Climate, environmental and socio-economic change: weighing up the balance in vector-borne disease transmission.

PubMed

Parham, Paul E; Waldock, Joanna; Christophides, George K; Hemming, Deborah; Agusto, Folashade; Evans, Katherine J; Fefferman, Nina; Gaff, Holly; Gumel, Abba; LaDeau, Shannon; Lenhart, Suzanne; Mickens, Ronald E; Naumova, Elena N; Ostfeld, Richard S; Ready, Paul D; Thomas, Matthew B; Velasco-Hernandez, Jorge; Michael, Edwin

2015-04-05

Arguably one of the most important effects of climate change is the potential impact on human health. While this is likely to take many forms, the implications for future transmission of vector-borne diseases (VBDs), given their ongoing contribution to global disease burden, are both extremely important and highly uncertain. In part, this is owing not only to data limitations and methodological challenges when integrating climate-driven VBD models and climate change projections, but also, perhaps most crucially, to the multitude of epidemiological, ecological and socio-economic factors that drive VBD transmission, and this complexity has generated considerable debate over the past 10-15 years. In this review, we seek to elucidate current knowledge around this topic, identify key themes and uncertainties, evaluate ongoing challenges and open research questions and, crucially, offer some solutions for the field. Although many of these challenges are ubiquitous across multiple VBDs, more specific issues also arise in different vector-pathogen systems. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Challenges to the Development and Implementation of Public Policies to Achieve Animal Welfare Outcomes.

PubMed

Rose, Margaret

2010-12-31

Although there is a long-established tradition of concern for the welfare of animals, it was not until the mid 1800's that governments sought to enact legislation to protect animals from cruelty. In the 1950's, questions concerning animal welfare re-emerged and in the ensuing years have been an on-going focus of government activities. These developments occurred against a backdrop of significant social change but there are important differences in what now underpins and informs these considerations. In the formulation and implementation of public policies, governments look for a course of action that represents and protects the interests of the community; the process may be challenging with competing interests but the final determination seeks a middle ground that best meets the needs and interests of the community as a whole. When policy development concerns our relationship with other animals, the complexity of this relationship presents particular challenges not only to the formulation of policies but also to the evaluation of outcomes. Notably, the depth of feelings and diversity of views in our community reflect the complex social, cultural and personal dimensions of this relationship. The use of animals for scientific purposes remains one of the most contentious animal welfare issues primarily because when animals are used for these purposes, accepted animal welfare benchmarks cannot always be met. Based on the Australian experience, this paper will discuss the influences in and on-going challenges to the development and implementation of public policy when animals are used for these purposes.

Meeting the Complex Needs of Urban Youth and Their Families through the 4Rs 2Ss Family Strengthening Program: The "Real World" Meets Evidence-Informed Care

ERIC Educational Resources Information Center

Small, Latoya A.; Jackson, Jerrold; Gopalan, Geetha; McKay, Mary McKernan

2015-01-01

Background: Youth living in poverty face compounding familial and environmental was challenges in utilizing effective community mental health services. Ongoing stressors increase their drop-out rate in mental health service use. Difficulties also exist in staying engaged in services when involved with the child welfare system. This study examines…

The Appropriateness of Scratch and App Inventor as Educational Environments for Teaching Introductory Programming in Primary and Secondary Education

ERIC Educational Resources Information Center

Papadakis, Stamatios; Kalogiannakis, Michail; Orfanakis, Vasileios; Zaranis, Nicholas

2017-01-01

Teaching programming is a complex task. The task is even more challenging for introductory modules. There is an ongoing debate in the teaching community over the best approach to teaching introductory programming. Visual block-based programming environments allow school students to create their own programs in ways that are more accessible than in…

Science-policy challenges for biodiversity, public health and urbanization: examples from Belgium

NASA Astrophysics Data System (ADS)

Keune, H.; Kretsch, C.; De Blust, G.; Gilbert, M.; Flandroy, L.; Van den Berge, K.; Versteirt, V.; Hartig, T.; De Keersmaecker, L.; Eggermont, H.; Brosens, D.; Dessein, J.; Vanwambeke, S.; Prieur-Richard, A. H.; Wittmer, H.; Van Herzele, A.; Linard, C.; Martens, P.; Mathijs, E.; Simoens, I.; Van Damme, P.; Volckaert, F.; Heyman, P.; Bauler, T.

2013-06-01

Internationally, the importance of a coordinated effort to protect both biodiversity and public health is more and more recognized. These issues are often concentrated or particularly challenging in urban areas, and therefore on-going urbanization worldwide raises particular issues both for the conservation of living natural resources and for population health strategies. These challenges include significant difficulties associated with sustainable management of urban ecosystems, urban development planning, social cohesion and public health. An important element of the challenge is the need to interface between different forms of knowledge and different actors from science and policy. We illustrate this with examples from Belgium, showcasing concrete cases of human-nature interaction. To better tackle these challenges, since 2011, actors in science, policy and the broader Belgian society have launched a number of initiatives to deal in a more integrated manner with combined biodiversity and public health challenges in the face of ongoing urbanization. This emerging community of practice in Belgium exemplifies the importance of interfacing at different levels. (1) Bridges must be built between science and the complex biodiversity/ecosystem-human/public health-urbanization phenomena. (2) Bridges between different professional communities and disciplines are urgently needed. (3) Closer collaboration between science and policy, and between science and societal practice is needed. Moreover, within each of these communities closer collaboration between specialized sections is needed.

Engaging Survivors of Human Trafficking: Complex Health Care Needs and Scarce Resources.

PubMed

Judge, Abigail M; Murphy, Jennifer A; Hidalgo, Jose; Macias-Konstantopoulos, Wendy

2018-05-01

Human trafficking, also known as modern-day slavery, is an egregious human rights violation associated with wide-ranging medical and mental health consequences. Because of the extensive health problems related to trafficking, health care providers play a critical role in identifying survivors and engaging them in ongoing care. Although guidelines for recognizing affected patients and a framework for developing response protocols in health care settings have been described, survivors' ongoing engagement in health care services is very challenging. High rates of disengagement, lost contact, premature termination, and attrition are common outcomes. For interventions to be effective in this marginalized population, challenges in engaging survivors in long-term therapeutic primary and mental health care must be better understood and overcome. This article uses the socioecological model of public health to identify barriers to engagement; offers evidence- and practice-based recommendations for overcoming these barriers; and proposes an interdisciplinary call to action for developing more flexible, adaptable models of care.

Prostate cancer diagnostics: Clinical challenges and the ongoing need for disruptive and effective diagnostic tools.

PubMed

Sharma, Shikha; Zapatero-Rodríguez, Julia; O'Kennedy, Richard

The increased incidence and the significant health burden associated with carcinoma of the prostate have led to substantial changes in its diagnosis over the past century. Despite technological advancements, the management of prostate cancer has become progressively more complex and controversial for both early and late-stage disease. The limitations and potential harms associated with the use of prostate-specific antigen (PSA) as a diagnostic marker have stimulated significant investigation of numerous novel biomarkers that demonstrate varying capacities to detect prostate cancer and can decrease unnecessary biopsies. However, only a few of these markers have been approved for specific clinical settings while the others have not been adequately validated for use. This review systematically and critically assesses ongoing issues and emerging challenges in the current state of prostate cancer diagnostic tools and the need for disruptive next generation tools based on analysis of combinations of these biomarkers to enhance predictive accuracy which will benefit clinical diagnostics and patient welfare. Copyright © 2016. Published by Elsevier Inc.

Food systems transition and disruptive low carbon innovation: implications for a food security research agenda.

PubMed

Tyfield, David

2011-07-01

There is a growing consensus that we are facing epochal challenges in global food security. Moreover, these challenges are multiple and complex. Meeting these challenges will involve nothing less than a wholesale socio-technical transition of the agri-food system. Optimizing the efficacy of the contribution of research to such a food security agenda will probably also need new institutional mechanisms and career structures to facilitate new kinds of collaborations and ongoing, longer-term projects. In short, the multiple challenges of food security demand a different political economy of research for effective intervention by science. In making this argument, the paper summarizes the major findings of a recent report regarding the potential impact of so-called 'disruptive' low-carbon innovations in China.

Critical care considerations in the management of the trauma patient following initial resuscitation

PubMed Central

2012-01-01

Background Care of the polytrauma patient does not end in the operating room or resuscitation bay. The patient presenting to the intensive care unit following initial resuscitation and damage control surgery may be far from stable with ongoing hemorrhage, resuscitation needs, and injuries still requiring definitive repair. The intensive care physician must understand the respiratory, cardiovascular, metabolic, and immunologic consequences of trauma resuscitation and massive transfusion in order to evaluate and adjust the ongoing resuscitative needs of the patient and address potential complications. In this review, we address ongoing resuscitation in the intensive care unit along with potential complications in the trauma patient after initial resuscitation. Complications such as abdominal compartment syndrome, transfusion related patterns of acute lung injury and metabolic consequences subsequent to post-trauma resuscitation are presented. Methods A non-systematic literature search was conducted using PubMed and the Cochrane Database of Systematic Reviews up to May 2012. Results and conclusion Polytrauma patients with severe shock from hemorrhage and massive tissue injury present major challenges for management and resuscitation in the intensive care setting. Many of the current recommendations for “damage control resuscitation” including the use of fixed ratios in the treatment of trauma induced coagulopathy remain controversial. A lack of large, randomized, controlled trials leaves most recommendations at the level of consensus, expert opinion. Ongoing trials and improvements in monitoring and resuscitation technologies will further influence how we manage these complex and challenging patients. PMID:22989116

NASA Langley Distributed Propulsion VTOL Tilt-Wing Aircraft Testing, Modeling, Simulation, Control, and Flight Test Development

NASA Technical Reports Server (NTRS)

Rothhaar, Paul M.; Murphy, Patrick C.; Bacon, Barton J.; Gregory, Irene M.; Grauer, Jared A.; Busan, Ronald C.; Croom, Mark A.

2014-01-01

Control of complex Vertical Take-Off and Landing (VTOL) aircraft traversing from hovering to wing born flight mode and back poses notoriously difficult modeling, simulation, control, and flight-testing challenges. This paper provides an overview of the techniques and advances required to develop the GL-10 tilt-wing, tilt-tail, long endurance, VTOL aircraft control system. The GL-10 prototype's unusual and complex configuration requires application of state-of-the-art techniques and some significant advances in wind tunnel infrastructure automation, efficient Design Of Experiments (DOE) tunnel test techniques, modeling, multi-body equations of motion, multi-body actuator models, simulation, control algorithm design, and flight test avionics, testing, and analysis. The following compendium surveys key disciplines required to develop an effective control system for this challenging vehicle in this on-going effort.

Echoes of the Past, Glimpses of the Future - Ongoing Trends in Assurance of EEE Parts for Spaceflight

NASA Technical Reports Server (NTRS)

Sampson, Michael J.

2017-01-01

This presentation will review some past NASA presentations that had identified challenges and future trends in the assurance of Electrical, Electronic and Electromechanical (EEE) parts for spaceflight applications. It will contrast the concerns expressed in those presentations with the challenges of today and identify trends that give insight into the future. Common themes include the use of commercial parts, limited technical and physical resources, the pace of technology change and the difficulties in handling and testing individual parts as they become smaller and more complex. Some options for dealing with these challenges will be suggested to accommodate increasing numbers of smallsats, cubesats, constellations and other disruptive concepts, as space becomes more and more commercialized.

Sensing Danger: Key to Activating Plant Immunity.

PubMed

Gust, Andrea A; Pruitt, Rory; Nürnberger, Thorsten

2017-09-01

In both plants and animals, defense against pathogens relies on a complex surveillance system for signs of danger. Danger signals may originate from the infectious agent or from the host itself. Immunogenic plant host factors can be roughly divided into two categories: molecules which are passively released upon cell damage ('classical' damage-associated molecular patterns, DAMPs), and peptides which are processed and/or secreted upon infection to modulate the immune response (phytocytokines). We highlight the ongoing challenge to understand how plants sense various danger signals and integrate this information to produce an appropriate immune response to diverse challenges. Copyright © 2017 Elsevier Ltd. All rights reserved.

Visualization, documentation, analysis, and communication of large scale gene regulatory networks

PubMed Central

Longabaugh, William J.R.; Davidson, Eric H.; Bolouri, Hamid

2009-01-01

Summary Genetic regulatory networks (GRNs) are complex, large-scale, and spatially and temporally distributed. These characteristics impose challenging demands on computational GRN modeling tools, and there is a need for custom modeling tools. In this paper, we report on our ongoing development of BioTapestry, an open source, freely available computational tool designed specifically for GRN modeling. We also outline our future development plans, and give some examples of current applications of BioTapestry. PMID:18757046

Challenges and Opportunities for Tribal Waters: Addressing Disparities in Safe Public Drinking Water on the Crow Reservation in Montana, USA.

PubMed

Doyle, John T; Kindness, Larry; Realbird, James; Eggers, Margaret J; Camper, Anne K

2018-03-21

Disparities in access to safe public drinking water are increasingly being recognized as contributing to health disparities and environmental injustice for vulnerable communities in the United States. As the Co-Directors of the Apsaálooke Water and Wastewater Authority (AWWWA) for the Crow Tribe, with our academic partners, we present here the multiple and complex challenges we have addressed in improving and maintaining tribal water and wastewater infrastructure, including the identification of diverse funding sources for infrastructure construction, the need for many kinds of specialized expertise and long-term stability of project personnel, ratepayer difficulty in paying for services, an ongoing legacy of inadequate infrastructure planning, and lack of water quality research capacity. As a tribal entity, the AWWWA faces additional challenges, including the complex jurisdictional issues affecting all phases of our work, lack of authority to create water districts, and additional legal and regulatory gaps-especially with regards to environmental protection. Despite these obstacles, the AWWWA and Crow Tribe have successfully upgraded much of the local water and wastewater infrastructure. We find that ensuring safe public drinking water for tribal and other disadvantaged U.S. communities will require comprehensive, community-engaged approaches across a broad range of stakeholders to successfully address these complex legal, regulatory, policy, community capacity, and financial challenges.

Challenges and Opportunities for Tribal Waters: Addressing Disparities in Safe Public Drinking Water on the Crow Reservation in Montana, USA

PubMed Central

Doyle, John T.; Kindness, Larry; Realbird, James; Camper, Anne K.

2018-01-01

Disparities in access to safe public drinking water are increasingly being recognized as contributing to health disparities and environmental injustice for vulnerable communities in the United States. As the Co-Directors of the Apsaálooke Water and Wastewater Authority (AWWWA) for the Crow Tribe, with our academic partners, we present here the multiple and complex challenges we have addressed in improving and maintaining tribal water and wastewater infrastructure, including the identification of diverse funding sources for infrastructure construction, the need for many kinds of specialized expertise and long-term stability of project personnel, ratepayer difficulty in paying for services, an ongoing legacy of inadequate infrastructure planning, and lack of water quality research capacity. As a tribal entity, the AWWWA faces additional challenges, including the complex jurisdictional issues affecting all phases of our work, lack of authority to create water districts, and additional legal and regulatory gaps—especially with regards to environmental protection. Despite these obstacles, the AWWWA and Crow Tribe have successfully upgraded much of the local water and wastewater infrastructure. We find that ensuring safe public drinking water for tribal and other disadvantaged U.S. communities will require comprehensive, community-engaged approaches across a broad range of stakeholders to successfully address these complex legal, regulatory, policy, community capacity, and financial challenges. PMID:29561815

Cerebral cartography and connectomics

PubMed Central

Sporns, Olaf

2015-01-01

Cerebral cartography and connectomics pursue similar goals in attempting to create maps that can inform our understanding of the structural and functional organization of the cortex. Connectome maps explicitly aim at representing the brain as a complex network, a collection of nodes and their interconnecting edges. This article reflects on some of the challenges that currently arise in the intersection of cerebral cartography and connectomics. Principal challenges concern the temporal dynamics of functional brain connectivity, the definition of areal parcellations and their hierarchical organization into large-scale networks, the extension of whole-brain connectivity to cellular-scale networks, and the mapping of structure/function relations in empirical recordings and computational models. Successfully addressing these challenges will require extensions of methods and tools from network science to the mapping and analysis of human brain connectivity data. The emerging view that the brain is more than a collection of areas, but is fundamentally operating as a complex networked system, will continue to drive the creation of ever more detailed and multi-modal network maps as tools for on-going exploration and discovery in human connectomics. PMID:25823870

Out-patient management of chronic heart failure.

PubMed

Terrovitis, John V; Anastasiou-Nana, Maria I; Nanas, John N

2005-09-01

Chronic heart failure is a clinical syndrome associated with an ominous long-term prognosis and major economic consequences for Western societies. In recent years, considerable progress has been made in the pharmacological management of heart failure, and several treatments have been confirmed to confer survival and symptomatic benefits. However, pharmaceuticals remain underutilised, and the combination of several different drugs present challenges for their optimal prescription, requiring a thorough knowledge of potential side effects and complex interactions. This article reviews in detail the evidence pertaining to the out-patient pharmacological management of chronic heart failure, and offers recommendations on the use of various drugs in complex clinical conditions, or in areas of ongoing controversy.

Critical considerations for developing nucleic acid macromolecule based drug products.

PubMed

Muralidhara, Bilikallahalli K; Baid, Rinku; Bishop, Steve M; Huang, Min; Wang, Wei; Nema, Sandeep

2016-03-01

Protein expression therapy using nucleic acid macromolecules (NAMs) as a new paradigm in medicine has recently gained immense therapeutic potential. With the advancement of nonviral delivery it has been possible to target NAMs against cancer, immunodeficiency and infectious diseases. Owing to the complex and fragile structure of NAMs, however, development of a suitable, stable formulation for a reasonable product shelf-life and efficacious delivery is indeed challenging to achieve. This review provides a synopsis of challenges in the formulation and stability of DNA/m-RNA based medicines and probable mitigation strategies including a brief summary of delivery options to the target cells. Nucleic acid based drugs at various stages of ongoing clinical trials are compiled. Copyright © 2016. Published by Elsevier Ltd.

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

Crolley, R.; Thompson, M.

There has been a need for a faster and cheaper deployment model for information technology (IT) solutions to address waste management needs at US Department of Energy (DOE) complex sites for years. Budget constraints, challenges in deploying new technologies, frequent travel, and increased job demands for existing employees have prevented IT organizations from staying abreast of new technologies or deploying them quickly. Despite such challenges, IT organizations have added significant value to waste management handling through better worker safety, tracking, characterization, and disposition at DOE complex sites. Systems developed for site-specific missions have broad applicability to waste management challenges andmore » in many cases have been expanded to meet other waste missions. Radio frequency identification (RFID) and global positioning satellite (GPS)-enabled solutions have reduced the risk of radiation exposure and safety risks. New web-based and mobile applications have enabled precision characterization and control of nuclear materials. These solutions have also improved operational efficiencies and shortened schedules, reduced cost, and improved regulatory compliance. Collaboration between US Department of Energy (DOE) complex sites is improving time to delivery and cost efficiencies for waste management missions with new information technologies (IT) such as wireless computing, global positioning satellite (GPS), and radio frequency identification (RFID). Integrated solutions developed at separate DOE complex sites by new technology Centers of Excellence (CoE) have increased material control and accountability, worker safety, and environmental sustainability. CoEs offer other DOE sister sites significant cost and time savings by leveraging their technology expertise in project scoping, implementation, and ongoing operations.« less

Challenges of NDE Simulation Tool Challenges of NDE Simulation Tool

NASA Technical Reports Server (NTRS)

Leckey, Cara A. C.; Juarez, Peter D.; Seebo, Jeffrey P.; Frank, Ashley L.

2015-01-01

Realistic nondestructive evaluation (NDE) simulation tools enable inspection optimization and predictions of inspectability for new aerospace materials and designs. NDE simulation tools may someday aid in the design and certification of advanced aerospace components; potentially shortening the time from material development to implementation by industry and government. Furthermore, modeling and simulation are expected to play a significant future role in validating the capabilities and limitations of guided wave based structural health monitoring (SHM) systems. The current state-of-the-art in ultrasonic NDE/SHM simulation cannot rapidly simulate damage detection techniques for large scale, complex geometry composite components/vehicles with realistic damage types. This paper discusses some of the challenges of model development and validation for composites, such as the level of realism and scale of simulation needed for NASA' applications. Ongoing model development work is described along with examples of model validation studies. The paper will also discuss examples of the use of simulation tools at NASA to develop new damage characterization methods, and associated challenges of validating those methods.

Cerebral cartography and connectomics.

PubMed

Sporns, Olaf

2015-05-19

Cerebral cartography and connectomics pursue similar goals in attempting to create maps that can inform our understanding of the structural and functional organization of the cortex. Connectome maps explicitly aim at representing the brain as a complex network, a collection of nodes and their interconnecting edges. This article reflects on some of the challenges that currently arise in the intersection of cerebral cartography and connectomics. Principal challenges concern the temporal dynamics of functional brain connectivity, the definition of areal parcellations and their hierarchical organization into large-scale networks, the extension of whole-brain connectivity to cellular-scale networks, and the mapping of structure/function relations in empirical recordings and computational models. Successfully addressing these challenges will require extensions of methods and tools from network science to the mapping and analysis of human brain connectivity data. The emerging view that the brain is more than a collection of areas, but is fundamentally operating as a complex networked system, will continue to drive the creation of ever more detailed and multi-modal network maps as tools for on-going exploration and discovery in human connectomics. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

The complexity of the discussion on effectiveness and evidence in health promotion practices.

PubMed

Bodstein, Regina

2007-01-01

This article discusses an evaluation framework based on an understanding of the constitutive elements and multistrategic characteristics of health promotion (HP) programs. Health promotion presents an ongoing challenge for traditional evaluation frameworks (Rootman et al., 2001; Potvin, 2006; Barnes et al., 2003) when it redefines its actions as empowerment, community participation, local development, health literacy and intersectorial activities for the purpose of reducing inequalities for individuals, organizations, and public policies (Kickbush, 1994). This challenge also applies to the discussion on effectiveness of H P practice; what is at stake is the knowledge about how health promotion actions generate changes and outcomes. In short, this article proposes to discuss this redefined HP perspective and identify its usefulness in terms of the debate on effectiveness and evidence of HP in Brazil.

Reforming funding for chronic illness: Medicare-CDM.

PubMed

Swerissen, Hal; Taylor, Michael J

2008-02-01

Chronic diseases are a major challenge for the Australian health care system in terms of both the provision of quality care and expenditure, and these challenges will only increase in the future. Various programs have been instituted under the Medicare system to provide increased funding for chronic care, but essentially these programs still follow the traditional fee-for-service model. This paper proposes a realignment and extension of current Medicare chronic disease management programs into a framework that provides general practitioners and other health professionals with the necessary "tools" for high quality care planning and ongoing management, and incorporating international models of outcome-linked funding. The integration of social support services with the Medicare system is also a necessary step in providing high quality care for patients with complex needs requiring additional support.

Dengue vaccines: recent developments, ongoing challenges and current candidates

PubMed Central

McArthur, Monica A.; Sztein, Marcelo B.; Edelman, Robert

2013-01-01

Summary Dengue is among the most prevalent and important arbovirus diseases of humans. In order to effectively control this rapidly spreading disease, control of the vector mosquito and a safe and efficacious vaccine are critical. Despite considerable efforts, the development of a successful vaccine has remained elusive. Multiple factors have complicated the creation of a successful vaccine, not the least of which are the complex, immune-mediated responses against four antigenically distinct serotypes necessitating a tetravalent vaccine providing long lasting protective immunity. Despite the multiple impediments, there are currently many promising vaccine candidates in pre-clinical and clinical development. Here we review the recent advances in dengue virus vaccine development and briefly discuss the challenges associated with the use of these vaccines as a public health tool. PMID:23984962

Thin Film Physical Sensor Instrumentation Research and Development at NASA Glenn Research Center

NASA Technical Reports Server (NTRS)

Wrbanek, John D.; Fralick, Gustave C.

2006-01-01

A range of thin film sensor technology has been demonstrated enabling measurement of multiple parameters either individually or in sensor arrays including temperature, strain, heat flux, and flow. Multiple techniques exist for refractory thin film fabrication, fabrication and integration on complex surfaces and multilayered thin film insulation. Leveraging expertise in thin films and high temperature materials, investigations for the applications of thin film ceramic sensors has begun. The current challenges of instrumentation technology are to further develop systems packaging and component testing of specialized sensors, further develop instrumentation techniques on complex surfaces, improve sensor durability, and to address needs for extreme temperature applications. The technology research and development ongoing at NASA Glenn for applications to future launch vehicles, space vehicles, and ground systems is outlined.

Computer-Aided Design/Computer-Assisted Manufacture Monolithic Restorations for Severely Worn Dentition: A Case History Report.

PubMed

Abou-Ayash, Samir; Boldt, Johannes; Vuck, Alexander

Full-arch rehabilitation of patients with severe tooth wear due to parafunctional behavior is a challenge for dentists and dental technicians, especially when a highly esthetic outcome is desired. A variety of different treatment options and prosthetic materials are available for such a clinical undertaking. The ongoing progress of computer-aided design/computer-assisted manufacture technologies in combination with all-ceramic materials provides a predictable workflow for these complex cases. This case history report describes a comprehensive, step-by-step treatment protocol leading to an optimally predictable treatment outcome for an esthetically compromised patient.

Biopiracy and the ethics of medical heritage: the case of India's traditional knowledge digital library'.

PubMed

Kidd, Ian James

2012-09-01

Medical humanities have a central role to play in combating biopiracy. Medical humanities scholars can articulate and communicate the complex structures of meaning and significance which human beings have invested in their ways of conceiving health and sickness. Such awareness of the moral significance of medical heritage is necessary to ongoing legal, political, and ethical debates regarding the status and protection of medical heritage. I use the Indian Traditional Knowledge Digital Library as a case study of the role of medical humanities in challenging biopiracy by deepening our sense of the moral value of medical heritage.

Rehabilitation and education are underutilized for mild stroke and TIA sufferers.

PubMed

Faux, Steven G; Arora, Pooja; Shiner, Christine T; Thompson-Butel, Angelica G; Klein, Linda A

2018-06-01

Transient ischemic attack (TIA) and mild stroke represent a large proportion of cerebrovascular events, at high risk of being followed by recurrent, serious events. The importance of early education addressing risk management, secondary prevention and lifestyle modifications is the centerpiece of further stroke prevention. However, delivering education and rehabilitation to this population can be complex and challenging. Via synthesis of a narrative review and clinical experience, we explore the unique and inherent complexities of rehabilitation management and education provision for patients following mild stroke and TIA. A considerable proportion of TIA/mild stroke survivors have ongoing rehabilitation needs that are poorly addressed. The need for rehabilitation in these patients is often overlooked, and available assessment tools lack the sensitivity to identify common subtle impairments in cognition, mood, language and fatigue. Active and accessible education interventions need to be initiated early after the event, and integrated with ongoing rehabilitation management. Priority areas in need of future development in this field are highlighted and discussed. Implications for rehabilitation Survivors of mild stroke and TIA have ongoing unmet rehabilitation needs and require a unique approach to rehabilitation and education. Rehabilitation needs are difficult to assess and poorly addressed in this cohort, where available assessment tools lack the sensitivity required to identify subtle impairments. Education needs to be initiated early after the event and involve active engagement of the patient in order to improve stroke knowledge, mood and motivate adherence to lifestyle modifications and secondary prevention. Rehabilitation physicians are currently an underutilized resource, who should be more involved in the management of all patients following TIA or mild stroke.

Evaluating the Benefits of Adaptation of Critical Infrastructures to Hydrometeorological Risks.

PubMed

Thacker, Scott; Kelly, Scott; Pant, Raghav; Hall, Jim W

2018-01-01

Infrastructure adaptation measures provide a practical way to reduce the risk from extreme hydrometeorological hazards, such as floods and windstorms. The benefit of adapting infrastructure assets is evaluated as the reduction in risk relative to the "do nothing" case. However, evaluating the full benefits of risk reduction is challenging because of the complexity of the systems, the scarcity of data, and the uncertainty of future climatic changes. We address this challenge by integrating methods from the study of climate adaptation, infrastructure systems, and complex networks. In doing so, we outline an infrastructure risk assessment that incorporates interdependence, user demands, and potential failure-related economic losses. Individual infrastructure assets are intersected with probabilistic hazard maps to calculate expected annual damages. Protection measure costs are integrated to calculate risk reduction and associated discounted benefits, which are used to explore the business case for investment in adaptation. A demonstration of the methodology is provided for flood protection of major electricity substations in England and Wales. We conclude that the ongoing adaptation program for major electricity assets is highly cost beneficial. © 2017 Society for Risk Analysis.

Security aspects of electronic data interchange between a state health department and a hospital emergency department.

PubMed

Magnuson, J A; Klockner, Rocke; Ladd-Wilson, Stephen; Zechnich, Andrew; Bangs, Christopher; Kohn, Melvin A

2004-01-01

Electronic emergency department reporting provides the potential for enhancing local and state surveillance capabilities for a wide variety of syndromes and reportable conditions. The task of protecting data confidentiality and integrity while developing electronic data interchange between a hospital emergency department and a state public health department proved more complex than expected. This case study reports on the significant challenges that had to be resolved to accomplish this goal; these included application restrictions and incompatibilities, technical malfunctions, changing standards, and insufficient dedicated resources. One of the key administrative challenges was that of coordinating project security with enterprise security. The original project has evolved into an ongoing pilot, with the health department currently receiving secure data from the emergency department at four-hour intervals. Currently, planning is underway to add more emergency departments to the project.

Ongoing Speciation and Gene Flow between Taxonomically Challenging Trochulus Species Complex (Gastropoda: Hygromiidae).

PubMed

Proćków, Małgorzata; Strzała, Tomasz; Kuźnik-Kowalska, Elżbieta; Proćków, Jarosław; Mackiewicz, Paweł

2017-01-01

Geographical isolation, selection and genetic drift can cause the geographical diversification of populations and lead to speciation. Land snail species in the genus Trochulus show overlaps in geographical ranges as well as in morphology, but genetic data do not always support the species-level taxonomy based on morphological characters. Such a group offers an excellent opportunity to explore the processes involved. We have addressed the problem by determining the status of the restricted endemic T. graminicola within the larger context of Trochulus taxonomy. We used an integrated approach based on morphological features, ecological preferences and two molecular markers: mitochondrial COI sequences and microsatellites. Comparison of these results demonstrated: (i) conchological distinction of T. striolatus and T. sericeus; (ii) anatomical, ecological and genetic differentiation of T. graminicola and (iii) concordance between morphological characters and mtDNA markers in T. striolatus. Moreover, our data showed an intricate evolutionary history within the genus Trochulus, which can be best explained by: (i) recent or ongoing gene flow between taxa or (ii) their large ancestral polymorphism. Both of these hypotheses suggest that diversification within this group of snails has occurred relatively recently. The mismatches between species defined on morphology and on molecular genetics indicate the complexity of the processes involved in the diversification of this genus.

Ongoing Speciation and Gene Flow between Taxonomically Challenging Trochulus Species Complex (Gastropoda: Hygromiidae)

PubMed Central

Proćków, Małgorzata; Strzała, Tomasz; Kuźnik-Kowalska, Elżbieta; Proćków, Jarosław; Mackiewicz, Paweł

2017-01-01

Geographical isolation, selection and genetic drift can cause the geographical diversification of populations and lead to speciation. Land snail species in the genus Trochulus show overlaps in geographical ranges as well as in morphology, but genetic data do not always support the species-level taxonomy based on morphological characters. Such a group offers an excellent opportunity to explore the processes involved. We have addressed the problem by determining the status of the restricted endemic T. graminicola within the larger context of Trochulus taxonomy. We used an integrated approach based on morphological features, ecological preferences and two molecular markers: mitochondrial COI sequences and microsatellites. Comparison of these results demonstrated: (i) conchological distinction of T. striolatus and T. sericeus; (ii) anatomical, ecological and genetic differentiation of T. graminicola and (iii) concordance between morphological characters and mtDNA markers in T. striolatus. Moreover, our data showed an intricate evolutionary history within the genus Trochulus, which can be best explained by: (i) recent or ongoing gene flow between taxa or (ii) their large ancestral polymorphism. Both of these hypotheses suggest that diversification within this group of snails has occurred relatively recently. The mismatches between species defined on morphology and on molecular genetics indicate the complexity of the processes involved in the diversification of this genus. PMID:28107432

Investigation into the efficacy of generating synthetic pathological oscillations for domain adaptation

NASA Astrophysics Data System (ADS)

Lewis, Rory; Ellenberger, James; Williams, Colton; White, Andrew M.

2013-11-01

In the ongoing investigation of integrating Knowledge Discovery in Databases (KDD) into neuroscience, we present a paper that facilitates overcoming the two challenges preventing this integration. Pathological oscillations found in the human brain are difficult to evaluate because 1) there is often no time to learn and train off of the same distribution in the fatally sick, and 2) sinusoidal signals found in the human brain are complex and transient in nature requiring large data sets to work with which are costly and often very expensive or impossible to acquire. Overcoming these challenges in today's neuro-intensive-care unit (ICU) requires insurmountable resources. For these reasons, optimizing KDD for pathological oscillations so machine learning systems can predict neuropathological states would be of immense value. Domain adaptation, which allows a way of predicting on a separate set of data than the training data, can theoretically overcome the first challenge. However, the challenge of acquiring large data sets that show whether domain adaptation is a good candidate to test in a live neuro ICU remains a challenge. To solve this conundrum, we present a methodology for generating synthesized neuropathological oscillations for domain adaptation.

A literature review for large-scale health information system project planning, implementation and evaluation.

PubMed

Sligo, Judith; Gauld, Robin; Roberts, Vaughan; Villa, Luis

2017-01-01

Information technology is perceived as a potential panacea for healthcare organisations to manage pressure to improve services in the face of increased demand. However, the implementation and evaluation of health information systems (HIS) is plagued with problems and implementation shortcomings and failures are rife. HIS implementation is complex and relies on organisational, structural, technological, and human factors to be successful. It also requires reflective, nuanced, multidimensional evaluation to provide ongoing feedback to ensure success. This article provides a comprehensive review of the literature about evaluating and implementing HIS, detailing the challenges and recommendations for both evaluators and healthcare organisations. The factors that inhibit or promote successful HIS implementation are identified and effective evaluation strategies are described with the goal of informing teams evaluating complex HIS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Natural and engineered biosynthesis of fluorinated natural products.

PubMed

Walker, Mark C; Chang, Michelle C Y

2014-09-21

Both natural products and synthetic organofluorines play important roles in the discovery and design of pharmaceuticals. The combination of these two classes of molecules has the potential to be useful in the ongoing search for new bioactive compounds but our ability to produce site-selectively fluorinated natural products remains limited by challenges in compatibility between their high structural complexity and current methods for fluorination. Living systems provide an alternative route to chemical fluorination and could enable the production of organofluorine natural products through synthetic biology approaches. While the identification of biogenic organofluorines has been limited, the study of the native organisms and enzymes that utilize these compounds can help to guide efforts to engineer the incorporation of this unusual element into complex pharmacologically active natural products. This review covers recent advances in understanding both natural and engineered production of organofluorine natural products.

HIV and mycobacteria.

PubMed

Procop, Gary W

2017-07-01

The importance of mycobacteria as opportunistic pathogens, particularly members of the M. avium complex (MAC), in patients with progressive HIV infection was recognized early in the AIDS epidemic. It took longer to appreciate the global impact and devastation that would result from the deadly synergy that exists between HIV and M. tuberculosis. This HIV/M. tuberculosis co-pandemic is ongoing and claiming millions of lives every year. In addition to MAC, a number of other non-tuberculous mycobacteria have been recognized as opportunistic pathogens in HIV-infected individuals; some of these are more commonly encountered (e.g., M. kansasii) than others (M. haemophilum and M. genevense). Finally, there are challenges to concomitantly treating the HIV and the infecting Mycobacterium species, because of antimicrobial resistance, therapeutic side-effects and the complex pharmacologic interactions of the antiretroviral and antimycobacterial multidrug therapy. Copyright © 2017 Elsevier Inc. All rights reserved.

Accelerated failure time models for semi-competing risks data in the presence of complex censoring.

PubMed

Lee, Kyu Ha; Rondeau, Virginie; Haneuse, Sebastien

2017-12-01

Statistical analyses that investigate risk factors for Alzheimer's disease (AD) are often subject to a number of challenges. Some of these challenges arise due to practical considerations regarding data collection such that the observation of AD events is subject to complex censoring including left-truncation and either interval or right-censoring. Additional challenges arise due to the fact that study participants under investigation are often subject to competing forces, most notably death, that may not be independent of AD. Towards resolving the latter, researchers may choose to embed the study of AD within the "semi-competing risks" framework for which the recent statistical literature has seen a number of advances including for the so-called illness-death model. To the best of our knowledge, however, the semi-competing risks literature has not fully considered analyses in contexts with complex censoring, as in studies of AD. This is particularly the case when interest lies with the accelerated failure time (AFT) model, an alternative to the traditional multiplicative Cox model that places emphasis away from the hazard function. In this article, we outline a new Bayesian framework for estimation/inference of an AFT illness-death model for semi-competing risks data subject to complex censoring. An efficient computational algorithm that gives researchers the flexibility to adopt either a fully parametric or a semi-parametric model specification is developed and implemented. The proposed methods are motivated by and illustrated with an analysis of data from the Adult Changes in Thought study, an on-going community-based prospective study of incident AD in western Washington State. © 2017, The International Biometric Society.

Closing the gap in a regional health service in NSW: a multi-strategic approach to addressing individual and institutional racism.

PubMed

2012-06-01

Building a culturally safe and respectful organisation that genuinely addresses individual and institutional racism is a substantial and complex undertaking. Achieving this outcome requires sustained commitment and a comprehensive strategy, including the active involvement of Aboriginal stakeholders. This paper describes the journey of a large regional health organisation in NSW. A multi-strategic approach is broadly described, with three strategies explored in depth. These are: staff education and training; leadership; and consultation, negotiation and partnerships. Challenges are discussed in the context of promising progress and an ongoing commitment to this important organisational goal.

Statutory Regulation of Traditional Medicine Practitioners and Practices: The Need for Distinct Policy Making Guidelines.

PubMed

Ijaz, Nadine; Boon, Heather

2018-04-01

The World Health Organization (WHO) has called for the increased statutory regulation of traditional and complementary medicine practitioners and practices, currently implemented in about half of nations surveyed. According to recent WHO data, however, the absence of policy guidelines in this area represents a significant barrier to implementation of such professional regulations. This commentary reviews several key challenges that distinguish the statutory regulation of traditional medicine practitioners and practices from biomedical professional regulation, providing a foundation for the development of policy making parameters in this area. Foremost in this regard are the ongoing impacts of the European colonial encounter, which reinforce biomedicine's disproportionate political dominance across the globe despite traditional medicine's ongoing widespread use (particularly in the global South). In this light, the authors discuss the conceptual and historical underpinnings of contemporary professional regulatory structures, the tensions between institutional and informal traditional medicine training pathways, and the policy challenges presented by the prospect of standardizing internally diverse indigenous healing approaches. Epistemic and evidentiary tensions, as well as the policy complexities surrounding the intersection of cultural and clinical considerations, present additional challenges to regulators. Conceptualizing professional regulation as an intellectual property claim under the law, the authors further consider what it means to protect traditional knowledge and prevent misappropriation in this context. Overall, the authors propose that innovative professional regulatory approaches are needed in this area to address safety, quality of care, and accessibility as key public interest concerns, while prioritizing the redress of historical inequities, protection of diverse indigenous knowledges, and delivery of care to underserved populations.

Statutory Regulation of Traditional Medicine Practitioners and Practices: The Need for Distinct Policy Making Guidelines

PubMed Central

Boon, Heather

2018-01-01

Abstract The World Health Organization (WHO) has called for the increased statutory regulation of traditional and complementary medicine practitioners and practices, currently implemented in about half of nations surveyed. According to recent WHO data, however, the absence of policy guidelines in this area represents a significant barrier to implementation of such professional regulations. This commentary reviews several key challenges that distinguish the statutory regulation of traditional medicine practitioners and practices from biomedical professional regulation, providing a foundation for the development of policy making parameters in this area. Foremost in this regard are the ongoing impacts of the European colonial encounter, which reinforce biomedicine's disproportionate political dominance across the globe despite traditional medicine's ongoing widespread use (particularly in the global South). In this light, the authors discuss the conceptual and historical underpinnings of contemporary professional regulatory structures, the tensions between institutional and informal traditional medicine training pathways, and the policy challenges presented by the prospect of standardizing internally diverse indigenous healing approaches. Epistemic and evidentiary tensions, as well as the policy complexities surrounding the intersection of cultural and clinical considerations, present additional challenges to regulators. Conceptualizing professional regulation as an intellectual property claim under the law, the authors further consider what it means to protect traditional knowledge and prevent misappropriation in this context. Overall, the authors propose that innovative professional regulatory approaches are needed in this area to address safety, quality of care, and accessibility as key public interest concerns, while prioritizing the redress of historical inequities, protection of diverse indigenous knowledges, and delivery of care to underserved populations. PMID:29359948

Time to face the fats: what can mass spectrometry reveal about the structure of lipids and their interactions with proteins?

PubMed

Brown, Simon H J; Mitchell, Todd W; Oakley, Aaron J; Pham, Huong T; Blanksby, Stephen J

2012-09-01

Since the 1950s, X-ray crystallography has been the mainstay of structural biology, providing detailed atomic-level structures that continue to revolutionize our understanding of protein function. From recent advances in this discipline, a picture has emerged of intimate and specific interactions between lipids and proteins that has driven renewed interest in the structure of lipids themselves and raised intriguing questions as to the specificity and stoichiometry in lipid-protein complexes. Herein we demonstrate some of the limitations of crystallography in resolving critical structural features of ligated lipids and thus determining how these motifs impact protein binding. As a consequence, mass spectrometry must play an important and complementary role in unraveling the complexities of lipid-protein interactions. We evaluate recent advances and highlight ongoing challenges towards the twin goals of (1) complete structure elucidation of low, abundant, and structurally diverse lipids by mass spectrometry alone, and (2) assignment of stoichiometry and specificity of lipid interactions within protein complexes.

Time to Face the Fats: What Can Mass Spectrometry Reveal about the Structure of Lipids and Their Interactions with Proteins?

NASA Astrophysics Data System (ADS)

Brown, Simon H. J.; Mitchell, Todd W.; Oakley, Aaron J.; Pham, Huong T.; Blanksby, Stephen J.

2012-09-01

Since the 1950s, X-ray crystallography has been the mainstay of structural biology, providing detailed atomic-level structures that continue to revolutionize our understanding of protein function. From recent advances in this discipline, a picture has emerged of intimate and specific interactions between lipids and proteins that has driven renewed interest in the structure of lipids themselves and raised intriguing questions as to the specificity and stoichiometry in lipid-protein complexes. Herein we demonstrate some of the limitations of crystallography in resolving critical structural features of ligated lipids and thus determining how these motifs impact protein binding. As a consequence, mass spectrometry must play an important and complementary role in unraveling the complexities of lipid-protein interactions. We evaluate recent advances and highlight ongoing challenges towards the twin goals of (1) complete structure elucidation of low, abundant, and structurally diverse lipids by mass spectrometry alone, and (2) assignment of stoichiometry and specificity of lipid interactions within protein complexes.

Perspectives Regarding Adherence to Prescribed Treatment in Highly Adherent HIV-Infected Gay Men.

PubMed

Brion, John M; Menke, Edna M

2008-01-01

Focus group methodology was used to describe the medication adherence experience of 24 HIV-infected gay men who reported being adherent to their medication regimens. A conceptualization of medication adherence as an evolving process consisted of challenges to adherence (learning the diagnosis, starting the medications, struggling with the medications, dealing with side effects, coping with stigma) as well as those factors supportive of adherence (believing in medications, finding motivating factors, using reminders, depending on others, owning the disease). Themes associated with challenges to adherence focused on diagnosis and the physical and emotional adjustments individuals made to incorporate antiretroviral medications into their daily lives and move toward medication adherence. The factors supportive of adherence were related to the ongoing behaviors identified with establishing and maintaining adherence behaviors. What can be taken from the study is that adherence is a complex and dynamic process rather than a static behavior.

Exemplar for simulation challenges: Large-deformation micromechanics of Sylgard 184/glass microballoon syntactic foams.

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

Brown, Judith Alice; Long, Kevin Nicholas

2018-05-01

Sylgard® 184/Glass Microballoon (GMB) potting material is currently used in many NW systems. Analysts need a macroscale constitutive model that can predict material behavior under complex loading and damage evolution. To address this need, ongoing modeling and experimental efforts have focused on study of damage evolution in these materials. Micromechanical finite element simulations that resolve individual GMB and matrix components promote discovery and better understanding of the material behavior. With these simulations, we can study the role of the GMB volume fraction, time-dependent damage, behavior under confined vs. unconfined compression, and the effects of partial damage. These simulations are challengingmore » and push the boundaries of capability even with the high performance computing tools available at Sandia. We summarize the major challenges and the current state of this modeling effort, as an exemplar of micromechanical modeling needs that can motivate advances in future computing efforts.« less

Freshwater Metaviromics and Bacteriophages: A Current Assessment of the State of the Art in Relation to Bioinformatic Challenges

PubMed Central

Bruder, Katherine; Malki, Kema; Cooper, Alexandria; Sible, Emily; Shapiro, Jason W.; Watkins, Siobhan C.; Putonti, Catherine

2016-01-01

Advances in bioinformatics and sequencing technologies have allowed for the analysis of complex microbial communities at an unprecedented rate. While much focus is often placed on the cellular members of these communities, viruses play a pivotal role, particularly bacteria-infecting viruses (bacteriophages); phages mediate global biogeochemical processes and drive microbial evolution through bacterial grazing and horizontal gene transfer. Despite their importance and ubiquity in nature, very little is known about the diversity and structure of viral communities. Though the need for culture-based methods for viral identification has been somewhat circumvented through metagenomic techniques, the analysis of metaviromic data is marred with many unique issues. In this review, we examine the current bioinformatic approaches for metavirome analyses and the inherent challenges facing the field as illustrated by the ongoing efforts in the exploration of freshwater phage populations. PMID:27375355

Working at the frontline in cases of elder abuse: 'it keeps me awake at night'.

PubMed

Cairns, Jane; Vreugdenhil, Anthea

2014-03-01

To explore the experiences of frontline health and welfare practitioners in working with older people experiencing abuse. In-depth interviews with 16 Tasmanian community-based health and welfare practitioners regarding their experiences of working in 49 recent cases of elder abuse. Interview transcripts were analysed using thematic analysis. All participants found working in cases of elder abuse challenging and the work itself was perceived as difficult, complex and at times dangerous. The cumulative effect of intimidating work contexts, practice dilemmas and a lack of support resulted in frustration and stress for many practitioners. Nevertheless, participants were committed to providing ongoing services and support for older people experiencing abuse. Frontline practitioners working in cases of elder abuse face significant challenges and could be better supported through strengthening organisational elder abuse policies, increased management support and more age-inclusive family violence support services. © 2013 The Authors. Australasian Journal on Ageing © 2013 ACOTA.

The Massachusetts HIV, hepatitis, addiction services integration (HHASI) experience: responding to the comprehensive needs of individuals with co-occurring risks and conditions.

PubMed

Hoffman, Heidi L; Castro-Donlan, Carolyn A; Johnson, Victoria M; Church, Daniel R

2004-01-01

Categorical funding mechanisms traditionally used to fund public health programs are a challenge to providers serving individuals with complex needs that often span multiple service areas. Integration--a formalized, collaborative process among service systems--responds to the challenge by decreasing fragmentation of care and improving coordination. In 2000, the Massachusetts Department of Public Health (MDPH) received a one-year planning grant from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) to evaluate opportunities for integrating HIV/AIDS programs and substance abuse treatment programs. The project was later expanded to include viral hepatitis programming. Outcomes include the development of a strategic plan, joint procurement initiatives, and an ongoing commitment to sustain inter-bureau integration efforts, even in the face of substantial budget reductions. Integrated approaches can promote greater efficiency, improving communication and coordination among clients, providers, and government funding agencies.

Potential Impact and Study Considerations of Metabolomics in Cardiovascular Health and Disease: A Scientific Statement From the American Heart Association.

PubMed

Cheng, Susan; Shah, Svati H; Corwin, Elizabeth J; Fiehn, Oliver; Fitzgerald, Robert L; Gerszten, Robert E; Illig, Thomas; Rhee, Eugene P; Srinivas, Pothur R; Wang, Thomas J; Jain, Mohit

2017-04-01

Through the measure of thousands of small-molecule metabolites in diverse biological systems, metabolomics now offers the potential for new insights into the factors that contribute to complex human diseases such as cardiovascular disease. Targeted metabolomics methods have already identified new molecular markers and metabolomic signatures of cardiovascular disease risk (including branched-chain amino acids, select unsaturated lipid species, and trimethylamine- N -oxide), thus in effect linking diverse exposures such as those from dietary intake and the microbiota with cardiometabolic traits. As technologies for metabolomics continue to evolve, the depth and breadth of small-molecule metabolite profiling in complex systems continue to advance rapidly, along with prospects for ongoing discovery. Current challenges facing the field of metabolomics include scaling throughput and technical capacity for metabolomics approaches, bioinformatic and chemoinformatic tools for handling large-scale metabolomics data, methods for elucidating the biochemical structure and function of novel metabolites, and strategies for determining the true clinical relevance of metabolites observed in association with cardiovascular disease outcomes. Progress made in addressing these challenges will allow metabolomics the potential to substantially affect diagnostics and therapeutics in cardiovascular medicine. © 2017 American Heart Association, Inc.

Genetic heterogeneity in cholangiocarcinoma: a major challenge for targeted therapies

PubMed Central

Brandi, Giovanni; Farioli, Andrea; Astolfi, Annalisa; Biasco, Guido; Tavolari, Simona

2015-01-01

Cholangiocarcinoma (CC) encompasses a group of related but distinct malignancies whose lack of a stereotyped genetic signature makes challenging the identification of genomic landscape and the development of effective targeted therapies. Accumulated evidences strongly suggest that the remarkable genetic heterogeneity of CC may be the result of a complex interplay among different causative factors, some shared by most human cancers while others typical of this malignancy. Currently, considerable efforts are ongoing worldwide for the genetic characterization of CC, also using advanced technologies such as next-generation sequencing (NGS). Undoubtedly this technology could offer an unique opportunity to broaden our understanding on CC molecular pathogenesis. Despite this great potential, however, the high complexity in terms of factors potentially contributing to genetic variability in CC calls for a more cautionary application of NGS to this malignancy, in order to avoid possible biases and criticisms in the identification of candidate actionable targets. This approach is further justified by the urgent need to develop effective targeted therapies in this disease. A multidisciplinary approach integrating genomic, functional and clinical studies is therefore mandatory to translate the results obtained by NGS into effective targeted therapies for this orphan disease. PMID:26142706

Race, socioeconomic status, and health: complexities, ongoing challenges, and research opportunities.

PubMed

Williams, David R; Mohammed, Selina A; Leavell, Jacinta; Collins, Chiquita

2010-02-01

This paper provides an overview of racial variations in health and shows that differences in socioeconomic status (SES) across racial groups are a major contributor to racial disparities in health. However, race reflects multiple dimensions of social inequality and individual and household indicators of SES capture relevant but limited aspects of this phenomenon. Research is needed that will comprehensively characterize the critical pathogenic features of social environments and identify how they combine with each other to affect health over the life course. Migration history and status are also important predictors of health and research is needed that will enhance understanding of the complex ways in which race, SES, and immigrant status combine to affect health. Fully capturing the role of race in health also requires rigorous examination of the conditions under which medical care and genetic factors can contribute to racial and SES differences in health. The paper identifies research priorities in all of these areas.

Seismic anisotropy and slab dynamics from SKS splitting recorded in Colombia

NASA Astrophysics Data System (ADS)

Porritt, Robert W.; Becker, Thorsten W.; Monsalve, Gaspar

2014-12-01

The Nazca, Caribbean, and South America plates meet in northwestern South America where the northern end of the Andean volcanic arc and Wadati-Benioff zone seismicity indicate ongoing subduction. However, the termination of Quaternary volcanism at ~5.5°N and eastward offset in seismicity underneath Colombia suggest the presence of complex slab geometry. To help link geometry to dynamics, we analyze SKS splitting for 38 broadband stations of the Colombian national network. Measurements of fast polarization axes in western Colombia close to the trench show dominantly trench-perpendicular orientations. Orientations measured at stations in the back arc, farther to the east, however, abruptly change to roughly trench parallel anisotropy. This may indicate along-arc mantle flow, possibly related to the suggested "Caldas" slab tear, or a lithospheric signature, but smaller-scale variations in anisotropy remain to be explained. Our observations are atypical globally and challenge our understanding of the complexities of subduction zone seismic anisotropy.

Pelvic fracture in multiple trauma: are we still up-to-date with massive fluid resuscitation?

PubMed

Burkhardt, Markus; Kristen, Alexander; Culemann, Ulf; Koehler, Daniel; Histing, Tina; Holstein, Joerg H; Pizanis, Antonius; Pohlemann, Tim

2014-10-01

Until today the mortality of complex pelvic trauma remains unacceptably high. On the one hand this could be attributed to a biological limit of the survivable trauma load, on the other hand side an ongoing inadequate treatment might be conceivable too. For the management of multiple trauma patients with life-threatening pelvic fractures, there is ongoing international debate on the adequate therapeutic strategy, e.g. arterial embolization or pelvic packing, as well as aggressive or restrained volume therapy. Whereas traditional pelvis-specific trauma algorithms still recommend massive fluid resuscitation, there is upcoming evidence that a restrained volume therapy in the preclinical setting may improve trauma outcomes. Less intravenous fluid administration may also reduce haemodilution and concomitant trauma-associated coagulopathy. After linking the data of the TraumaRegister DGU(®) and the German Pelvic Injury Register, for the first time, the initial fluid management for complex pelvic traumas as well as for different Tile/OTA types of pelvic ring fractures could be addressed. Unfortunately, the results could not answer the question of the adequate fluid resuscitation but confirmed the actuality of massive fluid resuscitation in the prehospital and emergency room setting. Low-volume resuscitation seems not yet accepted in practice in managing multiple trauma patients with pelvic fractures at least in Germany. Nevertheless, prevention of exsanguination and of complications like multiple organ dysfunction syndrome still poses a major challenge in the management of complex pelvic ring injuries. Even nowadays, fluid management for trauma, not only for pelvic fractures, remains a controversial area and further research is mandatory. Copyright © 2014 Elsevier Ltd. All rights reserved.

