansari, Jawaher; Al Twairqi, Abdullah; Al Fayea, Turki; Al Saleh, Khalid; Al Husaini, Hamed; Abdelhafiez, Nafisa; Mahrous, Mervat; Faris, Medhat; Al Omair, Ameen; Hebshi, Adnan; Al Shehri, Salem; Al Dayel, Foad; Bamefleh, Hanaa; Khalbuss, Walid; Al Ghanem, Sarah; Loutfi, Shukri; Khankan, Azzam; Al Rujaib, Meshael; Al Ghamdi, Majed; Ibrahim, Nagwa; Swied, Abdulmonem; Al Kayait, Mohammad; Datario, Marie

2017-01-01

BACKGROUND: Lung cancer management is getting more complex due to the rapid advances in all aspects of diagnostic and therapeutic options. Developing guidelines is critical to help practitioners provide standard of care. METHODS: The Saudi Lung Cancer Guidelines Committee (SLCGC) multidisciplinary members from different specialties and from various regions and healthcare sectors of the country reviewed and updated all lung cancer guidelines with appropriate labeling of level of evidence. Supporting documents to help healthcare professionals were developed. RESULTS: Detailed lung cancer management guidelines were finalized with appropriate resources for systemic therapy and short reviews highlighting important issues. Stage based disease management recommendation were included. A summary explanation for complex topics were included in addition to tables of approved systemic therapy. CONCLUSION: A multidisciplinary lung cancer guidelines was developed and will be disseminated across the country. PMID:29118855

Saudi lung cancer management guidelines 2017.

PubMed

Jazieh, Abdul Rahman; Al Kattan, Khaled; Bamousa, Ahmed; Al Olayan, Ashwaq; Abdelwarith, Ahmed; Ansari, Jawaher; Al Twairqi, Abdullah; Al Fayea, Turki; Al Saleh, Khalid; Al Husaini, Hamed; Abdelhafiez, Nafisa; Mahrous, Mervat; Faris, Medhat; Al Omair, Ameen; Hebshi, Adnan; Al Shehri, Salem; Al Dayel, Foad; Bamefleh, Hanaa; Khalbuss, Walid; Al Ghanem, Sarah; Loutfi, Shukri; Khankan, Azzam; Al Rujaib, Meshael; Al Ghamdi, Majed; Ibrahim, Nagwa; Swied, Abdulmonem; Al Kayait, Mohammad; Datario, Marie

2017-01-01

Lung cancer management is getting more complex due to the rapid advances in all aspects of diagnostic and therapeutic options. Developing guidelines is critical to help practitioners provide standard of care. The Saudi Lung Cancer Guidelines Committee (SLCGC) multidisciplinary members from different specialties and from various regions and healthcare sectors of the country reviewed and updated all lung cancer guidelines with appropriate labeling of level of evidence. Supporting documents to help healthcare professionals were developed. Detailed lung cancer management guidelines were finalized with appropriate resources for systemic therapy and short reviews highlighting important issues. Stage based disease management recommendation were included. A summary explanation for complex topics were included in addition to tables of approved systemic therapy. A multidisciplinary lung cancer guidelines was developed and will be disseminated across the country.

Setting performance standards for medical practice: a theoretical framework.

PubMed

Southgate, L; Hays, R B; Norcini, J; Mulholland, H; Ayers, B; Woolliscroft, J; Cusimano, M; McAvoy, P; Ainsworth, M; Haist, S; Campbell, M

2001-05-01

The assessment of performance in the real world of medical practice is now widely accepted as the goal of assessment at the postgraduate level. This is largely a validity issue, as it is recognised that tests of knowledge and in clinical simulations cannot on their own really measure how medical practitioners function in the broader health care system. However, the development of standards for performance-based assessment is not as well understood as in competency assessment, where simulations can more readily reflect narrower issues of knowledge and skills. This paper proposes a theoretical framework for the development of standards that reflect the more complex world in which experienced medical practitioners work. The paper reflects the combined experiences of a group of education researchers and the results of literature searches that included identifying current health system data sources that might contribute information to the measurement of standards. Standards that reflect the complexity of medical practice may best be developed through an "expert systems" analysis of clinical conditions for which desired health care outcomes reflect the contribution of several health professionals within a complex, three-dimensional, contextual model. Examples of the model are provided, but further work is needed to test validity and measurability.

From vision to reality--managing change in the provision of library and information services to nurses, midwives, health visitors and PAMs: (professions allied to medicine) a case study of the North Thames experience with the Inner London Consortium.

PubMed

Godbolt, S; Williamson, J; Wilson, A

1997-06-01

One of the North Thames' pioneering consortia, the Inner London Consortium (ILC) is a complex body which includes NHS Trusts with teaching hospital university connections, community-based Trusts and general hospital acute Trusts. Within the consortium there are 12,000 trained nurses, midwives, health visitors and other professional staff working in the professions allied to medicine (PAMs), all of whom require access to and provision of appropriate library information services. In 1994, taking into account experiences elsewhere in the Region and nationally, it became clear that library issues were complex and would become acute with the move of nursing libraries from ILC Trust sites over a very short timescale. A report on the issues commissioned by the Consortium recommended that a library project, which built on existing NHS Trust PGMDE funded library resources and moved these to a multidisciplinary base to serve the consortium membership, be implemented. The objective of providing access to library information services for nurses and PAMs was achieved. Successes that emerged from the implementation included: The registration in Trust libraries of almost 12 000 new members within the initial 6-month monitoring period. The development of service level agreements and standards for the delivery of services to these new user groups. This paper describes the processes behind these significant and complex changes.

Research ethics in dissertations: ethical issues and complexity of reasoning.

PubMed

Kjellström, S; Ross, S N; Fridlund, B

2010-07-01

Conducting ethically sound research is a fundamental principle of scientific inquiry. Recent research has indicated that ethical concerns are insufficiently dealt with in dissertations. To examine which research ethical topics were addressed and how these were presented in terms of complexity of reasoning in Swedish nurses' dissertations. Analyses of ethical content and complexity of ethical reasoning were performed on 64 Swedish nurses' PhD dissertations dated 2007. A total of seven ethical topics were identified: ethical approval (94% of the dissertations), information and informed consent (86%), confidentiality (67%), ethical aspects of methods (61%), use of ethical principles and regulations (39%), rationale for the study (20%) and fair participant selection (14%). Four of those of topics were most frequently addressed: the majority of dissertations (72%) included 3-5 issues. While many ethical concerns, by their nature, involve systematic concepts or metasystematic principles, ethical reasoning scored predominantly at lesser levels of complexity: abstract (6% of the dissertations), formal (84%) and systematic (10%). Research ethics are inadequately covered in most dissertations by nurses in Sweden. Important ethical concerns are missing, and the complexity of reasoning on ethical principles, motives and implications is insufficient. This is partly due to traditions and norms that discount ethical concerns but is probably also a reflection of the ability of PhD students and supervisors to handle complexity in general. It is suggested that the importance of ethical considerations should be emphasised in graduate and post-graduate studies and that individuals with capacity to deal with systematic and metasystematic concepts are recruited to senior research positions.

Semiconductor quantum dots as Förster resonance energy transfer donors for intracellularly-based biosensors

NASA Astrophysics Data System (ADS)

Field, Lauren D.; Walper, Scott A.; Susumu, Kimihiro; Oh, Eunkeu; Medintz, Igor L.; Delehanty, James B.

2017-02-01

Förster resonance energy transfer (FRET)-based assemblies currently comprise a significant portion of intracellularly based sensors. Although extremely useful, the fluorescent protein pairs typically utilized in such sensors are still plagued by many photophysical issues including significant direct acceptor excitation, small changes in FRET efficiency, and limited photostability. Luminescent semiconductor nanocrystals or quantum dots (QDs) are characterized by many unique optical properties including size-tunable photoluminescence, broad excitation profiles coupled to narrow emission profiles, and resistance to photobleaching, which can cumulatively overcome many of the issues associated with use of fluorescent protein FRET donors. Utilizing QDs for intracellular FRET-based sensing still requires significant development in many areas including materials optimization, bioconjugation, cellular delivery and assay design and implementation. We are currently developing several QD-based FRET sensors for various intracellular applications. These include sensors targeting intracellular proteolytic activity along with those based on theranostic nanodevices for monitoring drug release. The protease sensor is based on a unique design where an intracellularly expressed fluorescent acceptor protein substrate assembles onto a QD donor following microinjection, forming an active complex that can be monitored in live cells over time. In the theranostic configuration, the QD is conjugated to a carrier protein-drug analogue complex to visualize real-time intracellular release of the drug from its carrier in response to an external stimulus. The focus of this talk will be on the design, properties, photophysical characterization and cellular application of these sensor constructs.

A data-driven approach to quality risk management

PubMed Central

Alemayehu, Demissie; Alvir, Jose; Levenstein, Marcia; Nickerson, David

2013-01-01

Aim: An effective clinical trial strategy to ensure patient safety as well as trial quality and efficiency involves an integrated approach, including prospective identification of risk factors, mitigation of the risks through proper study design and execution, and assessment of quality metrics in real-time. Such an integrated quality management plan may also be enhanced by using data-driven techniques to identify risk factors that are most relevant in predicting quality issues associated with a trial. In this paper, we illustrate such an approach using data collected from actual clinical trials. Materials and Methods: Several statistical methods were employed, including the Wilcoxon rank-sum test and logistic regression, to identify the presence of association between risk factors and the occurrence of quality issues, applied to data on quality of clinical trials sponsored by Pfizer. Results: Only a subset of the risk factors had a significant association with quality issues, and included: Whether study used Placebo, whether an agent was a biologic, unusual packaging label, complex dosing, and over 25 planned procedures. Conclusion: Proper implementation of the strategy can help to optimize resource utilization without compromising trial integrity and patient safety. PMID:24312890

Care coordination of multimorbidity: a scoping study

PubMed Central

Burau, Viola

2015-01-01

Background A key challenge in healthcare systems worldwide is the large number of patients who suffer from multimorbidity; despite this, most systems are organized within a single-disease framework. Objective The present study addresses two issues: the characteristics and preconditions of care coordination for patients with multimorbidity; and the factors that promote or inhibit care coordination at the levels of provider organizations and healthcare professionals. Design The analysis is based on a scoping study, which combines a systematic literature search with a qualitative thematic analysis. The search was conducted in November 2013 and included the PubMed, CINAHL, and Web of Science databases, as well as the Cochrane Library, websites of relevant organizations and a hand-search of reference lists. The analysis included studies with a wide range of designs, from industrialized countries, in English, German and the Scandinavian languages, which focused on both multimorbidity/comorbidity and coordination of integrated care. Results The analysis included 47 of the 226 identified studies. The central theme emerging was complexity. This related to both specific medical conditions of patients with multimorbidity (case complexity) and the organization of care delivery at the levels of provider organizations and healthcare professionals (care complexity). Conclusions In terms of how to approach care coordination, one approach is to reduce complexity and the other is to embrace complexity. Either way, future research must take a more explicit stance on complexity and also gain a better understanding of the role of professionals as a prerequisite for the development of new care coordination interventions. PMID:29090157

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

Siegel, S.

An increased level of mathematical sophistication will be needed in the future to be able to handle the spectrum of information as it comes from a broad array of biological systems and other sources. Classification will be an increasingly complex and difficult issue. Several projects that are discussed are being developed by the US Department of Health and Human Services (DHHS), including a directory of risk assessment projects and a directory of exposure information resources.

The Meaning of "Sex": Using Title VII's Definition of Sex to Teach about the Legal Regulation of Business

ERIC Educational Resources Information Center

Kaminer, Debbie

2018-01-01

The lesson described in this article includes a number of overlapping learning goals. The first goal is to develop students' understanding of the complexities associated with the legal regulation of business in the United States. This case study is an excellent means of doing so, since it involves numerous interrelated legal issues. Real-world…

A Radial Basis Function Approach to Financial Time Series Analysis

DTIC Science & Technology

1993-12-01

including efficient methods for parameter estimation and pruning, a pointwise prediction error estimator, and a methodology for controlling the "data...collection of practical techniques to address these issues for a modeling methodology . Radial Basis Function networks. These techniques in- clude efficient... methodology often then amounts to a careful consideration of the interplay between model complexity and reliability. These will be recurrent themes

New ethical challenges in science and technology

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

NONE

The published research features some of the nation's leading scientists and engineers, as well as science policy experts, and discusses a wide range of issues and topics. These include the economic and social pressure impacting biomedical research, the impossibility of predicting all the behaviors of increasingly complex, engineered systems, a look at the new federal guidelines for misconduct and new wrinkles on faculty conflicts of interest.

Theoretical and Practical Issues of Systematization of Russian Energy Legislation When Bringing It into a Coherent System

ERIC Educational Resources Information Center

Shevchenko, Lyubov' I.; Ivanova, Svetlana A.

2016-01-01

The urgency of the problems stated in the paper is conditioned by the need to develop and adopt a new concept of legislation, which would have fixed the starting positions and the principles of legal regulation of relations in the sphere of fuel and energy complex, including the forms of Russia's participation in international projects in the…

Confronting Challenges at the Intersection of Rurality, Place, and Teacher Preparation: Improving Efforts in Teacher Education to Staff Rural Schools

ERIC Educational Resources Information Center

Azano, Amy Price; Stewart, Trevor Thomas

2016-01-01

Recruiting and retaining highly qualified teachers in rural schools is a persistent struggle in many countries, including the U.S. Salient challenges related to poverty, geographic isolation, low teacher salaries, and a lack of community amenities seem to trump perks of living in rural communities. Recognizing this issue as a complex and hard to…

Evaluation of potential effects of federal land management alternatives on trends of salmonids and their habitats in the interior Columbia River basin.

Treesearch

Bruce Rieman; James T. Peterson; James Clayton; Philip Howell; Russell Thurow; William Thompson; Danny Lee

2001-01-01

Aquatic species throughout the interior Columbia River basin are at risk. Evaluation of the potential effects of federal land management on aquatic ecosystems across this region is an important but challenging task. Issues include the size and complexity of the systems, uncertainty in important processes and existing states, flexibility and consistency in the...

Why do patients engage in medical tourism?

PubMed

Runnels, Vivien; Carrera, P M

2012-12-01

Medical tourism is commonly perceived and popularly depicted as an economic issue, both at the system and individual levels. The decision to engage in medical tourism, however, is more complex, driven by patients' unmet need, the nature of services sought and the manner by which treatment is accessed. In order to beneficially employ the opportunities medical tourism offers, and address and contain possible threats and harms, an informed decision is crucial. This paper aims to enhance the current knowledge on medical tourism by isolating the focal content of the decisions that patients make. Based on the existing literature, it proposes a sequential decision-making process in opting for or against medical care abroad, and engaging in medical tourism, including considerations of the required treatments, location of treatment, and quality and safety issues attendant to seeking care. Accordingly, it comments on the imperative of access to health information and the current regulatory environment which impact on this increasingly popular and complex form of accessing and providing medical care. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Enhancing metaproteomics-The value of models and defined environmental microbial systems

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

Herbst, Florian-Alexander; Lünsmann, Vanessa; Kjeldal, Henrik

Metaproteomicsthe large-scale characterization of the entire protein complement of environmental microbiota at a given point in timehas provided new features to study complex microbial communities in order to unravel these black boxes. Some new technical challenges arose that were not an issue for classical proteome analytics before that could be tackled by the application of different model systems. Here, we review different current and future model systems for metaproteome analysis. We introduce model systems for clinical and biotechnological research questions including acid mine drainage, anaerobic digesters, and activated sludge, following a short introduction to microbial communities and metaproteomics. Model systemsmore » are useful to evaluate the challenges encountered within (but not limited to) metaproteomics, including species complexity and coverage, biomass availability, or reliable protein extraction. Moreover, the implementation of model systems can be considered as a step forward to better understand microbial community responses and ecological functions of single member organisms. In the future, improvements are necessary to fully explore complex environmental systems by metaproteomics.« less

Enhancing metaproteomics-The value of models and defined environmental microbial systems

DOE PAGES

Herbst, Florian-Alexander; Lünsmann, Vanessa; Kjeldal, Henrik; ...

2016-01-21

Metaproteomicsthe large-scale characterization of the entire protein complement of environmental microbiota at a given point in timehas provided new features to study complex microbial communities in order to unravel these black boxes. Some new technical challenges arose that were not an issue for classical proteome analytics before that could be tackled by the application of different model systems. Here, we review different current and future model systems for metaproteome analysis. We introduce model systems for clinical and biotechnological research questions including acid mine drainage, anaerobic digesters, and activated sludge, following a short introduction to microbial communities and metaproteomics. Model systemsmore » are useful to evaluate the challenges encountered within (but not limited to) metaproteomics, including species complexity and coverage, biomass availability, or reliable protein extraction. Moreover, the implementation of model systems can be considered as a step forward to better understand microbial community responses and ecological functions of single member organisms. In the future, improvements are necessary to fully explore complex environmental systems by metaproteomics.« less

Complex multifault rupture during the 2016 Mw 7.8 Kaikōura earthquake, New Zealand.

PubMed

Hamling, Ian J; Hreinsdóttir, Sigrún; Clark, Kate; Elliott, John; Liang, Cunren; Fielding, Eric; Litchfield, Nicola; Villamor, Pilar; Wallace, Laura; Wright, Tim J; D'Anastasio, Elisabetta; Bannister, Stephen; Burbidge, David; Denys, Paul; Gentle, Paula; Howarth, Jamie; Mueller, Christof; Palmer, Neville; Pearson, Chris; Power, William; Barnes, Philip; Barrell, David J A; Van Dissen, Russ; Langridge, Robert; Little, Tim; Nicol, Andrew; Pettinga, Jarg; Rowland, Julie; Stirling, Mark

2017-04-14

On 14 November 2016, northeastern South Island of New Zealand was struck by a major moment magnitude ( M w ) 7.8 earthquake. Field observations, in conjunction with interferometric synthetic aperture radar, Global Positioning System, and seismology data, reveal this to be one of the most complex earthquakes ever recorded. The rupture propagated northward for more than 170 kilometers along both mapped and unmapped faults before continuing offshore at the island's northeastern extent. Geodetic and field observations reveal surface ruptures along at least 12 major faults, including possible slip along the southern Hikurangi subduction interface; extensive uplift along much of the coastline; and widespread anelastic deformation, including the ~8-meter uplift of a fault-bounded block. This complex earthquake defies many conventional assumptions about the degree to which earthquake ruptures are controlled by fault segmentation and should motivate reevaluation of these issues in seismic hazard models. Copyright © 2017, American Association for the Advancement of Science.

The Daily Readiness Huddle: a process to rapidly identify issues and foster improvement through problem-solving accountability.

PubMed

Donnelly, Lane F; Cherian, Shirley S; Chua, Kimberly B; Thankachan, Sam; Millecker, Laura A; Koroll, Alex G; Bisset, George S

2017-01-01

Because of the increasing complexities of providing imaging for pediatric health care services, a more reliable process to manage the daily delivery of care is necessary. Objective We describe our Daily Readiness Huddle and the effects of the process on problem identification and improvement. Our Daily Readiness Huddle has four elements: metrics review, clinical volume review, daily readiness assessment, and problem accountability. It is attended by radiologists, directors, managers, front-line staff with concerns, representatives from support services (information technology [IT] and biomedical engineering [biomed]), and representatives who join the meeting in a virtual format from off-site locations. Data are visually displayed on erasable whiteboards. The daily readiness assessment uses queues to determine whether anyone has concerns or outlier data in regard to S-MESA (Safety, Methods, Equipment, Supplies or Associates). Through this assessment, problems are identified and categorized as quick hits (will be resolved in 24-48 h, not requiring project management) and complex issues. Complex issues are assigned an owner, quality coach and report-back date. Additionally, projects are defined as improvements that are often strategic, are anticipated to take more than 60 days, and do not necessarily arise out of identified issues during the Daily Readiness Huddle. We tracked and calculated the mean, median and range of days to resolution and completion for complex issues and for projects during the first full year of implementing this process. During the first 12 months, 91 complex issues were identified and resolved, 11 projects were in progress and 33 completed, with 23 other projects active or in planning. Time to resolution of complex issues (in days) was mean 37.5, median 34.0, and range 1-105. For projects, time to completion (in days) was mean 86.0, median 84.0, and range 5-280. The Daily Readiness Huddle process has given us a framework to rapidly identify issues, bring accountability to problem-solving, and foster improvement. It has also had a positive effect on team-building and coordination.

Ethics beyond borders: how health professionals experience ethics in humanitarian assistance and development work.

PubMed

Hunt, Matthew R

2008-08-01

Health professionals are involved in humanitarian assistance and development work in many regions of the world. They participate in primary health care, immunization campaigns, clinic- and hospital-based care, rehabilitation and feeding programs. In the course of this work, clinicians are frequently exposed to complex ethical issues. This paper examines how health workers experience ethics in the course of humanitarian assistance and development work. A qualitative study was conducted to consider this question. Five core themes emerged from the data, including: tension between respecting local customs and imposing values; obstacles to providing adequate care; differing understandings of health and illness; questions of identity for health workers; and issues of trust and distrust. Recommendations are made for organizational strategies that could help aid agencies support and equip their staff as they respond to ethical issues.

Say No to DMSO: Dimethylsulfoxide Inactivates Cisplatin, Carboplatin and Other Platinum Complexes

PubMed Central

Hall, Matthew D.; Telma, Katherine A.; Chang, Ki-Eun; Lee, Tobie D.; Madigan, James P.; Lloyd, John R.; Goldlust, Ian S.; Hoeschele, James D.; Gottesman, Michael M.

2014-01-01

The platinum drugs cisplatin, carboplatin and oxaliplatin are highly utilized in the clinic and as a consequence are extensively studied in the laboratory setting. In this study, we examined the literature and found a significant number of studies (11 - 34%) in prominent cancer journals utilizing cisplatin dissolved in dimethylsulfoxide (DMSO). However, dissolving cisplatin in DMSO for laboratory-based studies results in ligand displacement and changes the structure of the complex. We examined the effect of DMSO on platinum complexes, including cisplatin, carboplatin and oxaliplatin, finding that DMSO reacted with the complexes, inhibited their cytotoxicity and their ability to initiate cell death. These results render a substantial portion of the literature on cisplatin uninterpretable. Raising awareness of this significant issue in the cancer biology community is critical, and we make recommendations on appropriate solvation of platinum drugs for research. PMID:24812268

Dual-phase evolution in complex adaptive systems

PubMed Central

Paperin, Greg; Green, David G.; Sadedin, Suzanne

2011-01-01

Understanding the origins of complexity is a key challenge in many sciences. Although networks are known to underlie most systems, showing how they contribute to well-known phenomena remains an issue. Here, we show that recurrent phase transitions in network connectivity underlie emergent phenomena in many systems. We identify properties that are typical of systems in different connectivity phases, as well as characteristics commonly associated with the phase transitions. We synthesize these common features into a common framework, which we term dual-phase evolution (DPE). Using this framework, we review the literature from several disciplines to show that recurrent connectivity phase transitions underlie the complex properties of many biological, physical and human systems. We argue that the DPE framework helps to explain many complex phenomena, including perpetual novelty, modularity, scale-free networks and criticality. Our review concludes with a discussion of the way DPE relates to other frameworks, in particular, self-organized criticality and the adaptive cycle. PMID:21247947

Dual-phase evolution in complex adaptive systems.

PubMed

Paperin, Greg; Green, David G; Sadedin, Suzanne

2011-05-06

Understanding the origins of complexity is a key challenge in many sciences. Although networks are known to underlie most systems, showing how they contribute to well-known phenomena remains an issue. Here, we show that recurrent phase transitions in network connectivity underlie emergent phenomena in many systems. We identify properties that are typical of systems in different connectivity phases, as well as characteristics commonly associated with the phase transitions. We synthesize these common features into a common framework, which we term dual-phase evolution (DPE). Using this framework, we review the literature from several disciplines to show that recurrent connectivity phase transitions underlie the complex properties of many biological, physical and human systems. We argue that the DPE framework helps to explain many complex phenomena, including perpetual novelty, modularity, scale-free networks and criticality. Our review concludes with a discussion of the way DPE relates to other frameworks, in particular, self-organized criticality and the adaptive cycle.

Cognitive Illusions as Hindrances to Learning Complex Environmental Issues.

ERIC Educational Resources Information Center

Groves, Fred H.; Pugh, Ava F.

2002-01-01

Describes a study investigating the effects of short-term interventions on preservice elementary teachers' understanding of the topic of ozone depletion and whether complex issues can be dealt with successfully through short-term intervention. Reports that preservice teachers' understanding improved through a short-term intervention using a mix of…

Critical Thinking as Room for Subjectification in Education for Sustainable Development

ERIC Educational Resources Information Center

Hasslöf, Helen; Malmberg, Claes

2015-01-01

Issues of sustainability are complex and often steeped with ethical and political questions without predefined or general answers. This paper deals with how secondary and upper secondary teachers discuss these complex issues, by analysing their aims for Education for Sustainable Development. With inspiration from discourse theory, their…

Stories Matter: The Complexity of Cultural Authenticity in Children's Literature.

ERIC Educational Resources Information Center

Fox, Dana L., Ed.; Short, Kathy G., Ed.

The controversial issue of cultural authenticity in children's literature resurfaces continually, always eliciting strong emotions and a wide range of perspectives. This collection explores the complexity of this issue by highlighting important historical events, current debates, and new questions and critiques. Articles in the collection are…

Spectroscopic and Statistical Techniques for Information Recovery in Metabonomics and Metabolomics

NASA Astrophysics Data System (ADS)

Lindon, John C.; Nicholson, Jeremy K.

2008-07-01

Methods for generating and interpreting metabolic profiles based on nuclear magnetic resonance (NMR) spectroscopy, mass spectrometry (MS), and chemometric analysis methods are summarized and the relative strengths and weaknesses of NMR and chromatography-coupled MS approaches are discussed. Given that all data sets measured to date only probe subsets of complex metabolic profiles, we describe recent developments for enhanced information recovery from the resulting complex data sets, including integration of NMR- and MS-based metabonomic results and combination of metabonomic data with data from proteomics, transcriptomics, and genomics. We summarize the breadth of applications, highlight some current activities, discuss the issues relating to metabonomics, and identify future trends.

Spectroscopic and statistical techniques for information recovery in metabonomics and metabolomics.

PubMed

Lindon, John C; Nicholson, Jeremy K

2008-01-01

Methods for generating and interpreting metabolic profiles based on nuclear magnetic resonance (NMR) spectroscopy, mass spectrometry (MS), and chemometric analysis methods are summarized and the relative strengths and weaknesses of NMR and chromatography-coupled MS approaches are discussed. Given that all data sets measured to date only probe subsets of complex metabolic profiles, we describe recent developments for enhanced information recovery from the resulting complex data sets, including integration of NMR- and MS-based metabonomic results and combination of metabonomic data with data from proteomics, transcriptomics, and genomics. We summarize the breadth of applications, highlight some current activities, discuss the issues relating to metabonomics, and identify future trends.

Editorial [Special issue on software defined networks and infrastructures, network function virtualisation, autonomous systems and network management

DOE PAGES

Biswas, Amitava; Liu, Chen; Monga, Inder; ...

2016-01-01

For last few years, there has been a tremendous growth in data traffic due to high adoption rate of mobile devices and cloud computing. Internet of things (IoT) will stimulate even further growth. This is increasing scale and complexity of telecom/internet service provider (SP) and enterprise data centre (DC) compute and network infrastructures. As a result, managing these large network-compute converged infrastructures is becoming complex and cumbersome. To cope up, network and DC operators are trying to automate network and system operations, administrations and management (OAM) functions. OAM includes all non-functional mechanisms which keep the network running.

The 1990 update to strategy for exploration of the inner planets

NASA Technical Reports Server (NTRS)

Esposito, Larry W.; Pepin, Robert O.; Cheng, Andrew F.; Jakosky, Bruce M.; Lunine, Jonathan I.; Mcfadden, Lucy-Ann; Mckay, Christopher P.; Mckinnon, William B.; Muhleman, Duane O.; Nicholson, Philip

1990-01-01

The Committee on Planetary and Lunar Exploration (COMPLEX) has undertaken to review and revise the 1978 report Strategy for Exploration of the Inner Planets, 1977-1987. The committee has found the 1978 report to be generally still pertinent. COMPLEX therefore issues its new report in the form of an update. The committee reaffirms the basic objectives for exploration of the planets: to determine the present state of the planets and their satellites, to understand the processes active now and at the origin of the solar system, and to understand planetary evolution, including appearance of life and its relation to the chemical history of the solar system.

Nutrition and the science of disease prevention: a systems approach to support metabolic health

PubMed Central

Bennett, Brian J.; Hall, Kevin D.; Hu, Frank B.; McCartney, Anne L.; Roberto, Christina

2017-01-01

Progress in nutritional science, genetics, computer science, and behavioral economics can be leveraged to address the challenge of noncommunicable disease. This report highlights the connection between nutrition and the complex science of preventing disease and discusses the promotion of optimal metabolic health, building on input from several complementary disciplines. The discussion focuses on (1) the basic science of optimal metabolic health, including data from gene–diet interactions, microbiome, and epidemiological research in nutrition, with the goal of defining better targets and interventions, and (2) how nutrition, from pharma to lifestyle, can build on systems science to address complex issues. PMID:26415028

Tree physiology research in a changing world.

PubMed

Kaufmann, Merrill R.; Linder, Sune

1996-01-01

Changes in issues and advances in methodology have contributed to substantial progress in tree physiology research during the last several decades. Current research focuses on process interactions in complex systems and the integration of processes across multiple spatial and temporal scales. An increasingly important challenge for future research is assuring sustainability of production systems and forested ecosystems in the face of increased demands for natural resources and human disturbance of forests. Meeting this challenge requires significant shifts in research approach, including the study of limitations of productivity that may accompany achievement of system sustainability, and a focus on the biological capabilities of complex land bases altered by human activity.

Optimization-based decision support to assist in logistics planning for hospital evacuations.

PubMed

Glick, Roger; Bish, Douglas R; Agca, Esra

2013-01-01

The evacuation of the hospital is a very complex process and evacuation planning is an important part of a hospital's emergency management plan. There are numerous factors that affect the evacuation plan including the nature of threat, availability of resources and staff the characteristics of the evacuee population, and risk to patients and staff. The safety and health of patients is of fundamental importance, but safely moving patients to alternative care facilities while under threat is a very challenging task. This article describes the logistical issues and complexities involved in planning and execution of hospital evacuations. Furthermore, this article provides examples of how optimization-based decision support tools can help evacuation planners to better plan for complex evacuations by providing real-world solutions to various evacuation scenarios.

Addressing health concerns of pregnant African American women using the lens of complexity theory.

PubMed

Sims, Traci

2014-01-01

Pregnant African American women are at higher risk for multiple complex health issues, including depression, than their European American counterparts (Canady, Bullen, Holzman, Broman, & Tian, 2008; Martin et al, 2011; Mathews & MacDorman, 2007; Orr, Blazer, & James, 2006; Segre, Losch, & O'Hara, 2006). Various strategies must be used to address depression through preventive care and promotion of access to appropriate mental health services. Nurses and other health care providers need to examine the relationships between the multifactorial problems to improve the health and well-being of pregnant African American women and their unborn children. This article presents a case study demonstrating the use of complexity science theory to understand and prevent poor health outcomes for pregnant African American women with depression and their unborn children.

