Multi-faceted identities and interactions in mixed health teams.

PubMed

Arieli, Daniella; Hirschfeld, Miriam J

2016-01-01

The literature in the area of the health workforce and societies in conflict encompasses a wide range of studies and potential directions. Lately, Keshet and Popper-Giveon reported on a study based on interviews with 13 Arab Israeli nurses who work in Israeli hospitals. This preliminary study describes how being an Arab nurse in Israel is experienced and perceived by those nurses. The results indicate the need for further studies on the complexity of health workers' experiences in their changing and multi-faceted professional, cultural, gender and national identities. In order to manage health systems, in particular in divided societies that are characterized by inter-group conflicts, special attention should be given to studying the everyday processes in mixed teams.

Selection and study performance: comparing three admission processes within one medical school.

PubMed

Schripsema, Nienke R; van Trigt, Anke M; Borleffs, Jan C C; Cohen-Schotanus, Janke

2014-12-01

This study was conducted to: (i) analyse whether students admitted to one medical school based on top pre-university grades, a voluntary multifaceted selection process, or lottery, respectively, differed in study performance; (ii) examine whether students who were accepted in the multifaceted selection process outperformed their rejected peers, and (iii) analyse whether participation in the multifaceted selection procedure was related to performance. We examined knowledge test and professionalism scores, study progress and dropout in three cohorts of medical students admitted to the University of Groningen, the Netherlands in 2009, 2010 and 2011 (n = 1055). We divided the lottery-admitted group into, respectively, students who had not participated and students who had been rejected in the multifaceted selection process. We used ancova modelling, logistic regression and Bonferroni post hoc multiple-comparison tests and controlled for gender and cohort. The top pre-university grade group achieved higher knowledge test scores and more Year 1 course credits than all other groups (p < 0.05). This group received the highest possible professionalism score more often than the lottery-admitted group that had not participated in the multifaceted selection process (p < 0.05). The group of students accepted in the multifaceted selection process obtained higher written test scores than the lottery-admitted group that had not participated (p < 0.05) and achieved the highest possible professionalism score more often than both lottery-admitted groups. The lottery-admitted group that had not participated in the multifaceted selection process earned fewer Year 1 and 2 course credits than all other groups (p < 0.05). Dropout rates differed among the groups (p < 0.05), but correction for multiple comparisons rendered all pairwise differences non-significant. A top pre-university grade point average was the best predictor of performance. For so-called non-academic performance, the multifaceted selection process was efficient in identifying applicants with suitable skills. Participation in the multifaceted selection procedure seems to be predictive of higher performance. Further research is needed to assess whether our results are generalisable to other medical schools. © 2014 John Wiley & Sons Ltd.

The Assembly Pathway of Mitochondrial Respiratory Chain Complex I.

PubMed

Guerrero-Castillo, Sergio; Baertling, Fabian; Kownatzki, Daniel; Wessels, Hans J; Arnold, Susanne; Brandt, Ulrich; Nijtmans, Leo

2017-01-10

Mitochondrial complex I is the largest integral membrane enzyme of the respiratory chain and consists of 44 different subunits encoded in the mitochondrial and nuclear genome. Its biosynthesis is a highly complicated and multifaceted process involving at least 14 additional assembly factors. How these subunits assemble into a functional complex I and where the assembly factors come into play is largely unknown. Here, we applied a dynamic complexome profiling approach to elucidate the assembly of human mitochondrial complex I and its further incorporation into respiratory chain supercomplexes. We delineate the stepwise incorporation of all but one subunit into a series of distinct assembly intermediates and their association with known and putative assembly factors, which had not been implicated in this process before. The resulting detailed and comprehensive model of complex I assembly is fully consistent with recent structural data and the remarkable modular architecture of this multiprotein complex. Copyright © 2017 Elsevier Inc. All rights reserved.

Egypt: Background and U.S. Relations

DTIC Science & Technology

2008-02-08

Hatshepsut tomb near Luxor in southern Egypt in November 1997, killing 58 foreign tourists and four Egyptians before committing suicide. Previously, Jamaah...U.S. Relations Summary This report provides an overview of Egyptian politics and current issues in U.S.- Egyptian relations. It briefly provides a... Egyptian relations are complex and multi-faceted, and this report addresses the following current topics: the Arab-Israeli peace process, Iraq, terrorism

Modern technologies of processing municipal solid waste: investing in the future

NASA Astrophysics Data System (ADS)

Rumyantseva, A.; Berezyuk, M.; Savchenko, N.; Rumyantseva, E.

2017-06-01

The problem of effective municipal solid waste (MSW) management is known to all the municipal entities of the Russian Federation. The problem is multifaceted and complex. The article analyzes the dynamics of municipal solid waste formation and its utilization within the territory of the EU and Russia. The authors of the paper suggest a project of a plant for processing municipal solid waste into a combustible gas with the help of high temperature pyrolysis. The main indicators of economic efficiency are calculated.

Organizing for the Future Requires the Non-Aristotelian Lens of a Dragonfly.

ERIC Educational Resources Information Center

Collins, Marla Del

To organize for the future requires non-Aristotelian thinking...a multifaceted wide-angle lens revealing hidden information. A multifaceted lens includes at least three general systems of evaluation, all of which promote complex thinking. The three systems are general semantics, postmodern feminist philosophy, and the unifying principle of…

Sports Coaching through the Ages with an Empirical Study of Predictors of Rowing Coaching Effectiveness

ERIC Educational Resources Information Center

Kiosoglous, Cameron Michael

2013-01-01

Coaching effectiveness is a result of a coach getting the best out of the people and resources in their environment. For coaches, learning from experience is vital in a role that is a complex, dynamic and multifaceted process of balancing fun and winning where one cannot be sure if results will go according to plan. At the Olympic level, due to…

USGS Capabilities to Study the Impacts of Drought and Climate Change in the Southeastern United States

USGS Publications Warehouse

,

2009-01-01

In the Southeast, U.S. Geological Survey (USGS) scientists are researching issues through technical studies of water availability and quality, geologic processes (marine, coastal, and terrestrial), geographic complexity, and biological resources. The USGS is prepared to tackle multifaceted questions associated with global climate change and resulting weather patterns such as drought through expert scientific skill, innovative research approaches, and accurate information technology.

2016 International Land Model Benchmarking (ILAMB) Workshop Report

NASA Technical Reports Server (NTRS)

Hoffman, Forrest M.; Koven, Charles D.; Keppel-Aleks, Gretchen; Lawrence, David M.; Riley, William J.; Randerson, James T.; Ahlstrom, Anders; Abramowitz, Gabriel; Baldocchi, Dennis D.; Best, Martin J.;

2016 International Land Model Benchmarking (ILAMB) Workshop Report

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

Hoffman, Forrest M.; Koven, Charles D.; Keppel-Aleks, Gretchen

As Earth system models become increasingly complex, there is a growing need for comprehensive and multi-faceted evaluation of model projections. To advance understanding of biogeochemical processes and their interactions with hydrology and climate under conditions of increasing atmospheric carbon dioxide, new analysis methods are required that use observations to constrain model predictions, inform model development, and identify needed measurements and field experiments. Better representations of biogeochemistry–climate feedbacks and ecosystem processes in these models are essential for reducing uncertainties associated with projections of climate change during the remainder of the 21st century.

Mitochondrial multifaceted dysfunction in schizophrenia; complex I as a possible pathological target.

PubMed

Ben-Shachar, Dorit

2017-09-01

Mitochondria are key players in various essential cellular processes beyond being the main energy supplier of the cell. Accordingly, they are involved in neuronal synaptic transmission, neuronal growth and sprouting and consequently neuronal plasticity and connectivity. In addition, mitochondria participate in the modulation of gene transcription and inflammation as well in physiological responses in health and disease. Schizophrenia is currently regarded as a neurodevelopmental disorder associated with impaired immune system, aberrant neuronal differentiation and abnormalities in various neurotransmitter systems mainly the dopaminergic, glutaminergic and GABAergic. Ample evidence has been accumulated over the last decade indicating a multifaceted dysfunction of mitochondria in schizophrenia. Indeed, mitochondrial deficit can be of relevance for the majority of the pathologies observed in this disease. In the present article, we overview specific deficits of the mitochondria in schizophrenia, with a focus on the first complex (complex I) of the mitochondrial electron transport chain (ETC). We argue that complex I, being a major factor in the regulation of mitochondrial ETC, is a possible key modulator of various functions of the mitochondria. We review biochemical, molecular, cellular and functional evidence for mitochondrial impairments and their possible convergence to impact in-vitro neuronal differentiation efficiency in schizophrenia. Mitochondrial function in schizophrenia may advance our knowledge of the disease pathophysiology and open the road for new treatment targets for the benefit of the patients. Copyright © 2016 Elsevier B.V. All rights reserved.

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.

Overlap and Differences in Brain Networks Underlying the Processing of Complex Sentence Structures in Second Language Users Compared with Native Speakers.

PubMed

Weber, Kirsten; Luther, Lisa; Indefrey, Peter; Hagoort, Peter

2016-05-01

When we learn a second language later in life, do we integrate it with the established neural networks in place for the first language or is at least a partially new network recruited? While there is evidence that simple grammatical structures in a second language share a system with the native language, the story becomes more multifaceted for complex sentence structures. In this study, we investigated the underlying brain networks in native speakers compared with proficient second language users while processing complex sentences. As hypothesized, complex structures were processed by the same large-scale inferior frontal and middle temporal language networks of the brain in the second language, as seen in native speakers. These effects were seen both in activations and task-related connectivity patterns. Furthermore, the second language users showed increased task-related connectivity from inferior frontal to inferior parietal regions of the brain, regions related to attention and cognitive control, suggesting less automatic processing for these structures in a second language.

The Home Stretch Almost! Science with the Hubble and James Webb Space Telescope V

NASA Technical Reports Server (NTRS)

Ochs, Bill

2017-01-01

JWST has Made tremendous progress in the last few years. JWST Is fully immersed in integration and test, but testing JWST is a formable challenge. JWST's size, complexity, and cryogenic characteristics require a multifaceted test plan to verify mission readiness. Each of these tests are opportunities to uncover issues which must be corrected to be able to move forward. All observatory control, science planning, and science data processing operational systems are on schedule.?

International Land Model Benchmarking (ILAMB) Workshop Report, Technical Report DOE/SC-0186

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

Hoffman, Forrest M.; Koven, Charles D.; Kappel-Aleks, Gretchen

2016-11-01

As Earth system models become increasingly complex, there is a growing need for comprehensive and multi-faceted evaluation of model projections. To advance understanding of biogeochemical processes and their interactions with hydrology and climate under conditions of increasing atmospheric carbon dioxide, new analysis methods are required that use observations to constrain model predictions, inform model development, and identify needed measurements and field experiments. Better representations of biogeochemistry–climate feedbacks and ecosystem processes in these models are essential for reducing uncertainties associated with projections of climate change during the remainder of the 21st century.

Physician leadership and quality improvement in the acute child and adolescent psychiatric care setting.

PubMed

Malloy, Erin; Butt, Shiraz; Sorter, Michael

2010-01-01

Inpatient child and adolescent psychiatry leadership roles are often multifaceted, necessitating strong clinical knowledge and skills, organizational and leadership abilities, and in the academic setting the desire and skill in teaching and research. Early career psychiatrists who do possess these attributes may find themselves unprepared for such challenges as dealing with complex administrative and economic issues, accreditation, legal matters, and multitasking. This article offers a primer addressing these basic issues and in managing change through quality improvement processes.

Challenges in treating post-traumatic stress disorder and attachment trauma.

PubMed

Allen, Jon G

2003-06-01

Treating women suffering from trauma poses significant challenges. The diagnostic prototype of post-traumatic stress disorder (PTSD) is based on single-event trauma, such as sexual assault in adulthood. Several effective cognitive- behavioral treatments for such traumas have been developed, although many treated patients continue to experience residual symptoms. Even more problematic is the complex developmental psychopathology stemming from a lifetime history of multiple traumas, often beginning with maltreatment in early attachment relationships. A history of attachment trauma undermines the development of capacities to regulate emotional distress and thereby complicates the treatment of acute trauma in adulthood. Such complex trauma requires a multifaceted treatment approach that must balance processing of traumatic memories with strategies to contain the intense emotions this processing evokes. Moreover, conducting such treatment places therapists at risk for secondary trauma such that trauma therapists also must process this stressful experience and implement strategies to regulate their own distress.

Understanding Parkinson Disease: A Complex and Multifaceted Illness.

PubMed

Gopalakrishna, Apoorva; Alexander, Sheila A

2015-12-01

Parkinson disease is an incredibly complex and multifaceted illness affecting millions of people in the United States. Parkinson disease is characterized by progressive dopaminergic neuronal dysfunction and loss, leading to debilitating motor, cognitive, and behavioral symptoms. Parkinson disease is an enigmatic illness that is still extensively researched today to search for a better understanding of the disease, develop therapeutic interventions to halt or slow progression of the disease, and optimize patient outcomes. This article aims to examine in detail the normal function of the basal ganglia and dopaminergic neurons in the central nervous system, the etiology and pathophysiology of Parkinson disease, related signs and symptoms, current treatment, and finally, the profound impact of understanding the disease on nursing care.

Followers are not enough: a multifaceted approach to community detection in online social networks.

PubMed

Darmon, David; Omodei, Elisa; Garland, Joshua

2015-01-01

In online social media networks, individuals often have hundreds or even thousands of connections, which link these users not only to friends, associates, and colleagues, but also to news outlets, celebrities, and organizations. In these complex social networks, a 'community' as studied in the social network literature, can have very different meaning depending on the property of the network under study. Taking into account the multifaceted nature of these networks, we claim that community detection in online social networks should also be multifaceted in order to capture all of the different and valuable viewpoints of 'community.' In this paper we focus on three types of communities beyond follower-based structural communities: activity-based, topic-based, and interaction-based. We analyze a Twitter dataset using three different weightings of the structural network meant to highlight these three community types, and then infer the communities associated with these weightings. We show that interesting insights can be obtained about the complex community structure present in social networks by studying when and how these four community types give rise to similar as well as completely distinct community structure.

What Difference Does It Make? Implicit, Explicit and Complex Social Cognition in Autism Spectrum Disorders

ERIC Educational Resources Information Center

Schaller, Ulrich M.; Rauh, Reinhold

2017-01-01

We tested social cognition abilities of adolescents with autism spectrum disorders (ASD) and neurotypically developed peers (NTD). A multi-faceted test-battery including facial emotion categorization (FEC), classical false belief tasks (FBT), and complex social cognition (SC), yielded significantly lower accuracy rates for FEC and complex SC tasks…

A Call for a Multifaceted Approach to Language Learning Motivation Research: Combining Complexity, Humanistic, and Critical Perspectives

ERIC Educational Resources Information Center

Pigott, Julian

2012-01-01

In this paper I give an overview of recent developments in the L2 motivation field, in particular the movement away from quantitative, questionnaire-based methodologies toward smaller-scale qualitative studies incorporating concepts from complexity theory. While complexity theory provides useful concepts for exploring motivation in new ways, it…

Analytic network process model for sustainable lean and green manufacturing performance indicator

NASA Astrophysics Data System (ADS)

Aminuddin, Adam Shariff Adli; Nawawi, Mohd Kamal Mohd; Mohamed, Nik Mohd Zuki Nik

2014-09-01

Sustainable manufacturing is regarded as the most complex manufacturing paradigm to date as it holds the widest scope of requirements. In addition, its three major pillars of economic, environment and society though distinct, have some overlapping among each of its elements. Even though the concept of sustainability is not new, the development of the performance indicator still needs a lot of improvement due to its multifaceted nature, which requires integrated approach to solve the problem. This paper proposed the best combination of criteria en route a robust sustainable manufacturing performance indicator formation via Analytic Network Process (ANP). The integrated lean, green and sustainable ANP model can be used to comprehend the complex decision system of the sustainability assessment. The finding shows that green manufacturing is more sustainable than lean manufacturing. It also illustrates that procurement practice is the most important criteria in the sustainable manufacturing performance indicator.

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…

Complexities of Racial Identity Development for Asian Pacific Islander Desi American (APIDA) College Students

ERIC Educational Resources Information Center

Chan, Jason

2017-01-01

Higher education research increasingly acknowledges the multiple identities and communities within the Asian Pacific Islander Desi American (APIDA) student population. This chapter explores the complex and multifaceted aspects of APIDA students and offers key considerations for student affairs practitioners working with today's APIDA student…

Complex Instruction: A Model for Reaching Up--and Out

ERIC Educational Resources Information Center

Tomlinson, Carol Ann

2018-01-01

Complex Instruction is a multifaceted instructional model designed to provide highly challenging learning opportunities for students in heterogeneous classrooms. The model provides a rationale for and philosophy of creating equity of access to excellent curriculum and instruction for a broad range of learners, guidance for preparing students for…

Followers Are Not Enough: A Multifaceted Approach to Community Detection in Online Social Networks

PubMed Central

2015-01-01

In online social media networks, individuals often have hundreds or even thousands of connections, which link these users not only to friends, associates, and colleagues, but also to news outlets, celebrities, and organizations. In these complex social networks, a ‘community’ as studied in the social network literature, can have very different meaning depending on the property of the network under study. Taking into account the multifaceted nature of these networks, we claim that community detection in online social networks should also be multifaceted in order to capture all of the different and valuable viewpoints of ‘community.’ In this paper we focus on three types of communities beyond follower-based structural communities: activity-based, topic-based, and interaction-based. We analyze a Twitter dataset using three different weightings of the structural network meant to highlight these three community types, and then infer the communities associated with these weightings. We show that interesting insights can be obtained about the complex community structure present in social networks by studying when and how these four community types give rise to similar as well as completely distinct community structure. PMID:26267868

Elusive silane-alane complex [Si-H⋅⋅⋅Al]: isolation, characterization, and multifaceted frustrated Lewis pair type catalysis.

PubMed

Chen, Jiawei; Chen, Eugene Y-X

2015-06-01

The super acidity of the unsolvated Al(C6F5)3 enabled isolation of the elusive silane-alane complex [Si-H⋅⋅⋅Al], which was structurally characterized by spectroscopic and X-ray diffraction methods. The Janus-like nature of this adduct, coupled with strong silane activation, effects multifaceted frustrated-Lewis-pair-type catalysis. When compared with the silane-borane system, the silane-alane system offers unique features or clear advantages in the four types of catalytic transformations examined in this study, including: ligand redistribution of tertiary silanes into secondary and quaternary silanes, polymerization of conjugated polar alkenes, hydrosilylation of unactivated alkenes, and hydrodefluorination of fluoroalkanes. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Pacing and Self-regulation: Important Skills for Talent Development in Endurance Sports.

PubMed

Elferink-Gemser, Marije T; Hettinga, Florentina J

2017-07-01

Pacing has been characterized as a multifaceted goal-directed process of decision making in which athletes need to decide how and when to invest their energy during the race, a process essential for optimal performance. Both physiological and psychological characteristics associated with adequate pacing and performance are known to develop with age. Consequently, the multifaceted skill of pacing might be under construction throughout adolescence, as well. Therefore, the authors propose that the complex skill of pacing is a potential important performance characteristic for talented youth athletes that needs to be developed throughout adolescence. To explore whether pacing is a marker for talent and how talented athletes develop this skill in middle-distance and endurance sports, they aim to bring together literature on pacing and literature on talent development and self-regulation of learning. Subsequently, by applying the cyclical process of self-regulation to pacing, they propose a practical model for the development of performance in endurance sports in youth athletes. Not only is self-regulation essential throughout the process of reaching the long-term goal of athletic excellence, but it also seems crucial for the development of pacing skills within a race and the development of a refined performance template based on previous experiences. Coaches and trainers are advised to incorporate pacing as a performance characteristic in their talent-development programs by stimulating their athletes to reflect, plan, monitor, and evaluate their races on a regular basis to build performance templates and, as such, improve their performance.

How to help depressed older people living in residential care: a multifaceted shared-care intervention for late-life depression.

PubMed

Llewellyn-Jones, R H; Baikie, K A; Castell, S; Andrews, C L; Baikie, A; Pond, C D; Willcock, S M; Snowdon, J; Tennant, C C

2001-12-01

To describe a population-based, multifaceted shared-care intervention for late-life depression in residential care as a new model of geriatric practice, to outline its development and implementation, and to describe the lessons learned during the implementation process. A large continuing-care retirement community in Sydney, Australia, providing three levels of care (independent living units, assisted-living complexes, and nursing homes). The intervention was implemented for the entire non-nursing home population (residents in independent and assisted living: N = 1,466) of the facility and their health care providers. Of the 1,036 residents whowere eligible and agreed to be interviewed, 281 (27.1%) were classified as depressed according to the Geriatric Depression Scale. INTERVENTION DESCRIPTION: The intervention included: (a) multidisciplinary collaboration between primary care physicians, facility health care providers, and the local psychogeriatric service; (b) training for primary care physicians and other facility health care providers about detecting and managing depression; and (c) depression-related health education/promotion programs for residents. The intervention was widely accepted by residents and their health care providers, and was sustained and enhanced by the facility after the completion of the study. It is possible to implement and sustain a multifaceted shared-care intervention for late-life depression in a residential care facility where local psychogeriatric services are scarce, staff-to-resident ratios are low, and the needs of depressed residents are substantial.

Multifaceted free-space image distributor for optical interconnects in massively parrallel processing

NASA Astrophysics Data System (ADS)

Zhao, Feng; Frietman, Edward E. E.; Han, Zhong; Chen, Ray T.

1999-04-01

A characteristic feature of a conventional von Neumann computer is that computing power is delivered by a single processing unit. Although increasing the clock frequency improves the performance of the computer, the switching speed of the semiconductor devices and the finite speed at which electrical signals propagate along the bus set the boundaries. Architectures containing large numbers of nodes can solve this performance dilemma, with the comment that main obstacles in designing such systems are caused by difficulties to come up with solutions that guarantee efficient communications among the nodes. Exchanging data becomes really a bottleneck should al nodes be connected by a shared resource. Only optics, due to its inherent parallelism, could solve that bottleneck. Here, we explore a multi-faceted free space image distributor to be used in optical interconnects in massively parallel processing. In this paper, physical and optical models of the image distributor are focused on from diffraction theory of light wave to optical simulations. the general features and the performance of the image distributor are also described. The new structure of an image distributor and the simulations for it are discussed. From the digital simulation and experiment, it is found that the multi-faceted free space image distributing technique is quite suitable for free space optical interconnection in massively parallel processing and new structure of the multifaceted free space image distributor would perform better.

A Multifaceted Approach to Teamwork Assessment in an Undergraduate Business Program

ERIC Educational Resources Information Center

Kemery, Edward R.; Stickney, Lisa T.

2014-01-01

We describe a multifaceted, multilevel approach to teamwork learning and assessment. It includes teamwork knowledge, peer and self-appraisal of teamwork behavior, and individual and team performance on objective tests for teaching and assessing teamwork in an undergraduate business program. At the beginning of this semester-long process, students…

TMT approach to observatory software development process

NASA Astrophysics Data System (ADS)

Buur, Hanne; Subramaniam, Annapurni; Gillies, Kim; Dumas, Christophe; Bhatia, Ravinder

2016-07-01

The purpose of the Observatory Software System (OSW) is to integrate all software and hardware components of the Thirty Meter Telescope (TMT) to enable observations and data capture; thus it is a complex software system that is defined by four principal software subsystems: Common Software (CSW), Executive Software (ESW), Data Management System (DMS) and Science Operations Support System (SOSS), all of which have interdependencies with the observatory control systems and data acquisition systems. Therefore, the software development process and plan must consider dependencies to other subsystems, manage architecture, interfaces and design, manage software scope and complexity, and standardize and optimize use of resources and tools. Additionally, the TMT Observatory Software will largely be developed in India through TMT's workshare relationship with the India TMT Coordination Centre (ITCC) and use of Indian software industry vendors, which adds complexity and challenges to the software development process, communication and coordination of activities and priorities as well as measuring performance and managing quality and risk. The software project management challenge for the TMT OSW is thus a multi-faceted technical, managerial, communications and interpersonal relations challenge. The approach TMT is using to manage this multifaceted challenge is a combination of establishing an effective geographically distributed software team (Integrated Product Team) with strong project management and technical leadership provided by the TMT Project Office (PO) and the ITCC partner to manage plans, process, performance, risk and quality, and to facilitate effective communications; establishing an effective cross-functional software management team composed of stakeholders, OSW leadership and ITCC leadership to manage dependencies and software release plans, technical complexities and change to approved interfaces, architecture, design and tool set, and to facilitate effective communications; adopting an agile-based software development process across the observatory to enable frequent software releases to help mitigate subsystem interdependencies; defining concise scope and work packages for each of the OSW subsystems to facilitate effective outsourcing of software deliverables to the ITCC partner, and to enable performance monitoring and risk management. At this stage, the architecture and high-level design of the software system has been established and reviewed. During construction each subsystem will have a final design phase with reviews, followed by implementation and testing. The results of the TMT approach to the Observatory Software development process will only be preliminary at the time of the submittal of this paper, but it is anticipated that the early results will be a favorable indication of progress.

Harnessing complexity: taking advantage of context and relationships in dissemination of school-based interventions.

PubMed

Butler, Helen; Bowes, Glenn; Drew, Sarah; Glover, Sara; Godfrey, Celia; Patton, George; Trafford, Lea; Bond, Lyndal

2010-03-01

Schools and school systems are increasingly asked to use evidence-based strategies to promote the health and well-being of students. The dissemination of school-based health promotion research, however, offers particular challenges to conventional approaches to dissemination. Schools and education systems are multifaceted organizations that sit within constantly shifting broader contexts. This article argues that health promotion dissemination needs to be rethought for school communities as complex systems and that this requires understanding and harnessing the dynamic ecology of the sociopolitical context. In developing this argument, the authors draw on their experience of the dissemination process of a multilevel school-based intervention in a complex educational context. Building on this experience, they argue for the need to move beyond conventional dissemination strategies to a focus on active partnerships between developers and users of school-based intervention research and offer a conceptual tool for planning dissemination.

Cybersecurity vulnerabilities in medical devices: a complex environment and multifaceted problem

PubMed Central

Williams, Patricia AH; Woodward, Andrew J

2015-01-01

The increased connectivity to existing computer networks has exposed medical devices to cybersecurity vulnerabilities from which they were previously shielded. For the prevention of cybersecurity incidents, it is important to recognize the complexity of the operational environment as well as to catalog the technical vulnerabilities. Cybersecurity protection is not just a technical issue; it is a richer and more intricate problem to solve. A review of the factors that contribute to such a potentially insecure environment, together with the identification of the vulnerabilities, is important for understanding why these vulnerabilities persist and what the solution space should look like. This multifaceted problem must be viewed from a systemic perspective if adequate protection is to be put in place and patient safety concerns addressed. This requires technical controls, governance, resilience measures, consolidated reporting, context expertise, regulation, and standards. It is evident that a coordinated, proactive approach to address this complex challenge is essential. In the interim, patient safety is under threat. PMID:26229513

Cybersecurity vulnerabilities in medical devices: a complex environment and multifaceted problem.

PubMed

Williams, Patricia Ah; Woodward, Andrew J

2015-01-01

The increased connectivity to existing computer networks has exposed medical devices to cybersecurity vulnerabilities from which they were previously shielded. For the prevention of cybersecurity incidents, it is important to recognize the complexity of the operational environment as well as to catalog the technical vulnerabilities. Cybersecurity protection is not just a technical issue; it is a richer and more intricate problem to solve. A review of the factors that contribute to such a potentially insecure environment, together with the identification of the vulnerabilities, is important for understanding why these vulnerabilities persist and what the solution space should look like. This multifaceted problem must be viewed from a systemic perspective if adequate protection is to be put in place and patient safety concerns addressed. This requires technical controls, governance, resilience measures, consolidated reporting, context expertise, regulation, and standards. It is evident that a coordinated, proactive approach to address this complex challenge is essential. In the interim, patient safety is under threat.

A Multifaceted Approach to Investigating Pre-Task Planning Effects on Paired Oral Test Performance

ERIC Educational Resources Information Center

Nitta, Ryo; Nakatsuhara, Fumiyo

2014-01-01

Despite the growing popularity of paired format speaking assessments, the effects of pre-task planning time on performance in these formats are not yet well understood. For example, some studies have revealed the benefits of planning but others have not. Using a multifaceted approach including analysis of the process of speaking performance, the…

A Multi-Faceted Formative Assessment Approach: Better Recognising the Learning Needs of Students

ERIC Educational Resources Information Center

Jenkins, James O.

2010-01-01

Students are increasingly subject to a series of learning pressures that prevent effective engagement in assessment. Thus, the aim of this study was to create a multi-faceted formative assessment approach that better enabled students to engage in the assessment process. A formative assessment approach, consisting of six key initiatives, is…

Methodological challenges and analytic opportunities for modeling and interpreting Big Healthcare Data.

PubMed

Dinov, Ivo D

2016-01-01

Managing, processing and understanding big healthcare data is challenging, costly and demanding. Without a robust fundamental theory for representation, analysis and inference, a roadmap for uniform handling and analyzing of such complex data remains elusive. In this article, we outline various big data challenges, opportunities, modeling methods and software techniques for blending complex healthcare data, advanced analytic tools, and distributed scientific computing. Using imaging, genetic and healthcare data we provide examples of processing heterogeneous datasets using distributed cloud services, automated and semi-automated classification techniques, and open-science protocols. Despite substantial advances, new innovative technologies need to be developed that enhance, scale and optimize the management and processing of large, complex and heterogeneous data. Stakeholder investments in data acquisition, research and development, computational infrastructure and education will be critical to realize the huge potential of big data, to reap the expected information benefits and to build lasting knowledge assets. Multi-faceted proprietary, open-source, and community developments will be essential to enable broad, reliable, sustainable and efficient data-driven discovery and analytics. Big data will affect every sector of the economy and their hallmark will be 'team science'.

Beauty and the brain: culture, history and individual differences in aesthetic appreciation.

PubMed

Jacobsen, Thomas

2010-02-01

Human aesthetic processing entails the sensation-based evaluation of an entity with respect to concepts like beauty, harmony or well-formedness. Aesthetic appreciation has many determinants ranging from evolutionary, anatomical or physiological constraints to influences of culture, history and individual differences. There are a vast number of dynamically configured neural networks underlying these multifaceted processes of aesthetic appreciation. In the current challenge of successfully bridging art and science, aesthetics and neuroanatomy, the neuro-cognitive psychology of aesthetics can approach this complex topic using a framework that postulates several perspectives, which are not mutually exclusive. In this empirical approach, objective physiological data from event-related brain potentials and functional magnetic resonance imaging are combined with subjective, individual self-reports.

Beauty and the brain: culture, history and individual differences in aesthetic appreciation

PubMed Central

Jacobsen, Thomas

2010-01-01

Human aesthetic processing entails the sensation-based evaluation of an entity with respect to concepts like beauty, harmony or well-formedness. Aesthetic appreciation has many determinants ranging from evolutionary, anatomical or physiological constraints to influences of culture, history and individual differences. There are a vast number of dynamically configured neural networks underlying these multifaceted processes of aesthetic appreciation. In the current challenge of successfully bridging art and science, aesthetics and neuroanatomy, the neuro-cognitive psychology of aesthetics can approach this complex topic using a framework that postulates several perspectives, which are not mutually exclusive. In this empirical approach, objective physiological data from event-related brain potentials and functional magnetic resonance imaging are combined with subjective, individual self-reports. PMID:19929909

Mesenchymal cell differentiation and diseases: involvement of translin/TRAX complexes and associated proteins.

PubMed

Kasai, Masataka; Ishida, Reiko; Nakahara, Kazuhiko; Okumura, Ko; Aoki, Katsunori

2018-05-08

Translin and translin-associated factor X (translin/TRAX) proteins have been implicated in a variety of cellular activities central to nucleic acid metabolism. Accumulating evidence indicates that translin/TRAX complexes participate in processes ensuring the replication of DNA, as well as cell division. Significant progress has been made in understanding the roles of translin/TRAX complexes in RNA metabolism, such as through RNA-induced silencing complex activation or the microRNA depletion that occurs in Dicer deficiency. At the cellular level, translin-deficient (Tsn -/- ) mice display delayed endochondral ossification or progressive bone marrow failure with ectopic osteogenesis and adipogenesis, suggesting involvement in mesenchymal cell differentiation. In this review, we summarize the molecular and cellular functions of translin homo-octamer and translin/TRAX hetero-octamer. Finally, we discuss the multifaceted roles of translin, TRAX, and associated proteins in the healthy and disease states. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of The New York Academy of Sciences.

Transit Vehicles for National Parks : Selection Factors and Technologies.

DOT National Transportation Integrated Search

2003-03-31

Increasingly, national parks are purchasing and operating buses and other alternative : transportation vehicles to transport visitors to and from or within park boundaries. : Selecting alternative transportation vehicles is a complex, multi-faceted p...

Taking a Return to School: Using Self-Study to Learn about Teacher Educator Practice

ERIC Educational Resources Information Center

McDonough, Sharon

2017-01-01

The work of teacher educators is complex and multifaceted and requires knowledge of pedagogy and practice in both schools and teacher education institutions. This complexity, combined with calls for teacher educators to work in close partnership with schools, sees some in teacher education working in hybrid roles and across the boundaries of…

Morphological, kinetic, membrane biochemical and genetic aspects of intestinal enteroplasticity

PubMed Central

Drozdowski, Laurie A; Clandinin, M Tom; Thomson, Alan BR

2009-01-01

The process of intestinal adaptation (“enteroplasticity”) is complex and multifaceted. Although a number of trophic nutrients and non-nutritive factors have been identified in animal studies, successful, reproducible clinical trials in humans are awaited. Understanding mechanisms underlying this adaptive process may direct research toward strategies that maximize intestinal function and impart a true clinical benefit to patients with short bowel syndrome, or to persons in whom nutrient absorption needs to be maximized. In this review, we consider the morphological, kinetic and membrane biochemical aspects of enteroplasticity, focus on the importance of nutritional factors, provide an overview of the many hormones that may alter the adaptive process, and consider some of the possible molecular profiles. While most of the data is derived from rodent studies, wherever possible, the results of human studies of intestinal enteroplasticity are provided. PMID:19230039

Application of Intervention Mapping to the Development of a Complex Physical Therapist Intervention.

PubMed

Jones, Taryn M; Dear, Blake F; Hush, Julia M; Titov, Nickolai; Dean, Catherine M

2016-12-01

Physical therapist interventions, such as those designed to change physical activity behavior, are often complex and multifaceted. In order to facilitate rigorous evaluation and implementation of these complex interventions into clinical practice, the development process must be comprehensive, systematic, and transparent, with a sound theoretical basis. Intervention Mapping is designed to guide an iterative and problem-focused approach to the development of complex interventions. The purpose of this case report is to demonstrate the application of an Intervention Mapping approach to the development of a complex physical therapist intervention, a remote self-management program aimed at increasing physical activity after acquired brain injury. Intervention Mapping consists of 6 steps to guide the development of complex interventions: (1) needs assessment; (2) identification of outcomes, performance objectives, and change objectives; (3) selection of theory-based intervention methods and practical applications; (4) organization of methods and applications into an intervention program; (5) creation of an implementation plan; and (6) generation of an evaluation plan. The rationale and detailed description of this process are presented using an example of the development of a novel and complex physical therapist intervention, myMoves-a program designed to help individuals with an acquired brain injury to change their physical activity behavior. The Intervention Mapping framework may be useful in the development of complex physical therapist interventions, ensuring the development is comprehensive, systematic, and thorough, with a sound theoretical basis. This process facilitates translation into clinical practice and allows for greater confidence and transparency when the program efficacy is investigated. © 2016 American Physical Therapy Association.

EPA EMERGENCY PLANNING TOOLBOX

EPA Science Inventory

EPA's Office of Research and Development and Office of Water/Water Security Division have jointly developed a Response Protocol Toolbox (RPTB) to address the complex, multi-faceted challenges of a water utility's planning and response to intentional contamination of drinking wate...

Practical experience with the maintenance and auditing of a large medical ontology.

PubMed

Baorto, David; Li, Li; Cimino, James J

2009-06-01

The Medical Entities Dictionary (MED) has served as a unified terminology at New York Presbyterian Hospital and Columbia University for more than 20 years. It was initially created to allow the clinical data from the disparate information systems (e.g., radiology, pharmacy, and multiple laboratories, etc.) to be uniquely codified for storage in a single data repository, and functions as a real time terminology server for clinical applications and decision support tools. Being conceived as a knowledge base, the MED incorporates relationships among local terms, between local terms and external standards, and additional knowledge about terms in a semantic network structure. Over the past two decades, we have sought to develop methods to maintain, audit and improve the content of the MED, such that it remains true to its original design goals. This has resulted in a complex, multi-faceted process, with both manual and automated components. In this paper, we describe this process, with examples of its effectiveness. We believe that our process provides lessons for others who seek to maintain complex, concept-oriented controlled terminologies.

Practical Experience with the Maintenance and Auditing of a Large Medical Ontology

PubMed Central

Baorto, David; Li, Li; Cimino, James J.

2012-01-01

The Medical Entities Dictionary (MED) has served as a unified terminology at New York Presbyterian Hospital and Columbia University for more than 20 years. It was initially created to allow the clinical data from the disparate information systems (e.g., radiology, pharmacy, and multiple laboratories, etc) to be uniquely codified for storage in a single data repository, and functions as a real time terminology server for clinical applications and decision support tools. Being conceived as a knowledge base, the MED incorporates relationships among local terms, between local terms and external standards, and additional knowledge about terms in a semantic network structure. Over the past two decades, we have sought to develop methods to maintain, audit and improve the content of the MED, such that it remains true to its original design goals. This has resulted in a complex, multi-faceted process, with both manual and automated components. In this paper, we describe this process, with examples of its effectiveness. We believe that our process provides lessons for others who seek to maintain complex, concept-oriented controlled terminologies. PMID:19285569

A Phenomenological Study of Urban Search and Rescue Members Who Responded to a Disaster

ERIC Educational Resources Information Center

Kerns, Terry L.

2012-01-01

The complicated world of disaster management requires urban search and rescue (US&R) members to be well trained to respond to complex, unpredictable, and difficult to manage disasters anywhere in the world on short notice. Disasters are becoming more complex and difficult to manage as was witnessed by the multi-faceted disaster in Japan in…

Developing a Service Management Strategy Facilitated by Action Learning: An Empirical Study from the UK Health & Fitness Industry

ERIC Educational Resources Information Center

Oliver, John

2006-01-01

One of the principle tenets of action learning is that it provides the potential to explore and solve complex organisational problems. The question of how best to develop a future business strategy is such a problem. Existing literature on strategy making presents a multi-faceted debate, suggesting that the complexity of competitive environments…

The multifaceted influence of gender in career progress in nursing.

PubMed

Tracey, Catherine; Nicholl, Honor

2007-10-01

The complex web of gender influence in the workplace results from a multifaceted interplay of factors [Walby et al. (1994) Medicine and Nursing. Sage Publications, London]. Literature reports that in nursing men's success compared with that of women is disproportionate and substantial evidence of gender-based disadvantage is found [Women in Management Review13 (1998) 184]. However, studies have not addressed the specific reasons for this and little is known of how or what influences nurses' career decisions and developments [Journal of Advanced Nursing25 (1997) 602]. Those studies which examine career developments and patterns are mainly found in the private business sector.

Complex Dynamic Systems View on Conceptual Change: How a Picture of Students' Intuitive Conceptions Accrue from Dynamically Robust Task Dependent Learning Outcomes

ERIC Educational Resources Information Center

Koponen, Ismo T.; Kokkonen, Tommi; Nousiainen, Maiji

2017-01-01

We discuss here conceptual change and the formation of robust learning outcomes from the viewpoint of complex dynamic systems (CDS). The CDS view considers students' conceptions as context dependent and multifaceted structures which depend on the context of their application. In the CDS view the conceptual patterns (i.e. intuitive conceptions…

A Project Manager’s Personal Attributes as Predictors for Success

DTIC Science & Technology

2007-03-01

Northouse (2004) explains that leadership is highly a researched topic with much written. Yet, a definitive description of this phenomenon is difficult to...express because of its complexity. Even though leadership has varied descriptions and conceptualizations, Northouse states that the concept of...characteristic of leadership is not an accurate predictor of performance. Leadership is a complex, multi-faceted attribute ( Northouse , 2004) and specific

The operations manual: a mechanism for improving the research process.

PubMed

Bowman, Ann; Wyman, Jean F; Peters, Jennifer

2002-01-01

The development and use of an operations manual has the potential to improve the capacity of nurse scientists to address the complex, multifaceted issues associated with conducting research in today's healthcare environment. An operations manual facilitates communication, standardizes training and evaluation, and enhances the development and standard implementation of clear policies, processes, and protocols. A 10-year review of methodology articles in relevant nursing journals revealed no attention to this topic. This article will discuss how an operations manual can improve the conduct of research methods and outcomes for both small-scale and large-scale research studies. It also describes the purpose and components of a prototype operations manual for use in quantitative research. The operations manual increases reliability and reproducibility of the research while improving the management of study processes. It can prevent costly and untimely delays or errors in the conduct of research.

Developing a multi-systemic fall prevention model, incorporating the physical environment, the care process and technology: a systematic review.

PubMed

Choi, Young-Seon; Lawler, Erin; Boenecke, Clayton A; Ponatoski, Edward R; Zimring, Craig M

2011-12-01

This paper reports a review that assessed the effectiveness and characteristics of fall prevention interventions implemented in hospitals. A multi-systemic fall prevention model that establishes a practical framework was developed from the evidence. Falls occur through complex interactions between patient-related and environmental risk factors, suggesting a need for multifaceted fall prevention approaches that address both factors. We searched Medline, CINAHL, PsycInfo and the Web of Science databases for references published between January 1990 and June 2009 and scrutinized secondary references from acquired papers. Due to the heterogeneity of interventions and populations, we conducted a quantitative systematic review without a meta-analysis and used a narrative summary to report findings. From the review, three distinct characteristics of fall prevention interventions emerged: (1) the physical environment, (2) the care process and culture and (3) technology. While clinically significant evidence shows the efficacy of environment-related interventions in reducing falls and fall-related injuries, the literature identified few hospitals that had introduced environment-related interventions in their multifaceted fall intervention strategies. Using the multi-systemic fall prevention model, hospitals should promote a practical strategy that benefits from the collective effects of the physical environment, the care process and culture and technology to prevent falls and fall-related injuries. By doing so, they can more effectively address the various risk factors for falling and therefore, prevent falls. Studies that test the proposed model need to be conducted to establish the efficacy of the model in practice. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

MEVA--An Interactive Visualization Application for Validation of Multifaceted Meteorological Data with Multiple 3D Devices.

PubMed

Helbig, Carolin; Bilke, Lars; Bauer, Hans-Stefan; Böttinger, Michael; Kolditz, Olaf

2015-01-01

To achieve more realistic simulations, meteorologists develop and use models with increasing spatial and temporal resolution. The analyzing, comparing, and visualizing of resulting simulations becomes more and more challenging due to the growing amounts and multifaceted character of the data. Various data sources, numerous variables and multiple simulations lead to a complex database. Although a variety of software exists suited for the visualization of meteorological data, none of them fulfills all of the typical domain-specific requirements: support for quasi-standard data formats and different grid types, standard visualization techniques for scalar and vector data, visualization of the context (e.g., topography) and other static data, support for multiple presentation devices used in modern sciences (e.g., virtual reality), a user-friendly interface, and suitability for cooperative work. Instead of attempting to develop yet another new visualization system to fulfill all possible needs in this application domain, our approach is to provide a flexible workflow that combines different existing state-of-the-art visualization software components in order to hide the complexity of 3D data visualization tools from the end user. To complete the workflow and to enable the domain scientists to interactively visualize their data without advanced skills in 3D visualization systems, we developed a lightweight custom visualization application (MEVA - multifaceted environmental data visualization application) that supports the most relevant visualization and interaction techniques and can be easily deployed. Specifically, our workflow combines a variety of different data abstraction methods provided by a state-of-the-art 3D visualization application with the interaction and presentation features of a computer-games engine. Our customized application includes solutions for the analysis of multirun data, specifically with respect to data uncertainty and differences between simulation runs. In an iterative development process, our easy-to-use application was developed in close cooperation with meteorologists and visualization experts. The usability of the application has been validated with user tests. We report on how this application supports the users to prove and disprove existing hypotheses and discover new insights. In addition, the application has been used at public events to communicate research results.

MEVA - An Interactive Visualization Application for Validation of Multifaceted Meteorological Data with Multiple 3D Devices

PubMed Central

Helbig, Carolin; Bilke, Lars; Bauer, Hans-Stefan; Böttinger, Michael; Kolditz, Olaf

2015-01-01

Background To achieve more realistic simulations, meteorologists develop and use models with increasing spatial and temporal resolution. The analyzing, comparing, and visualizing of resulting simulations becomes more and more challenging due to the growing amounts and multifaceted character of the data. Various data sources, numerous variables and multiple simulations lead to a complex database. Although a variety of software exists suited for the visualization of meteorological data, none of them fulfills all of the typical domain-specific requirements: support for quasi-standard data formats and different grid types, standard visualization techniques for scalar and vector data, visualization of the context (e.g., topography) and other static data, support for multiple presentation devices used in modern sciences (e.g., virtual reality), a user-friendly interface, and suitability for cooperative work. Methods and Results Instead of attempting to develop yet another new visualization system to fulfill all possible needs in this application domain, our approach is to provide a flexible workflow that combines different existing state-of-the-art visualization software components in order to hide the complexity of 3D data visualization tools from the end user. To complete the workflow and to enable the domain scientists to interactively visualize their data without advanced skills in 3D visualization systems, we developed a lightweight custom visualization application (MEVA - multifaceted environmental data visualization application) that supports the most relevant visualization and interaction techniques and can be easily deployed. Specifically, our workflow combines a variety of different data abstraction methods provided by a state-of-the-art 3D visualization application with the interaction and presentation features of a computer-games engine. Our customized application includes solutions for the analysis of multirun data, specifically with respect to data uncertainty and differences between simulation runs. In an iterative development process, our easy-to-use application was developed in close cooperation with meteorologists and visualization experts. The usability of the application has been validated with user tests. We report on how this application supports the users to prove and disprove existing hypotheses and discover new insights. In addition, the application has been used at public events to communicate research results. PMID:25915061

The Language Situation in Macao

ERIC Educational Resources Information Center

Yan, Xi

2017-01-01

In postcolonial societies, forces associated with globalization operate along with local geopolitical changes. The complex and multifaceted interactions between local, national, and global forces may take different sociolinguistic shapes in postcolonial societies. This study provides an overview of the language situation in Macao. The Portuguese…

The Spiritual Development of Nonheterosexual Undergraduate Students

ERIC Educational Resources Information Center

Payne Gold, Shaunna

2010-01-01

Spiritual development and nonheterosexual identity development are both slippery topics that are individually complex and multifaceted. Scholars from various disciplines have called for a deeper understanding of the intersection of spirituality and nonheterosexual identity (Buchanan, Dzelme, Harris & Hecker, 2001; Love, Bock Jannarone, &…

Decoding molecular interactions in microbial communities

PubMed Central

Abreu, Nicole A.; Taga, Michiko E.

2016-01-01

Microbial communities govern numerous fundamental processes on earth. Discovering and tracking molecular interactions among microbes is critical for understanding how single species and complex communities impact their associated host or natural environment. While recent technological developments in DNA sequencing and functional imaging have led to new and deeper levels of understanding, we are limited now by our inability to predict and interpret the intricate relationships and interspecies dependencies within these communities. In this review, we highlight the multifaceted approaches investigators have taken within their areas of research to decode interspecies molecular interactions that occur between microbes. Understanding these principles can give us greater insight into ecological interactions in natural environments and within synthetic consortia. PMID:27417261

Factors that Predict Quality Classroom Technology Use

ERIC Educational Resources Information Center

Hastings, Tricia A.

2009-01-01

Despite technological advancements intended to enhance teaching and learning in the 21st century, numerous teacher and school factors continue to impede quality classroom technology use. Determining the effectiveness of educational technology is challenging and requires a detailed understanding of multifaceted, complex, contextual relationships.…

Can Multilayer Networks Advance Animal Behavior Research?

PubMed

Silk, Matthew J; Finn, Kelly R; Porter, Mason A; Pinter-Wollman, Noa

2018-06-01

Interactions among individual animals - and between these individuals and their environment - yield complex, multifaceted systems. The development of multilayer network analysis offers a promising new approach for studying animal social behavior and its relation to eco-evolutionary dynamics. Copyright © 2018 Elsevier Ltd. All rights reserved.

New Principals' Perspectives of Their Multifaceted Roles

ERIC Educational Resources Information Center

Gentilucci, James L.; Denti, Lou; Guaglianone, Curtis L.

2013-01-01

This study utilizes Symbolic Interactionism to explore perspectives of neophyte principals. Findings explain how these perspectives are modified through complex interactions throughout the school year, and they also suggest preparation programs can help new principals most effectively by teaching "soft" skills such as active listening…

Preparing a Health Care White Paper: Providing Structure to the Writing Process.

PubMed

Rotarius, Timothy; Rotarius, Velmarie

2016-01-01

Health care leaders operate in a very complex and turbulent business environment. Both government regulations and market forces are very active in the industry. Thus, health care managers have many multifaceted and, sometimes, contradictory expectations placed upon them and their organizations. To ensure professional accountability, health care executives often join professional associations and strive for licenses and certifications that are intended to place the professional above the rest. One important avenue to achieve various licensing and certification accomplishments involves writing a white paper about a specific topic of interest to the industry and organization. Presented herein are structural processes that facilitate the creation and preparation of a health care white paper. Both conceptual and empirical structures of white papers are presented, with the similarities and the differences between conceptual and empirical papers highlighted.

Quantitative and qualitative approaches in educational research — problems and examples of controlled understanding through interpretive methods

NASA Astrophysics Data System (ADS)

Neumann, Karl

1987-06-01

In the methodological discussion of recent years it has become apparent that many research problems, including problems relating to the theory of educational science, cannot be solved by using quantitative methods. The multifaceted aspects of human behaviour and all its environment-bound subtle nuances, especially the process of education or the development of identity, cannot fully be taken into account within a rigid neopositivist approach. In employing the paradigm of symbolic interactionism as a suitable model for the analysis of processes of education and formation, the research has generally to start out from complex reciprocal social interactions instead of unambigious connections of causes. In analysing several particular methodological problems, the article demonstrates some weaknesses of quantitative approaches and then shows the advantages in and the necessity for using qualitative research tools.

Multi-Faceted Functions of Secretory IgA at Mucosal Surfaces

PubMed Central

Corthésy, Blaise

2013-01-01

Secretory IgA (SIgA) plays an important role in the protection and homeostatic regulation of intestinal, respiratory, and urogenital mucosal epithelia separating the outside environment from the inside of the body. This primary function of SIgA is referred to as immune exclusion, a process that limits the access of numerous microorganisms and mucosal antigens to these thin and vulnerable mucosal barriers. SIgA has been shown to be involved in avoiding opportunistic pathogens to enter and disseminate in the systemic compartment, as well as tightly controlling the necessary symbiotic relationship existing between commensals and the host. Clearance by peristalsis appears thus as one of the numerous mechanisms whereby SIgA fulfills its function at mucosal surfaces. Sampling of antigen-SIgA complexes by microfold (M) cells, intimate contact occurring with Peyer’s patch dendritic cells (DC), down-regulation of inflammatory processes, modulation of epithelial, and DC responsiveness are some of the recently identified processes to which the contribution of SIgA has been underscored. This review aims at presenting, with emphasis at the biochemical level, how the molecular complexity of SIgA can serve these multiple and non-redundant modes of action. PMID:23874333

The Mechanobiology of Aging

PubMed Central

Walston, Jeremy; Wirtz, Denis

2016-01-01

Aging is a complex, multifaceted process that induces a myriad of physiological changes over an extended period of time. Aging is accompanied by major biochemical and biomechanical changes at macroscopic and microscopic length scales that affect not only tissues and organs but also cells and subcellular organelles. These changes include transcriptional and epigenetic modifications; changes in energy production within mitochondria; and alterations in the overall mechanics of cells, their nuclei, and their surrounding extracellular matrix. In addition, aging influences the ability of cells to sense changes in extracellular-matrix compliance (mechanosensation) and to transduce these changes into biochemical signals (mechanotransduction). Moreover, following a complex positive-feedback loop, aging is accompanied by changes in the composition and structure of the extracellular matrix, resulting in changes in the mechanics of connective tissues in older individuals. Consequently, these progressive dysfunctions facilitate many human pathologies and deficits that are associated with aging, including cardiovascular, musculoskeletal, and neurodegenerative disorders and diseases. Here, we critically review recent work highlighting some of the primary biophysical changes occurring in cells and tissues that accompany the aging process. PMID:26643020

Emotion regulation: a theme in search of definition.

PubMed

Thompson, R A

1994-01-01

Contemporary interest in emotion regulation promises to advance important new views of emotional development as well as offering applications to developmental psychopathology, but these potential contributions are contingent on developmentalists' attention to some basic definitional issues. This essay offers a perspective on these issues by considering how emotion regulation should be defined, the various components of the management of emotion, how emotion regulation strategies fit into the dynamics of social interaction, and how individual differences in emotion regulation should be conceptualized and measured. In the end, it seems clear that emotion regulation is a conceptual rubric for a remarkable range of developmental processes, each of which may have its own catalysts and control processes. Likewise, individual differences in emotion regulation skills likely have multifaceted origins and are also related in complex ways to the person's emotional goals and the immediate demands of the situation. Assessment approaches that focus on the dynamics of emotion are well suited to elucidating these complex developmental and individual differences. In sum, a challenging research agenda awaits those who enter this promising field of study.

Standardized research protocols enable transdisciplinary research of climate variation impacts in corn production systems

USDA-ARS?s Scientific Manuscript database

The important questions about agriculture, climate, and sustainability have become increasingly complex and require a coordinated, multi-faceted approach for developing new knowledge and understanding. A multi-state, transdisciplinary project was begun in 2011 to study the potential for both mitigat...

RESPONSE PROTOCOL TOOLBOX: PLANNING FOR AND RESPONDING TO CONTAMINATION THREATS TO DRINKING WATER SYSTEMS

EPA Science Inventory

EPA's Office of Research and Development and Office of Water/Water Security Division have jointly developed a Response Protocol Toolbox (RPTB) to address the complex, multi-faceted challenges of a water utility's planning and response to intentional contamination of drinking wate...

A Larger Sense of Purpose: Higher Education and Society

ERIC Educational Resources Information Center

Shapiro, Harold T.

2005-01-01

Universities were once largely insular institutions whose purview extended no further than the campus gates. Not anymore. Today's universities have evolved into multifaceted organizations with complex connections to government, business, and the community. This thought-provoking book by Harold Shapiro, former president of both Princeton University…

Prenatal and Early Life Risk Factors of Schizophrenia

ERIC Educational Resources Information Center

Lattari, Fallon; Dragowski, Eliza A.

2011-01-01

Childhood-onset schizophrenia is an exceedingly rare mental illness whose complex, multifaceted behavioral presentation can disrupt child development and raise diagnostic and treatment difficulties for attending clinicians. The disorder, affecting one in 30,000 children, shares the same diagnostic criteria and symptoms as its adult counterpart,…

Uneven Terrain: Educational Policy and Equity in Nepal

ERIC Educational Resources Information Center

Shields, Robin; Rappleye, Jeremy

2008-01-01

This paper investigates the relationship between educational policy, equity, and national development in Nepal. It argues that current inequities in educational opportunities and outcomes are largely attributable to persistent inequities and biases in the educational policy framework. We begin by surveying the complex, multifaceted reality of…

Physician Verbal Compliance-Gaining Strategies and Patient Satisfaction

ERIC Educational Resources Information Center

Olynick, Janna; Iliopulos, Alexandra; Li, Han Z.

2017-01-01

Purpose: The patient healthcare experience is a complex phenomenon, as is encouraging patient compliance with medical advice. To address this multifaceted relationship, the purpose of this paper is to explore the ways resident physicians verbally encourage patient compliance and the relationship between these compliance-seeking strategies and…

A Principal Calling: Professionalism and Health Care Services

ERIC Educational Resources Information Center

Cornett, Becky Sutherland

2006-01-01

As health care professionals, our ''product'' is clinical service. We demonstrate professionalism by attitudes, knowledge, and behaviors that reflect a multi-faceted approach to the standards, regulations, and principles underlying successful clinical practices. The issues facing practitioners who work in health care environments are complex,…

Exploration of dynamics in a complex person-centred intervention process based on health professionals' perspectives.