AGU, Science and Engagement with the Energy Industry

NASA Astrophysics Data System (ADS)

Leinen, M.; Davidson, E. A.

2016-12-01

The relationship between science and society evolves over time and the social, political, and economic factors shaping this relationship are complex. When problems facing society become more challenging, the public, NGOs, and policy makers call for science to more directly inform solutions, to assure accountability for the use of funds and to address conflicts of interest. But when policy solutions for such challenges require significant economic and societal tradeoffs, discussion of the science can become polarized and politicized. When this occurs, AGU's policies that uphold the highest standards of scientific integrity, address conflicts of interests and promote independence for members are even more important. These policies are implemented through processes for: a) control of science presented at meeting and in publications; b) requirements for data cited in publications to be publicly accessible, and c) an organizational support policy that prohibits sponsors from influencing science presented in AGU programs. The private sector wields vast influence on human behavior and governmental policy through commerce and lobbying. These actions can be controversial when the profit motive appears incongruent with other societal opinions of what is in the public interest. Climate change is an example of this tension, where the economic exploitation of fossil fuels has complex effects on food and energy security as well as on the environment. Nonetheless, the AGU Board unanimously agreed that given our mission to advance science to create a more sustainable earth, engagement of the private sector rather than disengagement is the best way to influence decision makers on all sides because we believe that the private sector needs to be part of any solutions. We plan to use our convening power and scientific authority to bring together diverse views on climate change solutions from the private, NGO, policy, decision-maker and scientific sectors to begin a substantial, responsible and on-going dialogue. We want this dialogue to inform issues of energy, environment, security and the associated economic and societal benefits and tradeoffs in addressing climate change. AGU will share our initial ideas for convening such engagement and in the future will inform our membership on the successes and the on-going challenges.

Ethical challenges in FASD prevention: Scientific uncertainty, stigma, and respect for women's autonomy.

PubMed

Zizzo, Natalie; Racine, Eric

2017-11-09

Fetal alcohol spectrum disorder (FASD) is a leading form of neurodevelopmental delay in Canada, affecting an estimated 3000 babies per year. FASD involves a range of disabilities that entail significant costs to affected individuals, families, and society. Exposure to alcohol in utero is a necessary factor for FASD development, and this has led to FASD being described as "completely preventable". However, there are significant ethical challenges associated with FASD prevention. These challenges revolve around 1) what should be communicated about the risks of alcohol consumption during pregnancy, given some ongoing scientific uncertainty about the effects of prenatal alcohol exposure, and 2) how to communicate these risks, given the potential for stigma against women who give birth to children with FASD as well as against children and adults with FASD. In this paper, we share initial thoughts on how primary care physicians can tackle this complex challenge. First, we recommend honest disclosure of scientific evidence to women and the tailoring of information offered to pregnant women. Second, we propose a contextualized, patient-centred, compassionate approach to ensure that appropriate advice is given to patients in a supportive, non-stigmatizing way.

Human Mars Mission Design - The Ultimate Systems Challenge

NASA Technical Reports Server (NTRS)

Connolly, John F.; Joosten, B. Kent; Drake, Bret; Hoffman, Steve; Polsgrove, Tara; Rucker, Michelle; Andrews, Alida; Williams, Nehemiah

2017-01-01

A human mission to Mars will occur at some time in the coming decades. When it does, it will be the end result of a complex network of interconnected design choices, systems analyses, technical optimizations, and non-technical compromises. This mission will extend the technologies, engineering design, and systems analyses to new limits, and may very well be the most complex undertaking in human history. It can be illustrated as a large menu, or as a large decision tree. Whatever the visualization tool, there are numerous design decisions required to assemble a human Mars mission, and many of these interconnect with one another. This paper examines these many decisions and further details a number of choices that are highly interwoven throughout the mission design. The large quantity of variables and their interconnectedness results in a highly complex systems challenge, and the paper illustrates how a change in one variable results in ripples (sometimes unintended) throughout many other facets of the design. The paper concludes with a discussion of some mission design variables that can be addressed first, and those that have already been addressed as a result of ongoing National Aeronautics and Space Administration (NASA) developments, or as a result of decisions outside the technical arena. It advocates the need for a 'reference design' that can be used as a point of comparison, and to illustrate the system-wide impacts as design variables change.

A Tale of Two Regions: Landscape Ecological Planning for Shale Gas Energy Futures

NASA Astrophysics Data System (ADS)

Murtha, T., Jr.; Schroth, O.; Orland, B.; Goldberg, L.; Mazurczyk, T.

2015-12-01

As we increasingly embrace deep shale gas deposits to meet global energy demands new and dispersed local and regional policy and planning challenges emerge. Even in regions with long histories of energy extraction, such as coal, shale gas and the infrastructure needed to produce the gas and transport it to market offers uniquely complex transformations in land use and landcover not previously experienced. These transformations are fast paced, dispersed and can overwhelm local and regional planning and regulatory processes. Coupled to these transformations is a structural confounding factor. While extraction and testing are carried out locally, regulation and decision-making is multilayered, often influenced by national and international factors. Using a geodesign framework, this paper applies a set of geospatial landscape ecological planning tools in two shale gas settings. First, we describe and detail a series of ongoing studies and tools that we have developed for communities in the Marcellus Shale region of the eastern United States, specifically the northern tier of Pennsylvania. Second, we apply a subset of these tools to potential gas development areas of the Fylde region in Lancashire, United Kingdom. For the past five years we have tested, applied and refined a set of place based and data driven geospatial models for forecasting, envisioning, analyzing and evaluating shale gas activities in northern Pennsylvania. These models are continuously compared to important landscape ecological planning challenges and priorities in the region, e.g. visual and cultural resource preservation. Adapting and applying these tools to a different landscape allow us to not only isolate and define important regulatory and policy exigencies in each specific setting, but also to develop and refine these models for broader application. As we continue to explore increasingly complex energy solutions globally, we need an equally complex comparative set of landscape ecological planning tools to inform policy, design and regional planning. Adapting tools and techniques developed in Pennsylvania where shale gas extraction is ongoing to Lancashire, where industry is still in the exploratory phase offers a key opportunity to test and refine more generalizable models.

Frequency Agile Transceiver for Advanced Vehicle Data Links

NASA Technical Reports Server (NTRS)

Freudinger, Lawrence C.; Macias, Filiberto; Cornelius, Harold

2009-01-01

Emerging and next-generation test instrumentation increasingly relies on network communication to manage complex and dynamic test scenarios, particularly for uninhabited autonomous systems. Adapting wireless communication infrastructure to accommodate challenging testing needs can benefit from reconfigurable radio technology. Frequency agility is one characteristic of reconfigurable radios that to date has seen only limited progress toward programmability. This paper overviews an ongoing project to validate a promising chipset that performs conversion of RF signals directly into digital data for the wireless receiver and, for the transmitter, converts digital data into RF signals. The Software Configurable Multichannel Transceiver (SCMT) enables four transmitters and four receivers in a single unit, programmable for any frequency band between 1 MHz and 6 GHz.

Noise elimination algorithm for modal analysis

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

Bao, X. X., E-mail: baoxingxian@upc.edu.cn; Li, C. L.; Xiong, C. B.

2015-07-27

Modal analysis is an ongoing interdisciplinary physical issue. Modal parameters estimation is applied to determine the dynamic characteristics of structures under vibration excitation. Modal analysis is more challenging for the measured vibration response signals are contaminated with noise. This study develops a mathematical algorithm of structured low rank approximation combined with the complex exponential method to estimate the modal parameters. Physical experiments using a steel cantilever beam with ten accelerometers mounted, excited by an impulse load, demonstrate that this method can significantly eliminate noise from measured signals and accurately identify the modal frequencies and damping ratios. This study provides amore » fundamental mechanism of noise elimination using structured low rank approximation in physical fields.« less

Assuring safety without animal testing: Unilever's ongoing research programme to deliver novel ways to assure consumer safety.

PubMed

Westmoreland, Carl; Carmichael, Paul; Dent, Matt; Fentem, Julia; MacKay, Cameron; Maxwell, Gavin; Pease, Camilla; Reynolds, Fiona

2010-01-01

Assuring consumer safety without the generation of new animal data is currently a considerable challenge. However, through the application of new technologies and the further development of risk-based approaches for safety assessment, we remain confident it is ultimately achievable. For many complex, multi-organ consumer safety endpoints, the development, evaluation and application of new, non-animal approaches is hampered by a lack of biological understanding of the underlying mechanistic processes involved. The enormity of this scientific challenge should not be underestimated. To tackle this challenge a substantial research programme was initiated by Unilever in 2004 to critically evaluate the feasibility of a new conceptual approach based upon the following key components: 1.Developing new, exposure-driven risk assessment approaches. 2.Developing new biological (in vitro) and computer-based (in silico) predictive models. 3.Evaluating the applicability of new technologies for generating data (e.g. "omics", informatics) and for integrating new types of data (e.g. systems approaches) for risk-based safety assessment. Our research efforts are focussed in the priority areas of skin allergy, cancer and general toxicity (including inhaled toxicity). In all of these areas, a long-term investment is essential to increase the scientific understanding of the underlying biology and molecular mechanisms that we believe will ultimately form a sound basis for novel risk assessment approaches. Our research programme in these priority areas consists of in-house research as well as Unilever-sponsored academic research, involvement in EU-funded projects (e.g. Sens-it-iv, Carcinogenomics), participation in cross-industry collaborative research (e.g. Colipa, EPAA) and ongoing involvement with other scientific initiatives on non-animal approaches to risk assessment (e.g. UK NC3Rs, US "Human Toxicology Project" consortium).

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

PubMed Central

Broer, Tineke; Bal, Roland; Pickersgill, Martyn

2017-01-01

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

Extending the NIF DISCO framework to automate complex workflow: coordinating the harvest and integration of data from diverse neuroscience information resources

PubMed Central

Marenco, Luis N.; Wang, Rixin; Bandrowski, Anita E.; Grethe, Jeffrey S.; Shepherd, Gordon M.; Miller, Perry L.

2014-01-01

This paper describes how DISCO, the data aggregator that supports the Neuroscience Information Framework (NIF), has been extended to play a central role in automating the complex workflow required to support and coordinate the NIF’s data integration capabilities. The NIF is an NIH Neuroscience Blueprint initiative designed to help researchers access the wealth of data related to the neurosciences available via the Internet. A central component is the NIF Federation, a searchable database that currently contains data from 231 data and information resources regularly harvested, updated, and warehoused in the DISCO system. In the past several years, DISCO has greatly extended its functionality and has evolved to play a central role in automating the complex, ongoing process of harvesting, validating, integrating, and displaying neuroscience data from a growing set of participating resources. This paper provides an overview of DISCO’s current capabilities and discusses a number of the challenges and future directions related to the process of coordinating the integration of neuroscience data within the NIF Federation. PMID:25018728

Extending the NIF DISCO framework to automate complex workflow: coordinating the harvest and integration of data from diverse neuroscience information resources.

PubMed

Marenco, Luis N; Wang, Rixin; Bandrowski, Anita E; Grethe, Jeffrey S; Shepherd, Gordon M; Miller, Perry L

2014-01-01

This paper describes how DISCO, the data aggregator that supports the Neuroscience Information Framework (NIF), has been extended to play a central role in automating the complex workflow required to support and coordinate the NIF's data integration capabilities. The NIF is an NIH Neuroscience Blueprint initiative designed to help researchers access the wealth of data related to the neurosciences available via the Internet. A central component is the NIF Federation, a searchable database that currently contains data from 231 data and information resources regularly harvested, updated, and warehoused in the DISCO system. In the past several years, DISCO has greatly extended its functionality and has evolved to play a central role in automating the complex, ongoing process of harvesting, validating, integrating, and displaying neuroscience data from a growing set of participating resources. This paper provides an overview of DISCO's current capabilities and discusses a number of the challenges and future directions related to the process of coordinating the integration of neuroscience data within the NIF Federation.

Medical aspects of pediatric rehabilitation after moderate to severe traumatic brain injury.

PubMed

Cantore, Lisa; Norwood, Kenneth; Patrick, Peter

2012-01-01

Recovery from severe traumatic brain injury (TBI) is prolonged, complicated and challenging. Medical rehabilitation is the bridge from acute medical care and stabilization to community reintegration. The process of caring for the recovering brain introduces unknown challenges of neural plasticity with demands to restore and to also move the child and family back to the developmental trajectory they once knew. While the ongoing focus is to maintain and advance medical stability, co- morbid conditions are addressed, and a plan for ongoing health is established. While no one manuscript can cover all of the medical aspects, this article will present in a "systems review" manner the most challenging and demanding medical conditions that children may confront following severe brain injury.

Mobile Phones in Research and Treatment: Ethical Guidelines and Future Directions

PubMed Central

Liddle, Jacki; Hall, Wayne; Chenery, Helen

2015-01-01

Mobile phones and other remote monitoring devices, collectively referred to as "mHealth," promise to transform the treatment of a range of conditions, including movement disorders, such as Parkinson’s disease. In this viewpoint paper, we use Parkinson’s disease as an example, although most considerations discussed below are valid for a wide variety of conditions. The ability to easily collect vast arrays of personal data over long periods will give clinicians and researchers unique insights into disease treatment and progression. These capabilities also pose new ethical challenges that health care professionals will need to manage if this promise is to be realized with minimal risk of harm. These challenges include privacy protection when anonymity is not always possible, minimization of third-party uses of mHealth data, informing patients of complex risks when obtaining consent, managing data in ways that maximize benefit while minimizing the potential for disclosure to third parties, careful communication of clinically relevant information gleaned via mHealth technologies, and rigorous evaluation and regulation of mHealth products before widespread use. Given the complex array of symptoms and differences in comfort and literacy with technology, it is likely that these solutions will need to be individualized. It is therefore critical that developers of mHealth apps engage with patients throughout the development process to ensure that the technology meets their needs. These challenges will be best met through early and ongoing engagement with patients and other relevant stakeholders. PMID:26474545

Scaling up ART adherence clubs in the public sector health system in the Western Cape, South Africa: a study of the institutionalisation of a pilot innovation.

PubMed

MacGregor, Hayley; McKenzie, Andrew; Jacobs, Tanya; Ullauri, Angelica

2018-04-25

In 2011, a decision was made to scale up a pilot innovation involving 'adherence clubs' as a form of differentiated care for HIV positive people in the public sector antiretroviral therapy programme in the Western Cape Province of South Africa. In 2016 we were involved in the qualitative aspect of an evaluation of the adherence club model, the overall objective of which was to assess the health outcomes for patients accessing clubs through epidemiological analysis, and to conduct a health systems analysis to evaluate how the model of care performed at scale. In this paper we adopt a complex adaptive systems lens to analyse planned organisational change through intervention in a state health system. We explore the challenges associated with taking to scale a pilot that began as a relatively simple innovation by a non-governmental organisation. Our analysis reveals how a programme initially representing a simple, unitary system in terms of management and clinical governance had evolved into a complex, differentiated care system. An innovation that was assessed as an excellent idea and received political backing, worked well whilst supported on a small scale. However, as scaling up progressed, challenges have emerged at the same time as support has waned. We identified a 'tipping point' at which the system was more likely to fail, as vulnerabilities magnified and the capacity for adaptation was exceeded. Yet the study also revealed the impressive capacity that a health system can have for catalysing novel approaches. We argue that innovation in largescale, complex programmes in health systems is a continuous process that requires ongoing support and attention to new innovation as challenges emerge. Rapid scaling up is also likely to require recourse to further resources, and a culture of iterative learning to address emerging challenges and mitigate complex system errors. These are necessary steps to the future success of adherence clubs as a cornerstone of differentiated care. Further research is needed to assess the equity and quality outcomes of a differentiated care model and to ensure the inclusive distribution of the benefits to all categories of people living with HIV.

Medicine, madness and murderers: the context of English forensic psychiatric hospitals.

PubMed

McDonald, Ruth; Furtado, Vivek; Völlm, Birgit

2017-08-21

Purpose The purpose of this paper is to add to the understanding of context by shedding light on the relationship between context and organisational actors' abilities to resolve ongoing challenges. Design/methodology/approach The authors used qualitative data collection (interviews and focus groups with staff and site visits to English forensic psychiatry hospitals) and the analysis was informed by Lefebvre's writings on space. Findings Responses to ongoing challenges were both constrained and facilitated by the context, which was negotiated and co-produced by the actors involved. Various (i.e. societal and professional) dimensions of context interacted to create tensions, which resulted in changes in service configuration. These changes were reconciled, to some extent, via discourse. Despite some resolution, the co-production of context preserved contradictions which mean that ongoing challenges were modified, but not resolved entirely. Originality/value The paper highlights the importance of viewing context as co-produced in a continuous manner. This helps us to delineate and understand its dynamic nature and its relationship with the everyday actions and beliefs of the organisational actors concerned.

The Google Online Marketing Challenge and Research Opportunities

ERIC Educational Resources Information Center

Neale, Larry; Treiblmaier, Horst; Henderson, Vani; Hunter, Lee; Hudson, Karen; Murphy, Jamie

2009-01-01

The Google Online Marketing Challenge is an ongoing collaboration between Google and academics, to give students experiential learning. The Challenge gives student teams US$200 in AdWords, Google's flagship advertising product, to develop online marketing campaigns for actual businesses. The end result is an engaging in-class exercise that…

The Challenges and Opportunities of Residence Hall Facilities.

ERIC Educational Resources Information Center

Thaler-Carter, Ruth E.

2001-01-01

Explores the challenges facing college and university residence hall facility managers and how different schools address these issues in diverse ways. Ongoing concerns involving funding needs and maintenance are examined followed by discussions on the new challenges in managing student life, health, and safety. Concluding comments reveal where…

Design and Implementation of a Randomized Controlled Trial of Genomic Counseling for Patients with Chronic Disease

PubMed Central

Sweet, Kevin; Gordon, Erynn S.; Sturm, Amy C.; Schmidlen, Tara J.; Manickam, Kandamurugu; Toland, Amanda Ewart; Keller, Margaret A.; Stack, Catharine B.; García-España, J. Felipe; Bellafante, Mark; Tayal, Neeraj; Embi, Peter; Binkley, Philip; Hershberger, Ray E.; Sadee, Wolfgang; Christman, Michael; Marsh, Clay

2014-01-01

We describe the development and implementation of a randomized controlled trial to investigate the impact of genomic counseling on a cohort of patients with heart failure (HF) or hypertension (HTN), managed at a large academic medical center, the Ohio State University Wexner Medical Center (OSUWMC). Our study is built upon the existing Coriell Personalized Medicine Collaborative (CPMC®). OSUWMC patient participants with chronic disease (CD) receive eight actionable complex disease and one pharmacogenomic test report through the CPMC® web portal. Participants are randomized to either the in-person post-test genomic counseling—active arm, versus web-based only return of results—control arm. Study-specific surveys measure: (1) change in risk perception; (2) knowledge retention; (3) perceived personal control; (4) health behavior change; and, for the active arm (5), overall satisfaction with genomic counseling. This ongoing partnership has spurred creation of both infrastructure and procedures necessary for the implementation of genomics and genomic counseling in clinical care and clinical research. This included creation of a comprehensive informed consent document and processes for prospective return of actionable results for multiple complex diseases and pharmacogenomics (PGx) through a web portal, and integration of genomic data files and clinical decision support into an EPIC-based electronic medical record. We present this partnership, the infrastructure, genomic counseling approach, and the challenges that arose in the design and conduct of this ongoing trial to inform subsequent collaborative efforts and best genomic counseling practices. PMID:24926413

Biological network extraction from scientific literature: state of the art and challenges.

PubMed

Li, Chen; Liakata, Maria; Rebholz-Schuhmann, Dietrich

2014-09-01

Networks of molecular interactions explain complex biological processes, and all known information on molecular events is contained in a number of public repositories including the scientific literature. Metabolic and signalling pathways are often viewed separately, even though both types are composed of interactions involving proteins and other chemical entities. It is necessary to be able to combine data from all available resources to judge the functionality, complexity and completeness of any given network overall, but especially the full integration of relevant information from the scientific literature is still an ongoing and complex task. Currently, the text-mining research community is steadily moving towards processing the full body of the scientific literature by making use of rich linguistic features such as full text parsing, to extract biological interactions. The next step will be to combine these with information from scientific databases to support hypothesis generation for the discovery of new knowledge and the extension of biological networks. The generation of comprehensive networks requires technologies such as entity grounding, coordination resolution and co-reference resolution, which are not fully solved and are required to further improve the quality of results. Here, we analyse the state of the art for the extraction of network information from the scientific literature and the evaluation of extraction methods against reference corpora, discuss challenges involved and identify directions for future research. © The Author 2013. Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Changing therapeutic paradigms in CMV retinitis in AIDS.

PubMed

Piper, H; Ciulla, T A; Danis, R P; Pratt, L M

2000-12-01

Cytomegalovirus (CMV) retinitis is a common ocular complication of immunosuppression. The management of CMV retinitis has been continuously evolving over the last decade. The mainstay of therapy remains ganciclovir and foscarnet. However, increasing resistance and ongoing toxicities to these agents remain a challenge. Additional frequently utilised agents include cidofovir and fomivirsen. The advent of highly active antiretroviral therapy (HAART) has allowed the restoration of immunocompetency to many patients previously challenged by CMV infection. In some circumstances, HAART has even eliminated the need for ongoing antiviral therapy. This paper reviews the current treatment modalities, including their toxicities and dosing recommendations.

An innovative large scale integration of silicon nanowire-based field effect transistors

NASA Astrophysics Data System (ADS)

Legallais, M.; Nguyen, T. T. T.; Mouis, M.; Salem, B.; Robin, E.; Chenevier, P.; Ternon, C.

2018-05-01

Since the early 2000s, silicon nanowire field effect transistors are emerging as ultrasensitive biosensors while offering label-free, portable and rapid detection. Nevertheless, their large scale production remains an ongoing challenge due to time consuming, complex and costly technology. In order to bypass these issues, we report here on the first integration of silicon nanowire networks, called nanonet, into long channel field effect transistors using standard microelectronic process. A special attention is paid to the silicidation of the contacts which involved a large number of SiNWs. The electrical characteristics of these FETs constituted by randomly oriented silicon nanowires are also studied. Compatible integration on the back-end of CMOS readout and promising electrical performances open new opportunities for sensing applications.

Considerations and benefits of implementing an online database tool for business continuity.

PubMed

Mackinnon, Susanne; Pinette, Jennifer

2016-01-01

In today's challenging climate of ongoing fiscal restraints, limited resources and complex organisational structures there is an acute need to investigate opportunities to facilitate enhanced delivery of business continuity programmes while maintaining or increasing acceptable levels of service delivery. In 2013, Health Emergency Management British Columbia (HEMBC), responsible for emergency management and business continuity activities across British Columbia's health sector, transitioned its business continuity programme from a manual to automated process with the development of a customised online database, known as the Health Emergency Management Assessment Tool (HEMAT). Key benefits to date include a more efficient business continuity input process, immediate situational awareness for use in emergency response and/or advanced planning and streamlined analyses for generation of reports.

Usability of Security Management:Defining the Permissions of Guests

NASA Astrophysics Data System (ADS)

Johnson, Matthew; Stajano, Frank

Within the scenario of a Smart Home, we discuss the issues involved in allowing limited interaction with the environment for unidentified principals, or guests. The challenges include identifying and authenticating guests on one hand and delegating authorization to them on the other. While the technical mechanisms for doing so in generic distributed systems have been around for decades, existing solutions are in general not applicable to the smart home because they are too complex to manage. We focus on providing both security and usability; we therefore seek simple and easy to understand approaches that can be used by a normal computer-illiterate home owner, not just by a trained system administrator. This position paper describes ongoing research and does not claim to have all the answers.

Diversity in the US Infectious Diseases Workforce: Challenges for Women and Underrepresented Minorities.

PubMed

Aberg, Judith A; Blankson, Joel; Marrazzo, Jeanne; Adimora, Adaora A

2017-09-15

Research documents significant gender-based salary inequities among physicians and ongoing inadequacies in recruitment and promotion of physicians from underrepresented minority groups. Given the complexity of the social forces that promote these disparities, their elimination will likely require quantitative and qualitative research to understand the pathways that lead to them and to develop effective solutions. Interventions to combat implicit bias will be required, and structural interventions that hold medical school leadership accountable are needed to achieve and maintain salary equity and racial and gender diversity at all levels. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Is gene therapy a good therapeutic approach for HIV-positive patients?

PubMed Central

Marathe, Jai G; Wooley, Dawn P

2007-01-01

Despite advances and options available in gene therapy for HIV-1 infection, its application in the clinical setting has been challenging. Although published data from HIV-1 clinical trials show safety and proof of principle for gene therapy, positive clinical outcomes for infected patients have yet to be demonstrated. The cause for this slow progress may arise from the fact that HIV is a complex multi-organ system infection. There is uncertainty regarding the types of cells to target by gene therapy and there are issues regarding insufficient transduction of cells and long-term expression. This paper discusses state-of-the-art molecular approaches against HIV-1 and the application of these treatments in current and ongoing clinical trials. PMID:17300725

Recent progress in chemical and chemoenzymatic synthesis of carbohydrates.

PubMed

Muthana, Saddam; Cao, Hongzhi; Chen, Xi

2009-12-01

The important roles that carbohydrates play in biological processes and their potential application in diagnosis, therapeutics, and vaccine development have made them attractive synthetic targets. Despite ongoing challenges, tremendous progresses have been made in recent years for the synthesis of carbohydrates. The chemical glycosylation methods have become more sophisticated and the synthesis of oligosaccharides has become more predictable. Simplified one-pot glycosylation strategy and automated synthesis are increasingly used to obtain biologically important glycans. On the other hand, chemoenzymatic synthesis continues to be a powerful alternative for obtaining complex carbohydrates. This review highlights recent progress in chemical and chemoenzymatic synthesis of carbohydrates with a particular focus on the methods developed for the synthesis of oligosaccharides, polysaccharides, glycolipids, and glycosylated natural products.

Recent Progress in Chemical and Chemoenzymatic Synthesis of Carbohydrates

PubMed Central

Muthana, Saddam; Cao, Hongzhi; Chen, Xi

2011-01-01

Summary The important roles that carbohydrates play in biological processes and their potential application in diagnosis, therapeutics, and vaccine development have made them attractive synthetic targets. Despite ongoing challenges, tremendous progresses have been made in recent years for the synthesis of carbohydrates. The chemical glycosylation methods have become more sophisticated and the synthesis of oligosaccharides has become more predictable. Simplified one-pot glycosylation strategy and automated synthesis are increasingly used to obtain biologically important glycans. On the other hand, chemoenzymatic synthesis continues to be a powerful alternative for obtaining complex carbohydrates. This review highlights recent progress in chemical and chemoenzymatic synthesis of carbohydrates with a particular focus on the methods developed for the synthesis of oligosaccharides, polysaccharides, glycolipids, and glycosylated natural products. PMID:19833544

Software Configurable Multichannel Transceiver

NASA Technical Reports Server (NTRS)

Freudinger, Lawrence C.; Cornelius, Harold; Hickling, Ron; Brooks, Walter

2009-01-01

Emerging test instrumentation and test scenarios increasingly require network communication to manage complexity. Adapting wireless communication infrastructure to accommodate challenging testing needs can benefit from reconfigurable radio technology. A fundamental requirement for a software-definable radio system is independence from carrier frequencies, one of the radio components that to date has seen only limited progress toward programmability. This paper overviews an ongoing project to validate the viability of a promising chipset that performs conversion of radio frequency (RF) signals directly into digital data for the wireless receiver and, for the transmitter, converts digital data into RF signals. The Software Configurable Multichannel Transceiver (SCMT) enables four transmitters and four receivers in a single unit the size of a commodity disk drive, programmable for any frequency band between 1 MHz and 6 GHz.

Telerehabilitation clinical and vocational applications for assistive technology: research, opportunities, and challenges.

PubMed

Schmeler, Mark R; Schein, Richard M; McCue, Michael; Betz, Kendra

2009-01-01

Rehabilitation service providers in rural or underserved areas are often challenged in meeting the needs of their complex patients due to limited resources in their geographical area. Recruitment and retention of the rural clinical workforce are beset by the ongoing problems associated with limited continuing education opportunities, professional isolation, and the challenges inherent in coordinating rural community healthcare. People with disabilities who live in rural communities also face challenges accessing healthcare. Traveling long distances to a specialty clinic for necessary expertise may be troublesome due to inadequate or unavailable transportation, disability specific limitations, and financial limitations. Distance and lack of access are just two threats to quality of care that now being addressed by the use of videoconferencing, information exchange, and other telecommunication technologies that facilitate telerehabilitation. This white paper illustrates and summarizes clinical and vocational applications of telerehabilitation. We provide definitions related to the fields of telemedicine, telehealth, and telerehabilitation, and consider the impetus for telerehabilitation. We review the telerehabilitation literature for assistive technology applications; pressure ulcer prevention; virtual reality applications; speech-language pathology applications; seating and wheeled mobility applications; vocational rehabilitation applications; and cost-effectiveness. We then discuss external telerehabilitation influencers, such as the positions of professional organizations. Finally, we summarize clinical and policy issues in a limited context appropriate to the scope of this paper.

Challenges in managing elderly people with diabetes in primary care settings in Norway

PubMed Central

2013-01-01

Abstract Objective To explore the experiences and clinical challenges that nurses and nursing assistants face when providing high-quality diabetes-specific management and care for elderly people with diabetes in primary care settings. Design Focus-group interviews. Subjects and setting Sixteen health care professionals: 12 registered nurses and four nursing assistants from nursing homes (10), district nursing service (5), and a service unit (1) were recruited by municipal managers who had local knowledge and knew the workforce. All the participants were women aged 32–59 years with clinical experience ranging from 1.5 to 38 years. Results Content analysis revealed a discrepancy between the level of expertise which the participants described as important to delivering high-quality care and their capacity to deliver such care. The discrepancy was due to lack of availability and access to current information, limited ongoing support, lack of cohesion among health care professionals, and limited confidence and autonomy. Challenges to delivering high-quality care included complex, difficult patient situations and lack of confidence to make decisions founded on evidence-based guidelines. Conclusion Participants lacked confidence and autonomy to manage elderly people with diabetes in municipal care settings. Lack of information, support, and professional cohesion made the role challenging. PMID:24205973

Robotic System for Condition Assessment of Concrete Bridge Decks : Data Driven Decisions [Tech Brief

DOT National Transportation Integrated Search

2012-12-11

In the United States, the stewardship and management of approximately 599,000 bridges present ongoing planning, operational, maintenance, and economic challenges for Federal, State, and local transportation agencies. To help overcome these challenges...

Multisensory integration mechanisms during aging

PubMed Central

Freiherr, Jessica; Lundström, Johan N.; Habel, Ute; Reetz, Kathrin

2013-01-01

The rapid demographical shift occurring in our society implies that understanding of healthy aging and age-related diseases is one of our major future challenges. Sensory impairments have an enormous impact on our lives and are closely linked to cognitive functioning. Due to the inherent complexity of sensory perceptions, we are commonly presented with a complex multisensory stimulation and the brain integrates the information from the individual sensory channels into a unique and holistic percept. The cerebral processes involved are essential for our perception of sensory stimuli and becomes especially important during the perception of emotional content. Despite ongoing deterioration of the individual sensory systems during aging, there is evidence for an increase in, or maintenance of, multisensory integration processing in aging individuals. Within this comprehensive literature review on multisensory integration we aim to highlight basic mechanisms and potential compensatory strategies the human brain utilizes to help maintain multisensory integration capabilities during healthy aging to facilitate a broader understanding of age-related pathological conditions. Further our goal was to identify where further research is needed. PMID:24379773

Race, Socioeconomic Status and Health: Complexities, Ongoing Challenges and Research Opportunities

PubMed Central

Williams, David R.; Mohammed, Selina A.; Leavell, Jacinta; Collins, Chiquita

2012-01-01

This paper provides an overview of racial variations in health and shows that differences in socioeconomic status (SES) across racial groups are a major contributor to racial disparities in health. However, race reflects multiple dimensions of social inequality and individual and household indicators of SES capture relevant but limited aspects of this phenomenon. Research is needed that will comprehensively characterize the critical pathogenic features of social environments and identify how they combine with each other to affect health over the life course. Migration history and status are also important predictors of health and research is needed that will enhance understanding of the complex ways in which race, SES, and immigrant status combine to affect health. Fully capturing the role of race in health also requires rigorous examination of the conditions under which medical care and genetic factors can contribute to racial and SES differences in health. The paper identifies research priorities in all of these areas. PMID:20201869

Single-cell sequencing and tumorigenesis: improved understanding of tumor evolution and metastasis.

PubMed

Ellsworth, Darrell L; Blackburn, Heather L; Shriver, Craig D; Rabizadeh, Shahrooz; Soon-Shiong, Patrick; Ellsworth, Rachel E

2017-12-01

Extensive genomic and transcriptomic heterogeneity in human cancer often negatively impacts treatment efficacy and survival, thus posing a significant ongoing challenge for modern treatment regimens. State-of-the-art DNA- and RNA-sequencing methods now provide high-resolution genomic and gene expression portraits of individual cells, facilitating the study of complex molecular heterogeneity in cancer. Important developments in single-cell sequencing (SCS) technologies over the past 5 years provide numerous advantages over traditional sequencing methods for understanding the complexity of carcinogenesis, but significant hurdles must be overcome before SCS can be clinically useful. In this review, we: (1) highlight current methodologies and recent technological advances for isolating single cells, single-cell whole-genome and whole-transcriptome amplification using minute amounts of nucleic acids, and SCS, (2) summarize research investigating molecular heterogeneity at the genomic and transcriptomic levels and how this heterogeneity affects clonal evolution and metastasis, and (3) discuss the promise for integrating SCS in the clinical care arena for improved patient care.

CERN openlab: Engaging industry for innovation in the LHC Run 3-4 R&D programme

NASA Astrophysics Data System (ADS)

Girone, M.; Purcell, A.; Di Meglio, A.; Rademakers, F.; Gunne, K.; Pachou, M.; Pavlou, S.

2017-10-01

LHC Run3 and Run4 represent an unprecedented challenge for HEP computing in terms of both data volume and complexity. New approaches are needed for how data is collected and filtered, processed, moved, stored and analysed if these challenges are to be met with a realistic budget. To develop innovative techniques we are fostering relationships with industry leaders. CERN openlab is a unique resource for public-private partnership between CERN and leading Information Communication and Technology (ICT) companies. Its mission is to accelerate the development of cutting-edge solutions to be used by the worldwide HEP community. In 2015, CERN openlab started its phase V with a strong focus on tackling the upcoming LHC challenges. Several R&D programs are ongoing in the areas of data acquisition, networks and connectivity, data storage architectures, computing provisioning, computing platforms and code optimisation and data analytics. This paper gives an overview of the various innovative technologies that are currently being explored by CERN openlab V and discusses the long-term strategies that are pursued by the LHC communities with the help of industry in closing the technological gap in processing and storage needs expected in Run3 and Run4.

Verification Challenges at Low Numbers

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

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

2013-07-16

This paper will explore the difficulties of deep reductions by examining the technical verification challenges. At each step on the road to low numbers, the verification required to ensure compliance of all parties will increase significantly. Looking post New START, the next step will likely include warhead limits in the neighborhood of 1000 (Pifer 2010). Further reductions will include stepping stones at 100’s of warheads, and then 10’s of warheads before final elimination could be considered of the last few remaining warheads and weapons. This paper will focus on these three threshold reduction levels, 1000, 100’s, 10’s. For each, themore » issues and challenges will be discussed, potential solutions will be identified, and the verification technologies and chain of custody measures that address these solutions will be surveyed. It is important to note that many of the issues that need to be addressed have no current solution. In these cases, the paper will explore new or novel technologies that could be applied. These technologies will draw from the research and development that is ongoing throughout the national lab complex, and will look at technologies utilized in other areas of industry for their application to arms control verification.« less

Supporting the Thesis Writing Process of International Research Students through an Ongoing Writing Group

ERIC Educational Resources Information Center

Li, Linda Y.; Vandermensbrugghe, Joelle

2011-01-01

Evidence from research suggests writing support is particularly needed for international research students who have to tackle the challenges of thesis writing in English as their second language in Western academic settings. This article reports the development of an ongoing writing group to support the thesis writing process of international…

Supporting Children with Developmental Challenges.

ERIC Educational Resources Information Center

Brand, Marie

1998-01-01

Examines strategies for developing challenging but appropriate programs for children with disabilities. Discusses the importance of identifying and understanding the particular needs of individual children; developing appropriate routines; maintaining ongoing communication with, and the involvement of, family members; and playing an active support…

The Impact of Evidence-Based Practice Implementation and Fidelity Monitoring on Staff Turnover: Evidence for a Protective Effect

ERIC Educational Resources Information Center

Aarons, Gregory A.; Sommerfeld, David H.; Hecht, Debra B.; Silovsky, Jane F.; Chaffin, Mark J.

2009-01-01

Staff retention is an ongoing challenge in mental health and community-based service organizations. Little is known about the impact of evidence-based practice implementation on the mental health and social service workforce. The present study examined the effect of evidence-based practice implementation and ongoing fidelity monitoring on staff…

The MOOC and Learning Analytics Innovation Cycle (MOLAC): A Reflective Summary of Ongoing Research and Its Challenges

ERIC Educational Resources Information Center

Drachsler, H.; Kalz, M.

2016-01-01

The article deals with the interplay between learning analytics and massive open online courses (MOOCs) and provides a conceptual framework to situate ongoing research in the MOOC and learning analytics innovation cycle (MOLAC framework). The MOLAC framework is organized on three levels: On the micro-level, the data collection and analytics…

The national response for preventing healthcare-associated infections: research and adoption of prevention practices.

PubMed

Kahn, Katherine L; Mendel, Peter; Leuschner, Kristin J; Hiatt, Liisa; Gall, Elizabeth M; Siegel, Sari; Weinberg, Daniel A

2014-02-01

Healthcare-associated infections (HAIs) have long been the subject of research and prevention practice. When findings show potential to significantly impact outcomes, clinicians, policymakers, safety experts, and stakeholders seek to bridge the gap between research and practice by identifying mechanisms and assigning responsibility for translating research to practice. This paper describes progress and challenges in HAI research and prevention practices, as explained through an examination of Health and Human Services (HHS) Action Plan's goals, inputs, and implementation in each area. We used the Context-Input-Process-Product evaluation model, together with an HAI prevention system framework, to assess the transformative processes associated with HAI research and adoption of prevention practices. Since the introduction of the Action Plan, HHS has made substantial progress in prioritizing research projects, translating findings from those projects into practice, and designing and implementing research projects in multisite practice settings. Research has emphasized the basic science and epidemiology of HAIs, the identification of gaps in research, and implementation science. The basic, epidemiological, and implementation science communities have joined forces to better define mechanisms and responsibilities for translating HAI research into practice. Challenges include the ongoing need for better evidence about intervention effectiveness, the growing implementation burden on healthcare providers and organizations, and challenges implementing certain practices. Although these HAI research and prevention practice activities are complex spanning multiple system functions and properties, HHS is making progress so that the right methods for addressing complex HAI problems at the interface of patient safety and clinical practice can emerge.

Hunting down the chimera of multiple disciplinarity in conservation science.

PubMed

Pooley, Simon P; Mendelsohn, J Andrew; Milner-Gulland, E J

2014-02-01

The consensus is that both ecological and social factors are essential dimensions of conservation research and practice. However, much of the literature on multiple disciplinary collaboration focuses on the difficulties of undertaking it. This review of the challenges of conducting multiple disciplinary collaboration offers a framework for thinking about the diversity and complexity of this endeavor. We focused on conceptual challenges, of which 5 main categories emerged: methodological challenges, value judgments, theories of knowledge, disciplinary prejudices, and interdisciplinary communication. The major problems identified in these areas have proved remarkably persistent in the literature surveyed (c.1960-2012). Reasons for these failures to learn from past experience include the pressure to produce positive outcomes and gloss over disagreements, the ephemeral nature of many such projects and resulting lack of institutional memory, and the apparent complexity and incoherence of the endeavor. We suggest that multiple disciplinary collaboration requires conceptual integration among carefully selected multiple disciplinary team members united in investigating a shared problem or question. We outline a 9-point sequence of steps for setting up a successful multiple disciplinary project. This encompasses points on recruitment, involving stakeholders, developing research questions, negotiating power dynamics and hidden values and conceptual differences, explaining and choosing appropriate methods, developing a shared language, facilitating on-going communications, and discussing data integration and project outcomes. Although numerous solutions to the challenges of multiple disciplinary research have been proposed, lessons learned are often lost when projects end or experienced individuals move on. We urge multiple disciplinary teams to capture the challenges recognized, and solutions proposed, by their researchers while projects are in process. A database of well-documented case studies would showcase theories and methods from a variety of disciplines and their interactions, enable better comparative study and evaluation, and provide a useful resource for developing future projects and training multiple disciplinary researchers. © 2013 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

Hunting Down the Chimera of Multiple Disciplinarity in Conservation Science

PubMed Central

POOLEY, SIMON P; MENDELSOHN, J ANDREW; MILNER-GULLAND, E J

2014-01-01

The consensus is that both ecological and social factors are essential dimensions of conservation research and practice. However, much of the literature on multiple disciplinary collaboration focuses on the difficulties of undertaking it. This review of the challenges of conducting multiple disciplinary collaboration offers a framework for thinking about the diversity and complexity of this endeavor. We focused on conceptual challenges, of which 5 main categories emerged: methodological challenges, value judgments, theories of knowledge, disciplinary prejudices, and interdisciplinary communication. The major problems identified in these areas have proved remarkably persistent in the literature surveyed (c.1960–2012). Reasons for these failures to learn from past experience include the pressure to produce positive outcomes and gloss over disagreements, the ephemeral nature of many such projects and resulting lack of institutional memory, and the apparent complexity and incoherence of the endeavor. We suggest that multiple disciplinary collaboration requires conceptual integration among carefully selected multiple disciplinary team members united in investigating a shared problem or question. We outline a 9-point sequence of steps for setting up a successful multiple disciplinary project. This encompasses points on recruitment, involving stakeholders, developing research questions, negotiating power dynamics and hidden values and conceptual differences, explaining and choosing appropriate methods, developing a shared language, facilitating on-going communications, and discussing data integration and project outcomes. Although numerous solutions to the challenges of multiple disciplinary research have been proposed, lessons learned are often lost when projects end or experienced individuals move on. We urge multiple disciplinary teams to capture the challenges recognized, and solutions proposed, by their researchers while projects are in process. A database of well-documented case studies would showcase theories and methods from a variety of disciplines and their interactions, enable better comparative study and evaluation, and provide a useful resource for developing future projects and training multiple disciplinary researchers. PMID:24299167

[(H2O)(terpy)Mn(μ-O)2Mn(terpy)(OH2)](NO3)3 (terpy = 2,2′:6,2″-terpyridine) and its relevance to the oxygen-evolving complex of photosystem II examined through pH dependent cyclic voltametry

PubMed Central

Cady, Clyde W.; Shinopoulos, Katherine E.; Crabtree, Robert H.; Brudvig, Gary W.

2010-01-01

Photosynthetic water oxidation occurs naturally at a tetranuclear manganese center in the photosystem II protein complex. Synthetically mimicking this tetramanganese center, known as the oxygen-evolving complex (OEC), has been an ongoing challenge of bioinorganic chemistry. Most past efforts have centered on water-oxidation catalysis using chemical oxidants. However, solar energy applications have drawn attention to electrochemical methods. In this paper, we examine the electrochemical behavior of the biomimetic water-oxidation catalyst [(H2O)(terpy)Mn(μ-O)2Mn(terpy)(H2O)](NO3)3 [terpy = 2,2′:6′,2″-terpyridine] (1) in water under a variety of pH and buffered conditions and in the presence of acetate that binds to 1 in place of one of the terminal water ligands. These experiments will show that 1 not only exhibits proton-coupled electron-transfer reactivity analogous to the OEC, but also may be capable of electrochemical oxidation of water to oxygen. PMID:20372724

Communities of solution: partnerships for population health.

PubMed

Griswold, Kim S; Lesko, Sarah E; Westfall, John M

2013-01-01

Communities of solution (COSs) are the key principle for improving population health. The 1967 Folsom Report explains that the COS concept arose from the recognition that complex political and administrative structures often hinder problem solving by creating barriers to communication and compromise. A 2012 reexamination of the Folsom Report resurrects the idea of the COS and presents 13 grand challenges that define the critical links among community, public health, and primary care and call for ongoing demonstrations of COSs grounded in patient-centered care. In this issue, examples of COSs from around the country demonstrate core principles and propose visions of the future. Essential themes of each COS are the crossing of "jurisdictional boundaries," community-led or -oriented initiatives, measurement of outcomes, and creating durable connections with public health.

Professional Development Strategies to Enhance Nurses' Knowledge and Maintain Safe Practice.

PubMed

Bindon, Susan L

2017-08-01

Maintaining competence is a professional responsibility for nurses. Individual nurses are accountable for their practice, as outlined in the American Nurses Association's Nursing: Scope and Standards of Practice. Nurses across clinical settings face the sometimes daunting challenge of staying abreast of regulatory mandates, practice changes, equipment updates, and other workplace expectations. In the complex, evolving perioperative setting, professional development is a priority, and the need for ongoing education is critical. However, nurses' efforts to engage in their own development can be hampered by a lack of time, limited access to educational resources, or cost concerns. This article provides an overview of nursing professional development and offers some resources to help individual nurses maintain or enhance their knowledge, skills, and attitudes. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Data Acquisition and Linguistic Resources

NASA Astrophysics Data System (ADS)

Strassel, Stephanie; Christianson, Caitlin; McCary, John; Staderman, William; Olive, Joseph

All human language technology demands substantial quantities of data for system training and development, plus stable benchmark data to measure ongoing progress. While creation of high quality linguistic resources is both costly and time consuming, such data has the potential to profoundly impact not just a single evaluation program but language technology research in general. GALE's challenging performance targets demand linguistic data on a scale and complexity never before encountered. Resources cover multiple languages (Arabic, Chinese, and English) and multiple genres -- both structured (newswire and broadcast news) and unstructured (web text, including blogs and newsgroups, and broadcast conversation). These resources include significant volumes of monolingual text and speech, parallel text, and transcribed audio combined with multiple layers of linguistic annotation, ranging from word aligned parallel text and Treebanks to rich semantic annotation.

Funding emergency care: Australian style.

PubMed

Bell, Anthony; Crilly, Julia; Williams, Ged; Wylie, Kate; Toloo, Ghasem Sam; Burke, John; FitzGerald, Gerry

2014-08-01

The ongoing challenge for ED leaders is to remain abreast of system-wide changes that impact on the day-to-day management of their departments. Changes to the funding model creates another layer of complexity and this introductory paper serves as the beginning of a discussion about the way in which EDs are funded and how this can and will impact on business decisions, models of care and resource allocation within Australian EDs. Furthermore it is evident that any funding model today will mature and change with time, and moves are afoot to refine and contextualise ED funding over the medium term. This perspective seeks to provide a basis of understanding for our current and future funding arrangements in Australian EDs. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Dynamics of information diffusion and its applications on complex networks

NASA Astrophysics Data System (ADS)

Zhang, Zi-Ke; Liu, Chuang; Zhan, Xiu-Xiu; Lu, Xin; Zhang, Chu-Xu; Zhang, Yi-Cheng

2016-09-01

The ongoing rapid expansion of the Word Wide Web (WWW) greatly increases the information of effective transmission from heterogeneous individuals to various systems. Extensive research for information diffusion is introduced by a broad range of communities including social and computer scientists, physicists, and interdisciplinary researchers. Despite substantial theoretical and empirical studies, unification and comparison of different theories and approaches are lacking, which impedes further advances. In this article, we review recent developments in information diffusion and discuss the major challenges. We compare and evaluate available models and algorithms to respectively investigate their physical roles and optimization designs. Potential impacts and future directions are discussed. We emphasize that information diffusion has great scientific depth and combines diverse research fields which makes it interesting for physicists as well as interdisciplinary researchers.

Lentiviral and targeted cellular barcoding reveals ongoing clonal dynamics of cell lines in vitro and in vivo

PubMed Central

2014-01-01

Background Cell lines are often regarded as clonal, even though this simplifies what is known about mutagenesis, transformation and other processes that destabilize them over time. Monitoring these clonal dynamics is important for multiple areas of biomedical research, including stem cell and cancer biology. Tracking the contributions of individual cells to large populations, however, has been constrained by limitations in sensitivity and complexity. Results We utilize cellular barcoding methods to simultaneously track the clonal contributions of tens of thousands of cells. We demonstrate that even with optimal culturing conditions, common cell lines including HeLa, K562 and HEK-293 T exhibit ongoing clonal dynamics. Starting a population with a single clone diminishes but does not eradicate this phenomenon. Next, we compare lentiviral and zinc-finger nuclease barcode insertion approaches, finding that the zinc-finger nuclease protocol surprisingly results in reduced clonal diversity. We also document the expected reduction in clonal complexity when cells are challenged with genotoxic stress. Finally, we demonstrate that xenografts maintain clonal diversity to a greater extent than in vitro culturing of the human non-small-cell lung cancer cell line HCC827. Conclusions We demonstrate the feasibility of tracking and quantifying the clonal dynamics of entire cell populations within multiple cultured cell lines. Our results suggest that cell heterogeneity should be considered in the design and interpretation of in vitro culture experiments. Aside from clonal cell lines, we propose that cellular barcoding could prove valuable in modeling the clonal behavior of heterogeneous cell populations over time, including tumor populations treated with chemotherapeutic agents. PMID:24886633

Dua sakit (double sick): trauma and the settlement experiences of West Papuan refugees living in North Queensland.

PubMed

Rees, Susan; Silove, Derrick; Kareth, Moses

2009-08-01

There is mounting evidence of systematic abuses, including torture, rape and extrajudicial killings directed against independence activists as well as the civilian population in Indonesian occupied West Papua. Refugees from West Papua have sought safety in neighbouring Australia, experiencing hazardous journeys during their flight. We report early observations from a mental health study among West Papuan refugees living in North Queensland, Australia. The project includes qualitative methods aimed at gathering histories of trauma and human rights violations as well as standard mental health assessments and indices of acculturation and resettlement stresses. We consider the emerging data from the vantage point of the Adaptation and Development After Persecution and Trauma model that identifies five psychosocial domains that require repair following exposure to gross human rights violations and refugee trauma. The model emphasizes the inter-relatedness of key challenges, the compounding of adversity, and the bivalent effects of complex experiences, with both positive and negative elements shaping the adaptive trajectory of displaced persons. Refugee groups have their own approaches to conceptualizing the complexity of their problems, with the term dua sakit representing the expression used by West Papuans to identify the multiple challenges they face. The study highlights the importance of assessing each refugee group within its unique social and cultural context, taking into account such diverse factors as geographical location, employment, and ongoing conflict in the homeland in designing appropriate interventions.

Digital Workflows for Restoration and Management of the Museum Affandi - a Case Study in Challenging Circumstances

NASA Astrophysics Data System (ADS)

Herbig, U.; Styhler-Aydın, G.; Grandits, D.; Stampfer, L.; Pont, U.; Mayer, I.

2017-08-01

The appropriate restoration of architectural heritage needs a careful and comprehensive documentation of the existing structures, which even elaborates, if the function of the building needs special attention, like in museums. In a collaborative project between the Universitas Gadjah Mada, Yogyakarta, Indonesia and two universities in Austria (TU Wien and the Danube University Krems) a restoration and adaptation concept of the Affandi Museum in Yogyakarta is currently in progress. It provides a perfect case study for the development of a workflow to combine data from a building survey, architectural research, indoor climate measurements and the documentation of artwork in a challenging environment, from hot and humid tropical climate to continuous threads by natural hazards like earthquakes or volcanic eruptions. The Affandi Museum houses the collection of Affandi, who is considered to be Indonesia's foremost Expressionist painter and partly designed and constructed the museum by himself. With the spirit of the artist still perceptible in the complex the Affandi Museum is an important part of the Indonesian cultural heritage. Thus its preservation takes special attention and adds to the complexity of the development of a monitoring and maintenance concept. This paper describes the ongoing development of an approach to a workflow from the measurement and research of the objects, both architectural and artwork, to the semantically enriched BIM Model as the base for a sustainable monitoring tool for the Affandi Museum.

The opportunities and obstacles in developing a vascular birthmark database for clinical and research use.