Complex Problem Solving: What It Is and What It Is Not

PubMed Central

Dörner, Dietrich; Funke, Joachim

2017-01-01

Computer-simulated scenarios have been part of psychological research on problem solving for more than 40 years. The shift in emphasis from simple toy problems to complex, more real-life oriented problems has been accompanied by discussions about the best ways to assess the process of solving complex problems. Psychometric issues such as reliable assessments and addressing correlations with other instruments have been in the foreground of these discussions and have left the content validity of complex problem solving in the background. In this paper, we return the focus to content issues and address the important features that define complex problems. PMID:28744242

Large Spatial and Temporal Separations of Cause and Effect in Policy Making - Dealing with Non-linear Effects

NASA Astrophysics Data System (ADS)

McCaskill, John

There can be large spatial and temporal separation of cause and effect in policy making. Determining the correct linkage between policy inputs and outcomes can be highly impractical in the complex environments faced by policy makers. In attempting to see and plan for the probable outcomes, standard linear models often overlook, ignore, or are unable to predict catastrophic events that only seem improbable due to the issue of multiple feedback loops. There are several issues with the makeup and behaviors of complex systems that explain the difficulty many mathematical models (factor analysis/structural equation modeling) have in dealing with non-linear effects in complex systems. This chapter highlights those problem issues and offers insights to the usefulness of ABM in dealing with non-linear effects in complex policy making environments.

The World Atlas of Desertification assessment concept for conscious land use solutions

NASA Astrophysics Data System (ADS)

Cherlet, Michael; Ivits, Eva; Kutnjak, Hrvoje; Smid, Marek; Sommer, Stefan; Zucca, Claudio

2015-04-01

Land degradation and desertification are complex phenomena that result in environmental damage, economic inefficiency and social inequity and are reflected by a reducing productive capacity of the land and soil. Research indicated that they are driven by a multiple but a limited number of causal aspects that unbalance the capacity of the environment system to sustainably produce ecosystem services and economic value. Competition for land, driven by societal needs or economic opportunities, adds further stress on the land resources. To address these complex global challenges, a monitoring and assessment system offering up-to-date information on the status and trends of land degradation and their causes and effects is needed to provide science-based routes for possible land use solutions. The assessment concept that has been outlined for the compilation of the new World Atlas of Desertification (WAD) confronts this complexity by converging evidence of stress on the land system caused by various issues. These issues relate to sets of dynamics of the human-environment system and include changing agricultural or pastoral land use and management practices, changing population and societal aspects, changing aridity and drought. The WAD describes the issues, spatially documents their change, whenever data is available, highlights the importance of the issues in relation to land degradation processes and illustrates the integrated assessment concepts. The first step is the preparation of solid global data layers that are related to, or express aspects that can be related to, land-system productivity dynamics and status. These can be used for identifying and evaluating the interaction of spatial variables with the land-system productivity dynamics. Initial analysis of the land productivity dynamics within stratified land cover/use areas, such as the global croplands, show substantial differences in the extension, geographic location and possible related causes of potentially critical areas. The stratified integration of global data layers does not produce the 'mythical map of global land degradation' but allows locating areas where stress on the land system is observed that can be related to manifest causal issues. Preventing judgement on the complex status of 'land degradation' the WAD opens the way to a positive approach to deal with the problem, providing also helpful evidence for stakeholders to design more conscious solutions for land use.

BRCA1 genetic mutation and its link to ovarian cancer: implications for advanced practice nurses.

PubMed

Brunsvold, Amy N; Wung, Shu-Fen; Merkle, Carrie J

2005-12-01

The purpose of this paper is to review (a) the linkage between the BRCA1 gene and ovarian cancer and (b) BRCA1 testing and its related issues. This review is aimed for nurse practitioners (NPs), who may be in positions to identify those at risk for BRCA1-associated ovarian cancer and to assist patients with related issues. Data sources include reviews and original research from scholarly journals and Internet sites. Ovarian cancer is a deadly disease. Identification of those at risk because of BRCA1 mutation is possible through genetic testing. Testing for BRCA1 gene mutations has many implications whether results are positive or negative. Those with positive results will be faced with decisions regarding the best management strategies. Negative results do not completely eliminate ovarian cancer risk. Current management options for carriers of the BRCA1 mutation include taking no action, increasing surveillance for ovarian cancer, and chemoprevention with oral contraceptives or prophylactic oophorectomy for those who have completed childbearing. It is essential that NPs have knowledge underlying the issues and concerns of patients and their families at risk for BRCA1-associated ovarian cancer. NPs are in a unique position to help identify BRCA1 mutation carriers and to assist them and their families with the complex issues involving genetic testing and management options. Understanding these issues will allow NPs to give appropriate care that may include making appropriate referrals to certified genetic counselors and having balanced discussions on treatment options. Such measurements may improve early diagnosis of ovarian cancer and increase survival from this disease.

Mindfulness and discussing "thorny" issues in the classroom

NASA Astrophysics Data System (ADS)

Alexakos, Konstantinos; Pride, Leah D.; Amat, Arnau; Tsetsakos, Panagiota; Lee, Kristi J.; Paylor-Smith, Christian; Zapata, Corinna; Wright, Shequana; Smith, Theila

2016-09-01

Being in the moment, showing compassion, being non-judgmental, acknowledging deep emotional challenges without getting stuck: these are mindfulness characteristics important to us as teachers, yet not often included in teacher preparation. These concerns become magnified when we focus on difficult knowledge and thorny issues, like topics related to gender and race. Using a sociocultural framework, we address how mindfulness, heuristics, and other contemplative practices can be adopted to create safe, supporting, and healing spaces for such complex, often emotionally painful discussions. Participant narratives are used extensively to provide a voice to those marginalized or hurt. Drawing from these narratives and their experience in discussing thorny issues, we put forth possible solutions and interventions that can create spaces that encourage and support critical discourse through mindful practices. The development of a heuristic for discussing thorny issues whose characteristics can be adopted by interested teachers and educators to help frame and mediate this type of difficult discussion is an outcome of this research.

Forward progress of scientific inquiry into the early father-child relationship: introduction to the special issue on very young children and their fathers.

PubMed

Bocknek, Erika L; Hossain, Ziarat; Roggman, Lori

2014-01-01

Research on fathering and the father-child relationship has made substantial progress in the most recent 15 years since the last special issue of the Infant Mental Health Journal on fathers and young children. This special issue on fathers and young children contains a series of papers exemplifying this progress, including advances in methodology-more direct assessment and more observational measures-in addition to the increasing dynamic complexity of the conceptual models used to study fathers, the diversity of fathers studied, and the growth of programs to support early father involvement. In assessing the current state of the field, special attention is given to contributions made by the papers contained in this special issue, and two critical areas for continued progress are addressed: (1) methodological and measurement development that specifically address fathers and fathering relationships and (2) cross-cultural and ecologically valid research examining the diversity of models of fathering. © 2014 Michigan Association for Infant Mental Health.

Public health equity in refugee situations

PubMed Central

2011-01-01

Addressing increasing concerns about public health equity in the context of violent conflict and the consequent forced displacement of populations is complex. Important operational questions now faced by humanitarian agencies can to some extent be clarified by reference to relevant ethical theory. Priorities of service delivery, the allocation choices, and the processes by which they are arrived at are now coming under renewed scrutiny in the light of the estimated two million refugees who fled from Iraq since 2003. Operational questions that need to be addressed include health as a relative priority, allocations between and within different populations, and transition and exit strategies. Public health equity issues faced by the humanitarian community can be framed as issues of resource allocation and issues of decision-making. The ethical approach to resource allocation in health requires taking adequate steps to reduce suffering and promote wellbeing, with the upper bound being to avoid harming those at the lower end of the welfare continuum. Deliberations in the realm of international justice have not provided a legal or implementation platform for reducing health disparities across the world, although norms and expectations, including within the humanitarian community, may be moving in that direction. Despite the limitations of applying ethical theory in the fluid, complex and highly political environment of refugee settings, this article explores how this theory could be used in these contexts and provides practical examples. The intent is to encourage professionals in the field, such as aid workers, health care providers, policy makers, and academics, to consider these ethical principles when making decisions. PMID:21575218

The Complexity of HIV Persistence and Pathogenesis in the Lung Under Antiretroviral Therapy: Challenges Beyond AIDS

PubMed Central

2014-01-01

Abstract Antiretroviral therapy (ART) represents a significant milestone in the battle against AIDS. However, we continue learning about HIV and confronting challenges 30 years after its discovery. HIV has cleverly tricked both the host immune system and ART. First, the many HIV subtypes and recombinant forms have different susceptibilities to antiretroviral drugs, which may represent an issue in countries where ART is just being introduced. Second, even under the suppressive pressures of ART, HIV still increases inflammatory mediators, deregulates apoptosis and proliferation, and induces oxidative stress in the host. Third, the preference of HIV for CXCR4 as a co-receptor may also have noxious outcomes, including potential malignancies. Furthermore, HIV still replicates cryptically in anatomical reservoirs, including the lung. HIV impairs bronchoalveolar T-lymphocyte and macrophage immune responses, rendering the lung susceptible to comorbidities. In addition, HIV-infected individuals are significantly more susceptible to long-term HIV-associated complications. This review focuses on chronic obstructive pulmonary disease (COPD), pulmonary arterial hypertension, and lung cancer. Almost two decades after the advent of highly active ART, we now know that HIV-infected individuals on ART live as long as the uninfected population. Fortunately, its availability is rapidly increasing in low- and middle-income countries. Nevertheless, ART is not risk-free: the developed world is facing issues with antiretroviral drug toxicity, resistance, and drug–drug interactions, while developing countries are confronting issues with immune reconstitution inflammatory syndrome. Several aspects of the complexity of HIV persistence and challenges with ART are discussed, as well as suggestions for new avenues of research. PMID:24797368

Public health equity in refugee situations.

PubMed

Leaning, Jennifer; Spiegel, Paul; Crisp, Jeff

2011-05-16

Addressing increasing concerns about public health equity in the context of violent conflict and the consequent forced displacement of populations is complex. Important operational questions now faced by humanitarian agencies can to some extent be clarified by reference to relevant ethical theory. Priorities of service delivery, the allocation choices, and the processes by which they are arrived at are now coming under renewed scrutiny in the light of the estimated two million refugees who fled from Iraq since 2003.Operational questions that need to be addressed include health as a relative priority, allocations between and within different populations, and transition and exit strategies. Public health equity issues faced by the humanitarian community can be framed as issues of resource allocation and issues of decision-making. The ethical approach to resource allocation in health requires taking adequate steps to reduce suffering and promote wellbeing, with the upper bound being to avoid harming those at the lower end of the welfare continuum. Deliberations in the realm of international justice have not provided a legal or implementation platform for reducing health disparities across the world, although norms and expectations, including within the humanitarian community, may be moving in that direction.Despite the limitations of applying ethical theory in the fluid, complex and highly political environment of refugee settings, this article explores how this theory could be used in these contexts and provides practical examples. The intent is to encourage professionals in the field, such as aid workers, health care providers, policy makers, and academics, to consider these ethical principles when making decisions.

KSC-04PD-0801

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. -- On a tour of the Orbiter Processing Facility, Florida Gov. Jeb Bush (center) greets workers. The tour followed the launching ceremony at the KSC Visitor Complex for the new Florida quarter issued by the U.S. Mint. The ceremony was emceed by Center Director Jim Kennedy and included remarks by NASA Administrator Sean OKeefe, Bush, U.S. Mint Director Henrietta Holsman Fore and Deputy Secretary of the Treasury Samuel W. Bodman.

Study of Varying Boundary Layer Height on Turret Flow Structures

DTIC Science & Technology

2011-06-01

fluid dynamics. The difficulties of the problem arise in modeling several complex flow features including separation, reattachment, three-dimensional...impossible. In this case, the approach is to create a model to calculate the properties of interest. The main issue with resolving turbulent flows...operation and their effect is modeled through subgrid scale models . As a result, the the most important turbulent scales are resolved and the

Application of the Chimera overlapped grid scheme to simulation of Space Shuttle ascent flows

NASA Technical Reports Server (NTRS)

Buning, Pieter G.; Parks, Steven J.; Chan, William M.; Renze, Kevin J.

1992-01-01

Several issues relating to the application of Chimera overlapped grids to complex geometries and flowfields are discussed. These include the addition of geometric components with different grid topologies, gridding for intersecting pieces of geometry, and turbulence modeling in grid overlap regions. Sample results are presented for transonic flow about the Space Shuttle launch vehicle. Comparisons with wind tunnel and flight measured pressures are shown.

Conceptualizing the cross-cultural gaps in managing international aid: HIV/AIDS and TB project delivery in Southern Africa.

PubMed

Jackson, Terence

2011-01-01

There appears to be a gap between the billions of dollars inputted into fighting HIV/AIDS and TB and outcomes. This in part can be attributed to the lack of attention in International Development to managing programmes and projects within complex levels of cross-cultural interactions. International Development often ignores management issues, yet Management Studies is left wanting through a lack of engagement with development issues including the fight against disease and poverty. This paper attempts to link these two disciplines towards mutual benefit, through a critical cross-cultural approach. It provides contextualization of international development policies/strategies; conceptualization of dominant paradigms; structural analysis of how a programme/project fits into the global governance structure; analysis of complexities and levels of cross-cultural interaction and their consequences and the process and implications of knowledge transfer across cultural distances. It concludes with implications for policy and practice, as well as what is needed from cross-disciplinary research. This includes how feedback loops can be strengthened from local to global, how indigenous knowledge may be better understood and integrated, how power relations within the global governance structure could be managed, how cross-cultural interaction could be better understood, and how knowledge transfer/sharing should be critically managed. Copyright © 2010 John Wiley & Sons, Ltd.

Toward a National Framework for the Secondary Use of Health Data: An American Medical Informatics Association White Paper

PubMed Central

Safran, Charles; Bloomrosen, Meryl; Hammond, W. Edward; Labkoff, Steven; Markel-Fox, Suzanne; Tang, Paul C.; Detmer, Don E.

2007-01-01

Secondary use of health data applies personal health information (PHI) for uses outside of direct health care delivery. It includes such activities as analysis, research, quality and safety measurement, public health, payment, provider certification or accreditation, marketing, and other business applications, including strictly commercial activities. Secondary use of health data can enhance health care experiences for individuals, expand knowledge about disease and appropriate treatments, strengthen understanding about effectiveness and efficiency of health care systems, support public health and security goals, and aid businesses in meeting customers’ needs. Yet, complex ethical, political, technical, and social issues surround the secondary use of health data. While not new, these issues play increasingly critical and complex roles given current public and private sector activities not only expanding health data volume, but also improving access to data. Lack of coherent policies and standard “good practices” for secondary use of health data impedes efforts to strengthen the U.S. health care system. The nation requires a framework for the secondary use of health data with a robust infrastructure of policies, standards, and best practices. Such a framework can guide and facilitate widespread collection, storage, aggregation, linkage, and transmission of health data. The framework will provide appropriate protections for legitimate secondary use. PMID:17077452

Genetic mouse models relevant to schizophrenia: taking stock and looking forward.

PubMed

Harrison, Paul J; Pritchett, David; Stumpenhorst, Katharina; Betts, Jill F; Nissen, Wiebke; Schweimer, Judith; Lane, Tracy; Burnet, Philip W J; Lamsa, Karri P; Sharp, Trevor; Bannerman, David M; Tunbridge, Elizabeth M

2012-03-01

Genetic mouse models relevant to schizophrenia complement, and have to a large extent supplanted, pharmacological and lesion-based rat models. The main attraction is that they potentially have greater construct validity; however, they share the fundamental limitations of all animal models of psychiatric disorder, and must also be viewed in the context of the uncertain and complex genetic architecture of psychosis. Some of the key issues, including the choice of gene to target, the manner of its manipulation, gene-gene and gene-environment interactions, and phenotypic characterization, are briefly considered in this commentary, illustrated by the relevant papers reported in this special issue. Copyright © 2011 Elsevier Ltd. All rights reserved.

Making intelligent systems team players: Case studies and design issues. Volume 1: Human-computer interaction design

NASA Technical Reports Server (NTRS)

Malin, Jane T.; Schreckenghost, Debra L.; Woods, David D.; Potter, Scott S.; Johannesen, Leila; Holloway, Matthew; Forbus, Kenneth D.

1991-01-01

Initial results are reported from a multi-year, interdisciplinary effort to provide guidance and assistance for designers of intelligent systems and their user interfaces. The objective is to achieve more effective human-computer interaction (HCI) for systems with real time fault management capabilities. Intelligent fault management systems within the NASA were evaluated for insight into the design of systems with complex HCI. Preliminary results include: (1) a description of real time fault management in aerospace domains; (2) recommendations and examples for improving intelligent systems design and user interface design; (3) identification of issues requiring further research; and (4) recommendations for a development methodology integrating HCI design into intelligent system design.

The Need for Hydrologists in the Third World.

NASA Astrophysics Data System (ADS)

Sedlar, F.

2014-12-01

The United Nations estimates that by 2040 there will be 2 billion people living in slums around the world. Though the problems surrounding slums are varied and unique to each location, water is almost always the major concern. From physical issues such as water scarcity, treatment, and flooding to political issues including water privatization and distribution, water manifests itself in many complex, negative and unconventional ways in the global slums. Although many human rights and aid organizations are already doing important work in slums around the world I argue that the technical knowledge and perspectives that hydrologists have, particularly early career hydrologists, are extremely unique and desperately required in slums the world over.

BIG DATA AND STATISTICS

PubMed Central

Rossell, David

2016-01-01

Big Data brings unprecedented power to address scientific, economic and societal issues, but also amplifies the possibility of certain pitfalls. These include using purely data-driven approaches that disregard understanding the phenomenon under study, aiming at a dynamically moving target, ignoring critical data collection issues, summarizing or preprocessing the data inadequately and mistaking noise for signal. We review some success stories and illustrate how statistical principles can help obtain more reliable information from data. We also touch upon current challenges that require active methodological research, such as strategies for efficient computation, integration of heterogeneous data, extending the underlying theory to increasingly complex questions and, perhaps most importantly, training a new generation of scientists to develop and deploy these strategies. PMID:27722040

[Care continuity for patients with Prader-Willi syndrome during transition from childhood to adulthood].

PubMed

Saitoh, Shinji

2010-01-01

Prader-Willi syndrome(PWS) is a complex multisystem genetic disorder, of which characteristic phenotypes include neonatal hypotonia, hyperphagia resulting in obesity, mental retardation, hypogonadism, and behavioral and psychiatric problems. The diagnosis can be obtained as early as during neonatal period thanks to development of genetic testing. Clinical features of PWS will change depending on age, although core phenotypes of hyperphagia, obesity and psychiatric issues stay for lifetime. Therefore, integrated multidisciplinary approach starting from neonatal period is mandatory to ensure optimal management to improve lifelong quality of life. For successful transition from childhood to adulthood, multidisciplinary team need to share clinical information, and should keep the same policy about food, environment and psychiatric issues.

Totally Integrated Munitions Enterprise ''Affordable Munitions Production for the 21st Century''

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

Burleson, R.R.; Poggio, M.E.; Rosenberg, S.J.

2000-09-13

The U.S. Army faces several munitions manufacturing issues: downsizing of the organic production base, timely fielding of affordable smart munitions, and munitions replenishment during national emergencies. Totally Integrated Munitions Enterprise (TIME) is addressing these complex issues via the development and demonstration of an integrated enterprise. The enterprise will include the tools, network, and open modular architecture controllers to enable accelerated acquisition, shortened concept to volume production, lower life cycle costs, capture of critical manufacturing processes, and communication of process parameters between remote sites to rapidly spin-off production for replenishment by commercial sources. TIME addresses the enterprise as a system, integratingmore » design, engineering, manufacturing, administration, and logistics.« less

Totally Integrated Munitions Enterprise ''Affordable Munitions Production for the 21st Century''

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

Burleson, R.R.; Poggio, M.E.; Rosenberg, S.J.

2000-07-14

The U.S. Army faces several munitions manufacturing issues: downsizing of the organic production base, timely fielding of affordable smart munitions, and munitions replenishment during national emergencies. TIME is addressing these complex issues via the development and demonstration of an integrated enterprise. The enterprise will include the tools, network, and open modular architecture controller to enable accelerated acquisition, shortened concept to volume production, lower life cycle costs, capture of critical manufacturing processes, and communication of process parameters between remote sites to rapidly spin-off production for replenishment by commercial sources. TIME addresses the enterprise as a system, integrating design, engineering, manufacturing, administration,more » and logistics.« less

Totally Integrated Munitions Enterprise ''Affordable Munitions Production for the 21st Century''

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

Burleson, R.R.; Poggio, M.E.; Rosenberg, S.J.

2000-08-18

The U.S. Army faces several munitions manufacturing issues: downsizing of the organic production base, timely fielding of affordable smart munitions, and munitions replenishment during national emergencies. Totally Integrated Munitions Enterprise (TIME) is addressing these complex issues via the development and demonstration of an integrated enterprise. The enterprise will include the tools, network, and open modular architecture controllers to enable accelerated acquisition, shortened concept to volume production, lower life cycle costs, capture of critical manufacturing processes, and communication of process parameters between remote sites to rapidly spin-off production for replenishment by commercial sources. TIME addresses the enterprise as a system, integratingmore » design, engineering, manufacturing, administration, and logistics.« less

Ethical Issues in the Assessment and Treatment of a Rational Suicidal Client.

ERIC Educational Resources Information Center

Snipe, Rosetta M.

1988-01-01

Notes that rational client's decision to commit suicide may present complex ethical issues for therapist. Presents and discusses three-month account of therapy with client, from perspective of ethical values and principles upon which assessment and treatment decisions were made, and complex ethical dilemmas encountered as therapist juxtaposed…

77 FR 31870 - Final Comprehensive Conservation Plan for the Bowdoin National Wildlife Refuge Complex

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-30

... remaining complex waters do not support a sport fishery due high salinity levels or shallow water depth... addressing the salinity and blowing salts issue on Bowdoin National Wildlife Refuge. The Region 6 Regional... Thibadeau and Alternative 4 for addressing the salinity and blowing salts issue. These preferred...

78 FR 58316 - Complex Issues in Developing Medical Devices for Pediatric Patients Affected by Rare Diseases...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-1073] Complex Issues in Developing Medical Devices for Pediatric Patients Affected by Rare Diseases; Public Workshop; Request for Comments AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public workshop...

Using Digital Concept Maps to Distinguish between Young Refugees' Challenges

ERIC Educational Resources Information Center

Brooker, Abi; Lawrence, Jeanette; Dodds, Agnes

2017-01-01

Digital media are beneficial for research of complex refugee issues, as they allow refugees to express their personal experiences of complex issues in ways that are not restricted by language barriers or limited in authenticity, while also offering researchers a way to systematically compare refugees' varied experiences. We used a computerised…

Teaching Note--Heterosexism as Experienced by LGBT Social Work Educators

ERIC Educational Resources Information Center

Johnson, Lisa M.

2014-01-01

As social work educators, much of our practice involves helping students think critically about complex political, economic, and social issues. One of the most complex and contentious sociopolitical issues of our time has been civil rights for lesbian, gay, bisexual, and transgender (LGBT) persons. This teaching note considers how we, as LGBT…

Understanding the Complexity of Social Issues through Process Drama.

ERIC Educational Resources Information Center

O'Mara, Joanne

2002-01-01

Attempts to capture the process of understanding and questioning deforestation through process drama (in which students and teacher work both in and out of role to explore a problem, situation, or theme). Notes that moving topics such as the destruction of a rainforest into process drama introduces complexity into social issues. Considers how…

Using a Qualitative Vignette to Explore a Complex Public Health Issue.

PubMed

Jackson, Michaela; Harrison, Paul; Swinburn, Boyd; Lawrence, Mark

2015-10-01

This article discusses how qualitative vignettes were combined with interviews to explore a complex public health issue; that is, promoting unhealthy foods and beverages to children and adolescents. It outlines how the technique was applied in practice and the combination of vignette-based interviews with a broader approach involving Gadamerian hermeneutics. Twenty-one participants from the public health community and the marketing and food and beverage industries took part in vignette-based interviews between March and September 2012. Overall, the qualitative vignette method afforded an efficient, generally well-received technique that effectively explored the issue of promoting unhealthy foods and beverages to children and adolescents. The vignette provided structure to interviews but allowed certain responses to be investigated in greater depth. Through this research, we argue that qualitative vignettes allow researchers to explore complex public health issues. This article also provides a valuable resource for researchers seeking to explore this technique. © The Author(s) 2015.

Environmental Decision Making on Acid Mine Drainage Issues in South Africa: An Argument for the Precautionary Principle.

PubMed

Morodi, T J; Mpofu, Charles

2017-06-28

This paper examines the issue of acid mine drainage in South Africa and environmental decision making processes that could be taken to mitigate the problem in the context of both conventional risk assessment and the precautionary principle. It is argued that conventional risk assessment protects the status quo and hence cannot be entirely relied upon as an effective tool to resolve environmental problems in the context of South Africa, a developing country with complex environmental health concerns. The complexity of the environmental issues is discussed from historical and political perspectives. An argument is subsequently made that the precautionary principle is an alternative tool, and its adoption can be used to empower local communities. This work, therefore, adds to new knowledge by problematising conventional risk assessment and proposing the framing of the acid mine drainage issues in a complex and contextual scenario of a developing country-South Africa.

Medical photography: current technology, evolving issues and legal perspectives.

PubMed

Harting, M T; DeWees, J M; Vela, K M; Khirallah, R T

2015-04-01

Medical photographic image capture and data management has undergone a rapid and compelling change in complexity over the last 20 years. This is because of multiple factors, including significant advances in ease of photograph capture, alongside an evolution of mechanisms of data portability/dissemination, combined with governmental focus on health information privacy. Literature to guide medical, legal, governmental and business professionals when dealing with issues related to medical photography is virtually nonexistent. Herein, we will address the breadth of uses of medical photography, device properties/specific devices utilised for image capture, methods of data transfer and dissemination and patient perceptions and attitudes regarding photography in a medical setting. In addition, we will address the legal implications, including legal precedent, copyright and privacy law, informed consent, protected health information and the Health Insurance Portability and Accountability Act (HIPAA), as they pertain to medical photography. © 2015 John Wiley & Sons Ltd.

Ethical and epistemic issues in direct-to-consumer drug advertising: where is patient agency?

PubMed

Womack, Catherine A

2013-05-01

Arguments for and against direct-to-consumer drug advertising (DTCA) center on two issues: (1) the epistemic effects on patients through access to information provided by the ads; and (2) the effects of such information on patients' abilities to make good choices in the healthcare marketplace. Advocates argue that DTCA provides useful information for patients as consumers, including information connecting symptoms to particular medical conditions, information about new drug therapies for those conditions. Opponents of DTCA point out substantial omissions in information provided by the ads and argue that the framing of the ads may mislead patients about the indications, uses, and effectiveness of the drugs advertised. They also suggest that DTCA has a number of potentially negative effects on the doctor-patient relationship. The standard arguments appear to assume a simplistic correlation-more information means more agency for patients. However, empirical studies on medical decision making suggest that this relationship is much more complex and nuanced. I examine recent research on ways in which patients are vulnerable with respect to DTCA. In order to address the complex issues of information acquisition and consumer decision-making in the health care marketplace, the focus should not be simply on what information patients need in order to make medical decisions, but also on the conditions under which patients actually are able to make medical decisions requiring complex medication information. This requires examining both the cognitive limitations of patients with respect to drug information and investigating patients' preferences and needs in a variety of medical contexts.

A multidisciplinary approach to solving computer related vision problems.

PubMed

Long, Jennifer; Helland, Magne

2012-09-01

This paper proposes a multidisciplinary approach to solving computer related vision issues by including optometry as a part of the problem-solving team. Computer workstation design is increasing in complexity. There are at least ten different professions who contribute to workstation design or who provide advice to improve worker comfort, safety and efficiency. Optometrists have a role identifying and solving computer-related vision issues and in prescribing appropriate optical devices. However, it is possible that advice given by optometrists to improve visual comfort may conflict with other requirements and demands within the workplace. A multidisciplinary approach has been advocated for solving computer related vision issues. There are opportunities for optometrists to collaborate with ergonomists, who coordinate information from physical, cognitive and organisational disciplines to enact holistic solutions to problems. This paper proposes a model of collaboration and examples of successful partnerships at a number of professional levels including individual relationships between optometrists and ergonomists when they have mutual clients/patients, in undergraduate and postgraduate education and in research. There is also scope for dialogue between optometry and ergonomics professional associations. A multidisciplinary approach offers the opportunity to solve vision related computer issues in a cohesive, rather than fragmented way. Further exploration is required to understand the barriers to these professional relationships. © 2012 The College of Optometrists.

Multichromosomal median and halving problems under different genomic distances

PubMed Central

Tannier, Eric; Zheng, Chunfang; Sankoff, David

2009-01-01

Background Genome median and genome halving are combinatorial optimization problems that aim at reconstructing ancestral genomes as well as the evolutionary events leading from the ancestor to extant species. Exploring complexity issues is a first step towards devising efficient algorithms. The complexity of the median problem for unichromosomal genomes (permutations) has been settled for both the breakpoint distance and the reversal distance. Although the multichromosomal case has often been assumed to be a simple generalization of the unichromosomal case, it is also a relaxation so that complexity in this context does not follow from existing results, and is open for all distances. Results We settle here the complexity of several genome median and halving problems, including a surprising polynomial result for the breakpoint median and guided halving problems in genomes with circular and linear chromosomes, showing that the multichromosomal problem is actually easier than the unichromosomal problem. Still other variants of these problems are NP-complete, including the DCJ double distance problem, previously mentioned as an open question. We list the remaining open problems. Conclusion This theoretical study clears up a wide swathe of the algorithmical study of genome rearrangements with multiple multichromosomal genomes. PMID:19386099

Legal issues of the electronic dental record: security and confidentiality.

PubMed

Szekely, D G; Milam, S; Khademi, J A

1996-01-01

Computer-based, electronic dental record keeping involves complex issues of patient privacy and the dental practitioner's ethical duty of confidentiality. Federal and state law is responding to the new legal issues presented by computer technology. Authenticating the electronic record in terms of ensuring its reliability and accuracy is essential in order to protect its admissibility as evidence in legal actions. Security systems must be carefully planned to limit access and provide for back-up and storage of dental records. Carefully planned security systems protect the patient from disclosure without the patient's consent and also protect the practitioner from the liability that would arise from such disclosure. Human errors account for the majority of data security problems. Personnel security is assured through pre-employment screening, employment contracts, policies, and staff education. Contracts for health information systems should include provisions for indemnification and ensure the confidentiality of the system by the vendor.

Radiation Testing and Evaluation Issues for Modern Integrated Circuits

NASA Technical Reports Server (NTRS)

LaBel, Kenneth A.; Cohn, Lew M.

2005-01-01

Abstract. Changes in modern integrated circuit (IC) technologies have modified the way we approach and conduct radiation tolerance and testing of electronics. These changes include scaling of geometries, new materials, new packaging technologies, and overall speed and device complexity challenges. In this short course section, we will identify and discuss these issues as they impact radiation testing, modeling, and effects mitigation of modern integrated circuits. The focus will be on CMOS-based technologies, however, other high performance technologies will be discussed where appropriate. The effects of concern will be: Single-Event Effects (SEE) and steady state total ionizing dose (TID) IC response. However, due to the growing use of opto-electronics in space systems issues concerning displacement damage testing will also be considered. This short course section is not intended to provide detailed "how-to-test" information, but simply provide a snapshot of current challenges and some of the approaches being considered.

Finance issue brief: medical necessity: year end report-2003.

PubMed

MacEachern, Lillian

2003-12-31

The information in this issue brief is based on a 50--state survey and a recent literature review. The Health Policy Tracking Service recognizes the complexity of this issue and discourages the use of this document as a sole resource on the issue.

Finance issue brief: medical necessity: year end report-2002.

PubMed

Morgan, Rachel; MacEachern, Lillian

2002-12-31

The information in this issue brief is based on a 50--state survey and a recent literature review. The Health Policy Tracking Service recognizes the complexity of this issue and discourages the use of this document as a sole resource on the issue.

Outsourcing data processing: planning for the disentanglement.