PubMed

Friberg, Febe; Wallengren, Catarina; Håkanson, Cecilia; Carlsson, Eva; Smith, Frida; Pettersson, Monica; Kenne Sarenmalm, Elisabeth; Sawatzky, Richard; Öhlén, Joakim

2018-06-13

The assessment and evaluation of practical and sustainable development of health care has become a major focus of investigation in health services research. A key challenge for researchers as well as decision-makers in health care is to understand mechanisms influencing how complex interventions work and become embedded in practice, which is significant for both evaluation and later implementation. In this study, we explored nurses' and surgeons' perspectives on performing and participating in a complex multi-centre person-centred intervention process that aimed to support patients diagnosed with colorectal cancer to feel prepared for surgery, discharge and recovery. Data consisted of retrospective interviews with 20 professionals after the intervention, supplemented with prospective conversational data and field notes from workshops and follow-up meetings (n = 51). The data were analysed to construct patterns in line with interpretive description. Although the participants highly valued components of the intervention, the results reveal influencing mechanisms underlying the functioning of the intervention, including multiple objectives, unclear mandates and competing professional logics. The results also reveal variations in processing the intervention focused on differences in using and talking about intervention components. The study indicates there are significant areas of ambiguity in understanding how theory-based complex clinical interventions work and in how interventions are socially constructed and co-created by professionals' experiences, assumptions about own professional practice, contextual conditions and the researchers' intentions. This process evaluation reveals insights into reasons for success or failure and contextual aspects associated with variations in outcomes. Thus, there is a need for further interpretive inquiry, and not only descriptive studies, of the multifaceted characters of complex clinical interventions and how the intervention components are actually shaped in constantly shifting contexts.

RESPONSE PROTOCOL TOOLBOX: OVERVIEW, STATUS UPDATE, AND RELATIONSHIP TO OTHER WATER SECURITY PRODUCTS

EPA Science Inventory

The Response Protocol Toolbox was released by USEPA to address the complex, multi-faceted challenges of a water utility's planning and response to the threat or act of intentional contamination of drinking water (1). The Toolbox contains guidance that may be adopted voluntarily,...

RESPONSE PROTOCOL TOOLBOX: OVERVIEW, STATUS UPDATE, AND RELATIONSHIP TO OTHER WATER SECURITY PRODUCTS

EPA Science Inventory

The Response Protocol Toolbox was released by USEPA to address the complex, multi-faceted challenges of a water utility's planning and response to the threat or act of intentional contamination of drinking water(1). The Toolbox contains guidance that may be adopted voluntarily, a...

On Young People's Experience of Systems in Technology

ERIC Educational Resources Information Center

Svensson, Maria; Zetterqvist, Ann; Ingerman, Ake

2012-01-01

Immersed in a technologically complex world, young people make sense of a multi-faceted set of events in everyday life. This article investigates the variation in how Swedish young people experience technological systems and is based on interviews focusing three systems concerning transport, energy and communication--contextualised in relation to…

LAB ANALYSIS OF EMERGENCY WATER SAMPLES CONTAINING UNKNOWN CONTAMINANTS: CONSIDERATIONS FROM THE USEPA RESPONSE PROTOCOL TOOLBOX

EPA Science Inventory

EPA's Office of Research and Development and Office of Water/Water Security Division have jointly developed a Response Protocol Toolbox (RPTB) to address the complex, multi-faceted challenges of a water utility's planning and response to intentional contamination of drinking wate...

RESPONSE PROTOCOL TOOLBOX OVERVIEW, STATUS UPDATE, AND RELATIONSHIP TO OTHER WATER SECURITY PRODUCTS

EPA Science Inventory

The Response Protocol Toolbox was released by USEPA to address the complex, multi-faceted challenges of a water utility's planning and response to the threat or act of intentional contamination of drinking water (1). The Toolbox contains guidance that may be adopted voluntarily,...

Chemistry Education: Ten Facets to Shape Us

ERIC Educational Resources Information Center

Talanquer, Vicente

2013-01-01

The chemistry knowledge that we want our students to develop is rich, complex, and multifaceted. However, some teachers and instructors at the secondary school and college levels approach it in rather rigid and unidimensional ways. The central goal of this contribution is to describe and discuss 10 different complementary perspectives or…

African-Canadian Educators' Perspectives: Critical Factors for Success

ERIC Educational Resources Information Center

Finlayson, Maureen

2011-01-01

This study investigates the perspectives of African-Canadian educators on critical factors for success in their educational careers. Interviews were conducted and life histories were constructed to analyze the complex and multifaceted nature of the experiences of ten African-Canadian educators. These data indicate that family and community…

Tools to study and manage grazing behavior at multiple scales to enhance the sustainability of livestock

USDA-ARS?s Scientific Manuscript database

Free-ranging animal behavior is a multifaceted and complex phenomenon within rangeland ecology that must be understood and ultimately managed. Improving behavioral studies requires tools appropriate for use at the landscape scale. Though tools alone do not assure research will generate accurate in...

Capacity Building for Social Innovation: A Collective Impact Approach

ERIC Educational Resources Information Center

Szarleta, Ellen J.

2017-01-01

Business, nonprofit, and government institutions generally agree that a vibrant economy is critical to addressing the multi-faceted, complex issues faced by urban communities. Yet, despite significant targeted efforts aimed at revitalizing economic activity over the past few decades, the state of many communities remains unchanged. A collective…

Replacing Remediation with Readiness. An NCPR Working Paper

ERIC Educational Resources Information Center

Conley, David T.

2010-01-01

This paper critically examines traditional means of assessing college students' need for remediation and suggests as a replacement an expanded definition of college readiness, where readiness is more complex than rudimentary content knowledge and more multifaceted than a single cut point. The paper presents and explains four dimensions of…

Technology and Literary Analysis: Exploring New Literacies in Secondary English

ERIC Educational Resources Information Center

Marlatt, Rick

2017-01-01

The high school English classroom is a complex space of literacy practices and communicative interaction. Teachers and students engage in literature study in ways that are dialogic and multifaceted. The navigation of both print and digital texts along with the constructive operations surrounding those texts including the textual operations…

"Pedagogy of Third Space": A Multidimensional Early Childhood Curriculum

ERIC Educational Resources Information Center

Gupta, Amita

2015-01-01

This paper will illustrate how philosophical and pedagogical boundaries that are defined by diverse cultures and ideologies might be navigated in the practical implementation of an early childhood curriculum in postcolonial urban India. Findings from a qualitative naturalistic inquiry indicated that a complex, multifaceted curriculum shaped by…

Development of a Procurement Management Framework in Ghana: A New Paradigm for Interdisciplinary Postgraduate Education

ERIC Educational Resources Information Center

Owusu-Manu, D.; Badu, E.; Edwards, D. J.

2011-01-01

Procurement in the corporate world is increasingly complex, multi-faceted and interdisciplinary. This paper explores existing knowledge specifications relating to procurement management competencies and proposes a new procurement management competency framework (PMCF) and a competency-based postgraduate programme for postgraduate students in…

Physician Migration, Education, and Health Care

ERIC Educational Resources Information Center

Norcini, John J.; Mazmanian, Paul E.

2005-01-01

Physician migration is a complex and multifaceted phenomenon that is intimately intertwined with medical education. Imbalances in the production of physicians lead to workforce shortages and surpluses that compromise the ability to deliver adequate and equitable health care to large parts of the world's population. In this overview, we address a…

Stupid Tutoring Systems, Intelligent Humans

ERIC Educational Resources Information Center

Baker, Ryan S.

2016-01-01

The initial vision for intelligent tutoring systems involved powerful, multi-faceted systems that would leverage rich models of students and pedagogies to create complex learning interactions. But the intelligent tutoring systems used at scale today are much simpler. In this article, I present hypotheses on the factors underlying this development,…

[Not Available].

PubMed

Paturzo, Marco; Colaceci, Sofia; Clari, Marco; Mottola, Antonella; Alvaro, Rosaria; Vellone, Ercole

2016-01-01

. Mixed methods designs: an innovative methodological approach for nursing research. The mixed method research designs (MM) combine qualitative and quantitative approaches in the research process, in a single study or series of studies. Their use can provide a wider understanding of multifaceted phenomena. This article presents a general overview of the structure and design of MM to spread this approach in the Italian nursing research community. The MM designs most commonly used in the nursing field are the convergent parallel design, the sequential explanatory design, the exploratory sequential design and the embedded design. For each method a research example is presented. The use of MM can be an added value to improve clinical practices as, through the integration of qualitative and quantitative methods, researchers can better assess complex phenomena typical of nursing.

Challenges of space medical operations and life sciences management

NASA Technical Reports Server (NTRS)

Haddad, S. G.

1992-01-01

The Kennedy Space Center (KSC) has been the premier launch and landing site for America's space program since the early 1960s. Visitors are cognizant of space vehicles, processing facilities and launch pads which are treasured national resources. However, most are unaware of the unique organization which supports launch and landing activities and manages the center's occupational medicine, environmental health, ecological and environmental monitoring functions, as well as human and plant research programs. Management of this multifaceted organization can be complex because funding its different functions comes from a number of sources. Additionally the diverse disciplines of personnel present a special challenge in maintaining professional competencies while assuring efficiency in cyclical operations. This article explains the organization's structure and reviews some of its accomplishments.

Computational challenges, tools and resources for analyzing co- and post-transcriptional events in high throughput

PubMed Central

Bahrami-Samani, Emad; Vo, Dat T.; de Araujo, Patricia Rosa; Vogel, Christine; Smith, Andrew D.; Penalva, Luiz O. F.; Uren, Philip J.

2014-01-01

Co- and post-transcriptional regulation of gene expression is complex and multi-faceted, spanning the complete RNA lifecycle from genesis to decay. High-throughput profiling of the constituent events and processes is achieved through a range of technologies that continue to expand and evolve. Fully leveraging the resulting data is non-trivial, and requires the use of computational methods and tools carefully crafted for specific data sources and often intended to probe particular biological processes. Drawing upon databases of information pre-compiled by other researchers can further elevate analyses. Within this review, we describe the major co- and post-transcriptional events in the RNA lifecycle that are amenable to high-throughput profiling. We place specific emphasis on the analysis of the resulting data, in particular the computational tools and resources available, as well as looking towards future challenges that remain to be addressed. PMID:25515586

Numerical models of caldera deformation: Effects of multiphase and multicomponent hydrothermal fluid flow

USGS Publications Warehouse

Hutnak, M.; Hurwitz, S.; Ingebritsen, S.E.; Hsieh, P.A.

2009-01-01

Ground surface displacement (GSD) in large calderas is often interpreted as resulting from magma intrusion at depth. Recent advances in geodetic measurements of GSD, notably interferometric synthetic aperture radar, reveal complex and multifaceted deformation patterns that often require complex source models to explain the observed GSD. Although hydrothermal fluids have been discussed as a possible deformation agent, very few quantitative studies addressing the effects of multiphase flow on crustal mechanics have been attempted. Recent increases in the power and availability of computing resources allow robust quantitative assessment of the complex time-variant thermal interplay between aqueous fluid flow and crustal deformation. We carry out numerical simulations of multiphase (liquid-gas), multicomponent (H 2O-CO2) hydrothermal fluid flow and poroelastic deformation using a range of realistic physical parameters and processes. Hydrothermal fluid injection, circulation, and gas formation can generate complex, temporally and spatially varying patterns of GSD, with deformation rates, magnitudes, and geometries (including subsidence) similar to those observed in several large calderas. The potential for both rapid and gradual deformation resulting from magma-derived fluids suggests that hydrothermal fluid circulation may help explain deformation episodes at calderas that have not culminated in magmatic eruption.

What can complexity do for diabetes management? Linking theory to practice.

PubMed

Cooper, Helen C; Geyer, Robert

2009-08-01

Diabetes presents a multifaceted picture with its rapidly rising prevalence associated with changing demographics and increasing levels of obesity in the developed world. Deaths from diabetes are predicted to rise by 25% over the next 10 years. The enormity of this public health challenge has been recognized the world over, but little attention has been paid to the theoretical frameworks underpinning practical management. This paper aims to introduce complexity theory and discuss its practical application to diabetes, focusing on a single 'tool' to provide an example of how theory can be linked to practice. Critics have questioned the all inclusive nature of complexity seeing it as an intangible concept that fails to offer anything new to health care. However, few have appraised its practical application to a chronic disease that is currently managed using an outdated, linear, reduce and resolve model which fails to address the multiple interacting systems inherent within this condition. This article proposes that complexity theory provides an interprofessional perspective for describing and understanding the processes involved, and provides working 'tools' for patients, carers and practitioners that capture the reality of managing this chronic disease in modern life.

Introducing a complex health innovation--primary health care reforms in Estonia (multimethods evaluation).

PubMed

Atun, Rifat Ali; Menabde, Nata; Saluvere, Katrin; Jesse, Maris; Habicht, Jarno

2006-11-01

All post-Soviet countries are trying to reform their primary health care (PHC) systems. The success to date has been uneven. We evaluated PHC reforms in Estonia, using multimethods evaluation: comprising retrospective analysis of routine health service data from Estonian Health Insurance Fund and health-related surveys; documentary analysis of policy reports, laws and regulations; key informant interviews. We analysed changes in organisational structure, regulations, financing and service provision in Estonian PHC system as well as key informant perceptions on factors influencing introduction of reforms. Estonia has successfully implemented and scaled-up multifaceted PHC reforms, including new organisational structures, user choice of family physicians (FPs), new payment methods, specialist training for family medicine, service contracts for FPs, broadened scope of services and evidence-based guidelines. These changes have been institutionalised. PHC effectiveness has been enhanced, as evidenced by improved management of key chronic conditions by FPs in PHC setting and reduced hospital admissions for these conditions. Introduction of PHC reforms - a complex innovation - was enhanced by strong leadership, good co-ordination between policy and operational level, practical approach to implementation emphasizing simplicity of interventions to be easily understood by potential adopters, an encircling strategy to roll-out which avoided direct confrontations with narrow specialists and opposing stakeholders in capital Tallinn, careful change-management strategy to avoid health reforms being politicized too early in the process, and early investment in training to establish a critical mass of health professionals to enable rapid operationalisation of policies. Most importantly, a multifaceted and coordinated approach to reform - with changes in laws; organisational restructuring; modifications to financing and provider payment systems; creation of incentives to enhance service innovations; investment in human resource development - was critical to the reform success.

Systemic approaches to biodegradation.

PubMed

Trigo, Almudena; Valencia, Alfonso; Cases, Ildefonso

2009-01-01

Biodegradation, the ability of microorganisms to remove complex chemicals from the environment, is a multifaceted process in which many biotic and abiotic factors are implicated. The recent accumulation of knowledge about the biochemistry and genetics of the biodegradation process, and its categorization and formalization in structured databases, has recently opened the door to systems biology approaches, where the interactions of the involved parts are the main subject of study, and the system is analysed as a whole. The global analysis of the biodegradation metabolic network is beginning to produce knowledge about its structure, behaviour and evolution, such as its free-scale structure or its intrinsic robustness. Moreover, these approaches are also developing into useful tools such as predictors for compounds' degradability or the assisted design of artificial pathways. However, it is the environmental application of high-throughput technologies from the genomics, metagenomics, proteomics and metabolomics that harbours the most promising opportunities to understand the biodegradation process, and at the same time poses tremendous challenges from the data management and data mining point of view.

Effectiveness of medicines review with web-based pharmaceutical treatment algorithms in reducing potentially inappropriate prescribing in older people in primary care: a cluster randomized trial (OPTI-SCRIPT study protocol).

PubMed

Clyne, Barbara; Bradley, Marie C; Smith, Susan M; Hughes, Carmel M; Motterlini, Nicola; Clear, Daniel; McDonnell, Ronan; Williams, David; Fahey, Tom

2013-03-13

Potentially inappropriate prescribing in older people is common in primary care and can result in increased morbidity, adverse drug events, hospitalizations and mortality. In Ireland, 36% of those aged 70 years or over received at least one potentially inappropriate medication, with an associated expenditure of over €45 million.The main objective of this study is to determine the effectiveness and acceptability of a complex, multifaceted intervention in reducing the level of potentially inappropriate prescribing in primary care. This study is a pragmatic cluster randomized controlled trial, conducted in primary care (OPTI-SCRIPT trial), involving 22 practices (clusters) and 220 patients. Practices will be allocated to intervention or control arms using minimization, with intervention participants receiving a complex multifaceted intervention incorporating academic detailing, medicines review with web-based pharmaceutical treatment algorithms that provide recommended alternative treatment options, and tailored patient information leaflets. Control practices will deliver usual care and receive simple patient-level feedback on potentially inappropriate prescribing. Routinely collected national prescribing data will also be analyzed for nonparticipating practices, acting as a contemporary national control. The primary outcomes are the proportion of participant patients with potentially inappropriate prescribing and the mean number of potentially inappropriate prescriptions per patient. In addition, economic and qualitative evaluations will be conducted. This study will establish the effectiveness of a multifaceted intervention in reducing potentially inappropriate prescribing in older people in Irish primary care that is generalizable to countries with similar prescribing challenges. Current controlled trials ISRCTN41694007.

Curricular Innovation for Sustainability: The Piedmont/Ponderosa Model of Faculty Development

ERIC Educational Resources Information Center

Barlett, Peggy F.; Chase, Geoffrey W.

2012-01-01

Curricular innovation is at the center of the challenges many colleges and universities face as they seek to help students address more successfully than previous generations the complex, multi-faceted, systemic challenges of global climate change, population growth, loss of biodiversity, environmental justice, toxic wastes, and food insecurity.…

Learning from Transitioning to New Technology That Supports Online and Blended Learning: A Case Study

ERIC Educational Resources Information Center

Lock, Jennifer; Johnson, Carol

2017-01-01

Transitioning from one technology to another within educational institutions is complex and multi-faceted, and requires time. Such a transition involves more than making the new technology available for use. It requires knowing the people involved, designing differentiated support structures, and integrating various resources to meet their…

ROLE OF SOURCE WATER PROTECTION IN PLANNING FOR AND RESPONDING TO CONTAMINATION THREATS TO DRINKING WATER SYSTEMS

EPA Science Inventory

EPA has developed a "Response Protocol Toolbox" to address the complex, multi-faceted challenges of planning and response to intentional contamination of drinking water (http://www.epa.gov/safewater/security/ertools.html#toolbox). The toolbox is designed to be applied by a numbe...

EPA RESPONSE PROTOCOL TOOLBOX TO HELP EVALUATION OF CONTAMINATION THREATS & RESPONDING TO THREATS: MODULE 1-WATER UTILITY PLANNING GUIDE

EPA Science Inventory

EPA's Office of Research and Development and Office of Water/Water Security Division have jointly developed a Response Protocol Toolbox (RPTB) to address the complex, multi-faceted challenges of a water utility's planning and response to intentional contamination of drinking wate...

Revisiting First Language Acquisition through Empirical and Rational Perspectives

ERIC Educational Resources Information Center

Tahriri, Abdorreza

2012-01-01

Acquisition in general and first language acquisition in particular is a very complex and a multifaceted phenomenon. The way that children acquire a language in a very limited period is astonishing. Various approaches have been proposed so far to account for this extraordinary phenomenon. These approaches are indeed based on various philosophical…

Using Nitrogen Stable Isotope Tracers to Track Climate Change Impacts on Coastal Salt Marshes

EPA Science Inventory

Climate change impacts on coastal salt marshes are predicted to be complex and multi-faceted. In addition to rising sea level and warmer water temperatures, regional precipitation patterns are also expected to change. At least in the Northeast and Mid-Atlantic U.S., more severe s...

What Kind of Reflection Do We Need in Public Management?

ERIC Educational Resources Information Center

Knassmüller, Monika; Meyer, Renate E.

2013-01-01

In a rapidly changing and increasingly complex environment, the importance of reflection for public managers has been acknowledged almost unanimously by academics as well as practitioners. In this article we highlight the necessity to look at reflection in a more nuanced way. Reflection is a broad and multifaceted concept and public sector work…

Inspiring to Inspire: Developing Teaching in Higher Education

ERIC Educational Resources Information Center

Williams, Louise; Nixon, Sarah; Hennessy, Claire; Mahon, Elizabeth; Adams, Gill

2016-01-01

Following a three-year staff development initiative within one faculty in a UK university, the authors reflected on inspiring teaching and the role that staff development can play in enhancing individual practice. Teaching is a core component of Higher Education and is complex and multi-faceted both theoretically and in practice. Through…

Case Study of a Cancer Survivor: Beating the Odds

ERIC Educational Resources Information Center

Ocampo, Alaine

2011-01-01

Medulla blastomas are known to be invasive and rapidly growing tumors. This case study follows a boy's journey for 3 years from when he was first diagnosed with medulla blastoma. The journey illustrates the complexities and challenges faced by individuals treated for brain tumors. A multifaceted view based on psychometric, cognitive-neuroscience,…

Teaching Qualitative Research for Human Services Students: A Three-Phase Model

ERIC Educational Resources Information Center

Goussinsky, Ruhama; Reshef, Arie; Yanay-Ventura, Galit; Yassour-Borochowitz, Dalit

2011-01-01

Qualitative research is an inherent part of the human services profession, since it emphasizes the great and multifaceted complexity characterizing human experience and the sociocultural context in which humans act. In the department of human services at Emek Yezreel College, Israel, we have developed a three-phase model to ensure a relatively…

Key Success Factors for Statistical Literacy Poster Competitions

ERIC Educational Resources Information Center

MacFeely, Steve; Campos, Pedro; Helenius, Reija

2017-01-01

Statistical literacy is complex and multifaceted. In every country, education and numeracy are a function of a multitude of factors including culture, history, and societal norms. Nevertheless, since the launch of the International Statistical Poster Competition (ISLP) in 1994, a number of patterns have emerged to suggest there are some common or…

An Exploratory Study of Female Master of Divinity Students in a Conservative West Coast Evangelical Seminary

ERIC Educational Resources Information Center

Clemen, Valerie A.

2009-01-01

Issues surrounding female participation in graduate theological education are complex and multifaceted. One important problem concerning female theological students is the lack of research exploring the experiences and unique challenges faced by conservative evangelical female Master of Divinity (M. Div.) students as they pursue academic and…

Evaluating the Efficacy of a Healthcare Fellowship Certification Program as an Indication of Career Preparedness

ERIC Educational Resources Information Center

Jobes, Tammy L. Kester Engel

2017-01-01

Healthcare administration is a complex, multifaceted career path that requires constant adaptation and integration of external guidance. Organizations seeking the most qualified and skilled candidates draw from a multitude of applicants without having a single potential success indicator. The lack of a standard educational background,…

Natural enemies: people-wildlife conflicts in anthropological perspective

Treesearch

John Schelhas

2004-01-01

Human relationships with wildlife are complex and multifaceted. It is not uncommon for conservationists, in an effort to raise awareness and build support for biodiversity conservation, to focus on the positive side of human relations with wildlife such as the role of wild species in controlling pests and pollinating crops, sacred and totemic associations, and...

Using Developmental Evaluation as a Design Thinking Tool for Curriculum Innovation in Professional Higher Education

ERIC Educational Resources Information Center

Leonard, Simon N.; Fitzgerald, Robert N.; Riordan, Geoffrey

2016-01-01

This paper argues for the use of "developmental" evaluation as a design-based research tool for sustainable curriculum innovation in professional higher education. Professional education is multi-faceted and complex with diverse views from researchers, professional practitioners, employers and the world of politics leaving little…

If Honors Students Were People: Holistic Honors Education. National Collegiate Honors Council Monograph Series

ERIC Educational Resources Information Center

Schuman, Samuel

2013-01-01

Although honors students are highly motivated and intellectually promising, they are not empty cognitive vessels ready to be filled with professorial knowledge. They are, instead, complex, multifaceted young people, sometimes troubled, often delighted and delightful. While at college they are learning how to live their lives not just as…

Ghosts from the Nursery: Tracing the Roots of Violence.

ERIC Educational Resources Information Center

Karr-Morse, Robin; Wiley, Meredith S.

Noting that although the causes of violence are highly complex and multifaceted, this book argues that a growing body of scientific knowledge demonstrates that maltreatment during the 9 months of fetal growth and the first 24 months after birth often leads to violent older children and adults. Following an introduction, the book contains the…

Corruption in Higher Education: Conceptual Approaches and Measurement Techniques

ERIC Educational Resources Information Center

Osipian, Ararat L.

2007-01-01

Corruption is a complex and multifaceted phenomenon. Forms of corruption are multiple. Measuring corruption is necessary not only for getting ideas about the scale and scope of the problem, but for making simple comparisons between the countries and conducting comparative analysis of corruption. While the total impact of corruption is indeed…

Drawing on a Theoretical Model to Study Students' Understandings of Fractions

ERIC Educational Resources Information Center

Charalambous, Charalambos Y.; Pitta-Pantazi, Demetra

2007-01-01

Teaching and learning fractions has traditionally been one of the most problematic areas in primary school mathematics. Several studies have suggested that one of the main factors contributing to this complexity is that fractions comprise a multifaceted notion encompassing five interrelated subconstructs (i.e., part-whole, ratio, operator,…

Questioning the Validity of Inquiry Assessment in a High Stakes Physical Sciences Examination

ERIC Educational Resources Information Center

Ramnarain, Umesh

2014-01-01

The South African science curriculum advocates an inquiry-based approach to practical work. Inquiry is a complex and multifaceted activity involving both cognitive and physical activity; thus, paper-and-pencil items do not provide the authentic context for this assessment. This study investigates the construct validity of inquiry-related questions…

The impact of a multifaceted intervention including sepsis electronic alert system and sepsis response team on the outcomes of patients with sepsis and septic shock.

PubMed

Arabi, Yaseen M; Al-Dorzi, Hasan M; Alamry, Ahmed; Hijazi, Ra'ed; Alsolamy, Sami; Al Salamah, Majid; Tamim, Hani M; Al-Qahtani, Saad; Al-Dawood, Abdulaziz; Marini, Abdellatif M; Al Ehnidi, Fatimah H; Mundekkadan, Shihab; Matroud, Amal; Mohamed, Mohamed S; Taher, Saadi

2017-12-01

Compliance with the clinical practice guidelines of sepsis management has been low. The objective of our study was to describe the results of implementing a multifaceted intervention including an electronic alert (e-alert) with a sepsis response team (SRT) on the outcome of patients with sepsis and septic shock presenting to the emergency department. This was a pre-post two-phased implementation study that consisted of a pre-intervention phase (January 01, 2011-September 24, 2012), intervention phase I (multifaceted intervention including e-alert, from September 25, 2012-March 03, 2013) and intervention phase II when SRT was added (March 04, 2013-October 30, 2013) in a 900-bed tertiary-care academic hospital. We recorded baseline characteristics and processes of care in adult patients presenting with sepsis or septic shock. The primary outcome measures were hospital mortality. Secondary outcomes were the need for mechanical ventilation and length of stay in the intensive unit and in the hospital. After implementing the multifaceted intervention including e-alert and SRT, cases were identified with less severe clinical and laboratory abnormalities and the processes of care improved. When adjusted to propensity score, the interventions were associated with reduction in hospital mortality [for intervention phase II compared to pre-intervention: adjusted odds ratio (aOR) 0.71, 95% CI 0.58-0.85, p = 0.003], reduction in the need for mechanical ventilation (aOR 0.45, 95% CI 0.37-0.55, p < 0.0001) and reduction in ICU LOS and hospital LOS for all patients as well as ICU LOS for survivors. Implementing a multifaceted intervention including sepsis e-alert with SRT was associated with earlier identification of sepsis, increase in compliance with sepsis resuscitation bundle and reduction in the need for mechanical ventilation and reduction in hospital mortality and LOS.

Using a Multifaceted Approach to Working With Children Who Have Differences in Sensory Processing and Integration

PubMed Central

Glennon, Tara J.; Ausderau, Karla; Bendixen, Roxanna M.; Kuhaneck, Heather Miller; Pfeiffer, Beth; Watling, Renee; Wilkinson, Kimberly; Bodison, Stefanie C.

2017-01-01

Pediatric occupational therapy practitioners frequently provide interventions for children with differences in sensory processing and integration. Confusion exists regarding how best to intervene with these children and about how to describe and document methods. Some practitioners hold the misconception that Ayres Sensory Integration intervention is the only approach that can and should be used with this population. The issue is that occupational therapy practitioners must treat the whole client in varied environments; to do so effectively, multiple approaches to intervention often are required. This article presents a framework for conceptualizing interventions for children with differences in sensory processing and integration that incorporates multiple evidence-based approaches. To best meet the needs of the children and families seeking occupational therapy services, interventions must be focused on participation and should be multifaceted. PMID:28218599

Rigged or rigorous? Partnerships for research and evaluation of complex social problems: Lessons from the field of violence against women and girls.

PubMed

Zimmerman, Cathy; Michau, Lori; Hossain, Mazeda; Kiss, Ligia; Borland, Rosilyne; Watts, Charlotte

2016-09-01

There is growing demand for robust evidence to address complex social phenomena such as violence against women and girls (VAWG). Research partnerships between scientists and non-governmental or international organizations (NGO/IO) are increasingly popular, but can pose challenges, including concerns about potential conflicts of interest. Drawing on our experience collaborating on VAWG research, we describe challenges and contributions that NGO/IO and academic partners can make at different stages of the research process and the effects that collaborations can have on scientific inquiry. Partners may struggle with differing priorities and misunderstandings about roles, limitations, and intentions. Benefits of partnerships include a shared vision of study goals, differing and complementary expertise, mutual respect, and a history of constructive collaboration. Our experience suggests that when investigating multi-faceted social problems, instead of 'rigging' study results, research collaborations can strengthen scientific rigor and offer the greatest potential for impact in the communities we seek to serve.

Constructing a bricolage of nursing research, education and practice.

PubMed

Warne, T; McAndrew, S

2009-11-01

Drawing upon post doctoral reflections of a shared methodology, the authors explore the use of bricolage as a way of better understanding the inter-related connections between theory, nursing practice and the felt experiences of service users. The origins of bricolage can be traced back to the work of Levi-Strauss, and Denzin and Lincoln's contribution to qualitative methodologies. Bricolage is a multifaceted approach to the research process. Differing epistemological positions and mixed methods of data collection are utilised to bring a richer understanding of human beings and the complexities of their lived experiences. For the bricoleur the object of inquiry, cannot be separated from its context, that is the language used to describe it, its historical situatedness and the social and cultural interpretations of its meaning as an entity in the world. The paper discusses the importance of being able to move beyond the notion of the research method being merely a procedure, to one that respects the complexities of the lived world.

Multidisciplinary team, working with elderly persons living in the community: a systematic literature review.

PubMed

Johansson, Gudrun; Eklund, Kajsa; Gosman-Hedström, Gunilla

2010-01-01

As the number of elderly persons with complex health needs is increasing, teams for their care have been recommended as a means of meeting these needs, particularly in the case of elderly persons with multi-diseases. Occupational therapists, in their role as team members, exert significant influence in guiding team recommendations. However, it has been emphasized that there is a lack of sound research to show the impact of teamwork from the perspective of elderly persons. The aim of this paper was to explore literature concerning multidisciplinary teams that work with elderly persons living in the community. The research method was a systematic literature review and a total of 37 articles was analysed. The result describes team organisation, team intervention and outcome, and factors that influence teamwork. Working in a team is multifaceted and complex. It is important to enhance awareness about factors that influence teamwork. The team process itself is also of great importance. Clinical implications for developing effective and efficient teamwork are also presented and discussed.

Collaborative mining and interpretation of large-scale data for biomedical research insights.

PubMed

Tsiliki, Georgia; Karacapilidis, Nikos; Christodoulou, Spyros; Tzagarakis, Manolis

2014-01-01

Biomedical research becomes increasingly interdisciplinary and collaborative in nature. Researchers need to efficiently and effectively collaborate and make decisions by meaningfully assembling, mining and analyzing available large-scale volumes of complex multi-faceted data residing in different sources. In line with related research directives revealing that, in spite of the recent advances in data mining and computational analysis, humans can easily detect patterns which computer algorithms may have difficulty in finding, this paper reports on the practical use of an innovative web-based collaboration support platform in a biomedical research context. Arguing that dealing with data-intensive and cognitively complex settings is not a technical problem alone, the proposed platform adopts a hybrid approach that builds on the synergy between machine and human intelligence to facilitate the underlying sense-making and decision making processes. User experience shows that the platform enables more informed and quicker decisions, by displaying the aggregated information according to their needs, while also exploiting the associated human intelligence.

Collaborative Mining and Interpretation of Large-Scale Data for Biomedical Research Insights

PubMed Central

Tsiliki, Georgia; Karacapilidis, Nikos; Christodoulou, Spyros; Tzagarakis, Manolis

2014-01-01

Biomedical research becomes increasingly interdisciplinary and collaborative in nature. Researchers need to efficiently and effectively collaborate and make decisions by meaningfully assembling, mining and analyzing available large-scale volumes of complex multi-faceted data residing in different sources. In line with related research directives revealing that, in spite of the recent advances in data mining and computational analysis, humans can easily detect patterns which computer algorithms may have difficulty in finding, this paper reports on the practical use of an innovative web-based collaboration support platform in a biomedical research context. Arguing that dealing with data-intensive and cognitively complex settings is not a technical problem alone, the proposed platform adopts a hybrid approach that builds on the synergy between machine and human intelligence to facilitate the underlying sense-making and decision making processes. User experience shows that the platform enables more informed and quicker decisions, by displaying the aggregated information according to their needs, while also exploiting the associated human intelligence. PMID:25268270

Designing the future of healthcare.

PubMed

Fidsa, Gianfranco Zaccai

2009-01-01

This paper describes the application of a holistic design process to a variety of problems plaguing current healthcare systems. A design process for addressing complex, multifaceted problems is contrasted with the piecemeal application of technological solutions to specific medical or administrative problems. The goal of this design process is the ideal customer experience, specifically the ideal experience for patients, healthcare providers, and caregivers within a healthcare system. Holistic design is shown to be less expensive and wasteful in the long run because it avoids solving one problem within a complex system at the cost of creating other problems within that system. The article applies this approach to the maintenance of good health throughout life; to the creation of an ideal experience when a person does need medical care; to the maintenance of personal independence as one ages; and to the enjoyment of a comfortable and dignified death. Virginia Mason Medical Center is discussed as an example of a healthcare institution attempting to create ideal patient and caregiver experiences, in this case by applying the principles of the Toyota Production System ("lean manufacturing") to healthcare. The article concludes that healthcare is inherently dedicated to an ideal, that science and technology have brought it closer to that ideal, and that design can bring it closer still.

The Multifaceted Role of SNARE Proteins in Membrane Fusion

PubMed Central

Han, Jing; Pluhackova, Kristyna; Böckmann, Rainer A.

2017-01-01

Membrane fusion is a key process in all living organisms that contributes to a variety of biological processes including viral infection, cell fertilization, as well as intracellular transport, and neurotransmitter release. In particular, the various membrane-enclosed compartments in eukaryotic cells need to exchange their contents and communicate across membranes. Efficient and controllable fusion of biological membranes is known to be driven by cooperative action of SNARE proteins, which constitute the central components of the eukaryotic fusion machinery responsible for fusion of synaptic vesicles with the plasma membrane. During exocytosis, vesicle-associated v-SNARE (synaptobrevin) and target cell-associated t-SNAREs (syntaxin and SNAP-25) assemble into a core trans-SNARE complex. This complex plays a versatile role at various stages of exocytosis ranging from the priming to fusion pore formation and expansion, finally resulting in the release or exchange of the vesicle content. This review summarizes current knowledge on the intricate molecular mechanisms underlying exocytosis triggered and catalyzed by SNARE proteins. Particular attention is given to the function of the peptidic SNARE membrane anchors and the role of SNARE-lipid interactions in fusion. Moreover, the regulatory mechanisms by synaptic auxiliary proteins in SNARE-driven membrane fusion are briefly outlined. PMID:28163686

Identifying challenges in project consultants engagement practices

NASA Astrophysics Data System (ADS)

Shariffuddin, Nadia Alina Amir; Abidin, Nazirah Zainul

2017-10-01

Construction projects, green or conventional, involve multi-faceted disciplines engaged with the goal of delivering products i.e. building, infrastructure etc. at the best quality within stipulated budgets. For green projects, additional attention is added for environmental quality. Due to the various responsibilities and liabilities involved as well as the complexity of the construction process itself, formal engagement of multi-disciplinary professionals i.e. project consultants is required in any construction project. Poor selection of project consultants will lead to a multitude of complications resulting in delay, cost escalation, conflicts and poor quality. This paper explores the challenges that occur during the engagement of project consultants in a green project. As the engagement decision involves developers and architects, these two groups of respondents with green project backgrounds were approached qualitatively using interview technique. The challenges identified are limited experience and knowledge, consultants' fee vs. quality, green complexity, conflicts of interest, clients' extended expectation and less demand in green projects. The construction shifts to green project demands engagement of project consultants with added skills. It is expected that through the identification of challenges, better management and administration can be created which would give impact to the overall process of engagement in green projects.

The Multifaceted Role of SNARE Proteins in Membrane Fusion.

PubMed

Han, Jing; Pluhackova, Kristyna; Böckmann, Rainer A

2017-01-01

Membrane fusion is a key process in all living organisms that contributes to a variety of biological processes including viral infection, cell fertilization, as well as intracellular transport, and neurotransmitter release. In particular, the various membrane-enclosed compartments in eukaryotic cells need to exchange their contents and communicate across membranes. Efficient and controllable fusion of biological membranes is known to be driven by cooperative action of SNARE proteins, which constitute the central components of the eukaryotic fusion machinery responsible for fusion of synaptic vesicles with the plasma membrane. During exocytosis, vesicle-associated v-SNARE (synaptobrevin) and target cell-associated t-SNAREs (syntaxin and SNAP-25) assemble into a core trans-SNARE complex. This complex plays a versatile role at various stages of exocytosis ranging from the priming to fusion pore formation and expansion, finally resulting in the release or exchange of the vesicle content. This review summarizes current knowledge on the intricate molecular mechanisms underlying exocytosis triggered and catalyzed by SNARE proteins. Particular attention is given to the function of the peptidic SNARE membrane anchors and the role of SNARE-lipid interactions in fusion. Moreover, the regulatory mechanisms by synaptic auxiliary proteins in SNARE-driven membrane fusion are briefly outlined.

Developmental mechanisms in the prodrome to psychosis

PubMed Central

Walker, Elaine F.; Trotman, Hanan D.; Goulding, Sandra M.; Holtzman, Carrie W.; Ryan, Arthur T.; McDonald, Allison; Shapiro, Daniel I.; Brasfield, Joy L.

2014-01-01

Psychotic disorders continue to be among the most disabling and scientifically challenging of all mental illnesses. Accumulating research findings suggest that the etiologic processes underlying the development of these disorders are more complex than had previously been assumed. At the same time, this complexity has revealed a wider range of potential options for preventive intervention, both psychosocial and biological. In part, these opportunities result from our increased understanding of the dynamic and multifaceted nature of the neurodevelopmental mechanisms involved in the disease process, as well as the evidence that many of these entail processes that are malleable. In this article, we review the burgeoning research literature on the prodrome to psychosis, based on studies of individuals who meet clinical high risk criteria. This literature has examined a range of factors, including cognitive, genetic, psychosocial, and neurobiological. We then turn to a discussion of some contemporary models of the etiology of psychosis that emphasize the prodromal period. These models encompass the origins of vulnerability in fetal development, as well as postnatal stress, the immune response, and neuromaturational processes in adolescent brain development that appear to go awry during the prodrome to psychosis. Then, informed by these neurodevelopmental models of etiology, we turn to the application of new research paradigms that will address critical issues in future investigations. It is expected that these studies will play a major role in setting the stage for clinical trials aimed at preventive intervention. PMID:24342857

Examining Motivation in Online Distance Learning Environments: Complex, Multifaceted, and Situation-Dependent

ERIC Educational Resources Information Center

Hartnett, Maggie; St. George, Alison; Dron, John

2011-01-01

Existing research into motivation in online environments has tended to use one of two approaches. The first adopts a trait-like model that views motivation as a relatively stable, personal characteristic of the learner. Research from this perspective has contributed to the notion that online learners are, on the whole, intrinsically motivated. The…

Developing the Critical Intercultural Class-Space: Theoretical Implications and Pragmatic Applications of Critical Intercultural Communication Pedagogy

ERIC Educational Resources Information Center

Sobre, Miriam Shoshana

2017-01-01

Teaching intercultural communication presents pedagogical challenges due to the breadth and depth of the discipline and its recent critical turn. Teaching it with a social justice mission, and guiding students to understand critical and postcolonial approaches to its practice, requires complex and multifaceted approaches so as not to oppress or…

The Effects of Word Prediction on Writing Fluency for Students with Physical Disabilities

ERIC Educational Resources Information Center

Mezei, Peter John

2009-01-01

Writing is a multifaceted, complex task that involves interaction between physical and cognitive skills. Individuals with physical disabilities vary in terms of both their physical and cognitive abilities. Often they must overcome one or more significant barriers in order to engage in the task of writing. Minimizing or eliminating barriers is…

An Evaluation of the Influence of Case Method Instruction on the Reflective Thinking of MSW Students

ERIC Educational Resources Information Center

Milner, Marleen

2009-01-01

Social work practice requires that graduates be prepared to deal with complex, multifaceted problems which cannot be defined completely, do not have absolute, correct answers and can be approached from multiple perspectives. This study evaluated the influence of case-based instruction on MSW students' reflective judgment, an aspect of critical…

Let's Hear It from the Males: Issues Facing Male Primary School Teachers

ERIC Educational Resources Information Center

Cushman, P.

2005-01-01

As the number of male teachers in primary schools continues to decrease, the resultant gender imbalance has become the focus of increased discussion and debate. While the reasons for the decline in the number of males enrolling in teacher education are complex and multi-faceted, four factors which have been identified as contributing to the…

Neoliberalism is Not a Theory of Everything: A Bourdieuian Analysis of "Illusio" in Educational Research

ERIC Educational Resources Information Center

Rowlands, Julie; Rawolle, Shaun

2013-01-01

Despite the frequency with which the concept of neoliberalism is employed within academic literature, its complex and multifaceted nature makes it difficult to define and describe. Indeed, data reported in this article suggest that there is a tendency in educational research to make extensive use of the word "neoliberalism" (or its…

Benchmarking the Habits and Behaviours of Successful Students: A Case Study of Academic-Business Collaboration

ERIC Educational Resources Information Center

Archer, Elizabeth; Chetty, Yuraisha Bianca; Prinsloo, Paul

2014-01-01

Student success and retention is a primary goal of higher education institutions across the world. The cost of student failure and dropout in higher education is multifaceted including, amongst other things, the loss of revenue, prestige, and stakeholder trust for both institutions and students. Interventions to address this are complex and…

In-field volatile collection and analysis method utilizing a portable GC-MS: in situ headspace analysis of intact and damaged yellow starthistle flower heads

USDA-ARS?s Scientific Manuscript database

Introduction: Understanding the complex chemical signaling of plants and insects is an important component of chemical ecology. Accordingly, the collection of chemical cues from plants in their normal environment is integral to elucidation of multifaceted plant-insect communications. Often times rem...

Young Children's Meaning-Making through Drawing and "Telling": Analogies to Filmic Textual Features

ERIC Educational Resources Information Center

Wright, Susan

2007-01-01

Young children's meaning-making is a multifaceted, complex experience, where thought, body and emotion unite. Rich and intricate creations are brought to life through children's formation, communication and interpretation of "signs" which stand for or represent something else. The term drawing-telling is used to describe children's use of a range…

Considering Accreditation in Gerontology: The Importance of Interprofessional Collaborative Competencies to Ensure Quality Health Care for Older Adults

ERIC Educational Resources Information Center

Goldberg, Lynette R.; Koontz, Jennifer Scott; Rogers, Nicole; Brickell, Jean

2012-01-01

The health care needs of older adults can be complex and multifaceted. Safe, effective, equitable, and person-centered service provision relies on skilled interprofessional, team-based practice. Too often, students seeking a career specializing in gerontology are not exposed to such interprofessional, team-based learning and practice during their…

Embracing Social Sustainability in Design Education: A Reflection on a Case Study in Haiti

ERIC Educational Resources Information Center

Kjøllesdal, Anders; Asheim, Jonas; Boks, Casper

2014-01-01

Sustainable design issues are complex and multi-faceted and need integration in the education of young designers. Current research recommends a holistic view based on problem-solving and inter-disciplinary work, yet few design educators have brought these ideas to their full consequence. Sustainability education for designers is still often rooted…

Measuring School Performance To Improve Student Achievement and To Reward Effective Programs.

ERIC Educational Resources Information Center

Heistad, Dave; Spicuzza, Rick

This paper describes the method that the Minneapolis Public School system (MPS), Minnesota, uses to measure school and student performance. MPS uses a multifaceted system that both captures and accounts for the complexity of a large urban school district. The system incorporates: (1) a hybrid model of critical indicators that report on level of…

Meeting the Needs of Students with Disabilities Experiencing Homelessness: Federal, Community, and Educator Roles

ERIC Educational Resources Information Center

Sullivan-Walker, Melissa E.; Rock, Marcia L.; Popp, Patricia A.

2017-01-01

Homelessness is a complex and multifaceted condition that affects 2.5 million, or one in every 30, children annually. Based on these numbers, it is likely that at least one student has experienced or is experiencing homelessness in most public school classrooms. Sixteen percent of students experiencing homelessness also received services under…

The Motivational Foundations of Prosocial Behavior from a Developmental Perspective--Evolutionary Roots and Key Psychological Mechanisms: Introduction to the Special Section

ERIC Educational Resources Information Center

Davidov, Maayan; Vaish, Amrisha; Knafo-Noam, Ariel; Hastings, Paul D.

2016-01-01

Prosocial behavior is versatile, multifaceted, and complex. This special section seeks to advance coherent, integrative understanding of prosocial development by addressing this topic through the prism of motivations. This conceptual Introduction presents key ideas that provide a framework for thinking about motivation for prosocial behavior and…

In Quest of Indigeneity, Quality, and Credibility in Aboriginal Post-Secondary Education in Canada: Problematic, Contexts, and Potential Ways Forward

ERIC Educational Resources Information Center

Paquette, Jerald; Fallon, Gerald

2014-01-01

Learning involves conceptual frameworks embedded in worldviews and values. The overarching problematic of Aboriginal post-secondary education is complex and multifaceted. Normative and institutional forces as well as the credentialing and certification agenda of post-secondary education limit the degree to which Aboriginal education at any level…

Lesson Study and the Co-Construction of Pedagogical Knowledge among Secondary Specialty Teachers

ERIC Educational Resources Information Center

Mesa-Lema, Liliana

2014-01-01

Teacher learning in the workplace is situated within a complex context involving the individual and multiple aspects of an educational organization. The present action research study uses a socio-constructionist inquiry lens to further research the local and multifaceted nature of professional learning in schools. The goal is to re-conceptualize…

Gaeilge Gaming: Assessing How Games Can Help Children to Learn Irish

ERIC Educational Resources Information Center

Dalton, Gene; Devitt, Ann

2016-01-01

In the 2011 census almost one in three Irish teenagers claimed to be unable to speak Irish (Central Statistics Office, Ireland, 2012), despite the language being taught daily in school. The challenges facing the Irish language in schools are complex and multifaceted. The research reported here attempts to address some of these challenges by…

Globalization and the Changing Face of Educational Leadership: Current Trends and Emerging Dilemmas

ERIC Educational Resources Information Center

Litz, David

2011-01-01

This paper has used a deconstructivist conceptual framework in order to explore and analyze the multifaceted and complex impacts of globalization on educational leadership in the early 21st century. It will be argued that globalization has had far-reaching positive and negative effects on all of the various nation-states, cultures, economies, and…

Numerical Simulation of Molten Flow in Directed Energy Deposition Using an Iterative Geometry Technique

NASA Astrophysics Data System (ADS)

Vincent, Timothy J.; Rumpfkeil, Markus P.; Chaudhary, Anil

2018-03-01

The complex, multi-faceted physics of laser-based additive metals processing tends to demand high-fidelity models and costly simulation tools to provide predictions accurate enough to aid in selecting process parameters. Of particular difficulty is the accurate determination of melt pool shape and size, which are useful for predicting lack-of-fusion, as this typically requires an adequate treatment of thermal and fluid flow. In this article we describe a novel numerical simulation tool which aims to achieve a balance between accuracy and cost. This is accomplished by making simplifying assumptions regarding the behavior of the gas-liquid interface for processes with a moderate energy density, such as Laser Engineered Net Shaping (LENS). The details of the implementation, which is based on the solver simpleFoam of the well-known software suite OpenFOAM, are given here and the tool is verified and validated for a LENS process involving Ti-6Al-4V. The results indicate that the new tool predicts width and height of a deposited track to engineering accuracy levels.

Numerical Simulation of Molten Flow in Directed Energy Deposition Using an Iterative Geometry Technique

NASA Astrophysics Data System (ADS)

Vincent, Timothy J.; Rumpfkeil, Markus P.; Chaudhary, Anil

2018-06-01

The complex, multi-faceted physics of laser-based additive metals processing tends to demand high-fidelity models and costly simulation tools to provide predictions accurate enough to aid in selecting process parameters. Of particular difficulty is the accurate determination of melt pool shape and size, which are useful for predicting lack-of-fusion, as this typically requires an adequate treatment of thermal and fluid flow. In this article we describe a novel numerical simulation tool which aims to achieve a balance between accuracy and cost. This is accomplished by making simplifying assumptions regarding the behavior of the gas-liquid interface for processes with a moderate energy density, such as Laser Engineered Net Shaping (LENS). The details of the implementation, which is based on the solver simpleFoam of the well-known software suite OpenFOAM, are given here and the tool is verified and validated for a LENS process involving Ti-6Al-4V. The results indicate that the new tool predicts width and height of a deposited track to engineering accuracy levels.

When power does not corrupt: superior individuation processes among powerful perceivers.

PubMed

Overbeck, J R; Park, B

2001-10-01

To examine whether powerful people fail to individuate the less powerful, the authors assigned participants to either a high-power or low-power role for a computer E-mail role play. In 3 studies, participants in the high-power role made decisions and determined the outcomes of interactions; low-power role players had no power and relied on high-power targets for outcome decisions. Studies I and 2 found that high-power perceivers better individuated low-power targets. Study 3 demonstrated that high-power role players' superior judgment can be impaired by including a task that directs their responsibility toward organizational rather than interpersonal concerns. In all, results suggest that the effect of power on social judgment may be more complex and multifaceted than has previously been acknowledged.

Manualization of Occupational Therapy Interventions: Illustrations from the Pressure Ulcer Prevention Research Program

PubMed Central

Blanche, Erna Imperatore; Fogelberg, Donald; Diaz, Jesus; Carlson, Mike; Clark, Florence

2011-01-01

The manualization of a complex occupational therapy intervention is a crucial step in ensuring treatment fidelity for both clinical application and research purposes. Towards this latter end, intervention manuals are essential for assuring trustworthiness and replicability of randomized controlled trials (RCT’s) that aim to provide evidence of the effectiveness of occupational therapy. In this paper, literature on the process of intervention manualization is reviewed. The prescribed steps are then illustrated through our experience in implementing the University of Southern California/Rancho Los Amigos National Rehabilitation Center’s collaborative Pressure Ulcer Prevention Project (PUPP). In this research program, qualitative research provided the initial foundation for manualization of a multifaceted occupational therapy intervention designed to reduce incidence of medically serious pressure ulcers in people with SCI. PMID:22214116

Evolutionary history and functional traits determine the spatial pattern of multifaceted plant diversity in a typical temperate desert disturbed by an expressway.

PubMed

Li, Shuai; Dong, Shikui; Zhang, Xiangfeng; Liu, Shiliang; Shi, Jianbin; Gao, Xiaoxia; Swift, David; Xu, Yudan; Shen, Hao; Yang, Mingyue; Margarida, Canhoto Coxixo Ana

2018-04-20

Temperate desert is one of the globally important biomes with unique and valuable biodiversity, which might be threatened by environmental stresses and human disturbance associated with rapid development. However, few studies have documented the spatial distribution of the multifaceted plant diversity of the temperate desert and their relationships with external impacting factors. We sampled multifaceted plant species diversity including taxonomic diversity, functional diversity and phylogenetic diversity in the Alashan Desert along Beijing-Xinjiang Expressway (G6) in Northern China to identify the key factors and process which regulate the multifaceted plant diversity of the temperate desert. We found that the dynamics of species richness, functional richness, and phylogenetic richness along the elevational gradient corresponded to the unimodal model. Species phylogenetic development shifted from aggregation to divergence, while species functional traits were the opposite along the elevational gradient. The sites at an elevation around 1200-1400 m were the key habitats for the occurrence of high plant diversity including species richness, functional richness and phylogenetic richness. There were no significant differences (p > 0.05) in plant diversity at different distances from the road (500 m, 1000 m and 1500 m) and human disturbances (the distance from the nearest human settlements). Temperature, temperature variability, precipitation, precipitation variability, soil physical and chemistry properties showed no significant effects on plant diversity. It was concluded that evolutionary history and functional traits, not environmental or anthropogenic factors were the key determinants of the pattern of multifaceted plant diversity. Copyright © 2018 Elsevier B.V. All rights reserved.

Creativity Processes of Students in the Design Studio

ERIC Educational Resources Information Center

Huber, Amy Mattingly; Leigh, Katharine E.; Tremblay, Kenneth R., Jr.

2012-01-01

The creative process is a multifaceted and dynamic path of thinking required to execute a project in design-based disciplines. The goal of this research was to test a model outlining the creative design process by investigating student experiences in a design project assignment. The study used an exploratory design to collect data from student…

Implementing a knowledge translation intervention in long-term care: feasibility results from the Vitamin D and Osteoporosis Study (ViDOS).

PubMed

Kennedy, Courtney C; Thabane, Lehana; Ioannidis, George; Adachi, Jonathan D; Papaioannou, Alexandra

2014-12-01

To evaluate the feasibility of implementing an interdisciplinary, multifaceted knowledge translation intervention within long-term care (LTC) and to identify any challenges that should be considered in designing future studies. Cluster randomized controlled trial. Forty LTC homes across the province of Ontario, Canada. LTC teams composed of physicians, nurses, pharmacists, and other staff. Cluster-level feasibility measures, including recruitment, retention, data completion, and participation in the intervention. A process evaluation was completed by directors of care indicating which process/policy changes had been implemented. Recruitment and retention rates were 22% and 63%, respectively. Good fidelity with the intervention was achieved, including attendance at educational meetings. After ViDOS, 7 process indicators were being newly implemented by more than 50% of active intervention homes. Despite recruitment and retention challenges, the multifaceted intervention produced a number of policy/process changes and had good intervention fidelity. This study is registered at ClinicalTrials.gov NCT01398527. Copyright © 2014. Published by Elsevier Inc.

The Impact of Multifaceted Osteoporosis Group Education on Patients' Decision-Making regarding Treatment Options and Lifestyle Changes.

PubMed

Jensen, Annesofie L; Wind, Gitte; Langdahl, Bente Lomholt; Lomborg, Kirsten

2018-01-01

Patients with chronic diseases like osteoporosis constantly have to make decisions related to their disease. Multifaceted osteoporosis group education (GE) may support patients' decision-making. This study investigated multifaceted osteoporosis GE focusing on the impact of GE on patients' decision-making related to treatment options and lifestyle. An interpretive description design using ethnographic methods was utilized with 14 women and three men diagnosed with osteoporosis who attended multifaceted GE. Data consisted of participant observation during GE and individual interviews. Attending GE had an impact on the patients' decision-making in all educational themes. Patients decided on new ways to manage osteoporosis and made decisions regarding bone health and how to implement a lifestyle ensuring bone health. During GE, teachers and patients shared evidence-based knowledge and personal experiences and preferences, respectively, leading to a two-way exchange of information and deliberation about recommendations. Though teachers and patients explored the implications of the decisions and shared their preferences, teachers stressed that the patients ultimately had to make the decision. Teachers therefore refrained from participating in the final step of the decision-making process. Attending GE has an impact on the patients' decision-making as it can initiate patient reflection and support decision-making.

Analysis of Syllabi Intending to Prepare Teachers to Be Data Literate: An Interim Report

ERIC Educational Resources Information Center

WestEd, 2013

2013-01-01

This report documents the work of one component of a larger research effort. The objective of the project is to understand what schools of education are doing to prepare teachers to use data in their practice. The issue is multifaceted, complex, and systemic. Schools of education do not act alone to suddenly introduce courses on data-driven…

Constructing Videocases to Help Novices Learn to Facilitate Discussions in Science and English: How Does Subject Matter Matter?

ERIC Educational Resources Information Center

Rosaen, Cheryl L.; Lundeberg, Mary; Terpstra, Marjorie; Cooper, Marjorie; Niu, Rui; Fu, Jing

2010-01-01

Learning to conduct interactive classroom discussions is a high priority for becoming an effective teacher, and most teachers view conducting productive classroom discussions as a complex undertaking. Because the dynamics of facilitating classroom discussions are multifaceted and hard to analyze in real time, there is a growing interest in how…

Third-Generation British-Bangladeshis from East London: Complex Identities and a Culturally Responsive Pedagogy

ERIC Educational Resources Information Center

Hoque, Aminul

2018-01-01

This article examines the lives and multifaceted identities of a group of young Bangladeshis from east London. Qualitative research--involving predominantly group and in-depth one-to-one interviews--was undertaken with 16 young Bangladeshis aged 15-19. Two key findings emerge from this research. Firstly, the knotty and fluid concept of identity is…

Systematic development of a theory-informed multifaceted behavioural intervention to increase physical activity of adults with type 2 diabetes in routine primary care: Movement as Medicine for Type 2 Diabetes.

