Which Interpretation of Deconstruction? Reply to Biesta and Miedema in "Religious Education," Issue 106.1

ERIC Educational Resources Information Center

Noaparast, Khosrow Bagheri; Khosravi, Zohreh

2012-01-01

The very complicated nature of interpretation, in general, and ambiguities involved in Derrida's writings, in particular, makes it very difficult to hold what Derrida means by deconstruction. As Biesta and Miedema (2011, 105) state: "One of the main challenges here is to get the interpretation of Derrida's writings 'right.'" Surely, by putting…

Travelling Teens: A Parents' Guide to Family Relocation

ERIC Educational Resources Information Center

Linke, Pam

2005-01-01

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

Elicitation Techniques: Getting People to Talk about Ideas They Don't Usually Talk About

ERIC Educational Resources Information Center

Barton, Keith C.

2015-01-01

Elicitation techniques are a category of research tasks that use visual, verbal, or written stimuli to encourage participants to talk about their ideas. These tasks are particularly useful for exploring topics that may be difficult to discuss in formal interviews, such as those that involve sensitive issues or rely on tacit knowledge. Elicitation…

Fire in the Earth system.

PubMed

Bowman, David M J S; Balch, Jennifer K; Artaxo, Paulo; Bond, William J; Carlson, Jean M; Cochrane, Mark A; D'Antonio, Carla M; Defries, Ruth S; Doyle, John C; Harrison, Sandy P; Johnston, Fay H; Keeley, Jon E; Krawchuk, Meg A; Kull, Christian A; Marston, J Brad; Moritz, Max A; Prentice, I Colin; Roos, Christopher I; Scott, Andrew C; Swetnam, Thomas W; van der Werf, Guido R; Pyne, Stephen J

2009-04-24

Fire is a worldwide phenomenon that appears in the geological record soon after the appearance of terrestrial plants. Fire influences global ecosystem patterns and processes, including vegetation distribution and structure, the carbon cycle, and climate. Although humans and fire have always coexisted, our capacity to manage fire remains imperfect and may become more difficult in the future as climate change alters fire regimes. This risk is difficult to assess, however, because fires are still poorly represented in global models. Here, we discuss some of the most important issues involved in developing a better understanding of the role of fire in the Earth system.

Fire in the Earth system

USGS Publications Warehouse

Bowman, David M.J.S.; Balch, Jennifer; Artaxo, Paulo; Bond, William J.; Carlson, Jean M.; Cochrane, Mark A.; D'Antonio, Carla M.; DeFries, Ruth S.; Doyle, John C.; Harrison, Sandy P.; Johnston, Fay H.; Keeley, Jon E.; Krawchuk, Meg A.; Kull, Christian A.; Marston, J. Brad; Moritz, Max A.; Prentice, I. Colin; Roos, Christopher I.; Scott, Andrew C.; Swetnam, Thomas W.; van der Werf, Guido R.; Pyne, Stephen

2009-01-01

Fire is a worldwide phenomenon that appears in the geological record soon after the appearance of terrestrial plants. Fire influences global ecosystem patterns and processes, including vegetation distribution and structure, the carbon cycle, and climate. Although humans and fire have always coexisted, our capacity to manage fire remains imperfect and may become more difficult in the future as climate change alters fire regimes. This risk is difficult to assess, however, because fires are still poorly represented in global models. Here, we discuss some of the most important issues involved in developing a better understanding of the role of fire in the Earth system.

Avoiding failure: tools for successful and sustainable quality-improvement projects.

PubMed

Donnelly, Lane F

2017-06-01

Involvement in successful and sustained quality improvement can be a very rewarding experience. However, it can be very difficult work. Up to 70% of attempted organizational change is not sustained. There are many reasons why quality-improvement projects might not be successful. In this article, the author reviews items associated with an increased or decreased likelihood of success. Such items have been categorized as structural issues, human issues and environmental context. This paper is intended to serve those embarking on quality-improvement projects as a resource to help position them for success.

Active Bodies/Active Brains: The Relationship between Physical Engagement and Children's Brain Development

ERIC Educational Resources Information Center

Stevens-Smith, Deborah A.

2016-01-01

Educators often struggle daily with the issue of how to engage students for learning. Many instructional strategies are devoted to the concept of engagement to keep students interested and on task to enhance learning, but defining the term is difficult. Engagement may involve a combination of terms that relates to the effort of students when they…

A Fair Play Unit for Elementary School: Getting the Whole School Involved

ERIC Educational Resources Information Center

Johnson, Lynn V.

2005-01-01

Teaching elementary aged students about the importance of fair play and being a good sport is becoming a much more difficult task. Professional athletes, once touted as positive role models, have become increasingly poor examples for children. So, while physical educators often deal with issues of fair play in their classes, it has become a larger…

Studying the relationship between dreaming and sleep-dependent memory processes: methodological challenges.

PubMed

Schredl, Michael

2013-12-01

The hypothesis that dreaming is involved in off-line memory processing is difficult to test because major methodological issues have to be addressed, such as dream recall and the effect of remembered dreams on memory. It would be fruitful--in addition to studying the ancient art of memory (AAOM) in a scanner--to study the dreams of persons who use AAOM regularly.

Parallel software support for computational structural mechanics

NASA Technical Reports Server (NTRS)

Jordan, Harry F.

1987-01-01

The application of the parallel programming methodology known as the Force was conducted. Two application issues were addressed. The first involves the efficiency of the implementation and its completeness in terms of satisfying the needs of other researchers implementing parallel algorithms. Support for, and interaction with, other Computational Structural Mechanics (CSM) researchers using the Force was the main issue, but some independent investigation of the Barrier construct, which is extremely important to overall performance, was also undertaken. Another efficiency issue which was addressed was that of relaxing the strong synchronization condition imposed on the self-scheduled parallel DO loop. The Force was extended by the addition of logical conditions to the cases of a parallel case construct and by the inclusion of a self-scheduled version of this construct. The second issue involved applying the Force to the parallelization of finite element codes such as those found in the NICE/SPAR testbed system. One of the more difficult problems encountered is the determination of what information in COMMON blocks is actually used outside of a subroutine and when a subroutine uses a COMMON block merely as scratch storage for internal temporary results.

Unique topics and issues in rheumatology and clinical immunology.

PubMed

Selmi, Carlo

2014-08-01

Clinicians are facing unexpected issues in everyday practice, and these may become counterintuitive or challenging. Illustrative examples are provided by the hypersensitivity to universally used immunosuppressants such as corticosteroids or antibiotics such as beta-lactam. Secondly, additional issues are represented by the discovery of new pathogenetic mechanisms involved in rheumatoid and psoriatic arthritis or other chronic inflammatory diseases, genomic susceptibility to enigmatic diseases such as giant cell arteritis, or the shared role of specific mediators such as semaphorins. Third, the therapeutic armamentarium has dramatically changed over the past decade following the introduction of biotechnological drugs, and new mechanisms are being proposed to reduce adverse events or increase the drug effectiveness, particularly on cardiovascular comorbidities. Finally, rare diseases continue to represent difficult cases, as for Cogan's syndrome, with limited literature available for clinical recommendations. For these reason, the present issue of Clinical Reviews in Allergy and Immunology is timely and dedicated to these and other unique topics in clinical immunology and allergy. The aim of this issue is thus to help clinicians involved in internal medicine as well as allergists and clinical immunologists while discussing new pathways that will prove important in the near future.

Discussion of Extinction-Based Behavioral Sleep Interventions for Young Children and Reasons Why Parents May Find Them Difficult

PubMed Central

Etherton, Hayley; Blunden, Sarah; Hauck, Yvonne

2016-01-01

The majority of behavioral sleep interventions for young children involve extinction procedures where parents must ignore their child's cries for a period. Many parents have difficulties with this, contributing to attrition, non-compliance, and treatment avoidance. Yet why these methods are difficult to implement has rarely been addressed in the literature. This paper discusses seven potential reasons why parents may find extinction sleep interventions difficult: enduring crying, practical considerations, fear of repercussions, misinformation, incongruence with personal beliefs, different cultural practices, and parent wellness. These reasons are discussed in relation to the current literature. Practicing health professionals and sleep researchers could benefit from an awareness of these issues when suggesting extinction interventions and offering alternatives which may be more appropriate for family circumstances and facilitate parental informed choice. Citation: Etherton H, Blunden S, Hauck Y. Discussion of extinction-based behavioral sleep interventions for young children and reasons why parents may find them difficult. J Clin Sleep Med 2016;12(11):1535–1543. PMID:27655457

Doing the Scut Work of Infant Care: Does Religiousness Encourage Father Involvement?

PubMed

Demaris, Alfred; Mahoney, Annette; Pargament, Kenneth I

2011-04-01

Considerable debate exists regarding whether religiousness promotes or impedes greater father involvement in parenting. Our study addresses this issue using a Midwestern longitudinal dataset that tracks the transition to first parenthood for 169 married couples. We focus on performance of the "messier" tasks of infant care. We find little evidence that religiousness enhances father involvement in this domain. Biblically conservative couples exhibit a greater gender gap in childcare than others, with mothers more involved than fathers. The gender gap is also greater the more fathers work outside the home, the greater mothers' knowledge of infant development, and the more unadaptable the infant. Average daily childcare is lower the greater spouses' work hours, but higher with difficult pregnancies or fussy babies.

Doing the Scut Work of Infant Care: Does Religiousness Encourage Father Involvement?

PubMed Central

DeMaris, Alfred; Mahoney, Annette; Pargament, Kenneth I.

2011-01-01

Considerable debate exists regarding whether religiousness promotes or impedes greater father involvement in parenting. Our study addresses this issue using a Midwestern longitudinal dataset that tracks the transition to first parenthood for 169 married couples. We focus on performance of the “messier” tasks of infant care. We find little evidence that religiousness enhances father involvement in this domain. Biblically conservative couples exhibit a greater gender gap in childcare than others, with mothers more involved than fathers. The gender gap is also greater the more fathers work outside the home, the greater mothers’ knowledge of infant development, and the more unadaptable the infant. Average daily childcare is lower the greater spouses’ work hours, but higher with difficult pregnancies or fussy babies. PMID:21966024

An efficient and accurate solution methodology for bilevel multi-objective programming problems using a hybrid evolutionary-local-search algorithm.

PubMed

Deb, Kalyanmoy; Sinha, Ankur

2010-01-01

Bilevel optimization problems involve two optimization tasks (upper and lower level), in which every feasible upper level solution must correspond to an optimal solution to a lower level optimization problem. These problems commonly appear in many practical problem solving tasks including optimal control, process optimization, game-playing strategy developments, transportation problems, and others. However, they are commonly converted into a single level optimization problem by using an approximate solution procedure to replace the lower level optimization task. Although there exist a number of theoretical, numerical, and evolutionary optimization studies involving single-objective bilevel programming problems, not many studies look at the context of multiple conflicting objectives in each level of a bilevel programming problem. In this paper, we address certain intricate issues related to solving multi-objective bilevel programming problems, present challenging test problems, and propose a viable and hybrid evolutionary-cum-local-search based algorithm as a solution methodology. The hybrid approach performs better than a number of existing methodologies and scales well up to 40-variable difficult test problems used in this study. The population sizing and termination criteria are made self-adaptive, so that no additional parameters need to be supplied by the user. The study indicates a clear niche of evolutionary algorithms in solving such difficult problems of practical importance compared to their usual solution by a computationally expensive nested procedure. The study opens up many issues related to multi-objective bilevel programming and hopefully this study will motivate EMO and other researchers to pay more attention to this important and difficult problem solving activity.

A Case Study Approach to Nursing Home Placement: Smooth and Difficult Cases and Implications for Nursing.

PubMed

Koplow, Sarah M; Gallo, Agatha M; Knafl, Kathleen A; Vincent, Catherine; Paun, Olimpia; Gruss, Valerie

2015-07-01

Nursing home placement is one of the most challenging aspects of the caregiving journey. A case study approach was used to understand the experiences of caregivers during the first few months following nursing home placement. Two caregivers were selected from a larger qualitative descriptive study because their experiences exemplified smooth and difficult transitions for both themselves and their older family member. The caregivers were interviewed shortly after placement and 3 months post-placement. Four major contextual issues were identified that indicated the similarities and differences between the two cases, including (a) the caregiver's relationship with the older adult during the home caregiving time and post nursing home placement, (b) the circumstances surrounding placement, (c) support systems, and (d) continued involvement in care post-placement. Nursing home staff who understand these issues and address concerns through family-centered care can ease the transition and promote successful collaborations between staff and families. Copyright 2015, SLACK Incorporated.

Discussion of Extinction-Based Behavioral Sleep Interventions for Young Children and Reasons Why Parents May Find Them Difficult.

PubMed

Etherton, Hayley; Blunden, Sarah; Hauck, Yvonne

2016-11-15

The majority of behavioral sleep interventions for young children involve extinction procedures where parents must ignore their child's cries for a period. Many parents have difficulties with this, contributing to attrition, non-compliance, and treatment avoidance. Yet why these methods are difficult to implement has rarely been addressed in the literature. This paper discusses seven potential reasons why parents may find extinction sleep interventions difficult: enduring crying, practical considerations, fear of repercussions, misinformation, incongruence with personal beliefs, different cultural practices, and parent wellness. These reasons are discussed in relation to the current literature. Practicing health professionals and sleep researchers could benefit from an awareness of these issues when suggesting extinction interventions and offering alternatives which may be more appropriate for family circumstances and facilitate parental informed choice. © 2016 American Academy of Sleep Medicine

Strengthening stakeholder involvement in health workforce governance: why we need to talk about power.

PubMed

Kuhlmann, Ellen; Burau, Viola

2018-01-01

There is now widespread agreement on the benefits of an integrated, people-centred health workforce, but the implementation of new models is difficult. We argue that we need to think about stakeholders and power, if we want to ensure change in the health workforce. We discuss these issues from a governance perspective and suggest a critical approach to stakeholder involvement as an indicator of good governance. Three models of involving stakeholders in health workforce governance can be identified: corporatist professional involvement either in a continental European model of conservative corporatism or in a Nordic model of public corporatism; managerialist and market-centred involvement of professions as organizational agents; and a more inclusive, network-based involvement of plural professional experts at different levels of governance. The power relations embedded in these models of stakeholder involvement have different effects on capacity building for an integrated health workforce.

Social media and social work education: understanding and dealing with the new digital world.

PubMed

Fang, Lin; Mishna, Faye; Zhang, Vivian F; Van Wert, Melissa; Bogo, Marion

2014-10-01

Accompanying the multiple benefits and innovations of social media are the complex ethical and pedagogical issues that challenge social work educators. Without a clear understanding of the blurred boundaries between public and private, the potentially limitless and unintended audiences, as well as the permanency of the information shared online, social work students who use social media can find themselves in difficult situations in their personal and professional lives. In this article, we present three scenarios that illustrate issues and complexities involving social media use by social work students, followed by a discussion and recommendations for social work educators.

Hydropower Modeling Challenges

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

Stoll, Brady; Andrade, Juan; Cohen, Stuart

Hydropower facilities are important assets for the electric power sector and represent a key source of flexibility for electric grids with large amounts of variable generation. As variable renewable generation sources expand, understanding the capabilities and limitations of the flexibility from hydropower resources is important for grid planning. Appropriately modeling these resources, however, is difficult because of the wide variety of constraints these plants face that other generators do not. These constraints can be broadly categorized as environmental, operational, and regulatory. This report highlights several key issues involving incorporating these constraints when modeling hydropower operations in terms of production costmore » and capacity expansion. Many of these challenges involve a lack of data to adequately represent the constraints or issues of model complexity and run time. We present several potential methods for improving the accuracy of hydropower representation in these models to allow for a better understanding of hydropower's capabilities.« less

Neuro-prosthetic interplay. Comment on "Hand synergies: Integration of robotics and neuroscience for understanding the control of biological and artificial hands" by M. Santello et al.

NASA Astrophysics Data System (ADS)

Schieber, Marc H.

2016-07-01

Control of the human hand has been both difficult to understand scientifically and difficult to emulate technologically. The article by Santello and colleagues in the current issue of Physics of Life Reviews[1] highlights the accelerating pace of interaction between the neuroscience of controlling body movement and the engineering of robotic hands that can be used either autonomously or as part of a motor neuroprosthesis, an artificial body part that moves under control from a human subject's own nervous system. Motor neuroprostheses typically involve a brain-computer interface (BCI) that takes signals from the subject's nervous system or muscles, interprets those signals through a decoding algorithm, and then applies the resulting output to control the artificial device.

Public health decisions: Actions and consequences☆

PubMed Central

Pohl, H.R.; Jones, D.E.; Holler, J.S.; Murray, H.E.

2017-01-01

The goal of public health is to promote the best possible health for the whole population. Public health issues are numerous and can be unbelievably complex in form, scope, and possible consequence. Most public health decisions involve assessing several different options, weighing the respective benefits and risks of those options, and making difficult decisions that hopefully provide the greatest benefit to the affected populations. Many risk management decisions involve a variety of societal factors which modify risk assessment choices. The purpose of this paper is to point out difficulties in making decisions that impact public health. The intent of such decisions is to improve public health, but as illustrated in the paper, there can be unintended adverse consequences. Such unplanned issues require continued attention and efforts for responsible officials in the protection of environmental public health. This article presents examples of such events, when in the past, it was necessary to assess and regulate a number of potentially hazardous chemicals commonly used as insecticides, gasoline additives, and wood preservatives. PMID:25092130

Sports Medicine and Ethics

PubMed Central

Testoni, Daniela; Hornik, Christoph P.; Smith, P. Brian; Benjamin, Daniel K.; McKinney, Ross E.

2014-01-01

Physicians working in the world of competitive sports face unique ethical challenges, many of which center around conflicts of interest. Team-employed physicians have obligations to act in the club’s best interest while caring for the individual athlete. As such, they must balance issues like protecting versus sharing health information, as well as issues regarding autonomous informed consent versus paternalistic decision-making in determining whether an athlete may compete safely. Moreover, the physician has to deal with an athlete’s decisions about performance enhancement and return to play, pursuit of which may not be in the athlete’s long-term best interests but may benefit the athlete and team in the short term. These difficult tasks are complicated by the lack of evidence-based standards in a field influenced by the lure of financial gains for multiple parties involved. In this article, we review ethical issues in sports medicine with specific attention paid to American professional football. PMID:24024796

Deep and continuous palliative sedation (terminal sedation): clinical-ethical and philosophical aspects.

PubMed

Materstvedt, Lars Johan; Bosshard, Georg

2009-06-01

Terminal sedation continues to fuel debate. When confronted with a patient for whom terminal sedation is considered a possible treatment option, decision making can be difficult. In this paper we focus on the clinical-ethical issues, with an aim to provide clinicians with ways of framing the issue from an ethical point of view. In addition to the clinical-ethical issues, terminal sedation touches upon interesting and complex questions of an essentially philosophical nature. What it means to be a "person" is one such question, and is a topic that is relevant to clinical, daily practice. Accordingly, in the latter part of this paper we draw briefly on selected philosophical positions to elucidate this question. A doctor's belief of what it means to be a "person" might well affect their actions. For example, if a doctor believes terminal sedation involves the destruction of the person, they might not be willing to proceed with it.

Automated Bilateral Negotiation and Bargaining Impasse

NASA Astrophysics Data System (ADS)

Lopes, Fernando; Novais, A. Q.; Coelho, Helder

The design and implementation of autonomous negotiating agents involve the consideration of insights from multiple relevant research areas to integrate different perspectives on negotiation. As a starting point for an interdisciplinary research effort, this paper employs game-theoretic techniques to define equilibrium strategies for the bargaining game of alternating offers and formalizes a set of negotiation strategies studied in the social sciences. This paper also shifts the emphasis to negotiations that are "difficult" to resolve and can hit an impasse. Specifically, it analyses a situation where two agents bargain over the division of the surplus of several distinct issues to demonstrate how a procedure to avoid impasses can be utilized in a specific negotiation setting. The procedure is based on the addition of new issues to the agenda during the course of negotiation and the exploration of the differences in the valuation of these issues to capitalize on Pareto optimal agreements.

Sports medicine and ethics.

PubMed

Testoni, Daniela; Hornik, Christoph P; Smith, P Brian; Benjamin, Daniel K; McKinney, Ross E

2013-01-01

Physicians working in the world of competitive sports face unique ethical challenges, many of which center around conflicts of interest. Team-employed physicians have obligations to act in the club's best interest while caring for the individual athlete. As such, they must balance issues like protecting versus sharing health information, as well as issues regarding autonomous informed consent versus paternalistic decision making in determining whether an athlete may compete safely. Moreover, the physician has to deal with an athlete's decisions about performance enhancement and return to play, pursuit of which may not be in the athlete's long-term best interests but may benefit the athlete and team in the short term. These difficult tasks are complicated by the lack of evidence-based standards in a field influenced by the lure of financial gains for multiple parties involved. In this article, we review ethical issues in sports medicine with specific attention paid to American professional football.

Health impacts and research ethics in female trafficking.

PubMed

Dhital, S R; Aro, R A; Sapkota, K

2011-04-01

Female trafficking is a social and public health problem, associated with physical and sexual abuse, psychological trauma, injuries from violence, sexually transmitted infections, adverse reproductive outcomes and substance misuse. It faces several challenges ranging from the hidden nature of the problem to ethical and human rights issues. The objectives of this paper are to analyze health impact of trafficking; ethical and research issues and anti-trafficking strategies in the Nepalese context. We collected published and unpublished data assessing the public health, ethical burden and research needs from different sources. Trafficked female involved in sex-industry that face grave situation as depicted and it might a reservoir of sexually transmitted diseases. Ethical issues related to survey of assessing the burden are difficult to carry out. The best ways to prevent and control these problems are to enhance anti- trafficking laws and raise awareness, empower and mobilize females and establish organizational capacity.

Communicating Geographical Risks in Crisis Management: The Need for Research.

PubMed

French, Simon; Argyris, Nikolaos; Haywood, Stephanie M; Hort, Matthew C; Smith, Jim Q

2017-10-23

In any crisis, there is a great deal of uncertainty, often geographical uncertainty or, more precisely, spatiotemporal uncertainty. Examples include the spread of contamination from an industrial accident, drifting volcanic ash, and the path of a hurricane. Estimating spatiotemporal probabilities is usually a difficult task, but that is not our primary concern. Rather, we ask how analysts can communicate spatiotemporal uncertainty to those handling the crisis. We comment on the somewhat limited literature on the representation of spatial uncertainty on maps. We note that many cognitive issues arise and that the potential for confusion is high. We note that in the early stages of handling a crisis, the uncertainties involved may be deep, i.e., difficult or impossible to quantify in the time available. In such circumstance, we suggest the idea of presenting multiple scenarios. © 2017 Society for Risk Analysis.

11 things a geologist thinks an engineer should know about carbonate beaches

USGS Publications Warehouse

Halley, R.B.; ,

2000-01-01

A review is given on the geological aspects of carbonate beaches that a geologist thinks may be useful for an engineer. Though, Geologists not involved in engineering problems may find it difficult to know what an engineer should understand about carbonate beaches. Nevertheless, there are at least eleven topics that are potentially very useful for engineers to keep in mind. This paper emits the discussions of certain kinds of carbonate shorelines that are beyond the scope of engineering issues, and focuses on sand-sized coastal carbonate deposits.

Oocyte Cryopreservation for Fertility Preservation in Healthy Women.

PubMed

Stevenson, Eleanor L; Hurt, Melissa J; Trotter, Kathryn J

Advancements in methods of fertility preservation have resulted in more options available to women seeking to postpone reproduction. Preservation of unfertilized oocytes provides women with the possibility for reproduction even after age-related declines in fertility might make conceiving a child difficult to impossible. As oocyte cryopreservation rises in popularity among women, it is crucial for nurses and other clinicians to understand the background, process, ethical issues, and risks involved to help women make informed medical decisions. © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

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

Social networking and online recruiting for HIV research: ethical challenges.

PubMed

Curtis, Brenda L

2014-02-01

Social networking sites and online advertising organizations provide HIV/AIDS researchers access to target populations, often reaching difficult-to-reach populations. However, this benefit to researchers raises many issues for the protections of prospective research participants. Traditional recruitment procedures have involved straightforward transactions between the researchers and prospective participants; online recruitment is a more complex and indirect form of communication involving many parties engaged in the collecting, aggregating, and storing of research participant data. Thus, increased access to online data has challenged the adequacy of current and established procedures for participants' protections, such as informed consent and privacy/confidentiality. Internet-based HIV/AIDS research recruitment and its ethical challenges are described, and research participant safeguards and best practices are outlined.

Social Networking and Online Recruiting for HIV Research: Ethical Challenges

PubMed Central

Curtis, Brenda L.

2015-01-01

Social networking sites and online advertising organizations provide HIV/AIDS researchers access to target populations, often reaching difficult-to-reach populations. However, this benefit to researchers raises many issues for the protections of prospective research participants. Traditional recruitment procedures have involved straightforward transactions between the researchers and prospective participants; online recruitment is a more complex and indirect form of communication involving many parties engaged in the collecting, aggregating, and storing of research participant data. Thus, increased access to online data has challenged the adequacy of current and established procedures for participants’ protections, such as informed consent and privacy/confidentiality. Internet-based HIV/AIDS research recruitment and its ethical challenges are described, and research participant safeguards and best practices are outlined. PMID:24572084

The Difficult Patron in the Academic Library: Problem Issues or Problem Patrons?

ERIC Educational Resources Information Center

Simmonds Patience L.; Ingold, Jane L.

2002-01-01

Identifies difficult patron issues in academic libraries from the librarians' perspectives and offers solutions to try and prevent them from becoming problems. Topics include labeling academic library users; eliminating sources of conflict between faculty and library staff; and conflicts between students and library staff. (Author/LRW)

Comments of statistical issue in numerical modeling for underground nuclear test monitoring

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

Nicholson, W.L.; Anderson, K.K.

1993-03-01

The Symposium concluded with prepared summaries by four experts in the involved disciplines. These experts made no mention of statistics and/or the statistical content of issues. The first author contributed an extemporaneous statement at the Symposium because there are important issues associated with conducting and evaluating numerical modeling that are familiar to statisticians and often treated successfully by them. This note expands upon these extemporaneous remarks. Statistical ideas may be helpful in resolving some numerical modeling issues. Specifically, we comment first on the role of statistical design/analysis in the quantification process to answer the question ``what do we know aboutmore » the numerical modeling of underground nuclear tests?`` and second on the peculiar nature of uncertainty analysis for situations involving numerical modeling. The simulations described in the workshop, though associated with topic areas, were basically sets of examples. Each simulation was tuned towards agreeing with either empirical evidence or an expert`s opinion of what empirical evidence would be. While the discussions were reasonable, whether the embellishments were correct or a forced fitting of reality is unclear and illustrates that ``simulation is easy.`` We also suggest that these examples of simulation are typical and the questions concerning the legitimacy and the role of knowing the reality are fair, in general, with respect to simulation. The answers will help us understand why ``prediction is difficult.``« less

Managing the Difficult Child.

ERIC Educational Resources Information Center

Murphy, Linda; Della Corte, Suzanne

1990-01-01

This newsletter issue focuses on ways parents can manage the difficult child with special needs. Characteristics of the difficult child are listed including poor listening skills, irritableness, impulsivity, and tendency to have tantrums. Typical reactions to the difficult child by parents, siblings, other relatives, neighbors, the school, and…

A model for educational feedback based on clinical communication skills strategies: beyond the "feedback sandwich".

PubMed

Milan, Felise B; Parish, Sharon J; Reichgott, Michael J

2006-01-01

Feedback is an essential tool in medical education, and the process is often difficult for both faculty and learner. There are strong analogies between the provision of educational feedback and doctor-patient communication during the clinical encounter. Relationship-building skills used in the clinical setting-Partnership, Empathy, Apology, Respect, Legitimation, Support (PEARLS)-can establish trust with the learner to better manage difficult feedback situations involving personal issues, unprofessional behavior, or a defensive learner. Using the stage of readiness to change (transtheoretical) model, the educator can "diagnose" the learner's stage of readiness and employ focused interventions to encourage desired changes. This approach has been positively received by medical educators in faculty development workshops. A model for provision of educational feedback based on communication skills used in the clinical encounter can be useful in the medical education setting. More robust evaluation of the construct validity is required in actual training program situations.

Evaluating taboo trade-offs in ecosystems services and human well-being.

PubMed

Daw, Tim M; Coulthard, Sarah; Cheung, William W L; Brown, Katrina; Abunge, Caroline; Galafassi, Diego; Peterson, Garry D; McClanahan, Tim R; Omukoto, Johnstone O; Munyi, Lydiah

2015-06-02

Managing ecosystems for multiple ecosystem services and balancing the well-being of diverse stakeholders involves different kinds of trade-offs. Often trade-offs involve noneconomic and difficult-to-evaluate values, such as cultural identity, employment, the well-being of poor people, or particular species or ecosystem structures. Although trade-offs need to be considered for successful environmental management, they are often overlooked in favor of win-wins. Management and policy decisions demand approaches that can explicitly acknowledge and evaluate diverse trade-offs. We identified a diversity of apparent trade-offs in a small-scale tropical fishery when ecological simulations were integrated with participatory assessments of social-ecological system structure and stakeholders' well-being. Despite an apparent win-win between conservation and profitability at the aggregate scale, food production, employment, and well-being of marginalized stakeholders were differentially influenced by management decisions leading to trade-offs. Some of these trade-offs were suggested to be "taboo" trade-offs between morally incommensurable values, such as between profits and the well-being of marginalized women. These were not previously recognized as management issues. Stakeholders explored and deliberated over trade-offs supported by an interactive "toy model" representing key system trade-offs, alongside qualitative narrative scenarios of the future. The concept of taboo trade-offs suggests that psychological bias and social sensitivity may exclude key issues from decision making, which can result in policies that are difficult to implement. Our participatory modeling and scenarios approach has the potential to increase awareness of such trade-offs, promote discussion of what is acceptable, and potentially identify and reduce obstacles to management compliance.

History Museums and Social Cohesion: Building Identity, Bridging Communities, and Addressing Difficult Issues

ERIC Educational Resources Information Center

Rosenberg, Tracy Jean

2011-01-01

Museums have the capacity to enhance social cohesion, which is the product of a trusting, connected community. History museums and historic sites, in particular, can serve communities by stimulating dialogue on difficult issues, accurately representing all the people of a nation, and creating forums for discussion among groups with disparate…

Recruiting patients to clinical trials: lessons from studies of growth hormone treatment in renal failure.

PubMed

Postlethwaite, R J; Reynolds, J M; Wood, A J; Evans, J H; Lewis, M A; Eminson, D M

1995-07-01

Issues raised by the recruitment of children to trials of growth hormone treatment for short stature in chronic renal failure are reported. Information needs of parents and children are discussed, the latter should take account of the children's developmental level and anticipated involvement in decision making. When the incidence of certain side effects is low and probably unquantifiable there are particular problems; failure to include these in information sheets may compromise informed consent but inclusion will, at least for some families, make an already difficult decision even more complicated. A process of recruitment is described which attempts to protect against bias and which balances the requirement to impart neutral information with appropriate clinical involvement in the decision to enter the study. Other functions of the recruitment process are identified. Analysis of understanding and decision making demonstrates that good understanding is neither necessary nor sufficient for ease of decision making. The recruitment process was time consuming and needs planning and funding in future studies. Many of these issues are of general importance for trials of treatment in children.

Use of interpreters in individual psychotherapy.

PubMed

Baxter, H; Cheng, L Y

1996-02-01

This paper was written after one of the authors treated a case by individual therapy using an interpreter, as patient and therapist spoke different languages. There is little literature on this subject, and this paper describes our findings and recommendations for using this approach. A 15-year-old Chinese, Cantonese-speaking in-patient in Hong Kong was treated with individual psychodynamic psychotherapy by an English-speaking Caucasian psychotherapist. The Chinese interpreter attended each session, and therapy was supervised by a bilingual Chinese supervisor. The alternative was to not carry out any therapy, as there was no other therapist available. The patient was treated for a total of 32 sessions. Issues involving language and culture differences between therapist and patient, issues of therapy in a triadic situation involving group dynamics, and specific therapy difficulties raised by the presence of the interpreter are discussed. Therapy was not as effective as hoped, but the patient made some improvements. Finding a suitable interpreter is difficult and their role must be well defined. A bilingual supervisor is also needed to monitor the translation as well as supervising the therapist. Psychotherapy through an interpreter is feasible but not ideal.

Commercial fishing industry deaths - forensic issues.

PubMed

Byard, Roger W

2013-04-01

The commercial fishing industry has one of the highest injury and mortality rates of all occupational areas. This results from the nature of the work involving vessels often manned by only a few individuals who are working with heavy-duty equipment in dangerous environments at all hours. Economic pressures may force inappropriately geared vessels to operate further out to sea than is safe. Deaths result from a wide variety of situations involving vessel loss, falls overboard, fire and explosions, cable entanglements and gas exposure. Autopsies are often difficult as there are no diagnostic features of either drowning or hypothermia and features may be obscured by putrefaction and postmortem animal predation. The forensic implications of deaths in the fishing industry are reviewed. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

The Crisis Manual for Early Childhood Teachers: How To Handle the Really Difficult Problems.

ERIC Educational Resources Information Center

Miller, Karen

More and more teachers report the increasing incidence of crises in children's lives, crises that interfere with the child's ability to learn. Noting that developmentally appropriate curricula must respond to the issues of immediate concern and interest to children, this source book assists teachers in facing difficult issues in the classroom and…

Green College lectures. The responsibility of the doctor.

PubMed

Havard, J D

1989-08-19

Havard's theme is that there are situations in which the medical profession's concept of its responsibility to patients and to society may come into conflict with the law. Havard illustrates this theme with examples of consent issues, torture, and confidentiality. Among the consent issues he discusses are legal standards for disclosure, consent by and for minors and the mentally handicapped, and police requests for physician cooperation in obtaining forensic samples. Havard's discussion of torture concludes that physicians are individually responsible for taking a firm stand against any involvement that may cause harm to persons in detention. His overview of medical confidentiality is critical of England's Law Reform and Criminal Law Revision Committees, and includes the observation that "it would be difficult to name a democracy in the Western world that pays less respect to confidential medical information than the United Kingdom."

Policies for implementing network firewalls

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

Brown, C.D.

1994-05-01

Corporate networks are frequently protected by {open_quotes}firewalls{close_quotes} or gateway systems that control access to/from other networks, e.g., the Internet, in order to reduce the network`s vulnerability to hackers and other unauthorized access. Firewalls typically limit access to particular network nodes and application protocols, and they often perform special authentication and authorization functions. One of the difficult issues associated with network firewalls is determining which applications should be permitted through the firewall. For example, many networks permit the exchange of electronic mail with the outside but do not permit file access to be initiated by outside users, as this might allowmore » outside users to access sensitive data or to surreptitiously modify data or programs (e.g., to intall Trojan Horse software). However, if access through firewalls is severely restricted, legitimate network users may find it difficult or impossible to collaborate with outside users and to share data. Some of the most serious issues regarding firewalls involve setting policies for firewalls with the goal of achieving an acceptable balance between the need for greater functionality and the associated risks. Two common firewall implementation techniques, screening routers and application gateways, are discussed below, followed by some common policies implemented by network firewalls.« less

Evaluating taboo trade-offs in ecosystems services and human well-being

PubMed Central

Coulthard, Sarah; Cheung, William W. L.; Brown, Katrina; Abunge, Caroline; Galafassi, Diego; Peterson, Garry D.; McClanahan, Tim R.; Omukoto, Johnstone O.; Munyi, Lydiah

2015-01-01

Managing ecosystems for multiple ecosystem services and balancing the well-being of diverse stakeholders involves different kinds of trade-offs. Often trade-offs involve noneconomic and difficult-to-evaluate values, such as cultural identity, employment, the well-being of poor people, or particular species or ecosystem structures. Although trade-offs need to be considered for successful environmental management, they are often overlooked in favor of win-wins. Management and policy decisions demand approaches that can explicitly acknowledge and evaluate diverse trade-offs. We identified a diversity of apparent trade-offs in a small-scale tropical fishery when ecological simulations were integrated with participatory assessments of social–ecological system structure and stakeholders’ well-being. Despite an apparent win-win between conservation and profitability at the aggregate scale, food production, employment, and well-being of marginalized stakeholders were differentially influenced by management decisions leading to trade-offs. Some of these trade-offs were suggested to be “taboo” trade-offs between morally incommensurable values, such as between profits and the well-being of marginalized women. These were not previously recognized as management issues. Stakeholders explored and deliberated over trade-offs supported by an interactive “toy model” representing key system trade-offs, alongside qualitative narrative scenarios of the future. The concept of taboo trade-offs suggests that psychological bias and social sensitivity may exclude key issues from decision making, which can result in policies that are difficult to implement. Our participatory modeling and scenarios approach has the potential to increase awareness of such trade-offs, promote discussion of what is acceptable, and potentially identify and reduce obstacles to management compliance. PMID:26038547

Reunification: keeping families together in crisis.

PubMed

Blake, Nancy; Stevenson, Kathleen

2009-08-01

In reviewing the literature, there has not been a family reunification plan that has worked consistently during disasters. During Hurricane Katrina, there were children who were sent to a shelter in a different state than their patients. When children are involved, the issues become even more difficult, because some children who are preverbal cannot tell their names or their parents names. Tracking systems have been developed but are not interoperable. No central repository has been developed. There are also issues related to transporting patients, psychosocial issues as well as safety issues that are different when children will be unaccompanied by an adult. Two national meetings were held with experts from all over the country who have an expertise in the care of children. Six focused groups were identified: patient movement/transportation; technology/tracking; clinical issues, nonmedical issues; communication/regulatory issues; and pediatric psychosocial support. The second meeting was a consensus conference. Recommendations from each subgroup were presented and voted on. All recommendations were accepted. The issue of reunification of families in disaster is still a problem. Further work needs to be done on tracking systems that are interoperable before another large disaster strike, pediatric psychological issues after a disaster, transporting patients, and care of the pediatric patient who is not accompanied by an adult. Once a system has been developed, the system needs to be tested by large scale drills that practice moving children across state lines and from one area to another.

Critical issues in telemedicine.

PubMed

Bashshur, R L

1997-01-01

Critical issues facing the development of telemedicine today are described and analyzed as dilemmas or paradoxes. The technological dilemma involves the difficult choice between using the latest technology regardless of how well it fits specific needs on the one hand, and the reluctance to capitalize on the available technological capability to create efficient and effective organizations for expanding the reach of health care on the other hand. The evaluation paradox points to the disjuncture between policy making requirements and the scientific enterprise. This engenders the difficulty of producing scientifically valid and policy relevant results from programs that have not achieved maturity or a steady state of operation. The contextual hazards of limiting the scope of telemedicine to rural areas are discussed, as well as the potential for creating a second tier of care for the remote and isolated populations. Finally, professional maturation is addressed as it underscores the importance of self regulation and control.

Epistemic uncertainties and natural hazard risk assessment - Part 1: A review of the issues

NASA Astrophysics Data System (ADS)

Beven, K. J.; Aspinall, W. P.; Bates, P. D.; Borgomeo, E.; Goda, K.; Hall, J. W.; Page, T.; Phillips, J. C.; Rougier, J. T.; Simpson, M.; Stephenson, D. B.; Smith, P. J.; Wagener, T.; Watson, M.

2015-12-01

Uncertainties in natural hazard risk assessment are generally dominated by the sources arising from lack of knowledge or understanding of the processes involved. There is a lack of knowledge about frequencies, process representations, parameters, present and future boundary conditions, consequences and impacts, and the meaning of observations in evaluating simulation models. These are the epistemic uncertainties that can be difficult to constrain, especially in terms of event or scenario probabilities, even as elicited probabilities rationalized on the basis of expert judgements. This paper reviews the issues raised by trying to quantify the effects of epistemic uncertainties. Such scientific uncertainties might have significant influence on decisions that are made for risk management, so it is important to communicate the meaning of an uncertainty estimate and to provide an audit trail of the assumptions on which it is based. Some suggestions for good practice in doing so are made.

Social and Economic Considerations for Coastal and Watershed Restoration in the Puget Sound, Washington: A Literature Review

USGS Publications Warehouse

Stinchfield, Holly M.; Koontz, Lynne; Sexton, Natalie R.

2009-01-01

This literature review summarizes and synthesizes the available information regarding the impacts of socioeconomic factors on coastal and watershed restoration in the Puget Sound, Wash. Major topic areas which are explored include: institutions and restoration; beliefs, behaviors, and knowledge about restoration and the environment; stakeholder involvement in restoration, communication of restoration issues, and economic issues in restoration. The review revealed that socioeconomic factors play an important role in determining the designation, process, and success of restoration projects. Socioeconomic factors can facilitate or obstruct restoration, but few large-scale restoration projects emphasize them in either prioritization or monitoring procedures. Additionally, there are substantial gaps in the literature regarding restoration in the Puget Sound across all of the topics addressed in this review. The lack of research makes it difficult to provide a holistic view of the social and economic dimensions of restoration in the Sound but provides opportunity for future research.

Pharmacological treatment of diabetic neuropathic pain.

PubMed

Smith, Howard S; Argoff, Charles E

2011-03-26

Neuropathic pain continues to be a difficult and challenging clinical issue to deal with effectively. Painful diabetic polyneuropathy is a complex pain condition that occurs with reasonable frequency in the population and it may be extremely difficult for clinicians to provide patients with effective analgesia. Chronic neuropathic pain may occur in approximately one of every four diabetic patients. The pain may be described as burning or a deep-seated ache with sporadic paroxysms of lancinating painful exacerbations. The pain is often constant, moderate to severe in intensity, usually primarily involves the feet and generally tends to worsen at night. Treatment may be multimodal but largely involves pharmacological approaches. Pharmacological therapeutic options include antidepressants (tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors), α2δ ligands and topical (5%) lidocaine patch. Other agents may be different antiepileptic drugs (carbamazepine, lamotrigine, topiramate), topical capsaicin, tramadol and other opioids. Progress continues with respect to understanding various mechanisms that may contribute to painful diabetic neuropathy. Agents that may hold some promise include neurotrophic factors, growth factors, immunomodulators, gene therapy and poly (adenosine diphosphate-ribose) polymerase inhibitors. It is hoped that in the future clinicians will be able to assess patient pathophysiology, which may help them to match optimal therapeutic agents to target individual patient aberrant mechanisms.

Lesbian women's experiences with healthcare providers in the birthing context: a meta-ethnography.

PubMed

Dahl, Bente; Fylkesnes, Anne Margrethe; Sørlie, Venke; Malterud, Kirsti

2013-06-01

to explore research knowledge about lesbian women's experiences with health-care providers in the birthing context. a systematic search for relevant qualitative studies in selected databases identified 13 articles of sufficient quality. The findings were synthesized using a meta-ethnographic approach as described by Noblit and Hare. SYNTHESIS AND FINDINGS: issues related to covert or overt homophobia and prejudice were demonstrated and were sometimes mediated by subtle mechanisms that were difficult to understand and to manage. On the other hand, small gestures of support were described to make a huge difference. A lack of knowledge was demonstrated, contrasted by staff showing a positive and informed attitude. Disclosure was an important issue, but due to the risk involved the women demonstrated a need to be in control. Finally, being acknowledged, both as individuals and as family were considered vital. In this regard, it was essential to recognize and include co-mother as equal parent and to look upon lesbian sexuality as normal and natural. midwives' emotional involvement in the situation is significant for moral perception of the women's intimate citizenship, even when they are distressed by lesbian sexuality. our findings reveal the importance of including sexuality as an issue deserving reflection in maternity wards, whether or not this might cause unrest in midwives who do not feel comfortable with intimate citizenships beyond mainstream. Copyright © 2012 Elsevier Ltd. All rights reserved.

Transboundary environmental assessment: lessons from OTAG. The Ozone Transport Assessment Group.

PubMed

Farrell, Alexander E; Keating, Terry J

2002-06-15

The nature and role of assessments in creating policy for transboundary environmental problems is discussed. Transboundary environmental problems are particularly difficult to deal with because they typically require cooperation among independent political jurisdictions (e.g., states or nations) which face differing costs and benefits and which often have different technical capabilities and different interests. In particular, transboundary pollution issues generally involve the problem of an upstream source and a downstream receptor on opposite sides of a relevant political boundary, making it difficult for the jurisdiction containing the receptor to obtain relief from the pollution problem. The Ozone Transport Assessment Group (OTAG) addressed such a transboundary problem: the long-range transport of tropospheric ozone (i.e., photochemical smog) across the eastern United States. The evolution of the science and policy that led to OTAG, the OTAG process, and its outcomes are presented. Lessons that are available to be learned from the OTAG experience, particularly for addressing similar transboundary problems such as regional haze, are discussed.

Breaking bad news: issues relating to nursing practice.

PubMed

Warnock, Clare

2014-07-15

The breaking of bad news was traditionally regarded to be the time when a doctor and nurse sat down with a patient and family members to provide information about, for example, a life-limiting diagnosis or a poor prognosis. However, breaking bad news is now generally accepted as a process, not a one-off event, and is considered to refer to any bad, sad or difficult information that alters patients' perceptions of their present and future. Nurses have an important role in the process of providing information and helping patients prepare for, receive, understand and cope with the bad news they have been given. This article aims to help nurses understand the process of breaking bad news and discuss the challenges and difficulties that nurses can face when they are involved with patients who have been given bad news. It also provides guidance with regard to preparing for breaking bad news, giving difficult information, responding to possible reactions, and supporting patients and their relatives after they have received bad news.

Small Town Science Policy: Bringing Our Expertise Back Home

NASA Astrophysics Data System (ADS)

Larsen, K. W.

2017-12-01

Questions of science policy are more and more in the news, whether it is in regards to our nation's role in international agreements (Paris Climate Accords), the disbursement of limited research budgets, or a hundred other national issues. Influencing these decisions is a difficult, frustrating, and often ineffective endeavor. Where we can have a greater impact is by effecting change locally, either through interactions with and education of local elected officials or direct involvement in the political process. Advocating for scientifically sound policy at this level takes a different set of communication skills, but can ultimately reach a wider audience and have tangible effects.

All hazardous waste politics is local: Grass-roots advocacy and public participation in siting and cleanup decisions

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

Lowry, R.C.

1998-12-31

The combined effects of federalism and interest group pluralism pose particularly difficult problems for hazardous waste siting and cleanup decisions. Most national environmental groups have only limited involvement in local hazardous waste politics, while local grass-roots advocates have very different interests and sometimes are pitted against one another. Both the Environmental protection Agency and the Department of energy recently have begun to use site-specific citizen advisory boards at cleanup sites. This approach appears to improve communications at some sites, but does not address the issues of ``not in my back yard`` politics and alleged inequitable exposure to hazardous wastes.

Promises and challenges of stem cell research for regenerative medicine.

PubMed

Power, Carl; Rasko, John E J

2011-11-15

In recent years, stem cells have generated increasing excitement, with frequent claims that they are revolutionizing medicine. For those not directly involved in stem cell research, however, it can be difficult to separate fact from fiction or realistic expectation from wishful thinking. This article aims to provide internists with a clear and concise introduction to the field. While recounting some scientific and medical milestones, the authors discuss the 3 main varieties of stem cells-adult, embryonic, and induced pluripotent-comparing their advantages and disadvantages for clinical medicine. The authors have sought to avoid the moral and political debates surrounding stem cell research, focusing instead on scientific and medical issues.

Impact of managed care on the development of new medical technology: ethical concerns

NASA Astrophysics Data System (ADS)

Saha, Pamela; Saha, Subrata

1995-10-01

During the last three decades, development of new medical technology has been largely responsible for the spectacular advances in the diagnosis and treatment of many human diseases. This has contributed to improved medical care of our population. However, concerns have been raised that in today's managed care environment of health care, introduction of new medical technology will be difficult. Cost-sensitive health care providers should consider various ethical issues involved before demanding that only those technologies that save money and show highly positive cost benefit ratio will be reimbursed. The impact of such considerations on the innovations of new medical devices and their developments is discussed.

'Failure to fail' in nursing - A catch phrase or a real issue? A systematic integrative literature review.

PubMed

Hughes, Lynda J; Mitchell, Marion; Johnston, Amy N B

2016-09-01

'Failure to fail' is the allocation of pass grades to nursing students who do not display satisfactory clinical performance. This issue can have significant implications for individual students and assessors involved, as well as for nursing professionalism and patient safety. The aim of this systematic integrative literature review was to determine what is currently known about the issue of 'failure to fail' within undergraduate nursing programs. A literature search of five databases up to May 2015 was conducted to identify primary research papers. The search yielded 169 papers of which 24 met the inclusion criteria. The majority of papers had moderate or good methodological rigour, with most of the literature originating from the Northern Hemisphere. Five main themes emerged: failing a student is difficult; an emotional experience; confidence is required; unsafe student characteristics; and university support is required to fail students. The results suggest that 'failure to fail' is a real issue in tertiary facilities, with many complex facets. Given the costs of nurse education and the potential social and professional costs of poor quality nursing graduates, further rigorous research is required in this area. Copyright © 2016 Elsevier Ltd. All rights reserved.

Dying with Dignity: Difficult Times, Difficult Choices. A Report Presented by the Chairman of the Select Committee on Aging. House of Representatives, Ninety-Ninth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Select Committee on Aging.