PubMed

Sharma, Vishal K; Fraulin, Frankie Og; Harrop, A Robertson; McPhalen, Donald F

2011-01-01

Databases are useful tools in clinical settings. The authors review the benefits and challenges associated with the development and implementation of an efficient electronic database for the multidisciplinary Vascular Birthmark Clinic at the Alberta Children's Hospital, Calgary, Alberta. The content and structure of the database were designed using the technical expertise of a data analyst from the Calgary Health Region. Relevant clinical and demographic data fields were included with the goal of documenting ongoing care of individual patients, and facilitating future epidemiological studies of this patient population. After completion of this database, 10 challenges encountered during development were retrospectively identified. Practical solutions for these challenges are presented. THE CHALLENGES IDENTIFIED DURING THE DATABASE DEVELOPMENT PROCESS INCLUDED: identification of relevant data fields; balancing simplicity and user-friendliness with complexity and comprehensive data storage; database expertise versus clinical expertise; software platform selection; linkage of data from the previous spreadsheet to a new data management system; ethics approval for the development of the database and its utilization for research studies; ensuring privacy and limited access to the database; integration of digital photographs into the database; adoption of the database by support staff in the clinic; and maintaining up-to-date entries in the database. There are several challenges involved in the development of a useful and efficient clinical database. Awareness of these potential obstacles, in advance, may simplify the development of clinical databases by others in various surgical settings.

Challenges to the Transdisciplinarity of Climate Services: A Coffee Farming Case from Jamaica's Blue Mountains

NASA Astrophysics Data System (ADS)

Guido, Z.

2017-12-01

Climate information is heralded as helping to build adaptive capacity, improve resource management, and contribute to more effective risk management. However, decision makers often find it challenging to use climate information for reasons attributed to a disconnect between technical experts who produce the information and end users. Consequently, many climate service projects are now applying an end-to-end approach that links information users and producers in the design, development, and delivery of services. This collaboration confronts obstacles that can undermine the objectives of the project. Despite this, few studies in the burgeoning field of climate services have assessed the challenges. To address this gap, I provide a reflective account and analysis of the collaborative challenges experienced in an ongoing, complex four-year project developing climate services for small-scale coffee producers in Jamaica. The project has involved diverse activities, including social data collection, research and development of information tools, periodic engagement with coffee sector representatives, and community-based trainings. Contributions to the project were made routinely by 18 individuals who represent 9 institutions located in three countries. These individuals work for academic and governmental organizations and bring expertise in anthropology, plant pathology, and climatology, among others. In spanning diverse disciplines, large geographic distances, and different cultures, the project team has navigated challenges in communication, problem framing, organizational agendas, disciplinary integration, and project management. I contextualize these experiences within research on transdisciplinary and team science, and share some perspectives on strategies to lessen their impact.

DEVELOPMENT OF CFD SIMULATION APPLICATIONS FOR LOCAL-SCALE AREAS AND POTENTIAL INTERFACE WITH MESOSCALE MODELS

EPA Science Inventory

The presentation summarizes developments of ongoing applications of fine-scale (geometry specific) CFD simulations to urban areas within atmospheric boundary layers. Enabling technology today and challenges for the future are discussed. There is a challenging need to develop a ...

Community-Based Research Assessments: Some Principles and Practices.

ERIC Educational Resources Information Center

Marullo, Sam; Cooke, Deanna; Willis, Jason; Rollins, Alexandra; Burke, Jacqueline; Bonilla, Paul; Waldref, Vanessa

2003-01-01

Examines benefits and challenges of undertaking assessments in community-based research (CBR). Such assessments are compared and contrasted to more traditional research processes. Further, the challenges of integrating CBR assessments into an ongoing social change initiative are analyzed. Five principles to guide CBR assessments are articulated. A…

People with Learning Disabilities and "Active Ageing"

ERIC Educational Resources Information Center

Foster, Liam; Boxall, Kathy

2015-01-01

Background: People (with and without learning disabilities) are living longer. Demographic ageing creates challenges and the leading policy response to these challenges is "active ageing". "Active" does not just refer to the ability to be physically and economically active, but also includes ongoing social and civic engagement…

Identifying pathways for improving household food self-sufficiency outcomes in the hills of Nepal

USDA-ARS?s Scientific Manuscript database

Maintaining and improving food security in mountain regions is an ongoing challenge. There are many facets to the problem, including comparatively high levels of system diversity and crop-livestock integration, challenging terrain and transportation bottlenecks, declining labor availability due to o...

Telerehabilitation Clinical and Vocational Applications for Assistive Technology: Research, Opportunities, and Challenges

PubMed Central

Schmeler, Mark R.; Schein, Richard M.; McCue, Michael; Betz, Kendra

2009-01-01

Rehabilitation service providers in rural or underserved areas are often challenged in meeting the needs of their complex patients due to limited resources in their geographical area. Recruitment and retention of the rural clinical workforce are beset by the ongoing problems associated with limited continuing education opportunities, professional isolation, and the challenges inherent in coordinating rural community healthcare. People with disabilities who live in rural communities also face challenges accessing healthcare. Traveling long distances to a specialty clinic for necessary expertise may be troublesome due to inadequate or unavailable transportation, disability specific limitations, and financial limitations. Distance and lack of access are just two threats to quality of care that now being addressed by the use of videoconferencing, information exchange, and other telecommunication technologies that facilitate telerehabilitation. This white paper illustrates and summarizes clinical and vocational applications of telerehabilitation. We provide definitions related to the fields of telemedicine, telehealth, and telerehabilitation, and consider the impetus for telerehabilitation. We review the telerehabilitation literature for assistive technology applications; pressure ulcer prevention; virtual reality applications; speech-language pathology applications; seating and wheeled mobility applications; vocational rehabilitation applications; and cost-effectiveness. We then discuss external telerehabilitation influencers, such as the positions of professional organizations. Finally, we summarize clinical and policy issues in a limited context appropriate to the scope of this paper. PMID:25945163

Challenges And Lessons Learned From Communities Using Evidence To Adopt Strategies To Improve Healthy Food Environments.

PubMed

Willems Van Dijk, Julie A; Catlin, Bridget; Cofsky, Abbey; Carroll, Carrie

2015-11-01

Communities across the United States are increasingly tackling the complex task of changing their local environments and cultures to improve access to and consumption of healthy food. Communities that have received the Robert Wood Johnson Foundation Culture of Health Prize have deployed numerous evidence-informed strategies to enhance their local food environments. Their experiences can provide lessons for other communities working to improve health. In this article we examine how the prize-winning communities worked in a multidisciplinary collective manner to implement evidence-based strategies, deployed suites of strategies to expand the reach of food-related work, balanced evidence against innovation, and measured their own progress. Most of the communities also faced challenges in using evidence effectively to implement strategies to promote healthy food environments. Policy makers can accelerate the adoption of evidence-informed approaches related to food and health by embedding them in program standards and funding requirements. Establishing opportunities for ongoing training to enhance community practitioners' evaluation skills and collaborative leadership would also improve the effectiveness of community implementation of these strategies. Project HOPE—The People-to-People Health Foundation, Inc.

Path of infectious diseases in Brazil in the last 50 years: an ongoing challenge

PubMed Central

Waldman, Eliseu Alves; Sato, Ana Paula Sayuri

2016-01-01

ABSTRACT In this article, we comment on the main features of infectious diseases in Brazil in the last 50 years, highlighting how much of this path Revista de Saúde Pública could portray. From 1967 to 2016, 1,335 articles focusing on infectious diseases were published in Revista de Saúde Pública. Although the proportion of articles on the topic have decreased from about 50.0% to 15.0%, its notability remained and reflected the growing complexity of the research required for its control. It is noteworthy that studies design and analysis strategies progressively became more sophisticated, following the great development of epidemiology in Brazil in the recent decades. Thus, the journal has followed the success of public health interventions that permitted to control or eliminate numerous infectious diseases – which were responsible, in the past, for high rates of morbidity and mortality –, and also followed the reemergence of diseases already controlled and the emergence of until then unknown diseases, with a strong impact on the Brazilian population, establishing a little predictable and very challenging path. PMID:28099652

Via Method for Lithography Free Contact and Preservation of 2D Materials.

PubMed

Telford, Evan J; Benyamini, Avishai; Rhodes, Daniel; Wang, Da; Jung, Younghun; Zangiabadi, Amirali; Watanabe, Kenji; Taniguchi, Takashi; Jia, Shuang; Barmak, Katayun; Pasupathy, Abhay N; Dean, Cory R; Hone, James

2018-02-14

Atomically thin 2D materials span the common components of electronic circuits as metals, semiconductors, and insulators, and can manifest correlated phases such as superconductivity, charge density waves, and magnetism. An ongoing challenge in the field is to incorporate these 2D materials into multilayer heterostructures with robust electrical contacts while preventing disorder and degradation. In particular, preserving and studying air-sensitive 2D materials has presented a significant challenge since they readily oxidize under atmospheric conditions. We report a new technique for contacting 2D materials, in which metal via contacts are integrated into flakes of insulating hexagonal boron nitride, and then placed onto the desired conducting 2D layer, avoiding direct lithographic patterning onto the 2D conductor. The metal contacts are planar with the bottom surface of the boron nitride and form robust contacts to multiple 2D materials. These structures protect air-sensitive 2D materials for months with no degradation in performance. This via contact technique will provide the capability to produce "atomic printed circuit boards" that can form the basis of more complex multilayer heterostructures.

Overview of robotic colorectal surgery: Current and future practical developments

PubMed Central

Roy, Sudipta; Evans, Charles

2016-01-01

Minimal access surgery has revolutionised colorectal surgery by offering reduced morbidity and mortality over open surgery, while maintaining oncological and functional outcomes with the disadvantage of additional practical challenges. Robotic surgery aids the surgeon in overcoming these challenges. Uptake of robotic assistance has been relatively slow, mainly because of the high initial and ongoing costs of equipment but also because of limited evidence of improved patient outcomes. Advances in robotic colorectal surgery will aim to widen the scope of minimal access surgery to allow larger and more complex surgery through smaller access and natural orifices and also to make the technology more economical, allowing wider dispersal and uptake of robotic technology. Advances in robotic endoscopy will yield self-advancing endoscopes and a widening role for capsule endoscopy including the development of motile and steerable capsules able to deliver localised drug therapy and insufflation as well as being recharged from an extracorporeal power source to allow great longevity. Ultimately robotic technology may advance to the point where many conventional surgical interventions are no longer required. With respect to nanotechnology, surgery may eventually become obsolete. PMID:26981188

Integrated Data Capturing Requirements for 3d Semantic Modelling of Cultural Heritage: the Inception Protocol

NASA Astrophysics Data System (ADS)

Di Giulio, R.; Maietti, F.; Piaia, E.; Medici, M.; Ferrari, F.; Turillazzi, B.

2017-02-01

The generation of high quality 3D models can be still very time-consuming and expensive, and the outcome of digital reconstructions is frequently provided in formats that are not interoperable, and therefore cannot be easily accessed. This challenge is even more crucial for complex architectures and large heritage sites, which involve a large amount of data to be acquired, managed and enriched by metadata. In this framework, the ongoing EU funded project INCEPTION - Inclusive Cultural Heritage in Europe through 3D semantic modelling proposes a workflow aimed at the achievements of efficient 3D digitization methods, post-processing tools for an enriched semantic modelling, web-based solutions and applications to ensure a wide access to experts and non-experts. In order to face these challenges and to start solving the issue of the large amount of captured data and time-consuming processes in the production of 3D digital models, an Optimized Data Acquisition Protocol (DAP) has been set up. The purpose is to guide the processes of digitization of cultural heritage, respecting needs, requirements and specificities of cultural assets.

EM-21 Retrieval Knowledge Center: Waste Retrieval Challenges

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

Fellinger, Andrew P.; Rinker, Michael W.; Berglin, Eric J.

EM-21 is the Waste Processing Division of the Office of Engineering and Technology, within the U.S. Department of Energy’s (DOE) Office of Environmental Management (EM). In August of 2008, EM-21 began an initiative to develop a Retrieval Knowledge Center (RKC) to provide the DOE, high level waste retrieval operators, and technology developers with centralized and focused location to share knowledge and expertise that will be used to address retrieval challenges across the DOE complex. The RKC is also designed to facilitate information sharing across the DOE Waste Site Complex through workshops, and a searchable database of waste retrieval technology information.more » The database may be used to research effective technology approaches for specific retrieval tasks and to take advantage of the lessons learned from previous operations. It is also expected to be effective for remaining current with state-of-the-art of retrieval technologies and ongoing development within the DOE Complex. To encourage collaboration of DOE sites with waste retrieval issues, the RKC team is co-led by the Savannah River National Laboratory (SRNL) and the Pacific Northwest National Laboratory (PNNL). Two RKC workshops were held in the Fall of 2008. The purpose of these workshops was to define top level waste retrieval functional areas, exchange lessons learned, and develop a path forward to support a strategic business plan focused on technology needs for retrieval. The primary participants involved in these workshops included retrieval personnel and laboratory staff that are associated with Hanford and Savannah River Sites since the majority of remaining DOE waste tanks are located at these sites. This report summarizes and documents the results of the initial RKC workshops. Technology challenges identified from these workshops and presented here are expected to be a key component to defining future RKC-directed tasks designed to facilitate tank waste retrieval solutions.« less

Teaching Architecture - Contemporary Challenges and Threats in the Complexity of Built Environment

NASA Astrophysics Data System (ADS)

Borucka, Justyna; Macikowski, Bartosz

2017-10-01

The complexity of the modern built environment is a problem not only of architectural and urban issues. This issue extends to many other disciplines as well as covering a wide range of social engagements. The idea of writing this paper is generally initiated by the debate which took place in Gdańsk on 22.01.2016, and was prepared in order to meet representatives of the four circles of interest within the architectural sphere: universities, professional architectural organisations and associations, architectural practice (professionals running their own studios, managing projects and leading construction) and local social organisations active in city of Gdańsk. This paper is a comparison of the results of this discussion in relation to the policy and methodology of architecture teaching on the University level. Teaching architecture and urban planning according to the present discussion needs to be improved and advanced to meet the increasing complexity of both disciplines. Contemporary dynamic development of cities creates the necessity of engaging multiple stakeholders, participants and users of architecture and urban space. This is crucial to make them conscious of sharing responsibility for increasing the quality of living in the built environment. This discussion about architectural education is open and has the nature of an ongoing process adapting to a changing environment and is in fact a constant challenge which brings questions rather than simple answers. Transformation of architecture and urban planning, and consequently its education are increasingly entering into the related fields, especially into the professional practice and social environment. The question of how to teach architecture and urban planning and educate users of urban space should take place in the context of a wide discussion. This interdisciplinary debate seems to be a crucial and challenging step towards improving the future education of architecture and urban planning leading to a better life in the city.

Searching for Grey Literature for Systematic Reviews: Challenges and Benefits

ERIC Educational Resources Information Center

Mahood, Quenby; Van Eerd, Dwayne; Irvin, Emma

2014-01-01

There is ongoing interest in including grey literature in systematic reviews. Including grey literature can broaden the scope to more relevant studies, thereby providing a more complete view of available evidence. Searching for grey literature can be challenging despite greater access through the Internet, search engines and online bibliographic…

Applied Linguistics: The Challenge of Theory

ERIC Educational Resources Information Center

McNamara, Tim

2015-01-01

Language has featured prominently in contemporary social theory, but the relevance of this fact to the concerns of Applied Linguistics, with its necessary orientation to practical issues of language in context, represents an ongoing challenge. This article supports the need for a greater engagement with theory in Applied Linguistics. It considers…

Committed to Conservation

ERIC Educational Resources Information Center

Boulard, Garry

2009-01-01

Addressing ongoing and costly deferred-maintenance needs is a challenge for any two- or four-year school. During an economically challenging time, many HBCUs have put energy efficiency and other green projects on the back burner. However, some are finding that deferred maintenance does not have to be a barrier to becoming green. Despite budget…

Playing on Reality: Do Geomodels Improve the Perception of Geographical Terms?

ERIC Educational Resources Information Center

Czigány, Szabolcs; Császár, Zsuzsa; Kiss, Kinga; Halmai, Ákos; Lóczy, Dénes; Nagyváradi, László; Pirkhoffer, Ervin

2018-01-01

Remodeling of geography education has been an ongoing challenge recently. Constructivist pedagogy, employing tools of problem and model-based learning, offers new opportunities to meet these challenges. Geomodels, flumes and stream tables may ease the understanding of geographic processes through hand-on-experience for students. With a…

Researching across Boundaries and Borders: The Challenges for Research

ERIC Educational Resources Information Center

Bowl, Marion; Cooke, Sandra; Hockings, Christine

2008-01-01

This article explores some of the challenges of conducting action research in higher education. It arises from an ongoing research project funded by the Economic and Social Research Council's Teaching and Learning Research Programme (ESRC/TLRP), "Learning and Teaching for Social Diversity and Difference", which examines the dynamics of…

Inclusive Education for Students with Hearing Impairment in the Regular Secondary Schools in the North-West Region of Cameroon: Initiatives and Challenges

ERIC Educational Resources Information Center

Bamu, Beryl Ndongwa; De Schauwer, Elisabeth; Verstraete, Sara; Van Hove, Geert

2017-01-01

Although some initiatives are implemented in the education of students with hearing impairments in the regular school, challenges are still encountered in their education. This article which is part of the results from an ongoing qualitative study in the North-West region of Cameroon addresses the different initiatives and challenges involved with…

Reducing chronic obstructive pulmonary disease readmissions: the role of the durable medical equipment provider.

PubMed

Messenger, Robert W

2012-01-01

Exacerbation and frequent rehospitalization in chronic obstructive pulmonary disease exacts a heavy toll on the US health care system. To address these issues, new initiatives have been proposed that are largely based on financial penalties to promote patient education and postdischarge care. However, as laudable as these goals are, improving outcomes in the chronic obstructive pulmonary disease population is more confounding than it may first appear. Chronic hypoxia, cognitive dysfunction, poor nutrition, and economic disadvantage are just a few of the challenges that require creative solutions and ongoing support. Case managers need to utilize all the potential products and services that can assist in improving outcomes for these patients. Durable medical equipment providers are often viewed as purveyors of medical equipment that offer little in the form of clinical support. However, in many cases these providers represent an overlooked resource that provides individualized, highly structured patient education and ongoing support programs. The challenge is in identifying those durable medical equipment providers that offer patients contemporary technology, and have both the resources and the commitment to provide patient support that is amenable to the goals of the hospital. This article reviews many of the confounding issues that contribute to the frequent rehospitalization of chronic obstructive pulmonary disease patients. Recommendations to improve patient education and oxygen therapy outcomes are provided along with suggestions to aid in the vetting of durable medical equipment providers. Acute care hospitals, long-term acute care hospitals, extended care facilities, integrated delivery systems. 1. An understanding of the complex variables that play in the management of chronic obstructive pulmonary disease will help the case manager to plan an effective course of care. 2. Case managers need to ensure that patients receive long-term oxygen technology that supports their lifestyle, promotes compliance, and ultimately achieves the desired outcomes. 3. Case managers must advocate for coordinated, ongoing patient education and stress the need for continuing reinforcement. 4. Case managers must ensure that patients under their care be matched with durable medical equipment providers that provide the technology and support that favors positive clinical outcomes.

Ecosystem consequences of changing inputs of terrestrial dissolved organic matter to lakes: current knowledge and future challenges

USGS Publications Warehouse

Solomon, Christopher T.; Jones, Stuart E.; Weidel, Brian C.; Buffam, Ishi; Fork, Megan L; Karlsson, Jan; Larsen, Soren; Lennon, Jay T.; Read, Jordan S.; Sadro, Steven; Saros, Jasmine E.

2015-01-01

Lake ecosystems and the services that they provide to people are profoundly influenced by dissolved organic matter derived from terrestrial plant tissues. These terrestrial dissolved organic matter (tDOM) inputs to lakes have changed substantially in recent decades, and will likely continue to change. In this paper, we first briefly review the substantial literature describing tDOM effects on lakes and ongoing changes in tDOM inputs. We then identify and provide examples of four major challenges which limit predictions about the implications of tDOM change for lakes, as follows: First, it is currently difficult to forecast future tDOM inputs for particular lakes or lake regions. Second, tDOM influences ecosystems via complex, interacting, physical-chemical-biological effects and our holistic understanding of those effects is still rudimentary. Third, non-linearities and thresholds in relationships between tDOM inputs and ecosystem processes have not been well described. Fourth, much understanding of tDOM effects is built on comparative studies across space that may not capture likely responses through time. We conclude by identifying research approaches that may be important for overcoming those challenges in order to provide policy- and management-relevant predictions about the implications of changing tDOM inputs for lakes.

Cryptosporidium Priming Is More Effective than Vaccine for Protection against Cryptosporidiosis in a Murine Protein Malnutrition Model

PubMed Central

Bartelt, Luther A.; Bolick, David T.; Kolling, Glynis L.; Zaenker, Edna I.; Lara, Ana M.; Noronha, Francisco Jose; Cowardin, Carrie A.; Moore, John H.; Turner, Jerrold R.; Warren, Cirle A.; Buck, Gregory A.; Guerrant, Richard L.

2016-01-01

Cryptosporidium is a major cause of severe diarrhea, especially in malnourished children. Using a murine model of C. parvum oocyst challenge that recapitulates clinical features of severe cryptosporidiosis during malnutrition, we interrogated the effect of protein malnutrition (PM) on primary and secondary responses to C. parvum challenge, and tested the differential ability of mucosal priming strategies to overcome the PM-induced susceptibility. We determined that while PM fundamentally alters systemic and mucosal primary immune responses to Cryptosporidium, priming with C. parvum (106 oocysts) provides robust protective immunity against re-challenge despite ongoing PM. C. parvum priming restores mucosal Th1-type effectors (CD3+CD8+CD103+ T-cells) and cytokines (IFNγ, and IL12p40) that otherwise decrease with ongoing PM. Vaccination strategies with Cryptosporidium antigens expressed in the S. Typhi vector 908htr, however, do not enhance Th1-type responses to C. parvum challenge during PM, even though vaccination strongly boosts immunity in challenged fully nourished hosts. Remote non-specific exposures to the attenuated S. Typhi vector alone or the TLR9 agonist CpG ODN-1668 can partially attenuate C. parvum severity during PM, but neither as effectively as viable C. parvum priming. We conclude that although PM interferes with basal and vaccine-boosted immune responses to C. parvum, sustained reductions in disease severity are possible through mucosal activators of host defenses, and specifically C. parvum priming can elicit impressively robust Th1-type protective immunity despite ongoing protein malnutrition. These findings add insight into potential correlates of Cryptosporidium immunity and future vaccine strategies in malnourished children. PMID:27467505

Improving vocational rehabilitation services for injured workers in Washington State.

PubMed

Sears, Jeanne M; Wickizer, Thomas M; Schulman, Beryl A

2014-06-01

Workers who incur permanent impairments or have ongoing medical restrictions due to injuries or illnesses sustained at work may require support from vocational rehabilitation programs in order to return to work. Vocational rehabilitation programs implemented within workers' compensation settings are costly, and effective service delivery has proven challenging. The Vocational Improvement Project, a 5.5-year pilot program beginning in 2008, introduced major changes to the Washington State workers' compensation-based vocational rehabilitation program. In the evaluation of this pilot program, set within a large complex system characterized by competing stakeholder interests, we assessed effects on system efficiency and employment outcomes for injured workers. While descriptive in nature, this evaluation provided evidence that several of the intended outcomes were attained, including: (1) fewer repeat referrals, (2) fewer delays, (3) increased choice for workers, and (4) establishment of statewide partnerships to improve worker outcomes. There remains substantial room for further improvement. Retraining plan completion rates remain under 60% and only half of workers earned any wages within two years of completing their retraining plan. Ongoing communication with stakeholders was critical to the successful conduct and policy impact of this evaluation, which culminated in a 3-year extension of the pilot program through June 2016. Copyright © 2013 Elsevier Ltd. All rights reserved.

Diffusion-Limited Cargo Loading of an Engineered Protein Container.

PubMed

Zschoche, Reinhard; Hilvert, Donald

2015-12-30

The engineered bacterial nanocompartment AaLS-13 is a promising artificial encapsulation system that exploits electrostatic interactions for cargo loading. In order to study its ability to take up and retain guests, a pair of fluorescent proteins was developed which allows spectroscopic determination of the extent of encapsulation by Förster resonance energy transfer (FRET). The encapsulation process is generally complete within a second, suggesting low energetic barriers for proteins to cross the capsid shell. Formation of intermediate aggregates upon mixing host and guest in vitro complicates capsid loading at low ionic strength, but can be sidestepped by increasing salt concentrations or diluting the components. Encapsulation of guests is completely reversible, and the position of the equilibrium is easily tuned by varying the ionic strength. These results, which challenge the notion that AaLS-13 is a continuous rigid shell, provide valuable information about cargo loading that will guide ongoing efforts to engineer functional host-guest complexes. Moreover, it should be possible to adapt the protein FRET pair described in this report to characterize functional capsid-cargo complexes generated by other encapsulation systems.

Complexity of Gene Expression Evolution after Duplication: Protein Dosage Rebalancing

PubMed Central

Rogozin, Igor B.

2014-01-01

Ongoing debates about functional importance of gene duplications have been recently intensified by a heated discussion of the “ortholog conjecture” (OC). Under the OC, which is central to functional annotation of genomes, orthologous genes are functionally more similar than paralogous genes at the same level of sequence divergence. However, a recent study challenged the OC by reporting a greater functional similarity, in terms of gene ontology (GO) annotations and expression profiles, among within-species paralogs compared to orthologs. These findings were taken to indicate that functional similarity of homologous genes is primarily determined by the cellular context of the genes, rather than evolutionary history. Subsequent studies suggested that the OC appears to be generally valid when applied to mammalian evolution but the complete picture of evolution of gene expression also has to incorporate lineage-specific aspects of paralogy. The observed complexity of gene expression evolution after duplication can be explained through selection for gene dosage effect combined with the duplication-degeneration-complementation model. This paper discusses expression divergence of recent duplications occurring before functional divergence of proteins encoded by duplicate genes. PMID:25197576

Protein complexes, big data, machine learning and integrative proteomics: lessons learned over a decade of systematic analysis of protein interaction networks.

PubMed

Havugimana, Pierre C; Hu, Pingzhao; Emili, Andrew

2017-10-01

Elucidation of the networks of physical (functional) interactions present in cells and tissues is fundamental for understanding the molecular organization of biological systems, the mechanistic basis of essential and disease-related processes, and for functional annotation of previously uncharacterized proteins (via guilt-by-association or -correlation). After a decade in the field, we felt it timely to document our own experiences in the systematic analysis of protein interaction networks. Areas covered: Researchers worldwide have contributed innovative experimental and computational approaches that have driven the rapidly evolving field of 'functional proteomics'. These include mass spectrometry-based methods to characterize macromolecular complexes on a global-scale and sophisticated data analysis tools - most notably machine learning - that allow for the generation of high-quality protein association maps. Expert commentary: Here, we recount some key lessons learned, with an emphasis on successful workflows, and challenges, arising from our own and other groups' ongoing efforts to generate, interpret and report proteome-scale interaction networks in increasingly diverse biological contexts.

Commercial Video Games As Therapy: A New Research Agenda to Unlock the Potential of a Global Pastime.

PubMed

Colder Carras, Michelle; Van Rooij, Antonius J; Spruijt-Metz, Donna; Kvedar, Joseph; Griffiths, Mark D; Carabas, Yorghos; Labrique, Alain

2017-01-01

Emerging research suggests that commercial, off-the-shelf video games have potential applications in preventive and therapeutic medicine. Despite these promising findings, systematic efforts to characterize and better understand this potential have not been undertaken. Serious academic study of the therapeutic potential of commercial video games faces several challenges, including a lack of standard terminology, rapidly changing technology, societal attitudes toward video games, and understanding and accounting for complex interactions between individual, social, and cultural health determinants. As a vehicle to launch a new interdisciplinary research agenda, the present paper provides background information on the use of commercial video games for the prevention, treatment, and rehabilitation of mental and other health conditions, and discusses ongoing grassroots efforts by online communities to use video games for healing and recovery.

The NIH analytical methods and reference materials program for dietary supplements.

PubMed

Betz, Joseph M; Fisher, Kenneth D; Saldanha, Leila G; Coates, Paul M

2007-09-01

Quality of botanical products is a great uncertainty that consumers, clinicians, regulators, and researchers face. Definitions of quality abound, and include specifications for sanitation, adventitious agents (pesticides, metals, weeds), and content of natural chemicals. Because dietary supplements (DS) are often complex mixtures, they pose analytical challenges and method validation may be difficult. In response to product quality concerns and the need for validated and publicly available methods for DS analysis, the US Congress directed the Office of Dietary Supplements (ODS) at the National Institutes of Health (NIH) to accelerate an ongoing methods validation process, and the Dietary Supplements Methods and Reference Materials Program was created. The program was constructed from stakeholder input and incorporates several federal procurement and granting mechanisms in a coordinated and interlocking framework. The framework facilitates validation of analytical methods, analytical standards, and reference materials.

Soft Actuators for Small-Scale Robotics.

PubMed

Hines, Lindsey; Petersen, Kirstin; Lum, Guo Zhan; Sitti, Metin

2017-04-01

This review comprises a detailed survey of ongoing methodologies for soft actuators, highlighting approaches suitable for nanometer- to centimeter-scale robotic applications. Soft robots present a special design challenge in that their actuation and sensing mechanisms are often highly integrated with the robot body and overall functionality. When less than a centimeter, they belong to an even more special subcategory of robots or devices, in that they often lack on-board power, sensing, computation, and control. Soft, active materials are particularly well suited for this task, with a wide range of stimulants and a number of impressive examples, demonstrating large deformations, high motion complexities, and varied multifunctionality. Recent research includes both the development of new materials and composites, as well as novel implementations leveraging the unique properties of soft materials. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

A Situated Practice of Ethics for Participatory Visual and Digital Methods in Public Health Research and Practice: A Focus on Digital Storytelling

PubMed Central

Hill, Amy L.; Flicker, Sarah

2014-01-01

This article explores ethical considerations related to participatory visual and digital methods for public health research and practice, through the lens of an approach known as “digital storytelling.” We begin by briefly describing the digital storytelling process and its applications to public health research and practice. Next, we explore 6 common challenges: fuzzy boundaries, recruitment and consent to participate, power of shaping, representation and harm, confidentiality, and release of materials. We discuss their complexities and offer some considerations for ethical practice. We hope this article serves as a catalyst for expanded dialogue about the need for high standards of integrity and a situated practice of ethics wherein researchers and practitioners reflexively consider ethical decision-making as part of the ongoing work of public health. PMID:23948015

A situated practice of ethics for participatory visual and digital methods in public health research and practice: a focus on digital storytelling.

PubMed

Gubrium, Aline C; Hill, Amy L; Flicker, Sarah

2014-09-01

This article explores ethical considerations related to participatory visual and digital methods for public health research and practice, through the lens of an approach known as "digital storytelling." We begin by briefly describing the digital storytelling process and its applications to public health research and practice. Next, we explore 6 common challenges: fuzzy boundaries, recruitment and consent to participate, power of shaping, representation and harm, confidentiality, and release of materials. We discuss their complexities and offer some considerations for ethical practice. We hope this article serves as a catalyst for expanded dialogue about the need for high standards of integrity and a situated practice of ethics wherein researchers and practitioners reflexively consider ethical decision-making as part of the ongoing work of public health.

Commercial Video Games As Therapy: A New Research Agenda to Unlock the Potential of a Global Pastime

PubMed Central

Colder Carras, Michelle; Van Rooij, Antonius J.; Spruijt-Metz, Donna; Kvedar, Joseph; Griffiths, Mark D.; Carabas, Yorghos; Labrique, Alain

2018-01-01

Emerging research suggests that commercial, off-the-shelf video games have potential applications in preventive and therapeutic medicine. Despite these promising findings, systematic efforts to characterize and better understand this potential have not been undertaken. Serious academic study of the therapeutic potential of commercial video games faces several challenges, including a lack of standard terminology, rapidly changing technology, societal attitudes toward video games, and understanding and accounting for complex interactions between individual, social, and cultural health determinants. As a vehicle to launch a new interdisciplinary research agenda, the present paper provides background information on the use of commercial video games for the prevention, treatment, and rehabilitation of mental and other health conditions, and discusses ongoing grassroots efforts by online communities to use video games for healing and recovery. PMID:29403398

Using Public Posting as a Motivation Strategy in Physical Education, Sport, and Adult Exercise Settings

ERIC Educational Resources Information Center

Martin, Matt; Sharpe, Tom

2009-01-01

One of the ongoing challenges that physical educators, coaches, and fitness professionals face is discovering and implementing motivational strategies that encourage long-term participation and effort. This challenge exists in public school physical education classes, on the playing field, and in structured adult physical activity settings. In…

Revisiting the Media Generation: Youth Media Use and Computational Literacy Instruction

ERIC Educational Resources Information Center

Jenson, Jennifer; Droumeva, Milena

2017-01-01

An ongoing challenge of 21st century learning is ensuring everyone has the requisite skills to participate in a digital, knowledge-based economy. Once an anathema to parents and teachers, digital games are increasingly at the forefront of conversations about ways to address student engagement and provoke challenges to media pedagogies. While…

Challenges for an Interdisciplinary Consideration of Cognitive Training

ERIC Educational Resources Information Center

Birney, Damian Patrick

2015-01-01

Whether fluid cognitive functions are malleable has been a topic of ongoing debate for at least the past 100 years. Ever-evolving technology has led to new and diverse fields of investigation entering this debate. There are significant advantages to be gained by integrating different scientific paradigms, but there are also significant challenges.…

Creative Tension: Turn The Challenges of Learning Together Into Opportunities

ERIC Educational Resources Information Center

Dobbs, Christina L.; Ippolito, Jacy; Charner-Laird, Megin

2016-01-01

Effective and authentic communities of practice in schools have the potential to support teachers in improving their instructional practices around perennial challenges, such as improving the literacy skills of all students. But before they can achieve such goals, communities of practice take time to build, effort to sustain, and ongoing support…

Xtranormal Learning for Millennials: An Innovative Tool for Group Projects

ERIC Educational Resources Information Center

Stratton, Micheal T.; Julien, Mark

2014-01-01

Encouraging students to actively engage with course material is an ongoing challenge for many management educators. One common tactic is to use various technologies that allow tech-savvy Millennial Generation students to take a more active role in their learning. In this article, we describe an innovative group project that challenges students to…

Influence of Arbuscular Mycorrhizal Fungus (AMF) on degradation of iron-cyanide complexes

NASA Astrophysics Data System (ADS)

Sut, Magdalena; Boldt-Burisch, Katja; Raab, Thomas

2015-04-01

Soil contamination in the vicinities of former Manufactured Gas Plant (MGP) sites is a worldwide known environmental issue. The pollutants, in form of iron-cyanide complexes, originating from the gas purification process, create a risk for human health due to potential release of toxic free cyanide, CN(aq) and HCN(g), (aq).The management and remediation of cyanide contaminated soil can be very challenging due to the complex chemistry and toxicity of CN compounds. The employment of phytoremediation to remove or stabilize contaminants at a former MGP site is an inexpensive process, but can be limited through shallow rotting, decreased biomass, poor growing and the risk of secondary accumulation. However, this adaptation may be enhanced via arbuscular mycorrhizal fungi (AMF) activity, which may cooperate on the degradation, transformation or uptake of the contaminants. We would like to present our preliminary results from the ongoing project concerning toxic substrate-AMF-plant relation, based on studying the site of a former MGP site. In situ experiments contributed to identifying those fungi that are likely to persist in extremely acidic and toxic conditions. Subsequently, commercially available Rhizophagus irregularis was grown in sterilized, un-spiked soil with the roots of the host plant Calamagrostis epigejos. Extracted roots and AMF hyphae were used in the batch experiment, were the potential of this association on degradation of iron-cyanide complexes, in form of potassium ferrocyanide solution, was assessed.

Financial Management: Education Faces Challenges in Achieving Financial Management Reform. Testimony before the Subcommittee on Oversight and Investigations, Committee on Education and the Workforce, House of Representatives.

ERIC Educational Resources Information Center

Jarmon, Gloria L.

This report provides a fiscal analysis of the Department of Education's 1999 financial audit results. It focuses on the relationship between the audit findings and the potential for waste, fraud, and abuse, and examines the status of an ongoing study of the Department's grantback account. It describes the ongoing accounting problems that have…

Vaccine trials in the developing world: operational lessons learnt from a phase IV poliomyelitis vaccine trial in South Africa.

PubMed

Geldenhuys, H; Waggie, Z; Jacks, M; Geldenhuys, M; Traut, L; Tameris, M; Hatherill, M; Hanekom, W A; Sutter, R; Hussey, G; Mahomed, H

2012-08-31

Conducting vaccine trials in developing nations is necessary but operationally complex. We describe operational lessons learnt from a phase IV poliomyelitis vaccine trial in a semi-rural region of South Africa. We reviewed operational data collected over the duration of the trial with respect to staff recruitment and training, participant recruitment and retention, and cold chain maintenance. RESULTS-LESSONS LEARNT: The recruitment model we used that relied on the 24h physical presence of a team member in the birthing unit was expensive and challenging to manage. Forecasting of enrolment rates was complicated by incomplete baseline data and by the linear nature of forecasts that do not take into account changing variables. We found that analyzing key operational data to monitor progress of the trial enabled us to identify problem areas timeously, and to facilitate a collegial problem-solving process by the extended trial team. Pro-actively nurturing a working relationship with the public sector health care system and the community was critical to our success. Despite the wide geographical area and lack of fixed addresses, we maintained an excellent retention rate through community assistance and the use of descriptive residential information. Training needs of team members were ongoing and dynamic and we discovered that these needs that were best met by an in-house, targeted and systemized training programme. The use of vaccine refrigerators instead of standard frost-free refrigerators is cost-effective and necessary to maintain the cold-chain. Operational challenges of a vaccine trial in developing world populations include inexperienced staff, the close liaison required between researchers and public health care services, impoverished participants that require complex recruitment and retention strategies, and challenges of distance and access. These challenges can be overcome by innovative strategies that allow for the unique characteristics of the setting, trial population, and trial team. Copyright © 2012 Elsevier Ltd. All rights reserved.

Global change modeling for Northern Eurasia: a review and strategies to move forward

NASA Astrophysics Data System (ADS)

Monier, E.; Kicklighter, D. W.; Sokolov, A. P.; Zhuang, Q.; Sokolik, I. N.; Lawford, R. G.; Kappas, M.; Paltsev, S.; Groisman, P. Y.

2017-12-01

Northern Eurasia is made up of a complex and diverse set of physical, ecological, climatic and human systems, which provide important ecosystem services including the storage of substantial stocks of carbon in its terrestrial ecosystems. At the same time, the region has experienced dramatic climate change, natural disturbances and changes in land management practices over the past century. For these reasons, Northern Eurasia is both a critical region to understand and a complex system with substantial challenges for the modeling community. This review is designed to highlight the state of past and ongoing efforts of the research community to understand and model these environmental, socioeconomic, and climatic changes. We further aim to provide perspectives on the future direction of global change modeling to improve our understanding of the role of Northern Eurasia in the coupled human-Earth system. Modeling efforts have shown that environmental and socioeconomic changes in Northern Eurasia can have major impacts on biodiversity, ecosystems services, environmental sustainability, and the carbon cycle of the region, and beyond. These impacts have the potential to feedback onto and alter the global Earth system. We find that past and ongoing studies have largely focused on specific components of Earth system dynamics and have not systematically examined their feedbacks to the global Earth system and to society. We identify the crucial role of Earth system models in advancing our understanding of feedbacks within the region and with the global system. We further argue for the need for integrated assessment models (IAMs), a suite of models that couple human activity models to Earth system models, which are key to address many emerging issues that require a representation of the coupled human-Earth system.

A review of and perspectives on global change modeling for Northern Eurasia

NASA Astrophysics Data System (ADS)

Monier, Erwan; Kicklighter, David W.; Sokolov, Andrei P.; Zhuang, Qianlai; Sokolik, Irina N.; Lawford, Richard; Kappas, Martin; Paltsev, Sergey V.; Groisman, Pavel Ya

2017-08-01

Northern Eurasia is made up of a complex and diverse set of physical, ecological, climatic and human systems, which provide important ecosystem services including the storage of substantial stocks of carbon in its terrestrial ecosystems. At the same time, the region has experienced dramatic climate change, natural disturbances and changes in land management practices over the past century. For these reasons, Northern Eurasia is both a critical region to understand and a complex system with substantial challenges for the modeling community. This review is designed to highlight the state of past and ongoing efforts of the research community to understand and model these environmental, socioeconomic, and climatic changes. We further aim to provide perspectives on the future direction of global change modeling to improve our understanding of the role of Northern Eurasia in the coupled human-Earth system. Modeling efforts have shown that environmental and socioeconomic changes in Northern Eurasia can have major impacts on biodiversity, ecosystems services, environmental sustainability, and the carbon cycle of the region, and beyond. These impacts have the potential to feedback onto and alter the global Earth system. We find that past and ongoing studies have largely focused on specific components of Earth system dynamics and have not systematically examined their feedbacks to the global Earth system and to society. We identify the crucial role of Earth system models in advancing our understanding of feedbacks within the region and with the global system. We further argue for the need for integrated assessment models (IAMs), a suite of models that couple human activity models to Earth system models, which are key to address many emerging issues that require a representation of the coupled human-Earth system.

Patient experience in a coordinated care model featuring diabetes self-management education integrated into the patient-centered medical home.

PubMed

Janiszewski, Debra; O'Brian, Catherine A; Lipman, Ruth D

2015-08-01

The purpose of this study is to gain insight about patient experience of diabetes self-management education in a patient-centered medical home. Six focus groups consisting of 37 people with diabetes, diverse in race and ethnicity, were conducted at 3 sites. Participants described their experience in the program and their challenges in diabetes self-management; they also suggested services to meet their diabetes care needs. The most common theme was ongoing concerns about care and support. There was much discussion about the value of the support provided by health navigators integrated in the diabetes health care team. Frequent concerns expressed by participants centered on personal challenges in engaging in healthy lifestyle behaviors. Ongoing programmatic support of self-management goals was widely valued. Individuals who received health care in a patient-centered medical home and could participate in diabetes self-management education with integrated support valued both activities. The qualitative results from this study suggest need for more formalized exploration of effective means to meet the ongoing support needs of people with diabetes. © 2015 The Author(s).

Ethical challenges in resuscitation.

PubMed

Mentzelopoulos, Spyros D; Slowther, Anne-Marie; Fritz, Zoe; Sandroni, Claudio; Xanthos, Theodoros; Callaway, Clifton; Perkins, Gavin D; Newgard, Craig; Ischaki, Eleni; Greif, Robert; Kompanje, Erwin; Bossaert, Leo

2018-06-01

A rapidly evolving resuscitation science provides more effective treatments to an aging population with multiple comorbidites. Concurrently, emergency care has become patient-centered. This review aims to describe challenges associated with the application of key principles of bioethics in resuscitation and post-resuscitation care; propose actions to address these challenges; and highlight the need for evidence-based ethics and consensus on ethical principles interpretation. Following agreement on the article's outline, subgroups of 2-3 authors provided narrative reviews of ethical issues concerning autonomy and honesty, beneficence/nonmaleficence and dignity, justice, specific practices/circumstances such as family presence during resuscitation, and emergency research. Proposals for addressing ethical challenges were also offered. Respect for patient autonomy can be realized through honest provision of information, shared decision-making, and advance directives/care planning. Essential prerequisites comprise public and specific healthcare professionals' education, appropriate regulatory provisions, and allocation of adequate resources. Regarding beneficence/nonmaleficence, resuscitation should benefit patients, while avoiding harm from futile interventions; pertinent practice should be based on neurological prognostication and patient/family-reported outcomes. Regarding dignity, aggressive life-sustaining treatments against patients preferences should be avoided. Contrary to the principle of justice, resuscitation quality may be affected by race/income status, age, ethnicity, comorbidity, and location (urban versus rural or country-specific/region-specific). Current evidence supports family presence during resuscitation. Regarding emergency research, autonomy should be respected without hindering scientific progress; furthermore, transparency of research conduct should be promoted and funding increased. Major ethical challenges in resuscitation science need to be addressed through complex/resource-demanding interventions. Such actions require support by ongoing/future research.

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

PubMed

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

2016-09-06

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

Rethinking Traditional Behaviour Management to Better Support Complex Trauma-Surviving Students

ERIC Educational Resources Information Center

Howard, Judith

2016-01-01

Children and adolescents who have survived complex trauma have suffered the type of ongoing and repeated traumatic experience that includes factors such as physical, sexual, and/or emotional abuse, significant neglect, and/or family violence. Complex childhood trauma (sometimes referred to as paediatric or child maltreatment-related post traumatic…

Visual Complexity and Pictorial Memory: A Fifteen Year Research Perspective.

ERIC Educational Resources Information Center

Berry, Louis H.

For 15 years an ongoing research project at the University of Pittsburgh has focused on the effects of variations in visual complexity and color on the storage and retrieval of visual information by learners. Research has shown that visual materials facilitate instruction, but has not fully delineated the interactions of visual complexity and…

Opaque for the Reader but Transparent for the Brain: Neural Signatures of Morphological Complexity

ERIC Educational Resources Information Center

Meinzer, Marcus; Lahiri, Aditi; Flaisch, Tobias; Hannemann, Ronny; Eulitz, Carsten

2009-01-01

Within linguistics, words with a complex internal structure are commonly assumed to be decomposed into their constituent morphemes (e.g., un-help-ful). Nevertheless, an ongoing debate concerns the brain structures that subserve this process. Using functional magnetic resonance imaging, the present study varied the internal complexity of derived…

Organotypic liver culture models: Meeting current challenges in toxicity testing

PubMed Central

LeCluyse, Edward L.; Witek, Rafal P.; Andersen, Melvin E.; Powers, Mark J.

2012-01-01

Prediction of chemical-induced hepatotoxicity in humans from in vitro data continues to be a significant challenge for the pharmaceutical and chemical industries. Generally, conventional in vitro hepatic model systems (i.e. 2-D static monocultures of primary or immortalized hepatocytes) are limited by their inability to maintain histotypic and phenotypic characteristics over time in culture, including stable expression of clearance and bioactivation pathways, as well as complex adaptive responses to chemical exposure. These systems are less than ideal for longer-term toxicity evaluations and elucidation of key cellular and molecular events involved in primary and secondary adaptation to chemical exposure, or for identification of important mediators of inflammation, proliferation and apoptosis. Progress in implementing a more effective strategy for in vitro-in vivo extrapolation and human risk assessment depends on significant advances in tissue culture technology and increasing their level of biological complexity. This article describes the current and ongoing need for more relevant, organotypic in vitro surrogate systems of human liver and recent efforts to recreate the multicellular architecture and hemodynamic properties of the liver using novel culture platforms. As these systems become more widely used for chemical and drug toxicity testing, there will be a corresponding need to establish standardized testing conditions, endpoint analyses and acceptance criteria. In the future, a balanced approach between sample throughput and biological relevance should provide better in vitro tools that are complementary with animal testing and assist in conducting more predictive human risk assessment. PMID:22582993

Identifying and preparing the next generation of part-time clinical teachers from dental practice.

PubMed

Radford, D R; Hellyer, P; Meakin, N; Jones, K A

2015-10-09

Part-time general dental practitioners (GDPs) and dental care professionals (DCPs) working in practice are being increasingly utilised to deliver undergraduate clinical dental education to both dental and hygiene/therapy students. As such, there is a need for appropriate recruitment processes and ongoing staff development in the different and complex role of the clinical teacher. Recently a group of experienced dental practitioners, making a journey from GDP to part-time clinical teacher, identified common themes, experiences, challenges and realisations. These were: 'what is clinical dental education?'; 'me as a clinical teacher'; and 'specific teaching issues'. The themes highlighted the complexity of dental education and the different environment of the teaching clinic from general practice. Some of the themes identified could be a starting point for the induction process to facilitate an easier transition from experienced GDP to clinical teacher. With the current demands from both students and patients alike, the 'three way dynamic of patient, student and teacher' needs to be supported if dental schools are to attract and develop the highest quality clinical teachers. It is of critical importance to give an exceptional experience to students in their clinical education as well as to patients in terms of excellent and appropriate treatment. The challenge for deans and directors of education is to find the resources to properly fund teacher recruitment, induction and the development of part-time GDPs in order to produce the expert teachers of tomorrow.

Loads and loads and loads: the influence of prospective load, retrospective load, and ongoing task load in prospective memory.

PubMed

Meier, Beat; Zimmermann, Thomas D

2015-01-01

In prospective memory tasks different kinds of load can occur. Adding a prospective memory task can impose a load on ongoing task performance. Adding ongoing task load (OTL) can affect prospective memory performance. The existence of multiple target events increases prospective load (PL) and adding complexity to the to-be-remembered action increases retrospective load (RL). In two experiments, we systematically examined the effects of these different types of load on prospective memory performance. Results showed an effect of PL on costs in the ongoing task for categorical targets (Experiment 2), but not for specific targets (Experiment 1). RL and OTL both affected remembering the retrospective component of the prospective memory task. We suggest that PL can enhance costs in the ongoing task due to additional monitoring requirements. RL and OTL seem to impact the division of resources between the ongoing task and retrieval of the retrospective component, which may affect disengagement from the ongoing task. In general, the results demonstrate that the different types of load affect prospective memory differentially.

Loads and loads and loads: the influence of prospective load, retrospective load, and ongoing task load in prospective memory

PubMed Central

Meier, Beat; Zimmermann, Thomas D.

2015-01-01

In prospective memory tasks different kinds of load can occur. Adding a prospective memory task can impose a load on ongoing task performance. Adding ongoing task load (OTL) can affect prospective memory performance. The existence of multiple target events increases prospective load (PL) and adding complexity to the to-be-remembered action increases retrospective load (RL). In two experiments, we systematically examined the effects of these different types of load on prospective memory performance. Results showed an effect of PL on costs in the ongoing task for categorical targets (Experiment 2), but not for specific targets (Experiment 1). RL and OTL both affected remembering the retrospective component of the prospective memory task. We suggest that PL can enhance costs in the ongoing task due to additional monitoring requirements. RL and OTL seem to impact the division of resources between the ongoing task and retrieval of the retrospective component, which may affect disengagement from the ongoing task. In general, the results demonstrate that the different types of load affect prospective memory differentially. PMID:26082709

Additive manufacturing in production: challenges and opportunities

NASA Astrophysics Data System (ADS)

Ahuja, Bhrigu; Karg, Michael; Schmidt, Michael

2015-03-01

Additive manufacturing, characterized by its inherent layer by layer fabrication methodology has been coined by many as the latest revolution in the manufacturing industry. Due to its diversification of Materials, processes, system technology and applications, Additive Manufacturing has been synonymized with terminology such as Rapid prototyping, 3D printing, free-form fabrication, Additive Layer Manufacturing, etc. A huge media and public interest in the technology has led to an innovative attempt of exploring the technology for applications beyond the scope of the traditional engineering industry. Nevertheless, it is believed that a critical factor for the long-term success of Additive Manufacturing would be its ability to fulfill the requirements defined by the traditional manufacturing industry. A parallel development in market trends and product requirements has also lead to a wider scope of opportunities for Additive Manufacturing. The presented paper discusses some of the key challenges which are critical to ensure that Additive Manufacturing is truly accepted as a mainstream production technology in the industry. These challenges would highlight on various aspects of production such as product requirements, process management, data management, intellectual property, work flow management, quality assurance, resource planning, etc. In Addition, changing market trends such as product life cycle, mass customization, sustainability, environmental impact and localized production will form the foundation for the follow up discussion on the current limitations and the corresponding research opportunities. A discussion on ongoing research to address these challenges would include topics like process monitoring, design complexity, process standardization, multi-material and hybrid fabrication, new material development, etc.

Exercise and Sports Science Australia position statement on exercise and falls prevention in older people.

PubMed

Tiedemann, Anne; Sherrington, Catherine; Close, Jacqueline C T; Lord, Stephen R

2011-11-01

Falls affect a significant number of older Australians and present a major challenge to health care providers and health systems. The purpose of this statement is to inform and guide exercise practitioners and health professionals in the safe and effective prescription of exercise for older community-dwelling people with the goal of preventing falls. Falls in older people are not random events but can be predicted by assessing a number of risk factors. Of particular importance are lower limb muscle strength, gait and balance, all of which can be improved with appropriate exercise. There is now extensive evidence to demonstrate that many falls are preventable, with exercise playing a crucial role in prevention. Research evidence has identified that programs which include exercises that challenge balance are more effective in preventing falls than those which do not challenge balance. It is important for exercise to be progressively challenging, ongoing and of sufficient dose to maximise its benefits in reducing falls. Other (non-exercise) interventions are necessary for certain people with complex medical conditions or recent hospitalisation and risk factors relating to vision and the use of psychotropic medications. Qualified exercise professionals are well placed to implement the research evidence and to prescribe and supervise specific exercise aimed at preventing falls in both healthy older community-dwelling people and those with co-morbidities. Copyright © 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Operation and challenges of home-based medical practices in the US: findings from six aggregated case studies.

PubMed

Norman, Gregory J; Orton, Kristann; Wade, Amy; Morris, Andrea M; Slaboda, Jill C

2018-01-27

Home-based primary care (HBPC) is a multidisciplinary, ongoing care strategy that can provide cost-effective, in-home treatment to meet the needs of the approximately four million homebound, medically complex seniors in the U.S. Because there is no single model of HBPC that can be adopted across all types of health organizations and U.S. geographic regions, we conducted a six-site HBPC practice assessment to better understand different operation structures, common challenges, and approaches to delivering HBPC. Six practices varying in size, care team composition and location agreed to participate. At each site we conducted unstructured interviews with key informants and directly observed practices and procedures in the field and back office. The aggregated case studies revealed important issues focused on team composition, patient characteristics, use of technology and urgent care delivery. Common challenges across the practices included provider retention and unmet community demand for home-based care services. Most practices, regardless of size, faced challenges around using electronic medical records (EMRs) and scheduling systems not designed for use in a mobile practice. Although many practices offered urgent care, practices varied in the methods used to provide care including the use of community paramedics and telehealth technology. Learnings compiled from these observations can inform other HBPC practices as to potential best practices that can be implemented in an effort to improve efficiency and scalability of HBPC so that seniors with multiple chronic conditions can receive comprehensive primary care services in their homes.