PubMed

Avery, Leah; Charman, Sarah J; Taylor, Louise; Flynn, Darren; Mosely, Kylie; Speight, Jane; Lievesley, Matthew; Taylor, Roy; Sniehotta, Falko F; Trenell, Michael I

2016-07-19

Despite substantial evidence for physical activity (PA) as a management option for type 2 diabetes, there remains a lack of PA behavioural interventions suitable for delivery in primary care. This paper describes the systematic development of an evidence-informed PA behavioural intervention for use during routine primary care consultations. In accordance with the Medical Research Council Framework for the Development and Evaluation of Complex Interventions, a four-stage systematic development process was undertaken: (1) exploratory work involving interviews and workshop discussions identified training needs of healthcare professionals and support needs of adults with type 2 diabetes; (2) a systematic review with meta- and moderator analyses identified behaviour change techniques and optimal intervention intensity and duration; (3) usability testing identified strategies to increase implementation of the intervention in primary care and (4) an open pilot study in two primary care practices facilitated intervention optimisation. Healthcare professional training needs included knowledge about type, intensity and duration of PA sufficient to improve glycaemic control and acquisition of skills to promote PA behaviour change. Patients lacked knowledge about type 2 diabetes and skills to enable them to make sustainable changes to their level of PA. An accredited online training programme for healthcare professionals and a professional-delivered behavioural intervention for adults with type 2 diabetes were subsequently developed. This multifaceted intervention was informed by the theory of planned behaviour and social cognitive theory and consisted of 15 behaviour change techniques. Intervention intensity and duration were informed by a systematic review. Usability testing resolved technical problems with the online training intervention that facilitated use on practice IT systems. An open pilot study of the intervention with fidelity of delivery assessment informed optimisation and identified mechanisms to enhance implementation of the intervention during routine diabetes consultations. Movement as Medicine for Type 2 diabetes represents an evidence-informed multifaceted behavioural intervention targeting PA for management of type 2 diabetes developed for delivery in primary care. The structured development process undertaken enhances transparency of intervention content, replicability and scalability. Movement as Medicine for Type 2 diabetes is currently undergoing evaluation in a pilot RCT. ISRCTN67997502.

The role (or not) of economic evaluation at the micro level: can Bourdieu's theory provide a way forward for clinical decision-making?

PubMed

Lessard, Chantale; Contandriopoulos, André-Pierre; Beaulieu, Marie-Dominique

2010-06-01

Despite increasing interest in health economic evaluation, investigations have shown limited use by micro (clinical) level decision-makers. A considerable amount of health decisions take place daily at the point of the clinical encounter; especially in primary care. Since every decision has an opportunity cost, ignoring economic information in family physicians' (FPs) decision-making may have a broad impact on health care efficiency. Knowledge translation of economic evaluation is often based on taken-for-granted assumptions about actors' interests and interactions, neglecting much of the complexity of social reality. Health economics literature frequently assumes a rational and linear decision-making process. Clinical decision-making is in fact a complex social, dynamic, multifaceted process, involving relationships and contextual embeddedness. FPs are embedded in complex social networks that have a significant impact on skills, attitudes, knowledge, practices, and on the information being used. Because of their socially constructed nature, understanding preferences, professional culture, practices, and knowledge translation requires serious attention to social reality. There has been little exploration by health economists of whether the problem may be more fundamental and reside in a misunderstanding of the process of decision-making. There is a need to enhance our understanding of the role of economic evaluation in decision-making from a disciplinary perspective different than health economics. This paper argues for a different conceptualization of the role of economic evaluation in FPs' decision-making, and proposes Bourdieu's sociological theory as a research framework. Bourdieu's theory of practice illustrates how the context-sensitive nature of practice must be understood as a socially constituted practical knowledge. The proposed approach could substantially contribute to a more complex understanding of the role of economic evaluation in FPs' decision-making. Copyright 2010 Elsevier Ltd. All rights reserved.

Getting evidence-based pressure ulcer prevention into practice: a process evaluation of a multifaceted intervention in a hospital setting.

PubMed

Sving, Eva; Fredriksson, Lennart; Gunningberg, Lena; Mamhidir, Anna-Greta

2017-10-01

To describe registered nurses', assistant nurses' and first-line managers' experiences and perceptions of a multifaceted hospital setting intervention focused on implementing evidence-based pressure ulcer prevention. Pressure ulcer prevention is deficient. Different models exist to support implementation of evidence-based care. Little is known about implementation processes. A descriptive qualitative approach. Five focus-group nurse interviews and five individual first-line manager interviews were conducted at five Swedish hospital units. Qualitative content analysis was used. The findings support that the intervention and the implementation process changed the understanding and way of working with pressure ulcer prevention: from treating to preventing. This became possible as 'Changed understanding enables changed actions - through one's own performance and reflection on pressure ulcer prevention'. Having a common outlook on pressure ulcer prevention, easy access to pressure-reducing equipment, and external and internal facilitator support were described as important factors for changed practices. Bedside support, feedback and discussions on current results increased the awareness of needed improvements. The multifaceted intervention approach and the participants' positive attitudes seemed to be crucial for changing understanding and working more preventatively. The strategies used and the skills of the facilitators need to be tailored to the problems surrounding the context. Feedback discussions among the staff regarding the results of the care provided also appear to be vital. It is crucial that dedicated facilitators are involved to promote the implementation process. A preventative mindset should be strived for. Creating an implementation plan with an outcome and a process evaluation should be emphasised. It is important to give the staff regular feedback on the quality of care and on those occasions allocate time for discussion and reflection. © 2016 John Wiley & Sons Ltd.

Berlyne Revisited: Evidence for the Multifaceted Nature of Hedonic Tone in the Appreciation of Paintings and Music

PubMed Central

Marin, Manuela M.; Lampatz, Allegra; Wandl, Michaela; Leder, Helmut

2016-01-01

In his seminal book on esthetics, Berlyne (1971) posited an inverted-U relationship between complexity and hedonic tone in arts appreciation, however, converging evidence for his theory is still missing. The disregard of the multidimensionality of complexity may explain some of the divergent results. Here, we argue that definitions of hedonic tone are manifold and systematically examined whether the nature of the relationship between complexity and hedonic tone is determined by the specific measure of hedonic tone. In Experiment 1, we studied three picture categories with similar affective and semantic contents: 96 affective environmental scenes, which were also converted into 96 cartoons, and 96 representational paintings. Complexity varied along the dimension of elements. In a between-subjects design, each stimulus was presented for 5 s to 206 female participants. Subjective ratings of hedonic tone (either beauty, pleasantness or liking), arousal, complexity and familiarity were collected in three conditions per stimulus set. Complexity and arousal were positively associated in all conditions, with the strongest association observed for paintings. For environmental scenes and cartoons, there was no significant association between complexity and hedonic tone, and the three measures of hedonic tone were highly correlated (all rs > 0.85). As predicted, in paintings the measures of hedonic tone were less strongly correlated (all rs > 0.73), and when controlling for familiarity, the association with complexity was significantly positive for beauty (rs = 0.26), weakly negative for pleasantness (rs = -0.16) and not present for liking. Experiment 2 followed a similar approach and 77 female participants, all non-musicians, rated 92 musical excerpts (15 s) in three conditions of hedonic tone (either beauty, pleasantness or liking). Results indicated a strong relationship between complexity and arousal (all rs > 0.85). When controlling for familiarity effects, the relationship between complexity and beauty followed an inverted-U curve, whereas the relationship between complexity and pleasantness was negative (rs = -0.26) and the one between complexity and liking positive (rs = 0.29). We relate our results to Berlyne’s theory and the latest findings in neuroaesthetics, proposing that future studies need to acknowledge the multifaceted nature of hedonic tone in esthetic experiences of artforms. PMID:27867350

Lifestyle change in type 2 diabetes a process model.

PubMed

Whittemore, Robin; Chase, Susan K; Mandle, Carol Lynn; Roy, Callista

2002-01-01

Integration is an emerging concept in the study of self-management and chronic illness, yet this process and how it occurs is not well understood. This investigation, part of a triangulated study, focused on the experience of integrating type 2 diabetes treatment recommendations into an existing lifestyle while participating in a nurse-coaching intervention. An interpretive method elicited data from nurse-coaching sessions (4), field notes, and an interview in 9 women with type 2 diabetes. The process of data reduction and analysis (Miles & Huberman, 1994) was used to interpret data. The core process of integrating lifestyle change in type 2 diabetes was multifaceted and complex. Challenges to the process of integrating lifestyle change included reconciling emotions, composing a structure, striving for satisfaction, exploring self and conflicts, discovering balance, and developing a new cadence to life. These challenges required acknowledgment in order for participants to progress toward integration. Balance was an integral component to the experience of integration, between structure and flexibility, fear and hope, conflict and acceptance, diabetes and life. Conceptualizations identified with this investigation extend understanding of theories of integration and lifestyle change and invite the development and testing of nursing interventions.

Potential of PET-MRI for imaging of non-oncologic musculoskeletal disease.

PubMed

Kogan, Feliks; Fan, Audrey P; Gold, Garry E

2016-12-01

Early detection of musculoskeletal disease leads to improved therapies and patient outcomes, and would benefit greatly from imaging at the cellular and molecular level. As it becomes clear that assessment of multiple tissues and functional processes are often necessary to study the complex pathogenesis of musculoskeletal disorders, the role of multi-modality molecular imaging becomes increasingly important. New positron emission tomography-magnetic resonance imaging (PET-MRI) systems offer to combine high-resolution MRI with simultaneous molecular information from PET to study the multifaceted processes involved in numerous musculoskeletal disorders. In this article, we aim to outline the potential clinical utility of hybrid PET-MRI to these non-oncologic musculoskeletal diseases. We summarize current applications of PET molecular imaging in osteoarthritis (OA), rheumatoid arthritis (RA), metabolic bone diseases and neuropathic peripheral pain. Advanced MRI approaches that reveal biochemical and functional information offer complementary assessment in soft tissues. Additionally, we discuss technical considerations for hybrid PET-MR imaging including MR attenuation correction, workflow, radiation dose, and quantification.

Becoming musically enculturated: effects of music classes for infants on brain and behavior.

PubMed

Trainor, Laurel J; Marie, Céline; Gerry, David; Whiskin, Elaine; Unrau, Andrea

2012-04-01

Musical enculturation is a complex, multifaceted process that includes the development of perceptual processing specialized for the pitch and rhythmic structures of the musical system in the culture, understanding of esthetic and expressive norms, and learning the pragmatic uses of music in different social situations. Here, we summarize the results of a study in which 6-month-old Western infants were randomly assigned to 6 months of either an active participatory music class or a class in which they experienced music passively while playing. Active music participation resulted in earlier enculturation to Western tonal pitch structure, larger and/or earlier brain responses to musical tones, and a more positive social trajectory. Furthermore, the data suggest that early exposure to cultural norms of musical expression leads to early preferences for those norms. We conclude that musical enculturation begins in infancy and that active participatory music making in a positive social setting accelerates enculturation. © 2012 New York Academy of Sciences.

Music, empathy and cultural understanding: The need for developmental research. Comment on "Music, empathy and cultural understanding" by E. Clarke et al.

NASA Astrophysics Data System (ADS)

Rabinowitch, Tal-Chen

2015-12-01

Clarke, DeNora and Vuoskoski have carried out a formidable task of preparing a profound and encompassing review [3] that brings together two highly complex and multifaceted concepts, empathy and music, as well as a specific aspect of empathy that is highly relevant to society, cultural understanding. They have done an extraordinary service in synthesizing the growing, but still highly fragmented body of work in this area. At the heart of this review lies an intricate model that the authors develop, which accounts for a variety of mechanisms and cognitive processes underlying musical empathic engagement. In what follows I would like to first point out what I think is unique about this model. Then, I will briefly describe the need for including in any such model a developmental angle.

The "dreamer" by daylight: imaginative play, creativity, and generative identity.

PubMed

Raphael-Leff, Joan

2009-01-01

This paper attempts to answer the question: Why, when most children play imaginatively, do so few go on to become creators? The author reviews ideas about the interplay between psychic reality, imaginative play, and creativity, elaborated by generations of researchers since Freud first linked these. The transformational process of play is seen to cultivate a multifaceted inner world and greater complexity of the creative capacity. Developmental themes, age-specific preoccupations, and the changing nature of play are considered. The author's original contribution is the concept of "generative identity"-proposing that a young child's self-image is configured through growing distinctions of gender (components of which are redefined as embodiment, representation, desire). Generative identity is further consolidated by negotiating issues of generation (cohort), genesis (origins), generativity (procreation) and "genitive" issues-separateness, arbitrariness, and the irreversibility of birth and death.

Resurfacing the care in nursing by telephone: lessons from ambulatory oncology.

PubMed

Wilson, Rosemary; Hubert, John

2002-01-01

The practice of providing telephone mediated advice and assistance is often described as "telephone triage" in relevant literature. The decision-making processes required for priority-setting and the provision of advice have been found to be complex and multifaceted. Conceptualization of this valuable patient care activity as a linear "triage" function serves to make invisible the nursing care provided. This article explores the current practice of providing telephone mediated advice and assistance in the following 2 distinct nursing care settings: emergency departments and ambulatory oncology centers. Examination of this activity in these 2 settings provides a forum to discuss and critique legally and fiscally driven prescriptive protocol use to inform decision-making. The effectiveness of experiential knowledge coupled with the strengths of nurse-patient relationships suggests that a need exists to highlight the caring aspects of telephone mediated assistance.

Finding and accessing diagrams in biomedical publications.

PubMed

Kuhn, Tobias; Luong, ThaiBinh; Krauthammer, Michael

2012-01-01

Complex relationships in biomedical publications are often communicated by diagrams such as bar and line charts, which are a very effective way of summarizing and communicating multi-faceted data sets. Given the ever-increasing amount of published data, we argue that the precise retrieval of such diagrams is of great value for answering specific and otherwise hard-to-meet information needs. To this end, we demonstrate the use of advanced image processing and classification for identifying bar and line charts by the shape and relative location of the different image elements that make up the charts. With recall and precisions of close to 90% for the detection of relevant figures, we discuss the use of this technology in an existing biomedical image search engine, and outline how it enables new forms of literature queries over biomedical relationships that are represented in these charts.

On application of kernel PCA for generating stimulus features for fMRI during continuous music listening.

PubMed

Tsatsishvili, Valeri; Burunat, Iballa; Cong, Fengyu; Toiviainen, Petri; Alluri, Vinoo; Ristaniemi, Tapani

2018-06-01

There has been growing interest towards naturalistic neuroimaging experiments, which deepen our understanding of how human brain processes and integrates incoming streams of multifaceted sensory information, as commonly occurs in real world. Music is a good example of such complex continuous phenomenon. In a few recent fMRI studies examining neural correlates of music in continuous listening settings, multiple perceptual attributes of music stimulus were represented by a set of high-level features, produced as the linear combination of the acoustic descriptors computationally extracted from the stimulus audio. NEW METHOD: fMRI data from naturalistic music listening experiment were employed here. Kernel principal component analysis (KPCA) was applied to acoustic descriptors extracted from the stimulus audio to generate a set of nonlinear stimulus features. Subsequently, perceptual and neural correlates of the generated high-level features were examined. The generated features captured musical percepts that were hidden from the linear PCA features, namely Rhythmic Complexity and Event Synchronicity. Neural correlates of the new features revealed activations associated to processing of complex rhythms, including auditory, motor, and frontal areas. Results were compared with the findings in the previously published study, which analyzed the same fMRI data but applied linear PCA for generating stimulus features. To enable comparison of the results, methodology for finding stimulus-driven functional maps was adopted from the previous study. Exploiting nonlinear relationships among acoustic descriptors can lead to the novel high-level stimulus features, which can in turn reveal new brain structures involved in music processing. Copyright © 2018 Elsevier B.V. All rights reserved.

The challenge of transferring an implementation strategy from academia to the field: a process evaluation of local quality improvement collaboratives in Dutch primary care using the normalization process theory.

PubMed

Trietsch, Jasper; van Steenkiste, Ben; Hobma, Sjoerd; Frericks, Arnoud; Grol, Richard; Metsemakers, Job; van der Weijden, Trudy

2014-12-01

A quality improvement strategy consisting of comparative feedback and peer review embedded in available local quality improvement collaboratives proved to be effective in changing the test-ordering behaviour of general practitioners. However, implementing this strategy was problematic. We aimed for large-scale implementation of an adapted strategy covering both test ordering and prescribing performance. Because we failed to achieve large-scale implementation, the aim of this study was to describe and analyse the challenges of the transferring process. In a qualitative study 19 regional health officers, pharmacists, laboratory specialists and general practitioners were interviewed within 6 months after the transfer period. The interviews were audiotaped, transcribed and independently coded by two of the authors. The codes were matched to the dimensions of the normalization process theory. The general idea of the strategy was widely supported, but generating the feedback was more complex than expected and the need for external support after transfer of the strategy remained high because participants did not assume responsibility for the work and the distribution of resources that came with it. Evidence on effectiveness, a national infrastructure for these collaboratives and a general positive attitude were not sufficient for normalization. Thinking about managing large databases, responsibility for tasks and distribution of resources should start as early as possible when planning complex quality improvement strategies. Merely exploring the barriers and facilitators experienced in a preceding trial is not sufficient. Although multifaceted implementation strategies to change professional behaviour are attractive, their inherent complexity is also a pitfall for large-scale implementation. © 2014 John Wiley & Sons, Ltd.

EMDS 3.0: A modeling framework for coping with complexity in environmental assessment and planning.

Treesearch

K.M. Reynolds

2006-01-01

EMDS 3.0 is implemented as an ArcMap® extension and integrates the logic engine of NetWeaver® to perform landscape evaluations, and the decision modeling engine of Criterium DecisionPlus® for evaluating management priorities. Key features of the system's evaluation component include abilities to (1) reason about large, abstract, multifaceted ecosystem management...

When There Is No Blueprint: The Provision of Mental Health Services in Alternative School Programs for Suspended and Expelled Youth

ERIC Educational Resources Information Center

Goldenson, Julie

2011-01-01

A variety of alternative programs are being implemented in Canada and the United States for students who have exhibited conduct problems and who are suspended or expelled from their schools. Given the complexity of issues that these students frequently face, treatment must be multifaceted, wrap-around, delivered by trained professionals and be…

Serving the Cause: Duty Concepts and Combat Effectiveness in War

DTIC Science & Technology

2010-06-01

War II.10 Like moral factors, the notion of military effectiveness is complex and multi-faceted. Murray and Millet argue that military...The insights derived from this synthesis will provide the common reference point for analysis of the historical examples. Alan Millet and...1988). 4 Allan Millet and Williamson Murray, Military Effectiveness, Vol I, 2. 9 This dynamic interaction is particularly pronounced at the

Privacy: The Small and Large of It

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

NUSBAUM,ANNA W.

1999-10-22

The topic of Privacy is complex, multi-faceted, and often emotionally laden. This paper will cover the following topics, in an effort to further understanding of federal regulations and activities, the balancing act that necessarily occurs in business, and what role a records manager can play. The topics are: Definitions; The Privacy Act; ''Private'' companies; Potential areas of concern; Expectations; Corporate responsibilities; Case studies; and Records Manager's role.

Advancing a Vision for Regulatory Science Training

PubMed Central

Adamo, Joan E.; Wilhelm, Erin E.

2015-01-01

Abstract Regulatory science, a complex field which draws on science, law, and policy, is a growing discipline in medical‐related applications. Competencies help define both a discipline and the criteria to measure high‐quality learning experiences. This paper identifies competencies for regulatory science, how they were developed, and broader recommendations to enhance education and training in this burgeoning field, including a multifaceted training approach. PMID:26083660

Predicting High School Completion Using Student Performance in High School Algebra: A Mixed Methods Research Study

ERIC Educational Resources Information Center

Chiado, Wendy S.

2012-01-01

Too many of our nation's youth have failed to complete high school. Determining why so many of our nation's students fail to graduate is a complex, multi-faceted problem and beyond the scope of any one study. The study presented herein utilized a thirteen-step mixed methods model developed by Leech and Onwuegbuzie (2007) to demonstrate within a…

The effect of cutting conditions on power inputs when machining

NASA Astrophysics Data System (ADS)

Petrushin, S. I.; Gruby, S. V.; Nosirsoda, Sh C.

2016-08-01

Any technological process involving modification of material properties or product form necessitates consumption of a certain power amount. When developing new technologies one should take into account the benefits of their implementation vs. arising power inputs. It is revealed that procedures of edge cutting machining are the most energy-efficient amongst the present day forming procedures such as physical and technical methods including electrochemical, electroerosion, ultrasound, and laser processing, rapid prototyping technologies etc, such as physical and technical methods including electrochemical, electroerosion, ultrasound, and laser processing, rapid prototyping technologies etc. An expanded formula for calculation of power inputs is deduced, which takes into consideration the mode of cutting together with the tip radius, the form of the replaceable multifaceted insert and its wear. Having taken as an example cutting of graphite iron by the assembled cutting tools with replaceable multifaceted inserts the authors point at better power efficiency of high feeding cutting in comparison with high-speed cutting.

Experimental strategies to assess the biological ramifications of multiple drivers of global ocean change-A review.

PubMed

Boyd, Philip W; Collins, Sinead; Dupont, Sam; Fabricius, Katharina; Gattuso, Jean-Pierre; Havenhand, Jonathan; Hutchins, David A; Riebesell, Ulf; Rintoul, Max S; Vichi, Marcello; Biswas, Haimanti; Ciotti, Aurea; Gao, Kunshan; Gehlen, Marion; Hurd, Catriona L; Kurihara, Haruko; McGraw, Christina M; Navarro, Jorge M; Nilsson, Göran E; Passow, Uta; Pörtner, Hans-Otto

2018-06-01

Marine life is controlled by multiple physical and chemical drivers and by diverse ecological processes. Many of these oceanic properties are being altered by climate change and other anthropogenic pressures. Hence, identifying the influences of multifaceted ocean change, from local to global scales, is a complex task. To guide policy-making and make projections of the future of the marine biosphere, it is essential to understand biological responses at physiological, evolutionary and ecological levels. Here, we contrast and compare different approaches to multiple driver experiments that aim to elucidate biological responses to a complex matrix of ocean global change. We present the benefits and the challenges of each approach with a focus on marine research, and guidelines to navigate through these different categories to help identify strategies that might best address research questions in fundamental physiology, experimental evolutionary biology and community ecology. Our review reveals that the field of multiple driver research is being pulled in complementary directions: the need for reductionist approaches to obtain process-oriented, mechanistic understanding and a requirement to quantify responses to projected future scenarios of ocean change. We conclude the review with recommendations on how best to align different experimental approaches to contribute fundamental information needed for science-based policy formulation. © 2018 John Wiley & Sons Ltd.

Anorexia of aging and its role for frailty.

PubMed

Sanford, Angela M

2017-01-01

The purpose of this review is to examine the concept of anorexia of aging, including its complex pathophysiology and the multifaceted interventions required to prevent adverse health consequences from this geriatric syndrome. Anorexia of aging is extremely common, occurring in up to 30% of elderly individuals; however, this diagnosis is frequently missed or erroneously attributed to a normal part of the aging process. With aging, impairments in smell and taste can limit the desire to eat. Alterations in stress hormones and inflammatory mediators can lead to excess catabolism, cachexia, and reduced appetite. In addition, mood disorders, such as anxiety and depression, are powerful inhibitors of appetite. Anorexia of aging, with its negative consequences on weight and muscle mass, is a risk factor for the development of frailty and is important to screen for, as early intervention is key to reversing this debilitating condition. Anorexia of aging is a complex geriatric syndrome and a direct risk factor for frailty and thus should not be accepted as normal consequence of aging. Early diagnosis and formulating a plan for targeted interventions is critical to prevent disability and preserve function in elderly patients.

Patchy 'coherence': using normalization process theory to evaluate a multi-faceted shared decision making implementation program (MAGIC).

PubMed

Lloyd, Amy; Joseph-Williams, Natalie; Edwards, Adrian; Rix, Andrew; Elwyn, Glyn

2013-09-05

Implementing shared decision making into routine practice is proving difficult, despite considerable interest from policy-makers, and is far more complex than merely making decision support interventions available to patients. Few have reported successful implementation beyond research studies. MAking Good Decisions In Collaboration (MAGIC) is a multi-faceted implementation program, commissioned by The Health Foundation (UK), to examine how best to put shared decision making into routine practice. In this paper, we investigate healthcare professionals' perspectives on implementing shared decision making during the MAGIC program, to examine the work required to implement shared decision making and to inform future efforts. The MAGIC program approached implementation of shared decision making by initiating a range of interventions including: providing workshops; facilitating development of brief decision support tools (Option Grids); initiating a patient activation campaign ('Ask 3 Questions'); gathering feedback using Decision Quality Measures; providing clinical leads meetings, learning events, and feedback sessions; and obtaining executive board level support. At 9 and 15 months (May and November 2011), two rounds of semi-structured interviews were conducted with healthcare professionals in three secondary care teams to explore views on the impact of these interventions. Interview data were coded by two reviewers using a framework derived from the Normalization Process Theory. A total of 54 interviews were completed with 31 healthcare professionals. Partial implementation of shared decision making could be explained using the four components of the Normalization Process Theory: 'coherence,' 'cognitive participation,' 'collective action,' and 'reflexive monitoring.' Shared decision making was integrated into routine practice when clinical teams shared coherent views of role and purpose ('coherence'). Shared decision making was facilitated when teams engaged in developing and delivering interventions ('cognitive participation'), and when those interventions fit with existing skill sets and organizational priorities ('collective action') resulting in demonstrable improvements to practice ('reflexive monitoring'). The implementation process uncovered diverse and conflicting attitudes toward shared decision making; 'coherence' was often missing. The study showed that implementation of shared decision making is more complex than the delivery of patient decision support interventions to patients, a portrayal that often goes unquestioned. Normalizing shared decision making requires intensive work to ensure teams have a shared understanding of the purpose of involving patients in decisions, and undergo the attitudinal shifts that many health professionals feel are required when comprehension goes beyond initial interpretations. Divergent views on the value of engaging patients in decisions remain a significant barrier to implementation.

Patchy ‘coherence’: using normalization process theory to evaluate a multi-faceted shared decision making implementation program (MAGIC)

PubMed Central

2013-01-01

Background Implementing shared decision making into routine practice is proving difficult, despite considerable interest from policy-makers, and is far more complex than merely making decision support interventions available to patients. Few have reported successful implementation beyond research studies. MAking Good Decisions In Collaboration (MAGIC) is a multi-faceted implementation program, commissioned by The Health Foundation (UK), to examine how best to put shared decision making into routine practice. In this paper, we investigate healthcare professionals’ perspectives on implementing shared decision making during the MAGIC program, to examine the work required to implement shared decision making and to inform future efforts. Methods The MAGIC program approached implementation of shared decision making by initiating a range of interventions including: providing workshops; facilitating development of brief decision support tools (Option Grids); initiating a patient activation campaign (‘Ask 3 Questions’); gathering feedback using Decision Quality Measures; providing clinical leads meetings, learning events, and feedback sessions; and obtaining executive board level support. At 9 and 15 months (May and November 2011), two rounds of semi-structured interviews were conducted with healthcare professionals in three secondary care teams to explore views on the impact of these interventions. Interview data were coded by two reviewers using a framework derived from the Normalization Process Theory. Results A total of 54 interviews were completed with 31 healthcare professionals. Partial implementation of shared decision making could be explained using the four components of the Normalization Process Theory: ‘coherence,’ ‘cognitive participation,’ ‘collective action,’ and ‘reflexive monitoring.’ Shared decision making was integrated into routine practice when clinical teams shared coherent views of role and purpose (‘coherence’). Shared decision making was facilitated when teams engaged in developing and delivering interventions (‘cognitive participation’), and when those interventions fit with existing skill sets and organizational priorities (‘collective action’) resulting in demonstrable improvements to practice (‘reflexive monitoring’). The implementation process uncovered diverse and conflicting attitudes toward shared decision making; ‘coherence’ was often missing. Conclusions The study showed that implementation of shared decision making is more complex than the delivery of patient decision support interventions to patients, a portrayal that often goes unquestioned. Normalizing shared decision making requires intensive work to ensure teams have a shared understanding of the purpose of involving patients in decisions, and undergo the attitudinal shifts that many health professionals feel are required when comprehension goes beyond initial interpretations. Divergent views on the value of engaging patients in decisions remain a significant barrier to implementation. PMID:24006959

ATMOSPHERIC AMMONIA EMISSIONS FROM THE LIVESTOCK SECTOR: DEVELOPMENT AND EVALUATION OF A PROCESS-BASED MODELING APPROACH

EPA Science Inventory

We propose multi-faceted research to enhance our understanding of NH3 emissions from livestock feeding operations. A process-based emissions modeling approach will be used, and we will investigate ammonia emissions from the scale of the individual farm out to impacts on region...

Patterns of Learning. New Perspectives on Life-Span Education.

ERIC Educational Resources Information Center

Houle, Cyril O.

Basic methods of learning, most of which have been used through centuries of recorded thought, are discussed, along with learning as a lifelong process, and ways to enhance and diversify modern education. Numerous learning processes are studied by examining the lives of great individuals who have exemplified innovative and multifaceted approaches…

Investigating the Multifaceted Impact of HIF-1 during Prostate Cancer and Its Potential Value as a Therapeutic Target

DTIC Science & Technology

2015-10-01

individuals and collaborators affiliated with the research team. These same individuals are in the process of learning the colony management skills ...as well as the experimental skills needed for the proposed prostate cancer models. We have also become familiar with the sample processing protocols

Achieving change in primary care—effectiveness of strategies for improving implementation of complex interventions: systematic review of reviews

PubMed Central

Lau, Rosa; Stevenson, Fiona; Ong, Bie Nio; Dziedzic, Krysia; Treweek, Shaun; Eldridge, Sandra; Everitt, Hazel; Kennedy, Anne; Qureshi, Nadeem; Rogers, Anne; Peacock, Richard; Murray, Elizabeth

2015-01-01

Objective To identify, summarise and synthesise available literature on the effectiveness of implementation strategies for optimising implementation of complex interventions in primary care. Design Systematic review of reviews. Data sources MEDLINE, EMBASE, CINAHL, Cochrane Library and PsychINFO were searched, from first publication until December 2013; the bibliographies of relevant articles were screened for additional reports. Eligibility criteria for selecting studies Eligible reviews had to (1) examine effectiveness of single or multifaceted implementation strategies, (2) measure health professional practice or process outcomes and (3) include studies from predominantly primary care in developed countries. Two reviewers independently screened titles/abstracts and full-text articles of potentially eligible reviews for inclusion. Data synthesis Extracted data were synthesised using a narrative approach. Results 91 reviews were included. The most commonly evaluated strategies were those targeted at the level of individual professionals, rather than those targeting organisations or context. These strategies (eg, audit and feedback, educational meetings, educational outreach, reminders) on their own demonstrated a small to modest improvement (2–9%) in professional practice or behaviour with considerable variability in the observed effects. The effects of multifaceted strategies targeted at professionals were mixed and not necessarily more effective than single strategies alone. There was relatively little review evidence on implementation strategies at the levels of organisation and wider context. Evidence on cost-effectiveness was limited and data on costs of different strategies were scarce and/or of low quality. Conclusions There is a substantial literature on implementation strategies aimed at changing professional practices or behaviour. It remains unclear which implementation strategies are more likely to be effective than others and under what conditions. Future research should focus on identifying and assessing the effectiveness of strategies targeted at the wider context and organisational levels and examining the costs and cost-effectiveness of implementation strategies. PROSPERO registration number CRD42014009410. PMID:26700290

Towards sustainable infrastructure management: knowledge-based service-oriented computing framework for visual analytics

NASA Astrophysics Data System (ADS)

Vatcha, Rashna; Lee, Seok-Won; Murty, Ajeet; Tolone, William; Wang, Xiaoyu; Dou, Wenwen; Chang, Remco; Ribarsky, William; Liu, Wanqiu; Chen, Shen-en; Hauser, Edd

2009-05-01

Infrastructure management (and its associated processes) is complex to understand, perform and thus, hard to make efficient and effective informed decisions. The management involves a multi-faceted operation that requires the most robust data fusion, visualization and decision making. In order to protect and build sustainable critical assets, we present our on-going multi-disciplinary large-scale project that establishes the Integrated Remote Sensing and Visualization (IRSV) system with a focus on supporting bridge structure inspection and management. This project involves specific expertise from civil engineers, computer scientists, geographers, and real-world practitioners from industry, local and federal government agencies. IRSV is being designed to accommodate the essential needs from the following aspects: 1) Better understanding and enforcement of complex inspection process that can bridge the gap between evidence gathering and decision making through the implementation of ontological knowledge engineering system; 2) Aggregation, representation and fusion of complex multi-layered heterogeneous data (i.e. infrared imaging, aerial photos and ground-mounted LIDAR etc.) with domain application knowledge to support machine understandable recommendation system; 3) Robust visualization techniques with large-scale analytical and interactive visualizations that support users' decision making; and 4) Integration of these needs through the flexible Service-oriented Architecture (SOA) framework to compose and provide services on-demand. IRSV is expected to serve as a management and data visualization tool for construction deliverable assurance and infrastructure monitoring both periodically (annually, monthly, even daily if needed) as well as after extreme events.

Motivational Interviewing at the Intersections of Depression and Intimate Partner Violence among African American Women

PubMed Central

Wahab, Stéphanie; Trimble, Jammie; Mejia, Angie; Mitchell, S. Renee; Thomas, Mary Jo; Timmons, Vanessa; Waters, A. Star; Raymaker, Dora; Nicolaidis, Christina

2014-01-01

This article focuses on design, training, and delivery of a culturally-tailored, multi-faceted intervention which used motivational interviewing (MI) and case management to reduce depression severity among African American survivors of intimate partner violence (IPV). We present the details of the intervention and discuss its implementation as a means of creating and providing culturally appropriate depression and violence services to African American women. We used a CBPR approach to develop and evaluate the multi-faceted intervention. As part of the evaluation, we collected process measures about the use of MI, assessed MI fidelity, and interviewed participants about their experiences with the program. PMID:24857557

Exploring the Construction of Social Class in Educational Discourse: The Rational Order of the Nation State versus Global Uncertainties

ERIC Educational Resources Information Center

Rassool, Naz

2004-01-01

This article aims to create intellectual space in which issues of social inequality and education can be analyzed and discussed in relation to the multifaceted and multi-levelled complexities of the modern world. It is divided into three sections. Section One locates the concept of social class in the context of the modern nation state during the…

An Analysis of the Survey of Schools of Education on Use of Data in Their Teacher Preparation Programs: An Interim Report

ERIC Educational Resources Information Center

WestEd, 2013

2013-01-01

This report documents the work of one component of a larger research effort. The objective of the project is to understand what schools of education are doing to prepare teachers to use data in their practice. The issue is multifaceted, complex, and systemic. Schools of education do not act alone to suddenly introduce courses on data-driven…

Joint Vision for the Korean Peninsula -- Can We Get There?

DTIC Science & Technology

2012-03-11

complex problem that requires a multifaceted approach. Trilateral cooperation with China coupled with all the elements of the Alliance’s elements of...national power can set the conditions for the Joint Vision Statement to become a reality in this century. 15. SUBJECT TERMS Northeast Asia, China ...We Get There? FORMAT: Strategy Research Project DATE: 11 March 2012 WORD COUNT: 5,917 PAGES: 30 KEY TERMS: Northeast Asia, China

Missing Stories: The Messy Processes, Multifaceted Risks, & Multiple Roles of Critical Ethnographers

ERIC Educational Resources Information Center

Howard, Joy; Thompson, Candace; Nash, Kindel; Rodriguez, Sophia

2016-01-01

In this article, four critical ethnographers reflect on dilemmas that arose during individual research projects. We grappled with the question: What does critical ethnography require from us as we work to represent stories that emerge in contexts where students and/or teachers have been marginalized? After engaging in a three-year process of…

Elsevier Trophoblast Research Award lecture: The multifaceted role of Nodal signaling during mammalian reproduction.

PubMed

Park, C B; Dufort, D

2011-03-01

Nodal, a secreted signaling protein in the transforming growth factor-beta (TGF-β) superfamily, has established roles in vertebrate development. However, components of the Nodal signaling pathway are also expressed at the maternal-fetal interface and have been implicated in many processes of mammalian reproduction. Emerging evidence indicates that Nodal and its extracellular inhibitor Lefty are expressed in the uterus and complex interactions between the two proteins mediate menstruation, decidualization and embryo implantation. Furthermore, several studies have shown that Nodal from both fetal and maternal sources may regulate trophoblast cell fate and facilitate placentation as both embryonic and uterine-specific Nodal knockout mouse strains exhibit disrupted placenta morphology. Here we review the established and prospective roles of Nodal signaling in facilitating successful pregnancy, including recent evidence supporting a potential link to parturition and preterm birth. Copyright © 2011 Elsevier Ltd. All rights reserved.

Learning and change in a community mental health setting.

PubMed

Mancini, Michael A; Miner, Craig S

2013-10-01

This article offers methodological reflections and lessons learned from a three-year university-community partnership that used participatory action research methods to develop and evaluate a model for learning and change. Communities of practice were used to facilitate the translation of recovery-oriented and evidence-based programs into everyday practice at a community mental health agency. Four lessons were drawn from this project. First, the processes of learning and organizational change are complex, slow, and multifaceted. Second, development of leaders and champions is vital to sustained implementation in an era of restricted resources. Third, it is important to have the agency's values, mission, policies, and procedures align with the principles and practices of recovery and integrated treatment. And fourth, effective learning of evidence-based practices is influenced by organizational culture and climate. These four lessons are expanded upon and situated within the broader literature and implications for future research are discussed.

Finding and Accessing Diagrams in Biomedical Publications

PubMed Central

Kuhn, Tobias; Luong, ThaiBinh; Krauthammer, Michael

2012-01-01

Complex relationships in biomedical publications are often communicated by diagrams such as bar and line charts, which are a very effective way of summarizing and communicating multi-faceted data sets. Given the ever-increasing amount of published data, we argue that the precise retrieval of such diagrams is of great value for answering specific and otherwise hard-to-meet information needs. To this end, we demonstrate the use of advanced image processing and classification for identifying bar and line charts by the shape and relative location of the different image elements that make up the charts. With recall and precisions of close to 90% for the detection of relevant figures, we discuss the use of this technology in an existing biomedical image search engine, and outline how it enables new forms of literature queries over biomedical relationships that are represented in these charts. PMID:23304318

Lactoferrin: A bioinspired, anti-biofilm therapeutic

PubMed Central

Ammons, M.C.; Copié, V.

2013-01-01

Medically relevant biofilms have gained a significant level of interest, in part because of the epidemic rise in obesity and an aging population in the developed world. The associated comorbidities of chronic wounds such as pressure ulcers, venous leg ulcers, and diabetic foot wounds remain recalcitrant to the therapies available currently. Development of chronicity in the wound is due primarily to an inability to complete the wound healing process owing to the presence of a bioburden, specifically bacterial biofilms. New therapies are clearly needed which specifically target biofilms. Lactoferrin is a multifaceted molecule of the innate immune system found primarily in milk. While further investigation is warranted to elucidate mechanisms of action, in vitro analyses of lactoferrin and its derivatives have demonstrated that these complex molecules are structurally and functionally well suited to address the heterogeneity of bacterial biofilms. In addition, use of lactoferrin and its derivatives has proven promising in the clinic. PMID:23574002

Providing data science support for systems pharmacology and its implications to drug discovery.

PubMed

Hart, Thomas; Xie, Lei

2016-01-01

The conventional one-drug-one-target-one-disease drug discovery process has been less successful in tracking multi-genic, multi-faceted complex diseases. Systems pharmacology has emerged as a new discipline to tackle the current challenges in drug discovery. The goal of systems pharmacology is to transform huge, heterogeneous, and dynamic biological and clinical data into interpretable and actionable mechanistic models for decision making in drug discovery and patient treatment. Thus, big data technology and data science will play an essential role in systems pharmacology. This paper critically reviews the impact of three fundamental concepts of data science on systems pharmacology: similarity inference, overfitting avoidance, and disentangling causality from correlation. The authors then discuss recent advances and future directions in applying the three concepts of data science to drug discovery, with a focus on proteome-wide context-specific quantitative drug target deconvolution and personalized adverse drug reaction prediction. Data science will facilitate reducing the complexity of systems pharmacology modeling, detecting hidden correlations between complex data sets, and distinguishing causation from correlation. The power of data science can only be fully realized when integrated with mechanism-based multi-scale modeling that explicitly takes into account the hierarchical organization of biological systems from nucleic acid to proteins, to molecular interaction networks, to cells, to tissues, to patients, and to populations.

Machinability of drilling T700/LT-03A carbon fiber reinforced plastic (CFRP) composite laminates using candle stick drill and multi-facet drill

NASA Astrophysics Data System (ADS)

Wang, Cheng-Dong; Qiu, Kun-Xian; Chen, Ming; Cai, Xiao-Jiang

2015-03-01

Carbon Fiber Reinforced Plastic (CFRP) composite laminates are widely used in aerospace and aircraft structural components due to their superior properties. However, they are regarded as difficult-to-cut materials because of bad surface quality and low productivity. Drilling is the most common hole making process for CFRP composite laminates and drilling induced delamination damage usually occurs severely at the exit side of drilling holes, which strongly deteriorate holes quality. In this work, the candle stick drill and multi-facet drill are employed to evaluate the machinability of drilling T700/LT-03A CFRP composite laminates in terms of thrust force, delamination, holes diameter and holes surface roughness. S/N ratio is used to characterize the thrust force while an ellipse-shaped delamination model is established to quantitatively analyze the delamination. The best combination of drilling parameters are determined by full consideration of S/N ratios of thrust force and the delamination. The results indicate that candle stick drill will induce the unexpected ellipse-shaped delamination even at its best drilling parameters of spindle speed of 10,000 rpm and feed rate of 0.004 mm/tooth. However, the multi-facet drill cutting at the relative lower feed rate of 0.004 mm/tooth and lower spindle speed of 6000 rpm can effectively prevent the delamination. Comprehensively, holes quality obtained by multi-facet drill is much more superior to those obtained by candle stick drill.

The Neurodevelopmental Evaluation in a Private Pediatric Setting.

ERIC Educational Resources Information Center

Fomalont, Robert

1986-01-01

A comprehensive neurodevelopment evaluation technique known as PEERAMID is recommended for pediatricians in the evaluation of learning disabilities. This multifaceted system assesses the learning process individually, analyzing: minor neurological indicators, fine and gross motor function, language ability, temporal-sequential organization,…

Berlyne Revisited: Evidence for the Multifaceted Nature of Hedonic Tone in the Appreciation of Paintings and Music.

PubMed

Marin, Manuela M; Lampatz, Allegra; Wandl, Michaela; Leder, Helmut

2016-01-01

In his seminal book on esthetics, Berlyne (1971) posited an inverted-U relationship between complexity and hedonic tone in arts appreciation, however, converging evidence for his theory is still missing. The disregard of the multidimensionality of complexity may explain some of the divergent results. Here, we argue that definitions of hedonic tone are manifold and systematically examined whether the nature of the relationship between complexity and hedonic tone is determined by the specific measure of hedonic tone. In Experiment 1, we studied three picture categories with similar affective and semantic contents: 96 affective environmental scenes, which were also converted into 96 cartoons, and 96 representational paintings. Complexity varied along the dimension of elements. In a between-subjects design, each stimulus was presented for 5 s to 206 female participants. Subjective ratings of hedonic tone (either beauty, pleasantness or liking), arousal, complexity and familiarity were collected in three conditions per stimulus set. Complexity and arousal were positively associated in all conditions, with the strongest association observed for paintings. For environmental scenes and cartoons, there was no significant association between complexity and hedonic tone, and the three measures of hedonic tone were highly correlated (all r s > 0.85). As predicted, in paintings the measures of hedonic tone were less strongly correlated (all r s > 0.73), and when controlling for familiarity, the association with complexity was significantly positive for beauty ( r s = 0.26), weakly negative for pleasantness ( r s = -0.16) and not present for liking. Experiment 2 followed a similar approach and 77 female participants, all non-musicians, rated 92 musical excerpts (15 s) in three conditions of hedonic tone (either beauty, pleasantness or liking). Results indicated a strong relationship between complexity and arousal (all r s > 0.85). When controlling for familiarity effects, the relationship between complexity and beauty followed an inverted-U curve, whereas the relationship between complexity and pleasantness was negative ( r s = -0.26) and the one between complexity and liking positive ( r s = 0.29). We relate our results to Berlyne's theory and the latest findings in neuroaesthetics, proposing that future studies need to acknowledge the multifaceted nature of hedonic tone in esthetic experiences of artforms.

Displacement and adolescent suicide: introduction to a special section.

PubMed

van Dulmen, Manfred H M; Bossarte, Robert M; Swahn, Monica H

2011-01-01

Empirical findings from previous studies indicate that the risk factors for adolescent suicide are multifaceted and likely the result of the interaction between individual and contextual risk factors. In this special section, we focus on one subdomain of risk factors for adolescent suicide, namely, displacement. During adolescence, experiences of displacement due to changes in family or peer relationships may be particularly important because these relationships play a key role in meeting developmental tasks. This special section brings together new findings from four empirical studies investigating how displacement affects risk for suicide across individuals in different contexts and across various domains of displacement. The findings suggest that (a) these risk factors are multifaceted and (b) they often represent an interaction between individual and contextual risk factors. At the same time, the articles in this special section indicate that the role of displacement is complex, and it may sometimes serve a protective role when combined with other factors (e.g., mental health treatment).

A multifaceted FISH approach to study endogenous RNAs and DNAs in native nuclear and cell structures.

PubMed

Byron, Meg; Hall, Lisa L; Lawrence, Jeanne B

2013-01-01

Fluorescence in situ hybridization (FISH) is not a singular technique, but a battery of powerful and versatile tools for examining the distribution of endogenous genes and RNAs in precise context with each other and in relation to specific proteins or cell structures. This unit offers the details of highly sensitive and successful protocols that were initially developed largely in our lab and honed over a number of years. Our emphasis is on analysis of nuclear RNAs and DNA to address specific biological questions about nuclear structure, pre-mRNA metabolism, or the role of noncoding RNAs; however, cytoplasmic RNA detection is also discussed. Multifaceted molecular cytological approaches bring precise resolution and sensitive multicolor detection to illuminate the organization and functional roles of endogenous genes and their RNAs within the native structure of fixed cells. Solutions to several common technical pitfalls are discussed, as are cautions regarding the judicious use of digital imaging and the rigors of analyzing and interpreting complex molecular cytological results.

On the ordinality of numbers: A review of neural and behavioral studies.

PubMed

Lyons, I M; Vogel, S E; Ansari, D

2016-01-01

The last several years have seen steady growth in research on the cognitive and neuronal mechanisms underlying how numbers are represented as part of ordered sequences. In the present review, we synthesize what is currently known about numerical ordinality from behavioral and neuroimaging research, point out major gaps in our current knowledge, and propose several hypotheses that may bear further investigation. Evidence suggests that how we process ordinality differs from how we process cardinality, but that this difference depends strongly on context-in particular, whether numbers are presented symbolically or nonsymbolically. Results also reveal many commonalities between numerical and nonnumerical ordinal processing; however, the degree to which numerical ordinality can be reduced to domain-general mechanisms remains unclear. One proposal is that numerical ordinality relies upon more general short-term memory mechanisms as well as more numerically specific long-term memory representations. It is also evident that numerical ordinality is highly multifaceted, with symbolic representations in particular allowing for a wide range of different types of ordinal relations, the complexity of which appears to increase over development. We examine the proposal that these relations may form the basis of a richer set of associations that may prove crucial to the emergence of more complex math abilities and concepts. In sum, ordinality appears to be an important and relatively understudied facet of numerical cognition that presents substantial opportunities for new and ground-breaking research. © 2016 Elsevier B.V. All rights reserved.

FY 2016 Site-Directed Research & Development Annual Report

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

Bender, Howard

As the Nevada National Security Site (NNSS) continues to evolve and transition its mission to a broader scope, significant challenges lie ahead that present unique opportunities for our research and development (R&D) enterprise. At the juncture, we are poised to create a different future investment strategy. Our decisions at the beginning of a new tri-decade span must be guided as expertly as possible given the greater complexity and multifaceted nature of our work.

The Pivotal Role of Semantic Memory in Remembering the Past and Imagining the Future

PubMed Central

Irish, Muireann; Piguet, Olivier

2013-01-01

Episodic memory refers to a complex and multifaceted process which enables the retrieval of richly detailed evocative memories from the past. In contrast, semantic memory is conceptualized as the retrieval of general conceptual knowledge divested of a specific spatiotemporal context. The neural substrates of the episodic and semantic memory systems have been dissociated in healthy individuals during functional imaging studies, and in clinical cohorts, leading to the prevailing view that episodic and semantic memory represent functionally distinct systems subtended by discrete neurobiological substrates. Importantly, however, converging evidence focusing on widespread neural networks now points to significant overlap between those regions essential for retrieval of autobiographical memories, episodic learning, and semantic processing. Here we review recent advances in episodic memory research focusing on neurodegenerative populations which has proved revelatory for our understanding of the complex interplay between episodic and semantic memory. Whereas episodic memory research has traditionally focused on retrieval of autobiographical events from the past, we also include evidence from the recent paradigm shift in which episodic memory is viewed as an adaptive and constructive process which facilitates the imagining of possible events in the future. We examine the available evidence which converges to highlight the pivotal role of semantic memory in providing schemas and meaning whether one is engaged in autobiographical retrieval for the past, or indeed, is endeavoring to construct a plausible scenario of an event in the future. It therefore seems plausible to contend that semantic processing may underlie most, if not all, forms of episodic memory, irrespective of temporal condition. PMID:23565081

Peace Education and Childhood

ERIC Educational Resources Information Center

Lombardo, Lucien X.; Polonko, Karen A.

2015-01-01

Peace studies and peace education are multifaceted processes focusing on diverse audiences from children in elementary grades to those involved in political negotiations at the highest levels. This paper addresses the foundational importance of including conflict embedded in adult-child relationships in peace education. It conceptually grounds…

Exploration of the concept of collaboration within the context of nurse practitioner-physician collaborative practice.

PubMed

Bridges, Sharon

2014-07-01

Collaboration in the healthcare setting is a multifaceted process that calls for deliberate knowledge sharing and mutual accountability for patient care. The purpose of this analysis is to offer an increased understanding of the concept of collaboration within the context of nurse practitioner (NP)-physician (MD) collaborative practice. The evolutionary method of concept analysis was utilized to explore the concept of collaboration. The process of literature retrieval and data collection was discussed. The search of several nursing and medicine databases resulted in 31 articles, including 17 qualitative and quantitative studies, which met criteria for inclusion in the concept analysis. Collaboration is a complex, sophisticated process that requires commitment of all parties involved. The data analysis identified the surrogate and related terms, antecedents, attributes, and consequences of collaboration within the selected context, which were recognized by major themes presented in the literature and these were discussed. An operational definition was proposed. Increasing collaborative efforts among NPs and MDs may reduce hospital length of stays and healthcare costs, while enhancing professional relationships. Further research is needed to evaluate collaboration and collaborative efforts within the context of NP-MD collaborative practice. ©2013 American Association of Nurse Practitioners.

Sustainable intensification: a multifaceted, systemic approach to international development.

PubMed

Himmelstein, Jennifer; Ares, Adrian; van Houweling, Emily

2016-12-01

Sustainable intensification (SI) is a term increasingly used to describe a type of approach applied to international agricultural projects. Despite its widespread use, there is still little understanding or knowledge of the various facets of this composite paradigm. A review of the literature has led to the formalization of three principles that convey the current characterization of SI, comprising a whole system, participatory, agroecological approach. Specific examples of potential bottlenecks to the SI approach are cited, in addition to various technologies and techniques that can be applied to overcome these obstacles. Models of similar, succcessful approaches to agricultural development are examined, along with higher level processes. Additionally, this review explores the desired end points of SI and argues for the inclusion of gender and nutrition throughout the process. To properly apply the SI approach, its various aspects need to be understood and adapted to different cultural and geographic situations. New modeling systems and examples of the effective execution of SI strategies can assist with the successful application of the SI paradigm within complex developing communities. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

The use of indicators to improve the quality of intensive care: theoretical aspects and experiences from the Dutch intensive care registry.

PubMed

van der Voort, P H J; van der Veer, S N; de Vos, M L G

2012-10-01

In the concept of total quality management that was originally developed in industry, the use of quality indicators is essential. The implementation of quality indicators in the intensive care unit to improve the quality of care is a complex process. This process can be described in seven subsequent steps of an indicator-based quality improvement (IBQI) cycle. With this IBQI cycle, a continuous quality improvement can be achieved with the use of indicator data in a benchmark setting. After the development of evidence-based indicators, a sense of urgency has to be created, registration should start, raw data must be analysed, feedback must be given, and interpretation and conclusions must be made, followed by a quality improvement plan. The last step is the implementation of changes that needs a sense of urgency, and this completes the IBQI cycle. Barriers and facilitators are found in each step. They should be identified and addressed in a multifaceted quality improvement strategy. © 2012 The Authors. Acta Anaesthesiologica Scandinavica © 2012 The Acta Anaesthesiologica Scandinavica Foundation.

The role of risk-based prioritization in total quality management

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

Bennett, C.T.

1994-10-01

The climate in which government managers must make decisions grows more complex and uncertain. All stakeholders - the public, industry, and Congress - are demanding greater consciousness, responsibility, and accountability of programs and their budgets. Yet, managerial decisions have become multifaceted, involve greater risk, and operate over much longer time periods. Over the last four or five decades, as policy analysis and decisions became more complex, scientists from psychology, operations research, systems science, and economics have developed a more or less coherent process called decision analysis to aid program management. The process of decision analysis - a systems theoretic approachmore » - provides the backdrop for this paper. The Laboratory Integrated Prioritization System (LIPS) has been developed as a systems analytic and risk-based prioritization tool to aid the management of the Tri-Labs` (Lawrence Livermore, Los Alamos, and Sandia) operating resources. Preliminary analyses of the effects of LIPS has confirmed the practical benefits of decision and systems sciences - the systematic, quantitative reduction in uncertainty. To date, the use of LIPS - and, hence, its value - has been restricted to resource allocation within the Tri-Labs` operations budgets. This report extends the role of risk-based prioritization to the support of DOE Total Quality Management (TQM) programs. Furthermore, this paper will argue for the requirement to institutionalize an evolutionary, decision theoretic approach to the policy analysis of the Department of Energy`s Program Budget.« less

The role of immune dysfunction in the pathophysiology of autism

PubMed Central

Onore, Charity; Careaga, Milo; Ashwood, Paul

2012-01-01

Autism spectrum disorders (ASD) are a complex group of neurodevelopmental disorders encompassing impairments in communication, social interactions and restricted stereotypical behaviors. Although a link between altered immune responses and ASD was first recognized nearly 40 years ago, only recently has new evidence started to shed light on the complex multifaceted relationship between immune dysfunction and behavior in ASD. Neurobiological research in ASD has highlighted pathways involved in neural development, synapse plasticity, structural brain abnormalities, cognition and behavior. At the same time, several lines of evidence point to altered immune dysfunction in ASD that directly impacts some or all these neurological processes. Extensive alterations in immune function have now been described in both children and adults with ASD, including ongoing inflammation in brain specimens, elevated pro-inflammatory cytokine profiles in the CSF and blood, increased presence of brain-specific auto-antibodies and altered immune cell function. Furthermore, these dysfunctional immune responses are associated with increased impairments in behaviors characteristic of core features of ASD, in particular, deficits in social interactions and communication. This accumulating evidence suggests that immune processes play a key role in the pathophysiology of ASD. This review will discuss the current state of our knowledge of immune dysfunction in ASD, how these findings may impact on underlying neuro-immune mechanisms and implicate potential areas where the manipulation of the immune response could have an impact on behavior and immunity in ASD. PMID:21906670

Insight to the Interaction of the Dihydrolipoamide Acetyltransferase (E2) Core with the Peripheral Components in the Escherichia coli Pyruvate Dehydrogenase Complex via Multifaceted Structural Approaches*

PubMed Central

Chandrasekhar, Krishnamoorthy; Wang, Junjie; Arjunan, Palaniappa; Sax, Martin; Park, Yun-Hee; Nemeria, Natalia S.; Kumaran, Sowmini; Song, Jaeyoung; Jordan, Frank; Furey, William

2013-01-01

Multifaceted structural approaches were undertaken to investigate interaction of the E2 component with E3 and E1 components from the Escherichia coli pyruvate dehydrogenase multienzyme complex (PDHc), as a representative of the PDHc from Gram-negative bacteria. The crystal structure of E3 at 2.5 Å resolution reveals similarity to other E3 structures and was an important starting point for understanding interaction surfaces between E3 and E2. Biochemical studies revealed that R129E-E2 and R150E-E2 substitutions in the peripheral subunit-binding domain (PSBD) of E2 greatly diminished PDHc activity, affected interactions with E3 and E1 components, and affected reductive acetylation of E2. Because crystal structures are unavailable for any complete E2-containing complexes, peptide-specific hydrogen/deuterium exchange mass spectrometry was used to identify loci of interactions between 3-lipoyl E2 and E3. Two peptides from the PSBD, including Arg-129, and three peptides from E3 displayed statistically significant reductions in deuterium uptake resulting from interaction between E3 and E2. Of the peptides identified on E3, two were from the catalytic site, and the third was from the interface domain, which for all known E3 structures is believed to interact with the PSBD. NMR clearly demonstrates that there is no change in the lipoyl domain structure on complexation with E3. This is the first instance where the entire wild-type E2 component was employed to understand interactions with E3. A model for PSBD-E3 binding was independently constructed and found to be consistent with the importance of Arg-129, as well as revealing other electrostatic interactions likely stabilizing this complex. PMID:23580650

Insight to the interaction of the dihydrolipoamide acetyltransferase (E2) core with the peripheral components in the Escherichia coli pyruvate dehydrogenase complex via multifaceted structural approaches.