This report from the Select Committee on Aging examines financial, medical, and social issues surrounding terminally ill patients with special emphasis on the elderly terminally ill. The first section discusses topics related to the medical treatment of the terminally ill. Two basic issues are important: the right to have medical treatment and the…

Mine to market: The legal issues

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

Not Available

1985-01-01

The movement of mineral products from mine to market is the fundamental objective of every mining enterprise. However, the difficult and recurring legal problems encountered in these activities have been overlooked by legal scholars, and little literature is available. The manual from the Foundation's Special Institute on Mine to Market: The Legal Issues is intended to help cure this deficiency, and will be invaluable to individuals involved in any phase of the production and sale or purchase of minerals - from negotiating an initial lease to preparing an agreement for the purchase or sale of a refined product. Included inmore » the manual are discussions of: the mining process - from severance to saleable product; marketing strategy and the lawyer - methods of selling and hedging used in the mining industry; metal markets and pricing mechanisms; the impact of the uniform commercial code on contracts for the sale of minerals and other goods; contracts for the international sale of minerals; countertrade - commercial practices, legal issues, and policy dilemmas; commercial impracticability in mineral transactions; price and payment terms in mineral agreements; and mineral sales and processing agreements.« less

A consistent course of events or a series of coincidences: nursing in Poland from the 19(th) to the 21(st) century.

PubMed

Majda, Anna; Ziarko, Ewa; Zalewska-Puchała, Joanna

2015-12-01

The development of nursing began in Poland much later than it did elsewhere, for instance in the United Kingdom, the United States, or Germany, and it came up against difficult conditions. After a brief twenty-year period of development between 1918 and 1939, it almost stalled during the war (1939-45), only to be followed by nearly twenty years of chaos. Nursing started to come out of this difficult period at the beginning of the 1960s. The turn of the 21st century saw the emergence of extensive professional development and training opportunities for nurses. This change was brought about as much by political, social and economic issues, health care requirements, and the advancement of science, medicine, the birth of humanitarism, the growth of the feminist movement, the European Agreement on the Instruction and Education of Nurses, the WHO European Strategy for Nursing and Midwifery Education, the Bologna declaration, as well as the activities undertaken by the European Union, the International Council of Nurses, the American and Polish Red Cross, the Rockefeller Foundation, the Polish Association of Nurses, and the professional self-governing body. The transformation of nursing into an independent profession was further boosted by physicians deeply involved in the issue and female pioneers of nursing. © 2015 John Wiley & Sons Ltd.

Strategies to enhance patient recruitment and retention in research involving patients with a first episode of mental illness.

PubMed

Furimsky, Ivana; Cheung, Amy H; Dewa, Carolyn S; Zipursky, Robert B

2008-11-01

Recruitment and retention of research participants is often the most labor-intensive and difficult component of clinical trials. Poor recruitment and retention frequently pose as a major barrier in the successful completion of clinical trials. In fact, many studies are prematurely terminated, or their findings questioned due to low recruitment and retention rates. The conduct of clinical trials involving youth with a first episode of mental illness comes with additional challenges in recruitment and retention including barriers associated with engagement and family involvement. To develop effective early interventions for first episode mental illness, it is necessary to develop strategies to enhance recruitment and retention in this patient population. This article presents the recruitment and retention challenges experienced in two clinical trials: one involving participants experiencing a first episode of depression and one involving participants experiencing a first episode psychosis. Challenges with recruitment and retention are identified and reviewed at both the patient level and clinician level. Strategies that were implemented to enhance recruitment and retention in these two studies are also discussed. Finally, ethical issues to consider when implementing these strategies are also highlighted.

Community resilience and volcano hazard: the eruption of Tungurahua and evacuation of the faldas in Ecuador.

PubMed

Tobin, Graham A; Whiteford, Linda M

2002-03-01

Official response to explosive volcano hazards usually involves evacuation of local inhabitants to safe shelters. Enforcement is often difficult and problems can be exacerbated when major eruptions do not ensue. Families are deprived of livelihoods and pressure to return to hazardous areas builds. Concomitantly, prevailing socio-economic and political conditions limit activities and can influence vulnerability. This paper addresses these issues, examining an ongoing volcano hazard (Tungurahua) in Ecuador where contextual realities significantly constrain responses. Fieldwork involved interviewing government officials, selecting focus groups and conducting surveys of evacuees in four locations: a temporary shelter, a permanent resettlement, with returnees and with a control group. Differences in perceptions of risk and health conditions, and in the potential for economic recovery were found among groups with different evacuation experiences. The long-term goal is to develop a model of community resilience in long-term stress environments.

Disorganizing experiences in second- and third-generation holocaust survivors.

PubMed

Scharf, Miri; Mayseless, Ofra

2011-11-01

Second-generation Holocaust survivors might not show direct symptoms of posttraumatic stress disorder or attachment disorganization, but are at risk for developing high levels of psychological distress. We present themes of difficult experiences of second-generation Holocaust survivors, arguing that some of these aversive experiences might have disorganizing qualities even though they do not qualify as traumatic. Based on in-depth interviews with 196 second-generation parents and their adolescent children, three themes of disorganizing experiences carried across generations were identified: focus on survival issues, lack of emotional resources, and coercion to please the parents and satisfy their needs. These themes reflect the frustration of three basic needs: competence, relatedness, and autonomy, and this frustration becomes disorganizing when it involves stability, potency, incomprehensibility, and helplessness. The findings shed light on the effect of trauma over the generations and, as such, equip therapists with a greater understanding of the mechanisms involved.

Power system characteristics for more electric aircraft

NASA Technical Reports Server (NTRS)

Hansen, Irving G.

1993-01-01

It should not be suprising that more electric aircraft must meet significantly more difficult electrical power system requirements than were considereed when today's power distribution systems were being developed. Electric power, no longer a secondary system, will become a critical element of the primary control system. Functional reliability requiirements will be extremely stringent and can only be met by controlling element redundancy within a distributed power system. Existing electrical systems were not developed to have both the power system and the control/sensing elements distributed and yet meet the requirements of lighting tolerance and high intensity radio frequency (HIRF). In addition, the operation of electric actuators involves high transient loading and reverse energy flows. Such phenomena were also not anticipated when power quality was specified for either 270 vdc or 400 Hertz ac power systems. This paper will expand upon the issues and discuss some of the technologies involved in their resolution.

End-of-life issues: difficult decisions and dealing with grief.

PubMed

Loomis, Beth

2009-06-01

People face many challenging psychosocial and spiritual issues as they approach the end of their lives, and caregivers need advice on how to help them. Choosing among treatment options, handling grief, addressing unfinished business, and coping with loss of self-sufficiency are difficult for the dying person, and caregivers must deal with surrogate decision making, raw emotions in the patient and in family members, and the caregivers' own grief. Listening and coping skills are discussed.

Access to difficult airway equipment and training for rural GP-anaesthetists in Australia: results of a 2012 survey.

PubMed

Leeuwenburg, Tim J

2012-01-01

In rural Australia, general practitioners (GPs) form the frontline for provision of medical services. Besides responsibilities for primary care via private practice, rural doctors often provide emergency and inpatient services for rural hospitals. The aim of this study was to determine access to difficult airway equipment and training among the GP-anaesthetist cadre in rural Australia. an online survey regarding availability of difficult airway equipment, access to ongoing training and inviting comments on rural anaesthesia in general. a questionnaire was distributed to rural doctors in January 2012 via membership databases of the Rural Doctors Association of Australia and state-based Rural Doctor Workforce Agencies. 293 participants identified as a GP-anaesthetist working in rural Australia (65% response rate). Of these 83% were male, 17% female with the percentage of respondents from each state concordant with the distributions indicated by the 2010 Rural Health Workforce National Minimum Dataset. closed-ended questions were quantified and open-ended questions analysed to determine issues relevant to GP-anaesthetists. Only 53% of GP-anaesthetists reported access to a difficult airway trolley or box in their facility. Lack of availability of certain airway equipment was reported among GP-anaesthetists, with very few having access to advanced intubation aids such as videolaryngoscopes or fibreoptic devices (flexible fibrescopes and/or malleable fibreoptic stylets). Open-ended questions suggested that GP-anaesthetists desired such aids to manage difficult airways. Only 79% had access to surgical airway or paediatric airway equipment. Of the respondents, 58% reported involvement in prehospital medicine but only 12% had received training in this challenging environment. A formal arrangement for prehospital responses existed for only 7% of respondents. Despite the existence of well-publicised algorithms for difficult airway management and the need for specific equipment to manage the difficult airway, Australian GP-anaesthetists report difficulty accessing essential equipment for these infrequent but life-threatening events. This is surprising in the light of recommendations from the Australian and New Zealand College of Anaesthetists. The consequences of difficulty in airway management can be catastrophic. Equipment needs must be balanced against important considerations including ease of use, initial and ongoing training, and cost. Suggestions for affordable equipment and ongoing training for rural GP-anaesthetists are made. The involvement of GP-anaesthetists in prehospital responses occurs in the absence of formal arrangements and with a dearth of training. There is scope to improve rural prehospital responses in Australia, utilising the advanced skills of GP-anaesthetists in resuscitation and airway management.

Methodological Issues in Economic Evaluations Submitted to the Pan-Canadian Oncology Drug Review (pCODR).

PubMed

Masucci, Lisa; Beca, Jaclyn; Sabharwal, Mona; Hoch, Jeffrey S

2017-12-01

Public drug plans are faced with increasingly difficult funding decisions. In Canada, the pan-Canadian Oncology Drug Review (pCODR) makes funding recommendations to the provincial and territorial drug plans responsible for cancer drugs. Assessments of the economic models submitted by pharmaceutical manufacturers are publicly reported. The main objective of this research was to identify recurring methodological issues in economic models submitted to pCODR for funding reviews. The secondary objective was to explore whether there exists any observed relationships between reported methodological issues and funding recommendations made by pCODR's expert review committee. Publicly available Economic Guidance Reports from July 2011 (inception) until June 2014 for drug reviews with a final funding recommendation (N = 34) were independently examined by two authors. Major methodological issues from each review were abstracted and grouped into nine main categories. Each issue was also categorized based on perception of the reviewer's actions to manage it. The most commonly reported issues involved costing (59% of reviews), time horizon (56%), and model structure (36%). Several types of issues were identified that usually could not be resolved, such as quality of clinical data or uncertainty with indirect comparisons. Issues with costing or choice of utility estimates could usually be addressed or explored by reviewers. No statistically significant relationship was found between any methodological issue and funding recommendations from the expert review committee. The findings provide insights that can be used by parties who submit or review economic evidence for continuous improvement and consistency in economic modeling, reporting, and decision making.

Difficult relationships between parents and physicians of children with cancer: A qualitative study of parent and physician perspectives.

PubMed

Mack, Jennifer W; Ilowite, Maya; Taddei, Sarah

2017-02-15

Previous work on difficult relationships between patients and physicians has largely focused on the adult primary care setting and has typically held patients responsible for challenges. Little is known about experiences in pediatrics and more serious illness; therefore, we examined difficult relationships between parents and physicians of children with cancer. This was a cross-sectional, semistructured interview study of parents and physicians of children with cancer at the Dana-Farber Cancer Institute and Boston Children's Hospital (Boston, Mass) in longitudinal primary oncology relationships in which the parent, physician, or both considered the relationship difficult. Interviews were audiotaped, transcribed, and subjected to a content analysis. Dyadic parent and physician interviews were performed for 29 relationships. Twenty were experienced as difficult by both parents and physicians; 1 was experienced as difficult by the parent only; and 8 were experienced as difficult by the physician only. Parent experiences of difficult relationships were characterized by an impaired therapeutic alliance with physicians; physicians experienced difficult relationships as demanding. Core underlying issues included problems of connection and understanding (n = 8), confrontational parental advocacy (n = 16), mental health issues (n = 2), and structural challenges to care (n = 3). Although problems of connection and understanding often improved over time, problems of confrontational advocacy tended to solidify. Parents and physicians both experienced difficult relationships as highly distressing. Although prior conceptions of difficult relationships have held patients responsible for challenges, this study has found that difficult relationships follow several patterns. Some challenges, such as problems of connection and understanding, offer an opportunity for healing. However, confrontational advocacy appears especially refractory to repair; special consideration of these relationships and avenues for repairing them are needed. Cancer 2017;123:675-681. © 2016 American Cancer Society. © 2016 American Cancer Society.

Exploring the role and function of trial steering committees: results of an expert panel meeting.

PubMed

Harman, Nicola L; Conroy, Elizabeth J; Lewis, Steff C; Murray, Gordon; Norrie, John; Sydes, Matt R; Lane, J Athene; Altman, Douglas G; Baigent, Colin; Bliss, Judith M; Campbell, Marion K; Elbourne, Diana; Evans, Stephen; Sandercock, Peter; Gamble, Carrol

2015-12-30

The independent oversight of clinical trials, which is recommended by the Medical Research Council (MRC) Guidelines for Good Clinical Practice, is typically provided by an independent advisory Data Monitoring Committee (DMC) and an independent executive committee, to whom the DMC makes recommendations. The detailed roles and function of this executive committee, known as the Trial Steering Committee (TSC), have not previously been studied or reviewed since those originally proposed by the MRC in 1998. An expert panel (n = 7) was convened comprising statisticians, clinicians and trial methodologists with prior TSC experience. Twelve questions about the role and responsibilities of the TSC were discussed by the panel at two full-day meetings. Each meeting was transcribed in full and the discussions were summarised. The expert panel reached agreement on the role of the TSC, to which it was accountable, the membership, the definition of independence, and the experience and training needed. The management of ethical issues, difficult/complex situations and issues the TSC should not ask the DMC to make recommendations on were more difficult to discuss without specific examples, but support existed for further work to help share issues and to provide appropriate training for TSC members. Additional topics discussed, which had not been identified by previous work relating to the DMCs but were pertinent to the role of the TSC, included the following: review of data sharing requests, indemnity, lifespan of the TSC, general TSC administration, and the roles of both the Funder and the Sponsor. This paper presents recommendations that will contribute to the revision and update of the MRC TSC terms of reference. Uncertainty remains in some areas due to the absence of real-life examples; future guidance on these issues would benefit from a repository of case studies. Notably, the role of a patient and public involvement (PPI) contributor was not discussed, and further work is warranted to explore the role of a PPI contributor in independent trial oversight.

[Knowledge and life experiences of mothers facing certain addictive behaviours in youths in the region of Tunis].

PubMed

Askri, M; Belgacem, B; Zine, I; Haddad, M; Besrour, M

2008-01-01

We surveyed 415 mothers who regularly consult primary healthcare centres about their knowledge of addictive behavior in teenagers in relation to tobacco, alcohol and drugs. Most mothers considered the teenage period difficult. Apprehension of this period increased with the educational level of the mothers. Mothers did not often discuss the issue of addiction with their children, especially related to alcohol and drugs. Nevertheless, the mothers were aware of the risks of addiction. They considered information campaigns about this topic an efficient means of prevention. About half of the mothers had experience of addictive conduct involving a family member. They resolved the problems through family help or consultation with a specialist.

Ultimate Realities: Deterministic and Evolutionary

PubMed Central

Moxley, Roy A

2007-01-01

References to ultimate reality commonly turn up in the behavioral literature as references to determinism. However, this determinism is often difficult to interpret. There are different kinds of determinisms as well as different kinds of ultimate realities for a behaviorist to consider. To clarify some of the issues involved, the views of ultimate realities are treated as falling along a continuum, with extreme views of complete indeterminism and complete determinism at either end and various mixes in between. Doing so brings into play evolutionary realities and the movement from indeterminism to determinism, as in Peirce's evolutionary cosmology. In addition, this framework helps to show how the views of determinism by B. F. Skinner and other behaviorists have shifted over time. PMID:22478489

Dynamic Control of Plans with Temporal Uncertainty

NASA Technical Reports Server (NTRS)

Morris, Paul; Muscettola, Nicola; Vidal, Thierry

2001-01-01

Certain planning systems that deal with quantitative time constraints have used an underlying Simple Temporal Problem solver to ensure temporal consistency of plans. However, many applications involve processes of uncertain duration whose timing cannot be controlled by the execution agent. These cases require more complex notions of temporal feasibility. In previous work, various "controllability" properties such as Weak, Strong, and Dynamic Controllability have been defined. The most interesting and useful Controllability property, the Dynamic one, has ironically proved to be the most difficult to analyze. In this paper, we resolve the complexity issue for Dynamic Controllability. Unexpectedly, the problem turns out to be tractable. We also show how to efficiently execute networks whose status has been verified.

Current Status and Challenges of Atmospheric Data Assimilation

NASA Astrophysics Data System (ADS)

Atlas, R. M.; Gelaro, R.

2016-12-01

The issues of modern atmospheric data assimilation are fairly simple to comprehend but difficult to address, involving the combination of literally billions of model variables and tens of millions of observations daily. In addition to traditional meteorological variables such as wind, temperature pressure and humidity, model state vectors are being expanded to include explicit representation of precipitation, clouds, aerosols and atmospheric trace gases. At the same time, model resolutions are approaching single-kilometer scales globally and new observation types have error characteristics that are increasingly non-Gaussian. This talk describes the current status and challenges of atmospheric data assimilation, including an overview of current methodologies, the difficulty of estimating error statistics, and progress toward coupled earth system analyses.

Design of a high capacity long range cargo aircraft

NASA Technical Reports Server (NTRS)

Weisshaar, Terrence A.

1994-01-01

This report examines the design of a long range cargo transport to attempt to reduce ton-mile shipping costs and to stimulate the air cargo market. This design effort involves the usual issues but must also include consideration of: airport terminal facilities; cargo loading and unloading; and defeating the 'square-cube' law to design large structures. This report reviews the long range transport design problem and several solutions developed by senior student design teams at Purdue University. The results show that it will be difficult to build large transports unless the infrastructure is changed and unless the basic form of the airplane changes so that aerodynamic and structural efficiencies are employed.

Navigating "Thorny" Issues

ERIC Educational Resources Information Center

Hutchinson, Kashema; Gilbert, Aderinsola; Malyukova, Anna

2016-01-01

In their article "Mindfulness and discussing 'thorny' issues in the classroom" Konstantinos Alexakos et al. ("Cult Stud Sci Educ," 2016. doi: 10.1007/s11422-015-9718-0) describe "thorny" issues as "difficult topics to discuss because they are more personal to some perhaps even cause pain and violence." As…

Implementing programs for chronic illness management: the case of hypertension services.

PubMed

Christianson, J B; Pietz, L; Taylor, R; Woolley, A; Knutson, D J

1997-11-01

This article describes the process by which HealthSystem Minnesota (a vertically integrated health care organization), functioning in a competitive managed care environment, has been implementing a hypertension services program. The program involves a team approach to care, with emphasis on patient participation in treatment; decentralized care delivery by nurse coordinators at primary care practice sites; ongoing training and education for patients and providers; and the continuous monitoring and evaluation of patient outcomes and satisfaction. JOB-LEVEL ISSUES: A variety of issues, such as the role and responsibilities of the nurse coordinator, became evident as the program moved towards operational status at four primary care practice sites, which prolonged the implementation period. PROCESS-LEVEL ISSUES: Issues relating to work process changes were more complicated to resolve and required, in some cases, changes in the proposed model. The most significant process-level issues related to educating physicians about the program to secure their participation and support. ORGANIZATION-LEVEL ISSUES: Such issues, which were the most difficult for program implementors to anticipate and resolve, included an organizational culture that emphasized decision making autonomy at primary practice sites. In part, the difficulty encountered in resolving organization-level issues reflected the implementors' lack of awareness of the strength or complexity of the environmental pressures facing the organization, as well as a lack of sensitivity to nuances relating to organizational culture. Two groups of hypertensive patients--at the implementation and comparison sites--will be compared with respect to satisfaction with care, clinical outcomes, and costs. Expansion of the model to patients with other chronic conditions is under consideration.

"I wish he hadn't told me that": methodological and ethical issues in social trauma and conflict research.

PubMed

Chaitin, Julia

2003-10-01

Undertaking research on individuals who have experienced social traumas, such as being a victim or perpetrator of genocides and wars, presents difficult decisions for qualitative researchers. Deciding how to deal with these issues becomes more problematic when the researcher is a member of the society in conflict. To do this work, and to work collaboratively with researchers from the other side, sensitive ways to collect data have to be chosen. Interpretations of the materials can be no less difficult: Analyses often lead to information and understandings that may be difficult for the researcher to deal with from ethical, moral, and personal standpoints, especially when he or she is a member of the society and culture under study. In this keynote address, the author explores methodological and ethical issues connected to these topics. She brings examples from her work on the Palestinian-Israeli conflict and focuses on use of the life story methodology.

Ethico-legal issues related to ovarian tissue transplantation.

PubMed

Voultsos, P; Raikos, N; Vasileiadis, N; Spiliopoulou, Ch; Tarlatzis, B

2016-07-04

Ovarian tissue transplantation (OTT) is a promising experimental method which may soon become well-established. In cases of minor oncology, where patients' fertility is seriously threatened by treatment, it may be applied as a unique fertility preservation option. OTT has a dual nature ('organ' and 'gamete'). Many stakeholders are involved, including donor, recipient, child, health-care providers and society at large. There is considerable uncertainty about the long-term consequences of the application of OTT and OT cryopreservation (OTC). Thus, application of OTT gives rise to a number of very different ethico-legal issues and dilemmas which are hard to solve coherently through a principlism-based bioethical approach. This study focuses on such dilemmas and attempts to review them. The role of virtue ethics, which may be combined with principlism, is essential to solve such dilemmas coherently and reasonably. Dealing with conflicts of ethical principles equivalent between them, or moral dilemmas without available answers and mind-sharing in a difficult interpersonal process of decision making, requires a virtue-based ethical approach. Besides, ethico-legal issues related to OTC/OTT are complex issues requiring a multidisciplinary approach (ethical considerations, medical, psychological and social evaluations etc.). We stress the crucial role of multidisciplinary Ethics Committee which is considered indispensable for each reproductive health-care unit practicing OTC/OTT. © The Author(s) 2016.

"But You Look So Good!": Managing Specific Issues

MedlinePlus

... and resources about handling bladder or bowel problems. Self-esteem “I think the most difficult thing to cope ... feel. It’s understandable then that MS can impact self-esteem and confidence. “It’s difficult to feel powerful, competent, ...

Physical inactivity as a policy problem: applying a concept from policy analysis to a public health issue.

PubMed

Rütten, Alfred; Abu-Omar, Karim; Gelius, Peter; Schow, Diana

2013-03-07

Despite the recent rapid development of policies to counteract physical inactivity (PI), only a small number of systematic analyses on the evolution of these policies exists. In this article we analyze how PI, as a public health issue, "translates" into a policy-making issue. First, we discuss why PI has become an increasingly important public health issue during the last two decades. We then follow Guy Peters and conceptualize PI as a "policy problem" that has the potential to be linked to policy instruments and policy impact. Analysis indicates that PI is a policy problem that i) is chronic in nature; ii) involves a high degree of political complexity; iii) can be disaggregated into smaller scales; iv) is addressed through interventions that can be difficult to "sell" to the public when their benefits are not highly divisible; v) cannot be solved by government spending alone; vi) must be addressed through a broad scope of activities; and vii) involves interdependencies among both multiple sectors and levels of government.We conclude that the new perspective on PI proposed in this article might be useful and important for i) describing and mapping policies to counteract PI in different contexts; ii) evaluating whether or not existing policy instruments are appropriate to the policy problem of PI, and iii) explaining the factors and processes that underlie policy development and implementation. More research is warranted in all these areas. In particular, we propose to focus on comparative analyses of how the problem of PI is defined and tackled in different contexts, and on the identification of truly effective policy instruments that are designed to "solve" the PI policy problem.

Developing a methodology to assess the impact of research grant funding: a mixed methods approach.

PubMed

Bloch, Carter; Sørensen, Mads P; Graversen, Ebbe K; Schneider, Jesper W; Schmidt, Evanthia Kalpazidou; Aagaard, Kaare; Mejlgaard, Niels

2014-04-01

This paper discusses the development of a mixed methods approach to analyse research funding. Research policy has taken on an increasingly prominent role in the broader political scene, where research is seen as a critical factor in maintaining and improving growth, welfare and international competitiveness. This has motivated growing emphasis on the impacts of science funding, and how funding can best be designed to promote socio-economic progress. Meeting these demands for impact assessment involves a number of complex issues that are difficult to fully address in a single study or in the design of a single methodology. However, they point to some general principles that can be explored in methodological design. We draw on a recent evaluation of the impacts of research grant funding, discussing both key issues in developing a methodology for the analysis and subsequent results. The case of research grant funding, involving a complex mix of direct and intermediate effects that contribute to the overall impact of funding on research performance, illustrates the value of a mixed methods approach to provide a more robust and complete analysis of policy impacts. Reflections on the strengths and weaknesses of the methodology are used to examine refinements for future work. Copyright © 2014 Elsevier Ltd. All rights reserved.

Assisted dying in liberalised jurisdictions and the role of psychiatry: a clinician's view.

PubMed

Macleod, Sandy

2012-10-01

Assisted dying is a contentious and topical issue. Mental disorder is a relevant influence on requests of hastened death. The psychiatry of dying is not a prominent component in the assessment of euthanasia and physician-assisted suicide (PAS) in jurisdictions with liberalised assisted dying laws. The literature on the assessment processes, with particular reference to mental status, involved in euthanasia requests is considered. An experienced palliative medicine specialist and psychiatrist selectively reviewed the recent literature published about the mental health issues involved in euthanasia and PAS. Assessments of competency, sustained wish to die prematurely, depressive disorder, demoralisation and 'unbearable suffering' in the terminally ill are clinically uncertain and difficult tasks. There is a growing psychiatric and psychological literature on the mental status of the terminally ill. As yet psychiatry does not have the expertise to 'select' those whose wish for hastened death is rational, humane and 'healthy'. Rarely in those societies with liberalised assisted dying laws are psychiatrists involved in the decision-making for individuals requesting early death. This role is fulfilled by non-specialists. There remain significant concerns about the accuracy of psychiatric assessment in the terminally ill. Mental processes are more relevant influences on a hastened wish to die than are the physical symptoms of terminal malignant disease. Psychiatric review of persons requesting euthanasia is relevant. It is not obligatory or emphasised in those legislations allowing assisted dying. Psychiatry needs to play a greater role in the assessment processes of euthanasia and PAS.

A system performance throughput model applicable to advanced manned telescience systems

NASA Technical Reports Server (NTRS)

Haines, Richard F.

1990-01-01

As automated space systems become more complex, autonomous, and opaque to the flight crew, it becomes increasingly difficult to determine whether the total system is performing as it should. Some of the complex and interrelated human performance measurement issues are addressed that are related to total system validation. An evaluative throughput model is presented which can be used to generate a human operator-related benchmark or figure of merit for a given system which involves humans at the input and output ends as well as other automated intelligent agents. The concept of sustained and accurate command/control data information transfer is introduced. The first two input parameters of the model involve nominal and off-nominal predicted events. The first of these calls for a detailed task analysis while the second is for a contingency event assessment. The last two required input parameters involving actual (measured) events, namely human performance and continuous semi-automated system performance. An expression combining these four parameters was found using digital simulations and identical, representative, random data to yield the smallest variance.

Halogen bonding and pharmaceutical cocrystals: the case of a widely used preservative.

PubMed

Baldrighi, Michele; Cavallo, Gabriella; Chierotti, Michele R; Gobetto, Roberto; Metrangolo, Pierangelo; Pilati, Tullio; Resnati, Giuseppe; Terraneo, Giancarlo

2013-05-06

3-Iodo-2-propynyl-N-butylcarbamate (IPBC) is an iodinated antimicrobial product used globally as a preservative, fungicide, and algaecide. IPBC is difficult to obtain in pure form as well as to handle in industrial products because it tends to be sticky and clumpy. Here, we describe the preparation of four pharmaceutical cocrystals involving IPBC. The obtained cocrystals have been characterized by X-ray diffraction, solution and solid-state NMR, IR, and DSC analyses. In all the described cases the halogen bond (XB) is the key interaction responsible for the self-assembly of the pharmaceutical cocrystals thanks to the involvement of the 1-iodoalkyne moiety of IPBC, which functions as a very reliable XB-donor, with both neutral and anionic XB-acceptors. Most of the obtained cocrystals have improved properties with respect to the source API, in terms, e.g., of thermal stability. The cocrystal involving the GRAS excipient CaCl2 has superior powder flow characteristics compared to the pure IPBC, representing a promising solution to the handling issues related to the manufacturing of products containing IPBC.

[Hypopituitarism following traumatic brain injury: diagnostic and therapeutic issues].

PubMed

Lecoq, A-L; Chanson, P

2015-10-01

Traumatic Brain Injury (TBI) is a well-known public health problem worldwide and is a leading cause of death and disability, particularly in young adults. Besides neurological and psychiatric issues, pituitary dysfunction can also occur after TBI, in the acute or chronic phase. The exact prevalence of post-traumatic hypopituitarism is difficult to assess due to the wide heterogeneity of published studies and bias in interpretation of hormonal test results in this specific population. Predictive factors for hypopituitarism have been proposed and are helpful for the screening. The pathophysiology of pituitary dysfunction after TBI is not well understood but the vascular hypothesis is privileged. Activation of pituitary stem/progenitor cells is probably involved in the recovery of pituitary functions. Those cells also play a role in the induction of pituitary tumors, highlighting their crucial place in pituitary conditions. This review updates the current data related to anterior pituitary dysfunction after TBI and discusses the bias and difficulties encountered in its diagnosis. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Private volunteer medical organizations: how effective are they?

PubMed Central

Hoover, Eddie L.; Cole-Hoover, Gwendolyn; Berry, Paula K.; Hoover, Evan T.; Harris, Betsy; Rageh, Deman; Weaver, W. Lynn

2005-01-01

Religious and other secular organizations have been involved with medical missionary work in sub-Saharan Africa for centuries, especially in remote provinces and villages. In times past, most of these countries were under the control of foreign powers. Private volunteer organizations operated within a structured environment, which, perhaps, facilitated their mission and their ability to review and evaluate their effectiveness because of the tight control the colonial powers maintained over every facet of native life. However, the transition from colonialism to independence has resulted in a different environment in which healthcare is fragmented and a low priority in most countries because of financial constraints. The lack of standardization, vintage laboratory equipment, a manual medical record system, lack of a subsidized transportation system, infrequent postal service and the absence of phone systems in the remote provinces and villages make treatment and tracking of patients, monitoring therapy and measuring outcomes/results difficult. Therefore, judging the effectiveness of an initiative in remote district hospitals and village clinics can be difficult. This manuscript addresses some of these issues and provides solutions to some that have been effective for one organization. PMID:15712791

Eating and drinking interventions for people at risk of lacking decision-making capacity: who decides and how?

PubMed

Clarke, Gemma; Galbraith, Sarah; Woodward, Jeremy; Holland, Anthony; Barclay, Stephen

2015-06-11

Some people with progressive neurological diseases find they need additional support with eating and drinking at mealtimes, and may require artificial nutrition and hydration. Decisions concerning artificial nutrition and hydration at the end of life are ethically complex, particularly if the individual lacks decision-making capacity. Decisions may concern issues of life and death: weighing the potential for increasing morbidity and prolonging suffering, with potentially shortening life. When individuals lack decision-making capacity, the standard processes of obtaining informed consent for medical interventions are disrupted. Increasingly multi-professional groups are being utilised to make difficult ethical decisions within healthcare. This paper reports upon a service evaluation which examined decision-making within a UK hospital Feeding Issues Multi-Professional Team. A three month observation of a hospital-based multi-professional team concerning feeding issues, and a one year examination of their records. The key research questions are: a) How are decisions made concerning artificial nutrition for individuals at risk of lacking decision-making capacity? b) What are the key decision-making factors that are balanced? c) Who is involved in the decision-making process? Decision-making was not a singular decision, but rather involved many different steps. Discussions involving relatives and other clinicians, often took place outside of meetings. Topics of discussion varied but the outcome relied upon balancing the information along four interdependent axes: (1) Risks, burdens and benefits; (2) Treatment goals; (3) Normative ethical values; (4) Interested parties. Decision-making was a dynamic ongoing process with many people involved. The multiple points of decision-making, and the number of people involved with the decision-making process, mean the question of 'who decides' cannot be fully answered. There is a potential for anonymity of multiple decision-makers to arise. Decisions in real world clinical practice may not fit precisely into a model of decision-making. The findings from this service evaluation illustrate that within multi-professional team decision-making; decisions may contain elements of both substituted and supported decision-making, and may be better represented as existing upon a continuum.

Exploring Diversity in Supervision and Practice

ERIC Educational Resources Information Center

Heffron, Mary Claire; Grunstein, Sara; Tilmon, Shawniese

2007-01-01

Issues of diversity, such as culture, class, race, and ethnicity, affect all relationships. It can be difficult to explore these issues in supervision, but doing so is imperative to understanding and working effectively with each other and with families. This article explores the challenges associated with discussing issues of diversity, and…

The Interpersonal Challenges of Instructional Leadership: Principals' Effectiveness in Conversations about Performance Issues

ERIC Educational Resources Information Center

Le Fevre, Deidre M.; Robinson, Viviane M. J.

2015-01-01

Purpose: Principals commonly struggle to have effective conversations about staff performance issues, tending to tolerate, protect, and work around such issues rather than effectively addressing them. This article evaluates principals' effectiveness in having "difficult" conversations with parents and with teachers. Research Methodology:…

Academic and research misconduct in the PhD: issues for students and supervisors.

PubMed

Mitchell, Theresa; Carroll, Jude

2008-02-01

There are many pressures upon PhD students not least the requirement to make an original or significant contribution to knowledge. Some students, confronted with complex research processes, might adopt practices that compromise standards that are unacceptable within a research community. These practices challenge the PhD student-supervisor relationship and have implication for the individual, the supervisory team, the institution, the awarding body and the wider research context. Discussion relating to misconduct within the PhD is of international importance if the aim is to encourage and facilitate rigorous research practice. Cases involving academic and research misconduct, especially those occurring at PhD level, are likely to become more frequent as numbers of PhD students increase and will demand appropriate, defensible responses from supervisors. Misconduct during PhD study can be difficult to resolve because of lack of clarity in definitions, supervisor naiveté and failure to acknowledge students' decision making limitations. Using scenarios from the first author's supervisory practice to illustrate issues of concern for students and supervisors during PhD supervision, the authors aim to illuminate the importance of engagement with regulatory bodies; problems of knowledge and understanding transfer; culturally specific issues and meanings of academic theft.

A hot topic: the genetics of adaptation to geothermal vents in Mimulus guttatus.

PubMed

Ferris, Kathleen G

2016-11-01

Identifying the individual loci and mutations that underlie adaptation to extreme environments has long been a goal of evolutionary biology. However, finding the genes that underlie adaptive traits is difficult for several reasons. First, because many traits and genes evolve simultaneously as populations diverge, it is difficult to disentangle adaptation from neutral demographic processes. Second, finding the individual loci involved in any trait is challenging given the respective limitations of quantitative and population genetic methods. In this issue of Molecular Ecology, Hendrick et al. (2016) overcome these difficulties and determine the genetic basis of microgeographic adaptation between geothermal vent and nonthermal populations of Mimulus guttatus in Yellowstone National Park. The authors accomplish this by combining population and quantitative genetic techniques, a powerful, but labour-intensive, strategy for identifying individual causative adaptive loci that few studies have used (Stinchcombe & Hoekstra ). In a previous common garden experiment (Lekberg et al. 2012), thermal M. guttatus populations were found to differ from their closely related nonthermal neighbours in various adaptive phenotypes including trichome density. Hendrick et al. (2016) combine quantitative trait loci (QTL) mapping, population genomic scans for selection and admixture mapping to identify a single genetic locus underlying differences in trichome density between thermal and nonthermal M. guttatus. The candidate gene, R2R3 MYB, is homologous to genes involved in trichome development across flowering plants. The major trichome QTL, Tr14, is also involved in trichome density differences in an independent M. guttatus population comparison (Holeski et al. 2010) making this an example of parallel genetic evolution. © 2016 John Wiley & Sons Ltd.

A practical guideline for identifying research intent with projects that collect private, identifiable health information.

PubMed

Amdur, Robert J; Speers, Marjorie A

2003-06-01

Radiation oncologists frequently engage in activities that involve the collection and analysis of data from medical records. Access to health information is an ethical issue because, if not done according to appropriate guidelines, it constitutes an invasion of privacy or breach in confidentiality. To protect patients for the social harm that may result from medical record review, our society has established laws and regulations that apply to projects that require medical record review. A major branch point in the guidelines for such projects is whether private information will be collected for research or nonresearch purposes. However, a problem with discussing privacy protection in terms of a research versus nonresearch model is that it is difficult to make this distinction for many kinds of projects. The purpose of this paper is to establish a practical guideline that can be used to decide if a project that involves analysis of private, identifiable medical information should be considered research from the regulatory standpoint.

Why is recruitment to trials difficult? An investigation into recruitment difficulties in an RCT of supported employment in patients with severe mental illness

PubMed Central

Howard, Louise; de Salis, Isabel; Tomlin, Zelda; Thornicroft, Graham; Donovan, Jenny

2009-01-01

Background Under-recruitment to randomised controlled trials (RCTs) is often problematic and there may be particular difficulties in recruiting patients with severe mental illness. Aim To evaluate reasons for under-recruitment in an RCT of patients with severe mental illness Methods Qualitative study during the recruitment phase of an RCT of supported employment. Trial staff and recruiting clinicians were interviewed. Data were analyzed thematically using constant comparative techniques. Results Recruitment rates were low. Five main reasons for recruitment difficulties were found. These included: (i) misconceptions about trials, (ii) lack of equipoise, (iii) misunderstanding of the trial arms, (iv) variable interpretations of eligibility criteria, (v) paternalism. Conclusion Reasons for recruitment difficulties in trials involving patients with severe mental illness include issues that occur in trials in general, but others are more specific to these patients. Clinician and patient involvement in the study design may improve recruitment in future similar trials. PMID:18718555

Measuring Human Performance within Computer Security Incident Response Teams

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

McClain, Jonathan T.; Silva, Austin Ray; Avina, Glory Emmanuel

Human performance has become a pertinen t issue within cyber security. However, this research has been stymied by the limited availability of expert cyber security professionals. This is partly attributable to the ongoing workload faced by cyber security professionals, which is compound ed by the limited number of qualified personnel and turnover of p ersonnel across organizations. Additionally, it is difficult to conduct research, and particularly, openly published research, due to the sensitivity inherent to cyber ope rations at most orga nizations. As an alternative, the current research has focused on data collection during cyb er security training exercises. Thesemore » events draw individuals with a range of knowledge and experience extending from seasoned professionals to recent college gradu ates to college students. The current paper describes research involving data collection at two separate cyber security exercises. This data collection involved multiple measures which included behavioral performance based on human - machine transactions and questionnaire - based assessments of cyber security experience.« less

Measuring Involvement with Social Issues.

ERIC Educational Resources Information Center

Nowak, Glen J.; Salmon, Charles T.

A study applied research concepts from consumer product involvement to test a model for research on involvement with social issues. Issue involvement was defined as the state or level of perceived importance and/or interest evoked by a stimulus (issue) within a specific situation. Attitudes on four social issues--abortion, pornography, the…

A Disability Studies Response to JTE's Themed Issue on Diversity and Disability in Teacher Education

ERIC Educational Resources Information Center

Collins, Kathleen M.

2013-01-01

In a recent themed issue of "Journal of Teacher Education" ("JTE" 63.4) about issues of disability, diversity, and teacher education, guest editors Marleen Pugach, Linda Blanton, and Lani Florian (2012) invite readers to participate in "honest, difficult, and much needed dialogue across the many diversity constituencies in teacher education" (p.…

Rapid issue tracking: A method for taking the pulse of the public discussion of environmental policy

Treesearch

David N. Bengston; David P. Fan; Patrick Reed; Ashley Goldhor-Wilcock

2009-01-01

Environmental communication professionals and other decision makers need to understand public sentiment toward environmental issues to effectively carry out their stewardship responsibilities. However, it is often difficult to obtain timely and reliable information about public discussion and debate regarding these issues. This paper describes an approach designed to...

"We Must Look at Both Sides"--But a Denial of Genocide Too?: Difficult Moments on Controversial Issues in the Classroom

ERIC Educational Resources Information Center

Kubota, Ryuko

2014-01-01

In language education, controversial issues sometimes emerge in either planned or spontaneous ways. Based on a classroom episode, this article illuminates dilemmas of approaching controversial issues for teachers who embrace critical pedagogy. A review of interdisciplinary literature demonstrates a general agreement on presenting balanced views…

Gender Issues in Action Research: Implications for Adult Education

ERIC Educational Resources Information Center

Heiskanen, Tuula

2006-01-01

Gender equality is a widely recognized value. Still, on the practical level, it is not easy to achieve true gender equality. Gender has proved to be a complicated issue both for research and practice. Gender change projects trying to make changes in detected disadvantages have repeatedly run into a problem: it is difficult to put gender issues on…

Difficult Knowledge and Social Studies (Teacher) Education

ERIC Educational Resources Information Center

Garrett, H. James

2010-01-01

Social studies education is a field in which those involved--teachers and students--encounter what can be called "difficult knowledge". Difficult knowledge is a theoretical construct suggesting that when an individual encounters representations of social and historical trauma in a learning situation there exists a host of emotional and pedagogical…

Unique medical issues in adult patients with mucopolysaccharidoses.

PubMed

Mitchell, John; Berger, Kenneth I; Borgo, Andrea; Braunlin, Elizabeth A; Burton, Barbara K; Ghotme, Kemel A; Kircher, Susanne G; Molter, David; Orchard, Paul J; Palmer, James; Pastores, Gregory M; Rapoport, David M; Wang, Raymond Y; White, Klane

2016-10-01

The mucopolysaccharidoses are a group of inherited metabolic diseases caused by deficiencies in enzymes involved in the sequential degradation of glycosaminoglycans (GAGs) leading to substrate accumulation in various tissues and organs. GAG accumulation can cause growth retardation and progressive damage to respiratory, cardiovascular, musculoskeletal, nervous, gastrointestinal, auditory, and visual systems. In the past, few people with severe phenotypic mucopolysaccharidosis (MPS) reached adulthood. However, better methods for diagnosis, multi-disciplinary care, and new therapies have extended lifespan, leading to an increasing number of patients surviving beyond childhood. The growing number of adult MPS patients poses significant challenges for clinicians who may not be familiar with the clinical manifestations of MPS. In addition, as new interventions have changed the natural history of these disorders, it is difficult to anticipate both the impact on life expectancy and other complications that may occur as these patients age. Because the MPS disorders are multi-organ diseases, their management requires a coordinated multi-disciplinary approach. Here we discuss the unique pattern of medical issues and multi-organ involvement in adult patients with MPS and identify the challenges that are associated with management of MPS. This review is based on information from an expert investigator meeting with MPS specialists held October 2-4, 2014 in Dublin, Ireland, as well as on current literature searches focusing on MPS and adults. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Baccalaureate Student Perceptions of Challenging Family Problems: Building Bridges to Acceptance

ERIC Educational Resources Information Center

Floyd, Melissa; Gruber, Kenneth J.

2011-01-01

This study explored the attitudes of 147 undergraduate social work majors to working with difficult families. Students indicated which problems (from a list of 42, including hot topics such as homosexuality, transgender issues, abortion, and substance abuse) they believed they would find most difficult to work with and provided information…

When I Whisper, Nobody Listens: Helping Young People Write about Difficult Issues.

ERIC Educational Resources Information Center

Frost, Helen

This book offers guidance on how teachers can help their students write about sensitive topics or provide pragmatic suggestions for developing the skill and sensitivity necessary to venture into such difficult terrain. The book addresses students' need to articulate their thoughts and feelings about violence, anger, drug use, peer pressure, and…

What quality-of-life issues do women with ductal carcinoma in situ (DCIS) consider important when making treatment decisions?

PubMed

Mercieca-Bebber, Rebecca; King, Madeleine T; Boxer, Miriam M; Spillane, Andrew; Winters, Zoë E; Butow, Phyllis N; McPherson, Joan; Rutherford, Claudia

2017-09-01

To explore quality-of-life (QOL) issues considered important when deciding on treatment for ductal carcinoma in situ (DCIS). Breast Cancer Network of Australia members diagnosed with DCIS in the past 5 years (self-identified) participated in an online survey (Sep-Nov 2015). From a list of 74 QOL issues, participants selected all issues they experienced during DCIS diagnosis, treatment or recovery, then the issues they felt important to making a DCIS treatment decision, and completed the Health Literacy Questionnaire (HLQ). Associations between QOL issues and self-reported treatment received were assessed with χ 2 tests. The primary analysis included 38 participants treated with breast-conserving surgery (n = 15), mastectomy (n = 23), and/or radiotherapy (n = 14). Fatigue-related symptoms (82%) and "fear of progression" (50%) were the most frequently-experienced issues. When deciding on DCIS treatment, the most important consideration was "fear of progression" (50%). A higher proportion of mastectomy (compared to non-mastectomy) patients considered "difficultly looking at yourself naked" (p = 0.03). Radiotherapy (compared to non-radiotherapy) patients were more likely to consider "feeling unwell" important (p = 0.006). Results were similar in a sensitivity analysis involving all 101 respondents (i.e., including 63 respondents who reported receiving chemotherapy, endocrine therapy, and/or Herceptin, suggesting that they may have been treated for invasive breast cancer). Health literacy was high across all nine HLQ scales. Fear of progression is a key consideration in DCIS treatment decision making for women with high health literacy. QOL treatment considerations differed by treatments received. Women diagnosed with DCIS may benefit from evidence about QOL to inform treatment decision making.

Resilience vs soft crisis: dynamic risk assessment in complex hybrid systems. Case history of Ginosa (Taranto, Southern Italy)

NASA Astrophysics Data System (ADS)

Parisi, Alessandro; Argentiero, Ilenia; Fidelibus, Maria Dolores; Pellicani, Roberta; Spilotro, Giuseppe

2017-04-01

Considering a natural system without human-induced modifications, its resilience can be altered by many natural drivers (e.g. geological characteristics, climate) and their spatial modifications over time. Therefore, natural hazardous phenomena could shift natural system over tipping points in an easier or more difficult way. So long as natural system does not involve human settlements or transport infrastructures, natural system risk assessment could not be a basic topic. Nowadays, human activities have modified many natural systems forming, as a result, hybrid systems (both human and natural), in which natural and human-induced drivers modify hybrid systems vulnerability in order to decrease or increase their resilience: scientists define this new age Anthropocene. In this context, dynamic risk assessment of hybrid systems is required in order to avoid disaster when hazardous phenomena occur, but it is a quite complex issue. In fact, soft crisis emerging signals are difficult to identify because of wrong risk perception and lack of communication. Furthermore, natural and human-induced modifications are rarely registered and supervised by governments, so it is fairly difficult defining how systems resilience changes over time. Inhabitants of Ginosa (Taranto, South of Italy) had modified many old rock dwellings over thousand years since the Middle Ages. Indeed, they had built up three-storey houses on three hypogeum levels of rock dwellings along the ravine. The Matrice street collapse in Ginosa is an example of how natural and human-induced spatial modifications over time had led a soft crisis to evolve in a disaster, fortunately without fatalities. This research aim is to revisit events before the Matrice street collapse on the 21st January 2014. The will is to define the relationship between the hybrid system resilience and soft crisis variation over time and how human and natural drivers were involved in the shift.

Job and life satisfaction of nonstandard workers in South Korea.

PubMed

Lee, Bokim

2013-08-01

Since the South Korean financial crisis of the late 1990s, the number of nonstandard workers in South Korea has increased rapidly. With such a drastic change, it has been difficult to establish national welfare systems (e.g., accident insurance or support for families with dependent children) for nonstandard workers and identify critical aspects of their health. To evaluate job and life satisfaction among nonstandard workers, this study used a representative sample of South Koreans. Using data from the 2008 Korean Labor and Income Panel Study, the sample size totaled 4,340 observations, of which 1,344 (31.0%) involved nonstandard workers. Significant differences in job and life satisfaction between nonstandard workers and standard workers were found. The results also indicate discrimination in the welfare and fringe benefit systems in South Korea. Occupational health nurses must address the physical and psychological health issues, personal problems, and everyday life concerns of nonstandard workers. Given that the employment status of nonstandard workers in companies is generally unstable, it is difficult for these workers to report poor working conditions to employers or other authorities. Accordingly, occupational health nurses should advocate for nonstandard workers by notifying employers of the many problems they face. Copyright 2013, SLACK Incorporated.

Transition of Care from Childhood to Adulthood: Congenital Hypogonadotropic Hypogonadism.

PubMed

Dwyer, Andrew A; Pitteloud, Nelly

2018-01-01

Passage from childhood to adult life involves biological changes culminating in full reproductive capacity as well as psychosocial development. For patients with congenital hypogonadotropic hypogonadism (CHH), this can be an emotionally challenging time as their pubertal failure results in striking physical differences from their peers. CHH is difficult to differentiate from common disorders of puberty such as constitutional delay of growth and puberty. As such, delays in diagnosis are frequent, and it is a common source of stress and frustration for these adolescents. While effective treatments are available for inducing puberty and attaining fertility is possible in most cases, patients may find it difficult to cope with living with CHH. A critical issue for adolescents with CHH is the risk for being lost to follow-up during the transition from pediatric-centered care to adult care. This article will review the state of the art in diagnosis and treatment of patients with CHH with a particular focus on supporting an effective transition from pediatric-centered care to adult-oriented endocrine services. A synthesis of best practices is offered to help guide clinicians in supporting patients and families during this challenging period of care. © 2018 S. Karger AG, Basel.