PubMed

Moss, M E; Gordon, M L

1993-06-01

Outsourcing data processing operations may be considered a conventional acquisition transaction between a customer and supplier. The most distinctive feature of a DP outsourcing contract is that it involves complex issues relating to computer software and technology and, frequently, intense issues relating to employees. But, one must do more in order to provide for preservation of the integrity (and, therefore, the value) of the data center. The contract must include not just the sale of a facility to a supplier who will take over the operations, but also terms for reconveying the facility at a future date. Getting out of the arrangement can be very complex. Disentanglement can be made less complex however, if the customer and the supplier negotiate all or part of the disentanglement procedures during the original contract proposal. Know ahead of time the possible scenarios for when disentanglement may take place and know what to do during the contract negotiations and during the length of the agreement to keep track of each other's properties. Know also the risks involved in outsourcing DP operations, such as what happens when the supplier's business fails. Having the supplier set up a separate profit entity for your contracted business or using a lien on the data center properties may help avoid loss if such failure occurs.

Chemosignals, hormones, and amphibian reproduction.

PubMed

Woodley, Sarah

2015-02-01

This article is part of a Special Issue "Chemosignals and Reproduction". Amphibians are often thought of as relatively simple animals especially when compared to mammals. Yet the chemosignaling systems used by amphibians are varied and complex. Amphibian chemosignals are particularly important in reproduction, in both aquatic and terrestrial environments. Chemosignaling is most evident in salamanders and newts, but increasing evidence indicates that chemical communication facilitates reproduction in frogs and toads as well. Reproductive hormones shape the production, dissemination, detection, and responsiveness to chemosignals. A large variety of chemosignals have been identified, ranging from simple, invariant chemosignals to complex, variable blends of chemosignals. Although some chemosignals elicit straightforward responses, others have relatively subtle effects. Review of amphibian chemosignaling reveals a number of issues to be resolved, including: 1) the significance of the complex, individually variable blends of courtship chemosignals found in some salamanders, 2) the behavioral and/or physiological functions of chemosignals found in anuran "breeding glands", 3) the ligands for amphibian V2Rs, especially V2Rs expressed in the main olfactory epithelium, and 4) the mechanism whereby transdermal delivery of chemosignals influences behavior. To date, only a handful of the more than 7000 species of amphibians has been examined. Further study of amphibians should provide additional insight to the role of chemosignals in reproduction. Copyright © 2014 Elsevier Inc. All rights reserved.

Self-Disclosure and Adults with Learning Disabilities: Practical Ideas about a Complex Process

ERIC Educational Resources Information Center

Gerber, Paul J.; Price, Lynda A.

2008-01-01

Self-disclosure for adults with learning disabilities is very complex after the beyond-school years. The issues of invisibility, risk/benefit, and the multiple contexts of adult functioning create many challenges in the process of disclosure. Moreover, self-disclosure, one element of the larger issue of self-determination, is viewed as an entry…

Supporting Individuals with Autism Spectrum Disorder in Understanding and Coping with Complex Social Emotional Issues

ERIC Educational Resources Information Center

Ahlers, Kaitlyn P.; Gabrielsen, Terisa P.; Lewis, Danielle; Brady, Anna M.; Litchford, April

2017-01-01

Core deficits in autism spectrum disorder (ASD) center around social communication and behavior. For those with ASD, these deficits complicate the task of learning how to cope with and manage complex social emotional issues. Although individuals with ASD may receive sufficient academic and basic behavioral support in school settings, supports for…

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

Berman, M.; Boyack, K.; VanDevender, J.P.

Prosperity Games are an outgrowth and adaptation of move/countermove and seminar War Games. Prosperity Games are simulations that explore complex issues in a variety of areas including economics, politics, sociology, environment, education and research. These issues can be examined from a variety of perspectives ranging from a global, macroeconomic and geopolitical viewpoint down to the details of customer/supplier/market interactions in specific industries. All Prosperity Games are unique in that both the game format and the player contributions vary from game to game. This report documents the Environmental Prosperity Game conducted under the sponsorship of the Silicon Valley Environmental Partnership. Playersmore » were drawn from all stakeholders involved in environmental technologies including small and large companies, government, national laboratories, universities, environmentalists, the legal profession, finance, and the media. The primary objectives of this game were to: investigate strategies for developing a multi-agency (national/state/regional), one-step regulatory approval process for certifying and implementing environmental technologies and evaluating the simulated results; identify the regulatory hurdles and requirements, and the best approaches for surmounting them; identify technical problems and potential resources (environmental consultants, labs, universities) for solving them. The deliberations and recommendations of these players provided valuable insights as to the views of this diverse group of decision makers concerning environmental issues, including the development, licensing, and commercialization of new technologies.« less

Soliciting scientific information and beliefs in predictive modeling and adaptive management

NASA Astrophysics Data System (ADS)

Glynn, P. D.; Voinov, A. A.; Shapiro, C. D.

2015-12-01

Post-normal science requires public engagement and adaptive corrections in addressing issues with high complexity and uncertainty. An adaptive management framework is presented for the improved management of natural resources and environments through a public participation process. The framework solicits the gathering and transformation and/or modeling of scientific information but also explicitly solicits the expression of participant beliefs. Beliefs and information are compared, explicitly discussed for alignments or misalignments, and ultimately melded back together as a "knowledge" basis for making decisions. An effort is made to recognize the human or participant biases that may affect the information base and the potential decisions. In a separate step, an attempt is made to recognize and predict the potential "winners" and "losers" (perceived or real) of any decision or action. These "winners" and "losers" include present human communities with different spatial, demographic or socio-economic characteristics as well as more dispersed or more diffusely characterized regional or global communities. "Winners" and "losers" may also include future human communities as well as communities of other biotic species. As in any adaptive management framework, assessment of predictions, iterative follow-through and adaptation of policies or actions is essential, and commonly very difficult or impossible to achieve. Recognizing beforehand the limits of adaptive management is essential. More generally, knowledge of the behavioral and economic sciences and of ethics and sociology will be key to a successful implementation of this adaptive management framework. Knowledge of biogeophysical processes will also be essential, but by definition of the issues being addressed, will always be incomplete and highly uncertain. The human dimensions of the issues addressed and the participatory processes used carry their own complexities and uncertainties. Some ideas and principles are provided that may help guide and implement the proposed adaptive management framework and its public and stakeholder engagement processes. Examples and characteristics of issues that could be beneficially addressed through the proposed framework will also be presented.

Feasibility study for hydrocarbon complex in southern seaboard. Petroleum Authority of Thailand

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

NONE

This study, conducted by Fluor Daniel, was funded by the U.S. Trade and Development Agency, on behalf of the Petroleum Authority of Thailand. The primary objective of the study was to investigate the economic viability of the related facilities and determine how each could help to industrialize and build up the Southern Seaboard area of Thailand. The focus of the report is in three areas including; Crude Oil Transportation System, Refinery, and Petrochemical Complex. Another objective of the study was to offer an alternative for large crude carrier traffic by proposing the completion of a crude oil pipeline. The reportmore » is divided into the following sections: (1) Executive Summary; (2) Introduction; (3) Crude Oil Transportation System; (4) Refinery Project; (5) Petrochemical Complex; (6) Key Issues & Considerations; (7) Financial Evaluations; (8) Summary & Conclusions.« less

Designing and maintaining an effective chargemaster.

PubMed

Abbey, D C

2001-03-01

The chargemaster is the central repository of charges and associated coding information used to develop claims. But this simple description belies the chargemaster's true complexity. The chargemaster's role in the coding process differs from department to department, and not all codes provided on a claim form are necessarily included in the chargemaster, as codes for complex services may need to be developed and reviewed by coding staff. In addition, with the rise of managed care, the chargemaster increasingly is being used to track utilization of supplies and services. To ensure that the chargemaster performs all of its functions effectively, hospitals should appoint a chargemaster coordinator, supported by a chargemaster review team, to oversee the design and maintenance of the chargemaster. Important design issues that should be considered include the principle of "form follows function," static versus dynamic coding, how modifiers should be treated, how charges should be developed, how to incorporate physician fee schedules into the chargemaster, the interface between the chargemaster and cost reports, and how to include statistical information for tracking utilization.

Science and Technology Issues Relating to Data Quality in C2 Systems

DTIC Science & Technology

2011-01-01

domains. 2 Various investigators have given different definitions of the terms “information” and “data,” depending on the context. For this paper ...in a formalized man- ner suitable for communication, interpretation or processing [2]. In the context of this paper , data includes both raw and...operate faster. Modern C2 systems, especially in a coalition environment, are among the most complex systems imaginable. In this paper , we examine

The future of employer-sponsored retiree medical plans.

PubMed

Rappaport, A M; Kalman, R W

1987-01-01

Complex issues cloud the economic security of people who are covered by employer-sponsored retiree medical plans. The future stability of these plans is especially confusing. In their paper, the authors carefully analyze the current structure of retiree medical plans, including the effect of certain laws. Their clarifications are objective and concise. Of particular timeliness and practicality--particularly for public policy markers--is the authors' four-point strategy to help stabilize the future.

KSC-04pd0801

NASA Image and Video Library

2004-04-07

KENNEDY SPACE CENTER, FLA. -- On a tour of the Orbiter Processing Facility, Florida Gov. Jeb Bush (center) greets workers. The tour followed the launching ceremony at the KSC Visitor Complex for the new Florida quarter issued by the U.S. Mint. The ceremony was emceed by Center Director Jim Kennedy and included remarks by NASA Administrator Sean O’Keefe, Bush, U.S. Mint Director Henrietta Holsman Fore and Deputy Secretary of the Treasury Samuel W. Bodman.

Health care organizations as complex systems: new perspectives on design and management.

PubMed

McDaniel, Reuben R; Driebe, Dean J; Lanham, Holly Jordan

2013-01-01

We discuss the impact of complexity science on the design and management of health care organizations over the past decade. We provide an overview of complexity science issues and their impact on thinking about health care systems, particularly with the rising importance of information systems. We also present a complexity science perspective on current issues in today's health care organizations and suggest ways that this perspective might help in approaching these issues. We review selected research, focusing on work in which we participated, to identify specific examples of applications of complexity science. We then take a look at information systems in health care organizations from a complexity viewpoint. Complexity science is a fundamentally different way of understanding nature and has influenced the thinking of scholars and practitioners as they have attempted to understand health care organizations. Many scholars study health care organizations as complex adaptive systems and through this perspective develop new management strategies. Most important, perhaps, is the understanding that attention to relationships and interdependencies is critical for developing effective management strategies. Increased understanding of complexity science can enhance the ability of researchers and practitioners to develop new ways of understanding and improving health care organizations. This analysis opens new vistas for scholars and practitioners attempting to understand health care organizations as complex adaptive systems. The analysis holds value for those already familiar with this approach as well as those who may not be as familiar.

[The evolution of human cultural behavior: notes on Darwinism and complexity].

PubMed

Peric, Mikael; Murrieta, Rui Sérgio Sereni

2015-12-01

The article analyzes three schools that can be understood as central in studies of the evolution of human behavior within the paradigm of evolution by natural selection: human behavioral ecology (HBE), evolutionary psychology, and dual inheritance. These three streams of thought are used to depict the Darwinist landscape and pinpoint its strong suits and limitations. Theoretical gaps were identified that seem to reduce these schools' ability to account for the diversity of human evolutionary behavior. Their weak points include issues related to the concept of reproductive success, types of adaptation, and targets of selection. An interdisciplinary approach is proposed as the solution to this dilemma, where complex adaptive systems would serve as a source.

Coupled land surface/hydrologic/atmospheric models

NASA Technical Reports Server (NTRS)

Pielke, Roger; Steyaert, Lou; Arritt, Ray; Lahtakia, Mercedes; Smith, Chris; Ziegler, Conrad; Soong, Su Tzai; Avissar, Roni; Wetzel, Peter; Sellers, Piers

1993-01-01

The topics covered include the following: prototype land cover characteristics data base for the conterminous United States; surface evapotranspiration effects on cumulus convection and implications for mesoscale models; the use of complex treatment of surface hydrology and thermodynamics within a mesoscale model and some related issues; initialization of soil-water content for regional-scale atmospheric prediction models; impact of surface properties on dryline and MCS evolution; a numerical simulation of heavy precipitation over the complex topography of California; representing mesoscale fluxes induced by landscape discontinuities in global climate models; emphasizing the role of subgrid-scale heterogeneity in surface-air interaction; and problems with modeling and measuring biosphere-atmosphere exchanges of energy, water, and carbon on large scales.

Jungle Computing: Distributed Supercomputing Beyond Clusters, Grids, and Clouds

NASA Astrophysics Data System (ADS)

Seinstra, Frank J.; Maassen, Jason; van Nieuwpoort, Rob V.; Drost, Niels; van Kessel, Timo; van Werkhoven, Ben; Urbani, Jacopo; Jacobs, Ceriel; Kielmann, Thilo; Bal, Henri E.

In recent years, the application of high-performance and distributed computing in scientific practice has become increasingly wide spread. Among the most widely available platforms to scientists are clusters, grids, and cloud systems. Such infrastructures currently are undergoing revolutionary change due to the integration of many-core technologies, providing orders-of-magnitude speed improvements for selected compute kernels. With high-performance and distributed computing systems thus becoming more heterogeneous and hierarchical, programming complexity is vastly increased. Further complexities arise because urgent desire for scalability and issues including data distribution, software heterogeneity, and ad hoc hardware availability commonly force scientists into simultaneous use of multiple platforms (e.g., clusters, grids, and clouds used concurrently). A true computing jungle.

Current Issues: Critical Issues Confronting the Nation and the World [and] Current Issues Teacher's Guide.

ERIC Educational Resources Information Center

Whittaker, Lynn Page

1991-01-01

This annual publication contains reading materials designed to help students understand the complexities of the domestic and foreign policy issues facing the United States. The first portion of the book features background reading on the structure of the Federal Government. Next, 10 domestic policy issues are covered: the economy, education, civil…

Model-based metrics of human-automation function allocation in complex work environments

NASA Astrophysics Data System (ADS)

Kim, So Young

Function allocation is the design decision which assigns work functions to all agents in a team, both human and automated. Efforts to guide function allocation systematically has been studied in many fields such as engineering, human factors, team and organization design, management science, and cognitive systems engineering. Each field focuses on certain aspects of function allocation, but not all; thus, an independent discussion of each does not address all necessary issues with function allocation. Four distinctive perspectives emerged from a review of these fields: technology-centered, human-centered, team-oriented, and work-oriented. Each perspective focuses on different aspects of function allocation: capabilities and characteristics of agents (automation or human), team structure and processes, and work structure and the work environment. Together, these perspectives identify the following eight issues with function allocation: 1) Workload, 2) Incoherency in function allocations, 3) Mismatches between responsibility and authority, 4) Interruptive automation, 5) Automation boundary conditions, 6) Function allocation preventing human adaptation to context, 7) Function allocation destabilizing the humans' work environment, and 8) Mission Performance. Addressing these issues systematically requires formal models and simulations that include all necessary aspects of human-automation function allocation: the work environment, the dynamics inherent to the work, agents, and relationships among them. Also, addressing these issues requires not only a (static) model, but also a (dynamic) simulation that captures temporal aspects of work such as the timing of actions and their impact on the agent's work. Therefore, with properly modeled work as described by the work environment, the dynamics inherent to the work, agents, and relationships among them, a modeling framework developed by this thesis, which includes static work models and dynamic simulation, can capture the issues with function allocation. Then, based on the eight issues, eight types of metrics are established. The purpose of these metrics is to assess the extent to which each issue exists with a given function allocation. Specifically, the eight types of metrics assess workload, coherency of a function allocation, mismatches between responsibility and authority, interruptive automation, automation boundary conditions, human adaptation to context, stability of the human's work environment, and mission performance. Finally, to validate the modeling framework and the metrics, a case study was conducted modeling four different function allocations between a pilot and flight deck automation during the arrival and approach phases of flight. A range of pilot cognitive control modes and maximum human taskload limits were also included in the model. The metrics were assessed for these four function allocations and analyzed to validate capability of the metrics to identify important issues in given function allocations. In addition, the design insights provided by the metrics are highlighted. This thesis concludes with a discussion of mechanisms for further validating the modeling framework and function allocation metrics developed here, and highlights where these developments can be applied in research and in the design of function allocations in complex work environments such as aviation operations.

Overview on Clinical Relevance of Intra-Tumor Heterogeneity.

PubMed

Stanta, Giorgio; Bonin, Serena

2018-01-01

Today, clinical evaluation of tumor heterogeneity is an emergent issue to improve clinical oncology. In particular, intra-tumor heterogeneity (ITH) is closely related to cancer progression, resistance to therapy, and recurrences. It is interconnected with complex molecular mechanisms including spatial and temporal phenomena, which are often peculiar for every single patient. This review tries to describe all the types of ITH including morphohistological ITH, and at the molecular level clonal ITH derived from genomic instability and nonclonal ITH derived from microenvironment interaction. It is important to consider the different types of ITH as a whole for any patient to investigate on cancer progression, prognosis, and treatment opportunities. From a practical point of view, analytical methods that are widely accessible today, or will be in the near future, are evaluated to investigate the complex pattern of ITH in a reproducible way for a clinical application.

Special Issues in Working with Gifted Minority Adolescents.

ERIC Educational Resources Information Center

Lindstrom, Rena R.; Van Sant, Sondra

1986-01-01

Gifted adolescents from minority groups face the same issues all gifted young people face, but the addition of racial and cultural factors increases the complexity of these issues. Discusses individual versus cultural pressures that affect identity, issues related to assisting students with long-range planning, and two models for programming.…

Adsorptive removal and separation of chemicals with metal-organic frameworks: Contribution of π-complexation.

PubMed

Khan, Nazmul Abedin; Jhung, Sung Hwa

2017-03-05

Efficient removal and separation of chemicals from the environment has become a vital issue from a biological and environmental point of view. Currently, adsorptive removal/separation is one of the most promising approaches for cleaning purposes. Selective adsorption/removal of various sulfur- and nitrogen-containing compounds, olefins, and π-electron-rich gases via π-complex formation between an adsorbent and adsorbate molecules is very competitive. Porous metal-organic framework (MOF) materials are very promising in the adsorption/separation of various liquids and gases owing to their distinct characteristics. This review summarizes the literature on the adsorptive removal/separation of various π-electron-rich compounds mainly from fuel and gases using MOF materials containing metal ions that are active for π-complexation. Details of the π-complexation, including mechanism, pros/cons, applications, and efficient ways to form the complex, are discussed systematically. For in-depth understanding, molecular orbital calculations regarding charge transfer between the π-complexing species are also explained in a separate section. From this review, readers will gain an understanding of π-complexation for adsorption and separation, especially with MOFs, to develop new insight for future research. Copyright © 2016 Elsevier B.V. All rights reserved.

MoMaS reactive transport benchmark using PFLOTRAN

NASA Astrophysics Data System (ADS)

Park, H.

2017-12-01

MoMaS benchmark was developed to enhance numerical simulation capability for reactive transport modeling in porous media. The benchmark was published in late September of 2009; it is not taken from a real chemical system, but realistic and numerically challenging tests. PFLOTRAN is a state-of-art massively parallel subsurface flow and reactive transport code that is being used in multiple nuclear waste repository projects at Sandia National Laboratories including Waste Isolation Pilot Plant and Used Fuel Disposition. MoMaS benchmark has three independent tests with easy, medium, and hard chemical complexity. This paper demonstrates how PFLOTRAN is applied to this benchmark exercise and shows results of the easy benchmark test case which includes mixing of aqueous components and surface complexation. Surface complexations consist of monodentate and bidentate reactions which introduces difficulty in defining selectivity coefficient if the reaction applies to a bulk reference volume. The selectivity coefficient becomes porosity dependent for bidentate reaction in heterogeneous porous media. The benchmark is solved by PFLOTRAN with minimal modification to address the issue and unit conversions were made properly to suit PFLOTRAN.

A review of ethical issues in dementia.

PubMed

Johnson, Rebecca A; Karlawish, Jason

2015-10-01

Dementia raises many ethical issues. The present review, taking note of the fact that the stages of dementia raise distinct ethical issues, focuses on three issues associated with stages of dementia's progression: (1) how the emergence of preclinical and asymptomatic but at-risk categories for dementia creates complex questions about preventive measures, risk disclosure, and protection from stigma and discrimination; (2) how despite efforts at dementia prevention, important research continues to investigate ways to alleviate clinical dementia's symptoms, and requires additional human subjects protections to ethically enroll persons with dementia; and (3) how in spite of research and prevention efforts, persons continue to need to live with dementia. This review highlights two major themes. First is how expanding the boundaries of dementias such as Alzheimer's to include asymptomatic but at-risk persons generate new ethical questions. One promising way to address these questions is to take an integrated approach to dementia ethics, which can include incorporating ethics-related data collection into the design of a dementia research study itself. Second is the interdisciplinary nature of ethical questions related to dementia, from health policy questions about insurance coverage for long-term care to political questions about voting, driving, and other civic rights and privileges to economic questions about balancing an employer's right to a safe and productive workforce with an employee's rights to avoid discrimination on the basis of their dementia risk. The review highlights these themes and emerging ethical issues in dementia.

EPA guidance on improving the image of psychiatry.

PubMed

Möller-Leimkühler, A M; Möller, H-J; Maier, W; Gaebel, W; Falkai, P

2016-03-01

This paper explores causes, explanations and consequences of the negative image of psychiatry and develops recommendations for improvement. It is primarily based on a WPA guidance paper on how to combat the stigmatization of psychiatry and psychiatrists and a Medline search on related publications since 2010. Furthermore, focussing on potential causes and explanations, the authors performed a selective literature search regarding additional image-related issues such as mental health literacy and diagnostic and treatment issues. Underestimation of psychiatry results from both unjustified prejudices of the general public, mass media and healthcare professionals and psychiatry's own unfavourable coping with external and internal concerns. Issues related to unjustified devaluation of psychiatry include overestimation of coercion, associative stigma, lack of public knowledge, need to simplify complex mental issues, problem of the continuum between normality and psychopathology, competition with medical and non-medical disciplines and psychopharmacological treatment. Issues related to psychiatry's own contribution to being underestimated include lack of a clear professional identity, lack of biomarkers supporting clinical diagnoses, limited consensus about best treatment options, lack of collaboration with other medical disciplines and low recruitment rates among medical students. Recommendations are proposed for creating and representing a positive self-concept with different components. The negative image of psychiatry is not only due to unfavourable communication with the media, but is basically a problem of self-conceptualization. Much can be improved. However, psychiatry will remain a profession with an exceptional position among the medical disciplines, which should be seen as its specific strength.

Translational Cognition for Decision Support in Critical Care Environments: A Review

PubMed Central

Patel, Vimla L.; Zhang, Jiajie; Yoskowitz, Nicole A.; Green, Robert; Sayan, Osman R.

2008-01-01

The dynamic and distributed work environment in critical care requires a high level of collaboration among clinical team members and a sophisticated task coordination system to deliver safe, timely and effective care. A complex cognitive system underlies the decision-making process in such cooperative workplaces. This methodological review paper addresses the issues of translating cognitive research to clinical practice with a specific focus on decision-making in critical care, and the role of information and communication technology to aid in such decisions. Examples are drawn from studies of critical care in our own research laboratories. Critical care, in this paper, includes both intensive (inpatient) and emergency (outpatient) care. We define translational cognition as the research on basic and applied cognitive issues that contribute to our understanding of how information is stored, retrieved and used for problem-solving and decision-making. The methods and findings are discussed in the context of constraints on decision-making in real world complex environments and implications for supporting the design and evaluation of decision support tools for critical care health providers. PMID:18343731

Translational cognition for decision support in critical care environments: a review.

PubMed

Patel, Vimla L; Zhang, Jiajie; Yoskowitz, Nicole A; Green, Robert; Sayan, Osman R

2008-06-01

The dynamic and distributed work environment in critical care requires a high level of collaboration among clinical team members and a sophisticated task coordination system to deliver safe, timely and effective care. A complex cognitive system underlies the decision-making process in such cooperative workplaces. This methodological review paper addresses the issues of translating cognitive research to clinical practice with a specific focus on decision-making in critical care, and the role of information and communication technology to aid in such decisions. Examples are drawn from studies of critical care in our own research laboratories. Critical care, in this paper, includes both intensive (inpatient) and emergency (outpatient) care. We define translational cognition as the research on basic and applied cognitive issues that contribute to our understanding of how information is stored, retrieved and used for problem-solving and decision-making. The methods and findings are discussed in the context of constraints on decision-making in real-world complex environments and implications for supporting the design and evaluation of decision support tools for critical care health providers.

Critical issues for engineering cord blood stem cells to produce insulin.

PubMed

Denner, Larry; Urban, Randall J

2008-09-01

The objectives of using cord blood stem cells for treating type 1 diabetes are simple in principle yet complex in biological and molecular mechanisms. These are defined by the complexity of the insulin-producing unit of the pancreas, the islet. Islets are composed of various cell types that arise from diverse lineages and communicate by hormones, growth factors and small-molecule mediators. These processes are regulated by integration of signal transduction pathways. While advances have been made to engineer umbilical cord blood stem cells to produce insulin, these studies only illuminate the potential of such cells to fulfil a necessary, but not sufficient, requirement for transplantation. The challenges ahead demand detailed understanding of molecular mechanisms to move from an opportunistic, phenotypic approach to transplantation and amelioration of blood glucose, to an orderly and logical approach to a biologically and medically meaningful solution. The issues include expansion to generate large numbers of cells, self-renewal to regulate the destiny of cord blood stem cells to repopulate the hematopoietic system, and multipotency of stem cells to generate the distinct cell types of an islet.

Applications in Robotics and Controls

NASA Astrophysics Data System (ADS)

Youcef-Toumi, Kamal

2008-06-01

Recent industry trends have set new standards in business dealings and trades. Issues such as time to market, shoter market wondows, product performance, rapid increase of product complexity, costly mistakes, costly late introductions, and customer expectations have changed significantly. These trends have also influenced to a great extend the academic world. Some of these trends will be illustrated through examples which include automated systems, robotics, biotechnollogy, and nanotechnology. The examples will include concepts and prototypes of engineering systems in the macro, micro and nanodomains. The presentation also amphasizes the merging of the traditionally segregated disciplines into one multidisciplinary modeling, design, optimization and control approach.

PREFACE: Topics in the application of scattering methods to investigate the structure and dynamics of soft condensed matter

NASA Astrophysics Data System (ADS)

Chen, Sow-Hsin; Baglioni, Piero

2006-09-01

This special issue of Journal of Physics: Condensed Matter gathers together a series of contributions presented at the workshop entitled `Topics in the Application of Scattering Methods to Investigate the Structure and Dynamics of Soft Condensed Matter' held at Pensione Bencista, Fiesole, Italy, a wonderful Italian jewel tucked high in the hills above Florence. This immaculate 14th century villa is a feast for the eyes with antiques and original artwork everywhere you turn, and a stunning view of Florence, overlooking numerous villas and groves of olive trees. The meeting consisted of about 40 invited talks delivered by a selected group of prominent physicists and chemists from the USA, Mexico, Europe and Asia working in the fields of complex and glassy liquids. The topics covered by the talks included: simulations on the liquid-liquid transition phenomenon dynamic crossover in deeply supercooled confined water thermodynamics and dynamics of complex fluids dynamics of interfacial water structural arrest transitions in colloidal systems structure and dynamics in complex systems structure of supramolecular assemblies The choice of topics is obviously heavily biased toward the current interests of the two organizers of the workshop, in view of the fact that one of the incentives for organizing the meeting was to celebrate Sow-Hsin Chen’s life-long scientific activities on the occasion of his 70th birthday. The 21 articles presented in this issue are a state-of-the-art description of the different aspects reported at the workshop from all points of view---experimental, theoretical and numerical. The interdisciplinary nature of the talks should make this special issue of interest to a broad community of scientists involved in the study of the properties of complex fluids, soft condensed matter and disordered glassy systems. We are grateful to the Consorzio per lo Sviluppo dei Sistemi a Grande Interfase (CSGI), Florence, Italy and to the Materials Science Program of the US Department of Energy for their support of the workshop.

Ethical and practical challenges in implementing informed consent in HIV/AIDS clinical trials in developing or resource-limited countries.

PubMed

Mystakidou, Kyriaki; Panagiotou, Irene; Katsaragakis, Stelios; Tsilika, Eleni; Parpa, Efi

2009-09-01

Ethical issues regarding HIV/AIDS human research in the developing world remain under continuous evaluation; a critical area of concern includes informed consent. This paper reviews several of the most important ethical and practical aspects of informed consent in HIV research in developing countries. Enhancement of overall understanding of such key issues might promote higher ethical standards of future research. The major objective was to address informed consent in human research in non-Western societies, and specifically in HIV clinical trials of affected adults. Secondary end-points included the consent complexities in HIV research involving vulnerable patient populations in resource-limited nations, such as children, adolescents and women. A systematic review of the published literature using MEDLINE and EMBASE from 1998 until December 2008 was performed, using the search terms 'HIV/AIDS', 'informed consent', 'clinical trials', 'developing world'. Ethical complexities such as participants' diminished autonomy, coercion or monetary inducement, language difficulties, illiteracy or lack of true understanding of the entire study, cultural barriers mainly due to communitarianism and social diversities were identified in the 44 studies reviewed. Informed consent of vulnerable patient populations must be tailored to their sex and developmental age, while counselling is fundamental. Children and adolescents' assent must be ensured. Local language is to be used, while trusted community leaders and local cultural representatives may convey information. Despite the heterogeneity of studies, similarities were identified. Providing adequate and comprehensive information and assessing the true understanding of the research represent fundamental prerequisites. Potential solutions to the critical areas of concern include peer counselling and meetings with local community leaders or local cultural representatives. International investigators of HIV human research should bear in mind these ethical issues and their potential solutions, when trying to ensure ethical research conduct, based on a truly informed and culturally relevant consent.

Critical issues in assuring long lifetime and fail-safe operation of optical communications network

NASA Astrophysics Data System (ADS)

Paul, Dilip K.

1993-09-01

Major factors in assuring long lifetime and fail-safe operation in optical communications networks are reviewed in this paper. Reliable functionality to design specifications, complexity of implementation, and cost are the most critical issues. As economics is the driving force to set the goals as well as priorities for the design, development, safe operation, and maintenance schedules of reliable networks, a balance is sought between the degree of reliability enhancement, cost, and acceptable outage of services. Protecting both the link and the network with high reliability components, hardware duplication, and diversity routing can ensure the best network availability. Case examples include both fiber optic and lasercom systems. Also, the state-of-the-art reliability of photonics in space environment is presented.

Using the High-Level Based Program Interface to Facilitate the Large Scale Scientific Computing

PubMed Central

Shang, Yizi; Shang, Ling; Gao, Chuanchang; Lu, Guiming; Ye, Yuntao; Jia, Dongdong

2014-01-01

This paper is to make further research on facilitating the large-scale scientific computing on the grid and the desktop grid platform. The related issues include the programming method, the overhead of the high-level program interface based middleware, and the data anticipate migration. The block based Gauss Jordan algorithm as a real example of large-scale scientific computing is used to evaluate those issues presented above. The results show that the high-level based program interface makes the complex scientific applications on large-scale scientific platform easier, though a little overhead is unavoidable. Also, the data anticipation migration mechanism can improve the efficiency of the platform which needs to process big data based scientific applications. PMID:24574931

Competency to stand trial: rationalism, "contextualism" and other modest theories.

PubMed

Jan Brakel, S

2003-01-01

Determinations of competency to stand trial in criminal cases are complicated and rendered unpredictable by two sub-surface issues that are rarely articulated: (i) the place of the defendant's rationality in the substantive standard(s) for competency and (ii) the level or degree of incompetency required to stop the criminal process. The rare references to these issues, mostly indirect, that are made in the cases, commentary, and competency testing instruments devised (including those civil as well as criminal) are examined. The conclusion that emerges is that the level of capacity and rationality required of the defendant depends much on context-the type of case, its relative complexity, and the values and stakes implicated in the outcome. Copyright 2003 John Wiley & Sons, Ltd.

Florida coastal ecological characterization: a socioeconomic study of the southwestern region. Volume II. Data appendix, Part 3

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

French, C.O.; Parsons, J.W.