PubMed

Chandrasekhar, Krishnamoorthy; Wang, Junjie; Arjunan, Palaniappa; Sax, Martin; Park, Yun-Hee; Nemeria, Natalia S; Kumaran, Sowmini; Song, Jaeyoung; Jordan, Frank; Furey, William

2013-05-24

Multifaceted structural approaches were undertaken to investigate interaction of the E2 component with E3 and E1 components from the Escherichia coli pyruvate dehydrogenase multienzyme complex (PDHc), as a representative of the PDHc from Gram-negative bacteria. The crystal structure of E3 at 2.5 Å resolution reveals similarity to other E3 structures and was an important starting point for understanding interaction surfaces between E3 and E2. Biochemical studies revealed that R129E-E2 and R150E-E2 substitutions in the peripheral subunit-binding domain (PSBD) of E2 greatly diminished PDHc activity, affected interactions with E3 and E1 components, and affected reductive acetylation of E2. Because crystal structures are unavailable for any complete E2-containing complexes, peptide-specific hydrogen/deuterium exchange mass spectrometry was used to identify loci of interactions between 3-lipoyl E2 and E3. Two peptides from the PSBD, including Arg-129, and three peptides from E3 displayed statistically significant reductions in deuterium uptake resulting from interaction between E3 and E2. Of the peptides identified on E3, two were from the catalytic site, and the third was from the interface domain, which for all known E3 structures is believed to interact with the PSBD. NMR clearly demonstrates that there is no change in the lipoyl domain structure on complexation with E3. This is the first instance where the entire wild-type E2 component was employed to understand interactions with E3. A model for PSBD-E3 binding was independently constructed and found to be consistent with the importance of Arg-129, as well as revealing other electrostatic interactions likely stabilizing this complex.

Hormetic response triggers multifaceted anti-oxidant strategies in immature king penguins (Aptenodytes patagonicus).

PubMed

Rey, Benjamin; Dégletagne, Cyril; Bodennec, Jacques; Monternier, Pierre-Axel; Mortz, Mathieu; Roussel, Damien; Romestaing, Caroline; Rouanet, Jean-Louis; Tornos, Jeremy; Duchamp, Claude

2016-08-01

Repeated deep dives are highly pro-oxidative events for air-breathing aquatic foragers such as penguins. At fledging, the transition from a strictly terrestrial to a marine lifestyle may therefore trigger a complex set of anti-oxidant responses to prevent chronic oxidative stress in immature penguins but these processes are still undefined. By combining in vivo and in vitro approaches with transcriptome analysis, we investigated the adaptive responses of sea-acclimatized (SA) immature king penguins (Aptenodytes patagonicus) compared with pre-fledging never-immersed (NI) birds. In vivo, experimental immersion into cold water stimulated a higher thermogenic response in SA penguins than in NI birds, but both groups exhibited hypothermia, a condition favouring oxidative stress. In vitro, the pectoralis muscles of SA birds displayed increased oxidative capacity and mitochondrial protein abundance but unchanged reactive oxygen species (ROS) generation per g tissue because ROS production per mitochondria was reduced. The genes encoding oxidant-generating proteins were down-regulated in SA birds while mRNA abundance and activity of the main antioxidant enzymes were up-regulated. Genes encoding proteins involved in repair mechanisms of oxidized DNA or proteins and in degradation processes were also up-regulated in SA birds. Sea life also increased the degree of fatty acid unsaturation in muscle mitochondrial membranes resulting in higher intrinsic susceptibility to ROS. Oxidative damages to protein or DNA were reduced in SA birds. Repeated experimental immersions of NI penguins in cold-water partially mimicked the effects of acclimatization to marine life, modified the expression of fewer genes related to oxidative stress but in a similar way as in SA birds and increased oxidative damages to DNA. It is concluded that the multifaceted plasticity observed after marine life may be crucial to maintain redox homeostasis in active tissues subjected to high pro-oxidative pressure in diving birds. Initial immersions in cold-water may initiate an hormetic response triggering essential changes in the adaptive antioxidant response to marine life. Copyright © 2016 Elsevier Inc. All rights reserved.

EOSINOPHILS: MULTIFACETED BIOLOGIC PROPERTIES AND ROLES IN HEALTH AND DISEASE

PubMed Central

Kita, Hirohito

2011-01-01

Summary Eosinophils are leukocytes resident in mucosal tissues. During Th2-type inflammation, eosinophils are recruited from bone marrow and blood to the sites of immune response. While eosinophils have been considered end-stage cells involved in host protection against parasite infection and immunopathology in hypersensitivity disease, recent studies changed this perspective. Eosinophils are now considered multifunctional leukocytes involved in tissue homeostasis, modulation of adaptive immune responses, and innate immunity to certain microbes. Eosinophils are capable of producing immunoregulatory cytokines and are actively involved in regulation of Th2-type immune responses. However, such new information does not preclude earlier observations showing that eosinophils, in particular human eosinophils, are also effector cells with pro-inflammatory and destructive capabilities. Eosinophils with activation phenotypes are observed in biological specimens from patients with disease, and deposition of eosinophil products is readily seen in the affected tissues from these patients. Therefore, it would be reasonable to consider the eosinophil a multifaceted leukocyte that contributes to various physiological and pathological processes depending on their location and activation status. This review summarizes the emerging concept of the multifaceted immunobiology of eosinophils and discusses the roles of eosinophils in health and disease and the challenges and perspectives in the field. PMID:21682744

Creative Stories: A Storytelling Game Fostering Creativity

ERIC Educational Resources Information Center

Koukourikos, Antonis; Karampiperis, Pythagoras; Panagopoulos, George

2014-01-01

The process of identifying techniques for fostering creativity, and applying these theoretical constructs in real-world educational activities, is, by nature, multifaceted and not straightforward, pertaining to several fields such as cognitive theory and psychology. Furthermore, the quantification of the impact of different activities on…

Healthcare Learning Community and Student Retention

ERIC Educational Resources Information Center

Johnson, Sherryl W.

2014-01-01

Teaching, learning, and retention processes have evolved historically to include multifaceted techniques beyond the traditional lecture. This article presents related results of a study using a healthcare learning community in a southwest Georgia university. The value of novel techniques and tools in promoting student learning and retention…

Multifaceted Schwinger effect in de Sitter space

NASA Astrophysics Data System (ADS)

Sharma, Ramkishor; Singh, Suprit

2017-07-01

We investigate particle production à la the Schwinger mechanism in an expanding, flat de Sitter patch as is relevant for the inflationary epoch of our Universe. Defining states and particle content in curved spacetime is certainly not a unique process. There being different prescriptions on how that can be done, we have used the Schrödinger formalism to define instantaneous particle content of the state, etc. This allows us to go past the adiabatic regime to which the effect has been restricted in the previous studies and bring out its multifaceted nature in different settings. Each of these settings gives rise to contrasting features and behavior as per the effect of the electric field and expansion rate on the instantaneous mean particle number. We also quantify the degree of classicality of the process during its evolution using a "classicality parameter" constructed out of parameters of the Wigner function to obtain information about the quantum to classical transition in this case.

A multi-faceted approach to promote knowledge translation platforms in eastern Mediterranean countries: climate for evidence-informed policy.

PubMed

El-Jardali, Fadi; Ataya, Nour; Jamal, Diana; Jaafar, Maha

2012-05-06

Limited work has been done to promote knowledge translation (KT) in the Eastern Mediterranean Region (EMR). The objectives of this study are to: 1.assess the climate for evidence use in policy; 2.explore views and practices about current processes and weaknesses of health policymaking; 3.identify priorities including short-term requirements for policy briefs; and 4.identify country-specific requirements for establishing KT platforms. Senior policymakers, stakeholders and researchers from Algeria, Bahrain, Egypt, Iran, Jordan, Lebanon, Oman, Sudan, Syria, Tunisia, and Yemen participated in this study. Questionnaires were used to assess the climate for use of evidence and identify windows of opportunity and requirements for policy briefs and for establishing KT platforms. Current processes and weaknesses of policymaking were appraised using case study scenarios. Closed-ended questions were analyzed descriptively. Qualitative data was analyzed using thematic analysis. KT activities were not frequently undertaken by policymakers and researchers in EMR countries, research evidence about high priority policy issues was rarely made available, and interaction between policymakers and researchers was limited, and policymakers rarely identified or created places for utilizing research evidence in decision-making processes. Findings emphasized the complexity of policymaking. Donors, political regimes, economic goals and outdated laws were identified as key drivers. Lack of policymakers' abilities to think strategically, constant need to make quick decisions, limited financial resources, and lack of competent and trained human resources were suggested as main weaknesses. Despite the complexity of policymaking processes in countries from this region, the absence of a structured process for decision making, and the limited engagement of policymakers and researchers in KT activities, there are windows of opportunity for moving towards more evidence informed policymaking.

A multi-faceted approach to promote knowledge translation platforms in eastern Mediterranean countries: climate for evidence-informed policy

PubMed Central

2012-01-01

Objectives Limited work has been done to promote knowledge translation (KT) in the Eastern Mediterranean Region (EMR). The objectives of this study are to: 1.assess the climate for evidence use in policy; 2.explore views and practices about current processes and weaknesses of health policymaking; 3.identify priorities including short-term requirements for policy briefs; and 4.identify country-specific requirements for establishing KT platforms. Methods Senior policymakers, stakeholders and researchers from Algeria, Bahrain, Egypt, Iran, Jordan, Lebanon, Oman, Sudan, Syria, Tunisia, and Yemen participated in this study. Questionnaires were used to assess the climate for use of evidence and identify windows of opportunity and requirements for policy briefs and for establishing KT platforms. Current processes and weaknesses of policymaking were appraised using case study scenarios. Closed-ended questions were analyzed descriptively. Qualitative data was analyzed using thematic analysis. Results KT activities were not frequently undertaken by policymakers and researchers in EMR countries, research evidence about high priority policy issues was rarely made available, and interaction between policymakers and researchers was limited, and policymakers rarely identified or created places for utilizing research evidence in decision-making processes. Findings emphasized the complexity of policymaking. Donors, political regimes, economic goals and outdated laws were identified as key drivers. Lack of policymakers’ abilities to think strategically, constant need to make quick decisions, limited financial resources, and lack of competent and trained human resources were suggested as main weaknesses. Conclusion Despite the complexity of policymaking processes in countries from this region, the absence of a structured process for decision making, and the limited engagement of policymakers and researchers in KT activities, there are windows of opportunity for moving towards more evidence informed policymaking. PMID:22559007

Patterns of Transition Experience for Parents Going Home from Hospital with their Infant after First Stage Surgery for Complex Congenital Heart Disease.

PubMed

Gaskin, Kerry L

2017-12-04

The purpose of this study was to explore parents' experiences of one specific timepoint in their infant's journey: the transition from hospital to home, following the first stage of their infant's cardiac surgery for complex congenital heart disease. A prospective longitudinal mixed methods study, underpinned with Middle Range Transition Theory (Meleis, Sawyer, Im, Hilfinger Messias, & Schumacher, 2000). Face to face and telephone interviews were conducted and self-report forms completed by parents at four-time points: before discharge (T0), 2weeks after discharge (T1), 8weeks after discharge (T2) and after stage two surgery (T3). Interviews were transcribed verbatim before inductive thematic analysis. Parents were recruited over a 15-month period from 2013 to 2015. Twelve mothers and 4 fathers took part. The infants had functionally univentricular heart (left n=10, right n=1) and a systemic shunt dependent lesion, tetralogy of Fallot (n=1). Dynamic constructivist and constructionist social processes occurred for all parents, involving physical, physiological, psychological and cognitive elements within four 'patterns of experience', two of which 'safety and security' and 'love and support' are presented in this paper. Parental support is essential; parents need to be engaged in discharge planning process and given the opportunity to express their needs to ensure that discharge care is truly patient and family centered. Transition from hospital to home was complex and multi-faceted, with unanticipated physical and emotional transitions superimposed upon those that were expected. Copyright © 2017 Elsevier Inc. All rights reserved.

Computer-aided discovery of biological activity spectra for anti-aging and anti-cancer olive oil oleuropeins.

PubMed

Corominas-Faja, Bruna; Santangelo, Elvira; Cuyàs, Elisabet; Micol, Vicente; Joven, Jorge; Ariza, Xavier; Segura-Carretero, Antonio; García, Jordi; Menendez, Javier A

2014-09-01

Aging is associated with common conditions, including cancer, diabetes, cardiovascular disease, and Alzheimer's disease. The type of multi-targeted pharmacological approach necessary to address a complex multifaceted disease such as aging might take advantage of pleiotropic natural polyphenols affecting a wide variety of biological processes. We have recently postulated that the secoiridoids oleuropein aglycone (OA) and decarboxymethyl oleuropein aglycone (DOA), two complex polyphenols present in health-promoting extra virgin olive oil (EVOO), might constitute a new family of plant-produced gerosuppressant agents. This paper describes an analysis of the biological activity spectra (BAS) of OA and DOA using PASS (Prediction of Activity Spectra for Substances) software. PASS can predict thousands of biological activities, as the BAS of a compound is an intrinsic property that is largely dependent on the compound's structure and reflects pharmacological effects, physiological and biochemical mechanisms of action, and specific toxicities. Using Pharmaexpert, a tool that analyzes the PASS-predicted BAS of substances based on thousands of "mechanism-effect" and "effect-mechanism" relationships, we illuminate hypothesis-generating pharmacological effects, mechanisms of action, and targets that might underlie the anti-aging/anti-cancer activities of the gerosuppressant EVOO oleuropeins.

In vivo PET imaging of neuroinflammation in Alzheimer's disease.

PubMed

Lagarde, Julien; Sarazin, Marie; Bottlaender, Michel

2018-05-01

Increasing evidence suggests that neuroinflammation contributes to the pathophysiology of many neurodegenerative diseases, especially Alzheimer's disease (AD). Molecular imaging by PET may be a useful tool to assess neuroinflammation in vivo, thus helping to decipher the complex role of inflammatory processes in the pathophysiology of neurodegenerative diseases and providing a potential means of monitoring the effect of new therapeutic approaches. For this objective, the main target of PET studies is the 18 kDa translocator protein (TSPO), as it is overexpressed by activated microglia. In the present review, we describe the most widely used PET tracers targeting the TSPO, the methodological issues in tracer quantification and summarize the results obtained by TSPO PET imaging in AD, as well as in neurodegenerative disorders associated with AD, in psychiatric disorders and ageing. We also briefly describe alternative PET targets and imaging modalities to study neuroinflammation. Lastly, we question the meaning of PET imaging data in the context of a highly complex and multifaceted role of neuroinflammation in neurodegenerative diseases. This overview leads to the conclusion that PET imaging of neuroinflammation is a promising way of deciphering the enigma of the pathophysiology of AD and of monitoring the effect of new therapies.

Management applications of discontinuity theory | Science ...

EPA Pesticide Factsheets

1.Human impacts on the environment are multifaceted and can occur across distinct spatiotemporal scales. Ecological responses to environmental change are therefore difficult to predict, and entail large degrees of uncertainty. Such uncertainty requires robust tools for management to sustain ecosystem goods and services and maintain resilient ecosystems. 2.We propose an approach based on discontinuity theory that accounts for patterns and processes at distinct spatial and temporal scales, an inherent property of ecological systems. Discontinuity theory has not been applied in natural resource management and could therefore improve ecosystem management because it explicitly accounts for ecological complexity. 3.Synthesis and applications. We highlight the application of discontinuity approaches for meeting management goals. Specifically, discontinuity approaches have significant potential to measure and thus understand the resilience of ecosystems, to objectively identify critical scales of space and time in ecological systems at which human impact might be most severe, to provide warning indicators of regime change, to help predict and understand biological invasions and extinctions and to focus monitoring efforts. Discontinuity theory can complement current approaches, providing a broader paradigm for ecological management and conservation This manuscript provides insight on using discontinuity approaches to aid in managing complex ecological systems. In part

Modeling generic aspects of ideal fibril formation

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

Michel, D., E-mail: denis.michel@live.fr

Many different proteins self-aggregate into insoluble fibrils growing apically by reversible addition of elementary building blocks. But beyond this common principle, the modalities of fibril formation are very disparate, with various intermediate forms which can be reshuffled by minor modifications of physico-chemical conditions or amino-acid sequences. To bypass this complexity, the multifaceted phenomenon of fibril formation is reduced here to its most elementary principles defined for a linear prototype of fibril. Selected generic features, including nucleation, elongation, and conformational recruitment, are modeled using minimalist hypotheses and tools, by separating equilibrium from kinetic aspects and in vitro from in vivo conditions.more » These reductionist approaches allow to bring out known and new rudiments, including the kinetic and equilibrium effects of nucleation, the dual influence of elongation on nucleation, the kinetic limitations on nucleation and fibril numbers, and the accumulation of complexes in vivo by rescue from degradation. Overlooked aspects of these processes are also pointed: the exponential distribution of fibril lengths can be recovered using various models because it is attributable to randomness only. It is also suggested that the same term “critical concentration” is used for different things, involved in either nucleation or elongation.« less

Modeling generic aspects of ideal fibril formation

NASA Astrophysics Data System (ADS)

Michel, D.

2016-01-01

Many different proteins self-aggregate into insoluble fibrils growing apically by reversible addition of elementary building blocks. But beyond this common principle, the modalities of fibril formation are very disparate, with various intermediate forms which can be reshuffled by minor modifications of physico-chemical conditions or amino-acid sequences. To bypass this complexity, the multifaceted phenomenon of fibril formation is reduced here to its most elementary principles defined for a linear prototype of fibril. Selected generic features, including nucleation, elongation, and conformational recruitment, are modeled using minimalist hypotheses and tools, by separating equilibrium from kinetic aspects and in vitro from in vivo conditions. These reductionist approaches allow to bring out known and new rudiments, including the kinetic and equilibrium effects of nucleation, the dual influence of elongation on nucleation, the kinetic limitations on nucleation and fibril numbers, and the accumulation of complexes in vivo by rescue from degradation. Overlooked aspects of these processes are also pointed: the exponential distribution of fibril lengths can be recovered using various models because it is attributable to randomness only. It is also suggested that the same term "critical concentration" is used for different things, involved in either nucleation or elongation.

PINK1/Parkin-Dependent Mitochondrial Surveillance: From Pleiotropy to Parkinson's Disease

PubMed Central

Mouton-Liger, Francois; Jacoupy, Maxime; Corvol, Jean-Christophe; Corti, Olga

2017-01-01

Parkinson's disease (PD) is one of the most frequent neurodegenerative disease caused by the preferential, progressive degeneration of the dopaminergic (DA) neurons of the substantia nigra (SN) pars compacta. PD is characterized by a multifaceted pathological process involving protein misfolding, mitochondrial dysfunction, neuroinflammation and metabolism deregulation. The molecular mechanisms governing the complex interplay between the different facets of this process are still unknown. PARK2/Parkin and PARK6/PINK1, two genes responsible for familial forms of PD, act as a ubiquitous core signaling pathway, coupling mitochondrial stress to mitochondrial surveillance, by regulating mitochondrial dynamics, the removal of damaged mitochondrial components by mitochondria-derived vesicles, mitophagy, and mitochondrial biogenesis. Over the last decade, PINK1/Parkin-dependent mitochondrial quality control emerged as a pleiotropic regulatory pathway. Loss of its function impinges on a number of physiological processes suspected to contribute to PD pathogenesis. Its role in the regulation of innate immunity and inflammatory processes stands out, providing compelling support to the contribution of non-cell-autonomous immune mechanisms in PD. In this review, we illustrate the central role of this multifunctional pathway at the crossroads between mitochondrial stress, neuroinflammation and metabolism. We discuss how its dysfunction may contribute to PD pathogenesis and pinpoint major unresolved questions in the field. PMID:28507507

KDM5 lysine demethylases are involved in maintenance of 3′UTR length

PubMed Central

Blair, Lauren P.; Liu, Zongzhi; Labitigan, Ramon Lorenzo D.; Wu, Lizhen; Zheng, Dinghai; Xia, Zheng; Pearson, Erica L.; Nazeer, Fathima I.; Cao, Jian; Lang, Sabine M.; Rines, Rachel J.; Mackintosh, Samuel G.; Moore, Claire L.; Li, Wei; Tian, Bin; Tackett, Alan J.; Yan, Qin

2016-01-01

The complexity by which cells regulate gene and protein expression is multifaceted and intricate. Regulation of 3′ untranslated region (UTR) processing of mRNA has been shown to play a critical role in development and disease. However, the process by which cells select alternative mRNA forms is not well understood. We discovered that the Saccharomyces cerevisiae lysine demethylase, Jhd2 (also known as KDM5), recruits 3′UTR processing machinery and promotes alteration of 3′UTR length for some genes in a demethylase-dependent manner. Interaction of Jhd2 with both chromatin and RNA suggests that Jhd2 affects selection of polyadenylation sites through a transcription-coupled mechanism. Furthermore, its mammalian homolog KDM5B (also known as JARID1B or PLU1), but not KDM5A (also known as JARID1A or RBP2), promotes shortening of CCND1 transcript in breast cancer cells. Consistent with these results, KDM5B expression correlates with shortened CCND1 in human breast tumor tissues. In contrast, both KDM5A and KDM5B are involved in the lengthening of DICER1. Our findings suggest both a novel role for this family of demethylases and a novel targetable mechanism for 3′UTR processing. PMID:28138513

The Impact of a Multifaceted Approach to Teaching Research Methods on Students' Attitudes

ERIC Educational Resources Information Center

Ciarocco, Natalie J.; Lewandowski, Gary W., Jr.; Van Volkom, Michele

2013-01-01

A multifaceted approach to teaching five experimental designs in a research methodology course was tested. Participants included 70 students enrolled in an experimental research methods course in the semester both before and after the implementation of instructional change. When using a multifaceted approach to teaching research methods that…

Internationalization and Culture in Higher Education

ERIC Educational Resources Information Center

Lumby, Jacky; Foskett, Nick

2016-01-01

Internationalization has attained great significance in Higher Education, driven by both educational philosophy and commercial imperatives. Cultural change is implied as both a related process and as a goal. The article considers the multifaceted ways in which culture might be conceived and linked to different orientations to internationalization.…

Principal Stratification as a Framework for Investigating Mediational Processes in Experimental Settings

ERIC Educational Resources Information Center

Page, Lindsay C.

2012-01-01

Experimental evaluations are increasingly common in the U.S. educational policy-research context. Often, in investigations of multifaceted interventions, researchers and policymakers alike are interested in not only "whether" a given intervention impacted an outcome but also "why". What "features" of the intervention…

Creativity Development in Adolescence: Insight from Behavior, Brain, and Training Studies

ERIC Educational Resources Information Center

Kleibeuker, Sietske W.; De Dreu, Carsten K. W.; Crone, Eveline A.

2016-01-01

Creativity is a multifaceted construct that recruits different cognitive processes. Here, we summarize studies that show that creativity develops considerably during adolescence with different developmental trajectories for insight, verbal divergent thinking, and visuospatial divergent thinking. Next, these developmental time courses are mapped to…

Television & Literacy Development in the Czech Republic. Chapter 14.

ERIC Educational Resources Information Center

Hubik, Stanislav

This chapter begins by explaining that cultural literacy is the ability of a community to create relationships, processes, and institutions aimed at multifaceted community development using indigenous resources (natural, human, social, and cultural). Literacy development in a rural community involves three equally important dimensions--social,…

Individual Differences in Executive Functions Are Almost Entirely Genetic in Origin

ERIC Educational Resources Information Center

Friedman, Naomi P.; Miyake, Akira; Young, Susan E.; DeFries, John C.; Corley, Robin P.; Hewitt, John K.

2008-01-01

Recent psychological and neuropsychological research suggests that executive functions--the cognitive control processes that regulate thought and action--are multifaceted and that different types of executive functions are correlated but separable. The present multivariate twin study of 3 executive functions (inhibiting dominant responses,…

Preserved Affective Sharing But Impaired Decoding of Contextual Complex Emotions in Alcohol Dependence.

PubMed

Grynberg, Delphine; Maurage, Pierre; Nandrino, Jean-Louis

2017-04-01

Prior research has repeatedly shown that alcohol dependence is associated with a large range of impairments in psychological processes, which could lead to interpersonal deficits. Specifically, it has been suggested that these interpersonal difficulties are underpinned by reduced recognition and sharing of others' emotional states. However, this pattern of deficits remains to be clarified. This study thus aimed to investigate whether alcohol dependence is associated with impaired abilities in decoding contextual complex emotions and with altered sharing of others' emotions. Forty-one alcohol-dependent individuals (ADI) and 37 matched healthy individuals completed the Multifaceted Empathy Test, in which they were instructed to identify complex emotional states expressed by individuals in contextual scenes and to state to what extent they shared them. Compared to healthy individuals, ADI were impaired in identifying negative (Cohen's d = 0.75) and positive (Cohen's d = 0.46) emotional states but, conversely, presented preserved abilities in sharing others' emotional states. This study shows that alcohol dependence is characterized by an impaired ability to decode complex emotional states (both positive and negative), despite the presence of complementary contextual cues, but by preserved emotion-sharing. Therefore, these results extend earlier data describing an impaired ability to decode noncontextualized emotions toward contextualized and ecologically valid emotional states. They also indicate that some essential emotional competences such as emotion-sharing are preserved in alcohol dependence, thereby offering potential therapeutic levers. Copyright © 2017 by the Research Society on Alcoholism.

A lean Six Sigma team increases hand hygiene compliance and reduces hospital-acquired MRSA infections by 51%.

PubMed

Carboneau, Clark; Benge, Eddie; Jaco, Mary T; Robinson, Mary

2010-01-01

A low hand hygiene compliance rate by healthcare workers increases hospital-acquired infections to patients. At Presbyterian Healthcare Services in Albuquerque, New Mexico a Lean Six Sigma team identified the reasons for noncompliance were multifaceted. The team followed the DMAIC process and completed the methodology in 12 months. They implemented multiple solutions in the three areas: Education, Culture, and Environment. Based on methicillin-resistant Staphylococcus aureus (MRSA) mortality research the team's results included an estimated 2.5 lives saved by reducing MRSA infections by 51%. Subsequently this 51% decrease in MRSA saved the hospital US$276,500. For those readers tasked with increasing hand hygiene compliance this article will provide the knowledge and insight needed to overcome multifaceted barriers to noncompliance.

Beyond the G-spot: clitourethrovaginal complex anatomy in female orgasm.

PubMed

Jannini, Emmanuele A; Buisson, Odile; Rubio-Casillas, Alberto

2014-09-01

The search for the legendary, highly erogenous vaginal region, the Gräfenberg spot (G-spot), has produced important data, substantially improving understanding of the complex anatomy and physiology of sexual responses in women. Modern imaging techniques have enabled visualization of dynamic interactions of female genitals during self-sexual stimulation or coitus. Although no single structure consistent with a distinct G-spot has been identified, the vagina is not a passive organ but a highly dynamic structure with an active role in sexual arousal and intercourse. The anatomical relationships and dynamic interactions between the clitoris, urethra, and anterior vaginal wall have led to the concept of a clitourethrovaginal (CUV) complex, defining a variable, multifaceted morphofunctional area that, when properly stimulated during penetration, could induce orgasmic responses. Knowledge of the anatomy and physiology of the CUV complex might help to avoid damage to its neural, muscular, and vascular components during urological and gynaecological surgical procedures.

Multifaceted regulation of V(D)J recombination

NASA Astrophysics Data System (ADS)

Wang, Guannan

V(D)J recombination is responsible for generating an enormous repertoire of immunoglobulins and T cell receptors, therefore it is a centerpiece to the formation of the adaptive immune system. The V(D)J recombination process proceeds through two steps, site-specific cleavage at RSS (Recombination Signal Sequence) site mediated by the RAG recombinase (RAG1/2) and the subsequent imprecise resolution of the DNA ends, which is carried out by the ubiquitous non-homologous end joining pathway (NHEJ). The V(D)J recombination reaction is obliged to be tightly controlled under all circumstances, as it involves generations of DNA double strand breaks, which are considered the most dangerous lesion to a cell. Multifaceted regulatory mechanisms have been evolved to create great diversity of the antigen receptor repertoire while ensuring genome stability. The RAG-mediated cleavage reaction is stringently regulated at both the pre-cleavage stage and the post-cleavage stage. Specifically, RAG1/2 first forms a pre-cleavage complex assembled at the boarder of RSS and coding flank, which ensures the appropriate DNA targeting. Subsequently, this complex initiates site-specific cleavage, generating two types of double stranded DNA breaks, hairpin-ended coding ends (HP-CEs) and blunt signal ends (SEs). After the cleavage, RAG1/2 proteins bind and retain the recombination ends to form post-cleavage complexes (PCC), which collaborates with the NHEJ machinery for appropriate transfer of recombination ends to NHEJ for proper end resolution. However, little is known about the molecular basis of this collaboration, partly attributed to the lack of sensitive assays to reveal the interaction of PCC with HP-CEs. Here, for the first time, by using two complementary fluorescence-based techniques, fluorescence anisotropy and fluorescence resonance energy transfer (FRET), I managed to monitor the RAG1/2-catalyzed cleavage reaction in real time, from the pre-cleavage to the post-cleavage stages. By examining the dynamic fluorescence changes during the RAG-mediated cleavage reactions, and by manipulating the reaction conditions, I was able to characterize some fundamental properties of RAG-DNA interactions before and after cleavage. Firstly, Mg 2+, known as a physiological cofactor at the excision step, also promotes the HP-CEs retention in the RAG complex after cleavage. Secondly, the structure of pre-cleavage complex may affect the subsequent collaborations with NHEJ for end resolution. Thirdly, the non-core region of RAG2 may have differential influences on the PCC retention of HP-CEs and SEs. Furthermore, I also provide the first evidence of RAG1-mediated regulation of RAG2. Our study provides important insights into the multilayered regulatory mechanisms, in modulating recombination events in developing lymphocytes and paves the way for possible development of detection and diagnotic markers for defective recombination events that are often associated immunodeficiency and/or lymphoid malignancy.

An agent-based hydroeconomic model to evaluate water policies in Jordan

NASA Astrophysics Data System (ADS)

Yoon, J.; Gorelick, S.

2014-12-01

Modern water systems can be characterized by a complex network of institutional and private actors that represent competing sectors and interests. Identifying solutions to enhance water security in such systems calls for analysis that can adequately account for this level of complexity and interaction. Our work focuses on the development of a hierarchical, multi-agent, hydroeconomic model that attempts to realistically represent complex interactions between hydrologic and multi-faceted human systems. The model is applied to Jordan, one of the most water-poor countries in the world. In recent years, the water crisis in Jordan has escalated due to an ongoing drought and influx of refugees from regional conflicts. We adopt a modular approach in which biophysical modules simulate natural and engineering phenomena, and human modules represent behavior at multiple scales of decision making. The human modules employ agent-based modeling, in which agents act as autonomous decision makers at the transboundary, state, organizational, and user levels. A systematic nomenclature and conceptual framework is used to characterize model agents and modules. Concepts from the Unified Modeling Language (UML) are adopted to promote clear conceptualization of model classes and process sequencing, establishing a foundation for full deployment of the integrated model in a scalable object-oriented programming environment. Although the framework is applied to the Jordanian water context, it is generalizable to other regional human-natural freshwater supply systems.

Occupational therapy practitioners' perspectives regarding international cross-cultural work.

PubMed

Humbert, Tamera Keiter; Burket, Allison; Deveney, Rebecca; Kennedy, Katelyn

2011-08-01

The purpose of this study was to investigate the perspectives of occupational therapy practitioners who have engaged in cross-cultural work experiences. The research question was how do occupational therapy practitioners make meaning of their lived cross-cultural experiences.   This study utilised a qualitative, phenomenological design. Eleven open-ended, semi-structured interviews were conducted with occupational therapy practitioners educated in the United States and who engaged in international practice. The interviews were then coded and analysed using a constant comparative analysis approach. Three central themes emerged from the completed interviews and data analysis, including connectedness, cultural awareness and complexity. Connectedness is the process of forming relationships with others while engaging in cross-cultural experiences. Cultural awareness is the recognition and understanding of a different culture, comparing these insights with one's own culture and then responding to those differences. Complexity is the idea that cross-cultural experiences are dynamic, multi-faceted and intricate. This study helps provide an understanding of cross-cultural work experiences from the practitioners' perspective. The demands of such work require practitioners to go beyond developing basic skills related to cultural sensitivity and cultural awareness. Instead, practitioners need to embrace and integrate the ability to incorporate layers of cultural awareness, complexity and connectedness into practice. Further research is needed to understand how this is actually developed and utilised within practice. © 2011 The Authors. Australian Occupational Therapy Journal © 2011 Occupational Therapy Australia.

Online Microteaching: A Multifaceted Approach to Teacher Professional Development

ERIC Educational Resources Information Center

Kusmawan, Udan

2017-01-01

In this paper, the author proposes that microteaching may be practiced through online media. The core concept of traditional microteaching is that it is a manipulative technique used to facilitate self-reflective and critical thinking processes while teaching. Preliminary research was conducted with elementary teachers who were participating in…

SimilarityExplorer: A visual inter-comparison tool for multifaceted climate data

Treesearch

J. Poco; A. Dasgupta; Y. Wei; W. Hargrove; C. Schwalm; R. Cook; E. Bertini; C. Silva

2014-01-01

Inter-comparison and similarity analysis to gauge consensus among multiple simulation models is a critical visualization problem for understanding climate change patterns. Climate models, specifically, Terrestrial Biosphere Models (TBM) represent time and space variable ecosystem processes, for example, simulations of photosynthesis and respiration, using algorithms...

Rethinking the Eurocentric Library Workplace: A Multi-faceted Process.

ERIC Educational Resources Information Center

Jolivet, Linda C.; Knowles, Em Claire

1996-01-01

Defining and expanding diversity in the workplace may involve reassessment of the dominant workplace culture in libraries, in order to foster better understanding and more effective management, retention, and promotion of librarians of color. Highlights include a selected bibliography and a survey instrument that analyzes the dominant culture of a…

Systematic Assessment of a High-Impact Course Design Institute

ERIC Educational Resources Information Center

Palmer, Michael S.; Streifer, Adriana C.; Williams-Duncan, Stacy

2016-01-01

Herein, we describe an intensive, week-long course design institute (CDI) designed to introduce participants to the scholarly and evidence-driven process of learning-focused course design. Impact of this intervention is demonstrated using a multifaceted approach: (a) post-CDI satisfaction and perception surveys, (b) pre-/post-CDI surveys probing…

A Bifactor Approach to Model Multifaceted Constructs in Statistical Mediation Analysis

ERIC Educational Resources Information Center

Gonzalez, Oscar; MacKinnon, David P.

2018-01-01

Statistical mediation analysis allows researchers to identify the most important mediating constructs in the causal process studied. Identifying specific mediators is especially relevant when the hypothesized mediating construct consists of multiple related facets. The general definition of the construct and its facets might relate differently to…

The Creative Music Curriculum for Pre-Primary Schools

ERIC Educational Resources Information Center

Lam, Stella Wai Man; Wright, Susan

2004-01-01

This article examines the multifaceted nature of pre-primary music teachers' and supervisors' beliefs and practices in music education. It focuses on the general process of creativity (particularly as applied to music education); the classroom setting and how it influences the way music educators approach teaching and learning; and the structuring…

Education in the Rural American Community: A Lifelong Process.

ERIC Educational Resources Information Center

Galbraith, Michael W., Ed.

This book provides a conceptual and practical framework for understanding lifelong education in the context of the multifaceted rural community. The goal of the discussion is to develop educational programs involving new combinations of services and new organizational arrangements so that individuals will become resourceful, autonomous, and…

Understanding Latent Tuberculosis: A Moving Target

PubMed Central

Lin, Philana Ling; Flynn, JoAnne L.

2012-01-01

Tuberculosis (TB) remains a threat to the health of people worldwide. Infection with Mycobacterium tuberculosis can result in active TB or, more commonly, latent infection. Latently infected persons, of which there are estimated to be ~2 billion in the world, represent an enormous reservoir of potential reactivation TB, which can spread to other people. The immunology of TB is complex and multifaceted. Identifying the immune mechanisms that lead to control of initial infection and prevent reactivation of latent infection is crucial to combating this disease. PMID:20562268

Regulating billions of blood platelets: glycans and beyond

PubMed Central

Grozovsky, Renata; Giannini, Silvia; Falet, Hervé

2015-01-01

The human body produces and removes 1011 platelets daily to maintain a normal steady state platelet count. Platelet production must be regulated to avoid spontaneous bleeding or arterial occlusion and organ damage. Multifaceted and complex mechanisms control platelet production and removal in physiological and pathological conditions. This review will focus on different mechanisms of platelet senescence and clearance with specific emphasis on the role of posttranslational modifications. It will also briefly address platelet transfusion and the role of glycans in the clearance of stored platelets. PMID:26330242

Psychological models of suicide.

PubMed

Barzilay, Shira; Apter, Alan

2014-01-01

Suicidal behavior is highly complex and multifaceted. Consequent to the pioneering work of Durkheim and Freud, theoreticians have attempted to explain the biological, social, and psychological nature of suicide. The present work presents an overview and critical discussion of the most influential theoretical models of the psychological mechanisms underlying the development of suicidal behavior. All have been tested to varying degrees and have important implications for the development of therapeutic and preventive interventions. Broader and more in-depth approaches are still needed to further our understanding of suicidal phenomena.

Synthesis and P1' SAR exploration of potent macrocyclic tissue factor-factor VIIa inhibitors

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

Ladziata, Vladimir; Glunz, Peter W.; Zou, Yan

Selective tissue factor-factor VIIa complex (TF-FVIIa) inhibitors are viewed as promising compounds for treating thrombotic disease. In this contribution, we describe multifaceted exploratory SAR studies of S1'-binding moieties within a macrocyclic chemotype aimed at replacing cyclopropyl sulfone P1' group. Over the course of the optimization efforts, the 1-(1H-tetrazol-5-yl)cyclopropane P1' substituent emerged as an improved alternative, offering increased metabolic stability and lower clearance, while maintaining excellent potency and selectivity.

Cost-effectiveness of a multifaceted implementation strategy for the Dutch multidisciplinary guideline for nonspecific low back pain: design of a stepped-wedge cluster randomised controlled trial.

PubMed

Suman, Arnela; Schaafsma, Frederieke G; Elders, Petra J M; van Tulder, Maurits W; Anema, Johannes R

2015-05-31

Low back pain (LBP) is one of the most prevalent and expensive health care problems in industrialised countries. LBP leads to high health care utility and productivity losses; leaving the individual, the employer, and society with substantial costs. To improve the care for LBP patients and reduce the high societal and financial burden of LBP, in 2010 the 'Multidisciplinary care guideline for nonspecific low back pain' was developed in the Netherlands. The current paper describes the design of a study aiming to evaluate the (cost-) effectiveness of a multifaceted strategy to implement this guideline. In a cluster-randomised controlled trial, the (cost-) effectiveness of a multifaceted implementation strategy will be compared to passive guideline dissemination. Using a stepped-wedge approach, participating general practitioners, physiotherapists, and occupational physicians are allocated into clusters and will attend a multidisciplinary continuing medical education training session. The timing these clusters receive the training is the unit of randomisation. LBP patients visiting the participating health care providers are invited to participate in the trial and will receive access to a multimedia intervention aimed at improving beliefs, cognitions, and self-management. The primary outcome measure of this study is patient back beliefs. Secondary outcome measures on patient level include pain, functional status, quality of life, health care utility, and productivity losses. Outcome measures on professional level include knowledge and attitude towards the guideline, and guideline adherence. A process evaluation for the implementation strategy will be performed among the health care providers and the patients. Furthermore, a qualitative subgroup analysis among patients with various ethnic backgrounds will be performed. This study will give insight into the (cost-) effectiveness of a multifaceted implementation strategy for the Dutch multidisciplinary guideline for non-specific back pain to improve outcomes on patient and professional level. The valuable information gained with this study may prove useful for policy-makers, health care providers, and researchers who are in the process of reducing the burden of back pain on individuals and society. Netherlands Trial Register (NTR): NTR4329. Registered December 20th, 2013.

Predictive animal models of mania: hits, misses and future directions

PubMed Central

Young, Jared W; Henry, Brook L; Geyer, Mark A

2011-01-01

Mania has long been recognized as aberrant behaviour indicative of mental illness. Manic states include a variety of complex and multifaceted symptoms that challenge clear clinical distinctions. Symptoms include over-activity, hypersexuality, irritability and reduced need for sleep, with cognitive deficits recently linked to functional outcome. Current treatments have arisen through serendipity or from other disorders. Hence, treatments are not efficacious for all patients, and there is an urgent need to develop targeted therapeutics. Part of the drug discovery process is the assessment of therapeutics in animal models. Here we review pharmacological, environmental and genetic manipulations developed to test the efficacy of therapeutics in animal models of mania. The merits of these models are discussed in terms of the manipulation used and the facet of mania measured. Moreover, the predictive validity of these models is discussed in the context of differentiating drugs that succeed or fail to meet criteria as approved mania treatments. The multifaceted symptomatology of mania has not been reflected in the majority of animal models, where locomotor activity remains the primary measure. This approach has resulted in numerous false positives for putative treatments. Recent work highlights the need to utilize multivariate strategies to enable comprehensive assessment of affective and cognitive dysfunction. Advances in therapeutic treatment may depend on novel models developed with an integrated approach that includes: (i) a comprehensive battery of tests for different aspects of mania, (ii) utilization of genetic information to establish aetiological validity and (iii) objective quantification of patient behaviour with translational cross-species paradigms. LINKED ARTICLES This article is part of a themed issue on Translational Neuropharmacology. To view the other articles in this issue visit http://dx.doi.org/10.1111/bph.2011.164.issue-4 PMID:21410454

Multifaceted brain networks reconfiguration in disorders of consciousness uncovered by co-activation patterns.

PubMed

Di Perri, Carol; Amico, Enrico; Heine, Lizette; Annen, Jitka; Martial, Charlotte; Larroque, Stephen Karl; Soddu, Andrea; Marinazzo, Daniele; Laureys, Steven

2018-01-01

Given that recent research has shown that functional connectivity is not a static phenomenon, we aim to investigate the dynamic properties of the default mode network's (DMN) connectivity in patients with disorders of consciousness. Resting-state fMRI volumes of a convenience sample of 17 patients in unresponsive wakefulness syndrome (UWS) and controls were reduced to a spatiotemporal point process by selecting critical time points in the posterior cingulate cortex (PCC). Spatial clustering was performed on the extracted PCC time frames to obtain 8 different co-activation patterns (CAPs). We investigated spatial connectivity patterns positively and negatively correlated with PCC using both CAPs and standard stationary method. We calculated CAPs occurrences and the total number of frames. Compared to controls, patients showed (i) decreased within-network positive correlations and between-network negative correlations, (ii) emergence of "pathological" within-network negative correlations and between-network positive correlations (better defined with CAPs), and (iii) "pathological" increases in within-network positive correlations and between-network negative correlations (only detectable using CAPs). Patients showed decreased occurrence of DMN-like CAPs (1-2) compared to controls. No between-group differences were observed in the total number of frames CONCLUSION: CAPs reveal at a more fine-grained level the multifaceted spatial connectivity reconfiguration following the DMN disruption in UWS patients, which is more complex than previously thought and suggests alternative anatomical substrates for consciousness. BOLD fluctuations do not seem to differ between patients and controls, suggesting that BOLD response represents an intrinsic feature of the signal, and therefore that spatial configuration is more important for consciousness than BOLD activation itself. Hum Brain Mapp 39:89-103, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

The standards process: Technical committee X3B5 digital magnetic tape

NASA Technical Reports Server (NTRS)

Cheatham, Sam

1993-01-01

The definition of X3B5, where it fits in the national and international standards development process, and how it interfaces and influences the world community of standards developers are provided. Details concerning the focus of the committee, how it operates, and what the group sees as the future trends in the area of interchange standards utilizing the multifaceted, ubiquitous magnetic tape are presented.

Electronic Resources Evaluation Central: Using Off-the-Shelf Software, Web 2.0 Tools, and LibGuides to Manage an Electronic Resources Evaluation Process

ERIC Educational Resources Information Center

England, Lenore; Fu, Li

2011-01-01

A critical part of electronic resources management, the electronic resources evaluation process is multi-faceted and includes a seemingly endless range of resources and tools involving numerous library staff. A solution is to build a Web site to bring all of the components together that can be implemented quickly and result in an organizational…

Didactical determinants use of information and communication technology in process of training of future specialists.

PubMed

Palamar, Borys I; Vaskivska, Halyna O; Palamar, Svitlana P

In the article the author touches upon the subject of significance of computer equipment for organization of cooperation of professor and future specialists. Such subject-subject interaction may be directed to forming of professional skills of future specialists. By using information and communication technologies in education system range of didactic tasks can be solved. Improving of process of teaching of subjects in high school, self-learning future specialists, motivating to learning and self-learning, the development of reflection in the learning process. The authors considers computer equipment as instrument for development of intellectual skills, potential and willingness of future specialists to solve communicative and communication tasks and problems on the creative basis. Based on results of researches the author comes to certain conclusions about the effectiveness of usage of computer technologies in process of teaching future specialists and their self-learning. Improper supplying of high schools with computer equipment, lack of appropriate educational programs, professors' teachers' poor knowledge and usage of computers have negative impact on organization of process of teaching disciplines in high schools. Computer equipment and ICT in general are the instruments of development of intellectual skills, potential and willingness of future specialists to solve communicative and communication tasks and problems. So, the formation of psychosocial environment of development of future specialist is multifaceted, complex and didactically important issue.

Prevention of asthma: where are we in the 21st century?

PubMed

Propp, Phaedra; Becker, Allan

2013-12-01

Asthma is the most common chronic disease of childhood and, in the latter part of the 20th century, reached epidemic proportions. Asthma is generally believed to result from gene-environment interactions. There is consensus that a 'window of opportunity' exists during pregnancy and early in life when environmental factors may influence its development. We review multiple environmental, biologic and sociologic factors that may be important in the development of asthma. Meta-analyses of studies have demonstrated that multifaceted interventions are required in order to develop asthma prevention. Multifaceted allergen reduction studies have shown clinical benefits. Asthma represents a dysfunctional interaction with our genes and the environment to which they are exposed, especially in fetal and early infant life. The increasing prevalence of asthma also may be an indication of increased population risk for the development of other chronic non-communicable autoimmune diseases. This review will focus on the factors which may be important in the primary prevention of asthma. Better understanding of the complex gene-environment interactions involved in the development of asthma will provide insight into personalized interventions for asthma prevention.

Multifaceted intervention including education, rounding checklist implementation, cost feedback, and financial incentives reduces inpatient laboratory costs.

PubMed

Yarbrough, Peter M; Kukhareva, Polina V; Horton, Devin; Edholm, Karli; Kawamoto, Kensaku

2016-05-01

Inappropriate laboratory testing is a contributor to waste in healthcare. To evaluate the impact of a multifaceted laboratory reduction intervention on laboratory costs. A retrospective, controlled, interrupted time series (ITS) study. University of Utah Health Care, a 500-bed academic medical center in Salt Lake City, Utah. All patients 18 years or older admitted to the hospital to a service other than obstetrics, rehabilitation, or psychiatry. Multifaceted quality-improvement initiative in a hospitalist service including education, process change, cost feedback, and financial incentive. Primary outcomes of lab cost per day and per visit. Secondary outcomes of number of basic metabolic panel (BMP), comprehensive metabolic panel (CMP), complete blood count (CBC), and prothrombin time/international normalized ratio tests per day; length of stay (LOS); and 30-day readmissions. A total of 6310 hospitalist patient visits (intervention group) were compared to 25,586 nonhospitalist visits (control group). Among the intervention group, the unadjusted mean cost per day was reduced from $138 before the intervention to $123 after the intervention (P < 0.001), and the unadjusted mean cost per visit decreased from $618 to $558 (P = 0.005). The ITS analysis showed significant reductions in cost per day, cost per visit, and the number of BMP, CMP, and CBC tests per day (P = 0.034, 0.02, <0.001, 0.004, and <0.001). LOS was unchanged and 30-day readmissions decreased in the intervention group. A multifaceted approach to laboratory reduction demonstrated a significant reduction in laboratory cost per day and per visit, as well as common tests per day at a major academic medical center. Journal of Hospital Medicine 2016;11:348-354. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

Structured patient handoff on an internal medicine ward: A cluster randomized control trial.

PubMed

Tam, Penny; Nijjar, Aman P; Fok, Mark; Little, Chris; Shingina, Alexandra; Bittman, Jesse; Raghavan, Rashmi; Khan, Nadia A

2018-01-01

The effect of a multi-faceted handoff strategy in a high volume internal medicine inpatient setting on process and patient outcomes has not been clearly established. We set out to determine if a multi-faceted handoff intervention consisting of education, standardized handoff procedures, including fixed time and location for face-to-face handoff would result in improved rates of handoff compared with usual practice. We also evaluated resident satisfaction, health resource utilization and clinical outcomes. This was a cluster randomized controlled trial in a large academic tertiary care center with 18 inpatient internal medicine ward teams from January-April 2013. We randomized nine inpatient teams to an intervention where they received an education session standardizing who and how to handoff patients, with practice and feedback from facilitators. The control group of 9 teams continued usual non-standardized handoffs. The primary process outcome was the rate of patients handed over per 1000 patient nights. Other process outcomes included perceptions of inadequate handoff by overnight physicians, resource utilization overnight and hospital length of stay. Clinical outcomes included medical errors, frequency of patients requiring higher level of care overnight, and in-hospital mortality. The intervention group demonstrated a significant increase in the rate of patients handed over to the overnight physician (62.90/1000 person-nights vs. 46.86/1000 person-nights, p = 0.002). There was no significant difference in other process outcomes except resource utilization was increased in the intervention group (26.35/1000 person-days vs. 17.57/1000 person-days, p-value = 0.01). There was no significant difference between groups in medical errors (4.8% vs. 4.1%), need for higher level of care or in hospital mortality. Limitations include a dependence of accurate record keeping by the overnight physician, the possibility of cross-contamination in the handoff process, analysis at the cluster level and an overall low number of clinical events. Implementation of a multi-faceted resident handoff intervention did not result in a significant improvement in patient safety although did improve number of patients handed off. Novel methods to improve handoff need to be explored. Registered at ClinicalTrials.gov: NCT01796756.

Quantifying depression-focused recharge in a seasonally frozen, semi-arid landscape

NASA Astrophysics Data System (ADS)

Cey, Edwin; Noorduijn, Saskia; Mohammed, Aaron; Pavlovskii, Igor; Bentley, Laurence; Hayashi, Masaki

2016-04-01

Groundwater recharge in the northern prairie region is influenced by seasonal accumulation of snowmelt runoff in numerous closed topographic depressions (tens to 100's of meters in size) that dot the landscape. Estimating recharge is difficult due to the number and complexity of processes at play, including snow redistribution, runoff, infiltration, evapotranspiration, lateral water redistribution, and recharge, which take place on clay-rich, macroporous sediments that are seasonally frozen. A multi-faceted study, referred to as the Groundwater Recharge in the Prairies (GRIP) project, was undertaken on the Canadian prairies in order to better understand the key hydrologic processes and to generate reliable basin-scale estimates of groundwater recharge that are necessary for sustainable groundwater management. Detailed monitoring of hydrological fluxes across individual depression-midslope-upland complexes was undertaken at three field sites located in different ecoregions, yielding valuable insights into the hydrologic processes and feedbacks within these individual micro-catchments. This process understanding was incorporated into a relatively simple one-dimensional (1D) water budget model, to which a new upscaling scheme was applied to estimate recharge over a watershed or multiple watersheds. The 1D model links upland and depression processes for an individual micro-catchment, and then upscales to a larger model grid cell based on a categorization of depressions based on their surface area and density within the grid cell. This approach enables explicit incorporation of relevant recharge processes, thus producing realistic recharge estimates, while limiting computational demand. The model has been calibrated and tested against a long-term data set from one of the field sites. Results demonstrate complex relationships between upland-depression water transfers and catchment geometry, resulting in maximal groundwater recharge in catchments with intermediate ratios of depression to catchment area. Preliminary modeling results and field data also suggest that recharge is highly sensitive to local land use and climatic conditions, and thus the model represents a useful tool for evaluation of spatial and temporal variability of recharge in the face of changing land use and climatic conditions.

Enabling multi-faceted measures of success for protected area management in Trinidad and Tobago.

PubMed

Granderson, Ainka A

2011-08-01

A key challenge has been to define and measure "success" in managing protected areas. A case study was conducted of efforts to evaluate the new protected area management system in Trinidad and Tobago using a participatory approach. The aim of the case study was to (1) examine whether stakeholder involvement better captures the multi-faceted nature of success and (2) identify the role and influence of various stakeholder groups in this process. An holistic and systematic framework was developed with stakeholder input that facilitated the integration of expert and lay knowledge, a broad emphasis on ecological, socio-economic, and institutional aspects, and the use of both quantitative and qualitative data allowing the evaluation to capture the multi-faceted nature and impacts of protected area management. Input from primary stakeholders, such as local communities, was critical as they have a high stake in protected area outcomes. Secondary and external stakeholders, including government agencies, non-governmental organizations, academia and the private sector, were also important in providing valuable technical assistance and serving as mediators. However, a lack of consensus over priorities, politics, and limited stakeholder capacity and data access pose significant barriers to engaging stakeholders to effectively measure the management success of protected areas. Copyright © 2011 Elsevier Ltd. All rights reserved.

Effecting skin renewal: a multifaceted approach.

PubMed

Widgerow, Alan D; Grekin, Steven K

2011-06-01

The skin undergoes intrinsic aging as a normal course, but exposure to ultraviolet (UV) light results in major cumulative damage that manifests as the typical aged photodamaged skin. UV irradiation produces a sequence of changes within the skin layers starting with signaling processes following DNA damage and culminating in nonabsorbed fragmentation of collagen and other proteins within the extracellular matrix. These fragments promote the synthesis of matrix metalloproteinases (MMPs) that further aggravate the damage to the ground substance and add to fragment accumulation. This study describes a unique sequential approach to controlling this photodamage - inhibition of signaling, inhibition of MMPs, proteasome stimulation and mopping up of fragments, stimulation of procollagen and collagen production, and uniform packaging of new collagen fibers. Thus, a multifaceted approach is introduced with presentation of a unique product formulation based on these research principles. © 2011 Wiley Periodicals, Inc.

Motivating Communities To Go Beyond the Discovery Plateau

NASA Astrophysics Data System (ADS)

Habermann, T.; Kozimor, J.

2014-12-01

Years of emphasizing discovery and minimal metadata requirements have resulted in a culture that accepts that metadata are for discovery and complete metadata are too complex or difficult for researchers to understand and create. Evolving the culture past this "data-discovery plateau" requires a multi-faceted approach that addresses the rational and emotional sides of the problem. On the rational side, scientists know that data and results must be well documented in order to be reproducible, re-usable, and trustworthy. We need tools that script critical moves towards well-described destinations and help identify members of the community that are already leading the way towards those destinations. We need mechanisms that help those leaders share their experiences and examples. On the emotional side, we need to emphasize that high-quality metadata makes data trustworthy, divide the improvement process into digestible pieces and create mechanisms for clearly identifying and rewarding progress. We also need to provide clear opportunities for community members to increase their expertise and to share their skills.

Big Data Technologies: New Opportunities for Diabetes Management.

PubMed

Bellazzi, Riccardo; Dagliati, Arianna; Sacchi, Lucia; Segagni, Daniele

2015-04-24

The so-called big data revolution provides substantial opportunities to diabetes management. At least 3 important directions are currently of great interest. First, the integration of different sources of information, from primary and secondary care to administrative information, may allow depicting a novel view of patient's care processes and of single patient's behaviors, taking into account the multifaceted nature of chronic care. Second, the availability of novel diabetes technologies, able to gather large amounts of real-time data, requires the implementation of distributed platforms for data analysis and decision support. Finally, the inclusion of geographical and environmental information into such complex IT systems may further increase the capability of interpreting the data gathered and extract new knowledge from them. This article reviews the main concepts and definitions related to big data, it presents some efforts in health care, and discusses the potential role of big data in diabetes care. Finally, as an example, it describes the research efforts carried on in the MOSAIC project, funded by the European Commission. © 2015 Diabetes Technology Society.