Creating a national citizen engagement process for energy policy

PubMed Central

Pidgeon, Nick; Demski, Christina; Butler, Catherine; Parkhill, Karen; Spence, Alexa

2014-01-01

This paper examines some of the science communication challenges involved when designing and conducting public deliberation processes on issues of national importance. We take as our illustrative case study a recent research project investigating public values and attitudes toward future energy system change for the United Kingdom. National-level issues such as this are often particularly difficult to engage the public with because of their inherent complexity, derived from multiple interconnected elements and policy frames, extended scales of analysis, and different manifestations of uncertainty. With reference to the energy system project, we discuss ways of meeting a series of science communication challenges arising when engaging the public with national topics, including the need to articulate systems thinking and problem scale, to provide balanced information and policy framings in ways that open up spaces for reflection and deliberation, and the need for varied methods of facilitation and data synthesis that permit access to participants’ broader values. Although resource intensive, national-level deliberation is possible and can produce useful insights both for participants and for science policy. PMID:25225393

Creating a national citizen engagement process for energy policy.

PubMed

Pidgeon, Nick; Demski, Christina; Butler, Catherine; Parkhill, Karen; Spence, Alexa

2014-09-16

This paper examines some of the science communication challenges involved when designing and conducting public deliberation processes on issues of national importance. We take as our illustrative case study a recent research project investigating public values and attitudes toward future energy system change for the United Kingdom. National-level issues such as this are often particularly difficult to engage the public with because of their inherent complexity, derived from multiple interconnected elements and policy frames, extended scales of analysis, and different manifestations of uncertainty. With reference to the energy system project, we discuss ways of meeting a series of science communication challenges arising when engaging the public with national topics, including the need to articulate systems thinking and problem scale, to provide balanced information and policy framings in ways that open up spaces for reflection and deliberation, and the need for varied methods of facilitation and data synthesis that permit access to participants' broader values. Although resource intensive, national-level deliberation is possible and can produce useful insights both for participants and for science policy.

Using qualitative psychology to investigate HACCP implementation barriers.

PubMed

Taylor, Eunice; Taylor, Joanne Zaida

2004-02-01

Hazard Analysis Critical Control Point (HACCP) is a system of food safety management that in the last few decades has become an increasing part of national government and international strategy to reduce the prevalence of food borne disease. Yet despite wide dissemination and scientific support of its principles, successful HACCP implementation has been limited. There has been very little in-depth consideration of the reasons behind this, and qualitative psychological research examining the interplay of factors involved is almost non-existent. For this study therefore, four in-depth narrative interviews were carried out with small business owners attempting to implement HACCP. Non-prescriptive analysis of their interviews was carried out, and this revealed five key themes acting as 'barriers' to successful implementation. These were of HACCP as difficult, burdensome and unnecessary, and hindered by staff and external problems. The analysis showed furthermore the complexity of issues underpinning problems with HACCP implementation and the way in which they operate at knowledge, attitude and behavioural levels. From this, essential issues to be addressed in order for successful HACCP to be achieved are put forward.

Reliability Issues in Stirling Radioisotope Power Systems

NASA Technical Reports Server (NTRS)

Schreiber, Jeffrey; Shah, Ashwin

2005-01-01

Stirling power conversion is a potential candidate for use in a Radioisotope Power System (RPS) for space science missions because it offers a multifold increase in the conversion efficiency of heat to electric power and reduced requirement of radioactive material. Reliability of an RPS that utilizes Stirling power conversion technology is important in order to ascertain long term successful performance. Owing to long life time requirement (14 years), it is difficult to perform long-term tests that encompass all the uncertainties involved in the design variables of components and subsystems comprising the RPS. The requirement for uninterrupted performance reliability and related issues are discussed, and some of the critical areas of concern are identified. An overview of the current on-going efforts to understand component life, design variables at the component and system levels, and related sources and nature of uncertainties are also discussed. Current status of the 110 watt Stirling Radioisotope Generator (SRG110) reliability efforts is described. Additionally, an approach showing the use of past experience on other successfully used power systems to develop a reliability plan for the SRG110 design is outlined.

Reliability Issues in Stirling Radioisotope Power Systems

NASA Technical Reports Server (NTRS)

Shah, Ashwin R.; Schreiber, Jeffrey G.

2004-01-01

Stirling power conversion is a potential candidate for use in a Radioisotope Power System (RPS) for space science missions because it offers a multifold increase in the conversion efficiency of heat to electric power and reduced requirement of radioactive material. Reliability of an RPS that utilizes Stirling power conversion technology is important in order to ascertain long term successful performance. Owing to long life time requirement (14 years), it is difficult to perform long-term tests that encompass all the uncertainties involved in the design variables of components and subsystems comprising the RPS. The requirement for uninterrupted performance reliability and related issues are discussed, and some of the critical areas of concern are identified. An overview of the current on-going efforts to understand component life, design variables at the component and system levels, and related sources and nature of uncertainties are also discussed. Current status of the 110 watt Stirling Radioisotope Generator (SRG110) reliability efforts is described. Additionally, an approach showing the use of past experience on other successfully used power systems to develop a reliability plan for the SRG110 design is outlined.

"I spy, with my little sensor": fair data handling practices for robots between privacy, copyright and security

NASA Astrophysics Data System (ADS)

Schafer, Burkhard; Edwards, Lilian

2017-07-01

The paper suggests an amendment to Principle 4 of ethical robot design, and a demand for "transparency by design". It argues that while misleading vulnerable users as to the nature of a robot is a serious ethical issue, other forms of intentionally deceptive or unintentionally misleading aspects of robotic design pose challenges that are on the one hand more universal and harmful in their application, on the other more difficult to address consistently through design choices. The focus will be on transparent design regarding the sensory capacities of robots. Intuitive, low-tech but highly efficient privacy preserving behaviour is regularly dependent on an accurate understanding of surveillance risks. Design choices that hide, camouflage or misrepresent these capacities can undermine these strategies. However, formulating an ethical principle of "sensor transparency" is not straightforward, as openness can also lead to greater vulnerability and with that security risks. We argue that the discussion on sensor transparency needs to be embedded in a broader discussion of "fair data handling principles" for robots that involve issues of privacy, but also intellectual property rights such as copyright.

Spectrometric Analysis for Pulse Jet Mixer Testing

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

ZEIGLER, KRISTINE

2004-07-12

The Analytical Development Section (ADS) was tasked with providing support for a Hanford River Protection Program-Waste Treatment Program (RPP-WTP) project test involving absorption analysis for non-Newtonian pulse jet mixer testing for small scale (PJM) and prototype (CRV) tanks with sparging. Tanks filled with clay were mixed with various amounts of powdered dye as a tracer. The objective of the entire project was to determine the best mixing protocol (nozzle velocity, number of spargers used, total air flow, etc.) by determining the percent mixed volume through the use of an ultraviolet-visible (UV-Vis) spectrometer. The dye concentration within the sample could bemore » correlated to the volume fraction mixed in the tank. Samples were received in vials, a series of dilutions were generated from the clay, allowed to equilibrate, then centrifuged and siphoned for the supernate liquid to analyze by absorption spectroscopy. Equilibration of the samples and thorough mixing of the samples were a continuous issue with dilution curves being difficult to obtain. Despite these technical issues, useful data was obtained for evaluation of various mix conditions.« less

Initial conditions and modeling for simulations of shock driven turbulent material mixing

DOE PAGES

Grinstein, Fernando F.

2016-11-17

Here, we focus on the simulation of shock-driven material mixing driven by flow instabilities and initial conditions (IC). Beyond complex multi-scale resolution issues of shocks and variable density turbulence, me must address the equally difficult problem of predicting flow transition promoted by energy deposited at the material interfacial layer during the shock interface interactions. Transition involves unsteady large-scale coherent-structure dynamics capturable by a large eddy simulation (LES) strategy, but not by an unsteady Reynolds-Averaged Navier–Stokes (URANS) approach based on developed equilibrium turbulence assumptions and single-point-closure modeling. On the engineering end of computations, such URANS with reduced 1D/2D dimensionality and coarsermore » grids, tend to be preferred for faster turnaround in full-scale configurations.« less

Class Model Development Using Business Rules

NASA Astrophysics Data System (ADS)

Skersys, Tomas; Gudas, Saulius

New developments in the area of computer-aided system engineering (CASE) greatly improve processes of the information systems development life cycle (ISDLC). Much effort is put into the quality improvement issues, but IS development projects still suffer from the poor quality of models during the system analysis and design cycles. At some degree, quality of models that are developed using CASE tools can be assured using various. automated. model comparison, syntax. checking procedures. It. is also reasonable to check these models against the business domain knowledge, but the domain knowledge stored in the repository of CASE tool (enterprise model) is insufficient (Gudas et al. 2004). Involvement of business domain experts into these processes is complicated because non- IT people often find it difficult to understand models that were developed by IT professionals using some specific modeling language.

High stakes in INF verification

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

Krepon, M.

1987-06-01

The stakes involved in negotiating INF verification arrangements are high. While these proposals deal only with intermediate-range ground-launched cruise and mobile missiles, if properly devised they could help pave the way for comprehensive limits on other cruise missiles and strategic mobile missiles. In contrast, poorly drafted monitoring provisions could compromise national industrial security and generate numerous compliance controversies. Any verification regime will require new openness on both sides, but that means significant risks as well as opportunities. US and Soviet negotiators could spend weeks, months, and even years working out in painstaking detail verification provisions for medium-range missiles. Alternatively, ifmore » the two sides wished to conclude an INF agreement quickly, they could defer most of the difficult verification issues to the strategic arms negotiations.« less

Moral Fantasy in Genetic Engineering.

ERIC Educational Resources Information Center

Boone, C. Keith

1984-01-01

Discusses the main ethical issues generated by the new genetics and suggests ways to think about them. Concerns include "playing God," violation of the natural order of the universe, and abuse of genetic technology. Critical distinctions for making difficult decisions about genetic engineering issues are noted. (DH)

Mindfulness and discussing "thorny" issues in the classroom

NASA Astrophysics Data System (ADS)

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

2016-09-01

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

Cloning, Stem Cells, and the Current National Debate: Incorporating Ethics into a Large Introductory Biology Course

PubMed Central

2002-01-01

Discussing the ethical issues involved in topics such as cloning and stem cell research in a large introductory biology course is often difficult. Teachers may be wary of presenting material biased by personal beliefs, and students often feel inhibited speaking about moral issues in a large group. Yet, to ignore what is happening “out there” beyond the textbooks and lab work is to do a disservice to students. This essay describes a semester-long project in which upperclass students presented some of the most complex and controversial ideas imaginable to introductory students by staging a mock debate and acting as members of the then newly appointed President's Council on Bioethics. Because the upperclass students were presenting the ideas of real people who play an important role in shaping national policy, no student's personal beliefs were put on the line, and many ideas were articulated. The introductory audience could accept or reject what they were hearing and learn information important for making up their own minds on these issues. This project is presented as an example of how current events can be used to put basic cell biology into context and of how exciting it can be when students teach students. PMID:12669102

Puget Sound Shorelines and the Impacts of Armoring-Proceedings of a State of the Science Workshop, May 2009

USGS Publications Warehouse

Shipman, Hugh; Dethier, Megan N.; Gelfenbaum, Guy R.; Fresh, Kurt L.; Dinicola, Richard S.

2010-01-01

The widespread extent and continued construction of seawalls and bulkheads on Puget Sound's beaches has emerged as a significant issue in shoreline management and coastal restoration in the region. Concerns about the impacts of shoreline armoring and managing the potential risks to coastal property are in many ways similar to those in other places, but Puget Sound also poses unique challenges related to its sheltered setting, glacially formed geology, rich estuarine ecology, and historical development pattern. The effects of armoring on shorelines are complex, involving both physical and biological science and requiring consideration of the cumulative impacts of small-scale activities over large scales of space and time. In addition, the issue is controversial, as it often places strongly held private interests in protecting shoreline property against broad public mandates to preserve shorelines for public uses and to protect environmental resources. Communities making difficult decisions about regulating shoreline activities and prioritizing restoration projects need to be informed by the best science available. To address these issues, a scientific workshop was convened in May 2009, specifically to bring local and national experts together to review the state of the science regarding the physical and biological impacts of armoring on sheltered shorelines such as those of Puget Sound.

Issues surrounding the administration of a credit course for medical students: survey of US academic health sciences librarians*

PubMed Central

Miller, Jolene Michelle

2004-01-01

Objectives: For librarians developing a credit course for medical students, the process often involves trial and error. This project identified issues surrounding the administration of a credit course, so that librarians nationally can rely more upon shared knowledge of common practices and less upon trial and error. Methods: A questionnaire was sent to the education services librarian at each medical school listed in the 2000 AAMC Data Book. A second questionnaire was sent to those librarians who did not return the first one. Results: Of the 125 librarians surveyed, 82 returned the questionnaire. Of those 82, only 11 offered a credit course for medical students, though 19 more were in the process of developing one. Data were gathered on the following aspects of course administration: credit course offerings, course listing, information learned to administer the course, costs associated with the course, relationships with other departments on campus, preparation for teaching and grading, and evaluation of the course. Conclusions: Because of small number of respondents offering a credit course and institutional variations, making generalizations about issues surrounding the administration of a credit course is difficult. The article closes with a list of recommendations for librarians planning to develop a course. PMID:15243642

Improving School Climate & Culture. AASA Critical Issues Report No. 27.

ERIC Educational Resources Information Center

Gonder, Peggy Odell; Hymes, Donald, Ed.

Climate and culture are inherent in the life of every organization, including schools. They are difficult to define and even more difficult to change, yet any reform effort must address them first if it is to succeed. This report helps school leaders understand these crucial factors and measure their influences on the school. It offers various…

Identification of a low copy number plasmid in Xylella fastidiosa Strain Stag’s Leap

USDA-ARS?s Scientific Manuscript database

Xylella fastidiosa (Xf) causes Pierce’s Disease (PD) in grapevine. The Stag’s Leap strain is known for its high virulence level and is a model for PD research. Research on Xf has been difficult due to its nutritional fastidiousness. One difficult research issue is the low copy number plasmid. Plasmi...

Is Elevating Sir John A. Macdonald Really Worth It? Hitting the Reset Button on Canada's Founding Narrative in the Classroom

ERIC Educational Resources Information Center

Gaudry, Adam

2017-01-01

This special issue of "Canadian Social Studies," entitled "Monumental Mistakes? Confronting Difficult Pasts," has brought together a diverse range of scholars offering insights into discussions regarding removing or altering monuments, buildings, and other reminders of difficult histories. The editors have requested that…

Not Your Mother's College Affordability Crisis. Issue Brief

ERIC Educational Resources Information Center

Kirshstein, Rita J.

2012-01-01

Like many of her classmates, the author was a first-generation student, but that meant something quite different in the late 1960s than it does now. When she attended, college, the jobs parents had with high school degrees allowed them to provide considerable support for college educations. Paying for college was difficult but not as difficult as…

[Partnership around difficult teenagers in Brest].

PubMed

Saint-André, Stéphane; Botbol, Michel

2013-01-01

The issues surrounding difficult teenagers results in professionals formalising a partnership. Certain areas of focus are identified such as getting to know each other better in order to understand each other better, working in a "common language", understanding professional identities, or embracing long term partnership. Pressure to assess and rationalise spending, as well as political challenges, must be taken into consideration.

The Effect of Outsourcing on the Performance of Public Schools

ERIC Educational Resources Information Center

Rivera, Lonny J.

2009-01-01

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

The Legal Doctrine on the Liability of Physicians in Medical Malpractice Lawsuits Involving Complex Regional Pain Syndrome.

PubMed

Shin, SuHwan; Jang, Seung Gyeong; Min, KyeongTae; Lee, Won; Kim, So Yoon

2018-02-26

Complex regional pain syndrome (CRPS) involves severe pain and it is difficult to identify the exact cause or pathogenesis. Therefore, there are controversies regarding legal issues related to the establishment of damage in medical malpractice lawsuits involving CRPS. This study aimed to analyze malpractice lawsuits involving CRPS, which occurred after the disputed medical treatment, to provide information on the courts' opinion and characteristics of the cases. This study analyzed 23 lawsuit judgments involving CRPS that were sentenced from 2005 to 2015. A total of 12 of the 23 cases were partially ruled in favor of the plaintiff. The average amount (KRW) claimed was 470,638,385 ± 860,634,092 (21,000,000 to 4,020,000,000), and that awarded was 72,906,843 ± 53,389,367 (15,000,000 to 181,080,803). Sixteen of the 23 cases had CRPS type I. In 11 of 23 cases, the site of the pain was located in the lower limb and in 14 cases there was no presence of trauma or event prior to medical treatment. Nerve injury was the most frequent reason for taking responsibility in compensating damage in malpractice cases involving CRPS. Physicians should consider various possibilities of such complications in medical practices. It is important to identify and improve areas which need to be improved for patient safety through analyzing the lawsuit judgment cases. © 2018 The Korean Academy of Medical Sciences.

Expanding the three Rs to meet new challenges in humane animal experimentation.

PubMed

Schuppli, Catherine A; Fraser, David; McDonald, Michael

2004-11-01

The Three Rs are the main principles used by Animal Ethics Committees in the governance of animal experimentation, but they appear not to cover some ethical issues that arise today. These include: a) claims that certain species should be exempted on principle from harmful research; b) increased emphasis on enhancing quality of life of research animals; c) research involving genetically modified (GM) animals; and d) animals bred as models of disease. In some cases, the Three Rs can be extended to cover these developments. The burgeoning use of GM animals in science calls for new forms of reduction through improved genetic modification technology, plus continued attention to alternative approaches and cost-benefit analyses that include the large numbers of animals involved indirectly. The adoption of more expanded definitions of refinement that go beyond minimising distress will capture concerns for enhancing the quality of life of animals through improved husbandry and handling. Targeting refinement to the unpredictable effects of gene modification may be difficult; in these cases, careful attention to monitoring and endpoints are the obvious options. Refinement can also include sharing data about the welfare impacts of gene modifications, and modelling earlier stages of disease, in order to reduce the potential suffering caused to disease models. Other issues may require a move beyond the Three Rs. Certain levels of harm, or numbers and use of certain species, may be unacceptable, regardless of potential benefits. This can be addressed by supplementing the utilitarian basis of the Three Rs with principles based on deontological and relational ethics. The Three Rs remain very useful, but they require thoughtful interpretation and expansion in order for Animal Ethics Committees to address the full range of issues in animal-based research.

Participant recruitment from minority religious groups: the case of the Islamic population in South Australia.

PubMed

Mohammadi, N; Jones, T; Evans, D

2008-12-01

Participant recruitment is a fundamental component of the research process and the methods employed to attract individuals will depend on the nature of the study. Recruitment may be more challenging when the study involves people from a minority religious group. However, this issue has not been well addressed in the literature. To discuss the challenges of recruiting participants from a minority religious group (the Islamic population) to participate in an interpretive, hermeneutic study concerning the experience of hospitalization. The challenges of recruitment encountered during this study are used as the basis for a broader discussion of this important issue. To ensure the success of this phase of the study, a pre-planned recruitment strategy was essential. Multiple recruitment strategies were used, including hospital-based recruitment, snowball sampling, advertising and contact with key people. Despite the use of multiple strategies, recruitment of participants was difficult and required an extended period of time to achieve sufficiently rich data. Thirteen participants shared their lived experience to provide an in-depth understanding of the phenomenon. Recruiting participants from minority religious group involves potentially sensitive issues. There is an increased need for the researchers to carefully consider potential participants' rights and ensure that sound ethical principles underpin the study, as failure to do this may hinder the recruitment process. The two most effective strategies of recruitment were snowball sampling and contact with key Islamic people, with the least effective being advertising. This paper highlights the importance of anticipating potential difficulties and pre-planning strategies to overcome barriers to recruitment. Implementation of multiple strategies is recommended to ensure successful research recruitment.

A Vision for the Future of Environmental Research: Creating Environmental Intelligence Centers

NASA Astrophysics Data System (ADS)

Barron, E. J.

2002-12-01

The nature of the environmental issues facing our nation demands a capability that allows us to enhance economic vitality, maintain environmental quality, and limit threats to life and property through more fundamental understanding of the Earth. It is "advanced" knowledge of how the system may respond that gives environmental information most of its power and utility. This fact is evident in the demand for new forecasting products, involving air quality, energy demand, water quality and quantity, ultraviolet radiation, and human health indexes. As we demonstrate feasibility and benefit, society is likely to demand a growing number of new operational forecast products on prediction time scales of days to decades into the future. The driving forces that govern our environment are widely recognized, involving primarily weather and climate, patterns of land use and land cover, and resource use with its associated waste products. The importance of these driving forces has been demonstrated by a decade of research on greenhouse gas emissions, ozone depletion and deforestation, and through the birth of Earth System Science. But, there are also major challenges. We find the strongest intersection between human activity, environmental stresses, system interactions and human decision-making in regional analysis coupled to larger spatial scales. In addition, most regions are influenced by multiple-stresses. Multiple, cumulative, and interactive stresses are clearly the most difficult to understand and hence the most difficult to assess and to manage. Currently, we are incapable of addressing these issues in a truly integrated fashion at global scales. The lack of an ability to combine global and regional forcing and to assess the response of the system to multiple stresses at the spatial and temporal scales of interest to humans limits our ability to assess the impacts of specific human perturbations, to assess advantages and risks, and to enhance economic and societal well being in the context of global, national and regional stewardship. These societal needs lead to a vision that uses a regional framework as a stepping-stone to a comprehensive national or global capability. The development of a comprehensive regional framework depends on a new approach to environmental research - the creation of regional Environmental Intelligence Centers. A key objective is to bring a demanding level of discipline to "forecasting" in a broad arena of environmental issues. The regional vision described above is designed to address a broad range of current and future environmental issues by creating a capability based on integrating diverse observing systems, making data readily accessible, developing an increasingly comprehensive predictive capability at the spatial and temporal scales appropriate for examining societal issues, and creating a vigorous intersection with decision-makers. With demonstrated success over a few large-scale regions of the U.S., this strategy will very likely grow into a national capability that far exceeds current capabilities.

Can Formal Methods Provide (Necessary and) Sufficient Conditions for Measurement?

ERIC Educational Resources Information Center

Mari, Luca

2017-01-01

In his focus article, "Rethinking Traditional Methods of Survey Validation," published in this issue of "Measurement: Interdisciplinary Research and Perspectives," Andrew Maul introduces and discusses several foundational issues and concludes that self-report measures may be particularly difficult to validate and may fall short…

Student Disciplinary Issues: A Legal Compendium.

ERIC Educational Resources Information Center

Brown, Valerie L., Ed.; Buttolph, Katherine, Ed.

This legal compendium focuses on the difficult and volatile issues of student discipline in cases of both academic and nonacademic misconduct. Part I lists non-academic codes from University of Michigan, Yale College, Vanderbilt University, University of Iowa, City University of New York, Baylor University, Columbia University, George Washington…

Management of ethical issues related to care of seriously ill dialysis patients in free-standing facilities.

PubMed

Song, Mi-Kyung; Hanson, Laura C; Gilet, Constance A; Jo, Minjeong; Reed, Teresa J; Hladik, Gerald A

2014-09-01

There are few data on the frequency and current management of clinical ethical issues related to care of seriously ill dialysis patients in free-standing dialysis facilities. To examine the extent of clinical ethical challenges experienced by care providers in free-standing facilities and their perceptions about how those issues are managed. A total of 183 care providers recruited from 15 facilities in North Carolina completed a survey regarding the occurrence and management of ethical issues in the past year. Care plan meetings were observed at four of the facilities for three consecutive months. Also, current policies and procedures at each of the facilities were reviewed. The two most frequently experienced challenges involved dialyzing frail patients with multiple comorbidities and caring for disruptive/difficult patients. The most common ways of managing ethical issues were discussions in care plan meetings (n = 47) or discussions with the clinic manager (n = 47). Although policies were in place to guide management of some of the challenges, respondents were often not aware of those policies. Also, although participants reported that ethical issues related to dialyzing undocumented immigrants were fairly common, no facility had a policy for managing this challenge. Participants suggested that all staff obtain training in clinical ethics and communication skills, facilities develop ethics teams, and there be clear policies to guide management of ethical challenges. The scope of ethical challenges was extensive, how these challenges were managed varied widely, and there were limited resources for assistance. Multifaceted efforts, encompassing endeavors at the individual, facility, organization, and national levels, are needed to support staff in improving the management of ethical challenges in dialysis facilities. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Critical Assessment Issues in Work-Integrated Learning

ERIC Educational Resources Information Center

Ferns, Sonia; Zegwaard, Karsten E.

2014-01-01

Assessment has long been a contentious issue in work-integrated learning (WIL) and cooperative education. Despite assessment being central to the integrity and accountability of a university and long-standing theories around best practice in assessment, enacting quality assessment practices has proven to be more difficult. Authors in this special…

Mindfulness and Discussing "Thorny" Issues in the Classroom

ERIC Educational Resources Information Center

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

2016-01-01

Being in the moment, showing compassion, being non-judgmental, acknowledging deep emotional challenges without getting stuck: these are mindfulness characteristics important to us as teachers, yet not often included in teacher preparation. These concerns become magnified when we focus on difficult knowledge and thorny issues, like topics related…

A CASE STUDY IN RISK MANAGEMENT ISSUES: PERCHLORATE IN POTABLE WATER

EPA Science Inventory

Risk management brings together many issues. While some of these are scientific in nature, many come down to policy and even emotion. As a result, striking a balance among competing objectives can be difficult. This is especially true when problems are localized or solutions are ...

Working with Child Prostitutes in Thailand: Problems of Practice and Interpretation

ERIC Educational Resources Information Center

Montgomery, Heather

2007-01-01

Conducting anthropological fieldwork on the emotive issue of child prostitution raises difficult issues for anthropologists and other researchers. This article examines the ethical dilemmas of working with these extremely vulnerable children, focusing on the difference between the researcher's own interpretations and those given by the children…

Stirring up Justice

ERIC Educational Resources Information Center

Schmidt, Laurel

2009-01-01

Most students think about social justice issues, whether schools encourage this focus or not, and they look to the adults in their lives to help them decide what to do about them. Educators should encourage authentic conversations about difficult issues, embrace the question, What can we do about it? and teach students to act. Teachers can…

Lessening Sensitivity: Student Experiences of Teaching and Learning Sensitive Issues

ERIC Educational Resources Information Center

Lowe, Pam

2015-01-01

Despite growing interest in learning and teaching as emotional activities, there is still very little research on experiences of sensitive issues. Using qualitative data from students from a range of social science disciplines, this study investigates student's experiences. The paper highlights how, although they found it difficult and distressing…

Counselling Intervention for Family Security

ERIC Educational Resources Information Center

Fareo, Dorcas Oluremi

2015-01-01

All couples look forward to having normal healthy babies. The issues of disabilities in their children shake the families and serve as sources of severe psychological disruption to family adjustment. The parents of such children live with many difficult issues and frequently experience trauma, grief and stress. This article deals with counselling…

Servicing Issues. NASFAA Task Force Report

ERIC Educational Resources Information Center

National Association of Student Financial Aid Administrators, 2015

2015-01-01

Over the last several years the financial aid community has voiced concern about disruptions, inconsistencies, and lack of quality servicing on federal student loans. It has been difficult to fully grasp the extent to which servicing issues exist and to understand the disparate servicing practices between various servicers. The joint Servicing…

Understanding Patenting Decisions: A Classroom Exercise

ERIC Educational Resources Information Center

Bernard, John C.; Yiannaka, Amalia

2010-01-01

Although many students have some knowledge of patents, it can be difficult for them to understand the components of an innovator's decision-making process. Key issues, such as whether to patent or to use trade secrecy, how broad a scope to claim, and what to do in the event of patent infringement, can be difficult to grasp from a standard lecture.…

Understanding Evidence-Based Information for the Early Childhood Field: Tips from RAND's Promising Practices Network

ERIC Educational Resources Information Center

Mattox, Teryn; Kilburn, M. Rebecca

2012-01-01

With the growing and diverse use of the term "evidence-based practice" it can be difficult for policymakers, funders, program officers, and other professionals to separate the good evidence from the flawed. Furthermore, once good evidence has been identified, it can be difficult to know how to use it. This article discusses key issues to consider…

Ethical issues in prenatal diagnosis.

PubMed

Johnson, S R; Elkins, T E

1988-06-01

Prenatal diagnosis raises complex ethical issues not only in terms of individual decision making, but also in the development of clinical services and the formulation of public policy regarding access and funding. The motivation behind prenatal diagnosis is generally to provide the family with information regarding the pregnancy so that the outcome can be improved or, in the case of severely affected pregnancies, a decision can be made about pregnancy termination. Although many of the ethical issues involved in prenatal diagnosis and treatment overlap those common to all types of diagnostic procedures, the former situation is complicated by controversy about the moral status of the fetus and the use of selective abortion as a form of treatment. While there is general agreement that pregnancy termination after the 2nd trimester can be justified if the fetus is afflicted with a condition that is incompatible with postnatal survival or characterized by the virtual absence of cognitive functioning, the disposition of a fetus afflicted with a non-life-threatening physical or mental disability (e.g., Down's syndrome) is more controversial. An additional concern is that women with positive screening test results may choose elective abortion rather than undergo a definitive work-up. The issue of maternal versus fetal rights is perhaps the single most controversial dilemma. Here, the basic ethical dilemma is the conflict between respecting maternal autonomy versus acting beneficently toward the fetus. As a general rule, the more invasive the medical technique and the less certain the benefit to the fetus (e.g., laparotomy), the more difficult it is to make a convincing argument for forced interventions involving the mother's body. Situations in which compelling arguments can be made for forced interventions against the will of the mother are those where an otherwise healthy infant will die without immediate intervention or failure to perform a procedure will result in the birth of a newborn that is alive but seriously damaged. A final ethical issue is the need for the use of proxy decision makers for the fetus. Except in situations where there are doubts about a mother's capacity to make sound decisions, the role of proxy is ordinarily assigned to the parents.

Burn Injury and Explosions: An Australian Perspective

PubMed Central

Greenwood, John E.

2009-01-01

Objectives: Increasingly (but not exclusively), terrorist activity and the use of explosive devices have enjoyed the focus of the global media. This paper aims to bring a range of issues to attention, to highlight how burn injuries are sustained in such incidents and why burn injuries (and thus burn disasters) are so complicated to manage. Materials and Methods: The author's experience with burn injury caused during explosions and his involvement in burn disaster situations has been summarized to form the basis of the article. This has been expanded upon with discussion points which provide a strategy for planning for such events and by a broad sample of the literature. Results: Several strategies are suggested to facilitate planning for burn disasters and to illustrate to those not directly involved why forward planning is pivotal to success when these incidents occur. Conclusions: Disasters generating large numbers of burn-injured are relatively frequent. Explosive devices are widespread in their use both in military and increasingly in civilian fields. Encompassing a large range of aetiologies, geographical sites, populations, and resources; burn disaster management is difficult and planning essential. PMID:19834533

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

Baba, Seiki; Hoshino, Takeshi; Ito, Len

A new crystal-mounting method has been developed that involves a combination of controlled humid air and polymer glue for crystal coating. This method is particularly useful when applied to fragile protein crystals that are known to be sensitive to subtle changes in their physicochemical environment. Protein crystals are fragile, and it is sometimes difficult to find conditions suitable for handling and cryocooling the crystals before conducting X-ray diffraction experiments. To overcome this issue, a protein crystal-mounting method has been developed that involves a water-soluble polymer and controlled humid air that can adjust the moisture content of a mounted crystal. Bymore » coating crystals with polymer glue and exposing them to controlled humid air, the crystals were stable at room temperature and were cryocooled under optimized humidity. Moreover, the glue-coated crystals reproducibly showed gradual transformations of their lattice constants in response to a change in humidity; thus, using this method, a series of isomorphous crystals can be prepared. This technique is valuable when working on fragile protein crystals, including membrane proteins, and will also be useful for multi-crystal data collection.« less

Processing Pathways in Mental Arithmetic—Evidence from Probabilistic Fiber Tracking

PubMed Central

Glauche, Volkmar; Weiller, Cornelius; Willmes, Klaus

2013-01-01

Numerical cognition is a case of multi-modular and distributed cerebral processing. So far neither the anatomo-functional connections between the cortex areas involved nor their integration into established frameworks such as the differentiation between dorsal and ventral processing streams have been specified. The current study addressed this issue combining a re-analysis of previously published fMRI data with probabilistic fiber tracking data from an independent sample. We aimed at differentiating neural correlates and connectivity for relatively easy and more difficult addition problems in healthy adults and their association with either rather verbally mediated fact retrieval or magnitude manipulations, respectively. The present data suggest that magnitude- and fact retrieval-related processing seem to be subserved by two largely separate networks, both of them comprising dorsal and ventral connections. Importantly, these networks not only differ in localization of activation but also in the connections between the cortical areas involved. However, it has to be noted that even though seemingly distinct anatomically, these networks operate as a functionally integrated circuit for mental calculation as revealed by a parametric analysis of brain activation. PMID:23383194

Assessing obstetric patient experience: a SERVQUAL questionnaire.

PubMed

Garrard, Francesca; Narayan, Harini

2013-01-01

Across health services, there is a drive to respond to patient feedback and to incorporate their views into service improvement. The SERVQUAL method has been used in several clinical settings to quantify whether services meet patient expectations. However, work has been limited in the obstetric population. This paper seeks to address these issues. This study used an adapted SERVQUAL questionnaire to assess a reconfigured antenatal clinic service. The most important care aspects, as rated by patients, were used to construct the SERVQUAL questions. The questionnaire was administered to eligible women in two parts. The first was completed before their first hospital antenatal appointment and the second either at home (a postal-chasing exercise) or while waiting for their next appointment. Only fully completed questionnaires (both parts) were analysed. Service strengths included staff politeness, patient respect and privacy. Areas for improvement included hand cleanliness, women's involvement in decision making and communicating risk. However, the low variability in patient responses makes concrete conclusions difficult and methodological issues complicate evaluating hand cleanliness. The new antenatal clinic service received low negative weighted and un-weighted overall scores. The SERVQUAL measure was developed from patient feedback and used to further improve services. The SERVQUAL-based measure allowed an internal evaluation of patient experience and highlighted areas for improvement. However, without validation, the questionnaire cannot be used as an outcome measure and variation between published SERVQUAL questionnaires makes comparisons difficult. This highlights an important balance in patient evaluation measures--between locally responsive and externally comparable. The SERVQUAL approach allows healthcare teams to evaluate patient experience, while accounting for variation in their expectations and priorities. The study highlights several areas that are important to obstetric patients, where expectation scores are high. However, the similar means and small samples left little difference between excellence and room for improvement.

Standardisation of the FAERS database: a systematic approach to manually recoding drug name variants.

PubMed

Wong, Carmen K; Ho, Samuel S; Saini, Bandana; Hibbs, David E; Fois, Romano A

2015-07-01

The US Food and Drug Administration Adverse Event Reporting System (FAERS), one of the world's largest spontaneous reporting systems, is difficult to use because of report duplication and a lack of standardisation in the recording of drug names. Unresolved data quality issues may distort statistical analyses, rendering the results difficult to interpret when detecting and monitoring adverse effects of pharmaceutical products. The aim of this study was to develop and implement a data cleaning protocol to identify and resolve drug nomenclature issues. The key 'data treatment' plan involved standardising drug names held in the FAERS database. Four million five hundred and six thousand five hundred and seventy-seven. Individual Safety Reports submitted to the FAERS between 1 January 2003 and 31 August 2012 were included for this study. OpenRefine was used to standardise drug name variants in the database such that they were consistent with international non-proprietary nomenclature defined by the World Health Organisation Anatomical Therapeutic Chemical classification. Drug variants where generic constituents could not be confidently determined, undecipherable drug names and non-medicinal products were retained verbatim. After the standardisation process, more than 16 611 916 drug entries were cleaned to their relevant international non-proprietary name. The cleaned drug table comprised 71 858 drug name variants and includes both standardised and original terms. Ninety-nine per cent of drug names was standardised using this method. The millions of reports enclosed in the FAERS contain valuable information that is of interest to pharmacovigilance, toxicology and post-marketing surveillance researchers. With the standardisation of the drug nomenclature, the database can be better utilised by research groups around the world. Copyright © 2015 John Wiley & Sons, Ltd.

Challenges of Making a Diagnosis in the Outpatient Setting: A Multi-Site Survey of Primary Care Physicians

PubMed Central

Sarkar, Urmimala; Bonacum, Doug; Strull, William; Spitzmueller, Christiane; Jin, Nancy; Lopez, Andrea; Giardina, Traber Davis; Meyer, Ashley N.D.; Singh, Hardeep

2013-01-01

Background Although misdiagnosis in the outpatient setting leads to significant patient harm and wasted resources, it is not well studied. We surveyed primary care physicians (PCPs) about barriers to timely diagnosis in the outpatient setting and assessed their perceptions of diagnostic difficulty. Methods We conducted a survey of general internists and family physicians practicing in an integrated health system across 10 geographically dispersed states in 2005. The survey elicited information on key cognitive failures (such as in clinical knowledge or judgment) for a specific case, and solicited strategies for reducing diagnostic delays. Content analysis was used to categorize cognitive failures and strategies for improvement. We examined the extent and predictors of diagnostic difficulty, defined as reporting >5% patients difficult to diagnose. Results Of 1817 physicians surveyed, 1054 (58%) responded; 848 (80%) respondents primarily practiced in outpatient settings and had an assigned patient panel (inclusion sample). Inadequate knowledge (19.9%) was the most commonly reported cognitive factor. Half reported >5% of their patients were difficult to diagnose; more experienced physicians reported less diagnostic difficulty. In adjusted analyses, problems with information processing (information availability and time to review it) and the referral process, were associated with greater diagnostic difficulty. Strategies for improvement most commonly involved workload issues (panel size, non-visit tasks). Conclusions PCPs report a variety of reasons for diagnostic difficulties in primary care practice. In our study, knowledge gaps appear to be a prominent concern. Interventions that address these gaps as well as practice level issues such as time to process diagnostic information and better subspecialty input may reduce diagnostic difficulties in primary care. PMID:22626738

'Important… but of low status': male education leaders' views on gender in medicine.

PubMed

Risberg, Gunilla; Johansson, Eva E; Hamberg, Katarina

2011-06-01

The implementation of and communication about matters associated with gender in medical education have been predominantly perceived as women's issues. This study aimed to explore attitudes towards and experiences of gender-related issues among key male members of faculties of medicine. We conducted semi-structured interviews with 20 male education leaders from the six medical schools in Sweden. The interviews were analysed qualitatively using a modified grounded theory approach. The core category--'important… but of low status'--reflects ambivalent attitudes towards gender-related issues in medicine among male education leaders. All informants were able to articulate why gender matters. As doctors, they saw gender as a determinant of health and, as bystanders, they had witnessed inequalities and the wasting of women's competence. However, they had doubts about gender-related issues and found them to be overemphasised. Gender education was seen as a threat to medical school curricula as a consequence of the time and space it requires. Gender-related issues were considered to be unscientifically presented, to mostly concern women's issues and to tend to involve 'male bashing' (i.e. gender issues were often labelled as ideological and political). Interviewees asked for facts and knowledge, but questioned specific lessons and gender theory. Experiences of structural constraints, such as prejudice, hierarchies and homosociality, were presented, making gender education difficult and downgrading it. The results indicate that male faculty leaders embrace the importance of gender-related issues, but do not necessarily recognise or defend their impact on an area of significant knowledge and competence in medicine. To change this and to engage more men in gender education, faculty measures are needed to counteract prejudice and to upgrade the time allocation, merits and status of gender implementation work. Based on our findings, we present and discuss possible ways to interest more men and to improve gender education in medicine. © Blackwell Publishing Ltd 2011.

The Greater Involvement of People Living with AIDS principle: theory versus practice in Ontario's HIV/AIDS community-based research sector.

PubMed

Travers, R; Wilson, M G; Flicker, S; Guta, A; Bereket, T; McKay, C; van der Meulen, A; Cleverly, S; Dickie, M; Globerman, J; Rourke, S B

2008-07-01

Drawing on the Greater Involvement of People with HIV/AIDS (GIPA) principle, the HIV/AIDS movement began to "democratize" research in Canada in the mid-1990s. To date, there is little evidence about the success of the community-based research (CBR) movement in relation to the implementation of GIPA. We draw on findings from a larger study examining barriers and facilitating factors in relation to HIV-related CBR in Ontario, Canada. An online survey was completed by 39 senior managers in Ontario AIDS service organizations (ASOs). Twenty-five in-depth, semi-structured interviews were then conducted to further explore the survey findings. Survey respondents reported that, compared to researchers and frontline service providers, people living with HIV/AIDS (PLWHA) tended to be the least involved in all stages (input, process and outcome) of CBR projects. AIDS service organizations with a mandate that included serving rural and urban communities reported even lower levels of PLWHA involvement in CBR. Qualitative data reveal complex barriers that make meaningful PLWHA engagement in CBR difficult, including: HIV-related stigma; health-related challenges; "credentialism"; lack of capacity to engage in research; other issues taking priority; and mistrust of researchers. Facilitating factors included valuing lived experience; training and mentoring opportunities; financial compensation; trust building; and accommodating PLWHA's needs. While there is strong support for the GIPA principles in theory, practice lags far behind.

Same-Sex Parenting: Identification of Social Representations in a Sample of Portuguese Professionals.

PubMed

Xavier, Paula; Alberto, Isabel; Mendes, Francisco

2017-11-14

Although international scientific research and the position of professional associations reiterate that the parents' sexual orientation is not a criterion of parenting quality, the social recognition of same-sex parenting remains difficult in Portugal. Given the importance of forensic issues in this field, this study aims to identify the representations of psychologists, social workers, lawyers/attorneys, and judges regarding same-sex parenting. The study involves five homogeneous focus groups with a total of 19 professionals. Content analysis reveals reservations regarding same-sex couples' access to parenting, in particular among lawyers/attorneys. There also emerged narratives that highlight specific competencies in these families and that argue that sexual orientation does not define the quality of parenting. Social narratives are more expressive than scientific knowledge in support of professional representations. These findings have critical implications for professional practice and formation.

Needed: Global Collaboration for Comparative Research on Cities and Health

PubMed Central

Gusmano, Michael K.; Rodwin, Victor G.

2016-01-01

Over half of the world’s population lives in cities and United Nations (UN) demographers project an increase of 2.5 billion more urban dwellers by 2050. Yet there is too little systematic comparative research on the practice of urban health policy and management (HPAM), particularly in the megacities of middle-income and developing nations. We make a case for creating a global database on cities, population health and healthcare systems. The expenses involved in data collection would be difficult to justify without some review of previous work, some agreement on indicators worth measuring, conceptual and methodological considerations to guide the construction of the global database, and a set of research questions and hypotheses to test. We, therefore, address these issues in a manner that we hope will stimulate further discussion and collaboration. PMID:27694667

Needed: Global Collaboration for Comparative Research on Cities and Health.

PubMed

Gusmano, Michael K; Rodwin, Victor G

2016-04-16

Over half of the world's population lives in cities and United Nations (UN) demographers project an increase of 2.5 billion more urban dwellers by 2050. Yet there is too little systematic comparative research on the practice of urban health policy and management (HPAM), particularly in the megacities of middle-income and developing nations. We make a case for creating a global database on cities, population health and healthcare systems. The expenses involved in data collection would be difficult to justify without some review of previous work, some agreement on indicators worth measuring, conceptual and methodological considerations to guide the construction of the global database, and a set of research questions and hypotheses to test. We, therefore, address these issues in a manner that we hope will stimulate further discussion and collaboration. © 2016 by Kerman University of Medical Sciences.

Teacher-Student Sexual Relations: Key Risks and Ethical Issues

ERIC Educational Resources Information Center

Sikes, Pat

2010-01-01

Researching actual or purported sexual contact between teachers and students raises many difficult ethical issues, questions and dilemmas, which may help to explain why few have ventured into the field. This experientially based paper addresses key problem areas under the headings of: the ethics of researching a sensitive taboo topic; the ethics…

Attitudes toward Career Counseling: The Role of Public and Self-Stigma

ERIC Educational Resources Information Center

Ludwikowski, Wyndolyn M. A.; Vogel, David; Armstrong, Patrick Ian

2009-01-01

Although many students struggle with career-related issues in college, comparatively few engage the career services offered by their academic institutions for help with their difficulties. In addition, there is little research on the factors influencing students' decisions to engage in counseling for career-related issues, making it difficult to…

Cyberbullying: Emergent Concerns for Adolescents and Challenges for School Counselors

ERIC Educational Resources Information Center

Burnham, Joy J.; Wright, Vivian H.; Houser, Rick A.

2011-01-01

Cyberbullying is a complex and disturbing 21st century phenomena. School counselors must understand the dynamics and risks of cyberbullying in order to help students, parents, and faculty deal with this difficult issue. We examined the extent to which middle school students understand, participate, and cope with cyberbullying issues in today's…

Families Facing the Nuclear Taboo.

ERIC Educational Resources Information Center

Jacobs, Judith Bula

1988-01-01

Discusses attitudes of 12 families participating in group which was formed to focus on issues related to the possibility of a nuclear disaster. Why and how these families are facing the nuclear taboo plus various outcomes of doing so are discussed as well as the role of the professional in encouraging such openness about these difficult issues.…

Counselling Intervention and Support Programmes for Families of Children with Special Educational Needs

ERIC Educational Resources Information Center

Fareo, Dorcas Oluremi

2015-01-01

All couples look forward to having normal healthy babies. The issues of disabilities in their children shake the families and serve as sources of severe psychological disruption to family adjustment. The parents of such children live with many difficult issues and frequently experience trauma, grief and stress. Intervention programmes are…

Picturing Equality: Exploring Civil Rights' Marches through Photographs

ERIC Educational Resources Information Center

Santoli, Susan; Vitulli, Paige; Giles, Rebecca

2015-01-01

Exploring controversial and difficult events and issues with young children can be challenging. The Civil Rights Movement is an abstract, perhaps remote, issue for young children today. However, it is an important part of our country's history and a theme worthy of study. This article suggests ways to use photographs to explore this mature subject…

Guiding Your Child through Those Tough and Turbulent Teen Years.

ERIC Educational Resources Information Center

Beck, Irene

1994-01-01

As adolescents work through issues like independence, identity, and intimacy, parents must establish their role and guide their children through difficult years. The article suggests that parents stay informed and connected, talk to their children, take a stand on issues, select battles carefully, be approachable, and enhance self-esteem. (SM)

Understanding the Undertow: Innovative Responses to Labour Market Disadvantage and VET

ERIC Educational Resources Information Center

Bretherton, Tanya

2011-01-01

An Australian Government priority is to increase productivity by moving people from welfare into employment. Policy on this issue is difficult to develop because of the complexities surrounding both under- and unemployment. This report considers underutilisation from two different perspectives. Not only does it contemplate the issue from the…

Issues related to the use of genetic material and information.

PubMed

Giarelli, E; Jacobs, L A

2000-04-01

To review issues regarding the use of genetic materials and information. Professional literature, regional and federal legislation. An analysis is provided of the relationship among advances in genetic technology, use of genetic material and information, and the development of laws that protect the interests of donors, researchers, and insurers. Rapid technological achievements have generated complex questions that are difficult to answer. The Human Genome Project began and the scientific discoveries were put to use before adequate professional and public debate on the ethical, legal, social, and clinical issues. The term "proper use" of genetic material and information is not defined consistently. An incomplete patchwork of protective state and federal legislation exists. Many complicated issues surround the use and potential misuse of genetic material and information. Rapidly advancing technology in genetics makes it difficult for regulations that protect individuals and families to keep pace. Oncology nurses need to recognize their role as change agents, understand genetic technology, and advocate for patients by participating in the debate on the proper use and prevention of misuse of genetic material and information.

Poetry and Prose as Pedagogical Tools for Addressing Difficult Knowledges: Translocational Positionality and Issues of Collective Political Agency

ERIC Educational Resources Information Center

Keddie, Amanda

2012-01-01

In this paper the focus is on the possibilities that poetry and prose offer as pedagogical tools that can both accommodate and address difficult and painful knowledges. The paper presents and analyses poems and prose written by students at a non-traditional secondary school for disadvantaged girls (many of whom identify as Indigenous Australian).…

Cancer care in Romania: challenges and pitfalls of children's and adolescents' multifaceted involvement.