CCTC and the Process for Reauthorization of Bilingual Teacher Preparation Standards: A Critical-Historical Perspective

ERIC Educational Resources Information Center

Cadiero-Kaplan, Karen; Berta-Avila, Margarita; Flores, Juan

2007-01-01

California and the rest of the United Sates are undergoing significant challenges in providing educational opportunities for an increasingly diverse population. These challenges include inadequate literacy and numeracy skills among large segments of the student and adult populations; an ongoing shift in the demographic profile of the population,…

Student Retention: A Description of First-Generation Minority Male Students' Interaction with Faculty

ERIC Educational Resources Information Center

Alford, Keyimani L.

2017-01-01

Challenges in retaining minority male students is an on-going issue in higher education in America. In addition, research suggests that the challenge is greater at Predominantly White Institutions. For many years, institutions have adopted principles and strategies suggested by researchers to counterattack this concern. Although a vast wealth of…

Radiation Testing on State-of-the-Art CMOS: Challenges, Plans, and Preliminary Results

NASA Technical Reports Server (NTRS)

LaBel, Kenneth A.; Cohn, Lewis M.

2009-01-01

At GOMAC 2007 and 2008, we discussed a variety of challenges for radiation testing of modern semiconductor devices and technologies [1, 2]. In this presentation, we provide more specific details in this on-going investigation focusing on out-of-the-box lessons observed for providing radiation effects assurances as well as preliminary test results.

In Pursuit of Being Canadian: Examining the Challenges of Culturally Relevant Education in Teacher Education Programs

ERIC Educational Resources Information Center

Dlamini, S. Nombuso; Martinovic, Dragana

2007-01-01

This article is about an ongoing initiative that addresses the challenges confronted by teacher candidates to whom English is an additional language and whose cultures are considered different from those of the Canadian mainstream. The initiative is a seminar, Language and Cultural Engagement, in which teacher candidates are prepared for practice…

The Handbook of High-Risk Challenging Behaviors in People with Intellectual and Developmental Disabilities

ERIC Educational Resources Information Center

Luiselli, James K., Ed.

2012-01-01

Aggressive and destructive behaviors are an ongoing challenge for many children, adolescents, and adults with intellectual and developmental disabilities (I/DD). What's behind these high-risk behaviors, and how can professionals help manage them? Discover the answers in this comprehensive text, the most up-to-date compendium of knowledge on…

Enhancing Large-Class Teaching: A Systematic Comparison of Rich-Media Materials

ERIC Educational Resources Information Center

Saunders, F. C.; Hutt, I.

2015-01-01

Large cohorts (>200 students) are an ever-increasing presence in the UK higher education (HE) sector. Providing excellent teaching and learning to these large classes is an ongoing challenge for teaching faculty, a challenge intensified when the cohort comprises 85% non-native English speakers. This paper presents the findings of a project to…

One Goal, Two Institutions: How a Community College and 4-Year University Partner to Bridge Student College Readiness Gaps

ERIC Educational Resources Information Center

Wilson, Dawna; Lowry, Kimberly M.

2017-01-01

Recent national attention on college completion poses unique challenges and opportunities for community colleges. Moving underprepared students through basic skills educational courses to degree attainment represents an ongoing challenge. With more than 60% of community college students enrolled in remedial education, 2-year institutions must…

The Future Role of the United States in Global Health: Emphasis on Cardiovascular Disease.

PubMed

Fuster, Valentin; Frazer, Jendayi; Snair, Megan; Vedanthan, Rajesh; Dzau, Victor

2017-12-26

U.S. global health investment has focused on detection, treatment, and eradication of infectious diseases such as tuberculosis, malaria, and human immunodeficiency virus/acquired immunodeficiency syndrome, with significant results. Although efforts should be maintained and expanded to provide ongoing therapy for chronic infectious disease, there is a pressing need to meet the challenge of noncommunicable diseases, which constitute the highest burden of diseases globally. A Committee of the National Academies of Sciences, Engineering, and Medicine has made 14 recommendations that require ongoing commitments to eradication of infectious disease and increase the emphasis on chronic diseases such as cardiovascular disease. These include improving early detection and treatment, mitigating disease risk factors, shifting global health infrastructure to include management of cardiovascular disease, developing global partners and private-public ventures to meet infrastructure and funding challenges, streamlining medical product development and supply, increasing research and development capacity, and addressing gaps in global political and institutional leadership to meet the shifting challenge. Copyright © 2017. Published by Elsevier Inc.

Planning for the Future of Geo-Cybereducation: Outcomes of the Workshop, Challenges, and Future Directions

NASA Astrophysics Data System (ADS)

Ryan, J. G.; Eriksson, S. C.

2010-12-01

Inspired by the recommendations of the NSF report “Fostering Learning in the Networked World: The Cyberlearning Opportunity and Challenge” (NSF08204), the NSF National STEM Digital Learning program funded “Planning for the Future of Geocybereducation” Workshop sought to bring together leaders from the geoscience education community, from major geoscience research initiatives, and from the growing public- and private-sector geoscience information community. The objectives of the workshop were to begin conversations aimed at identifying best practices and tools for geoscience cyber-education, in the context of both the changing nature of learners and of rapidly evolving geo-information platforms, and to provide guidance to the NSF as to necessary future directions and needs for funding. 65 participants met and interacted live for the two-day workshop, with ongoing post-meeting virtual interactions via a collaborative workspace (www.geocybered.ning.com). Topics addressed included the rapidly changing character of learners, the growing capabilities of geoscience information systems and their affiliated tools, and effective models for collaboration among educators, researchers and geoinformation specialists. Discussions at the meeting focused on the implications of changing learners on the educational process, the challenges for teachers and administrators in keeping pace, and on the challenges of communication among these divergent professional communities. Ongoing virtual discussions and collaborations have produced a draft workshop document, and the workshop conveners are maintaining the workshop site as a venue for ongoing discussion and interaction. Several key challenges were evident from the workshop discussions and subsequent interactions: a) the development of most of the large geoinformatics and geoscience research efforts were not pursued with education as a significant objective, resulting in limited financial support for such activities after the fact; b) the “playing field” of cybertechnologies relevant to geoscience education, research and informatics changes so rapidly that even committed “players” find that staying current is challenging; c) the scholarly languages of geoscience education, geoscience research, and geoinformatics are different, making easy communication about respective needs and constraints surprisingly difficult; and d) the impact of “everyday” cybertechnologies on learner audiences is profound and (so far) not well addressed by educators. Discussions on these issues are ongoing in a number of other venues.

Assessment of anorexia nervosa: an overview of universal issues and contextual challenges

PubMed Central

2013-01-01

Aim Anorexia Nervosa (AN) is a complex and clinically challenging syndrome. Intended for specialist audiences, this narrative review aims to summarise the available literature related to assessment in the adult patient context, synthesising both research evidence and clinical consensus guidelines. Method We provide a review of the available literature on specialist assessment of AN focusing on common trajectories into assessment, obstacles accessing assessment, common presenting issues and barriers to the assessment process, the necessary scope of assessment, and tools and techniques. It describes the further step of synthesising assessment information in ways that can inform resultant care plans. Results In addition to assessment of core behaviours and diagnostic skills, considerations for the expert assessor include the functions of primary care, systemic and personal barriers, knowledge of current assessment tools and research pertaining to comorbid pathology in AN, assessing severity of illness, role of family at assessment, as well as medical, nutritional and compulsory elements of assessment. Conclusion Comprehensive assessment of AN in the current healthcare context still remains largely the remit of the specialist ED clinician. Assessment should remain an on-going process, paying particular attention to available empirical evidence, thereby reducing the gap between research and practice. PMID:24999408

The Effects of Surfaces on the Aerodynamics and Acoustics of Jet Flows

NASA Technical Reports Server (NTRS)

Smith, Matthew J.; Miller, Steven A. E.

2013-01-01

Aircraft noise mitigation is an ongoing challenge for the aeronautics research community. In response to this challenge, low-noise aircraft concepts have been developed that exhibit situations where the jet exhaust interacts with an airframe surface. Jet flows interacting with nearby surfaces manifest a complex behavior in which acoustic and aerodynamic characteristics are altered. In this paper, the variation of the aerodynamics, acoustic source, and far-field acoustic intensity are examined as a large at plate is positioned relative to the nozzle exit. Steady Reynolds-Averaged Navier-Stokes solutions are examined to study the aerodynamic changes in the field-variables and turbulence statistics. The mixing noise model of Tam and Auriault is used to predict the noise produced by the jet. To validate both the aerodynamic and the noise prediction models, results are compared with Particle Image Velocimetry (PIV) and free-field acoustic data respectively. The variation of the aerodynamic quantities and noise source are examined by comparing predictions from various jet and at plate configurations with an isolated jet. To quantify the propulsion airframe aeroacoustic installation effects on the aerodynamic noise source, a non-dimensional number is formed that contains the flow-conditions and airframe installation parameters.

Druggable orthosteric and allosteric hot spots to target protein-protein interactions.

PubMed

Ma, Buyong; Nussinov, Ruth

2014-01-01

Drug designing targeting protein-protein interactions is challenging. Because structural elucidation and computational analysis have revealed the importance of hot spot residues in stabilizing these interactions, there have been on-going efforts to develop drugs which bind the hot spots and out-compete the native protein partners. The question arises as to what are the key 'druggable' properties of hot spots in protein-protein interactions and whether these mimic the general hot spot definition. Identification of orthosteric (at the protein- protein interaction site) and allosteric (elsewhere) druggable hot spots is expected to help in discovering compounds that can more effectively modulate protein-protein interactions. For example, are there any other significant features beyond their location in pockets in the interface? The interactions of protein-protein hot spots are coupled with conformational dynamics of protein complexes. Currently increasing efforts focus on the allosteric drug discovery. Allosteric drugs bind away from the native binding site and can modulate the native interactions. We propose that identification of allosteric hot spots could similarly help in more effective allosteric drug discovery. While detection of allosteric hot spots is challenging, targeting drugs to these residues has the potential of greatly increasing the hot spot and protein druggability.

Genetic-based prediction of disease traits: prediction is very difficult, especially about the future†

PubMed Central

Schrodi, Steven J.; Mukherjee, Shubhabrata; Shan, Ying; Tromp, Gerard; Sninsky, John J.; Callear, Amy P.; Carter, Tonia C.; Ye, Zhan; Haines, Jonathan L.; Brilliant, Murray H.; Crane, Paul K.; Smelser, Diane T.; Elston, Robert C.; Weeks, Daniel E.

2014-01-01

Translation of results from genetic findings to inform medical practice is a highly anticipated goal of human genetics. The aim of this paper is to review and discuss the role of genetics in medically-relevant prediction. Germline genetics presages disease onset and therefore can contribute prognostic signals that augment laboratory tests and clinical features. As such, the impact of genetic-based predictive models on clinical decisions and therapy choice could be profound. However, given that (i) medical traits result from a complex interplay between genetic and environmental factors, (ii) the underlying genetic architectures for susceptibility to common diseases are not well-understood, and (iii) replicable susceptibility alleles, in combination, account for only a moderate amount of disease heritability, there are substantial challenges to constructing and implementing genetic risk prediction models with high utility. In spite of these challenges, concerted progress has continued in this area with an ongoing accumulation of studies that identify disease predisposing genotypes. Several statistical approaches with the aim of predicting disease have been published. Here we summarize the current state of disease susceptibility mapping and pharmacogenetics efforts for risk prediction, describe methods used to construct and evaluate genetic-based predictive models, and discuss applications. PMID:24917882

New ground-based lidar enables volcanic CO2 flux measurements.

PubMed

Aiuppa, Alessandro; Fiorani, Luca; Santoro, Simone; Parracino, Stefano; Nuvoli, Marcello; Chiodini, Giovanni; Minopoli, Carmine; Tamburello, Giancarlo

2015-09-01

There have been substantial advances in the ability to monitor the activity of hazardous volcanoes in recent decades. However, obtaining early warning of eruptions remains challenging, because the patterns and consequences of volcanic unrests are both complex and nonlinear. Measuring volcanic gases has long been a key aspect of volcano monitoring since these mobile fluids should reach the surface long before the magma. There has been considerable progress in methods for remote and in-situ gas sensing, but measuring the flux of volcanic CO2-the most reliable gas precursor to an eruption-has remained a challenge. Here we report on the first direct quantitative measurements of the volcanic CO2 flux using a newly designed differential absorption lidar (DIAL), which were performed at the restless Campi Flegrei volcano. We show that DIAL makes it possible to remotely obtain volcanic CO2 flux time series with a high temporal resolution (tens of minutes) and accuracy (<30%). The ability of this lidar to remotely sense volcanic CO2 represents a major step forward in volcano monitoring, and will contribute improved volcanic CO2 flux inventories. Our results also demonstrate the unusually strong degassing behavior of Campi Flegrei fumaroles in the current ongoing state of unrest.

Towards a robust green astro-comb for Earth-like exoplanet searches

NASA Astrophysics Data System (ADS)

Ravi, Aakash; Martin, Leopoldo; Phillips, David; Langellier, Nicholas; Milbourne, Timothy; Dolliff, Christian; Walsworth, Ronald

2017-04-01

The detection of exoplanets using the radial velocity (RV) method has become a very exciting and active area of research. Detecting Earth-like planets, however, is still very challenging as it requires extremely precise calibration of the spectrographs used in such measurements. To address this challenge, we employ a visible wavelength frequency comb - referenced to the global positioning system - as a calibration source. Our comb calibrator is realized by spectrally broadening and shifting the output of a 1 GHz repetition rate modelocked Ti:sapphire laser using a photonic crystal fiber and then filtering the comb lines to create a 16 GHz-spacing comb. This system has been implemented at the TNG telescope on La Palma to calibrate the HARPS-N spectrograph. However, the complexity of the system has thus far prevented its routine use as it requires frequency comb specialists to be on site during measurements. Here, we propose some automation strategies and present preliminary results from our efforts. We also discuss ongoing comb-calibrated astrophysical observations, including measurements of the Sun. The solar measurements are part of an effort to understand stellar noise sources in the RV data and demonstrate the sensitivity of the instrument to detect terrestrial exoplanets.

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

Vatsavai, Raju; Cheriyadat, Anil M; Bhaduri, Budhendra L

The high rate of urbanization, political conflicts and ensuing internal displacement of population, and increased poverty in the 20th century has resulted in rapid increase of informal settlements. These unplanned, unauthorized, and/or unstructured homes, known as informal settlements, shantytowns, barrios, or slums, pose several challenges to the nations, as these settlements are often located in most hazardous regions and lack basic services. Though several World Bank and United Nations sponsored studies stress the importance of poverty maps in designing better policies and interventions, mapping slums of the world is a daunting and challenging task. In this paper, we summarize ourmore » ongoing research on settlement mapping through the utilization of Very high resolution (VHR) remote sensing imagery. Most existing approaches used to classify VHR images are single instance (or pixel-based) learning algorithms, which are inadequate for analyzing VHR imagery, as single pixels do not contain sufficient contextual information (see Figure 1). However, much needed spatial contextual information can be captured via feature extraction and/or through newer machine learning algorithms in order to extract complex spatial patterns that distinguish informal settlements from formal ones. In recent years, we made significant progress in advancing the state of art in both directions. This paper summarizes these results.« less

The challenges of providing palliative care for people with intellectual disabilities: a literature review.

PubMed

Dunkley, Susie; Sales, Rachel

2014-06-01

People with intellectual disabilities are often marginalised from mainstream health-care services because of the complexities of their disability. They are under-referred to specialist palliative care owing to a limited understanding of its role and little collaborative working. Furthermore, professionals caring for people with intellectual disabilities and palliative care services often lack knowledge about and confidence in their ability to meet the needs of people with an intellectual disability who require palliative care. This literature review explores the challenges of providing palliative care for people with intellectual disability. It highlights that training requirements need to be effectively identified, referrals between professional groups made, and the perspectives of patients understood to overcome the marginalisation of people with intellectual disability. There is a need for ongoing staff development focusing on staff confidence, collaborative working between professionals, and the empowerment of people with intellectual disability to be involved in decisions about their end-of-life care. Further research is needed to examine the most effective way of capturing the perspectives of those with intellectual disability and of enabling people with intellectual disability to access and engage with health surveillance, cancer screening, and palliative care services.

Critical Pedagogy and APA: A Resonant (and Timely) Interdisciplinary Blend.

PubMed

Connolly, Maureen; Harvey, William J

2018-04-12

Critical pedagogy owes much of its emergence, development, and ongoing relevance to the work of Paulo Freire whose legacy remains relevant for a next generation of scholars who seek to explore issues of inclusion, oppression, social justice, and authentic expression. An interdisciplinary dialogue between critical pedagogy and adapted physical activity is timely, appropriate, and should focus on complex profiles of neurodiversity, mental illness, and mental health, with emphasis on pedagogic practices of practitioners in service delivery and teacher educators who prepare them for professional practice. A case-based scenario approach is used to present practitioner and teacher educator practices. Concrete examples are provided for analyzing and understanding deeper issues and challenges related to neurodiversity in a variety of embodied dimensions in educational and activity contexts. We work with Szostak's approach to interdisciplinary research and model an analysis strategy that integrates and applies the methodological features of interdisciplinarity, adapted physical activity, and critical pedagogy.

Novel Thin Film Sensor Technology for Turbine Engine Hot Section Components

NASA Technical Reports Server (NTRS)

Wrbanek, John D.; Fralick, Gustave C.

2007-01-01

Degradation and damage that develops over time in hot section components can lead to catastrophic failure of the turbine section of aircraft engines. A range of thin film sensor technology has been demonstrated enabling on-component measurement of multiple parameters either individually or in sensor arrays including temperature, strain, heat flux, and flow. Conductive ceramics are beginning to be investigated as new materials for use as thin film sensors in the hot section, leveraging expertise in thin films and high temperature materials. The current challenges are to develop new sensor and insulation materials capable of withstanding the extreme hot section environment, and to develop techniques for applying sensors onto complex high temperature structures for aging studies of hot propulsion materials. The technology research and development ongoing at NASA Glenn Research Center for applications to future aircraft, launch vehicles, space vehicles, and ground systems is outlined.

Use of orbital atherectomy in acute myocardial infarction via the transradial approach

PubMed Central

Mowakeaa, Samer; Snyder, Branden; Kakouros, Nikolaos

2016-01-01

Severe coronary artery calcifications pose an ongoing challenge when performing percutaneous coronary interventions, resulting in an increased likelihood of procedural complications. Orbital atherectomy (OA) has emerged as a promising technology that helps improve outcomes in this complex patient population. Its safety and efficacy are yet to be demonstrated in the setting of acute myocardial infarction. We present a case of a patient with acute ST-elevation myocardial infarction (STEMI) evaluated with emergent transradial coronary angiography. The culprit lesion was a severely stenotic, heavily calcified, segment of the right coronary artery. The use of OA facilitated lesion expansion and implantation of a drug-eluting stent. Although OA should be considered as contraindicated for the management of soft-ruptured plaque, which accounts for the majority of STEMI presentations, it may be well applied to the small subset of patients with calcified nodule pathology, even in the acute setting. PMID:28180008

Gender identity in disorders of sex development: review article.

PubMed

Yang, Jennifer H; Baskin, Laurence S; DiSandro, Michael

2010-01-01

Many concerns have been raised regarding the treatment and long-term outcome of infants born with complex genital anomalies. Debate among clinicians, psychologists, ethicists, and patient advocate groups regarding the optimal management of these individuals is ongoing. Although determining the most appropriate gender is a difficult task, this review will help clarify some of the issues at hand. A literature review which addresses the challenges of advising families about gender identity in infants and children with disorders of sex development. The evidence for endocrine effects on neurobiological development with regard to sexual behavior is compelling, although the existing outcome studies are largely anecdotal and somewhat contradictory. Gender assignment in infants born with a disorder of sex development remains only one of the many difficult decisions faced by both the treatment team and the family. Improved long-term follow-up of these patients will provide much needed feedback on previous and contemporary management. 2010 Elsevier Inc. All rights reserved.

Ethical issues and addiction.

PubMed

Lambert, Binta; Scheiner, Melissa; Campbell, Deborah

2010-04-01

The epidemic of substance abuse continues to pose a significant challenge to clinicians nationwide. Although there is a tendency to simply associate drug abuse with poverty, the problem affects every social stratum gender and race; and pregnant women are no exception. Caring for pregnant, substance-using women and their infants presents complex legal and ethical issues. Debate is ongoing about whether criminal penalties should be imposed on women based solely on their use of alcohol and other drugs during pregnancy. Furthermore, controversies persist about the rights and wishes of pregnant women versus the interests of their fetuses. For health professionals, conflict arises when the pregnant woman chooses behaviors that have the potential to harm the developing fetus. The ethical dilemma arises from competing autonomy-based and beneficence-based obligations to the maternal-fetal dyad. This chapter explores the ethics-based conflicts in the delivery of health care to drug abusing pregnant women.

Fatigue of Nitinol: The state-of-the-art and ongoing challenges.

PubMed

Mahtabi, M J; Shamsaei, Nima; Mitchell, M R

2015-10-01

Nitinol, a nearly equiatomic alloy of nickel and titanium, has been considered for a wide range of applications including medical and dental devices and implants as well as aerospace and automotive components and structures. The realistic loading condition in many of these applications is cyclic; therefore, fatigue is often the main failure mode for such components and structures. The fatigue behavior of Nitinol involves many more complexities compared with traditional metal alloys arising from its uniqueness in material properties such as superelasticity and shape memory effects. In this paper, a review of the present state-of-the-art on the fatigue behavior of superelastic Nitinol is presented. Various aspects of fatigue of Nitinol are discussed and microstructural effects are explained. Effects of material preparation and testing conditions are also reviewed. Finally, several conclusions are made and recommendations for future works are offered. Copyright © 2015 Elsevier Ltd. All rights reserved.

Psychological Processing in Chronic Pain: A Neural Systems Approach

PubMed Central

Simons, Laura; Elman, Igor; Borsook, David

2014-01-01

Our understanding of chronic pain involves complex brain circuits that include sensory, emotional, cognitive and interoceptive processing. The feed-forward interactions between physical (e.g., trauma) and emotional pain and the consequences of altered psychological status on the expression of pain have made the evaluation and treatment of chronic pain a challenge in the clinic. By understanding the neural circuits involved in psychological processes, a mechanistic approach to the implementation of psychology-based treatments may be better understood. In this review we evaluate some of the principle processes that may be altered as a consequence of chronic pain in the context of localized and integrated neural networks. These changes are ongoing, vary in their magnitude, and their hierarchical manifestations, and may be temporally and sequentially altered by treatments, and all contribute to an overall pain phenotype. Furthermore, we link altered psychological processes to specific evidence-based treatments to put forth a model of pain neuroscience psychology. PMID:24374383

Integrating CFD, CAA, and Experiments Towards Benchmark Datasets for Airframe Noise Problems

NASA Technical Reports Server (NTRS)

Choudhari, Meelan M.; Yamamoto, Kazuomi

2012-01-01

Airframe noise corresponds to the acoustic radiation due to turbulent flow in the vicinity of airframe components such as high-lift devices and landing gears. The combination of geometric complexity, high Reynolds number turbulence, multiple regions of separation, and a strong coupling with adjacent physical components makes the problem of airframe noise highly challenging. Since 2010, the American Institute of Aeronautics and Astronautics has organized an ongoing series of workshops devoted to Benchmark Problems for Airframe Noise Computations (BANC). The BANC workshops are aimed at enabling a systematic progress in the understanding and high-fidelity predictions of airframe noise via collaborative investigations that integrate state of the art computational fluid dynamics, computational aeroacoustics, and in depth, holistic, and multifacility measurements targeting a selected set of canonical yet realistic configurations. This paper provides a brief summary of the BANC effort, including its technical objectives, strategy, and selective outcomes thus far.

Plasmonic photothermal heating of intraperitoneal tumors through the use of an implanted near-infrared source.

PubMed

Bagley, Alexander F; Hill, Samuel; Rogers, Gary S; Bhatia, Sangeeta N

2013-09-24

Plasmonic nanomaterials including gold nanorods are effective agents for inducing heating in tumors. Because near-infrared (NIR) light has traditionally been delivered using extracorporeal sources, most applications of plasmonic photothermal therapy have focused on isolated subcutaneous tumors. For more complex models of disease such as advanced ovarian cancer, one of the primary barriers to gold nanorod-based strategies is the adequate delivery of NIR light to tumors located at varying depths within the body. To address this limitation, a series of implanted NIR illumination sources are described for the specific heating of gold nanorod-containing tissues. Through computational modeling and ex vivo studies, a candidate device is identified and validated in a model of orthotopic ovarian cancer. As the therapeutic, imaging, and diagnostic applications of plasmonic nanomaterials progress, effective methods for NIR light delivery to challenging anatomical regions will complement ongoing efforts to advance plasmonic photothermal therapy toward clinical use.

The impact of Alzheimer disease genetics on expert and advanced gerontological nursing practice.

PubMed

Schutte, D L

1998-11-01

Alzheimer disease (AD), a progressive neurodegenerative disorder, is the most common cause of dementia in the United States, affecting as many as 4 million people. Extensive research is under way to identify environmental and genetic risk factors for this complex disease. Currently, four genes are associated with an increased risk for AD: the amyloid precursor protein gene on chromosome 21, the Presenilin I gene on chromosome 14, the Presenilin II gene on chromosome 1, and the apolipoprotein E gene on chromosome 19. Expert and advanced practice gerontological nurses are faced with new challenges as a result of these gene discoveries. Gerontological nurses should assess for relevant environmental and genetic risk factors; obtain comprehensive family health histories recorded as pedigrees; integrate genetic information into diagnosis, intervention, and evaluation strategies; initiate and coordinate referrals to genetic specialists; and provide ongoing emotional and decision-making support for patients and families experiencing AD.

DNA-imprinted polymer nanoparticles with monodispersity and prescribed DNA-strand patterns

NASA Astrophysics Data System (ADS)

Trinh, Tuan; Liao, Chenyi; Toader, Violeta; Barłóg, Maciej; Bazzi, Hassan S.; Li, Jianing; Sleiman, Hanadi F.

2018-02-01

As colloidal self-assembly increasingly approaches the complexity of natural systems, an ongoing challenge is to generate non-centrosymmetric structures. For example, patchy, Janus or living crystallization particles have significantly advanced the area of polymer assembly. It has remained difficult, however, to devise polymer particles that associate in a directional manner, with controlled valency and recognition motifs. Here, we present a method to transfer DNA patterns from a DNA cage to a polymeric nanoparticle encapsulated inside the cage in three dimensions. The resulting DNA-imprinted particles (DIPs), which are 'moulded' on the inside of the DNA cage, consist of a monodisperse crosslinked polymer core with a predetermined pattern of different DNA strands covalently 'printed' on their exterior, and further assemble with programmability and directionality. The number, orientation and sequence of DNA strands grafted onto the polymeric core can be controlled during the process, and the strands are addressable independently of each other.

Split liver transplantation in adults.

PubMed

Hashimoto, Koji; Fujiki, Masato; Quintini, Cristiano; Aucejo, Federico N; Uso, Teresa Diago; Kelly, Dympna M; Eghtesad, Bijan; Fung, John J; Miller, Charles M

2016-09-07

Split liver transplantation (SLT), while widely accepted in pediatrics, remains underutilized in adults. Advancements in surgical techniques and donor-recipient matching, however, have allowed expansion of SLT from utilization of the right trisegment graft to now include use of the hemiliver graft as well. Despite less favorable outcomes in the early experience, better outcomes have been reported by experienced centers and have further validated the feasibility of SLT. Importantly, more than two decades of experience have identified key requirements for successful SLT in adults. When these requirements are met, SLT can achieve outcomes equivalent to those achieved with other types of liver transplantation for adults. However, substantial challenges, such as surgical techniques, logistics, and ethics, persist as ongoing barriers to further expansion of this highly complex procedure. This review outlines the current state of SLT in adults, focusing on donor and recipient selection based on physiology, surgical techniques, surgical outcomes, and ethical issues.

Professional convergence in forensic practice.

PubMed

Mercer, D; Mason, T; Richman, J

2001-06-01

This paper outlines the development and convergence of forensic science and secure psychiatric services in the UK, locating the professionalization of forensic nursing within a complex web of political, economic, and ideological structures. It is suggested that a stagnation of the therapeutic enterprise in high and medium security provision has witnessed an intrusion of medical power into the societal body. Expanding technologies of control and surveillance are discussed in relation to the move from modernity to postmodernity and the ongoing dynamic of medicalized offending. Four aspects of globalization are identified as impacting upon the organization and application of forensic practice: (i) organized capitalism and the exhaustion of the welfare state; (ii) security versus danger and trust versus risk; (iii) science as a meta-language; and (iv) foreclosure as a mechanism of censorship. Finally, as a challenge for the profession, some predictions are offered about the future directions or demise of forensic nursing.

Thinking and working relationally: interviewing and constructing hypotheses to create compassionate understanding.

PubMed

Sheinberg, Marcia; Brewster, Mary Kim

2014-12-01

In the initial interviews of family therapy sessions, the therapist faces the challenge of obtaining and organizing the information that is most relevant toward understanding the essential concerns that families and couples bring to therapy. This article describes the process of clinical interviewing and case conceptualization used in training family therapists at the Ackerman Institute for the Family. This approach helps the therapist bring forward, and organize, specific information into relational hypotheses, or systemic-relational conceptualizations, that allow both family members and the therapist to understand presenting problems within their relational contexts. While always provisional, relational hypotheses help anchor the therapist in a systemic-relational frame and provide a conceptual through-line to guide the ongoing work of the therapy. The process of interviewing and the construction of clear and complex conceptualizations of presenting problems are illustrated through case examples. © 2014 Family Process Institute.

Exploring stories of occupational engagement in a regional secure unit

PubMed Central

Morris, Karen; Cox, Diane L.; Ward, Kath

2016-01-01

Abstract This paper focuses on the occupational experiences of five men living within a forensic mental health unit over a year. This study used a descriptive qualitative case study methodology to explore the meaning and value placed on daily life (activities, occupations and routines), and how this changed over time. The men’s stories showed a complex picture of their experiences of daily life. This study demonstrated the impact of the environment on the men and the ongoing challenge of the need to balance treatment/therapy with security demands and opportunities. Three interrelated themes were identified: (1) Power and Occupation; (2) Therapy or Punishment; (3) Occupational Opportunities within Restrictions. These findings serve as a reminder to clinical teams to reassess the value of occupations attributed by their patients and the impact of the secure environment, whilst also acknowledging the potential for occupations to have a negative impact on well-being. PMID:27695388

[Adherence to the Ongoing Education Program for family doctors in a southeastern Brazilian state].

PubMed

d'Ávila, Luciana Souza; Assis, Lucília Nunes de; Melo, Marilene Barros de; Brant, Luiz Carlos

2014-02-01

Ongoing Health Education is a strategy for transformation of health practices, though the adherence of professionals is one of the challenges facing its implementation. Thus, the objective of this study was to investigate the factors associated with adherence of family doctors to the Ongoing Education Program in a southeastern Brazilian state from the perception of supervisors. It is a cross-sectional and quantitative study with the use of online questionnaires. Data were analyzed using the chi-square test with ongoing correction to determine the association between structure, topics, activities and difficulties of the supervisors working in Ongoing Health Education, difficulties of the physicians in Primary Health Care (PHC) and poor and good adherence to the program. Excellent medical participation was statistically related to the adequacy of physical space (p = 0.001), a multidisciplinary approach (p = 0.035) and epidemiological aspects (p = 0.043). Low adherence was associated with the inadequacy of the physical structure, difficulty understanding the methodology, less time in a supervisory position, multiple workdays, among others. A good adherence to Ongoing Health Education is a possibility for collective reconstruction of the everyday work of physicians in Primary Health Care.

The northwest Arkansas transit assessment study

DOT National Transportation Integrated Search

2000-03-01

Providing adequate public transportation, including transportation services for the disadvantaged in Northwest Arkansas is an ongoing challenge. Unmet transit needs for the four-county area (Washington, Benton, Carroll and Madison Counties) included ...

Ongoing measles outbreak in Wallonia, Belgium, December 2016 to March 2017: characteristics and challenges

PubMed Central

Grammens, Tine; Schirvel, Carole; Leenen, Sylvie; Shodu, Nathalie; Hutse, Veronik; Mendes da Costa, Elise; Sabbe, Martine

2017-01-01

We describe characteristics of an ongoing measles outbreak in Wallonia, Belgium, and difficulties in control measures implementation. As at 12 March 2017, 177 measles cases were notified, of which 50% were 15 years and older, 49% female. Atypical clinical presentation and severe complications, mainly among adults, in combination with late notification, low or unknown vaccination coverage of contacts, infected healthcare workers and increased workload due to contact tracing, are the main concerns for outbreak management. PMID:28488998

Occupational therapy in Australian acute hospitals: A modified practice.

PubMed

Britton, Lauren; Rosenwax, Lorna; McNamara, Beverley

2016-08-01

Ongoing changes to health-care funding Australia wide continue to influence how occupational therapists practise in acute hospitals. This study describes the practice challenges experienced by Western Australian acute care occupational therapists. Then, it explores if and how acute care occupational therapists are modifying their practice in response to these practice changes. This study used a qualitative grounded theory approach. Semi-structured interviews were completed with 13 purposively selected acute care occupational therapists from four Western Australian metropolitan hospitals. Data were analysed using a constant comparative method to provide detailed descriptions of acute care occupational therapy practice and to generate theory. Five conceptual categories were developed. The first two addressed practice challenges: pragmatic organisational influences on client care and establishing a professional identity within the multidisciplinary team. Three categories related to therapist responses are as follows: becoming the client advocate, being the facilitator and applying clinical reasoning. Finally, modified practice was identified as the core category which explains the process whereby acute care occupational therapists are ensuring they remain relevant and authentic in the acute care context. Western Australian acute care occupational therapists are practising in a highly complex health context that presents many challenges. They are responding by using a modified form of practice that ensures occupational therapy skills remain relevant within the narrow confines of this health setting. © 2016 Occupational Therapy Australia.

Successes and Challenges in School Meal Reform: Qualitative Insights From Food Service Directors.

PubMed

Asada, Yuka; Ziemann, Margaret; Zatz, Lara; Chriqui, Jamie

2017-08-01

The Healthy, Hunger-Free Kids Act of 2010 (HHFKA) directed the US Department of Agriculture (USDA) to revise school meal standards to increase healthy food offerings. A critical stakeholder in the implementation of standards is Food Service Directors (FSDs). We sought to examine FSDs' perspectives on revised school meal standards to gain insight into successful implementation strategies. Semistructured interviews were conducted with FSDs (N = 9) from high schools that had achieved HealthierUS Schools Challenge: Smarter Lunchrooms (HUSSC: SL) status. Qualitative interview data were team coded in Atlas.ti v7 and analyzed with principles of constant comparative analysis. FSDs reported overall positive perceptions of the revised school meal standards and its potential impacts, as well as improved fruit and vegetable consumption, despite initial challenges with plate waste, procurement of whole grain-rich products, and fast paced sodium targets. Implementation was described as complex, ongoing processes; with time and in-service trainings, student acceptance to these changes improved. These findings are directly relevant to future reauthorization of the Child Nutrition Act and to revisions to the implementation time line for the federal school meal standards related to sodium, whole grains, and flavored milk. Insights into FSDs' strategies suggest that more time and targeted technical assistance at federal, state, and local levels is warranted. © 2017, American School Health Association.

LeaderBeing: Critical Reflections on Context, Character and Challenge in the Culture of Research and Its Administration

ERIC Educational Resources Information Center

Gabriele, Edward F.; Caines, Vaughan V.

2014-01-01

Servant leadership is a critical concept for understanding the ongoing importance of research administration as a central profession of service within the culture of research itself. The leadership of research administrators is both a unique gift and a challenge to the research culture. To ensure the continued productivity of the research…

Overcoming the Challenges of Retaining Novice Teachers in a County Public School

ERIC Educational Resources Information Center

Albert, Ernst

2017-01-01

Retaining novice teachers in a Northeast Florida county public school is an ongoing challenge. Research indicates that 14% of new teachers will leave the field within 5 years. The purpose of this case study was to investigate the major factors that contributed to this unique group of novice teachers' decisions to continue to teach at the school…

Developing a Rural and Regional Science Challenge to Utilise Community and Industry-Based Partnerships

ERIC Educational Resources Information Center

Blake, Damian; Campbell, Coral

2009-01-01

Interest and participation in science in schools has been declining for many years and there is a genuine need to rejuvenate interest in science at the high school level. One possible solution is the completion of challenging science projects which fulfill an authentic purpose in the community. This paper discusses the results of ongoing research…

Threats to cross-border wildlife linkages in the Sky Islands Wildlands Network

Treesearch

Kim Vacariu

2005-01-01

One of the greatest challenges facing conservationists in the Sky Islands region is finding a realistic means to maintain historic travel routes for wide-ranging species crossing the United States-Mexico border. This challenge is made difficult due to the ongoing efforts by the Federal government to install additional security infrastructure to stem the flood of...

If the Shoe Doesn't Fit: A Case and a Place for Collaborative Learning for Music Practice in Higher Education

ERIC Educational Resources Information Center

Forbes, Melissa

2016-01-01

This article reviews relevant literature to provide a rationale for the use of collaborative learning for first year music practice courses at an Australian regional university. Higher music education is still grappling with the challenges posed by the Dawkins Review and ongoing reforms in the sector. These challenges include increased public…

Feminist Perceptions and the Challenges for Women's Education in Jeddah, Saudi Arabia in the 21st Century

ERIC Educational Resources Information Center

Bawazeer, Khadijah

2015-01-01

This article aims to contribute to the ongoing discussion about women's education. Conflicting discourses, regarding the positions of women as student learners, create an educational challenge that faces the GCC countries in the 21st century. This study explores the prevalent feminist positions in Jeddah in Saudi Arabia and presents the findings…

Ongoing ostomy self-care challenges of long-term rectal cancer survivors.

PubMed

Bulkley, Joanna E; McMullen, Carmit K; Grant, Marcia; Wendel, Christopher; Hornbrook, Mark C; Krouse, Robert S

2018-05-29

Surgical treatment for rectal cancer (RC) can result in an intestinal ostomy that requires lifelong adaptation and investment of physical, cognitive, and financial resources. However, little is known about the extent of ongoing challenges related to ostomy self-care among long-term RC survivors. We analyzed the prevalence of self-reported ostomy self-care challenges and the physical and environmental factors that can support or undermine ostomy self-care. We mailed surveys to long-term (≥ 5 years post-diagnosis) RC survivors, including 177 adults with ostomies who were members of integrated health systems in northern California, Oregon, and Washington State. Potential participants were identified through tumor registries. Data were also extracted from electronic health records. The response rate was 65%. The majority of respondents were male (67%), and the mean age was 75 years. Sixty-three percent of respondents reported at least one ostomy self-care challenge. The most common challenges were leakage or skin problems around the ostomy and needing to change the pouching system too frequently. Twenty-two percent reported difficulty caring for their ostomy. Younger age and higher BMI were consistently related to ostomy self-care challenges. The majority of RC survivors reported ostomy-related self-care challenges, and 31% experienced problems across multiple domains of ostomy self-care. In addition, most survivors reported significant physical challenges that could lead to ostomy-related disability. Although the participants surveyed had access to ostomy care nurses, the care gaps we found suggest that additional work is needed to understand barriers to ostomy care, reduce unmet needs, and improve well-being among this group.

Automation and apps for clinical dental biomechanics.

PubMed

Adams, Bruce W

2016-09-01

The aim of this research summary is to introduce the current and ongoing work using smartphone video, tracking markers to measure musculoskeletal disorders of cranial and mandibular origin, and the potential significance of the technology to doctors and therapists. The MPA™ biomechanical measuring apps are in beta trials with various doctors and therapists. The technique requires substantial image processing and statistical analysis, best suited to server-side processing. A smartphone environment has enabled a virtual laboratory, which provides automated generation of graphics and in some cases automated interpretation. The system enables highly accurate real-time biomechanics studies using only a smartphone and tracking markers. Despite the technical challenges in setting up and testing of the virtual environment and with interpretation of clinical relevance, the trials have enabled a demonstration of real-time biomechanics studies. The technology has prompted a lot of discussion about the relevance of rapid assessment tools in clinical practice. It seems that a prior bias against motion tracking and its relevance is very strong with occlusion related use cases, yet there has been a general agreement about the use case for cranial movement tracking in managing complex issues related to the head, neck, and TMJ. Measurement of cranial and mandibular functions using a smartphone video as the input have been investigated. Ongoing research will depend upon doctors and therapists to provide feedback as to which uses are considered clinically relevant.

Multi-wavelength Searches for Massive Black Holes in Dwarf Galaxies

NASA Astrophysics Data System (ADS)

Reines, Amy E.

2018-01-01

Contrary to conventional wisdom, low-mass, physically small dwarf galaxies can indeed host massive black holes (BHs). Moreover, the population and properties of BHs in nearby dwarf galaxies hold clues to the formation of the first seed BHs in the earlier Universe. Identifying BHs in dwarf galaxies, however, is challenging. AGNs powered by smaller BHs are less luminous and more difficult to detect than typical AGNs in more massive systems, and low-mass galaxies generally have ongoing star formation, gas and dust that can mimic or mask signatures of BH accretion. With these challenges in mind, I will present ongoing multi-wavelength searches for AGNs in dwarf galaxies, as well as follow-up studies of existing samples. I will also discuss how this work has implications for directly detecting BH activity in the first galaxies at high redshift.

'Nobody knows what's around the corner': the challenges of caring for people with long-term conditions in care homes.

PubMed

Martin, Susan; Martin, Joy

2018-06-02

People living with long-term conditions are increasingly being cared for in care homes. Prognostication in this population is particularly challenging, and outcomes are often uncertain. This case history highlights some of the difficulties encountered when clinicians give a time-bound prognosis. It also illustrates how education programmes with high facilitation and ongoing support for care home staff can sustain practice development and enable staff to become highly skilled in working with uncertainty. Practice development programmes such as those based on the Six Steps to Success Programme for care homes give care home staff a framework within which to regularly review a resident's clinical status and the confidence to have the ongoing conversations that empower residents to contribute to decision making and focus on their own goals for care.

Limited genetic divergence among Australian alpine Poa tussock grasses coupled with regional structuring points to ongoing gene flow and taxonomic challenges

PubMed Central

Griffin, Philippa C.; Hoffmann, Ary A.

2014-01-01

Background and Aims While molecular approaches can often accurately reconstruct species relationships, taxa that are incompletely differentiated pose a challenge even with extensive data. Such taxa are functionally differentiated, but may be genetically differentiated only at small and/or patchy regions of the genome. This issue is considered here in Poa tussock grass species that dominate grassland and herbfields in the Australian alpine zone. Methods Previously reported tetraploidy was confirmed in all species by sequencing seven nuclear regions and five microsatellite markers. A Bayesian approach was used to co-estimate nuclear and chloroplast gene trees with an overall dated species tree. The resulting species tree was used to examine species structure and recent hybridization, and intertaxon fertility was tested by experimental crosses. Key Results Species tree estimation revealed Poa gunnii, a Tasmanian endemic species, as sister to the rest of the Australian alpine Poa. The taxa have radiated in the last 0·5–1·2 million years and the non-gunnii taxa are not supported as genetically distinct. Recent hybridization following past species divergence was also not supported. Ongoing gene flow is suggested, with some broad-scale geographic structure within the group. Conclusions The Australian alpine Poa species are not genetically distinct despite being distinguishable phenotypically, suggesting recent adaptive divergence with ongoing intertaxon gene flow. This highlights challenges in using conventional molecular taxonomy to infer species relationships in recent, rapid radiations. PMID:24607721

An international borderland of concern: Conservation of biodiversity in the Lower Rio Grande Valley

USGS Publications Warehouse

Leslie,, David M.

2016-07-20

The Lower Rio Grande Valley (LRGV) of southern Texas is located on the United States-Mexico borderland and represents a 240-kilometer (150-mile) linear stretch that ends at the Gulf of Mexico. The LRGV represents a unique transition between temperate and tropical conditions and, as such, sustains an exceptionally high diversity of plants and animals—some of them found in few, or no other, places in the United States. Examples include Leopardus pardalis albescens (northern ocelot) and Falco femoralis septentrionalis (northern aplomado falcon)—both endangered in the United States and emblematic of the LRGV. The U.S. Fish and Wildlife Service (USFWS) manages three national wildlife refuges (Santa Ana, Lower Rio Grande Valley, and Laguna Atascosa) that together make up the South Texas Refuge Complex, which actively conserves biodiversity in about 76,006 hectares (187,815.5 acres) of native riparian and upland habitats in the LRGV. These diminished habitats harbor many rare, threatened, and endangered species. This report updates the widely used 1988 USFWS biological report titled “Tamaulipan Brushland of the Lower Rio Grande Valley of South Texas: Description, Human Impacts, and Management Options” by synthesizing nearly 400 peer-reviewed scientific publications that have resulted from biological and sociological research conducted specifically in the four Texas counties of the LRGV in the past nearly 30 years. This report has three goals: (1) synthesize scientific insights gained since 1988 related to the biology and management of the LRGV and its unique biota, focusing on flora and fauna of greatest conservation concern; (2) update ongoing challenges facing Federal and State agencies and organizations that focus on conservation or key natural resources in the LRGV; and (3) redefine conservation opportunities and land-acquisition strategies that are feasible and appropriate today, given the many new and expanding constraints that challenge conservation activities in the LRGV. The LRGV faces every contemporary conservation challenge of the 21st century, but ongoing human population growth and its associated demands, international border issues, and oil, gas, and alternative energy development dominate impacts that affect conservation in the LRGV. Continued careful syntheses of existing and future information collected in the LRGV are needed on many biological and sociological topics to guide conservation activities. Quick response will no doubt be necessary to face contemporary and difficult-to-predict challenges such as climate change, diminished water availability and quality, spread of invasive species, and habitat loss and fragmentation. Complexities of a guarded international borderland add pressure to small patches of native habitat that remain in many places of the LRGV, particularly along the Rio Grande. Large connected corridors of restored native habitat could be the best option to maintain, and even enhance, the exceptional biodiversity of the LRGV in the face of exceptional human demand.

Integration of DNA barcoding into an ongoing inventory of complex tropical biodiversity

USDA-ARS?s Scientific Manuscript database

The extensive use of DNA barcoding technology in a large inventory of Macrolepidoptera and their parasitoids is documented. The methodology used and its practical applications are summarized, and numerous examples of how DNA barcoding has untangled complexes of cryptic species of butterflies, moths...

Environmental Collaborations Between Indigenous Communities and Western Science: Case Studies and Reflections

NASA Astrophysics Data System (ADS)

Emanuel, R. E.

2016-12-01

The study of coupled natural and human systems in a changing world can benefit greatly from indigenous perspectives, which have the potential to bring deep, placed-based understanding to complex environmental issues while promoting sustainable solutions to pressing socio-environmental problems. In recent years, scientists have begun to embrace indigenous knowledge and perspectives, but indigenous voices in the sciences remain relatively few. At the same time, indigenous communities face wide ranging and unique vulnerabilities to global environmental change on a variety of fronts, particularly where water resources are concerned. Given this situation, indigenous scientists often find themselves bridging both western scientific and indigenous communities, sometimes embodying the nexus in a literal sense. Here I reflect on this nexus from the perspective of an indigenous hydrologist collaborating with American Indian communities in North Carolina, which has the largest American Indian population of any state in the eastern US. Intertwining case studies of coupled natural and human systems illustrate some of the the challenges, complexities, and successes of ongoing collaborations with tribal communities and Native-serving organizations on water resource issues, environmental impacts of food and energy production, and broadening participation of American Indians in the sciences.

Sulfonyl 3-alkynyl pantetheinamides as mechanism-based crosslinkers of ACP dehydratase

PubMed Central

Ishikawa, Fumihiro; Haushalter, Robert W.; Lee, D. John; Finzel, Kara; Burkart, Michael D.

2013-01-01

The acyl carrier protein (ACP) plays a central function in acetate biosynthetic pathways, serving as a tether for substrates and growing intermediates. Activity and structural studies have highlighted the complexities of this role, and its protein-protein interactions have recently come under scrutiny as a regulator of catalysis. As existing methods to interrogate these interactions have fallen short, we have sought to develop new tools to aid their study. Here we describe the design, synthesis, and application of pantetheinamides capable of crosslinking ACPs with catalytic β-hydroxyacyl carrier protein dehydratase (DH) domains based upon a 3-alkynyl sulfone warhead. We demonstrate this process by application to the Escherichia coli fatty acid synthase and apply it to probe protein-protein interactions with non-cognate carrier proteins. Finally, we use solution phase protein NMR to demonstrate that sulfonyl-3-alkynyl pantetheinamide is fully sequestered by the ACP, indicating that the crypto-ACP closely mimics the natural DH substrate. This crosslinking technology offers immediate potential to lock these biosynthetic enzymes in their native binding states by providing access to mechanistically-crosslinked enzyme complexes, presenting a solution to ongoing structural challenges. PMID:23718183

Solar upconversion with plasmon-enhanced bimolecular complexes

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

Dionne, Jennifer

2017-04-14

Upconversion of sub-bandgap photons is a promising approach to exceed the Shockley-Queisser limit in solar technologies. However, due to the low quantum efficiencies and narrow absorption bandwidths of upconverters, existing systems have only led to fractional percent improvements in photovoltaic devices (~0.01%). In this project, we aimed to develop an efficient upconverting material that could improve cell efficiencies by at least one absolute percent. To achieve this goal, we first used thermodynamic calculations to determine cell efficiencies with realistic upconverting materials. Then, we designed, synthesized, and characterized nanoantennas that promise >100x enhancement in both the upconverter absorption cross-section and emissivemore » radiative rate. Concurrently, we optimized the upconverer by designing new ionic and molecular complexes that promise efficient solid-state upconversion. Lastly, with Bosch, we simulated record-efficiency semi-transparent cells that will allow for ready incorporation of our upconverting materials. While we were not successful in designing record efficiency upconverters during our three years of funding, we gained significant insight into the existing limitations of upconverters and how to best address these challenges. Ongoing work is aimed at addressing these limitations, to make upconversion a cost-competitive solar technology in future years.« less

Dismantling of Highly Contaminated Process Installations of the German Reprocessing Facility (WAK) - Status of New Remote Handling Technology - 13287

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

Dux, Joachim; Friedrich, Daniel; Lutz, Werner

2013-07-01

Decommissioning and dismantling of the former German Pilot Reprocessing Plant Karlsruhe (WAK) including the Vitrification Facility (VEK) is being executed in different Project steps related to the reprocessing, HLLW storage and vitrification complexes /1/. While inside the reprocessing building the total inventory of process equipment has already been dismantled and disposed of, the HLLW storage and vitrification complex has been placed out of operation since vitrification and tank rinsing procedures where finalized in year 2010. This paper describes the progress made in dismantling of the shielded boxes of the highly contaminated laboratory as a precondition to get access to themore » hot cells of the HLLW storage. The major challenges of the dismantling of this laboratory were the high dose rates up to 700 mSv/h and the locking technology for the removal of the hot cell installations. In parallel extensive prototype testing of different carrier systems and power manipulators to be applied to dismantle the HLLW-tanks and other hot cell equipment is ongoing. First experiences with the new manipulator carrier system and a new master slave manipulator with force reflection will be reported. (authors)« less

The changing nature of life cycle assessment

PubMed Central

McManus, Marcelle C.; Taylor, Caroline M.

2015-01-01

LCA has evolved from its origins in energy analysis in the 1960s and 70s into a wide ranging tool used to determine impacts of products or systems over several environmental and resource issues. The approach has become more prevalent in research, industry and policy. Its use continues to expand as it seeks to encompass impacts as diverse as resource accounting and social well being. Carbon policy for bioenergy has driven many of these changes. Enabling assessment of complex issues over a life cycle basis is beneficial, but the process is sometimes difficult. LCA's use in framing is increasingly complex and more uncertain, and in some cases, irreconcilable. The charged environment surrounding biofuels and bioenergy exacerbates all of these. Reaching its full potential to help guide difficult policy discussions and emerging research involves successfully managing LCA's transition from attributional to consequential and from retrospective to prospective. This paper examines LCA's on-going evolution and its use within bioenergy deployment. The management of methodological growth in the context of the unique challenges associated with bioenergy and biofuels is explored. Changes seen in bioenergy LCA will bleed into other LCA arenas, especially where it is important that a sustainable solution is chosen. PMID:26664146

The Mother-Infant Study Cohort (MISC): Methodology, challenges, and baseline characteristics

PubMed Central

Hashim, Mona; Shaker Obaid, Reyad; Hasan, Hayder; Naja, Farah; Al Ghazal, Hessa; Jan Jan Mohamed, Hamid; Al Hilali, Marwa; Rayess, Rana; Izzaldin, Ghamra

2018-01-01

Background The United Arab Emirates (UAE) exhibits alarming high prevalence of Non-Communicable Diseases (NCDs) and their risk factors. Emerging evidence highlighted the role of maternal and early child nutrition in preventing later-onset NCDs. The objectives of this article are to describe the design and methodology of the first Mother and Infant Study Cohort (MISC) in UAE; present the baseline demographic characteristics of the study participants; and discuss the challenges of the cohort and their respective responding strategies. Methods The MISC is an ongoing two-year prospective cohort study which recruited Arab pregnant women in their third trimester from prenatal clinics in Dubai, Sharjah and Ajman. Participants will be interviewed six times (once during pregnancy, at delivery, and at 2, 6, 12 and 24months postpartum). Perinatal information is obtained from hospital records. Collected data include socio-demographic characteristics, lifestyle, dietary intake and anthropometry; infant feeding practices, cognitive development; along with maternal and infant blood profile and breast milk profile. Results The preliminary results reported that 256 completed baseline assessment (mean age: 30.5±6.0 years; 76.6% multiparous; about 60% were either overweight or obese before pregnancy). The prevalence of gestational diabetes was 19.2%. Upon delivery, 208 women-infant pairs were retained (mean gestational age: 38.5±1.5 weeks; 33.3% caesarean section delivery; 5.3% low birthweight; 5.7% macrosomic deliveries). Besides participant retention, the main encountered challenges pertained to cultural complexity, underestimation the necessary start-up time, staff, and costs, and biochemical data collection. Conclusions Despite numerous methodological, logistical and sociocultural challenges, satisfactory follow-up rates are recorded. Strategies addressing challenges are documented, providing information for planning and implementing future birth cohort studies locally and internationally. PMID:29851999

Digital Savings: A Study of Academic Libraries Finds that Going from Print to Electronic Journals Can Save Money, if It's Done Right, but Challenges Remain

ERIC Educational Resources Information Center

Schonfeld, Roger C.; Fenton, Eileen Gifford

2005-01-01

Without question, the ongoing transition from print to electronic periodicals has challenged librarians to rethink their strategies. While some effects of this change have been immediately apparent--greater breadth of material, easier access, exposure to new sources, publisher package deals, and open access--the broader outcomes on library…

From the National Academies: Ongoing Challenges to Evolution Education--Resources and Activities of the National Academies

ERIC Educational Resources Information Center

Labov, Jay B.