Catalysis-dependent stabilization of Bre1 fine-tunes histone H2B ubiquitylation to regulate gene transcription

PubMed Central

Wozniak, Glenn G.

2014-01-01

Monoubiquitylation of histone H2B on Lys123 (H2BK123ub1) plays a multifaceted role in diverse DNA-templated processes, yet the mechanistic details by which this modification is regulated are not fully elucidated. Here we show in yeast that H2BK123ub1 is regulated in part through the protein stability of the E3 ubiquitin ligase Bre1. We found that Bre1 stability is controlled by the Rtf1 subunit of the polymerase-associated factor (PAF) complex and through the ability of Bre1 to catalyze H2BK123ub1. Using a domain in Rtf1 that stabilizes Bre1, we show that inappropriate Bre1 levels lead to defects in gene regulation. Collectively, these data uncover a novel quality control mechanism used by the cell to maintain proper Bre1 and H2BK123ub1 levels, thereby ensuring proper control of gene expression. PMID:25085417

The Power of Materials Science Tools for Gaining Insights into Organic Semiconductors

NASA Astrophysics Data System (ADS)

Treat, Neil D.; Westacott, Paul; Stingelin, Natalie

2015-07-01

The structure of organic semiconductors can be complex because features from the molecular level (such as molecular conformation) to the micrometer scale (such as the volume fraction and composition of phases, phase distribution, and domain size) contribute to the definition of the optoelectronic landscape of the final architectures and, hence, to device performance. As a consequence, a detailed understanding of how to manipulate molecular ordering, e.g., through knowledge of relevant phase transitions, of the solidification process, of relevant solidification mechanisms, and of kinetic factors, is required to induce the desired optoelectronic response. In this review, we discuss relevant structural features of single-component and multicomponent systems; provide a case study of the multifaceted structure that polymer:fullerene systems can adopt; and highlight relevant solidification mechanisms such as nucleation and growth, liquid-liquid phase separation, and spinodal decomposition. In addition, cocrystal formation, solid solutions, and eutectic systems are treated and their relevance within the optoelectronic area emphasized.

Big Data Technologies

PubMed Central

Bellazzi, Riccardo; Dagliati, Arianna; Sacchi, Lucia; Segagni, Daniele

2015-01-01

The so-called big data revolution provides substantial opportunities to diabetes management. At least 3 important directions are currently of great interest. First, the integration of different sources of information, from primary and secondary care to administrative information, may allow depicting a novel view of patient’s care processes and of single patient’s behaviors, taking into account the multifaceted nature of chronic care. Second, the availability of novel diabetes technologies, able to gather large amounts of real-time data, requires the implementation of distributed platforms for data analysis and decision support. Finally, the inclusion of geographical and environmental information into such complex IT systems may further increase the capability of interpreting the data gathered and extract new knowledge from them. This article reviews the main concepts and definitions related to big data, it presents some efforts in health care, and discusses the potential role of big data in diabetes care. Finally, as an example, it describes the research efforts carried on in the MOSAIC project, funded by the European Commission. PMID:25910540

Land-use changes and the physical habitat of streams - a review with emphasis on studies within the U.S. Geological Survey Federal-State Cooperative Program

USGS Publications Warehouse

Jacobson, Robert B.; Femmer, Suzanne R.; McKenney, Rose A.

2001-01-01

Understanding the links between land-use changes and physical stream habitat responses is of increasing importance to guide resource management and stream restoration strategies. Transmission of runoff and sediment to streams can involve complex responses of drainage basins, including time lags, thresholds, and cumulative effects. Land-use induced runoff and sediment yield often combine with channel-scale disturbances that decrease flow resistance and erosion resistance, or increase stream energy. The net effects of these interactions on physical stream habitat—depth, velocity, substrate, cover, and temperature—are a challenge to predict. Improved diagnosis and predictive understanding of future change usually require multifaceted, multi-scale, and multidisciplinary studies based on a firm understanding of the history and processes operating in a drainage basin. The U.S. Geological Survey Federal-State Cooperative Program has been instrumental in fostering studies of the links between land use and stream habitat nationwide.

Innovations in information management and access for assessments

PubMed Central

Champion, Sarah M.; Kunkel, Kenneth E.; Tilmes, Curt

2017-01-01

The third National Climate Assessment (NCA3) included goals for becoming a more timely, inclusive, rigorous, and sustained process, and for serving a wider variety of decision makers. In order to accomplish these goals, it was necessary to deliberately design an information management strategy that could serve multiple stakeholders and manage different types of information - from highly mature government-supported climate science data, to isolated practitioner-generated case study information - and to do so in ways that are consistent and appropriate for a highly influential assessment. Meeting the information management challenge for NCA3 meant balancing relevance and authority, complexity and accessibility, inclusivity and rigor. Increasing traceability of data behind figures and graphics, designing a public-facing website, managing hundreds of technical inputs to the NCA, and producing guidance for over 300 participants on meeting the Information Quality Act were all aspects of a deliberate, multi-faceted, and strategic information management approach that nonetheless attempted to be practical and usable for a variety of participants and stakeholders. PMID:29081560

A socio-technical analytical framework on the EHR-organizational innovation interplay: Insights from a public hospital in Greece.

PubMed

Emmanouilidou, Maria

2015-01-01

The healthcare sector globally is confronted with increasing internal and external pressures that urge for a radical reform of health systems' status quo. The role of technological innovations such as Electronic Health Records (EHR) is recognized as instrumental in this transition process as it is expected to accelerate organizational innovations. This is why the widespread uptake of EHR systems is a top priority in the global healthcare agenda. The successful co-deployment though of EHR systems and organizational innovations within the context of secondary healthcare institutions is a complex and multifaceted issue. Existing research in the field has made little progress thus emphasizing the need for further research contribution that will incorporate a holistic perspective. This paper presents insights about the EHR-organizational innovation interplay from a public hospital in Greece into a socio-technical analytical framework providing a multilevel set of action points for the eHealth roadmap with worldwide relevance.

Identification and role of regulatory non-coding RNAs in Listeria monocytogenes.

PubMed

Izar, Benjamin; Mraheil, Mobarak Abu; Hain, Torsten

2011-01-01

Bacterial regulatory non-coding RNAs control numerous mRNA targets that direct a plethora of biological processes, such as the adaption to environmental changes, growth and virulence. Recently developed high-throughput techniques, such as genomic tiling arrays and RNA-Seq have allowed investigating prokaryotic cis- and trans-acting regulatory RNAs, including sRNAs, asRNAs, untranslated regions (UTR) and riboswitches. As a result, we obtained a more comprehensive view on the complexity and plasticity of the prokaryotic genome biology. Listeria monocytogenes was utilized as a model system for intracellular pathogenic bacteria in several studies, which revealed the presence of about 180 regulatory RNAs in the listerial genome. A regulatory role of non-coding RNAs in survival, virulence and adaptation mechanisms of L. monocytogenes was confirmed in subsequent experiments, thus, providing insight into a multifaceted modulatory function of RNA/mRNA interference. In this review, we discuss the identification of regulatory RNAs by high-throughput techniques and in their functional role in L. monocytogenes.

Thermal Spray Applications in Electronics and Sensors: Past, Present, and Future

NASA Astrophysics Data System (ADS)

Sampath, Sanjay

2010-09-01

Thermal spray has enjoyed unprecedented growth and has emerged as an innovative and multifaceted deposition technology. Thermal spray coatings are crucial to the enhanced utilization of various engineering systems. Industries, in recognition of thermal spray's versatility and economics, have introduced it into manufacturing environments. The majority of modern thermal spray applications are "passive" protective coatings, and they rarely perform an electronic function. The ability to consolidate dissimilar material multilayers without substrate thermal loading has long been considered a virtue for thick-film electronics. However, the complexity of understanding/controlling materials functions especially those resulting from rapid solidification and layered assemblage has stymied expansion into electronics. That situation is changing: enhancements in process/material science are allowing reconsideration for novel electronic/sensor devices. This review critically examines past efforts in terms of materials functionality from a device perspective, along with ongoing/future concepts addressing the aforementioned deficiencies. The analysis points to intriguing future possibilities for thermal spray technology in the world of thick-film sensors.

Enhanced implementation of low back pain guidelines in general practice: study protocol of a cluster randomised controlled trial.

PubMed

Riis, Allan; Jensen, Cathrine Elgaard; Bro, Flemming; Maindal, Helle Terkildsen; Petersen, Karin Dam; Jensen, Martin Bach

2013-10-20

Evidence-based clinical practice guidelines may improve treatment quality, but the uptake of guideline recommendations is often incomplete and slow. Recently new low back pain guidelines are being launched in Denmark. The guidelines are considered to reduce personal and public costs. The aim of this study is to evaluate whether a complex, multifaceted implementation strategy of the low back pain guidelines will reduce secondary care referral and improve patient outcomes compared to the usual simple implementation strategy. In a two-armed cluster randomised trial, 100 general practices (clusters) and 2,700 patients aged 18 to 65 years from the North Denmark region will be included. Practices are randomly allocated 1:1 to a simple or a complex implementation strategy. Intervention practices will receive a complex implementation strategy, including guideline facilitator visits, stratification tools, and quality reports on low back pain treatment. Primary outcome is referral to secondary care. Secondary outcomes are pain, physical function, health-related quality of life, patient satisfaction with care and treatment outcome, employment status, and sick leave. Primary and secondary outcomes pertain to the patient level. Assessments of outcomes are blinded and follow the intention-to-treat principle. Additionally, a process assessment will evaluate the degree to which the intervention elements will be delivered as planned, as well as measure changes in beliefs and behaviours among general practitioners and patients. This study provides knowledge concerning the process and effect of an intervention to implement low back pain guidelines in general practice, and will provide insight on essential elements to include in future implementation strategies in general practice. Registered as NCT01699256 on ClinicalTrials.gov.

Analyzing the molecular mechanism of lipoprotein localization in Brucella

PubMed Central

Goolab, Shivani; Roth, Robyn L.; van Heerden, Henriette; Crampton, Michael C.

2015-01-01

Bacterial lipoproteins possess diverse structure and functionality, ranging from bacterial physiology to pathogenic processes. As such many lipoproteins, originating from Brucella are exploited as potential vaccines to countermeasure brucellosis infection in the host. These membrane proteins are translocated from the cytoplasm to the cell membrane where they are anchored peripherally by a multifaceted targeting mechanism. Although much research has focused on the identification and classification of Brucella lipoproteins and their potential use as vaccine candidates for the treatment of Brucellosis, the underlying route for the translocation of these lipoproteins to the outer surface of the Brucella (and other pathogens) outer membrane (OM) remains mostly unknown. This is partly due to the complexity of the organism and evasive tactics used to escape the host immune system, the variation in biological structure and activity of lipoproteins, combined with the complex nature of the translocation machinery. The biosynthetic pathway of Brucella lipoproteins involves a distinct secretion system aiding translocation from the cytoplasm, where they are modified by lipidation, sorted by the lipoprotein localization machinery pathway and thereafter equipped for export to the OM. Surface localized lipoproteins in Brucella may employ a lipoprotein flippase or the β-barrel assembly complex for translocation. This review provides an overview of the characterized Brucella OM proteins that form part of the OM, including a handful of other characterized bacterial lipoproteins and their mechanisms of translocation. Lipoprotein localization pathways in gram negative bacteria will be used as a model to identify gaps in Brucella lipoprotein localization and infer a potential pathway. Of particular interest are the dual topology lipoproteins identified in Escherichia coli and Haemophilus influenza. The localization and topology of these lipoproteins from other gram negative bacteria are well characterized and may be useful to infer a solution to better understand the translocation process in Brucella. PMID:26579096

Do Creativity Self-Beliefs Predict Literacy Achievement and Motivation?

ERIC Educational Resources Information Center

Putwain, David W.; Kearsley, Rebecca; Symes, Wendy

2012-01-01

Previous work has suggested that creativity self-beliefs show only small relations with academic achievement and may only be related to intrinsic, not extrinsic motivation. We set out to re-examine these relationships accounting for the multifaceted and process embedded nature of creativity self-beliefs and the full domain range of extrinsic…

An Examination of the Construct Validity of the Inventory of Classroom Management Style.

ERIC Educational Resources Information Center

Martin, Nancy K.; Baldwin, Beatrice

Confirmatory factor analysis was used to examine the construct validity of a new instrument measuring perceptions toward classroom management: the Inventory of Classroom Management Style (ICMS). Classroom management was defined as a multifaceted process that includes three broad dimensions: (1) what teachers believe about students as persons; (2)…

Hands-On Writing: An Alternative Approach to Understanding Art

ERIC Educational Resources Information Center

Barnes, Natalie Selden

2009-01-01

Art is visual literacy, some would say more basic than writing and speaking, because it is not hampered by the barrier of language. The process of creating a visual narrative and understanding visual literacy is multi-faceted. Because similar cognitive strategies are used in the practice of both visual and written literacy, incorporation of…

Learning-Related Vision Problems: How Visual Processing Affects Reading Efficiency

ERIC Educational Resources Information Center

Solan, Harold A.

2004-01-01

Research during the past decade lends support to the notion that visual as well as phonological deficits are significantly correlated with reading and learning disorders. However, from the variety of visual anomalies discussed, it soon becomes evident that vision, itself, is not a unitary disorder. In this review, the multifaceted nature of…

When Leadership and Policy Making Collide: The Valley View Middle School Experience

ERIC Educational Resources Information Center

Hodge, Warren A.; Osborne-Lampkin, La'Tara

2014-01-01

This case demonstrates the multifaceted nature of the school uniform debate. It shows how conflicts and tensions between stakeholder groups develop and persist when policymakers and school leaders allow hidden agendas and communication barriers to subvert the decision- and policymaking processes. In particular, the case demonstrates what happens…

Making Physical Education a Fairer, Safer and Happier Place: Putting Critical Practices into Action

ERIC Educational Resources Information Center

Garrett, Robyne; Wrench, Alison

2011-01-01

In this research a number of approaches were used with pre-service physical education teachers in an attempt to foster inclusive and critical approaches to teaching physical education. Physical experiences, storytelling and lab school were used to highlight the multifaceted processes around students' engagement in physical education and…

Assessing Students' Learning of Internal Controls: Closing the Loop

ERIC Educational Resources Information Center

Amer, T. S.; Mohrweis, Lawrence C.

2009-01-01

This study describes the multifaceted components of an assessment process. The paper explains a novel approach in which an advisory council participated in a "fun," hands-on activity to rank-order learning outcomes. The top ranked learning competency, as identified by the advisory council, was the need for students to gain a better…

School Engagement among Urban Youth of Color: Criterion Pattern Effects of Vocational Exploration and Racial Identity

ERIC Educational Resources Information Center

Perry, Justin C.

2008-01-01

School engagement is a multifaceted psychosocial process that functions as a key mediator of academic achievement, motivation, and school dropout. This study investigated the effects of vocational exploration and racial identity on behavioral (attendance, attention, time spent on class work) and psychological (identification with school) factors…

Negotiating Authority in an Undergraduate Teacher Education Course: A Qualitative Investigation

ERIC Educational Resources Information Center

Brubaker, Nathan D.

2009-01-01

Negotiating authority, a multifaceted, on-going process of mutual bargaining over the power to determine or the right to control, permeates all facets of teaching experience. Considered by many educational theorists to be an outgrowth of collaborative dialogue and decision-making that helps foster active student engagement and investment in…

Autistic Symptomatology, Face Processing Abilities, and Eye Fixation Patterns

ERIC Educational Resources Information Center

Kirchner, Jennifer C.; Hatri, Alexander; Heekeren, Hauke R.; Dziobek, Isabel

2011-01-01

Deviant gaze behavior is a defining characteristic of autism. Its relevance as a pathophysiological mechanism, however, remains unknown. In the present study, we compared eye fixations of 20 adults with autism and 21 controls while they were engaged in taking the Multifaceted Empathy Test (MET). Additional measures of face emotion and identity…

ERP Evidence for Telicity Effects on Syntactic Processing in Garden-Path Sentences

ERIC Educational Resources Information Center

Malaia, Evguenia; Wilbur, Ronnie B.; Weber-Fox, Christine

2009-01-01

Verbs contain multifaceted information about both the semantics of an action, and potential argument structures. Linguistic theory classifies verbs according to whether the denoted action has an inherent (telic) end-point ("fall," "awaken"), or whether it is considered homogenous, or atelic ("read," "worship"). The aim of our study was to examine…

Hypervideo for Educational Purposes: A Literature Review on a Multifaceted Technological Tool

ERIC Educational Resources Information Center

Sauli, Florinda; Cattaneo, Alberto; van der Meij, Hans

2018-01-01

The term "hypervideo" has different interpretations in the scientific literature. The aim of this contribution is to define hypervideo as it is and can be (more optimally) used for teaching and learning purposes. Videos can promote learning by recreating real experiences and dynamic processes, although they do not necessarily enable…

Caldwell Community College and Technical Institute QEP: Writing across the Curriculum Professional Development Program

ERIC Educational Resources Information Center

Hampson, Margaret P.

2009-01-01

As part of its Southern Association of Colleges and Schools (SACS) reaffirmation process, Caldwell Community College (CCC) and Technical Institute's (TI) Quality Enhancement Plan (QEP), entitled "Enhancing Writing--Write On!" demonstrates the need to improve student writing through multifaceted interventions. The goals of CCC's and TI's…

Freeform diamond machining of complex monolithic metal optics for integral field systems

NASA Astrophysics Data System (ADS)

Dubbeldam, Cornelis M.; Robertson, David J.; Preuss, Werner

2004-09-01

Implementation of the optical designs of image slicing Integral Field Systems requires accurate alignment of a large number of small (and therefore difficult to manipulate) optical components. In order to facilitate the integration of these complex systems, the Astronomical Instrumentation Group (AIG) of the University of Durham, in collaboration with the Labor für Mikrozerspanung (Laboratory for Precision Machining - LFM) of the University of Bremen, have developed a technique for fabricating monolithic multi-faceted mirror arrays using freeform diamond machining. Using this technique, the inherent accuracy of the diamond machining equipment is exploited to achieve the required relative alignment accuracy of the facets, as well as an excellent optical surface quality for each individual facet. Monolithic arrays manufactured using this freeform diamond machining technique were successfully applied in the Integral Field Unit for the GEMINI Near-InfraRed Spectrograph (GNIRS IFU), which was recently installed at GEMINI South. Details of their fabrication process and optical performance are presented in this paper. In addition, the direction of current development work, conducted under the auspices of the Durham Instrumentation R&D Program supported by the UK Particle Physics and Astronomy Research Council (PPARC), will be discussed. The main emphasis of this research is to improve further the optical performance of diamond machined components, as well as to streamline the production and quality control processes with a view to making this technique suitable for multi-IFU instruments such as KMOS etc., which require series production of large quantities of optical components.

A multifaceted program for improving quality of care in intensive care units: IATROREF study.

PubMed

Garrouste-Orgeas, Maite; Soufir, Lilia; Tabah, Alexis; Schwebel, Carole; Vesin, Aurelien; Adrie, Christophe; Thuong, Marie; Timsit, Jean Francois

2012-02-01

To test the effects of three multifaceted safety programs designed to decrease insulin administration errors, anticoagulant prescription and administration errors, and errors leading to accidental removal of endotracheal tubes and central venous catheters, respectively. Medical errors and adverse events are associated with increased mortality in intensive care patients, indicating an urgent need for prevention programs. Multicenter cluster-randomized study. One medical intensive care unit in a university hospital and two medical-surgical intensive care units in community hospitals belonging to the Outcomerea Study Group. Consecutive patients >18 yrs admitted from January 2007 to January 2008 to the intensive care units. We tested three multifaceted safety programs vs. standard care in random order, each over 2.5 months, after a 1.5-month observation period. Incidence rates of medical errors/1000 patient-days in the multifaceted safety program and standard-care groups were compared using adjusted hierarchical models. In 2117 patients with 15,014 patient-days, 8520 medical errors (567.5/1000 patient-days) were reported, including 1438 adverse events (16.9%, 95.8/1000 patient-days). The insulin multifaceted safety program significantly decreased errors during implementation (risk ratio 0.65; 95% confidence interval [CI] 0.52-0.82; p = .0003) and after implementation (risk ratio 0.51; 95% CI 0.35-0.73; p = .0004). A significant Hawthorne effect was found. The accidental tube/catheter removal multifaceted safety program decreased errors significantly during implementation (odds ratio [OR] 0.34; 95% CI 0.15-0.81; p = .01]) and nonsignificantly after implementation (OR 1.65; 95% CI 0.78-3.48). The anticoagulation multifaceted safety program was not significantly effective (OR 0.64; 95% CI 0.26-1.59) but produced a significant Hawthorne effect. A multifaceted program was effective in preventing insulin errors and accidental tube/catheter removal. Significant Hawthorne effects occurred, emphasizing the need for appropriately designed studies before definitively implementing strategies. clinicaltrials.gov Identifier: NCT00461461.

The Meaning of Collaboration, from the Perspective of Iranian Nurses: A Qualitative Study

PubMed Central

Zamanzadeh, V.; Irajpour, A.; Valizadeh, L.; Shohani, M.

2014-01-01

Background. Interdisciplinary collaboration among nurses is a complex and multifaceted process, an essential element in nursing, which is crucial to maintain an efficient, safe, and viable medical setting. The aim of this study was to explore the meaning of concept of collaboration through conducting a qualitative research approach. Method. The present study is qualitatively conducted in a content analysis approach. The data collection process included 18 unstructured and in-depth interviews with nurses during 2012-2013 in educational medical centers of west and northwest of Iran. A purposive sampling method was used. All the interviews were recorded, transcribed, and finally analyzed using a qualitative content analysis with a conventional method. Result. Categories obtained from analysis of the data to explain the meaning of collaboration consist of (i) prerequisites of collaboration, (ii) actualization of collaboration, and (iii) achievement of a common goal. Conclusion. The results of the present study ended in the discovery of meaning of collaboration that confirm results of other related studies, hence clarifying and disambiguating the concept under study. These results also contribute to the development of collaboration theories and the relevant measurement tools. PMID:25587572

Early childhood experiences, parenting and the process of drug dependency among young people in Tehran, Iran.

PubMed

Mirlashari, Jila; Demirkol, Apo; Salsali, Mahvash; Rafiey, Hassan; Jahanbani, Jahanfar

2012-06-01

Substance abuse has become a major public health problem in Iran. The process of developing an addiction is complex and multifaceted. Early childhood experiences are thought to be one of the important determinants of addictive behaviour. The aim of this qualitative study is to explore the early childhood experiences, especially the experiences within the immediate family, of current substance-using young adults in Iran. The study is qualitative in nature. In-depth interviews were conducted with 15 young men and women who were either in treatment for their addiction or were active drug users at the time of the interviews. Moreover, four interviews have been conducted with family members of participants. The majority of the participants experienced traumatic events during childhood and came from dysfunctional families. There appears to be a significant disconnect between these individuals and their families. An obedience-instilling parenting style and parents' knowledge and attitude toward drug using and prevention were also identified as important determinants of substance use. The results of this research point out the need for early interventions for at-risk families as well as at-risk individuals. © 2011 Australasian Professional Society on Alcohol and other Drugs.

Knowledge flow and exchange in interdisciplinary primary health care teams (PHCTs): an exploratory study

PubMed Central

Sibbald, Shannon L.; Wathen, C. Nadine; Kothari, Anita; Day, Adam M. B.

2013-01-01

Objective: Improving the process of evidence-based practice in primary health care requires an understanding of information exchange among colleagues. This study explored how clinically oriented research knowledge flows through multidisciplinary primary health care teams (PHCTs) and influences clinical decisions. Methods: This was an exploratory mixed-methods study with members of six PHCTs in Ontario, Canada. Quantitative data were collected using a questionnaire and analyzed with social network analysis (SNA) using UCINet. Qualitative data were collected using semi-structured interviews and analyzed with content analysis procedures using NVivo8. Results: It was found that obtaining research knowledge was perceived to be a shared responsibility among team members, whereas its application in patient care was seen as the responsibility of the team leader, usually the senior physician. PHCT members acknowledged the need for resources for information access, synthesis, interpretation, or management. Conclusion: Information sharing in interdisciplinary teams is a complex and multifaceted process. Specific interventions need to be improved such as formalizing modes of communication, better organizing knowledge-sharing activities, and improving the active use of allied health professionals. Despite movement toward team-based models, senior physicians are often gatekeepers of uptake of new evidence and changes in practice. PMID:23646028

Constructing food choice decisions.

PubMed

Sobal, Jeffery; Bisogni, Carole A

2009-12-01

Food choice decisions are frequent, multifaceted, situational, dynamic, and complex and lead to food behaviors where people acquire, prepare, serve, give away, store, eat, and clean up. Many disciplines and fields examine decision making. Several classes of theories are applicable to food decision making, including social behavior, social facts, and social definition perspectives. Each offers some insights but also makes limiting assumptions that prevent fully explaining food choice decisions. We used constructionist social definition perspectives to inductively develop a food choice process model that organizes a broad scope of factors and dynamics involved in food behaviors. This food choice process model includes (1) life course events and experiences that establish a food choice trajectory through transitions, turning points, timing, and contexts; (2) influences on food choices that include cultural ideals, personal factors, resources, social factors, and present contexts; and (3) a personal system that develops food choice values, negotiates and balances values, classifies foods and situations, and forms/revises food choice strategies, scripts, and routines. The parts of the model dynamically interact to make food choice decisions leading to food behaviors. No single theory can fully explain decision making in food behavior. Multiple perspectives are needed, including constructionist thinking.

A Comparative Proteome Approach Reveals Metabolic Changes Associated with Flammulina velutipes Mycelia in Response to Cold and Light Stress.

PubMed

Liu, Jing-Yu; Chang, Ming-Chang; Meng, Jun-Long; Feng, Cui-Ping; Wang, Yu

2018-04-11

In some industrial processes, cold and light stresses are recognized as two important environmental triggers for the transformation of mycelia into fruit-bodies via intermediate primordia in Flammulina velutipes cultivation. To gain insights into the mechanism of regulation of F. velutipes mycelia in response to cold and light stress, proteins expressed abundantly and characteristically at particular stress states were investigated by using the isobaric tags for the relative and absolute quantitation labeling technique. Among the 1046 nonredundant proteins identified with a high degree of confidence, 264 proteins, which were detected as differentially expressed proteins, were associated with 176 specific KEGG pathways. In-depth data analysis revealed that the regulatory network underlying the cold and light response mechanisms of F. velutipes mycelia was complex and multifaceted, as it included varied functions such as rapid energy supply, the biosynthesis of lysine, phenylalanine, tyrosine, and γ-aminobutyric acid, the calcium signal transduction process, dynein-dependent actin and microtubule cytoskeleton formation, autolysis, oxidative stress adaptation, pigment secretion, tissue and organ morphogenesis, and other interesting stress-related processes. Insights into the proteins might shed light on an intuitive understanding of the cold and light stress response mechanism underlying the fruiting processes of F. velutipes. Furthermore, the data might also provide further insights into the stress response mechanism of macro-fungi and valuable information for scientific improvement of some mushroom cultivation techniques in practice.

Modeling Resource Hotspots: Critical Linkages and Processes

NASA Astrophysics Data System (ADS)

Daher, B.; Mohtar, R.; Pistikopoulos, E.; McCarl, B. A.; Yang, Y.

2017-12-01

Growing demands for interconnected resources emerge in the form of hotspots of varying characteristics. The business as usual allocation model cannot address the current, let alone anticipated, complex and highly interconnected resource challenges we face. A new paradigm for resource allocation must be adopted: one that identifies cross-sectoral synergies and, that moves away from silos to recognition of the nexus and integration of it. Doing so will result in new opportunities for business growth, economic development, and improved social well-being. Solutions and interventions must be multi-faceted; opportunities should be identified with holistic trade-offs in mind. No single solution fits all: different hotspots will require distinct interventions. Hotspots have varying resource constraints, stakeholders, goals and targets. The San Antonio region represents a complex resource hotspot with promising potential: its rapidly growing population, the Eagle Ford shale play, and the major agricultural activity there makes it a hotspot with many competing demands. Stakeholders need tools to allow them to knowledgeably address impending resource challenges. This study will identify contemporary WEF nexus questions and critical system interlinkages that will inform the modeling of the tightly interconnected resource systems and stresses using the San Antonio Region as a base; it will conceptualize a WEF nexus modeling framework, and develop assessment criteria to inform integrative planning and decision making.

Student Learning about Biomolecular Self-Assembly Using Two Different External Representations

PubMed Central

Höst, Gunnar E.; Larsson, Caroline; Olson, Arthur; Tibell, Lena A. E.

2013-01-01

Self-assembly is the fundamental but counterintuitive principle that explains how ordered biomolecular complexes form spontaneously in the cell. This study investigated the impact of using two external representations of virus self-assembly, an interactive tangible three-dimensional model and a static two-dimensional image, on student learning about the process of self-assembly in a group exercise. A conceptual analysis of self-assembly into a set of facets was performed to support study design and analysis. Written responses were collected in a pretest/posttest experimental design with 32 Swedish university students. A quantitative analysis of close-ended items indicated that the students improved their scores between pretest and posttest, with no significant difference between the conditions (tangible model/image). A qualitative analysis of an open-ended item indicated students were unfamiliar with self-assembly prior to the study. Students in the tangible model condition used the facets of self-assembly in their open-ended posttest responses more frequently than students in the image condition. In particular, it appears that the dynamic properties of the tangible model may support student understanding of self-assembly in terms of the random and reversible nature of molecular interactions. A tentative difference was observed in response complexity, with more multifaceted responses in the tangible model condition. PMID:24006395

Conceptualising the agency of highly marginalised women: Intimate partner violence in extreme settings.

PubMed

Campbell, Catherine; Mannell, Jenevieve

2016-01-01

How is the agency of women best conceptualised in highly coercive settings? We explore this in the context of international efforts to reduce intimate partner violence (IPV) against women in heterosexual relationships. Articles critique the tendency to think of women's agency and programme endpoints in terms of individual actions, such as reporting violent men or leaving violent relationships, whilst neglecting the interlocking social, economic and cultural contexts that make such actions unlikely or impossible. Three themes cut across the articles. (1) Unhelpful understandings of gender and power implicit in commonly used 'men-women' and 'victim-agent' binaries obscure multi-faceted and hidden forms of women's agency, and the complexity of agency-violence intersections. (2) This neglect of complexity results in a poor fit between policy and interventions to reduce IPV, and women's lives. (3) Such neglect also obscures the multiplicities of women's agency, including the competing challenges they juggle alongside IPV, differing levels of response, and the temporality of agency. We outline a notion of 'distributed agency' as a multi-level, incremental and non-linear process distributed across time, space and social networks, and across a continuum of action ranging from survival to resistance. This understanding of agency implies a different approach to those currently underpinning policies and interventions.

Student learning about biomolecular self-assembly using two different external representations.

PubMed

Höst, Gunnar E; Larsson, Caroline; Olson, Arthur; Tibell, Lena A E

2013-01-01

Self-assembly is the fundamental but counterintuitive principle that explains how ordered biomolecular complexes form spontaneously in the cell. This study investigated the impact of using two external representations of virus self-assembly, an interactive tangible three-dimensional model and a static two-dimensional image, on student learning about the process of self-assembly in a group exercise. A conceptual analysis of self-assembly into a set of facets was performed to support study design and analysis. Written responses were collected in a pretest/posttest experimental design with 32 Swedish university students. A quantitative analysis of close-ended items indicated that the students improved their scores between pretest and posttest, with no significant difference between the conditions (tangible model/image). A qualitative analysis of an open-ended item indicated students were unfamiliar with self-assembly prior to the study. Students in the tangible model condition used the facets of self-assembly in their open-ended posttest responses more frequently than students in the image condition. In particular, it appears that the dynamic properties of the tangible model may support student understanding of self-assembly in terms of the random and reversible nature of molecular interactions. A tentative difference was observed in response complexity, with more multifaceted responses in the tangible model condition.

Hypothesis: the chaos and complexity theory may help our understanding of fibromyalgia and similar maladies.

PubMed

Martinez-Lavin, Manuel; Infante, Oscar; Lerma, Claudia

2008-02-01

Modern clinicians are often frustrated by their inability to understand fibromyalgia and similar maladies since these illnesses cannot be explained by the prevailing linear-reductionist medical paradigm. This article proposes that new concepts derived from the Complexity Theory may help understand the pathogenesis of fibromyalgia, chronic fatigue syndrome, and Gulf War syndrome. This hypothesis is based on the recent recognition of chaos fractals and complex systems in human physiology. These nonlinear dynamics concepts offer a different perspective to the notion of homeostasis and disease. They propose that the essence of disease is dysfunction and not structural damage. Studies using novel nonlinear instruments have shown that fibromyalgia and similar maladies may be caused by the degraded performance of our main complex adaptive system. This dysfunction explains the multifaceted manifestations of these entities. To understand and alleviate the suffering associated with these complex illnesses, a paradigm shift from reductionism to holism based on the Complexity Theory is suggested. This shift perceives health as resilient adaptation and some chronic illnesses as rigid dysfunction.

Collaboratively reframing mental health for integration of HIV care in Ethiopia†

PubMed Central

Wissow, Lawrence S.; Tegegn, Teketel; Asheber, Kassahun; McNabb, Marion; Weldegebreal, Teklu; Jerene, Degu; Ruff, Andrea

2015-01-01

Background Integrating mental health with general medical care can increase access to mental health services, but requires helping generalists acquire a range of unfamiliar knowledge and master potentially complex diagnostic and treatment processes. Method We describe a model for integrating complex specialty care with generalist/primary care, using as an illustration the integration of mental health into hospital-based HIV treatment services in Ethiopia. Generalists and specialists collaboratively developed mental health treatments to fit the knowledge, skills and resources of the generalists. The model recognizes commonalities between mental health and general medical care, focusing on practical interventions acceptable to patients. It was developed through a process of literature review, interviews, observing clinical practice, pilot trainings and expert consultation. Preliminary evaluation results were obtained by debriefing generalist trainees after their return to their clinical sites. Results In planning interviews, generalists reported discomfort making mental health diagnoses but recognition of symptom groups including low mood, anxiety, thought problems, poor child behaviour, seizures and substance use. Diagnostic and treatment algorithms were developed for these groups and tailored to the setting by including possible medical causes and burdens of living with HIV. First-line treatment included modalities familiar to generalists: empathetic patient–provider interactions, psychoeducation, cognitive reframing, referral to community supports and elements of symptom-specific evidence-informed counselling. Training introduced basic skills, with evolving expertise supported by job aides and ongoing support from mental health nurses cross-trained in HIV testing. Feedback from trainees suggested the programme fit well with generalists’ settings and clinical goals. Conclusions An integration model based on collaboratively developing processes that fit the generalist setting shows promise as a method for incorporating complex, multi-faceted interventions into general medical settings. Formal evaluations will be needed to compare the quality of care provided with more traditional approaches and to determine the resources required to sustain quality over time. PMID:25012090

Collaboratively reframing mental health for integration of HIV care in Ethiopia.

PubMed

Wissow, Lawrence S; Tegegn, Teketel; Asheber, Kassahun; McNabb, Marion; Weldegebreal, Teklu; Jerene, Degu; Ruff, Andrea

2015-07-01

Integrating mental health with general medical care can increase access to mental health services, but requires helping generalists acquire a range of unfamiliar knowledge and master potentially complex diagnostic and treatment processes. We describe a model for integrating complex specialty care with generalist/primary care, using as an illustration the integration of mental health into hospital-based HIV treatment services in Ethiopia. Generalists and specialists collaboratively developed mental health treatments to fit the knowledge, skills and resources of the generalists. The model recognizes commonalities between mental health and general medical care, focusing on practical interventions acceptable to patients. It was developed through a process of literature review, interviews, observing clinical practice, pilot trainings and expert consultation. Preliminary evaluation results were obtained by debriefing generalist trainees after their return to their clinical sites. In planning interviews, generalists reported discomfort making mental health diagnoses but recognition of symptom groups including low mood, anxiety, thought problems, poor child behaviour, seizures and substance use. Diagnostic and treatment algorithms were developed for these groups and tailored to the setting by including possible medical causes and burdens of living with HIV. First-line treatment included modalities familiar to generalists: empathetic patient-provider interactions, psychoeducation, cognitive reframing, referral to community supports and elements of symptom-specific evidence-informed counselling. Training introduced basic skills, with evolving expertise supported by job aides and ongoing support from mental health nurses cross-trained in HIV testing. Feedback from trainees suggested the programme fit well with generalists' settings and clinical goals. An integration model based on collaboratively developing processes that fit the generalist setting shows promise as a method for incorporating complex, multi-faceted interventions into general medical settings. Formal evaluations will be needed to compare the quality of care provided with more traditional approaches and to determine the resources required to sustain quality over time. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

How to facilitate freshmen learning and support their transition to a university study environment

NASA Astrophysics Data System (ADS)

Kangas, Jari; Rantanen, Elisa; Kettunen, Lauri

2017-11-01

Most freshmen enter universities with high expectations and with good motivation, but too many are driven into performing instead of true learning. The issues are not only related to the challenge of comprehending the substance, social and other factors have an impact as well. All these multifaceted needs should be accounted for to facilitate student learning. Learning is an individual process and remarkable improvement in the learning practices is possible, if proper actions are addressed early enough. We motivate and describe a study of the experience obtained from a set of tailor-made courses that were given alongside standard curriculum. The courses aimed to provide a 'safe community' to address the multifaceted needs. Such support was integrated into regular coursework where active learning techniques, e.g. interactive small groups were incorporated. To assess impact of the courses we employ the feedback obtained during the courses and longitudinal statistical data about students' success.

Metrics of Justice. A Sundial's Nomological Figuration.

PubMed

Behrmann, Carolin

2015-01-01

This paper examines a polyhedral dial from the British Museum made by the instrument maker Ulrich Schniep, and discusses the status of multifunctional scientific instruments. It discerns a multifaceted iconic meaning considering different dimensions such as scientific functionality (astronomy), the complex allegorical figure of Justice (iconography), and the representation of the sovereign (politics), the court and the Kunstkammer of Albrecht v of Bavaria. As a numen mixtum the figure of "Justicia" touches different fields that go far beyond pure astronomical measurement and represents the power of the ruler as well as the rules of economic justice.

Wear of carbide inserts with complex surface treatment when milling nickel alloy

NASA Astrophysics Data System (ADS)

Fedorov, Sergey; Swe, Min Htet; Kapitanov, Alexey; Egorov, Sergey

2018-03-01

One of the effective ways of strengthening hard alloys is the creating structure layers on their surface with the gradient distribution of physical and mechanical properties between the wear-resistant coating and the base material. The article discusses the influence of the near-surface layer which is modified by low-energy high-current electron-beam alloying and the upper anti-friction layer in a multi-component coating on the wear mechanism of the replaceable multifaceted plates in the dry milling of the difficult to machine nickel alloys.

Considerations Regarding Embryo Culture Conditions: From Media to Epigenetics.

PubMed

Simopoulou, Mara; Sfakianoudis, Konstantinos; Rapani, Anna; Giannelou, Polina; Anifandis, George; Bolaris, Stamatis; Pantou, Agni; Lambropoulou, Maria; Pappas, Athanasios; Deligeoroglou, Efthimios; Pantos, Konstantinos; Koutsilieris, Michael

2018-01-01

There are numerous reports on embryo culture media and conditions in the laboratory, as the subject is multifaceted and complex, reflecting the variation in practice. In this scoping review, we attempt to approach the topic of culture media and conditions from the practitioners' perspective aiming to highlight, in a comprehensive fashion, important aspects regarding the options available, introduce points of debate and controversy, while maintaining the viewpoint of the practicing embryologist's concerns. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Application of decomposition techniques to the preliminary design of a transport aircraft

NASA Technical Reports Server (NTRS)

Rogan, J. E.; Mcelveen, R. P.; Kolb, M. A.

1986-01-01

A multifaceted decomposition of a nonlinear constrained optimization problem describing the preliminary design process for a transport aircraft has been made. Flight dynamics, flexible aircraft loads and deformations, and preliminary structural design subproblems appear prominently in the decomposition. The use of design process decomposition for scheduling design projects, a new system integration approach to configuration control, and the application of object-centered programming to a new generation of design tools are discussed.

Correction to white-johnson, ford, and sellers (2010).

PubMed

2015-01-01

Reports an error in "Parental racial socialization profiles: Association with demographic factors, racial discrimination, childhood socialization, and racial identity" by Rhonda L. White-Johnson, Kahlil R. Ford and Robert M. Sellers (Cultural Diversity and Ethnic Minority Psychology, 2010[Apr], Vol 16[2], 237-247). In the article, there was an error in the Measures subsection. The following citation should have been included in the third paragraph " Mothers' childhood racial socialization experiences. Prior racial socialization messages were assessed using four items adapted from the Comprehensive Race Socialization Inventory (Lesane- Brown, Brown, Caldwell, & Sellers, 2005)." Additionally, the included reference should have been included in the Reference section. (The following abstract of the original article appeared in record 2010-07475-016.) The authors examined patterns of racial socialization practices in a sample of 212 African American mothers. They investigated the relation between parent profiles of racial socialization messages with child and parent demographic factors and race-related experiences, as well as parent racial identity attitudes. Using latent class analyses, the authors identified 3 patterns of parent-reported racial socialization experiences: multifaceted, low race salience, and unengaged. In general, findings indicate that mothers in the multifaceted profile were more educated, experienced more racial discrimination, and talked about race during their childhood more than mothers in the unengaged profile. The multifaceted profile also differed from the low race salience and unengaged profiles on several racial identity dimensions. Although the patterned approach used in this study lends itself to a more complex study of racial socialization in future research, it also highlights the associations between parent's race-relevant experiences and the messages they communicate to their children about race. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Learning of Core Disciplinary Ideas: Efficacy Comparison of Two Contrasting Modes of Science Instruction

ERIC Educational Resources Information Center

Schuster, David; Cobern, William W.; Adams, Betty A. J.; Undreiu, Adriana; Pleasants, Brandy

2018-01-01

Science curricula and teaching methods vary greatly, depending in part on which facets of science are emphasized, e.g., core disciplinary ideas or science practices and process skills, and perspectives differ considerably on desirable pedagogies. Given the multi-faceted nature of science and the variety of teaching methods found in practice, it is…

The Long Term Effectiveness of Intensive Stuttering Therapy: A Mixed Methods Study

ERIC Educational Resources Information Center

Irani, Farzan; Gabel, Rodney; Daniels, Derek; Hughes, Stephanie

2012-01-01

Purpose: The purpose of this study was to gain a deeper understanding of client perceptions of an intensive stuttering therapy program that utilizes a multi-faceted approach to therapy. The study also proposed to gain a deeper understanding about the process involved in long-term maintenance of meaningful changes made in therapy. Methods: The…

Re-Engineering the Hospital Discharge: An Example of a Multifaceted Process Evaluation

DTIC Science & Technology

2005-01-01

health literacy : the Rapid Estimate of Adult Literacy in Medicine (REALM)29 and the Test of Functional Health Literacy in Adults (TOFHLA).30 These...Med 1991;23(6):433–5. 30. Parker RM, Baker DW, Williams MV, et al. The test of functional health literacy in adults: a new instrument for measuring

The Multifaceted Ecology of Language Play in an Elementary School EFL Classroom

ERIC Educational Resources Information Center

Kang, Dae-Min

2017-01-01

Language play (LP) in second language (L2) classrooms has attracted increasing attention in recent years, but descriptions and explanations of LP construction in English as a foreign language (EFL) settings remain insufficient. This paper reports the discursive processes of LP construction in an elementary school EFL classroom in Korea. I found…

Ethics Education: Using Inductive Reasoning to Develop Individual, Group, Organizational, and Global Perspectives

ERIC Educational Resources Information Center

Taft, Susan H.; White, Judith

2007-01-01

Ethics education that prepares students to address ethical challenges at work is a multifaceted and long-term endeavor. In this article, the authors propose an inductive ethics pedagogy that begins the process of ethics education by grounding students in their own individual ethical principles. The approach centers on developing students' ethical…

An Examination of Program Selection Criteria for Part-Time MBA Students

ERIC Educational Resources Information Center

Colburn, Michael; Fox, Daniel E.; Westerfelt, Debra Kay

2011-01-01

Prospective graduate students select a graduate program as a result of a multifaceted decision-making process. This study examines the selection criteria that part-time MBA students used in selecting a program at a private university. Further, it analyzes the methods by which the students first learned of the MBA program. The authors posed the…

Obstinate Actions-Oriented Behaviour towards Applying Theoractive Learning: An Ontology of Educational Learning and Leadership Theories in Practice

ERIC Educational Resources Information Center

Rajbhandari, Mani Man Singh

2018-01-01

Obstinate actions-oriented behaviour is the study of learning and practicing behaviour theoractively, which is acquired from the content based, process based learning and spawning critical reflexivity to the learnt theoretical phenomena into practical actions. Obstinate actions-oriented behaviour is a multi-faceted behaviour that is generally…

Orthoses: Not the Sole Solution for Running Ailments.

ERIC Educational Resources Information Center

Murphy, Patrick

1986-01-01

Orthotic devices are an important element of treatment for biomechanically disadvantaged runners, but alignment problems are multifaceted and require multifaceted solutions. Appropriate uses of orthoses are discussed. (MT)

WCSC environmental process improvement study and demonstration program

NASA Technical Reports Server (NTRS)

Pawlick, Joseph F., Jr.; Severo, Orlando C.

1993-01-01

CSTAR's objective to develop commercial infrastructure is multi-faceted and includes diverse elements of the orbital and suborbital missions. Goals to this eight-month project with the WCSC are aimed at simplifying the environmental assessment, approval, and licensing process for commercial users. Included in this overarching set of goals are two specific processes: (1) air pollution control, and (2) the environmental assessment mechanism. Resolution of the potentially user unfriendly aspects of these environmentally sensitive criteria are readily transferable to other ranges where commercial space activity will be supported.

Intelligent freeform manufacturing of complex organs.

PubMed

Wang, Xiaohong

2012-11-01

Different from the existing tissue engineering strategies, rapid prototyping (RP) techniques aim to automatically produce complex organs directly from computer-aided design freeform models with high resolution and sophistication. Analogous to building a nuclear power plant, cell biology (especially, renewable stem cells), implantable biomaterials, tissue engineering, and single/double/four nozzle RP techniques currently enable researchers in the field to realize a part of the task of complex organ manufacturing. To achieve this multifaceted undertaking, a multi-nozzle rapid prototyping system which can simultaneously integrate an anti-suture vascular system, multiple cell types, and a cocktail of growth factors in a construct should be developed. This article reviews the pros and cons of the existing cell-laden RP techniques for complex organ manufacturing. It is hoped that with the comprehensive multidisciplinary efforts, the implants can virtually replace the functions of a solid internal organ, such as the liver, heart, and kidney. © 2012, Copyright the Author. Artificial Organs © 2012, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Collaborative approach to Optimise MEdication use for Older people in Nursing homes (COME-ON): study protocol of a cluster controlled trial.

PubMed

Anrys, Pauline; Strauven, Goedele; Boland, Benoit; Dalleur, Olivia; Declercq, Anja; Degryse, Jean-Marie; De Lepeleire, Jan; Henrard, Séverine; Lacour, Valérie; Simoens, Steven; Speybroeck, Niko; Vanhaecht, Kris; Spinewine, Anne; Foulon, Veerle

2016-03-11

Ageing has become a worldwide reality and presents new challenges for the health-care system. Research has shown that potentially inappropriate prescribing, both potentially inappropriate medications and potentially prescribing omissions, is highly prevalent in older people, especially in the nursing home setting. The presence of potentially inappropriate medications/potentially prescribing omissions is associated with adverse drug events, hospitalisations, mortality and health-care costs. The Collaborative approach to Optimise MEdication use for Older people in Nursing homes (COME-ON) study aims to evaluate the effect of a complex, multifaceted intervention, including interdisciplinary case conferences, on the appropriateness of prescribing of medicines for older people in Belgian nursing homes. A multicentre cluster-controlled trial is set up in 63 Belgian nursing homes (30 intervention; 33 control). In each of these nursing homes, 35 residents (≥65 years) are selected for participation. The complex, multifaceted intervention comprises (i) health-care professional education and training, (ii) local concertation (discussion on the appropriate use of at least one medication class at the level of the nursing home) and (iii) repeated interdisciplinary case conferences between general practitioner, nurse and pharmacist to perform medication review for each included nursing home resident. The control group works as usual. The study period lasts 15 months. The primary outcome measures relate to the appropriateness of prescribing and are defined as (1) among residents who had at least one potentially inappropriate medication/potentially prescribing omission at baseline, the proportion of them for whom there is a decrease of at least one of these potentially inappropriate medications/potentially prescribing omissions at the end of study, and (2) among all residents, the proportion of them for whom at least one new potentially inappropriate medication/potentially prescribing omission is present at the end of the study, compared to baseline. The secondary outcome measures include individual components of appropriateness of prescribing, medication use, outcomes of the case conferences, clinical outcomes and costs. A process evaluation (focusing on implementation, causal mechanisms and contextual factors) will be conducted alongside the study. The COME-ON study will contribute to a growing body of knowledge concerning the effect of complex interventions on the use of medicines in the nursing home setting, and on factors influencing their effect. The results will inform policymakers on strategies to implement in the near future. Current Controlled Trials ISRCTN66138978.

Medical Decision-Making Among Adolescents with Neonatal Brachial Plexus Palsy and their Families: A Qualitative Study

PubMed Central

Squitieri, Lee; Larson, Bradley P.; Chang, Kate W-C; Yang, Lynda J-S.; Chung, Kevin C.

2016-01-01

Background Elective surgical management of neonatal brachial plexus palsy is complex, variable, and often individualized. Little is known about the medical decision-making process among adolescents with NBPP and their families faced with making complex treatment decisions. The experiences of these patients and their parents were analyzed to identify key factors in the decision-making process. Patients and Methods Eighteen adolescents with residual NBPP deficits between the ages of 10 to 17 years along with their parents were included in the present study. A qualitative research design was employed involving the use of separate one hour, in person, semi-structured interviews, which were audio recorded and transcribed. Grounded theory was applied by two independent members of the research team to identify recurrent themes and ultimately create a codebook that was then applied to the data. Results Medical decision-making among adolescents with NBPP and their families is multifaceted and individualized, comprised of both patient and system dependent factors. Four codes pertaining to the medical decision-making process were identified: 1) knowledge acquisition, 2) multidisciplinary care, 3) adolescent autonomy, and 4) patient expectations and treatment desires. Overall, parental decision-making was heavily influenced by system dependent factors, while adolescents largely based their medical decision-making on individual treatment desires to improve function and/or aesthetics. Conclusions There are many areas for improving the delivery of information and health care organization among adolescents with NBPP and their families. We recommend the development of educational interdisciplinary programs and decision aids containing evidence-based management guidelines targeted toward primary care providers and patients. We believe that a computer-based learning module may provide the best avenue to achieve maximum penetrance and convenience of information sharing. PMID:23714810

Are languages really independent from genes? If not, what would a genetic bias affecting language diversity look like?

PubMed

Dediu, Dan

2011-04-01

It is generally accepted that the relationship between human genes and language is very complex and multifaceted. This has its roots in the “regular” complexity governing the interplay among genes and between genes and environment for most phenotypes, but with the added layer of supraontogenetic and supra-individual processes defining culture. At the coarsest level, focusing on the species, it is clear that human-specific--but not necessarily faculty-specific--genetic factors subtend our capacity for language and a currently very productive research program is aiming at uncovering them. At the other end of the spectrum, it is uncontroversial that individual-level variations in different aspects related to speech and language have an important genetic component and their discovery and detailed characterization have already started to revolutionize the way we think about human nature. However, at the intermediate, glossogenetic/population level, the relationship becomes controversial, partly due to deeply ingrained beliefs about language acquisition and universality and partly because of confusions with a different type of gene-languages correlation due to shared history. Nevertheless, conceptual, mathematical and computational models--and, recently, experimental evidence from artificial languages and songbirds--have repeatedly shown that genetic biases affecting the acquisition or processing of aspects of language and speech can be amplified by population-level intergenerational cultural processes and made manifest either as fixed “universal” properties of language or as structured linguistic diversity. Here, I review several such models as well as the recently proposed case of a causal relationship between the distribution of tone languages and two genes related to brain growth and development, ASPM and Microcephalin, and I discuss the relevance of such genetic biasing for language evolution, change, and diversity.

From biofilm ecology to reactors: a focused review.

PubMed

Boltz, Joshua P; Smets, Barth F; Rittmann, Bruce E; van Loosdrecht, Mark C M; Morgenroth, Eberhard; Daigger, Glen T

2017-04-01

Biofilms are complex biostructures that appear on all surfaces that are regularly in contact with water. They are structurally complex, dynamic systems with attributes of primordial multicellular organisms and multifaceted ecosystems. The presence of biofilms may have a negative impact on the performance of various systems, but they can also be used beneficially for the treatment of water (defined herein as potable water, municipal and industrial wastewater, fresh/brackish/salt water bodies, groundwater) as well as in water stream-based biological resource recovery systems. This review addresses the following three topics: (1) biofilm ecology, (2) biofilm reactor technology and design, and (3) biofilm modeling. In so doing, it addresses the processes occurring in the biofilm, and how these affect and are affected by the broader biofilm system. The symphonic application of a suite of biological methods has led to significant advances in the understanding of biofilm ecology. New metabolic pathways, such as anaerobic ammonium oxidation (anammox) or complete ammonium oxidation (comammox) were first observed in biofilm reactors. The functions, properties, and constituents of the biofilm extracellular polymeric substance matrix are somewhat known, but their exact composition and role in the microbial conversion kinetics and biochemical transformations are still to be resolved. Biofilm grown microorganisms may contribute to increased metabolism of micro-pollutants. Several types of biofilm reactors have been used for water treatment, with current focus on moving bed biofilm reactors, integrated fixed-film activated sludge, membrane-supported biofilm reactors, and granular sludge processes. The control and/or beneficial use of biofilms in membrane processes is advancing. Biofilm models have become essential tools for fundamental biofilm research and biofilm reactor engineering and design. At the same time, the divergence between biofilm modeling and biofilm reactor modeling approaches is recognized.

Collaboration, negotiation, and coalescence for interagency-collaborative teams to scale-up evidence-based practice.

PubMed

Aarons, Gregory A; Fettes, Danielle L; Hurlburt, Michael S; Palinkas, Lawrence A; Gunderson, Lara; Willging, Cathleen E; Chaffin, Mark J

2014-01-01

Implementation and scale-up of evidence-based practices (EBPs) is often portrayed as involving multiple stakeholders collaborating harmoniously in the service of a shared vision. In practice, however, collaboration is a more complex process that may involve shared and competing interests and agendas, and negotiation. The present study examined the scale-up of an EBP across an entire service system using the Interagency Collaborative Team approach. Participants were key stakeholders in a large-scale county-wide implementation of an EBP to reduce child neglect, SafeCare. Semistructured interviews and/or focus groups were conducted with 54 individuals representing diverse constituents in the service system, followed by an iterative approach to coding and analysis of transcripts. The study was conceptualized using the Exploration, Preparation, Implementation, and Sustainment framework. Although community stakeholders eventually coalesced around implementation of SafeCare, several challenges affected the implementation process. These challenges included differing organizational cultures, strategies, and approaches to collaboration; competing priorities across levels of leadership; power struggles; and role ambiguity. Each of the factors identified influenced how stakeholders approached the EBP implementation process. System-wide scale-up of EBPs involves multiple stakeholders operating in a nexus of differing agendas, priorities, leadership styles, and negotiation strategies. The term collaboration may oversimplify the multifaceted nature of the scale-up process. Implementation efforts should openly acknowledge and consider this nexus when individual stakeholders and organizations enter into EBP implementation through collaborative processes.

Collaboration, Negotiation, and Coalescence for Interagency-Collaborative Teams to Scale-up Evidence-Based Practice

PubMed Central

Aarons, Gregory A.; Fettes, Danielle; Hurlburt, Michael; Palinkas, Lawrence; Gunderson, Lara; Willging, Cathleen; Chaffin, Mark

2014-01-01

Objective Implementation and scale-up of evidence-based practices (EBPs) is often portrayed as involving multiple stakeholders collaborating harmoniously in the service of a shared vision. In practice, however, collaboration is a more complex process that may involve shared and competing interests and agendas, and negotiation. The present study examined the scale-up of an EBP across an entire service system using the Interagency Collaborative Team (ICT) approach. Methods Participants were key stakeholders in a large-scale county-wide implementation of an EBP to reduce child neglect, SafeCare®. Semi-structured interviews and/or focus groups were conducted with 54 individuals representing diverse constituents in the service system, followed by an iterative approach to coding and analysis of transcripts. The study was conceptualized using the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Results Although community stakeholders eventually coalesced around implementation of SafeCare, several challenges affected the implementation process. These challenges included differing organizational cultures, strategies, and approaches to collaboration, competing priorities across levels of leadership, power struggles, and role ambiguity. Each of the factors identified influenced how stakeholders approached the EBP implementation process. Conclusions System wide scale-up of EBPs involves multiple stakeholders operating in a nexus of differing agendas, priorities, leadership styles, and negotiation strategies. The term collaboration may oversimplify the multifaceted nature of the scale-up process. Implementation efforts should openly acknowledge and consider this nexus when individual stakeholders and organizations enter into EBP implementation through collaborative processes. PMID:24611580

Credit use: psychological perspectives on a multifaceted phenomenon.