PubMed

Badarau, Domnita O; De Clercq, Eva; Wangmo, Tenzin; Dragomir, Monica; Miron, Ingrid; Kühne, Thomas; Elger, Bernice S

2016-12-01

Communication about diagnosis and medical treatment for children suffering from life-threatening illnesses is complex. It is a primary step in involving underage patients and families in care and lays the foundation for obtaining parental permission and patient assent for treatment. In practice child participation in care is often difficult to obtain due to patients' different and sometimes fluctuating preferences, but also parents' protective strategies. Physicians may be susceptible to parental wishes to limit information and feel uncomfortable discussing issues related to uncertainty of cure with patients. A qualitative study in Romanian paediatric oncology units was conducted to explore children's involvement from the perspectives of parents and oncologists. Interviews with participants discussed 18 patient cases. Data were transcribed and thematic analysis was used to interpret and mine patients' involvement during treatment. Different facets of patient participation were identified: restricting, widening and enhancing involvement. A fourth category, unintentional involvement, occurred for all patients due to children's observations during long-term hospitalisations and access to Internet. Uncertainty overarched parental attitudes regarding the extent to which children should be included. Physicians usually complied with parental wishes to limit involvement, but together with parents involved patients at least in a practical way. Adults' protective attitude may backfire, as adolescents' online searches often expose patients to worse-case scenarios. Further research should acknowledge the hazards of restricted diagnosis disclosure and develop clinician tools to support families in communicating with patients. This should be paralleled by physician efforts to elicit patients' needs regarding participation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Authoritative parenting and issue involvement as indicators of ad recall: an empirical investigation of anti-drug ads for parents.

PubMed

Quick, Brian L; Stephenson, Michael T

2007-01-01

This investigation explores the role of authoritative parenting and issue involvement in regard to the recall of parental anti-drug ads encouraging child monitoring. In addition, the study tested whether issue involvement mediates the association between authoritative parenting and recall of parental anti-drug television ads among parents (N = 185) with adolescents in Grades 6, 7, and 8. The results indicate that (a) authoritative parenting is positively associated with favorable attitudes toward monitoring children and issue involvement regarding adolescent drug use, (b) issue involvement is associated with ad recall, (c) issue involvement mediates the relationship between authoritative parenting and ad recall, (d) ad recall is not associated with favorable attitudes toward parental monitoring, and (e) favorable attitudes regarding parental monitoring are positively associated with intentions to engage in monitoring within the next 6 months.

Evaluation of a Blog Based Parent Involvement Approach by Parents

ERIC Educational Resources Information Center

Ozcinar, Zehra; Ekizoglu, Nihat

2013-01-01

Despite the well-known benefits of parent involvement in children's education, research clearly shows that it is difficult to effectively involve parents. This study aims to capture parents' views of a Blog Based Parent Involvement Approach (BPIA) designed to secure parent involvement in education by strengthening school-parent communication. Data…

Executive Functions and the Improvement of Thinking Abilities: The Intervention in Reading Comprehension

PubMed Central

García-Madruga, Juan A.; Gómez-Veiga, Isabel; Vila, José Ó.

2016-01-01

In this paper, we propose a preliminary theory of executive functions that address in a specific way their relationship with working memory (WM) and higher-level cognition. It includes: (a) four core on-line WM executive functions that are involved in every novel and complex cognitive task; (b) two higher order off-line executive functions, planning and revision, that are required to resolving the most complex intellectual abilities; and (c) emotional control that is involved in any complex, novel and difficult task. The main assumption is that efficiency on thinking abilities may be improved by specific instruction or training on the executive functions necessary to solving novel and complex tasks involved in these abilities. Evidence for the impact of our training proposal on WM's executive functions involved in higher-level cognitive abilities comes from three studies applying an adaptive program designed to improve reading comprehension in primary school students by boosting the core WM's executive functions involved in it: focusing on relevant information, switching (or shifting) between representations or tasks, connecting incoming information from text with long-term representations, updating of the semantic representation of the text in WM, and inhibition of irrelevant information. The results are consistent with the assumption that cognitive enhancements from the training intervention may have affected not only a specific but also a more domain-general mechanism involved in various executive functions. We discuss some methodological issues in the studies of effects of WM training on reading comprehension. The perspectives and limitations of our approach are finally discussed. PMID:26869961

Ethical dilemmas of recording and reviewing neonatal resuscitation.

PubMed

den Boer, Maria C; Houtlosser, Mirjam; van Zanten, Henriëtte Anje; Foglia, Elizabeth E; Engberts, Dirk P; Te Pas, Arjan B

2018-05-01

Neonatal resuscitation is provided to approximately 3% of neonates. Adequate ventilation is often the key to successful resuscitation, but this can be difficult to provide. There is increasing evidence that inappropriate respiratory support can have severe consequences. Several neonatal intensive care units have recorded and reviewed neonatal resuscitation procedures for quality assessment, education and research; however, ethical dilemmas sometimes make it difficult to implement this review process. We reviewed the literature on the development of recording and reviewing neonatal resuscitation and have summarised the ethical concerns involved. Recording and reviewing vital physiological parameters and video imaging of neonatal resuscitation in the delivery room is a valuable tool for quality assurance, education and research. Furthermore, it can improve the quality of neonatal resuscitation provided. We observed that ethical dilemmas arise as the review process is operating in several domains of healthcare that all have their specific moral framework with requirements and conditions on issues such as consent, privacy and data storage. These moral requirements and conditions vary due to local circumstances. Further research on the ethical aspects of recording and reviewing is desirable before wider implementation of this technique can be recommended. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Scalability and Validation of Big Data Bioinformatics Software.

PubMed

Yang, Andrian; Troup, Michael; Ho, Joshua W K

2017-01-01

This review examines two important aspects that are central to modern big data bioinformatics analysis - software scalability and validity. We argue that not only are the issues of scalability and validation common to all big data bioinformatics analyses, they can be tackled by conceptually related methodological approaches, namely divide-and-conquer (scalability) and multiple executions (validation). Scalability is defined as the ability for a program to scale based on workload. It has always been an important consideration when developing bioinformatics algorithms and programs. Nonetheless the surge of volume and variety of biological and biomedical data has posed new challenges. We discuss how modern cloud computing and big data programming frameworks such as MapReduce and Spark are being used to effectively implement divide-and-conquer in a distributed computing environment. Validation of software is another important issue in big data bioinformatics that is often ignored. Software validation is the process of determining whether the program under test fulfils the task for which it was designed. Determining the correctness of the computational output of big data bioinformatics software is especially difficult due to the large input space and complex algorithms involved. We discuss how state-of-the-art software testing techniques that are based on the idea of multiple executions, such as metamorphic testing, can be used to implement an effective bioinformatics quality assurance strategy. We hope this review will raise awareness of these critical issues in bioinformatics.

Revised classification/nomenclature of vitiligo and related issues: the Vitiligo Global Issues Consensus Conference

PubMed Central

Ezzedine, K.; Lim, H. W.; Suzuki, T.; Katayama, I.; Hamzavi, I.; Lan, C. C. E.; Goh, B. K.; Anbar, T.; de Castro, C. Silva; Lee, A. Y.; Parsad, D.; van Geel, N.; Le Poole, I. C.; Oiso, N.; Benzekri, L.; Spritz, R.; Gauthier, Y.; Hann, S. K.; Picardo, M.; Taieb, A.

2012-01-01

Summary During the 2011 International Pigment Cell Conference (IPCC), the Vitiligo European Taskforce (VETF) convened a consensus conference on issues of global importance for vitiligo clinical research. As suggested by an international panel of experts, the conference focused on four topics: classification and nomenclature; definition of stable disease; definition of Koebner’s phenomenon (KP); and ‘autoimmune vitiligo’. These topics were discussed in seven working groups representing different geographical regions. A consensus emerged that segmental vitiligo be classified separately from all other forms of vitiligo and that the term ‘vitiligo’ be used as an umbrella term for all non-segmental forms of vitiligo, including ‘mixed vitiligo’ in which segmental and non-segmental vitiligo are combined and which is considered a subgroup of vitiligo. Further, the conference recommends that disease stability be best assessed based on the stability of individual lesions rather than the overall stability of the disease as the latter is difficult to define precisely and reliably. The conference also endorsed the classification of KP for vitiligo as proposed by the VETF (history based, clinical observation based, or experimentally induced). Lastly, the conference agreed that ‘autoimmune vitiligo’ should not be used as a separate classification as published evidence indicates that the pathophysiology of all forms of vitiligo likely involves autoimmune or inflammatory mechanisms. PMID:22417114

Revised classification/nomenclature of vitiligo and related issues: the Vitiligo Global Issues Consensus Conference.

PubMed

Ezzedine, K; Lim, H W; Suzuki, T; Katayama, I; Hamzavi, I; Lan, C C E; Goh, B K; Anbar, T; Silva de Castro, C; Lee, A Y; Parsad, D; van Geel, N; Le Poole, I C; Oiso, N; Benzekri, L; Spritz, R; Gauthier, Y; Hann, S K; Picardo, M; Taieb, A

2012-05-01

During the 2011 International Pigment Cell Conference (IPCC), the Vitiligo European Taskforce (VETF) convened a consensus conference on issues of global importance for vitiligo clinical research. As suggested by an international panel of experts, the conference focused on four topics: classification and nomenclature; definition of stable disease; definition of Koebner's phenomenon (KP); and 'autoimmune vitiligo'. These topics were discussed in seven working groups representing different geographical regions. A consensus emerged that segmental vitiligo be classified separately from all other forms of vitiligo and that the term 'vitiligo' be used as an umbrella term for all non-segmental forms of vitiligo, including 'mixed vitiligo' in which segmental and non-segmental vitiligo are combined and which is considered a subgroup of vitiligo. Further, the conference recommends that disease stability be best assessed based on the stability of individual lesions rather than the overall stability of the disease as the latter is difficult to define precisely and reliably. The conference also endorsed the classification of KP for vitiligo as proposed by the VETF (history based, clinical observation based, or experimentally induced). Lastly, the conference agreed that 'autoimmune vitiligo' should not be used as a separate classification as published evidence indicates that the pathophysiology of all forms of vitiligo likely involves autoimmune or inflammatory mechanisms. © 2012 John Wiley & Sons A/S.

Ethical Decision Making: A Teaching and Learning Model for Graduate Students and New Professionals

ERIC Educational Resources Information Center

McDonald, William M.; Ebelhar, Marcus Walker; Orehovec, Elizabeth R.; Sanderson, Robyn H.

2006-01-01

Student affairs practitioners are inundated with a variety of ethical considerations when making day-to-day decisions regarding the welfare of students and colleagues. There is every reason to believe that confronting ethical issues will be an increasingly difficult issue for student affairs professionals in the future. This article provides a…

How Schools Address Students' Mental Health and Drug and Alcohol Concerns and Problems: Lessons from Student Assistance Programs

ERIC Educational Resources Information Center

Fertman, Carl I.; Tarasevich, Susan L.

2004-01-01

Conversations with school superintendents, board members, principals, teachers, counselors, and nurses about their students' social and emotional health show how actively they are working to help students confront difficult issues. Topping the list of issues are drug and alcohol use and abuse, depression, and violence among students. Equally…

Ensuring Every Child Matters: Issues and Implications for School Leadership

ERIC Educational Resources Information Center

Harris, Alma; Allen, Tracey

2009-01-01

This article considers the challenges and issues facing school leaders in the implementation of Every Child Matters. It outlines the factors that contribute to the effective delivery of Every Child Matters and outlines some of the barriers that make the delivery of this agenda more difficult. The article concludes that school leaders play a…

The Deficit and the Federal Budget. 1983 National Issues Forum.

ERIC Educational Resources Information Center

Melville, Keith, Ed.

Although designed for participants in the National Issues Forum, this booklet, which describes the impact of the federal deficit and the federal budget process, is also useful for secondary school social studies. The six sections begin with an introduction describing why the deficit grows yearly and why it is difficult for Congress to stop its…

Hard probes of short-range nucleon-nucleon correlations

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

J. Arrington, D. W. Higinbotham, G. Rosner, M. Sargsian

2012-10-01

The strong interaction of nucleons at short distances leads to a high-momentum component to the nuclear wave function, associated with short-range correlations between nucleons. These short-range, high-momentum structures in nuclei are one of the least well understood aspects of nuclear matter, relating to strength outside of the typical mean-field approaches to calculating the structure of nuclei. While it is difficult to study these short-range components, significant progress has been made over the last decade in determining how to cleanly isolate short-range correlations in nuclei. We have moved from asking if such structures exist, to mapping out their strength in nucleimore » and studying their microscopic structure. A combination of several different measurements, made possible by high-luminosity and high-energy accelerators, coupled with an improved understanding of the reaction mechanism issues involved in studying these structures, has led to significant progress, and provided significant new information on the nature of these small, highly-excited structures in nuclei. We review the general issues related to short-range correlations, survey recent experiments aimed at probing these short-range structures, and lay out future possibilities to further these studies.« less

The pros and cons of human therapeutic cloning in the public debate.

PubMed

Nippert, Irmgard

2002-09-11

Few issues linked to genetic research have raised as much controversial debate as the use of somatic cell nuclear transfer technology to create embryos specifically for stem cell research. Whereas European countries unanimously agree that reproductive cloning should be prohibited there is no agreement to be found on whether or not research into therapeutic cloning should be permitted. Since the UK took the lead and voted in favour of regulations allowing therapeutic cloning the public debate has intensified on the Continent. This debate reflects the wide spectrum of diverse religious and secular moralities that are prevalent in modern multicultural European democratic societies. Arguments range from putting forward strictly utilitarian views that weight the moral issues involved against the potential benefits that embryonic stem cell research may harbour to considering the embryo as a human being, endowed with human dignity and human rights from the moment of its creation, concluding that its use for research is unethical and should be strictly prohibited. Given the current state of dissension among the various European states, it is difficult to predict whether 'non-harmonisation' will prevail or whether in the long run 'harmonisation' of legislation that will allow stem cell research will evolve in the EU.

Pre-impact fall detection system using dynamic threshold and 3D bounding box

NASA Astrophysics Data System (ADS)

Otanasap, Nuth; Boonbrahm, Poonpong

2017-02-01

Fall prevention and detection system have to subjugate many challenges in order to develop an efficient those system. Some of the difficult problems are obtrusion, occlusion and overlay in vision based system. Other associated issues are privacy, cost, noise, computation complexity and definition of threshold values. Estimating human motion using vision based usually involves with partial overlay, caused either by direction of view point between objects or body parts and camera, and these issues have to be taken into consideration. This paper proposes the use of dynamic threshold based and bounding box posture analysis method with multiple Kinect cameras setting for human posture analysis and fall detection. The proposed work only uses two Kinect cameras for acquiring distributed values and differentiating activities between normal and falls. If the peak value of head velocity is greater than the dynamic threshold value, bounding box posture analysis will be used to confirm fall occurrence. Furthermore, information captured by multiple Kinect placed in right angle will address the skeleton overlay problem due to single Kinect. This work contributes on the fusion of multiple Kinect based skeletons, based on dynamic threshold and bounding box posture analysis which is the only research work reported so far.

Transition from Nondestructive Testing (NDT) to Structural Health Monitoring (SHM): potential and challenges (presentation video)

NASA Astrophysics Data System (ADS)

Cawley, Peter

2014-03-01

There is a gradual shift in emphasis from periodic inspection with detachable transducers (NDT) to permanently installed monitoring systems giving information about the structural integrity at pre-programmed intervals or on demand (SHM). The drivers of this change are discussed, together with the requirements of successful SHM systems. Particular issues are that NDT often involves scanning and this is not possible with typical SHM configurations; it therefore becomes important to cover a significant area of structure from each transducer position. Guided waves provide a possible solution to this problem and permanently installed guided wave pipe inspection systems are now available. The sensitivity obtained with a permanently installed system is significantly better than that in a one-off test as baseline subtraction can be employed. However, this is far from trivial as it is necessary to compensate for benign changes such as temperature. The guided wave technique does not provide accurate remaining thickness information and is best complemented by point measurements at selected locations. Another issue is that the SHM transducers must survive in operational conditions, which is particularly difficult at high temperatures. Recent work at Imperial College and associated spin-out companies on solutions to these problems is discussed.

Cancer screening in the older adult: issues and concerns.

PubMed

Craft, Melissa

2014-06-01

Making individual recommendations for cancer screening in older adult patients may be difficult and time consuming, because of the need to incorporate complex issues of life expectancy, health status, risks and benefits, and individual values and wishes. In this article, current recommendations and related risks and benefits are summarized. Specific issues and concerns are addressed, with suggestions for strategies to assist older adults in making screening decisions. Copyright © 2014 Elsevier Inc. All rights reserved.

A Heuristic Evaluation of the Generalized Intelligent Framework for Tutoring (GIFT) Authoring Tools

DTIC Science & Technology

2016-03-01

Software Is Difficult to Locate and Download from the GIFT Website 5 2.1.2 Issue: Unclear Process for Starting GIFT Software Installation 7 2.1.3 Issue...and change information availability as the user’s expertise in using the authoring tools grows. • Aesthetic and Minimalist Design: Dialogues should...public release; distribution is unlimited. 7 2.1.2 Issue: Unclear Process for Starting GIFT Software Installation Users may not understand how to

An Approach to Building a Traceability Tool for Software Development

NASA Technical Reports Server (NTRS)

Delgado, Nelly; Watson, Tom

1997-01-01

It is difficult in a large, complex computer program to ensure that it meets the specified requirements. As the program evolves over time, a11 program constraints originally elicited during the requirements phase must be maintained. In addition, during the life cycle of the program, requirements typically change and the program must consistently reflect those changes. Imagine the following scenario. Company X wants to develop a system to automate its assembly line. With such a large system, there are many different stakeholders, e.g., managers, experts such as industrial and mechanical engineers, and end-users. Requirements would be elicited from all of the stake holders involved in the system with each stakeholder contributing their point of view to the requirements. For example, some of the requirements provided by an industrial engineer may concern the movement of parts through the assembly line. A point of view provided by the electrical engineer may be reflected in constraints concerning maximum power usage. End-users may be concerned with comfort and safety issues, whereas managers are concerned with the efficiency of the operation. With so many points of view affecting the requirements, it is difficult to manage them, communicate information to relevant stakeholders. and it is likely that conflicts in the requirements will arise. In the coding process, the implementors will make additional assumptions and interpretations on the design and the requirements of the system. During any stage of development, stakeholders may request that a requirement be added or changed. In such a dynamic environment, it is difficult to guarantee that the system will preserve the current set of requirements. Tracing, the mapping between objects in the artifacts of the system being developed, addresses this issue. Artifacts encompass documents such as the system definition, interview transcripts, memoranda, the software requirements specification, user's manuals, the functional specifications, design reports, and system code. Tracing helps 1) validate system features against, the requirement specification, 2) identify error sources and, most importantly, 3) manage change. With so many people involved in the development of the system, it becomes necessary to identify the reasons behind the design requirements or the implementation decisions. This paper is concerned with an approach that maps documents to constraints that capture properties of and relationships between the objects being modeled by the program. Section 2 provides the reader with a background on traceability tools. Section 3 gives a brief description of the context monitoring system on which the approach suggested in this paper is based. Section 4 presents an overview of our approach to providing traceability. The last section presents our future direction of research.

A STERILIZATION STANDARD FOR ENDOSCOPES AND OTHER DIFFICULT TO CLEAN MEDICAL DEVICES

EPA Science Inventory

An array of difficult to clean devices are used for diagnostic and surgical procedures involving various degrees of invasiveness. These range from prophylaxis angles used for cleaning and polishing teeth to flexible fiberoptic endoscopes for surgical procedures that penetrate the...

A Difficult Journey: Reflections on Driving and Driving Cessation From a Team of Clinical Researchers.

PubMed

Liddle, Jacki; Gustafsson, Louise; Mitchell, Geoffrey; Pachana, Nancy A

2017-02-01

Recognizing the clinical importance and safety and well-being implications for the population, a multidisciplinary team has been researching older drivers and driving cessation issues for more than 15 years. Using empirical approaches, the team has explored quality of life and participation outcomes related to driving and nondriving for older people and has developed interventions to improve outcomes after driving cessation. The team members represent occupational therapists, medical practitioners, and clinical and neuropsychologists. While building the evidence base for driving- and driving cessation-related clinical practice, the researchers have also had first-hand experiences of interruptions to their own or parents' driving; involvement of older family members in road crashes; and provision of support during family members' driving assessment and cessation. This has led to reflection on their understandings and re-evaluation and refocusing of their perspectives in driving cessation research. This work will share the narratives of the authors and note their developing perspectives and foci within research as well as their clinical practice. Personal reflections have indicated the far-reaching implications for older drivers and family members of involvement in road crashes: the potential for interruptions to driving as a time for support and future planning and the conflicting and difficult roles of family members within the driving cessation process. Overall the lived, personal experience of the authors has reinforced the complex nature of driving and changes to driving status for the driver and their support team and the need for further research and support. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Adjustment to Cancer: Anxiety and Distress (PDQ®)—Patient Version

Cancer.gov

Expert-reviewed information summary about the difficult emotional responses many cancer patients experience. This summary focuses on normal adjustment issues, psychosocial distress, and adjustment disorders.

Middle Level Principals' Parent Involvement Practices

ERIC Educational Resources Information Center

Tomichek-Michalowski, Tracie V.

2017-01-01

The purpose of the exploratory research study was to identify middle level principals' parent involvement practices. Parent involvement impacts students in positive ways, and a principal must have the ability to involve parents. The job description of a principal can be difficult to place on paper. Principals multitask throughout the day and often…

An on-orbit viewpoint of life sciences research

NASA Technical Reports Server (NTRS)

Lichtenberg, Byron K.

1992-01-01

As a Payload Specialist and a life science researcher, I want to present several issues that impact life science research in space. During early space station operations, life science and other experiments will be conducted in a time-critical manner and there will be the added duties of both space shuttle and space station systems operation (and the concomittent training overhead). Life sciences research is different from other science research done in space because the crew is involved both as an operator and as a subject. There is a need for pre- and post-flight data collection as well as in flight data collection. It is imperative that the life science researcher incorporate the crew members into their team early enough in the training cycle to fully explain the science and to make the crew aware of the importance and sensitivities of the experiment. During the pre-flight phase, the crew is incredibly busy with a myriad of duties. Therefore, it is difficult to get 'pristine' subjects for the baseline data collection. There are also circadian shifts, travel, and late nights to confound the data. During this time it is imperative that the researcher develop, along with the crew, a realistic estimate of crew-time required for their experiment. In flight issues that affect the researcher are the additional activities of the crew, the stresses inherent in space flight, and the difficulty of getting early in-flight data. During SSF activities, the first day or two will be taken up with rendezvous and docking. Other issues are the small number of subjects on any given flight, the importance of complete and concise procedures, and the vagaries of on-board data collection. Post flight, the crew is tired and experiences a 'relaxation.' This along with circadian shifts and rapid re-adaptation to 1-g make immediate post-flight data collection difficult. Finally, the blending of operational medicine and research can result in either competition for resources (crew time, etc.) or influence on the physiological state of the crew. However, the unique opportunity to conduct research in an environment that cannot be duplicated on Earth outweighs the 'challenges' that exist for space life researchers.

Addressing Medical Errors in Hand Surgery

PubMed Central

Johnson, Shepard P.; Adkinson, Joshua M.; Chung, Kevin C.

2014-01-01

Influential think-tank such as the Institute of Medicine has raised awareness about the implications of medical errors. In response, organizations, medical societies, and institutions have initiated programs to decrease the incidence and effects of these errors. Surgeons deal with the direct implications of adverse events involving patients. In addition to managing the physical consequences, they are confronted with ethical and social issues when caring for a harmed patient. Although there is considerable effort to implement system-wide changes, there is little guidance for hand surgeons on how to address medical errors. Admitting an error is difficult, but a transparent environment where patients are notified of errors and offered consolation and compensation is essential to maintain trust. Further, equipping hand surgeons with a guide for addressing medical errors will promote compassionate patient interaction, help identify system failures, provide learning points for safety improvement, and demonstrate a commitment to ethically responsible medical care. PMID:25154576

Endoscopic management of hilar biliary strictures

PubMed Central

Singh, Rajiv Ranjan; Singh, Virendra

2015-01-01

Hilar biliary strictures are caused by various benign and malignant conditions. It is difficult to differentiate benign and malignant strictures. Postcholecystectomy benign biliary strictures are frequently encountered. Endoscopic management of these strictures is challenging. An endoscopic method has been advocated that involves placement of increasing number of stents at regular intervals to resolve the stricture. Malignant hilar strictures are mostly unresectable at the time of diagnosis and only palliation is possible.Endoscopic palliation is preferred over surgery or radiological intervention. Magnetic resonance cholangiopancreaticography is quite important in the management of these strictures. Metal stents are superior to plastic stents. The opinion is divided over the issue of unilateral or bilateral stenting.Minimal contrast or no contrast technique has been advocated during endoscopic retrograde cholangiopancreatography of these patients. The role of intraluminal brachytherapy, intraductal ablation devices, photodynamic therapy, and endoscopic ultrasound still remains to be defined. PMID:26191345

Some remarks on a current study involving preservice elementary teachers and some basic astronomical phenomena

NASA Astrophysics Data System (ADS)

Gangui, Alejandro; Iglesias, María; Quinteros, Cynthia

2011-06-01

Recent studies have shown that not only primary school students but also their future teachers reach science courses with pre-constructed and consistent models of the world surrounding them. These ideas include many misconceptions which turn out to be robust and hence make difficult an appropriate teaching-learning process. We have designed some tools (and show here results with a questionnaire) that proved helpful in putting in evidence some of the most frequently used alternative models on a few basic astronomical notions. We have tested this questionnaire with preservice elementary teachers from various normal schools in Buenos Aires and made a first analysis of the results. The collection of data recovered so far shows that some non-scientific conceptions are indeed part of the prospective teachers' (scientific) background and, therefore, that the issue deserves special attention during their formal training.

Landlords' experiences of housing tenants suffering from severe mental illness: a Swedish empirical study.

PubMed

Bengtsson-Tops, A; Hansson, L

2014-01-01

The aim of this Swedish study was to describe landlords' experiences of having tenants suffering from severe mental illness. Sixteen landlords working in private and public housing agencies participated in open in-depth interviews. Data were subjected to a thematic latent content analysis. The results showed that having tenants with severe mental illness entails being confronted with various difficult circumstances, ranging from mismanagement of apartments to sensitivity among neighbours as well as issues regarding provocative behaviour. It involved providing assistance that was far beyond their professional obligations and to be neglected by the community-based psychiatric service system when in need of help. In order to support landlords and to prevent evictions of individuals with severe mental illness, community-based psychiatric services need to be more pro-active in their attempts to achieve collaboration with the parties at hand.

Communication Problems in Requirements Engineering: A Field Study

NASA Technical Reports Server (NTRS)

Al-Rawas, Amer; Easterbrook, Steve

1996-01-01

The requirements engineering phase of software development projects is characterized by the intensity and importance of communication activities. During this phase, the various stakeholders must be able to communicate their requirements to the analysts, and the analysts need to be able to communicate the specifications they generate back to the stakeholders for validation. This paper describes a field investigation into the problems of communication between disparate communities involved in the requirements specification activities. The results of this study are discussed in terms of their relation to three major communication barriers: (1) ineffectiveness of the current communication channels; (2) restrictions on expressiveness imposed by notations; and (3) social and organizational barriers. The results confirm that organizational and social issues have great influence on the effectiveness of communication. They also show that in general, end-users find the notations used by software practitioners to model their requirements difficult to understand and validate.

Humidity control and hydrophilic glue coating applied to mounted protein crystals improves X-ray diffraction experiments

PubMed Central

Baba, Seiki; Hoshino, Takeshi; Ito, Len; Kumasaka, Takashi

2013-01-01

Protein crystals are fragile, and it is sometimes difficult to find conditions suitable for handling and cryocooling the crystals before conducting X-ray diffraction experiments. To overcome this issue, a protein crystal-mounting method has been developed that involves a water-soluble polymer and controlled humid air that can adjust the moisture content of a mounted crystal. By coating crystals with polymer glue and exposing them to controlled humid air, the crystals were stable at room temperature and were cryocooled under optimized humidity. Moreover, the glue-coated crystals reproducibly showed gradual transformations of their lattice constants in response to a change in humidity; thus, using this method, a series of isomorphous crystals can be prepared. This technique is valuable when working on fragile protein crystals, including membrane proteins, and will also be useful for multi-crystal data collection. PMID:23999307

ECM-Based Materials in Cardiovascular Applications: Inherent Healing Potential and Augmentation of Native Regenerative Processes

PubMed Central

Piterina, Anna V.; Cloonan, Aidan J.; Meaney, Claire L.; Davis, Laura M.; Callanan, Anthony; Walsh, Michael T.; McGloughlin, Tim M.

2009-01-01

The in vivo healing process of vascular grafts involves the interaction of many contributing factors. The ability of vascular grafts to provide an environment which allows successful accomplishment of this process is extremely difficult. Poor endothelisation, inflammation, infection, occlusion, thrombosis, hyperplasia and pseudoaneurysms are common issues with synthetic grafts in vivo. Advanced materials composed of decellularised extracellular matrices (ECM) have been shown to promote the healing process via modulation of the host immune response, resistance to bacterial infections, allowing re-innervation and reestablishing homeostasis in the healing region. The physiological balance within the newly developed vascular tissue is maintained via the recreation of correct biorheology and mechanotransduction factors including host immune response, infection control, homing and the attraction of progenitor cells and infiltration by host tissue. Here, we review the progress in this tissue engineering approach, the enhancement potential of ECM materials and future prospects to reach the clinical environment. PMID:20057951

Management of Orbital Diseases.

PubMed

Betbeze, Caroline

2015-09-01

Orbital diseases are common in dogs and cats and can present on emergency due to the acute onset of many of these issues. The difficulty with diagnosis and therapy of orbital disease is that the location of the problem is not readily visible. The focus of this article is on recognizing classical clinical presentations of orbital disease, which are typically exophthalmos, strabismus, enophthalmos, proptosis, or intraconal swelling. After the orbital disease is confirmed, certain characteristics such as pain on opening the mouth, acute vs. chronic swelling, and involvement of nearby structures can be helpful in determining the underlying cause. Abscesses, cellulitis, sialoceles, neoplasia (primary or secondary), foreign bodies, and immune-mediated diseases can all lead to exophthalmos, but it can be difficult to determine the cause of disease without advanced diagnostic imaging, such as ultrasound, magnetic resonance imaging, or computed tomography scan. Fine-needle aspirates and biopsies of the retrobulbar space can also be performed. Published by Elsevier Inc.

The surgical management of fibrous dysplasia of bone.

PubMed

Stanton, Robert P; Ippolito, Ernesto; Springfield, Dempsey; Lindaman, Lynn; Wientroub, Shlomo; Leet, Arabella

2012-05-24

The surgical management of Polyostotic Fibrous Dysplasia (FD) of bone is technically demanding. The most effective methods to manage the associated bone deformity remain unclear. The marked variation in the degree and pattern of bone involvement has made it difficult to acquire data to guide the surgeon's approach to these patients. In light of the paucity of data, but need for guidance, recognized experts in the management of these patients came together at the National Institutes of Health in Bethesda, Maryland as part of an International meeting to address issues related to fibrous dysplasia of bone to discuss and refine their recommendations regarding the surgical indications and preferred methods for the management of these challenging patients. The specific challenges, recommended approaches, and "lessons learned" are presented in hopes that surgeons faced with typical deformities can be guided in the surgical reconstruction of both children and adults with FD.

The Ventral Anterior Temporal Lobe has a Necessary Role in Exception Word Reading.

PubMed

Ueno, Taiji; Meteyard, Lotte; Hoffman, Paul; Murayama, Kou

2018-06-06

An influential account of reading holds that words with exceptional spelling-to-sound correspondences (e.g., PINT) are read via activation of their lexical-semantic representations, supported by the anterior temporal lobe (ATL). This account has been inconclusive because it is based on neuropsychological evidence, in which lesion-deficit relationships are difficult to localize precisely, and functional neuroimaging data, which is spatially precise but cannot demonstrate whether the ATL activity is necessary for exception word reading. To address these issues, we used a technique with good spatial specificity-repetitive transcranial magnetic stimulation (rTMS)-to demonstrate a necessary role of ATL in exception word reading. Following rTMS to left ventral ATL, healthy Japanese adults made more regularization errors in reading Japanese exception words. We successfully simulated these results in a computational model in which exception word reading was underpinned by semantic activations. The ATL is critically and selectively involved in reading exception words.

Metabolic syndrome and asthma.

PubMed

Garmendia, Jenny V; Moreno, Dolores; Garcia, Alexis H; De Sanctis, Juan B

2014-01-01

Metabolic syndrome (MetS) is a syndrome that involves at least three disorders dyslipidemia, insulin resistance, obesity and/or hypertension. MetS has been associated with several chronic diseases in the adulthood; however, in the recent years, the syndrome was redefined in children. Girls with early menarche and asthma, and children with MetS and asthma that reach adulthood appear to have higher risk to develop severe or difficult to control asthma and a higher probability to suffer cardiovascular diseases. It has been proposed that patients with MetS and endocrinological disorders should be considered a different entity in which pharmacologic treatment should be adjusted according to the individual. Recent patents on the field have addressed new issues on how endocrine control should be managed along with asthma therapeutics. In the near future, new approaches should decrease the high morbidity and mortality associated to these types of patients.

An Exercise in Exploring Big Data for Producing Reliable Statistical Information.

PubMed

Rey-Del-Castillo, Pilar; Cardeñosa, Jesús

2016-06-01

The availability of copious data about many human, social, and economic phenomena is considered an opportunity for the production of official statistics. National statistical organizations and other institutions are more and more involved in new projects for developing what is sometimes seen as a possible change of paradigm in the way statistical figures are produced. Nevertheless, there are hardly any systems in production using Big Data sources. Arguments of confidentiality, data ownership, representativeness, and others make it a difficult task to get results in the short term. Using Call Detail Records from Ivory Coast as an illustration, this article shows some of the issues that must be dealt with when producing statistical indicators from Big Data sources. A proposal of a graphical method to evaluate one specific aspect of the quality of the computed figures is also presented, demonstrating that the visual insight provided improves the results obtained using other traditional procedures.

Contaminated salmon and the public's trust

USGS Publications Warehouse

Luoma, Samuel N.; Löfstedt, Ragnar E.

2007-01-01

Scientific uncertainties often make it difficult for environmental policy makers to determine how to communicate risks to the public. A constructive, holistic, multisectoral dialogue about an issue can improve understanding of uncertainties from different perspectives and clarify options for risk communication. Many environmental issues could benefit from explicit promotion of such a dialogue. When issues are complex, unconstructive advocacy, narrow focus, and exclusion of selected parties from decision making can erode public trust in science and lead to cynicism about the policies of government and the private sector.

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

ERIC Educational Resources Information Center

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

2014-01-01

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

How Teachers Need to Deal with the Seen, the Unseen, the Improbable, and the Nearly Imponderable

ERIC Educational Resources Information Center

Gregory, Marshall

2010-01-01

In addition to dealing with the more or less obvious variables that affect classroom dynamics, teachers need to learn how to deal with the far more difficult issues related to learning, identity, selfhood, and autonomy. In this article, the author first discusses classroom issues that are most visible and vivid for teachers. Next, the author…

The Progressive Era: The Limits of Reform. Public Issues Series.

ERIC Educational Resources Information Center

Giese, James R.

This booklet is part of a series designed to help students take and defend a position on public issues. In this unit, the progressive era, a major reform period in U.S. history that stretched from about 1900 to 1915 is discussed. The book suggests that large scale reform is difficult to achieve because reformers often assume that their interests,…

Non-Custodial Gay Fathers: Considering the Issues.

ERIC Educational Resources Information Center

Strader, Scott C.

This paper applies what is currently known about gay fathers to the more specific issues of the non-custodial gay father. Good parenting is not easy for any father, but being a successful gay father is even more difficult. Since the gay father is typically a non-custodial parent, he must deal with his grief about the loss of contact and quality…

Last Breath: Art Therapy with a Lung Cancer Patient Facing Imminent Death

ERIC Educational Resources Information Center

Furman, Lisa R.

2011-01-01

Art therapy can be an effective way to focus on end of life issues with cancer patients facing imminent death. This viewpoint discusses ethical challenges in the treatment of a 63-year-old man with terminal lung cancer who was participating in short-term individual art therapy. Difficult issues that often surface in the final days of life may…

Joint Services Electronics Program

DTIC Science & Technology

1992-03-05

Packaging Considerations M. T. Raghunath (Professor Abhiram Ranade) A central issue in massively parallel computation is the design of the interconnection...programs on promising network architectures. Publications: [1] M. T. Raghunath and A. G. Ranade, A Simulation-Based Compari- son of Interconnection Networks...more difficult analog function approximation task. Network Design Issues for Fast Global Communication Professor A. Ranade with M.T. Raghunath A

Mutual Benefit for Foreign Medical Students and Chinese Postgraduates: A Mixed Team-Based Learning Method Overcomes Communication Problems in Hematology Clerkship

ERIC Educational Resources Information Center

Chen, Xianling; Chen, Buyuan; Li, Xiaofan; Song, Qingxiao; Chen, Yuanzhong

2017-01-01

Hematology is difficult for students to learn. A beneficial education method for hematology clerkship training is required to help students develop clinical skills. Foreign medical students often encounter communication issues in China. To address this issue, Chinese post-graduates from our institute are willing to assist with educating foreign…

Forest Health Monitoring in the Interior West: A baseline summary of forest issues, 1996-1999

Treesearch

Paul Rogers; David Atkins; Michelle Frank; Douglas Parker

2001-01-01

Although forest health may be difficult to define and measure, a strong demand exists for assessment of forest conditions at various state, regional, and national scales. Forest Health Monitoring (FHM) is a national program designed to measure the status, changes, and trends of forest conditions annually. This report presents a broad view of forest health issues...

Integrated Resources and Training Facilitation--A Strategic Priority When Promoting ICT in Developing Countries

ERIC Educational Resources Information Center

Khalid, Saifuddin; Islam, Kamrul; Nyvang, Tom

2013-01-01

In a rural context in a developing country purchasing a computer and connecting it to the Internet is in itself difficult, even when the lack of money is a minor issue. These issues prevent individuals in rural communities from familiarizing themselves with educational technology and ICT in general. The present study investigates the specific…

Adjustment to Cancer: Anxiety and Distress (PDQ®)—Health Professional Version

Cancer.gov

Expert-reviewed information summary about the difficult emotional responses many cancer patients experience. This summary focuses on normal adjustment issues, psychosocial distress, and adjustment disorders.

Manufacturing of glassy thin shell for adaptive optics: results achieved

NASA Astrophysics Data System (ADS)

Poutriquet, F.; Rinchet, A.; Carel, J.-L.; Leplan, H.; Ruch, E.; Geyl, R.; Marque, G.

2012-07-01

Glassy thin shells are key components for the development of adaptive optics and are part of future & innovative projects such as ELT. However, manufacturing thin shells is a real challenge. Even though optical requirements for the front face - or optical face - are relaxed compared to conventional passive mirrors, requirements concerning thickness uniformity are difficult to achieve. In addition, process has to be completely re-defined as thin mirror generates new manufacturing issues. In particular, scratches and digs requirement is more difficult as this could weaken the shell, handling is also an important issue due to the fragility of the mirror. Sagem, through REOSC program, has recently manufactured different types of thin shells in the frame of European projects: E-ELT M4 prototypes and VLT Deformable Secondary Mirror (VLT DSM).

Sweden: no easy choices.

PubMed

Calltorp, J

1995-10-01

This paper describes some characteristic aspects of the Swedish health care model which can explain why choices and prioritizing have been difficult to discuss officially until very recently. Health care is an important symbol and cornerstone of the welfare society and it is therefore difficult to admit and formulate the concept of limits regarding this part of society. Parallel to a considerable decrease in the health care sector's fraction of GDP during the last 10 years, where real cuts have been more and more visible, a public discussion on choices has emerged. A parliamentary committee of politicians and experts has addressed the issue and published a final report in the spring of 1995. It proposes an 'ethical platform' as a base for addressing the issue and describes guidelines for prioritizing on a political-administrative level and clinical level.

Key Issues in the Modes of Action and Effects of Trichloroethylene Metabolites for Liver and Kidney Tumorigenesis

PubMed Central

Caldwell, Jane C.; Keshava, Nagalakshmi

2006-01-01

Trichloroethylene (TCE) exposure has been associated with increased risk of liver and kidney cancer in both laboratory animal and epidemiologic studies. The U.S. Environmental Protection Agency 2001 draft TCE risk assessment concluded that it is difficult to determine which TCE metabolites may be responsible for these effects, the key events involved in their modes of action (MOAs), and the relevance of these MOAs to humans. In this article, which is part of a mini-monograph on key issues in the health risk assessment of TCE, we present a review of recently published scientific literature examining the effects of TCE metabolites in the context of the preceding questions. Studies of the TCE metabolites dichloroacetic acid (DCA), trichloroacetic acid (TCA), and chloral hydrate suggest that both DCA and TCA are involved in TCE-induced liver tumorigenesis and that many DCA effects are consistent with conditions that increase the risk of liver cancer in humans. Studies of S-(1,2-dichlorovinyl)-l-cysteine have revealed a number of different possible cell signaling effects that may be related to kidney tumorigenesis at lower concentrations than those leading to cytotoxicity. Recent studies of trichloroethanol exploring an alternative hypothesis for kidney tumorigenesis have failed to establish the formation of formate as a key event for TCE-induced kidney tumors. Overall, although MOAs and key events for TCE-induced liver and kidney tumors have yet to be definitively established, these results support the likelihood that toxicity is due to multiple metabolites through several MOAs, none of which appear to be irrelevant to humans. PMID:16966105

Experiencing cancer treatment decision-making in managed care.

PubMed

Wenzel, Jennifer; Shaha, Maya

2008-09-01

This paper is a report of a study to explore women's perceptions of and experiences with breast cancer treatment decision-making in managed care organizations (MCOs). Managed care organizations are the predominant form of employer-sponsored healthcare insurance in the United States of America. These healthcare financing entities minimize cost by streamlining healthcare delivery and may impose choice restrictions. The extent of these restrictions has not previously been studied from an in-depth patient perspective. A qualitative descriptive approach was adopted using interviews with a purposive sample of 14 managed care enrollees diagnosed with breast cancer at all stages. The data were collected between 2003 and 2005. Data analysis involved a reflexive process of transcript reading, categorization, data reduction and interpretation. The findings are presented as a single theme: 'decisional conflict in managed care', with two distinct categories: decisions regarding (1) the MCOs and (2) treatment. MCO selection was perceived to be limited by employer constraints, cost issues or healthcare plan providers. For study participants, selecting a MCO was less difficult than issues surrounding treatment decision-making. Women reported that their most important treatment-related decisions surrounded diagnosis and involved selecting a treatment facility and provider. Once a satisfactory facility and provider were selected, these women preferred to defer treatment decisions to their healthcare providers. Decision interventions should be focused on assisting women with provider and treatment facility selection early in diagnosis. Our findings might also serve as a basis for policy/practice changes to address healthcare financing limitations and to expand cancer treatment-related choices while providing desired treatment decision-making support.

Commentary: Moving towards policy coherence in trade and health.

PubMed

Walls, Helen; Baker, Phillip; Smith, Richard

2015-11-01

International trade has brought economic benefits to many countries, but the association of trade and investment liberalisation with poor health outcomes concerns the public health community. The need to secure more 'healthy' trade is a recognised priority, especially as countries move from global to regional/bilateral trade agreements - with greater public health risks. However, a transition towards 'healthier trade' may be hindered by worldview differences between the trade and health communities. There is a tendency for health actors to perceive trade as a threat to population health, and for trade actors to view health as a constraint to trade objectives of reducing barriers to cross-border commercial flows and economic growth. Unless such differing worldviews can be aligned, finding ways forward for addressing public health in trade policy is likely to be difficult. Moving forward will involve understanding the values and drivers of the respective groups, and developing solutions palatable to their various interests. Given the power imbalances between the two areas, it is likely that the health community will have to make the first moves in this respect. This article outlines the key issues involved and suggests areas where such moves have been, and may be made.

Principles of Liability for Athletic Trainers: Managing Sport-Related Concussion

PubMed Central

2001-01-01

Objective: To provide an overview of the general legal principles of negligence for sports medicine professionals and apply these principles to situations involving athletes with head injury. Data Sources: Case law dating back to 1976 and recent studies of sport-related concussion. Summary: One of the most difficult problems facing athletic trainers and team physicians is the recognition and treatment of sport-related concussion. Providing medical clearance for sports participation and treatment of athletic injuries involves legal as well as medical issues. The threat of lawsuits exists for the sports medicine professional, whether the athlete is allowed to play or not. In general, established medical malpractice principles govern claims by athletes for injury or death caused by improper treatment by health care providers. The elements of negligence are examined, as well as the primary defenses an athletic trainer would use in court and risk management techniques to avoid litigation. Conclusions/Recommendations: Athletic trainers may protect themselves from liability by including standardized cognitive or postural stability testing in preparticipation examinations, using objective tests rather than subjective judgement to evaluate athletes who have sport-related concussion, working closely with physicians, and keeping excellent records. PMID:12937503

Parent education in youth-directed nutrition interventions.

PubMed

Crockett, S J; Mullis, R; Perry, C L; Luepker, R V

1989-07-01

Since parents play a pivotal role in helping their children to implement eating pattern changes, interest in parent education in youth-directed nutrition interventions is likely to increase along with heightened interest in primary prevention. Previous experience indicates, however, that it may be difficult to recruit and sustain parent involvement. This article describes an evaluation of the effect on parents of two youth-directed interventions with a parent component, a classroom curriculum called Hearty Heart and Friends and a mailed-home, parent-taught approach called Hearty Heart Home Team. Using incentives, a participation rate of 85.6% was achieved in Hearty Heart Home Team. This parent-taught intervention had significantly greater impact on parent than did the school-only curriculum in the following areas: knowledge about diet and heart disease; attitudes of efficacy, intention, outcome expectation and modeling; and parent-child communication and child involvement in food or nutrition-related issues in the home. In addition, the parent-taught approach influenced foods present in the home as evidenced by Home Team groups having significantly more encouraged foods and more positive choices in six scores on a shelf inventory measure conducted by in-home interviewers.

Computational considerations for the simulation of shock-induced sound

NASA Technical Reports Server (NTRS)

Casper, Jay; Carpenter, Mark H.

1996-01-01

The numerical study of aeroacoustic problems places stringent demands on the choice of a computational algorithm, because it requires the ability to propagate disturbances of small amplitude and short wavelength. The demands are particularly high when shock waves are involved, because the chosen algorithm must also resolve discontinuities in the solution. The extent to which a high-order-accurate shock-capturing method can be relied upon for aeroacoustics applications that involve the interaction of shocks with other waves has not been previously quantified. Such a study is initiated in this work. A fourth-order-accurate essentially nonoscillatory (ENO) method is used to investigate the solutions of inviscid, compressible flows with shocks in a quasi-one-dimensional nozzle flow. The design order of accuracy is achieved in the smooth regions of a steady-state test case. However, in an unsteady test case, only first-order results are obtained downstream of a sound-shock interaction. The difficulty in obtaining a globally high-order-accurate solution in such a case with a shock-capturing method is demonstrated through the study of a simplified, linear model problem. Some of the difficult issues and ramifications for aeroacoustics simulations of flows with shocks that are raised by these results are discussed.

A Human-Autonomy Teaming Approach for a Flight-Following Task

NASA Technical Reports Server (NTRS)

Brandt, Summer L.; Russell, Ricky; Lachter, Joel; Shively, Robert

2017-01-01

Managing aircraft is becoming more complex with increasingly sophisticated automation responsible for more flight tasks. With this increased complexity, it is becoming more difficult for operators to understand what the automation is doing and why. Human involvement with increasingly autonomous systems must adjust to allow for a more dynamic relationship involving cooperation and teamwork. As part of an ongoing project to develop a framework for human-autonomy teaming (HAT) in aviation, a part-task study was conducted to demonstrate, evaluate and refine proposed critical aspects of HAT. These features were built into an automated recommender system on a ground station available from previous studies. Participants performed a flight-following task once with the original ground station (i.e., No HAT condition) and once with the HAT features enabled (i.e., HAT condition). Behavioral and subjective measures were collected; subjective measures are presented here. Overall, participants preferred the ground station with HAT features enabled compared to the station without the HAT features. Participants reported that the HAT displays and automation were preferred for keeping up with operationally important issues. Additionally, participants reported that the HAT displays and automation provided enough situation awareness to complete the task and reduced workload relative to the No HAT baseline.

End of Life Issues

MedlinePlus

... difficult. But by deciding what end-of-life care best suits your needs when you are healthy, ... making choices about the following: The goals of care (for example, whether to use certain medicines during ...

Individual social security accounts: issues in assessing administrative feasibility and costs.