1983-08-01

Data are compiled from existing sources on the social and economic characteristics of the southwestern coastal region of Florida, which is made up of Charlotte, Collier, DeSoto, Hillsborough, Lee, Manatee, Monroe, Pasco, Pinellas, and Sarasota Counties. Described are the components and interrelationships among complex processes that include population and demographics characteristics, mineral production, multiple-use conflicts, recreation and tourism, agricultural production, sport and commercial fishing, transportation, industrial and residential development, and environmental issues and regulations. Energetics models of socioeconomic systems are also presented. This volume contains appendices presenting data on mineral and oil production, and environmental issues and regulations. 255 references,more » 20 figures, 91 tables.« less

Lights, camera and action: learning necrophilia in a psychiatry movie club.

PubMed

Kalra, Gurvinder S

2013-04-01

Kissed (1996) is a serious film that portrays the disturbing and taboo issue of necrophilia in a delicate and viewer friendly way. Being a rare paraphilia, it may sometimes be difficult to get necrophilia related literature or even understand this complex behavior. An interested person may have to rely on the few case reports from forensic journals or law books in order to understand what and how necrophiles do what they do! A movie club can be an interesting and novel way to learn various issues in medicine and psychiatry, including necrophilia. This paper discusses the use of this film in academic sessions in order to learn necrophilia. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Redox and Nitric Oxide-Mediated Regulation of Sensory Neuron Ion Channel Function

PubMed Central

2015-01-01

Abstract Significance: Reactive oxygen and nitrogen species (ROS and RNS, respectively) can intimately control neuronal excitability and synaptic strength by regulating the function of many ion channels. In peripheral sensory neurons, such regulation contributes towards the control of somatosensory processing; therefore, understanding the mechanisms of such regulation is necessary for the development of new therapeutic strategies and for the treatment of sensory dysfunctions, such as chronic pain. Recent Advances: Tremendous progress in deciphering nitric oxide (NO) and ROS signaling in the nervous system has been made in recent decades. This includes the recognition of these molecules as important second messengers and the elucidation of their metabolic pathways and cellular targets. Mounting evidence suggests that these targets include many ion channels which can be directly or indirectly modulated by ROS and NO. However, the mechanisms specific to sensory neurons are still poorly understood. This review will therefore summarize recent findings that highlight the complex nature of the signaling pathways involved in redox/NO regulation of sensory neuron ion channels and excitability; references to redox mechanisms described in other neuron types will be made where necessary. Critical Issues: The complexity and interplay within the redox, NO, and other gasotransmitter modulation of protein function are still largely unresolved. Issues of specificity and intracellular localization of these signaling cascades will also be addressed. Future Directions: Since our understanding of ROS and RNS signaling in sensory neurons is limited, there is a multitude of future directions; one of the most important issues for further study is the establishment of the exact roles that these signaling pathways play in pain processing and the translation of this understanding into new therapeutics. Antioxid. Redox Signal. 22, 486–504. PMID:24735331

Teaching the Ethical Aspects of Environmental Science

NASA Astrophysics Data System (ADS)

Palinkas, C. M.

2014-12-01

Environmental and societal issues are often inherently linked, especially in coastal and estuarine environments, and science and social values must often be balanced in ecosystem management and decision-making. A new seminar course has been developed for the Marine Estuarine and Environmental Science (MEES) graduate program, an inter-institutional program within the University System of Maryland, to examine these issues. This 1-credit course, offered for the first time in Spring 2015, takes a complex systems perspective on major environmental and societal challenges to examine these linked issues in a variety of contexts. After a brief introduction to the emerging field of "geoethics," students develop a list of issues to examine throughout the seminar. Example topics could include fracking, offshore wind technology, dam removal, and iron fertilization, among others. A case-study approach is taken, with each class meeting focusing on one issue. For each case study, students are asked to 1) identify relevant scientific principles and major knowledge gaps, 2) predict potential outcomes, 3) identify stakeholders and likely viewpoints, and 4) construct communication plans to disseminate findings to these stakeholders. At the end of the semester, students give a brief presentation of the ethical aspects of their own research topics.

Survivorship in Non-Small Cell Lung Cancer: Challenges Faced and Steps Forward.

PubMed

Vijayvergia, Namrata; Shah, Prashant C; Denlinger, Crystal S

2015-09-01

Improvements in curative therapies and the advent of screening have led to increased numbers of non-small cell lung cancer (NSCLC) survivors. Most survivors have undergone invasive treatment (surgery, radiation therapy, and/or chemotherapy) and carry a higher comorbidity burden than survivors of other cancers. Overall quality of life (QOL) and health-related quality of life (HRQOL) suffer during the treatment phase, with the potential for long-term decline, and both clinical characteristics and treatment impact these measures. Physical and mental components of HRQOL seem to be most at risk for decline. The issues faced by survivors include physical symptoms such as respiratory issues, fatigue, hearing loss, neuropathy, and postsurgical pain; psychological distress leading to depression, financial issues, and poor compliance with recommended guidelines; and fear or risk of recurrence and secondary malignancies. This article summarizes the major issues faced by NSCLC survivors and suggests appropriate management. Future collaborative efforts are needed to further elucidate the complex issues that affect overall QOL and HRQOL in NSCLC survivors and to develop appropriate interventions in this large and diverse survivor population. Copyright © 2015 by the National Comprehensive Cancer Network.

A novel low-complexity digital filter design for wearable ECG devices

PubMed Central

Mehrnia, Alireza

2017-01-01

Wearable and implantable Electrocardiograph (ECG) devices are becoming prevailing tools for continuous real-time personal health monitoring. The ECG signal can be contaminated by various types of noise and artifacts (e.g., powerline interference, baseline wandering) that must be removed or suppressed for accurate ECG signal processing. Limited device size, power consumption and cost are critical issues that need to be carefully considered when designing any portable health monitoring device, including a battery-powered ECG device. This work presents a novel low-complexity noise suppression reconfigurable finite impulse response (FIR) filter structure for wearable ECG and heart monitoring devices. The design relies on a recently introduced optimally-factored FIR filter method. The new filter structure and several of its useful features are presented in detail. We also studied the hardware complexity of the proposed structure and compared it with the state-of-the-art. The results showed that the new ECG filter has a lower hardware complexity relative to the state-of-the-art ECG filters. PMID:28384272

Coarse-grained simulation of polymer-filler blends

NASA Astrophysics Data System (ADS)

Legters, Gregg; Kuppa, Vikram; Beaucage, Gregory; Univ of Dayton Collaboration; Univ of Cincinnati Collaboration

The practical use of polymers often relies on additives that improve the property of the mixture. Examples of such complex blends include tires, pigments, blowing agents and other reactive additives in thermoplastics, and recycled polymers. Such systems usually exhibit a complex partitioning of the components. Most prior work has either focused on fine-grained details such as molecular modeling of chains at interfaces, or on coarse, heuristic, trial-and-error approaches to compounding (eg: tire industry). Thus, there is a significant gap in our understanding of how complex hierarchical structure (across several decades in length) develops in these multicomponent systems. This research employs dissipative particle thermodynamics in conjunction with a pseudo-thermodynamic parameter derived from scattering experiments to represent polymer-filler interactions. DPD simulations will probe how filler dispersion and hierarchical morphology develops in these complex blends, and are validated against experimental (scattering) data. The outcome of our approach is a practical solution to compounding issues, based on a mutually validating experimental and simulation methodology. Support from the NSF (CMMI-1636036/1635865) is gratefully acknowledged.

The Alternative complex III: properties and possible mechanisms for electron transfer and energy conservation.

PubMed

Refojo, Patrícia N; Teixeira, Miguel; Pereira, Manuela M

2012-10-01

Alternative complexes III (ACIII) are recently identified membrane-bound enzymes that replace functionally the cytochrome bc(1/)b(6)f complexes. In general, ACIII are composed of four transmembrane proteins and three peripheral subunits that contain iron-sulfur centers and C-type hemes. ACIII are built by a combination of modules present in different enzyme families, namely the complex iron-sulfur molybdenum containing enzymes. In this article a historical perspective on the investigation of ACIII is presented, followed by an overview of the present knowledge on these enzymes. Electron transfer pathways within the protein are discussed taking into account possible different locations (cytoplasmatic or periplasmatic) of the iron-sulfur containing protein and their contribution to energy conservation. In this way several hypotheses for energy conservation modes are raised including linear and bifurcating electron transfer pathways. This article is part of a Special Issue entitled: 17th European Bioenergetics Conference (EBEC 2012). Copyright © 2012 Elsevier B.V. All rights reserved.

A novel low-complexity digital filter design for wearable ECG devices.

PubMed

Asgari, Shadnaz; Mehrnia, Alireza

2017-01-01

Wearable and implantable Electrocardiograph (ECG) devices are becoming prevailing tools for continuous real-time personal health monitoring. The ECG signal can be contaminated by various types of noise and artifacts (e.g., powerline interference, baseline wandering) that must be removed or suppressed for accurate ECG signal processing. Limited device size, power consumption and cost are critical issues that need to be carefully considered when designing any portable health monitoring device, including a battery-powered ECG device. This work presents a novel low-complexity noise suppression reconfigurable finite impulse response (FIR) filter structure for wearable ECG and heart monitoring devices. The design relies on a recently introduced optimally-factored FIR filter method. The new filter structure and several of its useful features are presented in detail. We also studied the hardware complexity of the proposed structure and compared it with the state-of-the-art. The results showed that the new ECG filter has a lower hardware complexity relative to the state-of-the-art ECG filters.

Interdisciplinary team care of cleft lip and palate: social and psychological aspects.

PubMed

Strauss, R P; Broder, H

1985-10-01

The organizational example of a university-based team and two patient case studies illustrate how team interaction affects decision making. The model presented for effective team organization is an egalitarian one. Interdependency, flexibility, and open communication among members are essential. Cleft lip and palate teams provide evaluation and treatment that include input from a variety of professional disciplines. The team context makes it possible for care to be coordinated and alleviates the fragmentation of seeking treatment from several independent specialists. Teams also have a special opportunity to address the complex social and psychological issues prevalent in treating persons with birth defects. Specialists, like psychologists and social workers, identify these issues so that surgeons, dentists, and other clinicians may provide a comprehensive treatment plan and management approach. If psychologists or social workers are not available to a team, the group may still successfully integrate a variety of social and personal factors into their decision making. Examples of problem areas and of issues that may be associated with difficulties in adjusting to cleft therapy are included in this article. Teams that effectively address the psychosocial needs of their patients will enhance patient satisfaction, cooperation, and treatment outcomes.

State of security at US colleges and universities: a national stakeholder assessment and recommendations.

PubMed

Greenberg, Sheldon F

2007-09-01

In 2004 the US Department of Justice, Office of Community Oriented Policing Services, sponsored a National Summit on Campus Public Safety. The summit brought together various stakeholders including campus police and security officials, local police chiefs, college and university faculty and administrators, federal officials, students and parents, and community leaders to address the issues and complexities of campus safety. Delegates to the summit identified key issues in campus safety and security, which included establishing a national center on campus safety, balancing traditional open environments with the need to secure vulnerable sites, improving coordination with state and local police, reducing internal fragmentation, elevating professionalism, and increasing eligibility of campus police and security agencies to compete for federal law enforcement funds. Focus on "active shooters" on campus, resulting from the Virginia Tech incident, should not diminish attention placed on the broader, more prevalent safety and security issues facing the nation's educational campuses. Recommendations resulting from the summit called for establishing a national agenda on campus safety, formation of a national center on campus public safety, and increased opportunity for campus police and security agencies to compete for federal and state funds.

The psychology of men's health: maximizing masculine capital.

PubMed

Gough, Brendan

2013-01-01

Mortality and morbidity statistics show that men on average die younger than women and are more prone to many nongendered illnesses. Social constructions of masculinity have been implicated in men's poorer health, although it is now recognized that masculinity is a complex, multifaceted entity, elements of which can prove health-promoting. This special issue, "Men's health: Masculinity and other influences on male health behaviors," brings together a range of psychological research that demonstrates how masculinities work in different health-related situations, ranging from lifestyle choices to life-threatening diseases. A cross-cutting theme concerns how masculine "capital" can function to both constrain and open up healthy practices. In the first of two sections, seven papers focus on public health issues, including physical exercise, alcohol consumption, and help-seeking. The second section then covers illness-related phenomena, including male-specific cancers, sports-induced disability, and male sterilization. These six papers examine how masculinities inhibit and promote coping with difficult embodied states with different groups of men. This special issue offers important insights on masculinities and health from methodologically diverse investigations, and highlights how masculinities can be deployed to improve the health of men across different contexts. PsycINFO Database Record (c) 2013 APA, all rights reserved

Health Care Financing In Iran; Is Privatization A Good Solution?

PubMed Central

Davari, M; Haycox, A; Walley, T

2012-01-01

Background: This paper considers a range of issues related to the financing of health care system and relevant government policies in Iran. Methods: This study used mixed methods. A systematic literature review was undertaken to identify relevant publications. This was supplemented by hand searching in books and journals, including government publications. The issues and uncertainties identified in the literature were explored in detail through semi-structured interviews with key informants. These were triangulated with empirical evidence in the form of the literature, government statistics and independent expert opinions to validate the views expressed in the interviews. Results: The systematic review of published literature showed that no previous publication has addressed issues relating to the financing of healthcare services in Iran. However, a range of opinion pieces outlined issues to be explored further in the interviews. Such issues summarised into four main categories. Conclusion: The health care market in Iran has faced a period in which financial issues have enhanced managerial complexity. Privatization of health care services would appear to be a step too far in assisting the system to confront its challenges at the current time. The most important step toward solving such challenges is to focus on a feasible, relevant and comprehensive policy, which optimises the use of health care resources in Iran. PMID:23113205

Health care financing in iran; is privatization a good solution?

PubMed

Davari, M; Haycox, A; Walley, T

2012-01-01

This paper considers a range of issues related to the financing of health care system and relevant government policies in Iran. This study used mixed methods. A systematic literature review was undertaken to identify relevant publications. This was supplemented by hand searching in books and journals, including government publications. The issues and uncertainties identified in the literature were explored in detail through semi-structured interviews with key informants. These were triangulated with empirical evidence in the form of the literature, government statistics and independent expert opinions to validate the views expressed in the interviews. The systematic review of published literature showed that no previous publication has addressed issues relating to the financing of healthcare services in Iran. However, a range of opinion pieces outlined issues to be explored further in the interviews. Such issues summarised into four main categories. The health care market in Iran has faced a period in which financial issues have enhanced managerial complexity. Privatization of health care services would appear to be a step too far in assisting the system to confront its challenges at the current time. The most important step toward solving such challenges is to focus on a feasible, relevant and comprehensive policy, which optimises the use of health care resources in Iran.

Formalizing the Role of Agent-Based Modeling in Causal Inference and Epidemiology

PubMed Central

Marshall, Brandon D. L.; Galea, Sandro

2015-01-01

Calls for the adoption of complex systems approaches, including agent-based modeling, in the field of epidemiology have largely centered on the potential for such methods to examine complex disease etiologies, which are characterized by feedback behavior, interference, threshold dynamics, and multiple interacting causal effects. However, considerable theoretical and practical issues impede the capacity of agent-based methods to examine and evaluate causal effects and thus illuminate new areas for intervention. We build on this work by describing how agent-based models can be used to simulate counterfactual outcomes in the presence of complexity. We show that these models are of particular utility when the hypothesized causal mechanisms exhibit a high degree of interdependence between multiple causal effects and when interference (i.e., one person's exposure affects the outcome of others) is present and of intrinsic scientific interest. Although not without challenges, agent-based modeling (and complex systems methods broadly) represent a promising novel approach to identify and evaluate complex causal effects, and they are thus well suited to complement other modern epidemiologic methods of etiologic inquiry. PMID:25480821

"Synergistic selection": a Darwinian frame for the evolution of complexity.

PubMed

Corning, Peter A; Szathmáry, Eörs

2015-04-21

Non-Darwinian theories about the emergence and evolution of complexity date back at least to Lamarck, and include those of Herbert Spencer and the "emergent evolution" theorists of the later nineteenth and early twentieth centuries. In recent decades, this approach has mostly been espoused by various practitioners in biophysics and complexity theory. However, there is a Darwinian alternative - in essence, an economic theory of complexity - proposing that synergistic effects of various kinds have played an important causal role in the evolution of complexity, especially in the "major transitions". This theory is called the "synergism hypothesis". We posit that otherwise unattainable functional advantages arising from various cooperative phenomena have been favored over time in a dynamic that the late John Maynard Smith characterized and modeled as "synergistic selection". The term highlights the fact that synergistic "wholes" may become interdependent "units" of selection. We provide some historical perspective on this issue, as well as a brief explication of the underlying theory and the concept of synergistic selection, and we describe two relevant models. Copyright © 2015 Elsevier Ltd. All rights reserved.

Molecular identification of organic compounds in atmospheric complex mixtures and relationship to atmospheric chemistry and sources.

PubMed

Mazurek, Monica A

2002-12-01

This article describes a chemical characterization approach for complex organic compound mixtures associated with fine atmospheric particles of diameters less than 2.5 m (PM2.5). It relates molecular- and bulk-level chemical characteristics of the complex mixture to atmospheric chemistry and to emission sources. Overall, the analytical approach describes the organic complex mixtures in terms of a chemical mass balance (CMB). Here, the complex mixture is related to a bulk elemental measurement (total carbon) and is broken down systematically into functional groups and molecular compositions. The CMB and molecular-level information can be used to understand the sources of the atmospheric fine particles through conversion of chromatographic data and by incorporation into receptor-based CMB models. Once described and quantified within a mass balance framework, the chemical profiles for aerosol organic matter can be applied to existing air quality issues. Examples include understanding health effects of PM2.5 and defining and controlling key sources of anthropogenic fine particles. Overall, the organic aerosol compositional data provide chemical information needed for effective PM2.5 management.

Advanced Kalman Filter for Real-Time Responsiveness in Complex Systems

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

Welch, Gregory Francis; Zhang, Jinghe

2014-06-10

Complex engineering systems pose fundamental challenges in real-time operations and control because they are highly dynamic systems consisting of a large number of elements with severe nonlinearities and discontinuities. Today’s tools for real-time complex system operations are mostly based on steady state models, unable to capture the dynamic nature and too slow to prevent system failures. We developed advanced Kalman filtering techniques and the formulation of dynamic state estimation using Kalman filtering techniques to capture complex system dynamics in aiding real-time operations and control. In this work, we looked at complex system issues including severe nonlinearity of system equations, discontinuitiesmore » caused by system controls and network switches, sparse measurements in space and time, and real-time requirements of power grid operations. We sought to bridge the disciplinary boundaries between Computer Science and Power Systems Engineering, by introducing methods that leverage both existing and new techniques. While our methods were developed in the context of electrical power systems, they should generalize to other large-scale scientific and engineering applications.« less

Fish consumption as a driver of risk-management decisions and human health-based water quality criteria.

PubMed

Judd, Nancy; Lowney, Yvette; Anderson, Paul; Baird, Suzanne; Bay, Steven M; Breidt, Jay; Buonanduci, Michele; Dong, Zhao; Essig, Don; Garry, Michael R; Jim, Rebecca C; Kirkwood, Gemma; Moore, Shelly; Niemi, Cheryl; O'Rourke, Rory; Ruffle, Betsy; Schaider, Laurel A; Vidal-Dorsch, Doris E

2015-11-01

The use and interpretation of fish consumption surveys and interviews, the application of fish consumption rates for sediment evaluation and cleanup, and the development of human health water quality criteria (HH WQC) are complex and interrelated issues. The present article focuses on these issues using examples from the United States, although the issues may be relevant for other countries. Some key considerations include the fact that there are many types of fish consumption surveys (e.g., 24-h recall surveys, food frequency questionnaires, creel surveys), and these surveys have different advantages and limitations. Identification of target populations for protection, identification of the species and quantities of fish consumed, and determination of bioaccumulation assumptions are important factors when developing water quality and sediment screening levels and standards. Accounting for the cultural importance of fish consumption for some populations is an even more complex element. Discussions about HH WQC often focus only on the fish consumption rate and may not have broad public input. Some states are trying to change this through extensive public participation efforts and use of probabilistic approaches to derive HH WQC. Finally, there are limits to what WQC can achieve. Solutions beyond the establishment of WQC that target toxics reduction from other sources may provide the greatest improvements to water quality and reductions in human health risks in the future. © 2015 SETAC.

Ethical Legal and Social Issues of Biobanking: Past, Present, and Future.

PubMed

Bledsoe, Marianna J

2017-04-01

The past 15 years has seen considerable changes in the research environment. These changes include the development of new sophisticated genetic and genomic technologies, a proliferation of databases containing large amount of genotypic and phenotypic data, and wide-spread data sharing among many institutions, nationally and internationally. These changes have raised new questions regarding how best to protect the participants of biobanking research. In response to these questions, best practices for addressing the legal, ethical, and social issues of biobanking have been developed. In addition, new ethical guidelines related to biobanking have been established, as well as new regulations regarding privacy and human subject protections. Finally, changes in the science and the research environment have raised complex ethical issues related to biobanking, such as questions about the most appropriate consent models to use for biobanking research, commercial use and ownership issues, and whether and how to return individual research results to biobank participants. This article reviews some of the developments over the past 15 years related to the ELSI of biobanking with a look toward the future.

Common Elements in Rare Kidney Diseases: Conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.

PubMed

Aymé, Ségolène; Bockenhauer, Detlef; Day, Simon; Devuyst, Olivier; Guay-Woodford, Lisa M; Ingelfinger, Julie R; Klein, Jon B; Knoers, Nine V A M; Perrone, Ronald D; Roberts, Julia; Schaefer, Franz; Torres, Vicente E; Cheung, Michael; Wheeler, David C; Winkelmayer, Wolfgang C

2017-10-01

Rare kidney diseases encompass at least 150 different conditions, most of which are inherited. Although individual rare kidney diseases raise specific issues, as a group these rare diseases can have overlapping challenges in diagnosis and treatment. These challenges include small numbers of affected patients, unidentified causes of disease, lack of biomarkers for monitoring disease progression, and need for complex care. To address common clinical and patient issues among rare kidney diseases, the KDIGO Controversies Conference entitled, Common Elements in Rare Kidney Diseases, brought together a panel of multidisciplinary clinical providers and patient advocates to address five central issues for rare kidney diseases. These issues encompassed diagnostic challenges, management of kidney functional decline and progression of chronic kidney disease, challenges in clinical study design, translation of advances in research to clinical care, and provision of practical and integrated patient support. Thus, by a process of consensus, guidance for addressing these challenges was developed and is presented here. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

Design and analysis issues in gene and environment studies

PubMed Central

2012-01-01

Both nurture (environmental) and nature (genetic factors) play an important role in human disease etiology. Traditionally, these effects have been thought of as independent. This perspective is ill informed for non-mendelian complex disorders which result as an interaction between genetics and environment. To understand health and disease we must study how nature and nurture interact. Recent advances in human genomics and high-throughput biotechnology make it possible to study large numbers of genetic markers and gene products simultaneously to explore their interactions with environment. The purpose of this review is to discuss design and analytic issues for gene-environment interaction studies in the “-omics” era, with a focus on environmental and genetic epidemiological studies. We present an expanded environmental genomic disease paradigm. We discuss several study design issues for gene-environmental interaction studies, including confounding and selection bias, measurement of exposures and genotypes. We discuss statistical issues in studying gene-environment interactions in different study designs, such as choices of statistical models, assumptions regarding biological factors, and power and sample size considerations, especially in genome-wide gene-environment studies. Future research directions are also discussed. PMID:23253229

Design and analysis issues in gene and environment studies.

PubMed

Liu, Chen-yu; Maity, Arnab; Lin, Xihong; Wright, Robert O; Christiani, David C

2012-12-19

Both nurture (environmental) and nature (genetic factors) play an important role in human disease etiology. Traditionally, these effects have been thought of as independent. This perspective is ill informed for non-mendelian complex disorders which result as an interaction between genetics and environment. To understand health and disease we must study how nature and nurture interact. Recent advances in human genomics and high-throughput biotechnology make it possible to study large numbers of genetic markers and gene products simultaneously to explore their interactions with environment. The purpose of this review is to discuss design and analytic issues for gene-environment interaction studies in the "-omics" era, with a focus on environmental and genetic epidemiological studies. We present an expanded environmental genomic disease paradigm. We discuss several study design issues for gene-environmental interaction studies, including confounding and selection bias, measurement of exposures and genotypes. We discuss statistical issues in studying gene-environment interactions in different study designs, such as choices of statistical models, assumptions regarding biological factors, and power and sample size considerations, especially in genome-wide gene-environment studies. Future research directions are also discussed.

Need for Enhanced Environmental Representation in the Implementation of One Health.

PubMed

Barrett, Meredith A; Bouley, Timothy A

2015-06-01

Issues of global environmental change, global health, emerging disease, and sustainability present some of the most complex challenges of the twenty-first century. Individual disciplines cannot address these issues in isolation. Proactive, innovative, and trans-disciplinary solutions are required. Recognizing the inherent connectedness of humans, animals, plants, and their shared environment, One Health encourages the collaboration of many disciplines-including human and veterinary medicine, public health, social science, public policy, environmental science, and others-to address global and local health challenges. Despite great progress in this shift toward transdisciplinarity, the environmental component of the One Health paradigm remains underrepresented in One Health discourse. Human and animal health issues are commonly discussed under the umbrella of the One Health paradigm, while upstream environmental drivers and solutions are less prominent. We assessed the current integration of environmental issues in One Health publications and leadership. There is room for enhanced integration of environmental knowledge in the implementation of One Health approaches. We discuss the potential benefits from the collaboration between One Health and ecohealth, and explore strategies for increased environmental involvement.

Evaluating New Technology.

PubMed

Carniol, Paul J; Heffelfinger, Ryan N; Grunebaum, Lisa D

2018-05-01

There are multiple complex issues to consider when evaluating any new technology. First evaluate the efficacy of the device. Then considering your patient population decide whether this technology brings an added benefit to your patients. If it meets these 2 criteria, then proceed to the financial analysis of acquiring this technology. The complete financial analysis has several important components that include but are not limited to cost, value, alternatives, return on investment, and associated marketing expense. Copyright © 2018 Elsevier Inc. All rights reserved.

MEDICARE SUBVENTION DEMONSTRATION: DOD’s Pilot HMO Appealed to Seniors, Underscored Management Complexities

DTIC Science & Technology

2001-06-01

Senior Prime illustrated issues that arose in bringing older retirees into DOD managed care. A major change in health care arrangements for Medicare...including dependents) aged 65 and older could receive limited health care. DOD delivers care through about 600 MTFs worldwide. TRICARE covers a broad range of...Medicare Subvention Demonstration Sites 7 Table 2: Age -ins Were One-Fifth of Total Senior Prime Enrollment 12 Figures Figure 1: Features of the

Interior design for dentistry.

PubMed

Unthank, M; True, G

1999-11-01

In the increasingly complex, competitive and stressful field of dentistry, effectively designed dental offices can offer significant benefits. Esthetic, functional and life-cycle cost issues to be considered when developing your interior design scheme include color, finishes, lighting, furnishings, art and accessories. An appropriately designed dental office serves as a valuable marketing tool for your practice, as well as a safe and enjoyable work environment. Qualified interior design professionals can help you make design decisions that can yield optimum results within your budget.

Infusing Sustainability Across Disciplines to Build Student Engagement

NASA Astrophysics Data System (ADS)

Bruckner, M. Z.; O'Connell, K.; McDaris, J. R.; Kirk, K. B.; Larsen, K.; Kent, M.; Manduca, C. A.; Egger, A. E.; Blockstein, D.; Mogk, D. W.; Taber, J.

2014-12-01

Establishing relevance and effective communication are key mechanisms for building student and community engagement in a topic and can be used to promote the importance of working across disciplines to solve problems. Sustainability, including the impacts of and responses to climate change, is an inherently interdisciplinary issue and can be infused across courses and curricula in a variety of ways. Key topics such as climate change, hazards, and food, water, and energy production and sustainability are relevant to a wide audience and can be used to build student engagement. Using real-world examples, service learning, and focusing on the local environment may further boost engagement by establishing relevance between sustainability issues and students' lives. Communication plays a key role in the exchange of information across disciplines and allows for a more holistic approach to tackling the complex climate and sustainability issues our society faces. It has the power to bridge gaps, break down disciplinary silos, and build connections among diverse audiences with a wide range of expertise, including scientists, policy-makers, stakeholders, and the general public. It also aids in planning and preparation for, response to, and mitigation of issues related to sustainability, including the impacts of climate change, to lessen the detrimental effects of unavoidable events such as sea level rise and extreme weather events. Several workshops from the InTeGrate and On the Cutting Edge projects brought together educators and practitioners from a range of disciplines including geoscience, engineering, social science, and more to encourage communication and collaboration across disciplines. They supported networking, community-building, and sharing of best practices for preparing our students for a sustainable future, both in and out of the workplace, and across disciplines. Interdisciplinary teams are also working together to author curricular materials that highlight societal issues. The InTeGrate Teaching Materials web pages highlight major outcomes from the workshops and feature community-contributed resources and pedagogic guidance designed to enhance teaching about sustainability across disciplines. Explore these materials at: serc.carleton.edu/integrate/teaching_materials/

Modelling the contribution of changes in family life to time trends in adolescent conduct problems.

PubMed

Collishaw, Stephan; Goodman, Robert; Pickles, Andrew; Maughan, Barbara

2007-12-01

The past half-century has seen significant changes in family life, including an increase in parental divorce, increases in the numbers of lone parent and stepfamilies, changes in socioeconomic well being, and a decrease in family size. Evidence also shows substantial time trends in adolescent mental health, including a marked increase in conduct problems over the last 25 years of the 20th Century in the UK. The aim of this study was to examine how these two sets of trends may be related. To illustrate the complexity of the issues involved, we focused on three well-established family risks for conduct problems: family type, income and family size. Three community samples of adolescents from England, Scotland and Wales were compared: 10,348 16-year olds assessed in 1974 as part of the National Child Development Study, 7234 16-year olds assessed in 1986 as part of the British Cohort Study, and 860 15-year olds assessed in the 1999 British Child and Adolescent Mental Health Survey. Parents completed comparable ratings of conduct problems in each survey and provided information on family type, income and size. Findings highlight important variations in both the prevalence of these family variables and their associations with conduct problems over time, underscoring the complex conceptual issues involved in testing causes of trends in mental health.

Global Learning in a Geography Course Using the Mystery Method as an Approach to Complex Issues

ERIC Educational Resources Information Center

Applis, Stefan

2014-01-01

In the study which is the foundation of this essay, the question is examined of whether the complexity of global issues can be solved at the level of teaching methodology. In this context, the first qualitative and constructive study was carried out which researches the Mystery Method using the Thinking-Through-Geography approach (David Leat,…

Development of pediatric vaccine recommendations and policies.

PubMed

Pickering, Larry K; Orenstein, Walter A

2002-07-01

A significant decrease in each vaccine-preventable disease has occurred since the introduction of the respective immunizations now included in the recommended childhood immunization schedule. The process through which a vaccine must travel from development to approval and implementation is complex. Hurdles include receiving approval from several advisory committees, government agencies, and professional organizations. At each step in the process, data regarding safety, immunogenicity, and efficacy are evaluated continuously and rigorously. Once a vaccine is approved by the Food and Drug Administration (FDA) and incorporated into the recommended childhood immunization schedule, continuing issues include those that deal with supply, safety, effectiveness, and financing. The logistics of development and implementation of pediatric vaccine recommendations and policies are reviewed.

Controversies in the Hydrosphere: an iBook exploring current global water issues for middle school classrooms

NASA Astrophysics Data System (ADS)

Dufoe, A.; Guertin, L. A.