PubMed

Kamleitner, Bernadette; Hoelzl, Erik; Kirchler, Erich

2012-01-01

Consumer borrowing is a highly topical and multifaceted phenomenon as well as a popular subject for study. We focus on consumer credit use and review the existing literature. To categorize what is known we identify four main psychological perspectives on the phenomenon: credit use as (1) a reflection of the situation, (2) a reflection of the person, (3) a cognitive process, and (4) a social process. On top of these perspectives we view credit use as a process that entails three distinct phases: (1) processes before credit acquisition, (2) processes at credit acquisition, and (3) processes after credit acquisition. We review the international literature along a two-tier structure that aligns the psychological perspectives with a process view of credit. This structure allows us to identify systematic concentrations as well as gaps in the existing research. We consolidate what is known within each perspective and identify what seems to be most urgently missing. Some of the most important gaps relate to research studying credit acquisition from the perspective of credit use as a reflection of the person or as a social process. In particular, research on credit use as a reflection of the person appears to focus exclusively on the first stage of the credit process. We conclude with a discussion that reaches across perspectives and identifies overarching gaps, trends, and open questions. We highlight a series of implicit linkages between perspectives and the geographical regions in which studies related to the perspectives were conducted. Beyond diagnosing a geographical imbalance of research, we argue for future research that systematically addresses interrelations between perspectives. We conclude with a set of global implications and research recommendations.

The constructed catchment Chicken Creek as Critical Zone Observatory under transition

NASA Astrophysics Data System (ADS)

Gerwin, Werner; Schaaf, Wolfgang; Elmer, Michael; Hinz, Christoph

2014-05-01

The constructed catchment Chicken Creek was established in 2005 as an experimental landscape laboratory for ecosystem research. The 6 ha area with clearly defined horizontal as well as vertical boundary conditions was left for an unrestricted primary succession. All Critical Zone elements are represented at this site, which allows the study of most processes occurring at the interface of bio-, pedo-, geo- and hydrosphere. It provides outstanding opportunities for investigating interactions and feedbacks between different evolving compartments during ecosystem development. The catchment is extensively instrumented since 2005 in order to detect transition stages of the ecosystem. Data recorded with a high spatial and temporal resolution include hydrological, geomorphological, pedological, limnological as well as biological parameters. In contrast to other Critical Zone Observatories, this site offers the unique situation of an early stage ecosystem with highly dynamic system properties. The first years of development were characterized by a fast formation of geomorphological structures due to massive erosion processes at the initially non-vegetated surface. Hydrological processes led to the establishment of a local groundwater body within 5 years. In the following years the influence of biological structures like vegetation patterns gained an increasing importance. Feedbacks between developing vegetation and e.g. hydrological features became more and more dominant. As a result, different phases of ecosystem development could be distinguished until now. This observatory offers manifold possibilities to identify and disentangle complex interactions between Critical Zone processes in situ under natural conditions. The originally low complexity of the system is growing with time facilitating the identification of influences of newly developing structures on system functions. Thus, it is possible to study effects of small-scale processes on the whole system at the landscape scale. In addition, the highly dynamic initial system properties allow the observation of multifaceted changes of Critical Zone properties and functions within short periods of time. Chicken Creek could complement the existing network of Critical Zone Observatories which are usually established at ecosystems in a mature state.

Striatal and Hippocampal Entropy and Recognition Signals in Category Learning: Simultaneous Processes Revealed by Model-Based fMRI

PubMed Central

Davis, Tyler; Love, Bradley C.; Preston, Alison R.

2012-01-01

Category learning is a complex phenomenon that engages multiple cognitive processes, many of which occur simultaneously and unfold dynamically over time. For example, as people encounter objects in the world, they simultaneously engage processes to determine their fit with current knowledge structures, gather new information about the objects, and adjust their representations to support behavior in future encounters. Many techniques that are available to understand the neural basis of category learning assume that the multiple processes that subserve it can be neatly separated between different trials of an experiment. Model-based functional magnetic resonance imaging offers a promising tool to separate multiple, simultaneously occurring processes and bring the analysis of neuroimaging data more in line with category learning’s dynamic and multifaceted nature. We use model-based imaging to explore the neural basis of recognition and entropy signals in the medial temporal lobe and striatum that are engaged while participants learn to categorize novel stimuli. Consistent with theories suggesting a role for the anterior hippocampus and ventral striatum in motivated learning in response to uncertainty, we find that activation in both regions correlates with a model-based measure of entropy. Simultaneously, separate subregions of the hippocampus and striatum exhibit activation correlated with a model-based recognition strength measure. Our results suggest that model-based analyses are exceptionally useful for extracting information about cognitive processes from neuroimaging data. Models provide a basis for identifying the multiple neural processes that contribute to behavior, and neuroimaging data can provide a powerful test bed for constraining and testing model predictions. PMID:22746951

Application of decomposition techniques to the preliminary design of a transport aircraft

NASA Technical Reports Server (NTRS)

Rogan, J. E.; Kolb, M. A.

1987-01-01

A nonlinear constrained optimization problem describing the preliminary design process for a transport aircraft has been formulated. A multifaceted decomposition of the optimization problem has been made. Flight dynamics, flexible aircraft loads and deformations, and preliminary structural design subproblems appear prominently in the decomposition. The use of design process decomposition for scheduling design projects, a new system integration approach to configuration control, and the application of object-centered programming to a new generation of design tools are discussed.

Operant conditioning-based behavior modification: one approach to treating somatic disorders.

PubMed

LeBow, M D

1975-01-01

The applicability of behavior modification as a process for treating somatic difficulties is examined within the framework of measurement, modification, and evaluation. Illustrations of this process are presented throughout. In particular, the last section of the paper gives an example of a currently operative and multifaceted approach to the problem of obesity. Among the topics considered herein are the use of behavioral contracts that specify ameliorative weight reduction practices and the assessment as well as manipulation of eating speed.

Being a Leadership Development Coach: A Multi-Faceted Role

ERIC Educational Resources Information Center

Forde, Christine; McMahon, Margery; Gronn, Peter; Martin, Margaret

2013-01-01

The use of coaching as a developmental methodology has been instituted as a way to develop leadership in schools in Scotland as elsewhere in the UK. While there are studies that examine the skills and impact of coaching, there is only limited discussion of the process of coaching and the role and experiences of the coaches. This article examines…

Gender and Job Mobility in Postsocialist China: A Longitudinal Study of Job Changes in Six Coastal Cities

ERIC Educational Resources Information Center

Cao, Yang; Hu, Chiung-Yin

2007-01-01

This study examines the gender differences in job mobility in urban China. Conceptualizing China's postsocialist transition as a multi-faceted process, we argue that the emergence of labor markets, gendered role differentiation within the family, and the state's declining involvement in promoting women's rights lead to widened gender gaps in job…

Discovering Aspects of Teacher Identity through Volunteering in the Noncredit ESL Classroom

ERIC Educational Resources Information Center

Jurkunas, Lina

2015-01-01

As many scholars in the field of TESOL (Danielewicz, 2001; Harlow & Cobb, 2014; Kanno & Stuart, 2011) point out, the development of teacher identity is an ongoing, multifaceted process. Thus, quite frequently, novice teachers feel as though they take on a role when they are in the classroom, as opposed to fully embodying an identity of a…

Five Contemporary Novelists' Views of Growing Up Turkish in the 1980s: A Literary Sociology. Occasional Papers. Turkish Studies Series Number Five.

ERIC Educational Resources Information Center

Stone, Frank Andrews

Literary sociology is a multifaceted process of analyzing texts. It moves beyond traditional literary criticism to incorporate such varied approaches as: appreciating literary schemata; textual analysis; seeking form, sound, and content regularities; examining the lasting values of the work; and contemplating the reader's own authentic life-world…

Testing the feasibility of using a conveyor belt to load weanling and nursery pigs for transportation

USDA-ARS?s Scientific Manuscript database

Transportation is known to be a multi-faceted stressor, with the process of loading being one of the most significant factors impacting the stress to which animals are exposed. This project was designed to determine if using a conveyor to load pigs into the top deck of a simulated straight deck trai...

"Nsaka Sunsum" (Touching the Spirit): A Pedagogy and Process of Black Educational Excellence

ERIC Educational Resources Information Center

Nobles, Wade W.; Nobles, Zetha Chinaza Adeleke

2011-01-01

The real crisis in Black education is a crisis of culture. It is a crisis of culture because culture, as the medium wherein life is defined and developed, is where the meaning of being human is found. Culture, though multifaceted, is where human beings give fundamental expression to their meaning, possibility and potential. Hence, the crisis in…

Multiobjective hyper heuristic scheme for system design and optimization

NASA Astrophysics Data System (ADS)

Rafique, Amer Farhan

2012-11-01

As system design is becoming more and more multifaceted, integrated, and complex, the traditional single objective optimization trends of optimal design are becoming less and less efficient and effective. Single objective optimization methods present a unique optimal solution whereas multiobjective methods present pareto front. The foremost intent is to predict a reasonable distributed pareto-optimal solution set independent of the problem instance through multiobjective scheme. Other objective of application of intended approach is to improve the worthiness of outputs of the complex engineering system design process at the conceptual design phase. The process is automated in order to provide the system designer with the leverage of the possibility of studying and analyzing a large multiple of possible solutions in a short time. This article presents Multiobjective Hyper Heuristic Optimization Scheme based on low level meta-heuristics developed for the application in engineering system design. Herein, we present a stochastic function to manage meta-heuristics (low-level) to augment surety of global optimum solution. Generic Algorithm, Simulated Annealing and Swarm Intelligence are used as low-level meta-heuristics in this study. Performance of the proposed scheme is investigated through a comprehensive empirical analysis yielding acceptable results. One of the primary motives for performing multiobjective optimization is that the current engineering systems require simultaneous optimization of conflicting and multiple. Random decision making makes the implementation of this scheme attractive and easy. Injecting feasible solutions significantly alters the search direction and also adds diversity of population resulting in accomplishment of pre-defined goals set in the proposed scheme.

Regulatory factors governing adenosine-to-inosine (A-to-I) RNA editing.

PubMed

Hong, HuiQi; Lin, Jaymie Siqi; Chen, Leilei

2015-03-31

Adenosine-to-inosine (A-to-I) RNA editing, the most prevalent mode of transcript modification in higher eukaryotes, is catalysed by the adenosine deaminases acting on RNA (ADARs). A-to-I editing imposes an additional layer of gene regulation as it dictates various aspects of RNA metabolism, including RNA folding, processing, localization and degradation. Furthermore, editing events in exonic regions contribute to proteome diversity as translational machinery decodes inosine as guanosine. Although it has been demonstrated that dysregulated A-to-I editing contributes to various diseases, the precise regulatory mechanisms governing this critical cellular process have yet to be fully elucidated. However, integration of previous studies revealed that regulation of A-to-I editing is multifaceted, weaving an intricate network of auto- and transregulations, including the involvement of virus-originated factors like adenovirus-associated RNA. Taken together, it is apparent that tipping of any regulatory components will have profound effects on A-to-I editing, which in turn contributes to both normal and aberrant physiological conditions. A complete understanding of this intricate regulatory network may ultimately be translated into new therapeutic strategies against diseases driven by perturbed RNA editing events. Herein, we review the current state of knowledge on the regulatory mechanisms governing A-to-I editing and propose the role of other co-factors that may be involved in this complex regulatory process.

Grand challenges in understanding the interplay of climate and land changes

DOE PAGES

Liu, Shuguang; Bond-Lamberty, Ben; Boysen, Lena R.; ...

2017-03-28

Half of the Earth s land surface has been altered by human activities, creating various consequences on the climate and weather systems at local to global scales, which in turn affects a myriad of land surface processes and our adaptation behaviors. We here review the status and major knowledge gaps of studying the interactions of land and atmospheric changes and present eleven grand challenge areas for scientific research and adaptation communities in the coming decade: (1) collective and separate impacts of major land changes and the interactions with non-land-change factors such as atmospheric CO2 increase, (2) carbon and other biogeochemicalmore » cycles, (3) climatically relevant biospheric emissions such as aerosols, (4) water cycle, (5) agriculture, (6) urbanization, (7) gradual acclimation of plants, communities, and ecosystems to climate and environmental changes, (8) plant migration, (9) land use projections, (10) reduction of uncertainties in models and data, and finally (11) adaptation strategies. We conclude that we need to create and maintain a close cross-disciplinary coordination between measurements and process representation in models to analyze complex multi-facet interrelated perturbations and feedbacks between land and climate changes. Along with major scientific research thrusts, land-use and land cover change mitigation and adaptation assessments should be strengthened to identify barriers that need to be overcome, evaluate and prioritize opportunities, and examine how decision making processes work in specific contexts.« less

Grand challenges in understanding the interplay of climate and land changes

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

Liu, Shuguang; Bond-Lamberty, Ben; Boysen, Lena R.

Half of the Earth s land surface has been altered by human activities, creating various consequences on the climate and weather systems at local to global scales, which in turn affects a myriad of land surface processes and our adaptation behaviors. We here review the status and major knowledge gaps of studying the interactions of land and atmospheric changes and present eleven grand challenge areas for scientific research and adaptation communities in the coming decade: (1) collective and separate impacts of major land changes and the interactions with non-land-change factors such as atmospheric CO2 increase, (2) carbon and other biogeochemicalmore » cycles, (3) climatically relevant biospheric emissions such as aerosols, (4) water cycle, (5) agriculture, (6) urbanization, (7) gradual acclimation of plants, communities, and ecosystems to climate and environmental changes, (8) plant migration, (9) land use projections, (10) reduction of uncertainties in models and data, and finally (11) adaptation strategies. We conclude that we need to create and maintain a close cross-disciplinary coordination between measurements and process representation in models to analyze complex multi-facet interrelated perturbations and feedbacks between land and climate changes. Along with major scientific research thrusts, land-use and land cover change mitigation and adaptation assessments should be strengthened to identify barriers that need to be overcome, evaluate and prioritize opportunities, and examine how decision making processes work in specific contexts.« less

Contrasting Ecological Processes and Functional Compositions Between Intestinal Bacterial Community in Healthy and Diseased Shrimp.

PubMed

Zhu, Jinyong; Dai, Wenfang; Qiu, Qiongfen; Dong, Chunming; Zhang, Jinjie; Xiong, Jinbo

2016-11-01

Intestinal bacterial communities play a pivotal role in promoting host health; therefore, the disruption of intestinal bacterial homeostasis could result in disease. However, the effect of the occurrences of disease on intestinal bacterial community assembly remains unclear. To address this gap, we compared the multifaceted ecological differences in maintaining intestinal bacterial community assembly between healthy and diseased shrimps. The neutral model analysis shows that the relative importance of neutral processes decreases when disease occurs. This pattern is further corroborated by the ecosphere null model, revealing that the bacterial community assembly of diseased samples is dominated by stochastic processes. In addition, the occurrence of shrimp disease reduces the complexity and cooperative activities of species-to-species interactions. The keystone taxa affiliated with Alphaproteobacteria and Actinobacteria in healthy shrimp gut shift to Gammaproteobacteria species in diseased shrimp. Changes in intestinal bacterial communities significantly alter biological functions in shrimp. Within a given metabolic pathway, the pattern of enrichment or decrease between healthy and deceased shrimp is correlated with its functional effects. We propose that stressed shrimp are more prone to invasion by alien strains (evidenced by more stochastic assembly and higher migration rate in diseased shrimp), which, in turn, disrupts the cooperative activity among resident species. These findings greatly aid our understanding of the underlying mechanisms that govern shrimp intestinal community assembly between health statuses.

Behavioral health coaching for rural veterans with diabetes and depression: a patient randomized effectiveness implementation trial.

PubMed

Cully, Jeffrey A; Breland, Jessica Y; Robertson, Suzanne; Utech, Anne E; Hundt, Natalie; Kunik, Mark E; Petersen, Nancy J; Masozera, Nicholas; Rao, Radha; Naik, Aanand D

2014-04-28

Depression and diabetes cause significant burden for patients and the healthcare system and, when co-occurring, result in poorer self-care behaviors and worse glycemic control than for either condition alone. However, the clinical management of these comorbid conditions is complicated by a host of patient, provider, and system-level barriers that are especially problematic for patients in rural locations. Patient-centered medical homes provide an opportunity to integrate mental and physical health care to address the multifaceted needs of complex comorbid conditions. Presently, there is a need to not only develop robust clinical interventions for complex medically ill patients but also to find feasible ways to embed these interventions into the frontlines of existing primary care practices. This randomized controlled trial uses a hybrid effectiveness-implementation design to evaluate the Healthy Outcomes through Patient Empowerment (HOPE) intervention, which seeks to simultaneously address diabetes and depression for rural veterans in Southeast Texas. A total of 242 Veterans with uncontrolled diabetes and comorbid symptoms of depression will be recruited and randomized to either the HOPE intervention or to a usual-care arm. Participants will be evaluated on a host of diabetes and depression-related measures at baseline and 6- and 12-month follow-up. The trial has two primary goals: 1) to examine the effectiveness of the intervention on both physical (diabetes) and emotional health (depression) outcomes and 2) to simultaneously pilot test a multifaceted implementation strategy designed to increase fidelity and utilization of the intervention by coaches interfacing within the primary care setting. This ongoing blended effectiveness-implementation design holds the potential to advance the science and practice of caring for complex medically ill patients within the constraints of a busy patient-centered medical home. Behavioral Activation Therapy for Rural Veterans with Diabetes and Depression: NCT01572389.

Examining neural correlates of skill acquisition in a complex videogame training program.

PubMed

Prakash, Ruchika S; De Leon, Angeline A; Mourany, Lyla; Lee, Hyunkyu; Voss, Michelle W; Boot, Walter R; Basak, Chandramallika; Fabiani, Monica; Gratton, Gabriele; Kramer, Arthur F

2012-01-01

Acquisition of complex skills is a universal feature of human behavior that has been conceptualized as a process that starts with intense resource dependency, requires effortful cognitive control, and ends in relative automaticity on the multi-faceted task. The present study examined the effects of different theoretically based training strategies on cortical recruitment during acquisition of complex video game skills. Seventy-five participants were recruited and assigned to one of three training groups: (1) Fixed Emphasis Training (FET), in which participants practiced the game, (2) Hybrid Variable-Priority Training (HVT), in which participants practiced using a combination of part-task training and variable priority training, or (3) a Control group that received limited game play. After 30 h of training, game data indicated a significant advantage for the two training groups relative to the control group. The HVT group demonstrated enhanced benefits of training, as indexed by an improvement in overall game score and a reduction in cortical recruitment post-training. Specifically, while both groups demonstrated a significant reduction of activation in attentional control areas, namely the right middle frontal gyrus, right superior frontal gyrus, and the ventral medial prefrontal cortex, participants in the control group continued to engage these areas post-training, suggesting a sustained reliance on attentional regions during challenging task demands. The HVT group showed a further reduction in neural resources post-training compared to the FET group in these cognitive control regions, along with reduced activation in the motor and sensory cortices and the posteromedial cortex. Findings suggest that training, specifically one that emphasizes cognitive flexibility can reduce the attentional demands of a complex cognitive task, along with reduced reliance on the motor network.

Examining neural correlates of skill acquisition in a complex videogame training program

PubMed Central

Prakash, Ruchika S.; De Leon, Angeline A.; Mourany, Lyla; Lee, Hyunkyu; Voss, Michelle W.; Boot, Walter R.; Basak, Chandramallika; Fabiani, Monica; Gratton, Gabriele; Kramer, Arthur F.

2012-01-01

Acquisition of complex skills is a universal feature of human behavior that has been conceptualized as a process that starts with intense resource dependency, requires effortful cognitive control, and ends in relative automaticity on the multi-faceted task. The present study examined the effects of different theoretically based training strategies on cortical recruitment during acquisition of complex video game skills. Seventy-five participants were recruited and assigned to one of three training groups: (1) Fixed Emphasis Training (FET), in which participants practiced the game, (2) Hybrid Variable-Priority Training (HVT), in which participants practiced using a combination of part-task training and variable priority training, or (3) a Control group that received limited game play. After 30 h of training, game data indicated a significant advantage for the two training groups relative to the control group. The HVT group demonstrated enhanced benefits of training, as indexed by an improvement in overall game score and a reduction in cortical recruitment post-training. Specifically, while both groups demonstrated a significant reduction of activation in attentional control areas, namely the right middle frontal gyrus, right superior frontal gyrus, and the ventral medial prefrontal cortex, participants in the control group continued to engage these areas post-training, suggesting a sustained reliance on attentional regions during challenging task demands. The HVT group showed a further reduction in neural resources post-training compared to the FET group in these cognitive control regions, along with reduced activation in the motor and sensory cortices and the posteromedial cortex. Findings suggest that training, specifically one that emphasizes cognitive flexibility can reduce the attentional demands of a complex cognitive task, along with reduced reliance on the motor network. PMID:22615690

Magnetic field reconnection. [energy conversion in space plasma

NASA Technical Reports Server (NTRS)

Sonnerup, U. O.

1979-01-01

A reasonably detailed description is obtained of the current status of our understanding of magnetic field reconnection. The picture that emerges is of a process, simple in concept but extremely complicated and multifaceted in detail. Nonlinear MHD processes in the external flow region, governed by distant boundary conditions, are coupled to nonlinear microscopic plasma processes in the diffusion region, in a manner not clearly understood. It appears that reconnection may operate in entirely different ways for different plasma parameters and different external boundary conditions. Steady reconnection may be allowed in some cases, forbidden in others, with intermediate situations involving impulsive or pulsative events.

OPPE, FPPE, QPS, and why the alphabet soup of physician assessment is essential for safer patient care.

PubMed

Loftus, Michael L

Creating a successful quality and patient safety program requires a multifaceted approach that systematically reviews overall systems and processes, but also creates a standardized framework for evaluating individual practitioner performance on a routine basis. There are two required elements of competency assessment that are typically tied to the hospital credentialing process: ongoing professional practice evaluation (OPPE) and focused professional practice evaluation (FPPE). Each of these processes are mandated by the Joint Commission, and form an important cornerstone for ensuring adequate physician performance and knowledge base. Copyright © 2017. Published by Elsevier Inc.

Nutrition in Wound Care Management: A Comprehensive Overview.

PubMed

Quain, Angela M; Khardori, Nancy M

2015-12-01

Wound care is a multidisciplinary specialty requiring many physiologic and immunologic processes as well as physical, social, and societal factors to achieve successful wound closure. Most wounds are treated with combinations of antimicrobials, protective barriers, and topical growth agents, including skin and biologic grafts.The role of nutrition in wound healing may be overlooked in the wound care patient. Like the specialty, it is often multifaceted, with many nutritional components playing a variety of roles in the wound healing process. Suboptimal nutrition can alter immune function, collagen synthesis, and wound tensile strength, all of which are essential in the wound healing process. It is also important to remember that not all wounds are equal: a burn is different from a diabetic foot ulcer, which is different from a pressure ulcer. Nonetheless, nutrition is a common denominator for all wound patients, and what is studied in 1 wound population is often relevant in another. Due to the complexities of monitoring and measuring both wound healing and dietary intake, randomized, controlled trials of wound care patients are difficult to conduct, and much of the data concerning nutrition in wound care relies on combined supplements. In summary, it appears that some nutrients are necessary only if deficient, whereas others may become conditionally essential and serve a therapeutic role. All of the nutrients discussed should be viewed as a component of a broader, complete diet. This article is a summary of wound healing and the roles of a variety of macronutrients and micronutrients in the process.

Supporting the Uptake of Nursing Guidelines: what you really need to know to move nursing guidelines into practice.

PubMed

Matthew-Maich, Nancy; Ploeg, Jenny; Dobbins, Maureen; Jack, Susan

2013-05-01

There is a current push to use best practice guidelines (BPGs) in health care to enhance client care and outcomes. Even though intensive resources have been invested internationally to develop BPGs, a gap in knowledge exists about how to consistently and efficiently move them into practice. Constructivist grounded theory was used to explore the complex processes of a breastfeeding BPG implementation and uptake in three acute care hospitals. Interviews (n = 120) with 112 participants representing clients, nurses, lactation consultants, midwives, physicians, managers, administrators, and nurse educators as well as document and field note analysis informed this study. Data were analyzed using constant comparison and coding steps outlined by Charmaz: initial coding, selective (focused) coding, then theoretical coding. Triangulation of data types and sources were used as well as theoretical sampling. Data were collected from 2009 to 2010. Two sites showed BPG uptake while one did not. Factors present in the uptake sites included, ongoing passionate frontline leaders, the use of multifaceted strategies, and processes that occurred at organizational, leadership, individual and social levels. Particularly noteworthy was the transformation of individual nurses to believing in and using the BPG. Impacts occurred at client, nurse, unit, inter-professional, organizational and system levels. A conceptual framework: Supporting the Uptake of Nursing Guidelines, was developed that reveals essential processes used to facilitate BPG uptake into nursing practice and a process of nurse transformation to believing in and using the BPG. © Sigma Theta Tau International.

Cultural boundary surfing in mental health nursing: a creative narration.

PubMed

Kidd, Jacquie

2010-01-01

In the mental health context, nurses navigate multifaceted boundaries every day in an effort to develop and maintain the therapeutic relationship; an endeavour that is breathtaking in its complexity. In this paper, I adopt an unconventional form of writing to explore the individual nature of cultural boundaries, and uncover hidden messages that impact on our efforts to build connections across cultures and ethnicities in mental health settings. Presented as a play, the conversation between protagonists explores cultural competence alongside the notion of 'discovery', and the potential of the Tidal Model to provide a vehicle for successful cultural boundary surfing.

Risk Factors in Adolescent Hypertension

PubMed Central

Ewald, D. Rose; Haldeman, Lauren A.

2016-01-01

Hypertension is a complex and multifaceted disease, with many contributing factors. While diet and nutrition are important influences, the confounding effects of overweight and obesity, metabolic and genetic factors, racial and ethnic predispositions, socioeconomic status, cultural influences, growth rate, and pubertal stage have even more influence and make diagnosis quite challenging. The prevalence of hypertension in adolescents far exceeds the numbers who have been diagnosed; studies have found that 75% or more go undiagnosed. This literature review summarizes the challenges of blood pressure classification in adolescents, discusses the impact of these confounding influences, and identifies actions that will improve diagnosis and treatment outcomes. PMID:27335997

The internationalization of health care: the UZ Brussel model for international partnerships.

PubMed

Noppen, Marc

2012-01-01

Globalization of health care, flat medicine, cross-boarder health care, medical tourism, are all terms describing some, but not all, aspects of a growing trend: patients seeking health care provision abroad, and health care providers travelling abroad for temporary or permanent health care delivery services. This trend is a complex, bilateral and multifaceted phenomenon, which in our opinion, cannot be sustained in a single, comprehensive description. Individual hospitals have the unique opportunity to develop a model for appropriate action. The specific model created by the university hospital UZ Brussel is presented here.

[Suicide and euthanasia : Discourse on physician-assisted suicide].

PubMed

Lewitzka, Dr U; Bauer, R

2016-05-01

Suicidal thoughts and behavior have been a part of human nature since the beginning of mankind. In his autobiographical work From my Life: Poetry and Truth Goethe summarized two important aspects: "Suicide is an event of human nature which, whatever may be said and done with respect to it, demands the sympathy of every man, and in every epoch must be discussed anew". The authors of this article aim to motivate the readership to question and analyze this complex topic and the accompanying multifaceted positions with a summarized presentation of historical aspects and the more recent political developments.

[Polycystic ovary syndrome: an example of obesity-related cardiovascular complication affecting young women].

PubMed

Orio, Francesco; Cascella, Teresa; Giallauria, Francesco; Palomba, Stefano; De Lorenzo, Anna; Lucci, Rosa; Ambrosino, Elena; Lombardi, Gaetano; Colao, Annamaria; Vigorito, Carlo

2006-03-01

Polycystic ovary syndrome (PCOS) is a good example of obesity-related cardiovascular complication affecting young women. PCOS is not only considered a reproductive problem but rather represents a complex endocrine, multifaceted syndrome with important health implications. Several evidences suggest an increased cardiovascular risk of cardiovascular disease associated with this syndrome, characterized by an impairment of heart structure and function, endothelial dysfunction and lipid abnormalities. All these features, probably linked to insulin-resistance, are often present in obese PCOS patients. Cardiovascular abnormalities represent important long-term sequelae of PCOS that need further investigations.

The redefinition of failure to thrive from a case study perspective.

PubMed

Locklin, Maryanne

2005-01-01

Explaining failure to thrive (FTT) in dichotomous terms--organic versus non-organic --no longer applies in the context of modern pediatric nursing. FTT has turned out to be much more multifaceted. One infant's story illustrates the complexities and long-term ramifications of a pediatric feeding disorder and the challenges faced by health care professionals and families in their care. The story illustrates how physiologic, sensorimotor, and behavioral issues can all impact a child's inability to gain weight as expected. With greater understanding, pediatric nurses can appreciate their role as members of a multidisciplinary pediatric feeding disorder team.

Leadership styles of service professionals aiding women of abuse: enhancing service delivery.

PubMed

Haeseler, Lisa Ann

2013-01-01

Leadership styles of service professionals--including social workers and teachers--in the area of family abuse were investigated. Leadership characteristics of the professionals were measured by their responses to a survey. Results indicated that the interviewed service professionals demonstrated productive leadership traits. Study findings are congruent with leadership styles described in the research. Holistic and collaborative services are required to enhance care for women of abuse, as their needs are multifaceted and complex. Specific leadership styles promote better care for women; leaders need to collaboratively initiate and deliver more interdisciplinary and unified service.

A dataset of human decision-making in teamwork management.

PubMed

Yu, Han; Shen, Zhiqi; Miao, Chunyan; Leung, Cyril; Chen, Yiqiang; Fauvel, Simon; Lin, Jun; Cui, Lizhen; Pan, Zhengxiang; Yang, Qiang

2017-01-17

Today, most endeavours require teamwork by people with diverse skills and characteristics. In managing teamwork, decisions are often made under uncertainty and resource constraints. The strategies and the effectiveness of the strategies different people adopt to manage teamwork under different situations have not yet been fully explored, partially due to a lack of detailed large-scale data. In this paper, we describe a multi-faceted large-scale dataset to bridge this gap. It is derived from a game simulating complex project management processes. It presents the participants with different conditions in terms of team members' capabilities and task characteristics for them to exhibit their decision-making strategies. The dataset contains detailed data reflecting the decision situations, decision strategies, decision outcomes, and the emotional responses of 1,144 participants from diverse backgrounds. To our knowledge, this is the first dataset simultaneously covering these four facets of decision-making. With repeated measurements, the dataset may help establish baseline variability of decision-making in teamwork management, leading to more realistic decision theoretic models and more effective decision support approaches.

Neurosurgery education: the pursuit of excellence.

PubMed

Benzel, Edward C

2010-01-01

The pursuit of excellence in education is a noble endeavor. Such has been the object of education and the goal of educators for eons. Neurosurgery education is no different from other domains in this regard. As with any discipline, this pursuit is complex and obligatorily multifaceted. It involves the use of what is often a broad and deep foundation of experience and knowledge. On this foundation, a modern and evolving infrastructure/suprastructure should be developed and nurtured. Once the infrastructure/suprastructure has taken form, a resident education plan can be derived. This plan, once enacted and executed, should be revisited, revised, and re-executed over and over again. One should never become satisfied with the status quo. A continued search for strategies and tools that achieve improvements over prior renditions of the education plan is mandatory if we hope to perpetually upgrade our process of education. Neurosurgical educators should seek criticism, admit mistakes, and modify educational behaviors accordingly. A strategy for achieving these goals regarding the pursuit of excellence in neurosurgical education is described in the pages that follow.

Biosimilar safety considerations in clinical practice.

PubMed

Choy, Edwin; Jacobs, Ira Allen

2014-02-01

Biologics are important treatments for a number of cancers. Patents for several biologics will expire over the next decade, removing a barrier to the development and commercialization of biosimilars. As biologics differ from small-molecule drugs due to their size and complexity, multifaceted manufacturing process, and their potential for immunogenicity, biosimilars cannot be considered "generic versions" of currently approved biologics. In highly regulated markets, biosimilars can be authorized only if they are demonstrated to be highly similar to the original drug from an analytical and clinical perspective. Any differences must be justified and shown to have no clinically meaningful effect on the safety and efficacy of the biosimilar. The European Medicines Agency has approved a number of biosimilars and the recent approval of the biosimilar infliximab monoclonal antibody is another regulatory milestone. This article will provide context regarding key safety issues addressed in biosimilar development, approval, and delivery, as well as inform oncologists on matters of safety to consider when prescribing biosimilars. Pertinent issues about safety from countries or regions where biosimilars are currently in use also will be reviewed. © 2014 Elsevier Inc. All rights reserved.

Investigation of virtual reality concept based on system analysis of conceptual series

NASA Astrophysics Data System (ADS)

Romanova, A.; Shuklin, D. A.; Kalinkina, M. E.; Gotskaya, I. B.; Ponomarev, Y. E.

2018-05-01

The paper covers approaches to the definition of virtual reality from the point of view of the humanitarian sciences and technology. Each approach analyzing problems of concept perception of methods interpreted by representatives of philosophy, psychology and sociology is singled out. Terminological analysis of the basic concepts is carried out and their refinement is constructed in the process of comparing the concepts of virtuality and virtual reality. Using the analysis of selected sources, a number of singularity characteristics of the given concept are singled out and its definition is specified. Results consist in combining the interpretation of all approaches to determine the concept of virtual reality. Due to the use of a comprehensive approach to the definition of the investigated concept, which allows us to consider the object of research as a set of elements that are subject to study with the help of a corresponding set of methods, one can conclude that the concept under study is complex and multifaceted. The authors noted that virtual reality technologies have a flexible concept depending on the field of application.

Partner or perish: experiences from the field about collaborations for reform.

PubMed

Boyer, Kim; Orpin, Peter; Walker, Judith

2010-01-01

Collaborations between researchers, policy makers, service providers and community members are critical to the journey of health service reform. Challenges are multifaceted and complex. Partners come with a variety of challenging agendas, value sets and imperatives, and see the drivers for reform from different perspectives. Different skills are required for managing the partnership and for providing academic leadership, and different structural frameworks need to be put in place for each task in each project. We have found through a series of partnerships across our research theme of healthy ageing, and consequent translation into policy and practice, that significant and innovative effort is required for both the collaboration and the research to succeed. A shared understanding of the issues and challenges is a start, but not sufficient for longer-term success. In addition to managing the research, our experience has demonstrated the need to understand the different challenges faced by each of the partners, recognise and respect personal and organisational value systems, and to establish separate mechanisms to manage strong egos alongside, but outside of, the research process.

Cancer Prevention for the Next Generation

PubMed Central

White, Mary C.; Peipins, Lucy A.; Watson, Meg; Trivers, Katrina F.; Holman, Dawn M.; Rodriguez, Juan L.

2015-01-01

Given the continued growth in the number of persons with cancer in the United States, the primary prevention of cancer remains an urgent public health priority. As the field of cancer prevention continues to mature and scientific knowledge evolves, it is imperative to challenge the status quo and embrace new approaches to cancer prevention. In this commentary, we summarize recent trends and some of the scientific advances that have been made over the past few decades regarding the complex process of cancer development and the interaction of individual and social risk factors. We examine some of the assumptions and terminology that have characterized cancer prevention approaches for more than a quarter century and the impact of these assumptions and our use of terminology. We propose that it is possible for today’s youth to experience lower cancer incidence rates as adults compared with previous generations. To accomplish this goal, a more transdisciplinary and multifaceted approach is needed, adapted as appropriate for different populations and stages of life. The greatest improvements in cancer prevention may occur as a result of innovative, multilevel interventions that build on the expanding scientific evidence base. PMID:23601606

A dataset of human decision-making in teamwork management

PubMed Central

Yu, Han; Shen, Zhiqi; Miao, Chunyan; Leung, Cyril; Chen, Yiqiang; Fauvel, Simon; Lin, Jun; Cui, Lizhen; Pan, Zhengxiang; Yang, Qiang

2017-01-01

Today, most endeavours require teamwork by people with diverse skills and characteristics. In managing teamwork, decisions are often made under uncertainty and resource constraints. The strategies and the effectiveness of the strategies different people adopt to manage teamwork under different situations have not yet been fully explored, partially due to a lack of detailed large-scale data. In this paper, we describe a multi-faceted large-scale dataset to bridge this gap. It is derived from a game simulating complex project management processes. It presents the participants with different conditions in terms of team members’ capabilities and task characteristics for them to exhibit their decision-making strategies. The dataset contains detailed data reflecting the decision situations, decision strategies, decision outcomes, and the emotional responses of 1,144 participants from diverse backgrounds. To our knowledge, this is the first dataset simultaneously covering these four facets of decision-making. With repeated measurements, the dataset may help establish baseline variability of decision-making in teamwork management, leading to more realistic decision theoretic models and more effective decision support approaches. PMID:28094787

Structural basis for regulation of GPR56/ADGRG1 by its alternatively spliced extracellular domains

PubMed Central

Salzman, Gabriel S.; Ackerman, Sarah D.; Ding, Chen; Koide, Akiko; Leon, Katherine; Luo, Rong; Stoveken, Hannah M.; Fernandez, Celia G.; Tall, Gregory G.; Piao, Xianhua; Monk, Kelly R.; Koide, Shohei; Araç, Demet

2016-01-01

Summary Adhesion G-protein-coupled receptors (aGPCRs) play critical roles in diverse neurobiological processes including brain development, synaptogenesis, and myelination. aGPCRs have large alternatively spliced extracellular regions (ECRs) that likely mediate intercellular signaling; however, the precise roles of ECRs remain unclear. The aGPCR GPR56/ADGRG1 regulates both oligodendrocyte and cortical development. Accordingly, human GPR56 mutations cause myelination defects and brain malformations. Here, we determined the crystal structure of the GPR56 ECR, the first structure of any complete aGPCR ECR, in complex with an inverse-agonist monobody, revealing a GPCR-Autoproteolysis-Inducing domain and a previously unidentified domain that we term Pentraxin/Laminin/neurexin/sex-hormone-binding-globulin-Like (PLL). Strikingly, PLL domain deletion caused increased signaling and characterizes a GPR56 splice variant. Finally, we show that an evolutionarily conserved residue in the PLL domain is critical for oligodendrocyte development in vivo. Thus, our results suggest that the GPR56 ECR has unique and multifaceted regulatory functions, providing novel insights into aGPCR roles in neurobiology. PMID:27657451

A Framework for Ethical Decision Making in the Rehabilitation of Patients with Anosognosia.

PubMed

Egbert, Anna Rita

2017-01-01

Currently, the number of patients diagnosed with impaired self-awareness of their own deficits after brain injury-anosognosia-is increasing. One reason is a growing understanding of this multifaceted phenomenon. Another is the development and accessibility of alternative measurements that allow more detailed diagnoses. Anosognosia can adversely affect successful rehabilitation, as often patients lack confidence in the need for treatment. Planning such treatment can become a complex process full of ethical dilemmas. To date, there is no systematic way to deal with different aspects of anosognosia rehabilitation planning. This is the first article to present a framework for ethical decision making in establishing rehabilitation plans that are focused on increasing patients' self-awareness of their own deficits after brain injury. It concentrates especially on addressing the ethical dilemmas that may arise, and describes stepwise procedures that can be applied to distinct theoretical approaches, as well as diagnostic and rehabilitation methods. To show the flexibility of the use of this framework, alternative approaches are discussed. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

Beyond 'doing': Supporting clinical leadership and nursing practice in aged care through innovative models of care.

PubMed

Venturato, Lorraine; Drew, Liz

2010-06-01

Contemporary health care environments are increasingly challenged by issues associated with the recruitment and retention of qualified nursing staff. This challenge is particularly felt by residential aged care providers, with registered nurse (RN) numbers already limited and resident acuity rapidly rising. As a result, aged care service providers are increasingly exploring creative and alternative models of care. This article details exploratory research into a pre-existing, alternative model of care in a medium sized, regional residential aged care facility. Research findings suggest that the model of care is complex and multi-faceted and is an example of an integrated model of care. As a result of the implementation of this model of care a number of shifts have occurred in the practice experiences and clinical culture within this facility. Results suggest that the main benefits of this model are: (1) increased opportunities for RNs to engage in clinical leadership and proactive care management; (2) improved management and communication in relation to work processes and practices; and (3) enhanced recruitment and retention of both RNs and care workers.

Importance of participation in major life areas matters for return to work.

PubMed

Kvam, Lisbeth; Vik, Kjersti; Eide, Arne Henning

2015-06-01

The complexity of the process and outcome of vocational rehabilitation yearns for a multifaceted approach. This article investigates whether importance of participation in major life areas for men and women predicts the outcome of vocational rehabilitation. This longitudinal study provides measure points at the start of the intervention (T1), at the end of the intervention (T2) and at a follow-up 6-12 months after completing the rehabilitation program (T3). Associations were assessed by nominal logistic regression. The importance of participation in work was positively associated to return to work (RTW), while the importance of participation in leisure activities and importance of participation in family was negatively associated with RTW after the rehabilitation. Gender and number of children also contributed significantly to the regression model. To identify individuals' subjective evaluation of the importance of participation may be of value in explaining return or not RTW and contribute to explain gender differences in outcomes. It may also inform rehabilitation counselors in collaboration with clients and facilitate tailoring interventions to the individual's needs.

Designing an Agent-Based Model for Childhood Obesity Interventions: A Case Study of ChildObesity180.

PubMed

Hennessy, Erin; Ornstein, Joseph T; Economos, Christina D; Herzog, Julia Bloom; Lynskey, Vanessa; Coffield, Edward; Hammond, Ross A

2016-01-07

Complex systems modeling can provide useful insights when designing and anticipating the impact of public health interventions. We developed an agent-based, or individual-based, computation model (ABM) to aid in evaluating and refining implementation of behavior change interventions designed to increase physical activity and healthy eating and reduce unnecessary weight gain among school-aged children. The potential benefits of applying an ABM approach include estimating outcomes despite data gaps, anticipating impact among different populations or scenarios, and exploring how to expand or modify an intervention. The practical challenges inherent in implementing such an approach include data resources, data availability, and the skills and knowledge of ABM among the public health obesity intervention community. The aim of this article was to provide a step-by-step guide on how to develop an ABM to evaluate multifaceted interventions on childhood obesity prevention in multiple settings. We used data from 2 obesity prevention initiatives and public-use resources. The details and goals of the interventions, overview of the model design process, and generalizability of this approach for future interventions is discussed.

Supporting ontology adaptation and versioning based on a graph of relevance

NASA Astrophysics Data System (ADS)

Sassi, Najla; Jaziri, Wassim; Alharbi, Saad

2016-11-01

Ontologies recently have become a topic of interest in computer science since they are seen as a semantic support to explicit and enrich data-models as well as to ensure interoperability of data. Moreover, supporting ontology adaptation becomes essential and extremely important, mainly when using ontologies in changing environments. An important issue when dealing with ontology adaptation is the management of several versions. Ontology versioning is a complex and multifaceted problem as it should take into account change management, versions storage and access, consistency issues, etc. The purpose of this paper is to propose an approach and tool for ontology adaptation and versioning. A series of techniques are proposed to 'safely' evolve a given ontology and produce a new consistent version. The ontology versions are ordered in a graph according to their relevance. The relevance is computed based on four criteria: conceptualisation, usage frequency, abstraction and completeness. The techniques to carry out the versioning process are implemented in the Consistology tool, which has been developed to assist users in expressing adaptation requirements and managing ontology versions.

Combining participatory and socioeconomic approaches to map fishing effort in small-scale fisheries.

PubMed

Thiault, Lauric; Collin, Antoine; Chlous, Frédérique; Gelcich, Stefan; Claudet, Joachim

2017-01-01

Mapping the spatial allocation of fishing effort while including key stakeholders in the decision making process is essential for effective fisheries management but is difficult to implement in complex small-scale fisheries that are diffuse, informal and multifaceted. Here we present a standardized but flexible approach that combines participatory mapping approaches (fishers' spatial preference for fishing grounds, or fishing suitability) with socioeconomic approaches (spatial extrapolation of social surrogates, or fishing capacity) to generate a comprehensive map of predicted fishing effort. Using a real world case study, in Moorea, French Polynesia, we showed that high predicted fishing effort is not simply located in front of, or close to, main fishing villages with high dependence on marine resources; it also occurs where resource dependency is moderate and generally in near-shore areas and reef passages. The integrated approach we developed can contribute to addressing the recurrent lack of fishing effort spatial data through key stakeholders' (i.e., resource users) participation. It can be tailored to a wide range of social, ecological and data availability contexts, and should help improve place-based management of natural resources.

Degradation Mechanisms for GaN and GaAs High Speed Transistors

PubMed Central

Cheney, David J.; Douglas, Erica A.; Liu, Lu; Lo, Chien-Fong; Gila, Brent P.; Ren, Fan; Pearton, Stephen J.

2012-01-01

We present a review of reliability issues in AlGaN/GaN and AlGaAs/GaAs high electron mobility transistors (HEMTs) as well as Heterojunction Bipolar Transistors (HBTs) in the AlGaAs/GaAs materials systems. Because of the complex nature and multi-faceted operation modes of these devices, reliability studies must go beyond the typical Arrhenius accelerated life tests. We review the electric field driven degradation in devices with different gate metallization, device dimensions, electric field mitigation techniques (such as source field plate), and the effect of device fabrication processes for both DC and RF stress conditions. We summarize the degradation mechanisms that limit the lifetime of these devices. A variety of contact and surface degradation mechanisms have been reported, but differ in the two device technologies: For HEMTs, the layers are thin and relatively lightly doped compared to HBT structures and there is a metal Schottky gate that is directly on the semiconductor. By contrast, the HBT relies on pn junctions for current modulation and has only Ohmic contacts. This leads to different degradation mechanisms for the two types of devices.

A metagenomic survey of forest soil microbial communities more than a decade after timber harvesting.

PubMed

Wilhelm, Roland C; Cardenas, Erick; Leung, Hilary; Maas, Kendra; Hartmann, Martin; Hahn, Aria; Hallam, Steven; Mohn, William W

2017-01-01

The scarcity of long-term data on soil microbial communities in the decades following timber harvesting limits current understanding of the ecological problems associated with maintaining the productivity of managed forests. The high complexity of soil communities and the heterogeneity of forest and soil necessitates a comprehensive approach to understand the role of microbial processes in managed forest ecosystems. Here, we describe a curated collection of well replicated, multi-faceted data from eighteen reforested sites in six different North American ecozones within the Long-term Soil Productivity (LTSP) Study, without detailed analysis of results or discussion. The experiments were designed to contrast microbial community composition and function among forest soils from harvested treatment plots with varying intensities of organic matter removal. The collection includes 724 bacterial (16S) and 658 fungal (ITS2) amplicon libraries, 133 shotgun metagenomic libraries as well as stable isotope probing amplicon libraries capturing the effects of harvesting on hemicellulolytic and cellulolytic populations. This collection serves as a foundation for the LTSP Study and other studies of the ecology of forest soil and forest disturbance.

A metagenomic survey of forest soil microbial communities more than a decade after timber harvesting

PubMed Central

Wilhelm, Roland C.; Cardenas, Erick; Leung, Hilary; Maas, Kendra; Hartmann, Martin; Hahn, Aria; Hallam, Steven; Mohn, William W.

2017-01-01

The scarcity of long-term data on soil microbial communities in the decades following timber harvesting limits current understanding of the ecological problems associated with maintaining the productivity of managed forests. The high complexity of soil communities and the heterogeneity of forest and soil necessitates a comprehensive approach to understand the role of microbial processes in managed forest ecosystems. Here, we describe a curated collection of well replicated, multi-faceted data from eighteen reforested sites in six different North American ecozones within the Long-term Soil Productivity (LTSP) Study, without detailed analysis of results or discussion. The experiments were designed to contrast microbial community composition and function among forest soils from harvested treatment plots with varying intensities of organic matter removal. The collection includes 724 bacterial (16S) and 658 fungal (ITS2) amplicon libraries, 133 shotgun metagenomic libraries as well as stable isotope probing amplicon libraries capturing the effects of harvesting on hemicellulolytic and cellulolytic populations. This collection serves as a foundation for the LTSP Study and other studies of the ecology of forest soil and forest disturbance. PMID:28765786

Management applications of discontinuity theory

USGS Publications Warehouse

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

2015-01-01

Human impacts on the environment are multifaceted and can occur across distinct spatiotemporal scales. Ecological responses to environmental change are therefore difficult to predict, and entail large degrees of uncertainty. Such uncertainty requires robust tools for management to sustain ecosystem goods and services and maintain resilient ecosystems.We propose an approach based on discontinuity theory that accounts for patterns and processes at distinct spatial and temporal scales, an inherent property of ecological systems. Discontinuity theory has not been applied in natural resource management and could therefore improve ecosystem management because it explicitly accounts for ecological complexity.Synthesis and applications. We highlight the application of discontinuity approaches for meeting management goals. Specifically, discontinuity approaches have significant potential to measure and thus understand the resilience of ecosystems, to objectively identify critical scales of space and time in ecological systems at which human impact might be most severe, to provide warning indicators of regime change, to help predict and understand biological invasions and extinctions and to focus monitoring efforts. Discontinuity theory can complement current approaches, providing a broader paradigm for ecological management and conservation.

Cognitive and neural components of the phenomenology of agency.

PubMed

Morsella, Ezequiel; Berger, Christopher C; Krieger, Stepehen C

2011-06-01

A primary aspect of the self is the sense of agency – the sense that one is causing an action. In the spirit of recent reductionistic approaches to other complex, multifaceted phenomena (e.g., working memory; cf. Johnson &Johnson, 2009), we attempt to unravel the sense of agency by investigating its most basic components, without invoking high-level conceptual or 'central executive' processes. After considering the high-level components of agency, we examine the cognitive and neural underpinnings of its low-level components, which include basic consciousness and subjective urges (e.g., the urge to breathe when holding one's breath). Regarding urges, a quantitative review revealed that certain inter-representational dynamics (conflicts between action plans, as when holding one's breath) reliably engender fundamental aspects both of the phenomenology of agency and of 'something countering the will of the self'. The neural correlates of such dynamics, for both primordial urges (e.g., air hunger) and urges elicited in laboratory interference tasks, are entertained. In addition, we discuss the implications of this unique perspective for the study of disorders involving agency.

A dataset of human decision-making in teamwork management

NASA Astrophysics Data System (ADS)

Yu, Han; Shen, Zhiqi; Miao, Chunyan; Leung, Cyril; Chen, Yiqiang; Fauvel, Simon; Lin, Jun; Cui, Lizhen; Pan, Zhengxiang; Yang, Qiang

2017-01-01

Today, most endeavours require teamwork by people with diverse skills and characteristics. In managing teamwork, decisions are often made under uncertainty and resource constraints. The strategies and the effectiveness of the strategies different people adopt to manage teamwork under different situations have not yet been fully explored, partially due to a lack of detailed large-scale data. In this paper, we describe a multi-faceted large-scale dataset to bridge this gap. It is derived from a game simulating complex project management processes. It presents the participants with different conditions in terms of team members' capabilities and task characteristics for them to exhibit their decision-making strategies. The dataset contains detailed data reflecting the decision situations, decision strategies, decision outcomes, and the emotional responses of 1,144 participants from diverse backgrounds. To our knowledge, this is the first dataset simultaneously covering these four facets of decision-making. With repeated measurements, the dataset may help establish baseline variability of decision-making in teamwork management, leading to more realistic decision theoretic models and more effective decision support approaches.

Combining participatory and socioeconomic approaches to map fishing effort in small-scale fisheries

PubMed Central

Collin, Antoine; Chlous, Frédérique; Gelcich, Stefan; Claudet, Joachim

2017-01-01

Mapping the spatial allocation of fishing effort while including key stakeholders in the decision making process is essential for effective fisheries management but is difficult to implement in complex small-scale fisheries that are diffuse, informal and multifaceted. Here we present a standardized but flexible approach that combines participatory mapping approaches (fishers’ spatial preference for fishing grounds, or fishing suitability) with socioeconomic approaches (spatial extrapolation of social surrogates, or fishing capacity) to generate a comprehensive map of predicted fishing effort. Using a real world case study, in Moorea, French Polynesia, we showed that high predicted fishing effort is not simply located in front of, or close to, main fishing villages with high dependence on marine resources; it also occurs where resource dependency is moderate and generally in near-shore areas and reef passages. The integrated approach we developed can contribute to addressing the recurrent lack of fishing effort spatial data through key stakeholders' (i.e., resource users) participation. It can be tailored to a wide range of social, ecological and data availability contexts, and should help improve place-based management of natural resources. PMID:28486509

Improved communication in post-ICU care by improving writing of ICU discharge letters: a longitudinal before-after study.

PubMed

Medlock, Stephanie; Eslami, Saeid; Askari, Marjan; van Lieshout, Erik Jan; Dongelmans, Dave A; Abu-Hanna, Ameen

2011-11-01

The discharge letter is the primary means of communication at patient discharge, yet discharge letters are often not completed on time. A multifaceted intervention was performed to improve communication in patient hand-off from the intensive care unit (ICU) to the wards by improving the timeliness of discharge letters. A management directive was operationalised by a working group of ICU staff in a longitudinal before-after study. The intervention consisted of (a) changing policy to require a letter for use as a transfer note at the time of ICU discharge, (b) changing the assignment of responsibility to an automatic process, (c) leveraging positive peer pressure by making the list of patients in need of letters visible to colleagues and (d) provision of decision support, through automatic copying of important content from the patient record to the letter and email reminders if letters were not written on time. Statistical process control charts were used to monitor the longitudinal effect of the intervention. The intervention resulted in a 77.9% absolute improvement in the proportion of patients with a complete transfer note at the time of discharge, and an 85.2% absolute improvement in the number of discharge letters written. Statistical process control shows that the effect was sustained over time. A multifaceted intervention can be highly effective for improving discharge communication from the ICU.

Molecular mechanisms of root gravity sensing and signal transduction.

PubMed

Strohm, Allison K; Baldwin, Katherine L; Masson, Patrick H

2012-01-01

Plants use gravity as a guide to direct their roots down into the soil to anchor themselves and to find resources needed for growth and development. In higher plants, the columella cells of the root tip form the primary site of gravity sensing, and in these cells the sedimentation of dense, starch-filled plastids (amyloplasts) triggers gravity signal transduction. This generates an auxin gradient across the root cap that is transmitted to the elongation zone where it promotes differential cell elongation, allowing the root to direct itself downward. It is still not well understood how amyloplast sedimentation leads to auxin redistribution. Models have been proposed to explain how mechanosensitive ion channels or ligand-receptor interactions could connect these events. Although their roles are still unclear, possible second messengers in this process include protons, Ca(2+), and inositol 1,4,5-triphosphate. Upon gravistimulation, the auxin efflux facilitators PIN3 and PIN7 relocalize to the lower side of the columella cells and mediate auxin redistribution. However, evidence for an auxin-independent secondary mechanism of gravity sensing and signal transduction suggests that this physiological process is quite complex. Furthermore, plants must integrate a variety of environmental cues, resulting in multifaceted relationships between gravitropism and other directional growth responses such as hydro-, photo-, and thigmotropism. Copyright © 2011 Wiley Periodicals, Inc.

Multidisciplinary and multisectoral coalitions as catalysts for action against antimicrobial resistance: Implementation experiences at national and regional levels.

PubMed

Joshi, Mohan P; Chintu, Chifumbe; Mpundu, Mirfin; Kibuule, Dan; Hazemba, Oliver; Andualem, Tenaw; Embrey, Martha; Phulu, Bayobuya; Gerba, Heran

2018-03-20

The multi-faceted complexities of antimicrobial resistance (AMR) require consistent action, a multidisciplinary approach, and long-term political commitment. Building coalitions can amplify stakeholder efforts to carry out effective AMR prevention and control strategies. We have developed and implemented an approach to help local stakeholders kick-start the coalition-building process. The five-step process is to (1) mobilise support, (2) understand the local situation, (3) develop an action plan, (4) implement the plan, and (5) monitor and evaluate. We first piloted the approach in Zambia in 2004, then used the lessons learned to expand it for use in Ethiopia and Namibia and to the regional level through the Ecumenical Pharmaceutical Network [EPN]. Call-to-action declarations and workshops helped promote a shared vision, resulting in the development of national AMR action plans, revision of university curricula to incorporate relevant topics, infection control activities, engagement with journalists from various mass media outlets, and strengthening of drug quality assurance systems. Our experience with the coalition-building approach in Ethiopia, Namibia, Zambia, and with the EPN shows that coalitions can form in a variety of ways with many different stakeholders, including government, academia, and faith-based organisations, to organise actions to preserve the effectiveness of existing antimicrobials and contain AMR.