PubMed

Olsen, K A; Salisbury, D L

1998-11-01

Whether to add individual accounts (IAs) to the Social Security system is a highly political issue. But almost lost in the debate so far have been any practical considerations about how to administer such accounts. Any discussion of whether to create individual accounts must also address the basic but critical questions of how they would work: Who would run them? What would they cost? Logistically, are they even possible? This EBRI Issue Brief provides an overview of the most salient administrative issues facing the current Social Security reform debate--issues that challenge proponents to carefully think through how their proposals could be implemented so as to achieve their policy goals. The options and difficulties in administering IAs raise concerns that cut across ideology. The object of this report is neither to dissuade the advocates nor support the critics of individual accounts. Rather, it is to bring practical considerations to a political debate that has largely ignored the pragmatic challenges of whether IAs would be too complex for participants to understand or too difficult for record keepers to administer. The major findings in this analysis include: Adding individual accounts to Social Security could be the largest undertaking in the history of the U.S. financial market, and no system to date has the capacity to administer such a system. The number of workers currently covered by Social Security--the largest single entitlement program in the nation--is at least four times higher than the combined number of all tax-favored employment-based retirement accounts in the United States, which are administered by hundreds of entities. Direct comparisons between employment-based retirement savings plans and Social Security reform are tenuous at best. Social Security covers workers and businesses that are disproportionately excluded from employment-based plans. Because of these differences, a system of individual Social Security accounts would be more difficult to administer than employment-based plans, and total administrative expenses would be larger relative to benefits. Credit-based systems such as the current Social Security program are less difficult to administer than cash-based systems, which must account for every dollar. Inherent in the "privatization" debate is generally the presumption that IA benefits would be based on cash contributions and investment returns. The current credit-based system tolerates small errors in wage reporting, because they rarely affect benefits. But every dollar counts in a cash-based IA system. To ensure that benefits are properly provided, an IA system would require more regulation, oversight, and error reconciliation than the current Social Security program. Social Security individual accounts cannot be administered like 401(k) plans without adding significant employer burdens--especially on small businesses. Under the current wage reporting and tax collection process, it would take at least 7-19 months for every dollar contributed to an individual's account to be sorted out from aggregate payments and credited to his or her IA. This 7-19 month "float period" could result in substantial benefit losses over time. Options for preventing such losses involve difficult trade-offs, such as increased government responsibility, increased complexity, greater employer burdens, and/or investment restrictions for beneficiaries. If legally considered personal property, the IAs of married participants could pose significant administrative challenges. Social Security today must obtain proof of marriage only at the time spousal benefits are claimed. But some IA proposals would require contributions to be split between spouses' individual accounts, requiring records on participants' marital status to be continuously update to ensure that contributions are correctly directed. Also, dealing with claims on individual account contributions in divorce cases could place IA record keepers in the middle o

How Older Adults and Their Families Perceive Family Talk about Aging-Related EOL Issues: A Dialectical Analysis.

PubMed

Egbert, Nichole; Child, Jeffrey T; Lin, Mei-Chen; Savery, Carol; Bosley, Tammy

2017-04-17

For older adults, approaching end-of-life (EOL) brings unique transitions related to family relationships. Unfortunately, most families greatly underestimate the need to discuss these difficult issues. For example, parents approaching EOL issues often struggle with receiving assistance from others, avoiding family conflict, and maintaining their sense of personhood. In addition, discussions of EOL issues force family members to face their parents' mortality, which can be particularly difficult for adult children to process emotionally. This study explored aging issues identified by aging parents and their families as they traverse these impending EOL changes. Ten focus groups of seniors ( n = 65) were conducted. Focus groups were organized according to race (African-American/European-American), gender, and whether the older adult was living independently or in an assisted care facility. When asked open-ended questions about discussing aging and EOL issues with family members, participants revealed tensions that led us to consider Relational Dialectics Theory as a framework for analysis. The predominant tension highlighted in this report was certainty versus uncertainty, with the two sub-themes of sustained life versus sustained personhood and confronting versus avoiding EOL issues. For these data, there were more similarities than differences as a result of gender, race, or living situation than one might expect, although culture and financial status were found to be influential in the avoidance of EOL discussions. The results of this study help to provide additional insight into relational dialectics related to aging, EOL, and the importance of communication in facilitating family coping.

Accountability: A Mosaic Image

ERIC Educational Resources Information Center

Turner, Teri

1977-01-01

The problems involved in definition, implementation and control of accountability processes are discussed. It is stated that "...emotional involvement in accountability is one of the most difficult aspects to deal with, the chief emotion being fear". (Author/RW)

Talk with Your Kids...before Everyone Else Does: Talking with Kids about Tough Issues.

ERIC Educational Resources Information Center

Children Now, Oakland, CA.

Parents are challenged daily with a wide range of disturbing issues that are difficult for children to understand and for adults to explain. This booklet offers practical, concrete tips and techniques for talking easily and openly with 8- to 12-year-olds about sex, HIV/AIDS, violence, drugs, and alcohol. The book is divided into five parts. Part 1…

Stem Cells and Society: An Undergraduate Course Exploring the Intersections among Science, Religion, and Law

ERIC Educational Resources Information Center

Pierret, Chris; Friedrichsen, Patricia

2009-01-01

The intersection of science and our society has led to legal and ethical issues in which we all play a part. To support development of scientific literacy, college science courses need to engage students in difficult dialogues around ethical issues. We describe a new course, Stem Cells and Society, in which students explore the basic biology of…

Issues of Shared Parenting of LGBTQ Children and Youth in Foster Care: Preparing Foster Parents for New Roles

ERIC Educational Resources Information Center

Craig-Oldsen, Heather; Craig, J. Ann; Morton, Thomas

2006-01-01

Foster parents have increasingly assumed new and challenging roles during the past decade. Meeting the developmental, attachment, and grieving needs of children and youth in out of home care is challenging by itself, but can become even more difficult with the issues that arise when the child is lesbian, gay, bisexual, transgender, or questioning…

Training Teachers To Work in Schools Considered Difficult. Fundamentals of Educational Planning Series, Number 59.

ERIC Educational Resources Information Center

Auduc, Jean-Louis

This book outlines challenges involved in ensuring that teacher training becomes the gateway to implementation of appropriate strategies for students to achieve and for managing the problems of authority, discipline, and aggressive behavior. The six chapters examine: (1) "Teaching in Schools or Classes Considered Difficult: A Contemporary…

Applying Critical Race Theory to Group Model Building Methods to Address Community Violence.

PubMed

Frerichs, Leah; Lich, Kristen Hassmiller; Funchess, Melanie; Burrell, Marcus; Cerulli, Catherine; Bedell, Precious; White, Ann Marie

2016-01-01

Group model building (GMB) is an approach to building qualitative and quantitative models with stakeholders to learn about the interrelationships among multilevel factors causing complex public health problems over time. Scant literature exists on adapting this method to address public health issues that involve racial dynamics. This study's objectives are to (1) introduce GMB methods, (2) present a framework for adapting GMB to enhance cultural responsiveness, and (3) describe outcomes of adapting GMB to incorporate differences in racial socialization during a community project seeking to understand key determinants of community violence transmission. An academic-community partnership planned a 1-day session with diverse stakeholders to explore the issue of violence using GMB. We documented key questions inspired by critical race theory (CRT) and adaptations to established GMB "scripts" (i.e., published facilitation instructions). The theory's emphasis on experiential knowledge led to a narrative-based facilitation guide from which participants created causal loop diagrams. These early diagrams depict how violence is transmitted and how communities respond, based on participants' lived experiences and mental models of causation that grew to include factors associated with race. Participants found these methods useful for advancing difficult discussion. The resulting diagrams can be tested and expanded in future research, and will form the foundation for collaborative identification of solutions to build community resilience. GMB is a promising strategy that community partnerships should consider when addressing complex health issues; our experience adapting methods based on CRT is promising in its acceptability and early system insights.

Hairy Slices: Evaluating the Perceptual Effectiveness of Cutting Plane Glyphs for 3D Vector Fields.

PubMed

Stevens, Andrew H; Butkiewicz, Thomas; Ware, Colin

2017-01-01

Three-dimensional vector fields are common datasets throughout the sciences. Visualizing these fields is inherently difficult due to issues such as visual clutter and self-occlusion. Cutting planes are often used to overcome these issues by presenting more manageable slices of data. The existing literature provides many techniques for visualizing the flow through these cutting planes; however, there is a lack of empirical studies focused on the underlying perceptual cues that make popular techniques successful. This paper presents a quantitative human factors study that evaluates static monoscopic depth and orientation cues in the context of cutting plane glyph designs for exploring and analyzing 3D flow fields. The goal of the study was to ascertain the relative effectiveness of various techniques for portraying the direction of flow through a cutting plane at a given point, and to identify the visual cues and combinations of cues involved, and how they contribute to accurate performance. It was found that increasing the dimensionality of line-based glyphs into tubular structures enhances their ability to convey orientation through shading, and that increasing their diameter intensifies this effect. These tube-based glyphs were also less sensitive to visual clutter issues at higher densities. Adding shadows to lines was also found to increase perception of flow direction. Implications of the experimental results are discussed and extrapolated into a number of guidelines for designing more perceptually effective glyphs for 3D vector field visualizations.

Application of the Water Needs Index: Can Tho City, Mekong Delta, Vietnam

NASA Astrophysics Data System (ADS)

Moglia, Magnus; Neumann, Luis E.; Alexander, Kim S.; Nguyen, Minh N.; Sharma, Ashok K.; Cook, Stephen; Trung, Nguyen H.; Tuan, Dinh D. A.

2012-10-01

SummaryProvision of urban water supplies to rapidly growing cities of South East Asia is difficult because of increasing demand for limited water supplies, periodic droughts, and depletion and contamination of surface and groundwater. In such adverse environments, effective policy and planning processes are required to secure adequate water supplies. Developing a Water Needs Index reveals key elements of the complex urban water supply by means of a participatory approach for rapid and interdisciplinary assessment. The index uses deliberative interactions with stakeholders to create opportunities for mutual understanding, confirmation of constructs and capacity building of all involved. In Can Tho City, located at the heart of the Mekong delta in Vietnam, a Water Needs Index has been developed with local stakeholders. The functional attributes of the Water Needs Index at this urban scale have been critically appraised. Systemic water issues, supply problems, health issues and inadequate, poorly functioning infrastructure requiring attention from local authorities have been identified. Entrenched social and economic inequities in access to water and sanitation, as well as polluting environmental management practices has caused widespread problems for urban populations. The framework provides a common language based on systems thinking, increased cross-sectoral communication, as well as increased recognition of problem issues; this ought to lead to improved urban water management. Importantly, the case study shows that the approach can help to overcome biases of local planners based on their limited experience (information black spots), to allow them to address problems experienced in all areas of the city.

The influence of viewing an entertainment-education program on cornea donation intention: a test of the theory of planned behavior.

PubMed

Bae, Hyuhn-Suhck; Kang, Seok

2008-01-01

This study was designed to examine the role of issue involvement and the 3 components of the theory of planned behavior in predicting intentions to sign a cornea donor card. This study also compares viewers and nonviewers of an entertainment-education program in terms of issue involvement and the theory of planned behavior. The breakdown of effects for the latent constructs confirms that issue involvement is an important intermediary in the persuasion process. Issue involvement is a common causal antecedent of attitude, subjective norm, and perceived behavioral control, the last 2 of which, in turn, predict intentions, whereas attitude does not. The revised path model confirms that involvement directly influences intentions. In the comparison of viewers with nonviewers, viewers exhibit a significantly higher degree of involvement, attitude toward cornea donation, subjective norm, perceived behavioral control, and intention to sign a cornea donor card. The overall findings of this study suggest that adding issue involvement in the theory of planned behavior enhances the explanatory power of the theory in predicting intentions.

Human Simulators and Standardized Patients to Teach Difficult Conversations to Interprofessional Health Care Teams

PubMed Central

Zimmerman, Christine; Kennedy, Christopher; Schremmer, Robert; Smith, Katharine V.

2010-01-01

Objective To design and implement a demonstration project to teach interprofessional teams how to recognize and engage in difficult conversations with patients. Design Interdisciplinary teams consisting of pharmacy students and residents, student nurses, and medical residents responded to preliminary questions regarding difficult conversations, listened to a brief discussion on difficult conversations; formed ad hoc teams and interacted with a standardized patient (mother) and a human simulator (child), discussing the infant's health issues, intimate partner violence, and suicidal thinking; and underwent debriefing. Assessment Participants evaluated the learning methods positively and a majority demonstrated knowledge gains. The project team also learned lessons that will help better design future programs, including an emphasis on simulations over lecture and the importance of debriefing on student learning. Drawbacks included the major time commitment for design and implementation, sustainability, and the lack of resources to replicate the program for all students. Conclusion Simulation is an effective technique to teach interprofessional teams how to engage in difficult conversations with patients. PMID:21088725

Difficult Decisions: Euthanasia.

ERIC Educational Resources Information Center

Parakh, Jal S.; Slesnick, Irwin L.

1992-01-01

Focuses on the moral arguments for and against the controversial topic of voluntary active euthanasia. Discusses the question of legalization and decriminalization of the practice. Provides a student worksheet with questions to stimulate discussion on the issue. (MDH)

Guidance for Catastrophic Emergency Situations Involving Asbestos

EPA Pesticide Factsheets

This document addresses the types of asbestos issues that may arise during catastrophic events and how EPA has addressed such issues. It replaces the Guidelines for Catastrophic Emergency Situations Involving Asbestos which was issued in 1992.

Gender bias in hospital leadership: a qualitative study on the experiences of women CEOs.

PubMed

Soklaridis, Sophie; Kuper, Ayelet; Whitehead, Cynthia R; Ferguson, Genevieve; Taylor, Valerie H; Zahn, Catherine

2017-04-10

Purpose The purpose of this paper is to examine the experiences of gender bias among women hospital CEOs and explore to what these female leaders attribute their success within a male-dominated hospital executive leadership milieu. Design/methodology/approach This qualitative study involved 12 women hospital CEOs from across Ontario, Canada. Purposeful sampling techniques and in-depth qualitative interview methods were used to facilitate discussion around experiences of gender and leadership. Findings Responses fell into two groups: the first group represented the statement "Gender inequality is alive and well". The second group reflected the statement "Gender inequity is not significant, did not happen to me, and things are better now". This group contained a sub-group with no consciousness of systemic discrimination and that claimed having no gendered experiences in their leadership journey. The first group described gender issues in various contexts, from the individual to the systemic. The second group was ambivalent about gender as a factor impacting leadership trajectories. Originality/value Representations of women's leadership have become detached from feminism, with major consequences for women. This study reveals how difficult it is for some women CEOs to identify gender bias. The subtle everyday norms and practices within the workplace make it difficult to name and explain gender bias explicitly and may explain the challenges in understanding how it might affect a woman's career path.

Scientific, Social, and Institutional Constraints Facing Coastal Restoration in Louisiana

NASA Astrophysics Data System (ADS)

Kleiss, B.; Shabman, L. A.; Brown, G.

2017-12-01

Due to multiple stressors, including subsidence, accelerated sea level rise, canal construction, tropical storm damages, and basin-wide river management decisions, southern Louisiana is experiencing some of the world's highest rates of coastal land loss. Although ideas abound, the solutions proposed to mitigate for land loss are often uncertain, complex, expensive, and difficult. There are significant scientific uncertainties associated with fundamental processes including the spatial distribution of rates of subsidence, the anticipated impacts of increased inundation on marsh plant species and questions about the resilience of engineered solutions. Socially and politically, there is the need to balance navigation, flood risk management and environmental restoration with the fact that the land involved is largely privately owned and includes many communities and towns. And layered within this, there are federal and state regulatory constraints which seek to follow a myriad of existing State and Federal laws, protect the benefits realized from previous federal investments, and balance the conflicting interests of a large number of stakeholders. Additionally, current practice when implementing some environmental regulations is to assess impacts against the baseline of current conditions, not projected future, non-project conditions, making it difficult to receive a permit for projects which may have a short-term detriment, but hope for a long-term benefit. The resolution (or lack thereof) of these issues will serve to inform similar future struggles in other low lying coastal areas around the globe.

Fertility Preservation in Pediatric and Adolescent Oncology Patients: The Decision-Making Process of Parents.

PubMed

Li, Nancy; Jayasinghe, Yasmin; Kemertzis, Matthew A; Moore, Paddy; Peate, Michelle

2017-06-01

Decisions surrounding fertility preservation (FP) in children, adolescents, and adults can be difficult due to the distress of a cancer diagnosis, time constraints for decision-making, and lack of efficacy data. This review examines the decision-making process of oncology patients and their parents (if patients are in the pediatric or adolescent population) to better understand experiences of decisional conflict and regret. Two electronic databases, Embase and Pubmed, were searched using the terms (Decision-making OR Conflict (Psychology) OR Decision regret) AND (Freezing OR Oocyte OR Ovarian tissue OR Semen preservation OR Fertility preservation OR Cryopreservation) AND (Neoplasms OR Cancer OR Chemotherapy OR Drug therapy OR Radiotherapy). Medical Subject Heading terms were utilized where possible. Included articles discussed FP decision-making from the patient's perspective. Thirty-five articles discussing FP decision-making were included (24 in the adult population, 11 in the pediatric and adolescent population). Key themes from these articles included the following: factors considered in FP decision-making, decision-making in established procedures and experimental procedures, decisional conflict and regret, the perceived importance of information, adolescent involvement in decision-making, and ethical considerations in the pediatric population. Unique ethical issues arise in the pediatric and adolescent population. Considering that the decision to pursue FP is known to be difficult in the adult population, decisional conflict and regret may be greater for parents who are making the decision for their child.

New technologies for advanced three-dimensional optimum shape design in aeronautics

NASA Astrophysics Data System (ADS)

Dervieux, Alain; Lanteri, Stéphane; Malé, Jean-Michel; Marco, Nathalie; Rostaing-Schmidt, Nicole; Stoufflet, Bruno

1999-05-01

The analysis of complex flows around realistic aircraft geometries is becoming more and more predictive. In order to obtain this result, the complexity of flow analysis codes has been constantly increasing, involving more refined fluid models and sophisticated numerical methods. These codes can only run on top computers, exhausting their memory and CPU capabilities. It is, therefore, difficult to introduce best analysis codes in a shape optimization loop: most previous works in the optimum shape design field used only simplified analysis codes. Moreover, as the most popular optimization methods are the gradient-based ones, the more complex the flow solver, the more difficult it is to compute the sensitivity code. However, emerging technologies are contributing to make such an ambitious project, of including a state-of-the-art flow analysis code into an optimisation loop, feasible. Among those technologies, there are three important issues that this paper wishes to address: shape parametrization, automated differentiation and parallel computing. Shape parametrization allows faster optimization by reducing the number of design variable; in this work, it relies on a hierarchical multilevel approach. The sensitivity code can be obtained using automated differentiation. The automated approach is based on software manipulation tools, which allow the differentiation to be quick and the resulting differentiated code to be rather fast and reliable. In addition, the parallel algorithms implemented in this work allow the resulting optimization software to run on increasingly larger geometries. Copyright

Designing a Citizen Involvement Program: A Guidebook for Involving Citizens in the Resolution of Environmental Issues.

ERIC Educational Resources Information Center

Howell, Robert E.; And Others

A model and supportive materials are presented for design and implementation of a program for involving citizens in decision-making concerning significant environmental issues. Chapter topics include: why citizen involvement? (potential benefits of the process); theoretical basis for citizen involvement (three fundamental perspectives underlying…

Strategic management and organizational behavior in dental education: reflections on key issues in an environment of change.

PubMed

Dunning, David G; Durham, Timothy M; Lange, Brian M; Aksu, Mert N

2009-06-01

With issues such as shrinking revenue, access to care, faculty workloads, and graying faculty, dental schools are faced with difficult challenges that fall to dental school deans to manage. Do dental school deans have the organizational skill sets and ethical frameworks necessary to address the challenges now facing dental schools? The purpose of this article is to pose questions and suggestions regarding some of the key issues in dental colleges today and to stimulate discussion in the dental community about needed changes in dental education.

Developing Pathways to Serving Together: Military Family Life Course and Decision-Making of Dual Military Couples

DTIC Science & Technology

2010-01-01

common theme for couples in their parent role. Many couples expect it to be emotionally difficult to leave their children for deployments but find it...and going which again is a career timing issue. Parents feel it will be emotionally and mentally difficult for the children to adapt to having...or command when parents have to come to work later of leave earlier because of daycare hours. Stephanie explains her negative reaction from peers

A Novel Training Program for Police Officers that Improves Interactions with Mentally Ill Individuals and is Cost-Effective

PubMed Central

Krameddine, Yasmeen I.; DeMarco, David; Hassel, Robert; Silverstone, Peter H.

2013-01-01

Police and law enforcement providers frequently come into contact with individuals who have psychiatric disorders, sometimes with tragic results. Repeated studies suggest that greater understanding of psychiatric conditions by police officers would be beneficial. Here we present a novel approach to training police officers to improve their interactions with those who might have a mental illness. This approach involved developing a carefully scripted role-play training, which involved police officers (n = 663) interacting with highly trained actors during six realistic scenarios. The primary goal of the training was to improve empathy, communication skills, and the ability of officers to de-escalate potentially difficult situations. Uniquely, feedback was given to officers after each scenario by several individuals including experienced police officers, a mental health professional, and by the actors involved (with insights such as “this is how you made me feel”). Results showed that there were no changes in attitudes of the police toward the mentally ill comparing data at baseline and at 6 months after the training in those who completed both ratings (n = 170). In contrast, there were significant improvements in directly measured behaviors (n = 142) as well as in indirect measurements of behavior throughout the police force. Thus, compared to previous years, there was a significant increase in the recognition of mental health issues as a reason for a call (40%), improved efficiency in dealing with mental health issues, and a decrease in weapon or physical interactions with mentally ill individuals. The training cost was $120 per officer but led to significant cost savings (more than $80,000) in the following 6 months. In conclusion, this novel 1-day training course significantly changed behavior of police officers in meaningful ways and also led to cost savings. We propose that this training model could be adopted by other police agencies. PMID:23515226

The 2015 Nepal earthquake disaster: lessons learned one year on.

PubMed

Hall, M L; Lee, A C K; Cartwright, C; Marahatta, S; Karki, J; Simkhada, P

2017-04-01

The 2015 earthquake in Nepal killed over 8000 people, injured more than 21,000 and displaced a further 2 million. One year later, a national workshop was organized with various Nepali stakeholders involved in the response to the earthquake. The workshop provided participants an opportunity to reflect on their experiences and sought to learn lessons from the disaster. One hundred and thirty-five participants took part and most had been directly involved in the earthquake response. They included representatives from the Ministry of Health, local and national government, the armed forces, non-governmental organizations, health practitioners, academics, and community representatives. Participants were divided into seven focus groups based around the following topics: water, sanitation and hygiene, hospital services, health and nutrition, education, shelter, policy and community. Facilitated group discussions were conducted in Nepalese and the key emerging themes are presented. Participants described a range of issues encountered, some specific to their area of expertize but also more general issues. These included logistics and supply chain challenges, leadership and coordination difficulties, impacts of the media as well as cultural beliefs on population behaviour post-disaster. Lessons identified included the need for community involvement at all stages of disaster response and preparedness, as well as the development of local leadership capabilities and community resilience. A 'disconnect' between disaster management policy and responses was observed, which may result in ineffective, poorly planned disaster response. Finding time and opportunity to reflect on and identify lessons from disaster response can be difficult but are fundamental to improving future disaster preparedness. The Nepal Earthquake National Workshop offered participants the space to do this. It garnered an overwhelming sense of wanting to do things better, of the need for a Nepal-centric approach and the need to learn the lessons of the past to improve disaster management for the future. Copyright © 2016.

Ethical issues in paleopathological and anthropological research experiences.

PubMed

Licata, Marta; Monza, Francesca

2017-10-23

In recent years, archaeologists and anthropologists involved in the study of human remains have had to take into consideration ethical issues, which have come to the fore. The aim of this study is to illustrate the ethical and religious issues involved in relation to the positions of researchers. Ethical issues involve the different study phases of human remains: archaeological excavation, anthropological analysis and, finally, museum display. Osteoarchaeological remains may find a place in museums. However, in recent years, even the display of human remains museum has had to face new important ethical issue involving previously ignored or neglected aspect. The adoption of Native American Grave Protection Act in 1990 in the United States and the Human Tissue Act in 2004 in England, has created new scenarios relating to the storage of human remains in museum. All this caused a series of changes in the study of human remains, but many issues remain open to debate.

Ecologies of Parental Engagement in Urban Education

ERIC Educational Resources Information Center

Barton, Angela Calabrese; Drake, Corey; Perez, Jose Gustavo; St. Louis, Kathleen; George, Magnia

2004-01-01

What we know about parental involvement in schools cuts across two areas: how and why parental involvement is important and the structural barriers that impede parental participation. However, it has been difficult to construct an account of parental involvement, grounded in everyday practice that goes beyond a laundry list of things that good…

Ethical issues in field trials of genetically modified disease-resistant mosquitoes.

PubMed

Resnik, David B

2014-04-01

Mosquito-borne diseases take a tremendous toll on human populations, especially in developing nations. In the last decade, scientists have developed mosquitoes that have been genetically modified to prevent transmission of mosquito-borne diseases, and field trials have been conducted. Some mosquitoes have been rendered infertile, some have been equipped with a vaccine they transmit to humans, and some have been designed to resist diseases. This article focuses on ethical issues raised by field trials of disease-resistant, genetically modified mosquitoes. Some of these issues include: protecting the public and the environment from harm, balancing benefits and risks, collaborating with the local community, avoiding exploitation, and safeguarding the rights and welfare of research subjects. One of the most difficult problems involves protecting the welfare of community members who will be impacted by the release of mosquitoes but who are not enrolled in the study as research subjects. To address this concern, field trials should take place only when the targeted disease is a significant public health problem in an isolated area, the benefits of the trial for the community are likely to outweigh the risks, community leaders approve of the trial, and there are measures in place to protect the welfare of un-enrolled community members, such as informing the community about the study and offering free treatment to people who contract mosquito-borne diseases. Since the justification of any field trial depends on a careful examination of the scientific and ethical issues, proposed studies should be evaluated on a case-by-case basis. Published 2012. This article is a US Government work and is in the public domain in the USA.

Parenting Outcomes of Single Active Duty Postpartum Women

DTIC Science & Technology

1998-04-15

Single active duty mothers face many of the same stressors as civilian single parents, including role strain, child care issues, and lack of...discretionary time. Child care is a difficult issue for single parents who need care that is flexible, convenient, and available at a reasonable cost...Deployments, work related travel, shift work, and relocations pose additional and unique problems for child care arrangements for military (Wahl & Randall

Building better understanding of sustainability and freight transport.

DOT National Transportation Integrated Search

2017-02-01

Public information on sustainability and freight transportation is difficult to find outside of technical research journals. Even among college curricula, the freight sector is often overlooked as a major transportation and environmental issue. To fi...

Health Care Issues in Southern Rural Black America.

ERIC Educational Resources Information Center

Turner, Henrie M.

1986-01-01

High infant and maternal mortality, poverty, isolation, a shortage of health professionals, inadequate health care facilities, and difficult geographic access to care are some of the health-related problems that plague Black rural southerners. (GC)

The right to an heir in the era of assisted reproduction.

PubMed

Benshushan, A; Schenker, J G

1998-05-01

The latest remarkable technological advances in assisted reproduction, which enable cryopreservation of spermatozoa, embryos and ovarian tissue, raise difficult and debatable legal, social, ethical and moral issues concerning the right to posthumous reproduction. Furthermore, reports on the attitudes of the general public and of centres licensed for infertility treatment in the United Kingdom found that the majority of women and centres support the idea of posthumous reproduction. In this paper we review the data published on this issue, and after considering the various aspects, we conclude that each case should be discussed and authorized by a multidisciplinary committee that includes physicians, clergy, psychiatrists, psychologists, sociologists and other appropriate parties. In our opinion, the main principles that should guide this committee would allow posthumous reproduction in the context of marriage when a prior consent exists. For unmarried persons, post-mortem donation of gametes should be done only anonymously, if they are in agreement with existing laws concerning infertility treatments in every country and after appropriate consent and proper counselling. Moreover, any case which involves consanguinity or a possibility of incest should be forbidden, both for ethical and genetic reasons. In a case of pre-existing siblings, they should be consulted and their informed consent should be granted in advance so as to avoid legal problems in the inheritance of property.

A new method to assess the sustainability performance of events: Application to the 2014 World Orienteering Championship

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

Scrucca, Flavio; Severi, Claudio; Galvan, Nicola

Nowadays an increasing attention of public and private agencies to the sustainability performance of events is observed, since it is recognized as a key issue in the context of sustainable development. Assessing the sustainability performance of events involves environmental, social and economic aspects; their impacts are complex and a quantitative assessment is often difficult. This paper presents a new quali-quantitative method developed to measure the sustainability of events, taking into account all its potential impacts. The 2014 World Orienteering Championship, held in Italy, was selected to test the proposed evaluation methodology. The total carbon footprint of the event was 165.34more » tCO{sub 2}eq and the avoided emissions were estimated as being 46 tCO{sub 2}eq. The adopted quali-quantitative method resulted to be efficient in assessing the sustainability impacts and can be applied for the evaluation of similar events. - Highlights: • A quali-quantitative method to assess events' sustainability is presented. • All the methodological issues related to the method are explained. • The method is used to evaluate the sustainability of an international sports event. • The method resulted to be valid to assess the event's sustainability level. • The carbon footprint of the event has been calculated.« less

National Vaccine Policy: ethical equity issues.

PubMed

Jayakrishnan, T

2013-01-01

The ministry of health and family welfare published the national vaccination policy in April 2011. The policy document drew severe criticism from several public health experts. A review of the print and web-based literature on the national vaccine policy was done and the issues of ethics and equity involved in introducing new vaccines under the Universal Immunisation Programme (UIP) were studied. The average coverage of the UIP vaccines at the national level is below 50%. Despite this, the policy document did not state any concrete strategy for increasing the coverage. The main stumbling block for evidence-based vaccine policy in India is the lack of reliable epidemiological data, which makes it difficult for the National Technical Advisory Group on Immunisation to offer sound technical advice to the government. No attempts have been made to prioritise diseases or the selection of vaccines. The policy suggests the introduction of the following vaccines in the UIP: Haemophilus influenzae type b, pneumococcal vaccine, rotavirus vaccines and human papillomavirus (HPV). This selection is on the grounds of the vaccines' availability, not on the basis of epidemiological evidence or proven cost-effectiveness. This is a critical review of the current vaccination policy and the move to include the rotavirus and HPV vaccines in the UIP.

Teaching/learning styles, performance, and students' teaching evaluation in S/T/E/S-focused science teacher education: A quasiquantitative probe of a case study

NASA Astrophysics Data System (ADS)

Toller, Uri

In response to the new needs for S/T/E/S-literate science teachers, an S/T/E/S-oriented ISMMC-IEE combination model of instruction was implemented in two specially designed undergraduate courses and one graduate course within college science teacher training programs. These three courses served as case studies for class-based, quasiquantitative pilot investigation aimed at gaining a deeper insight into some of the issues involved in the implementation in college of nontraditional, open-ended, problem-solving-oriented teaching strategies which are in dissonance with the cognitive or affective styles and functional paradigms of most students. This probe into the dissonance issue revealed that prospective teachers are capable of handling the new instructional model and do gain in their higher-level cognitive learning. However, undergraduates perceive these courses to be either difficult or not in accord with their needs, and their appreciation of the instructional techniques and style employed is different from that of graduate students accordingly. The current study suggests that although the ISMMC-IEE model is useful in S/T/E/S-oriented courses in science teacher training programs, special attention to the implementation stage is required to close the gap between students' and S/T/E/S educators' functional paradigms.

Issues for the future. Putting the jigsaw together.

PubMed

1998-07-01

Oxfam's efforts to support organizations working with disabled people in Bosnia highlight the necessity of taking into account other forms of disadvantage that increase vulnerability, such as gender, when planning interventions. When Oxfam began working in Bosnia in 1993, disability was widely perceived as a medical rather than a social development issue. An Oxfam-inspired inter-Association project set up the Lotos Resource Center to create badly needed joint social space and office space for vocational training. Realizing that it was difficult to reach women with disabilities, Oxfam representatives made home visits to encourage women to participate in activities. Oxfam also actively co-opted women to join the steering committee. This work gave Oxfam a better understanding of the fact that a diversity of needs exists for disabled men and women, for able-bodied women caring for disabled partners, and for women caring for disabled children. Lessons learned include 1) people with disabilities are not homogeneous in their needs; 2) it is essential to take positive action to involve disabled women; 3) gender and disability analysis must be inclusive and must consider different sources of marginalization or else marginalization will be reinforced; and 4) a basic rights approach provides a clear framework to understand dimensions of disadvantage within households.

Entertainment-education and recruitment of cornea donors: the role of emotion and issue involvement.

PubMed

Bae, Hyuhn-Suhck

2008-01-01

This study examined the role of emotional responses and viewer's level of issue involvement to an entertainment-education show about cornea donation in order to predict intention to register as cornea donors. Results confirmed that sympathy and empathy responses operated as a catalyst for issue involvement, which emerged as an important intermediary in the persuasion process. Issue involvement also was found to be a common causal antecedent of attitude, subjective norm, and perceived behavioral control, the last two of which predict intentions unlike attitude, which does not. The revised path model confirmed that involvement directly influences intention. The findings of this study suggest that adding emotion and involvement in the Theory of Planned Behavior (TPB) enhances the explanatory power of the theory in predicting intentions, which indicates the possibility of combining the Elaboration Likelihood Model (ELM) and the TPB in the prediction of human behaviors.

Micromanagement--a costly management style.

PubMed

Collins, Sandra K; Collins, Kevin S

2002-01-01

Micromanagement can be advantageous in certain short-term situations, such as while training new employees, increasing productivity of underperforming employees, controlling high-risk issues, and when there can be no question of who is in charge. However, the costs associated with long-term micromanagement can be exorbitant. Symptoms such as low employee morale, high staff turnover, reduction of productivity and patient dissatisfaction can be associated with micromanagement. The negative impacts are so intense that it is labeled among the top three reasons employees resign. Ultimately, micromanagement leads to decreased growth potential in a department. Managers who put too much emphasis on daily operational details can miss the broader picture and fail to plan for departmental expansion. Eventually, many micromanagers find themselves at considerable risk of burnout. Changing behavior associated with micromanagement can be a lengthy and difficult process. As with most problems, the first step is to realize that there is behavior that needs to be changed and to understand how it negatively impacts the department. Conducting a self-assessment of one's leadership style can be advantageous in this process. The true task is to find a balance between effectively performing daily obligations and strategically planning for the future. This task typically involves proper delegation of duties, and that in itself is a difficult challenge. Proper delegation of tasks may be the primary key to combating micromanaging behavior, however, some other suggestions include: 1. Develop a vision of what the department will look like in the future. 2. Hire people with the right skills for the job. 3. Develop a policy and procedures manual. 4. Develop solid lines of communication between managers and subordinates. 5. Expect some employee errors. Mistakes are an important process in the learning experience and should be viewed as a training expense. Employees who are allowed to be self-directed will be motivated to be more productive. Staffing issues such as low morale and high turnover will decrease; patient satisfaction will increase simultaneously.

Health and child labor in agriculture.

PubMed

Hurst, Peter

2007-06-01

Seventy percent of child laborers--more than 150 million girls and boys under 18--are agricultural workers. They are harshly exploited, toiling in poor to appalling conditions, performing dangerous jobs with little or no pay, and are deprived of an education. Because children's bodies and minds are still growing and developing, exposure to workplace hazards and risks can be more devastating and long-lasting for them. The line between what is acceptable work and what is not is easily crossed. However, not all work that children undertake in agriculture is bad for them. Age-appropriate, lower-risk tasks that do not interfere with schooling and leisure time are not at issue here. The goal of this paper is to examine the links between health and child labor in agriculture. It aims to explain why the International Labour Organization' goal of eliminating all of the worst forms of child labor by 2016 will only be possible if more work is done in agriculture. Review of the relevant literature and data on the hazards of child labor and the reasons why agricultural child labor is particularly difficult to tackle. Children who work in agriculture are exposed to a large number of health hazards, and yet the problem is particularly difficult to tackle because of the large numbers involved, the young age at which children start to work, the hazardous nature of the work, lack of regulation, invisibility of child laborers, denial of education, the effects of poverty, and ingrained attitudes and perceptions about the roles of children in rural areas. Policies for preventing and reducing agricultural child labor should mainstream and integrate child labor issues at the national and international levels with increasing emphasis on poverty alleviation and expanding and improving institutional mechanisms for education, law enforcement, health, and so forth. Cooperation between the International Labour Organization and international agricultural organizations is needed to ensure that child labor in agriculture is a thing of the past.

"Suspended animation," my mother's wife and cultural discernment: considerations for genetic research among immigrants.

PubMed

Kissell, Judith Lee

2005-01-01

One of the most difficult contemporary issues facing the bioethics of clinical research is balancing the maintaining of a universality of ethics standards with a sensitivity to cultural issues and differences. The concept of "vulnerability" for research subjects is especially apt for investigating the ethical and cultural issues surrounding the conduct of genetic research among new immigrants to the United States, using the Sudanese Nuer and Dinka tribes, recently settled in the Midwest, as an example. Issues of cultural vulnerability arise for some immigrants, related to relationship to the earth and to kinship issues, that threaten the narrative richness of a subject's life as well as the way she situates herself in the world.

Waste-to-energy: What are the issues?

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

Merritt, J.A.

1995-09-01

It is very difficult to have been associated with the Waste-to-Energy ({open_quotes}WTE{close_quotes}) Industry during the past twelve months without feeling a profound sense of being under attack and more than a little shell shocked. That is not to say that scrutiny and regulation haven`t been an important factor for WTE from its inception, only that it seems that certain difficult issues have been thrust to the fore through the recent actions of the courts and regulatory agencies. While ash management and flow control hit center stage with a flourish in a one-two punch last Spring with the Supreme Court inmore » the City of Chicago and Carbone decisions, significant compliance issues still remain with respect to implementing the Clean Air Act Amendments of 1990 ({open_quotes}CAAA{close_quotes}). In my state, the long term plans for waste management have WTE facilities responsible for turning 50% of the total waste stream into electricity, with other recycling accounting for all but 4% of the rest. With similar reliance upon WTE facilities elsewhere, it is critical that cost effective ways of managing these issues be found. Beyond these primarily regulatory and legal issues, there are also numerous challenges in the marketplace with increased reliance on recycling and the normal ebb and flow of the business cycle. Finally, there are always issues, including those already mentioned, which are best addressed in the political arena. Working together as an industry and regulated community will be essential if we are to make progress in addressing many of our challenges.« less

Early indicators and risk factors for ethical issues in clinical practice.

PubMed

Pavlish, Carol; Brown-Saltzman, Katherine; Hersh, Mary; Shirk, Marilyn; Nudelman, Olga

2011-03-01

Nurses in all clinical settings encounter ethical issues that frequently lead to moral distress. This critical incident study explored nurses' descriptions of ethically difficult situations to identify risk factors and early indicators of ethical conflicts. Employing the critical incident technique, researchers developed a questionnaire that collected information on ethically difficult situations, their risk factors and early indicators, nurse actions, and situational outcomes. Two nurse researchers independently analyzed and categorized data using a constant comparison technique. Most of the ethically difficult situations pertained to end-of-life care for children and adults. Conflicts in interpersonal relationships were prevalent. Nurses were especially moved by patient and family suffering and concerned about patient vulnerability, harm-benefit ratio, and patient autonomy. Researchers discovered risk factor categories for patients, families, healthcare providers, and health systems. Additionally, researchers found subcategories in six major categories of early indicators: signs of conflict, patient suffering, nurse distress, ethics violation, unrealistic expectations, and poor communication. Nurses are keenly aware of pertinent risk factors and early indicators of unfolding ethical conflicts. Many nurses reported feeling powerless in the face of ethical conflict. Research that develops interventions to strengthen nurses' voices in ethically difficult situation is warranted. Nurses are in a key position to identify patient situations with a high risk for ethical conflict. Initiating early ethics consultation and interventions can alter the course of pending conflicts and diminish the potential for patient and family suffering and nurses' moral distress. © 2011 Sigma Theta Tau International.

Adenomyosis: Difficult to Diagnose, and Difficult to Treat

PubMed Central

2001-01-01

Drug therapy may be effective in controlling symptoms but the frequent coexistence of endometriosis and the lack of controlled studies make their efficacy difficult to quantify. Danazol IUD has been shown to reduce symptoms. Conservative surgery involving endomyometrial ablation, laparoscopic myometrial electrocoagulation or excision has proven to be effective in more than 50% of patients, although follow up has been restricted to three years. Arterial uterine artery embolization is a new technique which may be tried before considering hysterectomy. Hysterectomy may still be necessary in severe cases of adenomyosis. PMID:18493552

Lessons Learned over Four Benchmark Exercises from the Community Structure-Activity Resource

PubMed Central

Carlson, Heather A.

2016-01-01

Preparing datasets and analyzing the results is difficult and time-consuming, and I hope the points raised here will help other scientists avoid some of the thorny issues we wrestled with. PMID:27345761

Sexual Health Issues in Men

Cancer.gov

Cancer treatments such as chemotherapy, radiation therapy and prostate surgery may affect a man’s sexual function, lower libido, and make it difficult to get an erection. Learn how to manage and treat these sexual problems, during cancer treatment.

GEOSPATIAL DATA ACCURACY ASSESSMENT

EPA Science Inventory

The development of robust accuracy assessment methods for the validation of spatial data represent's a difficult scientific challenge for the geospatial science community. The importance and timeliness of this issue is related directly to the dramatic escalation in the developmen...

The art and science of cross-border management.

PubMed

1998-07-01

Mergers, acquisitions, and even plain expansion means that more practices operate in multiple states. But there are different employment laws in each state, and benefits such as health insurance can vary from market to market. The first step to effective management of staffs across state lines is to work through the maze of legal differences. Then you have to make sure that the benefits you give to all your staff members are roughly equivalent. That may mean phasing out some benefits at one location, or providing completely new ones in another. Once you get through the nitty gritty of legal and benefit analysis, you have to work on remote management issues. It can be difficult to merge the cultures at two practices, and even more difficult to get the new staff to trust you. These issues can often take longer to resolve than the legal ones.

Low Income African Americans' Parental Involvement in Intermediate Schools: Perceptions, Practices, and Influences

ERIC Educational Resources Information Center

Petty, Benjamin

2012-01-01

Purpose: The purpose of this study was to examine how the parental involvement perceptions, practices, and influences of low-income African Americans in an intermediate school setting are affected by low-incomes. Although involving African American parents in the educational process is a difficult task for educators (Alldred & Edwards, 2000;…

Finding "Mathematics": Parents Questioning School-Centered Approaches to Involvement in Children's Mathematics Learning

ERIC Educational Resources Information Center

Jay, Tim; Rose, Jo; Simmons, Ben

2017-01-01

This paper reports on a study of parental involvement in children's mathematics learning in the context of a series of workshops carried out in four primary schools in the United Kingdom. Previous research suggests that, while there are high correlations between parental involvement and positive student outcomes, it can be difficult to raise…

Chiropractic care and public health: answering difficult questions about safety, care through the lifespan, and community action.

PubMed

Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre; Hestbaek, Lise; Injeyan, H Stephen; Puhl, Aaron; Green, Bart; Napuli, Jason G; Dunn, Andrew S; Dougherty, Paul; Killinger, Lisa Zaynab; Page, Stacey A; Stites, John S; Ramcharan, Michael; Leach, Robert A; Byrd, Lori D; Redwood, Daniel; Kopansky-Giles, Deborah R

2012-09-01

The purpose of this collaborative summary is to document current chiropractic involvement in the public health movement, reflect on social ecological levels of influence as a profession, and summarize the relationship of chiropractic to the current public health topics of: safety, health issues through the lifespan, and effective participation in community health issues. The questions that are addressed include: Is spinal manipulative therapy for neck and low-back pain a public health problem? What is the role of chiropractic care in prevention or reduction of musculoskeletal injuries in children? What ways can doctors of chiropractic stay updated on evidence-based information about vaccines and immunization throughout the lifespan? Can smoking cessation be a prevention strategy for back pain? Does chiropractic have relevance within the VA Health Care System for chronic pain and comorbid disorders? How can chiropractic use cognitive behavioral therapy to address chronic low back pain as a public health problem? What opportunities exist for doctors of chiropractic to more effectively serve the aging population? What is the role of ethics and the contribution of the chiropractic profession to public health? What public health roles can chiropractic interns perform for underserved communities in a collaborative environment? Can the chiropractic profession contribute to community health? What opportunities do doctors of chiropractic have to be involved in health care reform in the areas of prevention and public health? What role do citizen-doctors of chiropractic have in organizing community action on health-related matters? How can our future chiropractic graduates become socially responsible agents of change? Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

The lived experience of volunteering in a palliative care biography service.

PubMed

Beasley, Elizabeth; Brooker, Joanne; Warren, Narelle; Fletcher, Jane; Boyle, Christopher; Ventura, Adriana; Burney, Susan

2015-10-01

Many patients approaching death experience hopelessness, helplessness, and a depressed mood, and these factors can contribute to a difficult end-of-life (EoL) period. Biography services may assist patients in finding meaning and purpose at this time. The aim of our study was to investigate the lived experience of volunteers involved in a biography service in Melbourne, Australia, using a qualitative methodology. The participants were 10 volunteers who had participated in a biography service within a private palliative care service. Each volunteer was interviewed separately using a study-specific semistructured interview guide. The transcripts of these interviews were then subjected to thematic analysis. Analysis yielded the following themes: motivations for volunteering; dealing with death, dying, and existential issues; psychosocial benefits of volunteering; and benefits and challenges of working with patients and their families. Our results indicated that volunteering gave the volunteers a deeper appreciation of existential issues, and helped them to be more appreciative of their own lives and gain a deeper awareness of the struggles other people experience. They also suggested that volunteers felt that their involvement contributed to their own personal development, and was personally rewarding. Furthermore, the results highlighted that volunteers found that encounters with family members were sometimes challenging. While some were appreciative, others imposed time limits, became overly reliant on the volunteers, and were sometimes offended, hurt, and angered by what was included in the final biography. It is hoped that the findings of the current study will provide direction for improvements in the biography services that will benefit patients, family members, and volunteers. In particular, our findings highlight the need to provide ongoing support for volunteers to assist them in handling the challenges of volunteering in a palliative care setting.

A qualitative study explaining nurses' perceptions of quality care for older people in long-term care settings in Ireland.

PubMed

Murphy, Kathy

2007-03-01

The aim of this research was to explore nurses' perceptions of the attributes of quality care and the factors that facilitate or hinder high-quality nursing care in long-term care. The quality of care for older people living in long-term care has been identified as an issue of concern in many nursing research studies. While many factors have been identified, it is difficult to determine key factors from current research. The study was a qualitative exploration of nurses' perceptions of quality care for older people and the factors that facilitate or hinder quality care. It involved 20 interviews with nurses. Respondents were asked to illustrate their accounts with examples from practice. This phase of the research was guided by the principles of hermeneutic phenomenology and the analysis process by Van Manen. The findings indicated that nurses perceived quality care for older people in Ireland as holistic, individualized and focused on promoting independence and choice. The research revealed, however, that care in many practice areas was not individualized, patient choice and involvement in decision making was limited and some areas engendered dependency. While staffing was identified as a factor which had an impact on the provision of patient choice, other issues, such as the motivation of staff, the role of the ward manager and the dominance of routine were also highlighted. There is a need to review organizational approaches to care, develop patient centred approaches to care and provide educational support for managers. This research focuses on care for older people; it helps practitioners identify key factors in the provision of quality care for older people living in long-term care.

Who Really Wants an Ambitious Large-Scale Restoration of the Seine Estuary? A Strategic Analysis of a Science-Policy Interface Locked in a Stalemate.

PubMed

Coreau, Audrey; Narcy, Jean-Baptiste; Lumbroso, Sarah

2018-05-01

The development of ecosystem knowledge is an essential condition for effective environmental management but using available knowledge to solve environmental controversies is still difficult in "real" situations. This paper explores the conditions under which ecological knowledge could contribute to the environmental strategies and actions of stakeholders at science-policy interface. Ecological restoration of the Seine estuary is an example of an environmental issue whose overall management has run into difficulties despite the production of a large amount of knowledge by a dedicated organization, GIP Seine Aval. Thanks to an action-research project, based on a futures study, we analyze the reasons of these difficulties and help the GIP Seine Aval adopt a robust strategy to overcome them. According to our results, most local stakeholders involved in the large-scale restoration project emphasize the need for a clear divide between knowledge production and environmental action. This kind of divide may be strategic in a context where the robustness of environmental decisions is strongly depending on the mobilization of "neutral" scientific knowledge. But in our case study, this rather blocks action because some powerful stakeholders continuously ask for more knowledge before taking action. The construction and analysis of possible future scenarios has led to three alternative strategies being identified to counter this stalemate situation: (1) to circumvent difficulties by creating indirect links between knowledge and actions; (2) to use knowledge to sustain advocacy for the interests of each and every stakeholder; (3) to involve citizens in decisions about knowledge production and use, so that environmental issues weight more on the local political agenda.

Public Involvement Processes and Methodologies: An Analysis

Treesearch

Ernst Valfer; Stephen Laner; Daina Dravnieks

1977-01-01

This report explor'es some sensitive or critical areas in public involvement.. A 1972 RF&D workshop on public involvement identified a series of issues requiring research and analysis. A subsequent PNW study "Public Involvement and the Forest Service", (Hendee 1973) addressed many of these issues. This study assignment by the Chief's Office was...

Hable con sus hijos: Antes de que lo hagan todos los demas (Talk with Your Kids...before Everyone Else Does: Talking with Kids about Tough Issues).

ERIC Educational Resources Information Center

Children Now, Oakland, CA.

Parents are challenged daily with a wide range of disturbing issues that are difficult for children to understand and for adults to explain. This Spanish-language booklet offers practical, concrete tips and techniques for talking easily and openly with 8- to 12-year-olds about sex, HIV/AIDS, violence, drugs, and alcohol. The book is divided into…

Interdisciplinary Collaboration: Librarian Involvement in Grant Projects

ERIC Educational Resources Information Center

Brandenburg, Marci D.; Cordell, Sigrid Anderson; Joque, Justin; MacEachern, Mark P.; Song, Jean

2017-01-01

Librarians are excellent research collaborators, although librarian participation is not usually considered, thereby making access to research funds difficult. The University of Michigan Library became involved in the university's novel funding program, MCubed, which supported innovative interdisciplinary research on campus, primarily by funding…

Braving difficult choices alone: children's and adolescents' medical decision making.