2012-12-01

This project looks to help teachers utilize iPad technology in their classrooms as an instructional tool for Earth system science and connections to the Big Ideas in Earth Science. The project is part of Penn State University's National Science Foundation (NSF) Targeted Math Science Partnership grant, with one goal of the grant to help current middle school teachers across Pennsylvania engage students with significant and complex questions of Earth science. The free Apple software iBooks Author was used to create an electronic book for the iPad, focusing on a variety of controversial issues impacting the hydrosphere. The iBook includes image slideshows, embedded videos, interactive images and quizzes, and critical thinking questions along Bloom's Taxonomic Scale of Learning Objectives. Outlined in the introductory iBook chapters are the Big Ideas of Earth System Science and an overview of Earth's spheres. Since the book targets the hydrosphere, each subsequent chapter focuses on specific water issues, including glacial melts, aquifer depletion, coastal oil pollution, marine debris, and fresh-water chemical contamination. Each chapter is presented in a case study format that highlights the history of the issue, the development and current status of the issue, and some solutions that have been generated. The next section includes critical thinking questions in an open-ended discussion format that focus on the Big Ideas, proposing solutions for rectifying the situation, and/or assignments specifically targeting an idea presented in the case study chapter. Short, comprehensive multiple-choice quizzes are also in each chapter. Throughout the iBook, students are free to watch videos, explore the content and form their own opinions. As a result, this iBook fulfills the grant objective by engaging teachers and students with an innovative technological presentation that incorporates Earth system science with current case studies regarding global water issues.

Nursing home director of nursing leadership style and director of nursing-sensitive survey deficiencies.

PubMed

McKinney, Selina H; Corazzini, Kirsten; Anderson, Ruth A; Sloane, Richard; Castle, Nicholas G

2016-01-01

Nursing homes are becoming increasingly complex clinical environments because of rising resident acuity and expansion of postacute services within a context of historically poor quality performance. Discrete quality markers have been linked to director of nursing (DON) leadership behaviors. However, the impact of DON leadership across all measured areas of DON jurisdiction has not been tested using comprehensive domains of quality deficiencies. The aim of this study was to examine the effects of DON leadership style including behaviors that facilitate the exchange of information between diverse people on care quality domains through the lens of complexity science. Three thousand six hundred nine DONs completed leadership and intent-to-quit surveys. Quality markers that were deemed DON sensitive included all facility survey deficiencies in the domains of resident behaviors/facility practices, quality of life, nursing services, and quality of care. Logistic regression procedures estimated associations between variables. The odds of deficiencies for all DON sensitive survey domains were lower in facilities where DONs practiced complexity leadership including more staff input and shared decisional authority. DON quit intentions were aligned with higher odds of facility deficiencies across all domains. Results supported the hypotheses that DONs using complexity leadership approaches by interacting more freely with staff, discussing resident issues, and sharing decision making produced better care outcomes from every DON sensitive metric assessed by Centers for Medicare and Medicaid Services. The mechanism linking poor quality with high DON quit intentions is an area for future research. Encouraging DON use of complexity leadership approaches has the potential to improve a broad swath of quality outcomes.

Issues impacting therapeutic outcomes in pediatric patients: an overview.

PubMed

Kalra, Atin; Goindi, Shishu

2014-01-01

The quest for achieving optimal therapeutic outcomes in pediatric patients has evaded the healthcare professionals for long and often lack of child specific dosage forms and the associated events that follow with it have been considered to be major contributor towards suboptimal outcomes. Consequently, there have been sustained efforts over the years to address this issue with the enactment of legislations like Best Pharmaceutical for Children Act (BPCA), Pediatric Research Equity Act (PREA) and Pediatric Regulation by European Union (EU) to incentivise the participation of pharmaceutical industry towards development of child friendly dosage forms. Initiatives taken in past by organisations like World Health Organisation (WHO) and Drugs for Neglected Diseases Initiative (DNDi) to spur the development of child friendly dosage forms has helped to address issues pertaining to management of Human Immunodeficiency Virus (HIV) and malaria in pediatric patients. Present efforts aimed at developing child friendly dosage forms include oro-dispersible platforms including thin films and mini-tablets. Despite these leaps and advancements in developing better dosage forms for children, lower therapeutic outcomes in pediatric patients continue to remain an unresolved issue because of detrimental effects of additional factors such as parents understanding of label instructions and complexities involved in executing pediatric clinical studies thus requiring a concerted effort from pharmaceutical companies, academic researchers, parents and healthcare providers to work for better treatment outcomes in children.

Exploring the application of an evolutionary educational complex systems framework to teaching and learning about issues in the science and technology classroom

NASA Astrophysics Data System (ADS)

Yoon, Susan Anne

Understanding the world through a complex systems lens has recently garnered a great deal of interest in many knowledge disciplines. In the educational arena, interactional studies, through their focus on understanding patterns of system behaviour including the dynamical processes and trajectories of learning, lend support for investigating how a complex systems approach can inform educational research. This study uses previously existing literature and tools for complex systems applications and seeks to extend this research base by exploring learning outcomes of a complex systems framework when applied to curriculum and instruction. It is argued that by applying the evolutionary dynamics of variation, interaction and selection, complexity may be harnessed to achieve growth in both the social and cognitive systems of the classroom. Furthermore, if the goal of education, i.e., the social system under investigation, is to teach for understanding, conceptual knowledge of the kind described in Popper's (1972; 1976) World 3, needs to evolve. Both the study of memetic processes and knowledge building pioneered by Bereiter (cf. Bereiter, 2002) draw on the World 3 notion of ideas existing as conceptual artifacts that can be investigated as products outside of the individual mind providing an educational lens from which to proceed. The curricular topic addressed is the development of an ethical understanding of the scientific and technological issues of genetic engineering. 11 grade 8 students are studied as they proceed through 40 hours of curricular instruction based on the complex systems evolutionary framework. Results demonstrate growth in both complex systems thinking and content knowledge of the topic of genetic engineering. Several memetic processes are hypothesized to have influenced how and why ideas change. Categorized by factors influencing either reflective or non-reflective selection, these processes appear to have exerted differential effects on students' abilities to think and act in complex ways at various points throughout the study. Finally, an analysis of winner and loser memes is offered that is intended to reveal information about the conceptual system---its strengths and deficiencies---that can help educators assess curricular goals and organize and construct additional educational activities.

Remembering Complex Objects in Visual Working Memory: Do Capacity Limits Restrict Objects or Features?

PubMed Central

Hardman, Kyle; Cowan, Nelson

2014-01-01

Visual working memory stores stimuli from our environment as representations that can be accessed by high-level control processes. This study addresses a longstanding debate in the literature about whether storage limits in visual working memory include a limit to the complexity of discrete items. We examined the issue with a number of change-detection experiments that used complex stimuli which possessed multiple features per stimulus item. We manipulated the number of relevant features of the stimulus objects in order to vary feature load. In all of our experiments, we found that increased feature load led to a reduction in change-detection accuracy. However, we found that feature load alone could not account for the results, but that a consideration of the number of relevant objects was also required. This study supports capacity limits for both feature and object storage in visual working memory. PMID:25089739

Developing authentic clinical simulations for effective listening and communication in pediatric rehabilitation service delivery.

PubMed

King, Gillian; Shepherd, Tracy A; Servais, Michelle; Willoughby, Colleen; Bolack, Linda; Strachan, Deborah; Moodie, Sheila; Baldwin, Patricia; Knickle, Kerry; Parker, Kathryn; Savage, Diane; McNaughton, Nancy

2016-10-01

To describe the creation and validation of six simulations concerned with effective listening and interpersonal communication in pediatric rehabilitation. The simulations involved clinicians from various disciplines, were based on clinical scenarios related to client issues, and reflected core aspects of listening/communication. Each simulation had a key learning objective, thus focusing clinicians on specific listening skills. The article outlines the process used to turn written scenarios into digital video simulations, including steps taken to establish content validity and authenticity, and to establish a series of videos based on the complexity of their learning objectives, given contextual factors and associated macrocognitive processes that influence the ability to listen. A complexity rating scale was developed and used to establish a gradient of easy/simple, intermediate, and hard/complex simulations. The development process exemplifies an evidence-based, integrated knowledge translation approach to the teaching and learning of listening and communication skills.

Robotics: The next step?

PubMed

Broeders, Ivo A M J

2014-02-01

Robotic systems were introduced 15 years ago to support complex endoscopic procedures. The technology is increasingly used in gastro-intestinal surgery. In this article, literature on experimental- and clinical research is reviewed and ergonomic issues are discussed. literature review was based on Medline search using a large variety of search terms, including e.g. robot(ic), randomized, rectal, oesophageal, ergonomics. Review articles on relevant topics are discussed with preference. There is abundant evidence of supremacy in performing complex endoscopic surgery tasks when using the robot in an experimental setting. There is little high-level evidence so far on translation of these merits to clinical practice. Robotic systems may appear helpful in complex gastro-intestinal surgery. Moreover, dedicated computer based technology integrated in telepresence systems opens the way to integration of planning, diagnostics and therapy. The first high tech add-ons such as near infrared technology are under clinical evaluation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Debating complexity in modeling

USGS Publications Warehouse

Hunt, Randall J.; Zheng, Chunmiao

1999-01-01

As scientists trying to understand the natural world, how should our effort be apportioned? We know that the natural world is characterized by complex and interrelated processes. Yet do we need to explicitly incorporate these intricacies to perform the tasks we are charged with? In this era of expanding computer power and development of sophisticated preprocessors and postprocessors, are bigger machines making better models? Put another way, do we understand the natural world better now with all these advancements in our simulation ability? Today the public's patience for long-term projects producing indeterminate results is wearing thin. This increases pressure on the investigator to use the appropriate technology efficiently. On the other hand, bringing scientific results into the legal arena opens up a new dimension to the issue: to the layperson, a tool that includes more of the complexity known to exist in the real world is expected to provide the more scientifically valid answer.

Combining statistics from two national complex surveys to estimate injury rates per hour exposed and variance by activity in the USA.

PubMed

Lin, Tin-Chi; Marucci-Wellman, Helen R; Willetts, Joanna L; Brennan, Melanye J; Verma, Santosh K

2016-12-01

A common issue in descriptive injury epidemiology is that in order to calculate injury rates that account for the time spent in an activity, both injury cases and exposure time of specific activities need to be collected. In reality, few national surveys have this capacity. To address this issue, we combined statistics from two different national complex surveys as inputs for the numerator and denominator to estimate injury rate, accounting for the time spent in specific activities and included a procedure to estimate variance using the combined surveys. The 2010 National Health Interview Survey (NHIS) was used to quantify injuries, and the 2010 American Time Use Survey (ATUS) was used to quantify time of exposure to specific activities. The injury rate was estimated by dividing the average number of injuries (from NHIS) by average exposure hours (from ATUS), both measured for specific activities. The variance was calculated using the 'delta method', a general method for variance estimation with complex surveys. Among the five types of injuries examined, 'sport and exercise' had the highest rate (12.64 injuries per 100 000 h), followed by 'working around house/yard' (6.14), driving/riding a motor vehicle (2.98), working (1.45) and sleeping/resting/eating/drinking (0.23). The results show a ranking of injury rate by activity quite different from estimates using population as the denominator. Our approach produces an estimate of injury risk which includes activity exposure time and may more reliably reflect the underlying injury risks, offering an alternative method for injury surveillance and research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Introduction: Applying Clinical Psychological Science to Practice.

PubMed

Cha, Christine B; DiVasto, Katherine A

2017-05-01

Mental illness is a prevalent and extraordinarily complex phenomenon. Psychologists have developed distinct approaches toward understanding and treating mental illness, rooted in divergent epistemology. This introduction to the Special Issue on Clinical Psychological Science and Practice provides a brief overview of the scientist-practitioner gap, and explores one step (of many) toward bridging this divide. Seven compelling case illustrations featured in this Special Issue apply empirical findings to case formulation, treatment selection, and assessment across complex and varied clinical presentations. This issue thereby demonstrates the feasibility of integrating research and clinical expertise in mental healthcare. © 2017 Wiley Periodicals, Inc.

Complex Plasma Physics and Rising Above the Gathering Storm

NASA Astrophysics Data System (ADS)

Hyde, Truell

2008-11-01

Research in complex plasma is prevalent across a variety of regimes ranging from the majority of plasma processing environments to many astrophysical settings. Dust particles suspended within such plasmas acquire a charge from collisions with electrons and ions in the plasma. Depending upon the ratio of their interparticle potential energy to their average kinetic energy, once charged these particles can form a gaseous, liquid or crystalline structure with short to longer range ordering. The field of complex plasmas thus offers research opportunities across a wide range of academic disciplines including physics, chemistry, biology, mathematics, electrical engineering and nanoscience. The field of complex plasmas also offers unique educational research opportunities for combating many of the issues raised in Rising Above the Gathering Storm, recently published by the National Academies Press. CASPER's Educational Outreach programs, supported by the National Science Foundation, the Department of Education and the Department of Labor takes advantage of these opportunities through a variety of avenues including a REU / RET program, a High School Scholars Program, integrated curriculum development and the CASPER Physics Circus. Together, these programs impact thousands of students and parents while providing K-12 teachers with curriculum, supporting hands-on material and support for introducing plasma and basic physical science concepts into the classroom. Both research results and educational outreach concepts from the above will be discussed.

The Complexities of Using Direct-Input Hearing Aids with FM Systems.

ERIC Educational Resources Information Center

Thibodeau, Linda M.; McCaffrey, Helen A.

1992-01-01

This article reviews issues to be considered in the selection and monitoring of direct-input personal Frequency Modulation (FM) systems for individuals with hearing impairments. The article discusses boot configurations, signal options, ordering issues, and maintenance issues. (Author/JDD)

Analysis and meta-analysis of single-case designs: an introduction.

PubMed

Shadish, William R

2014-04-01

The last 10 years have seen great progress in the analysis and meta-analysis of single-case designs (SCDs). This special issue includes five articles that provide an overview of current work on that topic, including standardized mean difference statistics, multilevel models, Bayesian statistics, and generalized additive models. Each article analyzes a common example across articles and presents syntax or macros for how to do them. These articles are followed by commentaries from single-case design researchers and journal editors. This introduction briefly describes each article and then discusses several issues that must be addressed before we can know what analyses will eventually be best to use in SCD research. These issues include modeling trend, modeling error covariances, computing standardized effect size estimates, assessing statistical power, incorporating more accurate models of outcome distributions, exploring whether Bayesian statistics can improve estimation given the small samples common in SCDs, and the need for annotated syntax and graphical user interfaces that make complex statistics accessible to SCD researchers. The article then discusses reasons why SCD researchers are likely to incorporate statistical analyses into their research more often in the future, including changing expectations and contingencies regarding SCD research from outside SCD communities, changes and diversity within SCD communities, corrections of erroneous beliefs about the relationship between SCD research and statistics, and demonstrations of how statistics can help SCD researchers better meet their goals. Copyright © 2013 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Complex systems in metabolic engineering.

PubMed

Winkler, James D; Erickson, Keesha; Choudhury, Alaksh; Halweg-Edwards, Andrea L; Gill, Ryan T

2015-12-01

Metabolic engineers manipulate intricate biological networks to build efficient biological machines. The inherent complexity of this task, derived from the extensive and often unknown interconnectivity between and within these networks, often prevents researchers from achieving desired performance. Other fields have developed methods to tackle the issue of complexity for their unique subset of engineering problems, but to date, there has not been extensive and comprehensive examination of how metabolic engineers use existing tools to ameliorate this effect on their own research projects. In this review, we examine how complexity affects engineering at the protein, pathway, and genome levels within an organism, and the tools for handling these issues to achieve high-performing strain designs. Quantitative complexity metrics and their applications to metabolic engineering versus traditional engineering fields are also discussed. We conclude by predicting how metabolic engineering practices may advance in light of an explicit consideration of design complexity. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Citizen's Guide to U.S. Foreign Policy: Election '88. Nonpartisan Briefs on 18 Key Issues.

ERIC Educational Resources Information Center

Hoepli, Nancy, Ed.; And Others

In order to make informed voting decisions citizens need background information on complex foreign policy issues facing the United States. This guide presents current issues and provides information to help citizens cast a thoughtful vote. The guide is divided into six main headings: Leadership; Security; Economic and Social Issues; Critical…

A history of forensic anthropology.

PubMed

Ubelaker, Douglas H

2018-04-01

Forensic anthropology represents a dynamic and rapidly evolving complex discipline within anthropology and forensic science. Academic roots extend back to early European anatomists but development coalesced in the Americas through high-profile court testimony, assemblage of documented collections and focused research. Formation of the anthropology section of the American Academy of Forensic Sciences in 1972, the American Board of Forensic Anthropology in 1977/1978 and other organizational advances provided important stimuli for progress. While early pioneers concentrated on analysis of skeletonized human remains, applications today have expanded to include complex methods of search and recovery, the biomechanics of trauma interpretation, isotopic analysis related to diet and region of origin, age estimation of the living and issues related to humanitarian and human rights investigations. © 2018 Wiley Periodicals, Inc.

Mapping, fine mapping, and molecular dissection of quantitative trait Loci in domestic animals.

PubMed

Georges, Michel

2007-01-01

Artificial selection has created myriad breeds of domestic animals, each characterized by unique phenotypes pertaining to behavior, morphology, physiology, and disease. Most domestic animal populations share features with isolated founder populations, making them well suited for positional cloning. Genome sequences are now available for most domestic species, and with them a panoply of tools including high-density single-nucleotide polymorphism panels. As a result, domestic animal populations are becoming invaluable resources for studying the molecular architecture of complex traits and of adaptation. Here we review recent progress and issues in the positional identification of genes underlying complex traits in domestic animals. As many phenotypes studied in animals are quantitative, we focus on mapping, fine mapping, and cloning of quantitative trait loci.

Accelerated testing of space mechanisms

NASA Technical Reports Server (NTRS)

Murray, S. Frank; Heshmat, Hooshang

1995-01-01

This report contains a review of various existing life prediction techniques used for a wide range of space mechanisms. Life prediction techniques utilized in other non-space fields such as turbine engine design are also reviewed for applicability to many space mechanism issues. The development of new concepts on how various tribological processes are involved in the life of the complex mechanisms used for space applications are examined. A 'roadmap' for the complete implementation of a tribological prediction approach for complex mechanical systems including standard procedures for test planning, analytical models for life prediction and experimental verification of the life prediction and accelerated testing techniques are discussed. A plan is presented to demonstrate a method for predicting the life and/or performance of a selected space mechanism mechanical component.

Six degree of freedom simulation system for evaluating automated rendezvous and docking spacecraft

NASA Technical Reports Server (NTRS)

Rourke, Kenneth H.; Tsugawa, Roy K.

1991-01-01

Future logistics supply and servicing vehicles such as cargo transfer vehicles (CTV) must have full 6 degree of freedom (6DOF) capability in order to perform requisite rendezvous, proximity operations, and capture operations. The design and performance issues encountered when developing a 6DOF maneuvering spacecraft are very complex with subtle interactions which are not immediately obvious or easily anticipated. In order to deal with these complexities and develop robust maneuvering spacecraft designs, a simulation system and associated family of tools are used at TRW for generating and validating spacecraft performance requirements and guidance algorithms. An overview of the simulator and tools is provided. These are used by TRW for autonomous rendezvous and docking research projects including CTV studies.

Collaborative Paradigm of Preventive, Personalized, and Precision Medicine With Point-of-Care Technologies.

PubMed

Dhawan, Atam P

2016-01-01

Recent advances in biosensors, medical instrumentation, and information processing and communication technologies (ICT) have enabled significant improvements in healthcare. However, these technologies have been mainly applied in clinical environments, such as hospitals and healthcare facilities, under managed care by well-trained and specialized individuals. The global challenge of providing quality healthcare at affordable cost leads to the proposed paradigm of P reventive, Personalized, and Precision Medicine that requires a seamless use of technology and infrastructure support for patients and healthcare providers at point-of-care (POC) locations including homes, semi or pre-clinical facilities, and hospitals. The complexity of the global healthcare challenge necessitates strong collaborative interdisciplinary synergies involving all stakeholder groups including academia, federal research institutions, industry, regulatory agencies, and clinical communities. It is critical to evolve with collaborative efforts on the translation of research to technology development toward clinical validation and potential healthcare applications. This special issue is focused on technology innovation and translational research for POC applications with potential impact in improving global healthcare in the respective areas. Some of these papers were presented at the NIH-IEEE Strategic Conference on Healthcare Innovations and POC Technologies for Precision Medicine (HI-POCT) held at the NIH on November 9-10, 2015. The papers included in the Special Issue provide a spectrum of critical issues and collaborative resources on translational research of advanced POC devices and ICT into global healthcare environment.

Depression in medical students: current insights.

PubMed

Moir, Fiona; Yielder, Jill; Sanson, Jasmine; Chen, Yan

2018-01-01

Medical students are exposed to multiple factors during their academic and clinical study that have been shown to contribute to high levels of depression, anxiety, and stress. The purpose of this article was to explore the issue of depression in the medical student population, including prevalence, causes, and key issues, along with suggestions for early identification and support from one medical school in New Zealand. After establishing that the prevalence of depression is higher for medical students than the general population, the key issues explored include assessment used in the program, characteristics of the student population (such as Type A personality and perfectionism), resilience, selection procedures, students' motivation, and the nature of the clinical environment. This review includes several recommendations to improve students' psychological health such as positioning well-being within an overarching comprehensive workplace wellness model and integrating peer and faculty-led support into the day-to-day running of the institution. It also highlights the advantages of the addition of a well-being curriculum, as skills to prevent and manage distress and depression are relevant in supporting the competencies required by medical practitioners. It concludes that medical schools need wide-ranging strategies to address the complexities associated with the particular student population attracted to medicine and calls for educators to act, by noticing opportunities where they can introduce such initiatives into their medical programs.

Depression in medical students: current insights

PubMed Central

Moir, Fiona; Yielder, Jill; Sanson, Jasmine; Chen, Yan

2018-01-01

Medical students are exposed to multiple factors during their academic and clinical study that have been shown to contribute to high levels of depression, anxiety, and stress. The purpose of this article was to explore the issue of depression in the medical student population, including prevalence, causes, and key issues, along with suggestions for early identification and support from one medical school in New Zealand. After establishing that the prevalence of depression is higher for medical students than the general population, the key issues explored include assessment used in the program, characteristics of the student population (such as Type A personality and perfectionism), resilience, selection procedures, students’ motivation, and the nature of the clinical environment. This review includes several recommendations to improve students’ psychological health such as positioning well-being within an overarching comprehensive workplace wellness model and integrating peer and faculty-led support into the day-to-day running of the institution. It also highlights the advantages of the addition of a well-being curriculum, as skills to prevent and manage distress and depression are relevant in supporting the competencies required by medical practitioners. It concludes that medical schools need wide-ranging strategies to address the complexities associated with the particular student population attracted to medicine and calls for educators to act, by noticing opportunities where they can introduce such initiatives into their medical programs. PMID:29765261

Issues and Answers about Section 504.

ERIC Educational Resources Information Center

American School and University, 1979

1979-01-01

The first of several installments that address the complex issues and questions related to implementation of the requirement that persons should have equal educational opportunity despite handicap. (Author)

Food, health, and complexity: towards a conceptual understanding to guide collaborative public health action.

PubMed

Majowicz, Shannon E; Meyer, Samantha B; Kirkpatrick, Sharon I; Graham, Julianne L; Shaikh, Arshi; Elliott, Susan J; Minaker, Leia M; Scott, Steffanie; Laird, Brian

2016-06-08

What we eat simultaneously impacts our exposure to pathogens, allergens, and contaminants, our nutritional status and body composition, our risks for and the progression of chronic diseases, and other outcomes. Furthermore, what we eat is influenced by a complex web of drivers, including culture, politics, economics, and our built and natural environments. To date, public health initiatives aimed at improving food-related population health outcomes have primarily been developed within 'practice silos', and the potential for complex interactions among such initiatives is not well understood. Therefore, our objective was to develop a conceptual model depicting how infectious foodborne illness, food insecurity, dietary contaminants, obesity, and food allergy can be linked via shared drivers, to illustrate potential complex interactions and support future collaboration across public health practice silos. We developed the conceptual model by first conducting a systematic literature search to identify review articles containing schematics that depicted relationships between drivers and the issues of interest. Next, we synthesized drivers into a common model using a modified thematic synthesis approach that combined an inductive thematic analysis and mapping to synthesize findings. The literature search yielded 83 relevant references containing 101 schematics. The conceptual model contained 49 shared drivers and 227 interconnections. Each of the five issues was connected to all others. Obesity and food insecurity shared the most drivers (n = 28). Obesity shared several drivers with food allergy (n = 11), infectious foodborne illness (n = 7), and dietary contamination (n = 6). Food insecurity shared several drivers with infectious foodborne illness (n = 9) and dietary contamination (n = 9). Infectious foodborne illness shared drivers with dietary contamination (n = 8). Fewer drivers were shared between food allergy and: food insecurity (n = 4); infectious foodborne illness (n = 2); and dietary contamination (n = 1). Our model explicates potential interrelationships between five population health issues for which public health interventions have historically been siloed, suggesting that interventions targeted towards these issues have the potential to interact and produce unexpected consequences. Public health practitioners working in infectious foodborne illness, food insecurity, dietary contaminants, obesity, and food allergy should actively consider how their seemingly targeted public health actions may produce unintended positive or negative population health impacts.

Provider Experiences with Prison Care and Aftercare for Women with Co-occurring Mental Health and Substance Use Disorders: Treatment, Resource, and Systems Integration Challenges.

PubMed

Johnson, Jennifer E; Schonbrun, Yael Chatav; Peabody, Marlanea E; Shefner, Ruth T; Fernandes, Karen M; Rosen, Rochelle K; Zlotnick, Caron

2015-10-01

Incarcerated women with co-occurring mental health and substance use disorders (COD) face complex psychosocial challenges at community reentry. This study used qualitative methods to evaluate the perspectives of 14 prison and aftercare providers about service delivery challenges and treatment needs of reentering women with COD. Providers viewed the needs of women prisoners with COD as distinct from those of women with substance use alone and from men with COD. Providers described optimal aftercare for women with COD as including contact with the same provider before and after release, access to services within 24-72 hours after release, assistance with managing multiple social service agencies, assistance with relationship issues, and long-term follow-up. Providers also described larger service system and societal issues, including systems integration and ways in which a lack of prison and community aftercare resources impacted quality of care and reentry outcomes. Practice and policy implications are provided.

Mitochondria in the nervous system: From health to disease, Part I.

PubMed

Polster, Brian M; Carrì, Maria Teresa; Beart, Philip M

2017-10-01

In Part I of this Special Issue on "Mitochondria in the Nervous System: From Health to Disease", the editors bring together contributions from experts in brain mitochondrial research to provide an up-to-date overview of mitochondrial functioning in physiology and pathology. The issue provides cutting edge reviews on classical areas of mitochondrial biology that include energy substrate utilization, calcium handling, mitochondria-endoplasmic reticulum communication, and cell death regulation. Additional reviews and original research articles touch upon key mitochondrial defects seen across multiple neurodegenerative conditions, including fragmentation, loss of respiratory capacity, calcium overload, elevated reactive oxygen species generation, perturbed NAD + metabolism, altered protein acetylation, and compromised mitophagy. Emerging links between the genetics of neurodegenerative disorders and disruption in mitochondrial function are discussed, and a new mouse model of Complex I deficiency is described. Finally, novel ways to rescue mitochondrial structure and function in acute and chronic brain injury are explored. Copyright © 2017. Published by Elsevier Ltd.

Provider Experiences with Prison Care and Aftercare for Women with Co-occurring Mental Health and Substance Use Disorders: Treatment, Resource, and Systems Integration Challenges

PubMed Central

Johnson, Jennifer E.; Schonbrun, Yael Chatav; Peabody, Marlanea E.; Shefner, Ruth T.; Fernandes, Karen M.; Rosen, Rochelle K.; Zlotnick, Caron

2014-01-01

Incarcerated women with co-occurring mental health and substance use disorders (COD) face complex psychosocial challenges at community reentry. This study used qualitative methods to evaluate the perspectives of 14 prison and aftercare providers about service delivery challenges and treatment needs of reentering women with COD. Providers viewed the needs of women prisoners with COD as distinct from those of women with substance use alone and from men with COD. Providers described optimal aftercare for women with COD as including contact with the same provider before and after release, access to services within 24–72 hours after release, assistance with managing multiple social service agencies, assistance with relationship issues, and long-term follow-up. Providers also described larger service system and societal issues, including systems integration and ways in which a lack of prison and community aftercare resources impacted quality of care and reentry outcomes. Practice and policy implications are provided. PMID:24595815

Buprenorphine and Buprenorphine/Naloxone Diversion, Misuse, and Illicit Use: An International Review

PubMed Central

Yokell, Michael A.; Zaller, Nickolas D.; Green, Traci C.; Rich, Josiah D.

2011-01-01

The diversion, misuse, and non-medically supervised use of buprenorphine and buprenorphine/naloxone by opioid users are reviewed. Buprenorphine and buprenorphine/naloxone are used globally as opioid analgesics and in the treatment of opioid dependency. Diversion of buprenorphine and buprenorphine/naloxone represents a complex medical and social issue, and has been widely documented in various geographical regions throughout the world. We first discuss the clinical properties of buprenorphine and its abuse potential. Second, we discuss its diversion and illicit use on an international level, as well as motivations for those activities. Third, we examine the medical risks and benefits of buprenorphine’s non-medically supervised use and misuse. These risks and benefits include the effect of buprenorphine’s use on HIV risk and the risk of its concomitant use with other medications and drugs of abuse. Finally, we discuss the implications of diversion, misuse, and non-medically supervised use (including potential measures to address issues of diversion); and potential areas for further research. PMID:21466501

Emerging issues among adolescent and young adult cancer survivors.

PubMed

Patterson, Pandora; McDonald, Fiona E J; Zebrack, Brad; Medlow, Sharon

2015-02-01

To review the characteristics of cancer in the adolescence and young adult age group; the medical, psychosocial and behavioral late effects; survivorship care planning and transition; current research priorities; and practice implications. Published articles, research studies and position statements. Survivors of cancers that occurred during adolescence and young adulthood (AYA) are confronted with the dual demands of managing their transition to independent adulthood, concurrently with their transition from cancer patient to cancer survivors, with an associated reduction in support from medical services. AYA survivors also face complex medical, psychosocial and behavioral late effects, including fertility and mental health issues. An understanding of the impact of cancer diagnoses among this age group, including survivors' abilities to reintegrate into 'normal' life and potential long term consequences, is necessary to provide the best support. This care and support can be enhanced through multidisciplinary teams who work together to address the medical and psychosocial needs of AYAs diagnosed with cancer. Copyright © 2015 Elsevier Inc. All rights reserved.

Considering Research Outcomes as Essential Tools for Medical Education Decision Making.

PubMed

Miller, Karen Hughes; Miller, Bonnie M; Karani, Reena

2015-11-01

As medical educators face the challenge of incorporating new content, learning methods, and assessment techniques into the curriculum, the need for rigorous medical education research to guide efficient and effective instructional planning increases. When done properly, well-designed education research can provide guidance for complex education decision making. In this Commentary, the authors consider the 2015 Research in Medical Education (RIME) research and review articles in terms of the critical areas in teaching and learning that they address. The broad categories include (1) assessment (the largest collection of RIME articles, including both feedback from learners and instructors and the reliability of learner assessment), (2) the institution's impact on the learning environment, (3) what can be learned from program evaluation, and (4) emerging issues in faculty development. While the articles in this issue are broad in scope and potential impact, the RIME committee noted few studies of sufficient rigor focusing on areas of diversity and diverse learners. Although challenging to investigate, the authors encourage continuing innovation in research focused on these important areas.