Examples of finite element mesh generation using SDRC IDEAS

NASA Technical Reports Server (NTRS)

Zapp, John; Volakis, John L.

1990-01-01

IDEAS (Integrated Design Engineering Analysis Software) offers a comprehensive package for mechanical design engineers. Due to its multifaceted capabilities, however, it can be manipulated to serve the needs of electrical engineers, also. IDEAS can be used to perform the following tasks: system modeling, system assembly, kinematics, finite element pre/post processing, finite element solution, system dynamics, drafting, test data analysis, and project relational database.

Adversity and Redemption: Learning and Teaching in the Language Learning Histories of Two EFL Student-Teachers

ERIC Educational Resources Information Center

Baum, Miri Tashma

2015-01-01

A better understanding of the multifaceted, dynamic and situated identity of the language learner stands at the center of much current SLA research. One of the main ways in which it is investigated is through the examination of autobiographical language learning histories. In an effort to better understand some of the processes which lead to a…

An Inter-Correlational Study of the Reading Components in Profiling and Generating a Cognitive Equation for the Reading Performance of Students with Autism

ERIC Educational Resources Information Center

Elangovan, Saranya; Chia, Noel Kok Hwee

2013-01-01

Reading is a multifaceted process consisting of many interacting components. A plethora of research is available on reading. Yet, there is inadequate exploration, which ascertains the effects of the interaction of different reading components and how they affect the reading performance of students with autism. This inter-correlational research…

Multifacet structure of observed reconstructed integral images.

PubMed

Martínez-Corral, Manuel; Javidi, Bahram; Martínez-Cuenca, Raúl; Saavedra, Genaro

2005-04-01

Three-dimensional images generated by an integral imaging system suffer from degradations in the form of grid of multiple facets. This multifacet structure breaks the continuity of the observed image and therefore reduces its visual quality. We perform an analysis of this effect and present the guidelines in the design of lenslet imaging parameters for optimization of viewing conditions with respect to the multifacet degradation. We consider the optimization of the system in terms of field of view, observer position and pupil function, lenslet parameters, and type of reconstruction. Numerical tests are presented to verify the theoretical analysis.

Multifaceted spiral suture: A hemostatic technique in managing placenta praevia or accrete

PubMed Central

Meng, Yifan; Wu, Peng; Deng, Dongrui; Wu, Jianli; Lin, Xingguang; Beejadhursing, Rajluxmee; Zha, Ying; Qiao, Fuyuan; Feng, Ling; Liu, Haiyi; Zeng, Wanjiang

2017-01-01

Abstract Patients with total placenta previa and past history of cesarean delivery often experience overwhelming hemorrhage during childbirth. In order to control intraoperative and postoperative bleeding, we propose a novel multifaceted spiral suture of the lower uterine segment which directly sutures the bleeding site. To evaluate the efficacy and safety of multifaceted spiral suture, a retrospective study was conducted using data from 33 patients with total placenta praevia and caesarean history. All participants underwent multifaceted spiral suture and no patient experienced uncontrollable bleeding or underwent hysterectomy. The average blood loss of all patients involved was 1327.3 ± 1244.1 mL. Five patients reported blood loss exceeding 3000 mL (15.15%), and the highest reached to 4000 mL. No complications such as fever, pyometra, synechiae, or uterine necrosis were observed. Three cases (3/33, 9.09%) reported hematuria in the first 3 days following surgery and spontaneous resolution were observed within 3 to 7 days following insertion of indwelling catheters. No complaints were received during 6-month follow-up visits. These findings suggest that multifaceted spiral suture is a practical, feasible, and promising technique in potentially minimizing postpartum bleeding and avoiding hysterectomy for patients with placenta praevia or accrete. PMID:29245338

Co-Creativity and Interactive Repair: Commentary on Berta Bornstein's "The Analysis of a Phobic Child".

PubMed

Harrison, Alexandra

2014-01-01

My comments focus on a consideration of three issues central to child psychoanalysis stimulated by rereading the classic paper by Berta Bornstein, "The Analysis of a Phobic Child: Some Problems of Theory and Technique in Child Analysis": (1) the importance of "co-creativity" and its use in analysis to repair disruptions in the mother-child relationship; (2) working analytically with the "inner world of the child "; and (3) the fundamental importance of multiple simultaneous meaning-making processes. I begin with a discussion of current thinking about the importance of interactive processes in developmental and therapeutic change and then lead to the concepts of "co-creativity" and interactive repair, elements that are missing in the "Frankie" paper. The co-creative process that I outline includes multiple contributions that Frankie and his caregivers brought to their relationships--his mother, his father, his nurse, and even his analyst. I then address the question of how child analysts can maintain a central focus on the inner world of the child while still taking into account the complex nature of co-creativity in the change process. Finally, I discuss insights into the multiple simultaneous meaning-making processes in the analytic relationship to effect therapeutic change, including what I call the "sandwich model," an attempt to organize this complexity so that is more accessible to the practicing clinician. In terms of the specific case of Frankie, my reading of the case suggests that failure to repair disruptions in the mother-child relationship from infancy through the time of the analytic treatment was central to Frankie's problems. My hypothesis is that, rather than the content of his analyst's interpretations, what was helpful to Frankie in the analysis was the series of attempts at interactive repair in the analytic process. Unfortunately, the case report does not offer data to test this hypothesis. Indeed, one concluding observation from my reading of this classic case is how useful it would be for the contemporary analyst to pay attention to the multifaceted co-creative process in order to explain and foster the therapeutic change that can occur in analysis.

Src Homology 2 Domain-containing Phosphatase 2 (Shp2) Is a Component of the A-kinase-anchoring Protein (AKAP)-Lbc Complex and Is Inhibited by Protein Kinase A (PKA) under Pathological Hypertrophic Conditions in the Heart*

PubMed Central

Burmeister, Brian T.; Taglieri, Domenico M.; Wang, Li; Carnegie, Graeme K.

2012-01-01

Pathological cardiac hypertrophy (an increase in cardiac mass resulting from stress-induced cardiac myocyte growth) is a major factor underlying heart failure. Our results identify a novel mechanism of Shp2 inhibition that may promote cardiac hypertrophy. We demonstrate that the tyrosine phosphatase, Shp2, is a component of the A-kinase-anchoring protein (AKAP)-Lbc complex. AKAP-Lbc facilitates PKA phosphorylation of Shp2, which inhibits its protein-tyrosine phosphatase activity. Given the important cardiac roles of both AKAP-Lbc and Shp2, we investigated the AKAP-Lbc-Shp2 interaction in the heart. AKAP-Lbc-tethered PKA is implicated in cardiac hypertrophic signaling; however, mechanism of PKA action is unknown. Mutations resulting in loss of Shp2 catalytic activity are also associated with cardiac hypertrophy and congenital heart defects. Our data indicate that AKAP-Lbc integrates PKA and Shp2 signaling in the heart and that AKAP-Lbc-associated Shp2 activity is reduced in hypertrophic hearts in response to chronic β-adrenergic stimulation and PKA activation. Thus, while induction of cardiac hypertrophy is a multifaceted process, inhibition of Shp2 activity through AKAP-Lbc-anchored PKA is a previously unrecognized mechanism that may promote compensatory cardiac hypertrophy. PMID:23045525

Validation and calibration of structural models that combine information from multiple sources.

PubMed

Dahabreh, Issa J; Wong, John B; Trikalinos, Thomas A

2017-02-01

Mathematical models that attempt to capture structural relationships between their components and combine information from multiple sources are increasingly used in medicine. Areas covered: We provide an overview of methods for model validation and calibration and survey studies comparing alternative approaches. Expert commentary: Model validation entails a confrontation of models with data, background knowledge, and other models, and can inform judgments about model credibility. Calibration involves selecting parameter values to improve the agreement of model outputs with data. When the goal of modeling is quantitative inference on the effects of interventions or forecasting, calibration can be viewed as estimation. This view clarifies issues related to parameter identifiability and facilitates formal model validation and the examination of consistency among different sources of information. In contrast, when the goal of modeling is the generation of qualitative insights about the modeled phenomenon, calibration is a rather informal process for selecting inputs that result in model behavior that roughly reproduces select aspects of the modeled phenomenon and cannot be equated to an estimation procedure. Current empirical research on validation and calibration methods consists primarily of methodological appraisals or case-studies of alternative techniques and cannot address the numerous complex and multifaceted methodological decisions that modelers must make. Further research is needed on different approaches for developing and validating complex models that combine evidence from multiple sources.

Africanizing Science in Post-colonial Kenya: Long-Term Field Research in the Amboseli Ecosystem, 1963-1989.

PubMed

Lewis, Amanda E

2017-11-08

Following Kenya's independence in 1963, scientists converged on an ecologically sensitive area in southern Kenya on the northern slope of Mt. Kilimanjaro called Amboseli. This region is the homeland of the Ilkisongo Maasai who grazed this ecosystem along with the wildlife of interest to the scientists. Biologists saw opportunities to study this complex community, an environment rich in biological diversity. The Amboseli landscape proved to be fertile ground for testing new methods and lines of inquiry in the biological sciences that were generalizable and important for shaping natural resource management policies in Kenya. However, the local community was in the midst of its own transformation from a primarily transhumant lifestyle to a largely sedentary one, a complex political situation between local and national authorities, and the introduction of a newly educated generation. This article examines the intersection of African history and field science through the post-colonial Africanization of Kenyan politics, the broadening of scientific practices in Amboseli in previously Western-occupied spaces to include Kenyan participants, and an increasing awareness of the role of local African contexts in the results, methods, and implications of biological research. "Africanization" as an idea in the history of science is multifaceted encompassing not just Africans in the scientific process, but it needs an examination of the larger political and social context on both a local and national level.

Sleeping on the motor engram: The multifaceted nature of sleep-related motor memory consolidation.

PubMed

King, Bradley R; Hoedlmoser, Kerstin; Hirschauer, Franziska; Dolfen, Nina; Albouy, Genevieve

2017-09-01

For the past two decades, it has generally been accepted that sleep benefits motor memory consolidation processes. This notion, however, has been challenged by recent studies and thus the sleep and motor memory story is equivocal. Currently, and in contrast to the declarative memory domain, a comprehensive overview and synthesis of the effects of post-learning sleep on the behavioral and neural correlates of motor memory consolidation is not available. We therefore provide an extensive review of the literature in order to highlight that sleep-dependent motor memory consolidation depends upon multiple boundary conditions, including particular features of the motor task, the recruitment of relevant neural substrates (and the hippocampus in particular), as well as the specific architecture of the intervening sleep period (specifically, sleep spindle and slow wave activity). For our field to continue to advance, future research must consider the multifaceted nature of sleep-related motor memory consolidation. Copyright © 2017 Elsevier Ltd. All rights reserved.

MULTI-FACETED SUSTAINABILITY ON ITHACA COLLEGE NATURAL LANDS

EPA Science Inventory

This student-generated proposal presents a multi-faceted program for sustainable stewardship of the natural areas south of the built campus of Ithaca College. Our challenge is to use student research and class projects to enhance biodiversity, support education and research, and...

The ASYMMETRIC LEAVES Complex Employs Multiple Modes of Regulation to Affect Adaxial-Abaxial Patterning and Leaf Complexity[OPEN

PubMed Central

Husbands, Aman Y.; Benkovics, Anna H.; Nogueira, Fabio T.S.; Lodha, Mukesh; Timmermans, Marja C.P.

2015-01-01

Flattened leaf architecture is not a default state but depends on positional information to precisely coordinate patterns of cell division in the growing primordium. This information is provided, in part, by the boundary between the adaxial (top) and abaxial (bottom) domains of the leaf, which are specified via an intricate gene regulatory network whose precise circuitry remains poorly defined. Here, we examined the contribution of the ASYMMETRIC LEAVES (AS) pathway to adaxial-abaxial patterning in Arabidopsis thaliana and demonstrate that AS1-AS2 affects this process via multiple, distinct regulatory mechanisms. AS1-AS2 uses Polycomb-dependent and -independent mechanisms to directly repress the abaxial determinants MIR166A, YABBY5, and AUXIN RESPONSE FACTOR3 (ARF3), as well as a nonrepressive mechanism in the regulation of the adaxial determinant TAS3A. These regulatory interactions, together with data from prior studies, lead to a model in which the sequential polarization of determinants, including AS1-AS2, explains the establishment and maintenance of adaxial-abaxial leaf polarity. Moreover, our analyses show that the shared repression of ARF3 by the AS and trans-acting small interfering RNA (ta-siRNA) pathways intersects with additional AS1-AS2 targets to affect multiple nodes in leaf development, impacting polarity as well as leaf complexity. These data illustrate the surprisingly multifaceted contribution of AS1-AS2 to leaf development showing that, in conjunction with the ta-siRNA pathway, AS1-AS2 keeps the Arabidopsis leaf both flat and simple. PMID:26589551

[A couple in the sect: between freedom of membership and risks of abuse].

PubMed

Grattagliano, I; Tangari, D

2015-01-01

Psychological cults are of particular interest to criminologists due to their complex and multi-faceted structures. They may come in the form of organizations, movements, and training centers that make promises to their victims of developing or strengthening their psycho-relational capacities, thus resulting in improvements in their social, professional, and personal lives. Starting from the complex and delicate story of a professional couple who join a cult, the authors describe one case of a organization that are referred to as "psycho-sects", and with a significant number of followers. These cases came to our attention through judicial authorities, and they offer us an opportunity to look at two aspects associated with psycho-sects: The need of individuals to belong to such groups; and the risk of abuse and violence that they face.

Design Requirements for Communication-Intensive Interactive Applications

NASA Astrophysics Data System (ADS)

Bolchini, Davide; Garzotto, Franca; Paolini, Paolo

Online interactive applications call for new requirements paradigms to capture the growing complexity of computer-mediated communication. Crafting successful interactive applications (such as websites and multimedia) involves modeling the requirements for the user experience, including those leading to content design, usable information architecture and interaction, in profound coordination with the communication goals of all stakeholders involved, ranging from persuasion to social engagement, to call for action. To face this grand challenge, we propose a methodology for modeling communication requirements and provide a set of operational conceptual tools to be used in complex projects with multiple stakeholders. Through examples from real-life projects and lessons-learned from direct experience, we draw on the concepts of brand, value, communication goals, information and persuasion requirements to systematically guide analysts to master the multifaceted connections of these elements as drivers to inform successful communication designs.

The human CTC1/STN1/TEN1 complex regulates telomere maintenance in ALT cancer cells.

PubMed

Huang, Chenhui; Jia, Pingping; Chastain, Megan; Shiva, Olga; Chai, Weihang

2017-06-15

Maintaining functional telomeres is important for long-term proliferation of cells. About 15% of cancer cells are telomerase-negative and activate the alternative-lengthening of telomeres (ALT) pathway to maintain their telomeres. Recent studies have shown that the human CTC1/STN1/TEN1 complex (CST) plays a multi-faceted role in telomere maintenance in telomerase-expressing cancer cells. However, the role of CST in telomere maintenance in ALT cells is unclear. Here, we report that human CST forms a functional complex localizing in the ALT-associated PML bodies (APBs) in ALT cells throughout the cell cycle. Suppression of CST induces telomere instabilities including telomere fragility and elevates telomeric DNA recombination, leading to telomere dysfunction. In addition, CST deficiency significantly diminishes the abundance of extrachromosomal circular telomere DNA known as C-circles and t-circles. Suppression of CST also results in multinucleation in ALT cells and impairs cell proliferation. Our findings imply that the CST complex plays an important role in regulating telomere maintenance in ALT cells. Copyright © 2017 Elsevier Inc. All rights reserved.

Fate of Trace Metals in Anaerobic Digestion.

PubMed

Fermoso, F G; van Hullebusch, E D; Guibaud, G; Collins, G; Svensson, B H; Carliell-Marquet, C; Vink, J P M; Esposito, G; Frunzo, L

2015-01-01

A challenging, and largely uncharted, area of research in the field of anaerobic digestion science and technology is in understanding the roles of trace metals in enabling biogas production. This is a major knowledge gap and a multifaceted problem involving metal chemistry; physical interactions of metal and solids; microbiology; and technology optimization. Moreover, the fate of trace metals, and the chemical speciation and transport of trace metals in environments--often agricultural lands receiving discharge waters from anaerobic digestion processes--simultaneously represents challenges for environmental protection and opportunities to close process loops in anaerobic digestion.

Children's neural processing of moral scenarios provides insight into the formation and reduction of in-group biases.

PubMed

Meidenbauer, Kimberly L; Cowell, Jason M; Decety, Jean

2018-04-25

Survival is dependent on sociality within groups which ensure sustenance and protection. From an early age, children show a natural tendency to sort people into groups and discriminate among them. The computations guiding evaluation of third-party behaviors are complex, requiring integration of intent, consequences, and knowledge of group affiliation. This study examined how perceiving third-party morally laden behavior influences children's likelihood to exhibit or reduce group bias. Following a minimal group paradigm assignment, young children (4-7 years) performed a moral evaluation task where group affiliations and moral actions were systematically juxtaposed, so that they were exposed to disproportionately antisocial in-group and prosocial out-group scenarios. Electroencephalography was recorded, and group preference was assessed with a resource allocation game before and after the EEG session. Across all children, evaluations of others' moral actions arose from early and automatic processing (~150 ms), followed by later interactive processing of affiliation and moral valence (~500 ms). Importantly, individual differences in bias manifestation and attitude change were predicted by children's neural responses. Children with high baseline bias selectively exhibited a rapid detection (~200 ms) of scenarios inconsistent with their bias (in-group harm and out-group help). Changes in bias corresponded to distinct patterns in longer latency neural processing. These new developmental neuroscience findings elucidate the multifaceted processing involved in moral evaluation of others' actions, their group affiliations, the nature of the integration of both into full judgments, and the relation of individual differences in neural responses to social decision-making in childhood. © 2018 John Wiley & Sons Ltd.

One Iota Fills the Quota: A Paradox in Multifacet Reliability Coefficients.

ERIC Educational Resources Information Center

Conger, Anthony J.

1983-01-01

A paradoxical phenomenon of decreases in reliability as the number of elements averaged over increases is shown to be possible in multifacet reliability procedures (intraclass correlations or generalizability coefficients). Conditions governing this phenomenon are presented along with implications and cautions. (Author)

Multifaceted re-analysis of the enigmatic Kitimat slide complex, Canada

NASA Astrophysics Data System (ADS)

Stacey, Cooper D.; Lintern, D. Gwyn; Enkin, Randolph J.

2018-07-01

Repeat submarine landslides are challenging to study due to the tendency of subsequent slides to destroy previous deposits. Repeat slides are common in fjord head deltas where high amounts of sediment are focused in narrow valleys. This study examines a well-known slide deposit associated with the Kitimat Delta on Canada's west coast that has been linked to tsunamigenic landslides in 1974 and 1975. For the first time we incorporate multibeam bathymetry to a multifaceted dataset including new high resolution acoustic data and sediment cores to examine the history of submarine slides at the Kitimat Delta. Based on morphological analysis and age modelling using 210Pb and 14C data, we determine that the complex surface morphology of the slide lobe consists of at least two large slide deposits that reach 5 km from the delta: the known event that occurred in 1975 and an older event that occurred at 623 ± 83 cal BP (95% confidence interval). We demonstrate that slide deposits can be differentiated based on surface morphology and acoustic character. This is confirmed by age modelling. The 1975 slide resulted in a flow that ploughed through the seabed creating compression and translation along a basal shear plane, resulting in deep deformation and a surface characterized by pressure ridges. The 623 ± 83 cal BP event resulted in a large amount of blocky slide material that overran the former seafloor and was transported >5 km from the delta front. Several buried events are observed at depth, one of which occurred at 2592 ± 84 cal BP and appears to be on the same order of magnitude as the 1975 event and showing very similar acoustic characteristics. As for hazard implications, we show submarine landslides of varying sizes have naturally occurred on this delta throughout the past several thousand years.

The global regulator Crc plays a multifaceted role in modulation of type III secretion system in Pseudomonas aeruginosa

PubMed Central

Dong, Yi-Hu; Zhang, Xi-Fen; Zhang, Lian-Hui

2013-01-01

The opportunistic pathogen Pseudomonas aeruginosa utilizes type III secretion system (T3SS) to translocate effector proteins into eukaryotic host cells that subvert normal host cell functions to the benefit of the pathogen, and results in serious infections. T3SS in P. aeruginosa is controlled by a complex system of regulatory mechanisms and signaling pathways. In this study, we described that Crc, an RNA-binding protein, exerts a positive impact on T3SS in P. aeruginosa, as evidenced by promoter activity assays of several key T3SS genes, transcriptomics, RT-PCR, and immunoblotting in crc mutant. We further demonstrated that the regulatory function of Crc on the T3SS was mediated through the T3SS master regulator ExsA and linked to the Cbr/Crc signaling system. Expression profiling of the crc mutant revealed a downregulation of flagship T3SS genes as well as 16 other genes known to regulate T3SS gene expression in P. aeruginosa. On the basis of these data, we proposed that Crc may exert multifaceted control on the T3SS through various pathways, which may serve to fine-tune this virulence mechanism in response to environmental changes and nutrient sources. PMID:23292701

Nurse case-manager vs multifaceted intervention to improve quality of osteoporosis care after wrist fracture: randomized controlled pilot study.

PubMed

Majumdar, S R; Johnson, J A; Bellerose, D; McAlister, F A; Russell, A S; Hanley, D A; Garg, S; Lier, D A; Maksymowych, W P; Morrish, D W; Rowe, B H

2011-01-01

Few outpatients with fractures are treated for osteoporosis in the years following fracture. In a randomized pilot study, we found a nurse case-manager could double rates of osteoporosis testing and treatment compared with a proven efficacious quality improvement strategy directed at patients and physicians (57% vs 28% rates of appropriate care). Few patients with fractures are treated for osteoporosis. An intervention directed at wrist fracture patients (education) and physicians (guidelines, reminders) tripled osteoporosis treatment rates compared to controls (22% vs 7% within 6 months of fracture). More effective strategies are needed. We undertook a pilot study that compared a nurse case-manager to the multifaceted intervention using a randomized trial design. The case-manager counseled patients, arranged bone mineral density (BMD) tests, and prescribed treatments. We included controls from our first trial who remained untreated for osteoporosis 1-year post-fracture. Primary outcome was bisphosphonate treatment and secondary outcomes were BMD testing, appropriate care (BMD test-treatment if bone mass low), and costs. Forty six patients untreated 1-year after wrist fracture were randomized to case-manager (n = 21) or multifaceted intervention (n = 25). Median age was 60 years and 68% were female. Six months post-randomization, 9 (43%) case-managed patients were treated with bisphosphonates compared with 3 (12%) multifaceted intervention patients (relative risk [RR] 3.6, 95% confidence intervals [CI] 1.1-11.5, p = 0.019). Case-managed patients were more likely than multifaceted intervention patients to undergo BMD tests (81% vs 52%, RR 1.6, 95%CI 1.1-2.4, p = 0.042) and receive appropriate care (57% vs 28%, RR 2.0, 95%CI 1.0-4.2, p = 0.048). Case-management cost was $44 (CDN) per patient vs $12 for the multifaceted intervention. A nurse case-manager substantially increased rates of appropriate testing and treatment for osteoporosis in patients at high-risk of future fracture when compared with a multifaceted quality improvement intervention aimed at patients and physicians. Even with case-management, nearly half of patients did not receive appropriate care. clinicaltrials.gov identifier: NCT00152321.

Movement as Medicine for Type 2 Diabetes: protocol for an open pilot study and external pilot clustered randomised controlled trial to assess acceptability, feasibility and fidelity of a multifaceted behavioural intervention targeting physical activity in primary care.

PubMed

Avery, Leah; Sniehotta, Falko F; Denton, Sarah J; Steen, Nick; McColl, Elaine; Taylor, Roy; Trenell, Michael I

2014-02-03

Physical activity (PA) and nutrition are the cornerstones of diabetes management. Several reviews and meta-analyses report that PA independently produces clinically important improvements in glucose control in people with Type 2 diabetes. However, it remains unclear what the optimal strategies are to increase PA behaviour in people with Type 2 diabetes in routine primary care. This study will determine whether an evidence-informed multifaceted behaviour change intervention (Movement as Medicine for Type 2 Diabetes) targeting both consultation behaviour of primary healthcare professionals and PA behaviour in adults with Type 2 diabetes is both acceptable and feasible in the primary care setting. An open pilot study conducted in two primary care practices (phase one) will assess acceptability, feasibility and fidelity. Ongoing feedback from participating primary healthcare professionals and patients will provide opportunities for systematic adaptation and refinement of the intervention and study procedures. A two-arm parallel group clustered pilot randomised controlled trial with patients from participating primary care practices in North East England will assess acceptability, feasibility, and fidelity of the intervention (versus usual clinical care) and trial processes over a 12-month period. Consultation behaviour involving fidelity of intervention delivery, diabetes and PA related knowledge, attitudes/beliefs, intentions and self-efficacy for delivering a behaviour change intervention targeting PA behaviour will be assessed in primary healthcare professionals. We will rehearse the collection of outcome data (with the focus on data yield and quality) for a future definitive trial, through outcome assessment at baseline, one, six and twelve months. An embedded qualitative process evaluation and treatment fidelity assessment will explore issues around intervention implementation and assess whether intervention components can be reliably and faithfully delivered in routine primary care. Movement as Medicine for Type 2 Diabetes will address an important gap in the evidence-base, that is, the need for interventions to increase free-living PA behaviour in adults with Type 2 diabetes. The multifaceted intervention incorporates an online accredited training programme for primary healthcare professionals and represents, to the best of our knowledge, the first of its kind in the United Kingdom. This study will establish whether the multifaceted behavioural intervention is acceptable and feasible in routine primary care. Movement as Medicine for Type 2 Diabetes (MaMT2D) was registered with Current Controlled Trials on the 14th January 2012: ISRCTN67997502. The first primary care practice was randomised on the 5th October 2012.

Explaining the uptake of paediatric guidelines in a Kenyan tertiary hospital--mixed methods research.

PubMed

Irimu, Grace W; Greene, Alexandra; Gathara, David; Kihara, Harrison; Maina, Christopher; Mbori-Ngacha, Dorothy; Zurovac, Dejan; Santau, Migiro; Todd, Jim; English, Mike

2014-03-10

Evidence-based standards for management of the seriously sick child have existed for decades, yet their translation in clinical practice is a challenge. The context and organization of institutions are known determinants of successful translation, however, research using adequate methodologies to explain the dynamic nature of these determinants in the quality-of-care improvement process is rarely performed. We conducted mixed methods research in a tertiary hospital in a low-income country to explore the uptake of locally adapted paediatric guidelines. The quantitative component was an uncontrolled before and after intervention study that included an exploration of the intervention dose-effect relationship. The qualitative component was an ethnographic research based on the theoretical perspective of participatory action research. Interpretive integration was employed to derive meta-inferences that provided a more complete picture of the overall study results that reflect the complexity and the multifaceted ontology of the phenomenon studied. The improvement in health workers' performance in relation to the intensity of the intervention was not linear and was characterized by improved and occasionally declining performance. Possible root causes of this performance variability included challenges in keeping knowledge and clinical skills updated, inadequate commitment of the staff to continued improvement, limited exposure to positive professional role models, poor teamwork, failure to maintain professional integrity and mal-adaptation to institutional pressures. Implementation of best-practices is a complex process that is largely unpredictable, attributed to the complexity of contextual factors operating predominantly at professional and organizational levels. There is no simple solution to implementation of best-practices. Tackling root causes of inadequate knowledge translation in this tertiary care setting will require long-term planning, with emphasis on promotion of professional ethics and values and establishing an organizational framework that enhances positive aspects of professionalism. This study has significant implications for the quality of training in medical institutions and the development of hospital leadership.

Explaining the uptake of paediatric guidelines in a Kenyan tertiary hospital – mixed methods research

PubMed Central

2014-01-01

Background Evidence-based standards for management of the seriously sick child have existed for decades, yet their translation in clinical practice is a challenge. The context and organization of institutions are known determinants of successful translation, however, research using adequate methodologies to explain the dynamic nature of these determinants in the quality-of-care improvement process is rarely performed. Methods We conducted mixed methods research in a tertiary hospital in a low-income country to explore the uptake of locally adapted paediatric guidelines. The quantitative component was an uncontrolled before and after intervention study that included an exploration of the intervention dose-effect relationship. The qualitative component was an ethnographic research based on the theoretical perspective of participatory action research. Interpretive integration was employed to derive meta-inferences that provided a more complete picture of the overall study results that reflect the complexity and the multifaceted ontology of the phenomenon studied. Results The improvement in health workers’ performance in relation to the intensity of the intervention was not linear and was characterized by improved and occasionally declining performance. Possible root causes of this performance variability included challenges in keeping knowledge and clinical skills updated, inadequate commitment of the staff to continued improvement, limited exposure to positive professional role models, poor teamwork, failure to maintain professional integrity and mal-adaptation to institutional pressures. Conclusion Implementation of best-practices is a complex process that is largely unpredictable, attributed to the complexity of contextual factors operating predominantly at professional and organizational levels. There is no simple solution to implementation of best-practices. Tackling root causes of inadequate knowledge translation in this tertiary care setting will require long-term planning, with emphasis on promotion of professional ethics and values and establishing an organizational framework that enhances positive aspects of professionalism. This study has significant implications for the quality of training in medical institutions and the development of hospital leadership. PMID:24613001

Multifaceted toxicity assessment of catalyst composites in transgenic zebrafish embryos.

PubMed

Jang, Gun Hyuk; Lee, Keon Yong; Choi, Jaewon; Kim, Sang Hoon; Lee, Kwan Hyi

2016-09-01

Recent development in the field of nanomaterials has given rise into the inquiries regarding the toxicological characteristics of the nanomaterials. While many individual nanomaterials have been screened for their toxicological effects, composites that accompany nanomaterials are not common subjects to such screening through toxicological assessment. One of the widely used composites that accompany nanomaterials is catalyst composite used to reduce air pollution, which was selected as a target composite with nanomaterials for the multifaceted toxicological assessment. As existing studies did not possess any significant data regarding such catalyst composites, this study focuses on investigating toxicological characteristics of catalyst composites from various angles in both in-vitro and in-vivo settings. Initial toxicological assessment on catalyst composites was conducted using HUVECs for cell viability assays, and subsequent in-vivo assay regarding their direct influence on living organisms was done. The zebrafish embryo and its transgenic lines were used in the in-vivo assays to obtain multifaceted analytic results. Data obtained from the in-vivo assays include blood vessel formation, mutated heart morphology, and heart functionality change. Our multifaceted toxicological assessment pointed out that chemical composites augmented with nanomaterials can too have toxicological threat as much as individual nanomaterials do and alarms us with their danger. This manuscript provides a multifaceted assessment for composites augmented with nanomaterials, of which their toxicological threats have been overlooked. Copyright © 2016 Elsevier Ltd. All rights reserved.

Enhancement of Pyrometallurgical Teaching Using Excel Simulation Models

NASA Astrophysics Data System (ADS)

Grimsey, Eric J.

Steady state Excel models for a copper flash smelter and an iron blast furnace are used to enhance the teaching of pyrometallurgical smelting principles within a fourth year level process engineering unit delivered at the Western Australian School of Mines. A lecture/workshop approach has been adopted in which student teams undertake process simulation assignments that illustrate the multifaceted responses of process outputs to variation of inputs, the objectives being to reinforce their understanding of smelting principles. The approach has proven to be popular with students, as evidenced by the consistently high ratings the unit has received through student feedback. This paper provides an overview of the teaching approach and process models used.

The NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRC) for Greater Manchester: combining empirical, theoretical and experiential evidence to design and evaluate a large-scale implementation strategy.

PubMed

Harvey, Gill; Fitzgerald, Louise; Fielden, Sandra; McBride, Anne; Waterman, Heather; Bamford, David; Kislov, Roman; Boaden, Ruth

2011-08-23

In response to policy recommendations, nine National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) were established in England in 2008, aiming to create closer working between the health service and higher education and narrow the gap between research and its implementation in practice. The Greater Manchester (GM) CLAHRC is a partnership between the University of Manchester and twenty National Health Service (NHS) trusts, with a five-year mission to improve healthcare and reduce health inequalities for people with cardiovascular conditions. This paper outlines the GM CLAHRC approach to designing and evaluating a large-scale, evidence- and theory-informed, context-sensitive implementation programme. The paper makes a case for embedding evaluation within the design of the implementation strategy. Empirical, theoretical, and experiential evidence relating to implementation science and methods has been synthesised to formulate eight core principles of the GM CLAHRC implementation strategy, recognising the multi-faceted nature of evidence, the complexity of the implementation process, and the corresponding need to apply approaches that are situationally relevant, responsive, flexible, and collaborative. In turn, these core principles inform the selection of four interrelated building blocks upon which the GM CLAHRC approach to implementation is founded. These determine the organizational processes, structures, and roles utilised by specific GM CLAHRC implementation projects, as well as the approach to researching implementation, and comprise: the Promoting Action on Research Implementation in Health Services (PARIHS) framework; a modified version of the Model for Improvement; multiprofessional teams with designated roles to lead, facilitate, and support the implementation process; and embedded evaluation and learning. Designing and evaluating a large-scale implementation strategy that can cope with and respond to the local complexities of implementing research evidence into practice is itself complex and challenging. We present an argument for adopting an integrative, co-production approach to planning and evaluating the implementation of research into practice, drawing on an eclectic range of evidence sources.

A Multi-Faceted Approach to Successful Transition for Students with Intellectual Disabilities

ERIC Educational Resources Information Center

Dubberly, Russell G.

2011-01-01

This report summarizes the multi-faceted, dynamic instructional model implemented to increase positive transition outcomes for high school students with intellectual disabilities. This report is based on the programmatic methods implemented within a secondary-level school in an urban setting. This pedagogical model facilitates the use of…

Conceptualising Middle Management in Higher Education: A Multifaceted Discourse

ERIC Educational Resources Information Center

Clegg, Sue; McAuley, John

2005-01-01

Debates about middle management in higher education have been largely confined to the dominant discourse of managerialism. In this paper, we argue for an engagement with the broader management literature, with its multiple discourses of middle management. We present an analysis of middle management as a multifaceted phenomenon and review…

Multifaceted Inpatient Psychiatry Approach to Reducing Readmissions: A Pilot Study

ERIC Educational Resources Information Center

Lang, Timothy P.; Rohrer, James E.; Rioux, Pierre A.

2009-01-01

Context: Access to psychiatric services, particularly inpatient psychiatric care, is limited and lacks comprehensiveness in rural areas. Purpose: The purpose of this study was to evaluate the impact on readmission rates of a multifaceted inpatient psychiatry approach (MIPA) offered in a rural hospital. Methods: Readmissions within 30 days of…

An Investigational Analysis of Problem Drinking among a Commuter College Population.

ERIC Educational Resources Information Center

Bebo, Joseph A.

2003-01-01

Previous literature has identified a number of variables that lead to substance abuse behavior. Studies that take a multifaceted, theoretical approach are limited. This study proposes the integration of differential association, social learning, social bonding, seduction and self-control theories. Proposes that a multifaceted approach contributes…

Women's coping experiences in the spectrum of domestic violence abuse.

PubMed

Haeseler, Lisa Ann

2013-01-01

Through this phenomenological case study the author investigates the experience of coping by women in the spectrum of domestic violence abuse. An ecological view of women's coping is critically reviewed. Women of abuse cope with many factors simultaneously in their lives as there are numerous, multifaceted, and diverse issues that comprise and contribute to an abusive situation. Eight providers from four different agencies, two providers per agency, describe the coping experiences of women both in and out of the abusive situation. Study results corroborate with research and demonstrate that women's coping, both in and out of the abusive relationship is unique and complex.

Geriatric simulation: practicing management and leadership in care of the older adult.

PubMed

Miller, Sally; Overstreet, Maria

2015-06-01

According to the Centers for Disease Control and Prevention, patients age 65 and older account for 43% of hospital days. The complexity of caring for older adults affords nursing students opportunities to assess, prioritize, intervene, advocate, and experience being a member of an interdisciplinary health care team. However, these multifaceted hospital experiences are not consistently available for all students. Nursing clinical simulation (NCS) can augment or replace specific clinical hours and provide clinically relevant experiences to practice management and leadership skills while caring for older adults. This article describes a geriatric management and leadership NCS. Copyright © 2015 Elsevier Inc. All rights reserved.

["My Mirra, my world." Mirra Birens-Eitingon as a key to her husband Max Eitingon's persona].

PubMed

Ginor, Isabella; Remez, Gideon

2015-01-01

New reseach in Russia, Germany and Israel has revealed the complex and multifaceted figure of Mirra Eitingon (1877-1947), the wife for 31 years of Dr. Max Eitingon. Her character and her background in the Russian-Jewish intelligentsia and theatrical milieu provided a lifelong inspiration for Max in his many cultural interests as well as in his psychoanalytic activities, in Berlin and later in Jerusalem. His devotion to Mirra as well as to her two sons from previous marriages (one of them was the leading Soviet nuclear physicist Yuli Khariton) also highlight Max's own generosity and kindness.

Caring for burn patients at the United States Institute of Surgical Research: the nurses' multifaceted roles.

PubMed

Serio-Melvin, Maria; Yoder, Linda H; Gaylord, Kathryn M

2010-06-01

Nursing plays a critical role in the comprehensive burn care delivered at the US Army Institute of Surgical Research, otherwise known as the US Army's Burn Center serving the Department of Defense. This center serves as a model for burn units nationally and internationally. It also provides a challenging and innovative work environment for military and civilian nurses. Nurses in the Burn Center contribute to innovations in acute, rehabilitative, and psychological care for patients with burns. This article provides an overview of the complex nursing care provided to burn patients treated at the Burn Center. Copyright (c) 2010 Elsevier Inc. All rights reserved.

The overlooked terrestrial impacts of mountaintop mining

USGS Publications Warehouse

Wickham, James; Wood, Petra Bohall; Nicholson, Matthew C.; Jenkins, William; Druckenbrod, Daniel; Suter, Glenn W.; Strager, Michael P.; Mazzarella, Christine; Galloway, Walter; Amos, John

2013-01-01

Ecological research on mountaintop mining has been focused on aquatic impacts because the overburden (i.e., the mountaintop) is disposed of in nearby valleys, which leads to a wide range of water-quality impacts on streams. There are also numerous impacts on the terrestrial environment from mountaintop mining that have been largely overlooked, even though they are no less wide ranging, severe, and multifaceted. We review the impacts of mountaintop mining on the terrestrial environment by exploring six broad themes: (1) the loss of topographic complexity, (2) forest loss and fragmentation, (3) forest succession and soil loss, (4) forest loss and carbon sequestration, (5) biodiversity, and (6) human health and well-being.

Process evaluation of a multifaceted intervention to improve cardiovascular disease prevention in general practice.

PubMed

Lobo, Claudia M; Euser, Lya; Kamp, Jeanine; Frijling, Bernard D; Severens, Johan L; Hulscher, Marlies E J L; Grol, Richard P T M; Prins, Ad; van der Wouden, Johannes C

2003-09-01

To perform a process evaluation of a multifaceted intervention to improve cardiovascular and diabetes care in general practice. The feasibility of the intervention, carried out by outreach visitors in 62 practices, was addressed by evaluating whether the intervention programme was performed as planned and the extent to which it was accepted by the practice team. In addition, the costs of the programme were determined. The intervention was largely carried out as planned, although the intervention period had to be extended by three months. Of the 18 topics that could be addressed during the intervention period, 12 (mean) were addressed. The number of outreach visits per practice was 15.2 (mean), each visit lasted about one hour. Most practice members endorsed both the key recommendations for clinical decision-making and cardiovascular risk profiling. The majority of GPs (range 63-98%) agreed with the guidelines for clinical decision-making, and 29-97% had a positive opinion about the guidelines for practice organisation. According to practice staff members, the outreach visitor had sufficient knowledge and skills to support them in changing the practice organisation. GPs were less positive about the outreach visitor's knowledge and skills in optimising clinical decision-making; however 78% believed that the outreach visitor contributed to effecting change in their clinical decision-making. The total costs of the intervention per practice were Euro 4317. This process evaluation demonstrated that the intervention was usually carried out as planned and achieved a high satisfaction rating from the participating practice members.

A Framework for Business Process Change Requirements Analysis

NASA Astrophysics Data System (ADS)

Grover, Varun; Otim, Samuel

The ability to quickly and continually adapt business processes to accommodate evolving requirements and opportunities is critical for success in competitive environments. Without appropriate linkage between redesign decisions and strategic inputs, identifying processes that need to be modified will be difficult. In this paper, we draw attention to the analysis of business process change requirements in support of process change initiatives. Business process redesign is a multifaceted phenomenon involving processes, organizational structure, management systems, human resource architecture, and many other aspects of organizational life. To be successful, the business process initiative should focus not only on identifying the processes to be redesigned, but also pay attention to various enablers of change. Above all, a framework is just a blueprint; management must lead change. We hope our modest contribution will draw attention to the broader framing of requirements for business process change.

Exploring Scientific Information for Policy Making under Deep Uncertainty

NASA Astrophysics Data System (ADS)

Forni, L.; Galaitsi, S.; Mehta, V. K.; Escobar, M.; Purkey, D. R.; Depsky, N. J.; Lima, N. A.

2016-12-01

Each actor evaluating potential management strategies brings her/his own distinct set of objectives to a complex decision space of system uncertainties. The diversity of these objectives require detailed and rigorous analyses that responds to multifaceted challenges. However, the utility of this information depends on the accessibility of scientific information to decision makers. This paper demonstrates data visualization tools for presenting scientific results to decision makers in two case studies, La Paz/ El Alto, Bolivia, and Yuba County,California. Visualization output from the case studies combines spatiotemporal, multivariate and multirun/multiscenario information to produce information corresponding to the objectives defined by key actors and stakeholders. These tools can manage complex data and distill scientific information into accessible formats. Using the visualizations, scientists and decision makers can navigate the decision space and potential objective trade-offs to facilitate discussion and consensus building. These efforts can support identifying stable negotiatedagreements between different stakeholders.

Chips for Everyone: A Multifaceted Approach in Electrical Engineering Outreach

ERIC Educational Resources Information Center

Magill, J.; Roy, S.

2010-01-01

This paper reports on a multifaceted approach in electrical engineering outreach focused on the area of semiconductor technology. The activities developed can be used in combination for a very wide range of audiences in both age and stage of education, as has been demonstrated with great success. Moreover, the project has developed…

The Multifaceted Variable Approach: Selection of Method in Solving Simple Linear Equations

ERIC Educational Resources Information Center

Tahir, Salma; Cavanagh, Michael

2010-01-01

This paper presents a comparison of the solution strategies used by two groups of Year 8 students as they solved linear equations. The experimental group studied algebra following a multifaceted variable approach, while the comparison group used a traditional approach. Students in the experimental group employed different solution strategies,…

Measuring the Multifaceted Nature of Infant and Toddler Care Quality

ERIC Educational Resources Information Center

Mangione, Peter L.; Kriener-Althen, Kerry; Marcella, Jennifer

2016-01-01

Research Findings: The quality of group care infants and toddlers experience relates to their concurrent and later development. Recent quality improvement initiatives point to the need for ecologically valid measures that assess the multifaceted nature of child care quality. In this article, we present the psychometric properties of an infant and…

A Multifaceted Partner Presentation Assignment for Improving Educational Outcomes among College Students

ERIC Educational Resources Information Center

Wood, Claire A.; Perlman, Daniel

2017-01-01

This article reports a multifaceted course assignment involving the development of information literacy skills, speed partnering, a brief team VoiceThread presentation, and peer evaluations of the presentations. The assignment was rooted in Chickering and Gamson's (1989) highly regarded principles of good educational practice, as well as the…

THE DEPENDABILITY OF BEHAVIORAL MEASUREMENTS--MULTIFACET STUDIES OF GENERALIZABILITY. TECHNICAL REPORT, PRELIMINARY VERSION.

ERIC Educational Resources Information Center

CRONBACH, LEE J.; AND OTHERS

A MEASURING OPERATION IS A SAMPLE FROM A UNIVERSE OF ADMISSIBLE OBSERVATIONS....GENERALIZABILITY STUDIES ESTIMATE THE MAGNITUDE OF THE DISCREPENCIES LIKELY TO ARISE UNDER A GIVEN MEASURING PROCEDURE, AND PROVIDE FORMULAS FOR ESTABLISHING INTERVAL AND POINT ESTIMATES OF THE UNIVERSE SCORE. A MULTIFACET GENERALIZABILITY ANALYSIS DEPARTS IN SEVERAL…

A southern region conference on technology transfer and extension

Treesearch

Sarah F. Ashton; William G. Hubbard; H. Michael Rauscher

2009-01-01

Forest landowners and managers have different education and technology transfer needs and preferences. To be effective it is important to use a multi-faceted science delivery/technology transfer program to reach them. Multi-faceted science delivery programs can provide similar content over a wide range of mechanisms including printed publications, face-to-face...

Specialist outreach clinics in primary care and rural hospital settings.

PubMed

Gruen, R L; Weeramanthri, T S; Knight, S E; Bailie, R S

2004-01-01

Specialist medical practitioners have conducted clinics in primary care and rural hospital settings for a variety of reasons in many different countries. Such clinics have been regarded as an important policy option for increasing the accessibility and effectiveness of specialist services and their integration with primary care services. To undertake a descriptive overview of studies of specialist outreach clinics and to assess the effectiveness of specialist outreach clinics on access, quality, health outcomes, patient satisfaction, use of services, and costs. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) specialised register (March 2002), the Cochrane Controlled Trials Register (CCTR) (Cochrane Library Issue 1, 2002), MEDLINE (including HealthStar) (1966 to May 2002), EMBASE (1988 to March 2002), CINAHL (1982 to March 2002), the Primary-Secondary Care Database previously maintained by the Centre for Primary Care Research in the Department of General Practice at the University of Manchester, a collection of studies from the UK collated in "Specialist Outreach Clinics in General Practice" (Roland 1998), and the reference lists of all retrieved articles. Randomised trials, controlled before and after studies and interrupted time series analyses of visiting specialist outreach clinics in primary care or rural hospital settings, either providing simple consultations or as part of complex multifaceted interventions. The participants were patients, specialists, and primary care providers. The outcomes included objective measures of access, quality, health outcomes, satisfaction, service use, and cost. Four reviewers working in pairs independently extracted data and assessed study quality. 73 outreach interventions were identified covering many specialties, countries and settings. Nine studies met the inclusion criteria. Most comparative studies came from urban non-disadvantaged populations in developed countries. Simple 'shifted outpatients' styles of specialist outreach were shown to improve access, but there was no evidence of impact on health outcomes. Specialist outreach as part of more complex multifaceted interventions involving collaboration with primary care, education or other services was associated with improved health outcomes, more efficient and guideline-consistent care, and less use of inpatient services. The additional costs of outreach may be balanced by improved health outcomes. This review supports the hypothesis that specialist outreach can improve access, outcomes and service use, especially when delivered as part of a multifaceted intervention. The benefits of simple outreach models in urban non-disadvantaged settings seem small. There is a need for good comparative studies of outreach in rural and disadvantaged settings where outreach may confer most benefit to access and health outcomes.

KSC-2011-7851

NASA Image and Video Library

2011-11-21

CAPE CANAVERAL, Fla. – Members of the media tour several facilities, including the Multi-Payload Processing Facility, during the 21st Century Ground Systems Program Tour at Kennedy Space Center in Florida. Other tour stops were the Launch Equipment Test Facility, the Operations & Checkout Building and the Canister Rotation Facility. NASA’s 21st Century Ground Systems Program was initiated at Kennedy Space Center to establish the needed launch and processing infrastructure to support the Space Launch System Program and to work toward transforming the landscape of the launch site for a multi-faceted user community. Photo credit: NASA/Jim Grossmann

KSC-2011-7846

NASA Image and Video Library

2011-11-21

CAPE CANAVERAL, Fla. – Members of the media tour several facilities, including the Launch Equipment Test Facility in the Industrial Area, during the 21st Century Ground Systems Program Tour at Kennedy Space Center in Florida. Other tour stops were the Operations & Checkout Building, the Multi-Payload Processing Facility and the Canister Rotation Facility. NASA’s 21st Century Ground Systems Program was initiated at Kennedy Space Center to establish the needed launch and processing infrastructure to support the Space Launch System Program and to work toward transforming the landscape of the launch site for a multi-faceted user community. Photo credit: NASA/Jim Grossmann

KSC-2011-7847

NASA Image and Video Library

2011-11-21

CAPE CANAVERAL, Fla. – Members of the media tour several facilities, including the Launch Equipment Test Facility in the Industrial Area, during the 21st Century Ground Systems Program Tour at Kennedy Space Center in Florida. Other tour stops were the Operations & Checkout Building, the Multi-Payload Processing Facility and the Canister Rotation Facility. NASA’s 21st Century Ground Systems Program was initiated at Kennedy Space Center to establish the needed launch and processing infrastructure to support the Space Launch System Program and to work toward transforming the landscape of the launch site for a multi-faceted user community. Photo credit: NASA/Jim Grossmann

Hands4U: the effectiveness of a multifaceted implementation strategy on behaviour related to the prevention of hand eczema-a randomised controlled trial among healthcare workers.

PubMed

van der Meer, Esther W C; Boot, Cécile R L; Twisk, Jos W R; Coenraads, Pieter Jan; Jungbauer, Frank H W; van der Gulden, Joost W J; Anema, Johannes R

2014-07-01

To investigate the effects of a multifaceted implementation strategy on behaviour, behavioural determinants, knowledge and awareness of healthcare workers regarding the use of recommendations to prevent hand eczema. The Hands4U study is a randomised controlled trial. A total of 48 departments (n=1649 workers) were randomly allocated to the multifaceted implementation strategy or the control group (minimal implementation strategy). Within the departments designated to the multifaceted implementation strategy, participatory working groups were set up to enhance the implementation of the recommendations for hand eczema. In addition, working group members were trained to become role models, and an education session was given within the department. Outcome measures were awareness, knowledge, receiving information, behaviour and behavioural determinants. Data were collected at baseline, with a 3- and 6-month follow-up. Statistically significant effects were found after 6 months for awareness (OR 6.30; 95% CI 3.41 to 11.63), knowledge (B 0.74; 95% CI 0.54 to 0.95), receiving information (OR 9.81; 95% CI 5.60 to 17.18), washing hands (B -0.40; 95% -0.51 to -0.29), use of moisturiser (B 0.29; 95% CI 0.20 to 0.38), cotton under gloves (OR 3.94; 95% CI 2.04 to 7.60) and the overall compliance measure (B 0.14; 95% CI 0.02 to 0.26), as a result of the multifaceted implementation strategy. No effects were found for behavioural determinants. The multifaceted implementation strategy can be used in healthcare settings to enhance the implementation of recommendations for the prevention of hand eczema. NTR2812. 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.

Sowing the seeds of transformative practice to actualize women's rights to respectful maternity care: reflections from Kenya using the consolidated framework for implementation research.

PubMed

Warren, Charlotte E; Ndwiga, Charity; Sripad, Pooja; Medich, Melissa; Njeru, Anne; Maranga, Alice; Odhiambo, George; Abuya, Timothy

2017-08-30

Despite years of growing concern about poor provider attitudes and women experiencing mistreatment during facility based childbirth, there are limited interventions that specifically focus on addressing these issues. The Heshima project is an evidence-based participatory implementation research study conducted in 13 facilities in Kenya. It engaged a range of community, facility, and policy stakeholders to address the causes of mistreatment during childbirth and promote respectful maternity care. We used the consolidated framework for implementation research (CFIR) as an analytical lens to describe a complex, multifaceted set of interventions through a reflexive and iterative process for triangulating qualitative data. Data from a broad range of project documents, reports, and interviews were collected at different time points during the implementation of Heshima. Assessment of in-depth interview data used NVivo (Version 10) and Atlas.ti software to inductively derive codes for themes at baseline, supplemental, and endline. Our purpose was to generate categories of themes for analysis found across the intervention design and implementation stages. The implementation process, intervention characteristics, individual champions, and inner and outer settings influenced both Heshima's successes and challenges at policy, facility, and community levels. Implementation success stemmed from readiness for change at multiple levels, constant communication between stakeholders, and perceived importance to communities. The relative advantage and adequacy of implementation of the Respectful Maternity Care (RMC) resource package was meaningful within Kenyan politics and health policy, given the timing and national promise to improve the quality of maternity care. We found the CFIR lens a promising and flexible one for understanding the complex interventions. Despite the relatively nascent stage of RMC implementation research, we feel this study is an important start to understanding a range of interventions that can begin to address issues of mistreatment in maternity care; replication of these activities is needed globally to better understand if the Heshima implementation process can be successful in different countries and regions.

Developing and evaluating the implementation of a complex intervention: using mixed methods to inform the design of a randomised controlled trial of an oral healthcare intervention after stroke

PubMed Central

2011-01-01

Background Many interventions delivered within the stroke rehabilitation setting could be considered complex, though some are more complex than others. The degree of complexity might be based on the number of and interactions between levels, components and actions targeted within the intervention. The number of (and variation within) participant groups and the contexts in which it is delivered might also reflect the extent of complexity. Similarly, designing the evaluation of a complex intervention can be challenging. Considerations include the necessity for intervention standardisation, the multiplicity of outcome measures employed to capture the impact of a multifaceted intervention and the delivery of the intervention across different clinical settings operating within varying healthcare contexts. Our aim was to develop and evaluate the implementation of a complex, multidimensional oral health care (OHC) intervention for people in stroke rehabilitation settings which would inform the development of a randomised controlled trial. Methods After reviewing the evidence for the provision of OHC following stroke, multi-disciplinary experts informed the development of our intervention. Using both quantitative and qualitative methods we evaluated the implementation of the complex OHC intervention across patients, staff and service levels of care. We also adopted a pragmatic approach to patient recruitment, the completion of assessment tools and delivery of OHC, alongside an attention to the context in which it was delivered. Results We demonstrated the feasibility of implementing a complex OHC intervention across three levels of care. The complementary nature of the mixed methods approach to data gathering provided a complete picture of the implementation of the intervention and a detailed understanding of the variations within and interactions between the components of the intervention. Information on the feasibility of the outcome measures used to capture impact across a range of components was also collected, though some process orientated uncertainties including eligibility and recruitment rates remain to be further explored within a Phase II exploratory trial. Conclusions Complex interventions can be captured and described in a manner which facilitates evaluation in the form of exploratory and subsequently definitive clinical trials. If effective, the evidence captured relating to the intervention context will facilitate translation into clinical practice. PMID:21729277

Decision-making for risky gains and losses among college students with Internet gaming disorder.

PubMed

Yao, Yuan-Wei; Chen, Pin-Ru; Li, Song; Wang, Ling-Jiao; Zhang, Jin-Tao; Yip, Sarah W; Chen, Gang; Deng, Lin-Yuan; Liu, Qin-Xue; Fang, Xiao-Yi

2015-01-01

Individuals with Internet gaming disorder (IGD) tend to exhibit disadvantageous risky decision-making not only in their real life but also in laboratory tasks. Decision-making is a complex multifaceted function and different cognitive processes are involved in decision-making for gains and losses. However, the relationship between impaired decision-making and gain versus loss processing in the context of IGD is poorly understood. The main aim of the present study was to separately evaluate decision-making for risky gains and losses among college students with IGD using the Cups task. Additionally, we further examined the effects of outcome magnitude and probability level on decision-making related to risky gains and losses respectively. Sixty college students with IGD and 42 matched healthy controls (HCs) participated. Results indicated that IGD subjects exhibited generally greater risk taking tendencies than HCs. In comparison to HCs, IGD subjects made more disadvantageous risky choices in the loss domain (but not in the gain domain). Follow-up analyses indicated that the impairment was associated to insensitivity to changes in outcome magnitude and probability level for risky losses among IGD subjects. In addition, higher Internet addiction severity scores were associated with percentage of disadvantageous risky options in the loss domain. These findings emphasize the effect of insensitivity to losses on disadvantageous decisions under risk in the context of IGD, which has implications for future intervention studies.

Best practice principles for community-based obesity prevention: development, content and application.

PubMed

King, L; Gill, T; Allender, S; Swinburn, B

2011-05-01

Best practice in obesity prevention has generally been defined in terms of 'what' needs to be done while neglecting 'how'. A multifaceted definition of best practice, which combines available evidence on what actions to take, with an established process for interpreting this information in a specific community context, provides a more appropriate basis for defining the principles of best practice in community-based obesity prevention. Based on analysis of a range of literature, a preliminary set of principles was drafted and progressively revised through further analyses of published literature and a series of consultations. The framework for best practice principles comprises: community engagement, programme design and planning, evaluation, implementation and sustainability, and governance. Specific principles were formulated within this framework. While many principles were generic, distinctive features of obesity prevention were also covered. The engagement of end-users influenced the design of the formatting of the outputs, which represent three levels of knowledge transfer: detailed evidence summaries, guiding questions for programme planners and a briefer set of questions for simpler communication purposes. The best practice principles provide a valuable mechanism for the translation of existing evidence and experience into the decision-making processes for planning, implementing and evaluating the complex community-based interventions needed for successful obesity prevention. © 2010 The Authors. obesity reviews © 2010 International Association for the Study of Obesity.