PubMed

Ruggeri, Azzurra; Gummerum, Michaela; Hanoch, Yaniv

2014-01-01

What role should minors play in making medical decisions? The authors examined children's and adolescents' desire to be involved in serious medical decisions and the emotional consequences associated with them. Sixty-three children and 76 adolescents were presented with a cover story about a difficult medical choice. Participants were tested in one of four conditions: (1) own informed choice; (2) informed parents' choice to amputate; (3) informed parents' choice to continue a treatment; and (4) uninformed parents' choice to amputate. In a questionnaire, participants were asked about their choices, preference for autonomy, confidence, and emotional reactions when faced with a difficult hypothetical medical choice. Children and adolescents made different choices and participants, especially adolescents, preferred to make the difficult choice themselves, rather than having a parent make it. Children expressed fewer negative emotions than adolescents. Providing information about the alternatives did not affect participants' responses. Minors, especially adolescents, want to be responsible for their own medical decisions, even when the choice is a difficult one. For the adolescents, results suggest that the decision to be made, instead of the agent making the decision, is the main element influencing their emotional responses and decision confidence. For children, results suggest that they might be less able than adolescents to project how they would feel. The results, overall, draw attention to the need to further investigate how we can better involve minors in the medical decision-making process.

[Optimistic perspectives in communicating difficult news on fetal development].

PubMed

Ostermann, Ana Cristina; Frezza, Minéia; Rosa, Rafael Machado

2017-08-21

Communicating diagnostic news in health contexts is a potentially difficult event for all parties involved. However, despite this task's presence in the physician-patient context, it is rarely addressed during clinical training. The current study thus aimed to describe and evaluate how difficult news can be toned down during genetic counseling sessions involving cases of fetal syndromes and/or malformations. The study analyzed 33 naturalistic interactions (i.e. real situations), taped and transcribed, according to the theoretical and methodological perspective of Conversation Analysis, with an ethnomethodological basis. These interactions consisted of sessions in clinical genetics with pregnant women seen at the fetal medicine service of a reference hospital for maternal and child health in the Brazilian Unified National Health System (SUS). The analysis showed that communicating difficult news can be accompanied by optimistic perspectives that are scaled-up according to each situation's severity. In the absence of a positive diagnosis, the appointments can conclude with positive aspects such as recommendations for palliative care, so that the patient always leaves the appointment with some kind of recommendation. This study proposes to innovate and expand the scope of studies on communicating difficult news in the physician-patient relationship in Brazil, precisely by developing an analysis of real interactions in genetic counseling and thus providing interactional backing for training health professionals that deal with this challenge in their routine work.

Into, through, and beyond Secondary School: Critical Transitions for Immigrant Youths. Topics in Immigrant Education 1.

ERIC Educational Resources Information Center

Lucas, Tamara

Besides the difficult personal transitions involved in growth from childhood to adulthood, immigrant adolescents face difficult transitions to school as well, as they move from their native cultures to the U.S. culture, through the structures and gateposts of secondary school, and into higher education and work. This book discusses four specific…

Addressing Measurement Issues Related to Bullying Involvement

ERIC Educational Resources Information Center

Casper, Deborah M.; Meter, Diana J.; Card, Noel A.

2015-01-01

In this article, we address measurement issues related to select aspects of bullying involvement with the goal of moving psychometrically sound measurement practices toward applied bullying research. We first provide a nontechnical introduction to psychometric considerations in measuring bullying involvement, highlighting the importance of…

Difficult Decisions: Chemical Warfare.

ERIC Educational Resources Information Center

Slesnick, Irwin L.; Miller, John A.

1988-01-01

Gives the background history and chemistry of modern day chemical warfare from World War I to the present. Provides discussion questions to stimulate deeper thinking on the issue. Contains a discussion activity called "Can New Chemical Weapons Lead to Humane Warfare?" (CW)

What Role for Middle School Sports?

ERIC Educational Resources Information Center

McEwin, C. Kenneth; Dickinson, Thomas S.

1998-01-01

Safe, developmentally appropriate play is difficult to achieve when middle schools move into the competitive interscholastic arena. Problems associated with middle-level sports programs include students' predisposition to physical injury, psychological unreadiness, high attrition rates, improper coaching, and liability issues. Improving…

77 FR 66149 - Retirement of FASTforward Technology

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-02

...;Prices of new books are listed in the first FEDERAL REGISTER issue of each #0;week. #0; #0; #0; #0;#0... difficult. In February 2009, the USPS TM announced its intention to retire the FASTforward system by the end...

Prototype design for a predictive model to improve evacuation operations : technical report.

DOT National Transportation Integrated Search

2011-08-01

Mass evacuations of the Texas Gulf Coast remain a difficult challenge. These events are massive in scale, : highly complex, and entail an intricate, ever-changing conglomeration of technical and jurisdictional issues. : This project focused primarily...

Does self-efficacy mediate transfer effects in the learning of easy and difficult motor skills?

PubMed

Stevens, David; Anderson, David I; O'Dwyer, Nicholas J; Mark Williams, A

2012-09-01

The effect of task difficulty on inter-task transfer is a classic issue in motor learning. We examined the relation between self-efficacy and transfer of learning after practicing different versions of a stick balancing task. Practicing the same task or an easier version led to significant pre- to post-test transfer of learning, whereas practicing a more difficult version did not. Self-efficacy increased modestly from pre- to post-test with easy practice, but decreased significantly with difficult practice. In addition, self-efficacy immediately prior to the post-test was significantly lower after difficult practice than easy or intermediate practice. Self-efficacy immediately prior to the post-test, performance at the end of practice, and pre-test performance explained 75% of the variance in post-test performance. The mediating role of self-efficacy on transfer of learning offers an alternative explanation for recent findings on the superiority of easy-to-difficult transfer and may help clarify inconsistencies in earlier research. Copyright © 2012 Elsevier Inc. All rights reserved.

Being perceived as a 'visitor' in the nursing staff's working arena--the involvement of relatives in daily caring activities in nursing homes in an urban community in Sweden.

PubMed

Holmgren, Jessica; Emami, Azita; Eriksson, Lars E; Eriksson, Henrik

2013-09-01

It is both complex and difficult for relatives when a loved one moves into a nursing home and many relatives are not prepared for the realities these new situations entail. Little attention has been paid to scrutinising the involvement of relatives in patient care, particularly in relation to the structures and routines of nursing homes or to the staff's reasoning concerning their involvement. To describe, from a gender perspective, how nursing staff's routines and reasoning act to condition the involvement of relatives in nursing homes. Focused ethnographic fieldwork was conducted in a medium-sized urban community in central Sweden in three different nursing homes. The nursing staff assigns a certain code of conduct to all relatives they perceived as 'visitors' in their working arena. This code of conduct was related to the routines and subcultures existing among the nursing staff and stemmed from a division of labour; the underlying concept of 'visitor' predetermined the potential for relatives' involvement. This involvement is explicitly related to the general gendered characteristics that exist in the nursing staff's perception of the relatives. The study's limitations are primarily concerned with shortcomings associated with a research presence during the fieldwork. The discussion focuses on the dimensions of power structures observed in the nursing home routines and the staff's reasoning based on their gendered assumptions. We argue that it is important to develop mechanisms that provide opportunities for nursing staff in elderly care to reflect on these structures without downplaying the excellent care they provide. We stress the importance of further exploring these issues concerning relatives and their involvement in nursing homes to facilitate the transition from informal caregiver to 'visitor'. © 2012 The Authors Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

AIRBORNE CONTACT DERMATITIS – CURRENT PERSPECTIVES IN ETIOPATHOGENESIS AND MANAGEMENT

PubMed Central

Handa, Sanjeev; De, Dipankar; Mahajan, Rahul

2011-01-01

The increasing recognition of occupational origin of airborne contact dermatitis has brought the focus on the variety of irritants, which can present with this typical morphological picture. At the same time, airborne allergic contact dermatitis secondary to plant antigens, especially to Compositae family, continues to be rampant in many parts of the world, especially in the Indian subcontinent. The recognition of the contactant may be difficult to ascertain and the treatment may be even more difficult. The present review focuses on the epidemiological, clinical and therapeutic issues in airborne contact dermatitis. PMID:22345774

Ethical and Social Issues in Health Research Involving Incarcerated People.

PubMed

Coughlin, Steven S; Lewis, Sharon R; Smith, Selina A

2016-01-01

The use of inmates in research in the U.S. was restricted by the recommendations of the National Commission and by federal regulations and guidelines that followed. By the 1980s, many health care officials became concerned about the exclusion of inmates from experimental treatments for human immunodeficiency virus infection (HIV). These developments in ethics occurred in the context of racial/ethnic disparities in health. In this article, ethical considerations in clinical and public health research on HIV in prison and jail settings are considered. Ethical considerations in mental health research are summarized as well as issues pertaining to research involving female inmates. Issues related to oversight of research involving incarcerated people are considered along with the ethics of public health research. The ethics of research involving incarcerated people extends beyond traditional issues in human subjects ethics to include issues within the domains of bioethics and public health ethics.

Ethical and Social Issues in Health Research Involving Incarcerated People

PubMed Central

Coughlin, Steven S.; Lewis, Sharon R.; Smith, Selina A.

2016-01-01

The use of inmates in research in the U.S. was restricted by the recommendations of the National Commission and by federal regulations and guidelines that followed. By the 1980s, many health care officials became concerned about the exclusion of inmates from experimental treatments for human immunodeficiency virus infection (HIV). These developments in ethics occurred in the context of racial/ethnic disparities in health. In this article, ethical considerations in clinical and public health research on HIV in prison and jail settings are considered. Ethical considerations in mental health research are summarized as well as issues pertaining to research involving female inmates. Issues related to oversight of research involving incarcerated people are considered along with the ethics of public health research. The ethics of research involving incarcerated people extends beyond traditional issues in human subjects ethics to include issues within the domains of bioethics and public health ethics. PMID:27133509

School Involvement Leave: Providing Leave for Parental Involvement in School Activities. Policy Briefing Series. Issue 18

ERIC Educational Resources Information Center

Curlew, Mary; Weber, Julie

2009-01-01

One of the most important factors in school performance is parental involvement. However, many parents do not have the flexibility in their work schedules or the leave policies necessary to attend school functions. As a result, legislators are creating policies to address this issue. School involvement leave policies provide parents with…

What Knowledge and Skills Do Caregivers Need?

ERIC Educational Resources Information Center

Given, Barbara; Sherwood, Paula R.; Given, Charles W.

2008-01-01

Patients with chronic illnesses and multiple comorbid conditions have intricate treatment protocols that require caregiver involvement, further complicating this already-difficult care. Because better treatments have extended the life spans of most patients with chronic illnesses, caregiver involvement often is required for several years. Many…

A Case Study Approach to Marine and Aquatic Issues.

ERIC Educational Resources Information Center

Snively, Gloria

1993-01-01

Suggests using case studies of resource management conflict involving marine and aquatic resource issues to increase student involvement in decision-making processes. Provides information for a potential case involving oyster farms and six steps to help students explore problems and make decisions. (MDH)

Unresolved Technical Issues in Fair Interest Measurement.

ERIC Educational Resources Information Center

Cole, Nancy S.

The problem of sex differences in interest measurement involves many technical issues and procedures. The purpose of this paper is to provide a description of the technical problems involved in construction, scoring, and interpretation of interest measures as related to sex differences and to suggest guidelines within these technical issues which…

Hybrid pairwise likelihood analysis of animal behavior experiments.

PubMed

Cattelan, Manuela; Varin, Cristiano

2013-12-01

The study of the determinants of fights between animals is an important issue in understanding animal behavior. For this purpose, tournament experiments among a set of animals are often used by zoologists. The results of these tournament experiments are naturally analyzed by paired comparison models. Proper statistical analysis of these models is complicated by the presence of dependence between the outcomes of fights because the same animal is involved in different contests. This paper discusses two different model specifications to account for between-fights dependence. Models are fitted through the hybrid pairwise likelihood method that iterates between optimal estimating equations for the regression parameters and pairwise likelihood inference for the association parameters. This approach requires the specification of means and covariances only. For this reason, the method can be applied also when the computation of the joint distribution is difficult or inconvenient. The proposed methodology is investigated by simulation studies and applied to real data about adult male Cape Dwarf Chameleons. © 2013, The International Biometric Society.

Integrating laboratory robots with analytical instruments--must it really be so difficult?

PubMed

Kramer, G W

1990-09-01

Creating a reliable system from discrete laboratory instruments is often a task fraught with difficulties. While many modern analytical instruments are marvels of detection and data handling, attempts to create automated analytical systems incorporating such instruments are often frustrated by their human-oriented control structures and their egocentricity. The laboratory robot, while fully susceptible to these problems, extends such compatibility issues to the physical dimensions involving sample interchange, manipulation, and event timing. The workcell concept was conceived to describe the procedure and equipment necessary to carry out a single task during sample preparation. This notion can be extended to organize all operations in an automated system. Each workcell, no matter how complex its local repertoire of functions, must be minimally capable of accepting information (commands, data), returning information on demand (status, results), and being started, stopped, and reset by a higher level device. Even the system controller should have a mode where it can be directed by instructions from a higher level.

A new 3-D thin-skinned rock glacier model based on helicopter GPR results from the Swiss Alps

NASA Astrophysics Data System (ADS)

Merz, Kaspar; Green, Alan G.; Buchli, Thomas; Springman, Sarah M.; Maurer, Hansruedi

2015-06-01

Mountainous locations and steep rugged surfaces covered by boulders and other loose debris are the main reasons why rock glaciers are among the most challenging geological features to investigate using ground-based geophysical methods. Consequently, geophysical surveys of rock glaciers have only ever involved recording data along sparse lines. To address this issue, we acquired quasi-3-D ground-penetrating radar (GPR) data across a rock glacier in the Swiss Alps using a helicopter-mounted system. Our interpretation of the derived GPR images constrained by borehole information results in a novel "thin-skinned" rock glacier model that explains a concentration of deformation across a principal shear zone (décollement) and faults across which rock glacier lobes are juxtaposed. The new model may be applicable to many rock glaciers worldwide. We suggest that the helicopter GPR method may be useful for 3-D surveying numerous other difficult-to-access mountainous terrains.

Post-disaster resettlement, development and change: a case study of the 1990 Manjil earthquake in Iran.

PubMed

Badri, S Ali; Asgary, Ali; Eftekhari, A R; Levy, Jason

2006-12-01

Planned and involuntary resettlement after natural disasters has been a major policy in post-disaster reconstruction in developing countries over the past few decades. Studies show that resettlement can result in significant adverse impacts on the resettled population. Conversely, a well-planned and managed resettlement process can produce positive long-term development outcomes. This article presents the results of a case study undertaken 11 years after the 1990 Manjil earthquake in Iran. During the reconstruction period, a policy of involuntary planned resettlement was pursued extensively. The socioeconomic changes that occurred as a consequence of this policy of involuntary resettlement are analysed. Data were collected via a questionnaire survey that involved a sample of 194 relocated households (grouped into a settlement that later became a town). The paper shows that relocated families face difficult socioeconomic challenges after relocation and regrouping. This is especially true with respect to employment, income, the empowerment of women and lifestyle issues.

Understanding deficiencies of leadership in advancing health equity: a case of pit bulls, public health, and pimps.

PubMed

Clancy, Gerard P

2015-04-01

Market- and legislation-driven health reforms are being implemented across the United States. Within this time of great change for health care delivery systems and medical schools lie opportunities to address the country's long-standing health inequities by using community needs assessments, health information technologies, and new models for care and payment. In this Commentary, the author, a university regional campus leader, shares several difficult personal experiences to demonstrate that health equity work undertaken by academic institutions also requires institutional leaders to pay attention to and gain an understanding of issues that go beyond public health data. The author reflects on lessons learned and offers recommendations that may help academic health center and university leaders be more effective as they take on the complex tasks involved in improving health inequities. These include reflection on personal strengths and deficiencies, engagement with the community, recognition of the historical roots of health disparities, and the development of trusting relationships between the institution and the community.

Dynamic characteristics of Non Newtonian fluid Squeeze film damper

NASA Astrophysics Data System (ADS)

Palaksha, C. P.; Shivaprakash, S.; Jagadish, H. P.

2016-09-01

The fluids which do not follow linear relationship between rate of strain and shear stress are termed as non-Newtonian fluid. The non-Newtonian fluids are usually categorized as those in which shear stress depends on the rates of shear only, fluids for which relation between shear stress and rate of shear depends on time and the visco inelastic fluids which possess both elastic and viscous properties. It is quite difficult to provide a single constitutive relation that can be used to define a non-Newtonian fluid due to a great diversity found in its physical structure. Non-Newtonian fluids can present a complex rheological behaviour involving shear-thinning, viscoelastic or thixotropic effects. The rheological characterization of complex fluids is an important issue in many areas. The paper analyses the damping and stiffness characteristics of non-Newtonian fluids (waxy crude oil) used in squeeze film dampers using the available literature for viscosity characterization. Damping and stiffness characteristic will be evaluated as a function of shear strain rate, temperature and percentage wax concentration etc.

[Internationalization, science and health: global regenerative medicine and the parallel markets].

PubMed

Acero, Liliana

2015-02-01

Regenerative medicine involves a paradigm change due to organism regeneration at cellular and tissue level - a controversial contemporary issue and difficult to regulate. This article presents a summary of the main scientific, economic, social and regulatory global trends, analyzed according to relevant theoretical dilemmas in medical anthropology and in the sociology of science and health. This is especially true of the construction of a 'collective frame of reference' on the new biological and ontological entities, the shaping of biological citizenship, and governance through uncertainty. Empirical evidence is also presented on a key aspect in regulation and governance, namely the emergence of a new transnational demand in health research through the establishment of parallel markets for ova and experimental cellular therapies. Qualitative data collected for a broader research paper is analyzed, as well as journal reviews and information gathered during interviews with international leaders. The paper concludes with a discussion on the importance on international governance of clinical trials and on further exploration, towards a multilevel harmonization of a diversity of normative practices.

Inclusive Competitive Game Play Through Balanced Sensory Feedback.

PubMed

Westin, Thomas; Söderström, David; Karlsson, Olov; Peiris, Ranil

2017-01-01

While game accessibility has improved significantly the last few years, there are still barriers for equal participation and multiplayer issues have been less researched. Game balance is here about making the game fair in a player versus player competitive game. One difficult design task is to balance the game to be fair regardless of visual or hearing capabilities, with clearly different requirements. This paper explores a tentative design method for enabling inclusive competitive game-play without individual adaptations of game rules that could spoil the game. The method involved applying a unified design method to design an unbalanced game, then modifying visual feedback as a hypothetical balanced design, and testing the game with totally 52 people with and without visual or hearing disabilities in three workshops. Game balance was evaluated based on score differences and less structured qualitative data, and a redesign of the game was made. Conclusions are a tentative method for balancing a multiplayer, competitive game without changing game rules and how the method can be applied.

Discrete dynamic modeling of cellular signaling networks.

PubMed

Albert, Réka; Wang, Rui-Sheng

2009-01-01

Understanding signal transduction in cellular systems is a central issue in systems biology. Numerous experiments from different laboratories generate an abundance of individual components and causal interactions mediating environmental and developmental signals. However, for many signal transduction systems there is insufficient information on the overall structure and the molecular mechanisms involved in the signaling network. Moreover, lack of kinetic and temporal information makes it difficult to construct quantitative models of signal transduction pathways. Discrete dynamic modeling, combined with network analysis, provides an effective way to integrate fragmentary knowledge of regulatory interactions into a predictive mathematical model which is able to describe the time evolution of the system without the requirement for kinetic parameters. This chapter introduces the fundamental concepts of discrete dynamic modeling, particularly focusing on Boolean dynamic models. We describe this method step-by-step in the context of cellular signaling networks. Several variants of Boolean dynamic models including threshold Boolean networks and piecewise linear systems are also covered, followed by two examples of successful application of discrete dynamic modeling in cell biology.

Visualization for Hyper-Heuristics: Back-End Processing

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

Simon, Luke

Modern society is faced with increasingly complex problems, many of which can be formulated as generate-and-test optimization problems. Yet, general-purpose optimization algorithms may sometimes require too much computational time. In these instances, hyperheuristics may be used. Hyper-heuristics automate the design of algorithms to create a custom algorithm for a particular scenario, finding the solution significantly faster than its predecessor. However, it may be difficult to understand exactly how a design was derived and why it should be trusted. This project aims to address these issues by creating an easy-to-use graphical user interface (GUI) for hyper-heuristics and an easy-to-understand scientific visualizationmore » for the produced solutions. To support the development of this GUI, my portion of the research involved developing algorithms that would allow for parsing of the data produced by the hyper-heuristics. This data would then be sent to the front-end, where it would be displayed to the end user.« less

Controlled, Constrained, or Flexible? How Self-Management Goals Are Shaped By Patient-Provider Interactions.

PubMed

Franklin, Marika; Lewis, Sophie; Willis, Karen; Rogers, Anne; Venville, Annie; Smith, Lorraine

2018-06-01

A person-centered approach to goal-setting, involving collaboration between patients and health professionals, is advocated in policy to support self-management. However, this is difficult to achieve in practice, reducing the potential effectiveness of self-management support. Drawing on observations of consultations between patients and health professionals, we examined how goal-setting is shaped in patient-provider interactions. Analysis revealed three distinct interactional styles. In controlled interactions, health professionals determine patients' goals based on biomedical reference points and present these goals as something patients should do. In constrained interactions, patients are invited to present goals, yet health professionals' language and questions orientate goals toward biomedical issues. In flexible interactions, patients and professionals both contribute to goal-setting, as health professionals use less directive language, create openings, and allow patients to decide on their goals. Findings suggest that interactional style of health professionals could be the focus of interventions when aiming to increase the effectiveness of goal-setting.

How small is small enough? Role of robotics in paediatric urology

PubMed Central

Ganpule, Arvind P.; Sripathi, Venkat

2015-01-01

The well-known advantages of robotic surgery include improved dexterity, three-dimensional operating view and an improved degree of freedom. Robotic surgery is performed for a wide range of surgeries in urology, which include radical prostatectomy, radical cystectomy, and ureteric reimplantation. Robotic paediatric urology is evolving. The major hindrance in the development of paediatric robotics is, first, the differences in practice patterns in paediatric urology compared with adult urology thereby making development of expertise difficult and secondly it is challenging to conduct proper studies in the paediatric population because of the paucity of cases. The difficulties in conducting these studies include difficulty in designing a proper randomised study, difficulties with blinding, and finally, the ethical issues involved, finally the instruments although in the phase of evolution require a lot of improvement. In this article, we review the relevant articles for paediatric robotic surgery. We emphasise on the technical aspects and results in contemporary paediatric robotic case series. PMID:25598599

How small is small enough? Role of robotics in paediatric urology.

PubMed

Ganpule, Arvind P; Sripathi, Venkat

2015-01-01

The well-known advantages of robotic surgery include improved dexterity, three-dimensional operating view and an improved degree of freedom. Robotic surgery is performed for a wide range of surgeries in urology, which include radical prostatectomy, radical cystectomy, and ureteric reimplantation. Robotic paediatric urology is evolving. The major hindrance in the development of paediatric robotics is, first, the differences in practice patterns in paediatric urology compared with adult urology thereby making development of expertise difficult and secondly it is challenging to conduct proper studies in the paediatric population because of the paucity of cases. The difficulties in conducting these studies include difficulty in designing a proper randomised study, difficulties with blinding, and finally, the ethical issues involved, finally the instruments although in the phase of evolution require a lot of improvement. In this article, we review the relevant articles for paediatric robotic surgery. We emphasise on the technical aspects and results in contemporary paediatric robotic case series.

IGT-Open: An open-source, computerized version of the Iowa Gambling Task.

PubMed

Dancy, Christopher L; Ritter, Frank E

2017-06-01

The Iowa Gambling Task (IGT) is commonly used to understand the processes involved in decision-making. Though the task was originally run without a computer, using a computerized version of the task has become typical. These computerized versions of the IGT are useful, because they can make the task more standardized across studies and allow for the task to be used in environments where a physical version of the task may be difficult or impossible to use (e.g., while collecting brain imaging data). Though these computerized versions of the IGT have been useful for experimentation, having multiple software implementations of the task could present reliability issues. We present an open-source software version of the Iowa Gambling Task (called IGT-Open) that allows for millisecond visual presentation accuracy and is freely available to be used and modified. This software has been used to collect data from human subjects and also has been used to run model-based simulations with computational process models developed to run in the ACT-R architecture.

Reviewing Hit Discovery Literature for Difficult Targets: Glutathione Transferase Omega-1 as an Example.

PubMed

Xie, Yiyue; Dahlin, Jayme L; Oakley, Aaron J; Casarotto, Marco G; Board, Philip G; Baell, Jonathan B

2018-05-10

Early stage drug discovery reporting on relatively new or difficult targets is often associated with insufficient hit triage. Literature reviews of such targets seldom delve into the detail required to critically analyze the associated screening hits reported. Here we take the enzyme glutathione transferase omega-1 (GSTO1-1) as an example of a relatively difficult target and review the associated literature involving small-molecule inhibitors. As part of this process we deliberately pay closer-than-usual attention to assay interference and hit quality aspects. We believe this Perspective will be a useful guide for future development of GSTO1-1 inhibitors, as well serving as a template for future review formats of new or difficult targets.

Research during medical school: is it particularly difficult in developing countries compared to developed countries?

PubMed Central

Siddaiah-Subramanya, Manjunath; Singh, Harveen; Tiang, Kor Woi

2017-01-01

Objectives Medical student involvement in research has been declining over the years. We reviewed the factors that hinder participation in research with a focus on developing countries. Methods Literature search was performed using PubMed, MEDLINE and Cochrane Library. Peer-reviewed articles published between 1995 and 2017 were screened for relevance to identify key factors affecting medical student involvement in research with a particular focus on developing world. Analytical review is presented here in this article in relation to commonly reported aspects related to research during medical school. Results This search revealed varied contributing factors that hinder students’ growth and interest in research. It commonly highlighted few aspects in relation to research during medical school, and they were “variability in research uptake among students and issues related to them, their knowledge and attitude toward research and organizational input and its influence on students”. Conclusion While early introduction to research by inculcating a mindset aimed at research has been proposed, it has not been seen in practice during either the medical school or beyond to an extent that was expected. It appears that developing countries, while they share some of the reasons with developed countries, have their own set of difficulties, which are influenced by culture, beliefs and priorities. PMID:29180910

[Cardiovascular disease and aircraft transportation: specificities and issues].

PubMed

Touze, Jean-Étienne; Métais, Patrick; Zawieja, Philippe

2012-02-01

With the development of air transport and travel to distant destinations, the number of passengers and elderly passengers on board increases each year. In this population, cardiovascular events are a major concern. Among medical incidents occurring in-flight they are second-ranked (10%) behind gastrointestinal disorders (25%). Their occurrence may involve life-threatening events and require resuscitation, difficult to perform during flight or in a precarious health environment. Coronary heart disease and pulmonary thromboembolic disease are the most serious manifestations. They are the leading cause of hospitalization in a foreign country and sudden cardiac death occurring during or subsequent to the flight. Their occurrence is explained on aircraft by hypoxia, hypobaria and decreased humidity caused by cabin pressurization and upon arrival by a different environmental context (extreme climates, tropical diseases). Moreover, the occurrence of a cardiovascular event during flight can represent for the air carrier a major economic and logistic problem when diversion occurred. Furthermore, the liability of the practitioner passenger could be involved according to airlines or to the country in which the aircraft is registered. In this context, cardiovascular events during aircraft transportation can be easily prevented by identifying high risk patients, respect of cardiovascular indications to travel, the implementation of simple preventive measures and optimization of medical equipment in commercial flights. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

[Can court injunctions guarantee access to medicines in the public sector? The experience in the State of Rio de Janeiro, Brazil].

PubMed

Messeder, Ana Márcia; Osorio-de-Castro, Claudia Garcia Serpa; Luiza, Vera Lucia

2005-01-01

There are increasing numbers of legal suits concerning access to medicines brought against the Rio de Janeiro State Health Department. The situation indicated the need for a study to clarify the underlying issues. A sample of 389 court suits from January 1991 to December 2001 (stratified by year) was used. A cross-sectional design was used to describe and analyze the legal suits in relation to the responsibilities defined under the Unified National Health System (SUS). Results suggest major delays in court decisions. Most suits are filed by the Public Defender's Office for users of the National Health System. The most frequent cases involve medicines for the cardiovascular and nervous systems, many of which involve continuous use. Prescribing practices are institutionalized through the inclusion of the most frequently prescribed drugs in public financing lists, which makes rational drug use difficult to achieve. Municipalities are not fulfilling their responsibility to supply medicines to users, and the State is thus encumbered with these responsibilities. However, the State does not adequately supply medicines to the municipalities. The apparent lack of awareness among both lawyers and clients generates stress between the Executive and Judiciary branches and limits the resources for collective pharmaceutical services.

Neurogenesis as a new target for the development of antidepressant drugs.

PubMed

Pascual-Brazo, Jesus; Baekelandt, Veerle; Encinas, Juan Manuel

2014-01-01

Thirteen years have passed since the neurogenic hypothesis of depression was postulated. One of its aspects, that decreased neurogenesis could be causative of the onset of depression has been difficult to prove. Another aspect, the prediction that increasing neurogenesis would not only be supportive but also required to produce clinical results by antidepressants has gathered experimental validation. Thus a question arises: should new antidepressant strategies based solely on increasing neurogenesis be pursued? At the risk of disappointing the audience, we will not provide a straight answer to this question in this review, but we do hope to enlighten the reader regarding what is known about adult hippocampal neurogenesis, the indications and evidence of its involvement in the onset and treatment of depression, and the advances that have been made in the field in recent years. As we will recount here, the main body of support in favor of the neurogenic hypothesis of depression is based more on intimation than actual proof. However the rare examples that provide support are sufficiently robust to justify investment of resources and effort to clarify the issue, even if the involvement of neurogenesis, both in the etiology and the treatment of depression, is only partial and comprises only subtle components of this complex mental disorder.

When forensic odontology met biochemistry: Multidisciplinary approach in forensic human identification.

PubMed

Adserias-Garriga, Joe; Thomas, Christian; Ubelaker, Douglas H; C Zapico, Sara

2018-03-01

When human remains are found, the priority of the investigation is to ascertain the identity of the deceased. A positive identification is a key factor in providing closure for the family of the deceased; it is also required to issue the death certificate and therefore, to settle legal affairs. Moreover, it is difficult for any forensic investigation involving human remains to be solved without the determination of an identity. Therefore, personal identification is necessary for social, legal and forensic reasons. In the last thirty years forensic odontology has experienced an important transformation, from primarily involving occasional dental identification into a broader role, contributing to the determination of the biological profile. In the same way, "DNA fingerprinting" has evolved not only in terms of improving its technology, but also in its application beyond the "classical": helping with the estimation of sex, age and ancestry. As these two forensic disciplines have developed independently, their pathways have crossed several times through human identification operations, especially the ones that require a multidisciplinary approach. Thus, the aim of this review is to describe the contributions of both forensic odontology and molecular biology/biochemistry to human identification, demonstrating how a multidisciplinary approach can lead to a better and more efficient identification. Copyright © 2017 Elsevier Ltd. All rights reserved.

A novel approach to probe host-pathogen interactions of bovine digital dermatitis, a model of a complex polymicrobial infection.

PubMed

Marcatili, Paolo; Nielsen, Martin W; Sicheritz-Pontén, Thomas; Jensen, Tim K; Schafer-Nielsen, Claus; Boye, Mette; Nielsen, Morten; Klitgaard, Kirstine

2016-12-01

Polymicrobial infections represent a great challenge for the clarification of disease etiology and the development of comprehensive diagnostic or therapeutic tools, particularly for fastidious and difficult-to-cultivate bacteria. Using bovine digital dermatitis (DD) as a disease model, we introduce a novel strategy to study the pathogenesis of complex infections. The strategy combines meta-transcriptomics with high-density peptide-microarray technology to screen for in vivo-expressed microbial genes and the host antibody response at the site of infection. Bacterial expression patterns supported the assumption that treponemes were the major DD pathogens but also indicated the active involvement of other phyla (primarily Bacteroidetes). Bacterial genes involved in chemotaxis, flagellar synthesis and protection against oxidative and acidic stress were among the major factors defining the disease. The extraordinary diversity observed in bacterial expression, antigens and host antibody responses between individual cows pointed toward microbial variability as a hallmark of DD. Persistence of infection and DD reinfection in the same individual is common; thus, high microbial diversity may undermine the host's capacity to mount an efficient immune response and maintain immunological memory towards DD. The common antigenic markers identified here using a high-density peptide microarray address this issue and may be useful for future preventive measures against DD.

A Novel Identification Methodology for the Coordinate Relationship between a 3D Vision System and a Legged Robot.

PubMed

Chai, Xun; Gao, Feng; Pan, Yang; Qi, Chenkun; Xu, Yilin

2015-04-22

Coordinate identification between vision systems and robots is quite a challenging issue in the field of intelligent robotic applications, involving steps such as perceiving the immediate environment, building the terrain map and planning the locomotion automatically. It is now well established that current identification methods have non-negligible limitations such as a difficult feature matching, the requirement of external tools and the intervention of multiple people. In this paper, we propose a novel methodology to identify the geometric parameters of 3D vision systems mounted on robots without involving other people or additional equipment. In particular, our method focuses on legged robots which have complex body structures and excellent locomotion ability compared to their wheeled/tracked counterparts. The parameters can be identified only by moving robots on a relatively flat ground. Concretely, an estimation approach is provided to calculate the ground plane. In addition, the relationship between the robot and the ground is modeled. The parameters are obtained by formulating the identification problem as an optimization problem. The methodology is integrated on a legged robot called "Octopus", which can traverse through rough terrains with high stability after obtaining the identification parameters of its mounted vision system using the proposed method. Diverse experiments in different environments demonstrate our novel method is accurate and robust.

Blood, men and tears: keeping IUDs in place in Bangladesh.

PubMed

Bradley, Janet E; Alam, Mahboob-E-; Shabnam, Fatema; Beattie, Tara S H

2009-06-01

The Intra-Uterine Device (IUD) is an effective method of contraception, but in Bangladesh is associated with high levels of discontinuation within the first year. This study involved data collection from a retrospective cohort of women who had an IUD inserted 12 months earlier. In the cohort, 330 women were interviewed to identify factors associated with discontinuation. Later, 20 women, of the 103 who reported discontinuing because of excessive menstrual bleeding, were interviewed again and in depth about these issues. Of 330 women who had an IUD inserted, 47.3% had discontinued use one year post-insertion. In univariate and multivariate analyses, IUD discontinuation was strongly associated with side-effects (heavier periods; abdominal pain) and spousal factors (not discussing IUD with husband pre-insertion), but not with service delivery factors. In-depth interviews with women who reported excessive blood loss as the main reason for discontinuation found a doubling of both menstrual days and blood loss after IUD insertion. In Bangladesh, women cannot pray, have sexual intercourse, perform household tasks or participate in community activities during menstruation. Thus, women with menstrual side-effects faced serious physical, social and psychological challenges that made continuation difficult. Among those who discontinued, spouses were generally unsupportive and sometimes abusive, particularly when not involved in the decision to use the IUD.

Relational responsibilities in responsive evaluation.

PubMed

Visse, Merel; Abma, Tineke A; Widdershoven, Guy A M

2012-02-01

This article explores how we can enhance our understanding of the moral responsibilities in daily, plural practices of responsive evaluation. It introduces an interpretive framework for understanding the moral aspects of evaluation practice. The framework supports responsive evaluators to better understand and handle their moral responsibilities. A case is introduced to illustrate our argument. Responsive evaluation contributes to the design and implementation of policy by working with stakeholders and coordinating the evaluation process as a relationally responsible practice. Responsive evaluation entails a democratic process in which the evaluator fosters and enters a partnership with stakeholders. The responsibilities of an evaluator generally involve issues such as 'confidentiality', 'accountability' and 'privacy'. The responsive evaluator has specific responsibilities, for example to include stakeholders and vulnerable groups and to foster an ongoing dialogue. In addition, responsive evaluation involves a relational responsibility, which becomes present in daily situations in which stakeholders express expectations and voice demands. In our everyday work as evaluators, it is difficult to respond to all these demands at the same time. In addition, this article demonstrates that novice evaluators experience challenges concerning over- and underidenfitication with stakeholders. Guidelines and quality criteria on how to act are helpful, but need interpretation and application to the unique situation at hand. Copyright © 2011 Elsevier Ltd. All rights reserved.

Hospital doctors behave differently, and only by respecting the fundamentals of professional organizations will managers be able to create common goals with professionals.

PubMed

Van Dijck, H

2014-08-01

Hospital doctors behave differently from other hospital workers. The general and specific characteristics of the doctors' behavior are described. As professionals, doctors want to make autonomous decisions and more specifically, they negotiate differently. The best description of their negotiation style is one that features multi-actor, multi-issue characteristics. They behave as actors in a network in never-ending rounds of negotiations with variable issues up for discussion: one time you lose, the next you win. A doctor's career starts with a long residency period in which he or she absorbs professional habits. His or her knowledge and way of organizing are implicit. It is hard for him or her to explicitly describe what he or she is doing. This makes it difficult for managers to discuss quality issues with doctors. Dealing with disruptive behavior is not easy either. The difficult tasks of the chief medical officer, who acts as a go-between, are highlighted. Only when managers respect the fundamentals of the professional organization will they be able to create common goals with the professionals. Common goals bring about better care in hospitals.

Disability rights in dialogue with clinical genetics conference, May 31 to June 2, 1996

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

NONE

The issue of prenatal diagnosis and selective abortion has been hotly debated in the medical, genetic counselling, feminist, parents, disability rights and bio-ethics literature, each of the various positions critiquing each other. People from the disability rights community in particular have began to articulate a critical view of the practice of widespread prenatal diagnosis with intent to abort because the pregnancy might result in a child with a disability. Unfortunately, people from the various disciplines and perspectives, such as bioethics, disability rights, feminism and so forth, by and large, have tended only to write for themselves and their colleagues. Fewmore » people have crossed disciplines to try to talk to people with other views. The rapid advances of genome research have continued to produce new prenatal tests, raising many complex ethical questions regarding the applications of prenatal testing. But the widely disparate positions of the various factions has made it difficult to move toward formulation of public policy change necessary to encompass these new genetic technologies. Genetic counselling is in the front lines of the controversial social and ethical issues arising from prenatal diagnosis, in its interface between medical science and the consumer of services. The primary intent of the conference was to invite and facilitate productive dialogue between individuals and groups of people who have traditionally not interacted as a result of their disparate views on these issues and to learn from this process, emphasizing the involvement of people with disabilities and people who work in clinical genetics.« less

Hearing conservation and noise management practices in professional orchestras.

PubMed

O'Brien, Ian; Driscoll, Tim; Ackermann, Bronwen

2012-01-01

Hearing conservation and noise exposure management for professional orchestras is a difficult issue resistant to standard control measures as used in other industries with excessive noise problems. Although there has been a great deal of research into this area in terms of the audiological status of musicians and their exposure to noise, there are relatively few industry-specific strategies that can be adopted by an orchestra looking to address these issues. Australia does not have a uniform approach to hearing conservation management in its orchestras; however, each orchestra actively grapples with the challenges of balancing legal, practical, and artistic concerns. This study systematically investigated hearing conservation practices, noise exposure management, and audiological screening protocols in eight professional orchestras. The research involved personal interviews with staff at each orchestra, including inspection of venues and facilities. While all these orchestras were aware of the risks and were actively taking significant steps to reduce noise exposure, a range of approaches, with varying degrees of effectiveness and understanding of the issue, were found across the sector. There was limited evidence of educational programs for either the musicians at risk of excessive noise exposure or the staff responsible for devising and implementing control measures. In addition, the reported use of adequate personal hearing protection by musicians was poor. As Australia has recently introduced a national approach to workplace health and safety, a similar approach to noise and audiological management across the country's orchestral sector is proposed, drawn from existing research and practice. This will enable both consistent procedures and meaningful dialogue between the orchestras on the topics of hearing conservation, audiological monitoring, and educational practices.

The perception of online work-based assessments.

PubMed

Basu, Indraneil; Parvizi, Sahar; Chin, Kian

2013-04-01

Work-based assessments (WBAs) and the associated online feedback are fundamental parts of clinical training. Despite years of clinical use there is little evidence suggesting that they have a positive impact on learning or performance. This observational pilot study investigates the perceptions of online WBAs (OnWBAs) across specialties in an attempt to establish why these tools are not meeting their full academic potential. Structured questionnaires were given to 90 clinicians. Responses were analysed in excel, and spss 17 was used to test for statistical significance. All responders felt that OnWBAs were a poor reflection of clinical competency, and did not enhance learning significantly. Consultant OnWBAs rated poorly against those performed by other grades. Consultant OnWBAs were significantly more difficult to obtain and took significantly longer to complete than those from other grades. Several consultants were inadequately trained in the use of OnWBAs, and most were unaware of the number of assessments required by trainees. This study highlights several issues that may detract from the functionality of OnWBAs. Pockets of consultants are inadequately trained in the use of OnWBAs, and many lack knowledge of trainee requirements. In addition the delay between assessment and completion of feedback is a concern that goes against current recommendations. Simple measures in the workplace and the involvement of educational bodies could remedy some of these issues. Further studies investigating a wider population would help to establish the true extent of the problem and isolate the main causative factors behind these issues. © Blackwell Publishing Ltd 2013.

Improving the food waste composting facilities site selection for sustainable development using a hybrid modified MADM model.

PubMed

Liu, Kung-Ming; Lin, Sheng-Hau; Hsieh, Jing-Chzi; Tzeng, Gwo-Hshiung

2018-05-01

With the growth of population and the development of urbanization, waste management has always been a critical global issue. Recently, more and more countries have found that food waste constitutes the majority of municipal waste, if they are disposed of properly, will bring more benefits in sustainable development. Regarding the issue of selecting and improving the location to make the disposal facility towards achieving the aspiration level for sustainable development, since it involves multiple and complicated interaction factors about environment, society, and economy which have to be considered properly in the decision-making process of mutual influence relationship. It is basically a multiple attribute decision making (MADM) issue, a difficult problem which has been obsessing the governments of many countries is widely studied and discussed. This study uses the new hybrid modified MADM model, as follows, first to build an influential network relation map (INRM) via DEMATEL technique, next to confirm the influential weightings via DANP (DEMATEL-based ANP), and then to construct a decision-making model via a hybrid modified VIKOR method to improve and select the location for remaining the best disposal facilities. Finally, an empirical case study is illustrated to demonstrate that the proposed model can be effective and useful. In finding the process of decision making, environmental pollution is the main concern of many people in the area, but actually it is the resistance by the general public that has to be considered with first priority. Copyright © 2018. Published by Elsevier Ltd.

Unique issues raised by drug benefit design.

PubMed

Berndt, Ernst R

2004-01-01

In this Perspective on the preceding paper by Joseph Newhouse, I point out a number of features of the pharmaceutical industry that differentiate it from other health care sectors. These differences help explain why it has proved to be so very difficult to construct policies that simultaneously contain health care costs, provide patients with high-quality care, and generate continued incentives for innovation. I then summarize Newhouse's preferred Medicare prescription drug benefit program and the issues it raises.

Interpretations of Quantum Theory in the Light of Modern Cosmology

NASA Astrophysics Data System (ADS)

Castagnino, Mario; Fortin, Sebastian; Laura, Roberto; Sudarsky, Daniel

2017-11-01

The difficult issues related to the interpretation of quantum mechanics and, in particular, the "measurement problem" are revisited using as motivation the process of generation of structure from quantum fluctuations in inflationary cosmology. The unessential mathematical complexity of the particular problem is bypassed, facilitating the discussion of the conceptual issues, by considering, within the paradigm set up by the cosmological problem, another problem where symmetry serves as a focal point: a simplified version of Mott's problem.

Lay and professional stakeholder involvement in scoping palliative care issues: Methods used in seven European countries.

PubMed

Brereton, Louise; Ingleton, Christine; Gardiner, Clare; Goyder, Elizabeth; Mozygemba, Kati; Lysdahl, Kristin Bakke; Tummers, Marcia; Sacchini, Dario; Leppert, Wojciech; Blaževičienė, Aurelija; van der Wilt, Gert Jan; Refolo, Pietro; De Nicola, Martina; Chilcott, James; Oortwijn, Wija

2017-02-01

Stakeholders are people with an interest in a topic. Internationally, stakeholder involvement in palliative care research and health technology assessment requires development. Stakeholder involvement adds value throughout research (from prioritising topics to disseminating findings). Philosophies and understandings about the best ways to involve stakeholders in research differ internationally. Stakeholder involvement took place in seven countries (England, Germany, Italy, Lithuania, the Netherlands, Norway and Poland). Findings informed a project that developed concepts and methods for health technology assessment and applied these to evaluate models of palliative care service delivery. To report on stakeholder involvement in the INTEGRATE-HTA project and how issues identified informed project development. Using stakeholder consultation or a qualitative research design, as appropriate locally, stakeholders in seven countries acted as 'advisors' to aid researchers' decision making. Thematic analysis was used to identify key issues across countries. A total of 132 stakeholders (82 professionals and 50 'lay' people) aged ⩾18 participated in individual face-to-face or telephone interviews, consultation meetings or focus groups. Different stakeholder involvement methods were used successfully to identify key issues in palliative care. A total of 23 issues common to three or more countries informed decisions about the intervention and comparator of interest, sub questions and specific assessments within the health technology assessment. Stakeholders, including patients and families undergoing palliative care, can inform project decision making using various involvement methods according to the local context. Researchers should consider local understandings about stakeholder involvement as views of appropriate and feasible methods vary. Methods for stakeholder involvement, especially consultation, need further development.

Phototoxicity of Selected Nanomaterials

EPA Science Inventory

Quantification of exposure to nanomaterials is critical for assessing their environmental hazard and risk. This is an immediate issue for nano-TiO2 because it is one of more common nanomaterials now in commerce, and is difficult to analyze using common acid-digestion techniques. ...

STABLE CHLORINE ISOTOPE ANALYSIS OF CHLORINATED ORGANIC CONTAMINANTS

EPA Science Inventory

The biogeochemical cycling of chlorinated organic contaminants in the environment is often difficult to understand because of the complex distributions of these compounds and variability of sources. To address these issues from an isotopic perspective, we have measured the, 37Cl...

When the Personal Becomes Problematic: The Ethics of Using Experiential Teaching Methods.

ERIC Educational Resources Information Center

Grauerholz, Elizabeth; Copenhaver, Stacey

1994-01-01

Maintains that experiential methods that rely on students' own life experiences and involve self-disclosure are becoming increasingly common in sociology courses that deal with difficult subjects. Discusses benefits and risks involved in using such methods in a student-instructor dialog. (CFR)

[From the editor].

PubMed

Dudek, Dominika; Sobański, Jerzy A; Klasa, Katarzyna

2015-01-01

Dear Readers We are happy and proud to announce that we managed to achieve intention announced in the last issue: for the first time in PubMed there is a possibility of direct and free access to the full texts published in Polish Psychiatry (Polish and English language versions are available)!!! For the issue 6/2014 they have been downloaded by Medline users already 500 times. Owing to this, papers by Polish scientists-psychiatrists are more readily available to colleagues from around the world interested in them, and Polish Psychiatry actually becomes journal of international scope. We hope that it will result in a marked improvement in the bibliometric indicators (which, however, is unrealistic to expect in the current or next year) in the following years. Spring issue of Polish Psychiatry touches several important problems. We pay attention to the texts on addiction - behavioural (Internet addiction) and alcohol. Two papers by prof. M. Wojnar's team summarize the issues related to the coexistence of alcohol dependence with other psychiatric disorders. The issue of dual diagnosis has already appeared in our magazine (for example [1]). This is an extremely difficult problem, and patients are a real challenge, both therapeutic and diagnostic. They often require a comprehensive approach: pharmacotherapy of comorbid mental illness, psychoeducation, addiction treatment programmes. For these patients the maintenance of abstinence is particularly difficult, especially in a situation of exacerbation of psychopathological symptoms. An important direction is searching for additional pharmacotherapeutic methods which help to reduce the degree of alcohol abuse and the resulting damage. These include: acamprosate, drugs which are opioid receptor antagonists [2], and in the current issue the authors from the University of Cagliari focused on baclofen. (...).

Aesthetic possibilities in removable prosthodontics. Part 1: the aesthetic spectrum from perfect to personal.