2005-01-01

The problem of misconceptions about science is not unique to evolution, of course. In the case of evolution, the problem is compounded because many students have been told that their personal belief systems will be challenged or undermined by engaging in learning about this subject. This concern underlies the angst and anger that some parents,…

Making the Transition: Interim Results of the National Guard Youth ChalleNGe Evaluation

ERIC Educational Resources Information Center

Millenky, Megan; Bloom, Dan; Dillon, Colleen

2010-01-01

Young people who drop out of high school face long odds of success in a labor market that increasingly values education and skills. This report presents interim results from a rigorous, ongoing evaluation of the National Guard Youth ChalleNGe Program, which aims to "reclaim the lives of at-risk youth" who have dropped out of high school.…

Making the Transition: Interim Results of the National Guard Youth ChalleNGe Evaluation. [Executive Summary

ERIC Educational Resources Information Center

Millenky, Megan; Bloom, Dan; Dillon, Colleen

2010-01-01

Young people who drop out of high school face long odds of success in a labor market that increasingly values education and skills. This report presents interim results from a rigorous, ongoing evaluation of the National Guard Youth ChalleNGe Program, which aims to "reclaim the lives of at-risk youth" who have dropped out of high school. ChalleNGe…

Impact of Market Behavior, Fleet Composition, and Ancillary Services on Revenue Sufficiency

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

Frew, Bethany

This presentation provides an overview of new and ongoing NREL research that aims to improve our understanding of reliability and revenue sufficiency challenges through modeling tools within a markets framework.

Implementing three evidence-based program models: early lessons from the Teen Pregnancy Prevention Replication Study.

PubMed

Kelsey, Meredith; Layzer, Jean

2014-03-01

This article describes some of the early implementation challenges faced by nine grantees participating in the Teen Pregnancy Prevention Replication Study and their response to them. The article draws on information collected as part of a comprehensive implementation study. Sources include site and program documents; program officer reports; notes from site investigation, selection and negotiation; ongoing communications with grantees as part of putting the study into place; and semi-structured interviews with program staff. The issues faced by grantees in implementing evidence-based programs designed to prevent teen pregnancy varied by program model. Grantees implementing a classroom-based curriculum faced challenges in delivering the curriculum within the constraints of school schedules and calendars (program length and size of class). Grantees implementing a culturally tailored curriculum faced a series of challenges, including implementing the intervention as part of the regular school curriculum in schools with diverse populations; low attendance when delivered as an after-school program; and resistance on the part of schools to specific curriculum content. The third set of grantees, implementing a program in clinics, faced challenges in identifying and recruiting young women into the program and in retaining young women once they were in the program. The experiences of these grantees reflect some of the complexities that should be carefully considered when choosing to replicate evidence-based programs. The Teen Pregnancy Prevention replication study will provide important context for assessing the effectiveness of some of the more widely replicated evidence-based programs. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Snow in Earth System Models: Recent Progress and Future Challenges

NASA Astrophysics Data System (ADS)

Clark, M. P.; Slater, A. G.

2016-12-01

Snow is the most variable of terrestrial boundary conditions. Some 50 million km^2 of the Northern Hemisphere typically sees periods of accumulation and ablation in the annual cycle. The wonderous properties of snow, such as high albedo, thermal insulation and its ability to act as a water store make it an integral part of the global climate system. Earliest inclusions of snow within climate models were simple adjustments to albedo and a moisture store. Modern Earth Syetem Models now represent snow through a myriad of model architectures and parameterizations that span a broad range of complexity. Understanding the impacts of modeling decisions upon simulation of snow and other Earth System components (either directly or via feedbacks) is an ongoing area of research. Snow models are progressing with multi-layer representations and capabilities such as complex albedo schemes that include contaminants. While considerable advances have been made, numerous challenges also remain. Simply getting a grasp on the mass of snow (seasonal or permanent) has proved more difficult than expected over the past 30 years. Snow interactions with vegetation has improved but the details of vegetation masking and emergence are still limited. Inclusion of blowing snow processes, in terms of transport and sublimation, is typically rare and sublimation remains a difficult quantity to measure. Contemplation of snow crystal form within models and integration with radiative transfer schemes for better understanding of full spectrum interations (from UV to long microwave) may simultaneously advance simulation and remote sensing. A series of international modeling experiments and directed field campaigns are planned in the near future with the aim of pushing our knowledge forward.

BEYOND TEXT: USING ARRAYS TO REPRESENT AND ANALYZE ETHNOGRAPHIC DATA

PubMed Central

Abramson, Corey M.; Dohan, Daniel

2015-01-01

Recent methodological debates in sociology have focused on how data and analyses might be made more open and accessible, how the process of theorizing and knowledge production might be made more explicit, and how developing means of visualization can help address these issues. In ethnography, where scholars from various traditions do not necessarily share basic epistemological assumptions about the research enterprise with either their quantitative colleagues or one another, these issues are particularly complex. Nevertheless, ethnographers working within the field of sociology face a set of common pragmatic challenges related to managing, analyzing, and presenting the rich context-dependent data generated during fieldwork. Inspired by both ongoing discussions about how sociological research might be made more transparent, as well as innovations in other data-centered fields, the authors developed an interactive visual approach that provides tools for addressing these shared pragmatic challenges. They label the approach “ethnoarray” analysis. This article introduces this approach and explains how it can help scholars address widely shared logistical and technical complexities, while remaining sensitive to both ethnography’s epistemic diversity and its practitioners shared commitment to depth, context, and interpretation. The authors use data from an ethnographic study of serious illness to construct a model of an ethnoarray and explain how such an array might be linked to data repositories to facilitate new forms of analysis, interpretation, and sharing within scholarly and lay communities. They conclude by discussing some potential implications of the ethnoarray and related approaches for the scope, practice, and forms of ethnography. PMID:26834296

Shaping the midwifery profession in Nepal - Uncovering actors' connections using a Complex Adaptive Systems framework.

PubMed

Bogren, Malin Upper; Berg, Marie; Edgren, Lars; van Teijlingen, Edwin; Wigert, Helena

2016-12-01

To explore how actors connect in a system aiming at promoting the establishment of a midwifery profession in Nepal. A qualitative explorative study based on the framework of Complex Adaptive Systems. Semi-structured interviews were conducted with 17 key people representing eight different organisations (actors) promoting the development of the midwifery profession. The actors' connections can be described with a complex set of facilitators for and barriers to promoting the establishment of a midwifery profession. The identified facilitators for this establishment in Nepal are (1) a common goal and (2) a desire to collaborate, whilst the barriers are (1) different political interests and priorities, (2) competing interests of the nursing profession and societal views, (3) divergent academic opinions on a midwifery profession, and (4) insufficient communication. The results also showed that Nepalese society cannot distinguish between nursing and midwifery and that the public support for a midwifery profession was hence minimal. The move of midwifery from an occupation to a profession in Nepal is an on-going, challenging process. The study indicates the importance of understanding the motivations of, and barriers perceived by, actors that can promote or obstruct the establishment of the midwifery profession. It also points to the importance of informing the wider public about the role and responsibility of an autonomous midwifery profession. Copyright © 2016 Elsevier B.V. All rights reserved.

Health behavior change models for HIV prevention and AIDS care: practical recommendations for a multi-level approach.

PubMed

Kaufman, Michelle R; Cornish, Flora; Zimmerman, Rick S; Johnson, Blair T

2014-08-15

Despite increasing recent emphasis on the social and structural determinants of HIV-related behavior, empirical research and interventions lag behind, partly because of the complexity of social-structural approaches. This article provides a comprehensive and practical review of the diverse literature on multi-level approaches to HIV-related behavior change in the interest of contributing to the ongoing shift to more holistic theory, research, and practice. It has the following specific aims: (1) to provide a comprehensive list of relevant variables/factors related to behavior change at all points on the individual-structural spectrum, (2) to map out and compare the characteristics of important recent multi-level models, (3) to reflect on the challenges of operating with such complex theoretical tools, and (4) to identify next steps and make actionable recommendations. Using a multi-level approach implies incorporating increasing numbers of variables and increasingly context-specific mechanisms, overall producing greater intricacies. We conclude with recommendations on how best to respond to this complexity, which include: using formative research and interdisciplinary collaboration to select the most appropriate levels and variables in a given context; measuring social and institutional variables at the appropriate level to ensure meaningful assessments of multiple levels are made; and conceptualizing intervention and research with reference to theoretical models and mechanisms to facilitate transferability, sustainability, and scalability.

Ongoing measles outbreak in Wallonia, Belgium, December 2016 to March 2017: characteristics and challenges.

PubMed

Grammens, Tine; Schirvel, Carole; Leenen, Sylvie; Shodu, Nathalie; Hutse, Veronik; Mendes da Costa, Elise; Sabbe, Martine

2017-04-27

We describe characteristics of an ongoing measles outbreak in Wallonia, Belgium, and difficulties in control measures implementation. As at 12 March 2017, 177 measles cases were notified, of which 50% were 15 years and older, 49% female. Atypical clinical presentation and severe complications, mainly among adults, in combination with late notification, low or unknown vaccination coverage of contacts, infected healthcare workers and increased workload due to contact tracing, are the main concerns for outbreak management. This article is copyright of The Authors, 2017.

Ongoing outbreak with well over 4,000 measles cases in Italy from January to end August 2017 − what is making elimination so difficult?

PubMed Central

Filia, Antonietta; Bella, Antonino; Del Manso, Martina; Baggieri, Melissa; Magurano, Fabio; Rota, Maria Cristina

2017-01-01

We report an ongoing measles outbreak in Italy, with over 4,400 cases reported in 20 Regions from January to August 2017. Median age was 27 years, 88% of the cases were unvaccinated. The highest incidence was in infants below one year of age and 7% of cases occurred among healthcare workers. Three deaths occurred and two cases of encephalitis were reported. Wide immunity gaps and nosocomial transmission are major challenges to measles elimination in Italy. PMID:28933342

Proceedings of the August 2011 Traceability Research Summit.

PubMed

Bhatt, Tejas; Buckley, Greg; McEntire, Jennifer C

2013-12-01

IFT's Traceability Improvement Initiative aims to advance work in the area of food product tracing through several means including hosted events where thought leaders exchange knowledge and ideas. In August 2011, the Initiative, in collaboration with GS1 US, convened a group of 50 product tracing stakeholders, as a follow-on to a successful event the month prior. Representatives conducting pilots or implementation studies in produce, seafood, dairy, and other industries discussed the objectives, challenges and learnings. Some of the learnings from on-going initiatives included the sense that better information management provides a return of investment; data often exist but may not necessarily be appropriately linked through the supply chain; and enhanced product tracing enables better accountability and quality control. Challenges identified in enabling traceability throughout the supply chain were the distribution complexity; the need for training, communication, and collaboration; improving the reliability, quality and security of data captured, stored and shared as well as the importance of standards in data and interoperability of technology. Several approaches to overcoming these challenges were discussed. The first approach incrementally improves upon the current "one up/one down" system by requiring electronic records and tracking internal as well as external critical tracking events. The benefits of this approach are its similarity to existing regulatory requirements and low cost of implementation; resulting in a higher probability of adoption. The major disadvantage to this process is the longer response time required during a trace (back or forward). The second approach is similar to a "pedigree" approach where historical information about the food travels with it through the value chain. A major advantage of this approach is the quickest response time during a trace. Some of the disadvantages of this approach are potential for misuse of data, the volume of data required to be maintained at value chain end points, and data privacy concerns. The third approach requires individual nodes within the value chain to maintain electronic records for its own data and make them available for querying during a traceback for outbreak investigation. The major advantage of this approach is the protection of confidential information and the potential for quicker access during a trace. However, the primary disadvantage of this approach is the need for greater computational power and a more complex mechanism to linking the value chain through the data. As next steps, a subgroup will work on clarifying the approach to meeting the goals of traceability, better defining critical tracking events, and articulating the strategy and return on investment from a regulatory and industry perspective. This will result in improved alignment of on-going traceability pilots and initiatives as well as a more actionable guidance document for public review. © 2012 Institute of Food Technologists®

Long-life concrete : how long will my concrete last?

DOT National Transportation Integrated Search

2013-10-01

There is an ongoing discussion about moving toward performance-based specifications for concrete pavements. This document seeks to : move the discussion forward by outlining the needs and the challenges, and proposing some immediate actions. However,...

Notification: Municipal Sewer Systems - Consent Decree Progress and Challenges

EPA Pesticide Factsheets

Project #OPE-FY14-0045, August 6, 2014. The EPA OIG plans to begin preliminary research on the EPA's ongoing enforcement initiative focused on keeping raw sewage and contaminated stormwater out of our nation's waters.

Coast Guard : budget challenges for 2001 and beyond

DOT National Transportation Integrated Search

2000-03-15

The testimony today, which is based on recently completed and ongoing work, addresses two topics: (1) the Coast Guard's progress in justifying and managing its Deepwater Project and (2) opportunities for improving the Coast Guard's operating efficien...

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

Horowitz, Kelsey A; Ding, Fei; Mather, Barry A

This presentation was given at the 2017 NREL Workshop 'Benchmarking Distribution Grid Integration Costs Under High Distributed PV Penetrations.' It provides a brief overview of recent and ongoing NREL work on distribution system grid integration costs, as well as challenges and needs from the community.

Predicting food challenge outcomes for baked milk: role of specific IgE and skin prick testing.

PubMed

Bartnikas, Lisa M; Sheehan, William J; Hoffman, Elaine B; Permaul, Perdita; Dioun, Anahita F; Friedlander, James; Baxi, Sachin N; Schneider, Lynda C; Phipatanakul, Wanda

2012-11-01

Cow's milk allergy is the most common food allergy in childhood. Many children with IgE-mediated cow's milk allergy may tolerate baked milk products, but few data exist on predictors of outcomes of baked milk challenges. To determine the relation of milk protein allergen specific IgE (sIgE) levels and skin prick test (SPT) wheal size with baked milk challenge outcomes. A retrospective medical record review was conducted of 35 baked milk challenges. SPT results, sIgE levels, demographic characteristics, and food challenge results were analyzed. Thirty-five children underwent open challenges to baked milk and 29 (83%) passed. Of those who failed, 3 (50%) passed the initial clinic challenge but developed symptoms to ongoing exposure at home, days to months later. One child who ultimately failed at home required epinephrine. Compared with those who passed, children who failed were younger (median age, 8.9 and 3.7 years, respectively; P = .02). Children with a milk SPT wheal less than 12 mm were more than 90% likely to pass a baked milk challenge, and no child with a milk SPT wheal less than 7 mm failed a baked milk challenge. We were also able to establish more than 90% predictive values for passing baked milk challenges with a casein SPT wheal of 9 mm, a milk sIgE level of 1.0 kU/L, and a casein sIgE level of 0.9 kU/L. Most children allergic to cow's milk tolerated baked milk. Milk protein SPT wheal may be more reliable than sIgE level in predicting outcomes of baked milk challenges. It is important to be aware of the possibility of late reactions to ongoing baked milk exposure. Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Multigenerational challenges in academic medicine: UCDavis's responses.

PubMed

Howell, Lydia Pleotis; Servis, Gregg; Bonham, Ann

2005-06-01

Academic medicine is a unique work environment, one of the few where members of four different generations regularly interact and where multigenerational teams are key to fulfilling its missions, particularly education. This can lead to increased creativity, but also to intergenerational conflict, since each generation has different values and expectations. The authors describe multigenerational challenges confronted at the University of California, Davis, School of Medicine, and that school's responses to them. These challenges include issues related to work hours, workload, compensation, evaluation for advancement, recruitment and retention, and attendance at required meetings. Awareness of the different generational qualities and values allowed the school of medicine to identify the multigenerational origin of many of these ongoing issues and challenges and to plan appropriate solutions within the Office of Academic Affairs. These include policy changes related to work-life balance, utilizing multiple faculty tracks with different roles, allowing part-time faculty appointments, creating a variety of faculty development programs geared toward different generational needs (which utilize flexible modules, menus of options, and alternative technologies for presentation), defining appropriate reward and incentives through compensations plans, and creating peer-reviewed awards. The authors conclude that these efforts mitigate conflict, promote diversity, and allow multigenerational teams to function more effectively and creatively in education, research, and clinical care. Ongoing evaluation will further refine this approach.

Preface

NASA Technical Reports Server (NTRS)

Rosenzweig, Cynthia (Editor); Hillel, Daniel (Editor)

2015-01-01

The potential effects of climate change on the food production system are raising concern both globally and regionally. The system is already challenged to deliver sufficient and healthy sustenance to all people, and is certain to be even further challenged as world population grows and price shocks loom. The prospect of climate change intensifies these challenges, raising the risk that more frequent and intense extreme weather events threaten the stability of agricultural production in regions around the globe. This two-part set is an important contribution to the ongoing Imperial College Press (ICP) Series on Climate Change Impacts, Adaptation, and Mitigation. This series aims to provide the know ledge base necessary for understanding and responding to climate change, in both its current form and future manifestations. In these volumes, ·leading agricultural researchers have come together to contribute their expertise on actual and potential climate change impacts, adaptation strategies, and mitigation efforts. This ongoing series is jointly published by The American Society of Agronomy (ASA), Crop Science Society of America (CSSA), and Soil Science Society of America (SSSA), together with ICP. We hope that this fruitful cooperation will continue for many years to come, as it spurs the global effort to define and meet the great food security and climate change challenges of our time.

An Integrated Recovery-oriented Model (IRM) for mental health services: evolution and challenges.

PubMed

Frost, Barry G; Tirupati, Srinivasan; Johnston, Suzanne; Turrell, Megan; Lewin, Terry J; Sly, Ketrina A; Conrad, Agatha M

2017-01-17

Over past decades, improvements in longer-term clinical and personal outcomes for individuals experiencing serious mental illness (SMI) have been moderate, although recovery has clearly been shown to be possible. Recovery experiences are inherently personal, and recovery can be complex and non-linear; however, there are a broad range of potential recovery contexts and contributors, both non-professional and professional. Ongoing refinement of recovery-oriented models for mental health (MH) services needs to be fostered. This descriptive paper outlines a service-wide Integrated Recovery-oriented Model (IRM) for MH services, designed to enhance personally valued health, wellbeing and social inclusion outcomes by increasing access to evidenced-based psychosocial interventions (EBIs) within a service context that supports recovery as both a process and an outcome. Evolution of the IRM is characterised as a series of five broad challenges, which draw together: relevant recovery perspectives; overall service delivery frameworks; psychiatric and psychosocial rehabilitation approaches and literature; our own clinical and service delivery experience; and implementation, evaluation and review strategies. The model revolves around the person's changing recovery needs, focusing on underlying processes and the service frameworks to support and reinforce hope as a primary catalyst for symptomatic and functional recovery. Within the IRM, clinical rehabilitation (CR) practices, processes and partnerships facilitate access to psychosocial EBIs to promote hope, recovery, self-agency and social inclusion. Core IRM components are detailed (remediation of functioning; collaborative restoration of skills and competencies; and active community reconnection), together with associated phases, processes, evaluation strategies, and an illustrative IRM scenario. The achievement of these goals requires ongoing collaboration with community organisations. Improved outcomes are achievable for people with a SMI. It is anticipated that the IRM will afford MH services an opportunity to validate hope, as a critical element for people with SMI in assuming responsibility and developing skills in self-agency and advocacy. Strengthening recovery-oriented practices and policies within MH services needs to occur in tandem with wide-ranging service evaluation strategies.

ïSCOPE: Safer care for older persons (in residential) environments: A study protocol

PubMed Central

2011-01-01

Background The current profile of residents living in Canadian nursing homes includes elder persons with complex physical and social needs. High resident acuity can result in increased staff workload and decreased quality of work life. Aims Safer Care for Older Persons [in residential] Environments is a two year (2010 to 2012) proof-of-principle pilot study conducted in seven nursing homes in western Canada. The purpose of the study is to evaluate the feasibility of engaging front line staff to use quality improvement methods to integrate best practices into resident care. The goals of the study are to improve the quality of work life for staff, in particular healthcare aides, and to improve residents' quality of life. Methods/design The study has parallel research and quality improvement intervention arms. It includes an education and support intervention for direct caregivers to improve the safety and quality of their care delivery. We hypothesize that this intervention will improve not only the care provided to residents but also the quality of work life for healthcare aides. The study employs tools adapted from the Institute for Healthcare Improvement's Breakthrough Series: Collaborative Model and Canada's Safer Healthcare Now! improvement campaign. Local improvement teams in each nursing home (1 to 2 per facility) are led by healthcare aides (non-regulated caregivers) and focus on the management of specific areas of resident care. Critical elements of the program include local measurement, virtual and face-to-face learning sessions involving change management, quality improvement methods and clinical expertise, ongoing virtual and in person support, and networking. Discussion There are two sustainability challenges in this study: ongoing staff and leadership engagement, and organizational infrastructure. Addressing these challenges will require strategic planning with input from key stakeholders for sustaining quality improvement initiatives in the long-term care sector. PMID:21745382

Performance Measures for Evaluating Public Participation Activities in the Office of Environmental Management (DOE)

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

Carnes, S.A.

2001-02-15

Public participation in Office of Environmental Management (EM) activities throughout the DOE complex is a critical component of the overall success of remediation and waste management efforts. The challenges facing EM and its stakeholders over the next decade or more are daunting (Nuclear Waste News 1996). Achieving a mission composed of such challenges will require innovation, dedication, and a significant degree of good will among all stakeholders. EM's efforts to date, including obtaining and using inputs offered by EM stakeholders, have been notable. Public participation specialists have accepted and met challenges and have consistently tried to improve their performance. Theymore » have reported their experiences both formally and informally (e.g., at professional conferences and EM Public Participation Network Workshops, other internal meetings of DOE and contractor public participation specialists, and one-on-one consultations) in order to advance the state of their practice. Our research, and our field research in particular (including our interactions with many representatives of numerous stakeholder groups at nine DOE sites with diverse EM problems), have shown that it, is possible to develop coherent results even in a problem domain as complex as that of EM. We conclude that performance-based evaluations of public participation appear possible, and we have recommended an approach, based on combined and integrated multi-stakeholder views on the attributes of successful public participation and associated performance indicators, that seems workable and should be acceptable to diverse stakeholders. Of course, as an untested recommendation, our approach needs the validation that can only be achieved by application (perhaps at a few DOE sites with ongoing EM activities). Such an application would serve to refine the proposed approach in terms of its clarity, its workability, and its potential for full-scale use by EM and, potentially, other government agencies and private sector concerns.« less

Communication Network Integration and Group Uniformity in a Complex Organization.

ERIC Educational Resources Information Center

Danowski, James A.; Farace, Richard V.

This paper contains a discussion of the limitations of research on group processes in complex organizations and the manner in which a procedure for network analysis in on-going systems can reduce problems. The research literature on group uniformity processes and on theoretical models of these processes from an information processing perspective…

Integrated nonlinear photonics. Emerging applications and ongoing challenges - A mini review

DOE PAGES

Hendrickson, Scott M.; Foster, Amy C.; Camacho, Ryan M.; ...

2014-11-26

In this paper, we provide a review of recent progress in integrated nonlinear photonics with a focus on emerging applications in all-optical signal processing, ultra-low-power all-optical switching, and quantum information processing.

Results of the Ongoing Monitoring of the Position of a Geostationary Telecommunication Satellite by the Method of Spatially Separated Basis Receiving of Digital Satellite Television Signals

NASA Astrophysics Data System (ADS)

Bushuev, F.; Kaliuzhnyi, M.; Sybiryakova, Y.; Shulga, O.; Moskalenko, S.; Balagura, O.; Kulishenko, V.

2016-10-01

The results of the ongoing monitoring of the position of geostationary telecommunication satellite Eutelsat-13B (13° East) are presented in the article. The results were obtained using a radio engineering complex (RC) of four stations receiving digital satellite television and a data processing centre. The stations are located in Kyiv, Mukachevo, Kharkiv and Mykolaiv. The equipment of each station allows synchronous recording (by the GPS) of fragments of DVB-S signal from the quadrature detector output of the satellite television receiver. Samples of the complex signal are archived and sent to the data processing center through the Internet. Here three linearly independent slant range differences (Δr) for three pairs of the stations are determined as a result of correlation processing of received signals. Every second measured values of Δr are used to calculate Cartesian coordinates (XYZ) of the satellite in the coordinate system WGS84 by multilateration method. The time series of Δr, X, Y and Z obtained during continuous observations from March to May 2015 are presented in the article. Single-measurement errors of Δr, X, Y and Z are equal to 2.6 m, 3540 m, 705 m and 455 m, respectively. The complex is compared with known analogues. Ways of reduction of measurement errors of satellite coordinates are considered. The radio engineering complex could be considered a prototype of a system of independent ongoing monitoring of the position of geostationary telecommunication satellites.

Can NMR solve some significant challenges in metabolomics?

PubMed Central

Gowda, G.A. Nagana; Raftery, Daniel

2015-01-01

The field of metabolomics continues to witness rapid growth driven by fundamental studies, methods development, and applications in a number of disciplines that include biomedical science, plant and nutrition sciences, drug development, energy and environmental sciences, toxicology, etc. NMR spectroscopy is one of the two most widely used analytical platforms in the metabolomics field, along with mass spectrometry (MS). NMR's excellent reproducibility and quantitative accuracy, its ability to identify structures of unknown metabolites, its capacity to generate metabolite profiles using intact biospecimens with no need for separation, and its capabilities for tracing metabolic pathways using isotope labeled substrates offer unique strengths for metabolomics applications. However, NMR's limited sensitivity and resolution continue to pose a major challenge and have restricted both the number and the quantitative accuracy of metabolites analyzed by NMR. Further, the analysis of highly complex biological samples has increased the demand for new methods with improved detection, better unknown identification, and more accurate quantitation of larger numbers of metabolites. Recent efforts have contributed significant improvements in these areas, and have thereby enhanced the pool of routinely quantifiable metabolites. Additionally, efforts focused on combining NMR and MS promise opportunities to exploit the combined strength of the two analytical platforms for direct comparison of the metabolite data, unknown identification and reliable biomarker discovery that continue to challenge the metabolomics field. This article presents our perspectives on the emerging trends in NMR-based metabolomics and NMR's continuing role in the field with an emphasis on recent and ongoing research from our laboratory. PMID:26476597

Boxes of Model Building and Visualization.

PubMed

Turk, Dušan

2017-01-01

Macromolecular crystallography and electron microscopy (single-particle and in situ tomography) are merging into a single approach used by the two coalescing scientific communities. The merger is a consequence of technical developments that enabled determination of atomic structures of macromolecules by electron microscopy. Technological progress in experimental methods of macromolecular structure determination, computer hardware, and software changed and continues to change the nature of model building and visualization of molecular structures. However, the increase in automation and availability of structure validation are reducing interactive manual model building to fiddling with details. On the other hand, interactive modeling tools increasingly rely on search and complex energy calculation procedures, which make manually driven changes in geometry increasingly powerful and at the same time less demanding. Thus, the need for accurate manual positioning of a model is decreasing. The user's push only needs to be sufficient to bring the model within the increasing convergence radius of the computing tools. It seems that we can now better than ever determine an average single structure. The tools work better, requirements for engagement of human brain are lowered, and the frontier of intellectual and scientific challenges has moved on. The quest for resolution of new challenges requires out-of-the-box thinking. A few issues such as model bias and correctness of structure, ongoing developments in parameters defining geometric restraints, limitations of the ideal average single structure, and limitations of Bragg spot data are discussed here, together with the challenges that lie ahead.

From Systems Understanding to Personalized Medicine: Lessons and Recommendations Based on a Multidisciplinary and Translational Analysis of COPD.

PubMed

Roca, Josep; Cano, Isaac; Gomez-Cabrero, David; Tegnér, Jesper

2016-01-01

Systems medicine, using and adapting methods and approaches as developed within systems biology, promises to be essential in ongoing efforts of realizing and implementing personalized medicine in clinical practice and research. Here we review and critically assess these opportunities and challenges using our work on COPD as a case study. We find that there are significant unresolved biomedical challenges in how to unravel complex multifactorial components in disease initiation and progression producing different clinical phenotypes. Yet, while such a systems understanding of COPD is necessary, there are other auxiliary challenges that need to be addressed in concert with a systems analysis of COPD. These include information and communication technology (ICT)-related issues such as data harmonization, systematic handling of knowledge, computational modeling, and importantly their translation and support of clinical practice. For example, clinical decision-support systems need a seamless integration with new models and knowledge as systems analysis of COPD continues to develop. Our experience with clinical implementation of systems medicine targeting COPD highlights the need for a change of management including design of appropriate business models and adoption of ICT providing and supporting organizational interoperability among professional teams across healthcare tiers, working around the patient. In conclusion, in our hands the scope and efforts of systems medicine need to concurrently consider these aspects of clinical implementation, which inherently drives the selection of the most relevant and urgent issues and methods that need further development in a systems analysis of disease.

Kaiser Permanente's performance improvement system, Part 4: Creating a learning organization.

PubMed

Schilling, Lisa; Dearing, James W; Staley, Paul; Harvey, Patti; Fahey, Linda; Kuruppu, Francesca

2011-12-01

In 2006, recognizing variations in performance in quality, safety, service, and efficiency, Kaiser Permanente leaders initiated the development of a performance improvement (PI) system. Kaiser Permanente has implemented a strategy for creating the systemic capacity for continuous improvement that characterizes a learning organization. Six "building blocks" were identified to enable Kaiser Permanente to make the transition to becoming a learning organization: real-time sharing of meaningful performance data; formal training in problem-solving methodology; workforce engagement and informal knowledge sharing; leadership structures, beliefs, and behaviors; internal and external benchmarking; and technical knowledge sharing. Putting each building block into place required multiple complex strategies combining top-down and bottom-up approaches. Although the strategies have largely been successful, challenges remain. The demand for real-time meaningful performance data can conflict with prioritized changes to health information systems. It is an ongoing challenge to teach PI, change management, innovation, and project management to all managers and staff without consuming too much training time. Challenges with workforce engagement include low initial use of tools intended to disseminate information through virtual social networking. Uptake of knowledge-sharing technologies is still primarily by innovators and early adopters. Leaders adopt new behaviors at varying speeds and have a range of abilities to foster an environment that is psychologically safe and stimulates inquiry. A learning organization has the capability to improve, and it develops structures and processes that facilitate the acquisition and sharing of knowledge.

Unmet medical needs in systemic lupus erythematosus

PubMed Central

2012-01-01

Systemic lupus erythematosus (SLE) is an autoimmune disease of diverse manifestations, with onset usually in young women in the third to fourth decade of life. The chronic nature of this relapsing remitting disease leads to organ damage accrual over time. Mortality and morbidity are increased in patients with SLE compared with the general population. Therapeutic advances over the last few decades have led to significant improvements in patient outcomes. Five-year survival has improved to over 90% from a low of 50% in the 1950s. However, multiple aspects of the management of SLE patients are still far from optimal. Early diagnosis remains a challenge; diagnostic delays leading to delay in definitive treatment are common. Monitoring treatment remains problematic due to the paucity of sensitive biomarkers. Current treatment regimens rely heavily on corticosteroids, even though corticosteroids are well known to cause organ damage. Treatment of refractory disease manifestations such as nephritis, recalcitrant cutaneous lesions and neurological involvement require new approaches with greater efficacy. Cognitive dysfunction is common in SLE patients, but early recognition and adequate treatment are yet to be established. Premature accelerated atherosclerosis remains a leading cause of morbidity and mortality. Fatigue is one of the most disabling symptoms, and contributes to the poor quality of life in patients with SLE. Ongoing research in SLE faces many challenges, including enrollment of homogeneous patient populations, use of reliable outcome measures and a standard control arm. The current review will highlight some of the outstanding unmet challenges in the management of this complex disease. PMID:23281889

Can NMR solve some significant challenges in metabolomics?

NASA Astrophysics Data System (ADS)

Nagana Gowda, G. A.; Raftery, Daniel

2015-11-01

The field of metabolomics continues to witness rapid growth driven by fundamental studies, methods development, and applications in a number of disciplines that include biomedical science, plant and nutrition sciences, drug development, energy and environmental sciences, toxicology, etc. NMR spectroscopy is one of the two most widely used analytical platforms in the metabolomics field, along with mass spectrometry (MS). NMR's excellent reproducibility and quantitative accuracy, its ability to identify structures of unknown metabolites, its capacity to generate metabolite profiles using intact bio-specimens with no need for separation, and its capabilities for tracing metabolic pathways using isotope labeled substrates offer unique strengths for metabolomics applications. However, NMR's limited sensitivity and resolution continue to pose a major challenge and have restricted both the number and the quantitative accuracy of metabolites analyzed by NMR. Further, the analysis of highly complex biological samples has increased the demand for new methods with improved detection, better unknown identification, and more accurate quantitation of larger numbers of metabolites. Recent efforts have contributed significant improvements in these areas, and have thereby enhanced the pool of routinely quantifiable metabolites. Additionally, efforts focused on combining NMR and MS promise opportunities to exploit the combined strength of the two analytical platforms for direct comparison of the metabolite data, unknown identification and reliable biomarker discovery that continue to challenge the metabolomics field. This article presents our perspectives on the emerging trends in NMR-based metabolomics and NMR's continuing role in the field with an emphasis on recent and ongoing research from our laboratory.

A review of reverse vaccinology approaches for the development of vaccines against ticks and tick borne diseases.

PubMed

Lew-Tabor, A E; Rodriguez Valle, M

2016-06-01

The field of reverse vaccinology developed as an outcome of the genome sequence revolution. Following the introduction of live vaccinations in the western world by Edward Jenner in 1798 and the coining of the phrase 'vaccine', in 1881 Pasteur developed a rational design for vaccines. Pasteur proposed that in order to make a vaccine that one should 'isolate, inactivate and inject the microorganism' and these basic rules of vaccinology were largely followed for the next 100 years leading to the elimination of several highly infectious diseases. However, new technologies were needed to conquer many pathogens which could not be eliminated using these traditional technologies. Thus increasingly, computers were used to mine genome sequences to rationally design recombinant vaccines. Several vaccines for bacterial and viral diseases (i.e. meningococcus and HIV) have been developed, however the on-going challenge for parasite vaccines has been due to their comparatively larger genomes. Understanding the immune response is important in reverse vaccinology studies as this knowledge will influence how the genome mining is to be conducted. Vaccine candidates for anaplasmosis, cowdriosis, theileriosis, leishmaniasis, malaria, schistosomiasis, and the cattle tick have been identified using reverse vaccinology approaches. Some challenges for parasite vaccine development include the ability to address antigenic variability as well the understanding of the complex interplay between antibody, mucosal and/or T cell immune responses. To understand the complex parasite interactions with the livestock host, there is the limitation where algorithms for epitope mining using the human genome cannot directly be adapted for bovine, for example the prediction of peptide binding to major histocompatibility complex motifs. As the number of genomes for both hosts and parasites increase, the development of new algorithms for pan-genomic mining will continue to impact the future of parasite and ricketsial (and other tick borne pathogens) disease vaccine development. Copyright © 2015 Elsevier GmbH. All rights reserved.

Nanoscale platforms for messenger RNA delivery.

PubMed

Li, Bin; Zhang, Xinfu; Dong, Yizhou

2018-05-04

Messenger RNA (mRNA) has become a promising class of drugs for diverse therapeutic applications in the past few years. A series of clinical trials are ongoing or will be initiated in the near future for the treatment of a variety of diseases. Currently, mRNA-based therapeutics mainly focuses on ex vivo transfection and local administration in clinical studies. Efficient and safe delivery of therapeutically relevant mRNAs remains one of the major challenges for their broad applications in humans. Thus, effective delivery systems are urgently needed to overcome this limitation. In recent years, numerous nanoscale biomaterials have been constructed for mRNA delivery in order to protect mRNA from extracellular degradation and facilitate endosomal escape after cellular uptake. Nanoscale platforms have expanded the feasibility of mRNA-based therapeutics, and enabled its potential applications to protein replacement therapy, cancer immunotherapy, therapeutic vaccines, regenerative medicine, and genome editing. This review focuses on recent advances, challenges, and future directions in nanoscale platforms designed for mRNA delivery, including lipid and lipid-derived nanoparticles, polymer-based nanoparticles, protein derivatives mRNA complexes, and other types of nanomaterials. This article is categorized under: Nanotechnology Approaches to Biology > Nanoscale Systems in Biology Biology-Inspired Nanomaterials > Lipid-Based Structures Biology-Inspired Nanomaterials > Nucleic Acid-Based Structures. © 2018 Wiley Periodicals, Inc.

Assessing Daily Physical Activity in Older Adults: Unraveling the Complexity of Monitors, Measures, and Methods

PubMed Central

Cooper, Rachel; Koster, Annemarie; Shiroma, Eric J.; Murabito, Joanne M.; Rejeski, W. Jack; Ferrucci, Luigi; Harris, Tamara B.

2016-01-01

At the 67th Gerontological Society of America Annual Meeting, a preconference workshop was convened to discuss the challenges of accurately assessing physical activity in older populations. The advent of wearable technology (eg, accelerometers) to monitor physical activity has created unprecedented opportunities to observe, quantify, and define physical activity in the real-world setting. These devices enable researchers to better understand the associations of physical activity with aging, and subsequent health outcomes. However, a consensus on proper methodological use of these devices in older populations has not been established. To date, much of the validation research regarding device type, placement, and data interpretation has been performed in younger, healthier populations, and translation of these methods to older populations remains problematic. A better understanding of these devices, their measurement properties, and the data generated is imperative to furthering our understanding of daily physical activity, its effects on the aging process, and vice versa. The purpose of this article is to provide an overview of the highlights of the preconference workshop, including properties of the different types of accelerometers, the methodological challenges of employing accelerometers in older study populations, a brief summary of ongoing aging-related research projects that utilize different types of accelerometers, and recommendations for future research directions. PMID:26957472

Challenges in reducing the computational time of QSTS simulations for distribution system analysis.

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

Deboever, Jeremiah; Zhang, Xiaochen; Reno, Matthew J.

The rapid increase in penetration of distributed energy resources on the electric power distribution system has created a need for more comprehensive interconnection modelling and impact analysis. Unlike conventional scenario - based studies , quasi - static time - series (QSTS) simulation s can realistically model time - dependent voltage controllers and the diversity of potential impacts that can occur at different times of year . However, to accurately model a distribution system with all its controllable devices, a yearlong simulation at 1 - second resolution is often required , which could take conventional computers a computational time of 10more » to 120 hours when an actual unbalanced distribution feeder is modeled . This computational burden is a clear l imitation to the adoption of QSTS simulation s in interconnection studies and for determining optimal control solutions for utility operations . Our ongoing research to improve the speed of QSTS simulation has revealed many unique aspects of distribution system modelling and sequential power flow analysis that make fast QSTS a very difficult problem to solve. In this report , the most relevant challenges in reducing the computational time of QSTS simulations are presented: number of power flows to solve, circuit complexity, time dependence between time steps, multiple valid power flow solutions, controllable element interactions, and extensive accurate simulation analysis.« less

Measles control and elimination in Somalia: the good, the bad, and the ugly.

PubMed

Kamadjeu, Raoul; Assegid, Kebede; Naouri, Boubker; Mirza, Imran Raza; Hirsi, Abdurazak; Mohammed, Abdurahman; Omer, Mohammed; Dualle, Abdi Hassan; Mulugeta, Abraham

2011-07-01

Despite enormous challenges, Somalia has been successfully implementing accelerated measles control activities since 2005. Through innovative strategies and with the support of local and international partners, the country has shown potentials of implementing measles mortality reduction activities in complex emergencies. Measles incidence has been reduced by >80% after the measles catch-up campaigns of 2005-2007, and national reported measles routine immunization coverage with first dose measles containing vaccine has reached 59% for the first time in 2009. However, the near collapse of the health care system and the ongoing insecurity continue to hamper the implementation of recommended measles control and elimination strategies in some parts of the country, making these achievements fragile. Somalia exemplifies the challenges in meeting measles elimination goals in the World Health Organization Eastern Mediterranean region. As the region is entering its 2010 measles elimination goals, it appears necessary to establish realistic and flexible interim goals for measles control in Somalia that will take into consideration the specificities of the country. Maintaining flexibility in conducting field operations, securing financial resources, multiplying opportunities for measles vaccination, and improving disease monitoring systems will remain vital to sustain and improve current achievements. © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.

Institutional Ethical Review and Ethnographic Research Involving Injection Drug Users: A Case Study

PubMed Central

Small, Will; Maher, Lisa; Kerr, Thomas

2014-01-01

Ethnographic research among people who inject drugs (PWID) involves complex ethical issues. While ethical review frameworks have been critiqued by social scientists, there is a lack of social science research examining institutional ethical review processes, particularly in relation to ethnographic work. This case study describes the institutional ethical review of an ethnographic research project using observational fieldwork and in-depth interviews to examine injection drug use. The review process and the salient concerns of the review committee are recounted, and the investigators’ responses to the committee’s concerns and requests are described to illustrate how key issues were resolved. The review committee expressed concerns regarding researcher safety when conducting fieldwork and the investigators were asked to liaise with the police regarding the proposed research. An ongoing dialogue with the institutional review committee regarding researcher safety and autonomy from police involvement, as well as formal consultation with a local drug user group and solicitation of opinions from external experts, helped to resolve these issues. This case study suggests that ethical review processes can be particularly challenging for ethnographic projects focused on illegal behaviours, and that while some challenges could be mediated by modifying existing ethical review procedures, there is a need for legislation that provides legal protection of research data and participant confidentiality. PMID:24581074

NASA USAID Memorandum of Understanding

NASA Image and Video Library

2011-04-25

USAID Administrator Rajiv Shahspeaks prior to signing a five-year memorandum of understanding with NASA, Monday, April 25, 2011, at NASA Headquarters in Washington. The agreement formalizes ongoing agency collaborations that use Earth science data to address developmental challenges, and to assist in disaster mitigation and humanitarian responses. The agreement also encourages NASA and USAID to apply geospatial technologies to solve development challenges affecting the United States and developing countries. Photo Credit: (NASA/Paul E. Alers)

NASA USAID Memorandum of Understanding

NASA Image and Video Library

2011-04-25

USAID Administrator Rajiv Shah, left, and NASA Administrator Charles Bolden sign a five-year memorandum of understanding, Monday, April 25, 2011, at NASA Headquarters in Washington. The agreement formalizes ongoing agency collaborations that use Earth science data to address developmental challenges, and to assist in disaster mitigation and humanitarian responses. The agreement also encourages NASA and USAID to apply geospatial technologies to solve development challenges affecting the United States and developing countries. Photo Credit: (NASA/Paul E. Alers)

NASA USAID Memorandum of Understanding

NASA Image and Video Library

2011-04-25

USAID Administrator Rajiv Shah speaks prior to signing a five-year memorandum of understanding with NASA, Monday, April 25, 2011, at NASA Headquarters in Washington. The agreement formalizes ongoing agency collaborations that use Earth science data to address developmental challenges, and to assist in disaster mitigation and humanitarian responses. The agreement also encourages NASA and USAID to apply geospatial technologies to solve development challenges affecting the United States and developing countries. Photo Credit: (NASA/Paul E. Alers)

Geocomputation over Hybrid Computer Architecture and Systems: Prior Works and On-going Initiatives at UARK

NASA Astrophysics Data System (ADS)

Shi, X.

2015-12-01

As NSF indicated - "Theory and experimentation have for centuries been regarded as two fundamental pillars of science. It is now widely recognized that computational and data-enabled science forms a critical third pillar." Geocomputation is the third pillar of GIScience and geosciences. With the exponential growth of geodata, the challenge of scalable and high performance computing for big data analytics become urgent because many research activities are constrained by the inability of software or tool that even could not complete the computation process. Heterogeneous geodata integration and analytics obviously magnify the complexity and operational time frame. Many large-scale geospatial problems may be not processable at all if the computer system does not have sufficient memory or computational power. Emerging computer architectures, such as Intel's Many Integrated Core (MIC) Architecture and Graphics Processing Unit (GPU), and advanced computing technologies provide promising solutions to employ massive parallelism and hardware resources to achieve scalability and high performance for data intensive computing over large spatiotemporal and social media data. Exploring novel algorithms and deploying the solutions in massively parallel computing environment to achieve the capability for scalable data processing and analytics over large-scale, complex, and heterogeneous geodata with consistent quality and high-performance has been the central theme of our research team in the Department of Geosciences at the University of Arkansas (UARK). New multi-core architectures combined with application accelerators hold the promise to achieve scalability and high performance by exploiting task and data levels of parallelism that are not supported by the conventional computing systems. Such a parallel or distributed computing environment is particularly suitable for large-scale geocomputation over big data as proved by our prior works, while the potential of such advanced infrastructure remains unexplored in this domain. Within this presentation, our prior and on-going initiatives will be summarized to exemplify how we exploit multicore CPUs, GPUs, and MICs, and clusters of CPUs, GPUs and MICs, to accelerate geocomputation in different applications.

Control and Diagnosis in Integrated Product Development - Observations during the Development of an AGV

NASA Astrophysics Data System (ADS)

Stetter, R.; Simundsson, A.

2015-11-01

This paper is concerned with the integration of control and diagnosis functionalities into the development of complete systems which include mechanical, electrical and electronic subsystems. For the development of such systems the strategies, methods and tools of integrated product development have attracted significant attention during the last decades. Today, it is generally observed that product development processes of complex systems can only be successful if the activities in the different domains are well connected and synchronised and if an ongoing communication is present - an ongoing communication spanning the technical domains and also including functions such as production planning, marketing/distribution, quality assurance, service and project planning. Obviously, numerous approaches to tackle this challenge are present in scientific literature and in industrial practice, as well. Today, the functionality and safety of most products is to a large degree dependent on control and diagnosis functionalities. Still, there is comparatively little research concentrating on the integration of the development of these functionalities into the overall product development processes. The main source of insight of the presented research is the product development process of an Automated Guided Vehicle (AGV) which is intended to be used on rough terrain. The paper starts with a background describing Integrated Product Development. The second section deals with the product development of the sample product. The third part summarizes some insights and formulates first hypotheses concerning control and diagnosis in Integrated Product Development.

Quality of life : assessment for transportation performance measures.

DOT National Transportation Integrated Search

2013-01-01

Quality of life (QOL) is a commonly used term. Defining QOL, however, is an ongoing challenge that experts : often take on with minimal input from citizens. This groundbreaking research sought citizen input on what : comprised QOL and what role trans...

Military Vision Research Program

DTIC Science & Technology

2008-04-01

soldiers off the battlefield are important for flap stability in LASIK patients, and control of haze following PRK . Understanding how cell proliferation...investigate the effect of same vs . different contexts on inattentional blindness, has proved challenging and is ongoing. We have had several iterations of

Primary Care Practice Transformation Is Hard Work

PubMed Central

Crabtree, Benjamin F.; Nutting, Paul A.; Miller, William L.; McDaniel, Reuben R.; Stange, Kurt C.; Jaén, Carlos Roberto; Stewart, Elizabeth

2010-01-01

Background Serious shortcomings remain in clinical care in the United States despite widespread use of improvement strategies for enhancing clinical performance based on knowledge transfer approaches. Recent calls to transform primary care practice to a patient-centered medical home present even greater challenges and require more effective approaches. Methods Our research team conducted a series of National Institutes of Health funded descriptive and intervention projects to understand organizational change in primary care practice settings, emphasizing a complexity science perspective. The result was a developmental research effort that enabled the identification of critical lessons relevant to enabling practice change. Results A summary of findings from a 15-year program of research highlights the limitations of viewing primary care practices in the mechanistic terms that underlie current or traditional approaches to quality improvement. A theoretical perspective that views primary care practices as dynamic complex adaptive systems with “agents” who have the capacity to learn, and the freedom to act in unpredictable ways provides a better framework for grounding quality improvement strategies. This framework strongly emphasizes that quality improvement interventions should not only use a complexity systems perspective, but also there is a need for continual reflection, careful tailoring of interventions, and ongoing attention to the quality of interactions among agents in the practice. Conclusions It is unlikely that current strategies for quality improvement will be successful in transforming current primary care practice to a patient-centered medical home without a stronger guiding theoretical foundation. Our work suggests that a theoretical framework guided by complexity science can help in the development of quality improvement strategies that will more effectively facilitate practice change. PMID:20856145

Conceptual challenges in the study of caregiver-care recipient relationships.

PubMed

Lingler, Jennifer Hagerty; Sherwood, Paula R; Crighton, Margaret H; Song, Mi-Kyung; Happ, Mary Beth

2008-01-01

In the literature on family caregiving, care receiving and caregiving are generally treated as distinct constructs, suggesting that informal care and support flow in a unidirectional manner from caregiver to care recipient. Yet, informal care dynamics are fundamentally relational and often reciprocal, and caregiving roles can be complex and overlapping. To illustrate ways care dynamics may depart from traditional notions of dyadic unidirectional family caregiving and to stimulate a discussion of the implications of complex relational care dynamics for caregiving science. Exemplar cases of informal care dynamics were drawn from three ongoing and completed investigations involving persons with serious illness and their family caregivers. The selected cases provide examples of three unique, but not uncommon, care exchange patterns: (a) care dyads who are aging, are chronically ill, and who compensate for one another's deficits in reciprocal relationships; (b) patients who present with a constellation of family members and other informal caregivers, as opposed to one primary caregiver; and (c) family care chains whereby a given individual functions as a caregiver to one relative or friend and care recipient to another. These cases illustrate such phenomena as multiple caregivers, shifting and shared caregiving roles, and care recipients as caregivers. As caregiving science enters a new era of complexity and maturity, there is a need for conceptual and methodological approaches that acknowledge, account for, and support the complex, web-like nature of family caregiving configurations. Research that contributes to, and is informed by, a broader understanding of the reality of family caregiving will yield findings that carry greater clinical relevance than has been possible previously.

Conceptual Challenges in the Study of Caregiver-Care Recipient Relationships

PubMed Central

Lingler, Jennifer Hagerty; Sherwood, Paula R.; Crighton, Margaret H.; Song, Mi-Kyung; Happ, Mary Beth

2010-01-01

Background In the literature on family caregiving, care receiving and caregiving are treated generally as distinct constructs, suggesting that informal care and support flow in a unidirectional manner from caregiver to care recipient. Yet, informal care dynamics are fundamentally relational and often reciprocal, and caregiving roles can be complex and overlapping. Objectives To illustrate ways care dynamics may depart from traditional notions of dyadic, unidirectional family caregiving; and to stimulate a discussion of the implications of complex, relational care dynamics for caregiving science. Approach Exemplar cases of informal care dynamics were drawn from three ongoing and completed investigations involving persons with serious illness and their family caregivers. The selected cases provide examples of three unique, but not uncommon, care exchange patterns: (a) aging and chronically ill care dyads who compensate for one another's deficits in reciprocal relationships; (b) patients who present with a constellation of family members and other informal caregivers, as opposed to one primary caregiver; and (c) family care chains whereby a given individual functions as a caregiver to one relative or friend and care recipient to another. Conclusions These cases illustrate such phenomena as multiple caregivers, shifting and shared caregiving roles, and care recipients as caregivers. As caregiving science enters a new era of complexity and maturity, there is a need for conceptual and methodological approaches that acknowledge, account for, and support the complex, web-like nature of family caregiving configurations. Research that contributes to, and is informed by, a broader understanding of the reality of family caregiving will yield findings that carry greater clinical relevance than has been possible previously. PMID:18794721

Statistical assessment on a combined analysis of GRYN-ROMN-UCBN upland vegetation vital signs

USGS Publications Warehouse

Irvine, Kathryn M.; Rodhouse, Thomas J.

2014-01-01

As of 2013, Rocky Mountain and Upper Columbia Basin Inventory and Monitoring Networks have multiple years of vegetation data and Greater Yellowstone Network has three years of vegetation data and monitoring is ongoing in all three networks. Our primary objective is to assess whether a combined analysis of these data aimed at exploring correlations with climate and weather data is feasible. We summarize the core survey design elements across protocols and point out the major statistical challenges for a combined analysis at present. The dissimilarity in response designs between ROMN and UCBN-GRYN network protocols presents a statistical challenge that has not been resolved yet. However, the UCBN and GRYN data are compatible as they implement a similar response design; therefore, a combined analysis is feasible and will be pursued in future. When data collected by different networks are combined, the survey design describing the merged dataset is (likely) a complex survey design. A complex survey design is the result of combining datasets from different sampling designs. A complex survey design is characterized by unequal probability sampling, varying stratification, and clustering (see Lohr 2010 Chapter 7 for general overview). Statistical analysis of complex survey data requires modifications to standard methods, one of which is to include survey design weights within a statistical model. We focus on this issue for a combined analysis of upland vegetation from these networks, leaving other topics for future research. We conduct a simulation study on the possible effects of equal versus unequal probability selection of points on parameter estimates of temporal trend using available packages within the R statistical computing package. We find that, as written, using lmer or lm for trend detection in a continuous response and clm and clmm for visually estimated cover classes with “raw” GRTS design weights specified for the weight argument leads to substantially different results and/or computational instability. However, when only fixed effects are of interest, the survey package (svyglm and svyolr) may be suitable for a model-assisted analysis for trend. We provide possible directions for future research into combined analysis for ordinal and continuous vital sign indictors.