No Evidence for Emotional Empathy in Chickens Observing Familiar Adult Conspecifics

PubMed Central

Edgar, Joanne L.; Paul, Elizabeth S.; Harris, Lauren; Penturn, Sarah; Nicol, Christine J.

2012-01-01

The capacity of animals to empathise is of high potential relevance to the welfare of group-housed domestic animals. Emotional empathy is a multifaceted and multilayered phenomenon which ranges from relatively simple processes such as emotional matching behaviour to more complex processes involving interaction between emotional and cognitive perspective taking systems. Our previous research has demonstrated that hens show clear behavioural and physiological responses to the mild distress of their chicks. To investigate whether this capacity exists outside the mother/offspring bond, we conducted a similar experiment in which domestic hens were exposed to the mild distress of unrelated, but familiar adult conspecifics. Each observer hen was exposed to two replicates of four conditions, in counterbalanced order; control (C); control with noise of air puff (CN); air puff to conspecific hen (APC); air puff to observer hen (APH). During each test, the observer hens' behaviour and physiology were measured throughout a 10 min pre-treatment and a 10 min treatment period. Despite showing signs of distress in response to an aversive stimulus directed at themselves (APH), and using methodology sufficiently sensitive to detect empathy-like responses previously, observer hens showed no behavioural or physiological responses to the mild distress of a familiar adult conspecific. The lack of behavioural and physiological response indicates that hens show no basis for emotional empathy in this context. PMID:22348100

The ASYMMETRIC LEAVES Complex Employs Multiple Modes of Regulation to Affect Adaxial-Abaxial Patterning and Leaf Complexity.

PubMed

Husbands, Aman Y; Benkovics, Anna H; Nogueira, Fabio T S; Lodha, Mukesh; Timmermans, Marja C P

2015-12-01

Flattened leaf architecture is not a default state but depends on positional information to precisely coordinate patterns of cell division in the growing primordium. This information is provided, in part, by the boundary between the adaxial (top) and abaxial (bottom) domains of the leaf, which are specified via an intricate gene regulatory network whose precise circuitry remains poorly defined. Here, we examined the contribution of the ASYMMETRIC LEAVES (AS) pathway to adaxial-abaxial patterning in Arabidopsis thaliana and demonstrate that AS1-AS2 affects this process via multiple, distinct regulatory mechanisms. AS1-AS2 uses Polycomb-dependent and -independent mechanisms to directly repress the abaxial determinants MIR166A, YABBY5, and AUXIN RESPONSE FACTOR3 (ARF3), as well as a nonrepressive mechanism in the regulation of the adaxial determinant TAS3A. These regulatory interactions, together with data from prior studies, lead to a model in which the sequential polarization of determinants, including AS1-AS2, explains the establishment and maintenance of adaxial-abaxial leaf polarity. Moreover, our analyses show that the shared repression of ARF3 by the AS and trans-acting small interfering RNA (ta-siRNA) pathways intersects with additional AS1-AS2 targets to affect multiple nodes in leaf development, impacting polarity as well as leaf complexity. These data illustrate the surprisingly multifaceted contribution of AS1-AS2 to leaf development showing that, in conjunction with the ta-siRNA pathway, AS1-AS2 keeps the Arabidopsis leaf both flat and simple. © 2015 American Society of Plant Biologists. All rights reserved.

"It's Not All About Money": Toward a More Comprehensive Understanding of Financial Abuse in the Context of VAW.

PubMed

Eriksson, Marie; Ulmestig, Rickard

2017-12-01

Men's violence against women (VAW) is multifaceted and complex. Besides physical, psychological, and sexual violence, women subjected to VAW often suffer from economic hardship and financial abuse. Financial abuse involves different tactics used to exercise power and gain control over partners. Experiences of financial abuse make it difficult for women to leave an abusive partner and become self-sufficient. From an intersectional perspective, applying the concept of the continuum of violence, the aim of this article is to develop a more comprehensive understanding of how women subjected to men's violence in intimate relationships experience the complexity of financial abuse in their lives, in the context of VAW. Based on 19 in-depth interviews with women surviving domestic violence, the study describes how intertwined women's experiences of financial abuse are with other forms of abuse, influencing each other, simultaneously experienced as a distinct form of abuse with severe and longstanding consequences. Women in the study describe how men's abuse affects them financially, causing poverty and affecting their ability to have a reasonable economic standard. Financial abuse also causes women ill health, and damages their self-esteem and ability to work, associate, and engage in social life. The interviewed women describe how experiences of financial abuse continue across time, from their past into their present situation and molding beliefs about the future. According to the interviews, financial abuse in private life sometimes continues into the public sphere, reproduced by social workers mimicking patterns of ex-partners' abuse. Bringing out a more comprehensive understanding of the dynamic continuum of financial abuse, our results deepen knowledge about the complexity of VAW in women's lives, and thereby are important in processes of making victims of violence survivors of violence.

Common EEG features for behavioral estimation in disparate, real-world tasks.

PubMed

Touryan, Jon; Lance, Brent J; Kerick, Scott E; Ries, Anthony J; McDowell, Kaleb

2016-02-01

In this study we explored the potential for capturing the behavioral dynamics observed in real-world tasks from concurrent measures of EEG. In doing so, we sought to develop models of behavior that would enable the identification of common cross-participant and cross-task EEG features. To accomplish this we had participants perform both simulated driving and guard duty tasks while we recorded their EEG. For each participant we developed models to estimate their behavioral performance during both tasks. Sequential forward floating selection was used to identify the montage of independent components for each model. Linear regression was then used on the combined power spectra from these independent components to generate a continuous estimate of behavior. Our results show that oscillatory processes, evidenced in EEG, can be used to successfully capture slow fluctuations in behavior in complex, multi-faceted tasks. The average correlation coefficients between the actual and estimated behavior was 0.548 ± 0.117 and 0.701 ± 0.154 for the driving and guard duty tasks respectively. Interestingly, through a simple clustering approach we were able to identify a number of common components, both neural and eye-movement related, across participants and tasks. We used these component clusters to quantify the relative influence of common versus participant-specific features in the models of behavior. These findings illustrate the potential for estimating complex behavioral dynamics from concurrent measures from EEG using a finite library of universal features. Published by Elsevier B.V.

A systematic review on in vitro 3D bone metastases models: A new horizon to recapitulate the native clinical scenario?

PubMed

Salamanna, Francesca; Contartese, Deyanira; Maglio, Melania; Fini, Milena

2016-07-12

While the skeleton is not the only organ where metastasis can occur, it is one of the preferred sites, with a significant impact in patients' quality of life. With the aim of delineating the cellular and molecular mechanisms of bone metastasis, numerous studies have been employed to identify any contributing factors that trigger cancer progression. One of the major limitations of studying cancer-bone metastasis is the multifaceted nature of the native bone environment and the lack of reliable, simple, and not expensive models that strictly mimic the biological processes occurring in vivo allowing a correct translation of results. Currently, with the growing acceptance of in vitro models as effective tools for studying cancer biology, three-dimensional (3D) models have emerged as a compromise between two-dimensional cultures of isolated cancer cells and the complexity of human cancer xenografts in immunocompromised animal hosts. This descriptive systematic literature review summarizes the current status of advanced and alternative 3D in vitro bone metastases models. We have also reviewed the strategies employed by researchers to set-up these models with special reference to recent promising developments trying to better replicate the complexity and heterogeneity of a human metastasis in situ, with an outlook at their use in medicine. All these aspects will greatly contribute to the existing knowledge on bone metastases, providing a specific link to clinical scenarios and thus making 3D in vitro bone metastasis models an attractive tool for multidisciplinary experts.

Music in a Hospital Setting: A Multifaceted Experience

ERIC Educational Resources Information Center

Preti, Costanza; Welch, Graham F.

2004-01-01

The article offers an explanation of the effects of music on children within a hospital setting and points up the multifaceted nature of this experience. The nature of the client group allows the musical experience to work on many different levels, such as modifying the child's perception of pain and reducing stress, whilst at the same time having…

Classical, Generalizability, and Multifaceted Rasch Detection of Interrater Variability in Large, Sparse Data Sets.

ERIC Educational Resources Information Center

MacMillan, Peter D.

2000-01-01

Compared classical test theory (CTT), generalizability theory (GT), and multifaceted Rasch model (MFRM) approaches to detecting and correcting for rater variability using responses of 4,930 high school students graded by 3 raters on 9 scales. The MFRM approach identified far more raters as different than did the CTT analysis. GT and Rasch…

Infinity as a Multi-Faceted Concept in History and in the Mathematics Classroom

ERIC Educational Resources Information Center

Arzarello, Ferdinando; Bussi, Maria G., Bartolini; Robutti, Ornella

2004-01-01

This paper presents the conceptualisation of infinity as a multi-faceted concept, discussing two examples. The first is from history and illustrates the work of Euler, when using infinity in an algebraic context. The second sketches an activity in a school context, namely students who approach the definite integral with symbolic-graphic…

A multifaceted approach to prioritize and design bank stabilization measures along the Big Sioux River, South Dakota, USA

USDA-ARS?s Scientific Manuscript database

A multifaceted approach was used to manage fine-grained sediment loadings from river bank erosion along the Big Sioux River between Dell Rapids and Sioux Falls, South Dakota, USA. Simulations with the RVR Meander and CONCEPTS river-morphodynamics computer models were conducted to identify stream-ban...

Design of a multifaceted referral equine hospital.

PubMed

Bousum, Peter C

2009-12-01

There is no simple recipe for designing a multifaceted practice. However, keys to any design are the devotion of the people involved and proper positioning of such people in the organization. Anyone designing such a practice also must pay keen attention to details and a keep a finger constantly on the pulse of the business to ensure that it maintains a sound financial footing and a consistent vision. Little money is made from savings or pushing financials. Profits come mainly through building additional sales, maintaining a clear vision, and making shrewd investments. Like for every small business, success in the multifaceted practice is clearly tied to such factors as financial acumen, forward thinking, technology, lifestyle, vision, and a willingness to take a calculated risk.

"I've never been a yes person": Decision-making participation and self-conceptualization after severe traumatic brain injury.

PubMed

Knox, Lucy; Douglas, Jacinta M; Bigby, Christine

2017-11-01

Although adults who sustain a severe traumatic brain injury (TBI) require support to make decisions in their lives, little is known about their experience of this process. The aim of this study was to explore how participation in decision making contributes to self-conceptualization in adults with severe TBI. We used constructivist grounded theory methods. Data included 20 in-depth interviews with adults with severe TBI. Through a process of constant comparison, analysis involved open and focused coding until clear categories emerged and data saturation was achieved. Self-conceptualization emerged as a complex and multifaceted process, as individuals with TBI aimed to reestablish a sense of autonomy. We describe a recursive relationship in which decision-making participation assists the dynamic construction of self, and self-concept contributes to the experience of making decisions. The role of an individual's social support network in acting as a bridge between participation and self-conceptualization is presented. Findings emphasize that contributing to decisions about one's own goals across a range of life areas can reinforce a positive self-concept. It is vital that supporters understand that participation in decision making provides a pathway to conceptualizing self and aim to maximize the person's participation in the decision-making process. Implications for Rehabilitation Previous research has identified that the experience of sustaining TBI has a significant impact on a person's conceptualization of self. This study identified that decision-making experiences play an important role in the ongoing process of self-conceptualization after injury. Decision-making experiences can reinforce a person's self-concept or lead them to revise (positively or negatively) their sense of self. By maximizing the person's decision-making participation, those around them can support them to develop positive self-attributes and contribute to shaping their future goals.

Biomorphodynamics: Physical-biological feedbacks that shape landscapes

USGS Publications Warehouse

Murray, A.B.; Knaapen, M.A.F.; Tal, M.; Kirwan, M.L.

2008-01-01

Plants and animals affect morphological evolution in many environments. The term "ecogeomorphology" describes studies that address such effects. In this opinion article we use the term "biomorphodynamics" to characterize a subset of ecogeomorphologic studies: those that investigate not only the effects of organisms on physical processes and morphology but also how the biological processes depend on morphology and physical forcing. The two-way coupling precipitates feedbacks, leading to interesting modes of behavior, much like the coupling between flow/sediment transport and morphology leads to rich morphodynamic behaviors. Select examples illustrate how even the basic aspects of some systems cannot be understood without considering biomorphodynamic coupling. Prominent examples include the dynamic interactions between vegetation and flow/sediment transport that can determine river channel patterns and the multifaceted biomorphodynamic feedbacks shaping tidal marshes and channel networks. These examples suggest that the effects of morphology and physical processes on biology tend to operate over the timescale of the evolution of the morphological pattern. Thus, in field studies, which represent a snapshot in the pattern evolution, these effects are often not as obvious as the effects of biology on physical processes. However, numerical modeling indicates that the influences on biology from physical processes can play a key role in shaping landscapes and that even local and temporary vegetation disturbances can steer large-scale, long-term landscape evolution. The prevalence of biomorphodynamic research is burgeoning in recent years, driven by societal need and a confluence of complex systems-inspired modeling approaches in ecology and geomorphology. To make fundamental progress in understanding the dynamics of many landscapes, our community needs to increasingly learn to look for two-way, biomorphodynamic feedbacks and to collect new types of data to support the modeling of such emergent interactions. Copyright 2008 by the American Geophysical Union.

Genetic constraints on wing pattern variation in Lycaeides butterflies: A case study on mapping complex, multifaceted traits in structured populations.

PubMed

Lucas, Lauren K; Nice, Chris C; Gompert, Zachariah

2018-03-13

Patterns of phenotypic variation within and among species can be shaped and constrained by trait genetic architecture. This is particularly true for complex traits, such as butterfly wing patterns, that consist of multiple elements. Understanding the genetics of complex trait variation across species boundaries is difficult, as it necessitates mapping in structured populations and can involve many loci with small or variable phenotypic effects. Here, we investigate the genetic architecture of complex wing pattern variation in Lycaeides butterflies as a case study of mapping multivariate traits in wild populations that include multiple nominal species or groups. We identify conserved modules of integrated wing pattern elements within populations and species. We show that trait covariances within modules have a genetic basis and thus represent genetic constraints that can channel evolution. Consistent with this, we find evidence that evolutionary changes in wing patterns among populations and species occur in the directions of genetic covariances within these groups. Thus, we show that genetic constraints affect patterns of biological diversity (wing pattern) in Lycaeides, and we provide an analytical template for similar work in other systems. © 2018 John Wiley & Sons Ltd.

Reinstating district nursing: A UK perspective.

PubMed

Morris, Hannah

2017-09-01

As policy directives gather pace for service provision to be delivered in primary care, district nursing has not been recognised as a valuable asset to facilitate this agenda. Investment in district nursing and specialist district nursing education has fallen. This is concurrent with an ageing district nursing workforce, a lack of recruitment and growing caseloads, as district nursing adapts to meet the challenges of the complexities of contemporary healthcare in the community. The district nurse role is complex and multifaceted and includes working collaboratively and creatively to coordinate care. Redressing the shortages of specialist district nurse practitioners with increased numbers of health care support workers will not replace the skill, knowledge, experience required to meet the complex care needs of today's society. District nursing needs to be reinstated as the valuable asset it is, through renewed investment in the service, research development and in specialist practice education. To prevent extinction district nurses need to be able to demonstrate and articulate the complexities and dynamisms of the role to reinstate themselves to their commissioners as a valuable asset for contemporary practice that can meet current health and social care needs effectively. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Toward more transparent and reproducible omics studies through a common metadata checklist and data publications.

PubMed

Kolker, Eugene; Özdemir, Vural; Martens, Lennart; Hancock, William; Anderson, Gordon; Anderson, Nathaniel; Aynacioglu, Sukru; Baranova, Ancha; Campagna, Shawn R; Chen, Rui; Choiniere, John; Dearth, Stephen P; Feng, Wu-Chun; Ferguson, Lynnette; Fox, Geoffrey; Frishman, Dmitrij; Grossman, Robert; Heath, Allison; Higdon, Roger; Hutz, Mara H; Janko, Imre; Jiang, Lihua; Joshi, Sanjay; Kel, Alexander; Kemnitz, Joseph W; Kohane, Isaac S; Kolker, Natali; Lancet, Doron; Lee, Elaine; Li, Weizhong; Lisitsa, Andrey; Llerena, Adrian; Macnealy-Koch, Courtney; Marshall, Jean-Claude; Masuzzo, Paola; May, Amanda; Mias, George; Monroe, Matthew; Montague, Elizabeth; Mooney, Sean; Nesvizhskii, Alexey; Noronha, Santosh; Omenn, Gilbert; Rajasimha, Harsha; Ramamoorthy, Preveen; Sheehan, Jerry; Smarr, Larry; Smith, Charles V; Smith, Todd; Snyder, Michael; Rapole, Srikanth; Srivastava, Sanjeeva; Stanberry, Larissa; Stewart, Elizabeth; Toppo, Stefano; Uetz, Peter; Verheggen, Kenneth; Voy, Brynn H; Warnich, Louise; Wilhelm, Steven W; Yandl, Gregory

2014-01-01

Biological processes are fundamentally driven by complex interactions between biomolecules. Integrated high-throughput omics studies enable multifaceted views of cells, organisms, or their communities. With the advent of new post-genomics technologies, omics studies are becoming increasingly prevalent; yet the full impact of these studies can only be realized through data harmonization, sharing, meta-analysis, and integrated research. These essential steps require consistent generation, capture, and distribution of metadata. To ensure transparency, facilitate data harmonization, and maximize reproducibility and usability of life sciences studies, we propose a simple common omics metadata checklist. The proposed checklist is built on the rich ontologies and standards already in use by the life sciences community. The checklist will serve as a common denominator to guide experimental design, capture important parameters, and be used as a standard format for stand-alone data publications. The omics metadata checklist and data publications will create efficient linkages between omics data and knowledge-based life sciences innovation and, importantly, allow for appropriate attribution to data generators and infrastructure science builders in the post-genomics era. We ask that the life sciences community test the proposed omics metadata checklist and data publications and provide feedback for their use and improvement.

Common Neurogenetic Diagnosis and Meso-Limbic Manipulation of Hypodopaminergic Function in Reward Deficiency Syndrome (RDS): Changing the Recovery Landscape.

PubMed

Blum, Kenneth; Febo, Marcelo; Badgaiyan, Rajendra D; Demetrovics, Zsolt; Simpatico, Thomas; Fahlke, Claudia; M, Oscar-Berman; Li, Mona; Dushaj, Kristina; Gold, Mark S

2017-01-01

In 1990, Blum and associates provided the first confirmed genetic link between the DRD2 polymorphisms and alcoholism. This finding was based on an earlier conceptual framework, which served as a blueprint for their seminal genetic association discovery they termed "Brain Reward Cascade." These findings were followed by a new way of understanding all addictive behaviors (substance and non-substance) termed "Reward Deficiency Syndrome" (RDS). RDS incorporates a complex multifaceted array of inheritable behaviors that are polygenic. In this review article, we attempt to clarify these terms and provide a working model to accurately diagnose and treat these unwanted behaviors. We are hereby proposing the development of a translational model we term "Reward Deficiency Solution System™" that incorporates neurogenetic testing and meso-limbic manipulation of a "hypodopaminergic" trait/state, which provides dopamine agonistic therapy (DAT) as well as reduced "dopamine resistance," while embracing "dopamine homeostasis." The result is better recovery and relapse prevention, despite DNA antecedents, which could impact the recovery process and relapse. Understanding the commonality of mental illness will transform erroneous labeling based on symptomatology, into a genetic and anatomical etiology. WC: 184.

Management of eWork health issues: a new perspective on an old problem.

PubMed

Kirk, Elizabeth; Strong, Jenny

2010-01-01

Contact centres are vehicles for a rapidly growing group of knowledge workers, or eWorkers. Using computers and high-speed telecommunications connections as work tools, these employees spend long hours performing mentally demanding work while maintaining static, physically stressful, seated positions. The complex interplay between job demands, work environment, and individual differences combine to produce high levels of physical discomfort among eWorkers. This paper discusses a new view that has emerged, one that focuses on the management rather than the elimination of work related upper limb disorders (WRULD) and computer vision syndrome (CVS) issues that are prevalent among eWorkers. It also reviews a cultural shift among practitioners and business that moves towards a consultative process and the sharing of knowledge among all stakeholders. The controlled work conditions and large single location workforce found within contact centres provide the opportunity to understand the personal and industry cost of eWork injuries and the ability to develop and review new multifaceted interventions. Advances in training and workplace design aimed at decreasing discomfort and injury and reducing the associated economic burden may then be adapted for all eWorkforce groups.

Determinants of public attitudes to genetically modified salmon.

PubMed

Amin, Latifah; Azad, Md Abul Kalam; Gausmian, Mohd Hanafy; Zulkifli, Faizah

2014-01-01

The objective of this paper is to assess the attitude of Malaysian stakeholders to genetically modified (GM) salmon and to identify the factors that influence their acceptance of GM salmon using a structural equation model. A survey was carried out on 434 representatives from various stakeholder groups in the Klang Valley region of Malaysia. Public attitude towards GM salmon was measured using self-developed questionnaires with seven-point Likert scales. The findings of this study have confirmed that public attitudes towards GM salmon is a complex issue and should be seen as a multi-faceted process. The most important direct predictors for the encouragement of GM salmon are the specific application-linked perceptions about religious acceptability of GM salmon followed by perceived risks and benefits, familiarity, and general promise of modern biotechnology. Encouragement of GM salmon also involves the interplay among other factors such as general concerns of biotechnology, threatening the natural order of things, the need for labeling, the need for patenting, confidence in regulation, and societal values. The research findings can serve as a database that will be useful for understanding the social construct of public attitude towards GM foods in a developing country.

Assessment of Human Factors

NASA Technical Reports Server (NTRS)

Mount, Frances; Foley, Tico

1999-01-01

Human Factors Engineering, often referred to as Ergonomics, is a science that applies a detailed understanding of human characteristics, capabilities, and limitations to the design, evaluation, and operation of environments, tools, and systems for work and daily living. Human Factors is the investigation, design, and evaluation of equipment, techniques, procedures, facilities, and human interfaces, and encompasses all aspects of human activity from manual labor to mental processing and leisure time enjoyments. In spaceflight applications, human factors engineering seeks to: (1) ensure that a task can be accomplished, (2) maintain productivity during spaceflight, and (3) ensure the habitability of the pressurized living areas. DSO 904 served as a vehicle for the verification and elucidation of human factors principles and tools in the microgravity environment. Over six flights, twelve topics were investigated. This study documented the strengths and limitations of human operators in a complex, multifaceted, and unique environment. By focusing on the man-machine interface in space flight activities, it was determined which designs allow astronauts to be optimally productive during valuable and costly space flights. Among the most promising areas of inquiry were procedures, tools, habitat, environmental conditions, tasking, work load, flexibility, and individual control over work.

Toward More Transparent and Reproducible Omics Studies Through a Common Metadata Checklist and Data Publications.

PubMed

Kolker, Eugene; Özdemir, Vural; Martens, Lennart; Hancock, William; Anderson, Gordon; Anderson, Nathaniel; Aynacioglu, Sukru; Baranova, Ancha; Campagna, Shawn R; Chen, Rui; Choiniere, John; Dearth, Stephen P; Feng, Wu-Chun; Ferguson, Lynnette; Fox, Geoffrey; Frishman, Dmitrij; Grossman, Robert; Heath, Allison; Higdon, Roger; Hutz, Mara H; Janko, Imre; Jiang, Lihua; Joshi, Sanjay; Kel, Alexander; Kemnitz, Joseph W; Kohane, Isaac S; Kolker, Natali; Lancet, Doron; Lee, Elaine; Li, Weizhong; Lisitsa, Andrey; Llerena, Adrian; MacNealy-Koch, Courtney; Marshall, Jean-Claude; Masuzzo, Paola; May, Amanda; Mias, George; Monroe, Matthew; Montague, Elizabeth; Mooney, Sean; Nesvizhskii, Alexey; Noronha, Santosh; Omenn, Gilbert; Rajasimha, Harsha; Ramamoorthy, Preveen; Sheehan, Jerry; Smarr, Larry; Smith, Charles V; Smith, Todd; Snyder, Michael; Rapole, Srikanth; Srivastava, Sanjeeva; Stanberry, Larissa; Stewart, Elizabeth; Toppo, Stefano; Uetz, Peter; Verheggen, Kenneth; Voy, Brynn H; Warnich, Louise; Wilhelm, Steven W; Yandl, Gregory

2013-12-01

Biological processes are fundamentally driven by complex interactions between biomolecules. Integrated high-throughput omics studies enable multifaceted views of cells, organisms, or their communities. With the advent of new post-genomics technologies, omics studies are becoming increasingly prevalent; yet the full impact of these studies can only be realized through data harmonization, sharing, meta-analysis, and integrated research. These essential steps require consistent generation, capture, and distribution of metadata. To ensure transparency, facilitate data harmonization, and maximize reproducibility and usability of life sciences studies, we propose a simple common omics metadata checklist. The proposed checklist is built on the rich ontologies and standards already in use by the life sciences community. The checklist will serve as a common denominator to guide experimental design, capture important parameters, and be used as a standard format for stand-alone data publications. The omics metadata checklist and data publications will create efficient linkages between omics data and knowledge-based life sciences innovation and, importantly, allow for appropriate attribution to data generators and infrastructure science builders in the post-genomics era. We ask that the life sciences community test the proposed omics metadata checklist and data publications and provide feedback for their use and improvement.

Challenges to the rapid identification of children who have been trafficked for commercial sexual exploitation.

PubMed

Rafferty, Yvonne

2016-02-01

Child trafficking for commercial sexual exploitation (CSE) is a complex phenomenon, requiring multifaceted programs and policies by various stakeholders. A number of publications have focused on preventing this heinous crime. Less attention, however, has been paid to the recovery and rehabilitation of children who have been traumatized as a result of being trafficked for CSE. This article focuses on the first step in the protection and recovery process, which is to ensure that procedures are in place for their identification, so that they might access timely and appropriate assistance. It highlights three situational and two child-related challenges to identification. In addition, it describes the additional victimization experienced by children who are wrongly arrested for crimes associated with prostitution or illegal border crossings, rather than being identified as victims. An extensive literature review was conducted, and included academic publications, as well as governmental and non-governmental reports. In addition, field-based qualitative research was undertaken in South and Southeast Asia, and involved interviews with representatives from United Nations and governmental agencies, non-governmental organizations (NGOs), and aftercare recovery programs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Psychosis of epilepsy: a multifaceted neuropsychiatric disorder.

PubMed

Kanner, Andres M; Rivas-Grajales, Ana Maria

2016-06-01

Psychosis of epilepsy (POE) is a term applied to a group of psychotic disorders with a distinct phenomenology in which potential etiopathogenic mechanisms are believed to be closely related to a seizure disorder. POE can present as interictal psychotic episodes, which may often differ semiologically from primary schizophrenic disorder. They may present as ictal or postictal psychotic episodes and may be the expression of an iatrogenic process to pharmacologic and/or surgical interventions.Epilepsy and POE have a complex and bidirectional relation, as not only are patients with epilepsy at greater risk of developing a psychotic disorder, but patients with a primary psychotic disorder are also at greater risk of developing epilepsy. The prevalence of POE is more than 7 times higher than the frequency of primary schizophreniform disorders in the general population. While POE has been associated with focal epilepsy of temporal and frontal lobe origin, its etiology and pathophysiology of POE have yet to be established.The treatment of all forms of POE, with the exception of ictal psychotic episodes, requires the use of antipsychotic drugs, preferably the atypical antipsychotic agents with a very low or negligible potential to lower the seizure threshold (eg, risperidone, apiprazole), starting at a low dose with stepwise increments.

Telework rationale and implementation for people with disabilities: considerations for employer policymaking.

PubMed

Moon, Nathan W; Linden, Maureen A; Bricout, John C; Baker, Paul M A

2014-01-01

Telework has been promoted as a viable workplace accommodation for people with disabilities since the 1990s, when information and communication technologies (ICT) had developed sufficiently to facilitate its widespread adoption. This initial research and accompanying policy recommendations were prescriptive in nature and frequently aimed at employers. This article adds to existing policy models for facilitating successful telework outcomes for people with disabilities. Drawing upon two studies by the Rehabilitation Engineering Research Center on Workplace Accommodations, we expound on employee-side considerations in the implementation of telework. Our policy model utilizes established typologies for policy evaluation to develop a process model that considers rationales and implementation factors for telework among people with physical disabilities. Telework may be used as an accommodation for disability, but employee rationales for telework are more complex, involving work-life balance, strategies for pain and fatigue not formally recognized as disability, and expediency in travel and transportation. Implementation of telework as a component of workplace operations is similarly multifaceted, involving non-technology accommodations to realize job restructuring left incomplete by telework. Our model grounds new empirical research in this area. We also renew our call for additional research on effective telework practices for people with disabilities.

Development and validation of an instrument to measure nurse educator perceived confidence in clinical teaching.

PubMed

Nguyen, Van N B; Forbes, Helen; Mohebbi, Mohammadreza; Duke, Maxine

2017-12-01

Teaching nursing in clinical environments is considered complex and multi-faceted. Little is known about the role of the clinical nurse educator, specifically the challenges related to transition from clinician, or in some cases, from newly-graduated nurse to that of clinical nurse educator, as occurs in developing countries. Confidence in the clinical educator role has been associated with successful transition and the development of role competence. There is currently no valid and reliable instrument to measure clinical nurse educator confidence. This study was conducted to develop and psychometrically test an instrument to measure perceived confidence among clinical nurse educators. A multi-phase, multi-setting survey design was used. A total of 468 surveys were distributed, and 363 were returned. Data were analyzed using exploratory and confirmatory factor analyses. The instrument was successfully tested and modified in phase 1, and factorial validity was subsequently confirmed in phase 2. There was strong evidence of internal consistency, reliability, content, and convergent validity of the Clinical Nurse Educator Skill Acquisition Assessment instrument. The resulting instrument is applicable in similar contexts due to its rigorous development and validation process. © 2017 The Authors. Nursing & Health Sciences published by John Wiley & Sons Australia, Ltd.

Accepting or declining non-invasive ventilation or gastrostomy in amyotrophic lateral sclerosis: patients' perspectives.

PubMed

Greenaway, L P; Martin, N H; Lawrence, V; Janssen, A; Al-Chalabi, A; Leigh, P N; Goldstein, L H

2015-01-01

The objective was to identify factors associated with decisions made by patients with amyotrophic lateral sclerosis (ALS) to accept or decline non-invasive ventilation (NIV) and/or gastrostomy in a prospective population-based study. Twenty-one people with ALS, recruited from the South-East ALS Register who made an intervention decision during the study timeframe underwent a face-to-face in-depth interview, with or without their informal caregiver present. Sixteen had accepted an intervention (11 accepted gastrostomy, four accepted NIV and one accepted both interventions). Five patients had declined gastrostomy. Thematic analysis revealed three main themes: (1) patient-centric factors (including perceptions of control, acceptance and need, and aspects of fear); (2) external factors (including roles played by healthcare professionals, family, and information provision); and (3) the concept of time (including living in the moment and the notion of 'right thing, right time'). Many aspects of these factors were inter-related. Decision-making processes for the patients were found to be complex and multifaceted and reinforce arguments for individualised (rather than 'algorithm-based') approaches to facilitating decision-making by people with ALS who require palliative interventions.

Economic and social activities on ancient Cypriot terraced landscapes.

PubMed

Ridder, Elizabeth; Galletti, Christopher S; Fall, Patricia L; Falconer, Steven E

2017-11-01

We investigate ancient agricultural terraces and their associated social and economic activities across the site complex consisting of the village at Politiko-Troullia and its more extensive associated taskscape. Surface artifact distributions mapped over 12 ha are integrated with evidence excavated from this Bronze Age settlement in central Cyprus. Contrary to expectations, artifact densities do not diminish with distance from the village architecture. In particular, concentrations of Prehistoric Bronze Age ceramics and ground stone artifacts are most pronounced on nearby terraced hillsides. These terraces were not utilized for domestic structures, but for extensive processing of agricultural crops and copper ore. Bronze Age excavated plant remains indicate cultivation of olives, grapes and figs, with wood resources dominated by olive and pine. Larger, non-portable ground stones and gaming stones are associated with communal social and economic activities in open courtyard settings in Politiko-Troullia. This category of ground stone also is particularly common on the terraced hillsides around Troullia, suggesting that similar behaviors occurred beyond village structures. The terraced landscape of Politiko-Troullia exemplifies a multi-faceted taskscape with a range of agricultural, metallurgical and social activities. Copyright © 2016 Elsevier Ltd. All rights reserved.

Determinants of Public Attitudes to Genetically Modified Salmon

PubMed Central

Amin, Latifah; Azad, Md. Abul Kalam; Gausmian, Mohd Hanafy; Zulkifli, Faizah

2014-01-01

The objective of this paper is to assess the attitude of Malaysian stakeholders to genetically modified (GM) salmon and to identify the factors that influence their acceptance of GM salmon using a structural equation model. A survey was carried out on 434 representatives from various stakeholder groups in the Klang Valley region of Malaysia. Public attitude towards GM salmon was measured using self-developed questionnaires with seven-point Likert scales. The findings of this study have confirmed that public attitudes towards GM salmon is a complex issue and should be seen as a multi-faceted process. The most important direct predictors for the encouragement of GM salmon are the specific application-linked perceptions about religious acceptability of GM salmon followed by perceived risks and benefits, familiarity, and general promise of modern biotechnology. Encouragement of GM salmon also involves the interplay among other factors such as general concerns of biotechnology, threatening the natural order of things, the need for labeling, the need for patenting, confidence in regulation, and societal values. The research findings can serve as a database that will be useful for understanding the social construct of public attitude towards GM foods in a developing country. PMID:24489695

Relations among Teachers’ Emotion Socialization Beliefs and Practices, and Preschoolers’ Emotional Competence

PubMed Central

Morris, Carol A.S.; Denham, Susanne A.; Bassett, Hideko H.; Curby, Timothy W.

2013-01-01

Research Findings Utilizing a three-part model of emotion socialization that includes Modeling, Contingent Responding, and Teaching, this study examined the associations between 44 teachers’ self-reported and observed emotion socialization practices and 326 preschoolers’ emotion knowledge and observed emotional behavior. Multi-level analyses revealed that the majority of the variance in the children’s emotion knowledge scores and observed emotional behavior was predicted by factors within, rather than between, classrooms. Teachers’ use of all three emotion socialization techniques did contribute to the prediction of the children’s scores; however, the nature of these associations differed by children’s age and gender. Practice or Policy The development of children’s emotional competence is a complex, multi-faceted process in which many interaction partners play a role; early childhood teachers act as emotion socialization agents for the children in their care by modeling emotions, responding either supportively or punitively to children’s expressions of emotions, and engaging in direct instruction regarding emotional experience. This research may provide a basis for potential future interventions designed to assist teachers in developing their own emotion socialization skills so that they can be more effective emotion socialization agents for the children in their care. PMID:24159256

The Staff Nurse Clinical Leader at the Bedside: Swedish Registered Nurses' Perceptions.

PubMed

Larsson, Inga E; Sahlsten, Monika J M

2016-01-01

Registered nurses at the bedside are accountable for and oversee completion of patient care as well as directly leading and managing the provision of safe patient care. These nurses have an informal leadership role that is not associated with any given position. Leadership is a complex and multifaceted concept and its meaning is unclear, especially in the staff nurse context. The aim was to describe registered nurses' perceptions of what it entails to be the leader at the bedside in inpatient physical care. A phenomenographic approach was employed. Interviews were performed with Swedish registered nurses ( n = 15). Five descriptive categories were identified: demonstrating clinical knowledge, establishing a good atmosphere of collaboration, consciously structuring the work in order to ensure patients' best possible nursing care, customized presence in the practical work with patients according to predetermined prerequisites, and monitoring coworkers' professional practice. Registered nurses informal role as leader necessitates a social process of deliberate effort to attain and maintain leader status and authority. Participants used deliberate communicative approaches and interactive procedures. Leader principles grounded in the core values of the nursing profession that ensure nursing values and person-centered attributes were a key aspect.

Team Training for Dynamic Cross-Functional Teams in Aviation: Behavioral, Cognitive, and Performance Outcomes.

PubMed

Littlepage, Glenn E; Hein, Michael B; Moffett, Richard G; Craig, Paul A; Georgiou, Andrea M

2016-12-01

This study evaluates the effectiveness of a training program designed to improve cross-functional coordination in airline operations. Teamwork across professional specializations is essential for safe and efficient airline operations, but aviation education primarily emphasizes positional knowledge and skill. Although crew resource management training is commonly used to provide some degree of teamwork training, it is generally focused on specific specializations, and little training is provided in coordination across specializations. The current study describes and evaluates a multifaceted training program designed to enhance teamwork and team performance of cross-functional teams within a simulated airline flight operations center. The training included a variety of components: orientation training, position-specific declarative knowledge training, position-specific procedural knowledge training, a series of high-fidelity team simulations, and a series of after-action reviews. Following training, participants demonstrated more effective teamwork, development of transactive memory, and more effective team performance. Multifaceted team training that incorporates positional training and team interaction in complex realistic situations and followed by after-action reviews can facilitate teamwork and team performance. Team training programs, such as the one described here, have potential to improve the training of aviation professionals. These techniques can be applied to other contexts where multidisciplinary teams and multiteam systems work to perform highly interdependent activities. © 2016, Human Factors and Ergonomics Society.

Resolving the multifaceted mechanisms of the ferric chloride thrombosis model using an interdisciplinary microfluidic approach

PubMed Central

Ciciliano, Jordan C.; Sakurai, Yumiko; Myers, David R.; Fay, Meredith E.; Hechler, Beatrice; Meeks, Shannon; Li, Renhao; Dixon, J. Brandon; Lyon, L. Andrew; Gachet, Christian

2015-01-01

The mechanism of action of the widely used in vivo ferric chloride (FeCl3) thrombosis model remains poorly understood; although endothelial cell denudation is historically cited, a recent study refutes this and implicates a role for erythrocytes. Given the complexity of the in vivo environment, an in vitro reductionist approach is required to systematically isolate and analyze the biochemical, mass transfer, and biological phenomena that govern the system. To this end, we designed an “endothelial-ized” microfluidic device to introduce controlled FeCl3 concentrations to the molecular and cellular components of blood and vasculature. FeCl3 induces aggregation of all plasma proteins and blood cells, independent of endothelial cells, by colloidal chemistry principles: initial aggregation is due to binding of negatively charged blood components to positively charged iron, independent of biological receptor/ligand interactions. Full occlusion of the microchannel proceeds by conventional pathways, and can be attenuated by antithrombotic agents and loss-of-function proteins (as in IL4-R/Iba mice). As elevated FeCl3 concentrations overcome protective effects, the overlap between charge-based aggregation and clotting is a function of mass transfer. Our physiologically relevant in vitro system allows us to discern the multifaceted mechanism of FeCl3-induced thrombosis, thereby reconciling literature findings and cautioning researchers in using the FeCl3 model. PMID:25931587

Core stability training for injury prevention.

PubMed

Huxel Bliven, Kellie C; Anderson, Barton E

2013-11-01

Enhancing core stability through exercise is common to musculoskeletal injury prevention programs. Definitive evidence demonstrating an association between core instability and injury is lacking; however, multifaceted prevention programs including core stabilization exercises appear to be effective at reducing lower extremity injury rates. PUBMED WAS SEARCHED FOR EPIDEMIOLOGIC, BIOMECHANIC, AND CLINICAL STUDIES OF CORE STABILITY FOR INJURY PREVENTION (KEYWORDS: "core OR trunk" AND "training OR prevention OR exercise OR rehabilitation" AND "risk OR prevalence") published between January 1980 and October 2012. Articles with relevance to core stability risk factors, assessment, and training were reviewed. Relevant sources from articles were also retrieved and reviewed. Stabilizer, mobilizer, and load transfer core muscles assist in understanding injury risk, assessing core muscle function, and developing injury prevention programs. Moderate evidence of alterations in core muscle recruitment and injury risk exists. Assessment tools to identify deficits in volitional muscle contraction, isometric muscle endurance, stabilization, and movement patterns are available. Exercise programs to improve core stability should focus on muscle activation, neuromuscular control, static stabilization, and dynamic stability. Core stabilization relies on instantaneous integration among passive, active, and neural control subsystems. Core muscles are often categorized functionally on the basis of stabilizing or mobilizing roles. Neuromuscular control is critical in coordinating this complex system for dynamic stabilization. Comprehensive assessment and training require a multifaceted approach to address core muscle strength, endurance, and recruitment requirements for functional demands associated with daily activities, exercise, and sport.

A Multifaceted Mathematical Approach for Complex Systems

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

Alexander, F.; Anitescu, M.; Bell, J.

2012-03-07

Applied mathematics has an important role to play in developing the tools needed for the analysis, simulation, and optimization of complex problems. These efforts require the development of the mathematical foundations for scientific discovery, engineering design, and risk analysis based on a sound integrated approach for the understanding of complex systems. However, maximizing the impact of applied mathematics on these challenges requires a novel perspective on approaching the mathematical enterprise. Previous reports that have surveyed the DOE's research needs in applied mathematics have played a key role in defining research directions with the community. Although these reports have had significantmore » impact, accurately assessing current research needs requires an evaluation of today's challenges against the backdrop of recent advances in applied mathematics and computing. To address these needs, the DOE Applied Mathematics Program sponsored a Workshop for Mathematics for the Analysis, Simulation and Optimization of Complex Systems on September 13-14, 2011. The workshop had approximately 50 participants from both the national labs and academia. The goal of the workshop was to identify new research areas in applied mathematics that will complement and enhance the existing DOE ASCR Applied Mathematics Program efforts that are needed to address problems associated with complex systems. This report describes recommendations from the workshop and subsequent analysis of the workshop findings by the organizing committee.« less

Assessing and developing critical-thinking skills in the intensive care unit.

PubMed

Swinny, Betsy

2010-01-01

A lot of resources are spent on the development of new staff in the intensive care unit (ICU). These resources are necessary because the environment in the ICU is complex and the patients are critically ill. Nurses need an advanced knowledge base, the ability to accurately define and change priorities rapidly, good communication and teamwork skills, and the ability to work in a stressful environment in order to succeed and give their patients quality care. Critical thinking helps the nurse to navigate the complex and stressful environment of the ICU. Critical thinking includes more than just nursing knowledge. It includes the ability to think through complex, multifaceted problems to anticipate needs, recognize potential and actual complications, and to expertly communicate with the team. A nurse who is able to think critically will give better patient care. Various strategies can be used to develop critical thinking in ICU nurses. Nurse leaders are encouraged to support the development of critical-thinking skills in less experienced staff with the goal of improving the nurse's ability to work in the ICU and improving patient outcomes.

The Evolution of Software and Its Impact on Complex System Design in Robotic Spacecraft Embedded Systems

NASA Technical Reports Server (NTRS)

Butler, Roy

2013-01-01

The growth in computer hardware performance, coupled with reduced energy requirements, has led to a rapid expansion of the resources available to software systems, driving them towards greater logical abstraction, flexibility, and complexity. This shift in focus from compacting functionality into a limited field towards developing layered, multi-state architectures in a grand field has both driven and been driven by the history of embedded processor design in the robotic spacecraft industry.The combinatorial growth of interprocess conditions is accompanied by benefits (concurrent development, situational autonomy, and evolution of goals) and drawbacks (late integration, non-deterministic interactions, and multifaceted anomalies) in achieving mission success, as illustrated by the case of the Mars Reconnaissance Orbiter. Approaches to optimizing the benefits while mitigating the drawbacks have taken the form of the formalization of requirements, modular design practices, extensive system simulation, and spacecraft data trend analysis. The growth of hardware capability and software complexity can be expected to continue, with future directions including stackable commodity subsystems, computer-generated algorithms, runtime reconfigurable processors, and greater autonomy.

Movement as Medicine for Type 2 Diabetes: protocol for an open pilot study and external pilot clustered randomised controlled trial to assess acceptability, feasibility and fidelity of a multifaceted behavioural intervention targeting physical activity in primary care

PubMed Central

2014-01-01

Background Physical activity (PA) and nutrition are the cornerstones of diabetes management. Several reviews and meta-analyses report that PA independently produces clinically important improvements in glucose control in people with Type 2 diabetes. However, it remains unclear what the optimal strategies are to increase PA behaviour in people with Type 2 diabetes in routine primary care. Methods This study will determine whether an evidence-informed multifaceted behaviour change intervention (Movement as Medicine for Type 2 Diabetes) targeting both consultation behaviour of primary healthcare professionals and PA behaviour in adults with Type 2 diabetes is both acceptable and feasible in the primary care setting. An open pilot study conducted in two primary care practices (phase one) will assess acceptability, feasibility and fidelity. Ongoing feedback from participating primary healthcare professionals and patients will provide opportunities for systematic adaptation and refinement of the intervention and study procedures. A two-arm parallel group clustered pilot randomised controlled trial with patients from participating primary care practices in North East England will assess acceptability, feasibility, and fidelity of the intervention (versus usual clinical care) and trial processes over a 12-month period. Consultation behaviour involving fidelity of intervention delivery, diabetes and PA related knowledge, attitudes/beliefs, intentions and self-efficacy for delivering a behaviour change intervention targeting PA behaviour will be assessed in primary healthcare professionals. We will rehearse the collection of outcome data (with the focus on data yield and quality) for a future definitive trial, through outcome assessment at baseline, one, six and twelve months. An embedded qualitative process evaluation and treatment fidelity assessment will explore issues around intervention implementation and assess whether intervention components can be reliably and faithfully delivered in routine primary care. Discussion Movement as Medicine for Type 2 Diabetes will address an important gap in the evidence-base, that is, the need for interventions to increase free-living PA behaviour in adults with Type 2 diabetes. The multifaceted intervention incorporates an online accredited training programme for primary healthcare professionals and represents, to the best of our knowledge, the first of its kind in the United Kingdom. This study will establish whether the multifaceted behavioural intervention is acceptable and feasible in routine primary care. Trial registration Movement as Medicine for Type 2 Diabetes (MaMT2D) was registered with Current Controlled Trials on the 14th January 2012: ISRCTN67997502. The first primary care practice was randomised on the 5th October 2012. PMID:24491134

Multifaceted academic detailing program to increase pharmacotherapy for alcohol use disorder: interrupted time series evaluation of effectiveness.

PubMed

Harris, Alex H S; Bowe, Thomas; Hagedorn, Hildi; Nevedal, Andrea; Finlay, Andrea K; Gidwani, Risha; Rosen, Craig; Kay, Chad; Christopher, Melissa

2016-09-15

Active consideration of effective medications to treat alcohol use disorder (AUD) is a consensus standard of care, yet knowledge and use of these medications are very low across diverse settings. This study evaluated the overall effectiveness a multifaceted academic detailing program to address this persistent quality problem in the US Veterans Health Administration (VHA), as well as the context and process factors that explained variation in effectiveness across sites. An interrupted time series design, analyzed with mixed-effects segmented logistic regression, was used to evaluate changes in level and rate of change in the monthly percent of patients with a clinically documented AUD who received naltrexone, acamprosate, disulfiram, or topiramate. Using data from a 20 month post-implementation period, intervention sites (n = 37) were compared to their own 16 month pre-implementation performance and separately to the rest of VHA. From immediately pre-intervention to the end of the observation period, the percent of patients in the intervention sites with AUD who received medication increased over 3.4 % in absolute terms and 68 % in relative terms (i.e., 4.9-8.3 %). This change was significant compared to the pre-implementation period in the intervention sites and secular trends in control sites. Sites with lower pre-implementation adoption, more person hours of detailing, but fewer people detailed, had larger immediate increases in medication receipt after implementation. The average number of detailing encounters per person was associated with steeper increases in slope over time. This study found empirical support for a multifaceted quality improvement strategy aimed at increasing access to and utilization of pharmacotherapy for AUD. Future studies should focus on determining how to enhance the programs effects, especially in non-responsive locations.

Teaching Tree Thinking in an Upper Level Organismal Biology Course: Testing the Effectiveness of a Multifaceted Curriculum

ERIC Educational Resources Information Center

Novick, Laura R.; Catley, Kefyn M.

2018-01-01

The ability to interpret and reason from Tree of Life diagrams is a key component of twenty-first century science literacy. This article reports on the authors' continued development of a multifaceted research-based curriculum--including an instructional booklet, lectures, laboratories and a field activity--to teach such tree thinking to biology…

Reducing Anxiety and Increasing Self-Efficacy within an Advanced Graduate Psychology Statistics Course

ERIC Educational Resources Information Center

McGrath, April L.; Ferns, Alyssa; Greiner, Leigh; Wanamaker, Kayla; Brown, Shelley

2015-01-01

In this study we assessed the usefulness of a multifaceted teaching framework in an advanced statistics course. We sought to expand on past findings by using this framework to assess changes in anxiety and self-efficacy, and we collected focus group data to ascertain whether students attribute such changes to a multifaceted teaching approach.…

A Multifaceted Program To Improve Self-Esteem and Social Skills while Reducing Anxiety in Emotionally Handicapped Middle School Students.

ERIC Educational Resources Information Center

Poirier, Lynn

A practicum was developed to increase self-esteem, to lower anxiety, and to improve social skills in 13 emotionally handicapped (EH) middle school boys. An additional objective was to provide parenting classes which focused on increasing parents' knowledge and skills in improving their children's self esteem. The 8-month multifaceted program…

The Structural Validity of the Perceived Traits of the "Ideal Student" Multi-Faceted Theory among Education Students

ERIC Educational Resources Information Center

Maslovaty, Nava; Cohen, Arie; Furman, Sari

2008-01-01

The article presents a multi-faceted theory of "ideal high school student" traits. The trait system, as defined by several theories, is a translation of the teachers' belief system into educational objectives. The study focused on Bloom's taxonomies and the structural validity of its principles, using Similarity Structure Analysis. Aware of the…

Terminological Multifaceted Educational Dictionary of Active Type as a Possible Way of Special Discourse Presentation

ERIC Educational Resources Information Center

Fatkullina, Flyuza; Morozkina, Eugenia; Suleimanova, Almira; Khayrullina, Rayca

2016-01-01

The purpose of this article is to disclose the scientific basis of the author's academic terminological dictionary for future oil industry experts. Multifaceted terminological dictionary with several different entries is considered to be one of the possible ways to present a special discourse in the classroom. As a result of the study the authors…

The effect of a multifaceted educational intervention on medication preparation and administration errors in neonatal intensive care.

PubMed

Chedoe, Indra; Molendijk, Harry; Hospes, Wobbe; Van den Heuvel, Edwin R; Taxis, Katja

2012-11-01

To examine the effect of a multifaceted educational intervention on the incidence of medication preparation and administration errors in a neonatal intensive care unit (NICU). Prospective study with a preintervention and postintervention measurement using direct observation. NICU in a tertiary hospital in the Netherlands. A multifaceted educational intervention including teaching and self-study. The incidence of medication preparation and administration errors. Clinical importance was assessed by three experts. The incidence of errors decreased from 49% (43-54%) (151 medications with one or more errors of 311 observations) to 31% (87 of 284) (25-36%). Preintervention, 0.3% (0-2%) medications contained severe errors, 26% (21-31%) moderate and 23% (18-28%) minor errors; postintervention, none 0% (0-2%) was severe, 23% (18-28%) moderate and 8% (5-12%) minor. A generalised estimating equations analysis provided an OR of 0.49 (0.29-0.84) for period (p=0.032), (route of administration (p=0.001), observer within period (p=0.036)). The multifaceted educational intervention seemed to have contributed to a significant reduction of the preparation and administration error rate, but other measures are needed to improve medication safety further.

Effectiveness of implementation interventions in improving physician adherence to guideline recommendations in heart failure: a systematic review

PubMed Central

Shanbhag, Deepti; Graham, Ian D; Harlos, Karen; Haynes, R. Brian; Gabizon, Itzhak; Connolly, Stuart J; Van Spall, Harriette Gillian Christine

2018-01-01

Background The uptake of guideline recommendations that improve heart failure (HF) outcomes remains suboptimal. We reviewed implementation interventions that improve physician adherence to these recommendations, and identified contextual factors associated with implementation success. Methods We searched databases from January 1990 to November 2017 for studies testing interventions to improve uptake of class I HF guidelines. We used the Cochrane Effective Practice and Organisation of Care and Process Redesign frameworks for data extraction. Primary outcomes included: proportion of eligible patients offered guideline-recommended pharmacotherapy, self-care education, left ventricular function assessment and/or intracardiac devices. We reported clinical outcomes when available. Results We included 38 studies. Provider-level interventions (n=13 studies) included audit and feedback, reminders and education. Organisation-level interventions (n=18) included medical records system changes, multidisciplinary teams, clinical pathways and continuity of care. System-level interventions (n=3) included provider/institutional incentives. Four studies assessed multi-level interventions. We could not perform meta-analyses due to statistical/conceptual heterogeneity. Thirty-two studies reported significant improvements in at least one primary outcome. Clinical pathways, multidisciplinary teams and multifaceted interventions were most consistently successful in increasing physician uptake of guidelines. Among randomised controlled trials (RCT) (n=10), pharmacist and nurse-led interventions improved target dose prescriptions. Eleven studies reported clinical outcomes; significant improvements were reported in three, including a clinical pathway, a multidisciplinary team and a multifaceted intervention. Baseline assessment of barriers, staff training, iterative intervention development, leadership commitment and policy/financial incentives were associated with intervention effectiveness. Most studies (n=20) had medium risk of bias; nine RCTs had low risk of bias. Conclusion Our study is limited by the quality and heterogeneity of the primary studies. Clinical pathways, multidisciplinary teams and multifaceted interventions appear to be most consistent in increasing guideline uptake. However, improvements in process outcomes were rarely accompanied by improvements in clinical outcomes. Our work highlights the need for improved research methodology to reliably assess the effectiveness of implementation interventions. PMID:29511005

Effectiveness of implementation interventions in improving physician adherence to guideline recommendations in heart failure: a systematic review.

PubMed

Shanbhag, Deepti; Graham, Ian D; Harlos, Karen; Haynes, R Brian; Gabizon, Itzhak; Connolly, Stuart J; Van Spall, Harriette Gillian Christine

2018-03-06

The uptake of guideline recommendations that improve heart failure (HF) outcomes remains suboptimal. We reviewed implementation interventions that improve physician adherence to these recommendations, and identified contextual factors associated with implementation success. We searched databases from January 1990 to November 2017 for studies testing interventions to improve uptake of class I HF guidelines. We used the Cochrane Effective Practice and Organisation of Care and Process Redesign frameworks for data extraction. Primary outcomes included: proportion of eligible patients offered guideline-recommended pharmacotherapy, self-care education, left ventricular function assessment and/or intracardiac devices. We reported clinical outcomes when available. We included 38 studies. Provider-level interventions (n=13 studies) included audit and feedback, reminders and education. Organisation-level interventions (n=18) included medical records system changes, multidisciplinary teams, clinical pathways and continuity of care. System-level interventions (n=3) included provider/institutional incentives. Four studies assessed multi-level interventions. We could not perform meta-analyses due to statistical/conceptual heterogeneity. Thirty-two studies reported significant improvements in at least one primary outcome. Clinical pathways, multidisciplinary teams and multifaceted interventions were most consistently successful in increasing physician uptake of guidelines. Among randomised controlled trials (RCT) (n=10), pharmacist and nurse-led interventions improved target dose prescriptions. Eleven studies reported clinical outcomes; significant improvements were reported in three, including a clinical pathway, a multidisciplinary team and a multifaceted intervention. Baseline assessment of barriers, staff training, iterative intervention development, leadership commitment and policy/financial incentives were associated with intervention effectiveness. Most studies (n=20) had medium risk of bias; nine RCTs had low risk of bias. Our study is limited by the quality and heterogeneity of the primary studies. Clinical pathways, multidisciplinary teams and multifaceted interventions appear to be most consistent in increasing guideline uptake. However, improvements in process outcomes were rarely accompanied by improvements in clinical outcomes. Our work highlights the need for improved research methodology to reliably assess the effectiveness of implementation interventions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Lesbians and Gay Men's Vacation Motivations, Perceptions, and Constraints: A Study of Cruise Vacation Choice.

PubMed

Weeden, Clare; Lester, Jo-Anne; Jarvis, Nigel

2016-08-01

This study explores the push-pull vacation motivations of gay male and lesbian consumers and examines how these underpin their perceptions and purchase constraints of a mainstream and LGBT(1) cruise. Findings highlight a complex vacation market. Although lesbians and gay men share many of the same travel motivations as their heterosexual counterparts, the study reveals sexuality is a significant variable in their perception of cruise vacations, which further influences purchase constraints and destination choice. Gay men have more favorable perceptions than lesbians of both mainstream and LGBT cruises. The article recommends further inquiry into the multifaceted nature of motivations, perception, and constraints within the LGBT market in relation to cruise vacations.