PubMed

Besford, J N; Sutton, A F

2018-01-12

Patients requiring dentures are getting older and as a result can be difficult to treat owing to various co-morbidities. This series of papers presents an overview of the processes involved in making removable dentures which the patient considers to be functionally and aesthetically successful. We hope not only to provide technical suggestions but also to address the issue of the clinician's, technician's and dental nurse's relationships with the dentally depleted patient. It is increasingly clear from defence organisation reports that this has a decisive effect on the success of this fundamentally difficult enterprise ('The only branch of dentistry in which you are trying to attach something to nothing' [Hubert Aïche]). It seems best to conduct the planning and the treatment itself as a co-production - the patient assuming responsibility for choosing between the treatment options offered and playing the leading role in making aesthetic decisions. Distinctions are drawn between the idealised whiter-than-white, 'nobody-in-particular', attention-seeking denture at one extreme, and the highly personalised, discreet and naturalistic denture at the other. Reproducing nature in this way is time consuming and therefore expensive, but many 'denture sufferers' see it as good value. Methods for creating the latter, which through its very normality switches off the social observer's attention, are explained in detail in papers two and three of this series. These papers are designed to help clinicians and technicians involved in providing removable prosthodontics improve the appearance of their dentures and increase their patients' aesthetic satisfaction. They are not scientific articles in the Popperian sense of advancing theories which are capable of being falsified. Instead, they are an amalgamation of 72 years of combined experience in providing removable dental prostheses. We have found this branch of dentistry immensely interesting and have on many occasions had the satisfaction of seeing our patients' lives changed for the better.

Evaluation of an action research project in ophthalmic nursing practice.

PubMed

Waterman, Heather; Harker, Rona; MacDonald, Heather; McLaughlan, Rita; Waterman, Christine

2005-11-01

This paper reports the evaluation phase of an action research project that promoted face-down posturing of patients following vitreo-retinal surgery for macular hole to enhance patient outcomes. The evaluation phase identified areas of practice needing further development from the perspectives of those involved with the care of patients. To achieve best results following surgical repair of macular hole, patients are required to posture face down for several weeks. As a consequence, patients complain of severe back and neck ache and find it difficult to persist with the posturing. Work to advance nursing practice as surgical developments occur has relevance beyond ophthalmology and the particular context of this project. The first three phases of this action research--problem identification, planning and action--have been reported in another paper. Throughout the project an action research group comprising of representatives of key stakeholders were actively involved in researching and changing practice. During the evaluation phase, a qualitative methodology was chosen. Interviews with 17 members of staff from the inpatient area were carried out to elicit their perspectives on the posturing of patients. Qualitative interviews were selected to facilitate comparison with interview data from Phase 1. Data analysis ran concurrently with data collection, so that one could inform the other. Overall, nurses and healthcare support workers felt that patients were more agreeable to posturing and after surgery began to posture more quickly. Communication was still an issue in some instances, and patients having urgent as opposed to planned surgery were found to be more difficult to prepare and the psychological care of patients still posed problems for nursing staff. The evaluation suggests that improvements in the care of this group of patients have occurred. A 10-point plan to promote face-down posturing has been developed which will be of use to practitioners in other settings. Some aspects of practice remain less well-understood, for example, the psychological care of patients.

Ethics and infectious disease.

PubMed

Selgelid, Michael J

2005-06-01

Bioethics apparently suffers from a misdistribution of research resources analogous to the '10/90' divide in medical research. Though infectious disease should be recognized as a topic of primary importance for bioethics, the general topic of infectious disease has received relatively little attention from the discipline of bioethics in comparison with things like abortion, euthanasia, genetics, cloning, stem cell research, and so on. The fact that the historical and potential future consequences of infectious diseases are almost unrivalled is one reason that the topic of infectious disease warrants more attention from bioethicists. The 'Black Death' eliminated one third of the European population during the 14th Century; the 1989 flu killed between 20 and 100 million people; and, in the 20th Century smallpox killed perhaps three times more people than all the wars of that period. In the contemporary world, epidemics (AIDS, multi-drug resistant turberculosis, and newly emerging infectious diseases such as SARS) continue to have dramatic consequences. A second reason why the topic of infectious disease deserves further attention is that it raises difficult ethical questions of its own. While infected individuals can threaten the health of other individuals and society as a whole, for example, public health care measures such as surveillance, isolation, and quarantine can require the infringement of widely accepted basic human rights and liberties. An important and difficult ethical question asks how to strike a balance between the utilitarian aim of promoting public health, on the one hand, and libertarian aims of protecting privacy and freedom of movement, on the other, in contexts involving diseases that are--to varying degrees--contagious, deadly, or otherwise dangerous. Third, since their burden is most heavily shouldered by the poor (in developing countries), infectious diseases involve issues of justice--which should be a central concern of ethics. I conclude by providing sociological and historical explanations of why the topic of infectious disease has not already received more attention from bioethicists.

Lingual Abscess in the Setting of Recent Periodontal Antibiotic Injections.

PubMed

Lefler, Joshua E; Masullo, Lawrence N

2016-10-01

Lingual abscess is a rare clinical entity, with posterior involvement being much less common than anterior involvement. Typical inciting events include trauma or direct inoculation to the area. The clinical diagnosis can be difficult, and early imaging and specialist consultation should be pursued to make a definitive diagnosis and to prevent patient deterioration. We present a case of posterior lingual abscess in a 62-year-old man after he received antibiotic injections to the lower molars for periodontal disease. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Lingual abscess is a rare condition that is difficult to diagnose clinically. Misdiagnosis or delayed diagnosis can lead to acute airway compromise and increased morbidity. Published by Elsevier Inc.

Fort Collins Science Center- Policy Analysis and Science Assistance Branch : Integrating social, behavioral, economic and biological sciences

USGS Publications Warehouse

2010-01-01

The Fort Collins Science Center's Policy Analysis and Science Assistance (PASA) Branch is a team of approximately 22 scientists, technicians, and graduate student researchers. PASA provides unique capabilities in the U.S. Geological Survey by leading projects that integrate social, behavioral, economic, and biological analyses in the context of human-natural resource interactions. Resource planners, managers, and policymakers in the U.S. Departments of the Interior (DOI) and Agriculture (USDA), State and local agencies, as well as international agencies use information from PASA studies to make informed natural resource management and policy decisions. PASA scientists' primary functions are to conduct both theoretical and applied social science research, provide technical assistance, and offer training to advance performance in policy relevant research areas. Management and research issues associated with human-resource interactions typically occur in a unique context, involve difficult to access populations, require knowledge of both natural/biological science in addition to social science, and require the skill to integrate multiple science disciplines. In response to these difficult contexts, PASA researchers apply traditional and state-of-the-art social science methods drawing from the fields of sociology, demography, economics, political science, communications, social-psychology, and applied industrial organization psychology. Social science methods work in concert with our rangeland/agricultural management, wildlife, ecology, and biology capabilities. The goal of PASA's research is to enhance natural resource management, agency functions, policies, and decision-making. Our research is organized into four broad areas of study.

[Families Involved in Learning.

ERIC Educational Resources Information Center

Ashby, Nicole, Ed.

2001-01-01

This issue of "Community Update" focuses on families involved in learning. The first article briefly discusses the "Ready to Read, Ready to Learn" White House summit that highlighted new research on early childhood learning. The center spread of this issue offers "Priming the Primary Educator: A Look at L. A. County's Parent Involvement Programs"…

Identification of shareholder ethics and responsibilities in online reverse auctions for construction projects.

PubMed

Hatipkarasulu, Yilmaz; Gill, James H

2004-04-01

The increasing number of companies providing internet services and auction tools helped popularize the online reverse auction trend for purchasing commodities and services in the last decade. As a result, a number of owners, both public and private, accepted the online reverse auctions as the bidding technique for their construction projects. Owners, while trying to minimize their costs for construction projects, are also required to address their ethical responsibilities to the shareholders. In the case of online reverse auctions for construction projects, the ethical issues involved in the bidding technique directly reflects on the owner's ethical and social responsibilities to their shareholders. The goal of this paper is to identify the shareholder ethics and responsibilities in online reverse auctions for construction projects by analyzing the ethical issues for the parties involved in the process. The identification of the ethical issues and responsibilities requires clear definition and understanding of professional ethics and the roles of the involved parties. In this paper, first, the concept of professional ethics and social responsibility is described in a general form. To illustrate the ethical issues and responsibilities, a sample case of bidding for a construction project using online reverse auction techniques is presented in which the shareholders were actively involved in questioning the ethical issues. The issues involved in the bidding process and their reflection on the shareholder responsibilities are described and analyzed for each stage of the process. A brief discussion of the overall process is also included to address the general ethical issues involved in online reverse auctions.

Bridging the Divide: The Role of Perceived Control in Mediating Reasoning and Activism.

ERIC Educational Resources Information Center

Laird, Philip G.

2003-01-01

Reviews the Defining Issues Test and Spheres of Control results of students involved in the pro-choice or pro-life movements. Rates participation of student involvement in on-campus activities. Reveals abortion activists more frequently endorsed moral issues and scored higher on sociopolitical issues. Discusses results based on relationships among…

Using RNA Sequencing to Classify Organisms into Three Primary Kingdoms.

ERIC Educational Resources Information Center

Evans, Robert H.

1983-01-01

Using the biochemical record to class archaebacteria, eukaryotes, and eubacteria involves abstractions difficult for the concrete learner. Therefore, a method is provided in which students discover some basic tenets of biochemical classification and apply them in a "hands-on" classification problem. The method involves use of RNA…

Categories, Gender and Online Community

ERIC Educational Resources Information Center

Marshall, Jonathan Paul

2006-01-01

This article presents a sketch for a theory of the rhetorics involved in categorisation and the creation of culture in online communities. Persuasion, or shaping perceptions of the world, is never incidental to social life, but living online necessarily involves persuasion as it is difficult to bring force to bear, although people can be…

When 95% Accurate Isn't: Exploring Bayes's Theorem

ERIC Educational Resources Information Center

CadwalladerOlsker, Todd D.

2011-01-01

Bayes's theorem is notorious for being a difficult topic to learn and to teach. Problems involving Bayes's theorem (either implicitly or explicitly) generally involve calculations based on two or more given probabilities and their complements. Further, a correct solution depends on students' ability to interpret the problem correctly. Most people…

Involving Working Parents in Child Care.

ERIC Educational Resources Information Center

Lombardi, Joan

1995-01-01

Notes that working parents of preschoolers find it difficult to schedule time for direct involvement in their child's education or care program without special arrangements with employers, who frequently are unwilling to make arrangements. Presents ways schools or centers can create a community climate in which employers are encouraged and…

Reflections on the Ethics-Approval Process

ERIC Educational Resources Information Center

Murray, Lee; Pushor, Debbie; Renihan, Pat

2012-01-01

It is sometimes a difficult journey receiving ethics approval for research involving vulnerable populations, research involving our own children, or innovative research methodologies such as autoethnography. This autoethnographical account is a story about one student who wanted to write a PhD dissertation in a very different way and also the…

Community Involvement Manual.

DTIC Science & Technology

1979-05-01

and social problems, does not lend itself to a single or simple solution. This is why we must all be involved. For this reason we. believe that...of admission to decisionmaking. At times the implications of this relatively simple premise are not minor. Many people beginning community...involvement programs have found it extremely difficult to locate technical people able to translate technical reports into simple , every- day English. There

Braving Difficult Choices Alone: Children's and Adolescents' Medical Decision Making

PubMed Central

Ruggeri, Azzurra; Gummerum, Michaela; Hanoch, Yaniv

2014-01-01

Objective What role should minors play in making medical decisions? The authors examined children's and adolescents' desire to be involved in serious medical decisions and the emotional consequences associated with them. Methods Sixty-three children and 76 adolescents were presented with a cover story about a difficult medical choice. Participants were tested in one of four conditions: (1) own informed choice; (2) informed parents' choice to amputate; (3) informed parents' choice to continue a treatment; and (4) uninformed parents' choice to amputate. In a questionnaire, participants were asked about their choices, preference for autonomy, confidence, and emotional reactions when faced with a difficult hypothetical medical choice. Results Children and adolescents made different choices and participants, especially adolescents, preferred to make the difficult choice themselves, rather than having a parent make it. Children expressed fewer negative emotions than adolescents. Providing information about the alternatives did not affect participants' responses. Conclusions Minors, especially adolescents, want to be responsible for their own medical decisions, even when the choice is a difficult one. For the adolescents, results suggest that the decision to be made, instead of the agent making the decision, is the main element influencing their emotional responses and decision confidence. For children, results suggest that they might be less able than adolescents to project how they would feel. The results, overall, draw attention to the need to further investigate how we can better involve minors in the medical decision-making process. PMID:25084274

San Luis Basin Sustainability Metrics Project: A Methodology for Evaluating Regional Sustainability

EPA Science Inventory

Although there are several scientifically-based sustainability metrics, many are data intensive, difficult to calculate, and fail to capture all aspects of a system. To address these issues, we produced a scientifically-defensible, but straightforward and inexpensive, methodolog...

MANUAL: REAL TIME CONTROL OF COMBINED SEWERS

EPA Science Inventory

Managers, engineers, and operators of combined urban sewer systems are faced with difficult problems related to the operation and maintenance of their facilities. In addition to the issues related to the operation and upkeep of the system, many sewerage agencies are facing increa...

Climate policy: Uncovering ocean-related priorities

NASA Astrophysics Data System (ADS)

Barkemeyer, Ralf

2017-11-01

Given the complexity and multi-faceted nature of policy processes, national-level policy preferences are notoriously difficult to capture. Now, research applying an automated text mining approach helps to shed light on country-level differences and priorities in the context of marine climate issues.

ISSUES AND CHALLENGES IN MODELING CHILDREN'S LONGITUDINAL EXPOSURES: AN OZONE STUDY

EPA Science Inventory

Modeling children's exposures is a complicated, data-intensive process. Modeling longitudinal exposures, which are important for regulatory decision making, especially for most air toxics, adds another level of complexity and data requirements. Because it is difficult to model in...

CURRENT ISSUES IN HTE DETECTION OF HUMAN EXPOSURE TO THE CYANOBACTERIA TOXINS, MICROCYSTINS

EPA Science Inventory

Introduction: Toxic cyanobacteria are contaminants of surface waters worldwide. Microcystins are some of the most commonly detected toxins. Biological evidence of human exposure has been difficult to obtain due to technical, temporal, and biological limitations. However, evide...

Genetic privacy and confidentiality: why they are so hard to protect.

PubMed

Rothstein, M A

1998-01-01

Author notes that widespread concerns have been raised about protecting genetic privacy and confidentiality in insurance and employment. He argues that effective protections are difficult because complicated issues, such as the right of access to health care, are invariably implicated.

Complejidad en Educacion Ambiental.

ERIC Educational Resources Information Center

Gaudiano, Edgar Gonzalez

2000-01-01

Analyzes the complexity of our knowledge of environmental issues and their relationship with educational processes from an anti-essentialist point of view. The concept of complexity has several uses in everyday language where it is occasionally used to refer to something complicated or difficult. (Author/SAH)

Enabling the use of climate model data in the Dutch climate effect community

NASA Astrophysics Data System (ADS)

Som de Cerff, Wim; Plieger, Maarten

2010-05-01

Within the climate effect community the usage of climate model data is emerging. Where mostly climate time series and weather generators were used, there is a shift to incorporate climate model data into climate effect models. The use of climate model data within the climate effect models is difficult, due to missing metadata, resolution and projection issues, data formats and availability of the parameters of interest. Often the climate effect modelers are not aware of available climate model data or are not aware of how they can use it. Together with seven other partners (CERFACS, CNR-IPSL, SMHI, INHGA, CMCC, WUR, MF-CNRM), KNMI is involved in the FP7 IS ENES (http://www.enes.org) project work package 10/JRA5 ‘Bridging Climate Research Data and the Needs of the Impact Community. The aims of this work package are to enhance the use of Climate Research Data and to enhance the interaction with climate effect/impact communities. Phase one is to define use cases together with the Dutch climate effect community, which describe the intended use of climate model data in climate effect models. We defined four use cases: 1) FEWS hydrological Framework (Deltares) 2) METAPHOR, a plants and species dispersion model (Wageningen University) 3) Natuurplanner, an Ecological model suite (Wageningen University) 4) Land use models (Free University/JRC). Also the other partners in JRA5 have defined use cases, which are representative for the climate effect and impact communities in their country. Goal is to find commonalities between all defined use cases. The common functionality will be implemented as e-tools and incorporated in the IS-ENES data portal. Common issues relate to e.g., need for high resolution: downscaling from GCM to local scale (also involves interpolation); parameter selection; finding extremes; averaging methods. At the conference we will describe the FEWS case in more detail: Delft FEWS is an open shell system (in development since 1995) for performing hydrological predictions and the handling of time series data. The most important capabilities of FEWS are importing of meteorological and hydrological data and organizing the workflows of the different models which can be used within FEWS, like the Netherlands Hydrological Instrumentarium (NHI). Besides predictions, the system is currently being used for hydrological climate effects studies. Currently regionally downscaled data are used, but using model data will be the next step. This coupling of climate model data to FEWS will open a wider rage of climate impact and effect research, but it is a difficult task to accomplish. Issues to be dealt with are: regridding, downscaling, format conversion, extraction of required data and addition of descriptive metadata, including quality and uncertainty parameters. Finding an appropriate solution involves several iterations: first, the use case was defined, then we just provided a single data file containing some data of interest provided via FTP, next this data was offered through OGC services. Currently we are working on providing larger datasets and improving on the parameters and metadata. We will present the results (e-tools/data) and experiences gained on implementing the described use cases. Note that we are currently using experimental data, as the official climate model runs are not available yet.

VLBI Digital-Backend Intercomparison Test Report

NASA Technical Reports Server (NTRS)

Whitney, Alan; Beaudoin, Christopher; Cappallo, Roger; Niell, Arthur; Petrachenko, Bill; Ruszczyk, Chester A.; Titus, Mike

2013-01-01

Issues related to digital-backend (DBE) systems can be difficult to evaluate in either local tests or actual VLBI experiments. The 2nd DBE intercomparison workshop at Haystack Observatory on 25-26 October 2012 provided a forum to explicitly address validation and interoperability issues among independent global developers of DBE equipment. This special report discusses the workshop. It identifies DBE systems that were tested at the workshop, describes the test objectives and procedures, and reports and discusses the results of the testing.

Treatment issues for children with epilepsy transitioning to adult care.

PubMed

Nabbout, Rima; Camfield, Carol S; Andrade, Danielle M; Arzimanoglou, Alexis; Chiron, Catherine; Cramer, Joyce A; French, Jacqueline A; Kossoff, Eric; Mula, Marco; Camfield, Peter R

2017-04-01

This is the third of three papers that summarize the second symposium on Transition in Epilepsies held in Paris in June 2016. This paper focuses on treatment issues that arise during the course of childhood epilepsy and make the process of transition to adult care more complicated. Some AEDs used during childhood, such as stiripentol, vigabatrin, and cannabidiol, are unfamiliar to adult epilepsy specialists. In addition, new drugs are being developed for treatment of specific childhood onset epilepsy syndromes and have no indication yet for adults. The ketogenic diet may be effective during childhood but is difficult to continue in adult care. Regional adult epilepsy diet clinics could be helpful. Polytherapy is common for patients transitioning to adult care. Although these complex AED regimes are difficult, they are often possible to simplify. AEDs used in childhood may need to be reconsidered in adulthood. Rescue medications to stop prolonged seizures and clusters of seizures are in wide home use in children and can be continued in adulthood. Adherence/compliance is notoriously difficult for adolescents, but there are simple clinical approaches that should be helpful. Mental health issues including depression and anxiety are not always diagnosed and treated in children and young adults even though effective treatments are available. Attention deficit hyperactivity disorder and aggressive behavior disorders may interfere with transition and successful adulthood but these can be treated. For the majority, the adult social outcome of children with epilepsy is unsatisfactory with few proven interventions. The interface between pediatric and adult care for children with epilepsy is becoming increasingly complicated with a need for more comprehensive transition programs and adult epileptologists who are knowledgeable about special treatments that benefit this group of patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Strategies for teaching object-oriented concepts with Java

NASA Astrophysics Data System (ADS)

Sicilia, Miguel-Ángel

2006-03-01

A considerable amount of experiences in teaching object-oriented concepts using the Java language have been reported to date, some of which describe language pitfalls and concrete learning difficulties. In this paper, a number of additional issues that have been experienced as difficult for students to master, along with approaches intended to overcome them, are addressed. Concretely, practical issues regarding associations, interfaces, genericity and exceptions are described. These issues suggest that more emphasis is required on presenting Java programs as derivations of conceptual models, in order to guarantee that a thorough design of the object structure actually precedes implementation issues. In addition, common student misunderstandings about the uses of interfaces and exceptions point to the necessity of introducing both specific design philosophies and also a clear distinction between design-for-reuse and more specific implementation issues.

Parental Choices and Ethical Dilemmas Involving Disabilities: Special Education and the Problem of Deliberately Chosen Disabilities

ERIC Educational Resources Information Center

Kauffman, James M.; Hallahan, Daniel P.

2009-01-01

Ethical issues regarding children with disabilities have long involved their treatment after they are born. These issues remain important, but children may be deliberately created with or without characteristics that are usually thought of as disabilities. Preimplantation genetic diagnosis (PGD) and related technologies that involve human…

Use of the Legal-Institutional Analysis Model to assess hydropower licensing negotiations

USGS Publications Warehouse

Burkardt, N.; Lamb, B.L.; Lamb, B.L.; Garcia de Jalon, D.; Sabaton, C.; Souchon, Y.; Tamai, N.; Robinette, H.R.; Waddle, T.J.; Brinson, A.

2003-01-01

In the United States, the Federal Energy Regulatory Commission (FERC) is responsible for issuing or renewing licenses for hydropower projects owned and operated by power companies. During the licensing process, these companies are required to consult with agencies and other parties that are affected by project operating regimes. Typical participants include state and federal fish and wildlife agencies, environmental interest groups, and the FERC. One of the most difficult tasks facing participants is to reach agreement about what kinds of environmental conditions should be placed on license. Researchers at the United States Geological Survey developed a model to analyze the institutional context of natural resource disputes. The Legal-Institutional Analysis Model (LIAM) is a computerized model that allows an analyst to determine the likely behavior of each organization in a conflict. The model also analyzes the types and levels of negotiating power held by each organization. Researchers at the USGS have used the model in several cases involving hydropower license applications. To use the model, they facilitate workshops for stakeholder groups in order to develop a shared understanding of the likely obstacles and opportunities for successful resolution of the issues. This allows a systematic workshop analyses to develop strategies for successful negotiations, because they are able to better understand the negotiation problem and work more effectively with both their allies and their competitors.

Initiatives: Mauritius.

PubMed

Budory, B

1996-04-01

Field experience in Mauritius shows that reaching males in the community is more difficult than reaching other groups. Generally seeing sexual and reproductive health as women's issues, men visit the family planning association only in case of urgent need. Men also assume that they already know about sexuality. The Mauritius Family Planning Association (MFPA) has therefore developed a strategy for information, education, and communication designed to reach men by segmenting and intervening in male dominant sectors such as the fishing industry, the police force, the public transport sector, and the fire brigade. Since gaining access to men in those sectors through an aggressive campaign conducted in 1995 with sector heads, more than 2000 men aged 25-45 years have participated in seminars, workshops, and group discussions on sexual and reproductive health during their working hours. The program usually sparked lively discussions among the men and showed that there is a lack of information on sexual and reproductive health, inadequate knowledge resulting in an unwillingness to use condoms, insufficient information on hormonal contraceptives, little discussion between partners and spouses on family planning and reproductive health-related decisions, common premature ejaculation, and the belief that sexual and family planning issues are of low priority. The MFPA strategic plan for 1996-2000 includes provision for specialized counseling to men and will address relevant concerns relating to reaching out to men and increasing their level of involvement in family planning.

Communicative challenges in the home care of older persons - a qualitative exploration.

PubMed

Sundler, Annelie J; Eide, Hilde; van Dulmen, Sandra; Holmström, Inger K

2016-10-01

To explore communicative challenges in encounters between nurse assistants and older persons during home care visits. The older population is increasing worldwide. Currently, there is a shift in care for older people from institutional care to home care. Providing home care in a person's home involves several challenges, including the complexity of communication. A descriptive observational design with a qualitative approach was used. The data consisted of audio recordings of real-life encounters during home care visits between nurse assistants and older persons, collected in 2014. A hermeneutic phenomenological analysis was conducted. Communicative challenges were identified: (a) in situations where the older persons had a different view than the nurse assistants on the care task and its content; and (b) when unexpected actions or turns occurred in the communication. Challenges included older person's existential issues, fragility and worries and concerns, which often appeared to be only vaguely expressed and difficult to verbally detect and tackle. This engendered a risk of misinterpretation or ignorance of these challenges. The findings point to the importance of communication as the key to facilitate person-centred home care. Communication training should focus more on addressing needs and existential issues in older persons. Person-centred home care for older persons needs to be addressed at both an individual and an organizational level. © 2016 John Wiley & Sons Ltd.

Evolution of models to support community and policy action with science: Balancing pastoral livelihoods and wildlife conservation in savannas of East Africa.

PubMed

Reid, R S; Nkedianye, D; Said, M Y; Kaelo, D; Neselle, M; Makui, O; Onetu, L; Kiruswa, S; Kamuaro, N Ole; Kristjanson, P; Ogutu, J; BurnSilver, S B; Goldman, M J; Boone, R B; Galvin, K A; Dickson, N M; Clark, W C

2016-04-26

We developed a "continual engagement" model to better integrate knowledge from policy makers, communities, and researchers with the goal of promoting more effective action to balance poverty alleviation and wildlife conservation in 4 pastoral ecosystems of East Africa. The model involved the creation of a core boundary-spanning team, including community facilitators, a policy facilitator, and transdisciplinary researchers, responsible for linking with a wide range of actors from local to global scales. Collaborative researcher-facilitator community teams integrated local and scientific knowledge to help communities and policy makers improve herd quality and health, expand biodiversity payment schemes, develop land-use plans, and fully engage together in pastoral and wildlife policy development. This model focused on the creation of hybrid scientific-local knowledge highly relevant to community and policy maker needs. The facilitation team learned to be more effective by focusing on noncontroversial livelihood issues before addressing more difficult wildlife issues, using strategic and periodic engagement with most partners instead of continual engagement, and reducing costs by providing new scientific information only when deemed essential. We conclude by examining the role of facilitation in redressing asymmetries in power in researcher-community-policy maker teams, the role of individual values and character in establishing trust, and how to sustain knowledge-action links when project funding ends.

Evaluating hazardous waste generation in for-profit outpatient haemodialysis centres.

PubMed

García-Vicente, Sergio; Llopis-González, A; González-Steinbauer, C; Morales Suárez-Varela, M

2016-03-01

"Green" haemodialysis management to reduce the environmental impact of haemodialysis is growing. Dealing with hazardous waste production could heighten healthcare professionals' awareness of this problem, and improve their healthcare involvement in environmental sustainability and environmental-friendliness. A list of for-profit outpatient haemodialysis centres in the Valencian Community (E Spain) was compiled. Data on their hazardous waste production from 2008 to 2012 through the annual waste reports issued by official organisations competent in environmental issues were collected. There are 22 for-profit dialysis centres, that managed the treatment for 69.1% of all dialysis patients in the region. Data were collected from 16 centres that collectively offer 350 dialysis places (33.8% of all the places in this region). Mean annual hazardous waste production per dialysis session increased by 14% during the study period: 0.640 kg per session in 2008 vs. 0.740 kg in 2012. As hazardous waste production is high, we must examine the reasons why it is growing. Information about haemodialysis waste production and management is scarce and difficult to access. Having an evaluation of its production would motivate further research, especially as end-stage kidney disease is increasing, and whose main long-term treatment, haemodialysis, produces hazardous waste and employs substantial natural resources. Minimising its environmental impact is not mission impossible. © 2015 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Non-NSAID over-the-counter (OTC) remedies for arthritis: good, bad or indifferent?

PubMed

Whitehouse, M W; Butters, D E

1999-01-01

This overview looks at some of the issues involved with the ever-increasing availability of marketed non-prescription products, specifically claiming to treat the pain and inflammation of arthritis and other musculoskeletal problems.The question of whether the buyer is getting (any) value for their money cannot be answered without considering several key issues. These include: (a) reliability of claims; (b) placebo effect (but for how long?); (c) reliability of composition, and reproducibility (especially of natural products); (d) general safety; (e) interactions with other medications; (f) honest labelling (in the absence of stricter guidelines).A particularly difficult problem is to know how to recognise a 'drug of choice', particularly for such a multi-faceted disease as chronic arthritis, when there is so little information about the actual pharmacology/potential toxicity of these OTC products in the standard drug compendia and other readily available reference texts.This grey area can only be illuminated by (i) further introduction (and enforcement) of adequate standards/quality controls for products offered OTC; (ii) earliest prosecution of clinical trials to supercede unverified testimonial claims; (iii) appropriate funding to research/establish basic pharmacology of the active principles.In summary, more research, more regulation, and more realistic investment will be required to dispel present uncertainty about which non-NSAID drugs/nutriceuticals are indeed effective against arthritis/other forms of inflammation, and which are not.

A scoping review of anorexia of aging correlates and their relevance to population health interventions.

PubMed

Roy, Mathieu; Gaudreau, Pierrette; Payette, Hélène

2016-10-01

Anorexia of aging (AA, i.e., loss of appetite and/or reduction of food intake with aging) is an important public health issue. It leads to unintentional weight loss, which is an independent risk factor for morbidity and mortality among seniors. AA has mainly been studied from a biological perspective and regarded as a normal physiological consequence of aging, rather than a negative health outcome with underlying determinants. Some potentially modifiable correlates have however been found to be associated with this geriatric condition. Here, we conducted a scoping review of the literature to: 1) identify AA correlates, and 2) discuss their relevance to population health interventions. Our results indicate two main categories of AA correlates, namely, physiopathological and non-physiopathological. The first category relates to physiological dysfunctions, pathologies involving (or culminating in) biomarker dysregulation, and polypharmacy. These correlates are difficult to modify, especially through population health interventions. The second category, which contains fewer correlates, includes potentially modifiable public health targets, such as food-related properties, psychological, sociocultural, and environmental issues. We conclude that there are several AA correlates. Some of them are modifiable and could be targeted for development and implementation as appropriate population health interventions to prevent appetite loss and promote maintenance of adequate food intake in aging. Copyright © 2016 Elsevier Ltd. All rights reserved.

Radioactive waste storage issues

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

Kunz, Daniel E.

1994-08-15

In the United States we generate greater than 500 million tons of toxic waste per year which pose a threat to human health and the environment. Some of the most toxic of these wastes are those that are radioactively contaminated. This thesis explores the need for permanent disposal facilities to isolate radioactive waste materials that are being stored temporarily, and therefore potentially unsafely, at generating facilities. Because of current controversies involving the interstate transfer of toxic waste, more states are restricting the flow of wastes into - their borders with the resultant outcome of requiring the management (storage and disposal)more » of wastes generated solely within a state`s boundary to remain there. The purpose of this project is to study nuclear waste storage issues and public perceptions of this important matter. Temporary storage at generating facilities is a cause for safety concerns and underscores, the need for the opening of permanent disposal sites. Political controversies and public concern are forcing states to look within their own borders to find solutions to this difficult problem. Permanent disposal or retrievable storage for radioactive waste may become a necessity in the near future in Colorado. Suitable areas that could support - a nuclear storage/disposal site need to be explored to make certain the health, safety and environment of our citizens now, and that of future generations, will be protected.« less

3D data processing with advanced computer graphics tools

NASA Astrophysics Data System (ADS)

Zhang, Song; Ekstrand, Laura; Grieve, Taylor; Eisenmann, David J.; Chumbley, L. Scott

2012-09-01

Often, the 3-D raw data coming from an optical profilometer contains spiky noises and irregular grid, which make it difficult to analyze and difficult to store because of the enormously large size. This paper is to address these two issues for an optical profilometer by substantially reducing the spiky noise of the 3-D raw data from an optical profilometer, and by rapidly re-sampling the raw data into regular grids at any pixel size and any orientation with advanced computer graphics tools. Experimental results will be presented to demonstrate the effectiveness of the proposed approach.

Understanding Pregnancy and Birth Issues

MedlinePlus

... Navigation Bar Home Current Issue Past Issues Understanding Pregnancy and Birth Issues Past Issues / Winter 2008 Table ... turn Javascript on. What is a High-Risk Pregnancy? All pregnancies involve a certain degree of risk ...

C-17 Issues and Concerns

DTIC Science & Technology

1993-04-01

features such as electronic flight controls, blown flaps, winglets , and head-up displays proved more difficult than the contractor had estimated.’ To...air’ifter designed to provide the full range of strategic and tactical airlift capability. This blend of capabilities will enable it to carry outsize

Understanding the Family and Medical Leave Act.

PubMed

Zink-Pearson, E A

1997-03-01

In April 1995 final regulations for the Family and Medical Leave Act (FMLA) of 1993 were issued. The act is very detailed, complicated, and difficult to implement for home care agencies. Agencies need to gain a good working understanding of the FMLA to avoid inadvertent violations.

7 CFR 1940.307 - Environmental responsibilities within the State Office.

Code of Federal Regulations, 2010 CFR

2010-01-01

... any unresolved or difficult environmental issues in a timely manner; and (3) Incorporate into projects... 7 Agriculture 13 2010-01-01 2009-01-01 true Environmental responsibilities within the State Office..., DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL Environmental Program § 1940...

Teacher Evaluation 2.0

ERIC Educational Resources Information Center

Education Digest: Essential Readings Condensed for Quick Review, 2011

2011-01-01

Increasingly, school districts, states, and teachers' unions are advancing evaluation reform through legislation and by negotiating changes to collective bargaining agreements. This has compelled education leaders and policy makers to grapple with difficult issues that have received lip service in the past: How can they help all teachers reach…

On-Line Pesticide Training with Narrated Powerpoint Presentations

ERIC Educational Resources Information Center

Johnson, Steven B.

2015-01-01

UMaine Cooperative Extension is the primary educational delivery organization for pesticide recertification credits in Maine. Shrinking budgets and staff numbers are making traditional face-to-face delivery increasingly difficult to maintain. To address this issue, on-line pesticide applicator recertification training credits were developed. The…

Integrated Case Learning: Teaching Clinical Reasoning

ERIC Educational Resources Information Center

Radomski, Natalie; Russell, John

2010-01-01

Learning how to "think like doctors" can be difficult for undergraduate medical students in their early clinical years. Our model of collaborative Integrated Case Learning (ICL) and simulated clinical reasoning aims to address these issues. Taking a socio-cultural perspective, this study investigates the reflective learning interactions…

Evaluating Collaboration for Effectiveness: Conceptualization and Measurement

ERIC Educational Resources Information Center

Marek, Lydia I.; Brock, Donna-Jean P.; Savla, Jyoti

2015-01-01

Although collaboration is recognized as an effective means to address multifaceted community issues, successful collaboration is difficult to achieve and failure is prevalent. To effectively collaborate, collaborators must recognize the strengths and weaknesses within their own efforts. Using Mattessich and colleagues' work as a springboard, a…

Thermo-Mechanical Modeling and Analysis for Turbopump Assemblies

NASA Technical Reports Server (NTRS)

Platt, Mike; Marsh, Matt

2003-01-01

Life, reliability, and cost are strongly impacted by steady and transient thermo-mechanical effect. Design cycle can suffer big setbacks when working a transient stress/deflection issue. Balance between objectives and constrains is always difficult. Requires assembly-level analysis early in the design cycle.

Building Community-Based Consensus: The Oconto Experience.

ERIC Educational Resources Information Center

Behr, Chris; Shaffer, Ron; Lamb, Greg; Miller, Al; Sadowske, Sue

1998-01-01

Coastal communities face difficult choices regarding the use if their waterfront resources. The complexity of issues, contradictory scientific evidence, different visions of the future, and uncertainty regarding community interests add to the difficulty of reaching consensus. The community of Oconto, Wisconsin, attempted to integrate technical and…

Evaluation and purchase of confocal microscopes: numerous factors to consider.

PubMed

Zucker, Robert M; Chua, Michael

2010-10-01

The purchase of a confocal microscope is a difficult decision. Many factors need to be considered, which include hardware, software, company, support, service, and price. These issues are discussed to help guide the purchasing process. © 2010 by John Wiley & Sons, Inc.

[Coercion in Psychiatry - a taboo?].

PubMed

Meise, Ullrich; Frajo-Apor, Beatrice; Stippler, Stippler; Wancata, Johannes

2011-01-01

History shows that the discussion concerning coercive measures against mentally ill is as old as psychiatry itself. The dilemma of psychiatry lies in its double role - having both a therapeutic and a regulatory function. Violence against sick and disabled people conflicts with the ethical principles of helping professions. This, however, is where the danger lies: that the violent parts of psychiatric work - which in the opinion of experts cannot be entirely avoided - are repressed or seen as taboo and are therefore more difficult to control. Comparisons between EU countries of the nature, frequency and duration of coercive measures are difficult because of the heterogeneity of regulation and differences in established practice. Scientific examination of this issue seems to be insufficient. There are only a few studies on important issues such as how patients rate these measures. An open and thorough debate about the meaning and meaninglessness of coercion and violence in psychiatric treatment would be necessary to prevent "routine violence" or the excessive use of force against the mentally ill.

Fostering Parental Involvement in Writing: Development and Testing of the Program Cultivating Writing

ERIC Educational Resources Information Center

Camacho, Ana; Alves, Rui A.

2017-01-01

Learning to read and write efficiently is of the utmost importance in elementary school. However, writing is frequently difficult and can be demotivating for beginning writers. Fortunately these barriers can be partially alleviated with parental help. Many studies showed that parental involvement influences children's competence and motivation in…

Divorce and Special Education. PHP-c103

ERIC Educational Resources Information Center

PACER Center, 2004

2004-01-01

Every year the parents of a million American children are newly divorced. While divorce is difficult for all parties involved, children are often the most affected. If the children have disabilities and are involved with the special education system, the situation can be even more complex. The information in this document may help parents think…

Family Involvement in Creative Teaching Practices for All in Small Rural Schools

ERIC Educational Resources Information Center

Vigo Arrazola, Begoña; Soriano Bozalongo, Juana

2015-01-01

Parental involvement is interpreted as a key form of support that can contribute to the establishment of inclusive practices in schools, but this can be difficult in sparsely populated areas. Using ethnographic methods of participant observation, informal conversations and document analysis, this article therefore focuses on family involvement…

Parent Involvement and Technologically-Based Communications in Missouri's Top Performing Schools

ERIC Educational Resources Information Center

Wood, Gina M.

2009-01-01

With ever-increasing accountability requirements, public schools need to seek the support of the most invested parties, the parents. Despite the good intentions of all involved, finding meaningful ways for schools and parents to collaborate on student learning remains a difficult task. The purpose of this study was to explore perceptions of…

Ethics in Educational Technology: Towards a Framework for Ethical Decision Making in and for the Discipline

ERIC Educational Resources Information Center

Spector, J. Michael

2016-01-01

This special issue of "ETR&D" is devoted to ethics in the broad domain of educational technology. Many ethical issues arise involving the study and use of educational technologies. A well-known issue involves the digital divide and the degree to which the introduction of new technologies is increasing the digital divide and…

Can Fast and Slow Intelligence Be Differentiated?

ERIC Educational Resources Information Center

Partchev, Ivailo; De Boeck, Paul

2012-01-01

Responses to items from an intelligence test may be fast or slow. The research issue dealt with in this paper is whether the intelligence involved in fast correct responses differs in nature from the intelligence involved in slow correct responses. There are two questions related to this issue: 1. Are the processes involved different? 2. Are the…

Employee Involvement. Issues for Agencies To Consider in Designing and Implementing Programs. Report to the Ranking Minority Member, Subcommittee on Federal Services, Post Office, and Civil Service, Committee on Governmental Affairs, U.S. Senate.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. General Government Div.

An investigation identified issues that are important for federal agencies to consider in designing and implementing employee involvement programs. Employee involvement programs in the private sector and in the federal government were studied. The use of seven involvement practices was examined: suggestion systems, survey feedback, quality…

Theory and Practice on Teacher Performance Evaluation

ERIC Educational Resources Information Center

Yonghong, Cai; Chongde, Lin

2006-01-01

Teacher performance evaluation plays a key role in educational personnel reform, so it has been an important yet difficult issue in educational reform. Previous evaluations on teachers failed to make strict distinction among the three dominant types of evaluation, namely, capability, achievement, and effectiveness. Moreover, teacher performance…

MANAGEMENT OF DIFFUSE POLLUTION IN AGRICULTURAL WATERSHEDS: LESSONS FROM THE MINNESOTA RIVER BASIN. (R825290)

EPA Science Inventory

Abstract

The Minnesota River (Minnesota, USA) receives large non-point source pollutant loads. Complex interactions between agricultural, state agency, environmental groups, and issues of scale make watershed management difficult. Subdividing the basin's 12 major water...

Cyberbullying: A Review of the Legal Issues Facing Educators

ERIC Educational Resources Information Center

Hinduja, Sameer; Patchin, Justin W.

2011-01-01

School districts are often given the challenging task of addressing problematic online behaviors committed by students while simultaneously protecting themselves from civil liability by not overstepping their authority. This is difficult, because the law concerning these behaviors is ambiguous and continuously evolving, and little consensus has…

Scratching Records

ERIC Educational Resources Information Center

Wampfler, Rebecca; Haroldson, Rachelle

2016-01-01

Units on static electricity and electrical charges are always a third-grade favorite, with students finding the inquiry and hands-on activities, well, electrifying. However, teachers planning a unit on static electricity may find it difficult to navigate around latex bans. While latex allergy is a serious issue, removing balloons from the…

Science, Religion and Difficult Dialectics

ERIC Educational Resources Information Center

Long, David E.

2010-01-01

Discussing themes from my paper "Scientists at play in a field of the Lord," three forum participants identify and discuss continuing social and epistemological issues which continue to challenge effective evolution education. I extend these themes and further amplify the vexing nature of an effective dialectic regarding evolution, especially for…

User Authentication and Authorization Challenges in a Networked Library Environment.

ERIC Educational Resources Information Center

Machovec, George S.

1997-01-01

Discusses computer user authentication and authorization issues when libraries need to let valid users access databases and information services without making the process too difficult for either party. Common solutions are explained, including filtering, passwords, and kerberos (cryptographic authentication scheme for secure use over public…

Managing Difficult Behaviour in Young Children.

ERIC Educational Resources Information Center

Slee, June

2003-01-01

Managing antisocial behavior is a critical issue facing those who work with young children, as the presence of early socialization problems is the single greatest predictor of adolescent and adult antisocial behavior. This booklet highlights the effectiveness of behavior management strategies that introduce and reinforce positive behaviors, rather…

Supporting Academic Workloads in Online Learning

ERIC Educational Resources Information Center

Haggerty, Carmel E.

2015-01-01

Academic workloads in online learning are influenced by many variables, the complexity of which makes it difficult to measure academic workloads in isolation. While researching issues associated with academic workloads, professional development stood out as having a substantive impact on academic workloads. Many academics in applied health degrees…

Bootcamp Basics

ERIC Educational Resources Information Center

Jackson, Nancy Mann

2013-01-01

In the growing shipbuilding industry along the Gulf Coast, not only is it difficult to find skilled workers to fill open positions, but the problem is also compounded because various shipyards have different definitions of what a welder or shipfitter does. To combat the issue, the Alabama Technology Network (ATN)--the state's Manufacturing…

Difficulties in Initial Algebra Learning in Indonesia

ERIC Educational Resources Information Center

Jupri, Al; Drijvers, Paul; van den Heuvel-Panhuizen, Marja

2014-01-01

Within mathematics curricula, algebra has been widely recognized as one of the most difficult topics, which leads to learning difficulties worldwide. In Indonesia, algebra performance is an important issue. In the Trends in International Mathematics and Science Study (TIMSS) 2007, Indonesian students' achievement in the algebra domain was…

An approach to meeting the spent fuel standard

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

Makhijani, A.

1996-05-01

The idea of the spent fuel standard is that there should be a high surface gamma radiation to prevent theft. For purposes of preventing theft, containers should be massive, and the plutonium should be difficult to extract. This report discusses issues associated with the spent fuel standard.

Sustainable Transport Systems: Linkages Between Environmental Issues, Public Transport, Non-Motorized Transport And Safety

DOT National Transportation Integrated Search

2000-10-01

A sustainable transport system must provide mobility and accessibility to all urban residents in a safe and end environmentally friendly mode of transport. This is a complex and difficult task when the needs and demands of people belonging to differe...

The Difficult Pursuit of Truth: A Response to Kai Horsthemke

ERIC Educational Resources Information Center

Godon, Rafal

2017-01-01

In this article, Rafal Godon responds to Kai Horsthemke's article (this issue), "Inclusive Education and 'Barrierefreiheit': Some Social-Epistemological Considerations" (EJ1130978). The question raised by Kai Horsthemke, Godon says, draws readers' attention to a very specific aspect of the conference theme, "Philosophy as…

PHARMACEUTICALS AND PERSONAL CARE PRODUCTS IN THE ENVIRONMENT: OVERARCHING ISSUES AND OVERVIEW

EPA Science Inventory

While the point-source emissions of pollutants from manufacturing waste streams have long been monitored and subject to controls, the environmental impact of the public's (i.e., the individual's) activities regarding the use of chemicals is more difficult to assess. Of particula...

A toolkit for incorporating genetics into mainstream medical services: Learning from service development pilots in England

PubMed Central

2010-01-01

Background As advances in genetics are becoming increasingly relevant to mainstream healthcare, a major challenge is to ensure that these are integrated appropriately into mainstream medical services. In 2003, the Department of Health for England announced the availability of start-up funding for ten 'Mainstreaming Genetics' pilot services to develop models to achieve this. Methods Multiple methods were used to explore the pilots' experiences of incorporating genetics which might inform the development of new services in the future. A workshop with project staff, an email questionnaire, interviews and a thematic analysis of pilot final reports were carried out. Results Seven themes relating to the integration of genetics into mainstream medical services were identified: planning services to incorporate genetics; the involvement of genetics departments; the establishment of roles incorporating genetic activities; identifying and involving stakeholders; the challenges of working across specialty boundaries; working with multiple healthcare organisations; and the importance of cultural awareness of genetic conditions. Pilots found that the planning phase often included the need to raise awareness of genetic conditions and services and that early consideration of organisational issues such as clinic location was essential. The formal involvement of genetics departments was crucial to success; benefits included provision of clinical and educational support for staff in new roles. Recruitment and retention for new roles outside usual career pathways sometimes proved difficult. Differences in specialties' working practices and working with multiple healthcare organisations also brought challenges such as the 'genetic approach' of working with families, incompatible record systems and different approaches to health professionals' autonomous practice. 'Practice points' have been collated into a Toolkit which includes resources from the pilots, including job descriptions and clinical tools. These can be customised for reuse by other services. Conclusions Healthcare services need to translate advances in genetics into benefits for patients. Consideration of the issues presented here when incorporating genetics into mainstream medical services will help ensure that new service developments build on the body of experience gained by the pilots, to provide high quality services for patients with or at risk of genetic conditions. PMID:20470377

A toolkit for incorporating genetics into mainstream medical services: Learning from service development pilots in England.

PubMed

Bennett, Catherine L; Burke, Sarah E; Burton, Hilary; Farndon, Peter A

2010-05-14

As advances in genetics are becoming increasingly relevant to mainstream healthcare, a major challenge is to ensure that these are integrated appropriately into mainstream medical services. In 2003, the Department of Health for England announced the availability of start-up funding for ten 'Mainstreaming Genetics' pilot services to develop models to achieve this. Multiple methods were used to explore the pilots' experiences of incorporating genetics which might inform the development of new services in the future. A workshop with project staff, an email questionnaire, interviews and a thematic analysis of pilot final reports were carried out. Seven themes relating to the integration of genetics into mainstream medical services were identified: planning services to incorporate genetics; the involvement of genetics departments; the establishment of roles incorporating genetic activities; identifying and involving stakeholders; the challenges of working across specialty boundaries; working with multiple healthcare organisations; and the importance of cultural awareness of genetic conditions. Pilots found that the planning phase often included the need to raise awareness of genetic conditions and services and that early consideration of organisational issues such as clinic location was essential. The formal involvement of genetics departments was crucial to success; benefits included provision of clinical and educational support for staff in new roles. Recruitment and retention for new roles outside usual career pathways sometimes proved difficult. Differences in specialties' working practices and working with multiple healthcare organisations also brought challenges such as the 'genetic approach' of working with families, incompatible record systems and different approaches to health professionals' autonomous practice. 'Practice points' have been collated into a Toolkit which includes resources from the pilots, including job descriptions and clinical tools. These can be customised for reuse by other services. Healthcare services need to translate advances in genetics into benefits for patients. Consideration of the issues presented here when incorporating genetics into mainstream medical services will help ensure that new service developments build on the body of experience gained by the pilots, to provide high quality services for patients with or at risk of genetic conditions.

Vertical root fractures and their management

PubMed Central

Khasnis, Sandhya Anand; Kidiyoor, Krishnamurthy Haridas; Patil, Anand Basavaraj; Kenganal, Smita Basavaraj

2014-01-01

Vertical root fractures associated with endodontically treated teeth and less commonly in vital teeth represent one of the most difficult clinical problems to diagnose and treat. In as much as there are no specific symptoms, diagnosis can be difficult. Clinical detection of this condition by endodontists is becoming more frequent, where as it is rather underestimated by the general practitioners. Since, vertical root fractures almost exclusively involve endodontically treated teeth; it often becomes difficult to differentiate a tooth with this condition from an endodontically failed one or one with concomitant periodontal involvement. Also, a tooth diagnosed for vertical root fracture is usually extracted, though attempts to reunite fractured root have been done in various studies with varying success rates. Early detection of a fractured root and extraction of the tooth maintain the integrity of alveolar bone for placement of an implant. Cone beam computed tomography has been shown to be very accurate in this regard. This article focuses on the diagnostic and treatment strategies, and discusses about predisposing factors which can be useful in the prevention of vertical root fractures. PMID:24778502

Gender asymmetry

NASA Astrophysics Data System (ADS)

2016-05-01

Investigations of sexual harassment are difficult and potentially destructive to all involved. It is imperative that they are carried out quickly, with high priority and acted upon decisively where misconduct is identified.