Complex Span versus Updating Tasks of Working Memory: The Gap Is Not that Deep

ERIC Educational Resources Information Center

Schmiedek, Florian; Hildebrandt, Andrea; Lovden, Martin; Wilhelm, Oliver; Lindenberger, Ulman

2009-01-01

How to best measure working memory capacity is an issue of ongoing debate. Besides established complex span tasks, which combine short-term memory demands with generally unrelated secondary tasks, there exists a set of paradigms characterized by continuous and simultaneous updating of several items in working memory, such as the n-back, memory…

Ongoing outbreak with well over 4,000 measles cases in Italy from January to end August 2017 - what is making elimination so difficult?

PubMed

Filia, Antonietta; Bella, Antonino; Del Manso, Martina; Baggieri, Melissa; Magurano, Fabio; Rota, Maria Cristina

2017-09-14

We report an ongoing measles outbreak in Italy, with over 4,400 cases reported in 20 Regions from January to August 2017. Median age was 27 years, 88% of the cases were unvaccinated. The highest incidence was in infants below one year of age and 7% of cases occurred among healthcare workers. Three deaths occurred and two cases of encephalitis were reported. Wide immunity gaps and nosocomial transmission are major challenges to measles elimination in Italy. This article is copyright of The Authors, 2017.

Role of music therapy in integrative oncology.

PubMed

Magill, Lucanne

2006-01-01

Music therapy is an evidence-based complementary therapy that enhances quality of life in cancer patients and their caregivers. The role of music therapy in integrative oncology encompassed care and treatment of patients and family members , ongoing collaboration with the health care team, and the provision of music therapy services that may benefit the cancer center community. Clinical work includes ongoing assessment and the implementation of specific music therapy techniques aimed at reducing challenging symptoms and enhancing overall well-being and quality of life. This article outlines music therapy methods and the role that the music therapist has in integrative oncology programs.

The Indiana Public Health Emergency Surveillance System: Ongoing Progress, Early Findings, and Future Directions

PubMed Central

Grannis, Shaun; Wade, Michael; Gibson, Joseph; Overhage, J. Marc

2006-01-01

Beginning in 2004, the Indiana State Department of Health (ISDH) partnered with the Regenstrief Institute on a 4-year project to implement a statewide biosurveillance system incorporating more than 110 hospitals. This paper describes our evolving experience with the system including ongoing implementation challenges, how the system has helped to uncover events of public health significance, and future directions. The system currently receives emergency department visit data from 50 hospitals totaling nearly 5,000 visits per day, and is projected to have 65 hospitals connected by August 2006. PMID:17238352

Two decades of nation-wide community-based stroke support - The Singapore National Stroke Association.

PubMed

Venketasubramanian, Narayanaswamy; Yin, Ann; Lee, Lay B; De Silva, Deidre A

2017-04-01

The Singapore National Stroke Association, registered in 1996, offers support and information to stroke survivors and caregivers, and aims to raise public stroke awareness. In the last 20 years, we have developed programs to equip stroke survivors and caregivers with knowledge, life skills, comfort, and opportunities for socialization and reintegration. We have on-going public education and advocacy initiatives. Obtaining funding, member recruitment, volunteer retention, and leadership renewal are on-going challenges. Singapore National Stroke Association will continue to strive for the betterment of stroke survivors, their caregivers, and the public.

‘It's trying to manage the work’: a qualitative evaluation of recruitment processes within a UK multicentre trial

PubMed Central

Skea, Zoë Christina; Treweek, Shaun; Gillies, Katie

2017-01-01

Objectives To explore trial site staff's perceptions regarding barriers and facilitators to local recruitment. Design Qualitative semi-structured interviews with a range of trial site staff from four trial sites in the UK. Interviews were analysed thematically to identify common themes across sites, barriers that could be addressed and facilitators that could be shared with other sites. Participants 11 members of staff from four trial sites: clinical grant Co-applicant (n=1); Principal Investigators (n=3); Consultant Urologist (n=1); Research Nurses (n=5); Research Assistant (n=1). Setting Embedded within an ongoing randomised controlled trial (the TISU trial). TISU is a UK multicentre trial comparing therapeutic interventions for ureteric stones. Results Our study draws attention to the initial and ongoing burden of trial work that is involved throughout the duration of a clinical trial. In terms of building and sustaining a research culture, trial staff described the ongoing work of engagement that was required to ensure that clinical staff were both educated and motivated to help with the process of identifying and screening potential participants. Having adequate and sufficient organisational and staffing resources was highlighted as being a necessary prerequisite to successful recruitment both in terms of accessing potentially eligible patients and being able to maximise recruitment after patient identification. The nature of the research study design can also potentially generate challenging communicative work for recruiting staff which can prove particularly problematic. Conclusions Our paper adds to existing research highlighting the importance of the hidden and complex work that is involved in clinical trial recruitment. Those designing and supporting the operationalisation of clinical trials must recognise and support the mitigation of this ‘work’. While much of the work is likely to be contextually sensitive at the level of local sites and for individual trials, some aspects are ubiquitous issues for delivery of trials more generally. Trial registration number ISRCTN No 92289221; Pre-results. PMID:28801422

Urban and rural groundwater use in Zhengzhou, China: challenges in joint management

NASA Astrophysics Data System (ADS)

Sun, Ronglin; Jin, Menggui; Giordano, Mark; Villholth, Karen G.

2009-09-01

Groundwater plays an important role in the total water supply of much of China, particularly in the north. It has contributed substantially to both agricultural growth and urban and industrial expansion. However, overexploitation and poor management have contributed to infamous groundwater depletion problems and less publicized groundwater quality deterioration. One of the key challenges for China will be how to make groundwater use sustainable while still meeting increased food needs as well as the industrial and domestic demands of a rapidly urbanizing society. Zhengzhou City, one of China’s test cities for building a “water saving society” highlights both the difficulties and potential solutions to northern China’s joint rural and urban groundwater challenges. Based on secondary data and a primary survey of groundwater management in the region, this report provides an overview of Zhengzhou’s groundwater development and use as well as the ongoing institutional and policy reform processes within the water sector. The results highlight how a deepening of ongoing reforms, which simultaneously consider groundwater as an integral rural and urban issue and a fundamental economic and social asset, may improve groundwater outcomes, not only in Zhengzhou but in China, as the country’s economy and demography continue to change.

The ethics of research using electronic mail discussion groups.

PubMed

Kralik, Debbie; Warren, Jim; Price, Kay; Koch, Tina; Pignone, Gino

2005-12-01

The aim of this paper is to identify and discuss the ethical considerations that have confronted and challenged the research team when researchers facilitate conversations using private electronic mail discussion lists. The use of electronic mail group conversations, as a collaborative data generation method, remains underdeveloped in nursing. Ethical challenges associated with this approach to data generation have only begun to be considered. As receipt of ethics approval for a study titled; 'Describing transition with people who live with chronic illness' we have been challenged by many ethical dilemmas, hence we believe it is timely to share the issues that have confronted the research team. These discussions are essential so we can understand the possibilities for research interaction, communication, and collaboration made possible by advanced information technologies. Our experiences in this study have increased our awareness for ongoing ethical discussions about privacy, confidentiality, consent, accountability and openness underpinning research with human participants when generating data using an electronic mail discussion group. We describe how we work at upholding these ethical principles focusing on informed consent, participant confidentiality and privacy, the participants as threats to themselves and one another, public-private confusion, employees with access, hackers and threats from the researchers. A variety of complex issues arise during cyberspace research that can make the application of traditional ethical standards troublesome. Communication in cyberspace alters the temporal, spatial and sensory components of human interaction, thereby challenging traditional ethical definitions and calling to question some basic assumptions about identity and ones right to keep aspects of it confidential. Nurse researchers are bound by human research ethics protocols; however, the nature of research by electronic mail generates moral issues as well as ethical concerns. Vigilance by researchers is required to ensure that data are viewed within the scope of the enabling ethics approval.

Simulations and experiments of photon propagation in biological tissue and liquid crystal waveguides

NASA Astrophysics Data System (ADS)

Lines, Collin M.

The development of non-invasive methods to probe human tissue is an ongoing challenge in biomedical optics. In vivo measurements by conventional methods are limited by the mean free path (MFP) of a photon, which is governed by the spatial distribution of chromophores and the absorption and scattering properties of the tissue. As one of the strongest chromophores in human tissues, hemoglobin concentrations in human tissue greatly affect the MFP of photons in visible wavelengths (i.e. bruising). Changes in the concentration of hemoglobin and other chromophores within the tissue (minor trauma causing a contusion, increased bilirubin due to jaundice, etc.) will affect the MFP, leading to a visibly different appearance (color) of the tissue. As color perception is a complex physiological process, these changes are diffcult to quantify by human observation alone. The transport of hemoglobin and its breakdown products in tissue is related to a number of medical conditions that could benefit from a non-invasive method to determine the hemoglobin levels.

Evaluating 5 years' NIMART mentoring in South Africa's HIV treatment programme: Successes, challenges and future needs.

PubMed

Jones, M; Cameron, D

2017-09-22

Task shifting has enabled South Africa (SA) to rapidly expand its HIV treatment programme. This has been achieved by training and mentoring primary-care nurses in nurse initiation and management of antiretroviral therapy (NIMART). Five years into its clinical mentoring programme, the Foundation for Professional Development conducted an evaluation that identified improved knowledge, attitudes and confidence perceived by nurses who received NIMART mentoring. Low completion rates for the Department of Health (DoH) NIMART training process were identified and therefore targeted mentoring was introduced; this increased the percentage of primary nurses eligible for DoH certificates of clinical competence in NIMART from 12%, adding a further 30%. There remain a large number of primary nurses who require mentoring in order to complete the NIMART process. For those who have completed the process, there remains a need for ongoing mentoring as SA's HIV programme evolves, complex cases emerge and primary care undergoes change.

Improving plant functional groups for dynamic models of biodiversity: at the crossroads between functional and community ecology

PubMed Central

Isabelle, Boulangeat; Pauline, Philippe; Sylvain, Abdulhak; Roland, Douzet; Luc, Garraud; Sébastien, Lavergne; Sandra, Lavorel; Jérémie, Van Es; Pascal, Vittoz; Wilfried, Thuiller

2013-01-01

The pace of on-going climate change calls for reliable plant biodiversity scenarios. Traditional dynamic vegetation models use plant functional types that are summarized to such an extent that they become meaningless for biodiversity scenarios. Hybrid dynamic vegetation models of intermediate complexity (hybrid-DVMs) have recently been developed to address this issue. These models, at the crossroads between phenomenological and process-based models, are able to involve an intermediate number of well-chosen plant functional groups (PFGs). The challenge is to build meaningful PFGs that are representative of plant biodiversity, and consistent with the parameters and processes of hybrid-DVMs. Here, we propose and test a framework based on few selected traits to define a limited number of PFGs, which are both representative of the diversity (functional and taxonomic) of the flora in the Ecrins National Park, and adapted to hybrid-DVMs. This new classification scheme, together with recent advances in vegetation modeling, constitutes a step forward for mechanistic biodiversity modeling. PMID:24403847

Functional neuroanatomy of disorders of consciousness.

PubMed

Di Perri, Carol; Stender, Johan; Laureys, Steven; Gosseries, Olivia

2014-01-01

Our understanding of the mechanisms of loss and recovery of consciousness, following severe brain injury or during anesthesia, is changing rapidly. Recent neuroimaging studies have shown that patients with chronic disorders of consciousness and subjects undergoing general anesthesia present a complex dysfunctionality in the architecture of brain connectivity. At present, the global hallmark of impaired consciousness appears to be a multifaceted dysfunctional connectivity pattern with both within-network loss of connectivity in a widespread frontoparietal network and between-network hyperconnectivity involving other regions such as the insula and ventral tegmental area. Despite ongoing efforts, the mechanisms underlying the emergence of consciousness after severe brain injury are not thoroughly understood. Important questions remain unanswered: What triggers the connectivity impairment leading to disorders of consciousness? Why do some patients recover from coma, while others with apparently similar brain injuries do not? Understanding these mechanisms could lead to a better comprehension of brain function and, hopefully, lead to new therapeutic strategies in this challenging patient population. © 2013.

An Evolving Identity: How Chronic Care Is Transforming What it Means to Be a Physician.

PubMed

Bogetz, Alyssa L; Bogetz, Jori F

2015-12-01

Physician identity and the professional role physicians play in health care is rapidly evolving. Over 130 million adults and children in the USA have complex and chronic diseases, each of which is shaped by aspects of the patient's social, psychological, and economic status. These patients have lifelong health care needs that require the ongoing care of multiple health care providers, access to community services, and the involvement of patients' family support networks. To date, physician professional identity formation has centered on autonomy, authority, and the ability to "heal." These notions of identity may be counterproductive in chronic disease care, which demands interdependency between physicians, their patients, and teams of multidisciplinary health care providers. Medical educators can prepare trainees for practice in the current health care environment by providing training that legitimizes and reinforces a professional identity that emphasizes this interdependency. This commentary outlines the important challenges related to this change and suggests potential strategies to reframe professional identity to better match the evolving role of physicians today.

A computational workflow for designing silicon donor qubits

DOE PAGES

Humble, Travis S.; Ericson, M. Nance; Jakowski, Jacek; ...

2016-09-19

Developing devices that can reliably and accurately demonstrate the principles of superposition and entanglement is an on-going challenge for the quantum computing community. Modeling and simulation offer attractive means of testing early device designs and establishing expectations for operational performance. However, the complex integrated material systems required by quantum device designs are not captured by any single existing computational modeling method. We examine the development and analysis of a multi-staged computational workflow that can be used to design and characterize silicon donor qubit systems with modeling and simulation. Our approach integrates quantum chemistry calculations with electrostatic field solvers to performmore » detailed simulations of a phosphorus dopant in silicon. We show how atomistic details can be synthesized into an operational model for the logical gates that define quantum computation in this particular technology. In conclusion, the resulting computational workflow realizes a design tool for silicon donor qubits that can help verify and validate current and near-term experimental devices.« less

The kinetoplastid-infecting Bodo saltans virus (BsV), a window into the most abundant giant viruses in the sea

PubMed Central

Deeg, Christoph M; Chow, Cheryl-Emiliane T

2018-01-01

Giant viruses are ecologically important players in aquatic ecosystems that have challenged concepts of what constitutes a virus. Herein, we present the giant Bodo saltans virus (BsV), the first characterized representative of the most abundant group of giant viruses in ocean metagenomes, and the first isolate of a klosneuvirus, a subgroup of the Mimiviridae proposed from metagenomic data. BsV infects an ecologically important microzooplankton, the kinetoplastid Bodo saltans. Its 1.39 Mb genome encodes 1227 predicted ORFs, including a complex replication machinery. Yet, much of its translational apparatus has been lost, including all tRNAs. Essential genes are invaded by homing endonuclease-encoding self-splicing introns that may defend against competing viruses. Putative anti-host factors show extensive gene duplication via a genomic accordion indicating an ongoing evolutionary arms race and highlighting the rapid evolution and genomic plasticity that has led to genome gigantism and the enigma that is giant viruses. PMID:29582753

Fingerprinting Green Curry: An Electrochemical Approach to Food Quality Control.

PubMed

Chaibun, Thanyarat; La-O-Vorakiat, Chan; O'Mullane, Anthony P; Lertanantawong, Benchaporn; Surareungchai, Werasak

2018-06-07

The detection and identification of multiple components in a complex sample such as food in a cost-effective way is an ongoing challenge. The development of on-site and rapid detection methods to ensure food quality and composition is of significant interest to the food industry. Here we report that an electrochemical method can be used with an unmodified glassy carbon electrode for the identification of the key ingredients found within Thai green curries. It was found that green curry presents a fingerprint electrochemical response that contains four distinct peaks when differential pulse voltammetry is performed. The reproducibility of the sensor is excellent as no surface modification is required and therefore storage is not an issue. By employing particle swarm optimization algorithms the identification of ingredients within a green curry could be obtained. In addition, the quality and freshness of the sample could be monitored by detecting a change in the intensity of the peaks in the fingerprint response.

The expanding role of mass spectrometry in the field of vaccine development.

PubMed

Sharma, Vaneet Kumar; Sharma, Ity; Glick, James

2018-05-31

Biological mass spectrometry has evolved as a core analytical technology in the last decade mainly because of its unparalleled ability to perform qualitative as well as quantitative profiling of enormously complex biological samples with high mass accuracy, sensitivity, selectivity and specificity. Mass spectrometry-based techniques are also routinely used to assess glycosylation and other post-translational modifications, disulfide bond linkage, and scrambling as well as for the detection of host cell protein contaminants in the field of biopharmaceuticals. The role of mass spectrometry in vaccine development has been very limited but is now expanding as the landscape of global vaccine development is shifting towards the development of recombinant vaccines. In this review, the role of mass spectrometry in vaccine development is presented, some of the ongoing efforts to develop vaccines for diseases with global unmet medical need are discussed and the regulatory challenges of implementing mass spectrometry techniques in a quality control laboratory setting are highlighted. © 2018 The Authors. Mass Spectrometry Reviews Published by Wiley Periodicals, Inc.

Form--a matter of generation: the relation of generation, form, and function in the epigenetic theory of Caspar F. Wolff.

PubMed

Witt, Elke

2008-12-01

The question, how organisms obtain their specific complex and functional forms, was widely discussed during the eighteenth century. The theory of preformation, which was the dominant theory of generation, was challenged by different alternative epigenetic theories. By the end of the century it was the vitalist approach most famously advocated by Johann Friedrich Blumenbach that prevailed. Yet the alternative theory of generation brought forward by Caspar Friedrich Wolff was an important contribution to the treatment of this question. He turned his attention from the properties of matter and the forces acting on it towards the level of the processes of generation in order to explain the constitution of organismic forms. By regarding organic structures and forms to be the result of the lawfulness of ongoing processes, he opened up the possibility of a functional but non-teleological explanation of generation, and thereby provided an important complement to materialist and vitalist approaches.

Liver transplantation in the treatment of severe iatrogenic liver injuries

PubMed Central

Lauterio, Andrea; De Carlis, Riccardo; Di Sandro, Stefano; Ferla, Fabio; Buscemi, Vincenzo; De Carlis, Luciano

2017-01-01

The place of liver transplantation in the treatment of severe iatrogenic liver injuries has not yet been widely discussed in the literature. Bile duct injuries during cholecystectomy represent the leading cause of liver transplantation in this setting, while other indications after abdominal surgery are less common. Urgent liver transplantation for the treatment of severe iatrogenic liver injury may-represent a surgical challenge requiring technically difficult and time consuming procedures. A debate is ongoing on the need for centralization of complex surgery in tertiary referral centers. The early referral of patients with severe iatrogenic liver injuries to a tertiary center with experienced hepato-pancreato-biliary and transplant surgery has emerged as the best treatment of care. Despite widespread interest in the use of liver transplantation as a treatment option for severe iatrogenic injuries, reported experiences indicate few liver transplants are performed. This review analyzes the literature on liver transplantation after hepatic injury and discusses our own experience along with surgical advances and future prospects in this uncommon transplant setting. PMID:28932348

Predicting commuter flows in spatial networks using a radiation model based on temporal ranges

NASA Astrophysics Data System (ADS)

Ren, Yihui; Ercsey-Ravasz, Mária; Wang, Pu; González, Marta C.; Toroczkai, Zoltán

2014-11-01

Understanding network flows such as commuter traffic in large transportation networks is an ongoing challenge due to the complex nature of the transportation infrastructure and human mobility. Here we show a first-principles based method for traffic prediction using a cost-based generalization of the radiation model for human mobility, coupled with a cost-minimizing algorithm for efficient distribution of the mobility fluxes through the network. Using US census and highway traffic data, we show that traffic can efficiently and accurately be computed from a range-limited, network betweenness type calculation. The model based on travel time costs captures the log-normal distribution of the traffic and attains a high Pearson correlation coefficient (0.75) when compared with real traffic. Because of its principled nature, this method can inform many applications related to human mobility driven flows in spatial networks, ranging from transportation, through urban planning to mitigation of the effects of catastrophic events.

Historical evidence for nature disconnection in a 70-year time series of Disney animated films.

PubMed

Prévot-Julliard, Anne-Caroline; Julliard, Romain; Clayton, Susan

2015-08-01

The assumed ongoing disconnection between humans and nature in Western societies represents a profoundly challenging conservation issue. Here, we demonstrate one manifestation of this nature disconnection, via an examination of the representation of natural settings in a 70-year time series of Disney animated films. We found that natural settings are increasingly less present as a representation of outdoor environments in these films. Moreover, these drawn natural settings tend to be more and more human controlled and are less and less complex in terms of the biodiversity they depict. These results demonstrate the increasing nature disconnection of the filmmaking teams, which we consider as a proxy of the Western relation to nature. Additionally, because nature experience of children is partly based on movies, the depleted representation of biodiversity in outdoor environments of Disney films may amplify the current disconnection from nature for children. This reduction in exposure to nature may hinder the implementation of biodiversity conservation measures. © The Author(s) 2014.

Towards Precision Medicine in the Clinic: From Biomarker Discovery to Novel Therapeutics.

PubMed

Collins, Dearbhaile C; Sundar, Raghav; Lim, Joline S J; Yap, Timothy A

2017-01-01

Precision medicine continues to be the benchmark to which we strive in cancer research. Seeking out actionable aberrations that can be selectively targeted by drug compounds promises to optimize treatment efficacy and minimize toxicity. Utilizing these different targeted agents in combination or in sequence may further delay resistance to treatments and prolong antitumor responses. Remarkable progress in the field of immunotherapy adds another layer of complexity to the management of cancer patients. Corresponding advances in companion biomarker development, novel methods of serial tumor assessments, and innovative trial designs act synergistically to further precision medicine. Ongoing hurdles such as clonal evolution, intra- and intertumor heterogeneity, and varied mechanisms of drug resistance continue to be challenges to overcome. Large-scale data-sharing and collaborative networks using next-generation sequencing (NGS) platforms promise to take us further into the cancer 'ome' than ever before, with the goal of achieving successful precision medicine. Copyright © 2016 Elsevier Ltd. All rights reserved.

Viral factors in influenza pandemic risk assessment

PubMed Central

Lipsitch, Marc; Barclay, Wendy; Raman, Rahul; Russell, Charles J; Belser, Jessica A; Cobey, Sarah; Kasson, Peter M; Lloyd-Smith, James O; Maurer-Stroh, Sebastian; Riley, Steven; Beauchemin, Catherine AA; Bedford, Trevor; Friedrich, Thomas C; Handel, Andreas; Herfst, Sander; Murcia, Pablo R; Roche, Benjamin; Wilke, Claus O; Russell, Colin A

2016-01-01

The threat of an influenza A virus pandemic stems from continual virus spillovers from reservoir species, a tiny fraction of which spark sustained transmission in humans. To date, no pandemic emergence of a new influenza strain has been preceded by detection of a closely related precursor in an animal or human. Nonetheless, influenza surveillance efforts are expanding, prompting a need for tools to assess the pandemic risk posed by a detected virus. The goal would be to use genetic sequence and/or biological assays of viral traits to identify those non-human influenza viruses with the greatest risk of evolving into pandemic threats, and/or to understand drivers of such evolution, to prioritize pandemic prevention or response measures. We describe such efforts, identify progress and ongoing challenges, and discuss three specific traits of influenza viruses (hemagglutinin receptor binding specificity, hemagglutinin pH of activation, and polymerase complex efficiency) that contribute to pandemic risk. DOI: http://dx.doi.org/10.7554/eLife.18491.001 PMID:27834632

ARCUS Project Managers and the Intangible Infrastructure of Large Interdisciplinary Arctic Research Networks

NASA Astrophysics Data System (ADS)

Myers, B.; Wiggins, H. V.; Turner-Bogren, E. J.; Warburton, J.

2017-12-01

Project Managers at the Arctic Research Consortium of the U.S. (ARCUS) lead initiatives to convene, communicate with, and connect the Arctic research community across challenging disciplinary, geographic, temporal, and cultural boundaries. They regularly serve as the organizing hubs, archivists and memory-keepers for collaborative projects comprised of many loosely affiliated partners. As leading organizers of large open science meetings and other outreach events, they also monitor the interdisciplinary landscape of community needs, concerns, opportunities, and emerging research directions. However, leveraging the ARCUS Project Manager role to strategically build out the intangible infrastructure necessary to advance Arctic research requires a unique set of knowledge, skills, and experience. Drawing on a range of lessons learned from past and ongoing experiences with collaborative science, education and outreach programming, this presentation will highlight a model of ARCUS project management that we believe works best to support and sustain our community in its long-term effort to conquer the complexities of Arctic research.

Shared decision making for patients living with inflammatory arthritis.

PubMed

Palmer, Deborah; El Miedany, Yasser

Providing adequate care for people with inflammatory arthritis is an ongoing challenge. In recent years significant progress has been made in the treatment of inflammatory arthritic conditions. The availability of a wide range of disease-modifying anti-rheumatic drugs as well as biologic therapies has not only improved treatment, but also made treatment decisions much more complex. This wider range of improved treatment options happened at the same time as a clear move towards patient-centred care and implementing shared decision making for both medical and surgical conditions. Implementing shared decision making has been reported to be associated with higher satisfaction and better adherence to therapy. Electronic shared decision making has more recently been suggested as a tool for clinical practice. The aim of this article is to look at further integrating shared decision making in standard rheumatology practice in view of the available evidence and the outcomes of a study looking at a recently developed patient shared decision guide.

Neuropsychopharmacology of auditory hallucinations: insights from pharmacological functional MRI and perspectives for future research.

PubMed

Johnsen, Erik; Hugdahl, Kenneth; Fusar-Poli, Paolo; Kroken, Rune A; Kompus, Kristiina

2013-01-01

Experiencing auditory verbal hallucinations is a prominent symptom in schizophrenia that also occurs in subjects at enhanced risk for psychosis and in the general population. Drug treatment of auditory hallucinations is challenging, because the current understanding is limited with respect to the neural mechanisms involved, as well as how CNS drugs, such as antipsychotics, influence the subjective experience and neurophysiology of hallucinations. In this article, the authors review studies of the effect of antipsychotic medication on brain activation as measured with functional MRI in patients with auditory verbal hallucinations. First, the authors examine the neural correlates of ongoing auditory hallucinations. Then, the authors critically discuss studies addressing the antipsychotic effect on the neural correlates of complex cognitive tasks. Current evidence suggests that blood oxygen level-dependant effects of antipsychotic drugs reflect specific, regional effects but studies on the neuropharmacology of auditory hallucinations are scarce. Future directions for pharmacological neuroimaging of auditory hallucinations are discussed.

US EPA Testing of LP & MP UV Disinfection Technologies

EPA Science Inventory

Presentation will discuss the ongoing USEPA research on UV disinfection addressing the following objectives: Conservatively predict log inactivation and RED of adenovirus with surrogates; Conduct many (LP=61) UV reactor conditions challenged with Ad2, B. pumilus, and MS2 & conduc...

Cultural Diversity and the Imagined Community of the Global Academy

ERIC Educational Resources Information Center

Guerin, Cally; Green, Ian

2016-01-01

Transnational academic mobility and the ongoing push towards "internationalization" together raise challenges for the cultural climate of today's universities. This paper explores these issues from the perspective of supervisors of research degrees in an Australian university in which "internationalization" and "academic…

Using high-throughput literature mining to support read-across predictions of toxicity (SOT)

EPA Science Inventory

Building scientific confidence in the development and evaluation of read-across remains an ongoing challenge. Approaches include establishing systematic frameworks to identify sources of uncertainty and ways to address them. One source of uncertainty is related to characterizing ...

High-throughput literature mining to support read-across predictions of toxicity (ASCCT meeting)

EPA Science Inventory

Building scientific confidence in the development and evaluation of read-across remains an ongoing challenge. Approaches include establishing systematic frameworks to identify sources of uncertainty and ways to address them. One source of uncertainty is related to characterizing ...

Decoding ecosystem services using a DSRP approach

EPA Science Inventory

Remediation to Restoration to Revitalization (R2R2R) is a place-based practice that requires ongoing communication amongst agencies, local governments, and citizens. One of the challenges is that each of these entities have different relationships with and responsibilities to sit...

Water Biosensor Challenge to Address Toxicity of Water

EPA Science Inventory

An ongoing concern for water treatment systems and resource managers is the need to monitor for the presence of increasing number of pollutants from agricultural, municipal, and industrial outfalls that are present in U.S. source waters. The associated environmental compounds can...

A whole-genome, radiation hybrid map of wheat

USDA-ARS?s Scientific Manuscript database

Generating a reference sequence of bread wheat (Triticum aestivum L.) is a challenging task because of its large, highly repetitive and allopolyploid genome. Ordering of BAC- and NGS-based contigs in ongoing wheat genome-sequencing projects primarily uses recombination and comparative genomics-base...

Quantifying uncertainty in read-across assessment – an algorithmic approach - (SOT)

EPA Science Inventory

Read-across is a popular data gap filling technique within category and analogue approaches for regulatory purposes. Acceptance of read-across remains an ongoing challenge with several efforts underway for identifying and addressing uncertainties. Here we demonstrate an algorithm...

Sustainable Urban Waters: Opportunities to Integrate Environmental Protection in Multi-objective Projects

EPA Science Inventory

Abstract: Nonpoint source pollution is an ongoing challenge for environmental agencies who seek to protect waters of the U.S. Urban stream and waterfront redevelopment projects present opportunities to achieve integrated environmental, economic, and social benefits in urban water...

Provider Experiences with Chronic Care Management (CCM) Services and Fees: A Qualitative Research Study.

PubMed

O'Malley, Ann S; Sarwar, Rumin; Keith, Rosalind; Balke, Patrick; Ma, Sai; McCall, Nancy

2017-12-01

Support for ongoing care management and coordination between office visits for patients with multiple chronic conditions has been inadequate. In January 2015, Medicare introduced the Chronic Care Management (CCM) payment policy, which reimburses providers for CCM activities for Medicare beneficiaries occurring outside of office visits. To explore the experiences, facilitators, and challenges of practices providing CCM services, and their implications going forward. Semi-structured telephone interviews from January to April 2016 with 71 respondents. Sixty billing and non-billing providers and practice staff knowledgeable about their practices' CCM services, and 11 professional society representatives. Practice respondents noted that most patients expressed positive views of CCM services. Practice respondents also perceived several patient benefits, including improved adherence to treatment, access to care team members, satisfaction, care continuity, and care coordination. Facilitators of CCM provision included having an in-practice care manager, patient-centered medical home recognition, experience developing care plans, patient trust in their provider, and supplemental insurance to cover CCM copayments. Most billing practices reported few problems obtaining patients' consent for CCM, though providers felt that CMS could better facilitate consent by marketing CCM's goals to beneficiaries. Barriers reported by professional society representatives and by billing and non-billing providers included inadequacy of CCM payments to cover upfront investments for staffing, workflow modification, and time needed to manage complex patients. Other barriers included inadequate infrastructure for health information exchange with other providers and limited electronic health record capabilities for documenting and updating care plans. Practices owned by hospital systems and large medical groups faced greater bureaucracy in implementing CCM than did smaller, independent practices. Improving providers' experiences with and uptake of CCM will require addressing several challenges, including the upfront investment for CCM set-up and the time required to provide CCM to more complex patients.

Prevention of data duplication for high throughput sequencing repositories

PubMed Central

Gabdank, Idan; Chan, Esther T; Davidson, Jean M; Hilton, Jason A; Davis, Carrie A; Baymuradov, Ulugbek K; Narayanan, Aditi; Onate, Kathrina C; Graham, Keenan; Miyasato, Stuart R; Dreszer, Timothy R; Strattan, J Seth; Jolanki, Otto; Tanaka, Forrest Y; Hitz, Benjamin C

2018-01-01

Abstract Prevention of unintended duplication is one of the ongoing challenges many databases have to address. Working with high-throughput sequencing data, the complexity of that challenge increases with the complexity of the definition of a duplicate. In a computational data model, a data object represents a real entity like a reagent or a biosample. This representation is similar to how a card represents a book in a paper library catalog. Duplicated data objects not only waste storage, they can mislead users into assuming the model represents more than the single entity. Even if it is clear that two objects represent a single entity, data duplication opens the door to potential inconsistencies between the objects since the content of the duplicated objects can be updated independently, allowing divergence of the metadata associated with the objects. Analogously to a situation in which a catalog in a paper library would contain by mistake two cards for a single copy of a book. If these cards are listing simultaneously two different individuals as current book borrowers, it would be difficult to determine which borrower (out of the two listed) actually has the book. Unfortunately, in a large database with multiple submitters, unintended duplication is to be expected. In this article, we present three principal guidelines the Encyclopedia of DNA Elements (ENCODE) Portal follows in order to prevent unintended duplication of both actual files and data objects: definition of identifiable data objects (I), object uniqueness validation (II) and de-duplication mechanism (III). In addition to explaining our modus operandi, we elaborate on the methods used for identification of sequencing data files. Comparison of the approach taken by the ENCODE Portal vs other widely used biological data repositories is provided. Database URL: https://www.encodeproject.org/ PMID:29688363

Challenges to deployment of twenty-first century nuclear reactor systems

PubMed Central

2017-01-01

The science and engineering of materials have always been fundamental to the success of nuclear power to date. They are also the key to the successful deployment and operation of a new generation of nuclear reactor systems and their associated fuel cycles. This article reflects on some of the historical issues, the challenges still prevalent today and the requirement for significant ongoing materials R&D and discusses the potential role of small modular reactors. PMID:28293142

NASA USAID Memorandum of Understanding

NASA Image and Video Library

2011-04-25

USAID Administrator Rajiv Shah, left, and NASA Administrator Charles Bolden shake hands after signing a five-year memorandum of understanding, Monday, April 25, 2011, at NASA Headquarters in Washington. The agreement formalizes ongoing agency collaborations that use Earth science data to address developmental challenges, and to assist in disaster mitigation and humanitarian responses. The agreement also encourages NASA and USAID to apply geospatial technologies to solve development challenges affecting the United States and developing countries. Photo Credit: (NASA/Paul E. Alers)

Challenges to deployment of twenty-first century nuclear reactor systems.

PubMed

Ion, Sue

2017-02-01

The science and engineering of materials have always been fundamental to the success of nuclear power to date. They are also the key to the successful deployment and operation of a new generation of nuclear reactor systems and their associated fuel cycles. This article reflects on some of the historical issues, the challenges still prevalent today and the requirement for significant ongoing materials R&D and discusses the potential role of small modular reactors.

Language approaches used with deaf pupils in Scottish schools: 2001-2004.

PubMed

Grimes, Marian; Thoutenhoofd, Ernst D; Byrne, Delma

2007-01-01

In this article we address "language approach" data as a key variable in quantitative, large-scale research on educational achievement, focusing on our work for the Achievements of Deaf Pupils in Scotland (ADPS) project. The complexity of approaches is addressed, with a particular focus on a "no-exclusion" model of service. In this context 3 years of language-related data are discussed, using constructions of language variables that take into account the variability in deaf pupils' hearing loss levels, types of provision, and professional practice. We see this as a necessary first step toward offering a nuanced context for understanding patterns in the educational outcomes among the ADPS population to be reported in a later article. The ADPS data on language approach can reveal general patterns at macro levels: our analysis suggests that, in Scotland, the extent and quality of British Sign Language/English provision may be determined more by local factors than by linguistic requirements and that ostensibly responsive policies can mask a limited spectrum for pupils and their families. However, the ADPS data are insufficiently sensitive to detailed and local variations to reflect the full complexity of language situations over time-a situation which represents an ongoing challenge for all long-term, large-scale studies.

High resolution pollutant measurements in complex urban ...

EPA Pesticide Factsheets

Measuring air pollution in real-time using an instrumented vehicle platform has been an emerging strategy to resolve air pollution trends at a very fine spatial scale (10s of meters). Achieving second-by-second data representative of urban air quality trends requires advanced instrumentation, such as a quantum cascade laser utilized to resolve carbon monoxide and real-time optical detection of black carbon. An equally challenging area of development is processing and visualization of complex geospatial air monitoring data to decipher key trends of interest. EPA’s Office of Research and Development staff have applied air monitoring to evaluate community air quality in a variety of environments, including assessing air quality surrounding rail yards, evaluating noise wall or tree stand effects on roadside and on-road air quality, and surveying of traffic-related exposure zones for comparison with land-use regression estimates. ORD has ongoing efforts to improve mobile monitoring data collection and interpretation, including instrumentation testing, evaluating the effect of post-processing algorithms on derived trends, and developing a web-based tool called Real-Time Geospatial Data Viewer (RETIGO) allowing for a simple plug-and-play of mobile monitoring data. Example findings from mobile data sets include an estimated 50% in roadside ultrafine particle levels when immediately downwind of a noise barrier, increases in neighborhood-wide black carbon levels (3

CFD and ventilation research.

PubMed

Li, Y; Nielsen, P V

2011-12-01

There has been a rapid growth of scientific literature on the application of computational fluid dynamics (CFD) in the research of ventilation and indoor air science. With a 1000-10,000 times increase in computer hardware capability in the past 20 years, CFD has become an integral part of scientific research and engineering development of complex air distribution and ventilation systems in buildings. This review discusses the major and specific challenges of CFD in terms of turbulence modelling, numerical approximation, and boundary conditions relevant to building ventilation. We emphasize the growing need for CFD verification and validation, suggest ongoing needs for analytical and experimental methods to support the numerical solutions, and discuss the growing capacity of CFD in opening up new research areas. We suggest that CFD has not become a replacement for experiment and theoretical analysis in ventilation research, rather it has become an increasingly important partner. We believe that an effective scientific approach for ventilation studies is still to combine experiments, theory, and CFD. We argue that CFD verification and validation are becoming more crucial than ever as more complex ventilation problems are solved. It is anticipated that ventilation problems at the city scale will be tackled by CFD in the next 10 years. © 2011 John Wiley & Sons A/S.

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

Mizner, Jack Harry; Passell, Howard David; Keller, Elizabeth James Kistin

Sustainability is a critical national security issue for the U.S. and other nations. Sandia National Laboratories (SNL) is already a global leader in sustainability science and technology (SS&T) as documented in this report. This report documents the ongoing work conducted this year as part of the Sustainability Innovation Foundry (SIF). The efforts of the SIF support Sandia's national and international security missions related to sustainability and resilience revolving around energy use, water use, and materials, both on site at Sandia and externally. The SIF leverages existing Sandia research and development (R&D) in sustainability science and technology to support new solutionsmore » to complex problems. The SIF also builds on existing Sandia initiatives to support transformation of Sandia into a fully sustainable entity in terms of materials, energy, and water use. In the long term, the SIF will demonstrate the efficacy of sustainability technology developed at Sandia through prototyping and test bed approaches and will provide a common platform for support of solutions to the complex problems surrounding sustainability. Highlights from this year include the Sustainability Idea Challenge, improvements in facilities energy use, lectures and presentations from relevant experts in sustainability [Dr. Barry Hughes, University of Denver], and significant development of the Institutional Transformation (IX) modeling tools to support evaluation of proposed modifications to the SNL infrastructure to realize energy savings.« less

Audio-visual distraction as an adjunct to standby anaesthesia in persons with paraplegia: a case series of five operations.

PubMed

Ayub, Khurram; Corrigan, Ruth A; Misra, Jyoti; Galitzine, Svetlana

2018-01-01

Persons with paraplegia present complex challenges to anaesthetists. Complications experienced by these patients can require major orthoplastic surgery such as excision of infected bone and soft tissue due to pressure sores and soft tissue reconstruction. Anaesthetic strategies deemed both safe and acceptable to this population are essential. We report a case series of five procedures in four patients with complete chronic spinal cord injury (CSCI) who underwent operations in lateral position under standby anaesthesia and audio-visual distraction (AVD) with minimal sedation. Patients' experience was formally assessed as part of the ongoing AVD service evaluation in our institution. All stated that they were not concerned in the operating theatre and felt "comfortable" or "very comfortable" throughout. All patients rated the experience as "better" than their previous experience with general anaesthesia and felt "very satisfied" with their anaesthetic. Importantly, all patients would recommend sedation with AVD to other patients. To our knowledge, this is the first report of AVD application as an adjunct to standby anaesthesia during major surgery in persons with paraplegia. Patient feedback was extremely positive, therefore it is likely that by making standby anaesthesia more acceptable to patients the use of AVD could reduce anaesthetic risk in this complex patient group.

Deep-cascade: Cascading 3D Deep Neural Networks for Fast Anomaly Detection and Localization in Crowded Scenes.

PubMed

Sabokrou, Mohammad; Fayyaz, Mohsen; Fathy, Mahmood; Klette, Reinhard

2017-02-17

This paper proposes a fast and reliable method for anomaly detection and localization in video data showing crowded scenes. Time-efficient anomaly localization is an ongoing challenge and subject of this paper. We propose a cubicpatch- based method, characterised by a cascade of classifiers, which makes use of an advanced feature-learning approach. Our cascade of classifiers has two main stages. First, a light but deep 3D auto-encoder is used for early identification of "many" normal cubic patches. This deep network operates on small cubic patches as being the first stage, before carefully resizing remaining candidates of interest, and evaluating those at the second stage using a more complex and deeper 3D convolutional neural network (CNN). We divide the deep autoencoder and the CNN into multiple sub-stages which operate as cascaded classifiers. Shallow layers of the cascaded deep networks (designed as Gaussian classifiers, acting as weak single-class classifiers) detect "simple" normal patches such as background patches, and more complex normal patches are detected at deeper layers. It is shown that the proposed novel technique (a cascade of two cascaded classifiers) performs comparable to current top-performing detection and localization methods on standard benchmarks, but outperforms those in general with respect to required computation time.

Challenges with Evidence-Based Management of Stable Ischemic Heart Disease.

PubMed

Patel, Amit V; Bangalore, Sripal

2017-02-01

Stable ischemic heart disease (SIHD) is a highly prevalent condition associated with increased costs, morbidity, and mortality. Management goals of SIHD can broadly be thought of in terms of improving prognosis and/or improving symptoms. Treatment options include medical therapy as well as revascularization, either with percutaneous coronary intervention or coronary artery bypass grafting. Herein, we will review the current evidence base for treatment of SIHD as well as its challenges and discuss ongoing studies to help address some of these knowledge gaps. There has been no consistent reduction in death or myocardial infarction (MI) with revascularization vs. medical therapy in patients with SIHD in contemporary trials. Angina and quality of life have been shown to be relieved more rapidly with revascularization vs. optimal medical therapy; however, the durability of these results is uncertain. There have been challenges and limitations in several of the trials addressing the optimal treatment strategy for SIHD due to potential selection bias (due to knowledge of coronary anatomy prior to randomization), patient crossover, and advances in medical therapy and revascularization strategies since trial completion. The challenges inherent to prior trials addressing the optimal management strategy for SIHD have impacted the generalizability of results to real-world cohorts. Until the results of additional ongoing trials are available, the decision for revascularization or medical therapy should be based on patients' symptoms, weighing the risks and benefits of each approach, and patient preference.

Aerospace Measurements: Challenges and Opportunities

NASA Technical Reports Server (NTRS)

Conway, Bruce A.

1992-01-01

New aerospace research initiatives offer both challenges and opportunities to rapidly-emerging electronics and electro-optics technology. Defining and implementing appropriate measurement technology development programs in response to the aeronautical ground facility research and testing needs of the new initiatives poses some particularly important problems. This paper discusses today's measurement challenges along with some of the technological opportunities which offer some hope for meeting the challenges, and describes measurement technology activities currently underway in the Langley Research Center's Instrument Research Division to address modern aerospace research and design engineering requirements. Projected and realized benefits and payoffs from the ongoing measurement and instrumentation efforts will be emphasized. A discussion of future trends in the aerospace measurement technology field will be included.

EPOS: Integrating seismological Research Infrastructures within Europe

NASA Astrophysics Data System (ADS)

Eck Van, Torild; Clinton, John; Haslinger, Florian; Michelini, Alberto

2013-04-01

Seismological data, products and models are currently produced in Europe within individual countries or research organizations, and with the contribution of coordinating organizations like ORFEUS and EMSC. In spite of these partly scattered resources, significant scientific results are obtained, excellent monitoring and information systems are operational and a huge amount of research quality data is being archived and disseminated. The seismological community, however, realizes that an effective European-scale integration of seismological and related geophysical data, products and models, combined with broad and easy access, is needed to facilitate future top level geoscience, for example, to appropriately harness the technological advancements enabling large scale and near-real time data processing. Here we present the technical concepts and developments within European seismology that will build the next generation of integrated services. Within the EPOS initiative and a number of related projects, where seismology infrastructure and IT developments are merging, in depth discussions are on-going on how to realize an effective integration. Concepts and visions addressing the obviously complex challenges resulting from the current highly distributed facilities and resources in Europe are emerging and are already partly being implemented. We will provide an overview of developments within key EU projects (NERA, VERCE, COOPEUS, EUDAT, REAKT, COMMIT, etc) and demonstrate how these are in coherence with EPOS and other on-going global initiatives. Within seismology current focus is on addressing IT related challenges to a) organize distributed data archives, develop metadata attributes for improved data searching, specifically including quality indicators, and define products from data and/or models, and b) define and create(on-line) monitoring, data access and processing tools. While developments to meet those challenges originate partly from within the community itself, it is important to harvest relevant ideas and tools from other scientific communities dealing with similar issues. We will present a short summary of those developments and how they fit within the proposed visions and concepts. These integration developments address a wide framework of seismological services that include: basic seismological data services (waveform data from velocity and acceleration sensors from land and underwater sites); seismological data products (source mechanism and process estimates, earthquake catalogues, structural and tomography model estimations); seismological models (synthetic waveforms, earth and earthquake source models, hazard models).Our aim is to build significantlyimproved seismological services and valuable products for multidisciplinary earth science research.

A Longitudinal Investigation of Syndemic Conditions Among Young Gay, Bisexual, and Other MSM: The P18 Cohort Study.

PubMed

Halkitis, Perry N; Kapadia, Farzana; Bub, Kristen L; Barton, Staci; Moreira, Alvaro D; Stults, Christopher B

2015-06-01

The persistence of disparities in STI/HIV risk among a new generation of emerging adult gay, bisexual, and other men who have sex with men (YMSM) warrant holistic frameworks and new methodologies for investigating the behaviors related to STI/HIV in this group. In order to better understand the continued existence of these disparities in STI/HIV risk among YMSM, the present study evaluated the presence and persistence of syndemic conditions among YMSM by examining the co-occurrence of alcohol and drug use, unprotected sexual behavior, and mental health burden over time. Four waves of data, collected over the first 18 months of a 7 wave, 36-month prospective cohort study of YMSM (n=600) were used to examine the extent to which measurement models of drug use, unprotected sexual behavior, and mental health burden remained consistent across time using latent class modeling. Health challenges persisted across time as these YMSM emerged into young adulthood and the measurement models for the latent constructs of drug use and unprotected sexual behavior were essentially consistent across time whereas models for mental health burden varied over time. In addition to confirming the the robustness of our measurement models which capture a more holistic understandings of the health conditions of drug use, unprotected sex, and mental health burden, these findings underscore the ongoing health challenges YMSM face as they mature into young adulthood. These ongoing health challenges, which have been understood as forming a syndemic, persist over time, and add further evidence to support ongoing and vigilant comprehensive health programming for sexual minority men that move beyond a sole focus on HIV.

A longitudinal investigation of syndemic conditions among young gay, bisexual, and other MSM: The P18 Cohort Study

PubMed Central

Halkitis, Perry N.; Kapadia, Farzana; Bub, Kristen L.; Barton, Staci; Moreira, Alvaro D.; Stults, Christopher B.

2014-01-01

The persistence of disparities in STI/HIV risk among a new generation of emerging adult gay, bisexual, and other men who have sex with men (YMSM) warrant holistic frameworks and new methodologies for investigating the behaviors related to STI/HIV in this group. In order to better understand the continued existence of these disparities in STI/HIV risk among YMSM, the present study evaluated the presence and persistence of syndemic conditions among YMSM by examining the co-occurrence of alcohol and drug use, unprotected sexual behavior, and mental health burden over time. Four waves of data, collected over the first 18 months of a 7 wave, 36-month prospective cohort study of YMSM (n=598) were used to examine the extent to which measurement models of drug use, unprotected sexual behavior, and mental health burden remained consistent across time using latent class modeling. Health challenges persisted across time as these YMSM emerged into young adulthood and the measurement models for the latent constructs of drug use and unprotected sexual behavior were essentially consistent across time whereas models for mental health burden varied over time. In addition to confirming the the robustness of our measurement models which capture a more holistic understandings of the health conditions of drug use, unprotected sex, and mental health burden, these findings underscore the ongoing health challenges YMSM face as they mature into young adulthood. These ongoing health challenges, which have been understood as forming a syndemic, persist over time, and add further evidence to support ongoing and vigilant comprehensive health programming for sexual minority men that move beyond a sole focus on HIV. PMID:25192900

The contribution of case study design to supporting research on Clubhouse psychosocial rehabilitation.

PubMed

Raeburn, Toby; Schmied, Virginia; Hungerford, Catherine; Cleary, Michelle

2015-10-01

Psychosocial Clubhouses provide recovery-focused psychosocial rehabilitation to people with serious mental illness at over 300 sites in more than 30 countries worldwide. To deliver the services involved, Clubhouses employ a complex mix of theory, programs and relationships, with this complexity presenting a number of challenges to those undertaking Clubhouse research. This paper provides an overview of the usefulness of case study designs for Clubhouse researchers; and suggests ways in which the evaluation of Clubhouse models can be facilitated. The paper begins by providing a brief explanation of the Clubhouse model of psychosocial rehabilitation, and the need for ongoing evaluation of the services delivered. This explanation is followed by an introduction to case study design, with consideration given to the way in which case studies have been used in past Clubhouse research. It is posited that case study design provides a methodological framework that supports the analysis of either quantitative, qualitative or a mixture of both types of data to investigate complex phenomena in their everyday contexts, and thereby support the development of theory. As such, case study approaches to research are well suited to the Clubhouse environment. The paper concludes with recommendations for future Clubhouse researchers who choose to employ a case study design. While the quality of case study research that explores Clubhouses has been variable in the past, if applied in a diligent manner, case study design has a valuable contribution to make in future Clubhouse research.

Clinic, hospital try to fulfill vision of coordinated care with joint venture company.

PubMed

2000-09-01

Coordinated Care Services Inc., a joint venture of Carle Foundation and Carle Clinic Association in Urbana, IL, shares its initial successes and ongoing challenges after one year of operation. The biggest barrier to further improvements remains insufficient information management capability.

Improvisational Practices in Elementary General Music Classrooms

ERIC Educational Resources Information Center

Gruenhagen, Lisa M.; Whitcomb, Rachel

2014-01-01

Despite historic and ongoing support for the inclusion of improvisation in the elementary general music curriculum, music educators consistently report challenges with implementation of improvisational activities in their classes. This study was designed to examine (a) the extent to which improvisational activities were occurring in the…

On the Road

ERIC Educational Resources Information Center

Collins, Mary Ellen

2012-01-01

Veteran development officers say the experience of visiting and traveling to different places or countries often feels like an endless cycle of getting lost, missing flights, and eating midnight dinners from hotel vending machines. Despite ongoing travel challenges, experienced road warriors have learned how to maximize their effectiveness,…

State of the art evaluation of traffic detection and monitoring systems. Volume 1, phases A & B : design [Summary

DOT National Transportation Integrated Search

2007-10-01

Accurate, complete, and timely traffic data is critical to the effective management of Arizonas highway system. Limitations in current traffic monitoring abilities are an ongoing challenge for the Arizona Department of Transportation (ADOT) and fo...

Applications and advances in phytochemical compositional analysis

USDA-ARS?s Scientific Manuscript database

The search for new functional foods, environmentally friendly pest control, bio-fuels, and biodegradable consumer products and packaging is the ongoing challenge to 21st century agriculture research, which is being met by the scientists and staff of the USDA Agricultural Research Service. Interest i...

The Ethical, Legal, and Social Implications Program of the National Human Genome Research Institute: reflections on an ongoing experiment.

PubMed

McEwen, Jean E; Boyer, Joy T; Sun, Kathie Y; Rothenberg, Karen H; Lockhart, Nicole C; Guyer, Mark S

2014-01-01

For more than 20 years, the Ethical, Legal, and Social Implications (ELSI) Program of the National Human Genome Research Institute has supported empirical and conceptual research to anticipate and address the ethical, legal, and social implications of genomics. As a component of the agency that funds much of the underlying science, the program has always been an experiment. The ever-expanding number of issues the program addresses and the relatively low level of commitment on the part of other funding agencies to support such research make setting priorities especially challenging. Program-supported studies have had a significant impact on the conduct of genomics research, the implementation of genomic medicine, and broader public policies. The program's influence is likely to grow as ELSI research, genomics research, and policy development activities become increasingly integrated. Achieving the benefits of increased integration while preserving the autonomy, objectivity, and intellectual independence of ELSI investigators presents ongoing challenges and new opportunities.

Reconstructive Surgery of Auricular Defects: An Overview.