Concussion As a Multi-Scale Complex System: An Interdisciplinary Synthesis of Current Knowledge

PubMed Central

Kenzie, Erin S.; Parks, Elle L.; Bigler, Erin D.; Lim, Miranda M.; Chesnutt, James C.; Wakeland, Wayne

2017-01-01

Traumatic brain injury (TBI) has been called “the most complicated disease of the most complex organ of the body” and is an increasingly high-profile public health issue. Many patients report long-term impairments following even “mild” injuries, but reliable criteria for diagnosis and prognosis are lacking. Every clinical trial for TBI treatment to date has failed to demonstrate reliable and safe improvement in outcomes, and the existing body of literature is insufficient to support the creation of a new classification system. Concussion, or mild TBI, is a highly heterogeneous phenomenon, and numerous factors interact dynamically to influence an individual’s recovery trajectory. Many of the obstacles faced in research and clinical practice related to TBI and concussion, including observed heterogeneity, arguably stem from the complexity of the condition itself. To improve understanding of this complexity, we review the current state of research through the lens provided by the interdisciplinary field of systems science, which has been increasingly applied to biomedical issues. The review was conducted iteratively, through multiple phases of literature review, expert interviews, and systems diagramming and represents the first phase in an effort to develop systems models of concussion. The primary focus of this work was to examine concepts and ways of thinking about concussion that currently impede research design and block advancements in care of TBI. Results are presented in the form of a multi-scale conceptual framework intended to synthesize knowledge across disciplines, improve research design, and provide a broader, multi-scale model for understanding concussion pathophysiology, classification, and treatment. PMID:29033888

Energy supplies and future engines for land, sea, and air.

PubMed

Hidy, George M; Chow, Judith C; England, Glen C; Legge, Alan H; Lloyd, Alan C; Watson, John G

2012-11-01

The 2012 Critical Review Discussion complements Wilson, (2012), provides pointers to more detailed treatments of different topics and adds additional dimensions to the area of "energy". These include broader aspects of technologies driven by fuel resources and environmental issues, the concept of energy technology innovation, evolution in transportation resources, and complexities of energy policies addressing carbon taxes or carbon trading. National and global energy data bases are identified and evaluated and conversion factors are given to allow their comparability.

Regulation by consensus: The expanded use of regulatory negotiation under the Clean Air Act

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

Claiborne, M.L.

This article discusses the consensus building approach, which stems from the more formal regulatory negotiation process under the Negotiated Rulemaking Act of 1990, for improving air quality. The article uses as examples the joint plan to improve air quality and visibility in the Grand Canyon and 15 other national parks and wilderness areas in the SW USA, and the Southern Appalachian Mountain initiative tackling more complex issues including visibility, ground ozone, acid deposition, etc.

Need for Emission Cap on Complex Netting Sources

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Pollution Permanent Monitoring PANEL--2013 Annual Report

NASA Astrophysics Data System (ADS)

Everett, Lorne G.

2014-07-01

The following sections are included: * POLLUTION PANEL ACTIVITIES 2013 * NATIONAL ACADEMY OF SCIENCES 2013 * MTBE NEW HAMPSHIRE LITIGATION--APRIL 12, 2013 * ALTERNATIVES FOR MANAGING THE NATION's COMPLEX CONTAMINATED GROUNDWATER SITES--NATIONAL ACADEMY OF SCIENCES, 2013 * HUMAN HEALTH EFFECTS OF TRICHLOROETHYLENE: KEY FINDINGS AND SCIENTIFIC ISSUES. MARCH 1, 2013 REVIEWS * BAROMETRIC PRESSURE DRIVES SOIL-GAS CONCENTRATIONS * WATER RESOURCES--TERRORISM TARGETS * WITH A LITTLE INGENUITY THE PROBLEM IS NOT INSOLUBLE * HIGH RISE BUILDINGS * TERRORIST MATERIAL MAY DESTROY WATER TRANSMISSION INFRASTRUCTURE * WATER THREAT CONCLUSIONS * MULTINATIONAL REPOSITORIES

KSC-04PD-0802

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. -- On a tour of the Orbiter Processing Facility, Florida Gov. Jeb Bush (center) and his wife, Columba (left), listen to NASA Vehicle Manager Scott Thurston talk about the orbiter Atlantis overhead. The tour followed the launching ceremony at the KSC Visitor Complex for the new Florida quarter issued by the U.S. Mint. The ceremony was emceed by Center Director Jim Kennedy and included remarks by NASA Administrator Sean OKeefe, Bush, U.S. Mint Director Henrietta Holsman Fore and Deputy Secretary of the Treasury Samuel W. Bodman.

KSC-04PD-0804

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. -- On a tour of the Orbiter Processing Facility, Florida Gov. Jeb Bush (left) listens to NASA Vehicle Manager Scott Thurston talk about the orbiter Atlantis overhead. At right is Center Director Jim Kennedy. The tour followed the launching ceremony at the KSC Visitor Complex for the new Florida quarter issued by the U.S. Mint. The ceremony was emceed by Kennedy and included remarks by NASA Administrator Sean OKeefe, Bush, U.S. Mint Director Henrietta Holsman Fore and Deputy Secretary of the Treasury Samuel W. Bodman.

Meroterpenes from Marine Invertebrates: Structures, Occurrence, and Ecological Implications

PubMed Central

Menna, Marialuisa; Imperatore, Concetta; D’Aniello, Filomena; Aiello, Anna

2013-01-01

Meroterpenes are widely distributed among marine organisms; they are particularly abundant within brown algae, but other important sources include microorganisms and invertebrates. In the present review the structures and bioactivities of meroterpenes from marine invertebrates, mainly sponges and tunicates, are summarized. More than 300 molecules, often complex and with unique skeletons originating from intra- and inter-molecular cyclizations, and/or rearrangements, are illustrated. The reported syntheses are mentioned. The issue of a potential microbial link to their biosynthesis is also shortly outlined. PMID:23685889

KSC-04pd0804

NASA Image and Video Library

2004-04-07

KENNEDY SPACE CENTER, FLA. -- On a tour of the Orbiter Processing Facility, Florida Gov. Jeb Bush (left) listens to NASA Vehicle Manager Scott Thurston talk about the orbiter Atlantis overhead. At right is Center Director Jim Kennedy. The tour followed the launching ceremony at the KSC Visitor Complex for the new Florida quarter issued by the U.S. Mint. The ceremony was emceed by Kennedy and included remarks by NASA Administrator Sean O’Keefe, Bush, U.S. Mint Director Henrietta Holsman Fore and Deputy Secretary of the Treasury Samuel W. Bodman.

Detector sustainability improvements at LCLS

NASA Astrophysics Data System (ADS)

Browne, Michael C.; Carini, Gabriella; DePonte, Daniel P.; Galtier, Eric C.; Hart, Philip A.; Koralek, J. D.; Mitra, Ankush; Nakahara, Kazutaka

2017-06-01

The Linac Coherent Light Source (LCLS) poses a number of daunting and often unusual challenges to maintaining X-ray detectors, such as proximity to liquid-sample injectors, complex setups with moving components, intense X-ray and optical laser light, and Electromagnetic Pulse (EMP). The Detector and Sample Environment departments at LCLS are developing an array of engineering, monitoring, and administrative controls solutions to better address these issues. These include injector improvements and monitoring methods, fast online damage recognition algorithms, EMP mapping and protection, actively cooled filters, and more.

Inside the hotline: A compilation of 1992 monthly hotline reports. Annual report

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

Not Available

1993-03-01

The document is a compilation of questions and answers, Federal Register summaries from individual monthly Hotline reports for the period of January to December 1992. It includes indices arranged by subject, regulatory citation, and statutory citation. The reader can use the document to explore the application of the regulations to different scenarios or to shed light on complex issues. Neither the answers to questions nor the Federal Register summaries are intended to fully represent or to be used in place of the regulations.

Potential contributions of hypnosis to ego-strengthening procedures in EMDR. Eye Movement Desensitization Reprocessing.

PubMed

Phillips, M

2001-01-01

This paper explores how hypnotic principles can be systematically incorporated into the standard EMDR protocol to enhance various ego strength capacities during EMDR treatment. Expanding these skill areas can widen the therapeutic window of possibility for clients with a variety of complex clinical issues, including posttraumatic, dissociative or personality disorders, anxiety symptoms, and depressive difficulties. Clinical case examples are used to illustrate ways of integrating hypnotic principles within a proposed EMDR protocol to promote ego strengthening and facilitate therapeutic change.

Optical linear algebra processors - Architectures and algorithms

NASA Technical Reports Server (NTRS)

Casasent, David

1986-01-01

Attention is given to the component design and optical configuration features of a generic optical linear algebra processor (OLAP) architecture, as well as the large number of OLAP architectures, number representations, algorithms and applications encountered in current literature. Number-representation issues associated with bipolar and complex-valued data representations, high-accuracy (including floating point) performance, and the base or radix to be employed, are discussed, together with case studies on a space-integrating frequency-multiplexed architecture and a hybrid space-integrating and time-integrating multichannel architecture.

Dynamic Loading and Characterization of Fiber-Reinforced Composites

NASA Astrophysics Data System (ADS)

Sierakowski, Robert L.; Chaturvedi, Shive K.

1997-02-01

Emphasizing polymer based fiber-reinforced composites, this book is designed to provide readers with a significant understanding of the complexities involved in characterizing dynamic events and the corresponding response of advanced fiber composite materials and structures. These elements include dynamic loading devices, material properties characterization, analytical and experimental techniques to assess the damage and failure modes associated with various dynamic loading events. Concluding remarks are presented throughout the text which summarize key points and raise issues related to important research needed.

76 FR 29335 - Qualification, Service, and Use of Crewmembers and Aircraft Dispatchers

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-20

...On January 12, 2009, the FAA published a notice of proposed rulemaking on qualification, service, and use of crewmembers and aircraft dispatchers. Because of the complexity of the issues and the concerns raised by commenters, the FAA is issuing this supplemental notice of proposed rulemaking. The FAA proposes to amend the regulations for crewmember and aircraft dispatcher training programs in domestic, flag, and supplemental operations. The proposed regulations enhance traditional training programs by requiring the use of flight simulation training devices for flightcrew members and including additional training and evaluation requirements for all crewmembers and aircraft dispatchers in areas that are critical to safety. The proposal also reorganizes and revises the qualification, training, and evaluation requirements. The proposed changes are intended to contribute significantly to reducing aviation accidents.

The patient who believes and the analyst who does not (1).

PubMed

Lijtmaer, Ruth M

2009-01-01

A patient's religious beliefs and practices challenge the clinical experience and self-knowledge of the analyst owing to a great complexity of factors, and often take the form of the analyst's resistances and countertransference reactions to spiritual and religious issues. The analyst's feelings about the patient's encounters with religion and other forms of healing experiences may result in impasses and communication breakdown for a variety of reasons. These reasons include the analyst's own unresolved issues around her role as a psychoanalyst-which incorporates in some way psychoanalysis's views of religious belief-and these old conflicts may be irritated by the religious themes expressed by the patient. Vignettes from the treatments of two patients provide examples of the analyst's countertransference conflicts, particularly envy in the case of a therapist who is an atheist.

Implementation Considerations for Multisite Clinical Trials with Cognitive Neuroscience Tasks

PubMed Central

Keefe, Richard S. E.; Harvey, Philip D.

2008-01-01

Multisite clinical trials aimed at cognitive enhancement across various neuropsychiatric conditions have employed standard neuropsychological tests as outcome measures. While these tests have enjoyed wide clinical use and have proven reliable and predictive of functional disability, a number of implementation challenges have arisen when these tests are used in clinical trials. These issues are likely to be magnified in future studies when cognitive neuroscience (CN) procedures are explored in these trials, because in their current forms CN procedures are less standardized and more difficult to teach and monitor. For multisite trials, we anticipate that the most challenging issues will include assuring tester competence, monitoring tester performance, specific challenges with complex assessment methods, and having resources available for adequate monitoring of data quality. Suggestions for overcoming these implementation challenges are offered. PMID:18495645

iES - An Intelligent Electronic Sales Platform

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

Stanton, V L; Korbe III, W; Gao, J G

Current e-commerce systems support online shopping based on electronic product catalogs. The major issues associated with catalog-based commerce systems are: difficulty in distinguishing one retailer from another, complex navigation with confusing links, and a lack of personalized service. This paper reports an intelligent solution to address these issues. Our solution will provide a more personalized sales experience through the use of a transaction-based knowledge model that includes both the rules used for reasoning as well as the corresponding actions. Based on this solution, we have developed an intelligent electronic sales platform that is supported by a framework which provides themore » desired personalization as well as extensibility and customization capabilities. This paper reports our design and development of this system and application examples.« less

Global issues in drug development for Alzheimer's disease.

PubMed

Doody, Rachelle S; Cole, Patricia E; Miller, David S; Siemers, Eric; Black, Ronald; Feldman, Howard; Schindler, Rachel; Graham, Stephen; Heath, Theresa; Khachaturian, Ara S; Evans, Rebecca; Carrillo, Maria C

2011-03-01

The number of clinical trials for Alzheimer's disease conducted outside the United States in a broad array of countries is increasing. As the number of compounds ready for clinical testing increases, and as trials become longer and more complex, this trend is expected to grow. The cultural and ethical context of global clinical trials, potential benefits for those involved, and practical approaches to obstacles generated by these global trials were discussed at a meeting of the Alzheimer's Association Research Roundtable. Regulatory issues, including regional differences in study registration procedures, rules for collecting and reporting serious adverse events, requirements for national identity of study populations, and regulatory audits were also discussed by individuals who are knowledgeable about global clinical trials for Alzheimer's disease. Copyright © 2011 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

What does 'complex' mean in palliative care? Triangulating qualitative findings from 3 settings.

PubMed

Carduff, Emma; Johnston, Sarah; Winstanley, Catherine; Morrish, Jamie; Murray, Scott A; Spiller, Juliet; Finucane, Anne

2018-01-04

Complex need for patients with a terminal illness distinguishes those who would benefit from specialist palliative care from those who could be cared for by non-specialists. However, the nature of this complexity is not well defined or understood. This study describes how health professionals, from three distinct settings in the United Kingdom, understand complex need in palliative care. Semi-structured qualitative interviews were conducted with professionals in primary care, hospital and hospice settings. Thirty-four professionals including doctors, nurses and allied health professionals were recruited in total. Data collected in each setting were thematically analysed and a workshop was convened to compare and contrast findings across settings. The interaction between diverse multi-dimensional aspects of need, existing co-morbidities, intractable symptoms and complicated social and psychological issues increased perceived complexity. Poor communication between patients and their clinicians contributed to complexity. Professionals in primary and acute care described themselves as 'generalists' and felt they lacked confidence and skill in identifying and caring for complex patients and time for professional development in palliative care. Complexity in the context of palliative care can be inherent to the patient or perceived by health professionals. Lack of confidence, time constraints and bed pressures contribute to perceived complexity, but are amenable to change by training in identifying, prognosticating for, and communicating with patients approaching the end of life.

Obesity Prevention for Individuals with Spina Bifida.

PubMed

Polfuss, Michele; Bandini, Linda G; Sawin, Kathleen J

2017-06-01

Obesity is a common comorbidity in individuals with spina bifida. Carrying excess weight exacerbates the inherent health challenges associated with spina bifida, impedes the individual's ability to self-manage their condition, and creates further challenges for family members and caregivers. This manuscript provides a narrative review of key issues for understanding and prevention of obesity in persons with spina bifida within the context of the social ecological model. Specific variables related to obesity and spina bifida include individual factors (i.e., body composition and measurement issues, energy needs, eating patterns, physical activity, and sedentary activity) family factors (i.e., parenting/family, peers), community factors (i.e., culture, built environment, healthcare and healthcare providers, and school), and societal factors (i.e., policy issues). Due to the complex etiology of obesity and its increased prevalence in individuals with spina bifida, it is critical to initiate prevention efforts early with a multifactorial approach for this at-risk population. Increased research is warranted to support these efforts.

GunderKids: Design of a Clinical Care Management Program for Parents With Substance Abuse and Their Newborn Children with a Focus on Preventing Child Abuse.

PubMed

Budzak-Garza, Ann E; Allmon Dixson, Allison L; Holzer, Renee A; Lillard-Pierce, Kaitlin E; Devine, Carolynn J

2018-03-01

In response to an increased need to care for babies born to mothers with substance abuse issues, we developed GunderKids, a care management program that provides integrated medical care beyond standard-of-care, well-child appointments for these socially complex families. The program incorporates frequent visits to the pediatrician and the care team, which includes pediatric nurses, a pediatric social worker, and a child psychologist. Enrollment is voluntary. Each visit addresses parenting challenges, home environment, basic needs, safety issues, and maintenance of sobriety, as well as child development and health issues. We found that mothers and fathers (or parents) welcome intense support following delivery, appreciate the relationship that is built with the care team, and prefer frequent visits at the medical center over in-home visits, which they perceive as potentially intrusive. We describe here the planning and implementation of the program, as well as insights gained in our first year. Copyright© Wisconsin Medical Society.

Methodological issues in the study of violence against women

PubMed Central

Ruiz‐Pérez, Isabel; Plazaola‐Castaño, Juncal; Vives‐Cases, Carmen

2007-01-01

The objective of this paper is to review the methodological issues that arise when studying violence against women as a public health problem, focusing on intimate partner violence (IPV), since this is the form of violence that has the greatest consequences at a social and political level. The paper focuses first on the problems of defining what is meant by IPV. Secondly, the paper describes the difficulties in assessing the magnitude of the problem. Obtaining reliable data on this type of violence is a complex task, because of the methodological issues derived from the very nature of the phenomenon, such as the private, intimate context in which this violence often takes place, which means the problem cannot be directly observed. Finally, the paper examines the limitations and bias in research on violence, including the lack of consensus with regard to measuring events that may or may not represent a risk factor for violence against women or the methodological problem related to the type of sampling used in both aetiological and prevalence studies. PMID:18000113

The complex legal and ethical issues related to generic medications. Viral hepatitis: a case study.

PubMed

Danta, M; Ghinea, N

2017-04-01

The economic impact of medications is significant, with many countries unable to afford the essential medicines listed by the WHO. Generic medications are one strategy to address this issue. Generic medications are similar to but not the same as originator medications. They have a significant cost advantage because they do not require the background research and development studies to support registration. Consequently, they are gaining increased market share in both the developed and developing world. Many new medications are now licensed to generic manufacturers in the developing world. As a result, it is possible for patients to bypass regulatory and cost barriers by importing medications directly from generic producers. Importation of the novel hepatitis C direct-acting antiviral therapy into Australia before it was registered in the country is an illustrative case study. This review will characterise generic medications and some of the legal and ethical issues around their utilisation, focusing on the relevant players, including pharma, government, patients and doctors.

Digital Archive Issues from the Perspective of an Earth Science Data Producer

NASA Technical Reports Server (NTRS)

Barkstrom, Bruce R.

2004-01-01

Contents include the following: Introduction. A Producer Perspective on Earth Science Data. Data Producers as Members of a Scientific Community. Some Unique Characteristics of Scientific Data. Spatial and Temporal Sampling for Earth (or Space) Science Data. The Influence of the Data Production System Architecture. The Spatial and Temporal Structures Underlying Earth Science Data. Earth Science Data File (or Relation) Schemas. Data Producer Configuration Management Complexities. The Topology of Earth Science Data Inventories. Some Thoughts on the User Perspective. Science Data User Communities. Spatial and Temporal Structure Needs of Different Users. User Spatial Objects. Data Search Services. Inventory Search. Parameter (Keyword) Search. Metadata Searches. Documentation Search. Secondary Index Search. Print Technology and Hypertext. Inter-Data Collection Configuration Management Issues. An Archive View. Producer Data Ingest and Production. User Data Searching and Distribution. Subsetting and Supersetting. Semantic Requirements for Data Interchange. Tentative Conclusions. An Object Oriented View of Archive Information Evolution. Scientific Data Archival Issues. A Perspective on the Future of Digital Archives for Scientific Data. References Index for this paper.

Health educators in the workplace: helping companies respond to the AIDS crisis.

PubMed

Bauman, L J; Aberth, J

1986-01-01

As the number of cases of AIDS increases, more and more companies will have to decide how to handle employees with AIDS and those at high risk. AIDS creates medical, legal, and ethical issues in the workplace, all of which are emotional and complex; managers need expert assistance to guide their decision-making and policy development. This article identifies various dimensions of the AIDS-related issues emerging in corporations nationwide, including: confidentiality, the right of patients to work, benefits and insurance, HTLV-III screening, fears of contagion among workers, needs of companies to avoid financial and legal exposure, and effects on worker productivity. Health educators are in a unique position to contribute to the satisfactory resolution of AIDS-related problems in the workplace through their training and experience in education, policy development and the relevant legal and ethical issues in the health care field. However, they will have to initiate discussions with corporation executives themselves in order to reach this most important audience.

Engineering education as a complex system

NASA Astrophysics Data System (ADS)

Gattie, David K.; Kellam, Nadia N.; Schramski, John R.; Walther, Joachim

2011-12-01

This paper presents a theoretical basis for cultivating engineering education as a complex system that will prepare students to think critically and make decisions with regard to poorly understood, ill-structured issues. Integral to this theoretical basis is a solution space construct developed and presented as a benchmark for evaluating problem-solving orientations that emerge within students' thinking as they progress through an engineering curriculum. It is proposed that the traditional engineering education model, while analytically rigorous, is characterised by properties that, although necessary, are insufficient for preparing students to address complex issues of the twenty-first century. A Synthesis and Design Studio model for engineering education is proposed, which maintains the necessary rigor of analysis within a uniquely complex yet sufficiently structured learning environment.

Gas-Liquid Flows and Phase Separation

NASA Technical Reports Server (NTRS)

McQuillen, John

2004-01-01

Common issues for space system designers include:Ability to Verify Performance in Normal Gravity prior to Deployment; System Stability; Phase Accumulation & Shedding; Phase Separation; Flow Distribution through Tees & Manifolds Boiling Crisis; Heat Transfer Coefficient; and Pressure Drop.The report concludes:Guidance similar to "A design that operates in a single phase is less complex than a design that has two-phase flow" is not always true considering the amount of effort spent on pressurizing, subcooling and phase separators to ensure single phase operation. While there is still much to learn about two-phase flow in reduced gravity, we have a good start. Focus now needs to be directed more towards system level problems .

The Full Scope of Family Physicians' Work Is Not Reflected by Current Procedural Terminology Codes.

PubMed

Young, Richard A; Burge, Sandy; Kumar, Kaparaboyna Ashok; Wilson, Jocelyn

2017-01-01

The purpose of this study was to characterize the content of family physician (FP) clinic encounters, and to count the number of visits in which the FPs addressed issues not explicitly reportable by 99211 to 99215 and 99354 Current Procedural Terminology (CPT) codes with current reimbursement methods and based on examples provided in the CPT manual. The data collection instrument was modeled on the National Ambulatory Medical Care Survey. Trained assistants directly observed every other FP-patient encounter and recorded every patient concern, issue addressed by the physician (including care barriers related to health care systems and social determinants), and treatment ordered in clinics affiliated with 10 residencies of the Residency Research Network of Texas. A visit was deemed to include physician work that was not explicitly reportable if the number or nature of issues addressed exceeded the definitions or examples for 99205/99215 or 99214 + 99354 or a preventive service code, included the physician addressing health care system or social determinant issues, or included the care of a family member. In 982 physician-patient encounters, patients raised 517 different reasons for visit (total, 5278; mean, 5.4 per visit; range, 1 to 16) and the FPs addressed 509 different issues (total issues, 3587; mean, 3.7 per visit; range, 1 to 10). FPs managed 425 different medications, 18 supplements, and 11 devices. A mean of 3.9 chronic medications were continued per visit (range, 0 to 21) and 4.6 total medications were managed (range, 0 to 22). In 592 (60.3%) of the visits the FPs did work that was not explicitly reportable with available CPT codes: 582 (59.3%) addressed more numerous issues than explicitly reportable, 64 (6.5%) addressed system barriers, and 13 (1.3%) addressed concerns for other family members. FPs perform cognitive work in a majority of their patient encounters that are not explicitly reportable, either by being higher than the CPT example number of diagnoses per code or the type of problems addressed, which has implications for the care of complex multi-morbid patients and the growth of the primary care workforce. To address these limitations, either the CPT codes and their associated rules should be updated to reflect the realities of family physicians' practices or new billing and coding approaches should be developed. © Copyright 2017 by the American Board of Family Medicine.

A complex social-ecological disaster: Environmentally induced forced migration

PubMed Central

Rechkemmer, Andreas; O'Connor, Ashley; Rai, Abha; Decker Sparks, Jessica L.; Mudliar, Pranietha; Shultz, James M.

2016-01-01

ABSTRACT In the 21st century, global issues are increasingly characterized by inter-connectedness and complexity. Global environmental change, and climate change in particular, has become a powerful driver and catalyst of forced migration and internal displacement of people. Environmental migrants may far outnumber any other group of displaced people and refugees in the years to come. Deeper scientific integration, especially across the social sciences, is a prerequisite to tackle this issue.

A complex social-ecological disaster: Environmentally induced forced migration.

PubMed

Rechkemmer, Andreas; O'Connor, Ashley; Rai, Abha; Decker Sparks, Jessica L; Mudliar, Pranietha; Shultz, James M

2016-01-01

In the 21 st century, global issues are increasingly characterized by inter-connectedness and complexity. Global environmental change, and climate change in particular, has become a powerful driver and catalyst of forced migration and internal displacement of people. Environmental migrants may far outnumber any other group of displaced people and refugees in the years to come. Deeper scientific integration, especially across the social sciences, is a prerequisite to tackle this issue.

Critical issues in NASA information systems

NASA Technical Reports Server (NTRS)

1987-01-01

The National Aeronautics and Space Administration has developed a globally-distributed complex of earth resources data bases since LANDSAT 1 was launched in 1972. NASA envisages considerable growth in the number, extent, and complexity of such data bases, due to the improvements expected in its remote sensing data rates, and the increasingly multidisciplinary nature of its scientific investigations. Work already has begun on information systems to support multidisciplinary research activities based on data acquired by the space station complex and other space-based and terrestrial sources. In response to a request from NASA's former Associate Administrator for Space Science and Applications, the National Research Council convened a committee in June 1985 to identify the critical issues involving information systems support to space science and applications. The committee has suggested that OSSA address four major information systems issues; centralization of management functions, interoperability of user involvement in the planning and implementation of its programs, and technology.

Current Issues and Perspectives in Group Work. A Counseling Monograph.

ERIC Educational Resources Information Center

Roland, Catherine B., Ed.; Conneely, Rebecca J., Ed.

Group counseling presents counselors with an increasing complexity of issues. This collection of papers addresses a range of current issues and perspectives for group counselors. The first article examines self disclosure, particularly the effects of counselor self-disclosure on the therapeutic relationship in group counseling. Clinical…

Socio-Technical Considerations for the Use of Blockchain Technology in Healthcare.

PubMed

Wong, Ming Chao; Yee, Kwang Chien; Nøhr, Christian

2018-01-01

Blockchain technology is often considered as the fourth industrial revolution that will change the world. The enthusiasm of the transformative nature of blockchain technology has infiltrated healthcare. Blockchain is often seen as the much needed and perfect technology for healthcare, addressing the difficult and complex issues of security and inter-operability. More importantly, the "value" and trust-based system can deliver automated action and response via its smart contract mechanism. Healthcare, however, is a complex system. Health information technology (HIT) so far, has not delivered its promise of transforming healthcare due to its complex socio-technical and context sensitive interaction. The introduction of blockchain technology will need to consider a whole range of socio-technical issues in order to improve the quality and safety of patient care. This paper presents a discussion on these socio-technical issues. More importantly, this paper argues that in order to achieve the best outcome from blockchain technology, there is a need to consider a clinical transformation from "information" to "value " and trust. This paper argues that urgent research is needed to address these socio-technical issues in order to facilitate best outcomes for blockchain in healthcare. These socio-technical issues must then be further evaluated by means of working prototypes in the medical domain in coming years.

Handling Complexity in Learning Environments: Theory and Research. Advances in Learning and Instruction

ERIC Educational Resources Information Center

Elen, Jan, Ed.; Clark, Richard, Ed.

2006-01-01

What is meant when people say that "learning environments are increasingly complex"? What is known about the cognitive processing that occurs during complex learning? How can educators provide effective instructional support for students who must learn and apply complex knowledge? These questions, and related issues, have fascinated educators and…

Critical Design Issues of Tokamak Cooling Water System of ITER's Fusion Reactor

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

Kim, Seokho H; Berry, Jan

U.S. ITER is responsible for the design, engineering, and procurement of the Tokamak Cooling Water System (TCWS). The TCWS transfers heat generated in the Tokamak to cooling water during nominal pulsed operation 850 MW at up to 150 C and 4.2 MPa water pressure. This water contains radionuclides because impurities (e.g., tritium) diffuse from in-vessel components and the vacuum vessel by water baking at 200 240 C at up to 4.4MPa, and corrosion products become activated by neutron bombardment. The system is designated as safety important class (SIC) and will be fabricated to comply with the French Order concerning nuclearmore » pressure equipment (December 2005) and the EU Pressure Equipment Directive using ASME Section VIII, Div 2 design codes. The complexity of the TCWS design and fabrication presents unique challenges. Conceptual design of this one-of-a-kind cooling system has been completed with several issues that need to be resolved to move to next stage of the design. Those issues include flow balancing between over hundreds of branch pipelines in parallel to supply cooling water to blankets, determination of optimum flow velocity while minimizing the potential for cavitation damage, design for freezing protection for cooling water flowing through cryostat (freezing) environment, requirements for high-energy piping design, and electromagnetic impact to piping and components. Although the TCWS consists of standard commercial components such as piping with valves and fittings, heat exchangers, and pumps, complex requirements present interesting design challenges. This paper presents a brief description of TCWS conceptual design and critical design issues that need to be resolved.« less

The Science of Effectively Communicating about Drought in California

NASA Astrophysics Data System (ADS)

Gann, T. M.; Conklin, M. H.; Gonzales, J. P.; Matlock, T.

2014-12-01

The ongoing drought in California is having a tremendous impact on the state economy and the daily lives of its citizens. The impact of the drought is also exacerbated by the complexity of water issues in California, and the lack of understanding in the general public about this complexity. Our project has two goals, both focused on the broader issue of increasing the public's understanding of water issues by helping scientists engage more effectively with the public. The first is to use a survey to assess the perceptions of California residents regarding the ongoing drought affecting the state. The first portion of our survey allows our participants to share, in a free response format, their understanding of the causes, consequences, and potential solutions to the problems caused by drought. This allowed us to get some insight into how people view the drought prior to being lead by our questions, and allows us to conduct a detailed linguistic analysis of the text they provide. Next we asked a battery of questions meant to assess our participants' views on issues such as their views of water rights, the commoditization of water, and what role the government (both state and local) should play in managing California's water. The second goal is to use this data to create profiles that can then be used to more effectively communicate with and educate the public. Together, the results will provide new and valuable insights into how views of drought vary across stakeholders, and could inform policies related to water use. The presentation will include discussion of these results, their implications for best practices by science communicators, and potential impact on policy.

THE NGA-DOE GRANT TO EXAMINE CRITICAL ISSUES RELATED TO RADIOACTIVE WASTE AND MATERIALS DISPOSITION INVOLVING DOE FACILITIES

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

NONE

1998-01-01

Through the National Governors' Association (NGA) project ''Critical Issues Related to Radioactive Waste and Materials Disposition Involving DOE Facilities'' NGA brings together Governors' policy advisors, state regulators, and DOE officials to examine critical issues related to the cleanup and operation of DOE nuclear weapons and research facilities. Topics explored through this project include: Decisions involving disposal of mixed, low-level, and transuranic (TRU) waste and disposition of nuclear materials. Decisions involving DOE budget requests and their effect on environmental cleanup and compliance at DOE facilities. Strategies to treat mixed, low-level, and transuranic (TRU) waste and their effect on individual sites inmore » the complex. Changes to the FFCA site treatment plans as a result of proposals in the EM 2006 cleanup plans and contractor integration analysis. Interstate waste and materials shipments. Reforms to existing RCRA and CERCLA regulations/guidance to address regulatory overlap and risks posed by DOE wastes. The overarching theme of this project is to help the Department improve coordination of its major program decisions with Governors' offices and state regulators and to ensure such decisions reflect input from these key state officials and stakeholders. This report summarizes activities conducted during the quarter from October 1, 1997 through December 31, 1997, under the NGA project. The work accomplished by the NGA project team during the past four months can be categorized as follows: maintained open communication with DOE on a variety of activities and issues within the DOE environmental management complex; and maintained communication with NGA Federal Facilities Compliance Task Force members regarding DOE efforts to formulate a configuration for mixed low-level waste and low-level treatment and disposal, DOE activities in the area of the Hazardous Waste Identification Rule, and DOE's proposed National Dialogue.« less

DEVELOPMENT OF A PASSIVE, IN SITU, INTEGRATIVE ...