Focusing on customer service.

PubMed

1996-01-01

This booklet is devoted to a consideration of how good customer service in family planning programs can generate demand for products and services, bring customers back, and reduce costs. Customer service is defined as increasing client satisfaction through continuous concern for client preferences, staff accountability to clients, and respect for the rights of clients. Issues discussed include the introduction of a customer service approach and gaining staff commitment. The experience of PROSALUD in Bolivia in recruiting appropriate staff, supervising staff, soliciting client feedback, and marketing services is offered as an example of a successful customer service approach. The key customer service functions are described as 1) establishing a welcoming atmosphere, 2) streamlining client flow, 3) personalizing client services, and 4) organizing and providing clear information to clients. The role of the manager in developing procedures is explored, and the COPE (Client-Oriented Provider-Efficient) process is presented as a good way to begin to make improvements. Techniques in staff training in customer service include brainstorming, role playing, using case studies (examples of which are provided), and engaging in practice sessions. Training also leads to the development of effective customer service attitudes, and the differences between these and organizational/staff-focused attitudes are illustrated in a chart. The use of communication skills (asking open-ended questions, helping clients express their concerns, engaging in active listening, and handling difficult situations) is considered. Good recovery skills are important when things go wrong. Gathering and using client feedback is the next topic considered. This involves identifying, recording, and discussing customer service issues as well as taking action on these issues and evaluating the results. The booklet ends by providing a sample of customer service indicators, considering the maintenance of a customer service focus, and reporting comments from the reviewers of the booklet.

Access to primary health care services for Indigenous peoples: A framework synthesis.

PubMed

Davy, Carol; Harfield, Stephen; McArthur, Alexa; Munn, Zachary; Brown, Alex

2016-09-30

Indigenous peoples often find it difficult to access appropriate mainstream primary health care services. Securing access to primary health care services requires more than just services that are situated within easy reach. Ensuring the accessibility of health care for Indigenous peoples who are often faced with a vast array of additional barriers including experiences of discrimination and racism, can be complex. This framework synthesis aimed to identify issues that hindered Indigenous peoples from accessing primary health care and then explore how, if at all, these were addressed by Indigenous health care services. To be included in this framework synthesis papers must have presented findings focused on access to (factors relating to Indigenous peoples, their families and their communities) or accessibility of Indigenous primary health care services. Findings were imported into NVivo and a framework analysis undertaken whereby findings were coded to and then thematically analysed using Levesque and colleague's accessibility framework. Issues relating to the cultural and social determinants of health such as unemployment and low levels of education influenced whether Indigenous patients, their families and communities were able to access health care. Indigenous health care services addressed these issues in a number of ways including the provision of transport to and from appointments, a reduction in health care costs for people on low incomes and close consultation with, if not the direct involvement of, community members in identifying and then addressing health care needs. Indigenous health care services appear to be best placed to overcome both the social and cultural determinants of health which hamper Indigenous peoples from accessing health care. Findings of this synthesis also suggest that Levesque and colleague's accessibility framework should be broadened to include factors related to the health care system such as funding.

Enabling recruitment success in bariatric surgical trials: pilot phase of the By-Band-Sleeve study.

PubMed

Paramasivan, S; Rogers, C A; Welbourn, R; Byrne, J P; Salter, N; Mahon, D; Noble, H; Kelly, J; Mazza, G; Whybrow, P; Andrews, R C; Wilson, C; Blazeby, J M; Donovan, J L

2017-11-01

Randomized controlled trials (RCTs) involving surgical procedures are challenging for recruitment and infrequent in the specialty of bariatrics. The pilot phase of the By-Band-Sleeve study (gastric bypass versus gastric band versus sleeve gastrectomy) provided the opportunity for an investigation of recruitment using a qualitative research integrated in trials (QuinteT) recruitment intervention (QRI). The QRI investigated recruitment in two centers in the pilot phase comparing bypass and banding, through the analysis of 12 in-depth staff interviews, 84 audio recordings of patient consultations, 19 non-participant observations of consultations and patient screening data. QRI findings were developed into a plan of action and fed back to centers to improve information provision and recruitment organization. Recruitment proved to be extremely difficult with only two patients recruited during the first 2 months. The pivotal issue in Center A was that an effective and established clinical service could not easily adapt to the needs of the RCT. There was little scope to present RCT details or ensure efficient eligibility assessment, and recruiters struggled to convey equipoise. Following presentation of QRI findings, recruitment in Center A increased from 9% in the first 2 months (2/22) to 40% (26/65) in the 4 months thereafter. Center B, commencing recruitment 3 months after Center A, learnt from the emerging issues in Center A and set up a special clinic for trial recruitment. The trial successfully completed pilot recruitment and progressed to the main phase across 11 centers. The QRI identified key issues that enabled the integration of the trial into the clinical setting. This contributed to successful recruitment in the By-Band-Sleeve trial-currently the largest in bariatric practice-and offers opportunities to optimize recruitment in other trials in bariatrics.

A Case Study of Environmental, Health and Safety Issues Involving the Burlington, Massachusetts Public School System. "Tips, Suggestions, and Resources for Investigating and Resolving EHS Issues in Schools."

ERIC Educational Resources Information Center

Dresser, Todd H.

An investigation was initiated concerning the environmental health within the Burlington, Massachusetts public school system to determine what specific environmental hazards were present and determine ways of eliminating them. This report presents 20 case studies that detail the environmental health issues involved, the approaches taken in…

Disclosing the truth to terminal cancer patients: a discussion of ethical and cultural issues.

PubMed

Kazdaglis, G A; Arnaoutoglou, C; Karypidis, D; Memekidou, G; Spanos, G; Papadopoulos, O

2010-04-01

One of the most difficult ethical dilemmas facing health care professionals working in oncology is whether, when, how and how much to tell terminal cancer patients about their diagnosis and prognosis. The aim of this article is to review the trends in this issue worldwide. While a majority of physicians in both developed and developing countries tell the truth more often today than in the past, the assumption that truth-telling is always beneficial to patients can be questioned. The issue of truth-telling is still approached differently in different countries and cultures and there is a need for an increased awareness of cultural differences to truth-telling among patients from ethnic minorities.

Using guided debates to teach current issues.

PubMed

Hanna, Debra R

2014-06-01

A guided-debate strategy was developed for a graduate-level core course in current issues based on the Jesuit method of discernment (group decision making). The strategy encourages students to use up-to-date Internet sources to determine the range of opinions on current controversies in the discipline. In addition to providing a structured process to engage in persuasive discussion of difficult issues, the strategy facilitates critical thinking about the quality of the debate itself. Thus, students learn to avoid the pitfalls associated with consensus, such as failing to express reservations or negative opinions that might be important, while learning how to express concerns that might not be easily received by others in a group. Copyright 2014, SLACK Incorporated.

Challenges in verification and validation of autonomous systems for space exploration

NASA Technical Reports Server (NTRS)

Brat, Guillaume; Jonsson, Ari

2005-01-01

Space exploration applications offer a unique opportunity for the development and deployment of autonomous systems, due to limited communications, large distances, and great expense of direct operation. At the same time, the risk and cost of space missions leads to reluctance to taking on new, complex and difficult-to-understand technology. A key issue in addressing these concerns is the validation of autonomous systems. In recent years, higher-level autonomous systems have been applied in space applications. In this presentation, we will highlight those autonomous systems, and discuss issues in validating these systems. We will then look to future demands on validating autonomous systems for space, identify promising technologies and open issues.

Why Linking Budgets to Plans Has Proven Difficult in Higher Education.

ERIC Educational Resources Information Center

Schmidtlein, Frank A.

1990-01-01

Conclusions from two studies (including a three-year nationwide study of higher education institutional planning) concern types of planning (strategic, program, facility, operational, budget, and issue-specific), and limitations (the limited powers of prediction and the political character of planning and budgeting). Types of budgeting processes…

Why Is It So Difficult? Misconceptions about Eastern European Education in Transition.

ERIC Educational Resources Information Center

Sandi, Ana Maria

1992-01-01

Examines misconceptions in both Western and Eastern countries about educational systems in postcommunist Eastern Europe. Discusses issues of slow pace of educational reform, change through formal power structures, centralization versus decentralization, role of tradition, macro- and micro-level problems, Western assistance, and the relationship…

An Hour with the Internet Curmudgeon.

ERIC Educational Resources Information Center

Morgovsky, Joel

While the Internet undeniably contains an enormous amount of information, community colleges should consider some key issues before joining the headlong rush toward virtual classrooms. First, information can be very difficult to find on the Internet. Although search engines, web databases, and subject directories have been developed to help users…

Growing Pains: A Theory of Stress and Moral Conflict.

ERIC Educational Resources Information Center

Blakeney, Ronnie Ann; Blakeney, Charles David

1992-01-01

Outlines relationship between crises that create stress in one's life and periods of instability in moral development. Suggests that stressful issues are more difficult to resolve during periods of developmental instability and that, when problems are most stressful, people often experience impact of stress physiologically. Reconstructs stress and…

Interannual Variation in Stable Carbon and Nitrogen Isotope Biogeochemistry of the Mattaponi River, Virginia

EPA Science Inventory

This manuscript addresses the difficult issue of identifying the origin of particulate organic matter (POM) in estuaries . . . The objectives of this study were to quantify spatial and temporal variability of the C and N stable isotope composition of suspended POM, and to identif...

Bringing Reality to "Real Options": An Experiential Exercise

ERIC Educational Resources Information Center

Turner, Craig; Turner, Kyle Dean

2015-01-01

Issues surrounding the contextual environment in which strategic decisions are made are difficult concepts to grasp, particularly for undergraduate students with little business experience. They are also problematic for graduate students that have not been called on to make such decisions within their career. The authors propose an exercise that…

Difficult Choices about Environmental Protection. 1984 National Issues Forum.

ERIC Educational Resources Information Center

Melville, Keith, Ed.

Appropriate for secondary school social studies, this booklet considers the dilemmas and choices confronting Americans concerned with their environment. The document contains five sections. The first section, "The Gross National By-Product," discusses the progress that has been made in reducing air and water pollution while the nation has only…

Polyfibroblast: A Self-Healing and Galvanic Protection Additive

DTIC Science & Technology

2013-01-25

flour , the rapid addition of liquid created lumps in the powder that were difficult to remove. This issue did not appear to result from the material...probably the worst thing that one can do to the self-healing primer. Small scratches will prematurely rupture the microcapsules that tend to be enriched

Features and Feedback: Enhancing Metamnemonic Knowledge at Retrieval Reduces Source-Monitoring Errors

ERIC Educational Resources Information Center

Lane, Sean M.; Roussel, Cristine C.; Villa, Diane; Morita, Shelby K.

2007-01-01

Three experiments explored the issue of whether enhanced metamnemonic knowledge at retrieval can improve participants' ability to make difficult source discriminations in the context of the eyewitness suggestibility paradigm. The 1st experiment documented differences in phenomenal experience between veridical and false memories. Experiment 2…

OOPS! Retractions, Corrections, and Amplifications in Online Environments.

ERIC Educational Resources Information Center

Ojala, Marydee

1996-01-01

Examines the practice and implications of issuing corrections, retractions, and amplifications in online databases. All database producers do not provide mechanisms to accommodate retractions and corrections, and it can be difficult for a searcher to find evidence of error correction. Sidebars illustrate both the lack of and evidence of…

Understanding and Dealing with Bullying in Schools

ERIC Educational Resources Information Center

Yerger, William; Gehret, Cliff

2011-01-01

One of the most difficult problems that educators face today is dealing with bullying. This pervasive issue occurs in classrooms, lunch rooms, unsupervised areas, on playgrounds, and through electronic media. Based on the principles of protecting the child and establishing a safe environment for all students, this paper investigates the causes and…

Critical Performative Pedagogy: Emergent Bilingual Learners Challenge Local Immigration Issues

ERIC Educational Resources Information Center

Harman, Ruth; Varga-Dobai, Kinga

2012-01-01

Recent anti-immigration policies and practices in the Southeast of the United States have presented difficult challenges for newly arrived bilingual learners and their families. To validate student voices within this socio-political context, our school/university collaboration implemented an arts-based participatory approach to English Language…

Identifying and solving lead issues from water systems with materials/device replacement in drinking water system configurations

EPA Science Inventory

Identifying and assessing lead contamination and exposure potentialin single-family residences is difficult enough, but doing the samekind of assessment and remediation in buildings, schools, and daycare centers is even more challenging. It is of particular importancebecause of t...

Exploring component-based approaches in forest landscape modeling

Treesearch

H. S. He; D. R. Larsen; D. J. Mladenoff

2002-01-01

Forest management issues are increasingly required to be addressed in a spatial context, which has led to the development of spatially explicit forest landscape models. The numerous processes, complex spatial interactions, and diverse applications in spatial modeling make the development of forest landscape models difficult for any single research group. New...

Using a Wiki to Produce Journalistic Best Practices

ERIC Educational Resources Information Center

Hoewe, Jennifer; Bowe, Brian J.; Zeldes, Geri Alumit

2012-01-01

The difficult nature of reporting accurately and objectively on religion, coupled with world events and discrimination against Muslims, motivated a pilot course called "Reporting on Islam." The activity detailed in this article addressed two issues--improving the coverage of religion, specifically Islam, in the news media and using communication…

Early Childhood Folio 3: A Collection of Recent Research.

ERIC Educational Resources Information Center

Wright, Judith, Ed.; Podmore, Valerie, Ed.

This booklet is a collection of articles addressing current issues in early childhood education. The first article, "Would You Like to Pack Away Now?: Improving the Quality of Talk in Early Childhood Programs," (Laurie Makin) addresses how teachers talk to children. The second article, "Persistence When It's Difficult: A Disposition…

Reconciling Indigenous and Western Knowing.

ERIC Educational Resources Information Center

Hooley, Neil

Being able to consider the full range of social and economic issues from different cultural perspectives while maintaining respect and an open mind is a difficult task. The similarities between the latest thinking of Western cosmology and theoretical physics and Indigenous understandings of the bush and its components are striking and provide a…

Differential Diagnosis in Older Adults: Dementia, Depression, and Delirium.

ERIC Educational Resources Information Center

Gintner, Gary G.

1995-01-01

Examines three common disorders, dementia, depression, and delirium, which can be particularly difficult to diagnose in older adults. Presents three aspects that are helpful in making a decision: age-related differences, medical issues that need to be ruled out, and assessment methods particularly useful in the diagnostic process. (JPS)

GREAT LAKES BASIN LAND-COVER DATA: ISSUES AND OPPORTUNITIES

EPA Science Inventory

The US Environmental Protection Agency (EPA) is developing a consistent land-cover (LC) data set for the entire 480,000 km2 Great Lakes Basin (GLB). The acquisition of consistent LC data has proven difficult both within the US and across GLB political boundaries due to disparate...

Accounting for Unobserved Time-Varying Quality in Recreation Demand: An Application to a Sonoran Desert Wilderness

EPA Science Inventory

Environmental variables can be important factors in recreation demand. Analysts wishing to quantify environmental quality impacts face the difficult issue of isolating them from unobserved variables. Quality changes may occur in space, varying between sites, or in time, varying b...

EVALUATION OF EXTRACTION AND SPECTROSCOPIC METHODS FOR PB SPECIATION IN AN AMENDED SOIL

EPA Science Inventory

Immobilization of pyromorphite (Pbs(PO4hCI) via P amendments to Pb contaminated soils is proving to be a viable method of remediation. However, the issue of ascertaining the amount of soil Pb converted to pyromorphite is difficult in heterogeneous soil systems. Previous attempts ...

Drinking Water: A Community Action Guide.

ERIC Educational Resources Information Center

Boyd, Susan, Ed.; And Others

While much of the drinking water in the United States is safe for consumption, protecting its quality and assuring its availability are becoming increasingly difficult. This booklet is written for individuals and groups who are concerned about the drinking water in their communities. It provides a general introduction to the complex issues of…

The Curriculum, the Students, and the World.

ERIC Educational Resources Information Center

Williams, John A.

1996-01-01

Supports increasing emphasis on interethnic conflict around the world as part of an education in pluralism. Argues that the fuzzy moral relativism and feel-good message of most multicultural instruction tends to essentialize culture and inhibit any meaningful understanding. Maintains that facing difficult issues produces a true appreciation and…

Scaling issues and spatio-temporal variability in ecohydrological modeling on mountain topography: Methods for improving the VELMA model

EPA Science Inventory

The interactions between vegetation and hydrology in mountainous terrain are difficult to represent in mathematical models. There are at least three primary reasons for this difficulty. First, expanding plot-scale measurements to the watershed scale requires finding the balance...

Not Crying but Laughing: The Ethics of Horrifying Students.

ERIC Educational Resources Information Center

Brina, Carolyn

2003-01-01

Asserts that a shared set of unexamined norms and values about the constitution of the "academic" allows teachers and learners to collude in avoiding difficult political and social issues. The argument is grounded in the author's experience teaching a module that uses shocking, politically controversial material to communicate social…

Medical Readers' Theater: Relevance to Geriatrics Medical Education

ERIC Educational Resources Information Center

Shapiro, Johanna; Cho, Beverly

2011-01-01

Medical Readers' Theater (MRT) is an innovative and simple way of helping medical students to reflect on difficult-to-discuss topics in geriatrics medical education, such as aging stereotypes, disability and loss of independence, sexuality, assisted living, relationships with adult children, and end-of-life issues. The authors describe a required…

Developing Materials for Deliberative Forums

ERIC Educational Resources Information Center

Rourke, Brad

2014-01-01

When citizens deliberate together about important issues, they can reach decisions and take action together on problems that confront them. Deliberation does not require a certain kind of guide, or framework, or language, or facilitator, but, because it can be difficult to face such choices, supporting materials can make it easier. In Developing…

Towards Supporting Communication in Relationship and Sexuality Education through a VLE

ERIC Educational Resources Information Center

McGinn, Marion; Arnedillo-Sánchez, Inmaculada

2015-01-01

Formal sex education is a key strategy to help prevent unplanned teenage pregnancies, sexually transmitted diseases, sexual abuse and social discrimination. However, research highlights human sexuality is a difficult issue for educators to communicate with young people in traditional class settings. The growing tendency for young adolescents to…

Identifying and Solving Lead Issues from Water Systems with Materials/Device Replacement in Schools and other Buildings

EPA Science Inventory

Identifying and assessing lead contamination and exposure potential in single-family residences is difficult enough, but doing the same kind of assessment and remediation in buildings, schools, and day care centers is even more challenging. It is of particular importance because ...

Identifying and Solving Lead Issues from Water Systems with Materials/Device Replacement in Schools and other Buildings - slides

EPA Science Inventory

Identifying and assessing lead contamination and exposure potential in single-family residences is difficult enough, but doing the same kind of assessment and remediation in buildings, schools, and day care centers is even more challenging. It is of particular importance because ...

The Digital Divide: The View from Latin America and the Caribbean.

ERIC Educational Resources Information Center

Rodriguez, Adolfo

This paper discusses the digital divide from the perspective of Latin America and the Caribbean. Highlights include: new issues that make access to electronic resources difficult for users; differences in technological infrastructure among countries; how Internet users are distributed worldwide; Internet access in Africa; the number of students…

Using SysML to model complex systems for security.

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

Cano, Lester Arturo

2010-08-01

As security systems integrate more Information Technology the design of these systems has tended to become more complex. Some of the most difficult issues in designing Complex Security Systems (CSS) are: Capturing Requirements: Defining Hardware Interfaces: Defining Software Interfaces: Integrating Technologies: Radio Systems: Voice Over IP Systems: Situational Awareness Systems.

Sustainability and Action Research in Universities: Towards Knowledge for Organisational Transformation

ERIC Educational Resources Information Center

Wooltorton, Sandra; Wilkinson, Anne; Horwitz, Pierre; Bahn, Sue; Redmond, Janice; Dooley, Julian

2015-01-01

Purpose: Academic approaches to the challenge of enhancing sustainability in research in university contexts illustrate that universities are affected by the very same values and socio-ecological issues they set out to address, making transformation difficult at every level. A theoretical and practical framework designed to facilitate cultural…

Early-Onset Bipolar Spectrum Disorders: Diagnostic Issues

ERIC Educational Resources Information Center

Danner, Stephanie; Fristad, Mary A.; Arnold, L. Eugene; Youngstrom, Eric A.; Birmaher, Boris; Horwitz, Sarah M.; Demeter, Christine; Findling, Robert L.; Kowatch, Robert A.

2009-01-01

Since the mid 1990s, early-onset bipolar spectrum disorders (BPSDs) have received increased attention in both the popular press and scholarly press. Rates of diagnosis of BPSD in children and adolescents have increased in inpatient, outpatient, and primary care settings. BPSDs remain difficult to diagnose, particularly in youth. The current…

Recruitment of Hispanic and Black Students.

ERIC Educational Resources Information Center

Rivera, Manuel G.

The issue of recruitment of community college minority students who are underrepresented in higher education (Hispanics and Blacks) is complex and needs various programs which are unique and fit within the framework of the institution. Historical elements in Texas make it difficult to implement recruitment efforts. Recent statistics illustrate the…

Ethics and Social Responsibility in Science Education.

ERIC Educational Resources Information Center

Frazer, M. J., Ed.; Kornhauser, A., Ed.

Questions of ethics and social responsibility are considered by many to be important issues in science education. Teachers are being exposed to the difficult task of dealing with global problems and values. This book contains papers which deal with this apparent dilemma, raising questions about the responsibilities of science educators in the…

The Safety Zone, 2000.

ERIC Educational Resources Information Center

Fiscus, James W., Ed.; Pollack, Ira, Ed.

2000-01-01

This publication is concerned with how to keep schools safe. The spring 2000 issue "Zero Tolerance: Effective Policy or Display of Administrative Machismo?" (James W. Fiscus) discusses how difficult it is to determine just what zero tolerance means and reminds readers that schools were required to pass zero tolerance rules to remain eligible for…

Sustainable Assessment and Evaluation Strategies for Open and Distance Learning

ERIC Educational Resources Information Center

Okonkwo, Charity Akuadi

2010-01-01

This paper first presents an overview of the concepts of assessment and evaluation in Open and Distance Learning (ODL) environment. The large numbers of students and numerous courses make assessment and evaluation very difficult and administrative nightmare at Distance Learning (DL) institutions. These challenges informed exploring issues relating…

Effects of Issue Involvement and Framing of a Responsible Drinking Message on Attitudes, Intentions, and Behavior.

PubMed

de Graaf, Anneke; van den Putte, Bas; de Bruijn, Gert-Jan

2015-08-01

To decrease the prevalence and the amount of alcohol consumption among students, health messages advocating responsible alcohol behavior can be used. However, it is unclear whether responsible drinking messages are most effective when they use a gain frame, presenting the advantages of responsible drinking, or a loss frame, presenting the disadvantages of irresponsible drinking. This study tests the effects of framing and the moderating role of involvement with the issue of responsible drinking. A three-wave, between-subjects, experimental study was conducted, in which participants (N = 90) were exposed to either a gain- or loss-framed message about responsible drinking behavior at Wave 2. At all three waves, attitudes, intentions and behavior toward responsible drinking were measured. Results showed that for participants with low issue- involvement, a gain frame led to more positive attitudes and intentions toward responsible alcohol use, whereas a loss frame did not have any effects for them. For participants with high issue involvement, a loss frame led to more positive attitudes and intentions toward responsible alcohol use, whereas a gain frame did not have an effect on attitude and only a delayed effect on intention. However, there were no effects of frame and issue involvement on adhering to the guideline of responsible alcohol use and average drinking behavior.

Psychometric Framework for Modeling Parental Involvement and Reading Literacy. IEA Research for Education

ERIC Educational Resources Information Center

Punter, R. Annemiek; Glas, Cees A. W.; Meelissen, Martina R. M.

2016-01-01

Parental involvement is seen as one of the most malleable factors of the student's home situation, which makes it a relevant subject for schools, educational policies, and research. Though many studies have researched its role in student achievement, effects are not univocal. It is difficult to tell whether these inconsistent results are caused by…

Understanding Barriers to Parent Involvement in Head Start: A Research-Community Partnership.

ERIC Educational Resources Information Center

Lamb-Parker, Faith; Piotrkowski, Chaya S.; Baker, Amy J. L.; Kessler-Sklar, Susan; Clark, Beryl; Peay, Lenore

2001-01-01

This collaborative study examined barriers to parent involvement in the Head Start program among 68 mothers in New York City. Results revealed the presence of many difficult life experiences for mothers, but few were reported as barriers by many mothers. Five out of 20 experiences were associated with staff ratings of mothers' participation level.…

Ocular surgery in a child with Coffin Lowry syndrome: Anesthetic concerns.

PubMed

Singh, P M; Baidya, Dalim K; Govindarajan, Srinivasa; Trikha, Anjan

2013-01-01

Coffin Lowry syndrome is a rare disease involving multiple organ systems. From the anesthesiologists point of view it involves mental retardation, seizures, difficult airway, cardiac abnormalities (pediatric dilated cardiomyopathy) and skeletal deformities. We share our experience of management of a child with Coffin Lowry syndrome and also discuss the problems faced during perioperative period.

Corporate Culture as an Impediment to Employee Involvement: When You Can't Get There from Here.

ERIC Educational Resources Information Center

Chelte, Anthony F.; And Others

1989-01-01

Corporate culture may be the most difficult barrier to overcome in implementing an employee involvement program, and management action is critical in shaping and maintaining that culture. To eliminate resistance to basic changes, organizational values must be identified and recognized by the most powerful purveyor of corporate culture. (Author/JOW)

The Role of Parental Involvement in the Academic Achievement of Latino Youth

ERIC Educational Resources Information Center

Snyder-Hogan, Lindsey E.

2010-01-01

The educational plight of Latino students in the U.S. is an increasing concern given the low achievement and attainment status of this population. Although many risk factors associated with underachievement are difficult to alter, parent educational involvement has been shown to positively impact learning outcomes. In this study, parental home-…

"They Were a Little Family": An Exploratory Study of Parental Involvement in Nurture Groups--From a Practitioner and Parent Perspective

ERIC Educational Resources Information Center

Kirkbride, Rebecca

2014-01-01

The approach taken by nurture groups emphasises that difficult early experiences can be modified through creating opportunities to develop security and attachment from alternative sources other than parents. Despite previous research indicating the positive impact parental involvement can have on both parents and children, research into parental…

Technology-driven dietary assessment: a software developer’s perspective

PubMed Central

Buday, Richard; Tapia, Ramsey; Maze, Gary R.

2015-01-01

Dietary researchers need new software to improve nutrition data collection and analysis, but creating information technology is difficult. Software development projects may be unsuccessful due to inadequate understanding of needs, management problems, technology barriers or legal hurdles. Cost overruns and schedule delays are common. Barriers facing scientific researchers developing software include workflow, cost, schedule, and team issues. Different methods of software development and the role that intellectual property rights play are discussed. A dietary researcher must carefully consider multiple issues to maximize the likelihood of success when creating new software. PMID:22591224

Biofouling of Water Treatment Membranes: A Review of the Underlying Causes, Monitoring Techniques and Control Measures

PubMed Central

Nguyen, Thang; Roddick, Felicity A.; Fan, Linhua

2012-01-01

Biofouling is a critical issue in membrane water and wastewater treatment as it greatly compromises the efficiency of the treatment processes. It is difficult to control, and significant economic resources have been dedicated to the development of effective biofouling monitoring and control strategies. This paper highlights the underlying causes of membrane biofouling and provides a review on recent developments of potential monitoring and control methods in water and wastewater treatment with the aim of identifying the remaining issues and challenges in this area. PMID:24958430

A pathway for hospital librarians: why is it vital?

PubMed Central

Tooey, Mary Joan (M.J.)

2009-01-01

Objectives: By the mid 2000s, reports of hospital librarians losing jobs and hospital libraries closing were rife. In 2005, Vital Pathways: The Hospital Libraries Project was established by 2005/06 MLA President M.J. Tooey, AHIP, FMLA, to assess the truth of these reports and to study and develop strategies to support hospital librarians. Throughout this long-term project, opportunities were sought to understand the issues more clearly. Methods: A steering committee, along with three task forces, was established to carry out the work of the project. The steering committee provided oversight and had responsibility for promoting and marketing the project. The three task forces were responsible for conducting a survey on the status of hospital librarians, determining the involvement of librarians in medical education and accreditation, and researching and writing a document reviewing current and future roles for hospital librarians. Along the way, these responsibilities grew and evolved. Results: After a little more than three years, the Task Force on Vital Pathways for Hospital Librarians Steering Committee presented a final report regarding its accomplishments to the MLA Board of Directors. A sampling of these accomplishments includes the status of hospital librarians survey, a website, a position document with an accompanying executive summary, a short promotional brochure, and a final culminating activity, this symposium. Conclusions: Although these are difficult times for all libraries, hospital librarians and libraries seem particularly affected. In a competitive health care environment that is driven by the bottom line, influenced by real estate hunger, and affected by the belief of hospital administrators that access to health information comes from the Internet and is free, the hospital librarian seems doomed. However, even in these difficult times, there are hospital librarians who are not only surviving, but thriving. Is it because they are entrepreneurial? Opportunistic? Innovative? Flexible? All of the above? None of the above? There are no clear predictors of success or of failure. However, the Vital Pathways Project has shed light on some of the issues and identified opportunities and strategies for the future. PMID:19851490

A pathway for hospital librarians: why is it vital?

PubMed

Tooey, Mary Joan M J

2009-10-01

By the mid 2000s, reports of hospital librarians losing jobs and hospital libraries closing were rife. In 2005, Vital Pathways: The Hospital Libraries Project was established by 2005/06 MLA President M.J. Tooey, AHIP, FMLA, to assess the truth of these reports and to study and develop strategies to support hospital librarians. Throughout this long-term project, opportunities were sought to understand the issues more clearly. A steering committee, along with three task forces, was established to carry out the work of the project. The steering committee provided oversight and had responsibility for promoting and marketing the project. The three task forces were responsible for conducting a survey on the status of hospital librarians, determining the involvement of librarians in medical education and accreditation, and researching and writing a document reviewing current and future roles for hospital librarians. Along the way, these responsibilities grew and evolved. After a little more than three years, the Task Force on Vital Pathways for Hospital Librarians Steering Committee presented a final report regarding its accomplishments to the MLA Board of Directors. A sampling of these accomplishments includes the status of hospital librarians survey, a website, a position document with an accompanying executive summary, a short promotional brochure, and a final culminating activity, this symposium. Although these are difficult times for all libraries, hospital librarians and libraries seem particularly affected. In a competitive health care environment that is driven by the bottom line, influenced by real estate hunger, and affected by the belief of hospital administrators that access to health information comes from the Internet and is free, the hospital librarian seems doomed. However, even in these difficult times, there are hospital librarians who are not only surviving, but thriving. Is it because they are entrepreneurial? Opportunistic? Innovative? Flexible? All of the above? None of the above? There are no clear predictors of success or of failure. However, the Vital Pathways Project has shed light on some of the issues and identified opportunities and strategies for the future.

Eye movements when reading sentences with handwritten words.

PubMed

Perea, Manuel; Marcet, Ana; Uixera, Beatriz; Vergara-Martínez, Marta

2016-10-17

The examination of how we read handwritten words (i.e., the original form of writing) has typically been disregarded in the literature on reading. Previous research using word recognition tasks has shown that lexical effects (e.g., the word-frequency effect) are magnified when reading difficult handwritten words. To examine this issue in a more ecological scenario, we registered the participants' eye movements when reading handwritten sentences that varied in the degree of legibility (i.e., sentences composed of words in easy vs. difficult handwritten style). For comparison purposes, we included a condition with printed sentences. Results showed a larger reading cost for sentences with difficult handwritten words than for sentences with easy handwritten words, which in turn showed a reading cost relative to the sentences with printed words. Critically, the effect of word frequency was greater for difficult handwritten words than for easy handwritten words or printed words in the total times on a target word, but not on first-fixation durations or gaze durations. We examine the implications of these findings for models of eye movement control in reading.

Tracheal injury as a sequence of multiple attempts of endotracheal intubation in the course of a preclinical cardiopulmonary resuscitation.

PubMed

Jaeger, K; Ruschulte, H; Osthaus, A; Scheinichen, D; Heine, J

2000-01-01

Management of the difficult airway requires an appropriate approach based on personal clinical experiences. For every physician involved in rescue and emergency medicine, it is important to know the difficult airway algorithm and be familiar with alternative techniques of managing the difficult airway. We report a case of tracheal injury caused by multiple attempts at intubating the trachea. Based on current knowledge, apart from surgical equipment for cricothyroidotomy the laryngeal mask airway (LMA) and the Combitube (ETC) should be available on any ambulance vehicle staffed by an emergency physician. In future, blind intubation through the intubating laryngeal mask airway (ILMA) could offer a new opportunity.

Locating ethics in data science: responsibility and accountability in global and distributed knowledge production systems

PubMed Central

2016-01-01

The distributed and global nature of data science creates challenges for evaluating the quality, import and potential impact of the data and knowledge claims being produced. This has significant consequences for the management and oversight of responsibilities and accountabilities in data science. In particular, it makes it difficult to determine who is responsible for what output, and how such responsibilities relate to each other; what ‘participation’ means and which accountabilities it involves, with regard to data ownership, donation and sharing as well as data analysis, re-use and authorship; and whether the trust placed on automated tools for data mining and interpretation is warranted (especially as data processing strategies and tools are often developed separately from the situations of data use where ethical concerns typically emerge). To address these challenges, this paper advocates a participative, reflexive management of data practices. Regulatory structures should encourage data scientists to examine the historical lineages and ethical implications of their work at regular intervals. They should also foster awareness of the multitude of skills and perspectives involved in data science, highlighting how each perspective is partial and in need of confrontation with others. This approach has the potential to improve not only the ethical oversight for data science initiatives, but also the quality and reliability of research outputs. This article is part of the themed issue ‘The ethical impact of data science’. PMID:28336799

Empirically Derived Lessons Learned about What Makes Peer-Led Exercise Groups Flourish.

PubMed

Fletcher, Kathlyn E; Ertl, Kristyn; Ruffalo, Leslie; Harris, LaTamba; Whittle, Jeff

2017-01-01

Physical exercise confers many health benefits, but it is difficult to motivate people to exercise. Although community exercise groups may facilitate initiation and persistence in an exercise program, reports regarding factors that allow such groups to flourish are limited. We performed a prospective qualitative evaluation of our experience starting a program of community-based, peer-led exercise groups for military veterans to identify important lessons learned. We synthesized data from structured observations, post-observation debriefings, and focus groups. Our participants were trained peer leaders and exercise group members. Our main outcomes consisted of empirically derived lessons learned during the implementation of a peer-led group exercise program for veterans at multiple community sites. We collected and analyzed data from 40 observation visits (covering 14 sites), 7 transcribed debriefings, and 5 focus groups. We identified five lessons learned. (1) The camaraderie and social aspect of the exercise groups provided motivation for people to stay involved. (2) Shared responsibility and commitment to each other by the group members was instrumental to success. (3) Regular meeting times encouraged participation. (4) Variety, especially getting outdoors, was very popular for some groups. (5) Modest involvement of professionals encouraged ongoing engagement with the program. Both social and programmatic issues influence implementation of group exercise programs for older, predominantly male, veterans. These results should be confirmed in other settings.

Locating ethics in data science: responsibility and accountability in global and distributed knowledge production systems.

PubMed

Leonelli, Sabina

2016-12-28

The distributed and global nature of data science creates challenges for evaluating the quality, import and potential impact of the data and knowledge claims being produced. This has significant consequences for the management and oversight of responsibilities and accountabilities in data science. In particular, it makes it difficult to determine who is responsible for what output, and how such responsibilities relate to each other; what 'participation' means and which accountabilities it involves, with regard to data ownership, donation and sharing as well as data analysis, re-use and authorship; and whether the trust placed on automated tools for data mining and interpretation is warranted (especially as data processing strategies and tools are often developed separately from the situations of data use where ethical concerns typically emerge). To address these challenges, this paper advocates a participative, reflexive management of data practices. Regulatory structures should encourage data scientists to examine the historical lineages and ethical implications of their work at regular intervals. They should also foster awareness of the multitude of skills and perspectives involved in data science, highlighting how each perspective is partial and in need of confrontation with others. This approach has the potential to improve not only the ethical oversight for data science initiatives, but also the quality and reliability of research outputs.This article is part of the themed issue 'The ethical impact of data science'. © 2015 The Authors.

Common brain regions underlying different arithmetic operations as revealed by conjunct fMRI-BOLD activation.

PubMed

Fehr, Thorsten; Code, Chris; Herrmann, Manfred

2007-10-03

The issue of how and where arithmetic operations are represented in the brain has been addressed in numerous studies. Lesion studies suggest that a network of different brain areas are involved in mental calculation. Neuroimaging studies have reported inferior parietal and lateral frontal activations during mental arithmetic using tasks of different complexities and using different operators (addition, subtraction, etc.). Indeed, it has been difficult to compare brain activation across studies because of the variety of different operators and different presentation modalities used. The present experiment examined fMRI-BOLD activity in participants during calculation tasks entailing different arithmetic operations -- addition, subtraction, multiplication and division -- of different complexities. Functional imaging data revealed a common activation pattern comprising right precuneus, left and right middle and superior frontal regions during all arithmetic operations. All other regional activations were operation specific and distributed in prominently frontal, parietal and central regions when contrasting complex and simple calculation tasks. The present results largely confirm former studies suggesting that activation patterns due to mental arithmetic appear to reflect a basic anatomical substrate of working memory, numerical knowledge and processing based on finger counting, and derived from a network originally related to finger movement. We emphasize that in mental arithmetic research different arithmetic operations should always be examined and discussed independently of each other in order to avoid invalid generalizations on arithmetics and involved brain areas.

Polyvalent immunoglobulins with vitamin D3 and vitamin B12 in the treatment of Sjogren's syndrome in a vegetarian with stomatitis, glossodynia, xerostomia, and elevated antinuclear antibodies: Case report
.

PubMed

Cuny, Clemens; Vaerst, Barbara; Gabrielpillai, Jennis; Tahtali, Aykut; Balster, Sven; Lissner, Reinhard; Woodcock, Barry G

2018-01-01

Sjogren's syndrome, involving sicca symptoms with xerostomia, stomatitis, and considerable pain is a difficult-to-treat autoimmune disease where the treatment options are limited and, as in the case of methotrexate, have a low therapeutic index. This case report concerns a male patient, aged 75 years and vegetarian, with Sjogren's syndrome subsequently confirmed by salivary gland biopsy. Serum antinuclear antibodies (ANA) were elevated (1 : 320). Low serum vitamin B12 and iron levels could be improved after 20 days using vitamin B12 and iron oral supplements. Despite symptomatic treatment, xerostomia, glossitis, and glossodynia were still present, at times marked, after 12 months when the ANA titer was unchanged. Following treatment with an anti-inflammatory polyvalent immunoglobulin formulation (Lactobin^®N, 7 g daily), a bovine colostrum concentrate given orally in combination with oral vitamin D3 (2,000 IU daily), sicca symptoms and xerostomia progressively decreased and at day 750 were confined to occasional and minor glossitis of the upper lip. This case report demonstrates the satisfactory control of Sjogren's syndrome using oral polyvalent immunoglobulins with vitamin D3. In contrast to treatment options involving antimalarial drugs and methotrexate, there are no safety issues in patients tolerant to milk products.
.

A Novel Identification Methodology for the Coordinate Relationship between a 3D Vision System and a Legged Robot

PubMed Central

Chai, Xun; Gao, Feng; Pan, Yang; Qi, Chenkun; Xu, Yilin

2015-01-01

Coordinate identification between vision systems and robots is quite a challenging issue in the field of intelligent robotic applications, involving steps such as perceiving the immediate environment, building the terrain map and planning the locomotion automatically. It is now well established that current identification methods have non-negligible limitations such as a difficult feature matching, the requirement of external tools and the intervention of multiple people. In this paper, we propose a novel methodology to identify the geometric parameters of 3D vision systems mounted on robots without involving other people or additional equipment. In particular, our method focuses on legged robots which have complex body structures and excellent locomotion ability compared to their wheeled/tracked counterparts. The parameters can be identified only by moving robots on a relatively flat ground. Concretely, an estimation approach is provided to calculate the ground plane. In addition, the relationship between the robot and the ground is modeled. The parameters are obtained by formulating the identification problem as an optimization problem. The methodology is integrated on a legged robot called “Octopus”, which can traverse through rough terrains with high stability after obtaining the identification parameters of its mounted vision system using the proposed method. Diverse experiments in different environments demonstrate our novel method is accurate and robust. PMID:25912350

Overview of clinical research design.

PubMed

Hartung, Daniel M; Touchette, Daniel

2009-02-15

Basic concepts and terminology of clinical research design are presented for new clinical investigators. Clinical research, research involving human subjects, can be described as either observational or experimental. The findings of all clinical research can be threatened by issues of bias and confounding. Biases are systematic errors in how study subjects are selected or measured, which result in false inferences. Confounding is a distortion in findings that is attributable to mixing variable effects. Uncontrolled observation research is generally more prone to bias and confounding than experimental research. Observational research includes designs such as the cohort study, case-control study, and cross-sectional study, while experimental research typically involves a randomized controlled trial (RCT). The cohort study, which includes the RCT, defines subject allocation on the basis of exposure interest (e.g., drug, disease-management program) and follows the patients to assess the outcomes. The case-control study uses the primary outcome of interest (e.g., adverse event) to define subject allocation, and different exposures are assessed in a retrospective manner. Cross-sectional research evaluates both exposure and outcome concurrently. Each of these design methods possesses different strengths and weaknesses in answering research questions, as well as underlying many study subtypes. While experimental research is the strongest method for establishing causality, it can be difficult to accomplish under many scenarios. Observational clinical research offers many design alternatives that may be appropriate if planned and executed carefully.

A proactive password checker

NASA Technical Reports Server (NTRS)

Bishop, Matt

1990-01-01

Password selection has long been a difficult issue; traditionally, passwords are either assigned by the computer or chosen by the user. When the computer does the assignment, the passwords are often hard to remember; when the user makes the selection, the passwords are often easy to guess. This paper describes a technique, and a mechanism, to allow users to select passwords which to them are easy to remember but to others would be very difficult to guess. The technique is site, user, and group compatible, and allows rapid changing of constraints imposed upon the password. Although experience with this technique is limited, it appears to have much promise.

Neurosurgical rare disease: solitary plasmacytoma of the skull - case report and literature review.

PubMed

Rizea, Radu Eugen; Popescu, Mihai; Gheorghiţă, Karina Lidia; Popescu, George; Neamţu, Marius Cristian; Busuioc, Cristina Jana; Ciurea, Alexandru Vlad

2018-01-01

Solitary extranevraxial plasmacytoma (SEP), as a clinical entity without signs of systemic myelomatosis, is extremely rare; it is difficult to find literature on the issue of patient management and proper course of action in the presence of associated pathology. The authors present a rare case of plasmacytoma of the skull vault associated with severe cardiac pathology, which made surgery extremely difficult and possible only through temporization of the interventions, as presented. We discuss our findings and opportunities for treatment in this case, which seemed unapproachable at presentation, in connection with the associated cardiac pathology. The case was followed-up for eight years with no recurrences.

Behavioral genetics and criminal responsibility at the courtroom.

PubMed

Tatarelli, Roberto; Del Casale, Antonio; Tatarelli, Caterina; Serata, Daniele; Rapinesi, Chiara; Sani, Gabriele; Kotzalidis, Georgios D; Girardi, Paolo

2014-04-01

Several questions arise from the recent use of behavioral genetic research data in the courtroom. Ethical issues concerning the influence of biological factors on human free will, must be considered when specific gene patterns are advocated to constrain court's judgment, especially regarding violent crimes. Aggression genetics studies are both difficult to interpret and inconsistent, hence, in the absence of a psychiatric diagnosis, genetic data are currently difficult to prioritize in the courtroom. The judge's probabilistic considerations in formulating a sentence must take into account causality, and the latter cannot be currently ensured by genetic data. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Employees.

ERIC Educational Resources Information Center

Mawdsley, Ralph D.

This chapter covers the nearly 220 cases reported in 1989 involving precollegiate, public-sector employees. Those cases where purely procedural issues are involved are omitted, and procedural issues in the remaining cases are deemphasized. As in previous years, the section on dismissal, nonrenewal, demotion, and discipline has the greatest…

Employees.

ERIC Educational Resources Information Center

Mawdsley, Ralph D.

This chapter covers the nearly 230 cases reported in 1988 involving precollegiate, public-sector employees. Those cases where purely procedural issues are involved are omitted, and procedural issues in the remaining cases are deemphasized. As in previous years, the section on dismissal, nonrenewal, demotion, and discipline has the greatest…

Strategies for ensuring global consistency/comparability of water-quality data

USGS Publications Warehouse

Klein, J.M.

1999-01-01

In the past 20 years the water quality of the United States has improved remarkably-the waters are safer for drinking, swimming, and fishing. However, despite many accomplishments, it is still difficult to answer such basic questions as: 'How clean is the water?' and 'How is it changing over time?' These same questions exist on a global scale as well. In order to focus water-data issues in the United States, a national Intergovernmental Task Force on Monitoring Water Quality (ITFM) was initiated for public and private organizations, whereby key elements involved in data collection, analysis, storage, and management could be made consistent and comparable. The ITFM recommended and its members are implementing a nationwide strategy to improve water-quality monitoring, assessment, and reporting activities. The intent of this paper is to suggest that a voluntary effort be initiated to ensure the comparability and utility of hydrological data on a global basis. Consistent, long-term data sets that are comparable are necessary in order to formulate ideas regarding regional and global trends in water quantity and quality. The author recommends that a voluntary effort similar to the ITFM effort be utilized. The strategy proposed would involve voluntary representation from countries and international organizations (e.g. World Health Organization) involved in drinking-water assessments and/or ambient water-quality monitoring. Voluntary partnerships such as this will improve curability to reduce health risks and achieve a better return on public and private investments in monitoring, environmental protection, and natural resource management, and result in a collaborative process that will save millions of dollars.In this work it is suggested that a voluntary effort be initiated to ensure the comparability and utility of hydrological data on a global basis. The strategy proposed would involve voluntary representation from countries and international organizations involved in drinking-water assessments and/or ambient water-quality monitoring.

Role of the family doctor in the management of adults with obesity: a scoping review

PubMed Central

Elmitt, Nicholas; Haelser, Emily; Douglas, Kirsty A

2018-01-01

Objectives Obesity management is an important issue for the international primary care community. This scoping review examines the literature describing the role of the family doctor in managing adults with obesity. The methods were prospectively published and followed Joanna Briggs Institute methodology. Setting Primary care. Adult patients. Included papers Peer-reviewed and grey literature with the keywords obesity, primary care and family doctors. All literature published up to September 2015. 3294 non-duplicate papers were identified and 225 articles included after full-text review. Primary and secondary outcome measures Data were extracted on the family doctors’ involvement in different aspects of management, and whether whole person and person-centred care were explicitly mentioned. Results 110 papers described interventions in primary care and family doctors were always involved in diagnosing obesity and often in recruitment of participants. A clear description of the provider involved in an intervention was often lacking. It was difficult to determine if interventions took account of whole person and person-centredness. Most opinion papers and clinical overviews described an extensive role for the family doctor in management; in contrast, research on current practices depicted obesity as undermanaged by family doctors. International guidelines varied in their description of the role of the family doctor with a more extensive role suggested by guidelines from family medicine organisations. Conclusions There is a disconnect between how family doctors are involved in primary care interventions, the message in clinical overviews and opinion papers, and observed current practice of family doctors. The role of family doctors in international guidelines for obesity may reflect the strength of primary care in the originating health system. Reporting of primary care interventions could be improved by enhanced descriptions of the providers involved and explanation of how the pillars of primary care are used in intervention development. PMID:29453301

7 CFR 283.16 - Consolidation of issues.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 4 2010-01-01 2010-01-01 false Consolidation of issues. 283.16 Section 283.16... Claims of $50,000 or More § 283.16 Consolidation of issues. Similar issues involved in appeals by two or...) Disposition of consolidated issues. If the ALJ orders consolidation, the issues consolidated will be...

The international scale of the groundwater issue

USGS Publications Warehouse

Fienen, Michael; Arshad, Muhammad

2016-01-01

Throughout history, and throughout the world, groundwater has been a major source of water for sustaining human life. Use of this resource has increased dramatically over the last century. In many areas of the world, the balance between human and ecosystem needs is difficult to maintain. Understanding the international scale of the groundwater issue requires metrics and analysis at a commensurate scale. Advances in remote sensing supplement older traditional direct measurement methods for understanding the magnitude of depletion, and all measurements motivate the need for common data standards to collect and share information. In addition to metrics of groundwater availability, four key international groundwater issues are depletion of water, degradation of water quality, the water-energy nexus, and transboundary water conflicts. This chapter is devoted to introducing these issues, which are also discussed in more detail in later chapters.