PubMed

Ebrahimi, Ali; Kazemi, Alireza; Rasouli, Hamid Reza; Kazemi, Maryam; Kalantar Motamedi, Mohammad Hosein

2015-11-01

Despite the ongoing advances in surgical procedures and promising progress in bioengineering techniques, auricular reconstruction remains a significant challenge in plastic surgery. There are different causes for acquired auricular defects, including trauma, tumor ablation and burns. The management options for upper, middle and lower third auricular defects are briefly reviewed in the current paper. Original research papers investigating the plastic surgeons, otolaryngologists and maxillofacial surgeons in approaching the complicated issue of auricular reconstruction published from January 1995 to December 2014 were aggregated and used in the current study. Utilizing autologous stem cell populations to treat craniofacial defects is a promising field of ongoing investigations. Studies show that cartilage stem/progenitor cells (CSPCs) are highly chondrogenic and can produce elastic reconstructive material with long-term tissue restoration. Auricular reconstruction surgery is a challenging plastic procedure that requires great expertise and expert knowledge of the various techniques available. Novel techniques in the fields of reconstructive bioengineering and regenerative medicine are promising but further research is required before widespread clinical application.

Challenges associated with post-deployment screening for mild traumatic brain injury in military personnel.

PubMed

Iverson, Grant L; Langlois, Jean A; McCrea, Michael A; Kelly, James P

2009-11-01

There is ongoing debate regarding the epidemiology of mild traumatic brain injury (MTBI) in military personnel. Accurate and timely estimates of the incidence of brain injury and the prevalence of long-term problems associated with brain injuries among active duty service members and veterans are essential for (a) operational planning, and (b) to allocate sufficient resources for rehabilitation and ongoing services and supports. The purpose of this article is to discuss challenges associated with post-deployment screening for MTBI. Multiple screening methods have been used in military, Veterans Affairs, and independent studies, which complicate cross-study comparisons of the resulting epidemiological data. We believe that post-deployment screening is important and necessary--but no screening methodology will be flawless, and false positives and false negatives are inevitable. Additional research is necessary to refine the sequential screening methodology, with the goal of minimizing false negatives during initial post-deployment screening and minimizing false positives during follow-up evaluations.

Chondroradionecrosis of the larynx: 24-year University of Wisconsin experience.

PubMed

Gessert, Thomas G; Britt, Christopher J; Maas, Austin M W; Wieland, Aaron M; Harari, Paul M; Hartig, Gregory K

2017-06-01

Chondroradionecrosis (CRN) is an uncommon but significant complication of laryngeal radiotherapy that presents a diagnostic challenge to clinicians through its similarity in presentation to cancer recurrence. Two hundred ninety-four patients underwent primary, adjuvant, or salvage radiation for laryngeal cancer from 1991 to 2015 at the University of Wisconsin. Medical records were reviewed to identify and characterize patients with a diagnosis of CRN. Of the 294 patients, 7 cases (2.4%) of CRN were identified. Development of CRN was associated with the presence of cartilage invasion by tumor (p = .038) and ongoing alcohol use postradiotherapy (p = .036). Additionally, a trend between development of CRN and ongoing smoking postradiotherapy was observed (p = .067). The diagnosis of CRN is challenging, and the likelihood of successful resolution is modest. A high premium should be placed on efforts directed at prevention, such as tobacco and alcohol cessation. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1189-1194, 2017. © 2017 Wiley Periodicals, Inc.

Trauma-focused CBT for youth with complex trauma

PubMed Central

Mannarino, Anthony P.; Kliethermes, Matthew; Murray, Laura A.

2013-01-01

Objectives Many youth develop complex trauma, which includes regulation problems in the domains of affect, attachment, behavior, biology, cognition, and perception. Therapists often request strategies for using evidence-based treatments (EBTs) for this population. This article describes practical strategies for applying Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for youth with complex trauma. Methods TF-CBT treatment phases are described and modifications of timing, proportionality and application are described for youth with complex trauma. Practical applications include a) dedicating proportionally more of the model to the TF-CBT coping skills phase; b) implementing the TF-CBT Safety component early and often as needed throughout treatment; c) titrating gradual exposure more slowly as needed by individual youth; d) incorporating unifying trauma themes throughout treatment; and e) when indicated, extending the TF-CBT treatment consolidation and closure phase to include traumatic grief components and to generalize ongoing safety and trust. Results Recent data from youth with complex trauma support the use of the above TF-CBT strategies to successfully treat these youth. Conclusions The above practical strategies can be incorporated into TF-CBT to effectively treat youth with complex trauma. Practice implications Practical strategies include providing a longer coping skills phase which incorporates safety and appropriate gradual exposure; including relevant unifying themes; and allowing for an adequate treatment closure phase to enhance ongoing trust and safety. Through these strategies therapists can successfully apply TF-CBT for youth with complex trauma. PMID:22749612

State experiences implementing youth sports concussion laws: challenges, successes, and lessons for evaluating impact.

PubMed

Lowrey, Kerri McGowan; Morain, Stephanie R

2014-01-01

While provisions of youth sports concussion laws are very similar, little is known as to how they are being implemented, factors that promote or impede implementation, or the level of compliance in each jurisdiction. We aimed to describe state experiences with implementation in order to inform ongoing efforts to reduce the harm of sports-related traumatic brain injury and to guide future evaluations of the laws' impacts and the development of future public health laws. We conducted key-informant interviews in 35 states with recently enacted concussion legislation. States varied considerably in their readiness and capacity for implementation. Factors facilitating implementation included existing partnerships, procedures, and resources; centralized implementation authority; prior related efforts; and involvement in the policymaking process by those now charged with implementation. Inhibitors included ambiguous statutory language, unclear delegation of authority, and compliance difficulties. Ongoing challenges persist, including primary prevention; determining which providers are qualified to make return-to-play assessments and contents of those assessments; compliance difficulties in rural and under-served areas; and unclear responsibility for enforcement. Despite the similarity of youth sports concussion laws, early evidence suggests there is considerable variation in their implementation. These findings are critical for ongoing empirical investigations to accurately evaluate the laws' provisions and to identify successful legal approaches to protecting young athletes. © 2014 American Society of Law, Medicine & Ethics, Inc.

Learning to manage complexity through simulation: students' challenges and possible strategies.

PubMed

Gormley, Gerard J; Fenwick, Tara

2016-06-01

Many have called for medical students to learn how to manage complexity in healthcare. This study examines the nuances of students' challenges in coping with a complex simulation learning activity, using concepts from complexity theory, and suggests strategies to help them better understand and manage complexity.Wearing video glasses, participants took part in a simulation ward-based exercise that incorporated characteristics of complexity. Video footage was used to elicit interviews, which were transcribed. Using complexity theory as a theoretical lens, an iterative approach was taken to identify the challenges that participants faced and possible coping strategies using both interview transcripts and video footage.Students' challenges in coping with clinical complexity included being: a) unprepared for 'diving in', b) caught in an escalating system, c) captured by the patient, and d) unable to assert boundaries of acceptable practice.Many characteristics of complexity can be recreated in a ward-based simulation learning activity, affording learners an embodied and immersive experience of these complexity challenges. Possible strategies for managing complexity themes include: a) taking time to size up the system, b) attuning to what emerges, c) reducing complexity, d) boundary practices, and e) working with uncertainty. This study signals pedagogical opportunities for recognizing and dealing with complexity.

Electronic Communities of Practice: Guidelines from a Project

ERIC Educational Resources Information Center

Ho, Kendall; Jarvis-Selinger, Sandra; Norman, Cameron D.; Li, Linda C.; Olatunbosun, Tunde; Cressman, Celine; Nguyen, Anne

2010-01-01

The timely incorporation of health research into the routine practice of individual health practitioners and interprofessional teams is a widely recognized and ongoing challenge. Health professional engagement and learning is an important cog in the wheel of knowledge translation; passive dissemination of evidence through journals and clinical…

Fecal Coliform and E. coli Concentrations in Effluent-Dominated Streams of the Upper Santa Cruz Watershed

EPA Science Inventory

Balancing water quality and water quantity concerns is an ongoing challenge for communities in the semi-arid southwest. Over pumping of groundwater aquifers and limited surface water resources have created effluent-dominated sections of watersheds. As rapid urbanization increases...

How Can Innovative Learning Environments Promote the Diffusion of Innovation?

ERIC Educational Resources Information Center

Osborne, Mark

2016-01-01

Schools implementing innovative learning environments (ILEs) face many challenges, including the need to discard previously cherished practices and behaviours, adjust mindsets, and invent successful new ways of operating. Leaders can support these processes by implementing structures that: i) support ongoing, distributed, participatory innovation;…

Qualitatively Assessing Family Influence in Career Decision Making

ERIC Educational Resources Information Center

Chope, Robert C.

2005-01-01

Assessing influential factors in the family relative to career decision making is consistent with evolving postmodern approaches to career counseling. However, the challenge of measuring family influence is technically demanding considering the ongoing revolutionary changes in the structure of the family. Moreover, while measuring the impact of…

Teacher Efficacy in Rural Zimbabwe

ERIC Educational Resources Information Center

Dunham, Judy K.; Song'ony, Daniel

2008-01-01

The need to address contextual variables, such as cultural bias and cultural norms, is a common challenge for researchers in international education. This article highlights societal conditions and cultural issues that could have impacted teacher efficacy data in Zimbabwe, a country known for its ongoing economic crisis, political repression, and…

Fluorescence Sensors for Early Detection of Nitrification in Drinking Water Distribution Systems – Interference Corrections (Abstract)

EPA Science Inventory

Nitrification event detection in chloraminated drinking water distribution systems (DWDSs) remains an ongoing challenge for many drinking water utilities, including Dallas Water Utilities (DWU) and the City of Houston (CoH). Each year, these utilities experience nitrification eve...

Fluorescence Sensors for Early Detection of Nitrification in Drinking Water Distribution Systems – Interference Corrections (Poster)

EPA Science Inventory

Nitrification event detection in chloraminated drinking water distribution systems (DWDSs) remains an ongoing challenge for many drinking water utilities, including Dallas Water Utilities (DWU) and the City of Houston (CoH). Each year, these utilities experience nitrification eve...

"Smartening Up": Ongoing Challenges for Australia's Outback

ERIC Educational Resources Information Center

Cradduck, Lucy

2016-01-01

As the international community moves inexorably towards a "smart" future, the position of Australia's non-urban areas in that future is less certain. The (re-elected) Australian federal government made a commitment to moving Australian cities forward as part of the international "smart city" movement. However, the effectiveness…

Leadership in Education Transformation as Reshaping the Organisational Discourse

ERIC Educational Resources Information Center

Berkhout, Sarie

2007-01-01

The restructuring of South African education poses continuous challenges for educational leaders to contribute towards constituting a just and equitable society. Competing discourses, however, create ongoing tensions that have to be negotiated and meaningfully mediated. The widely diverse, often conflicting, local discourses shaped by particular…

Calling on Students Using Notecards: Engagement and Countering Communication Anxiety in Large Lecture

ERIC Educational Resources Information Center

Broeckelman-Post, Melissa; Johnson, Alexandra; Schweback, J. Reid

2016-01-01

Engaging students, checking for understanding, and encouraging oral participation are ongoing pedagogical challenges in large lecture courses. In this study, the instructor used notecard-facilitated cold-calling as a means of encouraging attendance and participation in a large-lecture biology class.

News about Newborn Screening

ERIC Educational Resources Information Center

Exceptional Parent, 2007

2007-01-01

For years "Exceptional Parent" ("EP") has been offering educational information and support to those challenged with disabilities and takes an equally pro-active role in disseminating vital information that could potentially prevent disabilities. This is evidenced by its past and ongoing efforts in being a proponent and champion for comprehensive…

Developing Fluorescence Sensor Systems for Early Detection of Nitrification Events in Chloraminated Drinking Water Distribution Systems

EPA Science Inventory

Detection of nitrification events in chloraminated drinking water distribution systems remains an ongoing challenge for many drinking water utilities, including Dallas Water Utilities (DWU) and the City of Houston (CoH). Each year, these utilities experience nitrification events ...

Can NMR solve some significant challenges in metabolomics?

PubMed

Nagana Gowda, G A; Raftery, Daniel

2015-11-01

The field of metabolomics continues to witness rapid growth driven by fundamental studies, methods development, and applications in a number of disciplines that include biomedical science, plant and nutrition sciences, drug development, energy and environmental sciences, toxicology, etc. NMR spectroscopy is one of the two most widely used analytical platforms in the metabolomics field, along with mass spectrometry (MS). NMR's excellent reproducibility and quantitative accuracy, its ability to identify structures of unknown metabolites, its capacity to generate metabolite profiles using intact bio-specimens with no need for separation, and its capabilities for tracing metabolic pathways using isotope labeled substrates offer unique strengths for metabolomics applications. However, NMR's limited sensitivity and resolution continue to pose a major challenge and have restricted both the number and the quantitative accuracy of metabolites analyzed by NMR. Further, the analysis of highly complex biological samples has increased the demand for new methods with improved detection, better unknown identification, and more accurate quantitation of larger numbers of metabolites. Recent efforts have contributed significant improvements in these areas, and have thereby enhanced the pool of routinely quantifiable metabolites. Additionally, efforts focused on combining NMR and MS promise opportunities to exploit the combined strength of the two analytical platforms for direct comparison of the metabolite data, unknown identification and reliable biomarker discovery that continue to challenge the metabolomics field. This article presents our perspectives on the emerging trends in NMR-based metabolomics and NMR's continuing role in the field with an emphasis on recent and ongoing research from our laboratory. Copyright © 2015 Elsevier Inc. All rights reserved.

30-year International Pediatric Craniofacial Surgery Partnership: Evolution from the “Third World” Forward

PubMed Central

Swanson, Jordan W.; Skirpan, Jan; Stanek, Beata; Kowalczyk, Maciej

2016-01-01

Background: Craniofacial diseases constitute an important component of the surgical disease burden in low- and middle-income countries. The consideration to introduce craniofacial surgery into such settings poses different questions, risks, and challenges compared with cleft or other forms of plastic surgery. We report the evolution, innovations, and challenges of a 30-year international craniofacial surgery partnership. Methods: We retrospectively report a partnership between surgeons at the Uniwersytecki Szpital Dzieciecy in Krakow, Poland, and a North American craniofacial surgeon. We studied patient conditions, treatment patterns, and associated complications, as well as program advancements and limitations as perceived by surgeons, patient families, and hospital administrators. Results: Since partnership inception in 1986, the complexity of cases performed increased gradually, with the first intracranial case performed in 1995. In the most recent 10-year period (2006–2015), 85 patients have been evaluated, with most common diagnoses of Apert syndrome, Crouzon syndrome, and single-suture craniosynostosis. In the same period, 55 major surgical procedures have been undertaken, with LeFort III midface distraction, posterior vault distraction, and frontoorbital advancement performed most frequently. Key innovations have been the employment of craniofacial distraction osteogenesis, the use of Internet communication and digital photography, and increased understanding of how craniofacial morphology may improve in the absence of surgical intervention. Ongoing challenges include prohibitive training pathways for pediatric plastic surgeons, difficulty in coordinating care with surgeons in other institutions, and limited medical and material resources. Conclusion: Safe craniofacial surgery can be introduced and sustained in a resource-limited setting through an international partnership. PMID:27200233

Breakthroughs in modern cancer therapy and elusive cardiotoxicity: Critical research‐practice gaps, challenges, and insights

PubMed Central

Li, Jin; Kros, Johan M

2017-01-01

Abstract To date, five cancer treatment modalities have been defined. The three traditional modalities of cancer treatment are surgery, radiotherapy, and conventional chemotherapy, and the two modern modalities include molecularly targeted therapy (the fourth modality) and immunotherapy (the fifth modality). The cardiotoxicity associated with conventional chemotherapy and radiotherapy is well known. Similar adverse cardiac events are resurging with the fourth modality. Aside from the conventional and newer targeted agents, even the most newly developed, immune‐based therapeutic modalities of anticancer treatment (the fifth modality), e.g., immune checkpoint inhibitors and chimeric antigen receptor (CAR) T‐cell therapy, have unfortunately led to potentially lethal cardiotoxicity in patients. Cardiac complications represent unresolved and potentially life‐threatening conditions in cancer survivors, while effective clinical management remains quite challenging. As a consequence, morbidity and mortality related to cardiac complications now threaten to offset some favorable benefits of modern cancer treatments in cancer‐related survival, regardless of the oncologic prognosis. This review focuses on identifying critical research‐practice gaps, addressing real‐world challenges and pinpointing real‐time insights in general terms under the context of clinical cardiotoxicity induced by the fourth and fifth modalities of cancer treatment. The information ranges from basic science to clinical management in the field of cardio‐oncology and crosses the interface between oncology and onco‐pharmacology. The complexity of the ongoing clinical problem is addressed at different levels. A better understanding of these research‐practice gaps may advance research initiatives on the development of mechanism‐based diagnoses and treatments for the effective clinical management of cardiotoxicity. PMID:28862319

Interviewing with or without the partner present?--an underexposed dilemma between ethics and methodology in nursing research.

PubMed

Norlyk, Annelise; Haahr, Anita; Hall, Elisabeth

2016-04-01

To discuss ethical and methodological challenges related to in-depth interviews with patients and partners when interviewed together or separately. Increased interest in exploring illness phenomena from both patients' and partners' perspectives has emerged. The decision about how to collect data is challenging. Patients and partners can be interviewed separately or together; in both scenarios researchers face complex questions of methodology and ethics. This paper contributes to the ongoing debate on individual or joint interviewing and the effect of absence/presence of the partner on data collection. Discussion paper that draws on data from three phenomenological studies. Referring to three cases from our phenomenological studies, we discuss the different types of ethical and methodological dilemmas faced when undertaking joint and separate interviews with couples. Furthermore, we discuss how the unexpected presence of the partner potentially influences the data gathered from the patient. The cases demonstrate the interrelatedness of ethics and methodology in studies based on in-depth interviews with couples. Nurse researchers may be caught up in a dilemma between ethical concerns and methodological considerations. We argue that the presence of the partner during an interview session might influence the data and favour expressions of shared rather than individual experiences of the phenomenon studied. Furthermore, we argue that ethical concerns must be given higher priority than methodology when interviewing couples. An increased awareness of the tension between ethical and methodological challenges in joint or individual interviewing with patients and partners is necessary, as this issue is underexposed. © 2015 John Wiley & Sons Ltd.

Jumping over the hurdles to effectively communicate the Operational Earthquake Forecast

NASA Astrophysics Data System (ADS)

McBride, S.; Wein, A. M.; Becker, J.; Potter, S.; Tilley, E. N.; Gerstenberger, M.; Orchiston, C.; Johnston, D. M.

2016-12-01

Probabilities, uncertainties, statistics, science, and threats are notoriously difficult topics to communicate with members of the public. The Operational Earthquake Forecast (OEF) is designed to provide an understanding of potential numbers and sizes of earthquakes and the communication of it must address all of those challenges. Furthermore, there are other barriers to effective communication of the OEF. These barriers include the erosion of trust in scientists and experts, oversaturation of messages, fear and threat messages magnified by the sensalisation of the media, fractured media environments and online echo chambers. Given the complexities and challenges of the OEF, how can we overcome barriers to effective communication? Crisis and risk communication research can inform the development of communication strategies to increase the public understanding and use of the OEF, when applied to the opportunities and challenges of practice. We explore ongoing research regarding how the OEF can be more effectively communicated - including the channels, tools and message composition to engage with a variety of publics. We also draw on past experience and a study of OEF communication during the Canterbury Earthquake Sequence (CES). We demonstrate how research and experience has guided OEF communications during subsequent events in New Zealand, including the M5.7 Valentine's Day earthquake in 2016 (CES), M6.0 Wilberforce earthquake in 2015, and the Cook Strait/Lake Grassmere earthquakes in 2013. We identify the successes and lessons learned of the practical communication of the OEF. Finally, we present future projects and directions in the communication of OEF, informed by both practice and research.

University of San Francisco Institutional-Level Financial Indicators, FY 1968-1969 to FY 1972-1973.

ERIC Educational Resources Information Center

Counelis, James S.; Rizzo, Claude J.

To manage effectively the higher education enterprise is a complex matter. Part of the problem of managing complexity is the need for monitoring data in time series such that the on-going enterprise is viewed at comparable times in comparable terms. Part of the answer at the University of San Francisco is the development of time series data on…

Current Challenges for HTCMC Aero-Propulsion Components

NASA Technical Reports Server (NTRS)

DiCarlo, James A.; Bansal, Narottam P.

2007-01-01

In comparison to the best metallic materials, HTCMC aero-propulsion engine components offer the opportunity of reduced weight and higher temperature operation, with corresponding improvements in engine cooling requirements, emissions, thrust, and specific fuel consumption. Although much progress has been made in the development of advanced HTCMC constituent materials and processes, major challenges still remain for their implementation into these components. The objectives of this presentation are to briefly review (1) potential HTCMC aero-propulsion components and their generic material performance requirements, (2) recent progress at NASA and elsewhere concerning advanced constituents and processes for meeting these requirements, (3) key HTCMC component implementation challenges that are currently being encountered, and (4) on-going activities within the new NASA Fundamental Aeronautics Program that are addressing these challenges.

Differences in the INR evaluation of two different thromboplastins in patients with positivity to lupus anticoagulant in ongoing oral anticoagulation.

PubMed

Ferrazzi, Paola; Colombo, Anna; Di Micco, Pierpaolo; Lodigiani, Corrado; Librè, Luca; Rota, Lidia Luciana; Montanelli, Alessandro; Quaglia, Ilaria

2010-01-01

A possible interference between lupus anticoagulant (LAC), a well characterized clotting inhibitor, in the International Normalized Ratio (INR) determination during oral anticoagulation (OA) has been reported in the literature. Few data are available about the relationship between this kind of interference and the daily clinical management of oral anticoagulation. The aim of the study is to evaluate the role of two different thromboplastins-RecombiPlasTin 2G and HepatoComplex-in the determination of INR values of several patients' ongoing OA for a previous thrombotic disorder with and without positivity to LAC, and to evaluate possible interferences in the daily therapeutic approach. We selected 16 patients (13 females and 3 males, mean age 59 ± 16 years) with LAC positivity ongoing OA and 11 control subjects (7 females and 4 males, mean age 58 ± 14.5 years) with similar characteristics (ie, ethnic background and weight) with LAC negativity ongoing OA. 165 assays for INR determination were analyzed from both groups. Statistical analysis was performed using STATA 10 software. P values were considered significant if <0.05. Mean values of INR for patients with LAC positivity were 3.79 ± 1.63 when tested with RecombiPlasTin 2G vs 3.18 ± 1.15 when tested with HepatoComplex (P < 0.001, s); while mean values of INR for patients with antiphospholipid syndrome (APS) with LAC negativity were 3.54 ± 1.39 when tested with RecombiPlasTin 2G vs 3.23 ± 1.14 when tested with HepatoComplex (P < 0.002, s). An INR value > than 4.5 was found in 31/165 samples in 9 subjects, 8 patients with LAC positivity, and 1 control group subject with LAC negativity. There was a great difference in INR values in these subjects if we use the common thromboplastin (ie, RecombiPlasTin 2G) with a INR range varying from 5.14 ± 0.35 vs 3.79 ± 0.38 if we use another thromboplastin (ie, HepatoComplex) (P < 0.001, s). A change in the therapeutic approach for OA is possible in these cases because different INR values were obtained using different thromboplastins. Our data confirm that INR evaluation does not reveal significant changes also if tested with two different thromboplastins, for patients ongoing OA with and without LAC positivity, when the INR value is < than 4. Over this INR value there is a significant difference in patients with LAC positivity if we use a different thromboplastin for the INR determination. For this reason values obtained by RecombiPlasTin 2G need to be confirmed and matched with another thromboplastin (ie, HepatoComplex). This approach may be useful in order to have a good INR testing for the chronic long-term treatment with OA in particular in patients with LAC positivity.

Integrated versus fragmented implementation of complex innovations in acute health care.

PubMed

Woiceshyn, Jaana; Blades, Kenneth; Pendharkar, Sachin R

Increased demand and escalating costs necessitate innovation in health care. The challenge is to implement complex innovations-those that require coordinated use across the adopting organization to have the intended benefits. We wanted to understand why and how two of five similar hospitals associated with the same health care authority made more progress with implementing a complex inpatient discharge innovation whereas the other three experienced more difficulties in doing so. We conducted a qualitative comparative case study of the implementation process at five comparable urban hospitals adopting the same inpatient discharge innovation mandated by their health care authority. We analyzed documents and conducted 39 interviews of the health care authority and hospital executives and frontline managers across the five sites over a 1-year period while the implementation was ongoing. In two and a half years, two of the participating hospitals had made significant progress with implementing the innovation and had begun to realize benefits; they exemplified an integrated implementation mode. Three sites had made minimal progress, following a fragmented implementation mode. In the former mode, a semiautonomous health care organization developed a clear overall purpose and chose one umbrella initiative to implement it. The integrative initiative subsumed the rest and guided resource allocation and the practices of hospital executives, frontline managers, and staff who had bought into it. In contrast, in the fragmented implementation mode, the health care authority had several overlapping, competing innovations that overwhelmed the sites and impeded their implementation. Implementing a complex innovation across hospital sites required (a) early prioritization of one initiative as integrative, (b) the commitment of additional (traded off or new) human resources, (c) deliberate upfront planning and continual support for and evaluation of implementation, and (d) allowance for local customization within the general principles of standardization.

Using Cooperative Learning Strategies to Teach Children Fitness

ERIC Educational Resources Information Center

Kane, Jennifer J.; Kane, Richard J., Jr.

2004-01-01

Educating children in the development of positive attitudes toward health related fitness so that they are motivated to engage in lifetime fitness activities both inside and outside of the physical education class is an ongoing challenge for physical education teachers. This article presents several lesson ideas which have been developed to…

The Management Development Needs of Front-Line Managers: Voices from the Field.

ERIC Educational Resources Information Center

Longenecker, Clinton O.; Neubert, Mitchell

2003-01-01

A survey of 524 managers identified key practices to improve performance in a changing environment: clarifying roles, goals, and expectations; ongoing performance evaluation, feedback, and coaching; mentoring; challenging assignments; formal career planning; customer contact; cross-training; and 360-degree feedback. (Contains 31 references.) (SK)

Nondestructive testing and evaluation of wood : a worldwide research update

Treesearch

Brian K. Brashaw; Voichita Bucur; Ferenc Divos; Raquel Goncalves; Jianxiong Lu; Roger Meder; Roy F. Pellerin; Simon Potter; Robert J Ross; Xiping Wang; Yafang Yin

2009-01-01

The international forest products research community is responding to these driving forces by conducting NDT/NDE research to provide the technologies needed to address these challenges. This article presents a sample of the on-going NDT/NDE research efforts being conducted in several areas of the world.

Four Methods for Engaging Young Children as Environmental Education Researchers

ERIC Educational Resources Information Center

Green, Carie

2017-01-01

This article contributes to the ongoing dialogue regarding what it means to engage young children as active researchers in Early Childhood Environmental Education (ECEE) and Early Childhood Education for Sustainability (ECEfS). Drawing from a participatory and phenomenological framework, this paper considers the advantages, challenges, and…

Senior Adult Bands: Music's New Horizon.

ERIC Educational Resources Information Center

Coffman, Don D.; Levy, Katherine M.

1997-01-01

Discusses the success of Iowa City's (Iowa) New Horizons Band that consists of 55 senior adult beginners and former instrumentalists. Describes the organization of the band program, the senior's performance skills and commitment, and the ongoing challenges. Gives a selected listing of the music the band plays at concerts and other events. (CMK)

Embrace the Chaos

ERIC Educational Resources Information Center

Huwe, Terence K.

2009-01-01

"Embracing the chaos" is an ongoing challenge for librarians. Embracing the chaos means librarians must have a plan for responding to the flood of new products, widgets, web tools, and gizmos that students use daily. In this article, the author argues that library instruction and access services have been grappling with that chaos with…

Systematically evaluating read-across prediction and performance using a local validity approach characterized by chemical structure and bioactivity information

EPA Science Inventory

Read-across is a popular data gap filling technique within category and analogue approaches for regulatory purposes. Acceptance of read-across remains an ongoing challenge with several efforts underway for identifying and addressing uncertainties. Here we demonstrate an algorithm...

Enhancing Family Engagement in Interventions for Mental Health Problems in Youth

ERIC Educational Resources Information Center

Herman, Keith C.; Borden, Lindsay A.; Hsu, Chinghui; Schultz, Tia R.; Carney, Megan Strawsine; Brooks, Connie M.; Reinke, Wendy M.

2011-01-01

Much progress has been made in helping families improve their relationships and provide effective environments for their children. However, an ongoing challenge in implementing these practices is to actively engage families in interventions for youth. Most effective treatments for youth require some level of caregiver involvement. Research has…

Lessons from Management 101: Learning to Manage Ourselves

ERIC Educational Resources Information Center

Miller, John A.

2017-01-01

The Management 101 Project continues to shape our understanding of what's essential to an introductory general education course in management. Our ongoing challenge is to integrate responsibilities to people (Who needs to learn? Everybody.), to best practices (How can we best learn? Active, experiential methods.), and to the contents of our…

A Multiyear Investigation of Combating Bullying in Middle School: Stakeholder Perspectives

ERIC Educational Resources Information Center

Shriberg, David; Burns, Mallory; Desai, Poonam; Grunewald, Stephanie; Pitt, Rachel

2015-01-01

Working collaboratively to address bullying among middle school students is an ongoing challenge. This study used participatory action research to collaborate with key stakeholders within a middle school to identify needs and implement more effective practices. Extensive qualitative and quantitative data are presented, along with process…

Afterword: Provisional Pedagogies toward Imagining Global Mobilities Otherwise

ERIC Educational Resources Information Center

Stein, Sharon; de Oliveira Andreotti, Vanessa

2017-01-01

In this afterword we bring insights from the special issue into conversation with the ongoing educational challenges of imagining the world differently. To do so, we consider how global mobilities are conceptualized and materialized within three "pillars" of the architecture of modern existence: the nation-state, global capital, and…

Conflict, Militarization, and Their After-Effects: Key Challenges for TESOL

ERIC Educational Resources Information Center

Nelson, Cynthia D.; Appleby, Roslyn

2015-01-01

Skyrocketing military spending, ongoing military conflicts, and human displacement worldwide have significant consequences for the teaching and learning of English. TESOL increasingly requires a robust research base that can provide informed, critical guidance in preparing English language teachers for work in and near conflict zones, for teaching…

Linux Incident Response Volatile Data Analysis Framework

ERIC Educational Resources Information Center

McFadden, Matthew

2013-01-01

Cyber incident response is an emphasized subject area in cybersecurity in information technology with increased need for the protection of data. Due to ongoing threats, cybersecurity imposes many challenges and requires new investigative response techniques. In this study a Linux Incident Response Framework is designed for collecting volatile data…

The Role of Curriculum in Organizational Significant Change Planning

ERIC Educational Resources Information Center

Chrusciel, Don

2006-01-01

Purpose: With significant change as an ongoing challenge, the development and use of a flexible change curriculum is identified as a success factor that will allow an organization to optimize the outcome from change transformations. Design/methodology/approach: After discussing significant change, this paper will contrast two organizations in…

A Tale of Two Cultures: The Ones We Straddle

ERIC Educational Resources Information Center

Doolittle, Gini

2003-01-01

Findings from this six-year study point to the challenge of providing substantive and on-going feedback to students in a non-traditional leadership preparation program. More importantly, this paper describes, from an inside-out perspective, the struggles encountered as faculty attempted to remedy inconsistencies in the program and reconcile…

On Sentimental Education among American College Students

ERIC Educational Resources Information Center

Sabin, Portia Culver

2007-01-01

Background/Context: This study attempts to join the debate around the definition of "education" by looking at it as an ongoing, everyday social practice. It follows decades of work done on "love" in America and opens an inquiry into "friendship" as a product of situated practical action. It also challenges social…

Organic Research Activities of the USDA’s Agricultural Research Service

USDA-ARS?s Scientific Manuscript database

Organic research is a vital and ongoing part of the overall ARS research portfolio and occurs at approximately 20 % of ARS research locations across the United States. The vision for ARS organic agriculture research is to help the organic industry overcome the challenges it faces related to producti...

Quantitative Literacy for Undergraduate Business Students in the 21st Century

ERIC Educational Resources Information Center

McClure, Richard; Sircar, Sumit

2008-01-01

The current business environment is awash in vast amounts of data that ongoing transactions continually generate. Leading-edge corporations are using business analytics to achieve competitive advantage. However, educators are not adequately preparing business school students in quantitative methods to meet this challenge. For more than half a…

Learner Perceptions of Online Peer Pronunciation Feedback through P-Check

ERIC Educational Resources Information Center

Yonesaka, Suzanne M.

2017-01-01

Receiving adequate pronunciation feedback is an ongoing challenge for L2 learners. Although instructors are the most important source of corrective pronunciation feedback (Szpyra, 2014; Timson, 2007), L2 learners can also benefit from peer pronunciation feedback (Lord, 2008; Kim & Yoon, 2014; Roccamo, 2015). This paper examines Japanese…

Decoding ecosystem services in the neighborhood through the development and utilization of a framework

EPA Science Inventory

Remediation to Restoration to Revitalization (R2R2R) is a place-based practice that requires ongoing communication amongst agencies, local governments, and citizens. One of the challenges is that each of these entities have different relationships with and responsibilities to sit...

Breaking Down Potential Barriers to Continued Program Participation

ERIC Educational Resources Information Center

Serido, Joyce; Borden, Lynne M.; Wiggs, Christine B.

2014-01-01

Participation in youth programming fosters positive developmental outcomes for youth, yet recruitment and retention are ongoing challenges. Given the imbalance in rates of participation of ethnic minority youth, compared with White youth, it is important to gain a greater understanding of the contextual factors that promote or inhibit…

Supporting Mathematics Teachers' Development through Higher Education

ERIC Educational Resources Information Center

Prendergast, Mark; Roche, Joseph

2017-01-01

Mathematics education, both nationally and internationally, is facing a number of challenges with significant on-going shifts in the structure, content, and core principles of mathematics curricula in countries around the world. For example, in Ireland there was an ambitious reform of the post-primary mathematics curricula in 2010 with further…

Green Chemistry Teaching in Higher Education: A Review of Effective Practices

ERIC Educational Resources Information Center

Andraos, John; Dicks, Andrew P.

2012-01-01

This account reviews published green chemistry teaching resources in print and online literature and our experiences in teaching the subject to undergraduate students. Effective practices in lecture and laboratory are highlighted and ongoing challenges are addressed, including areas in cutting edge green chemistry research that impact its teaching…

Skills for Innovation and Research

ERIC Educational Resources Information Center

OECD Publishing (NJ3), 2011

2011-01-01

Innovation holds the key to ongoing improvements in living standards, as well as to solving pressing social challenges. Skilled people play a crucial role in innovation through the new knowledge they generate, how they adopt and develop existing ideas, and through their ability to learn new competencies and adapt to a changing environment. This…

Making Space for Place-Making Pedagogies: Stretching Normative Mandated Literacy Curriculum

ERIC Educational Resources Information Center

Comber, Barbara

2011-01-01

In an era of normative standardised literacy curriculum continuing to make space for culturally responsive literacy pedagogy is on ongoing challenge for early childhood educators. Collaborative participatory research and ethnographic studies of teachers who accomplish innovative and inclusive early childhood education in culturally diverse high…

Enhancing Teacher Training Skills by Strengthening the Teaching Practice Component

ERIC Educational Resources Information Center

Phillips, Heather Nadia; Chetty, Rajendra

2018-01-01

Purpose: The ongoing theory vs practice debate reinforces the problems facing teacher training institutions which need to challenge traditional programmes and work towards a tighter coherence between coursework and practical experience. Working more closely with schools to restructure teaching practice is necessary in order to create better…

Framework for Evaluating Habitat Restoration Success with Respect to Fish Habitat- and Population-related Beneficial Use Impairments

EPA Science Inventory

A major challenge of evaluating restoration progress is establishing a cause-effect relationship between observed changes in fish abundance and ongoing aquatic habitat restoration. Since 1979, fish populations within the St. Louis River Area of Concern, which were severely degrad...

Preparation of biobased sponges from un-tanned hides

USDA-ARS?s Scientific Manuscript database

One of our research endeavors to address ongoing challenges faced by the U.S. hide and leather industries is to develop innovative uses and novel biobased products from hides to improve prospective markets and to secure a viable future for hides and leather industries. We had previously investigate...

Dehistoricized Cultural Identity and Cultural Othering

ERIC Educational Resources Information Center

Weiguo, Qu

2013-01-01

The assumption that each culture has its own distinctive identity has been generally accepted in the discussion of cultural identities. Quite often identity formation is not perceived as a dynamic and interactive ongoing process that engages other cultures and involves change in its responses to different challenges at different times. I will…

Activist Research and Organizing: Blurring the Boundaries, Challenging the Binaries

ERIC Educational Resources Information Center

Choudry, Aziz

2014-01-01

This article draws from ongoing research into the practices and processes of activist researchers. It discusses social relations of knowledge production located outside of academia with/in social movement milieus. Focusing on the politics of research in people's organizations and social movement organizations in the Philippines, it builds on…

Determinants of Adult Functional Outcome in Adolescents Receiving Special Educational Assistance

ERIC Educational Resources Information Center

McGeown, H. R.; Johnstone, E. C.; McKirdy, J.; Owens, D. C.; Stanfield, A. C.

2013-01-01

Background: This study investigates the role of IQ, autistic traits and challenging behaviours in affecting adult outcomes among adolescents who receive special educational assistance. Methods: A total of 58 participants were recruited from an ongoing longitudinal study. All received assessments of IQ, behavioural patterns (using the Childhood…

Moving beyond Dance, Dress, and Dining in Multicultural Canada

ERIC Educational Resources Information Center

Sensoy, Ozlem; Sanghera, Raj; Parmar, Geetu; Parhar, Nisha; Nosyk, Lianne; Anderson, Monica

2010-01-01

The mainstream curriculum is extremely efficient in furthering a neoliberal multicultural discourse, what is described as the dance, dress, and dining, or heroes and holidays, or Taco Tuesday approaches to diversity. Given this, doing anything else is an ongoing challenge. This paper shares details of a government-university-school collaboration…

When Personal and Political Processes Meet.

ERIC Educational Resources Information Center

Swenson, Gay Leah

1987-01-01

Reports and critiques the Rust workshop conducted in 1985 in Vienna, Austria. Provides an analysis of the challenges to the person-centered approach as applied to international tension reduction. Concludes with issues for further exploration and a declaration for an ongoing program in person-centered approaches in international relations. (BR)

76 FR 17658 - National Forum for State and Territorial Chief Executives (National Forum) Program Cooperative...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-30

... governors and their senior health policy advisors, including addressing the needs of uninsured, underinsured... addressing similar health policy challenges. A 1-year extension with funds will allow the National Forum to facilitate ongoing communication on emerging strategies addressing common priorities, public health policy...

Cold plasma inactivation of human pathogens on foods and regulatory status update

USDA-ARS?s Scientific Manuscript database

Contamination of foods with human pathogens such as Salmonella, Listeria monocytogenes, Escherichia coli O157:H7, norovirus, and other pathogens is an ongoing challenge for growers and processors. In recent years, cold plasma has emerged as a promising antimicrobial treatment for fresh and fresh-cut...

Professional Vision in Action: An Exploratory Study

ERIC Educational Resources Information Center

Sherin, Miriam Gamoran; Russ, Rosemary S.; Sherin, Bruce L.; Colestock, Adam

2008-01-01

The study of teachers' professional vision poses some unique challenges. The application of professional vision happens in a manner that is fleeting, and that is distributed through the moments of instruction. Because of the ongoing nature of instruction, it is not realistic to expect that one could "pause" instruction momentarily, ask a…

On the Need to Repoliticise Environmental and Sustainability Education: Rethinking the Postpolitical Consensus

ERIC Educational Resources Information Center

Sund, Louise; Öhman, Johan

2014-01-01

This article draws attention to the possibilities of the ongoing philosophical discussion about cosmopolitan universal values in relation to the normative challenges in environmental and sustainability education (ESE). The purpose of this paper is to clarify the philosophical problems of addressing universally sustainable responsibilities and…

Space Science in Chinese Schools: Solar Eclipse 22nd July 2009

ERIC Educational Resources Information Center

Baruch, John; Huang, Qian; ShongYi, Liu; Li, Li Su; Machell, James; Marley, Scott; Pickwick, Alan; Vlastuin, Marcel; Waley, Vlad; Zhang, Yie Niu

2009-01-01

In China, "Space Science" and "Our Place in the Universe" form part of the geography syllabus. Such cultural challenges are part of the everyday intellectual gymnastics necessary to sustain European-Chinese school collaborations. Belle Vue Girls' School in Bradford has an ongoing collaboration with Chang Zheng Secondary School…

Tool for evaluating research implementation challenges: A sense-making protocol for addressing implementation challenges in complex research settings

PubMed Central

2013-01-01

Background Many challenges arise in complex organizational interventions that threaten research integrity. This article describes a Tool for Evaluating Research Implementation Challenges (TECH), developed using a complexity science framework to assist research teams in assessing and managing these challenges. Methods During the implementation of a multi-site, randomized controlled trial (RCT) of organizational interventions to reduce resident falls in eight nursing homes, we inductively developed, and later codified the TECH. The TECH was developed through processes that emerged from interactions among research team members and nursing home staff participants, including a purposive use of complexity science principles. Results The TECH provided a structure to assess challenges systematically, consider their potential impact on intervention feasibility and fidelity, and determine actions to take. We codified the process into an algorithm that can be adopted or adapted for other research projects. We present selected examples of the use of the TECH that are relevant to many complex interventions. Conclusions Complexity theory provides a useful lens through which research procedures can be developed to address implementation challenges that emerge from complex organizations and research designs. Sense-making is a group process in which diverse members interpret challenges when available information is ambiguous; the groups’ interpretations provide cues for taking action. Sense-making facilitates the creation of safe environments for generating innovative solutions that balance research integrity and practical issues. The challenges encountered during implementation of complex interventions are often unpredictable; however, adoption of a systematic process will allow investigators to address them in a consistent yet flexible manner, protecting fidelity. Research integrity is also protected by allowing for appropriate adaptations to intervention protocols that preserve the feasibility of ‘real world’ interventions. PMID:23281623

Competency assessment of microbiology medical laboratory technologists in Ontario, Canada.

PubMed

Desjardins, Marc; Fleming, Christine Ann

2014-08-01

Accreditation in Ontario, Canada, requires that licensed clinical laboratories participate in external quality assessment (also known as proficiency testing) and perform competency evaluation of their staff. To assess the extent of ongoing competency assessment practices, the Quality Management Program--Laboratory Services (QMP-LS) Microbiology Committee surveyed all 112 licensed Ontario microbiology laboratories. The questionnaire consisted of a total of 21 questions that included yes/no, multiple-choice, and short-answer formats. Participants were asked to provide information about existing programs, the frequency of testing, what areas are evaluated, and how results are communicated to the staff. Of the 111 responding laboratories, 6 indicated they did not have a formal evaluation program since they perform only limited bacteriology testing. Of the remaining 105 respondents, 87% perform evaluations at least annually or every 2 years, and 61% include any test or task performed, whereas 16% and 10% focus only on problem areas and high-volume complex tasks, respectively. The most common methods of evaluation were review of external quality assessment (EQA) challenges, direct observation, and worksheet review. With the exception of one participant, all communicate results to staff, and most take remedial action to correct the deficiencies. Although most accredited laboratories have a program to assess the ongoing competency of their staff, the methods used are not standardized or consistently applied, indicating that there is room for improvement. The survey successfully highlighted potential areas for improvement and allowed the QMP-LS Microbiology Committee to provide guidance to Ontario laboratories for establishing or improving existing microbiology-specific competency assessment programs. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Competency Assessment of Microbiology Medical Laboratory Technologists in Ontario, Canada

PubMed Central

Fleming, Christine Ann

2014-01-01

Accreditation in Ontario, Canada, requires that licensed clinical laboratories participate in external quality assessment (also known as proficiency testing) and perform competency evaluation of their staff. To assess the extent of ongoing competency assessment practices, the Quality Management Program—Laboratory Services (QMP-LS) Microbiology Committee surveyed all 112 licensed Ontario microbiology laboratories. The questionnaire consisted of a total of 21 questions that included yes/no, multiple-choice, and short-answer formats. Participants were asked to provide information about existing programs, the frequency of testing, what areas are evaluated, and how results are communicated to the staff. Of the 111 responding laboratories, 6 indicated they did not have a formal evaluation program since they perform only limited bacteriology testing. Of the remaining 105 respondents, 87% perform evaluations at least annually or every 2 years, and 61% include any test or task performed, whereas 16% and 10% focus only on problem areas and high-volume complex tasks, respectively. The most common methods of evaluation were review of external quality assessment (EQA) challenges, direct observation, and worksheet review. With the exception of one participant, all communicate results to staff, and most take remedial action to correct the deficiencies. Although most accredited laboratories have a program to assess the ongoing competency of their staff, the methods used are not standardized or consistently applied, indicating that there is room for improvement. The survey successfully highlighted potential areas for improvement and allowed the QMP-LS Microbiology Committee to provide guidance to Ontario laboratories for establishing or improving existing microbiology-specific competency assessment programs. PMID:24899030

After-hour Versus Daytime Shifts in Non-Operating Room Anesthesia Environments: National Distribution of Case Volume, Patient Characteristics, and Procedures.

PubMed

Gabriel, Rodney A; Burton, Brittany N; Tsai, Mitchell H; Ehrenfeld, Jesse M; Dutton, Richard P; Urman, Richard D

2017-09-01

The objective of this study was to characterize workload during all hours of the day in the non-operating room anesthesia (NORA) environment and identify what type of patients and procedures were more likely to occur during after-hours. By investigating data from the National Anesthesia Clinical Outcomes Registry, we characterized the total number of ongoing NORA cases per hour of the day (0 - 23 h). Results were presented as the mean hour and standard error (SE). Multivariable logistic regression was applied to assess the association of various patient, procedural, and facility characteristics with time of day (after-hours = 17:01-06:59 local time versus day-time). Included in this analysis, there were a total of 4,948,634 cases performed on non-holiday weekdays. The mean hour for ongoing cases for gastroenterology, cardiac, radiology and "other" were: 10.8 with standard error (SE) of 0.002, 11.5 (SE of 0.005), 11.2 (SE of 0.005), and 10.8 (SE of 0.002), respectively. Pairwise differences between means for each NORA specialty were all statistically significant (p < 0.0001). During after-hour shifts (4.3% of cases), patients with higher American Society of Anesthesiologists physical status classification scores had increased odds for undergoing a NORA procedure, while procedures that were more physiologically complex had decreased odds. With the increasing demand for NORA services, it is prudent that we fully understand the challenges of providing safe and efficient anesthetic services particularly in locations where fewer resources are available.

Enhancing Community-Based Participatory Research Partnerships Through Appreciative Inquiry.

PubMed

Paige, Ciara; Peters, Ruth; Parkhurst, Malia; Beck, Leah Leilani; Hui, Brian; May, Vanessa Tui; Tanjasiri, Sora Park

2015-01-01

Challenges in community-based participatory research (CBPR) partnerships often pertain to trust and power, dilemmas posed by funding sources, and equitable community participation. Although challenges in CBPR can be welcomed because they present opportunities for growth and development of partnerships, tools are needed to facilitate issue identification and resolution. Moreover, such tools need to align with CBPR principles involving equal feedback among partners to improve the partnership and its outcomes. To describe how appreciative inquiry (AI) was used as an evaluation tool to contribute to the strengthening of empowerment of ongoing and future community-university relationships in CBPR collaborations. AI was applied at the end of a community-university partnership to promote breast and cervical cancer screening among Tongan women in Southern California. Through individual interviews and group discussion, tensions were identified and discussed in light of partnership and community strengths. Through AI, program staff emphasized community and university strengths of shared key values related to the program and aspects of program management that enabled them to contribute to successful program outcomes. They also discussed the following challenges: 1) approach of partners, 2) role definition, and 3) and time span of program development and implementation. Based on these discussions, recommendations were made to overcome current challenges and improve ongoing and future CBPR collaborations. The AI process helped the partners recommit to collaborate with each other, renewed their excitement about working together, and assisted with reclarification of their roles to inform future collaborations.

Enhancing Community-Based Participatory Research Partnerships Through Appreciative Inquiry

PubMed Central

Paige, Ciara; Peters, Ruth; Parkhurst, Malia; Beck, Leah Leilani; Hui, Brian; May, Vanessa Tui’one; Tanjasiri, Sora Park

2016-01-01

Background Challenges in community-based participatory research (CBPR) partnerships often pertain to trust and power, dilemmas posed by funding sources, and equitable community participation. Although challenges in CBPR can be welcomed because they present opportunities for growth and development of partnerships, tools are needed to facilitate issue identification and resolution. Moreover, such tools need to align with CBPR principles involving equal feedback among partners to improve the partnership and its outcomes. Objective To describe how appreciative inquiry (AI) was used as an evaluation tool to contribute to the strengthening of empowerment of ongoing and future community–university relationships in CBPR collaborations. Methods AI was applied at the end of a community–university partnership to promote breast and cervical cancer screening among Tongan women in Southern California. Through individual interviews and group discussion, tensions were identified and discussed in light of partnership and community strengths. Results Through AI, program staff emphasized community and university strengths of shared key values related to the program and aspects of program management that enabled them to contribute to successful program outcomes. They also discussed the following challenges: 1) approach of partners, 2) role definition, and 3) and time span of program development and implementation. Based on these discussions, recommendations were made to overcome current challenges and improve ongoing and future CBPR collaborations. Conclusions The AI process helped the partners recommit to collaborate with each other, renewed their excitement about working together, and assisted with reclarification of their roles to inform future collaborations. PMID:26548798

The Afya Bora Fellowship: An Innovative Program Focused on Creating an Interprofessional Network of Leaders in Global Health.

PubMed

Green, Wendy M; Farquhar, Carey; Mashalla, Yohana

2017-09-01

Most current health professions education programs are focused on the development of clinical skills. As a result, they may not address the complex and interconnected nature of global health. Trainees require relevant clinical, programmatic, and leadership skills to meet the challenges of practicing in an increasingly globalized environment. To develop health care leaders within sub-Saharan Africa, the Afya Bora Consortium developed a one-year fellowship for medical doctors and nurses. Fellows from nine institutions in the United States and sub-Saharan Africa participate in 12 learning modules focused on leadership development and program management. Classroom-based training is augmented with an experiential apprenticeship component. Since 2011, 100 fellows have graduated from the program. During their apprenticeships, fellows developed projects beneficial to their development and to host organizations. The program has developed fellows' skills in leadership, lent expertise to local organizations, and built knowledge in local contexts. Most fellows have returned to their countries of origin, thus building local capacity. U.S.-based fellows examine global health challenges from regional perspectives and learn from sub-Saharan African experts and peers. The Consortium provides ongoing support to alumni through career development awards and alumni network engagement with current and past fellow cohorts. The Consortium expanded from its initial network of five countries to six and continues to seek opportunities for geographical and institutional expansion.

The synaptic maintenance problem: membrane recycling, Ca2+ homeostasis and late onset degeneration

PubMed Central

2013-01-01

Most neurons are born with the potential to live for the entire lifespan of the organism. In addition, neurons are highly polarized cells with often long axons, extensively branched dendritic trees and many synaptic contacts. Longevity together with morphological complexity results in a formidable challenge to maintain synapses healthy and functional. This challenge is often evoked to explain adult-onset degeneration in numerous neurodegenerative disorders that result from otherwise divergent causes. However, comparably little is known about the basic cell biological mechanisms that keep normal synapses alive and functional in the first place. How the basic maintenance mechanisms are related to slow adult-onset degeneration in different diseasesis largely unclear. In this review we focus on two basic and interconnected cell biological mechanisms that are required for synaptic maintenance: endomembrane recycling and calcium (Ca2+) homeostasis. We propose that subtle defects in these homeostatic processes can lead to late onset synaptic degeneration. Moreover, the same basic mechanisms are hijacked, impaired or overstimulated in numerous neurodegenerative disorders. Understanding the pathogenesis of these disorders requires an understanding of both the initial cause of the disease and the on-going changes in basic maintenance mechanisms. Here we discuss the mechanisms that keep synapses functional over long periods of time with the emphasis on their role in slow adult-onset neurodegeneration. PMID:23829673

Common Origins of Diverse Misconceptions: Cognitive Principles and the Development of Biology Thinking

PubMed Central

Coley, John D.; Tanner, Kimberly D.

2012-01-01

Many ideas in the biological sciences seem especially difficult to understand, learn, and teach successfully. Our goal in this feature is to explore how these difficulties may stem not from the complexity or opacity of the concepts themselves, but from the fact that they may clash with informal, intuitive, and deeply held ways of understanding the world that have been studied for decades by psychologists. We give a brief overview of the field of developmental cognitive psychology. Then, in each of the following sections, we present a number of common challenges faced by students in the biological sciences. These may be in the form of misconceptions, biases, or simply concepts that are difficult to learn and teach, and they occur at all levels of biological analysis (molecular, cellular, organismal, population, and ecosystem). We then introduce the notion of a cognitive construal and discuss specific examples of how these cognitive principles may explain what makes some misconceptions so alluring and some biological concepts so challenging for undergraduates. We will argue that seemingly unrelated misconceptions may have common origins in a single underlying cognitive construal. These ideas emerge from our own ongoing cross-disciplinary conversation, and we think that expanding this conversation to include other biological scientists and educators, as well as other cognitive scientists, could have significant utility in improving biology teaching and learning. PMID:22949417

Common origins of diverse misconceptions: cognitive principles and the development of biology thinking.