EPA Pesticide Factsheets

Until recently, hydrophobic, bioconcentratable compounds have been the primary focus of most environmental organic contaminant investigations, There is an increasing realization that a holistic hazard assessment of complex environmental contaminant mixtures requires data on the concentrations of hydrophilic organic contaminants as well. This group of compounds includes a wide variety of chemicals, including potentially endocrine disrupting and estrogenic contaminants which have been shown to contribute to numerous abnormalities such as impaired reproduction in aquatic organisms exposed in environmental waters. To address this issue, we developed a passive, in situ, sampling device (the Polar Organic Chemical Integrative Sampler or POCIS) which integratively concentrates trace levels of complex mixtures of hydrophilic environmental contaminants, enables the determination of their time-weighted average water concentrations and provides a screening assessment of the toxicological significance of the complex mixture of waterborne contaminants. Using a prototype sampler (effective membrane sampling surface area = 18.2 cm 2) linear uptake of selected herbicides and pharmaceuticals was observed for up to 56 days. Estimation of the ambient water concentrations of chemicals of interest is achieved by using appropriate uptake models and determination of POCIS chemical sampling rates. The research focused on in the subtasks is the development and application of state-of

Issues and Answers about Section 504: Part 2.

ERIC Educational Resources Information Center

American School and University, 1979

1979-01-01

The second of several installments that address the complex issues and questions related to the implementation of the requirement that persons should have equal educational opportunity despite handicaps. (Author/MLF)

Issues promoting and hindering girls' well-being in Northern Finland.

PubMed

Wiens, Varpu; Kyngäs, Helvi; Pölkki, Tarja

2017-08-01

Well-being is a complex concept that includes elements of inequality due to socio-economics, living environment or gender. Every person also encounters unique situations and has different experiences of well-being. This qualitative study aims to describe what issues promote and hinder the well-being of girls aged 13-16 in Northern Finland. A total of 117 girls aged 13-16 living in Northern Finland were asked to write about the issues that hinder and promote their well-being. The girls' responses were analysed using content analysis. After analysis, two combining categories were discovered: issues hindering well-being were a debilitating sphere of life and negative experiences in life, and issues promoting well-being were positive subjective sensations and favourably perceived conditions. The results of this study indicate that girls' well-being is connected to their social and physical environment. As the girls' view of the issues that promote or hinder health are connected and interact with their living environment, there is also a need for health promotion measures to take into account both the individuals and the environment in which they function and live. This view challenges us to see health promotion in a broader way-a way which takes into account structural and political factors, individual consultation and empowerment. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Ethics support for GPs: what should it look like?

PubMed

Clark-Grill, Monika

2016-03-01

INTRODUCTION Ethics support services for hospital clinicians have become increasingly common globally but not as yet in New Zealand. However, an initiative to change this is gathering momentum. Its slogan 'Clinical ethics is everyone's business' indicates that the aim is to encompass all of health care, not just the hospital sector. General Practitioners (GPs) deal with ethical issues on a daily basis. These issues are often quite different from ethical issues in hospitals. To make future ethics support relevant for primary care, local GPs were interviewed to find out how they might envisage ethics support services that could be useful to them. METHODS A focus group interview with six GPs and semi-structured individual interviews with three GPs were conducted. Questions included how they made decisions on ethical issues at present, what they perceived as obstacles to ethical reflection and decision-making, and what support might be helpful. FINDINGS Three areas of ethics support were considered potentially useful: Formal ethics education during GP training, access to an ethicist for assistance with analysing an ethical issue, and professional guidance with structured ethics conversations in peer groups. CONCLUSION The complex nature of general practice requires GPs to be well educated and supported for handling ethical issues. The findings from this study could serve as input to the development of ethics support services. KEYWORDS General practice; primary care; ethics; support; education.

Viruses and mobile elements as drivers of evolutionary transitions

PubMed Central

2016-01-01

The history of life is punctuated by evolutionary transitions which engender emergence of new levels of biological organization that involves selection acting at increasingly complex ensembles of biological entities. Major evolutionary transitions include the origin of prokaryotic and then eukaryotic cells, multicellular organisms and eusocial animals. All or nearly all cellular life forms are hosts to diverse selfish genetic elements with various levels of autonomy including plasmids, transposons and viruses. I present evidence that, at least up to and including the origin of multicellularity, evolutionary transitions are driven by the coevolution of hosts with these genetic parasites along with sharing of ‘public goods’. Selfish elements drive evolutionary transitions at two distinct levels. First, mathematical modelling of evolutionary processes, such as evolution of primitive replicator populations or unicellular organisms, indicates that only increasing organizational complexity, e.g. emergence of multicellular aggregates, can prevent the collapse of the host–parasite system under the pressure of parasites. Second, comparative genomic analysis reveals numerous cases of recruitment of genes with essential functions in cellular life forms, including those that enable evolutionary transitions. This article is part of the themed issue ‘The major synthetic evolutionary transitions’. PMID:27431520

Viruses and mobile elements as drivers of evolutionary transitions.

PubMed

Koonin, Eugene V

2016-08-19

The history of life is punctuated by evolutionary transitions which engender emergence of new levels of biological organization that involves selection acting at increasingly complex ensembles of biological entities. Major evolutionary transitions include the origin of prokaryotic and then eukaryotic cells, multicellular organisms and eusocial animals. All or nearly all cellular life forms are hosts to diverse selfish genetic elements with various levels of autonomy including plasmids, transposons and viruses. I present evidence that, at least up to and including the origin of multicellularity, evolutionary transitions are driven by the coevolution of hosts with these genetic parasites along with sharing of 'public goods'. Selfish elements drive evolutionary transitions at two distinct levels. First, mathematical modelling of evolutionary processes, such as evolution of primitive replicator populations or unicellular organisms, indicates that only increasing organizational complexity, e.g. emergence of multicellular aggregates, can prevent the collapse of the host-parasite system under the pressure of parasites. Second, comparative genomic analysis reveals numerous cases of recruitment of genes with essential functions in cellular life forms, including those that enable evolutionary transitions.This article is part of the themed issue 'The major synthetic evolutionary transitions'. © 2016 The Authors.

Lessons learned studying design issues for lunar and Mars settlements

NASA Technical Reports Server (NTRS)

Litton, C. E.

1997-01-01

In a study of lunar and Mars settlement concepts, an analysis was made of fundamental design assumptions in five technical areas against a model list of occupational and environmental health concerns. The technical areas included the proposed science projects to be supported, habitat and construction issues, closed ecosystem issues, the "MMM" issues (mining, material processing, and manufacturing), and the human elements of physiology, behavior, and mission approach. Four major lessons were learned. First it is possible to relate public health concerns to complex technological development in a proactive design mode, which has the potential for long-term cost savings. Second, it became very apparent that prior to committing any nation or international group to spending the billions to start and complete a lunar settlement, over the next century, that a significantly different approach must be taken from those previously proposed, to solve the closed ecosystem and "MMM" problems. Third, it also appears that the health concerns and technology issues to be addressed for human exploration into space are fundamentally those to be solved for human habitation of the Earth (as a closed ecosystem) in the 21st century. Finally, it is proposed that ecosystem design modeling must develop new tools, based on probabilistic models as a step up from closed circuit models.

Lessons learned studying design issues for lunar and Mars settlements.

PubMed

Litton, C E

1997-01-01

In a study of lunar and Mars settlement concepts, an analysis was made of fundamental design assumptions in five technical areas against a model list of occupational and environmental health concerns. The technical areas included the proposed science projects to be supported, habitat and construction issues, closed ecosystem issues, the "MMM" issues (mining, material processing, and manufacturing), and the human elements of physiology, behavior, and mission approach. Four major lessons were learned. First it is possible to relate public health concerns to complex technological development in a proactive design mode, which has the potential for long-term cost savings. Second, it became very apparent that prior to committing any nation or international group to spending the billions to start and complete a lunar settlement, over the next century, that a significantly different approach must be taken from those previously proposed, to solve the closed ecosystem and "MMM" problems. Third, it also appears that the health concerns and technology issues to be addressed for human exploration into space are fundamentally those to be solved for human habitation of the Earth (as a closed ecosystem) in the 21st century. Finally, it is proposed that ecosystem design modeling must develop new tools, based on probabilistic models as a step up from closed circuit models.

Psychosocial assistance after environmental accidents: a policy perspective.

PubMed Central

Becker, S M

1997-01-01

There is a substantial body of literature on psychosocial impacts of chemical and nuclear accidents. Less attention, however, has been focused on the program and policy issues that are connected with efforts to provide psychosocial assistance to the victims of such accidents. Because psychosocial assistance efforts are certain to be an essential part of the response to future environmental emergencies, it is vital that relevant program and policy issues by more fully considered. This article discusses the highly complex nature of contamination situations and highlights some of the key policy issues that are associated with the provision of psychosocial services after environmental accidents. One issue concerns the potential for assistance efforts to become objects of conflict. In the context of the intense controversy typically associated with chemical or nuclear accidents, and with debates over the causation of illness usually at the center of environmental accidents, psychosocial assistance services may themselves become contested terrain. Other significant program and policy issues include determining how to interface with citizen self-help and other voluntary groups, addressing the problem of stigma, and deciding how to facilitate stakeholder participation in the shaping of service provision. This article offers a series of policy proposals that may help smooth the way for psychosocial assistance programs in future environmental emergencies. PMID:9467082

Closure of population biobanks and direct-to-consumer genetic testing companies.

PubMed

Zawati, Ma'n H; Borry, Pascal; Howard, Heidi Carmen

2011-09-01

Genetic research gained new momentum with the completion of the Human Genome Project in 2003. Formerly centered on the investigation of single-gene disorders, genetic research is increasingly targeting common complex diseases and in doing so is studying the whole genome, the environment and its impact on genomic variation. Consequently, biobanking initiatives have emerged around the world as a tool to sustain such progress. Whether they are small scale or longitudinal, public or private, commercial or non-commercial, biobanks should consider the possibility of closure. Interestingly, while raising important ethical issues, this topic has hardly been explored in the literature. Indeed, ethical issues associated with sale, insolvency, end of funding, or transfer of materials to other entities (which are all issues either related to or possible consequences of closure) are seldom the subject of discussion. In an attempt to fill this gap, this paper will discuss-using population and direct-to-consumer (DTC) genetic testing companies' biobanks as case studies-(1) international and national normative documents addressing the issue of closure and (2) the internal policies of population biobanks and DTC genetic testing companies. The analysis will inform the debate on biobank closure and elucidate the underlying ethical issues, which include, but are not limited to informed consent, storage and privacy.

Land contestation in Karachi and the impact on housing and urban development

PubMed Central

Hasan, Arif

2015-01-01

Karachi is one of the world’s fastest growing large cities. This paper describes the complex processes by which land is (formally and informally) made available for housing (and for commercial development), as well as who benefits – and how the low-income majority of Karachi citizens lose out. It also describes what underpins this – especially the political complications in a city that has grown so rapidly, has had fundamental changes in its ethnic composition (and thus also in its politics) and has attracted so many illegal immigrants. The paper describes the changes in formal and informal land markets over the last 50 years and the changing responses by government agencies to housing (and land for housing) issues. Also explored are the connections among land, housing and transport (which include different processes of densification) and the complex politics involved. The paper ends with recommendations for land titling, for changes in transport policies, for better use of land already owned by government agencies, for cross-political party agreement on how to address serious security issues (that are leading to loss of investment) and for increased political effectiveness of Karachi’s active civil society organizations. PMID:26321797

Moving sociohydrology forward: a synthesis across studies

NASA Astrophysics Data System (ADS)

Troy, T. J.; Konar, M.; Srinivasan, V.; Thompson, S.

2015-08-01

Sociohydrology is the study of coupled human-water systems, building on the premise that water and human systems co-evolve: the state of the water system feeds back onto the human system, and vice versa, a situation denoted as "two-way coupling". A recent special issue in HESS/ESD, "Predictions under change: water, earth, and biota in the Anthropocene", includes a number of sociohydrologic publications that allow for a survey of the current state of understanding of sociohydrology and the dynamics and feedbacks that couple water and human systems together, of the research methodologies being employed to date, and of the normative and ethical issues raised by the study of sociohydrologic systems. Although sociohydrology is concerned with coupled human-water systems, the feedback may be filtered by a connection through natural or social systems, for example, the health of a fishery or through the global food trade, and therefore it may not always be possible to treat the human-water system in isolation. As part of a larger complex system, sociohydrology can draw on tools developed in the social-ecological and complex systems literature to further our sociohydrologic knowledge, and this is identified as a ripe area of future research.

Automation of multi-agent control for complex dynamic systems in heterogeneous computational network

NASA Astrophysics Data System (ADS)

Oparin, Gennady; Feoktistov, Alexander; Bogdanova, Vera; Sidorov, Ivan

2017-01-01

The rapid progress of high-performance computing entails new challenges related to solving large scientific problems for various subject domains in a heterogeneous distributed computing environment (e.g., a network, Grid system, or Cloud infrastructure). The specialists in the field of parallel and distributed computing give the special attention to a scalability of applications for problem solving. An effective management of the scalable application in the heterogeneous distributed computing environment is still a non-trivial issue. Control systems that operate in networks, especially relate to this issue. We propose a new approach to the multi-agent management for the scalable applications in the heterogeneous computational network. The fundamentals of our approach are the integrated use of conceptual programming, simulation modeling, network monitoring, multi-agent management, and service-oriented programming. We developed a special framework for an automation of the problem solving. Advantages of the proposed approach are demonstrated on the parametric synthesis example of the static linear regulator for complex dynamic systems. Benefits of the scalable application for solving this problem include automation of the multi-agent control for the systems in a parallel mode with various degrees of its detailed elaboration.

Scepticism and trust: two counterpoint essentials in science education for complex socio-scientific issues

NASA Astrophysics Data System (ADS)

Fensham, Peter J.

2014-09-01

In this response to Tom G. K. Bryce and Stephen P. Day's (Cult Stud Sci Educ. doi: 10.1007/s11422-013-9500-0, 2013) original article, I share with them their interest in the teaching of climate change in school science, but I widen it to include other contemporary complex socio-scientific issues that also need to be discussed. I use an alternative view of the relationship between science, technology and society, supported by evidence from both science and society, to suggest science-informed citizens as a more realistic outcome image of school science than the authors' one of mini-scientists. The intellectual independence of students Bryce and Day assume, and intend for school science, is countered with an active intellectual dependence. It is only in relation to emerging and uncertain scientific contexts that students should be taught about scepticism, but they also need to learn when, and why to trust science as an antidote to the expressions of doubting it. Some suggestions for pedagogies that could lead to these new learnings are made. The very recent fifth report of the IPCC answers many of their concerns about climate change.

Unresolved issues in the understanding of the pathogenesis of local tissue damage induced by snake venoms.

PubMed

Gutiérrez, José María; Rucavado, Alexandra; Escalante, Teresa; Herrera, Cristina; Fernández, Julián; Lomonte, Bruno; Fox, Jay W

2018-06-15

Snakebite envenoming by viperid species, and by some elapids, is characterized by a complex pattern of tissue damage at the anatomical site of venom injection. In severe cases, tissue destruction may be so extensive as to lead to permanent sequelae, with serious pathophysiological, social and psychological consequences. Significant advances have been performed in the study of venom-induced tissue damage, including identification and characterization of the toxins involved, insights into the mechanisms of action of venoms and toxins, and study of tissue responses to venom-induced injury. Nevertheless, much remains to be known and understood on the pathogenesis of these alterations. This review focuses on some of the pending issues in the topic of snake venom-induced local tissue damage. The traditional 'reductionist' approach, which has predominated in the study of snake venoms and their actions, needs to be complemented by more integrative and holistic perspectives aimed at capturing the complexity of these pathological alterations. Future advances in the study of these topics will certainly pave the way for innovative therapeutic interventions, with the goal of reducing the impact of this aspect of snakebite envenoming. Copyright © 2018 Elsevier Ltd. All rights reserved.

Dynamics and control of high precision magnetically levitated vibration isolation systems

NASA Technical Reports Server (NTRS)

Youcef-Toumi, K.; Yeh, T-J.

1992-01-01

Vibration control of flexible structures has received a great deal of interest in recent years. Several authors have investigated this topic in the areas of robot manipulators, space structures, and flexible rotors. Key issues associated with the dynamics and control of vibration isolation systems are addressed. Among other important issues to consider in the control of such systems, the location and number of actuators and sensors are essential to effectively control and suppress vibration. We first address the selection of proper actuator and sensor locations leading to a controllable and observable system. The Rayleigh-Ritz modal analysis method is used to develop a lumped-parameter model of a flexible vibration isolation table top. This model is then used to investigate the system's controllability and observability including the coupling effects introduced by the magnetic bearing. This analysis results in necessary and sufficient conditions for proper selection of actuator and sensor locations. These locations are also important for both controller system's complexity and stability of point of views. A favorable pole-zero plot of the open loop transfer functions is presented. Necessary and sufficient conditions for reducing the controller complexity are derived. The results are illustrated by examples using approximate mode shape functions.

Priorities for autism spectrum disorder risk communication and ethics.

PubMed

Yudell, Michael; Tabor, Holly K; Dawson, Geraldine; Rossi, John; Newschaffer, Craig

2013-11-01

Autism spectrum disorders are an issue of increasing public health significance. The incidence of autism spectrum disorders has been increasing in recent years, and they are associated with significant personal and financial impacts for affected persons and their families. In recent years, a large number of scientific studies have been undertaken, which investigate genetic and environmental risk factors for autism, with more studies underway. At present, much remains unknown regarding autism spectrum disorder risk factors, but the emerging picture of causation is in many cases complex, with multiple genes and gene-environment interactions being at play. The complexity and uncertainty surrounding autism spectrum disorder risk factors raise a number of questions regarding the ethical considerations that should be taken into account when undertaking autism spectrum disorder risk communication. At present, however, little has been written regarding autism spectrum disorder risk communication and ethics. This article summarizes the findings of a recent conference investigating ethical considerations and policy recommendations in autism spectrum disorder risk communication, which to the authors' knowledge is the first of its kind. Here, the authors discuss a number of issues, including uncertainty; comprehension; inadvertent harm; justice; and the appropriate roles of clinicians, scientists, and the media in autism spectrum disorder risk communication.

Challenges of Developing New Classes of NASA Self-Managing Mission

NASA Technical Reports Server (NTRS)

Hinchey, M. G.; Rash, J. I.; Truszkowski, W. F.; Rouff, C. A.; Sterritt, R.

2005-01-01

NASA is proposing increasingly complex missions that will require a high degree of autonomy and autonomicity. These missions pose hereto unforeseen problems and raise issues that have not been well-addressed by the community. Assuring success of such missions will require new software development techniques and tools. This paper discusses some of the challenges that NASA and the rest of the software development community are facing in developing these ever-increasingly complex systems. We give an overview of a proposed NASA mission as well as techniques and tools that are being developed to address autonomic management and the complexity issues inherent in these missions.

Space station Simulation Computer System (SCS) study for NASA/MSFC. Volume 6: Study issues report

NASA Technical Reports Server (NTRS)

1989-01-01

The Simulation Computer System (SCS) is the computer hardware, software, and workstations that will support the Payload Training Complex (PTC) at the Marshall Space Flight Center (MSFC). The PTC will train the space station payload specialists and mission specialists to operate the wide variety of experiments that will be on-board the Freedom Space Station. This simulation Computer System (SCS) study issues report summarizes the analysis and study done as task 1-identify and analyze the CSC study issues- of the SCS study contract.This work was performed over the first three months of the SCS study which began in August of 1988. First issues were identified from all sources. These included the NASA SOW, the TRW proposal, and working groups which focused the experience of NASA and the contractor team performing the study-TRW, Essex, and Grumman. The final list is organized into training related issues, and SCS associated development issues. To begin the analysis of the issues, a list of all the functions for which the SCS could be used was created, i.e., when the computer is turned on, what will it be doing. Analysis was continued by creating an operational functions matrix of SCS users vs. SCS functions to insure all the functions considered were valid, and to aid in identification of users as the analysis progressed. The functions will form the basis for the requirements, which are currently being developed under task 3 of the SCS study.

Leishmania infection: painful or painless?

PubMed

Borghi, Sergio M; Fattori, Victor; Conchon-Costa, Ivete; Pinge-Filho, Phileno; Pavanelli, Wander R; Verri, Waldiceu A

2017-02-01

The complex life cycle and immunopathological features underpinning the interaction of Leishmania parasites and their mammalian hosts poses frequent poorly explored and inconclusively resolved questions. The altered nociceptive signals over the course of leishmaniasis remain an intriguing issue for nociceptive and parasitology researchers. Experimental investigations have utilized behavioral, morphological, and neuro-immune approaches in the study of experimental cutaneous leishmaniasis (CL). The data generated indicates new venues for the study of the pathological characteristics of nociceptive processing in this parasitic disease. Leishmania-induced pain may be easily observed in mice and rats. However, nociceptive data is more complex in human investigations, including the occurrence of painless lesions in mucocutaneous and cutaneous leishmaniasis. Data from recent decades indicate that humans can also be affected by pain-related symptoms, often distinct from the region of body infection. The molecular and cellular mechanisms underlying such variable nociceptive states in humans during the course of leishmaniasis are an active area of research. The present article reviews nociception in leishmaniasis, including in experimental models of CL and clinical reports.

Tier-2 Optimisation for Computational Density/Diversity and Big Data

NASA Astrophysics Data System (ADS)

Fay, R. B.; Bland, J.

2014-06-01

As the number of cores on chip continues to trend upwards and new CPU architectures emerge, increasing CPU density and diversity presents multiple challenges to site administrators. These include scheduling for massively multi-core systems (potentially including Graphical Processing Units (GPU), integrated and dedicated) and Many Integrated Core (MIC)) to ensure a balanced throughput of jobs while preserving overall cluster throughput, as well as the increasing complexity of developing for these heterogeneous platforms, and the challenge in managing this more complex mix of resources. In addition, meeting data demands as both dataset sizes increase and as the rate of demand scales with increased computational power requires additional performance from the associated storage elements. In this report, we evaluate one emerging technology, Solid State Drive (SSD) caching for RAID controllers, with consideration to its potential to assist in meeting evolving demand. We also briefly consider the broader developing trends outlined above in order to identify issues that may develop and assess what actions should be taken in the immediate term to address those.

Evidence-based policy-making in the NHS: exploring the interface between research and the commissioning process.

PubMed

Harries, U; Elliott, H; Higgins, A

1999-03-01

The UK National Health Service (NHS) R&D strategy acknowledges the importance of developing an NHS where practice and policy is more evidence-based. This paper is based on a qualitative study which aimed to identify factors which facilitate or impede evidence-based policy-making at a local level in the NHS. The study involved a literature review and case studies of social research projects which were initiated by NHS health authority managers or general practitioner (GP) fundholders in one region of the NHS. Data were collected through in-depth interviews with lead policy-makers, GPs and researchers working on each of the case studies and analysis of project documentation. An over-arching theme from the analysis was that of the complexity of R&D in purchasing. The two worlds of research and health services management often sit uncomfortably together. For this reason it was not possible to describe a 'blueprint' for successful R&D, although several important issues emerged. These include sharing an appropriate model for research utilization, the importance of relationships in shaping R&D, the importance of influence and commitment in facilitating evidence-based change, and the resourcing of R&D in purchasing. These issues have important implications for the strategic development of R&D as well as for individual project application. Moving beyond the rhetoric of evidence-based policy-making is more likely if both policy-makers and researchers openly acknowledge this complexity and give due concern to the issues outlined.

Applying Critical Race Theory to Group Model Building Methods to Address Community Violence.

PubMed

Frerichs, Leah; Lich, Kristen Hassmiller; Funchess, Melanie; Burrell, Marcus; Cerulli, Catherine; Bedell, Precious; White, Ann Marie

2016-01-01

Group model building (GMB) is an approach to building qualitative and quantitative models with stakeholders to learn about the interrelationships among multilevel factors causing complex public health problems over time. Scant literature exists on adapting this method to address public health issues that involve racial dynamics. This study's objectives are to (1) introduce GMB methods, (2) present a framework for adapting GMB to enhance cultural responsiveness, and (3) describe outcomes of adapting GMB to incorporate differences in racial socialization during a community project seeking to understand key determinants of community violence transmission. An academic-community partnership planned a 1-day session with diverse stakeholders to explore the issue of violence using GMB. We documented key questions inspired by critical race theory (CRT) and adaptations to established GMB "scripts" (i.e., published facilitation instructions). The theory's emphasis on experiential knowledge led to a narrative-based facilitation guide from which participants created causal loop diagrams. These early diagrams depict how violence is transmitted and how communities respond, based on participants' lived experiences and mental models of causation that grew to include factors associated with race. Participants found these methods useful for advancing difficult discussion. The resulting diagrams can be tested and expanded in future research, and will form the foundation for collaborative identification of solutions to build community resilience. GMB is a promising strategy that community partnerships should consider when addressing complex health issues; our experience adapting methods based on CRT is promising in its acceptability and early system insights.

Quantitative Outcomes of a One Health approach to Study Global Health Challenges.

PubMed

Falzon, Laura C; Lechner, Isabel; Chantziaras, Ilias; Collineau, Lucie; Courcoul, Aurélie; Filippitzi, Maria-Eleni; Laukkanen-Ninios, Riikka; Peroz, Carole; Pinto Ferreira, Jorge; Postma, Merel; Prestmo, Pia G; Phythian, Clare J; Sarno, Eleonora; Vanantwerpen, Gerty; Vergne, Timothée; Grindlay, Douglas J C; Brennan, Marnie L

2018-03-01

Having gained momentum in the last decade, the One Health initiative promotes a holistic approach to address complex global health issues. Before recommending its adoption to stakeholders, however, it is paramount to first compile quantitative evidence of the benefit of such an approach. The aim of this scoping review was to identify and summarize primary research that describes monetary and non-monetary outcomes following adoption of a One Health approach. An extensive literature search yielded a total of 42,167 references, of which 85 were included in the final analysis. The top two biotic health issues addressed in these studies were rabies and malaria; the top abiotic health issue was air pollution. Most studies described collaborations between human and animal (n = 42), or human and environmental disciplines (n = 41); commonly reported interventions included vector control and animal vaccination. Monetary outcomes were commonly expressed as cost-benefit or cost-utility ratios; non-monetary outcomes were described using disease frequency or disease burden measurements. The majority of the studies reported positive or partially positive outcomes. This paper illustrates the variety of health challenges that can be addressed using a One Health approach, and provides tangible quantitative measures that can be used to evaluate future implementations of the One Health approach.

Training in reproductive health and sexuality: the case of a regional program in Latin America.

PubMed

Ramos, S; Gogna, M

1997-01-01

Beginning in July 1993, a 5-year program has sought to provide social research, training, and technical assistance in reproductive health and sexuality in Argentina, Chile, Peru, and Colombia by 1) building research capacity and promoting an interdisciplinary approach to reproductive health and sexuality and 2) promoting a gender perspective to these issues. The target groups are women's nongovernmental organizations (NGOs); family planning, reproductive health, and women's health providers; and social scientists conducting health-related research. Training activities include regional workshops, a Regional Resident Fellowship Program to support graduate-level education, and provision of technical assistance. The first 3 years of the program have revealed that the basic training needs in these areas include 1) helping women's NGOs improve their record-keeping capacity, evaluation processes, theoretical and methodological background, and institutional-building ability; 2) sensitizing women's health providers to sociocultural dimension of health-illness issues and to a gender and human rights perspective; and 3) training social scientist researchers to apply their skills in applied research, develop their theoretical background, and improve research quality control procedures. The main challenges for training activities in the field of reproductive health and sexuality are posed by the complexity of the issues and their interdisciplinary nature.

Implementation issues of the nearfield equivalent source imaging microphone array

NASA Astrophysics Data System (ADS)

Bai, Mingsian R.; Lin, Jia-Hong; Tseng, Chih-Wen

2011-01-01

This paper revisits a nearfield microphone array technique termed nearfield equivalent source imaging (NESI) proposed previously. In particular, various issues concerning the implementation of the NESI algorithm are examined. The NESI can be implemented in both the time domain and the frequency domain. Acoustical variables including sound pressure, particle velocity, active intensity and sound power are calculated by using multichannel inverse filters. Issues concerning sensor deployment are also investigated for the nearfield array. The uniform array outperformed a random array previously optimized for far-field imaging, which contradicts the conventional wisdom in far-field arrays. For applications in which only a patch array with scarce sensors is available, a virtual microphone approach is employed to ameliorate edge effects using extrapolation and to improve imaging resolution using interpolation. To enhance the processing efficiency of the time-domain NESI, an eigensystem realization algorithm (ERA) is developed. Several filtering methods are compared in terms of computational complexity. Significant saving on computations can be achieved using ERA and the frequency-domain NESI, as compared to the traditional method. The NESI technique was also experimentally validated using practical sources including a 125 cc scooter and a wooden box model with a loudspeaker fitted inside. The NESI technique proved effective in identifying broadband and non-stationary sources produced by the sources.

Does uncontrolled cardiac death for organ donation raise ethical questions? An opinion survey.

PubMed

Goudet, V; Albouy-Llaty, M; Migeot, V; Pain, B; Dayhot-Fizelier, C; Pinsard, M; Gil, R; Beloucif, S; Robert, R

2013-11-01

Organ donation after uncontrolled cardiac death raises complex ethical issues. We conducted a survey in a large hospital staff population, including caregivers and administrators, to determine their ethical viewpoints regarding organ donation after uncontrolled cardiac death. Multicenter observational survey using a questionnaire, including information on the practical modalities of the procedure. Respondents were asked to answer 15 detailed ethical questions corresponding to different ethical issues raised in the literature. Ethical concerns was defined when respondents expressed ethical concerns in their answers to at least three of nine specifically selected ethical questions. One thousand one hundred ninety-six questionnaires were received, and 1057 could be analysed. According to our definition, 573 respondents out of 1057 (54%) had ethical concerns with regard to donation after cardiac death and 484 (46 %) had no ethical concerns. Physicians (55%) and particularly junior intensivists (65%) tended to have more ethical issues than nurses (52%) and hospital managers (37%). Junior intensivists had more ethical issues than senior intensivists (59%), emergency room physicians (46%) and transplant specialists (43%). Only 46% of hospital-based caregivers and managers appear to accept easily the legitimacy of organ donation after cardiac death. A significant number of respondents especially intensivists, expressed concerns over the dilemma between the interests of the individual and those of society. These results underline the need to better inform both healthcare professionals and the general population to help to the development of such procedure. © 2013 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Ethics and Neuropsychiatric Genetics: A Review of Major Issues

PubMed Central

Hoge, Steven K.; Appelbaum, Paul S.

2012-01-01

Advances in neuropsychiatric genetics hold great hopes for improved prevention, diagnosis, and treatment. However, the power of genetic testing to identify individuals at increased risk for disorders and to convey information about relatives creates a set of complex ethical issues. Public attitudes are inevitably affected by the shadow of eugenics, with its history of distorting scientific findings to serve socio-political ends. Nonetheless, the growing availability of genetic tests means that more patients will seek genetic information, and physicians must manage the process of informed consent to allow meaningful decisions. Patients should be helped to understand the often-limited predictive power of current knowledge, potential psychological impact, risks of stigma and discrimination, and possible implications for family members. Decisions for predictive testing of children raise additional concerns, including distortions of family dynamics and negative effects on children’s self-image; testing is best deferred until adulthood unless preventive interventions exist. Pharmacogenomic testing, part of personalized medicine, may bring collateral susceptibility information for which patients should be prepared. The implications of genetic findings for families raise the question of whether physicians have duties to inform family members of implications for their health. Finally, participation in research in neuropsychiatric genetics evokes a broad range of ethical concerns, including the contentious issue of the extent to which results should be returned to individual subjects. As genetic science becomes more widely applied, the public will become more sophisticated and will be likely to demand a greater role in determining social policy on these issues. PMID:22272758

Initiation of insulin for type 2 diabetes mellitus patients: what are the issues? A qualitative study.

PubMed

Tan, A M; Muthusamy, L; Ng, C C; Phoon, K Y; Ow, J H; Tan, N C

2011-11-01

Type 2 diabetes mellitus is a progressive condition in which the pancreatic beta-cell function deteriorates with increasing duration of the disease. When good glycaemic control is not achieved despite adherence to oral hypoglycaemic drugs, healthy diet and lifestyle, insulin should be initiated. However, this is often delayed due to various reasons. We aimed to determine the issues relating to insulin initiation for diabetic patients managed in primary care polyclinics in Singapore. Qualitative data was obtained during four focus group discussions, with participation from healthcare professionals (HCPs), including physicians and nurses, and type 2 diabetes mellitus patients. The data was transcribed into text, coded and grouped into themes. Launching the topic and doctor-patient communication on insulin therapy were key issues in insulin initiation. Patient barriers to insulin commencement included: refusal to acknowledge the need for insulin therapy; its perception as a social stigma, an inconvenient mode of treatment or punishment for failure; and fear of needles, side-effects and complications. The HCP's attitude and experience with insulin therapy were also possible barriers. Our findings highlight that insulin initiation is affected by the complex interaction between the patients and HCPs, and other system factors. Patients may harbour misconceptions about insulin due to the late introduction of insulin therapy by HCPs or the way the therapy is being communicated to them. The key issues to address are the disparity in perceptions of diabetic control between HCPs and patients, and education regarding the need for insulin therapy.

Group Development and Integration in a Cross-Disciplinary and Intercultural Research Team.

PubMed

Kirk-Lawlor, Naomi; Allred, Shorna

2017-04-01

Cross-disciplinary research is necessary to solve many complex problems that affect society today, including problems involving linked social and environmental systems. Examples include natural resource management or scarcity problems, problematic effects of climate change, and environmental pollution issues. Intercultural research teams are needed to address many complex environmental matters as they often cross geographic and political boundaries, and involve people of different countries and cultures. It follows that disciplinarily and culturally diverse research teams have been organized to investigate and address environmental issues. This case study investigates a team composed of both monolingual and bilingual Chilean and US university researchers who are geoscientists, engineers and economists. The objective of this research team was to study both the natural and human parts of a hydrologic system in a hyper-arid region in northern Chile. Interviews (n = 8) addressed research questions focusing on the interaction of cross-disciplinary diversity and cultural diversity during group integration and development within the team. The case study revealed that the group struggled more with cross-disciplinary challenges than with intercultural ones. Particularly challenging ones were instances the of disciplinary crosstalk, or hidden misunderstandings, where team members thought they understood their cross-disciplinary colleagues, when in reality they did not. Results showed that translation served as a facilitator to cross-disciplinary integration of the research team. The use of translation in group meetings as a strategy for effective cross-disciplinary integration can be extended to monolingual cross-disciplinary teams as well.

Partnering to enhance interprofessional service-learning innovations and addictions recovery.

PubMed

Mihalynuk, T V; Soule Odegard, P; Kang, R; Kedzierski, M; Johnson Crowley, N

2007-11-01

Service-learning programs are reported to benefit students, faculty, higher education institutions, community agencies and the relationships among these groups. An interprofessional service-learning paradigm may strengthen these benefits. Community settings can expose students to social and cultural determinants of health, in addition to those biomedical determinants more commonly addressed in health sciences curricula. These experiences can also enhance student understanding of the complexities underlying treatment and prevention of modern health problems, particularly chronic diseases. The purpose of this initiative was to create and deliver interprofessional service-learning innovations that would enhance student learning and addictions recovery. To address this initiative, the University of Washington's Health Science Partnerships in Interdisciplinary Clinical Education (HSPICE) and the Salvation Army Adult Rehabilitation Center (ARC) began a community-campus partnership in 1997. Innovations took into account student educational objectives established by HSPICE which included: participation in interdisciplinary teams, in conjunction with community partners to identify and reduce population-based health issues, realization and articulation of biases regarding issues faced by the participating community, acquiring an understanding of the broader determinants of health and developing an understanding of why the complexity of population health requires interdisciplinary strategies for cost effectiveness. Findings are reported from evaluations, needs assessments and ongoing feedback of men recovering from addictions, as applied to health education materials and presentations developed for the ARC. Future directions are highlighted, including the need for further research and evaluation efforts aimed at rigorously assessing cost savings and student knowledge, skills and cultural sensitivity, among others.

Group Development and Integration in a Cross-Disciplinary and Intercultural Research Team

NASA Astrophysics Data System (ADS)

Kirk-Lawlor, Naomi; Allred, Shorna

2017-04-01

Cross-disciplinary research is necessary to solve many complex problems that affect society today, including problems involving linked social and environmental systems. Examples include natural resource management or scarcity problems, problematic effects of climate change, and environmental pollution issues. Intercultural research teams are needed to address many complex environmental matters as they often cross geographic and political boundaries, and involve people of different countries and cultures. It follows that disciplinarily and culturally diverse research teams have been organized to investigate and address environmental issues. This case study investigates a team composed of both monolingual and bilingual Chilean and US university researchers who are geoscientists, engineers and economists. The objective of this research team was to study both the natural and human parts of a hydrologic system in a hyper-arid region in northern Chile. Interviews ( n = 8) addressed research questions focusing on the interaction of cross-disciplinary diversity and cultural diversity during group integration and development within the team. The case study revealed that the group struggled more with cross-disciplinary challenges than with intercultural ones. Particularly challenging ones were instances the of disciplinary crosstalk, or hidden misunderstandings, where team members thought they understood their cross-disciplinary colleagues, when in reality they did not. Results showed that translation served as a facilitator to cross-disciplinary integration of the research team. The use of translation in group meetings as a strategy for effective cross-disciplinary integration can be extended to monolingual cross-disciplinary teams as well.

Unveiling network-based functional features through integration of gene expression into protein networks.

PubMed

Jalili, Mahdi; Gebhardt, Tom; Wolkenhauer, Olaf; Salehzadeh-Yazdi, Ali

2018-06-01

Decoding health and disease phenotypes is one of the fundamental objectives in biomedicine. Whereas high-throughput omics approaches are available, it is evident that any single omics approach might not be adequate to capture the complexity of phenotypes. Therefore, integrated multi-omics approaches have been used to unravel genotype-phenotype relationships such as global regulatory mechanisms and complex metabolic networks in different eukaryotic organisms. Some of the progress and challenges associated with integrated omics studies have been reviewed previously in comprehensive studies. In this work, we highlight and review the progress, challenges and advantages associated with emerging approaches, integrating gene expression and protein-protein interaction networks to unravel network-based functional features. This includes identifying disease related genes, gene prioritization, clustering protein interactions, developing the modules, extract active subnetworks and static protein complexes or dynamic/temporal protein complexes. We also discuss how these approaches contribute to our understanding of the biology of complex traits and diseases. This article is part of a Special Issue entitled: Cardiac adaptations to obesity, diabetes and insulin resistance, edited by Professors Jan F.C. Glatz, Jason R.B. Dyck and Christine Des Rosiers. Copyright © 2018 Elsevier B.V. All rights reserved.

Cognitive engineering models: A prerequisite to the design of human-computer interaction in complex dynamic systems

NASA Technical Reports Server (NTRS)

Mitchell, Christine M.

1993-01-01

This chapter examines a class of human-computer interaction applications, specifically the design of human-computer interaction for the operators of complex systems. Such systems include space systems (e.g., manned systems such as the Shuttle or space station, and unmanned systems such as NASA scientific satellites), aviation systems (e.g., the flight deck of 'glass cockpit' airplanes or air traffic control) and industrial systems (e.g., power plants, telephone networks, and sophisticated, e.g., 'lights out,' manufacturing facilities). The main body of human-computer interaction (HCI) research complements but does not directly address the primary issues involved in human-computer interaction design for operators of complex systems. Interfaces to complex systems are somewhat special. The 'user' in such systems - i.e., the human operator responsible for safe and effective system operation - is highly skilled, someone who in human-machine systems engineering is sometimes characterized as 'well trained, well motivated'. The 'job' or task context is paramount and, thus, human-computer interaction is subordinate to human job interaction. The design of human interaction with complex systems, i.e., the design of human job interaction, is sometimes called cognitive engineering.

Nanoscale Reaction Vessels Designed for Synthesis of Copper-Drug Complexes Suitable for Preclinical Development

PubMed Central

Wehbe, Mohamed; Anantha, Malathi; Backstrom, Ian; Leung, Ada; Chen, Kent; Malhotra, Armaan; Edwards, Katarina; Bally, Marcel B.

2016-01-01

The development of copper-drug complexes (CDCs) is hindered due to their very poor aqueous solubility. Diethyldithiocarbamate (DDC) is the primary metabolite of disulfiram, an approved drug for alcoholism that is being repurposed for cancer. The anticancer activity of DDC is dependent on complexation with copper to form copper bis-diethyldithiocarbamate (Cu(DDC)2), a highly insoluble complex that has not been possible to develop for indications requiring parenteral administration. We have resolved this issue by synthesizing Cu(DDC)2 inside liposomes. DDC crosses the liposomal lipid bilayer, reacting with the entrapped copper; a reaction that can be observed through a colour change as the solution goes from a light blue to dark brown. This method is successfully applied to other CDCs including the anti-parasitic drug clioquinol, the natural product quercetin and the novel targeted agent CX-5461. Our method provides a simple, transformative solution enabling, for the first time, the development of CDCs as viable candidate anticancer drugs; drugs that would represent a brand new class of therapeutics for cancer patients. PMID:27055237

Nanoscale Reaction Vessels Designed for Synthesis of Copper-Drug Complexes Suitable for Preclinical Development.

PubMed

Wehbe, Mohamed; Anantha, Malathi; Backstrom, Ian; Leung, Ada; Chen, Kent; Malhotra, Armaan; Edwards, Katarina; Bally, Marcel B

2016-01-01

The development of copper-drug complexes (CDCs) is hindered due to their very poor aqueous solubility. Diethyldithiocarbamate (DDC) is the primary metabolite of disulfiram, an approved drug for alcoholism that is being repurposed for cancer. The anticancer activity of DDC is dependent on complexation with copper to form copper bis-diethyldithiocarbamate (Cu(DDC)2), a highly insoluble complex that has not been possible to develop for indications requiring parenteral administration. We have resolved this issue by synthesizing Cu(DDC)2 inside liposomes. DDC crosses the liposomal lipid bilayer, reacting with the entrapped copper; a reaction that can be observed through a colour change as the solution goes from a light blue to dark brown. This method is successfully applied to other CDCs including the anti-parasitic drug clioquinol, the natural product quercetin and the novel targeted agent CX-5461. Our method provides a simple, transformative solution enabling, for the first time, the development of CDCs as viable candidate anticancer drugs; drugs that would represent a brand new class of therapeutics for cancer patients.

Complex Networks Analysis of Manual and Machine Translations

NASA Astrophysics Data System (ADS)

Amancio, Diego R.; Antiqueira, Lucas; Pardo, Thiago A. S.; da F. Costa, Luciano; Oliveira, Osvaldo N.; Nunes, Maria G. V.

Complex networks have been increasingly used in text analysis, including in connection with natural language processing tools, as important text features appear to be captured by the topology and dynamics of the networks. Following previous works that apply complex networks concepts to text quality measurement, summary evaluation, and author characterization, we now focus on machine translation (MT). In this paper we assess the possible representation of texts as complex networks to evaluate cross-linguistic issues inherent in manual and machine translation. We show that different quality translations generated by MT tools can be distinguished from their manual counterparts by means of metrics such as in- (ID) and out-degrees (OD), clustering coefficient (CC), and shortest paths (SP). For instance, we demonstrate that the average OD in networks of automatic translations consistently exceeds the values obtained for manual ones, and that the CC values of source texts are not preserved for manual translations, but are for good automatic translations. This probably reflects the text rearrangements humans perform during manual translation. We envisage that such findings could lead to better MT tools and automatic evaluation metrics.

Putting Text Complexity in Context: Refocusing on Comprehension of Complex Text

ERIC Educational Resources Information Center

Valencia, Sheila W.; Wixson, Karen K.; Pearson, P. David

2014-01-01

The Common Core State Standards for English Language Arts have prompted enormous attention to issues of text complexity. The purpose of this article is to put text complexity in perspective by moving from a primary focus on the text itself to a focus on the comprehension of complex text. We argue that a focus on comprehension is at the heart of…

Fifth-order complex Korteweg-de Vries-type equations

NASA Astrophysics Data System (ADS)

Khanal, Netra; Wu, Jiahong; Yuan, Juan-Ming

2012-05-01

This paper studies spatially periodic complex-valued solutions of the fifth-order Korteweg-de Vries (KdV)-type equations. The aim is at several fundamental issues including the existence, uniqueness and finite-time blowup problems. Special attention is paid to the Kawahara equation, a fifth-order KdV-type equation. When a Burgers dissipation is attached to the Kawahara equation, we establish the existence and uniqueness of the Fourier series solution with the Fourier modes decaying algebraically in terms of the wave numbers. We also examine a special series solution to the Kawahara equation and prove the convergence and global regularity of such solutions associated with a single mode initial data. In addition, finite-time blowup results are discussed for the special series solution of the Kawahara equation.

Planning and evaluation parameters for offshore complexes

NASA Technical Reports Server (NTRS)

Sincoff, M. Z. (Editor); Dajani, J. S. (Editor)

1976-01-01

Issues are presented for consideration in the planning and design of offshore artificial complexes. The construction of such complexes, their social, economic, and ecological impacts, and the legal-political-institutional environments within which their development could occur, are discussed. Planning, design, and construction of near-shore complexes located off the Mid-Atlantic coast of the United States is emphasized.

Literacy at a Distance in Multilingual Contexts: Issues and Challenges

ERIC Educational Resources Information Center

Ofulue, Christine I.

2011-01-01

Literacy is perhaps the most fundamental skill required for effective participation in education (formal and non-formal) for national development. At the same time, the choice of language for literacy is a complex issue in multilingual societies like Nigeria. This paper examines the issues involved, namely language policy, language and teacher…

Early Elementary Students' Understanding of Complex Ecosystems: A Learning Progression Approach

ERIC Educational Resources Information Center

Hokayem, Hayat; Gotwals, Amelia Wenk

2016-01-01

Engaging in systemic reasoning about ecological issues is critical for early elementary students to develop future understanding of critical environmental issues such as global warming and loss of biodiversity. However, ecological issues are rarely taught in ways to highlight systemic reasoning in elementary schools. In this study, we conducted…

The National Issues Forum: Bridging the Human Gap through Innovative Learning.

ERIC Educational Resources Information Center

McMahan, Eva M.

The National Issues Forum model, a series of community based public discussions on key domestic issues, may be a partial solution to the "human gap" between growing complexity and a capacity to deal with it, by exemplifying "innovative learning." To engage in innovative learning, characterized by anticipation and participation,…

The Role of Socioscientific Issues in Biology Teaching: From the Perspective of Teachers

ERIC Educational Resources Information Center

Tidemand, Sofie; Nielsen, Jan Alexis

2017-01-01

Previous research has documented that students who engage with socioscientific issues can acquire some of the complex competences and skills typically related to scientific literacy. But an emerging field of research on science teachers' understanding and use of socioscientific issues, has documented that a range of challenges hinders the uptake…

Implementing programs for chronic illness management: the case of hypertension services.

PubMed

Christianson, J B; Pietz, L; Taylor, R; Woolley, A; Knutson, D J

1997-11-01

This article describes the process by which HealthSystem Minnesota (a vertically integrated health care organization), functioning in a competitive managed care environment, has been implementing a hypertension services program. The program involves a team approach to care, with emphasis on patient participation in treatment; decentralized care delivery by nurse coordinators at primary care practice sites; ongoing training and education for patients and providers; and the continuous monitoring and evaluation of patient outcomes and satisfaction. JOB-LEVEL ISSUES: A variety of issues, such as the role and responsibilities of the nurse coordinator, became evident as the program moved towards operational status at four primary care practice sites, which prolonged the implementation period. PROCESS-LEVEL ISSUES: Issues relating to work process changes were more complicated to resolve and required, in some cases, changes in the proposed model. The most significant process-level issues related to educating physicians about the program to secure their participation and support. ORGANIZATION-LEVEL ISSUES: Such issues, which were the most difficult for program implementors to anticipate and resolve, included an organizational culture that emphasized decision making autonomy at primary practice sites. In part, the difficulty encountered in resolving organization-level issues reflected the implementors' lack of awareness of the strength or complexity of the environmental pressures facing the organization, as well as a lack of sensitivity to nuances relating to organizational culture. Two groups of hypertensive patients--at the implementation and comparison sites--will be compared with respect to satisfaction with care, clinical outcomes, and costs. Expansion of the model to patients with other chronic conditions is under consideration.

Public Engagement on Climate Change

NASA Astrophysics Data System (ADS)

Curry, J.

2011-12-01

Climate change communication is complicated by complexity of the scientific problem, multiple perspectives on the magnitude of the risk from climate change, often acrimonious disputes between scientists, high stakes policy options, and overall politicization of the issue. Efforts to increase science literacy as a route towards persuasion around the need for a policy like cap and trade have failed, because the difficulty that a scientist has in attempting to make sense of the social and political complexity is very similar to the complexity facing the general public as they try to make sense of climate science itself. In this talk I argue for a shift from scientists and their institutions as information disseminators to that of public engagement and enablers of public participation. The goal of engagement is not just to inform, but to enable, motivate and educate the public regarding the technical, political, and social dimensions of climate change. Engagement is a two-way process where experts and decision-makers seek input and learn from the public about preferences, needs, insights, and ideas relative to climate change impacts, vulnerabilities, solutions and policy options. Effective public engagement requires that scientists detach themselves from trying to control what the public does with the acquired knowledge and motivation. The goal should not be to "sell" the public on particular climate change solutions, since such advocacy threatens public trust in scientists and their institutions. Conduits for public engagement include the civic engagement approach in the context of community meetings, and perhaps more significantly, the blogosphere. Since 2006, I have been an active participant in the climate blogosphere, focused on engaging with people that are skeptical of AGW. A year ago, I started my own blog Climate Etc. at judithcurry.com. The demographic that I have focused my communication/engagement activities are the technically educated and scientifically literate public, many of whom have become increasingly skeptical of climate science the more they investigate the topic. Specific issues that this group has with climate science include concerns that science that cannot easily be separated from risk assessment and value judgments; concern that assessments (e.g. IPCC) have become a Maxwell's daemon for climate research; inadequate assessment of our ignorance of this complex scientific issue; elite scientists and scientific institutions losing credibility with the public; political exploitation of the public's lack of understanding; and concerns about the lack of public accountability of climate science and climate models that are being used as the basis for far reaching decisions and policies. Individuals in this group have the technical ability to understand and examine climate science arguments and are not prepared to cede judgment on this issue to the designated and self-proclaimed experts. This talk will describe my experiences in engaging with this group and what has been learned, both by myself and by participants in the discussion at Climate Etc.

Introduction to the Special Issue: Precarious Solidarity-Preferential Access in Canadian Health Care.

PubMed

Reid, Lynette

2017-06-01

Systems of universal health coverage may aspire to provide care based on need and not ability to pay; the complexities of this aspiration (conceptual, practical, and ethical) call for normative analysis. This special issue arises in the wake of a judicial inquiry into preferential access in the Canadian province of Alberta, the Vertes Commission. I describe this inquiry and set out a taxonomy of forms of differential and preferential access. Papers in this special issue focus on the conceptual specification of health system boundaries (the concept of medical need) and on the normative questions raised by complex models of funding and delivery of care, where patients, providers, and services cross system boundaries.

Towards a comprehensive framework for cosimulation of dynamic models with an emphasis on time stepping

NASA Astrophysics Data System (ADS)

Hoepfer, Matthias

Over the last two decades, computer modeling and simulation have evolved as the tools of choice for the design and engineering of dynamic systems. With increased system complexities, modeling and simulation become essential enablers for the design of new systems. Some of the advantages that modeling and simulation-based system design allows for are the replacement of physical tests to ensure product performance, reliability and quality, the shortening of design cycles due to the reduced need for physical prototyping, the design for mission scenarios, the invoking of currently nonexisting technologies, and the reduction of technological and financial risks. Traditionally, dynamic systems are modeled in a monolithic way. Such monolithic models include all the data, relations and equations necessary to represent the underlying system. With increased complexity of these models, the monolithic model approach reaches certain limits regarding for example, model handling and maintenance. Furthermore, while the available computer power has been steadily increasing according to Moore's Law (a doubling in computational power every 10 years), the ever-increasing complexities of new models have negated the increased resources available. Lastly, modern systems and design processes are interdisciplinary, enforcing the necessity to make models more flexible to be able to incorporate different modeling and design approaches. The solution to bypassing the shortcomings of monolithic models is cosimulation. In a very general sense, co-simulation addresses the issue of linking together different dynamic sub-models to a model which represents the overall, integrated dynamic system. It is therefore an important enabler for the design of interdisciplinary, interconnected, highly complex dynamic systems. While a basic co-simulation setup can be very easy, complications can arise when sub-models display behaviors such as algebraic loops, singularities, or constraints. This work frames the co-simulation approach to modeling and simulation. It lays out the general approach to dynamic system co-simulation, and gives a comprehensive overview of what co-simulation is and what it is not. It creates a taxonomy of the requirements and limits of co-simulation, and the issues arising with co-simulating sub-models. Possible solutions towards resolving the stated problems are investigated to a certain depth. A particular focus is given to the issue of time stepping. It will be shown that for dynamic models, the selection of the simulation time step is a crucial issue with respect to computational expense, simulation accuracy, and error control. The reasons for this are discussed in depth, and a time stepping algorithm for co-simulation with unknown dynamic sub-models is proposed. Motivations and suggestions for the further treatment of selected issues are presented.

Practical Implementation of Semi-Automated As-Built Bim Creation for Complex Indoor Environments

NASA Astrophysics Data System (ADS)

Yoon, S.; Jung, J.; Heo, J.

2015-05-01

In recent days, for efficient management and operation of existing buildings, the importance of as-built BIM is emphasized in AEC/FM domain. However, fully automated as-built BIM creation is a tough issue since newly-constructed buildings are becoming more complex. To manage this problem, our research group has developed a semi-automated approach, focusing on productive 3D as-built BIM creation for complex indoor environments. In order to test its feasibility for a variety of complex indoor environments, we applied the developed approach to model the `Charlotte stairs' in Lotte World Mall, Korea. The approach includes 4 main phases: data acquisition, data pre-processing, geometric drawing, and as-built BIM creation. In the data acquisition phase, due to its complex structure, we moved the scanner location several times to obtain the entire point clouds of the test site. After which, data pre-processing phase entailing point-cloud registration, noise removal, and coordinate transformation was followed. The 3D geometric drawing was created using the RANSAC-based plane detection and boundary tracing methods. Finally, in order to create a semantically-rich BIM, the geometric drawing was imported into the commercial BIM software. The final as-built BIM confirmed that the feasibility of the proposed approach in the complex indoor environment.

What is data ethics?

PubMed

Floridi, Luciano; Taddeo, Mariarosaria

2016-12-28

This theme issue has the founding ambition of landscaping data ethics as a new branch of ethics that studies and evaluates moral problems related to data (including generation, recording, curation, processing, dissemination, sharing and use), algorithms (including artificial intelligence, artificial agents, machine learning and robots) and corresponding practices (including responsible innovation, programming, hacking and professional codes), in order to formulate and support morally good solutions (e.g. right conducts or right values). Data ethics builds on the foundation provided by computer and information ethics but, at the same time, it refines the approach endorsed so far in this research field, by shifting the level of abstraction of ethical enquiries, from being information-centric to being data-centric. This shift brings into focus the different moral dimensions of all kinds of data, even data that never translate directly into information but can be used to support actions or generate behaviours, for example. It highlights the need for ethical analyses to concentrate on the content and nature of computational operations-the interactions among hardware, software and data-rather than on the variety of digital technologies that enable them. And it emphasizes the complexity of the ethical challenges posed by data science. Because of such complexity, data ethics should be developed from the start as a macroethics, that is, as an overall framework that avoids narrow, ad hoc approaches and addresses the ethical impact and implications of data science and its applications within a consistent, holistic and inclusive framework. Only as a macroethics will data ethics provide solutions that can maximize the value of data science for our societies, for all of us and for our environments.This article is part of the themed issue 'The ethical impact of data science'. © 2016 The Author(s).

What is data ethics?

PubMed Central

2016-01-01

This theme issue has the founding ambition of landscaping data ethics as a new branch of ethics that studies and evaluates moral problems related to data (including generation, recording, curation, processing, dissemination, sharing and use), algorithms (including artificial intelligence, artificial agents, machine learning and robots) and corresponding practices (including responsible innovation, programming, hacking and professional codes), in order to formulate and support morally good solutions (e.g. right conducts or right values). Data ethics builds on the foundation provided by computer and information ethics but, at the same time, it refines the approach endorsed so far in this research field, by shifting the level of abstraction of ethical enquiries, from being information-centric to being data-centric. This shift brings into focus the different moral dimensions of all kinds of data, even data that never translate directly into information but can be used to support actions or generate behaviours, for example. It highlights the need for ethical analyses to concentrate on the content and nature of computational operations—the interactions among hardware, software and data—rather than on the variety of digital technologies that enable them. And it emphasizes the complexity of the ethical challenges posed by data science. Because of such complexity, data ethics should be developed from the start as a macroethics, that is, as an overall framework that avoids narrow, ad hoc approaches and addresses the ethical impact and implications of data science and its applications within a consistent, holistic and inclusive framework. Only as a macroethics will data ethics provide solutions that can maximize the value of data science for our societies, for all of us and for our environments. This article is part of the themed issue ‘The ethical impact of data science’. PMID:28336805

Using flawed, uncertain, proximate and sparse (FUPS) data in the context of complexity: learning from the case of child mental health.

PubMed

Wolpert, Miranda; Rutter, Harry

2018-06-13

The use of routinely collected data that are flawed and limited to inform service development in healthcare systems needs to be considered, both theoretically and practically, given the reality in many areas of healthcare that only poor-quality data are available for use in complex adaptive systems. Data may be compromised in a range of ways. They may be flawed, due to missing or erroneously recorded entries; uncertain, due to differences in how data items are rated or conceptualised; proximate, in that data items are a proxy for key issues of concern; and sparse, in that a low volume of cases within key subgroups may limit the possibility of statistical inference. The term 'FUPS' is proposed to describe these flawed, uncertain, proximate and sparse datasets. Many of the systems that seek to use FUPS data may be characterised as dynamic and complex, involving a wide range of agents whose actions impact on each other in reverberating ways, leading to feedback and adaptation. The literature on the use of routinely collected data in healthcare is often implicitly premised on the availability of high-quality data to be used in complicated but not necessarily complex systems. This paper presents an example of the use of a FUPS dataset in the complex system of child mental healthcare. The dataset comprised routinely collected data from services that were part of a national service transformation initiative in child mental health from 2011 to 2015. The paper explores the use of this FUPS dataset to support meaningful dialogue between key stakeholders, including service providers, funders and users, in relation to outcomes of services. There is a particular focus on the potential for service improvement and learning. The issues raised and principles for practice suggested have relevance for other health communities that similarly face the dilemma of how to address the gap between the ideal of comprehensive clear data used in complicated, but not complex, contexts, and the reality of FUPS data in the context of complexity.

Opportunities for improving the nation's health through collaboration with the mass media.

PubMed Central

Arkin, E B

1990-01-01

Understanding the mass media is a prerequisite to gaining the cooperation of those who control access to media time and space to improve the coverage of health issues about which the public needs, and often wants, to know. To address the complexities of the mass media and how they influence the public's health, a group of Public Health Service agencies, foundations, and research institutions collaborated to review recent changes in the mass media and public health sectors and to recommend steps for increased interaction. These included broadening strategies to include paid advertising, media advocacy, and other tactics beyond public service campaigns; increasing awareness within the public health sector of the media's perspective on health; working collaboratively with media professionals and organizations, including the minority media; and developing guidelines for public-private sector partnerships. These recommendations, and factors affecting the roles of the media and public health communities in informing the public about health, are described in this paper. A complete discussion of these recommendations and related issues can be found in "Mass Media and Health," edited by Caroline McNeil and Elaine Bratic Arkin, a forthcoming publication of the Office of Disease Prevention and Health Promotion, Public Health Service. PMID:2113678

Primary Care Research in the Patient-Centered Outcomes Research Institute's Portfolio.

PubMed

Selby, Joe V; Slutsky, Jean R

2016-04-01

In their article in this issue, Mazur and colleagues analyze the characteristics of early recipients of funding from the Patient-Centered Outcomes Research Institute (PCORI). Mazur and colleagues note correctly that PCORI has a unique purpose and mission and suggest that it should therefore have a distinct portfolio of researchers and departments when compared with other funders such as the National Institutes of Health (NIH). Responding on behalf of PCORI, the authors of this Commentary agree with the characterization of PCORI's mission as distinct from that of NIH and others. They agree too that data found on PCORI's Web site demonstrate that PCORI's portfolio of researchers and departments is more diverse and more heavily populated with clinician researchers, as would be expected. The authors take issue with Mazur and colleagues' suggestion that because half of clinical visits occur within primary care settings, half of PCORI's funded research should be based in primary care departments. PCORI's portfolio reflects what patients and others tell PCORI are the critical questions. Many of these do, in fact, occur with more complex conditions in specialty care. The authors question whether the research of primary care departments is too narrowly focused and whether it sufficiently considers study of these complex conditions. Research on more complex conditions including heart failure, coronary artery disease, and multiple comorbid conditions could be highly valuable when approached from the primary care perspective, where many of the comparative effectiveness questions first arise.

Spatial Modeling of Geometallurgical Properties: Techniques and a Case Study

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

Deutsch, Jared L., E-mail: jdeutsch@ualberta.ca; Palmer, Kevin; Deutsch, Clayton V.

High-resolution spatial numerical models of metallurgical properties constrained by geological controls and more extensively by measured grade and geomechanical properties constitute an important part of geometallurgy. Geostatistical and other numerical techniques are adapted and developed to construct these high-resolution models accounting for all available data. Important issues that must be addressed include unequal sampling of the metallurgical properties versus grade assays, measurements at different scale, and complex nonlinear averaging of many metallurgical parameters. This paper establishes techniques to address each of these issues with the required implementation details and also demonstrates geometallurgical mineral deposit characterization for a copper–molybdenum deposit inmore » South America. High-resolution models of grades and comminution indices are constructed, checked, and are rigorously validated. The workflow demonstrated in this case study is applicable to many other deposit types.« less

Balancing traditional values in academic medicine with advances in science and technology.

PubMed

Fenderson, Bruce A; Fenderson, Douglas A

2004-06-01

Scientific discovery, population growth, and world commerce are converging to reshape medicine in unforeseen ways. Instead of responding passively to change we must embrace each challenge as an opportunity. Critical issues facing academic medicine today include a revolution in molecular biology and biotechnology, spiraling costs of health care, lack of consensus on a frame of reference for strategic planning (global versus local), and lack of appropriate methods of assessment (outcome analysis). These issues are complex and broad. Thus, it may be that the best that can emerge from our discussion is to identify the major dimensions along which progress may be expected and to predict ways in which change can be directed to serve the needs of health care institutions and medical professionals around the world. Solutions will require innovation in medical education, leadership, and international collaboration.