PubMed

Coley, John D; Tanner, Kimberly D

2012-01-01

Many ideas in the biological sciences seem especially difficult to understand, learn, and teach successfully. Our goal in this feature is to explore how these difficulties may stem not from the complexity or opacity of the concepts themselves, but from the fact that they may clash with informal, intuitive, and deeply held ways of understanding the world that have been studied for decades by psychologists. We give a brief overview of the field of developmental cognitive psychology. Then, in each of the following sections, we present a number of common challenges faced by students in the biological sciences. These may be in the form of misconceptions, biases, or simply concepts that are difficult to learn and teach, and they occur at all levels of biological analysis (molecular, cellular, organismal, population, and ecosystem). We then introduce the notion of a cognitive construal and discuss specific examples of how these cognitive principles may explain what makes some misconceptions so alluring and some biological concepts so challenging for undergraduates. We will argue that seemingly unrelated misconceptions may have common origins in a single underlying cognitive construal. These ideas emerge from our own ongoing cross-disciplinary conversation, and we think that expanding this conversation to include other biological scientists and educators, as well as other cognitive scientists, could have significant utility in improving biology teaching and learning.

Institutional ethical review and ethnographic research involving injection drug users: a case study.

PubMed

Small, Will; Maher, Lisa; Kerr, Thomas

2014-03-01

Ethnographic research among people who inject drugs (PWID) involves complex ethical issues. While ethical review frameworks have been critiqued by social scientists, there is a lack of social science research examining institutional ethical review processes, particularly in relation to ethnographic work. This case study describes the institutional ethical review of an ethnographic research project using observational fieldwork and in-depth interviews to examine injection drug use. The review process and the salient concerns of the review committee are recounted, and the investigators' responses to the committee's concerns and requests are described to illustrate how key issues were resolved. The review committee expressed concerns regarding researcher safety when conducting fieldwork, and the investigators were asked to liaise with the police regarding the proposed research. An ongoing dialogue with the institutional review committee regarding researcher safety and autonomy from police involvement, as well as formal consultation with a local drug user group and solicitation of opinions from external experts, helped to resolve these issues. This case study suggests that ethical review processes can be particularly challenging for ethnographic projects focused on illegal behaviours, and that while some challenges could be mediated by modifying existing ethical review procedures, there is a need for legislation that provides legal protection of research data and participant confidentiality. Copyright © 2013 Elsevier Ltd. All rights reserved.

Verification Challenges at Low Numbers

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

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

2013-06-01

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

Practice-centred evaluation and the privileging of care in health information technology evaluation.

PubMed

Darking, Mary; Anson, Rachel; Bravo, Ferdinand; Davis, Julie; Flowers, Steve; Gillingham, Emma; Goldberg, Lawrence; Helliwell, Paul; Henwood, Flis; Hudson, Claire; Latimer, Simon; Lowes, Paul; Stirling, Ian

2014-06-05

Our contribution, drawn from our experience of the case study provided, is a protocol for practice-centred, participative evaluation of technology in the clinical setting that privileges care. In this context 'practice-centred' evaluation acts as a scalable, coordinating framework for evaluation that recognises health information technology supported care as an achievement that is contingent and ongoing. We argue that if complex programmes of technology-enabled service innovation are understood in terms of their contribution to patient care and supported by participative, capability-building evaluation methodologies, conditions are created for practitioners and patients to realise the potential of technologies and make substantive contributions to the evidence base underpinning health innovation programmes. Electronic Patient Records (EPRs) and telemedicine are positioned by policymakers as health information technologies that are integral to achieving improved clinical outcomes and efficiency savings. However, evaluating the extent to which these aims are met poses distinct evaluation challenges, particularly where clinical and cost outcomes form the sole focus of evaluation design. We propose that a practice-centred approach to evaluation - in which those whose day-to-day care practice is altered (or not) by the introduction of new technologies are placed at the centre of evaluation efforts - can complement and in some instances offer advantages over, outcome-centric evaluation models. We carried out a regional programme of innovation in renal services where a participative approach was taken to the introduction of new technologies, including: a regional EPR system and a system to support video clinics. An 'action learning' approach was taken to procurement, pre-implementation planning, implementation, ongoing development and evaluation. Participants included clinicians, technology specialists, patients and external academic researchers. Whilst undergoing these activities we asked: how can a practice-centred approach be embedded into evaluation of health information technologies? Organising EPR and telemedicine evaluation around predetermined outcome measures alone can be impractical given the complex and contingent nature of such projects. It also limits the extent to which unforeseen outcomes and new capabilities are recognised. Such evaluations often fail to improve understanding of 'when' and 'under what conditions' technology-enabled service improvements are realised, and crucially, how such innovation improves care. Our contribution, drawn from our experience of the case study provided, is a protocol for practice-centred, participative evaluation of technology in the clinical setting that privileges care. In this context 'practice-centred' evaluation acts as a scalable, coordinating framework for evaluation that recognises health information technology supported care as an achievement that is contingent and ongoing. We argue that if complex programmes of technology-enabled service innovation are understood in terms of their contribution to patient care and supported by participative, capability-building evaluation methodologies, conditions are created for practitioners and patients to realise the potential of technologies and make substantive contributions to the evidence base underpinning health innovation programmes.

The Bactrocera dorsalis species complex: comparative cytogenetic analysis in support of Sterile Insect Technique applications

PubMed Central

2014-01-01

Background The Bactrocera dorsalis species complex currently harbors approximately 90 different members. The species complex has undergone many revisions in the past decades, and there is still an ongoing debate about the species limits. The availability of a variety of tools and approaches, such as molecular-genomic and cytogenetic analyses, are expected to shed light on the rather complicated issues of species complexes and incipient speciation. The clarification of genetic relationships among the different members of this complex is a prerequisite for the rational application of sterile insect technique (SIT) approaches for population control. Results Colonies established in the Insect Pest Control Laboratory (IPCL) (Seibersdorf, Vienna), representing five of the main economic important members of the Bactrocera dorsalis complex were cytologically characterized. The taxa under study were B. dorsalis s.s., B. philippinensis, B. papayae, B. invadens and B. carambolae. Mitotic and polytene chromosome analyses did not reveal any chromosomal characteristics that could be used to distinguish between the investigated members of the B. dorsalis complex. Therefore, their polytene chromosomes can be regarded as homosequential with the reference maps of B. dorsalis s.s.. In situ hybridization of six genes further supported the proposed homosequentiallity of the chromosomes of these specific members of the complex. Conclusions The present analysis supports that the polytene chromosomes of the five taxa under study are homosequential. Therefore, the use of the available polytene chromosome maps for B. dorsalis s.s. as reference maps for all these five biological entities is proposed. Present data provide important insight in the genetic relationships among the different members of the B. dorsalis complex, and, along with other studies in the field, can facilitate SIT applications targeting this complex. Moreover, the availability of 'universal' reference polytene chromosome maps for members of the complex, along with the documented application of in situ hybridization, can facilitate ongoing and future genome projects in this complex. PMID:25471636

Hematopoietic stem cell transplantation for HIV cure.

PubMed

Kuritzkes, Daniel R

2016-02-01

The apparent cure of an HIV-infected person following hematopoietic stem cell transplantation (HSCT) from an allogeneic donor homozygous for the ccr5Δ32 mutation has stimulated the search for strategies to eradicate HIV or to induce long-term remission without requiring ongoing antiretroviral therapy. A variety of approaches, including allogeneic HSCT from CCR5-deficient donors and autologous transplantation of genetically modified hematopoietic stem cells, are currently under investigation. This Review covers the experience with HSCT in HIV infection to date and provides a survey of ongoing work in the field. The challenges of developing HSCT for HIV cure in the context of safe, effective, and convenient once-daily antiretroviral therapy are also discussed.

The Need For Ongoing Surveys About Physician Practice Costs.

PubMed

Berk, Marc L

2016-09-01

Physicians continue to be the subject of many survey efforts asking them about a wide range of issues including training, retirement plans, satisfaction with practice, practice organization, and practice costs. The resources dedicated to the collection of different types of data have changed over time. Collection efforts have both expanded and contracted. Here I discuss this phenomenon for several types of physician surveys, with particular focus on the reduction in ongoing survey efforts about physician practice costs. The diminution of efforts to collect information about these costs represents an important challenge since the lack of timely, high-quality data could impair the correct calculation of reimbursement rates. Project HOPE—The People-to-People Health Foundation, Inc.

NeuroTalk: Improving the Communication of Neuroscience

PubMed Central

Moser, Mary Anne; McCormick, Jennifer B.; Racine, Eric; Blakeslee, Sandra; Caplan, Arthur; Hayden, Erika Check; Ingram, Jay; Lohwater, Tiffany; McKnight, Peter; Nicholson, Christie; Phillips, Anthony; Sauvé, Kevin D.; Snell, Elaine; Weiss, Sam

2010-01-01

There is increasing pressure for neuroscientists to communicate their research and the societal implications of their findings to the public. Communicating science is challenging and the transformation of communication by digital and interactive media makes the challenge even greater. To successfully facilitate dialogue with the public in this new media landscape we suggest three courses of action for the neuroscience community: a cultural shift that explicitly recognizes and rewards public outreach, the identification and development of neuroscience communication experts, and ongoing empirical research on public communication of neuroscience. PMID:19953102

Indoor chemistry: research opportunities and challenges.

PubMed

Nazaroff, W W; Goldstein, A H

2015-08-01

In this editorial, we have highlighted key research opportunities and challenges in four topical themes for indoor chemistry: human occupants as agents influencing indoor chemistry; oxidative chemistry; surface phenomena; and semivolatile organic compounds. In each case, enough prior work has been done to demonstrate the importance of the theme and to create a foundation for future studies. Extensive achievements and ongoing progress in (outdoor) atmospheric chemistry—both in the analytical methods developed and in the scientific knowledge created—also contribute to a strong foundation from which to achieve rapid research progress in this exciting new domain.

Detector Developments for the High Luminosity LHC Era (1/4)

ScienceCinema

Straessner, Arno

2018-04-27

Calorimetry and Muon Spectrometers - Part I : In the first part of the lecture series, the motivation for a high luminosity upgrade of the LHC will be quickly reviewed together with the challenges for the LHC detectors. In particular, the plans and ongoing research for new calorimeter detectors will be explained. The main issues in the high-luminosity era are an improved radiation tolerance, natural ageing of detector components and challenging trigger and physics requirements. The new technological solutions for calorimetry at a high-luminosity LHC will be reviewed.

Annual Research Review: Discovery science strategies in studies of the pathophysiology of child and adolescent psychiatric disorders--promises and limitations.

PubMed

Zhao, Yihong; Castellanos, F Xavier

2016-03-01

Psychiatric science remains descriptive, with a categorical nosology intended to enhance interobserver reliability. Increased awareness of the mismatch between categorical classifications and the complexity of biological systems drives the search for novel frameworks including discovery science in Big Data. In this review, we provide an overview of incipient approaches, primarily focused on classically categorical diagnoses such as schizophrenia (SZ), autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD), but also reference convincing, if focal, advances in cancer biology, to describe the challenges of Big Data and discovery science, and outline approaches being formulated to overcome existing obstacles. A paradigm shift from categorical diagnoses to a domain/structure-based nosology and from linear causal chains to complex causal network models of brain-behavior relationship is ongoing. This (r)evolution involves appreciating the complexity, dimensionality, and heterogeneity of neuropsychiatric data collected from multiple sources ('broad' data) along with data obtained at multiple levels of analysis, ranging from genes to molecules, cells, circuits, and behaviors ('deep' data). Both of these types of Big Data landscapes require the use and development of robust and powerful informatics and statistical approaches. Thus, we describe Big Data analysis pipelines and the promise and potential limitations in using Big Data approaches to study psychiatric disorders. We highlight key resources available for psychopathological studies and call for the application and development of Big Data approaches to dissect the causes and mechanisms of neuropsychiatric disorders and identify corresponding biomarkers for early diagnosis. © 2016 Association for Child and Adolescent Mental Health.

Structure and dynamics of aqueous solutions from PBE-based first-principles molecular dynamics simulations.

PubMed

Pham, Tuan Anh; Ogitsu, Tadashi; Lau, Edmond Y; Schwegler, Eric

2016-10-21

Establishing an accurate and predictive computational framework for the description of complex aqueous solutions is an ongoing challenge for density functional theory based first-principles molecular dynamics (FPMD) simulations. In this context, important advances have been made in recent years, including the development of sophisticated exchange-correlation functionals. On the other hand, simulations based on simple generalized gradient approximation (GGA) functionals remain an active field, particularly in the study of complex aqueous solutions due to a good balance between the accuracy, computational expense, and the applicability to a wide range of systems. Such simulations are often performed at elevated temperatures to artificially "correct" for GGA inaccuracies in the description of liquid water; however, a detailed understanding of how the choice of temperature affects the structure and dynamics of other components, such as solvated ions, is largely unknown. To address this question, we carried out a series of FPMD simulations at temperatures ranging from 300 to 460 K for liquid water and three representative aqueous solutions containing solvated Na + , K + , and Cl - ions. We show that simulations at 390-400 K with the Perdew-Burke-Ernzerhof (PBE) exchange-correlation functional yield water structure and dynamics in good agreement with experiments at ambient conditions. Simultaneously, this computational setup provides ion solvation structures and ion effects on water dynamics consistent with experiments. Our results suggest that an elevated temperature around 390-400 K with the PBE functional can be used for the description of structural and dynamical properties of liquid water and complex solutions with solvated ions at ambient conditions.

Annual Research Review: Discovery science strategies in studies of the pathophysiology of child and adolescent psychiatric disorders: promises and limitations

PubMed Central

Zhao, Yihong; Castellanos, F. Xavier

2015-01-01

Background and Scope Psychiatric science remains descriptive, with a categorical nosology intended to enhance inter-observer reliability. Increased awareness of the mismatch between categorical classifications and the complexity of biological systems drives the search for novel frameworks including discovery science in Big Data. In this review, we provide an overview of incipient approaches, primarily focused on classically categorical diagnoses such as schizophrenia (SZ), autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), but also reference convincing, if focal, advances in cancer biology, to describe the challenges of Big Data and discovery science, and outline approaches being formulated to overcome existing obstacles. Findings A paradigm shift from categorical diagnoses to a domain/structure-based nosology and from linear causal chains to complex causal network models of brain-behavior relationship is ongoing. This (r)evolution involves appreciating the complexity, dimensionality and heterogeneity of neuropsychiatric data collected from multiple sources (“broad” data) along with data obtained at multiple levels of analysis, ranging from genes to molecules, cells, circuits and behaviors (“deep” data). Both of these types of Big Data landscapes require the use and development of robust and powerful informatics and statistical approaches. Thus, we describe Big Data analysis pipelines and the promise and potential limitations in using Big Data approaches to study psychiatric disorders. Conclusion We highlight key resources available for psychopathological studies and call for the application and development of Big Data approaches to dissect the causes and mechanisms of neuropsychiatric disorders and identify corresponding biomarkers for early diagnosis. PMID:26732133

Tank-automotive robotics

NASA Astrophysics Data System (ADS)

Lane, Gerald R.

1999-07-01

To provide an overview of Tank-Automotive Robotics. The briefing will contain program overviews & inter-relationships and technology challenges of TARDEC managed unmanned and robotic ground vehicle programs. Specific emphasis will focus on technology developments/approaches to achieve semi- autonomous operation and inherent chassis mobility features. Programs to be discussed include: DemoIII Experimental Unmanned Vehicle (XUV), Tactical Mobile Robotics (TMR), Intelligent Mobility, Commanders Driver Testbed, Collision Avoidance, International Ground Robotics Competition (ICGRC). Specifically, the paper will discuss unique exterior/outdoor challenges facing the IGRC competing teams and the synergy created between the IGRC and ongoing DoD semi-autonomous Unmanned Ground Vehicle and DoT Intelligent Transportation System programs. Sensor and chassis approaches to meet the IGRC challenges and obstacles will be shown and discussed. Shortfalls in performance to meet the IGRC challenges will be identified.

Using the Electronic Health Record in Nursing Research: Challenges and Opportunities.

PubMed

Samuels, Joanne G; McGrath, Robert J; Fetzer, Susan J; Mittal, Prashant; Bourgoine, Derek

2015-10-01

Changes in the patient record from the paper to the electronic health record format present challenges and opportunities for the nurse researcher. Current use of data from the electronic health record is in a state of flux. Novel data analytic techniques and massive data sets provide new opportunities for nursing science. Realization of a strong electronic data output future relies on meeting challenges of system use and operability, data presentation, and privacy. Nurse researchers need to rethink aspects of proposal development. Joining ongoing national efforts aimed at creating usable data output is encouraged as a means to affect system design. Working to address challenges and embrace opportunities will help grow the science in a way that answers important patient care questions. © The Author(s) 2015.

Acousto-optic pointing and tracking systems for free-space laser communications

NASA Astrophysics Data System (ADS)

Nikulin, V.; Khandekar, R.; Sofka, J.; Tartakovsky, G.

2005-08-01

Implementation of long-range laser communication systems holds great promise for high-bandwidth applications. They are viewed as a technology that in the nearest future will handle most of the "last mile" communication traffic for the individual subscribers, corporate offices, military, and possibly deep space probes. Indeed, lasers allow for concentration of energy within tightly focused beams and narrow spectral interval, thus offering high throughput, information security, weight and size of components and power requirements that could not be matched by RF systems. However, the advantages of optical communication systems come in the same package with several major challenges. In particular, high data rates should be complemented by high-precision wide-bandwidth position control of a laser beam. In many applications the ability to maintain a link is affected by the complex maneuvers performed by mobile communication platforms, resident vibrations, and atmospheric effects. The search for the most effective and reliable way to shape and steer the laser beam is an on-going effort. This paper is focused on the application of acousto-optic technology as an alternative to electro-mechanical devices. With realization that an acousto-optic Bragg cell is only a component of the entire communication system, which should perform complex tasks of acquisition, pointing, and tracking of the remote terminal, we present an attempt to consider this problem from the "systems" point of view.

The complexities of educating nurses in Uganda.

PubMed

Andrews, C M; Rottman, C J; Lematia, R M

1996-01-01

Imagine that you are a woman living in rural Uganda. Your husband has returned to the city to work as a manual labourer. With a toddler playing alongside, you work long hot hours in the field to provide for your family. For weeks you have run a low-grade fever which you suspect is related to your advancing pregnancy. As traditional medicines have provided no relief, you sacrifice a day in the field and wait in line for care at a medical clinic outpost that is staffed one day a week. Nearing your turn, you hear a rumour that the government now requires payment in advance for care. As you and most of the others waiting in line do not have money, you leave together and arrange to pool resources from a community project so that you can all return to the clinic next week. Your pain increases and your productivity goes down. When the clinic day finally comes, the nurse does not show up because her own children need food and she prefers to earn ready cash by selling crafts in the market rather than work at the clinic for barely subsistence pay. The story does not end here, nor does that of countless other women in Uganda, including the caregivers. The difficulties are ongoing. And meeting health needs in Uganda as in many countries in Sub-Sahara Africa is complex and challenging.

Risk of thromboembolic complications in adult congenital heart disease: A literature review.

PubMed

Karsenty, Clement; Zhao, Alexandre; Marijon, Eloi; Ladouceur, Magalie

2018-05-30

Adult congenital heart disease (ACHD) is a constantly expanding population with challenging issues. Initial medical and surgical treatments are seldom curative, and the majority of patients still experience late sequelae and complications, especially thromboembolic events. These common and potentially life-threating adverse events are probably dramatically underdiagnosed. Better identification and understanding of thromboembolic risk factors are essential to prevent long-term related morbidities. In addition to specific situations associated with a high risk of thromboembolic events (Fontan circulation, cyanotic congenital heart disease), atrial arrhythmia has been recognized as an important risk factor for thromboembolic events in ACHD. Unlike in patients without ACHD, thromboembolic risk stratification scores, such as the CHA 2 DS 2 -VASc score, may not be applicable in ACHD. Overall, after a review of the scientific data published so far, it is clear that the complexity of the underlying congenital heart disease represents a major risk factor for thromboembolic events. As a consequence, prophylactic anticoagulation is indicated in patients with complex congenital heart disease and atrial arrhythmia, regardless of the other risk factors, as opposed to simple heart defects. The landscape of ACHD is an ongoing evolving process, and specific thromboembolic risk scores are needed, especially in the setting of simple heart defects; these should be coupled with specific trials or long-term follow-up of multicentre cohorts. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Gene-Environment Interplay in Common Complex Diseases: Forging an Integrative Model—Recommendations From an NIH Workshop

PubMed Central

Bookman, Ebony B.; McAllister, Kimberly; Gillanders, Elizabeth; Wanke, Kay; Balshaw, David; Rutter, Joni; Reedy, Jill; Shaughnessy, Daniel; Agurs-Collins, Tanya; Paltoo, Dina; Atienza, Audie; Bierut, Laura; Kraft, Peter; Fallin, M. Daniele; Perera, Frederica; Turkheimer, Eric; Boardman, Jason; Marazita, Mary L.; Rappaport, Stephen M.; Boerwinkle, Eric; Suomi, Stephen J.; Caporaso, Neil E.; Hertz-Picciotto, Irva; Jacobson, Kristen C.; Lowe, William L.; Goldman, Lynn R.; Duggal, Priya; Gunnar, Megan R.; Manolio, Teri A.; Green, Eric D.; Olster, Deborah H.; Birnbaum, Linda S.

2011-01-01

Although it is recognized that many common complex diseases are a result of multiple genetic and environmental risk factors, studies of gene-environment interaction remain a challenge and have had limited success to date. Given the current state-of-the-science, NIH sought input on ways to accelerate investigations of gene-environment interplay in health and disease by inviting experts from a variety of disciplines to give advice about the future direction of gene-environment interaction studies. Participants of the NIH Gene-Environment Interplay Workshop agreed that there is a need for continued emphasis on studies of the interplay between genetic and environmental factors in disease and that studies need to be designed around a multifaceted approach to reflect differences in diseases, exposure attributes, and pertinent stages of human development. The participants indicated that both targeted and agnostic approaches have strengths and weaknesses for evaluating main effects of genetic and environmental factors and their interactions. The unique perspectives represented at the workshop allowed the exploration of diverse study designs and analytical strategies, and conveyed the need for an interdisciplinary approach including data sharing, and data harmonization to fully explore gene-environment interactions. Further, participants also emphasized the continued need for high-quality measures of environmental exposures and new genomic technologies in ongoing and new studies. PMID:21308768

The need for a prescribing competency framework to address the burden of complex polypharmacy among multiple long-term conditions.

PubMed

Picton, Catherine; Loughrey, Claire; Webb, Andrew

2016-10-01

The original requirement for a competency framework for prescribers was to identify the essential skills for non-medical prescribers. However, core prescribing competencies are relevant to any prescriber. The new, revised version is especially relevant for doctors/physicians. Doctors are the most frequent prescribers - prescribing is the most common therapeutic intervention. The quantity and complexity of medicine use is increasing through multiple treatment strategies/pathways for multiple comorbidities, resulting in polypharmacy - especially with long-term conditions. This is against a background of the ongoing introduction of new drugs with novel mechanisms of action with increased risks of adverse effects, compounded by drug-drug and disease-drug interactions. This has increased the need for monitoring and follow-up, including identification and management of poor adherence. It is challenging for doctors to maintain safe and effective prescribing and train other doctors and non-medical prescribers within the multidisciplinary team. The prescribing competency framework provides a systematic approach to support doctors to prescribe safely and effectively. It can be used by medical schools to teach prescribing, including preparation for the prescribing safety assessment; by F1/F2 doctors to support prescribing in early years; as part of prescribing quality improvement initiatives and as a continuing professional development framework in general practice or acute care settings. © Royal College of Physicians 2016. All rights reserved.

Elevated levels of antibodies against phosphatidylserine/prothrombin complex and/or cardiolipin associated with infection and recurrent purpura in a child: a forme fruste of antiphospholipid syndrome?

PubMed

Kinoshita, Yuri; Mayumi, Nobuko; Inaba, Motoyuki; Igarashi, Touru; Katagiri, Ichigen; Kawana, Seiji

2015-07-15

Antiphospholipid syndrome is an autoimmune disorder characterized by the occurrence of venous and arterial thrombosis, as well as morbidity in pregnancy, in the presence of anti-phospholipid antibodies. The diagnosis of antiphospholipid syndrome is usually established based on clinical and laboratory findings by strictly following the 2006 Sapporo classification. However, the diagnosis remains challenging owing to the ongoing debates on the serological criteria. We report a case we describe as forme fruste antiphospholipid syndrome in which these criteria were not fulfilled. Purpura appeared repeatedly in a female infant starting from the age of 6 months and following episodes of upper respiratory infections and vaccinations. The levels of anti-cardiolipin IgG antibodies and anti-phosphatidylserine/prothrombin complex antibodies were elevated in accordance with these events. Histopathological evaluation revealed multiple small vessel thrombi in the dermis and adipose tissue. After 2 weeks of treatment with aspirin and heparin, the cutaneous symptoms subsided. Infection has long been associated with antiphospholipid syndrome, and anti-phosphatidylserine/prothrombin antibodies are considered a new marker for the diagnosis of antiphospholipid syndrome. Forme fruste antiphospholipid syndrome should be considered even if the antiphospholipid syndrome diagnostic criteria are not completely fulfilled, especially in the presence of elevated levels of anti-phosphatidylserine/prothrombin antibodies and known preceding infections.

Science and animal welfare in France and European Union: Rules, constraints, achievements.

PubMed

Jacques, Servière

2014-11-01

The welfare of food-producing animals is a focus of public debate in Europe. Political institutions, have introduced regulations based on scientific data. Meanwhile, the practices of producers and transformers were modified. Implementation of care practices is added to the goal of sustainable basic health of animals. Nevertheless urban consumers still look for the "naturalness" of living animals. A brief historical perspective introduces the building process of European regulations. A short list of Directories and Recommendations provides a clue on the complexity of resulting construct. Now, this complexity is calling for simplification of rules while practices should be compatible with professional constraints. Few selected examples are brought to illustrate how the concepts initially studied by scientists (welfare, pain, stress, "consciousness"/awareness) were integrated in regulations and implemented by producers and meat industry in order to simultaneously maintain the requirements for high quality and security standards. At the same time, free trade market constraints introduced new distortions, in particular those linked to the world demand for proteins. Indeed, the controversy about animal welfare, initially brought on ethical grounds, became a case for ongoing adjustements of EU policy, requesting to combine scientific knowledge on animals, consequent evolution in the representation of animals by urban consumers with the challenge of adaptation and implemention of regulations. Copyright © 2014 Elsevier Ltd. All rights reserved.

Challenges and opportunities in dermal/transdermal delivery

PubMed Central

Paudel, Kalpana S; Milewski, Mikolaj; Swadley, Courtney L; Brogden, Nicole K; Ghosh, Priyanka; Stinchcomb, Audra L

2010-01-01

Transdermal drug delivery is an exciting and challenging area. There are numerous transdermal delivery systems currently available on the market. However, the transdermal market still remains limited to a narrow range of drugs. Further advances in transdermal delivery depend on the ability to overcome the challenges faced regarding the permeation and skin irritation of the drug molecules. Emergence of novel techniques for skin permeation enhancement and development of methods to lessen skin irritation would widen the transdermal market for hydrophilic compounds, macromolecules and conventional drugs for new therapeutic indications. As evident from the ongoing clinical trials of a wide variety of drugs for various clinical conditions, there is a great future for transdermal delivery of drugs. PMID:21132122

Explaining Strengthening Mechanisms, Institutional Orientations and Problematic Challenges of University Agricultural Research in Iran

ERIC Educational Resources Information Center

Sharifzadeh, Aboulghasem; Abdollahzadeh, Gholamhossein

2009-01-01

According to empirical evidence and noted implications of sustainable agricultural development as a systemic and multi-actor process, integration of the research function of higher agricultural education in Iranian agricultural research systems seems to be an ongoing and considerable necessity. With the aim of identification and analysis of…

"What Happens in the Historian's Head?"

ERIC Educational Resources Information Center

Weiler, Kathleen

2011-01-01

The three articles that make up this issue on theory in educational history are a welcome engagement with the challenges raised by poststructuralism and other theoretical developments. They contribute to what should be an ongoing conversation about the nature of the enterprise of writing the history of education. The three articles in the special…

Professional Learning in Higher Education: Making Good Practice Relevant

ERIC Educational Resources Information Center

Daniels, Jeannie

2017-01-01

Professionals working in a range of contexts are increasingly expected to engage in ongoing professional learning to maintain their skills and develop their practices. In this paper, I focus on professional learning in Higher Education and challenge the standardisation of professional learning that is becoming prevalent in a number of countries. I…

The Assessment Journey: Defining and Refining Instrument Dilemmas

ERIC Educational Resources Information Center

Gallo, Ann Marie; Carr, Michael T.; Gallo, Joseph A.

2010-01-01

Designing and implementing assessment instruments are ongoing challenges for physical educators. The initial design phase includes asking the question, "What do I want the students to know and/or be able to do?" Seemingly, the question is direct and should lead to a concrete answer. In addition to designing assessment instruments, one of the most…

Tracking Behavioral Progress within a Children's Mental Health System: The Vermont Community Adjustment Tracking System.

ERIC Educational Resources Information Center

Bruns, Eric J.; Burchard, John D.; Froelich, Peter; Yoe, James T.; Tighe, Theodore

1998-01-01

Describes the Vermont Community Adjustment Tracking System (VT-CATS), which utilizes four behavioral instruments to allow intensive, ongoing, and interpretable behavioral assessment of a service system's most challenging children and adolescents. Also explains the adjustment indicator checklists and the ability of VT-CATS to address agencies'…

Cardiac Vagal Regulation and Early Peer Status

ERIC Educational Resources Information Center

Graziano, Paulo A.; Keane, Susan P.; Calkins, Susan D.

2007-01-01

A sample of 341 5 1/2-year-old children participating in an ongoing longitudinal study was the focus of a study on the relation between cardiac vagal regulation and peer status. To assess cardiac vagal regulation, resting measures of respiratory sinus arrhythmia (RSA) and RSA change (suppression) to 3 cognitively and emotionally challenging tasks…

A Study of Perceived Admission and Achievement Barriers of Learning-Disabled Students in Postsecondary Institutions

ERIC Educational Resources Information Center

Lamberg, Catherine Denise

2012-01-01

Learning-disabled students face ongoing challenges in higher education. Despite efforts to promote recruitment and retention of students with learning disabilities to trade schools, colleges, and universities, barriers to enrollment and academic achievement persist. Barriers for learning-disabled students are not fully understood and might be…

Is seeing believing? Perceptions of wildfire risk over time

Treesearch

Patricia A. Champ; Hannah Brenkert-Smith

2016-01-01

Ongoing challenges to understanding how hazard exposure and disaster experiences influence perceived risk lead us to ask: Is seeing believing? We approach risk perception by attending to two components of overall risk perception: perceived probability of an event occurring and perceived consequences if an event occurs. Using a two-period longitudinal data set...

The Role of Feedback in the Assimilation of Information in Prediction Markets

ERIC Educational Resources Information Center

Jolly, Richard Donald

2011-01-01

Leveraging the knowledge of an organization is an ongoing challenge that has given rise to the field of knowledge management. Yet, despite spending enormous sums of organizational resources on Information Technology (IT) systems, executives recognize there is much more knowledge to harvest. Prediction markets are emerging as one tool to help…

"Do Thyself No Harm": Protecting Ourselves as Autoethnographers

ERIC Educational Resources Information Center

Chatham-Carpenter, April

2010-01-01

Autoethnographers have grappled with how to represent others in the stories they tell. However, very few have written about the need to protect themselves in the process of doing autoethnographic writing. In this paper, I explore the ethical challenges faced when writing about a potentially-ongoing disorder, such as anorexia, when the research…

The Urban Food Hubs Solution: Building Capacity in Urban Communities

ERIC Educational Resources Information Center

O'Hara, Sabine

2017-01-01

Access to affordable fresh food is an ongoing challenge for underserved urban neighborhoods across the United States. Several are designated food deserts with no access to a full-service grocery store within a one-mile radius. The Urban Food Hubs of the College of Agriculture, Urban Sustainability, and Environmental Sciences (CAUSES) of the…

Plasma Treatment for Severe Influenza Deemed Well-Tolerated in Clinical Study | Frederick National Laboratory for Cancer Research

Cancer.gov

The upcoming flu season is just around the corner, and an ongoing challenge for researchers has been how to best respond to cases of severe influenza in the event of an outbreak. The Frederick National Laboratory for Cancer Research has helped the Na

Student Experiences at Off-Campus Parties: Results from a Multicampus Survey

ERIC Educational Resources Information Center

Jakeman, Rick C.; Silver, Blake R.; Molasso, William

2014-01-01

The need to understand the settings in which students drink represents an ongoing challenge for universities. Undergraduate students (N = 2,146) completed an online multicampus survey to capture the perceptions of off-campus party guests regarding common party behaviors and events. Results indicate that students frequently attend off-campus…

Residential Environmental Education Center Program Evaluation: An Ongoing Challenge

ERIC Educational Resources Information Center

Bourke, Nicholas; Buskist, Connie; Herron, Julie

2014-01-01

Residential environmental education centers (REECs) have been criticized for their lack of quality program evaluation. However, the last national study done on the practices of REECs was Chenery and Hammerman's (1985) research. This article presents the results of a national survey of directors of REECs (n = 114) that gives insight into the…

Professional Learning of Teachers in Ethiopia: Challenges and Implications for Reform

ERIC Educational Resources Information Center

Tuli, Fekede; Tynjälä, Päivi

2015-01-01

Continuous professional development of teachers is of growing interest globally, as it is considered vital to cope effectively with ongoing changes and to improve the quality of education. This qualitative case study explores potential and actual barriers that hinder teachers' professional development in Ethiopian schools. Data was collected via…

Raising Standards through INQUIRE in Pre-Service Teacher Education

ERIC Educational Resources Information Center

Elster, D.; Barendziak, T.; Haskamp, F.; Kastenholz, L.

2014-01-01

Raising standards through inquiry-based science education (IBSE)--what are the challenges for pre-service teacher education? What do ongoing teachers and active teachers learn from each other when planning, conducting and evaluating minds-on and hands-on IBSE activities in the classroom? What do they learn "beyond" IBSE? The Bremen…

The Pre-Designed Lesson: Teaching with Transdisciplinary Pedagogical Templates (TPTs)

ERIC Educational Resources Information Center

Dobozy, Eva

2017-01-01

An ongoing challenge in higher education is the support of educators in their development of effective pedagogies. The field of educational research and practice referred to as Learning Design may be able to help educators with no or limited pedagogical training deliver highly interactive and contemporary teaching and learning offerings. The…

Leveraging the Power of Social Media to Maximize Organizational Learning and Drive Performance

ERIC Educational Resources Information Center

Nguyen, Camilla C.

2014-01-01

This qualitative ethnographic study addresses the phenomenon of rapid social media expansion, which creates organizational challenges. Ongoing development of advanced technology products means that effective organizations must be more adaptive and receptive to new approaches and changes in their environment. In a hyper connected society, one where…

Species pool, human population, and global versus regional invasion patterns

Treesearch

Qinfeng Guo; Basil V. Iannone III; Gabriela C. Nunez-Mir; Kevin M. Potter; Christopher M. Oswalt; Songlin Fei

2017-01-01

Context Biological invasions are among the greatest global and regional threats to biomes in the Anthropocene. Islands, in particular, have been perceived to have higher vulnerability to invasions. Because of the dynamic nature of ongoing invasions, distinguishing regional patterns from global patterns and their underlying determinants remains a challenge. Objectives...

Shifting Occupational Identity: Doing, Being, Becoming and Belonging in the Academy

ERIC Educational Resources Information Center

Ennals, Priscilla; Fortune, Tracy; Williams, Anne; D'Cruz, Kate

2016-01-01

Becoming more scholarly can be challenging for many in the academy, including for those transitioning from professional roles. This paper presents the initial findings of an ongoing action research project that set out to explore and develop aspects of identity among a group of Australian occupational therapy academics. Thirteen participants…

Becoming Embedded: Incorporating Instant Messaging and the Ongoing Evolution of a Virtual Reference Service

ERIC Educational Resources Information Center

Stormont, Sam

2010-01-01

The creation of an instant messaging (IM) service is described. The challenges encountered in developing, launching, and maintaining the project are examined and include technical support, archiving, balancing different formats, privacy, assessment, training, and the effectiveness of the IM channel. The process of choosing an aggregator and a…

A Case Study of Private Middle School Principals' and Parents' Perceptions of Student Bullying

ERIC Educational Resources Information Center

Taylor, David

2013-01-01

Student bullying is an ongoing educational, social, and public health phenomenon facing countless students, parents, and educators. Educators and parents are challenged with distinguishing student bullying from normal student conflict. The purpose of this qualitative multiple case study was to compare private middle school principals' and middle…

Norms and Goals of Appraisal of German Teachers for Students with Learning Disabilities

ERIC Educational Resources Information Center

Wilbert, Jurgen; Grunke, Matthias

2010-01-01

Although there is an ongoing debate about which achievement feedback is most useful, the majority of researchers agree that social comparisons and a focus on competition are inappropriate for students with learning disabilities and otherwise academically-challenged students. They are highly at-risk to be unfavorably influenced by inappropriate…

What's in a Name? Changing Names and Challenges to Professional Identification

ERIC Educational Resources Information Center

Alber, Julia; Chaney, Don; O'Rourke, Thomas W.

2013-01-01

Name changes of university departments that have professional preparation health education programs have been ongoing and significant. This study analyzes changes in the names of health education degree-offering departments between 1974 and 2009. It also discusses the implications for the health education discipline going forward with respect to…

Encouraging a Culture of Research in Practicing Teachers in Singapore

ERIC Educational Resources Information Center

Ebbeck, Marjory; Chan, Yvonne Yoke Yin; Yim, Hoi Yin Bonnie

2011-01-01

Upgrading the status of early childhood teaching and improving job satisfaction are areas of concern to practitioners, policy makers and other stakeholders in the early childhood field. Ways to upgrade practicing teachers, including their involvement in research, is an on-going challenge. This paper reports on a research in Singapore where a…

What Makes Your Wheels Turn?

ERIC Educational Resources Information Center

DiJulio, Betsy

2010-01-01

In the author's ongoing attempt to design creative challenges that are relevant, based on observational drawing, and that place students squarely in the creative problem-solving driver's seat, she chose cars and engines as subjects. After all, they have a parking lot full of them and their administrative staff members, who park side-by-side, were…

Self-Monitoring in Clinical Practice: A Challenge for Medical Educators

ERIC Educational Resources Information Center

Epstein, Ronald M.; Siegel, Daniel J.; Silberman, Jordan

2008-01-01

Recent literature has described how the capacity for concurrent self-assessment--ongoing moment-to-moment self-monitoring--is an important component of the professional competence of physicians. Self-monitoring refers to the ability to notice our own actions, curiosity to examine the effects of those actions, and willingness to use those…

Doctoral Success as Ongoing Quality Business: A Possible Conceptual Framework

ERIC Educational Resources Information Center

Bitzer, E. M.

2011-01-01

The challenges involving doctoral non-completion and a lack of academic or scholarly quality are not restricted to putting the blame on doctoral candidates themselves, their supervisors or the institutions where they enrol. As candidates carry huge responsibilities when entering doctoral studies, success can be associated with an array of factors…

Race, Choice and Richmond Public Schools: New Possibilities and Ongoing Challenges for Diversity in Urban Districts

ERIC Educational Resources Information Center

Siegel-Hawley, Genevieve

2014-01-01

Several contemporary demographic trends suggest that school systems in America's central cities, typically characterized by high levels of racial and economic isolation, are being presented with new opportunities to create quality, diverse schools. Still, numerous obstacles linger. Using multiple sources of data and innovative mapping tools, this…

American Red Cross Disaster Mental Health Services: Implementation and Recent Developments.

ERIC Educational Resources Information Center

Morgan, Jane

1995-01-01

The American Red Cross (ARC) Disaster Mental Health Services program uses a multidisciplinary approach to deliver crisis intervention to disaster workers and victims after hurricanes. Discusses the impetus for the ARC's development of the program, its early implementation, and ongoing challenges in the further development of this approach to…

Promoting Positive Social Behavior in Physical Education

ERIC Educational Resources Information Center

Balderson, Daniel; Sharpe, Tom

2004-01-01

An ongoing challenge that both classroom and physical education teachers face on a daily basis is how to organize and manage large groups of students. This is particularly true in many urban settings where classrooms and gymnasiums are typically understaffed and/or under equipped. Educators in these settings often struggle with how to minimize…

Challenges in Social Communication in Asperger Syndrome and High-Functioning Autism

ERIC Educational Resources Information Center

Rubin, Emily; Lennon, Laurie

2004-01-01

Despite the inclusion of Asperger syndrome in the Diagnostic and Statistical Manual of Mental Disorders--Fourth Edition (DSM-IV) American Psychiatric Association [APA], 1994) 10 years ago, there is ongoing debate regarding its validity as a diagnostic construct, particularly relative to the diagnosis of autistic disorder when it is not accompanied…

Teacher Education Reform and Challenges in Norway

ERIC Educational Resources Information Center

Munthe, Elaine; Malmo, Kari-Anne Svensen; Rogne, Magne

2011-01-01

Teacher education in Norway is nationally regulated and is currently undergoing extensive changes. This paper briefly outlines the various education routes for teachers and some of the ongoing work to improve teacher education, but concentrates mainly on the reform that has come the farthest: initial teacher education for grades 1-7 and grades…

Neoliberalism in the Academic Borderlands: An On-Going Struggle for Equality and Human Rights

ERIC Educational Resources Information Center

Darder, Antonia

2012-01-01

The article examines the negative impact of neoliberal policies upon the work of border intellectuals within the university, whose scholarship seeks to explicitly challenge longstanding structural inequalities and social exclusions. More specifically, the notion of neoliberal multiculturalism is defined and discussed with respect to the phenomenon…

Views on Adults Re-Learning Mathematics: A Comparative Study.

ERIC Educational Resources Information Center

Angiama, R. O.

This paper is based on the on-going research, work, and teaching carried out in the Mathematics Foundations Course (MFC) at Goldsmiths College, University of London. Teaching is a very intimate and rewarding experience for the mathematics lecturer as well as for the adult student. Mathematics lecturers and adults should be challenged by their…

Post-Racial Pedagogy--Challenges and Possibilities

ERIC Educational Resources Information Center

Singh, Gurnam

2018-01-01

Against the backdrop of ongoing discussions about how best to conceptualise, confront and ultimately eradicate racism, this paper seeks to critically examine the relevance of 'post-racial' thinking, both in a general sense, but also in relation to education. The argument is framed around a concern that multi-cultural, and to a lesser extent,…

Reaching Learning Goals through Learning On-Site in Germany

ERIC Educational Resources Information Center

Alberts, Heike C.; Niendorf, Bruce D.

2017-01-01

Getting students interested in events that are distant in time and space is an ongoing challenge in education. In this article, the authors demonstrate how learning at the sites where historical events happened abroad engages undergraduate students by reducing the effects of time and distance. Using student quotations gathered during three…

Jumping into the Deep End: Developing Culturally Responsive Urban Teachers through Community-Immersive Partnerships

ERIC Educational Resources Information Center

Mustian, April L.; Lee, Robert E.; Nelson, Carlos; Gamboa-Turner, Valentina; Roule, Lisa

2017-01-01

Preparing special educators for the highest-need schools remains an ongoing challenge in urban districts across the United States. One university's collaborative community-based immersive partnership model, with emphasis on service learning, has demonstrated promising levels of impact on candidates' preparation as preservice teachers learning how…

Promoting the School Learning Processes: Principals as Learning Boundary Spanners

ERIC Educational Resources Information Center

Benoliel, Pascale; Schechter, Chen

2017-01-01

Purpose: The ongoing challenge to sustain school learning and improvement requires schools to explore new ways, and at the same time exploit previous experience. The purpose of this paper is to attempt to expand the knowledge of mechanisms that can facilitate school learning processes by proposing boundary activities and learning mechanisms in…

The Multiple Challenges of Multimedia: Development, Implementation, and Evaluation.

ERIC Educational Resources Information Center

Kassen, Margaret Ann

1998-01-01

This article presents an overview of an ongoing initiative to develop, integrate, and evaluate multimedia lessons to enhance listening comprehension in Spanish language classes at the Catholic University of America (District of Columbia). Focusing on the process involved, the two phases of the project that have been completed are examined,…

Skills Development and Structural Change: Possibilities for and Limitations of Redressing Structural Racial Inequalities in South Africa

ERIC Educational Resources Information Center

Groener, Zelda

2013-01-01

Improving structural racial equality for historically-disadvantaged Black South Africans, including low-skilled and unemployed adults and youths, is a pertinent challenge for the South African government during the ongoing transition from apartheid capitalism to post-apartheid capitalism. Within the framework of the National Skills Development…

Getting What They Want: Aligning Student Expectations of Advising with Perceived Advisor Behaviors

ERIC Educational Resources Information Center

Anderson, Whitney; Motto, Justin S.; Bourdeaux, Renee

2014-01-01

Maintaining effective undergraduate academic advising programs that meet the needs of students is an ongoing challenge for universities across the country. Using expectancy violations theory as a lens, this study argues that student satisfaction with advising is linked to alignment between student expectations of the advising process and perceived…

Using Student Voice to Respond to Middle School Bullying: A Student Leadership Approach

ERIC Educational Resources Information Center

Shriberg, David; Brooks, Keeshawna; Jenkins, Kisha; Immen, Jennifer; Sutter, Caroline; Cronin, Karen

2017-01-01

Bullying prevention and intervention are ongoing challenges for all educators, school psychologists included. A lack of research exists regarding the potential role of middle school students as direct actors in bullying prevention and intervention. This article describes a novel student leadership group for seventh graders in which the primary…

Does Calibration Reduce Variability in the Assessment of Accounting Learning Outcomes?

ERIC Educational Resources Information Center

O'Connell, Brendan; De Lange, Paul; Freeman, Mark; Hancock, Phil; Abraham, Anne; Howieson, Bryan; Watty, Kim

2016-01-01

Reliable, consistent assessment process that produces comparable assessment grades between assessors and institutions is a core activity and an ongoing challenge with which universities have failed to come to terms. In this paper, we report results from an experiment that tests the impact of an intervention designed to reduce grader variability…

High School Students' Understanding of Acid-Base Concepts: An Ongoing Challenge for Teachers

ERIC Educational Resources Information Center

Damanhuri, Muhd Ibrahim Muhamad; Treagust, David F.; Won, Mihye; Chandrasegaran, A. L.

2016-01-01

Using a quantitative case study design, the "Acids-Bases Chemistry Achievement Test" ("ABCAT") was developed to evaluate the extent to which students in Malaysian secondary schools achieved the intended curriculum on acid-base concepts. Responses were obtained from 260 Form 5 (Grade 11) students from five schools to initially…

The physical properties, morphology and viscoelasticity of biobased sponges prepared from un-tanned hides

USDA-ARS?s Scientific Manuscript database

One of our research endeavors to address ongoing challenges faced by the U.S. hide and leather industries is to develop innovative uses and novel biobased products from hides to improve prospective markets and to secure a viable future for hides and leather industries. We had previously investigate...

Social Resilience: Challenging Neo-Colonial Thinking and Practices around "Risk"

ERIC Educational Resources Information Center

Gale, Fran; Bolzan, Natalie

2013-01-01

Understandings of resilience which primarily focus on the individual are of limited applicability unless we recognise the historical, economic and political factors in which social life occurs. To explore the social foundations of resilience is to chart the ongoing influence of these factors. An appreciation of this context is pivotal to any…

Actuarial Science at One Four-Year Comprehensive University

ERIC Educational Resources Information Center

Charlwood, Kevin E.

2014-01-01

Building an Actuarial Science program designated as advanced requires dedicated faculty, support from the administration, and a core group of strong students. Washburn University may serve as a model for those wishing to start or enhance such a program at their institution. We face three main ongoing challenges: first, the hiring and retention of…

Behind the Brotherhood: Rewards and Challenges for Wives of Firefighters

ERIC Educational Resources Information Center

Regehr, Cheryl; Dimitropoulos, Gina; Bright, Elaine; George, Sharon; Henderson, Joscelyn

2005-01-01

Support of family is paramount to reducing the impact of highly stressful work on firefighters. Yet the degree of stress encountered by the family members, particularly spouses, resulting from ongoing job demands and exposure to traumatic situations is unclear. This qualitative study examined the effects of emergency service work on spouses of…

California College and University Collaborations: Facilitators, Challenges, and Impact on Student Mental Health

ERIC Educational Resources Information Center

Woodbridge, Michelle W.; Yu, Jennifer; Goldweber, Asha; Golan, Shari; Stein, BradleyD.

2015-01-01

One key objective of California's Statewide Prevention and Early Intervention (PEI) Student Mental Health (SMH) initiative funded under Proposition 63 was to establish a formal process for ongoing collaboration between higher education systems and county mental health, and to increase collaboration among higher education campuses to improve…

Professional Development in the Digital Age: Case Studies of Blended Communities of Practice

ERIC Educational Resources Information Center

Wagner, Jennifer Michelle

2010-01-01

The need for sustainable, meaningful teacher professional development to support the rising professional demands remains an on-going challenge for education. The use of current technologies, such as online learning systems, to leverage the development of learning communities, including communities of practice (CoPs), where teachers with a common…

Reforming Schools: The Collective Doubting Perspective

ERIC Educational Resources Information Center

Schechter, Chen; Ganon-Shilon, Sherry

2015-01-01

Purpose: The ongoing challenge to sustain educational reforms requires a learning process through which doubt is induced as a means of fostering productive school change. The purpose of this paper is to explore the concept of doubt as well as the doubting process and its importance to the school community, particularly with regard to educational…

Responding with Care to Students Facing Trauma

ERIC Educational Resources Information Center

Souers, Kristin

2018-01-01

Exposure to trauma--which many experts view as include ongoing life stressors like poverty, parents divorcing, death of a family member, or drug abuse in the home--is prevalent among school-aged children. Teachers know that facing trauma impedes students' ability to focus and learn, but it can be challenging to keep responding caringly to a…

CareerTech VISION 2012--Transforming CTE Together

ERIC Educational Resources Information Center

Bray, Janet B.

2012-01-01

As the leader in career and technical education (CTE), the Association for Career and Technical Education (ACTE) understands the ongoing challenges faced by the CTE community. That is why ACTE has created CareerTech VISION 2012, a bold and visionary event that addresses the evolving needs of the global society and meets all individual and…

Five Recession-Driven Strategies for Planning and Managing Campus Facilities

ERIC Educational Resources Information Center

Rudden, Michael S.

2010-01-01

Colleges and universities continue to face significant fiscal challenges in the current recession. A review of ongoing campus facilities planning projects, coupled with a review of more than 30 recent campus master planning requests for proposals and the relevant literature, indicates that colleges and universities are finding innovative ways to…

Common Purpose and Different Approaches to Support College-Going in Five Southwestern Districts

ERIC Educational Resources Information Center

Bosworth, Kris; Convertino, Christina; Hurwitz, Jason T.

2014-01-01

School-wide approaches to increase college-going can potentially improve postsecondary education outcomes for all students. The ongoing process and challenges to establish such approaches are, however, little understood. Using qualitative analysis of semi-structured interviews conducted with leaders at five public high schools in the Southwest,…

America's Children: Key National Indicators of Well-Being, 2011

ERIC Educational Resources Information Center

Cook, Traci; Blachman, Dara; Dye, Jane; Macartney, Suzanne; Lukacs, Susan; Howie, LaJeana; Kena, Grace; Sonnenberg, William; Axelrad, Daniel; Steffen, Barry; Truman, Jennifer; Cotto, Jessica; Jekielek, Susan; Mueggenborg, Mary; Coleman-Jensen, Alisha; Denton, Stephanie; Avenevoli, Shelli; Singleton, James; Knighton, Cindi; Han, Beth; O'Connell, Kellie; Guenther, Patricia; Hiza, Hazel; Kuczynski, Kevin; Koegel, Kristin; Radel, Laura

2011-01-01

"America's Children: Key National Indicators of Well-Being, 2011" is a compendium of indicators depicting both the promises and the challenges confronting our Nation's young people. The report, the 15th in an ongoing series, presents 41 key indicators on important aspects of children's lives. These indicators are drawn from the most…

The Impact of Task Difficulty and Performance Scores on Student Engagement and Progression

ERIC Educational Resources Information Center

Lynch, Raymond; Patten, James Vincent; Hennessy, Jennifer

2013-01-01

Background: This article considers the impact of differential task difficulty on student engagement and progression within an Irish primary school context. Gaining and maintaining student engagement during learning tasks such as homework is a significant and understandable on-going challenge for teachers. The findings of this study hold the…

The Bradley Challenge: A Sea Change for Australian Universities?

ERIC Educational Resources Information Center

Putnam, Thomas; Gill, Judith

2011-01-01

This paper begins with a focus on the problematic nature of one key term in the Bradley Report. "Socioeconomic status," or SES as commonly used, lacks clear definition leading to ongoing debates about its measurement. A working consensus on SES and its measurement is necessary for the report's recommendations to proceed effectively. Next…

Electronic Patient Registries Improve Diabetes Care and Clinical Outcomes in Rural Community Health Centers

ERIC Educational Resources Information Center

Pollard, Cecil; Bailey, Kelly A.; Petitte, Trisha; Baus, Adam; Swim, Mary; Hendryx, Michael

2009-01-01

Context: Diabetes care is challenging in rural areas. Research has shown that the utilization of electronic patient registries improves care; however, improvements generally have been described in combination with other ongoing interventions. The level of basic registry utilization sufficient for positive change is unknown. Purpose: The goal of…

The emerging infectious disease crisis and pathogen pollution: a question of ecology and evolution

USDA-ARS?s Scientific Manuscript database

Risk of emerging infectious diseases (EID) on a global scale has accelerated over the past 10,000 years in conjunction with agriculture, domestication, and globalization as the interfaces for people and environments have been altered over time. EID exist at the junction of 3 ongoing global challenge...